bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of tobacco dependence in Romanian women – a vulnerable population that needs a more personalized approach
Authors: Trofor L. , Gherghesanu R. , Chirita R. , Trofor A.
Published: May 2016

Background

Women face unique and greater health risks from smoking than men and have a different nicotine dependence pattern.

Aim

To design a personalized approach for women addressing Romanian tobacco dependence treatment centers to quit smoking.

Material and methods

A group of 68 smoking women received a 3 months tobacco dependence treatment intervention, consisting of 3 DVD educational sessions, 20 minutes each and a face to face cognitive – behavioral counseling intervention, emphasizing particularities of tobacco dependence in women (pregnancy risks, passive smoking, female hormones configuration, nicotinic receptors interactions, efficacy of nicotine dependence therapy according to gender, etc.).

Results

Females under study were heavy smokers (17.16 ± 8.03 SD packs cigarettes/years) with high nicotine dependence scores (6.52 ± 6.03 SD).

Abstinence rate evaluated in end of treatment (3EOT) phase by an office visit (self-declared abstinence and exhaled carbon monoxide validation) was 38% and increased at 44.1% at 6 months follow-up when evaluated by a telephone contact visit (6TCV).

Conclusions

Personalized tobacco dependence treatment approach, focusing on specific women tobacco use concerns increased abstinence rates, comparatively to previous data in women not benefiting educational DVD and face to face sessions [1].

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive factors in social adaptation of opium addicts in remission
Authors: Tursunkhodjaeva L. , Muzaffarova L.
Published: May 2016

Given significant influence of factors contributing or preventing social adaptation of drug addicts after termination of drug abuse on the stabilization of remission, their study is quite a challenge. To study cognitive factors in social adaptation of opium addicts in remission, a patient's ability to predict people's behavior in various everyday situations, to discern intentions, feelings and emotional states of a person by non-verbal and verbal expression we used M. Sullivan's method in examination of 75 opium addicts at the Republican Tertiary Detox Center.

More than 80% of the patients demonstrated low scores in a number of subtests, such as “a story to be completed”, “a verbal expression” and “a story to be extended”. That was the evidence for the patients’ poor understanding association between behavior and its consequences, which can cause them to get into conflict or dangerous situations. The patients had poor ability to understand changes in initial meanings of verbal reactions by the context of the situation caused. They poorly discerned various meanings one and the same verbal messages may have by the character of relationships between people and peculiarities of communication. Even during the period of prolonged withdrawal, the patients are found to poorly discern associations between behavior and outcomes, to misunderstand character of social relationships, and find it difficult to predict people's behavior. All above makes difficult the process of interaction with the persons surrounding them, reduces possibilities for social adaptation, prevent stabilization of remission and poses the risk of the addiction recurrence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Nalmefene for daily consumption of alcohol
Authors: Valdés Valdazo J. , Velilla Diaz L.T. , Martínez Martínez C. , Serrano García A. , Manso Bazus C. , Llanes Álvarez C.
Published: May 2016

Introduction

The level of high-risk alcohol consumption WHO is estimated at more than 40 mg for women and 60 mg for men.

Nalmefene is a new treatment that breaks the cycle of continued use of alcohol.

Methodology

A sample of 18 patients of a Mental Health Centre in the province of Leon alcohol dependent and high consumption They received nalmefene 18 mg daily continuous treatment for 6–9 months is selected. We appreciate the adherence of patients and the efficacy, tolerability and impact on physical health.

Results

We appreciate reduction in the amount of alcohol ingested observed by both the patient and their relatives without any cases of neglect and few side effects.

We got two patients leave the alcohol completely and an average decline in consumption over 9 Basic Units of Drink.* (90 g).

We observed improvement in the quality of life in patients with multiple pathologies and difficult social situation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The relationship between sensory processing disorder and temperament on emotional functioning and self-efficacy in childhood
Authors: Buchris Bazak S.
Published: May 2016

My study presents and explores the emotional functions and the sense of self-efficacy among school-age children (6–10) with sensory processing disorder manifested in sensory processing disorder (SPD) while addressing their temperament. Central questions in this study involve the element of temperament, which determined the emotional functioning of children who suffer from SPD and examined whether temperament explaining the variance in these children's self-efficacy. The SPD was the independent variable. Emotional functioning and the sense of self-efficacy were the dependent variables and temperament served as the mediating variable.The study focused on 209 students (129 boys, 80 girls) between the ages 6–10 (M = 8, SD = 1.13), studying in schools in different geographical areas in Israel. The Short Sensory Profile (SPS) Questionnaire was administered to the students in order to characterize their sensory profiles and served as a tool for screening and identifying the children with SPD and children who will be included in the control group. The questions raised in this study, have both educational and clinical research importance. They can be used as the basis for educational interventions for children with SOR and may be useful in supporting the building of an integrated intervention and treatment program.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Body dysmorphic disorder and psychosis: A case report and review of literature
Authors: Maatallah H. , Ben Ammar H. , Said M. , Aissa A.
Published: May 2016

Introduction

Patients with body dysmorphic disorder (BDD) are concerned about a slight or non-existent defect on their appearance, causing significant stress and interfering on their social and professional life.

Despite its prevalence and psychosocial impact, this disorder remains unknown by many clinicians.

Methods and objective

Through a review of literature and illustration in our case report we will define: the symptomatology of this pathology, psychopathological models of the disorder and the etiopathogenic assumptions associated with it, in terms of risk factors and neurobiological correlations.

Case report

Patient 33 years old unmarried having been the victim of an AVP at the age of 25 years causing him a head injury above right eye for which he undergoes cosmetic surgery three times but the patient still not satisfied with installation of psychotic and delusional disorders requiring the use of antipsychotics.

Conclusion

The complexity of body dysmorphic disorder should not discourage clinicians to confront this disease. The management requires more than putting under medical treatment associated to psychotherapy, we also need a good relationship of trust and maintain effective working alliance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
When a hypochondriasis forced a patient to emigrate
Authors: Marinho M. , Ribeiro A.M. , Pinto C. , Esteves M. , Vieira-Coelho M. , Reis M.C. , Bragança M.
Published: May 2016

Introduction

Illness anxiety disorder, or hypochondriasis, is one the most difficult and complex psychiatric disorders to treat.

Objectives

To describe a case of a patient with illness anxiety disorder and summarize the most important aspects on this theme.

Methods

Interviews with the patient and literature review searching the PubMed/MEDLINE were performed.

Results

A 42-year-old married man, dentist, Angolan citizen, who had recently arrived in Portugal, was referred to psychiatry assessment during his hospitalization in medicine service, after an exhaustive medical evaluation. He was excessively anxious and worried about having a severe heart disease because he has gradually become more aware of palpitations and chest pain. Although negative results of the examinations he was worried that “something has been missed”. After he had consulted several medical providers in Luanda, he decided to seek medical advice in Portugal. Patient believed that his symptoms exacerbated with activity and intake food, so he gradually restricted them. Due to his health anxiety, he stopped his work and lost 36 kilos. Shortly before the onset of the clinical picture, his daughter was hospitalized for the first time.

Conclusion

Illness anxiety disorder often begins in early to middle adulthood. Its core feature is the fear or idea of having a serious disease, based on the misinterpretation of bodily signs and sensations as evidence of disease, which persists despite appropriate medical evaluations and reassurance. This patient fulfills the DSM-5 criteria of Illness anxiety disorder and has a clinical profile similar to those found in literature.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychogenic astasia-abasia: A case report and a review of the literature
Authors: Mota A.
Published: May 2016

Introduction

Psychogenic movement disorders are the result of a psychiatric rather than a primary neurological disorder. Astasia-abasia refers to the inability to stand or walk despite having good motor strength and conserved voluntary coordination.

Objectives

Starting from a case report of a patient with an unusual gait disturbance the author intends to discuss the history and knowledge evolution on psychogenic gait disorders until the present time.

Aims

To debate the nosology, clinical features, diagnosis and treatment of psychogenic movement disorders.

Methods

Non-systematic review of the literature. Case presentation with the exhibition of a video showing the patient's gait.

Case presentation

A 48-year-old female was admitted to a psychiatry ward after attempting to commit suicide by cutting her throat. On day 3, she suddenly could not walk or stand without help. The neurological examination revealed some inconsistencies and all laboratory, electroencephalogram, and imaging studies performed were normal. After 2 weeks of treatment she started gradually getting better until the full recovery.

Discussion

The gait disturbance presented might be regarded as a form of astasia-abasia. This term was first coined by Paul Blocq (1888) when he described a group of patients who showed inability to maintain an upright posture. Similar movement disorders were previously described as hysteria by authors like Charcot. Nowadays, these case descriptions would be likely considered cases of conversion or psychogenic gait disorder.

Conclusion

The etiology of these disorders is still not very well understood. These patients usually benefit from a multidisciplinary approach that includes psychiatry, neurology, physiotherapy, among others. Pharmacological and non-pharmacological treatments should address the underlying psychiatric condition.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Psychotherapy anxiety and phobic disorders
Authors: Chorna T.
Published: May 2016

The aim of the study: the development of a comprehensive system of psychotherapy and psychocorrection of anxiety disorders of neurotic case, based on the study of their clinical structure and peculiarities of emotional damages.

Methodologies

Spielberger, Eysenck Personality Questionnaire (EPQ), the Hamilton Rating Scale for Depression (HRSD), the study of accentuation of personality by K. Leonhard.

Scope and contributing research

One hundred patients with diagnostic categories: F41.0 – Panic disorder (episodic paroxysmal anxiety, F41.1 – Generalized anxiety disorder, F41.2 – mixed anxiety-depressive disorder who are on the examination and treatment at the psychiatric unit. A control group included 40 patients.

We performed the exploration of the peculiarities of clinical anxiety and patterns of therapeutic effect, based on the influence of short-term group and individual psychotherapy in the treatment of anxiety disorders, and evaluation the effectiveness of its recognition.

The development of the methodology of applying a short-term group and individual psychotherapy in the treatment of anxiety disorders based on combination relaxation, hypnosis, cognitive-behavioral techniques in combination on with short-term group therapy.

In fact, this is a new real model psychotherapy based on integrative principles. The high efficacy was shown in 82% patients, compared with 54% efficacy in control group patients.

We will offer a new comprehensive methodology in the treatment of anxiety disorders of neurotic case that will improve the therapeutic efficacy of the treatment process, reduce the time of treatment, reduce the period of drug therapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
21st century psychiatry: The need for a unitary framework
Authors: Maj M.
Published: May 2016

While the plurality of approaches is a richness of psychiatry, we need today a unitary framework in which the vast majority of psychiatrists are able to place and recognize themselves. An essential component of this framework should be the awareness that a major outcome of research efforts of the past thirty years is the notion that a simple deterministic etiological model cannot be applied to mental disorders, which instead represent the product of the complex interaction of a multiplicity of vulnerability and protective factors of different nature (biological, intrapsychic, interpersonal, psychosocial). Most current significant etiological research in psychiatry can be accommodated within this framework, thus appearing much less chaotic, inconsistent and fragmentary. This first level of the framework affects in a probabilistic, not a deterministic, way the second one, that of neurobiological, cognitive and psychological intermediate processes. It is unavoidable that different languages be used to describe these processes, but these languages may be translatable into each other to some extent. Furthermore, comprehensive pathogenetic models usually require the integration of different languages. This second level leads, again in a probabilistic way, to the third level, that of symptoms, signs, cognitive dysfunctions and psychopathological dimensions. These are the elements composing the fourth level, the syndromal one. The ICD/DSM formulation of this fourth level is not optimal, but it is the best we have at the moment. Certainly, the fact that two major diagnostic systems exist in psychiatry adds to the confusion and the uncertainty, and should be overcome in the future.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Evolution of inflammatory dysregulation and oxidative stress in patients with first episode of mania
Authors: García S. , López Peña P. , Zorrilla I. , García-Alocen A. , Martínez-Cengotitabengoa M. , Bermúdez-Ampudia C. , Mac-Dowell K.S. , Rodríguez S. , Leza J.C. , González-Pinto A.
Published: May 2016

Introduction

Recent studies have focused on the imbalance in inflammatory and antioxidant pathways as possible causes of the underlying neurodegenerative processes in bipolar disorder. Thus, the study of these pathways in first episodes of mania (FEM) can increase knowledge about this issue.

Aim

To compare plasma concentrations of pro-inflammatory (MCP-1, PGE2, TNFα) and oxidative parameters (TAS, NO2 and TBARS) between controls and FEM patients and to analyze the evolution of these parameters in patients from baseline to 6 months assessment time.

Methods

This study included 44 FEM patients and 79 healthy controls, aged 18 to 40. Blood samples were available for controls at baseline and for patients at baseline and 6 months after. TAS and TBARS were measured using non-EIA assay kits, N02 was measured with Griess method and PGE2, MCP-1 and TNFα with ELISA kits.

Results

At baseline, TAS was significantly lower in patients than in controls and TBARS, MCP-1 and TNFα were significantly higher in patients. Among patients, TAS and MCP1 were lower at 6 months than at the illness onset and PGE2 and NO2 were significantly higher than at baseline.

Conclusion

Patients presented an increased oxidative damage and also a higher activation of pro-inflammatory pathways than healthy controls at baseline. After 6 months their level of oxidative stress continue increased. Pro-inflammatory parameters decreased overtime (MCP-1 and TNF α) but PGE2, increased surprisingly. This can be due to the fact that antipsychotics are not able to completely reverse baseline inflammation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depot aripiprazole as maintenance treatment in bipolar disorder: Report of a case
Authors: Gómez Sánchez-Lafuente C. , Reina Gonzalez R. , De Severac Cano A. , Tilves Santiago I. , Moreno De Lara F. , Mateos Carrasco E.
Published: May 2016

Introduction

Recently, depot aripiprazole was approved as a maintenance treatment for schizophrenia. However, long-acting antipsychotics has not been established efficacy in manic episode or maintenance treatment of bipolar disorder.

Aims

Describe a clinical case of multiresistant bipolar disorder.

Methods

Thirty-nine years old male, diagnosed since 8 years ago with bipolar disorder, current episode manic with psychotic symptoms, admitted to Acute Psychiatrist Unit. It was his seventh internment. He was dysphoric, had insomnia, and showed many psychotic symptoms like grandiose delusions and delusions of reference. He thought he was a famous painter from nineteenth century.

His disorder was refractory to mood stabilizers monotherapy and to many neuroleptic and, like olanzapine 30 mg/day, depot risperidone, zuclopenthixol, haloperidol, palmitate paliperidone, He was on treatment with lithium 1200 mg/day (lithemia 0.62 prior to admission) and oral aripiprazole 15 mg/day that he was not taking regularly. Poor compliance to oral treatment. No awareness of illness.

Results

during the patient admission, we started long-acting aripiprazole 400 mg per 28–30 days. First 3 days he persisted dysphoric, hostile, and showing delusions of mind being read. From the fourth day, delusions disappeared and later he was calmer and more friendly, He was discharged 9 days later fully euthymic.

For 6 months follow-up, the patient came once a month to community center for aripiprazole injection and he was taking lithium regularly. Last lithemia 0.65 mEQ/L.

Conclusion

Long-acting antipsychotics, like depot aripiprazole could be a useful alternative to oral medication, specially when there is no awareness of illness and there is low adherence to oral treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sexual behavior in women with bipolar disorder
Authors: Guermazi F. , Charfeddine F. , Mdhaffer K. , Aribi L. , Bouattour W. , Elleuch E. , Aloulou J. , Amami O.
Published: May 2016

Introduction

Women with bipolar disorder warrant special consideration with regard to sexual health. The impairment in sexual function would be frequent but underestimated and contributes to non-compliance with treatments.

Aims

(1) Evaluate sexuality among a population of women affected by bipolar disorder.

(2) Determine the factors associated with impaired sexual function.

Methods

This is a cross-sectional and descriptive study during the period ranging from 1st September to 15 October 2015.

It was conducted in 40 women suffering from bipolar disorder.

The exclusion criteria were: relapse period in sick, age over 60 years or severe somatic comorbidity.

The evaluation of sexual function was made using the “Sexual Behavior Questionnaire” (SBQ).

Results

The mean age was 30 years. Bipolar disorder type I accounted for 72.5%.

According to the SBQ, 37.5% of patients had a desire disorder, 57.5% had a frequency less than 3 times per week sexual intercourse, 45% had a drop in excitation and 42.5% were not satisfied with their sex life.

Sexual problems are positively correlated at an early age of onset of bipolar disorder (P = 0.001).

The lack of desire, the sexual excitation disorder and the decrease in the frequency of sexual intercourse are positively correlated with the depressive phase of bipolar disorder.

Conclusion

A better understanding of sexual behavior in women with bipolar disorder and the early screening of the sexual disorders must be integrated into the management of the disease. It can improve their quality of life and adherence to therapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mood disorder in epilepsy: A case report
Authors: Baena R.A. , Mesián I. , Mendoza L. , Lázaro Y.
Published: May 2016

Introduction

A lot of studies have described that up to 50% of patients with epilepsy develop psychiatric disorders: depression, anxiety and psychotic symptoms. We can classify these symptoms according to how they relate in time to seizure occurrence, i.e. pre-ictal/prodromal, ictal, post-ictal or inter-ictal. In this case, we have a 76 years old woman that develops a maniac-episode previously that she has an episode.

Objectives

Make a review about the prevalence, risk factors of psychiatric problem in epilepsy (biological, psychosocial and iatrogenic) and report of clinical case.

Methods

Review the bi-directional associations between epilepsy and bipolar disorder (epidemiological links, evidence for shared etiology, and the impact of these disorders) with a integrated clinical approach.

Results

Theoretically, epilepsy and bipolar disorder share an important number of clinical and neurobiological features. Classic neuropsychiatric literature focused on major depression with data on bipolar disorder remains limited. However, actually there are many evidences that mood instability, mixed irritability even mania is not uncommon in patients with epilepsy.

Conclusions

It is important develop more sensitive and specific screening instruments to identify mood disorder in epilepsy's patients. Future research becomes decisive for a better understanding of the similarities between epilepsy and BD, and the treatment of both.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A case of a varenicline-induced mania in a patient with the history of depression
Authors: Onur O. , Teksin G. , Karsıdag C.
Published: May 2016

Introduction

Varenicline is an alpha 4 beta 2 nicotinic receptor partial agonist with dopaminergic effects, approved for smoking cessation. The complex interactions and modulations of serotonin and nicotine receptors caused by varenicline may cause mania by its serotonin agonist activity and by its release of dopamine in the striatum. We report a case of a varenicline-induced mania with the history of depression.

Case

A 38-year-old female, with the history of depression and have been using sertraline 50 mg/day for a year, admitted for grandiose delusions, decreased need for sleep, increased amount and rapid speech, and agitation. These symptoms began 1 week after she started taking varenicline as prescribed for smoking cessation. Young Mania Score (YMS) was 32. She discontinued sertraline and varenicline after 1 week of use but symptoms of mania continued. The patient smoked about 20 cigarettes a day for more than 10 years. She had a positive history of depression in her family. Her lab work up was unremarkable; including negative urine toxicology and brain CT scan. The patient met DSM-5 criteria for a manic episode and was started on olanzapine 10 mg/day and quetiapine 100 mg/day. The patient's symptoms gradually improved within 1 week with attainment of euthymic mood, improved sleep, and resolution of grandiosity. YMS was 7.

Conclusion

Based on this case it might be suggested that patient's and family's psychiatric history should be assessed cautiously before prescribing varenicline for smoking cessation due to development of mood symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The importance of establishing a good differential diagnosis in bipolar disorder
Authors: Peñuelas Calvo I. , Sevilla Llewellyn-Jones J. , Cervesi C. , Sareen A. , González Moreno A.
Published: May 2016

Diagnosis plays a key role in identification of a disease, learn about its course, management and predicting prognosis. In mental health, diseases are often complex and coalesce of different symptoms. Diagnosing a mental health condition requires careful evaluation of the symptoms and excluding other differential disorders that may share common symptoms. Diagnose hastily can lead to misdiagnosis. A premature diagnosis or misdiagnosis has clear negative consequences. This is one of the problems related to mental health and one needs to optimize the diagnostic process to achieve a balance between sensitivity and specificity. Currently, the diagnosis of bipolar disorder (BD) is one of the major mental health conditions that is often misdiagnosed.

To differentiate BD from unipolar depression with recurrent episodes or with personality disorder (PD), especially type Cluster B – with features shared with mania/hypomania like mental instability or impulsivity, it is important to differentiate between a diagnosis and its comorbidity. BD is often misdiagnosed as personality disorder and vice versa specially when both are coexisting (almost 20% of patients with bipolar disorder type II are misdiagnosed as personality disorders). This is common especially with borderline PD, although in some cases the histrionic PD may also be misdiagnosed as mania.

Due to the inconsistency in patient care involving different psychiatrists combined with difficulty in obtaining a precise patient history and family history leads to loss of key information which in turn leads to misdiagnosis of the condition. The time delay in making the correct diagnosis cause by such inconsistencies may worsen the prognosis of the disease in the patient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Monitoring of biochemicals changes in antipsychotics and anti-depressive therapy
Authors: Prifti A. , Qemalli V. , Zikaj L.
Published: May 2016

Objective

Biochemical changes in treatment of schizophrenic and bipolar disorders, in Albanian patients, with atypical antipsychotic and anti-depressive drugs. Some of the adverse effects related to their use are hyperlipidemia, hepatic enzymes, type 2 diabetes and CK level, which may result in development of metabolic syndrome. This study aimed to investigate a possible increase of biochemical parameters, in patients with schizophrenia and bipolar disorders treated with atypical antipsychotic and antidepressive drugs (Olanzapin, Risperidon, Clozapin, Antidepresiv triciclik, SSRI, SNRI).

Methods

Forty subjects with schizophrenia and bipolar disorders were evaluated, 12 women and 28 men, aged between 17 and 72 years. Blood collection of the patients was taken in our laboratory and this values were measure in long treatment patients, after years of treatment. Analyses were perform in our laboratory with autoanalysator SAT 450.

Results

Evaluation after measurements showed significant differences when comparing the mean values obtained in each patients. The biochemical indicators of development of metabolic syndrome measured in our study, show that is an increasement of lipids panel, specially triglycerides and total cholesterol, also in glucose, CK level and hepatic enzymes, presenting statistically significant changes (P < 0.05) for prolong treatment.

Conclusion

We conclude that the treatment with atypical antipsychotic and antidepressive drugs, promoted a substantial increasing of biochemical blood parameters. Lipids panel, hepatic enzymes, type 2 diabetes, CK levels are observed in among subjects evaluated.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evolution of bipolar disorder in dual pathology
Authors: Silvia C.F. , Sánchez García M.D. , Gómez Peinado A. , Cano Ruiz P.
Published: May 2016

Introduction

The substance use is common among people with a diagnosis of bipolar disorder. In addition, alcoholism and bipolar disorder coexist with a high frequency. This association is higher in men than in women, and this consumption is the factor that most strongly influences the hospitalization.

Objectives

To analyze the clinical, epidemiological, diagnostic approach and evolution of bipolar disorder and alcoholism.

Methods

Review of the subject on recent articles of alcoholism in bipolar disorder.

Results

The stages of mania associated with alcohol consumption up to 40% of cases and are more common at this stage that in depressive. This association is greater than that which occurs between alcoholism and schizophrenia or depression. Patients with bipolar disorder who have mixed and irritative states and those with rapid cycling have a prevalence of alcohol consumption and substance use higher than those who do not use substances. It has also been observed that the consumption of alcohol and substance use can change the symptoms of mania and turn them into a mixed state symptoms. It also states that rapid cycles can be precipitated by increased alcohol consumption during rotation from mania to depression.

Conclusions

The association of bipolar disorder with addictive behaviors is a factor that worsens the prognosis and comorbid alcohol itself is associated with a poor prognosis. Close monitoring of bipolar patients and especially in those who consume alcohol is very important.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessing risky sexual behavior among patients with bipolar disorder in euthymic period
Authors: Staali N.
Published: May 2016

Introduction

Risky sexual behaviors are typically seen in patients with bipolar disorder, especially during the manic phases.

Disinhibition, impulsivity and risk taking expose these patients to unplanned pregnancies and sexually transmitted infections.

However, there is a lack of studies regarding these behaviors in stabilized bipolar patients during euthymia.

Objectives

The objective of this study was to look for a risky sexual behavior by evaluating sexual knowledge and sexual behavior of patients with bipolar disorder in the euthymic phase.

Methods

We conducted a descriptive cross-sectional study including 30 patients diagnosed with bipolar disorder I or II (DSM-IV).

Data were obtained through a semi-structured interview evaluating the following: sexually transmitted infections, condom use, multiple sexual partners, sex under the influence of drugs or alcohol, and prostitution.

The Young Mania Scale and the Hamilton Depression Scale were used for clinical assessment.

Results

The preliminary results suggest a lack of knowledge leading to a tendency to risky sexual behavior in both male and female, married and unmarried patients.

Conclusions

Patients with bipolar disorder are exposed to risky and unsafe sex because of the clinical features of their disease and associated comorbidities.

Prevention and awareness of sexual risks are unavoidable in the management of these patients.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Aggression as risk factor of delinquent behaviour (gender aspect)
Authors: Bokhan N. , Abolonin A. , Nazarova I.
Published: May 2016

In many studies it is noted that common traits of aggressive adolescents are frustration, dissatisfaction with social environment; emotional coarseness, hostility against people around. Substance abuse leads to restructuring the motifs and gender roles. Heightened aggression of offenders as compared with common people is noted.

Objective

To study characteristics of aggression of male and female offenders with substance dependence.

Materials and methods

One hundred and fifty-five male and 110 female adolescents abusing psychoactive substances and serving their sentence were examined. “Hand-test” and Buss-Durkee questionnaire were used in this study.

Results

During comparison of number of offences committed by male and female adolescents, it was revealed that male adolescents commit significantly more crimes against life and female adolescents more crimes against property. Conducted analysis showed high level of aggressive and hostile reactions in this sample, indices of female adolescents (13.7 ± 2.95 and 27.6 ± 5.5) are significantly higher (P < 0.05), than in male adolescents (8.6 ± 2.8 and 23.6 ± 5.3). Significant correlations between level of aggression in female adolescents and beginning of substance use were revealed (r = 0.46, P < 0.05). In male adolescents, long-term substance use correlated with increase in level of physical aggression and tendency to manipulative behaviour (r = 0.37, P < 0.05). In male adolescents, high potential of adjustability, use of communication for self-assertion and achievement of goals, low level of attachment were revealed. Female adolescents are more aggressive in contacts, build relationships according to type of control-submission.

Discussion

Conducted study allowed revealing gender traits of juvenile offenders influencing the structure of aggressive behaviour, allowing the broadening the understanding of mechanisms of aggressive behaviour.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A major depression or a bipolar disorder type 2? A cased-focussed psycopathological and psychophysiological challenge for a resident
Authors: Targa I. , Soler J. , Alemany T. Gómez
Published: May 2016

A 41-year-old woman is diagnosed with a major depression after a few weeks of having been operated of a stomach reduction (bariatric surgery). She goes into old antidepressant medication for a few weeks with an increasing worsening of her state, at the point she is sent to the emergency room with high irritability, intense agitation, suicide thoughts as the highlight symptoms of what we think to be a mixed episode of a bipolar disorder and how we orient the case during hospitalization. The patient follows both public and private psychiatric services and after discharge from acute hospitalization, still with residual depressions symptoms, her private psychiatrist substitutes the given treatment, including mood stabilizers, by only antidepressants. Two weeks after discharge from the hospital, the patient is relocated to our partial hospitalization resource. During her stay in our resource, we decide to keep the new treatment and diagnosis and increase the dosage of one of the antidepressants, which immediately yields to hypomania symptoms, at what we conclude that our patient is better treated as a bipolar type II with a mood stabilizer and low doses of an SRI. We find this to be an interesting case in the both psychopathological and psychophysiological point of view. To understand the case beyond clinical diagnosis, we discuss profoundly whether the bariatric surgery may have a role as a trigger.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The impact of illness variables of a sample of ADHD children on their parents
Authors: Abdelhameed M. , Hassan M. , Abdelfadeel N. , Abdelshaheed M.
Published: May 2016

Introduction

The symptoms and behavior of children with ADHD impose demands and difficulties on part of their caring parents, which may cause the latter group to suffer psychological stress.

Objectives

The study of the suffering and symptomatic expression of psychological stress in parents of children with ADHD.

Aims

To study type and severity of symptoms in children with ADHD and the effect of that on the stress response of their parents.

Methods

Thirty-seven children with ADHD diagnosed clinically and with Conner's Test were studied using Child Behavior Chick List (CBCL). Available parents for each child were interviewed and studied with Symptom Chick List 90 Revised (SCL90R). Two control groups were used for both ADHD children and their parents.

Results

The mean age of the children with ADHD was 7.1 ± 1.6, they were 22 males and 15 females. Parents of these children scored highly on total and subscales of SCL90R, they were significantly higher than their control group on total and some of these subscales including somatization, interpersonal, depression, paranoid ideation and hostility domains. Depression and paranoid ideation of ADHD children parents were positively and significantly correlated with most of the sub-items of Conner's test of their children. In addition, somatization, depression and hostility of parents were positively and significantly correlated with most of the sub-items of CBCL of their ADHD children.

Conclusions

The symptoms, behavior and severity of illness of children with ADHD have a great impact on their parents’ psychological state of suffering and stress.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gender dysphoria in USMIJ of Toledo. Report of a case
Authors: González Rivera P. , Hidalgo Borreguero A. , Bolaño Mendoza S. , Soto Laguna M. , Preckler Peña K. , Gonzalez Díaz F.J. , Zafra Villena A. , Perez Castellanos M. , Prados Gómez J. , Alvites Ahumada P. , Perez Asenjo R. , Benito Ruiz A.J. , Perez López A. , Landa Contreras E. , Fernandez-Torija Daza M.
Published: May 2016

The start of Child and Adolescent attention to gender dysphoria is very recent. In our Unit, it has objectified a growing increase in such demand over recent years.

As a typical example would be a patient of 13 years following gender dysphoria begins to present school failure and behavior problems at home with emotional instability.

According to the recommendations of the Group Identity and Sexual Differentiation (GIDSEEN) after early detection is to guide parents towards a comprehensive treatment at a specialized interdisciplinary teams and a psychosocial approach to improve the quality of life, decrease mental comorbidity and gender dysphoria own. Having no such care in our community has been necessary to make a referral to another community to attend this demand.

Currently it is giving adequate attention to these cases, but except for referral to another community. However, as we are seeing progression care in our area in the future could be feasible. Therefore, we consider as a first step dysphoria quantify each case in our area.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Disturbed sleep and activity as early signs of ADHD in preschool children
Authors: Bundgaard A.K. , Bilenberg N. , Asmussen J. , Munk Jørgensen P.
Published: May 2016

Introduction

Attention-deficit-hyperactivity-disorder (ADHD) is the most frequent psychiatric disorder present in childhood, and sleep-problems are a prominent, pervasive and clinically important feature of ADHD. Our understanding of whether sleep-problems mimic or exacerbate daytime ADHD-symptom expression remains insufficient. Furthermore we lack knowledge about the connection between objective measuring and subjective observations in children with early symptoms of ADHD.

Objective

Future research that examines sleep-problems and daily activity in very young children with and without ADHD-like symptoms might help us identify early risk factors and achieve a better understanding of the importance of sleep in ADHD.

Aims

To investigate if sleep-problems and activity level during day time is associated with early signs of ADHD.

Methods

A sample of 50 preschool children ages 2–3 and their parents recruited in a birth cohort are invited to participate and divided into two groups of 25 cases and 25 controls based on ADHD-symptom score. An actigraph on the child's non-dominant wrist measures sleep and daily activity. Sleep-latency, total sleep time and awakenings are examined. Moderate-to-vigorous-activity (MVPA) is the measure for daily activity. Subjective observations from parents are provided through questionnaires. Furthermore we examine the stability of the sleep problem score from child behavior checklist, which parents fulfilled when their child was 27 months old and again at the age of 5.

Results

The results will be presented at the EPA March 2016 in Madrid.

Conclusion

Results from this study together with other findings of risk factors in the cohort may lead to a preschool ADHD risk-index, which can guide future early intervention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Strange behavior as defense mechanism related to sensorial impairment in autism
Authors: Cancino Botello M.C. , Peña Serrano A. , Canseco Navarro M.D.L.A. , Hernández Sánchez J.M. , Molina López F.
Published: May 2016

Introduction

So far, autism etiology is not known yet, it is believed that is due a combination of neurobiological, structural, genetic and environmental factors. This disorder is characterized by social interaction and communication impairments and presence of restricted and repetitive behaviors. Some authors have spoken about Sensorial Perception Theory that tries to explain how sensorial impairment of people with autism causes “strange” conducts, as a protective mechanism to stimuli they perceive as disturbing.

Objectives

To highlight the role of sensorial perception in people with autism in their way of interacting over the environment.

Method

systematic review of the literature in English (PubMed), with the following keywords: “Autism”, “sensory perception”, and “Asperger syndrome”.

Results

According to Sensorial Perception Theory, people with autism perceive sensorial information from environment in different ways. It is believed that each sense operates as a hyper or hyposensitive sense, according to the intensity and the moment the stimulus is produced. This fact provokes “abnormal” responses as repetitive or restricted behavior, in order to protect themselves form the disturbing stimuli.

Conclusions

Sensorial hyper o hyposensitive may be related to the strange behavior that can be present in people with autism. If we could interpret such conducts, we will be able to imagine how patients are perceiving the world and then we could help them to develop strategies in order to function more properly.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric symptoms in patients with cystic fibrosis
Authors: Gonçalves M. , Pinho C.
Published: May 2016

Introduction

Cystic fibrosis (CF) is an autosomal recessive disease characterized by abnormal airways secretions, chronic endobronchial infection, and progressive airway obstruction. In Portugal is estimated 30–40 born children with CF per year. The prognosis of CF has changed over the last decade, death in childhood is now rare, and children born today are likely to have a mean life expectancy of over 40–50 years. An understanding of the psychiatric aspects of CF is more important than ever.

Methods

Review published and referenced scientific articles on MedLine/PubMed.

Results

Researchers found CF can affect the patient and their family in many ways. Physical and social restrictions, the rigorous medical regimen, hospital admissions, concerns about illness, and uncertainties of the future can create anxiety and depression in patients and parent alike. They also may have problems with interpersonal relationships resulting in isolation and social maladjustment. Some studies also reported an increased risk of develop an insecure attachment and less adapted eating behaviors. The essential responsibilities of psychiatrist are: evaluating the psychiatric effects of living with CF, comprehensive assessment and intervention when emotional, behavioural and psychological difficulties arise and providing support.

Conclusions

Awareness of types of emotional strain experienced by these children and their families can be of use to avert potential problems which may seriously impair therapeutic effectiveness and the patient's well being. Management requires an interdisciplinary team to maximise longevity and quality of life. All patients and their families must be offered the opportunity to meet with a Child and adolescents psychiatrist.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Catatonic features in adolescence: Interfaces with affective disorders
Authors: Peixoto I. , Santos C. , Sousa M. , Pimenta S.
Published: May 2016

Introduction

Catatonia is a potentially life-threatening but treatable neuropsychiatric syndrome. The prevalence of catatonia in children and adolescents is probably underestimated since investigation on this matter is still lacking. Different studies have led to the recognition of catatonia as a separate psychiatric entity, as reflected in DSM-5, renewing interest on this subject. While in the adult population there is evidence highlighting the strong association between catatonia and affective disorders, this has been poorly reflected in child and adolescent psychiatry literature. In fact, most of the research in this population focuses on associations with organic, psychotic or developmental disorders.

Objectives

We aim to illustrate the diagnostic challenges when facing an adolescent with catatonia encompassing psychiatric, neurologic and immunologic factors known as possible causes for this condition. We aim to explain the diagnostic procedure and the possible clinical results of this workup, as well as raise the discussion around treatment options.

Methods

We used a clinical case vignette of a 14-year-old adolescent, presenting with a stress-induced catatonic syndrome and depressive symptoms without any prior organic or psychiatric condition. We reviewed the most relevant literature in order to contextualize our clinical case.

Results and conclusion

Catatonia is an under-recognized condition in children and adolescents without a prior medical or psychiatric condition, especially when associated with affective disorders. The inclusion of catatonia as a specific syndrome in the psychiatric nosography may help its recognition. Case reports on this matter are therefore especially important as a way of pushing clinical investigation on this matter forward.

Disclosure of interest

The authors have not supplied their declaration of competing interest.