bluuebunny/crossref_metadata_2025 huggingface dataset:
Cannabidiolɗs Role as a Potential Target in the Treatment for Schizophrenia
Authors: Carvalho A. , Felgueiras J. , Abreu T. , Freitas C. , Silva J.
Published: June 2017

Objectives

Schizophrenia is a debilitating psychiatric disorder which places a significant emotional and economic strain on the individual and society-at-large. Unfortunately, currently available therapeutic strategies do not provide adequate relief and some patients are treatment-resistant. Therefore there is urgent need for the development of mechanistically different and less side effect prone antipsychotic compounds. Recently, the endocannabinoid system has emerged as a potential therapeutic target for pharmacotherapy that is involved in a wide range of disorders, including schizophrenia. Modulation of this system by the main psychoactive component in cannabis, Δ9tetrahydrocannabinol (THC), induces acute psychotic effects and cognitive impairment. However, the non-psychotropic, plant-derived cannabinoid agent cannabidiol shows great promise for the treatment of psychosis, and is associated with fewer extrapyramidal side effects than conventional antipsychotic drugs.

Methods

The aim of this review is to analyse the involvement of the endocannabinoid system in schizophrenia and the potential role of cannabidiol in its treatment.

Results and conclusions

There is still considerable uncertainty about the mechanism of action of cannabidiol as well as the brain regions which are thought to mediate its putative antipsychotic effect. Further data is warrant before this novel therapy can be introduced into clinical practice.

Disclosure of interest

The authors have not supplied their declaration of competing interest
The Relationship Between Responsiveness to Social and Monetary Rewards and ADHD Symptoms
Authors: Sutcubasi Kaya B. , Metin B. , Krzan F.Z. , Tarhan N. , Tas C.
Published: June 2017

Introduction

Alterations in reward processing are frequently reported in ADHD. One important factor that affects reward processing is the quality of reward, as social and monetary, rewards are processed by different neural networks. However, effect of reward type on reward processing in ADHD was not extensively studied.

Aims

We aimed to explore the effect of reward type (i.e., social or monetary) on different phases of reward processing and also to test the hypothesis that ADHD symptoms may be associated with a problem in processing of social rewards.

Methods

We recorded event-related potentials (ERPs) during a spatial attention paradigm in which cues heralded availability and type of the upcoming reward and feedbacks informed about the reward earned. Thirty-nine (19 males and 20 females) healthy individuals (age range: 19–27) participated in the study. ADHD symptoms were measured using ADHD self-report scale (ASRS).

Results

The feedback related potentials, namely feedback related negativity (FRN), P200 and P300 amplitudes, were larger for social rewards compared to monetary rewards (Fig. 1). There was a consistent negative correlation between the hyperactivity subscale of ASRS and almost all feedback related ERPs. ERP amplitudes after social rewards were smaller for individuals with more hyperactivity.

Conclusions

Our findings suggest that hypo responsiveness to social rewards may be associated with hyperactivity. However, the results have to be confirmed with clinical populations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adenylate-cyclase Activity in Obsessive-compulsive Patients
Authors: Marazziti D. , Baroni S. , Mucci F. , Palego L. , Piccinni A.
Published: June 2017

Introduction

A possible role of second messengers, such as cyclic adenosine monophosphate (cAMP) signalling, in the development of obsessive-compulsive disorder (OCD) has been recently postulated.

Aims

The aim of the present study was to explore and to compare the adenylate cyclase (AC) activity in both basal conditions and after the stimulation by isoprenaline (ISO) in platelets of OCD patients and healthy control subjects. The AC activity was measured both in the absence and in the presence of α- and β- adrenoreceptor antagonists.

Materials and methods

Forty patients were included in the study and compared with healthy volunteers. Biological assays were carried out with a method developed by us.

Results

The basal AC activity was similar in both groups. The addition of 10 μM ISO enhanced significantly (P < .05) platelet basal AC in both groups. A stimulatory response following ISO in all subjects even without α-antagonists was also observed.

Discussion

No difference in the basal AC activity in platelet membranes of healthy subjects and OCD patients was found. Our findings showed that there is an inhibitory component of ISO effect on platelet AC, due to the agonist interaction with α2 receptors, at its higher concentrations (>1 μM), as well as a condition of supersensitive β-receptors. Our study suggests the presence of cathecolamine system disturbances in OCD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Antipsychotic Adjuvant Treatment in OCD
Authors: Reula L. Monte. , García H. Saiz , Fernández A. Portilla
Published: June 2017

Antidepressant drugs selective inhibitors of serotonin reuptake (IRS) are the drugs effective in obsessive compulsive disorder. It has not been proven more effective none of them except clomipramine. Around 40–60% of the Patients with obsessive-compulsive disorder (OCD) remain unimproved by serotonin reuptake inhibitors (SRIs).

Two cases are presented in relation to this disorder and its treatment.

Twenty-three year old woman begins to present anhedonia, apathy, isolation and low mood. Treatment was initiated with escitalopram with partial improvement.

Obsessive component traits

Thirty year old man with obsessive clinic of years of evolution, with worsening in recent months treatment with 200 mg sertraline.

In both cases treatment with oral aripiprazole it was associated with a dose of 5 mg daily with improvement in obsessive symptoms.

Results

The efficacy of aripiprazole as adjunctive drug treatment and obsessive anxiety is observed. However, we must take into account the potential risks posed as neuroleptic malignant syndrome and QTc prolongation.

Conclusion

Aripiprazole is an antipsychotic which has a novel mechanism of action to be a partial agonist of dopamine D2 receptors. This fact has led to its inclusion in the group of antipsychotics called third generation, also called partial dopamine agonists, dopamine stabilizers or “dopamine-serotonin modulators system.” Its most common side effects such as nausea, headaches, agitation and akathisia were observed in studies on schizophrenia, schizoaffective disorder and bipolar disorder. Unlike other atypical antipsychotics, is considered a relatively neutral drug to weight gain, hyperprolactinemia, changes in metabolic parameters and sedation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Intolerance for Uncertainty is a Prognostic Factor of Negative Response After Intensive Inpatient CBT for Medication-resistant Obsessive-compulsive Disorder
Authors: Pozza A. , Mazzoni G.P. , Dèttore D.
Published: June 2017

Introduction

Cognitive theories of Obsessive–Compulsive Disorder (OCD) have identified six types of beliefs, which have a role as vulnerability and maintaining factors: Inflated sense of responsibility, Threat overestimation, Importance of thoughts, Control of thoughts, Perfectionism and Intolerance for uncertainty. As previous research showed that strong obsessive beliefs are linked to severe OCD symptoms, it could be hypothesized that they act as prognostic factors of negative response after cognitive behavioural therapy (CBT). However, poor research investigated this aspect.

Objectives

The aim of the current study was to examine which obsessive beliefs could predict a worse response after intensive CBT in a group of inpatients with medication-resistant OCD.

Methods

Forty inpatients [mean baseline Y-BOCS = 26.70, SD = 7.01] with medication-resistant OCD underwent 5-week intensive CBT including daily and prolonged exposure and response prevention (2.5 hours in the morning, 2.5 hours in the afternoon). All individuals have had inadequate symptom response after prior serotonin-reuptake inhibitor trials. The Y-BOCS, BAI, OBQ-87, and BDI-II were administered at baseline and post-treatment.

Results

Inpatients who endorsed stronger intolerance for uncertainty, measured by higher scores on the OBQ-87 Intolerance for uncertainty scale, showed worse response after CBT, measured by having still higher Y-BOCS scores at post-treatment (β = 0.37, t = 2.48, r2 = 0.14, P < 0.05). No effect of the other beliefs emerged.

Conclusions

Current data demonstrated the role of intolerance for uncertainty as predictor of negative response after intensive CBT for resistant OCD in inpatient setting. Augmentation strategies should be introduced to improve outcomes of inpatients with intolerance for uncertainty.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Frontotemporal Dementia: A Diagnostic Challenge
Authors: Crisan C.A. , Parau I. , Perju-Dumbrava L.
Published: June 2017

Introduction

Frontotemporal dementia (FTD), the second commonest cause of degenerative dementia after Alzheimer's disease in patients aged 65 years or less is characterized clinically by progressive changes in social, behavioural, and language function.

Objectives

To do a complete psychiatric and neurological examination of a case with pick dementia.

Aims

This case report wants to highlight the combination of psychiatric and neurological symptoms in FTD in order to improve the early diagnosis and therapeutical management.

Methods

We report the case of a 62-years-old male who was admitted in psychiatric clinic, I Cluj-Napoca after he was transferred from neurology clinic I for distractibility, impersistence, apathy, loss of interest, emotional blunting, hyperorality, dietary changes, stereotyped behaviour, decline in personal hygiene. The delay in diagnosis was approximately 3 years, probably because his MMSE total score was 30 points and because he presented behavioural and verbal disinhibition, irritability, inappropriate emotional reacting and a CT with minimal changes.

Results

Psychometric evaluations revealed: Frontal Assessment Batery (13/18), Frontotemporal Dementia Rating Scale (50% impairment, moderate severity level), ADL (activities of daily living) (Katz score = 4/7, moderate dependence, low self-care) and IADL (instrumental activities of daily living) (2/8 = high dependency level, low self-maintenance). MRI: fronto-temporal atrophy. The anamnesis, heteroanamnesis, para-clinical investigations led us to a diagnosis of FTD (Pick dementia).

Conclusions

We should acknowledge that behavioural changes progress whatever the presentation, that cognitive decline occurs later and that FTD is a disease with a longer delay in onset of cognitive symptoms and diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Telomere Length and Depressive and Anxiety Disorders: Longitudinal Associations and Underlying Mechanisms
Authors: Penninx B. , Verhoeven J.
Published: June 2017

Many psychiatric disorders have been associated with increased risk of mortality and various aging-related somatic diseases. In addition to unhealthy lifestyles, also various stress-related physiological processes likely play a role in explaining these detrimental health consequences of psychiatric disorders. The impact could be visible at the cellular level, with psychiatric patients presenting more signals of physiological aging for instance as determined by measuring telomere length. In this talk we will first highlight the current state-of-the art evidence that various psychiatric conditions, including e.g. depression, anxiety and PTSD, are associated with shorter telomere length. Second, we will provide results from the Netherlands Study of depression and anxiety (n = 2981) that tested longitudinal associations using 6 year data on psychiatric status and telomere length. These results indicate that the association between depressive and anxiety disorders with telomere length is stable over time, and doesn’t show many dynamic associations. Finally, in the same study we have also tested to what extent lifestyle and dysregulations of physiological stress systems such as the immune, HPA-axis and autonomic nervous systems are partly responsible for the observed shorter telomere length in depressed or anxious patients. Results indicate that especially smoking behavior and systemic inflammation partly contribute to the shorter telomere length, but can’t completely explain found associations.

In sum, this talk will highlight the current state-of-evidence for an association between various psychiatric conditions with shorter telomere length, and will provide insights into its dynamics and its contributing mechanisms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Decrease Selected Graphomotor Skills in Early Stages of Alzheimer's Dementia
Authors: Gorzelańczyk E.J. , Pasgreta K. , Walecki P.
Published: June 2017

Introduction

In the early stages of Alzheimer's disease (AD) motor and cognitive dysfunctions has been observed.

Objectives

In previous studies we have shown that AD patients present abnormalities of selected graphomotor skills, but results were vary and not conclusive. In this study, we conducted more extensive tests on a larger study group.

Aims

The aim of the study is to identify which graphomotor functions are impaired in the early stages of AD.

Methods

Seventy-one patients with mild and moderate AD (F.00.0, F.00.1, F.00.2) (MMSE 20.3 ± 3.8; age 79.1 ± 5.21) were examined. Forty-four healthy ones (C) without symptoms of dementia, matched for demographic characteristics (MMSE 29 ± 1.1; age 78.3 ± 4.7) were examined. Graphomotor skills were assessed by the original drawing test (the eight figures and the signature) performed in a magnetic field (resolution 2540 dpi and 1024 pressure levels). These test were implemented on a graphic tablet (Wacom Intuos) with the specialized software. The length and time of drawing, the average and maximum speed of drawing, the average and maximum momentary speed, the amplitude and frequency (with FFT spectrum analysis) of hand tremors were measured.

Results

Statistical analysis of the graphomotor signal revealed differences between the AD group and the C group with respect to various parameters. The largest differences have been observed in partially automated skills such as signature, and not drawing shapes (lines, spiral, etc.). The average speed of signature and maximum momentary speed of signature is lower in the AD group.

Conclusions

This method allows for quantitative and objective measurement of the biophysical signal and assessment of the graphomotor skills.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pupillometric Assessment of Cholinergic Functioning in People with Alzheimer Disease: A Study from India
Authors: Jilani A.Q. , Srivastava S. , Shukla D. , Tiwari S.C.
Published: June 2017

Background

Diagnosis of Alzheimer disease is mainly clinical, based on longitudinal history and clinical criteria due to lack of specific biochemical tests and neuroimaging studies. Deficient central cholinergic activity of AD pathology is said to be reflected as decreased peripheral cholinergic activity. Assessing peripheral cholinergic function with pupillometer for diagnostic and prognostic purpose may be beneficial, as it may be a non-invasive, acceptable, and easily administered diagnostic tool if proven so.

Method

This is a single point case control pilot study with sample size of 45 (25 AD patient and 20 controls). CAMDEX-R based interview, HMSE, and DSM-IV criteria were used for detailed assessment and diagnosis. The pupillometric parameters (Horizontal and vertical diameters of pupil) were measured by Oasis Colvard pupillometer (SKU-0401A) under three conditions namely after 5 minute of dark adaptation in dark room (PD-5min-DA i.e. Baseline PD); after 5 minutes (PD-5min-T) and 15 minutes (PD-15min-T) of instillation of 2–3 drops of 1.0% Tropicamide.

Results

There was no difference in baseline pupil diameter (horizontal + vertical) of AD patients and age matched healthy controls. 1% tropicamide induced significant increment in pupil diameters from baseline to after 5 (‘PD-5min-T’) and 15 minutes (‘PD-15min-T’) of its instillation in both AD patients and age matched healthy controls. But tropicamide induced increment in pupil diameters were approximately equal in cases and controls.

Conclusion

The study did not find the role of 1% tropicamide induced pupillary hypersensitivity in AD patients for diagnostic purpose.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Attitudes Toward Euthanasia: Contradictory Views and Ideas of Alzheimer Patients’ Relatives
Authors: Nikolaev E.
Published: June 2017

Introduction

Alzheimer's disease (AD) is one of the pressing social problems as the negative effects of the disease often manifest on patients’ relatives. Relatives of AD patients experience physical and psychological burden during the care.

Objectives

To clarify what kind of views on euthanasia are more common among relatives of patients with AD.

Methods

The study involved 23 AD patients’ relatives (mean age 60, SD = 2). There were 5 men (22%) and 18 women (78%). All participants were directly involved in caring for their relatives with AD. A 19-item structured questionnaire (E. Nikolaev, 2016) was used for measuring medical, legal, ethical, socio-cultural, spiritual and personal aspects of attitudes to euthanasia.

Results

The respondents were less likely to see euthanasia as medical issue. They also referred it to kind of ethical and legal problems. Legal aspects were determined by greater consent to its legalization and by awareness of imperfections of legal basis for its immediate implementation. Ethical issues according to which euthanasia practice was related to the development of humanity complemented this vision. These settings were in conflict with socio-cultural perceptions of euthanasia. Respondents were convinced in possibility of various forms of abuse during euthanasia. Supporting the ideas of euthanasia in general, many respondents on a personal level were not ready to apply them to their relatives with AD in practice.

Conclusions

Attitudes to euthanasia in AD patients’ relatives was contradictory. It was determined by divergent ideas about euthanasia in field of legal, social, cultural, spiritual and personal issues of this interdisciplinary phenomenon.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The Association of Recurrent Affective Disorders with Functional Capabilities in the Subjects Over 60 Yeras of Age. a Preliminary Findings
Authors: Rachel W. , Krupnik S. , Datka W. , Dudek D. , Zak M.
Published: June 2017

Introduction

Major depressive disorder (MDD) in the older adults is correlated with a significant decline in daily physical activity, consequently resulting in chronically impaired quality of life and an increased exposure to falls-risk.

Objectives

Establishing whether geriatric depression Scale (GDS) scores, found correlated with dual motor tasks (TUGTMAN), are also correlated under the cognitive test constraints (TUGCOG).

Aims

The study aimed to analyse the relationship of MDD symptoms, the number of depressive episodes and hospitalisations, with the efficiency of gait in single and dual task conditions, motor and cognitive, functional capabilities.

Methods

The study was conducted in the outpatient clinic, university hospital, department of psychiatry, Krakow, on 30 patients over 60 years of age presenting recurrent MDD. The assessment consisted of GDS, MMSE, TUGT, TUGMAN, TUGCOG, 30sChS, SLS. Spearman rho rank correlation was applied to determine the relationship between the variables.

Results

Statistical analysis showed a significant association between the intensity of depressive symptoms expressed in the GDS and the number of completed episodes and depression and TUGT. The number of hospitalisations was associated with gait under motor (TUGMAN) and cognitive (TUGCOG) constraints.

Conclusion

Duration of the disorder and the number of hospital admissions are related to the functional efficiency of the single and dual-task performance in the persons suffering from this disorder for at least 10 years. Aged persons should effectively be encouraged to undertake physical activities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Comparative Study of Elder Mistreatment Between Community-dwelling Elders and Those Residing in Long-term Care Facilities
Authors: Saguem B. , Saoussen B. , Béchir B.H.A.
Published: June 2017

Introduction

Elderly who live in settings other than their own homes or those of relatives have received little attention from researchers in Tunisia.

Aims

To compare sociodemographic and clinical factors associated with elder abuse between community-dwelling elders and those residing in nursing home.

Methods

A comparative study was conducted, including 50 subjects aged 65 years and older living in the community and 20 age- and sex-matched subjects living in a nursing home. Cognitive status, depressive symptoms and autonomy were assessed using mini-mental state examination (MMSE), geriatric depression scale (GDS) and activities of daily living scale (ADL). Elder abuse was evaluated with Indicators of Abuse Screen (IOA).

Results

Elder abuse was more prevalent in elderly residing in nursing home (P = 0.009) with a prevalence of 35% and 8% and a mean IOA score of 12.75 and 7.74. Psychological, physical, financial abuse and neglect were reported by elderly residing in nursing home. Those living in community reported exclusively psychological abuse. The victim's reactions were passive in all cases.

Elders living in nursing home were more single or divorced (0.000) and financially independent (0.003). They had lower scores of MMSE (0.002) and ADL (0.014), and higher scores of GDS (0.022). A binary logistic regression confirmed that elder abuse was significantly more prevalent in nursing home after eliminating these confounding variables: age, gender, MMSE, GDS and ADL scores (P = 0.018).

Conclusion

Our results confirm that elderly who live in long-term care facilities are at particular risk for abuse and neglect.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical Personality Patterns in Patients with Acute Lymphoblastic Leukemia Waiting for Bone Marrow Transplantation
Authors: Vybornykh D. , Khrushchev S. , Rasskazova E. , Kuzmina L. , Parovichnikova E. , Tkhostov A.
Published: June 2017

Introduction

Personality disorders are rather widespread in oncology settings demanding special attention of clinician. Serious illness threatening person's life as well as severe treatment and side effects lead to specific self-regulatory emotional and cognitive efforts. Personality could both play an important role in this process predicting adjustment and survival and change in line with illness pathogenesis.

Objectives

The personality patterns could be important predictors of operation success and further adjustment for patients with acute lymphoblastic leukemia (ALL) waiting for bone marrow transplantation.

Aim

To reveal personality patterns specific for patients with ALL.

Methods

Twenty-five patients with ALL (11 males, 37.4 ± 9.5 years old) filled Millon Clinical Multiaxial Inventory–III and Big Five Questionnairie–2. Comparison group included 180 people of the same age and gender without history of mental or severe somatic disorders.

Results

Male patients comparing to healthy males were lower on emotional control and higher in negativistic personality pattern (P < .05). Female patients were higher on dynamism but lower in openness to culture and antisocial pattern (P < .05). They rarely expressed patterns of borderline disorder and drug dependence but reported more compulsive traits (P < .05).

Conclusions

Severe illness could increase likelihood of emotion regulation difficulties and passive-aggressive coping in male patients while stimulate activity and compulsive behaviour in females. These patterns should be taken into account in psychological support of patents to bone marrow transplantation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Carry on: Study of Psychosocial Needs of Oncological Patients of the Azores–Proposal for a Support Model
Authors: Sousa M. , Carvalho C. Barreto , Moreira H. , Canavarro M.C.
Published: June 2017

The number of new cases of cancer in Azores and the transfer of oncological patients to mainland Portugal for specialized treatment raise concerns about psychological adaptation and suitable support care. Further studies regarding the lack of support interventions available to meet the needs of Azorean oncological patients and survivors are required. The main objectives of this study are: (1) to evaluate psychosocial needs and other psychological adaptation variables among adult oncological survivors from the Azores; and (2), ensuing from objective (1), to develop a pilot study to test a model of support with a group of oncological patients from the Azores. Two studies will be performed. The first deals with objective (1) as described. Based on results obtained, a randomized control trial assessment will be run to test a support model based on the patient advocacy movement with oncological patients. The assessment protocol will be administrated three times: before and after the model's implementation and, again, as a follow-up. Results should enhance knowledge of assessing psychological adaptation variables involved in disease trajectory while testing a support model addressing this study major concerns. These, as suggested, relate to lack of support interventions to meet the psychosocial needs of oncological patients and survivors from the Azores. Given the peculiar experience of Azorean oncological patients’, while away from their homes, there is a need to ensure adequate health care services on their behalf. Hence, the importance of devising ways to monitor their psychosocial needs in order to overcome some of these constraints.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neuronal Potassium Channel Openers Flupirtine (SNEPCO) in the Treatment of the Pharmacoresistant Epilepsy
Authors: Aliyev N.A. , Qafarov T.A. , Aliyev Z.N.
Published: June 2017

Introduction

Flupirtine is used in many European countries for the treatment of different pain states because of its analgesic attributes. It is a centrally acting, non-opioid analgesic.

Objective

The aim of the study was to investigate an entire study the possibility of applying flupirtine (ktadolona) – selective neuronal potassium channel activators in the treatment of pharmacoresistant epilepsy and related non-psychotic depressive disorder in adults.

Material and methods

A total of 20 patients with the diagnosis of primary – generalized idiopathic epilepsy (IGE) and “non-psychotic depressive disorder due to epilepsy (F06.362)”. Before applying katadolon forte, patients received standard antiepileptic and antidepressant drugs (Depakine-Chrono 1000 mg/day, 150 mg lamotrigine/day, levitiratsetam 3000 mg/day of citalopram 20 mg/day). Assigning a first katadolon fote 14 days 200 mg 2 times a day, followed by 200 mg three in day inside.

Results

Of the 20 patients, 10 had no seizures, 8 marked decrease in the frequency of seizures in 2 patients therapy was not effective.

Conclusion

Our data should be considered preliminary, because small sample of patients and duration of follow-up (18 months). The next phase of work will be carried out on a large sample of patients and a longer observation, placebo – controlled, double blind study.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Emotional and personal development of preschool age children with speech disorders: Drawing test study
Authors: Burlakova N. , Fedorova Y. , Pechnikova L. , Oleshkevich V.
Published: June 2017

Introduction

Drawing tests provide good opportunity to research potential risks in emotional and personal development of a child with speech disorder, because drawing tests almost do not involve speech.

Aims and objects

The research was aimed at detecting potential risks in emotional and personal development of children with speech disorders. The study involved 28 children (15 girls and 13 boys) with moderate speech disorders and 30 normally developing children. All the children attended kindergarten and were of age 5.5 years at the moment of the research.

Methods

The following methods were used: non-participant and participant observation, expert assessment, structured interview with educators, individually conducted family drawing test.

Results

Most children (86%) expressed willingness to perform a task, in some cases (14%) children failed to perform a task because of emotional numbing. The children's perception of a specialist was marked by increased anxiety and stress, in some cases it was expressed in a drawing by filled areas (38%) or by barely visible figures (62%). Most children (87%) tried to demonstrate their abilities and were diligent, but their drawings were generally poorer than that of normally developing children. This phenomenon reflects deficit of skills, imagination deficit and low level of aspiration. Quality of drawings and their visible from differ from the drawings of normally developing children that indicates low self-esteem and feeling of personal incapacity formed by speech disorder.

Conclusion

Increased anxiety, constriction and imagination deficit characterize children with speech disorders. Their emotional attitude to speech behavior influences their graphical self-fulfilment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
What happened with the homeless during economical crisis? Evolution of the prevalence of homelessness in north-Catalonia (2006–2015)
Authors: Calvo F. , Giralt C. , Carbonell X.
Published: June 2017

Introduction

There exists a great number of empirical studies which refer as causes of homelessness not only individual factors such as mental disorders or addictions, but also structural factors such as poverty rates or unemployment.

Objective

To describe the evolution of the prevalence of homelessness in Girona from 2006 to 2015, and compare it with the evolution of unemployment in the same region.

Methods

The absolute number of homelessness is obtained from the official records in the city of Girona, which include the data of the open medium intervention team, the local police, and the specific municipal hostel. The rates are calculated on the annual totals of population. Correlations are used to compare quantitative variables.

Results

The yearly homelessness rates increased progressively from 2006 to 2014, the year in which they began to decrease. Similarly, unemployment both in Spain and in the city of Girona in particular evolves in a similar way, with the burden of the worldwide economic crisis. There exists a positive correlation between the evolution of homelessness in Girona and unemployment both in Spain (r = 9.4, P < .001) and in Girona (r = 9.5, P < .001).

Conclusion

The effect of the economic crisis affects the people who are socially excluded in a direct way. These results prompt the investigation of the causes of homelessness, which in many cases are attributed to the responsibility of the individuals.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessing the risk of venous thromboembolism in psychiatric in-patients
Authors: Ellis N. , Quraishy M. , Grubb C.M. , Fitch S. , Harrison J.
Published: June 2017

Introduction

Venous thromboembolism (VTE) is a potentially fatal condition. Hospital-associated VTE leads to more than 25,000 deaths per year in the UK. Therefore identification of at-risk patients is crucial. Psychiatric in-patients have unique factors which may affect their risk of VTE (antipsychotic prescription, restraint) however there are currently no UK guidelines which specifically address VTE risk in this population.

Objectives

We assessed VTE risk among psychiatric inpatients in Cardiff and Vale university health board, Wales, UK, and whether proformas currently provided for VTE risk assessment were being completed.

Methods

All acute adult in-patient and old age psychiatric wards were assessed by a team of medical students and a junior doctor over three days. We used the UK department of health VTE risk assessment tool which was adapted to include factors specific for psychiatric patients. We also assessed if there were concerns about prescribing VTE prophylaxis (compression stockings or anticoagulants), because of a history of self-harm or ligature use.

Results

Of the 145 patients included, 0% had a completed VTE risk assessment form. We found 38.6% to be at an increased risk of VTE and there were concerns about prescribing VTE prophylaxis in 31% of patients.

Conclusions

Our findings suggest that VTE risk assessment is not being carried out on psychiatric wards. Staff education is needed to improve awareness of VTE. Specific guidance for this population is needed due to the presence of unique risk factors in psychiatric in-patients and concerns regarding VTE prophylaxis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sensation seeking and religious orientation: Correlation study
Authors: Hatam S. , Baranovich D. Lea , Shahbazi-Fard M.
Published: June 2017

Introduction

Religious orientation is a tendency to religious thoughts and performances, which contain the attitudes, beliefs and religious practices. Sensation seeking is a personality trait whereby seeking new feelings and experiences, innovative, complex and intense desire for taking physical and social risks.

Aim

The purpose of the study is to predict the religious orientation based on emotional intelligence.

Method

The current study utilized Alport's religious orientation questionnaire and Zukerman's sensation seeking questionnaire and applied the correlation method that provides an illustration of anticipating religious orientation. Of all the population of one university in IRAN, 116 participations were selected by using a multistage random sampling method.

Result

The finding indicates that based on the emotional intelligence and its components, religious orientation is predictable.

Conclusion

It is found that a significant positive correlation holds for emotional intelligence with external religious orientation. In addition, it is showed that a significant negative correlation holds for emotional intelligence with internal religious orientation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Perfectionism is related with academic stress in medical student
Authors: Kim C. , Seockhoon C. , Suyeon L. , Soyoun Y. , Boram P.
Published: June 2017

Objective

Especially medical students set high academic standard, and try hard to achieve because they are requested to studying medicine perfectly. Multidimensional perfectionism scale (MPS) is used to measure perfectionism in medical student. The purpose of the present study was to investigate the relationships between stress and various factors including perfectionism.

Methods

We enrolled 159 medical students from University of Ulsan college of Medicine. We used the Medical Stress scale (MSS), the Multidimensional Perfectionism Scale(MPS), the patient health questionnaire-9(PHQ-9), the academic motivation scale (AMS), the insomnia severity scale(ISS), and The revised neo personality inventory.

Result

To analyze data, we used Pearson's correlation and logistic regression analysis. In the first step- Pearson's correlation analysis, a motivation, PHQ-9, ISI, perfectionism and neuroticism traits of NEO-PI significantly correlated with stress level (P < 0.001). In the second step, logistic regression analysis indicated that students who feel high level of academic stress (MSS score ≥ 28) are also related to a motivation, insomnia, perfectionism and neuroticism traits of NEO-PI (R2 = 0.389, P < 0.05).

Conclusion

Student who tend to be perfect feel more academic stress. The high level of stress related to insomnia and a motivation in medical student. Moreover, personality trait also can influences their psychological stress level.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Community behavioral health care linkages for youth
Authors: Leukefeld C. , Tilson M. , McNees-Winston E. , Seaver R. , Dickson M.
Published: June 2017

Introduction and objective

behavioral health (BH) agencies have care linkages for youth including juvenile justice (JJ). However, there are few studies on youth care linkages. This study focuses on six sites with the objective of examining BH and JJ staff perceptions about information exchange on screening, assessment and treatment.

Methods

We developed an index to quantify BH and JJ staff perceptions of information exchange on youth screening, assessment and treatment. After Informed Consent, staff rated past year interactions from agree to disagree on a 7-point Likert scale. Chi-squares and T-tests were used.

Results

All 64 staff consented 17 (26.5%) BH staff and 47 (73.5%) JJ staff. Significant differences included BH staff were more likely to be licensed (P < .001) and had a masters degree or higher (P = < .01). Professional experience ranged from 9.8 to 15.8 years. However, there were no statistically significant differences. BH staff was somewhat higher from 5.7 for “shared assessment results” to 6.8 for “been easy to talk to” while JJ staff were from 5.1 for “shared screening results” to 6.1 for “treated youth with respect”.

Conclusions

This pilot study found high rates of staffs agreement including ease of talking and listening, sharing screenings and assessments information, and helping begin, continue, and complete treatment. This high agreement was not expected with confidentiality restrictions and traditions. Future studies should target care linkages including letters of agreement, case conferences, and guidelines.

The study is supported by the National Institutes of Health.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparison of noise effects to state anxiety levels of patients and nurses
Authors: Akgun B. Mala. , Akgün M.
Published: June 2017

Introduction

An quiet environment is comfortable and peaceful. Also, healthy and safety environment is a human right. But, exposure to noise may cause negative effects on psychology and performance. Also, it is a problem in public hospitals, because, noise is an important issue for both nurses and patients.

Objectives

The study was designed to determine decibel levels on the hospital's four unified clinics and compare noise effects to state anxiety levels of patients and nurses.

Methods

Information Form, Spielberger State-Trait Anxiety Inventory (STAI) were applied to participating 40 patients and 14 nurses. A measurement of the sound level of unified clinics was performed for two days in the morning and after lunch for two days.

Results

The range of minimum to maximum decibel levels was significantly greater in nurses’ station (38.66 dB versus 82.48 dB) than patient rooms (24.61 dB versus 74.2 dB) (P < .05). 25 patients and 14 nurses stated that there was noise in the clinic. 19 patients and 10 nurses expressed that it caused a headache. The state anxiety levels were 39.29 ± 5.61 for nurses and 45.4 ± 4.86 for patients. The state anxiety level of patients were 44.83 ± 3.86 in 1. Clinic, 48.8 ± 4.37 in 2. Clinic, 43.82 ± 4.9 in 3. clinic, 44 ± 5.57 in 4. Clinic.

Conclusions

We should reduce the noise level to reduce the level of state anxiety. This study describes one reason to reduce peak noise levels on unified clinics. Standards applied across studies to measure and characterize acoustic environments are urgently needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sex differences in psychiatric inpatients: Demographics, psychiatric diagnoses and medical comorbidities
Authors: Oliveira P. , Coroa M. , Madeira N. , Santos V.
Published: June 2017

Objectives

There are few published studies on the relationship between gender and psychiatric disorders. We assessed sex differences in a sample of first-admission psychiatric inpatients to identify possible risk factors and targets for sex-tailored treatment interventions.

Methods

A retrospective study of admissions to the psychiatry department, Coimbra hospital Universitary Centre, Portugal, in 2015 was accomplished (n = 924). The two groups were compared for demographic features, psychiatric diagnoses and medical comorbidities.

Results

Male patients were significantly younger (age average = 47.7 vs. 53.3). Differences in employment, educational, and marital statuses were found between male and female psychiatric patients. Having a degree was a protective factor for males, whereas it was a risk factor for females. Being divorced and single were both risk factors for medical co-morbidity in females. A higher proportion of men among patients hospitalized for schizophrenia (14.9 vs. 5.5%) or substance use disorder (10.3 vs. 2.1%) and a higher proportion of women among those admitted for affective disorders (43.3 vs. 25.9%), including bipolar disorder (13.4 vs. 9.0%), were found. No significant differences in duration of hospitalization between the two groups (22.8 in male vs. 22.2 days in female)

Conclusions

The differences between the two groups of inpatients were very pronounced. A better understanding of these differences may help to establish more effective treatment strategies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Who are the Europeans admitted to psychiatric hospital in Tunisia?
Authors: Ouali U. , Ben Neticha K. , Jomli R. , Ouertani A. , Nacef F.
Published: June 2017

Introduction

A large number of foreign travellers and expatriates visits or lives in Tunisia.

Objectives

To explore socio-demographic, clinical and therapeutic characteristics of European patients admitted to psychiatric care in Tunisia.

Methods

This is a retrospective, descriptive study on all European patients admitted to Razi psychiatric university hospital, which is situated at the outskirts of the capital Tunis, between 2000 and 2015.

Results

A total of 44 Europeans was admitted. Most frequent nationalities were: French and Germans (19 and 16 patients). The stay in Tunisia was mainly due to pathologic travel (17 subjects) and tourism (13 subjects). In total, 25 patients travelled without being accompanied. Average age was 51.3 years with extremes from 16 to 78 years. A history of psychiatric disorder was found in 15 patients, of whom almost all had stopped treatment. A majority (19 patients) was diagnosed with bipolar I disorder, and 8 patients suffered from schizophrenia. Average duration of hospitalization was 19 days. A total of, 22 patients were repatriated for medical reasons. Major difficulties during hospitalization were the language barrier, difficulties to contact family members or former treating psychiatrists for further information on the patient and his medical history, and the lack of insurance covering repatriation for medical reasons.

Conclusion

Psycho-education and early action on the precipitating factors could help to prevent psychiatric illness or relapse in these patients. Furthermore, attention of public authorities should be drawn to incomplete insurance coverage in many psychiatric patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Hyperinsulinism as evidence of munchausen syndrome by proxy: A case report
Authors: Khouadja S. , Younes S. , Fathallah S. , Soussia R. Ben , Zarrouk L. , Nasr M.
Published: June 2017

Introduction

Hyperinsulinism is one of the most important causes of hypoglycemia. Rarely, drug toxicity can be a reason. In the context of Munchausen syndrome by proxy (MSBP), toxicity usually occurs in children due to drug administration by a parent or caregiver.

Methods

we report a case of a 2-year-old girl with hyperinsulinaemic hypoglycaemia due to insulin injections by her mother.

Case report

Mrs. W. is a 28-year-old mother of three children. In her medical history, she was diagnosed with gestational diabetes and treated briefly with insulin. She was hospitalized several times for hypoglycemia and she was diagnosed with factitious disorder. Lately, her youngest daughter aged 2 years old was hospitalized in the pediatric department for repeated unexplained loss of consciousness. The hospitalization lasted 2 months with recurrence of severe hypoglycemia. A full metabolic screen revealed no abnormalities. The mood of the mother appeared quite discordant with the situation. Strict monitoring of maternal behavior showed that the mother gives insulin injections to her daughter. She denied deliberately injecting insulin, and then she accused the health workers. She was referred to our psychiatric department and we diagnosed the MSBP.

Conclusion

MSBP should be considered particularly in patients who have been evaluated by more than one hospital and have discordant test results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personality Traits and Specialty Choice Among Oman Medical Specialty Board Residents
Authors: Al Alawi M. , Al Sinawi H. , Al Huseini S.
Published: June 2017

Introduction

Understanding factors that determine the choice of a specialty among junior doctors are crucial for career counseling and candidates selection. Most studies focused on working hours, income and other lifestyle factors. However, few studies have explored the role of personality traits of the doctors in influencing specialty choice.

Aims

To examine the relation between personality traits and specialty choice among residents at Oman Medical Specialty Board (OMSB).

Methodology

Residents from different specialties were invited to participate in this study by completing Eysenck Personality Questionnaire – Revised (EPQ-R) and Behavioral Inhibition System (BIS) & Behavioral Activation System (BAS) scale.

Results

A total of 255 residents participated in the study (M = 40%, F = 60%). Surgical residents scored significantly higher on the Psychoticism sub-scale (P-value, 0.002) and the Behavioral Activation System (BAS) scale compared to nonsurgical residents (P-value, 0.05). On the other hand, medical residents scored higher in Behavioral Inhibition System sub-scale suggesting a tendency towards avoidance of anxiety-provoking situation (P = 0.023). Concerning neuroticism trait, psychiatrists had the lowest score indicating more emotional stability. Residents from diagnostic specialties score the highest in BAS–Fun seeking with a difference reaching the level of statistical significance.

Conclusion

The findings of this study suggest a possible correlation between career choice and personality traits. Therefore, adapting a well-constructed, efficient and standardized selection approach is of great importance. A reasonable framework for conceptualizing specialty choice would be recognizing one's own personality traits along with exploring social and technical factors related to a particular specialty.

Disclosure of interest

The authors have not supplied their declaration of competing interest.