bluuebunny/crossref_metadata_2025 huggingface dataset:
Verbal and visual-spatial working memory performance in Arabic monolingual and English/Arabic bilingual Kuwaiti children
Authors: Khashawi F.
Published: May 2016

Introduction

Research in psycholinguistics focusing on cognitive processing in bilinguals and the role played by working memory about cognitive processing indicated that Working Memory (WM) was instrumental in cognitive processing in bilinguals, but that its role was different and generally more complex than it was in monolinguals. However, the specific manner in which the use of WM differed between monolinguals and bilinguals was not always clear.

Objectives

This research explored the verbal and visual-spatial WM performance in an Arabic monolingual group and a bilingual English/Arabic group.

Methods

The participants were 396 Kuwaiti (198 monolingual aged 7.99 ± 1.97 years and 198 bilingual aged 8.03 ± 1.92) with no significant age differences (t = 0.23, P > 0.05). The two groups were compared on how they performed in the Automated Working Memory Assessment (AWMA), to measure a verbal and visual-spatial WM tasks. The tasks were Listening Recall, Counting Recall, Mr. X, Backward Digit Recall, Odd-one-out and Spatial Span. All tasks were internally consistent (Alpha = 0.91, 0.93, 0.87, 0.88, 0.87, and 0.91 respectively). The data was analyzed using Independent Sample t Test.

Results

The findings showed that there was significant group difference as the monolingual Arabic group (L1) performed better than bilingual English/Arabic group (L2) on both of verbal WM (t = 3.25, P < 0.002) and visuospatial WM (t = 3.04, P < 0.002).

Conclusion

The monolingual children obtained higher scores on both verbal and visuospatial WM. These findings were explained in terms of the complexity of the Arabic language and cultural context in which the second language is being practiced. This warrants further investigation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cloninger's temperament dimensions and longitudinal alcohol use in early mid-life: A Northern Finland birth cohort 1966 study
Authors: Vladimirov D. , Niemelä S. , Auvinen J. , Timonen M. , Keinänen-Kiukaanniemi S. , Ala-Mursula L. , Laitinen J. , Miettunen J.
Published: May 2016

Background

Longitudinal studies on how temperament is related to alcohol use in general population are scarce.

Objectives

Finding relations with temperament and problematic alcohol use using prospective birth cohort data.

Aims

To investigate trends in self-reported alcohol consumption in adulthood.

Methods

In the Northern Finland Birth Cohort 1966 (n = 5247), alcohol use was studied with questionnaires at ages 31 and 46. Participants were classified into abstainers, bingers, heavy drinkers, steady drinkers, increasers or reducers based on the change in consumption (g/day). Cloninger's TCI-scores were calculated for each group. Multinomial regression analysis was conducted with TCI-scores as factors influencing the change in alcohol consumption.

Results

High novelty seeking was associated with increased consumption, binging and heavy drinking among both sexes at both time points (P < 0.01). Lower persistence was associated with increased consumption at both time points among men and among women at age 46. Baseline novelty seeking predicted both increasing (OR 1.1; 95% CI: 1.0–1.1) and reducing (1.1; 1.0–1.1) for men and for women also increasing (1.1; 1.0–1.1) and reducing (1.1; 1.0–1.1), but when adjusted with baseline alcohol use novelty seeking only predicted increasing for men (1.0; 1.0–1.1).

Conclusions

High novelty seeking and low persistence are associated with problematic alcohol use among middle-aged Northern Finns. Gender differences in predictors existed: novelty seeking predicted increase only for men in the adjusted model. Temperament scores do not seem to affect strongly changes in alcohol use.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Toxic consumption among patients suffering delusional disorder
Authors: Carrillo de Albornoz Calahorro C.M. , Porras A. , Guerrero M. , Cervilla Ballesteros J.
Published: May 2016

Introduction

Several epidemiological studies describe the association between substance abuse and appearance of psychotic symptoms. There is a higher prevalence of psychotic symptoms among cannabis and cocaine consumers compared to the general population.

The cannabinoid receptors regulate the release of dopamine and cocaine has a strong inhibitory action on reuptake of the same. This may explain the greater proportion of subjects moderately or heavily dependent on cocaine or cannabis experience symptoms of psychotic sphere.

Objectives/Aims

Describing the profile of drug consumption among a group of patients diagnosed with delusional disorder.

Methods

Our data come from a case register study of delusional disorder in Andalucía (Spanish largest region). By accessing digital health data, we selected 1927 cases who meet criteria DSM 5 for delusional disorder collecting different toxic consumption habits.

Results

It was found that 1070 (93.4%) of patients diagnosed as delusional disorder according DSM 5 did not consume cannabis, compared to 75 (6.6%) who do so. Among patients diagnosed as “other psychoses”, 243 (85%) did not use drugs and 43 (15%) consume other drugs of different types of cannabis.

Conclusion

In our sample, we found that the use of drugs such as cannabis and cocaine is less common among patients diagnosed with delusional disorder compared with other individuals diagnosed as “other psychosis”.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric manifestations in porphyria: A case report of psychosis
Authors: González-Parra S. , Aparicio Reinoso T. , Leonor M. , Molina J.D.D. , Hernan I. , Ricote F.
Published: May 2016

Introduction

Porphyrias are rare inherited disorders due to specific enzyme abnormalities of heme biosynthesis. Among the hepatic forms, three of them are clinically characterized by acute abdominal pain and neuropathy, sometimes associated with psychiatric disorders like mood changes, organic brain syndrome and psychosis.

Case report

Here, we present a 38-year-old male patient with intermittent porphyria and chronic psychosis who was hospitalized. He had been treated by benzodiacepines and neuroleptic medication for several years. Exposure to certain drugs, dieting, starvation and infection may precipitate AIP attacks.

Discussion

Underlying organic causes of psychiatric disorders such as psychosis should be considered among patients with atypical symptoms and/or resistance to standard therapy.

Conclusion

It is important to increase awareness amongst psychiatric and neurological professionals with regard to certain inborn errors of metabolism. Early detection of porphyria may diminish morbidity and mortality rates, and perhaps heal some chronic atypical psychiatric illnesses.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Is social attachment an addictive disorder? Role of the latest findings in the opioid system
Authors: Montero González G. , Mondragón Egaña M.S.
Published: May 2016

Introduction

The endogenous opiate system (EOS) has been linked to social attachment in classical animal experiments, to addictive disorders (AD) and, more recently, to specific traits of personality through research in genetic polymorphisms and neuroimaging techniques.

Objectives

To expose the relation between social bonding and AD, via the latest neurobiological findings in the EOS. To propose a theoretical framework which may allow a clinical approach based upon respect and no stigmatization.

Methods

Literature review in MEDLINE database with the keywords “opioid”, “polymorphism”, “object attachment”, “addictive behavior”, “personality”.

Results

Polymorphisms in the mu-opioid receptor gene lead to different attachment behaviors in primates. The EOS in humans has been related to pain and placebo effect and recently, to social rejection and acceptance. Thus, some authors talk about “social pain”. Interestingly, the EOS has a role in harm avoidance and in the reward system. These traits of personality (harm avoidance and reward dependence) predispose to AD, and likely, pathological models of social bonding may drive to a need of palliating excessive discomfort originated by an altered opioid function through addictive behaviors. The origin of AD must be focused on the individual vulnerability rather than in the addictive substance/behavior.

Conclusions

The latest findings in the EOS yield concrete evidences that support the classical hypothesis of an opioid nexus between social attachment and AD, and shift the spotlight from the addictive object to the vulnerable subject. This theoretical framework may ease a clinical approach based upon respect and no stigmatization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental health and hearing impairment - A German survey
Authors: Abdel-Hamid M. , Tretbar K. , Grabemann M. , Meyer-Rötz S. , Scherbaum N. , Jens W. , Kis B.
Published: May 2016

Introduction

Only few international studies have focused on mental diseases among the hearing-impaired population. However, Fellinger et al. (2012) underline the high discrepancy between the current and future demand of mental treatment and the simultaneous impeded access to health care.

Aims

The aim of this multicenter project is to conduct the first analysis of mental diseases among the hearing-impaired population in Germany in order to quantify and qualify the specific demands of treatment.

Objectives

In order to achieve this aim, we compiled an extensive questionnaire battery.

Methods

This questionnaire battery measured sociodemographic data, non-verbal intelligence, quality of life, perception and suffering from stress, psychosomatic symptoms as well as personality traits.

Results

Our three samples consisted of 21 hearing-impaired patients with a history of mental diseases (EG-HI), 21 hearing-impaired subjects without mental diseases (CG-HI) and 21 hearing participants without any psychological disease (CG-H). Compared to the two control groups, the EG-HI shows significantly higher rates in different fields, i.e. participants perceive a lower quality of life, suffer from more psychosomatic symptoms and show more pronounced personality traits. The two control groups did not differ significantly from each other.

Conclusions

Certain psychological characteristics among hearing-impaired patients can be detected which need to be accounted for in treatment. Furthermore, a hearing impairment is not inevitably linked to a reduced quality of life or even mental disorders. Therefore, future research should focus on risk factors and protective factors which could prevent mental diseases among the hearing-impaired population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Illness or simulation
Authors: Alvarez Montoya A.M. , Diago Labrador C. , Ruano Hernandez T.
Published: May 2016

Objectives

The revision of the differential diagnosis of simulation cases versus real psychopathological cases. Analysis of a case of the Ganser syndrome by revising the diagnosis criterions and their historical characteristics.

Method

We analyze the case of a 38-year-old male who came to the community mental health team and reference hospital. Following symptoms were observed: involuntary movements of the upper extremities associated with delirium coinciding with the premature birth of a child. This refers also to a compatible episode of a dissociative fugue.

Results

To establish the diagnosis, we differentiate against disorders such as Simulation, factitious disorders with psychological symptoms or Factitious Disorders with somatic symptoms (Münchhausen syndrome). In order to support our diagnosis, we base on the CIE-10 and the DSM-IVTR classification.

Conclusions

We don’t diagnose the clinical pictures in which we don’t think. The Syndrome of Ganser could be positioned between neurosis and psychosis and between illness and simulation. The recommended treatment includes hospitalization in order to insure the diagnosis. While some authors recommend neuroleptics and others - anxiolytics, the psychotherapy is obligatory. The goal is to help the patient restore function and adapt to his environment again.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Speechless soma: The trauma's language in the psychosomatic
Authors: Becker J. , Da Silva G.A. , Dal Sasso A.
Published: May 2016

The study begins by approaching the psychological traumatism concept, recognizing it as an important precipitating of psychosomatic disorders. Based on studies of anthropologists, psychiatrists and psychoanalysts, we present trauma as a consequence of an unexpected event from where is originated intense fear, an abruption, which disorganizes and incapacitates the victim. The Institut Psychosomatique de Paris (IPSO) works with the theory that trauma is an excessive disorganization in the mental apparatus and the psychosomatic disease is the alternative that the body finds to discharge excitation, is an attempt to resolve a conflict. The psychosomatic patient is characterized by difficulty to qualify his affections, it is observed in his super adapted speech and his linear thought, which, together, differ him from neurotic and psychotic patients. Considerations about the child development and the affects qualification are made to introduce the importance of this primitive period, but we pretend to demonstrate that they are not determinants to produce psychosomatic symptoms. When the psychological pain is intense and constant, it provokes a split between mind (psyche) and body (soma) and, in the place of the elaboration and representation about the experience, explodes psychosomatic disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Risk factors for a new cardiac event after a first acute coronary syndrome
Authors: Ossola P. , Scagnelli F. , Longhi A. , De Panfilis C. , Tonna M. , Marchesi C.
Published: May 2016

Introduction

Depression is an established risk factor for acute coronary syndrome (ACS), nonetheless the mechanisms underlying this association are still unclear and literature disagrees on the role played by anxiety. Moreover, most of the studies included subjects with a long lasting history of heart disease or recurrent depressive episodes that could bias the results.

Objectives

We performed serial assessments of anxiety, depression and new cardiac events in a cohort of never-depressed patients in the two years after their first ACS.

Aims

Clarify the role of anxiety and depression in predicting new cardiac events.

Methods

Two hundred and fifty-one consecutive patients completed the two-years follow-up. The presence of depression was evaluated with the Primary Care Evaluation of Mental Disorders (PRIME-MD) and its severity with the Hospital Anxiety and Depression Scale (HADS). Evaluations were collected at baseline, when GRACE-score was calculated, and at 1, 2, 4, 6, 9, 12 and 24-months follow-ups.

Results

Forty-two patients (16.7%) developed a second cardiac event and, of these, eighteen (42.9%) had a previous depressive episode. At Cox Regression, controlling for confounding clinical variables (e.g. GRACE-score), developing a first-ever depressive episode was a significant risk factor (OR = 2.38; 95%CI = 1.11–5.14; P = 0.027) whereas baseline anxiety was protective (OR = 0.56; 95%CI = 0.38–0.81; P= 0.002). The latter, moreover, moderated the effect of incident depression on new cardiac events.

Conclusion

Our results confirm the well-established detrimental effect of depression on cardiac prognosis and suggest clinicians to keep in mind anxious symptoms when facing a patient at his/her first ACS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Seizure as a conversion symptom, a case report
Authors: Salgado N. , Benavente S. , Macias B. , Coll J.M.
Published: May 2016

Introduction

Patients with conversive disorder could show atypical clinical presentations with neurological symptoms that are not frequently seen currently.

Case Report

A 21-year-old female who was diagnosed of conversive disorder was admitted into a short-stay psychiatric unit for two weeks to introduce treatment and receiving a diagnosis. She presented few seconds long seizures in members without bitting her tongue and keeping control of sphincters, always surrounded by relatives. A neurological study was made with CT scan and electroencephalography and no evidences of neurological abnormalities were found. Various treatments were used but seizures went worse. Venlafaxine (150 mg/day) was prescribed after hipothymc reactive symptoms were observed, which together with pshycotherapy achieved clinical improvement in the two months follow-up.

Discussion

Patients with conversive disorder don’t respond appropriately to pharmacologic treatment. In order for patients to understand the situation it is important to keep themupdated in an empathic manner. It is important to exclude other causes.

Conclusions

A detailed psychopathological exploration should be made in all conversive patients, to explore symptoms and comorbidities that could reveal new therapeutic treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Detection of perceptions and thoughts that may lead to disruption of insulin use in type 2 diabetes mellitus patients
Authors: KIrlI- E. , Berkol T.D. , Sarıdogan G. , Erensoy H.
Published: May 2016

Aim

In this study we aimed to identify the perceptions and thoughts and their association with state/trait anxiety, depression that may lead to resistance to insulin treatment in patients with previously diagnosed type 2 diabetes mellitus (DM) patients in order to facilitate their compliance with insulin treatment.

Method

In this study, 120 patients were recruited with a previous type 2 DM diagnosis from the diabetes outpatient clinic. Patients were evaluated with sociodemographic data, State-Trait Anxiety Inventory, Problem Areas in Diabetes Scale, Insulin Treatment Appraisal Scale, Beck Depression Inventory.

Results

A majority of the patients were found to have resistance for startinginsulin treatment. Most of the patientswho were on other treatment alternatives reported that they wouldn’t use insulin even if they were prescribed insulin. A significant number of patients reported negative perceptions and thoughts about insulin treatment such as “insulin is a punishment”, “it is a shame to use insulin where other people can see”. In women injection phobia was significantly higher. Injection avoidance was significantly high and was more related to feeling insufficient about administration instead of worries about pain. Psychological resistance to insulin was significantly related to depression but not associated with state or trait anxiety levels. Lack of education and knowledge was found to be another important contributor to this resistance.

Results

Type 2 DM patients show psychological resistance to insulin treatment due to negative perceptions and thoughts about the treatment. Cognitive interventions targeting these factors may be useful to overcome psychological insulin resistance and faciliate glisemic control.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Attitude of attendants for E.C.T. to be given in patients of psychiatric disorders
Authors: Srivastava S.
Published: May 2016

Introduction

Utilization of E.C.T. has diminished since the middle of 20th century but, inspite of widespread use of pharmacological agents for treatment of major psychiatric disorders, E.C.T. is still treatment of choice for patients with severe suicidal symptoms, catatonia and diseases resistant to various pharmacological agents. But inspite of its excellent effect in various psychiatric disorders, acceptance of E.C.T. is very poor in society.

Objective

Objective of this study was to know the attitude of attendants for E.C.T. and acceptance after detailed description of procedure and discussing merits and demerits of E.C.T.

Aims

As still it is the best treatment for certain psychiatric disorders, so to increase the awareness about its benefits and try to remove the negativity regarding E.C.T. in society.

Method

In this study, 61 patients were randomly selected who had indication for E.C.T. without any discrimination of male and female. Their attendants were categorized by their socioeconomic status. All the attendants were asked open questions regarding their opinion for E.C.T. before taking consent.

Result

Sixty patients were selected who had indication for E.C.T. and their attendants were asked to give their opinion for E.C.T. Amongst them 9.84% were from upper socioeconomic status, 68.86% were from middle socioeconomic status and 21.31% were from lower socioeconomic status. Only 11.48% had a positive attitude, 75.40% had a negative attitude and 16.39% had no comments.

Conclusion

After developing good rapport and confidence with attendants and detailed explanation of E.C.T. procedure, its merits and demerits 75.40% had given a positive attitude, 22.95% had given negative attitude and still 1.64% had no comments.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Haloperidol, risperidone and quetiapine in the treatment of acute severe manic episode in bipolar disorder: The experience at the mood disorder unit in Milan
Authors: Delmonte D. , De Santis C. , Brioschi S. , Barbini B. , Colombo C.
Published: May 2016

Introduction

Patients affected by severe manic episode, often with delusional symptoms, are commonly treated with a combination of mood stabilizers, antipsychotics and other sedatives. The choice of a specific drug, dose and term is still debated.

Objectives

A naturalistic study on a sample of 84 inpatients affected by acute severe mania treated with a combination therapy.

Aims

To compare efficacy and tolerability of haloperidol/risperidone/quetiapine in association with lithium and/or valproate.

Methods

Eighty-four bipolar inpatients affected by a manic episode according to DSM-5 criteria. Drugs administered according to our best practice. Clinical course weekly monitored with Young Mania Rating Scale (YMRS) for 4weeks. Extrapiramidal side effects (EPSE) monitored with Saint Hans Rating Scale (SHRS).

Results

Twenty-five men (29.76%) and 59 women (70.24%); mean age 43.37 ± 13.58 years. Mean YMRS score T0 40.27 ± 9.04. Forty-one patients (48.81%) treated with haloperidol (3.4 mg/die); 16 (19.05%) with risperidone (4.3 mg/die); 27 (32.14%) with quetiapine (438 mg/die). The 3 groups showed no difference regarding clinical characteristics and YMRS basal scores. Chi2 analysis confirmed an higher response rate (50% of reduction of YMRS final score compared to T0) with haloperidol (χ2 = 14.88; P = 0.00). The repeated-measures model analysis showed a significant decrease (P < 0.05) in YMRS scores in haloperidol vs. risperidone vs. quetiapine patients for all time points from second week. No statistical difference for EPSE was found.

Conslusions

We suggest that haloperidol could be advisable in the treatment of severe mania, with rapid efficacy, even with low doses. Occurrence of EPSE was not considerable during the acute treatment. Studies with a larger sample size, randomization, fixed doses, double blind design are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Augmentation strategies in the treatment of major depressive disorder
Authors: Bise S. , Kurtovic B. , Begic D. , Cemalovic O.
Published: May 2016

Augmentation strategies for the treatment of Major depressive disorder (MDD) are needed when patients with MDD have a partial, or not responded to antidepressant monotherapy. The focus of augmentation therapy has been combining an antidepressant (AD) medication with another AD. Atypical antipsychotics (AAP) are becoming commonly used to augment antidepressants. Beyond AD and AAP, alternative augmentation strategies include mood stabilizers (MS).

Aim

To analyze the characteristics of therapy in patients with diagnosis of MDD and to investigate the frequency of augmentation therapy.

Method

Study included 28 patients hospitalized during one year with MDD diagnosis. Statistical analysis was performed with x2 and t-test.

Result

Among patients with MDD there were 18 (64.28%) women with an average age 57.5 and 10 (35.71%) men with an average age 53.5. Of the 28 patients with MDD, 25 (89.28%) were treated with a combination therapy, and monotherapy in the remaining 3 patients (10.71%). Of 25 patients with augmentation strategy treatment, 22 (88%) used two medications and the remaining 3 (12%) tree psychotropic medications (AAP, AD, MS). The most frequent combinations were a combination of AD and AAP (17 patients, 68%). Beyond that frequent combination were AD and MS (6 patients, 24%). Two patients used combination two AAP, and one patient with two AD and one patients used AAP and MS.

Conclusion

Augmentation strategy is often used in patients with MDD. There is no significant difference in the use combination therapy based on gender and age.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety and depression in patients with hepatic versus cardiac disease
Authors: Dolfi A. , Anton A. , Marinescu V.
Published: May 2016

Background

In both hepatic and cardiac disease, a bidirectional relationship exists between somatic and psychiatric symptoms: is anxiety/depression caused by the somatic burden of the symptoms or the psychiatric symptoms and stress are an important pathophysiologic factor for the somatic disease?

Objective

The objectives of our observational study were to see if any differences exist regarding the anxiety level in patients with hepatic versus cardiac disease and if the depressive symptomatology differs between the two groups of patients.

Materials and methods

: We conceived a 2X2 study model by including two independent variables (the somatic pathology, hepatic and cardiac) and two dependent variables (anxiety and depression) which included 66 patients (35 with hepatic and 31 with cardiac pathology) who completed both STAI X1 scale for anxiety and BECK scale for depression with good reliability for both scales (Cronbach's alpha value of 0.74 for STAI X1 and 0.76 for BECK), data analyzed with SPSS 17.

Results

We obtained a low level for anxiety (mean = 17.76) and a medium level for depression (mean = 49), both anxiety and depression level being higher in the patients with hepatic disease versus cardiac patients (P > 0.05). The patients with hepatic failure had a higher medium anxiety score (54.66) vs cardiac failure patients (42.61). The depression score was 19.71 in patients with hepatic failure and 15.55 in patients with cardiac failure.

Conclusion

Both anxiety and depression severity scores were increased in patients with hepatic disease vs patients with cardiac disease in the studied groups.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessment of mature serum brain-derived neurotrophic factor (BDNF) is not superior to total serum BDNF in prediction of antidepressant treatment outcome
Authors: Eckert A. , Mikoteit T. , Beck J. , Hemmeter U.M. , Brand S. , Schmitt K. , Bischof R. , Delini-Stula A. , Holsboer-Trachsler E.
Published: May 2016

Background

Serum BDNF levels are decreased in major depressive disorder (MDD) and tend to normalize under antidepressant treatment, serving as a treatment outcome predictor. BDNF is initially synthetized as precursor protein proBDNF and is cleaved to mature BDNF (mBDNF) while only the latter exerts neurotrophic activity.

Aim

The aim was to explore if a specific enzyme-linked immunosorbent assay (ELISA) kit for mBDNF in serum would be superior to the unspecific assessment of total serum BDNF in predicting treatment response in MDD.

Methods

Twenty-five patients with MDD underwent standardized treatment with duloxetine. Severity of depression was measured by Hamilton Depression Rating Scale (HDRS) at baseline (BL), after one (W1), two (W2) and six weeks (W6) of treatment. Treatment response was defined as a HDRS ≥ 50% reduction of BL score at W6. mBDNF and total BDNF serum levels were determined at BL, W1 and W2.

Results

A high and stable correlation was found between mBDNF and total BDNF serum levels over all measurements. The predictive value of mBDNF BL levels and mBDNFΔW1 to response was similar to that of total BDNF BL and total BDNFΔW1. The assessment of serum mBDNF was not superior to total BDNF in prediction of treatment outcome.

Conclusions

Not only baseline total BDNF but also mBDNF is predictive to treatment outcome. The later might represent the main player in this respect, which supports the idea of a functional link between neuroplasticity and MDD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship between drug dreams, affect, mood disorders and lucid awakening in psychotic patients on a treatment
Authors: Frías Ortiz D.F. , León Alegria J.M. , Fernández Guerra Z. , Ali Al Shaban Rodriguez O.W.M. , Fernández Miranda J.J. , Gonzalez Fernández A.
Published: May 2016

Introduction

This experimental trial aims to describe the experiences felt by a group of patients diagnosed with different psychotic disorders (schizophrenia, delusional chronic disorder, etc.) in which the use of Benzodiazepine derivatives were related to emergence of lucid dreaming and dissociative events (to see oneself out of your one body, etc.), and to a lesser extent had subsequent depressive symptoms. Fifty-six patients were monitored and linked to the emergence of depressive symptoms related to the use of Benzodiazepines or sedative-hypnotic. While on this treatment, they had vivid or lucid dreaming.

Aims-objectives

To explore the relationship between occurrence of drug dreams (DDs) and daytime negative affect with lucid awakening during the course of a 9-week treatment.

Methods

Using the dream journal methodology, 56 participants reported occurrence of dreams, dream content, and ratings of affect. The relationships between the experience of DD, dream content (“active” vs “passive”), and affect were analysed using mixed model methods.

Results

The experience of DD was associated with higher levels of negative affect (P < 0.001). The occurrence of DD did not decrease significantly over the 9 weeks of the study. Benzodiazepine users reported a higher occurrence of Lucid Awakening (P < 0.05) than the other drug groups (zolpidem and clometiazol).

Conclusions

These results are consistent with the hypothesis that DD can act as drug-conditioned stimuli to elevate negative affect. Although correlational, such findings support the implementation of psychological and pharmacological interventions aimed at minimizing the impact of DD on patients with lucid awakening and psychosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Regulation of serum spadin propeptide: An antidepressant response probe
Authors: Mazella J. , Devader C. , Roulot M. , Borsotto M. , Heurteaux C.
Published: May 2016

Objectives

We previously discovered that spadin, a short analogue of the propeptide (PE) released from the maturation of sortilin, displays potent antidepressant properties. Since the PE level can be measured in the blood, we aimed to investigate how the PE serum concentration is regulated in mice. We wondered whether the PE serum levels vary between healthy subjects and patients with major depressive disorder (MDD).

Methods

We developped a dosing method based on the AlphaScreen™ technology (Perkin) which allow to selectively detect both PE, spadin and metabolic products from these peptides with a detection range of 1 ng/mL.

Results

We found that insulin significantly up-regulated serum PE concentration from 26.15 ± 2.63 to 41.43 ± 6.27 nM (P = 0.0318). Analysis during circadian cycle in mice revealed that the amount of PE and its derivatives significantly varied during the cycle being higher during the period of maximal activity (dark period). We also measured serum insulin concentration between 1 and 7 pm and observed a significant rise confirming the relationships between insulin and PE concentration. We showed that the serum level of PE is lower in depressive patients than in healthy non-psychiatric. We observed that the weaker level of PE in depressive patients can recover the level of healthy subjects after a chronic antidepressant treatment.

Conclusions

Dosing the serum level of PE could be a promising approach for the diagnosis of depression and to determine the remission of the disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety, depression, perceived social support and quality of life in Malaysian breast cancer patients: A 1-year prospective study
Authors: Ng C.G. , Mohamed S. , See M.H. , Harun F. , Sulaiman A.H. , Zainal N.Z. , Taib N.A.
Published: May 2016

Background

Depression and anxiety were common psychiatric morbidity among breast cancer patient. This study aims to study the level of depression, anxiety, QoL and PSS among Malaysian breast cancer women over a period of 12 months and their associations at baseline, 6 and 12 months.

Methods

It is a 12-months prospective cohort study. Two hundred and twenty one female patients were included into the study. They were assessed at the time of diagnosis, 6 months and 12 month using Hospital Anxiety and Depression Scale (HADS), Quality-of-Life Questionnaire (QLQ–C30), Version 3.0 and Multidimensional Scale of Perceived Social Support (MSPSS). Relevant socio-clinical characteristic information was collected.

Results

The HADS anxiety and depression subscales scores of the subjects were relatively low. The level of anxiety reduced significantly at 6 and 12 months (baseline – 6 months, P = 0.002; baseline – 12 months, P < 0.001). There were no changes in the level of depression over the study period. The global status of QoL and MSPSS scores were relatively high. There was positively correlation between the global status of QoL and MSPSS for the study subjects (Spearman's rho = 0.31–0.36). Global status of QoL and MSPSS scores were negatively correlated with anxiety and depression.

Conclusion

Malaysian breast cancer women had relatively better QoL with lower level of anxiety and depression. Perceived social support was important associated factor for better QoL with low level of psychological distress. It reflected the importance of enhancing and maintaining the social support system for breast cancer patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impact of pain and remission in the functioning of patients with depression in China
Authors: Novick D. , Shi Q. , Yue L. , Montgomery W. , Moneta M.V. , Siddi S. , Haro J.M.
Published: May 2016

Introduction

Major depressive disorder (MDD) is the second leading cause of disability in China.

Objective

To analyze functioning during the course of treating MDD in China, Taiwan and Hong Kong.

Aims

To study the influence of pain and clinical remission on functioning.

Methods

This was a post-hoc analysis of a 6-month, prospective, observational study (n = 909) with 422 patients enrolled from China (n = 205; 48.6%), Taiwan (n = 199; 47.2%) and Hong Kong (n = 18; 4.2%). Functioning was measured with the Sheehan Disability Scale (SDS), pain with the Somatic Symptom Inventory, and severity of depression with the Quick Inventory of Depressive Symptomatology-Self Report 16 (QIDS). Patients were classified as having no pain, persistent pain (pain at any visit) or remitted pain (pain only at baseline). A mixed model with repeated measures was fitted to analyze the relationship between pain and functioning.

Results

At baseline, 40% of the patients had painful physical symptoms. Patients with pain had a higher QIDS and lower SDS (P < 0.05) at baseline. At 6 months, patients with persistent pain had lower functioning (P < 0.05). The regression model confirmed that clinical remission was associated with higher functioning at endpoint and that patients with persistent pain had lower functioning at endpoint when compared with the no pain group.

Conclusions

Patients presenting with pain symptoms had lower functioning at baseline. At 6 months, pain persistence was associated with significantly lower functioning as measured by the SDS. Clinical remission was associated with better functional outcomes. The course of pain was related to the likelihood of achieving remission.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Effects Of Shame, Self-compassion And Perfectionistic Self-presentation Of Body Image On Eating Psychopathology
Authors: Mendes A.L. , Ferreira C. , Marta-Simões J. , Trindade I.A.
Published: May 2016

Shame is considered a painful emotion that emerges in social contexts when the individual perceives that others see the self as inferior, inadequate or defective. This emotion is associated with decreased levels of self-compassion and may trigger several defensive responses, such as the need to present a perfect body image. Furthermore, shame has been conceptualized as a key component of eating psychopathology.

This study aims to explore the role of external shame in the engagement in disordered eating attitudes and behaviours through the mechanisms of self-compassion and body image-related perfectionistic self-presentation. A path analysis testing a mediational model was conducted in a sample of 469 women from the general community, aged between 18 and 35 years old.

The tested model explained 49% of the eating psychopathology's variance and presented excellent fit indices. Results demonstrated that external shame has a direct effect on disordered eating behaviours and simultaneously an indirect effect through the mechanisms of self-compassion and the need to present a perfect physical appearance.

These results seem to corroborate the link between shame and eating psychopathology. Additionally, these data suggest that women who present higher levels of shame show decreased self-compassion and tend to adopt compensatory maladaptive strategies, such as striving for a perfect body. Furthermore, these findings have significant clinical implications, highlighting the importance of developing new programs focused on shame and on the promotion of adaptive emotion regulation strategies, such as self-compassion.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Atypical Antipsychotics Use In Eating Disorders. Review
Authors: Hernández Sánchez J.M. , Molina López M.F. , Cancino Botello M.C. , Canseco Navarro M.Á. , Peña Serrano D.
Published: May 2016

Introduction

Eating disorders often have serious medical complications, including the highest mortality rates of any psychiatric disorder. The search for an optimal therapeutic strategy during the last decades has been difficult and it has included antidepressants, antipsychotics, anticonvulsants, benzodiazepines and mood stabilisers.

Objectives

To review the medical literature related to the treatment of eating disorders with atypical antipsychotics.

Methods

Medline search and ulterior review of the related literature. Keywords: “eating disorders”; “anorexia nervosa”; “bulimia nervosa”; “binge eating disorder”; “antypsychotic agents”.

Results

To the date, most of the studies have been with olanzapine. Olanzapine has shown effects, not only on weight gain, but also on management of other psychological features such as obsessive-compulsive symptoms, depression, aggression, persistence and interpersonal distrust. However, most of these studies have been compared to placebo, and binge-eating behaviour has also been described when using olanzapine (not with aripiprazole or ziprasidone). Recently, Marzola et al, when comparing olanzapine + SSRIs versus aripiprazol + SSRIs, described that aripiprazole (compared to olanzapine) is significantly more effective in reducing purging episodes, eating preoccupations and rituals.

Conclusions

So far, aripiprazol and olanzapine have been proved to be the most effective atypical antypsichotics in eating disorders, especially in anorexia nervosa. However, most of studies were placebo-controlled and in quite small samples. Further investigation is needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anorexia Nervosa And Dissociative Disorders In Males: a Case Report
Authors: Lázaro Redondo M.D.M. , De la Torre Brasas F. , Duque Domínguez A. , Echeverría Hernández N. , Martín Díaz L. , García Montero C. , Otálora Navarro M. , Mas Villaseñor A. , Bango Suárez J.I.
Published: May 2016

Introduction

There is a low prevalence of eating disorders among men. In many cases, the disorder arises as a means of avoiding psychosocial maturation. Various psychiatric comorbidities such as depression or obsessive-compulsive disorder are frequently found in these patients.

Objectives

To analyze psychiatric symptoms in relation to a case of anorexia nervosa.

Methods

Pubmed revision on clinical presentation of anorexia nervosa in male. Review of patient medical records.

Results

A 23-years-old male with diagnosis of restricting anorexia nervosa was treated and followed since 2012. In July 2015, the patient, who was clinically stabilized for a year, had decreased gradually intake. Suddenly he showed a decreased consciousness, followed by an absence of response and mutism that motivated hospital admission. The diagnosis was dissociative stupor. A research in women with eating disorders shows a prevalence of pathological dissociation between 4.8 and 48.6%. After recovering a normal consciousness, he presented clinical features of anorexia nervosa according DSM 5 criteria. The patient remained two months until he reached his previous BMI (17) to continue an outcome treatment. Despite of several years of specific treatment for anorexia nervosa, both parents and patient still did not accept the diagnosis. Cultural constructions of eating disorders as a “women's illness” mean that men may fail to recognise their disorder.

Conclusions

There is a delay of diagnosis of anorexia nervosa in men. The lack of research on men's experiences and the cultural construction of anorexia nervosa as a female problem may contribute to underdiagnose eating disorders in men.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
“Reflective Learning” In Psychiatric Education: Does It Have Any Merit?
Authors: Adamis D. , McCarthy G.
Published: May 2016

Introduction

Nowadays “reflection” and “reflective practice” is nearly in every curriculum for psychiatric training. Trainees are asked to keep reflection diaries, journals, and participate in “reflection workshops”.

Aims

To prove that reflection on or in action does not lead to learning.

Methods

Using epistemological notation.

Results/proofs

Because sciences including psychiatry are approximate, evolving and inexact, the classical definition of propositional knowledge becomes: A knows that p if:

– (a’) A believes that p is an approximate true;

– (b’) p is approximate truth;

– (c’) A has reason to claim that p is a better approximation than its rivals on available evidence.

Condition (c’) implies that A is not possible at the same time to have two mutually contradictive approximate truths.

In reflective learning we need to add two more conditions:

– (d’) A knows the outcome of p;

– (e’) A is satisfied in believing that p.

In cases of reflection in-action, the (e’) remains even the outcome is not favourable. Similarly, in reflection on-action the condition (e’) remains unchanged since this happened in the past. This leads to controversy. Is p better or worse approximation of truth than its’ rival p’? However, p has passed rigorous and different scientific tests and has proved scientifically superior to its rival p’. Therefore subject A cannot change his knowledge despite the unfavourable outcome, but A can tests further the p. Within the former reflecting learning does not occur, within the latter “critical thinking” occurred.

Conclusions

Reflection does not lead to learning but critical thinking does.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Before And After: Effect Of 4-week Psychiatry Attachment On Medical Students’ Attitude To Psychiatry As a Career Choice
Authors: Adekunte O. , Owen B. , Oliver C.
Published: May 2016

Background

Psychiatry is historically unpopular amongst medical students. The perception that psychiatry is remote from the rest of medicine and not evidence-based has been identified. However, there is evidence that psychiatry placement has positive effects on students. There are reports that medical students experience a positive change of attitude towards psychiatry following their undergraduate psychiatric attachment. There is evidence that medical students experience a positive change of attitude towards psychiatry following their undergraduate psychiatric attachment.

Aim

To determine the effect of a four-week psychiatry placement on 3rd year medical students’ attitudes towards psychiatry.

Methods

Pre-and post-attachment questionnaires were administered to four cohorts of 3rd year students. Responses were anonymised and based on Yes/No, free-text, order of preference and Likert scale. Analysis was by basic statistical methods.

Results

A total of 98 pre- and 81 post-placement students responded. Mean positive attitude increased by 6% and the percentage of students choosing psychiatry in their top three career choices increased from 7 to 20%. Ninety percent of students post-attachment thought that psychiatry is relevant to their future jobs, compared to 86% pre-attachment. The percentage of students who think that psychiatry makes little use of medical training decreased from 20% to 16%.

Conclusions

The survey showed a period of 4 weeks psychiatry placement has a positive effect on the attitudes of medical students towards psychiatry. It also increases the number of students wanting to pursue a career in psychiatry.

Disclosure of interest

The authors have not supplied their declaration of competing interest.