bluuebunny/crossref_metadata_2025 huggingface dataset:
Decrease in prolactine levels after treatment with aripiprazole during a maniac episode: A case report
Authors: Coll J.M. , Martínez-Alés G. , Salgado N.
Published: May 2016

Introduction

Hyperprolactinemia can produce clinical symptoms affecting the patient's quality of life and therefore limiting therapeutic approaches to bipolar disorder.

Case report

We report a case of a 46-year-old woman, with a 10 year history of type I bipolar disorder and a microprolactinoma, who was admitted to a psychiatry inpatient unit due to a maniac episode. Current symptoms at the moment of admission included hyperthymia, verbiage, flight of ideas and insomnia. Menstrual changes and galactorrea had been present previously. Aripiprazole was introduced, reaching a dose of 30 mg/day, in addition to her usual treatment with lithium and gabapentin. Response to treatment was good and euthymia was reached within 10 days. Moreover, gabapentin was substituted by Valproic acid, and the patient was discharged once therapeutic levels were attained. Prolactin levels were measured at the moment of admission (128.75 ng/mL) and after 11 days of treatment (92.93 ng/mL).

Discussion

Choosing an adequate antipsychotic agent can reduce the risk of iatrogenesis and thus enhance adherence to treatment and quality of life. Aripiprazole had previously shown a high potential at decreasing levels of prolactine. In this case, clinical practice supports scientific evidence.

Conclusions

Aripiprazole is an effective treatment for type I bipolar disorder. Especially, it can be a treatment of choice in patients suffering from symptoms related to high levels of prolactine, even using a high dosage.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical and socio-demographic profile of bipolar I disorder patients
Authors: Khemakhem R. , Homri W. , Karoui D. , Belhadj H. , Mouelhi L. , Bram N. , Ben Romdhane I. , Labbene R.
Published: May 2016

Introduction

The bipolar disorder (BD) is a chronic and severe disease which diagnosis and treatment are still raising the issues.

Aims

To show a potential clinical and socio-demographic profile in BD patients.

Objective

We hypothesized that BD patients have a particular clinical and socio-demographic characteristics.

Methods

This was a descriptive and retrospective study which assesses 49 BD's outpatients. The diagnosis was accorded to DSM-IV criteria. The enrollment was conducted from January 2010 to August 2015. The socio-demographic and clinical data were collected by a preestablished railing.

Results

The mean age was 39.7 years with a sex ratio of 1.33. Six patients (12.2%) lived in urban zones and 61% (n = 30) patients have a lowly socioeconomic conditions. Celibacy was the prevailing civil status in 57.1% (n = 28) among which 17 lived in family home. Thirty-four (69.4%) patients were unemployed.

A primary school level was found in 34.7% of the cases (n = 17). Nineteen patients (38.8%) were schooled until the secondary level and 9 patients (18.4%) followed a university program.

Addiction to smoking was found at 26 patients (53%) whose half of them had moreover an alcoholic poisoning. The mean age at the diagnosis was 35.6 years with an inaugural manic episode in 63.4% (n = 31) of the cases. The average number of relapse was 1.23 and the mean duration of follow-up was 3.2 years.

Conclusion

The knowledge of the profile of the consultants, their socio-demographic and clinical characteristics would allow to adapt the offer of care to the request.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The role of medical condition in perplexity inside psychotic mixed states in bipolar disorder: Case series and literature review
Authors: Preve M. , Bolla E. , Godio M. , Suardi N.E. , Traber R. , Colombo R.A.
Published: May 2016

Introduction

In literature Leonard introduce, after Wernike (1900) and Kleist (1928), the concept of cycloid psychoses, and he gives again a weight to the mixed forms in affective disorders [1–4]. A lot of different medical conditions cause pychiatric problems, like hyperammonemia, hyponatiremia, thyroid disfunction, urinary infections and still others. The aim of our study is to evaluate the role of a medical condition in perplexity inside psychotic mixed states in bipolar disorder (BD). We propouse three different cases and literature review.

Method

Three patients with perplexity in BD were assessed with: the SCID-P for axis I diagnosis, HRSD, YMRS, internistical examination, blood test exams and urinanalysis, and first level brain imagin (CT and/or MRI). We conducted a systematic review of the literature (PubMed, Embase, PsychInfo), using the terms “bipolar disorder”, “mixed states”, “perplexity” and “medical condition”.

Results

All our patients present: hyperammonemia, reduction of TSH and presence of infection at the urinanalysis, and a resolution of perplexity with the normalization of the blood test and urinanalysis.

Discussion and conclusion

To our knowledge there are not studies that confirm the relationship between thyroid and epatic dysfunction, and urinary infection with perplexity in psychotic mixed states in BD, and the resolution with the normalization of blood and urinary exams. Further research is warranted to replicate our clinical observations and to confirm our results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adherence to rehabilitation treatment in HIV-positive and HIV-negative opioid-addicted patients with psychiatric comorbidity
Authors: Bereza Z.
Published: May 2016

Introduction

Early diagnostics and treatment of comorbid disorders in drug addicts is an integral part of the rehabilitation process and a critical factor in the success of rehabilitation measures as a whole.

Subjects

One hundred and thirty-three patient of inpatient rehabilitation department. The inclusion criteria in the study were: age above 18 years, withdrawal status, diagnosis (F 11.20 ICD-10). They were divided into two groups: HIV positive (n = 38) and HIV negative (n = 95).

Aims

To estimate the prevalence of HIV infection and comorbid mental disorders in substance abuse patients and the impact of comorbidities disorders on the compliance.

Methods

Clinico-anamnestic method, clinical-psychopathological method (criteria ICD-10 and clinical diagnostic scales: PANSS, HADS, MMPI). All participants also had serological blood test for antibodies to HIV.

Results

According to our data, the incidence of comorbid mental disorders among HIV negative patients is 65%. The research also showed a correlation (P < 0.05) between HIV infection and mental disorders. So, mental disorders were diagnosed in 82% of HIV infected patients. Patients who stopped their treatment early (n = 42) significantly (P < 0.05) more often had specific personality disorders (17%). Most of them suffered from dissocial personality disorder (9%) and borderline personality disorder (18%).

Conclusions

This analysis showed that HIV is not significant factor (P > 0.05) of early rehabilitation treatment interruption. But comorbid personality disorders in both groups are a significant factor (P < 0.05) of the treatment interruption, while the endogenous, neurotic or affective mental disorders are not.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Prevalence of insulin resistance and diabetes mellitus type II in bipolar disorders
Authors: Steardo L. , Tortorella A. , Fabrazzo M. , Del Buono G. , Ambrosio S. , Monteleone P.
Published: May 2016

Introduction

Bipolar disorder (BD) is associated with high morbidity and mortality. Patients are symptomatic almost half of their lives and experience significant disability. One subtype of BD is associated with a more chronic course, refractoriness to treatment and poor outcome. Diabetes mellitus type 2 (T2D) and insulin resistance (IR) have been identified as risk factors for this more severe form of BD.

Objectives and aims

We investigated the rates of IR and T2D in patients with BD and whether this comorbidity is associated with specific clinical features of BD such as rapid cycling or treatment resistance.

Methods

IR and T2D were screened in patients with BD types I or II, who were on stable treatment with mood stabilizers. The response to treatment was assessed by means of the Alda scale.

Results

In a preliminary sample, we made a new diagnosis of IR in 40% of patients. The 1% of this sample had a diagnosis of T2D. The treatment response was worse in BD patients with comorbid IR or T2D as compared to those without metabolic abnormalities.

Conclusions

These findings show that IR and T2D have high prevalence in BD patients and have negative impact on treatment response.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Acute psychosis in an adolescent with cerebral palsy
Authors: Moreira C.A. , Soares A.R. , Maia G.
Published: May 2016

Introduction

Cerebral Palsy is a movement, posture or muscle toning disorder caused by an insult to the immature, developing brain, most often before birth. It is a leading cause for serious disabilities in childhood and a risk factor for the development of psychiatric disorders, particularly in adolescents. Moreover, according to DSM-5, a Brief psychotic disorder is a short-term illness with psychotic symptoms, which arise suddenly, but last for less than one month, after which the person recovers completely.

Objectives/Aims

The authors aim to present a case of an adolescent with cerebral palsy who has developed secondary psychotic symptoms, a rare and sparsely understood phenomenon.

Methods

A non-systematic review of English scientific literature was conducted through research in the PubMed search engine, using the keywords “Cerebral Palsy” and “Brief Psychotic Disorder”.

Results

A 16-year-old female adolescent with history of Cerebral Palsy (due to neonatal anoxia) was admitted in the paediatric ward due to behaviour disorder characterized by incoherent speech, full insomnia, agitation and auto/alo-aggression. A complete clinical investigation was performed, in which trauma, organic brain injury, degenerative and inflammatory diseases, infection or toxic ingestion were all excluded. The hypothesis of an acute psychotic disorder was considered and after antipsychotic treatment, a total remission of the symptoms was obtained.

Conclusions

Although rare, the association between cerebral palsy and psychotic disorders should be considered in the diagnostic investigation of behavioural changes. Early identification allows a proper therapeutic intervention and a better quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Conversion disorder in adolescents: A review and case report
Authors: De Cos Milas A. , Garcia Moreno M. , Gómez Macías V. , Chinchurreta de Lora N.E. , Rodríguez Criado N. , Sánchez Sánchez B.
Published: May 2016

Introduction

Conversion disorder (CD) is an uncommon but highly disabling condition. Affected children and adolescents are often severely impaired and at risk of serious long-term physical and psychosocial complications. Despite the enormous personal suffering and health resource implications of CD, little research has been done.

Objectives

To update our knowledge about CD in adolescents, with a comprehensive review of the literature with special focus in prevalence, psychosocial factors, diagnosis, treatment and outcome.

Aims

To present the most relevant data of our review with a clinical illustration that provides a practical vision of this disorder.

Methods

A systematic literature review was performed in MEDLINE, with particular interest in papers published in the last 10 years. Clinical illustration is provided by a case selected from an outpatient child and adolescent mental health service.

Results

Few reliable prevalence data are available; the range goes from 0.2 in a German study to 31% in non-western clinical settings. Diagnosis is based on a constellation of features and treatment should involve several heath care professionals. CD has a favourable outcome in children and adolescents. However, mood and/or anxiety disorders are encountered at a considerable rate even after recovery from conversion symptoms. Long clinical follow-up seems appropriate.

Conclusions

The expression of emotional distress in the form of physical complaints is common in children. Nevertheless, the most severe presentation of physical symptoms is not a common topic in literature. More research should be done to improve our understanding of this disabling disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Is lithium implicated in tobacco addiction?
Authors: Houas I. , Haj Mouhamed D. , Gallelo G. , Douki W. , Gaha L. , Cervera M.L. , De la Guardia M.
Published: May 2016

Introduction

Tobacco is a source of mineral elements that can affect human health in various ways, such as lithium, which is used as a psychiatric medication. Lithium salts are used as mood-stabilizing drugs and indicated in the treatment of manic-depressive psychosis.

Objective

Studying the lithium content in tobacco over the smokers’plasma content and evaluate the potential role of lithium in tobacco addiction.

Methods

A total of 18 different tobacco products (cigarettes, smokeless and water pipe tobacco) and 125 plasma samples (45 from smokers, 10 from ex-smokers and 70 from non-smokers) were collected to determinate the lithium content. Tobacco samples were digested with nitric acid and lithium concentration was measured by inductively coupled plasma-optical emission. The collected plasma samples were diluted 1/10 with a nitric acid solution and the lithium level was measured by inductively coupled plasma-mass spectrometry.

Results

The average concentration of lithium in the cigarettes (16.59 ± 0.59 μg/g) was higher compared to those in the smokeless tobacco (8.39 ± 4.44 μg/g) and in the water pipe tobacco (6.13 ± 6.32 μg/g) but with no significant difference (P = 0.182). For plasma lithium levels, there was no significant difference (P = 0.186) between smokers and non-smokers (6.20 ± 6.24 vs. 4.98 ± 6.20 μg/g). However, a significant negative correlation was noted between plasma and the lithium content in tobacco products (r = –0.435; P = 0.04). The lithium plasma level was significantly and negatively correlated with the dependence score (r = –0.316; P = 0.031).

Conclusion

The correlation between plasmatic lithium and dependence score in smokers suggests that lithium would be involved in tobacco addiction probably through his regulating action of mood.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The other 25%: Autistic girls and women
Authors: Gill M.
Published: May 2016

Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by impairments in social and communicative abilities, along with the presence of ritualistic and/or repetitive behaviors. One of the under-researched areas in the ASD literature is the large gender difference in the diagnosis rates. On average, the male to female ratio stands at 4.3:1, increasing to 9:1 in the absence of comorbid intellectual impairment. It has been evidenced that compared to boys, ASD is diagnosed later in cognitively able girls, despite there being no difference in the number of visits to a health-care professional during the diagnostic process and the age at which parents first express concern. The suboptimal identification of the disorder in cognitively able girls causes a large magnitude of gender discrepancy. These statistics may not be accurate since females may camouflage their difficulties and may be undetected due to their ability to disguise their symptoms better than males. The other hypothesis of under diagnosing ASD in girls is how we quantify and diagnose it. It is based on a male-centric presentation, which does not accurately reflect the disorder in girls. Altogether, these differences may make it more challenging for medical professionals and clinicians to identify potential early signs of the disorder in girls. Hence, there is a need to develop programs to mentor girls and women on the autism spectrum in schools, colleges and industry. And there should be an insistence on inclusion of females on the autism spectrum in pharmacological research and other research projects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Fears in anxious children
Authors: Hernandez Arroyo L. , Santesteban Echarri O. , Güerre Lobera M.J. , Espin Jaime J.C. , Jimenez-Arriero M.Á.
Published: May 2016

Introduction

Fear is a distressing emotion aroused by a risk or a damage, real or imaginary. Fears have a warning function against dangers. Nevertheless, fear can also become in one of the most limiting elements of a person's life.

Objectives

To characterize the profile of fears presented in a sample of 19 children, aged between 8 and 13 years old, who had previously been diagnosed with one of the following: Generalized Anxiety Disorder, Separation Anxiety Disorder or Social Phobia.

Material and methods

The sample was taken from patients who participated in a cognitive-behavioral group therapy. The Spanish version of the Fear Survey Schedule for Children-Revised (FSSC-R) questionnaire was employed. The FSSC-R asks children to indicate on a 3-point scale (‘none’, ‘some’, ‘a lot’) how much they fear 80 specific stimuli or situations. Five basic categories of fears can be stablished: failure and criticism (17 items); the unknown (17 items); minor injury and small animals (13 items); danger and death (16 items); medical fears (5 items).

Results

The sample includes 19 children: 12 boys (63.2%) and 7 girls (36.8%). The median age is 10.74 years. The sample shows 15 excessive fears on average (those scored as ‘a lot’). Girls show higher rates of excessive fears than boys: 19 versus 13. The most common fears were ‘being hit by a car or truck’, ‘bombing attacks. Being invaded’, ‘a burglar breaking into our house’ and ‘falling from high places’.

Conclusions

Most common excessive fears belong to danger and death category. Females report more fears than males.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differential diagnosis of recurrent hypersomnia. Case report of primary narcolepsy and acute transient psychotic attack
Authors: Kıyak J. , Köse S. , Özbaran B.
Published: May 2016

Introduction

We report a case of 17-year-old boy with excessive daytime sleepiness.

Objectives

Case presented in our study is an example of atypical narcolepsy with coexistence of psychotic symptoms that were especially prominent during the first attack. Excessive daytime sleepiness period was followed by psychotic symptoms including delusions of reference and persecution, as well as visual and acoustic hallucinations. However, during the second attack, negative psychotic symptoms were more prominent.

Aims

Clinicians should not forget that child and adolescent patients, which demonstrate psychotic symptoms and excessive daytime sleepiness component, should be evaluated for a diagnosis of primary hypersomnia.

Method

Patient did not exhibit any comorbidities that would match with secondary hypersomnia. The initial sleep study did however reveal increased REM sleep latency (43% of total sleep time). The result of polysomnographic study was abnormal and suggestive of narcolepsy. In multi-sleep latency test mean REM latency was 1.7 min, sleep-onset REM (SOREM) was observed 3 times. Between the tests he had no episodes of cataplexy.

Result

Patient was diagnosed with primary hypersomnia-narcolepsy without cataplexy. We found that mixed symptoms of narcolepsy and psychotic attack improved with anti-psychotic agent treatment.

Conclusion

Child and adolescent patients, which demonstrate psychotic symptoms and excessive daytime sleepiness component, should be evaluated for a diagnosis of primary hypersomnia following a multidisciplinary cooperation of neurologists, pediatricians and psychiatrists.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive and functional outcomes after a trial of an mTOR inhibitor in an adolescent with neuropsychiatric sequelae of TSC
Authors: Lachman A. , van de Merwe C. , De Vries P.
Published: May 2016

Tuberous sclerosis complex (TSC) is a genetic autosomal dominant condition with multi-organ involvement and highly variable clinical manifestations. Neurological manifestations (subependymal nodules, cortical tubers, and subependymal giant cell astrocytomas [SEGAs]) are a leading cause of morbidity and mortality leading to cognitive impairment, behavioural disturbances and refractory seizure disorders. Experimental and human evidence suggest that the use of mTOR inhibitors may induce regression of TSC tumor types and provide an alternative to surgical resection of SEGA's. In the EXIST-1 trial everolimus (mTORi) was associated with clinically meaningful increases in the time to progression of subependymal giant cell astrocytomas and skin lesion response rate compared with placebo. We present a case of a 16-year-old girl (MM) referred with neuropsychiatric sequelae including disruptive and dangerous behaviours not responding to outpatient management. Multiple trials of anti-convulsants and antipsychotic treatments achieved poor responses. During admission to a state facility, MM had several seizures followed by aggressive outbursts, inappropriate behaviour and confusion. Her intrusiveness, sexual disinhibition and lack of response inhibition suggested frontal lobe dysfunction impacting on executive functioning. Despite seizure control being optimized to an acceptable rate with anticonvulsants, improvement in social or cognitive functioning was limited. She required individual constant supervision for personal safety and independent functioning. A trial of mTor inhibitor was initiated, and achieved an improvement in cognitive, social and psychiatric functioning. This report will discuss the challenges in this complex case, and report on baseline as well as 6month post medication outcomes measured by radiological, functional and cognitive testing.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How does psychotropic medication consent work for youth in foster care
Authors: Pataki C. , Thompson C. , Crecelius G. , Tesoro J. , Polsky G. , Kambam P.
Published: May 2016

Introduction

It is well known that youth in foster care are at high risk for psychiatric disorders, recently reported in up to 89%, with over 55% exhibiting ADHD in one sample (Linares et al., 2013). Psychotropic medication use was reported in 59% of foster care youth within a 2-month period (Brenner et al., 2013). The psychotropic medication consent process in Los Angeles for dependent children is multidisciplinary, starting with the treating psychiatrist's written authorization request to Children's Dependency Court. Once received, it is distributed to the child's attorney, social worker, and Juvenile Court Mental Health Service (JCMHS). JCMHS reviews and provides recommendations to the judicial officer who ultimately approves, modifies, or denies consent.

Objectives

To present the steps and reasoning in the process of review, consultation, recommendations and decisions in psychotropic medication consent for dependent youth.

Aims

To provide an understanding of the multidisciplinary review process involved in determining psychotropic medication consent in foster care youth.

Method

Presentation of a timeline, forms and guidelines used in the process including the “Psychotropic Medication Authorization Form” (PMA) (Judicial Council of California, 2008).

Results

Categories of recommendations and approvals provided to the judicial officer will be presented and rationales for in-person consultations.

Conclusion

The psychotropic medication consent process for foster care youth is a complex multidisciplinary process which includes a clinically significant set of recommendations from JCMHS to the judicial officer to aid in making informed decisions regarding psychotropic medication.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
PCP analogues in samples of Barcelona from 2009 to 2015
Authors: Angelats M. , Galindo L. , Grifell M. , Palma Á. , Martínez L. , Pujol L. , Ventura M. , Fornís I. , Torrens M. , Farré M.
Published: May 2016

Introduction

Novel psychoactive substances (NPS) use is progressively increasing year on year. The new analogues of phencyclidine are frequently sold as legal dissociative anesthetic drug with hallucinogenic and sedative effects, a legal alternative to ketamine, acting as a high affinity and selective ligand of NMDA receptor antagonists.

Objectives

To describe the presence of 3- and 4-MeO-PCP in samples delivered to Energy Control from 2009 to 2015 in Spain.

Methods

A total of 21,198 samples were analyzed from august 2009 to august 2015. Only those samples containing 4-MeO-PCP or 3-MeO-PCP were studied. They were analyzed by Energy Control, a Spanish harm reduction NGO that offers the possibility of analyzing the substances that users report. Analysis was done by gas chromatography–mass spectrometry.

Results

All the samples resulted to be the acquired drug of the consumer. Three samples were adulterated with substances as tramadol, cocaine, acetone among others.

Conclusions

Three and 4-MeO-PCP consumption is not found to be an emerging issue according to the results of our samples. Even the potential harmful effects of these dissociative drugs, our indirect indicator seems to show that consumption has not increased. A more precise monitoring would make a better approach to the real consumption and the impact of these substances in our society.

Disclosure of interest

The authors declare that they have no competing interest.
Emotional and behavioral functioning among 10–14-year-old children who were very low birth weight at birth
Authors: Serrano Villar M. , Barga P. , Coronado A. , Alcami M. , Ortiz A. , Ares S. , Omenaca F. , Bravo Ortiz M.F.
Published: May 2016

Objective

This study examined the emotional and behavioral functioning among 10–14 year-old children who were born with very low birth weight (VLBW, <1500).

Method

Prospective and cross-sectional study of 90 VLBW (<1500 g) survivors born at the Hospital Universitario la Paz in Madrid, Spain, from 2000 to 2005 who were assessed by interviewers using the Strengths and Difficulties Questionnaire (SDQ). Parents also reported on their children's functioning. Children who showed an abnormal SDQ score on the total difficulties subscale or who had psychiatric history were also assessed using the K-SADS-PL.

Results

The proportion of children with abnormal-self-rated-SDQ scores was as follows: almost 25% of children showed an abnormal score on hyperactivity, nearly 15% on emotional problems, 15% on conduct problems and 10% on peer problems. Overall, 15% of children showed an abnormal score on the total difficulties subscale. Most children (99%) showed a normal score on the prosocial subscale. These proportions were higher when the questionnaire was rated by parents. Thirty-eight percent of children were assessed using the K-SADS and very few of them meet the criteria for at least one psychiatric disorder. Biomedical variables were associated in the expected direction to children's SDQ scores such as birth weight, head circumference and Apgar scores.

Conclusion

To conclude, being born with very low birth weight seems to be related to the emotional and behavioral functioning that these children appear to show between 10 and 15 years later.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Advantages of telepsychiatry in child and adolescent mental health
Authors: Szeftel R. , Piacentini L. , Pataki C.
Published: May 2016

Introduction

Telepsychiatry is increasingly utiilized to evaluate and treat diagnostically and geographically diverse youth. (Szeftel et al., 2012; Hilty et al., 2013). Important public health implications arise for US psychiatrically ill youth, most of whom receive no treatment, others depend on pediatricians without input from a child psychiatrist (Goldstein and Myers, 2014). Potential advantages of telepsychiatry include increased access to care from child psychiatrists directly, and through collaborations with pediatricians, and uniquely positive response in patients more communicative in this setting (Pakyrek et al., 2010).

Objectives

– To present the effectiveness of Telepsychiatry in psychiatrically ill youth, and specific subgroups who especially benefit.

– To show increased access to psychiatric care occurs through collaborations between child psychiatrists and pediatricians.

Aims

To present the advantages of telepsychiatry for child and adolescent mental health and clinicians.

Methods

Review of selected published Telepsychiatric evidence-based research and best practice recommendations.

Results

– Psychiatrically ill youth are effectively evaluated and treated using Telepsychiatry (Myers et al. (2011), Hilty et al., 2013).

– Very young children and youth with Autism Spectrum Disorders, or anxiety disorders respond particularly positively to Telepsychiatry (Szeftel et al., 2012; Pakyuerek et al., 2010: Myers et al., 2010).

– Telepsychiatry provides increased access to care through collaborations between child psychiatrists and pediatricians (Goldstein and Myers, 2014; Myers et al., 2011).

Conclusion

Telepsychiatry is a promising advantageous modality for youth based on effectiveness, broad administration and unique benefit for very young and socially impaired youth.

References not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Presentation of the Comprehensive and Brief International Classification of Functioning, Disability and Health Core Sets (ICF-CS) for schizophrenia
Authors: Pino O. , Guilera G. , Rojo E. , Gómez-Benito J.
Published: May 2016

Objective

The aim this presentation is present the results of the preparatory studies were presented at an international consensus conference, a multi-stage, iterative, decision-making and consensus process that took place 12–14 May 2015 in Barcelona, Spain. At this consensus conference, schizophrenia experts from different countries worldwide and working in a broad range of professions decided which ICF categories should be included in the first version of the ICF Core Sets for schizophrenia.

Method

Four preliminary studies intend to capture the researcher's perspective, the patient's perspective, the expert's perspective and the clinician's perspective, respectively, on the most relevant aspects of functioning of persons living with schizophrenia. The final definition of ICF Core Sets for schizophrenia have been determined by integrating the results of preliminary studies in a consensus conference with international expert.

Result

The experts included 97 categories in the Comprehensive ICF Core Set and 25 categories in the Brief ICF-CS. The specific categories of each ICF-CS are shown in this presentation. The Comprehensive ICF-CS can guide multidisciplinary assessments of functioning in persons with schizophrenia, and the brief version is ideal for use in both clinical and epidemiological research, since it includes a small and practical number of categories, but sufficiently wide for finding utility in clinical assessments.

Conclusion

ICF-CS are being designed with the goal of providing useful standards for research, clinical practice and teaching, and it will stimulate research and will improve understanding of functioning, health and environmental factors in schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Presence and evolution of a new psychoactive tryptamines branch
Authors: Palma Conesa Á. , Galindo Guarin L. , Grifell Guardia M. , Quintana Mathe P. , Gil Lladanosa C. , Fornís Espinosa I. , Ventura Vilamala M. , Torrens Melich M. , Farré Albaladejo M. , Fonseca Casals M.F.
Published: May 2016

Introduction

New psychoactive substances (NPS) are substances that have recently appeared on the market and are not under international control. NPS use is experiencing an unprecedented increase. DiPT, 4-HO-DiPT and 4-AcO-DiPT are new psychoactive tryptamines and their effects may differ from those of other psychoactive tryptamines.

Objective

To explore the presence of DiPT, 4-HO-DiPT and 4-AcO-DiPT from samples delivered to and analyzed by Spanish harm reduction service Energy Control.

Materials and methods

All samples analyzed from 2009 to 2014 delivered as DiPT, 4-HO-DiPT and 4-AcO-DPT or containing these substances. Analysis was performed by gas chromatography–mass spectrometry.

Results

From 17,432 samples, 4-HO-DiPT was found in 16, delivered as 4-HO-DiPT (6); 4-AcO-DiPT (7); DiPT (1); 4-AcO-DMT (1) and cocaine (1). 4-AcO-DiPT was found in 16, delivered as 4-AcO-DiPT (12); 5-MeO-DMT (1); 5-MeO-DiPT (1); 4-AcO-DMT (1) and cocaine (1). Only 4 samples contained DiPT, all presented as DiPT. Nine samples contained both 4-AcO-DiPT and 4-HO-DiPT. During the years of study, 4-HO-DiPT deliverance was increasing (4 samples in 2014) while deliverance of 4-AcO-DiPT and DiPT was decreasing (1 sample in 2014).

Conclusions

Increasing 4-HO-DiPT presence could translate a progressive replacement of 4-AcO-DiPT and DiPT recreational use. Clinical relevance comes from its growing use and the absence of scientific evidence on humans, therefore relying on users subjective experience to predict the effects.

Disclosure of interest

The authors declare that they have no competing interest.
Instructional influence on learning and decision making with respect to cognitive functioning
Authors: Frydecka D. , Drapała J. , Misiak B.
Published: May 2016

Introduction

Humans learn how to behave both through rules and instructions (explicit learning) as well as through environmental experiences (implicit learning). It has been shown that instructions can powerfully control people's choices, often leading to a confirmation bias.

Aim

To explore confirmation bias with respect to cognitive functioning in healthy adult participants.

Methods

We recruited 25 healthy adult control subjects (9 males, 16 females, age 31.40 ± 6.08 years). Participants completed Repeatable Battery of Neuropsychological Status (RBANSS) as well as Instructed Version of Probabilistic Selection Task (IPST) (Doll et al., 2009).

Results

Based on the performance on IPST into two groups: a group with higher and lower susceptibility to confirmation bias. We found no difference between these groups with respect to any of the cognitive domains measured with RBANSS (immediate memory, visuospatial abilities, language, attention and delayed memory) (U Mann-Whitney test, P > 0.05).

Conclusion

In healthy adults, susceptibility to confirmation bias is independent of cognitive functioning (immediate and delayed memory, visuospatial abilities, language and attention).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Tardive dyskinesia: When one should suspect of another diagnosis?
Authors: Almendra R. , Figueiredo A.R. , Espirito Santo V. , Almeida A. , Guimarães P. , Velon A.G.
Published: May 2016

Introduction

Tardive dyskinesia is a collection of symptoms related to the side effects of neuroleptic medications that can mimic other types of disorders. Accurate diagnosis can be challenging, as there is no single test for tardive dyskinesia.

Case report

Female patient, 64 years old, with personal history of Chronic Myeloid Leukaemia and psychosis since forth decade, currently medicated with quetiapine 350 mg/day, risperidone IM 50 mg 15/15 days and trazodone 150 mg/day (previously medicated with haloperidol, amisulpride and olanzapine). She started with involuntary movements interpreted as tardive dyskinesia after 2 years on neuroleptic treatment. The difficult control of involuntary movements motivated the reference to ambulatory Neurology department. The review of personal history suggested a family history of involuntary movements and psychiatric illness. Physical examination showed generalized choreic movements. The analytical and imagiologic study was unremarkable. The presence of family history and involuntary movements atypical to be classified as tardive dyskinesia supported a genetic test for Huntington's disease who detected a CAG expansion with 43 repetitions in HTT gene. Despite treatment with amantadine and riluzole she maintains disease progression and evident cognitive deterioration.

Conclusion

The diagnostic process of involuntary movements may involve more than one physician and requires the review of a detailed medical history, a physical examination and a neuropsychological evaluation in order to determine whether one is indeed suffering from tardive dyskinesia or a different neurological disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Quality of life in patients with asthma
Authors: Ennaoui R. , Turki M. , Moussa N. , Sellami S. , Halouani N. , Gassara I. , Hamza N. , Aloulou J. , Kammoun S. , Amami O.
Published: May 2016

Introduction

Quality of life (QoL) is a complex concept that depends on many factors such as life style, past experiences, expectations, future plans and ambitions. It may be altered in patients suffering from chronic disease.

Objectives

Assess QoL in patients with asthma as well as associated factors.

Methods

We conducted a cross-sectional, descriptive and analytic study, including 30 patients followed for asthma at pulmonary outpatient department, Hedi Chaker Hospital, Sfax, Tunisia. Asthma control level was evaluated by the Asthma Control Test (ACT). QoL was assessed using the 36-item Short Form Health Survey (SF-36), that contains 36 questions grouped into 8 domains (D1: Physical Functioning, D2: Role limitations due to physical problems, D3: Bodily Pain, D4: General Health, D5: Vitality, D6: Social Functioning, D7: Role limitations due to emotional problems and D8: Mental Health).

Results

The mean age was 51 ans. The mean duration of disease was 11 years. The average ACT score was 16.8 points. Asthma was uncontrolled in 1/3 of patients. The mean of average overall scores SF-36 was 46.22. QoL was altered in 83.3% of patients. The most altered domains were D8 followed by D7then D4 and D2. The average overall score SF-36 was correlated to ACT score (P < 0.001), early age of onset of the disease (P = 0.049) and poor asthma control (P < 0.001). Altered QoL was associated to advanced age (P = 0.016), long duration of disease (P < 0.001) and low ACT score (P = 0.034).

Conclusion

Optimum asthma and associated comorbidities support would improve control and therefore the patient's quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Study of sleep disturbances in patients with alcohol abuse or dependence
Authors: García Mahía M.D.C. , Fernández Quintana Á.
Published: May 2016

Introduction

Previous studies inform that psychiatric patients often report problems with their sleep and alcohol increase sleep disturbances.

Aims

To analyze the prevalence of sleep disturbances in patients diagnosed of Alcohol Abuse or Dependence and to study clinical and sociodemographic variables associated with sleep disorders.

Methods

The sample is composed of a randomized sample of patients diagnosed of Alcohol Abuse or Dependence following DSM-IV-TR criteria and treated in a Mental Health Clinic in a period of 3 years. Medical records were reviewed. Quality and patterns of sleep were evaluated using the Pittsburg Sleep Quality Index (PSQI) with a cut-off point 5-6.

Results

A total of 102 patients were included in the study, 69% were male and 31% were female. Mean age 39.4 years (SD 9.26).

Sleep disorders were found in 91.6% of patients. The most altered subscales in the overall sample were the Use of Sleeping Medication and Sleep Disturbances. Women presented worse sleep quality compared to men (P < 0.01) with higher number of altered subscales. The most altered subscales in women were Subjective Sleep Quality (P < 0.005) and Sleep Disturbances (P < 0.02).

Comorbidity with other psychiatric disorders and other clinical and sociodemographic variables are analyzed.

Conclusions

Sleep disorders have high prevalence in patients with alcohol abuse of dependence, especially in women and patients with other psychiatric comorbidity. Poor quality sleep may have a powerful impact on the global functioning and prognosis of these groups of psychiatric patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dual pathology in users of early intervention program in psychosis
Authors: Girela Serrano B. , Guerrero Jiménez M. , Carrillo de Albornoz Calahorro C.M. , Rodrigo Manzano J.A. , Martínez García O.B.
Published: May 2016

Introduction

The existence of independent services and facilities for mental health and for addictions in Andalusia stand in the way of addressing dual pathology. The strong comorbidity between substance use and early psychosis has been deeply studied in recent literature. The aim of this paper is to analyse a group of consumers in the First Episode Psychosis Program (FEP) to address the lack of the actual interventions performed.

Methods

Descriptive statistical analysis of demographic and clinical variables of a group with drug consumption (n = 17) is compared to a non-consumer group (n = 7).

Results

Our sample of patients included, consumers who represent 71% of the sample. All consumers were users of cannabis or derivatives and 35% of consumers were diagnosed at some point of Toxic psychosis. Only 23% received care in drug addiction centers. They have less education. The duration of untreated psychosis (DUP) is greater than in non-users and only 35% of the cases were detected in Primary Care. PANSS with higher scores. Greater differences in general psychopathology. The Social Functioning Scale (SFS) were worse in the Isolation scale. The Family Questionnaire (FQ) showed more difficulties in the family setting. Finally the Global Assessment of Functioning (GAF) gives an average of 8 points lower (severe symptoms).

Discussion

We would like to point out the low percentage of users who receive specialized care for their addiction. Better collaboration with Primary Care is required to improve the capacity of detection to reduce the time slot of untreated symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Huntington's disease-comorbidity
Authors: Ortega Garcia M. , Marti Garnica V. , Martinez Martinez C. , Blanco del Valle P. , Gómez Martinez R. , Garcia Acebes P. , Garcia Marin S. , Franch Pato C.
Published: May 2016

Huntington's Korea or Huntington's disease is a pathology of the nervous central system that provokes involuntary movements those who are named Korea or San Vito's evil, changes of conduct, psychiatric alterations and dementia. It thinks that it is a slightly frequent disease among the caucasian ones (1 every 100,000 or 200,000 persons), except in Venezuela that has the highest rate of the world (1 every 10,000). It is named badly of San Vito because he was the saint, the one that was evoked to treat this type of disease. It is a neurodegenerative disease and is accompanied of atrophy of the fluted body and loss of neurons on decrease of neurotransmitters. Members’ spasmodic movements and facial muscles as dance, uncoordination motorboat. These movements woke fear and superstition up in an epoch. Alterations motorboats attitude, march and abnormal movements. Loss of weight for faults in swallowing besides the loss of calories (approximately 4000 daily ones for the constant movement). Not only it is a disease motorboat, the patient loses aptitude to communicate and dies in 10-15 years. There are psychiatric symptoms as the depression, changes of personality, decrease of intellectual capacity and suicide. Let's sense beforehand a clinical case of a 69-year-old patient with psychiatric depressive precedents of years of evolution with treatment psychopharmacology and worsening in last 2 years. Treatment is prescribed with antipsychotic and before a not well-taken quake, is studied by neurology who diagnoses Huntington's disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
ADHD “Symptomatic contamination” in dual pathology (II): Specific analysis of the “Sym_Con” sample
Authors: Pino Calderon F.J. , Zoido Ramos J.M. , Gutierrez Casares J.R.
Published: May 2016

Introduction

The general data of this sample were presented in “ADHD symptomatic contamination in a Dual Pathology (I): General Analysis of the Sym_Con Sample”. We evaluated the presence of symptomatic contamination by ADHD in a SUD group compared with a group of non-consumers adults (parents of children treated in a CAP unit).

Objective and aims

Describe more specifically the peculiarities of the sample Sym_Con according to the type of substance consumption (Alcohol [n = 65], Cocaine [n = 48], Cannabis [n = 49] assessing the presence of ADHD symptomatic contamination.

Methods

We use differents Visual Analogical Scales plus the WURS, BDI, and Exploratory Lists of symptoms of ADHD.

Results

As can be seen in Fig. 1 and 2, the subgroup of Alcohol has a poorer “scalar” status with worse general state, more sadness and anxiety, being the subgroup of cocaine the most “suspicious”. The presence of ADHD-symptomatic contamination is more noticeable in the Cannabis subgroup.

Conclusions

ADHD symptomatic contamination in our Sym_Con sample is frequent, being the cannabis subgroup the more contaminated one. More studies that corroborate the results obtained in this sample are required.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Interest of admission clinical and paraclinical examinations for the detection of organic comorbidities in psychiatry
Authors: Turki M. , Halouani N. , Hamza N. , Naoui R. , Gassara I. , Aloulou J. , Amami O.
Published: May 2016

Introduction

Somatic comorbidities in patients with mental disorders have become an important issue. They complicate therapeutic management and aggravate the prognosis.

Objectives

Outline the nature of somatic disorders observed in psychiatry and assess the different interactions between psychiatric pathologies and organic diseases.

Methods

We conducted a descriptive retrospective study including 60 patients hospitalized in a psychiatry department during 2 years (2013 and 2014). We included patients having presented a somatic disorder at their admission. Data collection was based on psychiatric and clinical observations.

Results

At the admission, somatic examination was abnormal in 53.3% of cases: skin abnormalities 28.3%; blood pressure abnormalities 8.3%. An abnormality of the initial biological tests has been reported in 51.7% of patients: leukocytosis 18.3%; liver test abnormalities 13.3%; hematologic abnormalities 8.3%. The electro-cardiograph was pathologic in 35% of cases. These anomalies have required advices from medical and surgical services: cardiology 33.3%; endocrinology 10%, orthopedics 10%. The relationship between somatic and psychiatric pathology was: a comorbidity: 55%; a side effect of psychotropic drug: 5%; an organic origin of the psychiatric disorder: 6.6% and a somatic disorder secondary to the psychiatric pathology: 10%. In the course of this investigation, 6.6% of patients were transferred urgently to a specialist department, the psychotropic treatment was stopped in 10% of cases, and a therapeutic adjustment was necessary in 6.6% of cases.

Conclusion

Our study confirms the importance of somatic assessment of patients with mental illnesses. This must be a systematic practice in order to detect in time patients at risk of somatic complications.

Disclosure of interest

The authors have not supplied their declaration of competing interest.