bluuebunny/crossref_metadata_2025 huggingface dataset:
Can Reducing Psychological Distress Slow Down the Rate of Telomere Attrition?
Authors: Epel E. , Verhoeven J.
Published: June 2017

Specific types of cognitions and mental processes may lead to greater stress arousal and may subsequently impact cell longevity. The study of telomeres and telomere-related molecular systems may provide a pathway for exploring the link between psychological domains and cell physiology. Based on findings emerging from clinical and preclinical data, we hypothesize that the telomere-telomerase system contributes to explain certain biological underpinnings of psychological interventions.

In this symposium we’ll present the preliminary evidence on the complex translational relationships between specific psychological domains (i.e. childhood adversities, stressful life events, mindfulness-based interventions and perceived distress), the telomere-telomerase system and clinical outcomes. Further, we’ll discuss preliminary data on the effect of mindfulness- and meditation-based interventions on cellular ageing and disease-associated molecular phenotypes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cardiac Issues Raised by an Examination of the Antipsychotic Prescribing Practices in the Elderly of St. James's Hospital (SJH), Dublin
Authors: McCarthy B. , Power C. , Lawlor B. , Greene E.
Published: June 2017

Background

Antipsychotic medication use may be associated with prolongation of the QTc interval, increasing the risk of potentially fatal arrhythmias [1]. This is particularly pertinent in the elderly due to comorbid cardiovascular disease and polypharmacy. Attention to the ECG and co-prescribed medications is essential to minimise cardiac risk when prescribing antipsychotics.

Methods

On 23rd February 2016 all inpatients aged over 65 who were prescribed antipsychotic medications were identified as part of a hospital-wide survey. Data was collected from medical and electronic patient notes and medication kardexes.

Results

Complete data was obtained for 36 patients aged over 65 who were newly-prescribed an antipsychotic or had their antipsychotic changed. Of these, 39%(n = 13) had a cardiac history. One quarter did not have an ECG in the 12 months preceding antipsychotic initiation. Of the 28 patients with an ECG, 57% (n = 16) had a QTc > 450ms before starting antipsychotic treatment. Only 11% (n = 4) had an ECG within 24 hours of starting the antipsychotic. The average change of the QTc interval in those with a repeat ECG was 30msecs. 42% (n = 15) were co-prescribed another QTc-prolonging medication.

Conclusion

Current monitoring of QTc interval in an elderly population newly prescribed antipsychotic medications is inadequate and a cause for significant safety concerns. Education and clear guidance is warranted to improve safety and minimise risk in this population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Characteristics of Elder Mistreatment's Perpetrators in Tunisian Community-dwelling Elders
Authors: Saguem B. , Bouhlel S. , Ali B. Ben Hadj
Published: June 2017

Introduction

While research is illuminating characteristics of elderly that are associated with mistreatment, far less research has investigated characteristics of the perpetrator that are involved in elder mistreatment cases.

Aim

To address the characteristics of elder mistreatment's perpetrators in a population of community-dwelling elders.

Methods

A cross-sectional study was conducted, including 80 subjects aged 65 years and older, with sufficient cognitive ability to complete the interview. Elderly were asked about several characteristics of mistreatment's perpetrators. Indicators of Abuse Screen (IOA) was used to evaluate abuse.

Results

Findings show that 13.8% of the participants suffered from elder mistreatment, with a mean IOA's score of 8.35. According to subtypes, 10% reported psychological, 2.5% physical and 1.3% financial abuse. Abuse was recurrent and the victim's reactions were passive in all cases.

Perpetrators were family members in all cases, with being a partner in 63.6%, a child in 18.2%, a sibling in 9.1% and a stepdaughter in 9.1% of cases. They were men in 72.7% of cases and their mean-age was 64.09 years. Financial difficulties and psychological problems were reported in 54.5% and 36.4% of perpetrators, respectively. Perpetrators were most likely living with the victims (P = 0.009). Partners were the perpetrators of half of the psychological abuse, and the totality of the physical and financial abuse. Abusive marital relationships were significantly associated with the perpetrator (P = 0.04).

Conclusion

Our findings suggest that the cause of elder abuse is rarely unique, and that this phenomenon is consequent to many pre-existing underlying problems affecting both elderly and perpetrators.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Can Positive Community Practice Models Help Prevent Abuse?
Authors: Hall I. , O’Kane N.
Published: June 2017

All different types of abuse can happen to people with intellectual disabilities living in community setting. This can include physical abuse, including the use of restrictive practices, financial abuse by strangers but also by family and carers. They can also be victim to sexual abuse. Neglect is a relatively common concern, which is perhaps more likely in the community compared to institutional settings.

In this presentation we will discuss the fundamental balancing act between paternalism an autonomy that is so often an issue when supporting people with intellectual disabilities in the community, and how to decide where to draw the line in individual cases. We will consider a range of examples to illustrate this, including unlawful deprivation of liberty, people choosing life partners that others regard as unsuitable, why families might restrict access to services, and whether giving people more control over their care through direct payments and individual budgets can lead to financial exploitation.

Finally we will discuss potential solutions to preventing abuse including robust Safeguarding procedures, integrated working between health and social services, a program of Positive Behavioral Support, maximizing communication, promoting access to health and the recognition of mental health problems, how to disseminate training, and the importance of advocacy and regular review.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Study of empathy in Romanian general nursing students
Authors: Romosan F. , Romosan R.S. , Romosan A.M.
Published: June 2017

Introduction

Empathy is of most importance in the medical field. The ability to comprehend and connect with the emotional state of another person is essential for establishing a successful interaction between patients and health care professionals.

Objectives

The aim of this study was to assess empathic response in general nursing (GN) students.

Methods

The study was conducted between 2015–2016 on 75, sixth-year Romanian GN undergraduates from the Timisoara “Victor Babes” university of medicine and pharmacy. To evaluate the level of empathy, we used the empathy quotient (EQ), a 60-item self-report inventory with 40 questions empathy-related and 20 filler questions.

Results

We included in this study 12 (16%) males and 63 (84%) females, with a mean age of 23.48 years (SD = 2.17). Female GN students had significantly higher EQ mean scores than the general female population. Compared to female students, males obtained significantly lower EQ mean scores. There were no significant differences between male and female students regarding age distribution.

Conclusions

Female GN students showed greater empathy than their male colleagues, as well as than the general female population. These results support the theory on women's understanding of others mental states, vital to the provision of a worthy nursing care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Selfie as a Method of Perception of the Virtual Environment
Authors: Sulaimanova M. , Sulaimanov R.
Published: June 2017

Nowadays selfie is one of the significant communication methods in the conditions of the developing internet space.

Goal

The study of psychological mechanisms motivating perception of internet space via selfie.

Objectives

The identification of:

– The personal-social necessity in selfie, as a method of the virtual world perception;

– The factors of personal-social necessity of the virtual communication via selfie;

– The personal features, which contribute to self-presentation in virtual space via selfie.

Research methods

One hundred and thirty-four respondents aging between16–28 (1stgroup: 68 respondents fond of selfie(50.8%), 2ndgroup: 66 respondents not fond of selfie(49.2%)) were studied using standardized scales of anxiety (Spilberger-Hanin), depression (Zung), ego-defense mechanisms(EGMs)(Plutchik-Kellerman-Konte), and life quality(WHO, 1991).

Results

Desire of high evaluation dominates in 47.8% of respondents(r = 0.3; P < 0.01). Fifty point seven percent of the 1stgroup and13.4% in 2ndgroup have heightened anxiety (r = 0.3; P < 0.01). Forty-three point two percent in1stgroup and 23.9% in 2ndgroup don’t have depression.

Subdepressive level dominates in 19,4% of 2ndgroup(r = 0.36; P < 0.01), against 11.9% of 1stgroup.

In 1stgroup dominate: denial (17.9%), projection (16.4%), regression (7.5%); in 2ndgroup: denial(17.9%), intellectualization(13.4%), projection(7.5%)(P < 0.05). Forty-four point eight percent in 1stgroup and 40.3% in 2ndgroup have a high level of EGM stress (P < 0.05). Forty-six point eight percent in 1stgroup have high level of subjective life quality, 0% had low one; in 2ndgroup: 26.9% have high level, 13.4% low one.

Conclusions

Personal-social necessity of virtual space perception via selfie reflects the severity of narcissistic tendencies. Selfie in conditions of illusory reality increases the subjective level of life quality. Isolation of narcissistic personality from communication through selfie suggests subjective decrease of life quality. Effects of the selfie should be considered in the development of rational methods of use of internet-technologies and in the psycho-correction of people with low life quality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental Illness is an Inevitable Consequence of the Singular Diversity of Human Beings
Authors: Schwartz M. , Moskalewicz M. , Schwartz E.
Published: June 2017

Nowadays, we increasing value the broad physical, ethnic, racial, and cultural diversity of human beings. “How wonderful that humans come in all sorts of sizes, shapes, colors, ethnic groups and cultures.” So long as we conduct our behaviour within sanctioned norms. This presentation will focus upon the above paradox: In stark contrast to our delight in the physical, ethnic and cultural expressions of human diversity, there is, at the same time, a perhaps increasingly narrow tolerance for a variety of behavioural and experiential human differences. In such human realms, present-day cosmopolitan societies increasingly call for behavioural and experiential conformity rather than diversity. And if we cannot conform? We propose that the phenomenon of mental illness arises as a consequence of the phenomenon of human diversity coming up against constraints and limitations in expressed and experienced mental and behavioural realms. This presentation will focus upon the primary role that human diversity plays in mental illness. We will discuss adaptive strengths associated with the extraordinary diversity of humans (and our pets and domestic animals) as well as vulnerabilities accompanying this diversity. For example, diversity associated with skin pigmentation has enabled humans to extend across the globe. A consequence, however, is an enhanced vulnerability to skin cancer for some with fair skin and to Vitamin D deficiency for others with dark skin. Psychological diversities can be viewed in an analogous, pervasively more problematic manner. And furthermore, unlike physical diversities, often increasingly celebrated, mental and psychological diversity are – with notable exceptions, increasingly problematic.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Internet Addiction and the Virtual Self-image
Authors: Leménager T. , Dieter J. , Hill H. , Mann K. , Kiefer F.
Published: June 2017

Background

Internet gaming disorder appears to be associated with self-concept deficits and increased identification with one's avatar. For increased social network use, the few existing studies suggest striatal-related positive social feedback as an underlying factor. Furthermore, few study findings indicate that internet addicts generally have problems in emotional inhibitory control processing.

Methods

Pathological and addicted internet gamers as well as social network users were compared with healthy controls regarding psychometric and neurobiological measures of self-concept-related characteristics, avatar identification and emotional inhibitory control processing.

Results and conclusion

Psychometric results indicated that both subgroups showed higher self-concept deficits compared to healthy controls. Neurobiologically, different brain activation patterns were observed in the subgroups during self-knowledge retrieval and inhibition of emotional stimuli. Furthermore, addicted internet gamers showed a higher identification with the own avatar, mirrored in an increased left angular gyrus activation, a region functionally associated with identification processing and feelings of empathy.

These findings provide a starting point for the deduction of specific psychotherapeutic treatment approaches for addicted internet gamers and social network users.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Insomnia and aggressiveness in affective disorders: Self-assessment versus clinical examination
Authors: Nascimento M. , Lázaro M. , Reis J. , Pereira G. , Bacelar F. , Nobre A.
Published: June 2017

Introduction

Although, disturbances of sleep, as well as aggressiveness, have been described in patients with mood disorders, these patients may not be aware of them.

Objectives/aims

To access the personal perception of sleep, disturbances and aggressiveness in patients with mood disorders, admitted to an acute psychiatric ward.

Methods

Diagnostic data (ICD-10: F31–33), including mood evaluation, were prospectively collected for all patients admitted at the affective disorder ward at Centro Hospitalar Psiquiátrico de Lisboa (Portugal), during the third trimester of 2016. Then, 2 auto-questionnaires – Athens insomnia scale (AIS) and Buss and Perry aggression scale (both validated to the Portuguese population) – were applied to these patients. Statistical analysis was performed for possible correlations between patients’ mood and the questionnaires’ scores, using R software.

Results

Thirty-eight patients admitted were enrolled in this study: 28 with bipolar disorder (19 manic, 4 depressive and 5 mixed episodes), and 10 with depressive disorder. Depressed patients presented statistically higher values in the AIS (average = 20), compared to manic (14) and mixed ones (17.2) (P = 0.031). However, there were no statistical differences found between depressed patients (bipolar versus non-bipolar). Even though manic patients presented an increased average score in the Buss and Perry questionnaire (both total–65; but also sub-scores), these values were not significantly different than depressed (60) or mixed patients’ scores (57.4).

Conclusions

Even though some symptoms (like sleep or aggressiveness) seem to be relevant to the clinics, patients with affective disorders do not seem to be aware these disturbances, and therefore are not able to acknowledge their relevance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Use of eye-tracker device to detect attention deficits in adults with ADHD
Authors: Adamis D. , Unal M. , O’Mahony E.
Published: June 2017

Introduction

Adult patients with ADHD may go unrecognized. This can result in psychosocial and functional decline.

Objectives

To investigate the use of objective testing, with an eye-tracker device in the diagnosis of adult patients with ADHD.

Methods

Case control study. Inclusion criteria were aged 18–65, minimum 5 years of education and literate in English. Exclusion criteria were visual impairment, amnesia and learning difficulties. ADHD was diagnosed with Conners’ adult ADHD diagnostic interview (group A, n = 15) and were matched for gender and age against normal controls (group B, n = 33). Participants completed four computer-based tasks while their eye movements were recorded. The tests included (i) Stroop effect test, (ii) Stroop effect test with visual aid, (iii) perceptual selectivity test and (iv) Saccadic interference. accuracy (%) and response time (msec) for tests (i–iii) measured while for test (iv), saccade count, average saccade amplitude and average fixation duration.

Results

Stroop test accuracy showed a statistically significant difference between group A and group B (P = 0.004). Stroop response time also showed a statistically significant difference between the two groups (t = 3.228, df: 46, P = 0.001). For test (ii), there was a significant difference for response time (t = 2.326, df: 46, P = 0.024) but not for accuracy. For test (iii), the results were statistically significant for accuracy; (t = 2.682, df: 46, P = 0.010) and for response time (t = 4.028, df: 46, P = 0.001). There were no significant differences in the saccadic interference test.

Conclusion

Adults with ADHD have a longer response time and perform less accurately than controls. Thus, these data demonstrate that there is a use for objective tests (tests i–iii) in the diagnosis of adult ADHD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Smooth pursuit eye movements in psychiatric inpatients
Authors: Mandolesi L. , Piraccini G. , Ambrosini F. , Vetere F.L. , Sant’Angelo R.P. , Raggini R. , Benassi M.
Published: June 2017

Introduction

Eye movements are used in several studies as a biomarker in order to evaluate cortical alterations in psychiatric disorders. Pursuit eye movements’ deficits were found both in schizophrenia and in affective disorder patients. Nevertheless, these findings are still controversial.

Objectives

Set up a system to record and evaluate the eye movements in psychiatric patients.

Aims

To verify the applicability of a smooth pursuit task in a sample of psychiatric inpatients and to prove its efficiency in discriminating patient and control group performance.

Methods

A sample of psychiatric inpatients was tested at psychiatric service of diagnosis and care of AUSL Romagna-Cesena. Eye movement measures were collected at a sampling rate of 60 Hz using the eye tribe tracker, a bar plugged into a PC, placed below the screen and containing both webcam and infrared illumination. Subjects underwent to a smooth pursuit eye movement task. They had to visually follow a white dot target moving horizontally on a black background with a sinusoidal velocity. At the end of the task, a chart of the eye movements done is shown on the screen. Data are off-line analyzed to calculate several eye movement parameters: gain, eye movement delay with respect to the movement of the target, maximum speed and number of saccades exhibited during pursuit.

Results

Patients compared to controls showed higher delay and lower gain values.

Conclusions

Findings confirm the adequacy of this method in order to detect eye movement differences between psychiatric patients and controls in a smooth pursuit task.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Epigenetic Signatures of Early Life Adversities in Animal Models: A Role for Psychopathology Vulnerability
Authors: Riva M.A.
Published: June 2017

Stressful experiences early in life (ELS) represent one of the most relevant factors for the vulnerability to psychopathologies. Epigenetic changes, such as DNA methylation, have emerged as a major mechanism through which ELS can alter adult behaviour leading to persistent changes of gene regulation.

We performed DNA methylation analyses in the hippocampus and prefrontal cortex of adult rats exposed to stress during gestation (PNS), a model that is associated with persistent behavioral alterations relevant for psychiatric disorders.

Using an epigenome-wide analysis, an overlap of 893 differentially methylated genes was observed between hippocampus and prefrontal cortex of adult male and female rats exposed to PNS. The list includes several genes previously associated with schizophrenia and other psychiatric conditions, such as calcium and potassium voltage operated channels as well as GABA and glutamate receptor subunits. By restricting the overlap to genes that were modulated in the same direction, we identified miR-30a as being less methylated in PNS rats. Interestingly one of the targets for this miRNA is the neurotrophin BDNF, whose expression was indeed reduced as a consequence of the prenatal manipulation. Interestingly chronic treatment of PNS rats with the multi-receptor modulator lurasidone during adolescence was able to prevent the changes in miR30a and BDNF expression.

These results highlight the importance for the identification of methylation signatures through which stress exposure early in life could engrave on the outcome of the adult phenotype, and may allow the identification of novel genes and pathways that are affected as a consequence of ELS.

Disclosure of interest

M.A.R. has received compensation as speaker/consultant from Lundbeck, Otzuka, Sumitomo Dainippon Pharma and Sunovion. He has received research grants from Lundbeck, Sumitomo Dainippon Pharma and Sunovion.
Cultural Reflections in Practicing Exposure Therapy for Social Anxiety
Authors: Aly R.
Published: June 2017

Evidence-based practice of exposure therapy has long been adopted as an effective therapy for treating anxiety disorders including social anxiety. In many situations, it is the chosen therapy for such a debilitating disease. Due to its proven efficacy and readiness applicability, it has proven to be the 1st choice of therapy for social anxiety across different life spans from adolescents to geriatrics. Yet, cross-cultural differences have seldom been considered in the approach towards managing social anxiety. Many differences lie between populations and countries in defining what is accepted and what is not with regard to social interactions. Even across the one country, many differences may color the perception of appropriate social communication. Hence, no one-size-fits all can be adopted here. Some interactions are accepted and encouraged while others are basically banned. Thus, during the application of exposure therapy, therapists should modify the conceptual framework while still trying to abide with the fundamental notion of therapy of exposure experiments. In doing this, many therapists may be challenged in their work. While still lacking a strong body of research, clinical experience can provide us with some helpful innovations for successful practice. Our aim is to provide therapists and psychiatrists across the Arab world with tools for applying successful therapy for social anxiety. A series of case studies are discussed to present some innovations in applying Cognitive Behavior Therapy for patients suffering from social inhibitions. Moreover, essentials of past research are reviewed and needs for further research directions in the field are discussed.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Doctor-Patient Relationship: The impact of Mindfulness on Empathy
Authors: Darbeda S. , Etchevers M.
Published: June 2017

Introduction..

The doctor-patient relationship has an increasingly important place in medical studies. Empathy is one of the quality criteria of the relationship. The development of mindfulness in medical schools is booming.

Objectives

To investigate the relation between empathy and mindfulness among residents and doctors.

Methods.

Doctors and residents were asked to complete a demographic questionnaire – questions on their personal development practices – and two scales. The Mindful Awareness Warning Scale (MAAS) is a unidimensional scale measuring attention and mindfulness and Jefferson Physician Empathy Scale (JSPE) is a scale measuring the clinical empathy across 3 dimensions: “perspective taking”, “compassionate care” and “in the patient's shoes”. Multivariate linear regressions were performed to analyse the correlation between each score of JSPE and explanatory variables.

Results.

One hundred ninety-three questionnaires were analyzed: 87% were general practitioners, the average age was 34 years old (SD 11) and 69% were women. Regarding personal development practices, 18% practised mindfulness meditation regularly or occasionally (23% for yoga and 31% for relaxation). No correlation between the scores of JSPE and the MAAS score was found. However, doctors who practiced mindfulness had a highest score of “compassionate care” (95% CI [1.26; 4.91], P = 0.0012).

Conclusions.

The mindfulness would be an effective tool for the development of the welfare of the doctors, and improving the quality of empathy and therapeutic efficacy. To support these data, it would be interesting to conduct an interventional study by offering French doctors and interns the possibility of following courses of mindfulness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Outcome of A Counseling Intervention. The Experience of the Counseling Service UPO
Authors: Gambaro E. , Rossi A. , Gattoni E. , Gramaglia C. , Ponzetti D. , Zeppegno P.
Published: June 2017

Background.

Counseling addresses the emotional social, work, school and physical health concerns that people may have at different stages in their lives. It focuses on typical life stresses and more severe issues. It may be addressed to individuals, groups, organisations.

Aim and methods.

The objective of our study was to assess the outcome of a counseling intervention offered to students of the University of Piemonte Orientale, aged between 18 and 20 years. Baseline features and reasons for consultation will be described and the outcome will be assessed with CGI (Clinical Global Impression) and HONOS (Health of the Nation Outcome Scales) at T0 (time 0), T1 (4 weeks) and T2 (8 months). We will present the data of the period between 1st January 2014 to 31st December 2016.

Results/discussion.

Data analysis is ongoing. The results will be discussed in the light of the current literature about counseling services for university student.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Specifics of Psychotherapy of Nuns
Authors: Pastuszak-Draxler A. , Jawor M. , Bętkowska-Korpała B. , Gierowski J.K.
Published: June 2017

Introduction

Nuns undertaking psychotherapeutic treatment are a particular group of patients. As human beings, they experience similar emotions, everyday worries, crises and difficulties as everyone else during social interaction, but at the same time they fill a special role in society. Presented behaviours, reactions to stressful situations, unaccepted emotional states that appear to be maladaptive, are often intensified by the rules of monastery life.

Objectives

The aim of this investigation was to uncover the most significant issues in terms of the specificity of therapeutic work with nuns.

Methods

The subjects were 12 patients (nuns) with the diagnosis of depressive-anxiety disorder (F41.2 according to ICD-10 criteria). Over the course of the last 10 years (since 2005) we observed the therapy processes of 12 nuns. The psychotherapy group consists of 12 patients at our ward. Every time there was only one nun in the group.

Results

This study gives an overview of issues and problems reported by the nuns: their sex significantly determines their position in the community of consecrated sociality, their obligations to perform specific work, the rules to follow as well as the resulting consequences for the functioning of mental health.

Conclusions

In the process of psychotherapy is important and necessary to distinguish between theological and psychological aspects, between what is secular and what is spiritual. The psychotherapy group's as well as the therapist's perception of a nun is of special importance as it is sometimes difficult to distinguish between her social role and her needs, desires, difficulties and conflicts as a human being.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Prospective Intervention in Patients with Complicated Grief
Authors: Pinheiro M. , Carvalho N. , Mendes D. , Rocha J.
Published: June 2017

Introduction

Most reactions to grief are adaptive. However, there is the possibility that some individuals present a complicated grief disorder, where there is a pathological intensification of symptoms lasting more than 6 months, deserving special treatment.

Objectives/aims

Evaluate the effectiveness of two types of intervention in complicated grief: group intervention (GI) and cognitive-narrative (CN) therapy.

Methods

Patients in a complicated grief process were selected (n = 70), and distributed in three groups: cognitive–narrative therapy group (CNTG), group intervention group (GIG) and a control group (CG). Inclusion criteria: adults, with a reference to mourning situation, with personal meaning, for over six months and results in ICG ≥30points (cutoff). The Inventory of Complicated Grief (ICG), the Center for epidemiologic studies depression scale (CES-D) and the trauma questionnaire (ICD-11) were used. Follow-up was performed 3 months after the end of each intervention. Data analysis was performed using the statistical package from social sciences (SPSS 20).

Results

With respect to complicated grief symptoms (CGx) and depression symptoms (Dx) there were statistically significant differences between the CNTG and the CG, but not with the GIG. There was no statistically significant effect in post-traumatic symptoms (PTx), even though both interventions had a slight decrease. When the CNTG and the GIG were directly compared, there was only a statistically significant difference between PTx.

Conclusions

In our single center cohort, CNTG was a more effective intervention in complicated grief patients for CGx and Dx reduction. For PTx, no intervention was superior. Larger multi-center studies are needed to validate these results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Quality of Life at work and Motivation for Research Activities for Residents of General Practice in two Different Surgical Departments in Greece
Authors: Christodoulou I. , Apostolou K. , Kazantzi G. , Xenodoxidou E. , Pogonidis C. , Babalis D.
Published: June 2017

Introduction

Quality of life at work has very much to do with educational efforts during medical residence years. Constant changes of work environment for general practice residents, is a strong reason for high levels of stress at work.

Objectives

Our study is to present the general rules of work for general practice residents in surgical departments in Greece and the quality of their lives and career motivation.

Methods

We use information coming from two hospitals, a large city hospital which covers a population of 780.000 of citizens during all-night duties, and a provincial hospital, which covers a population of 50.000 citizens.

Results

In both workplaces, general practice residents spend much of their education time in the emergencies department or the outpatient clinics of surgery. Stress is more intense in the large hospital, based on the number of patients examined per day and the frustration they receive at work. However, the heavy duty to accompany a patient for a transfer to other hospital is much more often in province, and then the stress is much more intense and lasting. Frustration is also often in the urban hospital where the residents of various specialties are more experienced and have more confidence due to their departments expertise. Satisfaction at work varies according to the personality of every doctor.

Conclusions

Opportunities for scientific development through participation in scientific meetings was stronger in the provincial Hospital due to a good team of strongly motivated researchers that happened to be there and better work environment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Ecopsychotherapy of Mental Health Problems Children and Adolescents
Authors: Mykhaylov B. , Vodka M. , Alieva T. , Vashkite I.
Published: June 2017

Ukraine is the problem of children's mental health. Contemporary one of the most urgent health problems in Ukraine. In recent years a number of studies confirms the trend of mental pathology of growth with an increase in the number of clinical forms of psychotic register, including behavioral disorders in children. In turn, this is due to the increasing number of emergency situations (antiterrorist operations on the territory of Ukraine) for the last time. Ukraine now is an urgent need to establish a system of psychosocial rehabilitation of children with impaired mental development. International Charity Fund “Alexander Feldman Fund” in the Ecopark established the center for psychosocial rehabilitation of children and adolescents with psychological, emotional and behavioral disorders. The center created the conditions for the restoration of a bio-psycho-social harmony of the child in the conditions of modern urban-deformed medium. The aim of the center is to restore the level of social functioning and quality of life of children with ADHD, children with autism, cerebral palsy, Down syndrome and other neuropsychiatric disorders. The Center based on ecotherapy, also used animal therapy, garden therapy, play therapy, art therapy (studio for painting, sculpting). Individual and group work included various elements of cognitive-behavioral, rational, analytical child, relaxation, and other methods of psychotherapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Fine Line Between Schizophrenia and Hashimoto Encephalopathy
Authors: Amado I.
Published: June 2017

Introduction

Hashimoto encephalopathy (HE) is an uncommon syndrome associated with Hashimoto thyroiditis. The relationship between these entities is unclear. Even being rare, it appears to be underrecognized.

Objectives

Report a case of an atypical presentation of psychosis in a patient with elevated serum levels of antithyroid antibodies and review the literature about similar situations.

Methods

Access clinical process, research PubMed, using the mesh terms “Hashimoto encephalopathy” and “psychosis”.

Results

A 21-year-old Portuguese female was conducted by authorities to our emergency department after she called for help and was spotted walking barefoot on the streets. Throughout clinical course she presented persecutory ideas, thought blocks, auditory hallucinations, soliloquies, perplexity, total insomnia, bizarre behaviors like coprophagia, trichotillomania and self-injured burns. After some tests, it was found that the patient had high serum levels of antithyroid peroxidase antibody (TPO) and antithyroglobulin antibody (TGO) and reduced folic acid, without other changes. Trials with corticosteroids showed clinical improvement for short periods, as with antipsychotics. No consistent remission was achieved with either approaches.

Conclusion

HE is an uncommon syndrome presenting with high titers of antithyroid antibodies that may preconize an acute state of atypical psychosis. Usually, it responds to corticosteroids and so, has a generally good prognosis when treated accordingly. Evidence suggests that HE is an autoimmune disorder instead of thyroid disease.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Continuity of ADHD Across the Lifespan
Authors: Asherson P.
Published: June 2017

Introduction

For many years ADHD was thought to be a childhood onset disorder that has limited impact on adult psychopathology. However, the symptoms and impairments that define ADHD often affect the adult population, with similar responses to drugs such as methylphenidate, dexamphetamine and atomoxetine to those seen in children and adolescents. As a result, there has been a rapidly increasing awareness of ADHD in adults and an emergence of new clinical practice across the world. Despite this, treatment of adult ADHD in Europe and many other regions of the world is not yet common practice and diagnostic services are often unavailable or restricted to a few specialist centres.

Objective

Here we address some of the key conceptual issues surrounding the continuity of ADHD across the lifespan, with a focus relevant to practicing health care professionals working with adult populations.

Conclusions

We conclude that ADHD should be recognised within adult mental health in the same way as other common adult mental health disorders. Failure to recognise and treat ADHD will be detrimental to the well being of many patients seeking help for common mental health problems.

Disclosure of interest

The author declares that he has no competing interest.
Effectiveness in controlling symptoms with long-acting injectable aripiprazole
Authors: Sánchez Blanco L. , Juncal Ruíz M. , Santayana Jenaro G. Pardo de , Landera Rodríguez R. , Gómez Revuelta M. , Porta Olivares O. , Pérez Herrera M. , Nuñez Moral N.I.
Published: June 2017

Introduction

Depot antipsychotic treatment has been a radical change in the evolution and prognosis of patients with schizophrenia. Long-acting injectable aripiprazole is an anti-psychotic dopamine partial agonist. It has a good tolerance in terms of metabolism and prolactine level.

Objetives

Studying the causes of readmission at the acute unit of Marqués de Valdecilla university hospital (HUMV) in patients treated with Long-acting injectable aripiprazole LAI 400 mg.

Methodology

This is a descriptive study which pretends to assess the causes of readmission in a sample of 30 patients (12 women, 18 men) with non-affective psychosis, which had entered the acute unit of HUMV from 1st January to 30th September 2016 because of psychotic decompensations and had been treated with long-acting injectable aripiprazole 400 mg.

Results

Out of the 30 patients there were five readmissions during the observation time. Two of them for psychotic decompensation, two because of premature abandonments, with oral aripiprazole supplementation and the last one because of desertion of injectable drug. No gender differences were observed.

Conclusions

It is necessary 15 days of oral supplementation before and after the first dose of long-acting injectable aripiprazole to ensure that adequate therapeutic levels are achieved and to avoid readmissions by misuse of the drug. One of the limitations encountered in this work would be the small sample size and limited observation time. A longer-term research may allow to find more scientific evidence to clarify the clinical safety and efficacy of long-acting injectable aripiprazole in patients with non-affective psychosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impairment of visual working memory among patients with paranoid schizophrenia
Authors: Stoimenova-Popova M. , Veleva I. , Chumpalova P. , Tumbev L. , Todorov A. , Valkova M. , Valtchev V.
Published: June 2017

Introduction

Schizophrenia is associated with working memory (WM), executive dysfunction and access visual WM dysfunctions among patients with paranoid schizophrenia (PSz).

Material and methods

We examined 89 patients (41.35 ± 11.52 years old, 65 males, 24 females, 15 with basic, 52 with middle and 22 with high formal education) with PSz (65% with prevalence of positive and 31 of negative syndromes) by Benton visual retention test (BVRT, var.A and E).

Results

The average number of correct performed items was 3.12 ± 1.1.83, the average errors, 13.04 ± 3.70 (6.51 ± 3.05 at left and 5.35 ± 2.30 at right visual field (VF)). Females had more corrects (P = 0.0256). Education is associated with less errors and more corrects. Patients with prevalence of negative syndromes showed more errors at left VF than those with positive, although the total number of errors and corrects were similar. Ageing was not directly associated with total number of corrects and errors. Twenty-three percent of our patients had addictions, 52% had omissions, 96% distortions (average 4.12 ± 2.31), 78% perseverations, 79% rotations, 83% misplacements and 61% size errors. Horizontal displacements were obtained from 42%.

Conclusions

Visual WM dysfunction is frequent among patients with PSz. Female sex and high education are associated with better test performances. Negative syndromes are related with high number of errors at left VF, but not with total numbers of corrects and errors. We suggest horizontal displacement as specific error among patients with PSz.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Issues surrounding severe psychiatric post-patients’ community living in Japan; how can we best prepare them?
Authors: Tanoue M. , Niimura J. , Hirabayashi M. , Nonaka Y.
Published: June 2017

Introduction

The average length of stay in Japan at psychiatric hospital is 292 days. In recent years, measures to shorten the hospitalisation period are being promoted.

Objective

To understand patients who were discharged from emergency ward/acute psychiatric care units the needs post-discharge, in order to improve the quality of psychiatric nursing care at the psychiatric out patient care.

Methods

Sixty-two patients who have been hospitalised in emergency ward/acute psychiatric care units, with a diagnosis of schizophrenia and mood disorders, and currently visiting the outpatient department of psychiatric care were selected as the subject. Semi-structured interviews were conducted.

Results

The issues that patients faced post-discharged were;

– daily life issues: how to support themselves, how to cook, what to eat, and how to sleep;

– relationship with families and supporters;

– concerns of their conditions such as anxiety, restlessness, disaffection, loneliness, isolated feeling, drowsiness. Patients consulted their family members, their doctors, or professionals other than doctors.

Conclusion

The needs for the support for patients who recently discharged from an acute psychiatric ward were high, with the instability of the patient as well as the possibility of worsening their symptoms. There was a high demand for professionals other than a doctor as a consultant, given the limited consulting resources the patients have. The patients’ concerns post-discharge varied widely, focusing mainly on their daily lives. Support system, including monitoring, is necessary during early stages of discharge.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Muscarinic mechanisms in psychosis: A multimodal imaging study
Authors: Van Amelsvoort T.
Published: June 2017

Background

The majority of people with psychosis suffer from cognitive problems. These cognitive problems are among the most disabling features of the illness and have a negative effect on clinical outcome. Research has demonstrated that acetylcholine including muscarinic receptors play an important role in cognitive function. A post-mortem study in chronic patients with schizophrenia demonstrated a decrease of 75% of muscarinic M1 receptors.

Aim

The aim of this study was to investigate the role of M1 receptors in-vivo in brain and cognitive function in psychosis.

Methods

Thirty medication free patients with psychosis and 30 healthy controls matched for age, gender and IQ were included for 1) 1x IDEX Spect scan to determine M1 binding potential; 2) 2x fMRI scan using a visual memory task; 3) 2x MRS to determine choline concentrations; 2x CANTAB cognitive battery. Except for SPECT all subjects were tested twice, once with placebo and once with biperiden M1 antagonist.

Resultaten

Patients demonstrated a significant negative correlation between M1 binding potential and cognitive impairments and negative symptom scores on PANSS. Following biperiden challenge, performance on verbal learning and memory was worse. Hippocampal activity was larger during a visual memory task in patients.

Conclusie

These results support a role for the M1 receptor in cognitive function in psychosis.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Evaluation of self-esteem and childhood trauma in patients with sexual disorders
Authors: Teksin Unal G. , Sahmelikoglu Onur O. , Karsidag C. , Teksin Bakir M.G.
Published: June 2017

Introduction

Sexual dysfunction (SD) is defined as the deterioration of sexual response cycles caused by anatomic, physiologic or psychologic reasons.

Objectives

We believe that SD is closely related to self-esteem and childhood trauma (CT).

Aim

In this study, the level of self-esteem and CT in patients diagnosed with SD vs. controls are aimed to be compared. In addition, relationship between complaints of SD self-esteem and CT variable subgroups are planned to be investigated.

Method

Twenty-four patients visited Prof. Dr. Mazhar Osman Psychiatric Hospital with matching defined criteria and 24 control counterparts statistically matching were taken sociodemographic data form, Rosenberg Self-esteem Scale (RSS) and Childhood Trauma Questionnaire (CTQ-28) was applied.

Results

CTQ-28 averages and RSS variables which are sensitivity to criticism, depressive mood, psychosomatic symptoms, feeling threatened in interpersonal relationships, degree to participate in discussions, relationship with father were higher in patients with SD (P < 0.05). Considering the relationship between complaints of SD and CTQ-28 subscales, physical abuse, emotional abuse, physical neglect, emotional neglect averages of patients were observed significantly different rooted by genitopelvic pain/penetration disorder and premature ejaculation and in emotional neglect by premature ejaculation and low libido combination (P < 0.05).

Conclusions

In literature, there are many studies that show CT leads to SD and several studies state that self-esteem is affected in patients with SD [1]. CT must be considered and determined in the goal of treatment of SD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.