bluuebunny/crossref_metadata_2025 huggingface dataset:
2254 – Analysis Of The Effect Of Memantine In Reducing Clinical Symptoms In Patients With Moderate To Severe Alzheimer's Disease
Authors: Moruzzi E.
Published: July 2013

Introduction

Alzheimer's disease is a progressive neurodegenerative disorder in which the patient experiences progressive loss of cognitive and functional abilities and concomitant behavioural disturbances. Memantine, a moderate affinity, uncompetitive N-methyl-d aspartate (NMDA) receptor antagonist, is approved for the treatment of moderate to sever Alzheimer disease.

The NMDA receptor subtype of glutamate receptors is involved en regulating synaptic plasticity and likely plays a role in learning and memory. The stimulation of this receptor can result in excessive intracellular calcium concentrations and might possibly contribute to both acute and chronic forms of neurodegeneration. Memantine has been shown to improve symptoms and reduce the rate of clinical deterioration among patients with moderate to severe Alzheimer's disease.

Methods

A safety anlysis of Alzheimer’s disease patients from four randomized placebo controlled, double-blind memantine dementia studies included 50 and 50 memantine and placebo the aled patients. A vast majority of the patients received memantine 20 mg/day for a duration of at least 12 weeks, with most receving treatment for 28 weeks. Active and placebo groups were well matched demographically.

Conclusions

Overal, memantine showed statistically significant benefits on global and statistically significant benefit on cognition. Memantine consistently benefited patients in all stages of Alzheimer's disease and was well-tolerated.
2257 – Family Interventions For The Severe Mentally Ill In Portugal: a Country-level Project Of Training And Implementation
Authors: Xavier M. , Cardoso A. , Carvalho Á. , Mateus P.
Published: July 2013

Introduction

Psychiatric deinstitutionalization has been frequently associated with an increase in family burden in most Western countries. Research shows that notwithstanding of evidence of its usefulness, family interventions for psychotic disorders are not routinely applied in most public mental health services. This applies especially to countries where family issues are not so well documented, such as Portugal. To address that issue, the Ministry of Health hurled a training program on family interventions for the severe mentally ill, ensuing the recommendations of the National Mental Health Plan.

Objectives

a)

to launch a family intervention training program on a national level, and

b)

to identify the obstacles to implementation in routine settings.

Methods

Professionals from public mental health services throughout Portugal attended a 3 days full-time course in which they were trained in the family intervention, consisting in guidelines presentation and discussion, demonstrative audios/videos and role-playing sessions.

Results

The trainees' acquisition of competences was found rather encouraging. Perceived obstacles to the implementation of the family intervention in routine practice comprised work overload, the nuisance to integrate weekly family sessions with other professional tasks, and the stunted availability of time to run the intervention on a regular basis.

Conclusions

Arrangements need to be envisaged in order to overcome deal with barriers limiting the implementation of family interventions in routine settings. Amelioration have to focus on changing the organisation of the mental health facilities, like greater handiness of dedicated hours and career inducements for professionals working with the families of psychotic patients.
2258 – Architectural Features And Design Principals Of Residential Spaces For Children's Creativity Promotion
Authors: Sadjadi A. , Nazarboland N.
Published: July 2013

The aim of this study is to findout the architectural features and principals of residential spaces which can help children to promote their creativity. To do so, we explored the environmental variables of creativity which were used as a questionnaire. 164 children aged from 4 to 7 years old, were surveyed in two groups of creative (n=80) and noncreative (n=84). The effective factors are revealed by using factor analysis method and based on relation of variables, a hypothetical model is developed. By the use of path analysis, results showed that stimulation of natural environmental elements, using colorful and exciting images, shape and space flexibility for child’s participation, play the most important role in promoting children’s curiosity, which could be led to their creativity. The findings are more discussed in the main article.
2259 – Translating Evidence Into Practice: Renewed Perspectives In Mental Health Services Organisation
Authors: Mateus P. , Carvalho Á. , Xavier M.
Published: July 2013

Introduction

The science of implementation consider the steps that influence the translation of evidence-based treatments into routine use. The implementation of a new Portuguese National Mental Health Plan started in 2007. In order to improved the way that services are delivered, an implementation process of a case-management (CM) was initiated by the National Programme for Mental Health.

Objectives

To assess the results of a implementation programme considering the following dimensions:

a)

mental health services main characteristics,

b)

leadership profile,

c)

main obstacles to implementation,

d)

implementation fidelity.

Methods

40 public and private mental health services were included for evaluation. Implementation activities included a CM training programme. Implementation degree and main obstacles to implementation were rated by: Barriers and Facilitators Assessment Instrument (Peters, 2001) and Illness Management Fidelity Scale (Mueser, 2009).

Results

Assessment of services showed: liaison (50%), guidelines use (57%), single clinical records (50%), in service formal education plan (85%), research practice (21%). Regarding professionals profile, 70% used case management in practice, only 20% with formal training. Full implementation occurred in 36,3% of services, fair implementation in 45,4%, but still not enough implemented in 18,3%. Main barriers were lack of time (61%), lack of dedicated facilities (61%), low motivation (38%) and absence of financial incentives (38%).

Conclusions

In spite the efforts to implement evidence based practices in Portuguese mental health services, there are still several obstacles that difficult full implementation. Structured implementation programmes may constitute coadjutants to ameliorate the delivery of effective practices.
2262 – Community's Attitude Toward Cancer Diagnosis Disclosure
Authors: Eslami Shahrbabaki M. , Khalili N. , Mehdizadeh Zare Anari A. , Moshrafi A. , Bashardost N. , Yousefzadeh M.
Published: July 2013

Objectives

Bad news is ''any news that adversely and seriously affects an individual's view of his or her future and it is usually perceived to be related to incurable diagnosis or diagnosis leading to death. The physicians should not uncover main information especially about the future or present patient's situation, Today more than ever patient's legal and ethical right to understand the reality of his disease is respected This study was carried out to probe Iran community's attitude toward breaking bad news.

Method

This was a cross-sectional study in which 200 patients' companions in various wards of Afzalipour Hospital in Kerman were included. Data were entered in the questionnaires designed to evaluate people's attitude toward giving bad news and its quality.

Results

93 percent preferred to get aware of diagnosis in a supposed cancer situation. The majority agreed with expressing treatment strategies, complications, cure probability and estimated survival. Most agreed that decision making should be based on physician priorities, with having patients' desire in mind.

Conclusion

In terms of giving bad news, physicians ought to build up a more efficacious relationship with patients regarding their individual needs and requests.
2275 – Depression And Anxiety In Women With Breast Cancer At The First Oncology Consultation After Surgery
Authors: Grazioli L. , Martinelli V. , Dionigi F. , Grasso D. , Sgarella A. , Ferrari A. , Riboni G. , Politi P.
Published: July 2013

Introduction

There is evidence that women with breast cancer can develop anxiety and depression, ultimately affecting patients’ compliance and quality of life.

Objectives

Previous studies investigated psychological distress in women with breast cancer at different stages of the disease. However, few data are available about Italian women in the early steps of their clinical history.

Aims

To investigate psychological distress, anxiety and depressive symptoms in a sample of women with a recent diagnosis of breast cancer.

Methods

This cross-sectional study involved twenty-five women consecutively attending the oncology outpatient clinic for their first oncology evaluation after surgery. Anxious and depressive symptomatology was assessed through the Hospital Anxiety and Depression Scale (HADS) and Distress Thermometer (DT). Socio-demographic and clinical characteristics were also collected. Correlations were analyzed using Spearman's correlation coefficient.

Results

The mean values (±SD) of the HADS Anxiety and Depression Subscales were 7.6 (±4.7) and 5.7 (±4.4) respectively. Five patients (24%) scored ≥10 at the HADS Anxiety subscale and 16% scored ≥10 at the HADS Depression subscale, suggesting the presence of clinically relevant symptomatology. DT mean score (±SD) was 5.36 (±3.5), with 48% of patients scoring ≥7, indicative of significant psychological distress. Multivariate analysis showed an inverse correlation between psychological distress severity and time after cancer diagnosis.

Conclusions

These preliminary findings show a prevalence of anxious and depressive symptoms in one out four women with breast cancer. Further prosecution of the study will help to identify women at risk for psychiatric comorbidities, suggesting the development of targeted interventions.
2279 – Post Traumatic Stress Symptoms And Anxiety As Attentional Bias Modulators In “control” Population
Authors: Nachon O. , Gindt M. , Garcia R. , Faure S.
Published: July 2013

Introduction

Information processing studies, such as attentional bias, help to distinguish anxious pathologies. If Vigilance and disengagement bias have been widely demonstrated in generalized anxiety and post traumatic stress disorder (PTSD), their existence has not been reported in non clinical sample with or without anxiety and/or PTSD symptoms.

Objectives and aims

The aim of the present study was to examine the possible presence of specific attentional bias in these populations and compare them with classical bias in PTSD patients.

Methods

One hundred and thirty-one students completed a visual search task with a lexical decision component, and anxiety and PTSD scales. We controlled attentional bias: vigilance / disengagement and words valence: neutral / general threat-related / trauma-related. Ten PTSD patients were assessed for PTSD with CAPS and completed the same protocol.

Results

Among non clinical sample, four groups were distinguished: without symptom, anxious, PTSS (Post-Traumatic Stress Symptom) and, anxious and PTSS groups. Analysis of response time and error rate show different pattern of bias in each non clinical group. Considering the PTSS group response times were higher for trauma-related words, while for threat-related words, the anxious group was characterized by lower response times. Without symptom participants showed an attentional bias for negative information. Anxious and PTSS participants were characterized by a generalization of both biases.

Conclusions

These data reveal the existence of different types of information processing between these four non clinical groups. A putative role of anxious symptoms, in anxiety pathologies such as PTSD, on attentional bias is discussed.
2280 – Oestrogen Related Features And Gynaecological Service Use In Delusional Disorder
Authors: González-Rodríguez A. , Molina-Andreu O. , Imaz Gurrutxaga M.L. , Penadés Rubio R. , Bernardo Arroyo M. , Catalán Campos R.
Published: July 2013

Introduction

Oestrogens may be a protective factor in psychosis. Women with schizophrenia have a later age of menarche, fewer pregnancies and earlier age of menopause. However, little information is available focusing on delusional disorder (DD).

Objectives

To evaluate gynaecological variables and psychopathology in women with DD.

Aim

To investigate the relationship between age of menarche and onset, and psychopathology in DD.

Methods

Forty-five outpatients with DD (DSM-IV-TR) were recruited at the Hospital Clinic of Barcelona, from 2008 to 2012. Twenty-five females underwent a demographic and gynaecological questionnaire. HRSD-17 for depression, PANSS for psychopathology, PSP for functionality and C-SSRS for suicide were assessed. The sample was divided into two groups according to the age of menarche: 12 years or less and more than 12.

Results

Mean age of menarche (SD) was 12.6(1.4) years, mean age of menopause 49.1(3.15), mean age at onset of DD was 49.9(12.58). 33.3% of the sample did not receive gynaecological service in the last 3 years. The group with the earliest age of menarche was older [67.33(11.67) vs.56(9.6); p=0.026], presented an earlier age of menopause [46.80(2.84) vs.50.71(2.29) p=0.018] and latest onset of DD (53.50(14.32) vs.47.44(11.5); p=NS], than those with later age of menarche. No differences were found regarding psychopathology, suicidal behaviour or functionality.

Conclusions

Although a small sample size, this is the first study to specifically examine gynaecological variables in DD. A low compliance rate in gynaecological service use was found. An earlier age of menarche was associated to an earlier age of onset of DD.
2283 – Safety And Tolerability Of Aripiprazole Once-monthly Initiated In Adults With Schizophrenia Stabilized On Atypical Oral Antipsychotics Other Than Aripiprazole
Authors: Potkin S. , Raoufinia A. , Mallikaarjun S. , Bricmont P. , Peters-Strickland T. , Kasper W. , Jin N. , Baker R.A. , Eramo A. , Sanchez R. , McQuade R.D.
Published: July 2013

Objective

Evaluate the safety and tolerability of aripiprazole once-monthly (ARI-OM) initiation in patients stabilized on oral antipsychotics other than aripiprazole. Previous pivotal Phase III trials have evaluated initiating ARI-OM in patients stabilized on oral aripiprazole1.

Methods

Eligible patients were treated with oral atypical antipsychotics other than aripiprazole with a history of oral aripiprazole tolerability. The study included a screening phase (30 days) and a treatment phase (28 days). Patients were stabilized per investigator's judgment for ≥14 days on risperidone, olanzapine, quetiapine, or ziprasidone, before administration of ARI-OM (400 mg). Current oral antipsychotic was co-administered with ARI-OM for 2 weeks to determine safety and tolerability of a single ARI-OM dose following treatment initiation. Safety assessments were adverse events (AEs); extrapyramidal symptoms (EPSs) using standard objective rating scales; Columbia-Suicide Severity Rating Scale; clinical laboratory measures; and weight changes.

Results

60 patients initiated ARI-OM, while continuing treatment for ≤2 weeks with oral risperidone (n=24), quetiapine (n=28), ziprasidone (n=5) or olanzapine (n=3). Treatment-emergent (TE) AEs (≥5%) were fatigue, injection-site pain, and restlessness (risperidone); insomnia, dystonia, injection-site pain, and toothache (quetiapine); and muscle spasm, tooth abscess, and toothache (ziprasidone). Prior olanzapine did not cause any AEs. Incidence of TE-EPSs were similar in all groups (< 5%). There were no unusual changes in objective EPS rating scales, suicidality, weight, laboratory values or fasting metabolic parameters across all groups.

Conclusions

The AE profile of patients receiving ARI-OM concomitant with oral atypical antipsychotics other than aripiprazole was consistent with prior reports1.
2286 – The Difficulty Of Diagnosing Dementia In Patients With Intellectual Disability: Experience From a Uk Memory Clinic
Authors: Sommerlad A. , Dudley A.
Published: July 2013

Introduction

The prevalence rate of dementia in older adults with intellectual disability (ID) is comparable with that of the general population and is significantly higher in people with Down Syndrome (DS). It is recommended that diagnosis should be made following history, physical and mental state examination, cognitive assessment, blood tests and, ideally, neuroimaging. However, experience suggests that dementia may be underdiagnosed in this patient group thereby restricting access to appropriate management.

Aims

We aimed to elucidate the barriers to a timely diagnosis of dementia in the ID population attending a specialised ID memory clinic in London, UK.

Methods

We conducted a service review of the Clinic, retrospectively reviewing the records of all patients seen in 2011 to assess attendance and diagnosis rate, co-morbid physical and mental illness and the completion of neuroimaging and blood tests.

Results

32 patients were seen at least once during 2011 in the memory clinic, of whom 11 (34%) received a diagnosis of dementia. 22 (69%) of those seen had DS and 18 (56%) were male. 12 (38%) patients have thyroid dysfunction and 8 (25%) have epilepsy. 23 patients had completed a DLD in the past year and 14 (44%) had completed more than one DLD. 12 (38%) patients had a previous brain scan and 27 (84%) patients had had blood tests in the previous year.

Conclusions

Comorbid physical illnesses, consistent attendance at appointments, access to psychological assessment and willingness to undergo neuroimaging and phlebotomy are significant barriers to diagnosis of dementia in patients with ID.
2289 – Integration Of Emotions Towards Decision-making: Behavioural Performances Of Ocd Patients And Their Meg Correlates Compared To Healthy Controls
Authors: Lerebours A.-E. , Haynes W.I.A. , N’Diaye K. , Mallet L.
Published: July 2013

Obsessive compulsive disorder is characterised by repetitive behaviour, which is most often repetitive checking. Literature has suggested that these may be due to a lack of cognitive control on automated behavioural patterns. This can be interpreted as a dysfunction of behavioural selection by cortico-basal ganglionic loops. More precisely, we hypothesise that this dysfunction is due to a modification of decisional thresholds.

OCD patients show modifications in a circuit involving the frontal cortex and basal ganglia. Therefore, modifications in the decisional threshold and faulty behavioural selection could be due to altered integration of limbic and associative information coded by prefrontal areas.

To this aim, we compared behavioural performances of 20 OCD patients and 20 healthy volunteers on a decision-making task. This task included different difficulty levels (associative information), different emotional primes (IAPS) and feedback (limbic information). We hypothesised a lesser variability of the decisional threshold in patients, as well as less interaction between limbic and associative information. These would be linked to modifications in the power spectrum of prefrontal electrophysiological activities.
2294 – Treatment Induced Hyperprolactinemia In Psychotic Patients
Authors: Dehelean L. , Dehelean P. , Zosin I. , Stefan E.D. , Vasilian C.C. , Sfat D.C. , Giurgi-Oncu C. , Balas M. , Golu I. , Dumitrascu V.
Published: July 2013

Background

Important reciprocal relationships exist between the central nervous, the endocrine and the immune systems.

Objectives

The main objective was the quantitative determination of prolactin levels in acute and remitted psychotic patients receiving conventional and atypical antipsychotic treatment. Possible correlations between prolactin levels and psychotic, endocrine or immune disorders in patients' medical history or family history were checked.

Method

58 patients (42 women and 16 men) receiving antipsychotic treatment were included in the study in order of their presentation to control visits or admission in the psychiatric hospital. They were classified into the following ICD 10 diagnostic categories: acute and transient psychotic disorders, schizophrenia, persistent delusional disorder, schizoaffective disorder and bipolar disorder. The following data were collected: prolactinemia (chemiluminescence method), ASAT, ALAT liver enzymes, glycemia, serum creatinine, thyroid hormones, sexual hormones, the intensity of psychiatric symptoms measured with BPRS, personal and family history of psychiatric, endocrine, immune disorders or treatments.

Results

47 patients (81%) presented hyperprolactinemia (33 women and 14 men). 9 patients (16%) presented a history of autoimmune disorders, 4 (7%) having also a family history of autoimmune disorders. 9 women had amenorrhea or irregular menstrual cycle. 5 patients were on long acting antipsychotic treatment.

Conclusions

Regardless of the antipsychotic treatment received, the majority of the patients presented hyperprolactinemia. Women presented a higher increase in prolactin levels than men. The results were interpreted according to the thyroid and sexual hormonal status. A positive correlation between prolactin levels and BPRS scores was found (r = 0.2628 P= 0.0463, 95% CI).
2299 – Social Capital And Common Mental Disorder: Analysis Of The Adult Psychiatric Morbidity Survey 2007
Authors: Nair A. , Clarke C. , Stansfeld S.
Published: July 2013

Purpose

Social capital is emerging as an important component of mental well-being. Our aim was to assess the relationship between social capital and common mental disorders and to explore the role of social capital in the relationship between deprivation and common mental disorders.

Methods

This study used data collected from 7023 adults in England who completed the Adult Psychiatric Morbidity Survey (2007). Common mental disorders (CMD) were measured using CIS-R. Questions on both cognitive (CSC) and structural social capital were included, as well as data on area level deprivation.

Results

We found a strong association between higher CSC and lower levels of CMD, depression and anxiety. Structural social capital was associated with lower levels of CMD and depression but was not conclusively associated with lower levels of anxiety. While there is a relationship between low social capital and deprivation, we found that higher CSC was still associated with lower CMD in participants living in deprived areas. Results for structural social capital were less conclusive although an association with lower overall CMD was still found in the most deprived communities.

Conclusion

In a nationally representative sample, higher social capital is associated with lower levels of CMD. There appears to be a relationship between low social capital and deprivation and this may have implications for the mental wellbeing of individuals living in deprived communities.
2320 – Nurses’ Opinions About The Consultation-liaison Psychiatry And The Relationship Between Empathy And Communication Skills
Authors: Tun H. , Senyurt M. , Balikci A.
Published: July 2013

Purpose

This descriptive study aims to determine that nurses who working in medical and surgical clinics for opinions about Consultation-Liaison Psychiatry Unit and the relationship between emphatic tendency and communication skills.

Method

The sample of the study is consisted of 116 nurses who working in medical and surgical clinics between Agust- October 2012 and who are volunteer to participate the study. The data were obtained from Sociodemographic Data Collection Form, Empathic Tendency Scale and the Communication Skills Scale. Correlation, t-test, ANOVA tests were used in data analyzes.

Findings

50.5% of the nurses were worked in medical clinics, 52.2% of them were between the occupational experience of 1–5, 85.1% were registered nurse. 58.1% of the nurses directed patients to the Consultation-Liaison Psychiatry Unit (CLPU) and 66.2% nurses wanted to be receive consultancy on psychiatric nurse.

Average point of emphatic tendency of the nurses is 72.62±7.82 and average point of communication skills is 76,22±9.65. There was a positive correlation between emphatic tendency and communication skills score (r=0.499, p=0.00) in nurses. The nurses who working in psychiatric clinic were more empathic tendencies than the others (t=2.618, p=0.014). More experienced nurses are directed to the CLPU (F=8.618, p=0.00). The majority of nurses were correctly identified of function CLPU. The most consultation is required for patients who are suffering from anxiety and depression. Nurses were required to counseling on communication techniques.

Result

CLPU is very important that both nurses and their patients in helping to psychosocial problems.
2326 – Disgust And Its Domains Across The Anxiety Disorders
Authors: Chorot P. , Valiente R.M. , Sandín B. , Santed M.A. , Olmedo M. , Pineda D.
Published: July 2013

The emotion of disgust has been involved in various anxiety disorders, specifically in the etiology and maintenance of specific phobias and obsessive-compulsive disorder. A sample of participants with a diagnosis of anxiety disorder, representing the six DSM-IV anxiety disorders (i.e., specific phobias, social phobia, panic disorder, generalized anxiety disorder, posttraumatic stress disorder, and obsessive-compulsive disorder), completed the Multidimensional Disgust Scale (MDS; see Sandin et al.) and the Positive and Negative Affect Schedule (PANAS; Watson et al., 1988; Sandin et al., 1999). The MDS is a 30-item selfreport measure that assesses a total of five different dimensions of disgust, i.e., hygiene (body products), moral, sexual, body transgression, small-animals, atypical food, and disease. Multivariate analyses of variance showed that MDS total scores associated with each anxiety disorder were greater than those of the control group. Relative to other diagnostic groups, specific phobia and obsessive-compulsive disorder were associated with greater levels of disgust. In addition, these two disorders were particularly related to elevated scores on the hygiene and small-animals disgust subscales. The content of such subscales of disgust imply possible transmission of contaminants and disease, and they correspond to the “core disgust” suggested by Rozin, Haidt and McCauley (2000). The pattern of results remained when negative affectivity was used as covariate (two main risk factors of anxiety disorders). The subscale of sexual disgust was not able to differentiate between individuals with anxiety disorders and the control group, nor between the diagnostic groups. The clinical implications of these findings are discussed.
2337 – Assessing The Impact Of a Full-time Clerkship In a Portuguese Medical School: a Focus On Attitudes And Career Choice
Authors: Xavier M. , Mateus P. , Caldas Almeida J.
Published: July 2013

Introduction

Due to the scarcity of mental health professionals, recruitment of psychiatrists is presently a major issue in Portugal. A negative attitude towards psychiatry or the psychiatrist's role has frequently been observed in rather different countries - this is troublesome, given that medical graduates’ attitudes toward psychiatry has been pointed as a predictor of recruitment. On the other side, research suggests that a clerkship may improve the student's attitudes, namely when they are stimulated to participate in the delivery of care.

Objectives

To assess the impact of a clerkship in the attitudes toward psychiatry among Portuguese medical graduates, as well as in the motivation to choose psychiatry for future training.

Methods

Balon's self-reported questionnaires were administered to all 6th year students in a medical school in Lisbon, before and after a 4-weeks full-time psychiatric clerkship.

Results

153 students were evaluated. After the clerkship, perceptions about the overall merits of psychiatry, efficacy, role definition, functioning of psychiatrists and use of legal powers to hospitalize patients were significantly improved. There was also a meaningful increase of trainees considering the possibility to take a residency in psychiatry. However, perceptions of low prestige and negative pressure from family and peers regarding a future choice of psychiatry remained unchanged in about one-third of the students.

Conclusions

Clerkship had an auspicious overall impact on the student attitude towards psychiatry,as well as in the number of students considering a future career in psychiatry. Attitudes toward psychiatry seems a promising outcome indicator of the clerkship's quality.
2338 – Organizational Culture And Managers Profiles In The Portuguese Mental Health Services
Authors: Mateus P. , Caldas Almeida J. , Xavier M.
Published: July 2013

Introduction

There is emerging evidence that organizational culture and leadership profiles influence the way health services implement their systems of care. Studies regarding organizational culture of services are widespread in economical and managerial areas but very few evaluate mental health care contexts. Most of these studies aim to help in the management of human resources.

Objectives

To assess the organizational culture and leadership profiles in the Portuguese mental health services.

Methods

Cross-sectional study, made in public and private mental health services. Evaluation was made by means of the competing values framework tool (Quinn, 1990) (Portuguese version - MJ Felício, 2007), which includes dimensions such as organizational culture and leadership profiles in the framework of more open or close systems and with more control or flexibility strategies.

Results

There is no organizational or leadership profile clearly outstanding in the Portuguese mental health services. However Director and Coordinator leadership profiles scored higher in the results. These higher scores profiles were linked with assignment of duties, delegation of tasks and planning activities. Innovation profiles had the lowest scores, linked with the ability to cope with change and to manage change.

Conclusions

Further studies are critical to develop a clearer view regarding the influence of organizational culture and leadership profiles in the organization of mental health services. Low scores on innovation components may influence the way evidence based practices are welcomed and implemented in services.
2344 – Psychiatrization Of Society - a Concept Or Reality?
Authors: Jonovska S.
Published: July 2013

In the context of concept “panta rei” everything changes continuously: people, their knowledge and comprehension, environment and nature, society, attitudes and concepts in general, also in medicine and psychiatry. Many changes in social frameworks like informatization and social network, globalization, wars etc. influences psychiatry and changes its place and role in modern society. Many questions meet modern psychiatry like comorbidity, well-being, actual concept of health and disease also influences psychiatry and its role in society which is bigger and wider from day to day. Are we talking about the real fact of enormous role of psychiatry in modern society of narcistic culture forming the concept of psychiatrization of society, or is it just an illusion inflated with secondary interest for particular interest groups? This is a question we are looking for an answer in this study through the review of the literature and a critical view on a problem of the role of psychiatry in modern society.
2346 – Cocaine-induced Psychosis And Impulsivity In Cocaine-dependent Patients
Authors: Roncero C. , Grau-López L. , Daigre C. , Rodriguez-Cintas L. , Miquel L. , Martínez-Luna N. , Barral C. , Bachiller D. , Egido A. , Alvarós J. , Miguel C.
Published: July 2013

Introduction

Cocaine induced psychosis (CIP) is common but not developed in all cases. Many risk factors have been linked with CIP. A lifetime diagnosis of ADHD has been associated with the categorical presence of CIP.

Objectives

The objective of this study is to determinate the relationship between impulsivity and impulsivity-realetd disorders (BPD, BN and ADHD) and CIP.

Aims

We study the presence of psychotic symptoms using a clinical interview for psychotic symptoms in a large sample of cocaine-dependent patients. Patients suffering from schizophrenia or bipolar disorders were excluded. Finally we included 287 patients in the study.

Methods

A structured interview about psychotic symptoms were systematically conducted. The Structured Clinical Interview for DSM IV Axis I and Axis II disorders were used in order to identify the comorbidity. CAADID-II (Conners’ Adult ADHD Diagnostic Interview for DSM-IV) were used in order to identify ADHD comorbidity. Barrat impulsivity scale were used for evaluate impulsivity.

Results

BIS total were 63.78. We identify a significant association between CIP and BIS cognitive subscale p < 0.003 and BIS total p < 0.021. We also identify a significant association between CIP and adult ADHD in cocaine-dependent patients p < .0.002. We fail to identify association between CIP and BPD and BN.

Conclusions

CIP is related with BIS cognitive subscale and BIS total scores, and with ADHD comorbidity in cocaine-dependent patients. As well these findings could be useful for a clinical approach to the risks of psychotic states in cocaine-dependent patients.
2347 – Consultation-liaison Psychiatry And Antipsychotics
Authors: Ginés J.M. , Martín M. , Alvaro P. , García B. , Arcega J.M. , Nascimento M.T. , Corcoles D. , Bulbena A.
Published: July 2013

Introduction

Liaison psychiatry is the branch of psychiatry that specialises in the interface between medicine and psychiatry. The liaison psychiatrist uses a wide range of drugs and antipsychotics are among them.

Objectives

To analyse the prescription of antipsychotics at the liaison psychiatry service of a general hospital.

Methods

This is a transversal study. All patients evaluated by the liaison psychiatry service of a general hospital from the 1/01/2012 to the 31/05/2012 were included.

Results

The sample consisted of 128 patients (53’1% women; mean age 65’34±17’18). The majority of them were Spanish (92’2%). Internal Medicine was the service who asked for more psychiatric evaluations, followed by General Surgery (19’5%) and Nephrology (10’2%). The most frequent main complain was depression (46’9%), behavioural disorders (18%) and anxiety (10’2%). The diagnosis given were more often affective disorders (43’8%), delirium (11’7%), psychotic disorders (10’9%) and anxious disorders (9’4%).

Within the 128 patients, 34 (26’6%) did receive antipsychotics during the admission. We compared the two groups (antipsychotic group vs non-antipsychotic group) and obtained the following results: we found that the antipsychotic group more often had behavioural disorders (34’3%) and delusions/hallucinations (20%). A significant increase in delirium diagnose was to be seen (42’9%).

Conclusions

Antipsyhotics are the second most used treatment at the liaison psychiatry service. Patients who receive them are more often affected by delirium and to a minor extent by a psychotic disorder. The first generation antipsychotics such as haloperidol still are the first option. However, the use of second generation antipsychotics is increasing remarkably.
2356 – Case Report: Autoamputation Of The Penis In a Patient With Shizophrenia
Authors: Štimac Z. , Bagarić L. , Godan B.J. , Jakovljević M.
Published: July 2013

Schizophrenia is a psychiatric disorder that often manifests itself as chronic, serious mental illness which primarily affects one's ability to think, coupled with impaired perception of reality, which causes a change in behavior followed by unpleasant sensations. The following case report describes an act of genital self mutilation. An employed, unmarried male suffering from schizophrenia, auto castrated his genitalia during a period of illness. Psychotic patients with delusions (often of religious nature), sexual conflict associated with guilt, past suicide attempts or other self-destructive behavior and depression, severe childhood deprivation, and major premorbid personality disorder, are the group at risk of genital self-amputation. The objective of this case study is to gain a better understanding of the consequences of certain symptoms of schizophrenia, however rare and bizarre they might be.
2358 – The Rorschach Test In The “crime Of Impetus”. Data From a Pilot Study
Authors: Cimino L. , Atti A. , De Ronchi D.
Published: July 2013

Introduction

The Rorschach is a projective test frequently used in the forensic ambit for the information it can give in both the cognitive and affective areas. The purpose of our work is to identify the traits recurring in perpetrators of the “crime of impetus” through the examination of the psychometric indices of the Rorschach.

Method

15 male subjects between 22 and 60 years (mean age = 43.2 ± 10.96 years) authors of murders, without previous psychiatric disorders, were tested; the control group was represented by 15 subjects without history of crimes. All protocols were collected and signed through the method “Scuola Romana Rorschach” and the scores of psychometric indices were compared between and within groups by Student's t-test.

Results

From the cognitive point of view there were no significant differences concerning the sense of reality between the murderers and control samples (R+% = 75,87 vs 70,73; p = 0,241. F+% = 75,47 vs 76,93; p = 0,653), but the number of responses was lower than average (16,67 vs 25,27; p < 0,0001). The most significant differences in the murderers appeared in the G/M Index (G = 7,73vs9,35; p < 0,005. M = 2,37vs 1,00; p < 0,0001) and in the Impulsivity Index (0,96 vs 0,33; p=0,0002).

Conclusions

According to the most recent literature the Rorschach indices showed in the perpetrators of the “crime of impetus” the absence of mental disorders; however, the disproportion of the Index G/M and Impulsivity Index may indicate a “vulnerable anthropology” as a risk factor for impulsive crime in the presence of emotional stress.
2360 – Infants’ Vaccination Pain Management And Effect Of Breast Feeding, Sucking The Pacifier And Mother's Hug: a Randomized Control Trial
Authors: Taavoni S. , Shahali S. , Haghani H.
Published: July 2013

Infants’ vaccination pain management by using lowest side effect methods is very important. The aim of this study was to examine pain relieving effect of breast- feeding, sucking pacifier or being in mother's hug during DPT vaccination.

Methods

This controlled trial study, was performed on 152) healthy2- 4 months term infants, whom was brought to the health centers of west of Tehran for DPT vaccination and their parents filled in informed consent. (Year 2008–2010) By randomized collection infants divided to three intervention group (Breast feeding, Sucking pacifier and being in mothers hug, and each group had intervention 2 minutes before, during, and 15 seconds after the injection) and control group, whom lied on the examining bed as routine of clinics (38 in each group). Objective changes in appearance of Neonates were assessed by Modified Behavioral Pain Scale (MBPS) during 5 second before immunization to 15 second after it. Descriptive and inferential statistics were used. All ethical points were considered and approved by Research ethics committee of TUMS and had registered in Iranian Registry of Clinical Trials (IRCT).

Result

Equality of age, gender and the time of feeding prior to vaccination were controlled. There were significant differences in Behavioral Pain Scores of four groups. (P < 0.0001) and routine group had highest pain score.

Conclusions

Breast feeding is more analgesic than pacifier use with maternal holding. Maternal holding had less effect, but had more significant effect than routine. It is suggested to use these simple interventions during infant's vaccination.
2374 – Traumatic Experiences And Humor Disorders
Authors: Espirito-Santo H. , Rocha P.
Published: July 2013

Traumatic experiences as vulnerability factors for mood disorders (MDs) remain unknown. The present study examined the potential differences of traumatic experiences amongst inpatients with mood disorders and between inpatients with mood disorders and non-patients. Of the participants assessed with Traumatic Experiences Checklist (TEC) (mean age = 31.12 ± 13.70), 50.8% had MDs, and 49.2% were non-patients (n = 29). The group of thirty individuals with Structured Clinical Interview for DSM-IV (SCID)-diagnosed MDs included 19 patients with major depression disorder (32.2%), 5 with Depressive Disorder Not Otherwise Specified (8.5%), 6 with Bipolar I Disorder, Most Recent Episode Depressed (10.2%).

Of the patients 76.7% endorsed having experienced at least three TEs in their life time, of the non-patients 86.2% reported less than three TEs in their life time. Patients had significantly (t = 4.96, p < 0.001) more TEs (M = 6.20 ± 2.98) than the control group (M= 2.38 ± 2.94), the distinction was specially relevant on the severity of emotional trauma (M = 7.80 ± 8.74; t = 3.71, p < 0.001). Amongst MDs, there were not statistical differences. Only major depression disorder was distinct from the control group in what concerns total TEC (p < 0.001), specially owing to trauma occurred under 6 years of age.

These findings are generally supportive of the role of trauma, specially trauma that took place in infancy, on major depression disorder, suggesting the need for consideration of traumatic experiences on the treatment of this mood disorder.
2393 – Why do some Psychotropic Drugs Work and some Others Don’t?
Authors: Höschl C.
Published: July 2013

Non-specific efficacy of psychotropic (and also other) drugs can be influenced by placebo effect including fashion and cultural differences in expectations, by genetic variability, e.g. in degrading enzymes and therefore in drug availability and pharmacokinetics, and largely by adherence to treatment. In other words, the drugs which we trust in, metabolize slowly and swallow obediently are much more efficient than that with minimum psychological effect, rapidly destroyed or even not used. These three variables also interact with each other.
2553 – Eating Disorders in Psoriatic Patients
Authors: Crosta M.L. , Fraietta S. , Craba A. , Caldarola G. , Sollena P. , Benedetti C. , De Simone C. , Rinaldi L.
Published: July 2013

Introduction:

Psoriasis is a multifactorial chronic infiammatory skin disease that often occurs in patients with overweight or obesity; obesity makes psoriasis less susceptible to therapy and a moderate weight loss improves drug response. Many studies shows connections between obesity and eating disorders, but few studies investigated the link between eating disorders and psoriasis.

Objectives:

To evaluate the presence of eating disorders and psychopathological traits in patients affected by psoriasis compared with a control population, and correlate this data with different features of cutaneous disease and BMI.

Aims:

To suggest the importance of a psychological support that could reduce the occurrence of loss of control over food.

Methods:

We enrolled 100 consecutive psoriatic outpatients and a control group of 100 selected non psoriatic outpatients, matched by BMI to the study group. The assessment battery was composed by the Psoriasis Area and Severity Index (PASI) score, the EDI and SCL-90R.

Results:

Most of EDI and SCL-90R subscales resulted more altered in psoriatic population compared to the controls (p < .001 for IA and ID, and p < .05 for GSI). Moreover, we noticed an association between the progressive weight gain and the impairment of most of EDI subscales, indicating the presence of an ED in only psoriasis group (p < .01).

Conclusion:

Psoriasis is associated with psychopathological traits and symptoms commonly associated with eating disorders. A multidisciplinary approach could have an important role to reduce the loss of control over food, to loss weight and to improve the drug response.
2554 – Cognitive Deficits Related to Alcohol Abuse: A Preliminary Study
Authors: Smeraldi C. , Movalli M. , Cavicchioli M. , Angelone S.M. , Maffei C.
Published: July 2013

Objective:

Cognitive deficits may compromise patients’ utilization of rehabilitative information. There is an increasing attention on the opportunity to integrate a specific support to cognitive functions in alcohol detox programme and the first step to program the clinical intervention is to have a complete overview of cognitive deficits in alcoholics clinical sample.

Methods:

62 patients who refer to alcoholism service were screened at admission time. Cognitive functions were assessed by trained psychologist with a specific neuropsychological battery. The impact of clinical features as age, gender, scholarship and concurrent polyabuse was evaluated for each function.

Results:

The 45,7% of our sample shows a generalized decline. Subtests shows impairment's different degrees (26,1% verbal memory; 32,6% working memory; 50,0% psychomotor speed and coordination; 30,4% verbal fluency; 58,7% selective attention; 13,0% tower of London task; 41,3% executive functions; 56,5% sustained attention). Clinical features have different impact on cognitive functions.

Conclusion:

Alcoholics patients shows a diffuse range of cognitive impairment. For this reasons a cognitive remediation programme could be a useful adjunctive intervention for the treatment of alcohol dependence.
2561 – A National Survey of Physician-Industry Relationship in Saudi Arabia
Authors: Alosaimi F.D. , Albahlal A. , Al-Abduljabbar M. , Alabdulkarim Y. , Alqahtani F. , Qadi M. , AlKabba A.
Published: July 2013

Background:

Relationships between physicians and pharmaceutical & other medically related industries have received considerable attention in recent years. We surveyed physicians all around Saudi Arabia (SA) to collect information about their knowledge, behaviors and attitudes regarding their relationships with the industry.

Methods:

A cross-sectional survey that used a 47-item, anonymous, self-administered questionnaire, was sent to all accessible doctors in SA. The questionnaire was developed based on literature review, discussed between authors and reviewed by experts. The survey

Results:

600 doctors (physicians and surgeons), 15% of them were psychiatrists who filled in the survey. Preliminary results of only 15% of the total sample indicated that 40.9% (n = 38) of participants have encountered a pharmaceutical company representatives (PRs) at least once in their life. Psychiatrists were among the top specialties in accepting gifts and promotions presented to them by PRs. 4.3% (n = 4) of participants mentioned that PRs almost always offer a gift and promotion after every meeting. The most frequently mentioned gifts presented to participants by PRs are stationary such as pens or notepads (26.9%). Although 60.2% (n = 56) of participants had been educated about the ethics in physician industry relationships, 34.4% of participants accept gifts and promotions presented to them by PRs.

The final results of this study will be ready by Feb 2013. It will be presented fully in the EPA 2013.

Conclusions:

The results of this survey indicate that relationships between physicians and industry are common and underscore the variation among such relationships according to specialty, practice type, and professional activities.