bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrative approach to the construction of psychosocial rehabilitation of mental and behaviour disorders in children moved out of “Anti-Terrorist Operation” zone
Authors: Mykhaylov B. , Vodka M. , Aliieva T. , Vashkite I.
Published: May 2016

Introduction

The problem of children's mental health in Ukraine – it is one of the most pressing problems in the country's health. This is due to the increasing number of extreme situations (military operations in the territory of Ukraine) for the last time that calls for the training of specialists capable of carrying out psychosocial rehabilitation to victims of “anti-terrorist operation”(ATO).

Objectives

The mental and behaviour disorders in children affected of ATO. We studied 261 families: 107 adults and 154 children. The aim of the project was to optimize the provision of psycho-social support for children and adolescents with problems of the psychic sphere by developing a system of psychological adjustment and social education at the Centre for psychosocial rehabilitation of children, as well as the creation of the necessary conditions that expand the comfort and a safe space for the child to enhance positive impacts and mitigate negative impacts of the social environment.

Methods

The leading role was played by a combination of two areas of work, namely the psychocorrection (trainings, art-, individual-, family-, hyppo-therapy) and social work.

Results

In 85.4% of the children showed stabilization of mental and emotional state, reducing aggression, increasing motivation to social activity. In 56.3% of families – reducing conflict relations.

Conclusions

The non-standard way of psycho-correction allowed organizing a fruitful and creative leisure, which resulted in the reduction of aggression and anxiety, increased motivation for the successful development of new activities and problem-solving skills and conflict situations with peers and family members.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Increased libido as a buproion-SR side effect: Clinical description of a case
Authors: Gallardo Borge L. , Noval Canga C. , Rodíguez Andrés L. , Sevillano Benito I. , Hernández García M. , Álvarez Astorga A. , Hernández Antón R. , Gómez Sánchez S. , Isidro García G. , Marqués Cabezas P.
Published: May 2016

Introduction

Bupropion is a dual antidepressant, a norepinephrine and dopamine reuptake inhibitor. Its main use is in affective disorders as major depression. Antidepressants have been commonly associated with sexual side effects in the libido, sexual arousal, orgasm and erectile function. Bupropion has negative influence in sexual function, even it could increase the libido. Due to this, it could be a good option in patients with active sexual life and affective disorder.

Clinical report

A 58-year-old female with a long history of depression disorder for 5 years. History of lots of side effects with different treatments, sexual dysfunction with serotonin-antidepressants. Treated with bupropion SR 150 mg/day and alprazolam, she suffered a relapse. The bupropion was increased to 300 mg/day. Three days later she appeared in the consultation room, presented a sense of pre-orgasmic of 72 hours of evolution, high increased libido, tiredness, muscle tension and insomnia. This sense did not improve after the sexual act. It had never happened previously. The side effect improved when the bupropion was reduced to 150 mg/day and disappeared with its withdrawal.

Conclusions

The case made a relationship between the increased of bupropion's dose and the appearance of unusual sexual side effects (increased of libido and pre-orgasmic sense). Not only bupropion is one of the antidepressants that do not cause sexual dysfunction, if not it was reported in some trials that could be a treatment against this dysfunction due to its prosexual effects. The mechanism is unknown but could be related with norepinephrine or dopamine transmission.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sociodemographic variables and efficacy study in psychotic patients after 12 months of outpatient treatment with paliperidone palmitate (PP)
Authors: Manzur Rojas P. , Botias Cegarra P. , Raposo Hernandez M.R. , Ibernon Caballero M.I. , Sanchez Bahillo A. , Gonzalez Galdamez A.L. , Martinez Mirete M.J. , Belmar Simo A. , Carrillo Cordoba M.A.
Published: May 2016

Introduction

Psychotic disorders are serious mental illnesses that compromise the quality of life of patients. It is important to know the characteristics of the affected population, seek to improve the adhesion and functionality.

Objectives

To describe the sociodemographic characteristics of patients treated with Palmitato Paliperidona (PP). Analyze the efficacy variables, adherence to treatment.

Methods

Cross-sectional study of 15 patients in outpatient follow-up after 12 months of treatment with PP. Sociodemographic characteristics are collected, mean dose of PP, through a mirror study. Scales to measure the functionality, clinical status and attitude towards medication apply: Scale of personal and social functioning (PSP), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression Scale (CGI-SI) and attitudes toward Inventory Medication (DAI).

Results

The sample consists of 15 patients (54% male). 81% are single; 77% live alone and 94% not working. The mean dose of PP is 147 mg/month. DAI shows a good attitude to the treatment (80%). The PSP shows that 22% of patients have serious difficulties in its development. The CGI-SI shows that 67% are moderately sick and the BPRS that 33% of patients have a serious disorder.

Conclusions

The demographic profile of patients after 12 months of treatment with PP coincides with male, unmarried, unemployed, living alone. Most have good adherence. The variables measured by the CGI-SI, BPRS and PSP, displayed moderately ill patients with severe difficulties or marked on their autonomy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pseudoakathisia in a patient with clotiapine abuse: Report of a case
Authors: Quandt P. , Cejas Méndez M.D.R.
Published: May 2016

Introduction

Objective symptoms of akathisia in the absence of subjective symptoms is known as pseudoakathisia, more often diagnosed in older patients with long-term antipsychotic treatment.

Objective

To describe a case of pseudoakathisia in a patient with clotiapine abuse.

Aims

Pseudoakathisia management.

Methods

X is a 47-year-old male with chronic insomnia treated with clotiapine 40 mg/day for four years. He admits abusive neuroleptic consumption in the past eight months (160 mg/day), without any psychiatric control for years. In recent months he has experienced different organic complications, requiring multiple hospitalizations. During psychiatric examinations due to confusional states, repeated lower limbs movements were objectified. X reported he presented these movements for at least six months, without complaints of inner restlessness feeling. Neurological examination showed normal DAT-SCAN result. Clinical progression was evaluated using BARS scale (Barnes Akathisia Rating Scale).

Results

Following the results of tests and statements of drug history, X was diagnosed with clotiapine-induced pseudoakathisia. Neuroleptic treatment was suspended, and clonazepam 6 mg/day and propranolol in ascending doses up to 80 mg/day were initiated. In subsequent evaluations, progressive decrease in movement intensity was observed. However, complete remission after four months from clotiapine suspension was not achieved.

Conclusions

Pseudoakathisia is a concept not well defined at this moment and different hypotheses about its nature are considered. It has been suggested that it is a form of delayed dyskinesia, or a clinical progression from akathisia, with acquired subjective discomfort tolerance. The most widely used treatment includes benzodiazepines, beta-blockers and anticholinergics, although their effectiveness is limited.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mega-review of meta-analyses investigating the short-term efficacy of pharmacologic augmentation strategies of antipsychotics in patients with schizophrenia
Authors: Rubio J.M. , Inczedy-Farkas G. , Leucht S. , Kane J.M. , Correll C.
Published: May 2016

Antipsychotics are the cornerstone of treatment for schizophrenia, but they have limited effectiveness, as most patients require subsequent strategies at some point of their treatment. Despite being widely used, the efficacy of pharmacologic augmentation of antipsychotics is controversial and no combination treatment has been approved for schizophrenia. We conducted a systematic review in PubMed and PsycInfo on June 1st 2015 and a random effects meta-analysis of meta-analyses of short-term, placebo-controlled studies of pharmacological augmentation strategies of antipsychotics in schizophrenia. Methodological quality of meta-analyses was measured using the AMSTAR, plus 6 additional items developed to rate the content quality of the meta-analyzed trials. Out of 3062 publications, we identified 36 eligible augmenting strategies. For total symptom reduction, 25 strategies augmenting antipsychotics and 5 strategies augmenting clozapine were eligible and examined. Eleven strategies were more efficacious than placebo, none of them augmenting clozapine. Significant effect sizes ranged between SMD −1.03 and −0.23. Efficacy was not correlated with the quality of the meta-analyses. Only the meta-analysis for NSAIDs augmentation had a score greater than half of the possible points for content quality. Only antipsychotics, azapirones, antidepressants and lithium were less discontinued than placebo. Serotonin-3-receptor antagonists, lamotrigine, mirtazapine/mianserine, minocycline and estrogens had large effect sizes augmenting antipsychotics. However the quality of the content of most meta-analyses was low. The NSAIDs augmentation meta-analysis had the best content quality, yet with a low effect size for efficacy. The evidence for short-term augmentation strategies of antipsychotics in schizophrenia is inconclusive, due to the limited quality of the available trials.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The impact of tobacco smoking in patients taking long-action injection drugs – A retrospective comparative study between haloperidol and risperidone
Authors: Silva J. , Prata-Ribeiro H.
Published: May 2016

Introduction

Smoking rate seems to be higher among patients with schizophrenia, comparing to other psychiatric entities, mainly in those who are on typical antipsychotics. Tobacco is known to have enzyme inducer properties, due to cytochrome P450 complex activity: CYP1A1, CYP1A2, CYP2E1 and CYP2D6. CYP2D6 and CYP1A2 play an important role in antipsychotics metabolism, mainly in the first generation ones, like haloperidol, despite its importance in risperidone metabolism.

Aim

To analyze the importance of tobacco smoking in patients taking long-action injections.

Objectives

To investigate how sexual dysfunction varies with tobacco smoking, in patients taking long-action injections.

Methods

Individuals from both sexes, from 18 to 55 years old, taking antipsychotic long-action injections, answered the Arizona Sexual Experience Scale (ASEX).

Results

In the studied population (n = 44), there were 20 individuals on haloperidol and 24 individuals on risperidone. In a total of 18 (40.9%) positive results for sexual dysfunction, 6 were on haloperidol (30%), 12 (50%) were on risperidone. Seventeen individuals of the 20 who were on haloperidol were smokers, but only 4 were considered to have sexual dysfunction, 35.3%; 12 of the 24 individuals who were on risperidone were smokers, but only 5 were considered to have sexual dysfunction, 41.7%.

Conclusions

Patients treated with haloperidol smoke more, comparing to risperidone. Sexual dysfunction is more frequent in patients taking risperidone than in patients taking haloperidol. This data supports that CYP2D6-CYP1A2 induction by tobacco, mainly interacts with haloperidol, which may be helpful for patients to try less side effects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Awkward movements: Extrapyramidal symptoms in a group of patients treated with aripiprazole long acting injectable
Authors: Victor C. , Berta S. , Ivan T. , Silvia O. , Sandra C. , Estanislao M. , Luis Miguel M. , Moreno J.
Published: May 2016

Introduction

Extrapyramidal symptoms are well known as side effects in therapy with antipsychotics. Explore this side effects is mandatory because they normally are a cause of treatment discontinuation or assess a change in medication. Some studies notice how long acting injectable antipsychotic cause less extrapyramidal symptoms than oral treatment, others does not find differences.

Objective

The aim of this study is to analyze the extrapyramidal symptoms presented on a group of patients treated with aripiprazole long acting injectable (ALAI) follow-up in a mental health care center.

Methods

Descriptive study of a group of patients treated with ALAI. To assess the possible extrapyramidal symptoms due to treatment we have used the Simpson-Angus Scale (SAS). The follow up was 3 months after initiation of treatment.

Results

Six patients were included in the study, 2 women (33.3%) and 4 men (66.7%). The mean age of the sample was 37 years old. The different diagnoses of the group were 4 patients with psychotic disorder (66.7%; 2 schizophrenia, 1 schizoaffective disorder and 1 delusional chronic disorder) and the other 2 had an affective disorder (33.3%; both bipolar disorder). The average score for the SAS was 1.2 meaning normal results and therefore no significant extrapyramidal symptoms.

Conclusions

In our sample the average of the results obtained by applying the SAS is considered within normal limits. In our case as to extrapyramidal effects ALAI treatment has been well tolerated. A larger sample would be needed to obtain more reliable results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impact of expressive writing on everyday memory functioning
Authors: Abuhamda B. , Soliman A.
Published: May 2016

Introduction

The suppression of negative feelings and traumatic events has detrimental effect on mental and physical health. One of the promising techniques to reduce stress related to trauma is expressive writing. Expressive writing has been found successful with different types of maladaptive behaviors e.g., pain, depression, anxiety and cognitive dysfunctioning.

Objectives

This study investigates the impact of different categories of expressive writing on improving every day memory performance and cognitive functioning.

Aims

Examining the impact of cognitive functioning and everyday memory.

Methods

A sample of 90 participants took part in this study. The participants aged (21 and 65 yrs.) 47 of them are females aged between average of (21.64 yrs.), and 43 males aged between average of (21, 49 yrs.). The participants were classified randomly into three groups (a control group, and two experimental groups [pen and oral writing]). The three groups were administered the Every Memory Questionnaire and Taranto Alexithymia Scale.

Results

The results showed that there were no significant differences among the three groups in each of the Alexithymia and Everyday memory, which indicates random distribution of the three groups. The results showed that both of the experimental groups were improved on everyday memory functioning. More importantly, the results indicated that there were no significant differences between using pen or figures in expressive writing to improve Everyday memory.

Conclusion

Study results showed the significant impact of expressive writing on every day memory functioning, furthermore, the study results are used to empathize on the cognitive rehabilitation of the individuals as well as to improve self-esteem on general psychological individual cases.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Functional somatic syndromes, mentalizing impairment and psychotherapy as the way to soothe suffering. A group psychotherapy experience in an outpatient setting
Authors: Ramos J. , Alonso E. , Tur N. , Sanz-Correcher P.
Published: May 2016

Functional somatic symptoms and syndromes are a major health issue. They are common, costly, persistent and may be disabling. From Mentalization Based Treatment perspective, mentalizing impairments are a key factor in these issues. In that sense, many times, emotional suffering is rendered into physical pain, and it is the body that conveys affects and moods while the patients search frantically for an objective diagnosis and a biological cause for their symptoms and complaints. Taking this premise as a starting point, this poster analyses the importance of working on affects, connecting to them, naming them, and thinking about them. Linking symptoms to emotions, to attachment strategies, and interpersonal issues in order to achieve the recovery of mentalization. Considering this as the main goal to release the body from pain and suffering, we specify a proposal of group psychotherapy developed throughout the last eight years in an outpatient setting.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A study for development and validation of the computer-based working memory tasks for school-aged children
Authors: Shin M.S. , Oh S.J. , Lee J.J. , Lee J.E.
Published: May 2016

Introduction

Working memory (WM) is the ability to retain and manipulate information during a short period of time. According to previous studies, children who have neurocognitive dysfunctions, such as ADHD and learning disorder were found to have a WM problem, which was associated with frontal lobe dysfunction, especially dysfunctions in dorsolateral prefrontal cortex.

Objectives

In the present study, we developed the computer-based WM tasks for school-aged children, which help to provide a timely assessment of risk and preventive intervention for children with subclinical attention problems.

Aims

We evaluated the construct and concurrent validity of newly developed WM tasks.

Methods

A hundred and fourteen 8- to 10-year-old children were recruited. The newly developed, computer-based WM tasks consist of two domains:

– auditory-verbal WM;

– visual-spatial WM.

We examined the construct validity of the tasks through examining the developmental trend of the WM abilities with age. To determine the concurrent validity of those tasks, we conducted correlation analyses between the participants’ scores and their scores on well-known measures of verbal and visual WM; Arithmetic and Letter-Number Sequencing subtest of intelligence scale (KEDI WISC), and Corsi block test.

Results

There are marked linear increasing trends of the response accuracy with age. Further, there were high correlations between the scores of two WM tasks and the corresponding scores of standardized assessment tools.

Conclusions

This study showed promising evidence for the validity of computer-based tasks assessing WM, which might have the utility for school-aged children in research and clinical settings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Voluntary and involuntary admission to a subacute psychiatric hospitalization unit
Authors: Orejas O. , Flores Martínez P. , Macías Castellví C. , Campillo Sanz M.T. , Vallvé Elias M. , Casals Arnau A. , Masferrer Herrera C.
Published: May 2016

Introduction

Involuntary admissions continue to be a controversial topic in psychiatry. However, it is well known that psychosocial rehabilitation treatment is more successful when the patient is involved in it improving awareness and adherence to treatment.

Objectives

This study examined admissions patterns, including voluntary, involuntary, and partly voluntary admissions to a subacute psychiatric hospital.

Methods

This is a transversal study. All patients admitted for a medium-term psychiatric treatment since 01/06/2014 to 30/11/2015 were included. Patients's basic sociodemographic and clinical data were collected and compiled in a database. Descriptive statistics were performed using SPSS Software.

Results

A total of 88 patients (52% men; mean age: 48.6 years) composed the sample. In 58% of cases, schizophrenia and schizoaffective disorder were the diagnoses motivating the admission. Among 88 patients, 44 (50%) had voluntary admissions, 16 (18.2%) had involuntary admissions, 27 (30.7%) had partly voluntary admissions and just one patient (1.1%) had partly involuntary admissions. Seventy-one (80.1%) patients had voluntary admissions at discharge, and only one of them escape from hospital and did not finish the treatment.

Conclusions

In the short term involuntary hospitalization has benefits, however also can have adverse long-term consequences for the patient-therapist allegiance, breaking the psychotherapeutic relationship and making the patient abandon treatment. It's important to reassess the condition of admission and work with the patient the need to engage in treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Advantages and obstacles for community based approach using case management method in the work with users that have psychotic disorders – Case study
Authors: Racetovic G. , Popovic S. , Rosic B. , Grujic Timarac S.
Published: May 2016

Introduction

Case management (CM) is accepted as the most recommended approach for the treatment of people with severe mental illnesses (SMI) in Community Mental Health Centers (CMHC) in whole Bosnia and Herzegovina (BH) in the last 3 years.

Objective

All team members of CMHC Prijedor are certificated case managers. Part of our daily activities is work with and for the users included in CM (mostly with schizophrenia or similar disorders) using multidisciplinary approach to find best possible solutions of both treatment and rehabilitation for users that we are in charge. In this moment CMHC cares for 12 mostly younger users involved in the CM.

Aims

To show advantages as well as obstacles of the CM.

Methods

Case study of young user with schizoaffective disorder included in the CM in the last 2 years.

Results

Improvements in user's daily activities and using of the remaining capacities with confrontation of partial or entire poor responses of most other community services.

Conclusions

CM has many advantages for the user involved in it, mostly medical and psychological (adequate treatment followed by users wishes, avoidance of hospitalization, improving existing or building new skills, use of remaining capacities, planed activities, minimize of the psychopharmacological treatment, social skills and more new contacts with people, etc.). But, still are existing the obstacles in the community mostly considering employment and social care as an part of the stigmatization of the people with SMI.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatrists’ opinion on treatment adherence in Delusional Disorder
Authors: Girela Serrano B. , Aguado Bailón L. , Calvo P. , Muñoz Negro J.E. , Cervilla Ballesteros J.
Published: May 2016

Introduction

Delusional Disorder (DD) F22 is a disease with low prevalence, probably underdiagnosed by clinical specialists due to the high level of functionality, low awareness of disease, low deterioration of patients and poor adherence to prescribed treatment. Adherence to treatment is considered to be one of the major difficulties that stand in the way of the treatment of DD. The present paper assessed psychiatrists’ opinion of the adherence to treatment of patients with DD.

Material and methods

A self-administered survey was conducted on a sample of psychiatrists proceeding on a wide array of mental health care services. Participants provided their opinions regarding adherence to treatment. Descriptive statistics were subsequently calculated with SPSS.

Results

In the opinion of our participants none of the patients have an active compliance of the treatment, 36% consider that the participation is partial or passive. It is also estimated that 57.5% reject the treatment but not totally and 6.5% believe that rejection is absolute.

Conclusions

Literature informs of the association of poor adherence to treatment and little or no improvement of patients, suggesting the need to address the lack of compliance and adherence to treatment as a crucial aspect to improve the prognosis of DD. To address this problem Long Acting Injections (LAIs) of Atypical Antipsychotics are postulated to be a plausible solution as a good treatment strategy. In order to improve the clinical practice in DD and obtain information for further effectiveness we emphasize the need of implementing clinical studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Internet-based survey applied to experts in schizophrenia: Socio-demographic and professional variables associated to response pattern
Authors: Guilera G. , Barrios M. , Pino O. , Salas D. , Gómez-Benito J.
Published: May 2016

Introduction

In the framework of the development of the International Classification of Functioning, Disability and Health Core Set for schizophrenia, we conducted a cross-sectional, internet-based survey using open-ended questions. An international pool of experts from diverse health care disciplines was surveyed to identify problems in functioning experienced by individuals with schizophrenia.

Objectives

The purpose of the study is to explore possible associations between experts’ socio-demographic and professional profiles, and whether they answered or not the survey.

Methods

Out of 307 invited experts, 189 (61.56%) filled in the survey. However, 37 experts were excluded in the data analysis as they had completed only a part of the questionnaire. Thus, there were 152 of the experts classified as “respondents” and the remaining 155 as “non-respondents”. The association between the response pattern and the socio-demographic and professional variables (i.e., gender, World Health Organization region, discipline, and years of experience) was analysed by means of Chi2 tests.

Results

There was a statistically significant association between the response pattern and the gender of the expert (χ2(1) = 4.927, P = 0.026; V = 0.127), showing that 56.3% of female and 43.6% of male experts answered the survey. When comparing the response pattern in terms of discipline, a statistically significant association was also found (χ2(4) = 10.101, P = 0.039; V = 0.183), showing that those who tend to answer the survey are occupational therapists (71.4%), followed by psychologists (58.0%), social workers (52.6%), nurses (52.0%), and psychiatrists (41.3%).

Conclusions

Females and occupational therapists presented the higher response rate to the expert survey.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Self-continuity across time in schizophrenia: An exploration of phenomenological and narrative continuity in the past and future
Authors: Allé M. , D’Argembeau A. , Schneider P. , Potheegadoo J. , Coutelle R. , Danion J.M. , Berna F.
Published: May 2016

Disorders of the self, such as the “loss of continuity” of the self in time, are a core symptom of schizophrenia, but one, which is still poorly understood. In the present study, we investigated two complementary aspects of self-continuity, namely phenomenological and narrative continuity, in 27 patients with schizophrenia, and compared them with 27 control participants. Participants were asked to identify 7 important past events and to narrate a story taken from their life that included these events. They were then asked to imagine 3 important events that might happen in their personal future and to build a narrative of their future life. The memory vividness of these important life-events and the proportion of self-event connections in the narratives were used as a measure of phenomenological and narrative continuity, respectively. Our results showed that the difficulty for patients to construct vivid representations of personally significant events was observed in both temporal directions, past and future. Patients’ ability to establish explicit connections between personal events and attributes of self in life narratives was also impaired, but only in the case of past narratives. Our results yield a fresh understanding of the cognitive mechanisms of self-disorders in schizophrenia. The clinical and therapeutic implications of these findings are discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A comprehensive systematic screening protocol for assessment of medical comorbidities in schizophrenia
Authors: Bucci P. , Durante Mangoni E. , Pafundi P.C. , De Simone S. , Malgeri U. , Mucci A. , Galderisi S. , Maj M.
Published: May 2016

Introduction

Difficult access and low quality of health care are recognized as factors that may account for the excess deaths widely reported in patients with schizophrenia. As a matter of fact, psychiatrists not always possess adequate competences in the assessment of physical health, while non-psychiatric physicians receive little training in psychiatry and are not prepared to take care of subjects with severe mental illnesses.

Objectives

We present a comprehensive and systematic algorithm for screening medical comorbidities, conceived to be easy to use for psychiatrists, after a brief training.

Aims

The study is aimed to implement an instrument for proper detection and management of physical illnesses in people with schizophrenia.

Methods

The screening protocol, developed by internal medicine specialists, was applied to 15 subjects in two independent assessments, one performed by trainees in psychiatry, after a brief training, and one carried out by one specialist and two trainees in internal medicine. The analysis of the inter-rater reliability was carried out by calculating the Cohen's kappa coefficient and the intraclass correlation coefficient as appropriate.

Results

The agreement among raters resulted excellent for 61% of items, good for 17%, moderate for 18% and scarce for 4%. The few items showing scarce inter-rater reliability were excluded. The final algorithm is being tested for feasibility in psychiatric settings.

Conclusions

The proposed screening protocol resulted in a suitable tool, showing moderate to excellent inter-rater reliability, that can be used in clinical practice by psychiatrists after a brief training.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
LAI versus oral antipsychotic maintenance treatment of schizophrenia: A case-control study on subjective experience of treatment
Authors: Pietrini F. , Spadafora M. , Tatini L. , Talamba G.A. , Burchi E. , Calderani E. , Gemignani S. , Mallardo L. , Andrisano C. , Boncompagni G. , Manetti M. , Ballerini A. , Ricca V.
Published: May 2016

Introduction

Limited research has been devoted to the subjective impact of switching antipsychotic maintenance treatment (AMT) from oral to LAI formulation in schizophrenia.

Objective

To compare LAI AMT with oral AMT in terms of subjective experience of treatment, taking into account the effects on psychopathology.

Methods

Twenty outpatients (7 males, mean age 40.55 ± 11.00 years) with remitted schizophrenia treated with either olanzapine or paliperidone and switching from oral to LAI AMT were recruited before the switch (LAI-AMT group). A group of 20 remitted schizophrenic subjects with oral AMT and matched for the main socio-demographic, clinical and treatment variables made up the controls (oral-AMT group). All participants were assessed by means of the PANSS and of the SWN-K at baseline (T0) and after 6 months (T1).

Results

Between T0 and T1, general psychopathology of the PANSS and all but one of the SWN-K dimensions (except for “social integration”), showed significantly higher percent improvements in the LAI-AMT group compared to the oral-AMT group. After 6 months (T1), the LAI-AMT group showed significantly lower PANSS total and general psychopathology scores, as well as higher mean score of perceived “mental functioning” compared to the oral-AMT group. Item analysis of the general PANSS at T1 showed significant differences between the two groups in anxiety, tension, depression, guilt feelings, poor attention, and active social avoidance.

Conclusions

Our data on switching from oral to LAI AMT in remitted schizophrenia suggest a better efficacy of the latter in terms of improvement of general psychopathology and subjective experience of treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Study of the contributory factors to metabolic abnormalities in resistant schizophrenia
Authors: Ramos Perdigues S. , Mane Santacana A. , Salgado Serrano P. , Jove Badia E. , Valiente Torrelles X. , Ortiz Sanz L. , Fortuny Olive J.R. , Perez Sola V. , Dinamarca F.
Published: May 2016

Introduction

Schizophrenia is a developmental disorder that includes non-psychiatric abnormalities [2]. Metabolic abnormalities prior to antipsychotic treatment exist. The clozapine metabolic profile causes clozapine underuse in resistant schizophrenia [1].

Objectives

To correlate metabolic profile with psychiatric severity and compare the correlations between clozapine/non-clozapine patients.

Aims

To determine possible contributory factors to metabolic abnormalities in schizophrenia.

Methods

We cross-sectionally analyzed all patients from a Spanish long-term mental care facility (n = 139). Schizophrenic/schizoaffective patients were selected (n = 118). N = 31 used clozapine. We paired clozapine and non-clozapine patients by sex and age and assessed metabolic and psychopathologic variables.

We compared psychopathologic variables between patients with/without cardiometabolic treatment and the differences between clozapine/non-clozapine groups.

Results

We analyzed: 27 clozapine/29 non-clozapine patients. A total of 67,9% males with a mean age of 51.3 (SD 9.6) years. In the whole sample TG negatively correlated with Negative-CGI (r: −0,470, P: 0.049) and HDL-cholesterol correlates with Global-CGI(r: 0,505, P: 0.046). Prolactin correlated with the number of antipsychotics (r: 0.581, P: 0.023) and IMC (r: 0.575, P: 0.025). Clozapine group took less antipsychotics [Fisher (P: 0.045)] and had higher scores in total BRPS scale [t-Student (P: 0.036)]. They did not use more cardiometabolic treatment. There were no psychopathological differences between cardiometabolic treated/non-treated patients. In the non-cardiometabolic treated group (n = 35/62,5%), IMC negatively correlated with positive and total BPRS, positive, cognitive and global-CGI. We found negative correlations between metabolic parameters and psychopathology in clozapine (40%) and non-clozapine subgroups (60%). In the cardiometabolic treated group (n = 21/37,5%), we did not find these correlations in either of clozapine (61.9%) or non-clozapine (38.1%) subgroups.

Conclusions

Severity [2], prolactine [3] and treatment [1] could play a role in metabolic parameters. In our sample we found negative correlations between psychopathological and metabolic parameters.

References not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A case of rare allele T 126, 30,32 base pairs in a schizophrenic patient: A study case
Authors: Sabau A.I. , Cristina P. , Valerica B. , Delia Marina P.
Published: May 2016

Introduction

Schizophrenia is a severe and complex disease clinically characterized by disturbed thought processes, delusions, hallucinations and reduced social skills. Gene coding for neregulin 1 (NRG 1) located in 8 p21chromosomeand single nucleotide polymorphism (SNPs) have been identified strongly supporting NRG1 gene as a susceptibility gene for schizophrenia.

Objective

The present preliminary study, determines the relationship between polymorphism nucleotide sites (SNPs2) of NRG1 gene and schizophrenia.

Aims

Identifying rare allele T of neregulin 1 genein schizophrenic patients.

Method

We analyzed the polymorphism (SNPs2) of NRG1 gene in 20 patients recruited from Psychiatry Department of Emergency Clinical Hospital of Arad diagnosed with schizophrenia according to DSM-5-TM and ICD-10 criteria and 10 healthy controls. From all subjects, we obtained 2 mL of peripheral blood samples. Genomic DNA was extracted using the phenol-chloroform method. Genotyping was performed byPCR-based RFLP analysis for all subjects. The obtained PCR product mixture was completely digested with restriction enzyme, separated on SNP1 and SNP2 agarose gel. We present the case of a 31 years old, male, schizophrenic patient with the SNPs2 polymorphism and rare allele T 126.

Results

In both groups, common allele G 127 and 60 base pairs was identified but only 2 schizophrenic patients presented rare allele T 126 and 30,32 base pairs.

Conclusions

The polymorphism SNPs2 of NRG1 gene with rare allele T 126 and 30,32 base pairs, may play a role in predisposing an individual to schizophrenia. Further and extended replicating studies with multiple sequencing of NRG1 gene are necessary.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Substance abuse in first episode psychosis: Baseline characteristics and clinical outcome
Authors: Toll A. , Mané A. , Bergé D. , Pérez-Solà V.
Published: May 2016

Introduction

There are high rates of substance use disorders (SUD) amongst first episode psychosis (FEP). SUD have been linked to better premorbid adjustment, more severe positive and negative symptoms at presentation and poorer symptomatic and functional outcome [1]. Moreover, shorter duration of untreated psychosis (DUP) has been described as an important predictor of outcome in FEP [2].

Aims

With this study, we want to know which baseline characteristics and clinical outcomes differ between FEP patients with and without substance use.

Methods

One hundred and seventy-five FEP were consecutively admitted to Hospital del Mar since January 2008 to September 2014 and entered the FEP programme of the institution. The included evaluation was socio-demographic and clinical data at baseline and 1 year follow-up. We studied differences in age, gender, DUP, GAF scores at baseline and 1 year follow-up and PANSS subscale scores at base and 1 year follow-up between substance users and non-users.

Results

Cannabis: we found that users were significative younger (P < 0.01), had a higher proportion of males (P < 0.01) and a significative shorter DUP in users (P = 0.008).

Alcohol: we found that users were significative younger (P < 0.009), had a higher proportion of males (P < 0.003) and a significative lower PANNS negative scores at baseline (P = 0.01) and 1 year follow-up (P = 0.03).

Conclusions

In our sample of first episode psychosis, cannabis and alcohol use is linked with a younger age and a high proportion of males. Moreover, it seems that cannabis use could be associated with a shorter DUP.

References not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Socio-demographic features of gender dysphoria in a Sardinian adult population
Authors: Bandecchi C. , Deiana V. , Pinna F. , Corda E. , Pusceddu R. , Pintore S. , Oppo A. , Mariotti S. , Argiolas A. , Carpiniello B.
Published: May 2016

Gender dysphoria (GD) is a rare entity in psychiatry; there are a lot of studies about its clinical aspects, but only few investigations considering the socio-demographic characteristics of these patients, especially concerning Italian population.

The aim of this study is to evaluate socio-demographic characteristics of GD individuals seeking assistance for gender transition and to assess possible differences between MtFs and FtMs.

A consecutive series of 25 patients (56% MtF and 44% FtM), from 17 to 49 years old (mean age: 29.6 ± 9.52), were evaluated for gender dysphoria from June 2011 to May 2015. All subjects met the criteria for gender identity disorder (GID), based on DSM-IV-TR.

The results have shown that FtMs refer for psychiatric help in younger age than MtFs (21–25 years vs. 36–50 years, P = .038); most of the patients are unemployed (48%; P = .014) and live with their parents (68%; P = .001), without statistically significant gender differences. Regarding sexual orientation, 84% of the sample report to feel attracted by individuals of the same-genotypic sex (P < .001); 81.8% of FtMs have a stable relationship instead of 21.4% of MtFs (P = .007). Moreover, a significant statistical difference was found between the two groups in the “real-life experience”; all FtMs live as males, while only 50% of MtFs show themselves as females in the daily life and activities (P = .008).

This is a preliminary study comparing the socio-demographic features of a MtF and FtM GD population in Sardinia. Although the limitation of a small sample, our results do not differ from the literature data; in particular, FtMs display significantly better global functioning and less problems in social integration.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personality traits and personality disorders in gender dysphoria
Authors: Deiana V. , Corda E. , Bandecchi C. , Pintore S. , Pinna F. , Pusceddu R. , Oppo A. , Mariotti S. , Argiolas A. , Carpiniello B.
Published: May 2016

Investigations in the field of gender dysphoria (GD) have been mostly related to psychiatric comorbidity and severe psychiatric disorders, but have focused less on personality traits and personality disorders (PDs).

We aimed to assess personality and the presence of PDs in a sample of 25 persons with GD attending the Psychiatric Clinic or the Department of Endocrinology of the University of Cagliari requesting sex reassignment therapy. They were assessed through the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Structured Clinical Interview for DSM-IV Axis II (SCID-II).

The sample consisted of 14 MtF and 11 FtM, with a mean age of 29.6 ± 9.5. Overall, 39.1% of the sample met the criteria for at least one PD, more frequently cluster-B PD (21.7%). MtF met a higher number of SCID-II criteria than FtM, especially regarding histrionic personality traits (P = 0.001). A total of 20 persons (9 MtF and 11 FtM) completed the MMPI-2. Mean T scores did not differ from the general population, except for the Psychopathic Deviate (Pd) scale (mean T = 66.2 ± 11.2). The Masculinity-Femininity (Mf) scale was slightly increased, and its score reduced after correction for perceived sex (P = 0.037). MtF scored significantly higher at the Family Problems (FAM) scale (P = 0.052) and lower at the Social Discomfort (SOD) scale (P = 0.005) compared to FtM.

The high prevalence of PDs confirms that this kind of assessment in GD is of great importance, as a key part of personalized treatment plan tailoring. The high scores on the Pd scale suggest misidentification with societal standards.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
I am trapped in a wrong body
Authors: Hernandez Anton R. , Noval Canga C. , Rybak Koite E. , De La Red Gallego H. , Gallardo Borge L. , Alonso Sanchez A. , Sevillano Benito I. , Garcia Cantalapiedra M.J. , Marques Cabezas P. , Uribe Ladron De Cegama F. , Espina Barrio J.A. , Isidro Garcia G.
Published: May 2016

Introduction

Gender dysphoria is incoherence between the sex a person feels or expresses and the biological.

Objective

Revise the inclusion criteria for hormone therapy and sex reassignment surgery in gender dysphoria. Expose the multidisciplinary approach. Make differential diagnosis with other psychological disorders.

Methodology

A 45 years old male patient (biological female), who was sent from Endocrinology Unit for a psychiatric evaluation before restart a hormonal treatment. Since his childhood, he has presented dissatisfaction with his sexual characteristics; he has had fantasies and dreams, in which he belonged to the other sex. He has always chosen male activities and male stereotypes companies. He has presented preference for cross-dressing from 9 years. Always felt the sexual attraction for women. He first consulted for this reason in 1995.

Results

It reported favorably to start hormone treatment after completing the eligibility criteria: > 18 years old; knowledge of the effects of hormones; and more 3 months documented real-life experience. The hormone therapy caused the growth of microprolactinoma, which was treated with dopamine agonists until it disappeared and the cessation of galactorrhea. Testosterone treatment is restarted. Laboratory tests are done every 3 months during the first year and then, every 6 months.

Conclusions

Is the gender disphoria a pathology? The EU recommends a reclassification as no pathological disorders in ICD-11. The treatment of gender dysphoria is necessary, and there is no reason to postpone it. The main difficulty is the differential diagnosis; there may be comorbidity with others mental disorders which are not exclusive (psychotic disorder, OCD, personality disorders and other disorders of gender identity).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The influence of the Foehn wind (Halny) on the occurrence of suicide in the Tatra Mountains, 1999–2014
Authors: Koszewska I. , Walawender E. , Baran A. , Zieliński J. , Ustrnul Z.
Published: May 2016

Introduction

In the dawn of increasing interest in climate changes, including extreme weather events, e.g. the Foehn winds, and their influence on public health, it is of great importance to understand their role in suicide.

Objectives

The association between suicides in the Tatra Mountains, Poland from 1999 to 2014 and the Foehn wind (called Halny in this region) was examined. The belief that suicides are affected by Halny seems to be firmly rooted in local language and culture.

Aims

The purpose of the study was to assess the Halny wind as a suicide risk factor.

Method

Data concerning all suicides in the region were included. Meteorological data were derived every three hours during the period of the study. Halny was defined as a complex of interacting meteorological conditions. The two days preceding and following the wind were recognized as the period of the Foehn influence (FI). The probability of suicide in the presence of Halny and during the FI period was calculated.

Results

From 1st January 1999 to 31 December 2014 (5844 days), 210 consecutive suicides were registered. The number of suicides in men was markedly higher than in women. Halny did not change the overall probability of suicide. However, the presence of Halny modified the suicide risk according to the season (P = 0.00095, two-way ANOVA test). The FI periods appeared to increase suicide risk in summer and autumn.

Conclusion

Halny may contribute to the increased suicide risk in summer and autumn. It should be taken into account in suicide preventive interventions in this region.

Disclosure of interest

The authors have not supplied their declaration of competing interest.