bluuebunny/crossref_metadata_2025 huggingface dataset:
Social stigma and disclosure of diagnosis among women with breast cancer in Azerbaijan
Authors: Mammadzada G.
Published: June 2017

Objective

The current practice in medical and surgical care of women with breast cancer in Azerbaijan is to hold back disclosure of cancer diagnosis unless the patient actively asserts full disclosure. This study aimed to serve as a pilot, to appraise the level of anxiety and depression in women diagnosed with breast cancer and explore ways to develop approaches to further elucidating the important issue of cancer information disclosure.

Methods

The subjects in the study were women recruited consecutively with confirmed oncological diagnosis of breast cancer (n = 23; mean age = 50 (SD ± 11; range 27–73 years) and who were scheduled for mastectomy. All the subjects consented to be directly interviewed. The interview comprised of a socio-demographic questionnaire and inquiry regarding the subjects’ understanding of the nature of their breast condition. All the subjects were also administered the Hospital Anxiety and Depression Scale (HADS) in Azerbaijani. The patients who knew their diagnosis of cancer were ascertained subsequently from the record (n = 11 [42.3%]).

Results

There was a significant correlation between anxiety scores (P = 0.006) and anxiety/depression scores combined (P = 0.009) with the level of subjects’ awareness regarding diagnosis of cancer; the correlation was not significant for depression scores alone (P = 0.068).

Conclusions

The findings are consistent with studies from culturally similar regions and reflect the need for improvement on disclosure, patient participation, and family support in treatment of women with breast cancer.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Persons with mental disorder in jails and prisons – legislation and practice in Georgia
Authors: Zavradashvili N. , Eliashvili M. , Zhorzholadze E. , Makhashvili N.
Published: June 2017

Introduction

Statistics shows that in most countries prevalence of mental health problems are much higher among prisoners than the general population. Country approach to regulating mental health needs of persons with mental disorder who come into contact with justice system depends on variety of cultural or legal traditions, as well as on different concepts and structures of mental health care delivery.

Objective

The aim of the survey was to study and assess the established practice of implementation of the legal procedure relating to individuals who commit crime and have mental health problems in Georgia.

Methods

Qualitative analysis including desk review, in-depth interview and focus group discussion was conducted. Preceding from the research objectives the current legislation with regard of people with the mental disorder has been analyzed; the interviews on the shortcomings and problems of the implementation of the law in practice have been conducted with key informants.

Results

The study acknowledges that recent changes in Georgian legislation imports much of the civil law standards and processes relating to admission, detention and compulsory treatment of criminal detainees with mental health problems. However, due to the ambiguous, ambivalent and incomplete nature of the aforementioned changes, the penal and administrative courts, as well as the clinicians are facing serious difficulties and confusions in their work.

Conclusions

It is discussed that there is a strong need for closer cooperation between mental health and justice systems to treat mentally disordered persons both in the system and after they are released into the community.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Preliminary study on the analysis of cognitive profile in subjects with ASD: WISC-IV
Authors: Galletta D.
Published: June 2017

Autism spectrum disorder (ASD) is a neurodevelopmental disorder, observed in several contexts and characterized by persistent deficits in the communication, social interaction and behavioral areas (DSM V, 2013). ASD includes a wide range, “a spectrum,” of symptoms, skills, and levels of disability. In the last years, we have noticed a substantial change in the diagnostic criteria due to the fact that, although the huge heterogeneity shown by the disorder, in the majority of autistic subjects, both those with high and low IQ, we can identify a common profile of functioning, as regards communicative, social, motor and behavioral skills (Sharma et al., 2012). As reported by Frith (1989; 2003), this kind of functioning is based on a different cognitive style, characterized by a strong prevalence of “bottom-up” elaboration processes, coexistent with the inability of the subject to integrate perceptual data into a global and coherent representation (weak central coherence theory). In this study, we have administered WISC IV to two adolescents (16 years old), already diagnosed for ASD with a low functioning. As expected, results have evidenced the presence of a rigid cognitive style with impaired conceptualization abilities and high attention to details. Specifically main falls have occurred in the area of visual-perceptual reasoning, underlining a lack of visual-spatial processing skills, as well as a lack of fluid reasoning skills. Particularly deficit resulted in the categorization capabilities and abstraction.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adult ADHD and the use of mindfulness-based practice: A pilot study
Authors: Allen A. , Ansari R. , Thurley J. , Murphy L. , Chan E. , McKinnon C. , Fitzgerald R. , Deeley A. , Wachter R. , Rajewski J.
Published: June 2017

Educational objectives

The goal of this poster is to discuss a brief pilot study in which mindfulness – and yoga-based practices were utilized with a group of adult ADHD patients.

Methods

A sample of 10 adults participated in a pilot group which utilized the use mindfulness-based and yoga practices to address ADHD. This group was a single 2 hour session which was a pilot for a future 6-week psycho-educational group. The participants completed the following questionnaires: the Cognitive and Affective Mindfulness Scale (CAMS-R), the Freiburg mindfulness inventory and the Mindful Attention Awareness Scale (MAAS) in addition to a survey regarding levels of knowledge of yoga and mindfulness prior to the beginning of the session. The participants completed a survey at the end of the session.

Results

In our small sample group, all respondents reported that they found the session helpful (43% strongly agreed; 57% agreed). When asked if the participants were likely to explore and learn more about ADHD and meditation on their own based on what they learned in the session, most indicated that they were likely to (43% strongly agreed; 43% agreed and 14% were neutral).

Conclusions

The use of treatment modalities involving the use of meditation and mindfulness-based techniques in a group setting are thought to be helpful in addressing some of the target symptoms of ADHD. Based on the preliminary data collected in our small pilot study, our group intends to further explore the efficacy of meditation-based groups in the form of a 6-week training program in 2017.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental heath in republic of moldova: The way from in-patient to community-based care services
Authors: Chihai J.
Published: June 2017

Introduction

The history of mental health in Moldova has been centered on psychiatric institutions. Current reform goals are centered on the reduction in psychiatric hospital beds, shifting the focus towards outpatient therapy, where community mental health centers have a central role in coordinating recovery and social reintegration.

Objectives

to collect different data according guidance for establishing a situational analyses about Moldova.

Methodology

we elaborated a guidance with outline: the historical perspective:

– a. back a 5–10 years events/developments; epidemiologic data;

– b. the service delivery system;

– c. mental health system: laws/regulations, role of the government as well as civil organizations, mechanisms for data collection, monitoring of performance, costs, quality of care and outcomes;

– d. opportunities, barriers, and needed changes/innovations needed to address these.

Results

The current focus is on moving from a relatively centralized system towards a more community-based approach to psychiatric care and community supports, as well as deinstitutionalization and integration of mental health care with primary care. Besides over reliance on institutionalization, the Moldovan mental health care system faces other challenges, including access to care, workforce limitations, and stigma.

Conclusion

Looking forward, success in these efforts will require continued strong political will to bring domestic law, policies and practices into line with international standards in the field of human rights for persons with disabilities. By supporting deinstitutionalization and improving the accessibility of mainstream services, more people will have the opportunity for social inclusion and the ability to contribute to the communities’ social and economic growth.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Anxiety, Stress and Depression on COPD Patients. A Qualitative Research
Authors: Kotrotsiou E. , Tzounis E. , Daniil Z. , Hatzoglou C. , Skenteris N. , Gourgoulianis K.
Published: June 2017

Introduction

COPD is a common disease, has an impact not only on psychical but also on psychological well-being. Anxiety, stress, depression are common comorbidities for COPD patients.

Objectives

This paper proposes to study from a qualitative point of view the effect of depression on COPD patients.

Aims

A qualitative methodology was chosen in order to explore 75 (male n = 69, female n = 6) COPD patients’ symptoms and signs of anxiety, stress and depression.

Methods

Data were collected through semi-structured interviews. All patients also completed the Beck Inventory and the GDS 15 questionnaires. The interviews were conducted both in the general university hospital of Larissa and in patients’ homes.

Results

We enrolled 75 patients (15: normal, 17: mild depression, 7: moderate and 1 severe). Persistent low mood and lack of interest was expressed by most of the participants. “Before I get this thing, I was in a good mood, but not now”. Poor self-management was associated with anxiety disorders and high temper: “I withdrew, due to my health”…“I was really stressed, and depressed, and quick-tempered”. COPD diagnosis was difficult for some patients: “At the beginning, I wasn’t in the mood for anything, just sleeping and more of watching TV”. Other patients seemed to be in a good mood: “I was never scared of anything, I am happy”.

Conclusions

This research shows that depressive and anxiety symptoms are common among COPD patients. Depression has a significant impact on the daily life of patients while breathlessness made patients feel housebound and social isolated.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental Health Conditions and Co-morbidities Among Internally Displaced Populations (IDPs) in Ukraine
Authors: Makhashvili N. , Javakhishvili J. , Pinchuk I. , Roberts B.
Published: June 2017

Reliable epidemiological data on the burden of mental health conditions and key risk factors is crucial in helping to design appropriate trauma-informed mental health and psychosocial support responses for the estimated 1.4 million IDPs in Ukraine. The aim of the proposed study is to collect evidence on mental health and psychosocial support needs among IDPs in order to help inform mental health policy in Ukraine.

The specific objectives were to:

– measure the prevalence of mental health conditions of post-traumatic stress disorder (PTSD), depression, anxiety, and their co-morbidity;

– examine the characteristics associated with the mental disorders (e.g. gender, age, trauma exposure, socio-economic stressors);

– draft evidence-based recommendations for mental health and psychosocial support to relevant governmental and professional bodies in Ukraine.

The study used a cross-sectional survey conducted throughout Ukraine in 2016 with 2203 IDPs aged 18 years and over. Descriptive and multivariate regression analyses were used. PTSD prevalence was 32% (22% men; 36% women), depression–22% (16% men; 25% women), and anxiety prevalence was 17% (13% men; 20% women). There were also high levels of co-morbidity between PTSD, anxiety and depression. Key factors statistically significantly associated with mental disorders included female gender, older age, cumulative trauma exposure, more recent displacement and a bad household economic situation. The findings provided sufficient evidence to draft the trauma-informed mental health policy recommendations to key policy-makers in Ukraine.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Burning Mouth Syndrome: Problem in the Mouth?
Authors: Petrykiv S. , de Jonge L. , Arts M.
Published: June 2017

Introduction

Burning mouth syndrome (BMS) is characterized by an intraoral burning sensation for which no medical or dental cause can be found. Sporadic evidence suggests that drug induced conditions may evoke BMS. Intriguingly, we observed a patient who developed BMS after induction of citalopram.

Objectives & aims

A case report of patient with BMS from our psychiatric ward will be presented here, followed by a literature review on drugs induced BMS.

Methods

Based on a recent literature search, we present a first case report of BMS that was apparently induced in patient shortly after beginning of citalopram. We performed a systematic search through PubMed, EMBASE and Cochrane's Library to find more cases of psychotropic induced BMS.

Results

Ms. A. was a 72-year old woman meeting DSM-IV diagnostic criteria for melancholic depression, who was observed in a clinical setting. We started citalopram 10 mg. 1dd1, with 10 mg. 1dd1 increase over 7 days to 20 mg, 1dd1. The following day, she displayed a persistent burning painful sensation in the mouth. Other than BMS oropharyngological syndromes were excluded after consultation with qualified medical specialists. Citalopram therapy was discontinued, and nortrilen treatment was initiated. BMS symptoms resolved over four days. Twelve case reports have linked BMS to the use antidepressants and anxiolytics.

Conclusion

Contrasting the statement that no medical cause can be found for BMS, we found that psychotropics may evoke the syndrome. Compared to other psychotropic drugs, antidepressant medication has the strongest association with BMS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Narcissism in Bulgarian Adults
Authors: Stoyanova S. , Giannouli V.
Published: June 2017

Introduction

Narcissistic personality disorder influences relationships and beliefs in different life spheres.

Objective

We aimed to measure narcissism among Bulgarian adults by establishing validity of two scales measuring narcissism, specifying some social and demographic factors and differentiating narcissistic features.

Method

One hundred and thirty-four Bulgarians (17–62 years old, M = 31; SD = 11) were examined with two scales measuring narcissism. Higher score on Narcissistic personality disorder scale from the Personality Diagnostic Questionnaire-4 correlated positively (r = .346; P < .001) with higher score on A. T. Beck and J. S. Beck's scale measuring Narcissistic beliefs from Personality Belief Questionnaire that indicated their validity.

Results

No significant gender differences in narcissism were found, with female participants prevailing in the sample (n = 118). Family status (FPDQ−4(4,128) = 0.593; pPDQ-4 = 569; FPBQ(4,128) = 0.295; pPBQ = .881), occupational status – student, employed or unemployed (FPDQ−4(4,128) = 0.593; pPDQ−4 = .569; FPBQ(4,128) = 0.295; pPBQ = .881), secondary or university education (tPDQ−4(112) = 1.809; pPDQ−4 = .073; tPBQ(112) = 1.338; pPBQ = .184), and the length of work experience did not differentiate narcissism (RPDQ−4 = .168; tPDQ−4 = −1.853; pPDQ−4 = .066; RPBQ = .063; tPBQ = −0.681; pPBQ = .497). Advance in age was related to diminished levels of narcissism (RPDQ−4 = .21; R2PDQ−4 = .044; BPDQ−4 = −0.034; tPDQ−4 = −2.463; pPDQ−4 = .015). Higher narcissism was related to the belief of being a special person (70.8%) and to the perceptions of other people as being envy of one's personality–own achievements (60.9%).

Conclusions

Narcissistic personality disorder is rare in the studied Bulgarian adult population – 4.5% of the subjects (n = 6) had the highest levels of narcissism on both scales that corresponded to the proportion of 6% prevalence of lifetime narcissism in USA, according to Stinson et al.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personality Disorders and Temperament Traits in Patients with Breast Disease: Preliminary Results
Authors: Prisco V. , Iannaccone T. , Di Grezia G.
Published: June 2017

Aim of the study was to identify individual characteristics in patients with a benign or malignant breast disease diagnosis. The role of specific personality traits has been considered in the assessment of temperament and character as a predictor of a certain psychopathological state in patients with breast disease diagnosis. Participants were interviewed using a structured clinical test (SCID-II, version 2.0) disorders, and the Italian version of Akiskal's semi-structured clinical interview for temperamental profiles (TEMPS-I) after clinical breast exams and ultrasonography. All patients presented different personality disorders and heterogeneity in temperamental profiles. Of 29 patients with benign breast disease diagnosis, twelve presented histrionic, seven narcissistic, five dependent, four obsessive, two borderline, one antisocial and one paranoid personality disorder. The histrionic-narcissistic disorder is associated with benign breast disease. The three patients with malignant diagnosis presented the same temperamental profile: depressive temperament was associated with malignant breast disease diagnosis. According to recent literature personality disorders cannot influence breast cancer or its prognosis. However, a psychological consultation represent a very important step to pre-dispose specific interventions, treating psychiatric reactive comorbidities. The study shows the relevance of psychiatric counselling in breast units in the diagnostic cluster detection. Future purpose is to extend the sample and to add a follow-up evaluation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Change in Attitude Towards Psychotherapy in the Course of Clinical Practice: Qualitative Analysis of Experience of Students from Various Health Care Fields
Authors: Sapezinskiene L. , Jukstaite-Pacesiene L. , Vagonis A. , Liutkus S. , Mickuviene N.
Published: June 2017

Introduction

A stigmatizing attitude towards psychiatry and psychotherapy still prevails in Lithuania. It is evidenced by a variety of patterns, especially by a controversial social opinion about a person suffering from mental disorders.

Objectives

To investigate the experiences of students in Psychiatry and General Practitioner Residency studies and those in Bachelor's and Master's degree programs of Psychology who during their clinical psychiatric practice joined a multi-professional team at the Stress Related Disorders Department as temporary members; and to analyse how their attitude towards psychotherapy changed in the process.

Aims

To analyse students’ feedback about their experiences and involvement into the activity of the multi-professional team at the Stress Related Disorders Department (day care) during their clinical psychiatric practice.

Methods

Qualitative research methods based on phenomenological sociology were employed in the study. Students responded to five questions in writing during interview. Collected qualitative research material was analysed while applying content analysis.

Results

Eighteen subthemes were obtained and they were matched with the following nine main thematic codes: (1) past, present, future; (2) difficult beginning: “birth”; (3) childbirth pain; (4) childhood challenges; (5) birthing team; (6) adulthood; (7) mourning; (8) joining the team; and (9) future prospect.

Conclusions

Clinical psychiatric practice develops a multidisciplinary attitude towards psychiatry including both pharmaceutical and non-pharmaceutical treatment while using individual and group psychotherapy. Significant experience and attitude of health care students changed during clinical psychiatric practice as they acquired deeper understanding of the meaningfulness of psychotherapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Diagnosis of Predominant Negative Symptoms: Post-hoc Analyses of a Phase 3 Clinical Trial with Cariprazine Monotherapy and Risperidone
Authors: Laszlovszky I. , Barabássy Á. , Szalai E. , Szatmári B. , Harsányi J. , Németh G.
Published: June 2017

Objective

To present, post hoc analyses from a controlled, prospective study of predominant negative symptoms (PNS) of schizophrenia on baseline patient characteristics, severity of symptoms and their variability among participating countries.

Methods

Data were analyzed from a phase 3, randomized, double-blind, active-controlled, parallel-group study in adult PNS patients with schizophrenia (EudraCT Number 2012-005485-36). Subjects with a PANSS factor score for negative symptoms (PANSS-FSNS) ≥ 24 and no pseudo-specific factors (e.g. high positive symptoms, extrapyramidal symptoms, depression) were randomized to cariprazine 4.5 mg/d (dose range: 3–6 mg/d) or risperidone 4 mg/d (dose range: 3–6 mg/d) for 26 weeks. Baseline values of PANSS-FSNS, individual PANSS items, personal and social performance (PSP), and clinical global impression of severity (CGI-S) were analyzed based on the data gained from 11 European participating countries.

Results

Average PANSS-FSNS of patients was 27.6 ± 2.48, reflecting severe negative symptoms. Patients were moderately ill (CGI-S 4.2 ± 0.75), with marked difficulties (PSP 48.4 ± 10.78) predominantly in social functioning. The investigated patient population was fairly homogeneous as shown by small variability in all three scores. Moreover, baseline values in the 11 countries presented low variability while number of enrolled patients per country showed high variance (n = 7–118). Narrative description of symptoms and individual PANSS items rated as most severe and prominent were in high correlation.

Conclusion

Post hoc evaluation of this predominant negative symptom study showed that, this patient population can be identified reliably by psychiatrist. Additional training on the judgment of personal and social relationships can increase the diagnostic accuracy.

Disclosure of interest

Employee of Gedeon Richter Plc.
Economic Aspects in the Treatment of Schizophrenia in Italy: Cost Consequences of an Early Long-acting Injectable Anti-Psychotics (lais) Approach
Authors: Marcellusi A. , Mennini F.S. , Brugnoli R. , Rapinesi C. , Kotzalidis G.D. , De Filippis S. , Carrus D. , Ballerini A. , Francomano A. , Ducci G. , Del Casale A. , Girardi P.
Published: June 2017

Purpose

The aim of this analysis was to evaluate the economic consequences of a new treatment approach in the treatment of schizophrenia in the Italian setting. In terms of direct costs, in Italy was estimated that the main driver were represented by hospitalization and residential cost (71% of total direct cost per patient), followed by semi-residential services (13%), anti-psychotic and other drugs (8%) and ambulatory services (8).

Methods

A probabilistic cost consequence model was developed to estimate the potential cost reductions derived from an early treatment with atypical long-acting injectable anti-psychotics (aLAIs) drugs. A systematic literature review was carried out to identify direct and indirect costs associated to the management of schizophrenic patients in Italy. The model projects a scenario analysis in order to estimate potential cost reductions applying a new model management (MoMa) based on patient recovery and early aLAIs treatment.

Results

Overall, the total economic burden associated with schizophrenia was estimated at €2.7 billion per year. A total of 50.5% of the economic burden was related to indirect costs and 49.5% to direct costs. Drug costs correspond to 10% of the total expenditure in terms of direct costs, while hospitalization and residential costs accounts for 81%. Scenario analysis demonstrate a potential cost reduction between 200 million and 300 million based on the effects of MoMa over the reduction of hospitalization and residential costs.

Conclusions

This analysis was the first attempt to translate clinical management aspects in economic consequences and will be a useful instruments for decision maker.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Efficacy and Quality of Life in Patients with Schizophrenia and Schizoaffective Disorders Treated with Long-acting Paliperidone Palmitate: A Naturalistic Longitudinal Study
Authors: Nivoli A. , Folini L. , Floris L. , Antonioli M. , Pinna F. , Paolo M. , Bernardo C. , liliana L.
Published: June 2017

Introduction

Intramuscular paliperidone palmitate (PP) is a long-acting, atypical antipsychotic for ntramuscular (IM) administration in the treatment of patients with schizophrenia.

Objective

To study efficacy and quality of life in patients with schizophrenia and schizoaffective disorders treated with long-acting paliperidone palmitate.

Method

A non-randomized, prospective naturalistic study was performed in out-patients with schizophrenia and schizoaffective disorder unsuccessfully treated with oral antipsychotics. Efficacy of PP over time was evaluated by using BPRS 24-items (Brief Psychiatric Rating Scale) Quality of life was evaluated by the QL-Index (Quality of life Index) at T0 and at most recent visit (T1).

Results

Data were available for 16 outpatients consecutively prescribed PP and naturalistically treated attending at the Psychiatric Clinic, University of Sassari. Patients were predominantly male (n = 9; 56.2%), with schizophenia (n = 10; 62.5%). Three patients dropped out (18.8%). Mean time on PP treatment was 870.0 days (sd 217.02) at a mean PP maintenance dose of 97.82 ± 37.17 mg eq. BPRS mean total score at T0 was 55 (sd 14.5) and at T1 was 44.8 (sd 11.8). Ql-Index mean total score was 5 (sd 1.6) at T0 and 7.2 (sd 2.4) at T1. Paired sample test showed a statistically significant difference in deacreasing symptoms at BPRS over time (P = 0.009) and in improving Quality of life at QL-Index (P = 0.017). The analyses showed a significant improving at the following BPRS sub-items: Depression (P = 0.021), Hostility (P = 0.022), Suspiciousness (P = 0.005), Hallucinations (P = 0.050), Unusual thought content (P = 0.029), Self-neglet (P = 0.028), Conceptual disorganization (P = 0.044), Emotional withdrawal (P = 0.028) and Distractibility (P = 0.014).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Audit on Prescribing Practice of Depot Antipsychotic Injections in the Adult Community Mental Health Service
Authors: Ray M. , Rao S.
Published: June 2017

Introduction

There are a number of good standard practices available for prescribing long acting antipsychotics. Adherence to these guidelines will minimise any harm to the service users.

Aims

To compare depot antipsychotic prescribing practice with good standard practice guidelines of BNF, Trust and Maudsley guidelines.

Objectives

To compare practice with standards in the areas of:

– licensed indication;

– dose/frequency range;

– avoiding poly-pharmacy;

– regular review of clinical and side effects.

Methods

Case notes of a randomly selected sample of 30 patients from the depot clinic at the City East Adult Community Mental Health Team Leicester, UK were retrospectively investigated. The data collected was analysed and the results were produced. Compliance with the best practice guidelines was calculated and recommendations made based on the findings.

Results

One hundred percent compliance was noticed in licensed indications and dose/frequency within BNF range. However, 14% patients received poly-pharmacotherapy, 86% had regular outpatient review, but only 46% had review of side effects.

Conclusions

Better quality of documentations by the clinicians, improvised technology to elicit automatic review reminders, introduction of checklist for clinics to include review of all clinically important information, wider dissemination of the findings of this investigation, and re-auditing practice to explore impact of this investigation was recommended.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychological Traits of Skin Picking Disorder and Psychogenic Itch
Authors: Rupchev G. , Vinogradova M. , Malyutina A. , Tkhostov A. , Ryzhov A.
Published: June 2017

Introduction

Despite the intense discussion of psychiatric comorbidity in psychodermatology, research on psychological components of skin picking and psychogenic itch is limited, especially when it concerns patients’ representation of skin perception and their attitude towards disease.

Objectives

To characterize psychological traits of skin picking and psychogenic itch disorder by comparing aspects of bodily experience.

Aims

To reveal internal relations of different components of bodily experience in skin picking and psychogenic itch.

Methods

Thirty patients with skin picking disorder (L98.1) and 18 patients with psychogenic itch (F45.8) participated in the study. The psychosemantic method “Classification of sensations” was used to assess bodily experience. It includes estimation of 80 descriptors from 6 classes of bodily sensations: skin (ex. “itch”), inner body (ex. “sickness”), receptor (ex. “sticky”), emotional (ex. “anxiety”), dynamics (ex. “exhaustion”) and attitudinal descriptors (ex. “bad”). Cluster and factor analysis were performed.

Results

The most significant aspect of bodily experience in skin picking was its dynamics as a transition from irritation to calmness connected with the sensation of itch opposed to all other sensations (there were opposite signs of factor loadings of these variables and they were included in the factor explaining 45% of total variance). In contrast, in psychogenic itch these relations are diffuse and consist of connections between skin sensations and inner bodily sensations and descriptors of emotions reflecting functional origin of disorder.

Conclusion

Traits of psychological components in skin picking disorder and psychogenic itch should be concerned in the complex (psychiatric, psychological and dermatological) treatment of these disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The peculiarity of Experiencing Body by Patients in Schizophrenia
Authors: Rupchev G. , Alekseev A. , Tkhostov A. , Spivakovskaya A. , Guldan V.
Published: June 2017

Introduction

By the present, the study of corporeality as a psychological phenomenon in schizophrenia has had a lack of attention. At the focus of works, there have been mainly psychopathological phenomena: cenestopathies, visceral hallucinations and body scheme disturbances. There is an evidence of the necessity for psychological investigations: the execution of radical changes in appearance, a frequent turning to plastic surgery, dysfunctional wearing and transsexuality.

Objectives

The experimental group consisted of 23 patients in schizophrenia of paranoid type (F 20.00). The control group consisted of 27 healthy subjects.

Aim

It is to study the peculiarity of experiencing their own body by patients in schizophrenia.

Methods

There are projective techniques, such as: “A Picture of Me”, “Verbal Self-Portrait”, ‘A Picture of Inner Body” and the psychosemantic test “Classification of Sensations”.

Results

There are statistically significant differences (P < 0.005) found between the groups:

– patients with schizophrenia are characterized for their deficit of experiencing their body. It does not refer to “Myself” and is deinvidualized. The body does not serve as a physical presentation of the subject in a social world;

– a wary attitude is observed in relation to body displays in the form of inner body sensations with a minor (than in norm) awareness relatively to the inner arrangement of their own body. This causes the increase of the quantity of intraceptive sensations categorized by patients in schizophrenia as unhealthy or a threat.

Conclusion

The above-mentioned peculiar features of corporeality in schizophrenia make it a source of negative experiences.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness of Paliperidone Palmitate Long-Acting Injectable in the Initial Stages of Psychosis: Clinical and Functional Impact
Authors: Sánchez Blanco L. , Gómez Revuelta M. , Gajardo Galán V. , Juncal Ruíz M. , Landera Rodríguez R. , Santayana Jenaro G. Pardo de , Porta Olivares O. , Núñez Morales N.I.
Published: June 2017

Introduction

An appropriate early intervention (EI) after the onset of a first episode of psychosis (FEP) is a key factor to prevent relapse, cognitive and functional impairment related to neurotoxicity as it is a critical period in order to get good adherence to treatment. This is the most reported factor linked to relapse. Therefore, interventions focused on getting good adherence to treatment may make the difference in terms of outcome.

Aims

To compare relapse rates, symptom severity and level of functionality before and after treatment with Paliperidone Palmitate Long-Acting Injectable (PP-LAI). To analyze prior antipsychotic treatments and side effects registered before and after the introduction of (PP-LAI).

Material and method

This is a cross-sectional descriptive study. We analyzed a sample of 15 patients, recruited from PAFIP (an specialized EI unit) and treated with variable doses of PP-LAI. They all met diagnostic criteria for schizophrenia according to DSM-IV. Clinical and functional data of the two years before and after treatment intoroduction were recorded.

Results

Twenty-seven percent of the patients resumed their work activity or studies and 33% of the patients increased their social activity. Thirteen percent of the patients improved from negative symptoms. Prior to treatment introduction, more than a half of the simple, had suffered one or two relapses. After treatment introduction, 87% did not experience more relapses while 13% experienced another relapse.

Conclusions

Treatment with PP-LAI is associated to a recovery of functional abilities, and a trend to clinical stability with high adherence to treatment related to few side effects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Self-Image and Risk of Suicide in Eating Disorders
Authors: Birgegård A. , Andersen M.
Published: June 2017

Introduction

Suicide risk is increased in eating disorders (ED), and detection is key to prevention. Self-image as operationalized in the structural analysis of social behavior (SASB) model has been shown to be associated with symptoms, treatment dropout, and outcome. SASB is a circumplex organizing self-directed behaviors along affiliation (love vs. hate) and autonomy (set free vs. control) dimensions. In a recent study, SASB related to health care-detected suicide attempts in ED. Methodology in that study ensured high specificity but risked lower sensitivity in suicide variables, and with such a high-threat outcome, research is needed on additional variables related to risk.

Objectives and aims

We aimed to study associations between SASB self-image and clinician- and self-rated suicidality at presentation and predicted over 12 months in ED patients.

Methods

Adult patients (n = 551) from a Swedish clinical database included 19% anorexia, 32% bulimia, 7% binge ED, and 42% other ED. We ran separate regression models for these diagnostic groups using SASB questionnaire data, also controlling for general psychiatric and ED symptoms, and in longitudinal models including baseline of each outcome.

Results

SASB alone was associated with suicidality at presentation (9–67% variance explained) and predictively over 12 months (7–29%), and in the majority of models explained additional variance beyond baseline and clinical variables. Both affiliation and autonomy related to dependent variables in diagnosis-specific patterns.

Conclusions

The findings have implications for both theory and detection tools for suicide risk, as well as suggesting intervention targets to mitigate risk in treatment based on the well-validated SASB theory.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Rosa Damascena Improved Sexual Dysfunction in Males Under Methadone Treatment – Results from a Double-Blind, Randomized, Placebo-Controlled Clinical Trial
Authors: Farnia V. , Tatari F. , Alikhani M. , Shakeri J. , Taghizadeh M. , Ngo V.T. , Sadeghi Bahmani D. , Holsboer-Trachsler E. , Brand S.
Published: June 2017

Introduction

Patients with severe opioid dependency might be treated with methadone, a pure μ-opioid-receptor, with promising results. Though, as for opioids, side effects are high, and among those, sexual dysfunction is among the most disturbing side effects.

Aims

Investigating the influence of Rosa Damascena oil to improve sexual dysfunction among male methadone users.

Methods

A total of 60 male patients (mean age: 30 years) with diagnosed opioid dependence and currently under treatment of methadone were randomly assigned either to the verum (Rosa Damascenca oil drops) or placebo condition. At baseline, and four and eight weeks later, patients completed self-rating questionnaires covering sexual dysfunction and happiness.

Results

Over time sexual dysfunction decreased and happiness increased in the verum, but not in the placebo condition.

Conclusions

Results from this double blind, randomized, and placebo-controlled clinical trial showed that Rosa Damascena oil improved sexual dysfunction and happiness among male opioid addicts while under substitution treatment with methadone.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sexual Dysfunction in Oncology
Authors: Cochat Costa Rodrigues M.C. , Faria R.G. , Almeida S.
Published: June 2017

Introduction

Sexual dysfunction is a common consequence of cancer treatment that affects at least half of men and women treated for pelvic tumors and more than one quarter of individuals with other malignancies.

Objectives/aims

Identification of the main sexual dysfunctions related to cancer treatments. Awareness to the importance of addressing sexuality to cancer patients, identifying the main reasons why healthcare providers usually do not.

Methods

Literature review concerning researched articles published in Pubmed/Medline as well as related bibliography.

Results

Most sexual problems are not caused by the cancer itself, but by toxicities of cancer treatment. Damage during cancer treatment to pelvic nerves, blood vessels and organ structures leads to the highest rates of sexual dysfunction. The most common sexual dysfunction in men under cancer treatment is the loss of desire for sex and erectile dysfunction. In women, the most common sexual dysfunctions are vaginal dryness, dyspareunia and loss of sexual desire, usually accompanied by difficulties in both the arousal and orgasm phases. According to literature, there are many cancer patients who would like to be informed and advised by their healthcare providers about the consequences of cancer treatment on their sexual health. Unfortunately, this rarely happens.

Conclusions

This work intends to publicize current existing information on sexual dysfunction in oncology, focusing on the prevalence, etiology and clinical presentation. The authors also intend to promote communication about sexual function and possible sexual dysfunctions resulting from cancer treatments.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental Illness and Mental Health Care as Experienced by Persons who Die by Suicide; a Qualitative Analysis of Suicide Notes
Authors: Furqan Z. , Zaheer J. , Sinyor M. , Schaffer A.
Published: June 2017

While mental illness is a risk factor for suicidal behaviour and many suicide victims receive mental health care prior to death, there is a comparative lack of research that explores their narratives of care. Suicide notes offer unique insight into these subjective experiences. Our study explores the following questions: “How is mental health care experienced by those who die by suicide?” and “What role does this experience play in an individual's journey to suicide?” Our sample is a set of 21 purposefully selected notes that explicitly make mention of mental illness and/or mental health care, from a larger sample of 255 notes obtained through the Toronto Coroner's Office. We utilized a constructivist grounded theory framework to engage in line-by-line open coding, axial coding, memo-ing and theorizing of the data. Preliminary themes include (1) perception of recurrent utilization of mental health care as personal failure, (2) recurrent utilization of mental health care as a manifestation of accumulating hopelessness, (3) the construction of suicide as being beyond the scope of mental health care, (4) tensions between the conceptualization of mental illness as an inherent part of the self and mental illness as a disease to be fought or overcome, and (5) suicide as an exertion of self-autonomy, distinct from the influence of mental illness. An exploration of the complexity of an individual's relationship with mental illness and mental health care can foster better identification, understanding and support for those at risk for suicide.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric Ward Consumption Before Suicide: A Case-Control Study
Authors: Sellin T. , Holländare F. , Tillfors M.
Published: June 2017

Introduction

There is a need of identifying predictors of suicide. With effective treatment interventions for those at highest risk, suicide can be prevented.

Aim

To investigate variables possibly associated with suicide, by comparing patients in psychiatry deceased by suicide to matched controls. We compared the psychiatric ward consumption two years prior to suicide, previous medical and psychological treatments, somatic co-morbidity and the professions of health care staff in previous visits.

Method

The 153 suicide cases, 101 (66%) men and 52 (34%) women, aged between 13 and 96 years, were identified from the National Cause of death registry. All cases had previous contact in psychiatry in Örebro County and died between January 1st 2007 through December 31st 2013. Each case had one gender-, age- and diagnosis matched patient control from psychiatry. Data on care usage were collected from medical records. Correlations were calculated between ward variables and the outcome variable suicide yes/no. Variables significantly correlated to suicide were used in an adjusted logistic regression model to analyse possible associations with suicide.

Results

Among the cases deceased by suicide, we found significantly fewer psychiatric outpatient visits (P < .01), a smaller amount receiving systematic psychological treatment (P < .01), less pharmacological interventions (P < .01) and a smaller amount of treatment provided by a multi-professional team (P < .01). Less occurrence of psychological treatment (OR(adj): 0.459; 95% CI 0.224–0.874, P < .05) was significantly associated to suicide.

Conclusions

Results indicate that not only repeated visits in psychiatric care, but the content of visits (i.e. psychological interventions) seems to make an important difference between life and death.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Drug Metabolizing Enzyme and Transporter Genes Associated with Plasma Risperidone Level in Thai Autism Spectrum Disorder
Authors: Sukasem C.
Published: June 2017

Background

The associations between genetic variants of drug metabolizing enzyme and transporter (DMET) genes and steady-state plasma concentrations of risperidone, 9-hydroxyrisperidone, total active-moiety, and metabolic ratio remain unclear.

Objective

The objective of the present study was to present the results of the association between genetic variants of DMET gene and steady-state plasma concentration risperidone and its metabolite using Affymetrix DMET Plus genotyping microarray.

Methods

Subjects eligible for this study included male and female adolescents with ASD diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and being treated with risperidone for at least 4 weeks prior to the blood sample collection. Blood samples were drawn prior to the next dose of risperidone intake to determine the steady-state plasma trough concentrations of risperidone and 9-hydroxyrisperidone. Genotyping profile was obtained using the microarray. Steady-state plasma risperidone and 9-hydroxyrisperidone were measured using liquid chromatography/tandem mass spectrometry (LC-MS/MS) assay.

Results

The polymorphisms of UGT2B4, CYP2D6 were highly associated with metabolic ratio. Of all the DMET analysis, ABCB11 (3084A > G, 420A > G, 368G > A, and 236G > A) and ADH7 (690G > A and –5360G > A) were found to be associated with plasma concentrations of risperidone (P < 0.01). In addition, 6 genetic variations among the SLC transporter family were associated with the plasma concentration of 9-hydroxyrisperidone.

Discussions

This study provides a pharmacogenomic approach to investigate further among the DMET genetic variants which influence plasma concentration of risperidone. The treatment of ASD should be based on genetic factors making the challenge of psychopharmacological treatment more efficacious with lesser adverse events.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.