bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Novel Psychoactive Substances and Induced Psychiatric Symptoms: Outcomes From the Eivissa Project
Authors: Martinotti G. , Montemitro C. , Corbo M. , Sarchione F. , Cinosi E. , Pasquini A. , Mancini V. , Merino del Villar C.
Published: June 2017

Introduction

Polydrug abuse seems to be especially popular in Ibiza, an important market for new psychoactive substances (NPS). The misuse of psychoactive substances can lead to serious psychiatric symptoms.

Aims

To evaluate symptoms induced by NPSs and other club drugs, correlating with the main classes of drugs.

Methods

Ninety subjects (M/F 59/31) admitted in the Psychiatric Unit of Can Misses Hospital (Ibiza) referring a recent intake of substances were enrolled. The following scales were administered: TLFB (Timeline follow-back); Positive and Negative Symptoms Scale (PANSS); Symptom checklist-90 (SCL-90) ; Young Mania Rating Scale (YMRS) ; Hamilton Depression Scale (HAM-D); Hamilton Anxiety Scale (HAM-A); Modified Overt Aggression Scale (MOAS); Columbia Suicide Severity Rating Scale (C-SSRS).

Results

Polydrug abuse was reported by 67.4% of the sample; the sample was grouped by the main preferred substance in THC-, stimulants-, and depressors-users. The majority of patients reported a previous psychiatric history. Positive symptoms resulted to be higher among THC-users (P < .05). Anxiety evaluated by SCL-90 was prevalent in the group of Depressors-users (P < .05). The scores of MOAS and SCL-90 subscale for hostility/aggression resulted to be significantly (P < .01) greater in the THC-users group.

Conclusions

Some specific psychiatric symptoms are characteristic of some classes of substances and may help to identify them when a urine sample is not available. The possibility to develop psychiatric symptoms after a recent drug use is more common in two situations: (1) patients with a previous psychiatric history; (2) subjects with a history of very strong substance use.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Association Between School Achievement and Subsequent Development of Bipolar Disorder
Authors: Pedersen S.D. , Petersen L. , Mors O. , Østergaard S.D.
Published: June 2017

Introduction

Prior studies have indicated that both high and low school achievement are associated with development of bipolar disorder (BD). We believe that the latter association may be due to the confounding effect of family history of mental disorder.

Objective

To further investigate the association between school achievement and subsequent development of BD by adding adjustment for family history of mental disorder.

Methods

We are conducting a historical prospective cohort study based on data from nationwide Danish registers. The cohort consists of all individuals born in Denmark 1986–97 of Danish-born parents, who were alive and living in Denmark at age 16 years, and who have completed final examinations in 9th grade between 2002 and 2014 (n = 578,247). The cohort members will be followed until death, emigration, development of bipolar disorder, or end of study, whichever comes first. Hazard rate ratios for bipolar disorder will be calculated in a Cox model using the z-score for examination grades as unit of exposure. The regression analyses will be adjusted for a series of potential confounders including family history of mental disorder.

Results

We expect to find a positive association between high school achievement and development of BD. In contrast, we expect to demonstrate that the association between low school achievement and BD detected in prior studies is due to confounding by family history of mental disorder. The results will be shown at the conference.

Conclusions

By further testing the potential link between eminence and BD, we hope to contribute to a more balanced perception of BD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Analysis of Applied Behavior Treatment for Children with Autism Spectrum Disorder
Authors: Nunez Rodriguez A. , Hernandez Y. , Guzmán G. , Jiménez Martinez M.C. , Jimenez M.C. , Guzman G. , Hernandez Y. , Nunez A.L.
Published: June 2017

According to Boesch et al., people with autism spectrum disorder (ASD) are at a greater risk of developing harmful behaviors, such as self-aggression and other challenging behaviors than individuals with normal development do not exhibit. The method of approach that is supported by scientific evidence for interventional procedures is applied behavior analysis, reported by Carr et al. [1].

Aim

In order to provide evidence-based intervention for autism from this approach in practice.

Method

In reference to a longitudinal approach, an intervention program was designed and implemented to serve 40 children with ASD, who were treated for one (1) year at the Victory BRT Institute in Florida, US. The behaviors targeted for reduction (excess behavioral), are the following: physical aggression, self-aggression and non-compliance. The program began with a baseline (12 consecutive days) with observations at home and others different natural contexts. The last three (3) months of the year consisted of monthly follow-up sessions to monitor the treatment implemented. The results were analyzed by repeated measures, ANOVA Sig (P = 0.003) (F = 8). Analyses show that the critical level associated with the effect of time-content interaction is strong, so the treatment generated a positive effect by reducing the behaviors targeted in time.

Conclusions

These results provide evidence that interventions from applied behavior analysis are effective.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric Disorders Run in Families. Children of Parents With Serious Mental Disorders: A Case History
Authors: Ortega Garcia M.D. , Marti Garnica M.V. , Garcia Marin S. , Martinez Martinez C. , Gomez Martinez R. , Blanco del Valle P. , Lopez Bernal M.A.
Published: June 2017

Aims/method

Publications and studies have shown that the existence of serious mental disorders in parents is a risk in the development of children and is more common the existence of mental illness in them than in the general pediatric population. This work aims to reflect in depth on the study of the influence of psychotic parents on child development through a review of a clinical study. We present the case of 14 years old adolescent who is being treated in a mental health center, whose parents suffers from a severe mental illness. We also defend the importance of a preventive approach or treatment that impinges on the child and family environment.

Results/conclusions

A way of community work, in coordination with the different teams (social services, educational services, etc.) allows more efficient and appropriate treatment, using various resources. When risk factors for developing mental health problems in childhood, family history and especially the existence of one or both parents of mentally pathology type schizophrenia or other psychoses are studied become important. It seems essential to address as a priority to the social group have called “high-risk group of psychosis’, and in particular to the” sons of patients diagnosed with psychosis”, both for its size and the severity and chronicity of psychopathology if developing means for early psychosocial care does not occur.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Kaufman Brief Intelligence Test Analysis of its Usefulness in Children Population for the Assessment of Intelligence Quotient (IQ)
Authors: Palomo Monge M. , Calvo Mauri J.F. , Romo Barrientos M.D.C. , Alcocer Lanza M.F.
Published: June 2017

Introduction

The determination of IQ is essential in the assessment and diagnosis of children. There are multitude of tests, one of the most used are the Wechsler Scales.

Aims

Hypothesis: Assessment of IQ is equivalent using the Wechsler Intelligence Scale for Children-Revised (WISCr) and Kaufman inteligence brief test (KBIT).

Subjects Children undergoing treatment at Unit Child and Adolescent Mental Health of Talavera with determination IQ at some point in the intervention: 39 pairings determination of IQ subjects atended: 20 males and 19 females, aged between 4 and 14 years.

Material

Subjects are evaluated with KBIT and WISCr tests.

Methods

Design: Quasi-experimental with two conditions.

Independent variables: IQ Total WISCr and age management KBIT (for eight years application of the full test, under this age not full test).

Dependent variable: IQ KBIT.

Analysis

Calculation of correlation between IQ by non-parametric test. Comparison between groups using non-parametric test for dependent data (sign test). Rejecting null hypothesis for alpha significance P < 0.05.

Results

Partial KBIT; 21 comments, 11 males, 10 females; Spearman r = .714 (P < .001); average estimate of 12.71 points higher in KBIT, Dt 18.07, sign test Z = –2.012 (P < .041).

Full KBIT

18 observations, 9 males, 9 females; Spearman r = .739 (P < .001); lower average estimate of 3.44 points in KBIT, Dt 12.43, sign test Z = –.236 (P < .815).

Conclusions

The results support high validity regardless of age management KBIT, although IQ scores obtained before 8 years should be considered with caution. The KBIT has the advantage of its shorter evaluation, however the information obtained from WISCr is wider.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association Between Irritability and Depressive Symptoms in Children and Adolescents
Authors: Busto-garrido M. , Gutierrez-castillo D. , Navas-gonzalez J.R. , Gutierrez-bedmar M. , Gutierrez-casares J.R. , Martin-lunar M.T. , Rodriguez-rosado A. , Pena-andreu J.M.
Published: June 2017

Introduction

Irritability is the most frequently reported symptom in child and adolescent depression. The association of both has been linked with high rates of chronicity, comorbility and impairment.

Objectives

To study the association between irritability and depressive symptoms in children and adolescents.

Methods

We have studied 857 participants recruited from the only child and adolescent mental health clinic in a catchment area of 122,968 people under 18 (2004–2010). A sample of 857 participants (112 controls and 745 patients) was included to carry out a cross-sectional study. Irritability was measured by a Visual Analog Scale (VAS irritability)–scored from 0 to 10–, and depressive symptoms by the Children's Depression Inventory (CDI). The participants were categorized into controls and patients, and according to their irritability (≤ 4 [I], 5 [II] and ≥ 6 [III]). The mean of CDI score was calculated for each of the groups, adjusted by sex and age, and analyzed by ANCOVA.

Results

The following means were obtained from the controls: 13,71 (group I), 9,82 (group II) and 17,45 (group III). Regarding to the patients: 13,92 (group I), 11,54 (group II) and 15,64 (group III). A quadratic association (P < 0.0015) was found between VAS irritability score and CDI score.

Conclusions

There is not a linear association between irritability and depressive symptoms in children and adolescent. High rates of depressive symptoms were associated both with high and low rates of irritability. Several questions remain unexplained about the status of irritability in psychiatry, as Stringaris group has been pointed out.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Review of Othello Syndrome and its Relationship with Neurological Disorders
Authors: Michielsen P. , De Jonge L. , Petrykiv S. , Arts M.
Published: June 2017

Introduction

Othello syndrome is a psychotic disorder characterized by delusion of infidelity or jealousy. It predominantly occurs in the context of specific psychiatric or neurological disorders. Othello syndrome is associated with mental changes including excessive aggression, hostility, and irritability. Patients with Othello syndrome misinterpret the behaviour of the spouse or sexual partner to provide evidence for their false perception.

Objectives and aims

The purpose of this paper is to examine the phenomenon of Othello syndrome as a result of specific neurological diseases.

Methods

The study design was a retrospective case series of patients with Othello syndrome. We searched the electronic databases PubMed and Embase for review articles and original research using the search terms ‘Othello syndrome, Morbid Jealousy, Pathological Jealousy, Delusional Jealousy, Delusions and Infidelity, Delusions of Jealousy or Infidelity’.

Results

In the present study of 95 case reports, the relationship between Othello syndrome and a neurological pathology was described. This syndrome was most commonly associated with neurodegenerative diseases (59%), followed by medication induced Othello syndrome (13.7%) and vascular dementia (8.4%). Lesions particularly in the right (dorsolateral) frontal lobes were associated with this syndrome.

Conclusion

This study demonstrates that Othello syndrome occurs most frequently in patients with right frontal lobe dysfunction. It is predominantly related with Lewy Body Disease and Alzheimer's disease. Clinicians should keep an “index of suspicion” regarding dementia when Othello syndrome presents in elderly persons.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The New Great Imitator – Neuropsychiatric Symptoms of Lyme Disease
Authors: Cochat Costa Rodrigues M.C. , Moreira I. , Peixoto M.J. , Silveira C.
Published: June 2017

Introduction

Lyme disease, caused by the spirochete Borrelia burgdorferri as recognized as a possible cause of multisystemic signals and symptoms, including symptomatology of the central as well as the peripheral nervous system.

Objectives

Identification of neuropsychiatric symptoms associated with Lyme disease.

Methods

Literature review in the light of researched articles published in Pubmed/Medline as well as related bibliography.

Results

Since the identification of the etiology of syphilis in the early twentieth century, mental health professionals consider the fact that serious psychiatric symptoms can be caused by infections of the central nervous system and that early antibiotic treatment can prevent permanent neurological/psychiatric damage. Syphilis was known as “the great imitator” because its multiple manifestations mimic other known diseases. In recent years, a new epidemic, also with multiple manifestations emerged–Lyme disease, also known as the “new great imitator”. Like syphilis, Lyme disease may be associated with neuropsychiatric symptoms, which means that often these cases are initially referred for psychiatric services, before another diagnosis is made. The incorrect assessment of these patients as individuals with functional psychiatric disease can result in a delay in the start of antibiotic treatment and may cause serious neurological and psychiatric damage.

Conclusions

According to the review, the authors propose that in the evaluation of acute psychiatric disease or atypical chronic disease, with poor therapeutic response, Lyme disease should be considered and ruled out, especially if there is epidemiological context and absence of psychiatric family antecedents.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Features of Coronary Heart Disease Course in Patients with Depressive Disorders
Authors: Garganeeva N. , Belokrylova M.
Published: June 2017

Multifactor risk for coronary heart disease (CHD) development is associated with susceptibility and depressive reaction to stressful situations that causes search for ways of optimization of integrative assistance to CHD patients with depressive disorders.

Objective

To carry out comparative analysis of dynamics of mental and physical state in CHD pateints.

Material and methods

Two hundred and eighty (57.74 ± 5.59 years) CHD patients with grade II–III angina pectoris were examined. Psychopathological method, Center of Epidemiological Studies-Depression scale (CES-D) were used.

Results

Ninety patients (32.1%) had depressive disorders within depressive episode, dysthymia, adjustment disorder. The level of depression according to CES-D varied from 19 to 28 points. Comparative analysis of two groups of patients showed that CHD patients with depression had more severe grade III angina (22.1% vs. 11.6%; P = 0.036) more frequently. Differences regarding frequency of arterial hypertension (AH) (91.1% vs. 63.2%; P = 0.0002), type 2 diabetes mellitus (DM) (26.8% vs. 17.5%; P = 0.038), obesity (30.7 ± 3.9 vs. 29.5 ± 4.5; P = 0.015), arrhythmias (34.4% vs. 25.2%; P = 0.015); cases of myocardial infarction (47.8% vs. 17.9%; P = 0.0001) were revealed. Among patients with depressive disorders persons with experience of surgical myocardial revascularization (P = 0.004), degree II–III of disability (23.3% vs. 11.6%; P = 0.0118) were present more frequently. Patients with depression were characterized by low economic status (64.4% vs. 23.7%; P = 0.0001); absence of social support (34.4% vs. 12.6%; P = 0.0001); frequent stress situations in personal history (71.1% vs. 32.6%; P = 0.0002).

Conclusions

Depressive disorders caused by psychosocial stress influence negatively CHD course that requires complex approach to therapy of comorbid pathology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depression Among Cancer Patients–A Reality Where Therapeutic Nihilism Cannot be Accepted
Authors: Marinho M. , Marques J. , Bragança M.
Published: June 2017

Introduction

Cancer is a life-threatening disease, characterized by a great deal of uncertainty and unpredictability. Thus, several stressors and emotional upheavals pervade the everyday life of cancer patients and can lead to the development of depression.

Objectives

To review the recent research related to depression in cancer patients.

Methods

Literature review based on PubMed/MEDLINE, using the keywords “cancer” and “depression”.

Results

It is estimated that 20–25% of cancer patients meet the criteria for major depressive syndrome at some point in their illness. Depression is associated with a negative impact on treatment adhesion, cancer progression and quality of life, besides increasing suicide risk. However, it is often unrecognized and untreated. Importantly, the mistaken belief that depressive symptoms are expected in this group, the overlap between the neurovegetative symptoms of depression, the somatic symptoms of cancer and its treatment, as well as the effects of comorbid diseases make the diagnosis of major depression so complex in these patients. Some of the most helpful diagnostic indicators are feelings of hopelessness, worthlessness, excessive guilt, loss of self-esteem, and wishes to die. The several risk factors for the development of depression in cancer patients can be divided into four broad categories, namely cancer-related factors, cancer treatment-related factors, psychiatric history, and social factors. Effective management of depression consists in a combination of psychotherapy and psychopharmacology.

Conclusion

Depression in cancer patients has serious consequences, however appropriate psychiatric intervention can do it over. Thus, its early recognition and appropriate management is imperative.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Childhood parental childrearing differently influences on adulthood fears, agoraphobia and navigation strategy selection in females and males
Authors: Kállai J. , Rózsa S. , Vincze G. , Martin L. , Csathó Á. , Dorn K. , Török I.
Published: June 2017

Introduction

Using self-report assessment methods, the present study examined affective factors that influenced the gender specific use of a survey-based orientation strategy and landmark-based route-finding strategy in an unfamiliar environment. First, we analyzed the role of early navigation experiences and the influence of early parental attachment (emotional warmth, overprotection and rejection) on way finding strategy. Second, the study analyzed the intercorrelations between way finding strategies and fear-related avoidance behavior and anxiousness.

Methods

Three hundred and sixteen male and female students were recruited in a study to analyze the relationships between navigation strategies, fears, early parental childrearing behavior and navigation experiences. We proposed that use of navigation strategy depends on not only the physical features of the current environment and the participants’ gender, but also fears of closed and opened spaces and types of perceived parental childrearing behavior.

Results

We found that when exploring strange places, females used a route-finding strategy in contrast to males who used an orientation strategy for exploring a strange environment. Fear enhanced the preference for a route-finding strategy in both females and males. A route-finding strategy was associated with agoraphobic scores in females and with social fears in males. Perceived rejection from father and emotional warmth from mother together induces usage of route-finding navigation strategy.

Conclusion

The family background influence on the capability to have personal experiences in unfamiliar environment and to cope with fears and behavioral avoidance in strange opened and closed places.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Interaction Between Oxytocin Gene Variants and Perceived Parenting in Relation to Social Anxiety in Adolescents: Evidence for Differential Susceptibility Effects
Authors: Olofsdotter S. , Åslund C. , Furmark T. , Comasco E. , Nilsson K.
Published: June 2017

Introduction

Adolescence is a period of increasing demands in independent social functioning where parenting style may have an impact on social anxiety. A context-dependent effect of oxytocin on human social behavior has been suggested, however research on the gene coding for oxytocin (OXT) has mostly been reported without considering contextual factors.

Aim

This study investigated interactions between parenting style and polymorphic variations in the OXT gene in association with social anxiety symptoms in a community sample of adolescents.

Methods

The study group consisted of 1359 adolescents. Two single nucleotide polymorphisms located near OXT, rs4813625 and rs2770378, were genotyped. Social anxiety and perceived parenting style were assessed by behavioral questionnaires.

Results

Significant joint effects in line with the differential susceptibility framework were observed for rs4813625 with parenting style. The levels of social anxiety among C allele carriers were conditional on the level of supportive parenting style whereas homozygote G carriers’ levels of social anxiety were unaffected by supportive parenting style. The nature of the interactions between rs2770378 and parenting style was in line with the diatheses-stress model. However, associations of rs2770378 and parenting style with social anxiety became nonsignificant in nonlinear models.

Conclusions

The study provides preliminary evidence for a modifying effect of supportive parenting style on the relationship between rs4813625 and social anxiety symptoms in adolescents, independent of sex. The findings may be interpreted from the perspective of the social salience hypotheses of oxytocin, with rs4813625 affecting social anxiety levels along a perceived unsafe–safe social context dimension.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Epidemiology of Bipolar Spectrum Disorder: Results from the General Population Survey of South Korea
Authors: Chang S. , Young C. Tae , Sung-Won J.
Published: June 2017

Introduction

Patients with subthreshold bipolar disorder (sub-BP) experience severe clinical courses and functional impairments, which are comparable to those with bipolar I and II disorders (BP-I and -II). Nevertheless, lifetime prevalence, socioeconomic correlates and diagnostic overlaps of bipolar spectrum disorder (BPS) have not yet been estimated in the general population of South Korean adults.

Aims

This study aimed to estimate the lifetime prevalence, correlates and diagnostic comorbidities of BPS using a validated screening instrument in the nationwide general population of South Korea.

Methods

A total of 3013 adults among the 2011 Korean Epidemiologic Catchment Area survey (KECA-2011) completed face-to-face interviews using the Korean versions of the composite international diagnostic interview 2.1 and mood disorder questionnaire (K-CIDI and K-MDQ).

Results

The lifetime prevalence of BPS in the South Korean adults was measured to be 4.3% (95% CI 2.6–6.9). Nearly 80% of the subjects with BPS were codiagnosed with other DSM-IV nonpsychotic mental disorders: 35.4% (95% CI 24.2–48.5) for major depression and dysthymic disorder, 35.1% (95% CI 27.7–43.3) for anxiety disorders and 51.9% (95% CI 40.5–63.1) for alcohol and nicotine use disorders. Younger age (18–34 years) was the only sociodemographic predictor of BPS positivity (P = 0.014) and the diagnostic overlap patterns were different between men and women.

Conclusions

Positivity for BPS was estimated to be much greater than the prevalence of DSM-IV BP in South Korea. Most of the respondents with BPS were diagnosed with other major mental disorders and this might be related with mis and/or underdiagnosis of clinically relevant Sub-BP.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Longitudinal Effects of Experiential Avoidance on Depression Symptoms in Patients with Inflammatory Bowel Disease
Authors: Trindade I.A. , Ferreira C. , Pinto-Gouveia J.
Published: June 2017

Inflammatory bowel disease (IBD) has been vastly associated with the development of depression and it is thus considered that the mechanisms that underlie this link should be explored. The present study aimed to examine the longitudinal effects of IBD symptoms and a maladaptive emotion regulation process, experiential avoidance (defined as the tendency to attempt to control internal experiences), on depression symptoms. The sample comprised 116 IBD patients of both sexes that completed validated self-report measures on an online platform in three different times (equally spaced 9 months apart) during an 18-month period. Results demonstrated that IBD symptomatology at baseline was linked to experiential avoidance and depressed mood 9 and 18 months later. The level of experiential avoidance at baseline was also correlated with the subsequent experience of depression symptoms, 9 and 18 months later. Results also revealed that, although IBD symptomatology at baseline predicted depressive symptomatology 18 months later (β = 0.24; P = 0.008), when experiential avoidance at baseline was added to this model, this process became the only predictor of the outcome (β = 0.60; P < 0.001; R2 = 0.41). These results corroborate previous literature by indicating that IBD symptomatology may lead to depression symptomatology. Nevertheless, the current study additionally revealed that the engagement in experiential avoidance – that is, in attempts at controlling the frequency, form or intensity of internal experiences – might have a greater role on the determination of patients’ depressed mood than the experience of adverse physical symptomatology. Maladaptive forms of emotion regulation in IBD patients should be targeted to prevent depression symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Impact of Age on the Prevalence and Clinical Relevance of Attenuated Psychotic Symptoms in Patients of an Early Detection Service
Authors: Schultze-Lutter F. , Michel C. , Schimmelmann B.G. , Hubl D.
Published: June 2017

Introduction

Compared to 16–40-year-olds, 8–15-year-olds of the community reported higher frequencies of perceptual and lesser clinical significance of non-perceptual attenuated psychotic symptoms (APS).

Objectives/aims

We examined if a similar age effect is present in a clinical never-psychotic sample (n = 133) referred to a specialized service for clinical suspicion of developing psychosis.

Methods

APS and brief intermittent psychotic symptoms (BIPS) were assessed using items P1-3 and P5 (non-perceptual) and P4 (perceptual) of the structured interview for psychosis-risk syndromes, current axis-I disorders with the mini-international neuropsychiatric interview and psychosocial functioning with the Social and Occupational Functioning Assessment Scale (score < 71 indicative of at least some difficulty in social, occupational, or school functioning).

Results

Overall, 64% reported APS (61%) or BIPS (7%); any perceptual APS/BIPS was reported by 43% and any non-perceptual APS/BIPS by 44%. In correspondence to the results of the community study, perceptual but not non-perceptual APS/BIPS were significantly more frequent in younger age groups below the age of 16 (8–12 yrs: OR = 4.7 (1.1–19.5); 13–15 yrs: OR = 2.7 (0.9–7.7); 20–24-year-olds as reference group). An age effect of APS/BIPS on presence of any current axis-I disorder (59%) or functional difficulties (67%) could not be detected. Yet, when APS onset requirements were met, the likelihood of a psychiatric diagnosis increased significantly with advancing age.

Conclusion

Overall, the replicated age effect on perceptual APS in this clinical sample highlights the need to examine ways to distinguish clinically relevant perceptual APS from perceptual aberrations likely remitting over the course of adolescence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Cross-correlation Analysis of the Cyclicity of Italian Suicide Rates and Online Suicide-related Search Volumes
Authors: Solano P. , Ustulin M. , Vichi M. , Vecchio R. , Poggio A. , Pompili M. , Serafini G. , Amore M.
Published: June 2017

Introduction

People seeking information and news regarding suicide are likely to use the Internet. There is contrasting evidence about the relationship between the cyclicity of suicide-related search volumes and national suicide-rates in different countries.

Objectives

The objectives were to investigate first the cyclicity of Italian suicides and online suicide-related searches carried out by the Italian population in the same time frame (2008–2012) and analyze the correlation between the two cyclicities.

Aims

The study aimed to gain further insights on suicide-related internet use and its relationships to completed suicides.

Methods

Italian mortality database provided monthly national data concerning suicides (2008–2012). Google trends provided data of online monthly search-volumes of the term “suicide”; “commit suicide”; “how to commit suicide” in Google search (2008–2014).

Results

Seasonal AR model suits the trend of Italian suicides with a periodic 1-year cycle. No specific cyclicity for Google search volumes for “how to commit suicide” and “to commit suicide” was found (ARIMA [0,1,1] and ARIMA [1,0,1] respectively). Google search time series for “suicide” performed with ARIMA (1,1,1) and the cross correlation analysis showed that it lags national suicides of three months (ρ = 0.482, P-value < 0.001).

Conclusions

Online searches for suicide-related terms in Italy are more linked to factors other than suicidality such as personal interest and bereavement. To our knowledge, no previous study reported a lag of three months between online searches for “suicide” and national suicides. This may shed further light on the grieving process being of help in organizing effective supportive strategies for the survivors.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Influence of Gender in Patients Attended in Emergency Rooms for Suicidal Tendencies
Authors: Mata Saenz B. , Segura Escobar E. , Lopez Lavela E. , Asensio Aguerri L.-M. , Nuevo Fernandez L. , Rodriguez Cano T. , Beato Fernández L.
Published: June 2017

Introduction

The first time when people attempt suicide first contact is critical. Psychiatrists must decide to hospitalize them or follow-up in mental health units and the bases of a doctor-patient relationship are formed.

Objectives

An analysis of referrals to psychiatry from the emergency room (ER) was developed. Our objective was to discover if there was a statistical correlation between gender and other variables, especially repeated visits and admissions.

Methods

Our sample was composed of patients who visited the ER for suicidal tendencies for 20 months. We carried out an observational retrospective study. The variables collected were: age, gender, cause, repeated visit (visit to the ER in the following two months), previous attempts, previous follow-up, method used, use of toxic substances during the attempt, intentionality, referral from the ER, later follow-up and diagnostic impression at the ER.

Results

A total of 620 patients were sampled. The relationship between gender and repeated visit, previous attempts, dysfunctional personality traits, use of substances and later follow-up was found (Chi2). Although the relationship between admissions and gender were not statistically significant, influence by gender (over all in males) can be observed in logistic regression models. As well as, in patients who visited the ER several times, dysfunctional personality traits seem to be the most common but gender marks significant differences between groups.

Conclusions

The data obtained is consistent with those reported in previous studies. To know who the riskier groups are can allow professionals to plan protocols and unify admission criteria.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Genetic Counselling in Psychiatric Disorder with High Suicide Risk
Authors: Cozman D. , Moldovan R. , Nemes B.
Published: June 2017

Introduction

A better understanding of the genomics of mental illnesses allowed genetic counselling to be provided to individuals with severe mental illness and their families.

Aim

The present study was aimed at assessing the efficacy of genetic counselling for severe mental illnesses with high suicide risk.

Method

Assessment was performed before and after genetic counselling session. Measures used were evaluation of traumatic events in childhood, multidimensional scale for perception of social support (SMSSP), positive and negative affect schedule (PANAS-X), Brief Psychiatric Rating Scale (BPRS), Paykel questionnaire and Genetic Counselling Outcome Scale (GCOS). Paykel's questionnaire consists of five questions about suicidal thoughts and attempts, including: life-weariness, death wishes, suicidal ideation, suicidal plans and suicide attempts. Intervention and assessment lasted approximately one and a half hour. Data from 48 patients was analysed.

Results

Mean age of participants was M = 38.4, SD = 9.7, and the group was batter represented by females (57%). The participants had various diagnoses, 22% had schizophrenia, 36% bipolar disorder and 42% recurrent depressive disorder. Forty percent of participants reported suicidal ideation and 22,5% had a past history of suicide attempt. Genetic counselling had a direct positive influence upon GCOS specific items and reduced the Paykel scores among participants presenting with suicidal ideation.

Conclusion

Genetic counselling offers information about the disorder, the role of genetics and the impact of environmental factors. Preliminary data suggest that providing genetic counselling decreases the suicidal ideation frequency.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Risperidone-treated Children and Adolescents with Behavioral Disorders: Do Drug Dose and Patients’ Gender and Age Relate to Drug and Metabolite Plasma Levels?
Authors: Piacentino D. , Grözinger M. , Saria A. , Scolati F. , Arcangeli D. , Girardi P. , Pompili M. , Conca A.
Published: June 2017

Introduction

Behavioral disorders, such as conduct disorder, influence choice of treatment and its outcome. Less is known about other variables that may have an influence.

Objectives/Aims

We aimed to measure the parent drug and metabolite plasma levels in risperidone-treated children and adolescents with behavioral disorders and investigate the role of drug dose and patients’ gender and age.

Methods

We recruited 115 children/adolescents with DSM-5 behavioral disorders (females = 24; age range: 5–18 years) at the Departments of Psychiatry of the Hospitals of Bolzano, Italy, and Innsbruck, Austria. We measured risperidone and its metabolite 9-hydroxyrisperidone plasma levels and the parent drug-to-metabolite ratio in the plasma of all patients by using LC-MS/MS. A subsample of 15 patients had their risperidone doses measured daily. We compared risperidone and 9-hydroxyrisperidone plasma levels, as well as risperidone/9-hydroxyrisperidone ratio, in males vs. females and in younger (≤ 14 years) vs. older (15–18 years) patients by using Mann-Whitney U test. We fitted linear models for the variables “age” and “daily risperidone dose” by using log-transformation, regression analysis and applying the R2 statistic.

Results

Females had significantly higher median 9-hydroxyrisperidone plasma levels (P = 0.000). Younger patients had a slightly lower median risperidone/9-hydroxyrisperidone ratio (P = 0.052). At the regression analysis, daily risperidone doses and metabolite, rather than parent drug–plasma levels were correlated (R2 = 0.35).

Conclusions

Gender is significantly associated with plasma levels, with females being slower metabolizers than males. Concerning age, younger patients seem to be rapid metabolizers, possibly due to a higher activity of CYP2D6. R2 suggests a clear-cut elimination of the metabolite.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Grey Matter Volume Patterns in Thalamic Nuclei are Associated with Schizotypy in Healthy Subjects
Authors: Di Carlo P. , Pergola G. , Cariello M. , Bonvino A. , Mancini M. , Taurisano P. , Caforio G. , Bertolino A. , Blasi G.
Published: June 2017

Introduction

Schizotypy refers to a set of temporally stable traits that are observed in the general population and that resemble, in attenuated form, the symptoms of schizophrenia. In a previous work, we identified volumetric patterns in thalamic subregions which were associated with disease status, and trained a random forests classifier, accounting for such thalamic volumetric patterns, that discriminated healthy controls (HC) from patients with schizophrenia (SCZ) (81% accuracy) [1].

Objectives

i) to assess performance of random forests classifier developed by Pergola and coworkers [1], in an independent sample of healthy subjects; ii) to test whether false positives (FP), i.e. HC classified as SCZ based on such classifier would be associated with greater schizotypy compared with true negatives (TN), i.e. HC classified as such.

Methods

A total of 167 HC participated in the MRI study and filled the Schizotypal Personality Questionnaire (SPQ). We pre-processed MRI data with SPM8 and DARTEL. Then, we used thalamic grey matter volumes (GMV) as features in the random forests prediction of disease status at the single subject level. Finally, we tested SPQ scores differences between FP and TN with Mann-Whitney test.

Results

The classification accuracy was 71%. FP had greater SPQ scores compared to TN (P = 0.007).

Conclusions

Classification accuracy of our classifier in an independent sample suggests that thalamic GMV patterns are reproducible markers of disease status. Furthermore, the present results also suggest that variability of thalamic GMV patterns in HC may have relevance for subclinical phenotypes related to schizophrenia spectrum.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The burnout's prevalence among Tunisian military consultants in psychiatry
Authors: Belhadj H. , Krir W. , Bencheikh C. , Elkefi H. , Oumaya A.
Published: June 2017

Introduction

Burnout causes a considerable human cost. Army employees are, in fact, particularly exposed to this risk.

Objective

To determinate the prevalence of burnout syndrome among military consultants in psychiatry and to study its socio-familial repercussions.

Method

A cross-sectional study was conducted in a military outpatient clinic in Tunis and included 30 military patients with a seniority of more than 15 years. Burnout and major depression were assessed with the instrument Burnout Measure Short version (BMS-10) and the Patient Health Questionnaire “PHQ-9”, respectively.

Results

Eighty percent of participants (n = 24) had a very high degree of burnout exposure according to BMS-10. Twenty of these (83.3%) had a moderate to severe depression. All married patients (n = 22) having burnout syndrome reported a conjugopathy and a tendency to physical and verbal aggressiveness against their children.

Conclusion

Military employees are particularly vulnerable to burnout. Detecting burnout in time is therefore essential in order to prevent its undeniable socio-familial repercussions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neuroimaging correlates of insight in obsessive compulsive disorder: A fMRI study
Authors: Gadad A. , Reddy D.Y.C.J. , Venkatasubramanian D.G. , C.N D.J.
Published: June 2017

Aim of the study

To study the neural substrates of insight in OCD by comparing patients with good insight, patients with poor insight and matched healthy controls using functional MRI.

Methodology

Subjects were recruited from among patients attending OCD clinic, adult psychiatry services and psychiatry ward inpatients of National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore. They were further divided into ‘good insight’ (n = 30) and ‘poor insight’ (n = 14) using Brown's assessment of belief's scale. Control subjects (n = 30) were recruited from consenting volunteers. 3 T MRI was used mental rotation task was paradigm used for fMRI and analysis was done by SPM 8.

Results

Poor insight patients and good insight patients comparison revealed differential activation in left superior/medial frontal gyrus (corresponding to the DLPFC). A negative correlation between BABS score and activation of right inferior parietal lobule. Mental rotation task behavioural data results: OCD patients as a group had significantly lower accuracy compared to healthy controls. Poor insight group had significantly decreased accuracy ratio compared to good insight group and healthy controls. A negative correlation was noted between BABS score and accuracy ratio, indicating that poorer the insight, greater the errors during the active task.

Conclusion

Insight has been important prognostic factor in OCD. Poor insight patients had specific deficits in left medial frontal gyrus and right inferior parietal lobule as compared to good insight patients and healthy controls. Together, these indicate that insight has a strong neurobiological underpinning in OCD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of psychological interview before prominent ear reconstruction: Three cases report
Authors: Karatas K.S. , Ercan A.C. , Murat A. , Polat S. , Hocaoglu C. , Bahceci B.
Published: June 2017

Medical and mental health professionals have long been interested in understanding both the motivations for seeking a change in physical appearance as well as the psychological outcomes of cosmetic surgery. By time to time researchers began to incorporate standardized psychometric tests and psychiatric evaluation into their studies. Psychiatrists have studied the personality characteristics and psychological state of these patients with the hope of identifying patients who may be psychologically inappropriate for surgery or those who are likely to be dissatisfied with a technically successful surgical outcome. There were some degree of congruence in the factors that appeared to be associated with poor outcome, demographic factors like being male, younger age, psychological/psychiatric factors such as history of depression or anxiety, dysmorphophobia, personality disorder as narcissistic or borderline, previous surgical procedure with which the patient was dissatisfied and minimal deformity. As a cosmetic surgery, prominent ear deformity is the most common abnormality of the external ear. We have used both clinical interview and psychometric assessments in three cases who want to go surgery because of their prominent ear. Two of the cases have used cyanoacrylate adhesive to their postauricular skin for camouflage of their prominent ear deformity. We have evaluated the patients’ psychiatric state with psychosocial viewpoint of the deformity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How painful is this? Idiosyncrasies of attention in irritable Bowel syndrome
Authors: Martin M. , Chapman S.
Published: June 2017

Introduction

Theoretical controversy surrounds the issue of the extent to which cognitive processes can be identified which are characteristic of patients with irritable Bowel syndrome (IBS). The issue is important because particular patterns of idiosyncrasies would suggest tailored therapeutic interventions.

Objectives

To map the processing of pain information in IBS and healthy participants in relation to physical and social threat, using latency as well as frequency metrics.

Methods

Participants (20 with IBS and 33 controls) were tested in an extended exogenous cuing paradigm whose derived measures included assessments of bias, engagement and disengagement. They also completed a battery of health and illness activity tests.

Results

There was a significant interaction between bias in processing of pain (physical threat) and of neutral stimuli, as shown on Fig. 1. Further significant idiosyncrasies were observed in the relations between measures of attention and levels both of symptoms and of illness behaviour.

Conclusions

Detailed evidence was obtained of anomalies in attention in IBS. The results may be interpreted in terms of interactive feedback between pain perception in relation to the gut, pain-specific attentional processes, and health behaviour. It will be discussed how mindfulness based cognitive therapy can be used as an intervention to disrupt this feedback.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Fig. 1

Attentional bias in IBS and healthy groups with pain and neutral stimuli. Target in the same (valid) or different (invalid) position as the cue, bias = (RT invalid − RT valid).