bluuebunny/crossref_metadata_2025 huggingface dataset:
Faux Pas: Assessing Theory of Superior Mind. A Control-case Study
Authors: Magallón-Neri E. , Figueras J. , Amat C. , Benages M.
Published: June 2017

Often, children with autism spectrum disorder (ASD) can present deficits for acquiring superior level of theory of mind (ToM) in the detection of false beliefs o blunder situations. The objective of this study is to assess 51 subjects with a primary education level (18 with ASD compared to 33 control subjects) comparing ToM level by using the test of Faux Pas test by Baron-Cohen et al. (1999) in two groups divided in 2 layers by age of 7 and 11 years. Results showed significant differences in this construct (ToM) between control group and ASD group only at the age of 11 years (z-score = 2.26; P = .023), but not at the age of 7 years (z-score = 1.89; P = .062). This suggests that ToM's superior capacity acquires greater expression and maturity towards late childhood, just before transition to adolescence stage.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pharmacogenomics and Efficacy of Risperidone Long-term Treatment in Thai Autistic Children and Adolescence
Authors: Nuntamool N. , Ngamsamut N. , Vanwong N. , Puangpetch A. , Chamnanphon M. , Hongkaew Y. , Limsila P. , Sukasem C.
Published: June 2017

Risperidone, atypical antipsychotics, was approved for irritability in autistic disorder. However, some patients had minimal improvement or no response to this treatment. The purpose of this study was to evaluate the association of pharmacogenomics factors and clinical outcomes in autistic children and adolescence who treated with risperidone for long periods. Sixty-seven autistic subjects diagnosed with DSM-IV criteria and treated with risperidone more than 1 year were evaluated clinical symptom by CGI, aggressive, over activity, and repetitive score. Polymorphisms of ABCB1, CYP2D6, DRD2, DRD3, and HTR2A were analyzed. Almost patients showed stable symptom on aggressive (91.04%), over activity (73.13%), repetitive (68.25%) behavior, and all clinical symptoms (82.09%). Only 4.48% of patients showed minimally worse on CGI-I score. Patients in non-stable of all symptom group had DRD2 Taq1A non-wildtype (TT and CT) frequencies higher than clinical stable group (P = 0.046), whereas other genes polymorphism showed no significant association. Interestingly, there was no patient with HTR2A-1438G > A wildtype in all non-stable symptoms. However, there was no significant association due to small sample sizes. Drug levels (RIS, 9OH-RIS, and active moiety) did not show the association with any clinical outcome. Increased appetite was the common ADRs, which associated with high body weight, whereas there was not significantly associated with genetic variations and non-genetic information. In conclusion, risperidone showed efficacy to control autism, especially aggressive symptom in long-term treatment. However, dopamine 2 gene variation affect to non-stable in risperidone treated patients. This study supports pharmacogenomics testing for personalized therapeutics of risperidone in autistic disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Population Service Evaluation of the ADHD Pathway of Children and Young People's Services, Malta
Authors: Saliba A. , Agius D. , Sciberras E. , Camilleri N.
Published: June 2017

Introduction

ADHD is the commonest neurodevelopmental disorder in young people (YP) aged 5–18 years. YP with untreated ADHD are 5 times more likely to develop co-morbid psychiatric disorders.

Objectives

To carry out a population service evaluation of the assessment process and management of YP with ADHD at Child and Young People's Service (CYPS), Malta age 0–16 years for 2014.

Aims

To describe the service input, assessment and treatment of YP attending CYPS and compare to ADHD NICE guidelines 2008.

Methods

All patients diagnosed with ADHD at CYPS throughout 2014 were included. The incidence of YP with ADHD on treatment age 3–16 years in Malta was calculated. Information was collected from; (i) retrospective case file review and (ii) methylphenidate and atomoxetine registry and compared with NICE guidelines.

Results

One hundred and thirty-six YP were diagnosed with ADHD. The minimum 12-month incidence of ADHD on treatment (3–16 years) in Malta was 553 per 100,000. Pre-diagnosis assessments were more frequently performed by other YP services (n = 97, 71.3%, P ≤ 0.01). A psychiatrist or paediatrician confirmed the diagnosis in 113 (83.1%). Sixty-two (45.3%) of YP were prescribed medication, 50 (36.8%) were referred for parental skills course and 55 (40.4%) psychotherapy. Mean waiting time for first appointment was 187.6 days (CI ± 26.9, 0–720), and first specialist review was 301.0 days (CI ± 34.4, 0–800) (1–3).

Conclusions

The incidence for YP (3–16 years) with ADHD on treatment was lower than the US. Since most pre-diagnostic assessments were carried out by other services, this raised the question about the reliability and validity. We recommend a diagnostic MDT meeting following the multimodal assessment to diagnose ADHD. Medication prescribing followed NICE overall, standardising non-pharmacological management is required.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anti-basal Ganglia Antibodies (ABGA) and Excitatory Neurotransmitters in Obsessive-compulsive Disorder (OCD)
Authors: Gnanavel S. , Parmar A. , Sharan P. , Subbiah V. , Sharma U. , Nr J.
Published: June 2017

Introduction

OCD is a complex disorder with multiple aetiological theories. Recent research points to role of autoimmunity as well as hyperactivity of glutaminergic pathways in aetiopathogenesis of the disorder. It is possible that autoimmune mechanisms may modulate excitatory neurotransmission resulting in OCD.

Aims/objectives

This study aimed to study the association between serum anti-basal ganglia autoantibodies (ABGA) and Glx (glutamate + glutamine) levels in caudate nucleus and anterior cingulate cortex as demonstrated by 1H-MRS (proton magnetic resonance spectroscopy).

Methods

Thirty psychotropic-naive OCD patients and an equal number of age, gender matched healthy controls were studied using 1H-MRS and levels of Glx were obtained. ABGA was measured using ELISA (enzyme linked immunosorbent assay) technique and categorised as present or absent in the serum.

Results

ABGA was present in significantly higher proportion of patients as compared to controls (P < 0.05). Glx level was significantly higher (as measured by 1H-MRS) in patients with ABGA as compared to those without ABGA (P = 0.02). The study results did not differ based on age, gender, disease severity and illness duration.

Conclusions

The study demonstrates presence of ABGA in at least a subset of OCD population. The significant correlation between brain Glx levels and presence of ABGA provides a putative neurobiological framework for OCD. The strengths of the study include psychotropic-naive patients, blinded investigators and use of standardized instruments. The limitations include small sample size, use of Glx as proxy measure of glutamate and lack of other disorder controls. Similar studies on a larger sample are warranted for a better understanding.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Party Hard: Drug-related Fatalities in Ibiza from 2010 to 2016
Authors: Santacroce R. , Bennasar C. Ruiz , Jaraiz J.R. Sancho , Montemitro C. , Baroni G. , Corbo M. , Pasquini A. , Sarchione F. , Angelini F. , Catalano G. , Carenti M.L. , Di Taranto C. , Tenuta S. , Lecciso U. , De Angelis M. , Rondoni A. , Di Giannantonio M. , Martinotti G.
Published: June 2017

Introduction

Illicit drug use is well known as an important contributor to the global burden of diseases, but the physical and psychopathological risks of recreational drugs misuse are often underestimated and drug-related fatalities in specific settings are under-investigated.

Objectives and methods

In the framework of the EU-funded project “EU-Madness”, we collected and analysed all the reports of drug-related fatalities in Ibiza from January 2010 to September 2016, with the aim of characterising the sample, and identifying the involved substances and the nature of deaths associated with their consumption.

Results

Overall, 58 drug-related fatalities were registered from 2010 to September 2016 (87.9% males, 12.1% females, mean age 33.16; females were significantly younger than males). Most of the deceased were Britons (36.2%), followed by Spanish (22.4%), Italians (6.9%) and Germans (5.2%). In half the cases, the substance identified in post-mortem analyses was a stimulant; in 24.1% of the sample it was a depressor a prescription drug or more than two substances in 22.4%. Most of the fatalities were due to cardiovascular accidents (62%); 22.4% were deaths by drowning, 12% by fall from heights and 3.4% were due to mechanical asphyxia.

Conclusions

According to the results from our sample, stimulants (mainly MDMA and cocaine) are the substances of abuse involved in most drug-caused fatalities. The number of fatalities per year has been steadily increasing, but the growing diffusion of novel psychoactive substances (NPS) does not seem to be a direct cause (although better methods of their analysis in post-mortem samples should be designed).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Mediation Analysis of Childhood Maltreatment and Suicidal Behavior among Patients with Depressive or Bipolar Disorders
Authors: Aaltonen K. , Rosenström T. , Baryshnikov I. , Karpov B. , Melartin T. , Näätänen P. , Heikkinen M. , Koivisto M. , Suominen K. , Joffe G. , Isometsä E.
Published: June 2017

Introduction

Substantial evidence supports association between childhood maltreatment and suicidal behaviour, however, a limited number of studies have examined psychological mechanisms mediating the relationship among patients with mood disorders.

Objective

To investigate directly the potential intermediating mechanisms between childhood maltreatment and suicidal behaviour among patients with mood disorders.

Aims

We examine by formal mediation analyses, if:

– the effect of childhood maltreatment on suicidal behaviour is mediated through borderline personality disorder traits;

– the mediation effect differs between lifetime suicidal ideation and lifetime suicide attempts.

Methods

Depressive disorder and bipolar disorder (ICD-10-DCR) patients (n = 287) from the Helsinki university psychiatric consortium (HUPC) Study were surveyed on self-reported childhood experiences, current depressive symptoms, borderline personality disorder traits and lifetime suicidal behaviour. Psychiatric records served to complement the information on suicide attempts.

Results

The influence of childhood maltreatment on lifetime suicidal ideation and lifetime suicide attempts showed comparable total effects. In formal mediation analyses, borderline personality disorder traits mediated all of the total effect of childhood maltreatment on lifetime suicide attempts, but only 21% of the total effect on lifetime suicide ideation. The mediation effect was stronger for lifetime suicide attempts compared to ideation (P = 0.002) and independent of current depressive symptoms.

Conclusions

The mechanisms of the effect of childhood maltreatment on suicidal ideation and attempts may diverge among psychiatric patients with mood disorders. Borderline personality disorder traits may contribute to these mechanisms, although the influence appears considerably stronger for suicide attempts than for suicide ideation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Incidence and Predictors of Suicide Attempts in Bipolar I and II Disorders: A Five-year Follow-up
Authors: Pallaskorpi S. , Suominen K. , Ketokivi M. , Valtonen H. , Arvilommi P. , Mantere O. , Leppämäki S. , Isometsä E.
Published: June 2017

Introduction

Although suicidal behavior is very common in bipolar disorder (BD), few long-term studies have investigated incidence and risk factors of suicide attempts (SAs) specifically related to illness phases of BD.

Objectives

We examined incidence of SAs during different phases of BD in a long-term prospective cohort of bipolar I (BD-I) and II (BD-II) patients and risk factors specifically for SAs during major depressive episodes (MDEs).

Methods

In the Jorvi bipolar study (JoBS), 191 BD-I and BD-II patients were followed using life-chart methodology. Prospective information on SAs of 177 patients (92.7%) during different illness phases was available up to five years. Incidence of SAs and their predictors were investigated using logistic and Poisson regression models. Analyses of risk factors for SAs occurring during MDEs were conducted using two-level random-intercept logistic regression models.

Results

During the five-year follow-up, 90 SAs per 718 patient-years occurred. Compared with euthymia the incidence was highest, over 120-fold, during mixed states (765/1000 person-years [95% confidence interval (CI) 461–1269]) and also very high in MDEs, almost 60-fold (354/1000 [95%CI 277–451]). For risk of SAs during MDEs, the duration of MDEs, severity of depression and cluster C personality disorders were significant predictors.

Conclusions

In this long-term study, the highest incidences of SAs occurred in mixed phases and MDEs. The variations in incidence rates between euthymia and illness phases were remarkably large, suggesting that the question “when” rather than “who” may be more relevant for suicide risk in BD. However, risk during MDEs is likely also influenced by personality factors.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Impact of Mental Factor as an Indicator of the Population State of Health
Authors: Vasileva A. , Neznanov N.
Published: June 2017

In the framework of biopsychosocial model of health and pathology that is nowadays widely recognized in the different fields of modern medicine the mind, building the core of personality and the brain as the central regulatory organ play an essential role in the interdisciplinary approach to somatic illnesses. It is a common knowledge that comorbid anxiety and depression disorders can influence the course of various somatic illnesses and worsen their prognosis. We also have evidence-based studies that depression for example is an independent risk factor of heart infarct onset. On the other hand, we observe the somatization of clinical picture of mental disorders, the increase of atypical forms manifesting through pain or other somatic syndromes that leads to the increase of mental illnesses in the primary care. The research of common pathways of mental and somatic pathology should be the subject of further interdisciplinary research programs. The other issue is the patient's compliance that plays in important role in the success of every kind of treatment. Personality traits and status of mental health can influence ones attitude to illness as well as motivation to therapy. We cannot assess the population state of health without taking into consideration the evaluation of mental status as well as such definitions like subjective well being, life quality and stigmatization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Efficacy and Safety of Lurasidone in Adolescent Patients with Schizophrenia: Results of Functional and Quality of Life Measures from a 6-week, Double-blind, Placebo-controlled Study
Authors: Findling R. , Goldman R. , Cucchiaro J. , Deng L. , Loebel A.
Published: June 2017

Introduction

Lurasidone, an atypical antipsychotic, demonstrated efficacy and safety in adults with schizophrenia.

Objective/Aims

To evaluate the efficacy and safety of lurasidone in adolescent patients with schizophrenia.

Methods

Adolescents (13–17 years old) with schizophrenia were randomly assigned to six weeks of double-blind treatment with lurasidone 37 mg/day, 74 mg/day or placebo. An ANCOVA using an LOCF approach was performed to assess change from baseline on secondary study endpoints: Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q) and Children's Global Assessment Scale (CGAS).

Results

Patients were randomized to lurasidone 37 mg/d (n = 108), 74 mg/day (n = 106), or placebo (n = 112). Placebo-adjusted LS mean improvement at week 6 on the PQ-LES-Q was 5.3 (P = 0.001) and 5.8 (P < 0.001) for the 37 mg/day and 74 mg/day groups, respectively; and, on the CGAS was 4.6 (P = 0.002) and 4.9 (P < 0.001) for the 37 mg/day and 74 mg/d groups, respectively. The most common adverse events occurring at ≥ 5% in either lurasidone group and at least twice the rate of placebo were: nausea, somnolence, akathisia, vomiting and sedation. Mean change in weight at week 6 for placebo, 37 mg/day, and 74 mg/day groups was 0.05 kg, 0.17 kg, and 0.49 kg, respectively. Lurasidone treated patients did not show clinically meaningful differences from placebo on laboratory measures of cholesterol, triglycerides, glucose, and prolactin.

Conclusions

Adolescent patients with schizophrenia treated with lurasidone demonstrated significant improvement in quality of life and function. Lurasidone was generally well-tolerated and associated with minimal changes in weight and metabolic parameters. Sponsored by Sunovion Pharmaceuticals Inc. ClinicalTrials.gov identifier: NCT01911429.

Disclosure of interest

Dr. Findling receives or has received research support, acted as a consultant and/or served on a speaker's bureau for Alcobra, American Academy of Child & Adolescent Psychiatry, American Physician Institute, American Psychiatric Press, Bracket, CogCubed, Cognition Group, Coronado Biosciences, Dana Foundation, Elsevier, Forest, Guilford Press, Ironshore, Johns Hopkins University Press, Jubilant Clinsys, KemPharm, Lundbeck, Merck, NIH, Neurim, Novartis, Otsuka, Oxford University Press, Pfizer, Physicians Postgraduate Press, Purdue, Rhodes Pharmaceuticals, Roche, Sage, Shire, Sunovion, Supernus Pharmaceuticals, Transcept Pharmaceuticals, Tris, Validus, and WebMD. Drs. Goldman, Cucchiaro, Deng, and Loebel are employees of Sunovion Pharmaceuticals Inc.
Association Between Two Single-nucleotide Polymorphism of TAAR1 Gene and Suicide Attempts
Authors: Zdanowicz A. , Sakowicz A. , Kusidel E. , Wierzbinski P.
Published: June 2017

Introduction

TAAR1 is a G protein-coupled receptor expressed broadly throughout the brain. Recently, TAAR1 has been demonstrated to be an important modulator of the dopaminergic, serotonergic and glutamatergic activity.

Aims

Assessment of the relation between two single-nucleotide polymorphisms of TAAR1 gene, suicide attempts and alcohol abuse.

Methods

A total of 150 Polish patients were included, 59 subjects after suicide attempt vs. 91 controls. The chosen SNPs (rs759733834 and rs9402439) were studied using RFLP-PCR methods. The Hardy-Weinberg equilibrium was tested in control group.

Statistical tests

Chi2 or Yeates Chi2 Test were used.

Results

The mean age of study subjects and controls was: 38 ± 12.3 and 42 ± 12.8 respectively; 49% study males vs. 54% male controls. We did not observe the association between the carriage of the genotypes GG, GA and AA of rs759733834 polymorphisms in either of the groups. The distribution of genotypes in respect to rs9402439 polymorphism (CC, CG, GG) was also insignificant. Among patients with alcohol dependence, the frequency G allele of rs9402439 polymorphism was lower compared to non-addicted ones (27 vs. 47%) P < 0.01.

Conclusions

TAAR1 polymorphisms rs759733834 and rs9402439 are not related to suicide attempts. The carriage of allele G of rs9402439 polymorphism is related to lower risk of alcohol addiction OR 0.40 95%Cl 0.20–0.81. To our knowledge, this is the first study on the TAAR1 receptor and the risk of suicide and it might offer a new insight into genetic etiology of TAAR1 receptor.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Functioning in Schizophrenia: Similarities and Differences Between Clinical, Patient and Expert Perspectives
Authors: Barrios M. , Guilera G. , Pino O. , Rojo E. , Wright S. , Gómez-Benito J.
Published: June 2017

Introduction

In 2001, the World Health Organization (WHO) created the International Classification of Functioning, Disability and Health (ICF) to offer a comprehensive and universally accepted framework to describe functioning, disability and health. The ICF Core Sets (ICF-CS) are a selection of categories that serve as a minimal standard for the assessment of functioning and disability in a specific health condition. The ICF-CS for schizophrenia was created in 2015 based on four preliminary studies that intend to capture different perspectives.

Objectives

The aim of this study is to describe the similarities (i.e. overlap) and discrepancies (i.e. unique contribution) between the clinical, patient and expert perspectives on the most relevant problems in functioning of individuals with schizophrenia, being focused on the European WHO region.

Methods

Forty-four experts from 14 European countries participated in an expert survey, patients with schizophrenia were involved in four focus groups, and health professionals assessed 127 patients in relation to daily life functioning. Information gathered from these three preliminary studies was linked to the ICF.

Results

Data showed that although a considerable number of second-level ICF categories agreed on the three preparatory studies (n = 54, 27.7%), each perspective provided a unique set of ICF categories. Specifically, experts reported 65 unique ICF categories, patients 23 and health professionals 11.

Conclusions

Even though there were similarities between perspectives, each one underlined different areas of functioning, showing the importance of including different perspectives in order to get a complete view of functioning and disability in individuals with schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Does depression explain poor effort on Symptom Validity Tests (SVT)?
Authors: De Jonghe J. , Schoemaker T. , Meyer S. , Lam D.
Published: June 2017

Background and aims

Valid assessments require sufficient effort from the part of the testee. Motivation may be compromised, particularly in psychiatric conditions. We examined associations between response bias on free recall and self-reported symptoms in depressed and PTSD patients.

Participants and methods

This is a cross-sectional study. Patients had depression (n = 48), or PTSD or other anxiety disorders (n = 37). A control group (n = 47%) had chronic pain disorder, fibromyalgia or chronic fatigue. The Green Word Memory Test (GWMT) was administered to all subjects. The Structured Inventory of Malingered. Symptomatology (SIMS), and the Beck Depression Inventory (BDI-II) were administered in subsamples. Study outcome was self-reported depressive symptoms in Symptom Validity Test (SVT) negative cases.

Results

Average age of the participants was 45.1 years (SD 9.5), 48.5% were female. GWMT was positive in 52.3% of all cases, GWMT and SIMS were positive in 33.8%, and GWMT and SIMS were negative in 37.7%. No significant group effects on GWMT were found. Average BDI-II scores were 32.8 (SD 13.9) for depressed patients, 28.3 (15.5) for those with anxiety disorders, and 27.6 (14.1) for controls (P = 0.43). Seventy-eight percent of depressed GWMT negative cases reported at least moderate depressive symptoms (BDI-II > 18), and 44.4% severe symptoms (BDI-II > 29). Approximately half of the GWMT negative cases with anxiety disorders and controls scored BDI-II > 18.

Conclusions

Non credible test performance is prevalent in disability claimants with affective, mood disorders. However, depressive symptoms per se do not explain poor effort on cognitive tasks.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The relationship of social phobia and personality characters in colleague students
Authors: Mokhtaree M. , Aghamohammad Hasani P.
Published: June 2017

Social anxiety disorder, pervasive and debilitating disorder with a high rate that affects many aspects of human life. The aim of the study was to assess the relation between social phobia and personality traits of Rafsanjan University of medical sciences students. By using Cochran formula and random stratified sampling, 284 person of Rafsanjan University of medical sciences students selected. Participants responded to questions of the NEO Personality and Social Phobia questionnaire. Data analyzed with Pearson correlation coefficient, analysis of variance and regression. Among the individuals, 11.6% had severe social phobia and 4.6% very severe. The relationship between social phobia and neuroticism was reversed and significant and other personality characters were significantly. Neuroticism and openness predicted social phobia significantly. The academic courses in terms of social phobia had not different with them but there were significant differences in the character of personality. It seems that dimensions of personality associated with Social phobia and be able to explain it.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Duloxetine augmentation in resistant obsessive compulsive disorder: Surveying a new medication for challenges in treatment of OCD
Authors: Mowla A.
Published: June 2017

Introduction

Up to 50% of patients with OCD have failed to respond in SSRI trials, so looking for pharmacological alternatives in treatment of obsessive compulsive disorder (OCD) seems necessary.

Objectives

Surveying duloxetine augmentation in treatment of resistant OCD.

Aims

Study the effects of serotonin-norepinephrine enhancers for treatment of OCD.

Methods

This augmentation trial was designed as an 8-week randomized controlled, double blind study. Forty-six patients suffering from OCD who had failed to respond to at least 12 weeks of treatment with a selective serotonin reuptake inhibitor (fluoxetine, citalopram or fluvoxamine) were randomly allocated to receive duloxetine or sertraline plus their current anti OCD treatment. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure.

Results

Forty-six patients (24 of 30 in duloxetine group and 22 of 27 in sertraline group) completed the trial. Both groups showed improvement over the 8-week study period (mean Y-BOCS total score at week 8 as compared with baseline: P < 0.001 and P < 0.001) without significant difference (P = 0.861). Those receiving duloxetine plus their initial medications experienced a mean decrease of 33.0% in Y-BOCS score and the patients with sertraline added to their initial medication experienced a mean decrease of 34.5% in Y-BOCS.

Conclusions

Our double blind controlled clinical trial showed duloxetine to be as effective as sertraline in reducing obsessive and compulsive symptoms in resistant OCD patients. However, it needs to be noted that our study is preliminary and larger double blind placebo controlled studies are necessary to confirm the results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Contribution for the Portuguese validation of the Depression, Anxiety and Stress Scales (DASS-21): Comparison between dimensional models in a sample of students
Authors: Xavier S. , João Martins M. , Pereira A.T. , Paula Amaral A. , João Soares M. , Roque C. , Macedo A.
Published: June 2017

Introduction

The Depression, Anxiety and Stress Scales are widely used in clinical and non-clinical populations, both in research and clinical settings. The need for briefer but valid and reliable instruments has motivated the reduction of the original 42-item scale to a short 21-version. On Portuguese samples, Pais-Ribeiro et al. (2004) found that the original 3-factor solution (stress, anxiety and depression) explained 50.35% of the variance and in an exploratory analysis; Xavier et al. (2015) presented a two factor solution and a modified three-factor solution with a sample of pregnant women, both with adequate factors’ reliability (< 0.70) and explaining above 50% of the variance.

Aims

Based on the previous results of factor analysis with Portuguese samples, the present study aimed to perform confirmatory factor analyses (using Mplus software) to evaluate which dimensional structure best fitted the data.

Methods

The sample comprised 234 students (78.2% female), between 18–26 years old (M = 20.55; SD = 1.66). Eighty-five percent of the participants were on their first three years of college education. Participants filled the Portuguese version of the DASS-21.

Results

Our results showed that the original 3-factor structure had the best model fit [χ2(186) = 475.465, P < 0.05; RMSEA = 0.082, 90% CI = 0.073–0.091; CFI = 0.918; TLI = 0.908; SRMR = 0.05]. Good reliability was found for all subscales (0.92 for stress, 0.87 for anxiety and 0.91 for depression subscale).

Conclusions

The DASS-21 is a reliable instrument that, with student populations, seems to have better performance when used with a 3-factor structure. Further research is needed to confirm this structure in Portuguese clinical samples.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Acupuncture decreases competitive anxiety prior to a competition in young athletes: A randomized controlled trial study
Authors: Zarei Serkani S. , Shayestefar M. , Memari A.H.
Published: June 2017

Introduction

Although a certain level of competitive anxiety may increase performance, many athletes with anxiety experience uncontrolled negative feelings and cognition that in turn can have overwhelming effects on their performance.

Objectives

Indeed, we aimed to assess the effect of the acupuncture on competitive anxiety in a sample of young football players using physiological biomarkers and subjective anxiety measures.

Methods

We aimed to assess the effect of acupuncture on competitive anxiety of the adolescent football players prior to the competition using psychological and physiological markers. A total of 30 athletes were randomly and equally allocated to either acupuncture or sham control group.

Results

The results of t-test on posttest scores showed that acupuncture had a significant effect on cognitive anxiety (P = 0.001) and somatic anxiety (P < 0.001) but not self-confidence (P > 0.05). Furthermore, the results showed that acupuncture significantly decreased the skin conductance in acupuncture group compared to sham group (P = 0.006) (P < 0.001).

Conclusions

In conclusion, the results suggested that acupuncture have the capacity to decrease cognitive and somatic anxiety prior to competition in adolescent athletes while this was accompanied by significant physiological changes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Valproate used during pregnancy: What should be done?
Authors: Beezhold J.N. , Fagard D. , Harabajiu C.
Published: June 2017

Background

Sodium valproate can cause serious developmental disorders in unborn babies if taken while pregnant, especially in the first trimester.

Aim

To review recent literature and advice or treatment for women who have or are using valproate whilst pregnant.

Design

Literature review.

Methods

Literature review using Pubmed with search terms: ‘bipolar’; ‘pregnant’; ‘valproate’ and following up references.

Results

There are several small methodologically flawed studies that attempt to address this question and will be reprised. Three key population register studies found high rates of malformations. A retrospective study of longer-term outcomes found high rates of developmental issues. There are several relevant treatment guidelines, including from the National Institute for Health and Clinical Excellence (NICE). There is a 40% risk of developmental disorder, a 10% risk of congenital malformations and a 3% risk of IQ deterioration.

Conclusions

Avoid valproate in women of childbearing age if at all possible, and consider effective contraception if used. If already pregnant then consider, with involvement from the patient, stopping or minimizing the dose of sodium valproate. Assess the risks and benefits of using sodium valproate during pregnancy versus stopping the treatment for the first trimester as symptoms of the disorder may return. Seek advice from a perinatal psychiatrist. Add 5 mg of folic acid daily for the remainder of the pregnancy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessment of psychotic symptoms in bipolar disorder
Authors: Cazan F. , Paunescu R. , Tamas A.
Published: June 2017

Introduction

Bipolar disorder is a disabling condition characterized by the presence of manic, depressive, hypomanic or mixed episodes, affective symptoms that may coexist with several types of psychotic features.

Objectives

The purpose is to evaluate the frequency of psychotic symptoms among bipolar disorder.

Method

The study included 55 bipolar patients admitted in the Psychiatry Clinical Hospital from January 2012 until May 2013. Inclusion criteria were represented by diagnosis of bipolar disorder, manic or depressive episode, according to DSM-IV-TR and ICD 10 criteria. Clinical instruments used to assess the severity of the current affective episode were Young Mania Rating Scale (YMRS) for manic patients and Hamilton Depression Rating Scale-17 items – (HDRS) for the depressive ones. Psychotic symptoms were evaluated with the Brief Psychiatric Rating Scale-18 items – (BPRS).

Results

Out of the 55 patients, 32 had psychotic symptoms upon admission to the hospital. BPRS results showed delusions of guilt, inutility, hypochondriac and nihilistic delusions for the depressed patients. Delusions of grandiosity and megalomania accounted for most of psychotic symptoms in manic patients. A smaller number of patients showed delusions of invention and reform. Perception disturbances such as auditory hallucinations were present in both diagnosis categories but in a higher percentage in depressive bipolar patients.

Conclusions

Even if less frequently than in schizophrenia or schizoaffective disorder, psychotic symptoms are present in bipolar disorder. They influence the general functioning and the outcome of patients diagnosed with this illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mindfulness effects on cognition: Preliminary results
Authors: Flores A. , González G. , Lahera G. , Bayón C. , Bravo M. , Rodríguez Vega B. , Avedillo C. , Villanueva R. , Barbeito S. , Saenz M. , García Alocén A. , Ugarte A. , González Pinto A. , Vaughan M. , Carballeira L. , Pérez P. , Barga P. , García N. , De Dios C.
Published: June 2017

Background

Mindfulness-based cognitive therapy (MBCT) is a psychotherapeutic intervention that has been shown effective in several clinical conditions. Nevertheless, research is still needed on its effectiveness on cognition.

Objective

To analyze possible effects on cognition of the addition of MBCT intervention versus a brief structured group psycho-education to the standard treatment of subsyndromal bipolar depression. Our hypothesis was that MBCT could improve some aspects of cognitive function to a higher degree than psycho-education and treatment as usual (TAU).

Methods/design

A randomized, multicenter, prospective, versus active comparator, evaluator-blinded clinical trial was conducted. Forty patients with BD and subclinical or mild depressive symptoms were randomly allocated to:

– MBCT added to psychopharmacological treatment (n = 16);

– a brief structured group psycho-educational intervention added to psychopharmacological treatment (n = 17);

– standard clinical management, including psychopharmacological treatment (n = 7).

Assessments were conducted at screening, baseline, post-intervention (8 weeks) and 4-month follow-up.

Results

Cognition results point to significant improvement in Stroop Color test as well as processing speed in TMT A test (P < 0.05) in the two psychological intervention groups versus TAU.

Conclusion

These preliminary findings suggest that the addition of MBCT or psycho-education to usual treatment could improve some cognitive dimensions in subsyndromal bipolar depressive patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Features of pubertal patients with schizophrenia neurocognitive profile
Authors: Barylnik Y. , Pakhomova S. , Samoylova D. , Abrosimova J. , Kolesnichenko E. , Sizov S. , Bachilo E. , Antonova A. , Deeva M. , Filippova N.
Published: June 2017

Identifying the patterns of neurocognitive disorders in pubertal schizophrenia is actual.

Methods

Benton Test of visual retention, methods of forward and reverse bills, Bourdon correction sample, Wechsler's subtests (subtest 11 – “Encryption”, subtest 12 – “Labyrinths” 1, 2, 3, 4, 5), Trail Creating a Test Part A.

Results

All patients were divided into 3 groups. The first group (schizophrenia) and second group (other psychic disorders) showed the worst results than healthy subjects. Qualitative analysis of the “Benton Test” results showed similar variations of difficulty and types of errors in the subjects of the first and second groups – ignoring the number of the figure sides, as well as difficulties in the structuring element of the image corners. The “Methods of forward and reverse bills” demonstrated the fatigue and attention instability. “Bourdon test” showed a high level of the stability index (K = 0.09). Wechsler's subtest “Encryption B” obtained poor results, indicating a pathological decrease in visual-motor speed. During the subtest “Labyrinths 1, 2, 3, 4, 5” the subjects of first and second groups exceeded the allowable time limit, but the first group of schizophrenia patients allowed more blunders during pubertal study (ignored the walls of the maze, torn pencil despite the given instructions). The test groups 1 and 2 while passing “Trail Creating a Test Part A” have shown good results – job data did not cause difficulties and carried out in accordance with the specified instructions.

Conclusions

Neurocognitive disorders allow to confirm the presence of morphological and functional brain changes when endogenous mental illness occurs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Emotion regulation during looking in the mirror in patients with eating disorders
Authors: Bernátová T. , Světlák M.
Published: June 2017

Emotion regulation is complex ability involving many emotional processes. One of the main assumptions of adaptive emotion regulation is emotional awareness, or the ability to identify and interpret own emotions. The absence of these fractional skills at patients with eating disorders can lead to rigid maladaptive control strategies that are underlying etiological factor of eating disorders. Sixteen patients underwent a psychological diagnostic focused on work with emotions. In the experimental part, patients were exposed to their own image through the mirror, during which were supposed to regulate their emotions, according to specific instructions. While patients were looking into the mirror, we monitored psychophysiological activity. Latest results based on the data processing of averages excitation of skin conductance describe the course of the experiment as we expected. Calming phases alternated with mirror exposure were clearly noticeable and consistent during changes in skin conductance and varies almost significantly [F(3,6) = 2.5, P = 0.068, η2 = 0.22], which supports the suitability of the selected eliciting material. The difference between mirror exposures with instructions on how to regulate emotions and without them is not statistically significant, but the continuance of the skin conductance describes the phases of the experiment consistently. The most striking response was detected at the first exposure to the mirror, which may suggest a lack of internal resources to regulate such an important stimulus as their own body. The results indicate that exposure to mirror is a negative emotional stimulus, with whom the patient can hardly cope.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Executive functions disorders in high functioning autism and rehabilitation implications
Authors: Di Santantonio A. , Manfredini M. , Varucciu N. , Fabbri M. , Cutrone M.C. , Villanova M. , Resca F. , Di Sarro R.
Published: June 2017

Introduction

The term executive functions (EFs) includes a set of cognitive processes such as planning, working memory, attention, problem solving, inhibition, mental flexibility, multi-tasking, and initiation and monitoring of actions. EFs are the higher order control processes to guide behaviour.

Some studies on the relationship between EFs and autism spectrum disorder (ASD) showed deficit in the cognitive flexibility and speed processing, particularly with Asperger syndrome. Recently, Merchán-Naranjo et al. [1] supported that children's and adolescents with autism without intellectual disability are insufficient in at least 5 domains: attention, working memory, cognitive flexibility, inhibitory control and problem-solving.

Aims

Our work is aimed at verifying if the presence of a dysexecutive syndrome significantly impacts on the adaptive functioning of people with high functioning autism.

Methods

A group of young adults with ASD were administered traditional neuropsychological assessment, specific assessment, focusing on the planning strategies for solving problems (Test Tower of London), abstraction and categorization (Wisconsin Card Sorting Test), and the Dysexecutive Questionnaires.

Results

The results showed the presence of a specific deficit in the executive functioning in an average cognitive functioning.

Conclusions

Integrate the standard cognitive screening with a specific EFs assessment resulted to be very useful for the clinician to realize neuropsychological and psychotherapeutic individualized treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical and social outcome of children and adolescents presenting in the emergency room for disruptive behavior in Lyon and the Rhône-Alpes region: A multidisciplinary approach
Authors: Gansel Y. , Behrouz K. , Sonia G. , Lamia E.A. , Mohamed T. , Dominique P. , Nadine B. , Bertrand R.
Published: June 2017

Over the last decade, the frequency of emergency room (ER) visits for pediatric psychiatric disorders has increased in the most western countries. Although data available in France is scarce, a similar trend was observed concerning violent or runaway youth. There is no medical consensus on the status and care management of disruptive behavior (DB) in children and adolescents in ER. Seclusion and physical restraint are often requested to treat violence. With a blur lawful framework for minors, such coercive measures raise ethical issues while contradicting the idea of the patients’ autonomy and well-being. Moreover, consulting in the ER for such situations could lead to an inappropriate use of the healthcare system, a poor assessment of associated psychiatric disorders or comorbidities and an underestimation of suicide risk. Thus, the ER visit for a disruptive child or adolescent is characterized by its uncertainty. It represents a situation of heterogeneity in care management as well as a stake of social exclusion and of dangerous behavior.

The study aims to:.

– analyze these uncertainties by presenting a multidisciplinary and integrative research methodology through combining clinical evidence and social sciences comprehension;

– to implement a cohort to describe children and adolescents admitted to the ER for DB (aggressiveness, violence, fugue or theft), their care management and their social and clinical outcome;

– to pool these clinical data with an ethnographic fieldwork focused on DB as a “trouble” experienced by various professionals in the ER.

We will focus our presentation on these methodological considerations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Retarded sexual maturity and adolescent conflicts
Authors: Mohammadi M.
Published: June 2017

Most of the educational psychologists believe that co-education can help the young people to have their sexual instincts activated so that they could release their sexual emotions easily during puberty. In contrast, Islamic educational authorities in Iran strongly insist that children arriving elementary schools must be separated and the teachers and textbooks are chosen according to their sexes. Therefore, men are teaching in boys’ schools and women in girls’ schools. There has been great effort to include men's pictures in boys’ textbooks to prevent from the sexual arousal. As there are not enough universities in the country, the university candidates are mixed in their classes and courses. This can bring flame to the ashes of hidden sexuality and involve the students in abnormal behaviours to control or suppress them. The conflict of interaction with the opposite sex in university with that in the family setting or even society has been proved to create depression among the first year students especially those coming from small and closed environments and rural settings. The statistics of referrals to the counselling office in the university show that self-involvement to control sexual instincts have been the great concern of the students. They spend most of their time thinking about their classmates of different sexes. This paper aims to study the psychological and social outcomes of suppressed instincts for young people having entered the university and the effect on marriage.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparison of cognitive functions children with the autism spectrum disorders and schizophrenia
Authors: Zvereva N. , Simashkova N. , Koval-Zaitsev A.
Published: June 2017

Introduction

Autism spectrum disorder and early onset schizophrenia have many similar symptoms, however, these are different disorders. It is important to identify the main similarities\differences in the structure of cognitive impairment to define further assistance these children correctly. We distinguished two options for cognitive defect (total and partial) in children with schizophrenia.

Aims

Comparison of cognitive functions at children with autism spectrum disorder and early onset schizophrenia.

Objectives

Two groups with autism spectrum disorder (ASD1 – 22 patients of MHRC mean age 8.9; ASD2 – 27 pupils of special school mean age 7,4). Two groups with early onset schizophrenia (F20.8 – 16 patients of MHRC mean age 10,2; F21 – 18 patients of MHRC mean age 10.0).

Methods

Battery of pathopsychological tests for assessing cognitive functions (memory, attention, thinking), test figures of Leeper for visual perception. Z-scales were used for estimation of cognitive deficit or defect.

Results

Patients demonstrate variety of cognitive functioning. Normal cognitive functioning: ASD1* – 22%, F20.8 – 18%, F21* – 50% (* – P ≤ 0.05); partial cognitive defect: ASD1 – 27%, F20.8 – 18%, F21 – 22%; total cognitive defect: ASD1** – 50%, F20.8 – 64%, F21** – 27% (** – P ≤ 0.01). ASD1 and F20 were the worth in thinking. Children ASD1 and ASD2 demonstrate similar success in recognizing Leeper's figures.

Conclusions

There are some common features of cognitive development in children with severe forms of ASD and early onset schizophrenia, first of all in thinking.

No significant differences obtained between severe – mild forms of autistic disorders in visual perception (ASD1 and ASD2).

Disclosure of interest

The authors have not supplied their declaration of competing interest.