bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and Safety of Antidepressants as Analgesics in Chronic Pain: A Review
Authors: Fennema J. , Petrykiv S. , de Jonge L. , Arts M.
Published: June 2017

Introduction

Due to the aging population worldwide, chronic pain is becoming an important public health concern. Chronic pain is bidirectional associated with psychiatric disorders including depression and anxiety. Antidepressants are widely used as adjuvant therapy for the treatment of chronic pain for many disorders.

Objectives and aims

To review available literature on the efficacy and safety of antidepressants for the treatment of chronic pain, including neuropathic pain, fibromyalgia, low back pain, and chronic headache or migraine.

Methods

We performed a detailed literature review through PubMed, EMBASE and Cochrane's Library to assess the efficacy and safety of antidepressants in chronic pain conditions.

Results

In neuropathic pain, fibromyalgia, low back pain, and chronic headaches/migraine, tricyclic antidepressants (TCAs) showed a significant analgesic effect. Selective serotonin reuptake inhibitors (SSRIs) are not effective for the treatment of low back pain and headaches or migraine. Venlafaxine, a serotonin norepinephrine reuptake inhibitor (SNRI) showed significant improvement of fibromyalgia and neuropathic pain. Duloxetine (SNRI) also reduced the pain in fibromyalgia.

Conclusion

TCAs are the ‘gold standard’ antidepressant analgesics. However, an electrocardiogram and postural blood pressure should be implemented prior to TCA treatment and TCAs should be initiated at low dosages and subsequently increased to the maximum tolerated dose. One should pay attention to their cardiotoxic potential, especially in the older population. For the treatment of neuropathic pain, SNRIs are second-line agents. Although better tolerated, in most types of chronic pain conditions, the effectiveness of SSRIs is limited. To conclude: start low, go slow, and prescribe with caution.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Electroconvulsive Therapy in Drug-Resistant Paranoid Schizophrenia on Patient with Transplanted Kidney – Case Study
Authors: Zdanowicz A. , Wierzbinski P.
Published: June 2017

The 22-year-old female patient had her first direct encounter with a psychiatrist in 2009 due to low mood, anxiety, anhedonia, lack of energy and olfactory hallucinations. Diagnosed with delusional depression syndrome, she was treated with SSRI group, and then combined with LLP group. In 2009, she was hospitalized in the Ward of kidney diseases and dialysis due to severe kidney failure, HA affecting the heart and the kidneys and facial nerve paralysis. In May 2012, she had a kidney transplanted from the deceased donor, which led to graft-versus-host disease. She received immunosuppressive therapy. In October 2012, she was diagnosed with paranoid syndrome. She was initially treated with levomepromazine 75 mg/d and amisulpride 800 mg/d (no results), then Olanzapine 20 mg/d and aripiprazole 15 mg/d (no results). After 10 week hospitalization she was discharged in a slightly improved mental state. Three weeks later, she was hospitalized again in a psychiatric institution where she received olanzapine 20 mg/d and haloperidol 6 mg/d (no results). Due to the severe mental condition, she was qualified for electroconvulsive therapy. In the end, the therapy met with the general positive reviews of consultants of different specialties. After 7 (of the 18) treatments the patient reached a significantly improved mental state with almost no sign of psychotic experiences and with a better day-to-day functioning. To the best of the authors’ knowledge, it is the first case of ECT on the patient who was the subject of a kidney transplant, and is one of the very few that have taken place in the entire world.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental Disorders are Increasing among Children and Adolescents in Sweden – a Nationwide Study with Focus on Gender Differences
Authors: Salmi P. , Berlin M.
Published: June 2017

Introduction

An increasing number of young people in Sweden are diagnosed with mental disorders and there appears to be significant gender differences in disease pattern.

Objective

To more thoroughly characterize the increase in mental disorders among young people with focus on gender differences.

Aim

To increase the knowledge of age and sex-specific trends in incidence and prevalence rates of mental disorders among children and adolescents.

Method

Data on psychiatric diagnoses for the last 10 years were obtained from Swedish national registers held by the National Board of Health and Welfare in Sweden.

Results

Neuropsychiatric, depressive and anxiety disorders have increased markedly among young people the last decade. In addition, men are increasingly diagnosed with substance-related disorders whereas women with borderline personality disorder.

Conclusion

The increase in mental disorders among young people is marked and disease affects men and women differently. Because of greater awareness today, some conditions like ADHD are more frequently diagnosed. However, the increase in depressive and anxiety disorders appears genuine and represents an additional challenge.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Efficacy of Lurasidone on PANSS Subscales in Adolescent Patients with Schizophrenia: Results from a 6-week, Double-blind, Placebo-controlled, Multicenter Study
Authors: Correll C. , Goldman R. , Cucchiaro J. , Deng L. , Loebel A.
Published: June 2017

Introduction

Lurasidone is an atypical antipsychotic that demonstrated efficacy in the treatment of adults with schizophrenia in the dose range of 37–148 mg/day.

Objective/Aims

The objective of this analysis was to evaluate the efficacy of lurasidone in adolescent patients with schizophrenia.

Methods

Adolescents (13–17 years old) diagnosed with schizophrenia were randomly assigned to six weeks of double-blind treatment with lurasidone 37 mg/day, 74 mg/day or placebo. Changes from baseline to week 6 in PANSS total and subscale (positive, negative, general psychopathology, excitability) scores were evaluated using mixed-model repeated-measures analysis.

Results

A total of 326 patients (mean age, 15.4 years) were randomized and received lurasidone 37 mg/day (n = 108), 74 mg/day (n = 106), or placebo (n = 112). The PANSS total score at week 6 demonstrated a placebo-adjusted, least-squares (LS) mean improvement of –8.0 (P < 0.001; effect size [ES], 0.51) for the 37 mg/day group and –7.7 (P < 0.001; ES = 0.48) for the 74 mg/day group. Placebo-adjusted LS mean change for lurasidone 37 mg/day and 74 mg/day, respectively, was –3.2 (P < 0.001; ES = 0.62) and –3.2 (P < 0.001; ES = 0.60) on the PANSS positive subscale, –1.7 (P = 0.011; ES = 0.41) and –1.6 (P = 0.022; ES = 0.35) on the PANSS negative subscale, –2.8 (P = 0.012; ES = 0.38) and –2.8 (P = 0.011; ES = 0.37) on the PANSS general psychopathology subscale, and –1.1 (P = 0.016; ES = 0.36) and –1.8 (P < 0.001; ES = 0.53) on the PANSS excitability subscale.

Conclusions

In adolescent patients with schizophrenia, lurasidone (37 mg/day and 74 mg/day) demonstrated statistically significant efficacy and clinically meaningful improvement across a wide spectrum of symptoms associated with schizophrenia. Sponsored by Sunovion Pharmaceuticals Inc. ClinicalTrials.gov identifier: NCT01911429.

Disclosure of interest

Dr Correll reports being a consultant and/or advisor for Alkermes, Forum Pharmaceuticals Inc., Gerson Lehrman Group, IntraCellular Therapies, Janssen/J&J, Lundbeck, Medavante, Medscape, Otsuka, Pfizer Inc, ProPhase, Sunovion Pharmaceuticals Inc., Supernus, Takeda, and Teva providing expert testimony for Bristol-Myers Squibb Company, Janssen, and Otsuka serving on a Data Safety Monitoring Board for Lundbeck and Pfizer Inc and receiving grant support from Takeda. Drs Goldman, Cucchiaro, Deng and Loebel are employees of Sunovion Pharmaceuticals Inc.
Prevalence of Psychopathological Features in Intellectual Diability: The Italian SPAID-G Multicentric Study
Authors: Scuticchio D. , Bertelli M.O. , Chiodelli G. , Cavagnola R. , Manna F.
Published: June 2017

Introduction

Despite increasing awareness of high prevalence of psychiatric disorders in people with intellectual disability (ID), diagnostic tools are few and scarcely used in daily practice. SPAID-G (psychiatric instrument for the intellectually disabled adult-general version) is the first Italian for carrying out psychiatric diagnostic orientations in adults with ID. It was designed to be easy and quick instrument for daily clinical practice.

Objectives/Aims

The present study was aimed at evaluating psychometric and psychodiagnostic characteristics of the SPAID-G and at supplying new data on the prevalence rate of psychiatric disorders in a multicentric Italian sample of people with ID living in different settings.

Methods

The SPAID-G was consecutively administered to more than 800 persons with ID attending residential, rehabilitative or clinical services across Italy. A part of the sample was also assessed for psychopathology through the use of DASH-II, PDD-MRS and clinically diagnosed in accordance to DSM-IV-TR and DSM-5 criteria.

Results

SPAID internal consistency, inter-rater reliability and concordance with DASH-II and PDD-MRS resulted to be good. Around 40% of the sample was assessed to have a cluster of psychopathological symptoms that could be consistent with a psychiatric diagnosis. Autism, impulse control disorder and personality disorder resulted to be the most frequent over threshold scores.

Conclusions

The SPAID-G seems to be a valid and cost-effective screening tool for the psychiatric assessment within the Italian population with ID.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Acceptance and commitment therapy and anxiety disorders: Clinical case
Authors: Guijarro R. , Cerviño M. , Castrillo P.
Published: June 2017

Acceptance and commitment therapy (ACT) is a third-generation therapy that relates to human suffering as an inherent part of life in the human condition. Concerning personal values, ACT is focused on the acceptance of suffering, by doing away with the avoidance of things that cause us discomfort.

The goal of the therapy is to make a person's reactions to suffering more flexible, working with the role of the symptoms rather than with the eliminating the symptoms themselves.

This paper shows how the application of this therapy to a person with generalized anxiety disorder helps to reduce symptoms such as uncontrollable worrying, lack of concentration and muscular tension that these patients often suffer. The modification of symptoms has been measured by a single case study, where the symptoms are assessed by questionnaires before and after the treatment's application. Diagnosis was made according to the Diagnostic and Statistical Manual of Mental Disorders’ (DSM-IV) criteria.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The prevalence and risk factors of anxiety disorders in an Egyptian sample of school and students at the age of 12–18 years
Authors: Ismail A.
Published: June 2017

Background

generalized anxiety disorder (GAD) are highly prevalent and impairing conditions among children and adolescent. There are some general population studies that have examined these conditions during the early life course.

The primary objectives of this study were to examine the prevalence, and socio-demographic factors related to GAD in representative sample of Egyptian school students (prep, middle and secondary students), and the correlation between adolescence and socio psychological factors that lead to anxiety disorders in adolescents.

Methods

The study included 1200 student (600 from rural area, and 600 from urban area), their age ranged from 12–18 years m we used GHQ (28 items with cut point 14), the anxiety scale and SCID I.

Results

The positive clinical cases represent 20.6%, depression is the most prevalent 23.8%, anxiety was (6.69%), body dysmorphic disorder (15.2%), adjustment disorder (13.8%); GAD (9.2%); obsession (7.4%)

Conclusions

Findings demonstrate the clinical significance socio demographic factors related to GAD among adolescent youth, and highlighting on the paternal relations.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Depression, anxiety and stress symptoms among students in Albania explored by DASS-42
Authors: Pilika A. , Simaku A.
Published: June 2017

Introduction

In Albania, at the current time, no research has been conducted to assess students’ risk for depression, anxiety and stress.

Objectives

To explore which group of students are at risk for depression, anxiety and stress.

Aim

The aim of this study is to explore the symptoms of depression, anxiety and stress among students according to the 42-item Depression Anxiety and Stress Scale (DASS-42).

Material and methods

The DASS-42 was translated from English to Albanian, culturally verified, back-translated and administered to 570 students in university campus of Tirana district. Exploratory factor analyses (EFA) and Cronbach's alpha, were performed to identify the psychometric properties of the Depression, Anxiety, and Stress subscales and the overall scale.

Results

EFA with equamax rotation indicated that the 42 items loaded on three factors accounting for 53.2% of the total variance, 19.9% for depression, 17.6% for anxiety and 16.7% for stress subscale. The internal consistency coefficients were high, ranging from 0.90 to 0.93 for subscales and 0.96 for the scale. The mean score of females for the overall scale M = 28.0 (± 36.3 SD) was significantly higher as compared to males, M = 22.9 (± 36.5 SD), (t = 2.6, P < 0.01). Females also had a significant higher score M = 11.5 (± 12.8 SD), for depression as compared to males M = 8.7 (± 12.6 SD), (t = 2.4, P = 0.02), whereas no difference was found with regard to anxiety (P = 0.2) and stress subscales (P = 0.07).

Conclusions

Female students, students from rural areas and married individuals have more total scores for depression, anxiety and stress symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A case report of patient who had two manic episodes with psychotic features induced by nasal decongestant
Authors: Kandeger A. , Tekdemir R. , Sen B. , Selvi Y.
Published: June 2017

Objective

Phenylephrine, pseudoephedrine and ephedrine are the sympathomimetic drugs that have been used most commonly in oral preparations for the relief of nasal congestion. These drugs stimulate the central nervous system that is affected by the alpha and beta adrenergic agonism. Sympathomimetic agents used in the treatment of flu and common cold with ephedrine and pseudoephedrine are case reports. That the manic and psychotic episodes are triggered. In this article, we would like to present a bipolar manic disorder with two manic episodes and both of them triggered by influenza drugs.

Case

A 25-year-old man patient was admitted to psychiatric outpatient clinic with increasing complaints such as increasing energy, speaking much, decreasing sleep, increasing the libido after using the flu drug that prescribed to him containing phenylephrine. Also, 2 years ago, he has manic attack triggered after the flu drug.

Discussion

In recent years the study of epilepsy and bipolar disorder in common suggests that bipolar disorder may affect the kindling phenomenon. In our case, two of reasons in the neurobiology of developing manic attacks the kindling phenomenon is likely to be effective. First, the possibility of using cold medicine containing ephedrine or pseudoephedrine in the first manic episode, in the second manic episode having spent the attack with FAQ stimulant effect of lower phenylephrine. Second, in the first episode after using the 5–6 tablets developing manic attacks. In the second attack to be triggered with just 2 doses may indicate the effect of kindling.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Exercise for depression in adolescents: A meta-analysis of randomised controlled trials
Authors: Carter T. , Morres I. , Meade O. , Patrick C.
Published: June 2017

Background

The reported lifetime prevalence of depression in adolescents has increased drastically in recent decades. Depression in this population can be particularly damaging and can frequently have a long-lasting adverse impact. The common treatment approach includes psychological therapy and/or anti-depressant medication. However, the efficacy of these approaches, both singularly and combined, is far from conclusive. Recently, there have been an increased number of studies investigating the effect of exercise and physical activity on adolescent depression, however, despite this increased attention, there are no recent reviews and meta-analyses synthesising such studies.

Aim

The review examines the treatment effect of exercise on depression symptoms for adolescents aged 13–17 years of age.

Methods

A systematic search of seven electronic databases identified relevant randomised controlled trials. Screening, data extraction and trial methodological quality were undertaken by two independent researchers. Standardized mean differences were used for pooling post-intervention depressive symptom scores.

Results

Eleven trials met the inclusion criteria, eight of which provided the necessary data for calculation of standardized effect size. Exercise showed a statistically significant moderate overall effect on depressive symptom reduction. Sensitivity analyses were also conducted and will be presented.

Discussion

Exercise and physical activity appear to improve depression symptoms in adolescents, especially in clinical samples, suggesting that exercise may be a useful treatment strategy for adolescents with depression.

Conclusion

Despite the positive findings, large clinical trials that adequately minimise bias are required for firmer conclusions on the effectiveness of exercise as an antidepressant treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessment of test anxiety in Portuguese adolescents: Psychometric properties of the Cognitive Test Anxiety Revised
Authors: Silva J. , Cunha M. , Galhardo A. , Couto M. , Massano-Cardoso I.
Published: June 2017

Introduction

Test anxiety represents a considerable personal burden due to its interfering nature and is associated with a range of deleterious life trajectories, encompassing school difficulties and health consequences. Although test anxiety seems to be highly prevalent and the pathological symptoms are similar to those of other childhood anxiety disorders, there are specificities that deserve a more in-depth approach. Given that adolescents seem to experience test anxiety in several school grades there is a need for a valid and reliable scale to measure test anxiety in school age students.

Objective

This study aims to adapt and analyse the psychometric properties of the Cognitive Test Anxiety Revised (CTAR25) for Portuguese adolescents. In addition, the convergent and divergent validities were examined with related constructs.

Methods

Participants were 279 adolescents, with ages between 12 and 19 years old, attending middle and high schools. Together with CTAR25, participants also filled out self-report questionnaires assessing tests anxiety (TAI), self-esteem (RSES), procrastination (QPE) and worry (PSWQ-C).

Results

The scale showed good internal consistency, good test-retest reliability, and good validity. Factor analysis revealed the existence of two factors with good internal consistency.

Discussion

Results showed that the Portuguese version of CTAR-25 is a valid and reliable self-report instrument for the assessment of test anxiety in adolescents, replicating the findings of the original version.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Significance of oral language delays and writing for early detection of developmental disorders
Authors: De Santiago Herrero F.J. , García-Mateos D.M. , Arconada Díez I. , Torres Delgado C. , Trigo Bensusan A.M.
Published: June 2017

Introduction

The study of the oral and written language delayed at the school makes possible the early detection of scholar, behavioral and psychiatric disorders. These difficulties could affect to the personal and professional development.

Objectives

To confirm the relationship between language oral and written delayed for the early detection of developmental disorders.

Method

A sample of 350 subjects among 5 and 23 years of age is analyzed with oral and/or written language difficulties. It is studied diagnosis, gender, age, reason for treatment, grade and submitter.

Results

The specific learning disabilities (SLD) request a 62.3% of the treatment among 7–10 years. The percentages of SLD are: reading comprehension difficulties (17.4%), dysorthography (13.4%), reading fluency and reading comprehension difficulties (12.9%), reading fluency (11.7%) and, dysorthography and reading fluency (6.9%). There exist percentage differences between repeaters (39.4%) and no repeaters (22.9%) students with DALE. The oral/written language provides the early detection of Intellectual disabilities (8.6% of the simple). The relation between the reason for treatment and diagnosis do not coincide: the consults was 3.7% for oral language delay, 2.6% for reading comprehension difficulties, 1.4% for dysorthography and 0.9% for reading fluency. The school demand more treatment (50.9%), next to medical centers (22.3%) and family initiative (15.7%).

Conclusions

The oral/written language delayed – especially the reading comprehension difficulties – are a good early detection for the developmental disorders (intellectual disabilities minor, SLD and TDAH at the primary stage). There is more percentage of boys than girls (2:1) with language delayed, except at Intellectual disabilities, because there is an identical percentage (4.3%).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The screening of the risk of autism spectrum disorders in children aged 16–24 months in Russia, 2015
Authors: Ivanov M. , Simashkova N. , Kozlovskaya G. , Makushkin E.
Published: June 2017

Introduction

Improving the mental health diagnosis in young children is the high-priority problem in reducing the rate of child disability due to mental illnesses. In 2015, the Ministry of Healthcare (Russia) introduced the pilot project – the total screening of the paediatric population at an early age, detecting autism spectrum disorders (ASD) risk group.

Objectives

To determine the broad range of mental disorders: from minor borderline states (states of risk) to serious mental disorders, with an emphasis on determination of ASD in children aged 16–24 months in general population.

Methods

The survey was conducted by the total screening in primary health care institutions (in the three largest regions of Russia: Volgograd, Novosibirsk, Chelyabinsk regions). The screening tool: checklist for parents aimed at detection of risk of occurrence of ASD in early children, for screening in general population.

Results and conclusions

During 2015, 34,770 parents of children aged 16–24 were questioned. Of these 4102 children or 11.8% (118:1000) formed the risk group in ASD. By the risk group in ASD predisposition (diathesis) is understood, that does not correspond fully to the clinical criteria of illness. This state of predisposition may last for several years and pass either to illness or to health.

The part of the children of the risk group in ASD were consulted by psychiatrist on a voluntary basis (2774 cases). Fifteen children (0.4:1000) were diagnosed with prominent clinical disorders in ICD-10 (F84). This prevalence rate cannot be extrapolated on the general population of the children at the considered age.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Child obsessive-compulsive disorder presenting with catatonic-like features: Case presentation
Authors: Kodra V. , Alikaj V. , Allkoja B. , Zenelaj B. , Sanxhaku D.
Published: June 2017

Introduction

Although catatonia was conceptualized as a subtype of schizophrenia, it is now recognized to occur most commonly in the course of other psychiatric disorders, in drug-induced disorders [1] or neurologic conditions [2]. Catatonia is rarely seen together with OCD and there are a limited number of case reports in the literature [3,4].

Objective

We describe the case of a 12 year boy who presented in our clinic with mutism, negativism, immobility, social withdrawn, rigid posture, refusal to eat.

Method

We performed a thorough psychiatric diagnostic assessment of the child as well as laboratory tests and MRI of the brain.

Results

The child's first symptoms appeared 2 years ago: initially the child became socially withdrawn, spent most of time at his room, and became preoccupied with rituals of hand washing, walking back and forth, preoccupations with food contamination, became aggressive if someone would interrupt what he was doing, stopped going at school, and stopped calling his parents “mother” or “father”. Brain MRI showed lateral ventricular asymmetry and suboccipital cyst.

Conclusions

The child was put on therapy with lorazepam and sertraline. His obsessive-compulsive symptoms improved, and the apparent catatonic like features resolved and did not return over follow-up.

Discussion

Catatonia is not uncommon among children and adolescents, and the relationship between OCD and catatonia is still misunderstood, but it may be an indicator of the severity of the OCD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical features of PTSD in patients with TBI
Authors: Khaustova O. , Smashna O.
Published: June 2017

Objective

Modern scientific researches about interaction between TBI and PTSD are characterized by few amounts and contradiction of conclusions.

Method

Twenty-eight persons with TBI were examined by means of questionnaires and structured clinical interviews. 17 patients were suffering from PTSD. We compared clinical features in patients with isolated TBI and group with both disorders.

Results

Four groups of symptoms were analyzed–sleep, emotions, cognition and personality features. Disorders of sleep were presented with violation of REM cycle, nightmares, hyperexcitation, increase watchfulness during the sleep. Emotional disorders were expressed as lability without external irritations; an excessive emotional reaction is on small events, agitation, irritability, inadequacy of emotional reactions and apathy (loss of desire to think, to feel, and/or to operate). Cognitive disorders included deceleration of psychomotor reactions, difficulties of searching of words in communication, problems of switching of attention, rigidity, difficulties in planning, decision of multistage tasks, violation of operative memory, executive dysfunction. Features of personality disorders were loss of initiation and self-control, decline of spontaneity, surplus attention is to the details, inadequacy of self-appraisal, feeling of inferiority, an increase necessity is for control and lordship over other, aggression (socially inadequate behavior, episodes of anger).

Conclusions

Psychopathological features presented in patients with comorbidity of PTSD and TBI are not specific and can be within the framework of other psychogenic, exogenous, organic, posttraumatic or neurological disorders and diseases. PTSD can combine with other psychical and somatic disorders that caused chronological and pathogenetical comorbidity in patients with both states.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
From ‘Big 4′ to ‘Big 5′: A review and epidemiological study on the relationship between psychiatric disorders and World Health Organization preventable diseases
Authors: Chartier G. , Cawthorpe D.
Published: June 2017

Introduction

Chronic diseases, such as heart disease, stroke, chronic respiratory diseases and diabetes, are by far the leading causes of mortality in the world, representing 60% of all deaths. However, chronic disease rarely exists in isolation. Nevertheless, study of chronic disease rarely takes into account comorbidity and virtually none examine their occurrence in populations.

Objectives

and aims To review the association between psychiatric disorders and other medical comorbidities.

To study the association between psychiatric diseases and medical comorbidities on a population-scale.

To reconsider our approach to medical comorbidities.

Methods

Using an informatics approach, a dataset containing physician billing data for 764 731 (46% male) individuals spanning sixteen fiscal years (1994–2009) in Calgary, Alberta, Canada was compiled permitting examination of the relationship between Physical Disorders and Mental Disorders, based on the International Classification of Diseases (ICD).

Results

All major classes of ICD physical disorders had odd ratios with confidence intervals above the value of 1.0. Ranging from 1.47 (Injury poisoning) to Circulatory systems (3.82). More precisely, when a psychiatric disorder is present, the likelihood to develop one of the four preventable diseases is significantly increased: Stroke (4.27), Hypertension (3.34), Diabetes (2.66) and COPD (2.43).

Conclusion

We postulate that psychiatric disorder should be included in the classification of preventable chronic diseases that have a profound impact on society. Developing a consistent and standardized approach to describe these features of disease has the potential to dramatically shift the format of both clinical practice and medical education.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neuropsychiatric manifestations in patients with HIV treated with antiretroviral drugs versus untreated
Authors: Gonçalves V. , Ribeirinho A. , Ferreira L. , Cintra P.
Published: June 2017

Introduction

Untreated patients for H.I.V can present various types of neuropsychiatric syndromes (NPS): subclinical cognitive symptoms, behavioral changes, agitation, personality changes, dementia complex associated with H.I.V and delirium, depressive disorder, bipolar affective disorder or manic episode. However, it is controversial whether antiretroviral induce NPS, or on the contrary, when there are patients will evolve into an AIDS stage for therapeutic resistance or noncompliance.

Aims

Describe qualitatively and quantify the epidemiological point of the main subclinical and NPS symptoms in patients untreated and treated with antiretroviral drugs and their frequencies. Propose pharmacological treatments for each of the specified conditions.

Methods

Search in PubMed with the words “Neuropsychiatric and antiretroviral therapy” by applying the limits: full and free texts, past 10 years, Human, English language and adults; research liaison psychiatry textbooks.

Results

Results yielded 381 articles with the criteria selecting 102, the most relevant for the purposes of work. They chose four most relevant chapters in the literature.

Conclusions

The most effective treatment of NPS in unmedicated patients is to start antiretroviral therapy; only if it does not improve them should be introduced psychiatric drugs as if they were functional. 50% of treated with efavirenz patients will develop NPS in the early days with gradual decrease. The dropout rate associated with these adverse events varies from 2.6–16%. Treatment of these NPS a challenge by the existence of numerous drug interactions, it is essential to know to deal with these entities to improve the quality of life of people with this chronic disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Is increased screen time associated with the development of anxiety or depression in young people?
Authors: Khouja J. , Munafò M. , Tilling K. , Wiles N. , Joinson C. , Etchells P. , John A. , Gage S. , Cornish R.
Published: June 2017

Introduction

Emerging evidence suggests that sedentary behaviour, specifically time spent taking part in screen-based activities, such as watching television, may be associated with mental health outcomes in young people [1]. However, recent reviews have found limited and conflicting evidence for both anxiety and depression [2].

Objectives

The purpose of the study was to explore associations between screen time at age 16 years and anxiety and depression at 18.

Methods

Subjects (n = 1958) were from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK-based prospective cohort study. We assessed associations between screen time (measured via questionnaire at 16 years) and anxiety and depression (measured in a clinic at 18 years using the Revised Clinical Interview Schedule) using ordinal logistic regression, before and after adjustment for covariates (including sex, maternal education, family social class, parental conflict, bullying and maternal depression).

Results

After adjusting for potential confounders, we found no evidence for an association between screen time and anxiety (OR = 1.02; 95% CI 0.95–1.09). There was weak evidence that greater screen time was associated with a small increased risk of depression (OR = 1.05, 95% CI 0.98–1.13).

Conclusions

Our results suggest that young people who spend more time on screen-based activities may have a small increased risk of developing depression but not anxiety. Reducing youth screen time may lower the prevalence of depression. The study was limited by screen time being self-reported, a small sample size due to attrition and non-response, and the possibility of residual confounding. Reverse causation cannot be ruled out.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Peculiarities of depressive disorders of “working” emigrants and re-emigrants
Authors: Maruta N. , Venger O.
Published: June 2017

Introduction

The problem of emigration and re-emigration in Ukraine is among the most actual state and social problems.

Objectives

To research clinical-psychopathological peculiarities of depressions in “working” emigrants and re-emigrants.

Methodology

The investigation was carried out in Ternopil Region. Psychogenic depressive disorders (F43.21 and F43.22 according to ICD-10) were diagnosed in 69 non-emigrants, 68 emigrants, and 67 re-emigrants; endogenous ones (F31.3, F31.4, F32.1, F32.2, F33.1, and F33.2 according to ICD-10) were diagnosed in 65, 66, and 63 persons correspondingly; and organic ones (F06.3 according to ICD-10) were diagnosed in 64, 62, and 61 persons correspondingly.

Results

It was found out an influence of emigration and re-emigration factors on psychoemotional sphere of the patients. The influence of the emigration factor was the most manifested in patients with psychogenic depressive disorders and was a less manifested in patients with endogenous and organic depression. Re-emigrants had the most severe depressive symptoms that might be explained by an impact of psychosocial factors. In the syndromological structure of depressive disorders it was determined that re-emigrants were more affected by typical affective syndromes – vital and apathic depression, whereas emigrants were more affected by atypical affective syndromes, including anxious-depressive and agitation ones. It might be explained by an influence of objective social-psychological factors as well as an intrapsychic transformation of actual stressors connected with emigration and re-emigration.

Conclusions

Emigration should be considered as a factor promoting a pathologically characterological development towards anxious-depressive changes, whereas re-emigration should be considered as a factor of asthenic-depressive and apathic-depressive transformations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How does lifestyle affect depression?
Authors: Raboch J. , Ptacek R. , Vnukova M. , Tkacova S.
Published: June 2017

Objective

The aim of this study was to test the assumption that there seems to be association between depression and lifestyle choices. The hypothesis was that unhealthy lifestyle will have an association with increased score on BDI II.

Methods

Czech version of BDI II was used and a questionnaire of lifestyle was distributed among Czech economically active population. Combination of interviews (for older population) and questionnaires (for younger population) was used. Stepwise multiple linear regression was applied to test whether and to what extend is lifestyle associated with depression.

Results

In total data from 1027 participants was collected; 675 persons aged 25–50 years and 352 persons aged 51–65 years. The model explains 31% of variance of depression and the model is highly significant F (8,1018) = 57.66, P = 0.001. Lifestyle choices that were found to be associated with depression were sleeping habits, regular eating and drinking habits and generally conscious adherence to healthy lifestyle.

Conclusion

Overall, an association was found between depression and certain lifestyle choices. Importantly it was also found conscious maintenance of healthy lifestyle is an important factor. This study thus confirmed the hypothesis that there is an association between depression and lifestyle. The most important factor of lifestyle in this study was shown to be regular sleeping pattern lasting at least 6 hours. Regular eating and maintaining drinking regime during the day were also found to be crucial.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Antidepressant withdrawal mania: Two case reports
Authors: Pereira D. , Carreira Figueiredo I. , Marinho M. , Fernandes R. , Viveiros V.
Published: June 2017

Introduction

Although rarely reported, antidepressant discontinuation may induce hypomania or mania even in the absence of bipolar disorder [1,2].

Objectives

We report two cases of antidepressant withdrawal induced mania.

Methods

Clinical process consultation and PubMed search were performed in November 2016 using the search keywords antidepressant, mania and discontinuation.

Results

Case report 1: a dysthymic 60 years old woman with 20 years of psychiatric following had been treated with venlafaxine 150 mg/daily the past year. She abruptly stopped taking this drug, developing heightened mood, irritability and racing thoughts five days later. She was admitted at our hospital, initiating then valproate and antipsychotics. Two weeks later, the hypomania clinical state remitted completely.

Case report 2: a 64 years old woman, with a 12-year-old diagnosis of unipolar depression was brought to our emergency service with complaints of disorganized behavior, paranoid delusional ideas, excessive speech, irritable mood and reduced need for sleep, 1 week after abrupt trazodone 150 mg/daily discontinuation. Valproic acid 1000 mg/daily and olanzapine 20 mg/daily were introduced, with gradual improvement of symptoms. Two weeks later she was completely asymptomatic.

Conclusion

Psychiatrists should be aware of the risk of antidepressant withdrawal induced mania. More studies should be conducted about this subject, aiming for the clarification of risk factors and the establishment of clinical criteria for this phenomenon.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neurometabolic alterations in a depression-like rat model of chronic forced swimming stress using in vivo proton magnetic resonance spectroscopy at 7 T
Authors: Yoo C.H. , Song K.H. , Lim S.I. , Woo D.C. , Choe B.Y.
Published: June 2017

Although recent investigations of major depressive disorder (MDD) have focused on the monoaminergic system, accumulating evidence suggests that alternative pathophysiological models of MDD and treatment options for patients with MDD are needed. Animals subjected to chronic forced swim stress (CFSS) develop behavioral despair. The purpose of this study was to investigate the in vivo effects of CFSS in the rat prefrontal cortex (PFC) with 7 T and short-echo-time proton magnetic resonance spectroscopy (1H MRS). Ten male Wistar rats underwent 14 days of CFSS, and in vivo1H MRS and forced swim tests were performed before and after CFSS. Point-resolved spectroscopy was used to quantify metabolite levels in the rat PFC. The spectral analyses showed that in vivo1H MRS can be used to reliably assess the Glu system. The rats showed significantly increased immobility times and decreased climbing times in the FST after CFSS, which suggested that the rats developed behavioral despair. The pre-CFSS and post-CFSS Glu and Gln levels did not significantly differ (P > 0.050). The levels of myo-inositol, total choline, and N-acetylaspartate, myo-inositol/creatine, and total choline/creatine increased significantly (P < 0.050). Similar findings have been reported in patients with MDD. Taken together, these results suggested that the CFSS-induced metabolic alterations were similar to those found in patients and that high-field and short-echo-time in vivo1H MRS can be used to investigate depression-induced metabolic alterations. Such investigations might provide alternative insights into the nonmonoaminergic pathophysiology and treatment of depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Avoiding refeeding syndrome in anorexia nervosa
Authors: Brigadeiro D. , Nunes J. , Gil T. Ventura , Costa P.
Published: June 2017

The term refeeding syndrome has been used to describe the adverse consequences that can occur in all malnourished patients in the early stages of nutrition repletion whether the method of refeeding is oral, enteral or parenteral. Those consequences include acute thiamine deficiency resulting in Wernicke's encephalopathy and Korsakoff syndrome, with the potential for permanent cognitive impairment; hypophosphatemia, hypokalemia, hypomagnesemia and fluid overload resulting in cardiac failure. Adaptive changes in metabolism occur during a period of starvation or fasting: levels of glucose fall within 24 to 72 hours, as response, glucagon levels rise and insulin concentrations decrease. Glucose levels are maintained by glycogenolysis at first and gluconeogenesis latter. The reintroduction of nutrition leads to a switch from fat to carbohydrate metabolism and an increase of insulin concentration. Insulin stimulates the movement of potassium, phosphate, and magnesium into the cell leading to its depletion in extracellular compartment. Reactivation of carbohydrate metabolism increases degradation of thiamine, a cofactor required for cellular enzymatic reactions in Kreb's cycle. Deficiency in all these nutrients can then occur. Patients with anorexia nervosa are at risk of suffering from refeeding syndrome. This psychiatric disorder causes potentially life-threatening, physical complications and has the highest mortality rate among psychiatric disorders. The purpose of this review is to clarify recommendations for prevention and treatment of refeeding syndrome in anorexia nervosa.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The central role of body image in the explanation of the engagement in disordered eating attitudes and behaviors
Authors: Ferreira C. , Mendes A.L. , Marta-Simões J.
Published: June 2017

Shame is a universal emotion, that has been emphasized as a pathogenic phenomenon in well-being and mental health. In fact, although shame has been considered an adaptive defensive response, higher levels of this painful emotion are strongly associated with different mental health conditions. The current study aimed to test whether the association of external shame with eating psychopathology would be explained by the mechanisms of body image-related cognitive fusion, psychological inflexibility, and also dietary restraint. A path analysis testing a mediational model was conducted in a sample of 787 women from the general community, aged between 18 and 51 years old. The tested model accounted for 71% of the variance of eating psychopathology and revealed an excellent fit to the data. Results demonstrated that external shame's impact on disordered eating attitudes and behaviors is indirect, carried through increased body image-related cognitive fusion, psychological inflexibility related to physical appearance, and dietary restraint. These findings seem to support the association between shame and eating psychopathology. Furthermore, these data add to literature by suggesting that individuals who present higher levels of shame may present increased tendency to engage in dietary restraint and other maladaptive eating behaviors, through higher levels of body image-related psychological inflexibility and cognitive fusion. The current study seems to hold important clinical implications, highlighting the importance of developing intervention programs in the community which target shame and body image-related maladaptive attitudes and behaviors and, in turn, promote adaptive emotion regulation strategies (e.g., acceptance abilities).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The genetic study of computer game addiction
Authors: Mavani D. , Soldatkin V. , Mashkina E. , Dyachenko A. , Karpova E. , Bukhanovskaya O.
Published: June 2017

Introduction

Addiction to computer games (CA) is growing with a lightning speed in whole world. Very few studies are focused in the genetic basis of this disorder.

Objectives

To study the COMT and MAOA polymorphism in addicts to computer games.

Methods

Totally 42 persons were included in this study, 22 of them had CA and 20 were totally healthy. Out of 22 gamers, 10 persons had only CA. The rest of 12 patients suffered from another psychiatric disorder besides of CA (Schizotypal disorder, depression, bipolar disorder). Their mean age was 16 years (15; 17) and all of them were males.

Results

The total frequency of alleles 3R and 5R of MAOA gene in patients with CA was 30.0%, which doesn’t have any statistical difference with the healthy persons. The genotype frequency of Val158Met of COMT gene is high in CA rather than in healthy persons (χ2 = 6.85, P = 0.03). Also, the homozygotes Val are much more in CA patients (59.1%) than in healthy persons (25%). On the other hand, the Val/Met combination is lower in CA patients (18.2%) than in healthy persons (55.0%).

Conclusion

The Val158Met polymorphism of gene COMT may lead to CA formation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.