bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuro-Behçet's psychiatric symptoms
Authors: Maduro F. , Neiva S. , Pissarra C. , Duarte F. , Marques L.
Published: May 2016

Neuro-Behçet (NB) results from inflammatory peri-vasculitis affecting the central nervous system. Non-specific neurological and psychiatric symptoms are rarely the first presentation and may difficult or delay diagnosis and treatment.

We review, based on a case study and published literature, the psychiatric symptoms of NB when no clear evidence of neurologic disease activity is present.

We present the case of a female patient, who was diagnosed NB at age 23 for recurrent meningo-encephalitis, that showed progressive behavioral changes, with increased impulsivity, disinhibition, hostility and self-neglect.

Raised in a dysfunctional family, she ran away from home at 16, abandoned her studies, started abusing cannabinoids and showed an erratic life course.

In 2015, because of increasing psychiatric symptoms, she was admitted to hospital and a complete neuropsychological evaluation showed that she had a significant decline from an above average premorbid cognitive function, specifically related to memory deficits. CT and MRI didn’t show typical signs of active disease. However, a SPECT scan showed hypo-perfusion of the frontal cortex compatible with the patient's symptoms.

It is difficult to assess NB's activity as brain inflammation is only observed after structural changes are present. In this case the SPECT correlated well with psychiatric symptoms. The differential diagnosis includes organic pathology with psychiatric symptoms, psychiatric disease, personality disorders and substance abuse.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical neuroscience and psychosocial rehabilitation
Authors: Vaccaro A.G. , Manfrin F. , Zoppellaro C. , Catania A.
Published: May 2016

There is a physical world and a world of meanings, symbols and social relationships. Neuroscience considers brain as a biological machine. Social science studies the human relationships.

Nowadays we know cerebral processes underlying several aspects of social behavior.

Cerebral damages or dysfunctions can influence the social behavior, as well as the social experiences can shape the development, structuring and functioning of the brain and, consequently, condition the further responses of the individuals to the social events. Humans are embodied subject. In an objective sense we are bodies with a brain, in a subjective sense we are individuals in a social world. This is a relevant matter for all the medical sciences, not only for psychiatry.

The real-life functioning of individuals with schizophrenia shows deficits in several daily-life abilities, in social relationships and in the work activities. According to literature and clinical practice, basic criterions are: bio-psycho-social vulnerability, stressful life events, coping strategies as well as social and relational competence.

Neurocognitive activity shows a straight correlation, albeit indirect, with the real-life functioning. Positive symptoms, negative symptoms and disorganized behavior can considerably influence the real-life functioning. While social and relational competence, the general functioning and resilience are protective factors that can positively condition real-life functioning. Moreover, welfare services (i.e. assisted job placement; disability subsidies; etc.) and a good family and social network can considerably influence the results.

According to the results above, we can affirm the importance to adopt integrated and personalized therapeutic-rehabilitative program for the treatment of schizophrenia and other serious mental disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The role of mirror neurons in autism impairment
Authors: Guedes Neta M.D.L. , Varanda C.
Published: May 2016

Introduction

The discovery of mirror neurons, considered to be responsible for empathy, intrigued researchers all over the world. Many studies have been developed associating mirror neurons to the incidence of Autism Spectrum Disorder (ASD).

Objective

Identifying a possible influence of mirror neuron in autism.

Aims

Reviewing the recent trajectory of neuroscience in relation to the connection of impaired mirror neurons in autism.

Method

Bibliographical review of studies in English, published in SciELO and LILACS databases, between 2008 and 2013. The keywords used were: autism, brain, cortex and mirror neuron.

Results

Different subjects explored the influence of mirror neurons in autism as shown below (Fig. 1). Among 17 studies, 12 were bibliographical reviews and 5 involved experiments. Seventy-six percent of the studies were favorable to the influence of these neurons, while 24% were not.

Conclusion

There was a balance in the distribution of themes explored in the articles and few studies exploring the role of mirror neurons in autism. Even though the current research may not be conclusive, it can be said that currently neuroscientists tend to agree that mirror neurons significantly influence ASD. Recent studies suggest that, if properly stimulated, ASD individuals can develop their social skill and, consequently, be socially inserted. According to most author studied, technological development is needed in order to enable scientific advances involving mirror-neurons and ASD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Opioids consumption and delusional symptomatology
Authors: Duque Domínguez A. , Duque Domínguez R. , Martín Díaz L. , García Montero C. , Palomo Monge M. , Lázaro Redondo M.D.M. , de la Torre Brasas F. , Echeverría Hernández N.
Published: May 2016

Introduction

Opioids are the most powerful drugs commercialised for acute and chronic pain relief. The main emerging problem in our midst is the abuse and addiction to synthetic opioids iatrogenically established in general population.

Objectives

We report the case of a female patient aged 48 admitted to the Acute Psychiatric Unit after a suicide attempt. She refers she finds herself more irritable and depressed since she began a treatment with oxycodone after she was diagnosed with fibromyalgia. She has lost a lot of weight, is not able to get to sleep and has become socially isolated.

Methodology

During the first few days, the patient is uncooperative and shows a marked self-referentiality and verbalises delusional ideation related to her immediate surroundings. Once the treatment with opioids was withdrawn and we had prescribed paliperidone ER, she seemed more cooperative and calmed. She was discharged from the Psychiatric Day Hospital showing a good evolution.

Results

Paranoid personality disorder (F60); mental and behavioural disorders due to use of opioids (F11); recurrent depressive disorder, current episode moderate (F33.1); fibromyalgia (M79.7).

Conclusions

The use of synthetic opioids (tramadol, fentanyl, oxycodone) in easy-to-use formats (patches, pills, dispersible tablets, lollipops) and their dissemination in pain treatment, is leading to an increase of problems related to it, both their side effects (psychotic symptoms) and the generation of misuse and addiction. We should pay greater attention to the prescription of opioids to patients with dysfunctional personality traits.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The effect of alcohol administration on social behavior of rats with experimental schizophrenia
Authors: Egorov A. , Kutcher E. , Chernikova N. , Dorofeikova M.
Published: May 2016

Experimental animal modeling of schizophrenia and alcoholism allows understanding the mechanisms of comorbid pathology formation. The aim was to investigate the effect of ethanol administration on social relations in rats with experimental schizophrenia.

The study was carried out on 30 Wistar adult male rats aged. After 2 weeks isolation rat social ranks were determined. Alcohol preference was evaluated in the two-bottle test. Schizophrenia was modeled by administering to rats (n = 15) dopamine precursor levodopa-carbidopa (LC) during 5 days each month in four months experiment. The control animals (n = 15) received water. All animals were subjected to intermittent alcoholization throughout the experiment after the introduction of the LC. The behavioral parameters evaluated in the “open field” and “despair” tests.

It was found out that the experimental rats who received alcohol did not differ in the number of interactions compared to the rats who received only alcohol. In the rats with experimental schizophrenia a significantly higher social interactions were observed compared to the control group. This is consistent with the results of the clinical studies, which have shown that patients often drink alcohol to relieve anxiety and tension. The two-bottle test has shown the difference between the experimental and control groups only in the first week of the experiment. Apparently, this can be explained by the prolonged isolation. In the despair test, before the alcoholization, the rats with experimental schizophrenia were completely immobilized, compared to the controls. After alcoholization the differences in the despair test were not observed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Parkinsonism and mental health disorders among Latino migrants
Authors: Herrera Duran L. , Mejia N. , Wang Y. , Alegria M.
Published: May 2016

Introduction

Mental health disorders and parkinsonism (mobility slowness, rigidity, rest tremor, gait instability) often co-exist. Approximately 40% of the 7-10 million people living with Parkinson's disease globally experience co-existent depression and/or anxiety. Furthermore, people treated with dopamine-blocking medications (antipsychotics, antiemetics) or those who suffer vascular, infectious, toxic, or structural brain insults may have symptoms of “secondary” parkinsonism.

Objectives

To describe the existence of parkinsonism among Latino immigrants with behavioral health and substance abuse problems.

Methods

Data from the International Latino Partnership (ILRP) gathered at primary care clinics in Boston, Madrid, and Barcelona included 4 parkinsonism screening questions.

Results

A total of 151 participants out of 567 (26.6%) screened positive for at least one parkinsonism question and 15 (2.6%) screened positive for all 4 questions. A small group of participants who screened positive for parkinsonism had co-existent schizophrenia, schizoaffective disorder, bipolar disorder, and/or exposure to lithium or valproic acid. We found that age 50+, depression, and anxiety were more often associated with people having parkinsonism (P < 01). Gender, race, language, and educational level were not significant predictors of parkinsonism.

Conclusions

Parkinsonism and behavioral health disorders co-exist among Latino immigrants in the United States and Spain. This may be related in part to exposure to dopamine-blocking medications. Future studies should focus on early detection of mental health co-morbidities among Parkinson's disease patients as well as on prevention of “secondary” parkinsonism among people living with mental health disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Peculiarities of comorbid addictions in neurotic disorders
Authors: Maruta N.O. , Kolyadko S.P. , Denysenko M.M. , Kalenska G.Y. , Fedchenko V.Y.
Published: May 2016

Introduction

Under contemporary social circumstances, there is a tendency to increasing of amount of persons disposed to addictive behavior (AB) as a mean to remove psychoemotional tension and to solve their significant problems. This tendency raises in patients with neurotic disorders (ND) that influences on clinical manifestations of the pathology and impedes diagnosis and timely care for this category of patients.

Aim

To investigate AB in the structure of neurotic disorders (F44.7, F40.8, F48.0).

Methods

Assessment of personal addictive status with AUDIT-like tests to detect disorders related to substance and non-substance abuse; 109 patients with ND (main group) and 52 persons without ND (control group) were examined.

Results

It was revealed that patients with ND had significantly higher risk of AB formation (59.73% compared with 21.15% in healthy persons; P < 0.0001). According to the group comparison, in patients with ND levels of AB expression on parameters of “Job” (12.06 points), “Food” (11.98 points), “Internet” (11.10 points), “TV” (8.82 points), “Shopping” (6.59 points) were significantly higher than in healthy persons (9.73; 9.23; 9.00; 7.38; 4.25 points, respectively; P < 0.05). However, levels of keenness on computer were significantly higher in healthy persons (3.48 points) than in patients with ND (2.34 points; P < 0.05). AB connected with substance abuse was not registered in the groups.

Conclusions

The results suggest that the patients use AB in forms of food, Internet, job, TV, shopping dependencies as a subconscious mechanism substituting unsatisfied needs and decreasing motivation-emotional tension under conditions of a frustration conflict.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Epilepsy and self-esteem
Authors: Turki M. , Bouchhima I. , Halouani N. , Turki E. , Bouzidi N. , Dammak M. , Amami O. , Mhiri C.
Published: May 2016

Introduction

Epilepsy is a public health problem that often affects personal and social patients’ life. Self-esteem, an important factor contributing to psychosocial well-being, is generally disrupted in epilepsy.

Objective

The aim of our study was to assess self-esteem and factors associated in patients suffering from epilepsy.

Methods

We conducted a cross-sectional, descriptive and analytic study, including 20 patients followed for epilepsy at neurology outpatient department, Habib Bourguiba hospital, Sfax, Tunisia. We collected socio-demographic and clinical characteristics, and used the Rosenberg Self-Esteem Scale (RSES).

Results

The mean age was 35.9 ans. Sex-ratio (M/F) was 3. Hobby practice was noted in 45% of cases. The disease evolves since 19.9 years on average. A worsening of health in the last year was felt in 30% of cases. The stigma was reported in 30% of patients. Self-esteem was: very low 5%, low 40%, average 40%, and high 15%. It was better among married patients, living in family and those with disease evolving since more than 10 years, but without a significant correlation. The factors correlated with good self-esteem were: practicing a hobby (P = 0.006) and absence of stigma (P = 0.001). Poor self-esteem was significantly correlated with perceived health worsened during the last 12 months (P = 0.02). It was poor in unstable patients professionally, but without significant correlation.

Conclusion

Our study confirms the decline of self-esteem in patients with epilepsy. A better education of these patients to accept their illness, as well as raising public awareness on this affection could facilitate social insertion and improve self-esteem.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pediatric asthma biomarkers in relation to mental disorders of asthmatic children and their caregivers
Authors: Zaky E. , Fouda E. , Samir E. , Ahmed F.
Published: May 2016

Background

Pediatric bronchial asthma as a chronic airway inflammatory disorder has a significant impact on asthmatic children both biologically and psychologically. On the other hand, parental stress and depression has been linked to pediatric asthma and claimed to play an important role in its morbidity.

Objectives

Assessment of pediatric asthma biomarkers as parameters of disease severity in relation to mental disorders of an Egyptian sample of asthmatic children and their caregivers.

Methodology

The current cross-sectional study comprised 60 Egyptian asthmatic children as Group I and 35 clinically healthy children of comparable age and sex as Group II. Thorough clinical evaluation and psychometric assessment were carried out for all enrolled children and their caregivers. In addition, pulmonary function testing and measurement of esinophilic count, IL-5, and total IgE were carried out for children of both studied groups.

Results

Enrolled asthmatics had significant elevation of all studied asthma biomarkers with significant reduction of measured pulmonary functions compared to controls. Furthermore, asthmatics had significantly more encountered poor self-esteem, clinically manifest anxiety, and psychosocial impairment compared to controls. Meanwhile, parents of studied asthmatics had higher frequency of severer grades of clinically manifest isolation, anxiety, depression, and stress. Strikingly, the severer the asthma, the more the elevation of studied asthma biomarkers, the severer the asthmatic child's and caregivers’ anxiety and depression, and the more the caregivers’ isolation and stress.

Conclusion

Pediatric asthma biomarkers as parameters of disease severity has been proven to be linked to mental health impairment of asthmatic children and their caregivers.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Misdiagnosis of anterior cutaneous nerve entrapment syndrome as a somatization disorder
Authors: Arts M. , Buis J. , de Jonge L.
Published: May 2016

Introduction

Anterior cutaneous nerve entrapment syndrome (ACNES) is a frequently overlooked disease, causing chronic abdominal wall pain due to entrapment of an anterior cutaneous branch of one or more thoracic intercostal nerves. It is often misdiagnosed as a psychiatric condition, particularly under the heading of a somatization disorder.

Objectives

We describe the case of a patient who developed depressive symptoms after months of suffering from chronic abdominal wall pain.

Aims

To report a case-study, describing ACNES as a cause of persistent depressive symptoms.

Methods

A case-study is presented and discussed, followed by a literature review.

Results

A 35-year-female was referred to a psychiatrist for her depressive symptoms and persistent cutaneous abdominal pain for months. There she was diagnosed with a depression and possible somatization disorder and she received psychotherapy. Through Internet search, the patient found ACNES as a possible cause for her persistent abdominal pain. Since administration of anesthetic agents only shortly relieved her symptoms, a surgeon decided to remove the nerve end twigs. After surgery, her somatic problems and depressive mood disappeared.

Conclusion

The awareness of ACNES is still very limited in medicine. This may lead to incorrect diagnoses, including psychiatric disorders such as somatization disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Liasion psychiatry–1 year review in psychiatry department of centro hospitalar Trás-os-Montes e Alto Douro, Portugal
Authors: Figueiredo A.R. , Silva M. , Fornelos A. , Macedo P. , Nunes S. , Viseu M.
Published: May 2016

Introduction

Liasion psychiatry is a clinical area of psychiatry that includes psychiatric assistant activities in other medical and surgical areas of a general hospital. In Portugal, it has developed as a result of psychiatry integration in general hospitals. Historically, it started at the beginning of 1930s in USA. In Portugal, the law 413 of 1971 definned the articulation of mental health services with other health services–liasion psychiatry.

Objective

We aim to define patients evaluated in the context of liasion psychiatry, as well as other medical and surgical areas needs of psychiatry collaboration.

Methods

Retrospective analyses of collaboration requests realized to psychiatry department of centro hospitalar Trás-os-Montes e Alto Douro–Vila Real, between October 2014 and October 2015.

Discussion

Most of collaboration requests came from Internal Medicine Service. Authors systematize the reasons for the requests, the time of response to those, the existence of psychiatric history, the type of intervention, the number of observations in the same patient, the most frequent diagnosis and treatment. This psychiatric service consists of four specialists and activity evaluated in this article is one of the clinical areas where these professionals intervene. Depending on the results, it is interesting then to assess needs and optimize available resources.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Healthy living and smart choices - A project for developing a web-based Turkish obesity treatment program
Authors: Hepdurgun C. , Elbi H. , Pırıldar Ş. , Saygılı F.L. , Ünalır M.O. , Can Ö. , Rudarlı Nalçakan G. , Sezer E. , Seçkiner S.
Published: May 2016

Introduction

Obesity is a major public health problem in the world and getting obesity under control is one of the most important goals of the World Health Organization. Cognitive behavioral therapy techniques are helpful for adjusting lifestyle to stay at a healthy weight range. Success of web-based programs which designed with evidence-based behavioral strategies has been proven with different studies. However, a web-based program suitable for Turkish culture and eating habits is still missing.

Objectives

Primary objective of this project is to develop and test a web-based obesity behavioral treatment program in collaboration with experienced academicians from different disciplines.

Aims

The aim of this project is to develop a program which will help Turkish primary care physicians in treating and tracking obesity patients.

Method

The web-based program will include a 12-week-long core behavioral program. Participants will be asked to record their daily dietary intakes and automatic feedback will be given by the system. Weekly behavioral training videos will be available during the core program. As participants watch the videos and record their daily intakes, they will get instant awards such as virtual diet-coin which they will be able to spend for gifts such as low calorie recipes. One hundred obese patients (with body mass index greater than 30 kg/m2) will be recruited to evaluate the effectiveness of the program. The changes in their blood pressures, body weights and waist circumferences will be recorded.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Beneficial effect of mindfulness based art therapy in patients with breast cancer - A randomized controlled trial
Authors: Lee S.Y. , Duck-In J. , Kyung-Joon M. , Hye-Jin L. , Kwang-heun L.
Published: May 2016

Background

Mindfulness based art therapy induces emotional relaxation in cancer patients and is a treatment known to improve psychological stability. The objective of this research was to evaluate the treatment effects of MBAT for breast cancer patients.

Methods

Twenty-four breast cancer patients were selected as subjects of the study. Two groups, the MBAT group and control group with 12 patients each, were randomly assigned. The patients in the MBAT group were given 12 sessions of treatments. To measure depression and anxiety, low scales of the Personality Assessment Inventory (PAI) was used. Health-related quality of life was evaluated using the European organization for research and treatment of cancer quality of life questionnaire (EORTC-QLQ-C30). The treatment results were analyzed using Ancova and two-way repeated measures Anova.

Results

The results showed that depression and anxiety decreased significantly and health-related quality of life improved significantly in the MBAT group. In the control group, however, there was no significant change.

Conclusions

MBAT can be seen as an effective treatment method that improves breast cancer patients’ psychological stability and quality of life. Evaluation of treatment effects using program development and large-scale research for future clinical application is needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
New interferon-free therapies on HCV+ chronic hepatitis: Overcoming psychiatric side effects in a real world setting
Authors: Moneglia M. , Santangelo A. , Ballerini A. , Ricca V. , Zignego A.L.
Published: May 2016

Introduction

Interferon-alpha (IFNα) was the backbone therapy for HCV+ related chronic hepatitis (CH-C). However, it was associated with significant neuropsychiatric side effects and impaired health-related quality of life. Second Generation IFNα-free direct-acting antiviral agents (DAAs) seem to be associated with fewer side effects, better tolerability, high efficacy rates and better patient reported outcomes (PROs) [Younoussi, 2014].

Aims

To describe the neuropsychiatric symptoms and PROs during Second Generation DAAs plus ribavirin oral treatment in a group of CH-C real world patients.

Methods

Nineteen CH-C outpatients, scheduled for IFNα-free treatment, were assessed at enrolment (T0), at 4 (T1) and at 12 (T2) weeks, the end of treatment, by means of MDRS, HAM-D, HAM-A, MRS, Y-BOCS and SF-36. A pharmacological therapy, based on clinical evidence, was provided at psychiatric symptoms onset.

Results

During the treatment, we didn’t report any worsening in the administred psychometric scales. Furthermore, we observed a general improvement at week 12 (T2), statistically significant only for MRS (P < 0.05). Any statistically significant difference was found for SF-36 mean scores comparing T0, T1 and T2. However, SF-36 cluster analysis showed between T0 and T2 a meaningful and significant rise of global health clusters “General health perceptions” (P < 0.05), “Change in overall health status” (P < 0.001) and a significant impairment in cluster “Emotional role functioning” (P < 0.05).

Conclusions

Our real world data are consistent with trial setting results [Younoussi, 2014]. Contrary to previous IFNα-based therapy, new regimens don’t seem to be associated with psychiatric side effects and suggest an immediate gain in general health PROs over the treatment period.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Apathy and impulse control disorders association: A study in a sample of Parkinson's disease patients
Authors: Sáez-Francàs N. , Ramirez N. , Alegre-Martin J. , De Fabregues O. , Alvarez-Sabin J. , Hernandez-Vara J.
Published: May 2016

Introduction

Parkinson's disease (PD) is a neurodegenerative disorder that is associated with a wide range of motor symptoms, cognitive deficits and behavioral disorders. Apathy and impulse control disorders (ICDs) are common in these patients and have been considered opposite ends of a reward and motivation disorders continuum.

Aim

To evaluate the association and impact of ICDs presence on apathy symptoms in PDs patients, considering the influence of other psychopathological symptoms on this association.

Methods

This is a cross-sectional, observational study in which 115 consecutive medicated PD patients without dementia (mean age 61.22 ± 13.5 years; 63.5% men) were recruited. All the patients underwent a psychiatric and neurologic evaluation. Motor dysfunction was assessed with the Unified Parkinson's disease Rating Scale (UPDRS), ICDs were evaluated with the Minnesota Impulse Control Disorders Inventory (MIDI) and apathy with the Lille Apathy Scale (LARS). The Hamilton Depression scale (HAM-D). The State-Trait Anxiety Inventory (STAI-S) and Barrat Impulsivity Scale (BIS) were also administrated.

Results

Twenty-seven (23.5%) patients showed an ICD. Patients with an ICD scored higher in apathy (P = 0.012), trait anxiety (P = 0.003) and impulsivity (P = 0.008). There were no differences in depressive symptoms. In the linear regression analysis, TCI was associated with more severe apathy (b = 4.20, t = 2.15, P = 0.034).

Conclusions

ICDs and apathy are frequent in PD. Although ICDs have been related with a hyperdopaminergic state and apathy with low dopamine levels, the observed frequent association suggests common etiopathological mechanisms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Diabetes: Psychiatric and somatic comorbidity
Authors: Monforte Porto J.Á. , San Román Uría A. , Llanes Álvarez C. , Herguedas Vela P. , Escuer Núñez I.E. , Alcalá Dueñas J.A. , Conde Ledesma M.T.
Published: May 2016

Introduction

Diabetes mellitus (DM) has been associated with major depressive disorder, schizophrenia, Alzheimer's, Parkinson's and mild cognitive impairment. To determine the psychiatric and somatic comorbidity in diabetic patients treated by our Liaison Psychiatry Unit.

Methods

Sociodemographic variables (age, sex, marital status, place of residence) and clinical (somatic disease that motivates the admission, comorbid somatic pathology, number of concomitant somatic diseases, drug consumption and its type, psychiatric history, previous psychiatric diagnosis, number of concomitant psychiatric disorders).

Study Design

Epidemiological study of 172 diabetic patients, from the total of 906 consulted from 1 January 2012 until 31 December 2014.

Bioethical considerations

The study complies with the principles of justice, non-maleficence, autonomy and beneficence.

Results

The average age is 72 years, 50% are women, 49.4% are married, and 54.1% live in rural areas. Somatic diseases that most frequently motivate admission at the hospital are the endocrine-metabolic (14%), gastrointestinal (12%) and cardiovascular (12.2%). A total of 32.5% of the sample have six comorbid somatic diseases and 55.2% five. A percentage of 14.5 of patients recognize consumption of toxic (cigarettes–12.2%–7.6% Alcohol). One hundred and eight patients have a history of psychiatric disorders (62.8%), especially anxiety disorders (28.4%), depression (14.5%) and organic mental disorders (11.1%).

Conclusions

There is a high psychiatric and somatic comorbidity in diabetic patients, therefore it would be desirable early diagnosis and treatment to provide symptomatic control of both types of pathologies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental health of traumatized refugees and asylum seekers: Experiences of a centre of transcultural psychiatry in Hannover, Germany
Authors: Altunoz U. , Castro Nunez S. , Graef Calliess I.T.
Published: May 2016

Introduction

Germany has always been an important host country for traumatized refugees and asylum seekers. Although, recently an increasing number of investigations about mental health of individual migrant groups have been published in Germany, there is a paucity of research concerning mental health of asylum seekers and refugees.

Aims-objectives

To investigate socio-demographic and clinical characteristics of traumatized refugees-asylum seekers who were applied to an outpatient psychiatry clinic in Germany.

Method

A standardized data collection form (socio-demographics, diagnosis, suicidality, etc.) was filled by therapists for each traumatized refugee-asylum seeker who was applied to outpatient clinic of Klinikum Wahrendorff-Centre of Transcultural Psychiatry between April 2013 and October 2015.

Results

Fifty-eight traumatized refugees-asylum seekers (F/M = 27/31, age: 34.7 ± 1.4) were assessed. 53 (91.4%) of them were assessed via interpreters. Thirty (51.7%) of them were staying in refugee-dormitories, 25 (43.1%) of them were living alone. They’ve been living in Germany for 19.9 ± 16 months (min: 1–max: 82). Psychiatric symptoms appeared before 29.9 ± 19 months. Time to reach to psychiatric care in Germany was 14.2 ± 11 months. Psychiatric diagnoses were posttraumatic stress disorder (PTSD): 12 (21%), depression + PTSD: 44 (76%), depression: 2 (3%). Fifty-three (91.4%) of them had suicidal ideation and 16 (27.6%) of them had at least one suicide attempt before.

Conclusions

Traumatized refugees in this study have high rates of suicidal ideation and suicide attempts and it takes months to years for them to reach a psychiatric care. Therefore, strategies should be developed for early detection of PTSD symptoms in traumatized refugees and access barriers to reach a psychiatric care should be overcome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The challenges of post conflict reintegration in Africa
Authors: Okpaku S.
Published: May 2016

Introduction

In the past 50 years, the continent of Africa has witnessed major conflicts ranging from civil wars and liberation wars to chaos from failed States. Increasingly in these political upheavals, kidnapping and abductions of women and young persons have become more prominent.

Aims/objectives/methods

In this paper the consequences of political upheavals will be discussed. For the community there are economic, political and social disruptions. For the individuals there are family disruptions and improvements. For the abducted and kidnapped individuals there are physical, psychological and cognitive impairments, as well as consequences of sexual injuries.

Findings

There is controversy as to prevention, reduction, and management of young victims of war and conflicts. Some workers have suggested that:

–the imposition of peace agreements by foreign powers may not be strictly relevant to the parties engaged in the conflicts;

–culturally appropriate rituals have efficiency in the readjustment of boy soldiers and abducted girls. Nevertheless the guidelines suggested in international disagreements provide a basis for there adjustment of young war conflict victims.

Conclusion

–Traditional healing rituals have a place in the healing and reintegration in person's abduction in post conflict situations.

– Community approaches are superior to individual approaches.

Disclosure of interest

The author has not supplied their declaration of competing interest.
Recent and childhood adversities in patients with depressive disorders
Authors: Abdelhameed M. , Kamal A. , Abdelfadeel N. , Morsy S.
Published: May 2016

Introduction

A strong association is believed to exist between stressful life events and the development of depressive disorders. Childhood adverse experiences contribute to person's vulnerability to such disorders.

Objective

The study of the complex interplay between child abuse, stressful life events and the development of depression.

Aims

To study the effect of type and severity of child abuse and magnitude of pre-onset stress on the severity and duration of adulthood depression.

Methods

Seventy-five patients with depressive disorders not having a comorbid mental illness were studied using Social Readjustment Rating scale (SRRS) and Childhood Trauma Questionnaire (CTQ).

Results

The mean age of the patients was 34.96 ± 12.32 years, 69.3% of patients were females, duration of the illness ranged from 2–288 weeks with a mean of 30.94 ± 54.61 and 36% of the sample had severe depression. There was a statistically significant relationship between urban residence and magnitude of stress (P = 0.049), married patients suffered less severe depression than unmarried ones (P = 0.02) and a positive and significant correlation was found between magnitude of stress and severity of depression (P ≤ 0.001).

Duration of depressive illness was positively and significantly correlated to the raw score of SRRS and to the severity of emotional neglect as measured by CTQ (P = 0.02 and 0.04 respectively).

Conclusions

The development of depression in adulthood is significantly associated with past exposure to child abuse and stressful life events. Childhood history of emotional neglect and magnitude of pre-onset stress may be contributing factors to duration of depressive illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Agomelatine vs fluoxetine: Efficacy and improvement of cognitive functions in patients with MDD
Authors: Aydın E. , Güleç M. , Oral E. , Daloğlu A.G.
Published: May 2016

Introduction

In major depressive disorder (MDD) neurocognitive functions are impaired. In addition to melatonergic properties of agomelatine, via 5-HT2C antagonism it increases extracellular noradrenaline and dopamine in frontal cortex and may improve the neurocognitive functions of patients with MDD.

Aims and objectives

To investigate the extent of neurocognitive improvement and efficacy of agomelatine and fluoxetine in patients with MDD.

Material and method

Agomelatine 25 mg/day (n: 24) and fluoxetine 20 mg/day (n: 24) were administered to drug-naive unipolar, non-psychotic, non-suicidal MDD patients according to DSM-IV. Evaluations were performed just before the treatment and at the sixth week of treatment via administering Hamilton Depression Rating Scale, Rey Auditory Verbal Learning Test, Controlled Oral Word Association Test (COWAT), Digit Span Test (DST), Trail Making Test (TMT-A/B), Stroop Test and Wisconsin Card Sorting Test.

Results

Both agomelatine and fluoxetine was found to be efficacious for the treatment of MDD (P < 0.05 for both). Further there was no difference between the antidepressant efficacy of two drugs. Both of the drugs improved measured neurocognitive functions (P < 0.05), except scores of DST (P > 0.05) and only fluoxetine improved significantly scores of COWAT (P < 0.05). Only in terms of TMT-B there was significant difference between groups and agomelatine was superior to fluoxetine (P < 0.05).

Conclusion

Agomelatine and fluoxetine were efficacious in treatment of MDD. Furthermore both of the drugs improved cognitive functions in patients with MDD. Superiority of agomelatine in improvement of executive functioning (TMT-B) is important and therefore it could be an appropriate choice for MDD patients who have pronounced executive disturbances.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The presence of chronic pain in patients with major depressive disorder and its inter-correlation
Authors: Batinic B. , Nesvanulica J. , Stankovic I.
Published: May 2016

Introduction

Chronic pain is a common experienced symptom among patients diagnosed with major depressive disorder (MDD). The intensity of depression and chronic pain inter-correlated, having negative impact on the daily functioning of the patients.

Objectives

Our aim was to explore the presence of chronic pain in patients diagnosed with MDD (single episode or recurrent), correlation between intensity of depression and chronic pain, its interference on daily functioning, as well as sex differences regarding the explored variables.

Methods

The study sample consisted of 51 (62.2%) female and 31 (37.8%) male patients diagnosed with MDD (n = 82), aged between 18 and 65 years old (mean age of 46.21). Assessment instruments included The Beck Depression Inventory-II (BDI-II), The Brief Pain Inventory-Short Form (BPI) (consisting of BPI-I factor of pain intensity, and BPI-II-factor of pain interference with daily functioning), and semistructured questionnaire for sociodemographic characteristics.

Results

The presence of chronic pain was found in the 51 (62, 2%) of patients with MDD. The mean score on the BDI-II for the whole sample was 22.5 (SD 12.8). There was a positive correlation between intensity of depression (BDI-II) and intensity of chronic pain (BPI-1), and its interference on the level of daily functioning (BPI-2) (P < 0.01). Women diagnosed with MDD experienced chronic pain of higher intensity and with greater interference on daily functioning.

Conclusion

Our research data show a high frequency of chronic pain among patients diagnosed with MDD and its positive inter-correlation which results in negative impact on daily functioning, especially in females.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Does the supplementation of vitamin D affect depressive symptoms?
Authors: Kolarov P. , Stoimenova M.
Published: May 2016

Introduction

Depression has been linked to decreased levels of vitamin D in adults and the altered dietary intake of calcium and vitamin D has been reported to have implications for the development of depressive symptoms. Although, the relation between vitamin D and depression has been established, it is not yet clear whether the supplementation of vitamin D could affect the clinical manifestation of depression. Therefore, the aim of this study was to determine whether the supplementation of vitamin D could affect the development/course of depression.

Material and methods

A systematic literature search was performed for randomized control trials (RCTs) in which vitamin D was supplemented and depression was measured.

Results and discussion

Six studies were identified as being eligible to be included in this review. The results regarding the supplementation of vitamin D and its effect on the course and manifestation of depression were conflicting. One study concluded that the supplementation of vitamin D3 had beneficial effect in depression and another study reported no improvement in the indices of mental well-being in the vitamin D supplemented group and rejected the hypothesis that an annual high dose of vitamin D3 could prevent depressive symptoms. The remainder four studies reported inconclusive results regarding vitamin D supplementation and the course of depression.

Conclusion

As current literature displayed contradictory results and no sound conclusion could be drawn regarding the supplementation of vitamin D and its effect on depression, there is a need of RCTs to determine whether the supplementation of vitamin D levels could affect depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Metabolic dysregulation as predictor for the course of late-life depression
Authors: Marijnissen R. , Vogelzangs N. , Mulder M. , van den Brink R. , Comijs H. , Oude Voshaar R.
Published: May 2016

Introduction

Depression is associated with the metabolic syndrome (MS). Recently, the concept of ‘metabolic depression’ has been proposed based on a protracted course of depressive symptoms over time.

Objective and aims

Within the Netherlands study of depression in older persons, we examined whether metabolic dysregulation predicted the two-year course of depression.

Methods

A cohort study (n = 285) of depressed persons (≥60 years) with two-year follow up. Depression was classified according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Severity of depression was assessed with sum score as well as subscale scores of the Inventory of Depressive Symptomatology (IDS) at six-month intervals. The metabolic syndrome was defined according the National Cholesterol Education Program (NCEP-ATP III). We applied logistic regression and linear mixed models adjusted for a wide range of confounders and severity of depression at baseline.

Results

The number of MS-components predicted non-remission at two-years (OR = 1.28 [95% CI: 1.00–1.58], P = 0.047), which was driven by waist-circumference, HDL-cholesterol and triglycerides. MS was only associated with the somatic symptom subscale score of the IDS over time, but not with its sum score (interaction time × somatic subscale, P = 0.002). This effect was driven by waist circumference, elevated fasting glucose level and hypertension.

Conclusion

Metabolic dysregulation predicts the course of late-life depression. This effect seems to be driven by visceral obesity (as indicated by the waist circumference) and lipid dysregulations and with respect to the somatic symptoms of depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Interictal depressive disorders in epilepsy patients
Authors: Matos Pires A. , Martins Y. , Suarez Gomez M.
Published: May 2016

Introduction

Depression is recognized as more frequent psychiatric disorder in epilepsy patients with significant impact on their health-related quality of life.

Aims

To analyze the occurrence and clinical particularities of different types of interictal depression in epilepsy patients.

Methods

One hundred and fourteen epilepsy patients with interictal depression were assessed with a clinical interview and Hamilton depression and anxiety rating scales. Diagnostic criteria of ICD-10 and of the International League Against Epilepsy (ILAE) were used.

Results

A total of 45.6% of patients met ILAE criteria of inerictal dysforic disorder (IDD) with predominance of depressive mood, irritability, fear and atypical pain. All patients had chronic epilepsy with specific epileptic personality changes. Comorbid adjustment disorders (depressive and anxious-depressive reactions) were diagnosed in 27.2% of patients. The most frequent trigger situations were: family problems, serious illness, unemployment, financial difficulties. In more than half of patients were registered specific personality changes whose severity was in inverse ratio with trauma severity. A total of 18.4% of patients met criteria of comorbid affective disorder (depressive and bipolar) with some specific clinical traits due to personality changes. In 8.8% of patients, anticonvulsant-induced depression was observed; it was clinically simple, resolved after offending medication withdrawal.

Conclusions

Observed depressive disorders were heterogeneous: comorbid or attributed to epilepsy or its treatment. The most frequent condition was IDD. Specific personality changes may contribute to higher susceptibility and development of psychogenic depression. We emphasize the importance of treatment history (possibility of anticonvulsant-induced depression).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Toward evidence-based medical statistics: Re-evaluate the efficacy of antidepressants by using Bayes factors
Authors: Monden R. , Stijn D.V. , Klaas W. , Annelieke R. , Richard M. , Eric-Jan W.
Published: May 2016

Introduction

Studies have been reported the similar efficacy of antidepressants (effect size around 0.3), and it is difficult for clinicians to select an antidepressant. This may partly due to the use of a p<.05 null-hypothesis significance testing (NHST) framework to evaluate “substantial evidence”. This framework only allows dichotomous conclusions and does not quantify the strength of evidence supporting efficacy. In addition, meta-analyses based on publications may offer positively biased results due to selective publications.

Objectives

Demonstrate that the Bayesian framework can provide valuable information on the strength of the evidence for drug efficacy.

Aims

Re-evaluate the efficacy of FDA-approved antidepressants applied to anxiety disorders and depression by means of Bayes factors.

Methods

To avoid selective publication, data of double-blind placebo-controlled trials for FDA-approved antidepressants for the treatment of anxiety disorders and depression were extracted from the FDA. Bayes factors (BFs) were calculated and compared with the results obtained under NHST framework.

Results

A large variance of evidence for the efficacy of antidepressants was found for both depression and anxiety disorders. Among trials providing “substantial evidence” according to the FDA for anxiety disorders, only 27 out of 59 dose groups obtained strong support for efficacy according to the typically used cut-off of BF≥20. For depression, all FDA-approved antidepressants had BF≥20, except for bupriopion. Moreover, it was shown that the tested antidepressants can be differentiated based on the strength of evidence and effect size.

Conclusions

The BFs quantified the comparative evidence base for the efficacy of antidepressants.

Disclosure of interest

The authors have not supplied their declaration of competing interest.