bluuebunny/crossref_metadata_2025 huggingface dataset:
Structure of psychic sphere pathology of patients of the regional medical consultative and diagnostic center of sub-arctic territory
Authors: Shapovalov K. , Shapovalova L.
Published: June 2017

In the structure of pathology 5356 psychiatric patients according to nosology forms, the first place ranking diagnosed by a psychiatrist of the regional advisory diagnostic center occupy organic, including symptomatic, mental disorders (F00–F09) to 48.2%. The second place ranking occupied by neurotic, stress-related and somatoform disorders (F40–F49) to 37.8%. This pathology includes various phobic, anxiety, depressive, hypochondria, obsessive-compulsive, dissociative (conversion), somatoform disorders, as well as response to heavy stress and adjustment disorders. The combination of anxiety and depression observed took place in 70.0% of patients. The majority of patients with anxiety disorders only part of the symptoms is found, however, and they are extremely painful. These people are in most cases not immediately come to the attention of psychiatrists, moving from a general practitioner to a neurologist, cardiologist and doctors of other medical specialists. They have initially diagnoses as vegetative-vascular dystonia, and then diencephalic crises, etc. The third rank place took patients with mental retardation - the proportion of an average of 1.3%. Mental disorder primarily characterized by impaired ability, manifested in the ripening period, provides a common level of intelligence: cognitive, speech, motor and social abilities. For the most part the clinical manifestations of these patients there are two groups of disorders: (1) Disorders of cognitive functions (memory, intelligence, learning, attention); (2) perception of disorder, the content of the thoughts, emotions and behavior.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
500 years of reformation: The history of Martin Luther's pathography and its ethical implications
Authors: Braun B. , Demling J.
Published: June 2017

Introduction

In the context of the 500th anniversary of the Reformation, it is time to take a survey of the history of Martin Luther's (1483–1546) pathography.

Method

Relevant writings were evaluated.

Results

While in a 1035 page work written in German between 1937 and 1941, the Dane Paul Reiter retrospectively diagnosed Luther as manic-depressive, Kretschmer (1888–1964) in 1955 saw in Luther “a great polemic and organizer”. In 1956, Grossmann was unable to prove persistent synchronicity of depressive mood and reduced motivation in Luther in the key years 1527 and 1528, which led him to conclude that Luther had a cyclothymic personality with a pyknic constitution. In Roper's view in 2016, Luther suffered from “a condition […], that we would call depression today”.

Discussion

In 1948, Werner concluded that Reiter's pathography was based on an incorrect assumption: Luther's solution of the cloister conflict as a dilemma situation between paternal and clerical authority was not a flight into “the mysticism of despair”. Hamm adopted this interpretation in 2015 in viewing the escalation of the emotional conflict potential as a logical consequence of an interiorized and individualized intensified piety. In 2015, Scott saw a cyclothymic temperament in Luther starting in about 1519, but emphasized the elasticity of Luther's emotional reserves: “For the rest of his life, Luther oscillated between euphoria and dejection but not to the point of dysfunction”.

Conclusion

Luther can be used as an example of the importance of religiousness as a curative resource for the psyche.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The phenomenon of serial killers from the perspective of the seven deadly sins
Authors: De Santiago Herrero F.J. , Trigo Bensusan A.M. , Montfragüe G.M. , Torres Delgado C.
Published: June 2017

Objectives

The aim of this paper is to make a comparative study on serial killers from different countries and link them to one of the traditional seven deadly sins in the Judeo-Christian culture.

Methods

Firstly, it was necessary to define each different deadly sin and establish its behavioural correlate. This was achieved thanks to a questionnaire designed to measure the interrate agreement within a sample population. Once the categories were defined (pride, lust, envy, sloth, wrath, gluttony and greed), 30 serial killers from America and Europe were analyzed in order to determine the sin behind their motivation to commit a crime. The evaluation was based on the Coding Guide – Serial Killers Research Project – created by the unit of analysis of criminal behavioural (University of Salamanca, Spain). Afterwards, an ex post facto descriptive non experimental study was carried out to find out the relation between the serial killer's own characteristics and the deadly sin linked to their motivation.

Results/conclusions

The results show a clear predominance of pride, lust and greed as the main motivations within the study sample. As well as some possible dependency relations between killers’ motivations and some other variables, which could be helpful when applied to the offender profiling field like sex or personality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How to interview terrorists? A forensic psychiatrist experience
Authors: Leistedt S.
Published: June 2017

Introduction

Because of their intrinsic characteristics, forensic interviews with terrorist suspects are perhaps one of the most challenging interviews forensic psychiatrists and psychologists will experience.

Objectives

This work presents a theoretical and practical framework for understanding terrorist individual psychology and effective interviewing techniques. It will show how the psychopathology of the terrorist, as well as social factors, have to be integrated in the preparation of the interview and in the interviewing process itself.

Methods

Forty-eight incarcerated Middle Eastern terrorists (1 women and 47 men) have been interviewed. These terrorists were involved – directly or indirectly – in several attacks claimed by Al-Qaeda or ISIS. Verbal communications were evaluated through questions and key points related to personality disorders described in the DSM-V. Non-verbal communications were analyzed through modalities such as facial expressions, eye contact, and body gestures.

Results

Several verbal and nonverbal characteristics have been identified as common in all the interviewees.

Conclusions

In a way to improve the quality and the quantity of the information gathering, it is suggested, especially with terrorists (but not only), to based the investigative and forensic interviewing on a personality-focused approach. Further studies are also needed to evaluate if terrorists have specific communication skills. Finally, this work proves that indirect assessment, such as consulting records, interviewing partners, family members or friends, is very important in the terrorist forensic assessment.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The profile of sexual abusers of minors: A forensic-psychiatric study
Authors: Nunes J. , Figueiredo D. , Ventura Gil T. , Colón M. , Pissarra da Costa A.
Published: June 2017

The World Health Organization (WHO, 2006) defines sexual abuse as the involvement of a child in sexual activity that he or she does not fully comprehend, being unable to give informed consent to, or for which the child is not developmentally prepared, or else that violates the laws or social taboos of society. In Portugal, the law that regulates the sexual abuse of underage people (minors) is enclosed in crimes of sexual auto-determination, which are described as child sexual abuse (article 171°) and sexual acts with a teenager (article 172°), and those are applied to the person that has copulation, anal intercourse and oral intercourse with underage abusing from their inexperience. Our objective is to investigate the profile of sexual abusers of minors, namely, the socio-demographic features, clinical correlations, and the level of penal responsibility of sexual offenders who were referred by court to forensic psychiatric assessment in the Institute of Legal Medicine of the City of Coimbra. Moreover, verify if these individuals present mental disorders at the time of the offence. The present study is of descriptive nature, being based on the observation and consultation of 30 clinical processes of sexual abusers. All written reports were obtained from 2005 to 2015 by court-appointed psychiatric experts on individuals that have been charged of committing sexual crimes against minors and referred to the main forensic institute in the city of Coimbra. This study will contribute to the increase of more information on these offenders, promoting the development of more adequate contingency plans for this population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The role of spitefulness in personality disorders: Toward a better comprehension of the cluster B
Authors: Velotti  , Rogier G. , Garofalo C.
Published: June 2017

Introduction

Cluster B personality disorders (i.e., Antisocial, Borderline, Histrionic, and Narcissistic Personality Disorders), is characterized by a dramatic pattern of relating to others, with symptoms characterized by a difficulty regulating emotional states and behavior (APA, 2000). The desire to cause pain often characterized these disorders (i.e. borderline) involving vindictively harming another with serious and often negative interpersonal consequences. Nevertheless, there is a paucity of research about the nature of relationships between spitefulness and personality disorders.

Objective

This study aims to investigate the association between spitefulness and personality disorders in an offenders samples (N = 305).

Aims

To investigate the associations among spitefulness and personality disorders. We hypothesized that spitefulness would be differently associated with emotional and impulsive personality disorders (cluster B: antisocial, borderline, histrionic and narcissistic).

Results

As expected, spitefulness and some personality, disorders were positively associated. Specifically, ASPD and Borderline are strongly associated with high levels of spitefulness.

Conclusions

Such results confirm the theorization that the assessment of spitefulness improve the accuracy of diagnosing of these personality disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
SHANK3 mutation in consanguineous schizophrenia family in northwest Algeria
Authors: Dahdouh A. , Prados J. , Guipponi M. , Bena F. , Adouan W. , Antonarakis S.
Published: June 2017

Introduction

Several studies have asserted the existence of a strong and complex genetic component in the determination of psychotic disorders. GWAS studies conducted over the past decade lead to the identification of only a few low effect associations, calling questioning the hypothesis of “common disease – common variants” for a model involving a large number of rare variants.

Aims

Here, we studied a multigenerational multiplex family with schizophrenia a high rate of consanguinity, located in the northwest of Algeria. This study aims to identify inherited rare variants of schizophrenia using new genetic technologies.

Methods

This family has received complete clinical (DIGS, DSM-IV criteria), genealogical investigations, CNV analysis using CGH Microarray Kit 244 K (Santa Clara, CA) and WES (by GAIIx Illumina/HiSeq 2000) focused in CNV regions, that were performed in the department of genetics in the university hospital of Geneva.

Results

We identify 11 affected members by psychotic disorders. The main CNVs analysis results found in a schizophrenic member a Del 22q13.33 affecting SHANK3 gene. WES regarding these regions identified a mutation at position 511178000 in SHANK3 gene in all the selected affected relatives.

Discussion

Several studies have asserted the association of SHANK3 mutations with schizophrenia and autism disorders. This is the first observation of rs511,178,000 in schizophrenia phenotype.

Conclusion

In total, this highly informative family have identified new rare genetic variant of schizophrenia. The search for this mutation in wider control population in would be useful to validate these data.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Formative Exploration of the Relationship Between Waiting Times and Attendance at General Adult Psychiatry Clinics, at a Hospital in Pennine Care NHS Foundation Trust
Authors: Gan M. , Salujha S.
Published: June 2017

Introduction

An audit was done to assess new patient wait times. As part of this project we reviewed possible relationships between wait times and clinic attendance.

Objective

To examine available data, for possible explanations of patients’ attendance behaviour at outpatient clinics.

Aims

To identify possible correlation between length of waiting time for adult psychiatry appointments and status of attendance.

Method

Service Line: New patient referrals to adult outpatient psychiatry (January–December 2015)

Sample size: 401.

Results

Fig. 1 and Table 1 show wait times compared with clinic attendance outcome. Percentage attendance appeared to gradually fall as wait times increased; while cancellation (%) by the NHS, and DNAs (did not attend) by the patient, appeared to rise over time.

Conclusions

This review has demonstrated a possible correlation between wait time for a clinic appointment and how patients behave. The shorter a patient has to wait; it appears they are more likely to actually attend clinic. If so, this potentially has implications for discussions around possible reorganization of services, to improve engagement and outcomes, by coming up with innovative ways of reducing wait times.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Increased Prevalence of Psychosis in Patients Who Get Admitted with Acute Myocardial Infarction with Worse Outcomes
Authors: Mansuri Z. , Patel S. , Patel P. , Jayeola O. , Das A. , Shah J. , Gul M.H. , Karnik K. , Ganti A. , Shah K.
Published: June 2017

Objective

To determine trends and impact on outcomes of acute myocardial infarction (AMI) in patients with pre-existing psychosis.

Background

While post-AMI psychosis has been extensively studied, contemporary studies including temporal trends on impact of pre-AMI Psychosis on AMI and post-AMI outcomes are lacking.

Methods

We used Nationwide Inpatient Sample (NIS) from Healthcare Cost and Utilization Project(HCUP) from 2002 to 2012. We identified AMI and psychosis as primary and secondary diagnosis respectively using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD9CM) codes, and Cochrane-Armitage trend test and multivariate regression to generate adjusted odds ratios (aOR).

Results

We analyzed total of 7,174,274 AMI hospital admissions from 2002 to 2012 of which 1.77% had psychosis. Proportion of hospitalizations with psychosis increased from 6.94% to 11.85% (P-trend < 0.001). Utilization of percutaneous coronary intervention (PCI) was lower in patients with psychosis (29.98% vs. 40.36%, P < 0.001). Utilization of coronary artery bypass grafting (CABG) was lower in patients with psychosis (8.01% vs. 9.18%, P < 0.001). In-hospital mortality was significantly lower in patients with psychosis (aOR 0.677; 95% CI 0.630–0.727; P < 0.001) but discharge to specialty care higher (aOR 1.870; 95%CI 1.786–1.958; P < 0.001). In addition, median length of hospitalization (3.77 vs. 2.90 days; P < 0.001) was higher in hospitalizations with psychosis.

Conclusions

Our study displayed increasing proportion of patients with psychosis admitted due to AMI in last decade with lower mortality but higher morbidity post-infarction, and significantly less utilization of PCI and CABG. There was also increased length of stay patients with MDD. There is need to explore reasons behind this disparity in outcomes and PCI and CABG utilization to improve post-AMI outcomes in this vulnerable population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
What is the Prevailing Diagnosis on Admission Into Adult Psychiatric Wards? A Meta-analysis of Trends in the United Kingdom
Authors: Shoka A. , Lazzari C. , Gower Katherine
Published: June 2017

Introduction

There seems to be an upsurge in psychiatric admissions related to female patients with borderline personality disorder. Does this reflect the actual trend?

Objectives

Study of the typology of admission into acute psychiatric wards for an adult population.

Aims

To understand the trend of actual psychopathology in the general population admitted into psychiatric wards.

Methods

A total population of 197 psychiatric admissions was diagnosed in the period March 2015–March 2016 in a general psychiatric ward in the United Kingdom. The four major diagnostic categories were: personality disorder (mostly inclusive of borderline p.d.) (n = 77), paranoid schizophrenia (n = 24), schizoaffective (n = 11) and other (n = 82). Meta-analysis of the population analyzed the results. Gender was divided into 82 male and 125 female admissions, with 181 informal admissions, 68 under Sections of the Mental Health Act, and 5 under recall from Community Treatment Order.

Results

Meta-analysis (Fig. 1) of the whole study showed a statistically significant heterogeneity in results with Tau squared t2 = 0.031, Cochrane's Q (df = 3) = 141.90, P < .001, and I2 = 97.87, a prevalence of borderline personality disorder over other diagnoses; a prevalence of female over male admissions, (t2 = .02, Q (df = 1) = 18.67, P < .001, I2 = 94.64), and a prevalence of patients admitted informally (t2 = 0.131, Q (df = 2) = 586.366, P < .001, I2 = 99.65).

Conclusions

The prevailing population of acute psychiatric wards for the general adult population is females who are admitted informally with diagnosis of borderline personality disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Situational Dysphoria Scale (SITDS): Development and Validation of a Self-report Questionnaire for Assessing Situational Dysphoria in Borderline Patients
Authors: D’Agostino A. , Aportone A. , Rossi Monti M. , Starcevic V.
Published: June 2017

Introduction

According to contemporary phenomenological literature, dysphoria is the background mood characterizing patients with borderline personality disorders (BPD). In particular circumstances, it can take the form of a state of pressure, urge to act, and quasi-explosion, which is very dependent on situational triggers. There are currently no instruments able to measure this situational form of dysphoria.

Objectives

To develop and analyze psychometric properties of the Situational Dysphoria Scale (SITDS), a self-report questionnaire that measures situational dysphoria.

Aims

To validate the SITDS for a future use in routine clinical practice and, more generally, to assess different forms of dysphoria in BPD in a more precise way.

Methods

The preliminary 58-item SITDS was administered to 105 BPD patients, along with other conceptually similar (Nepean Dysphoria Scale) and conceptually distinct (Cynical Distrust Scale, Inventory of Interpersonal Problems-47, empathy quotient, and borderline personality severity Index-IV) instruments. The psychometric characteristics (reliability, internal structure, convergent and divergent validity) of the SITDS were then examined.

Results

The final 24-item SITDS (with each item rated on three subscales: internal pressure, urge to act, and quasi-explosion) demonstrated excellent internal consistency (alpha = .91). A three-cluster solution was found, with clusters pertaining to personal events, interpersonal events, and environmental events. There were medium to strong correlations with NDS, and weaker but still significant correlations with CynDis, IIP-47, EQ, and BPDSI-IV.

Conclusions

The SITDS is a useful and easy-to-handle instrument for measuring situational dysphoria. Further research in clinical samples is needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Confirmatory Factor Analysis of the Hewitt & Flett Multidimensional Perfectionism Scale-13 (H&F-MPS13)
Authors: Soares M.J. , Marques C. , Pereira A.T. , Araújo A.I. , Madeira N. , Nogueira V. , Macedo A.
Published: June 2017

Introduction

H&F Multidimensional Perfectionism Scale is a widely used measure of perfectionism developed to measure Self-oriented perfectionism (SOP), Socially-prescribed perfectionism (SPP) and Other-oriented perfectionism (OOP) dimensions. The original scale comprises 45-likert items. We have previously developed a short version of The H&F-MPS, with 13 items, showing adequate validity in a sample of university students, using principal component analyses method with factors varimax rotation.

Objective

To examine the factor structure of the H&F-MPS13 with confirmatory factor analysis (CFA), using a different sample of Portuguese university students.

Methods

The sample comprises 245 university students (68.9% females), with a mean age of 20.95 years (SD= 2.19; range= 17–33) who completed the H&F-MPS13. CFA was used to test the model suggested by prior exploratory factor analyses of H&F-MPS13.

Results

After correlated errors, we obtained a good fit for the second-order factor (X2/d= 2.577; CFI= 0.928; GFI= 0.915, RMSEA= 0.080; P[rmsea ≤ 0.05] = 0.001). The H&F-MPS13 showed acceptable internal consistency (α= 0.77) and the three dimensions presented Cronbach's alphas ranging between acceptable and good (α OOP = 0.67; SPP = 0.73; SOP = 0.89).

Conclusions

The H&F-MPS13 obtained through CFA is a reliable and valid measure to assess perfectionism in Portuguese university students.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship Between Personality Traits and Mental Health in Athletes Students
Authors: Mosavi Amiri S.J. , Abbasalipour M. , Mousavi Amiri S.K. , Ghaemi Amiri R. , Sheikholeslami Amiri M. , Mousavi Amiri S.J. , Nikkhou Amiri A. , Nadalinezhad M.
Published: June 2017

Aim

The purpose of this study was to investigate relationship between personality traits and mental health in athlete students. This study was a descriptive and correlation design.

Method

Sixty athletes students were randomly selected and responded to NEO-PIR inventory and General Health Questionnaire (GHQ 28). NEO assesses five personality traits: Neuroticism (N), Extroversion (E), Agreeableness (A), Openness to new experience (O) and Conscientiousness (C), and GHQ assesses four dimensions: Somatic symptoms (A), Anxiety (B), Social withdrawal (C) and Depression (D). NEO assesses five personality traits: Neuroticism, Extroversion, Agreeableness, Conscientiousness, Openness to experience. The data were analyzed with Pearson correlation test.

Results

The findings showed that there was positive significant correlation between neuroticism with somatic symptoms and depression, and negative significant correlation between extroversion, agreeableness, openness to new experience and conscientiousness with depression.

Conclusion

Based on findings, it is concluded that physical exercises and sport plans have positive effects on mood and affect of students, and decrease physical and mental diseases in athletes students.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
DBT for Co-morbid Borderline Personality Disorder and Substance use Disorder Without Drug Replacement in Egyptian Outpatient Settings: A Non-randomized Trial
Authors: Abdelkarim A. , Molokhia T. , Rady A. , Ivanoff A.
Published: June 2017

Background

Dialectical behavior therapy has demonstrated effectiveness for patients suffering from co-morbid borderline personality and substance use disorder. The current study tries to replicate results of previous studies in a mixed gender sample of Egyptian outpatients.

Aim

The aim of the current study was to examine the effectiveness of DBT without drug replacement relative to treatment as usual “TAU” in improving behavioral outcomes related to SUD and BPD, and improving emotional regulation.

Methods

Forty outpatients with co-morbid BPD and SUD in Alexandria and Cairo were assigned for one year either to comprehensive DBT program (20 patients), or TAU defined as ongoing outpatient psychotherapeutic treatment from referring center (20 patients). Patients were assessed at baseline and follow up assessment at 4, 8, 12 and 16 months was done using Arabic version of Difficulties in Emotion Regulation Scale (DERS), urine multidrug screen and time line follow-back method for assessment of alcohol and substance use history.

Results

Following one year of treatment, DBT group showed significantly lower doses of drugs used, DERS score, rates of hospital admission, ER visits, suicidal attempts and episodes of NSSI. Also, DBT patients showed markedly increased retention in treatment and longer duration of total alcohol abstinence and other drugs of abuse. Positive outcomes were maintained for four months post-treatment.

Conclusion

DBT demonstrated superior efficacy in comparison to TAU for treatment of Egyptian patients suffering from co-morbid borderline personality and substance use disorder across behavioral domains of SUD, BPD and reduction hospital admission, emergency room visits and DERS score.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relapse After First-Episode Psychosis: A 3-Year Follow-Up
Authors: Pereira E. , Mota Oliveira M. , Guedes R. , Peixoto M.J. , Ferraz I. , Silveira C.
Published: June 2017

Introduction

Relapse after first-episode psychosis (FEP) is a frequent problem, which can lead to patients’ poorer functioning and response to treatment. Its prevention is one of the most important and challenging targets in the treatment of psychotic disorders.

Objectives

To characterize and evaluate relapse rates after FEP, during the course of 3 years, of a group of patients admitted at a psychiatry department.

Methods

A retrospective observational study was conducted. Patients with a FEP between ages 18 to 40, admitted at the Clinic of Psychiatry and Mental Health at São João Hospital Centre between January 1, 2007 and September 30, 2013. Only patients with, at least, 3 years of follow-up at the clinic were included.

Results

Final sample of 58 patients, 39 of which were male (mean age = 26.4 years). Forty patients were excluded by not completing the 3 years follow-up at our department. The cumulative relapse rates were 32.8% at 12 months, 53.4% at 24 months and 63.8% at 36 months. Patients with at least one relapse were younger (25.78 years vs. 27.52 years) and had shorter periods of first hospitalization (19.25 days vs. 23.52 days). These data did not reach statistical significance. Non-adherence to prescribed medication was described in 73.0% (n = 27) of patients at the time of relapse. Eight of them (21.6%) presented with cannabis use.

Conclusions

Although no statistical significance was reached, our findings are consistent with other studies. A future study with a bigger sample would be important in achieving statistical significant results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Link Between Sleep, Stress and BDNF
Authors: Eckert A. , Karen S. , Beck J. , Brand S. , Hemmeter U. , Hatzinger M. , Holsboer-Trachsler E.
Published: June 2017

The protein brain derived neurotrophic factor (BDNF) is a major contributor to neuronal plasticity. There is numerous evidence that BDNF expression is decreased by experiencing psychological stress and that accordingly a lack of neurotrophic support causes depression. The use of serum BDNF concentration as a potential indicator of brain alteration is justified through extensive evidence. Recently, we reported, for the first time, a relationship between BDNF and insomnia, since we could show that reduced levels of serum BDNF are correlated with sleep impairment in control subjects, while partial sleep deprivation was able to induce a fast increase in serum BDNF levels in depressed patients. Using a bi-directional stress model as an explanation approach, we propose the hypothesis that chronic stress might induce a deregulation of the HPA system leading in the long term to sleep disturbance and decreased BDNF levels, whereas acute sleep deprivation, can be used as therapeutical intervention in some insomniac or depressed patients as compensatory process to normalize BDNF levels. Indeed, partial sleep deprivation (PSD) induced a very fast increase in BDNF serum levels within hours after PSD which is similar to effects seen after ketamine infusion, another fast-acting antidepressant intervention, while traditional antidepressants are characterized by a major delay until treatment response as well as delayed BDNF level increase. Moreover, we revealed that stress experience and subjective sleep perception interact with each other and affect serum BDNF levels. We identified sleep as a mediator of the association between stress experience and serum BDNF levels.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Burnout in Medical Residents: Prevalence and Risk Factors
Authors: Feki I. , Hentati S. , Sallemi R. , Bahloul N. , Zalila D. , Kammoun S. , Masmoudi J.
Published: June 2017

Background

Burnout is a state of mental and physical exhaustion related to work. It is manifested in a variety of professions and is prevalent in contexts in which health professionals are required to interact directly with the public.

Objectives

To estimate the burnout syndrome (BOS) prevalence and to identify its associated factors among medical residents.

Methods

A descriptive and analytic study conducted during a period from 2012 until 2014, including 184 residents exerting at the two university hospitals of Sfax, Tunisia. Data collection was conducted using an anonymous self-questionnaire, including demographic items and working conditions items. Maslach Burn-out Inventory (MBI) was used to assess BOS.

Results

The average age was 25.14 ± 1.47 years. The sex-ratio was 0.65. The majority (154 residents) was single. Over than half (58.2%) of medical residents endure a high emotional exhaustion, 62.5% a high depersonalisation and 12.5% a low personal accomplishment. About eighty percent (79.3%) of them were in burn out with 37% at intermediate and 11.3% at a severe degree. No statistical association was found between the personal characteristics and BOS. Whereas, several factors related to employment status were correlated with the presence of BOS such us: number of working hours > 30 h/week, a number of free weekends < 2/month and a number of days off ≤ 30 days/year. In addition, we found that psychotropic and alcohol consumption were significantly associated to BOS with respectively P = 0.050 and P = 0.002.

Conclusion

Burnout is a worrying reality among young doctors. Individual as well as organizational interventions should be targeted to prevention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Palatable Food Access During Adolescence Increased BDNF Expression in the Nucleus Accumbens and Anxiety-/Depression-Like Behaviors in Males, But Not in Females
Authors: Jahng J.W. , Kim J.Y. , Lee J.H.
Published: June 2017

Objectives

This study was conducted to examine sexual dimorphic effects of highly palatable food access during adolescence and youth on psychoemotional behaviors of rats and its underlying neural mechanism.

Methods

Male and female Sprague Dawley pups had free access to chocolate cookie rich in fat (highly palatable food) from postnatal day 28 in addition to ad libitum chow, and the control groups received chow only. The food conditions were continued though out the entire experimental period, and the neurochemical and behavioral measurements were performed during young adulthood. Corticosterone levels during 2 h of restraint stress were analyzed with radioimmunoassay, and ΔFosB and brain-derived neurotrophic factor (BDNF) expression in the nucleus accumbens (NAc) with western blot analysis.

Results

Cookie access did not affect body weight gain and total caloric intake in both sexes; however, it increased retroperitoneal fat depot only in males. The time spent in open arms during elevated plus maze test was decreased and immobility during forced swim test was increased in cookie-fed males, but not in cookie-fed females. Main effect of food condition on the stress-induced corticosterone increase was observed in males, but not in females, and cookie access increased BDNF expression in the NAc only in males.

Conclusions

Increased BDNF expression in the NAc and fat depot, in addition to the HPA axis dysfunction, may play roles in the pathophysiology of depression- and/or anxiety-like behaviors induced by cookie access.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparative Assessment of Cognitive Function and Mood Dynamics in Patients with Depression and Eating Disorders in the Process of Treatment
Authors: Makhortova I. , Shiryaev O.
Published: June 2017

Eating disorders of bulimic type are among the most common comorbidities with depression. The objective is to evaluate cognitive function and mood dynamics in patients with depression and eating disorders in pharmacotherapy. In total, 52 outpatients, who met criteria for “major depressive episode” (ICD-10), participated. The level of depression was estimated with Hamilton Depression rating scale (HAM-D) and cognitive function–Montreal Cognitive Assessment (MoCa). Sample was divided into two groups. Patients of group 1 also met criteria for eating disorder of bulimic type and patients of group 2 did not have any eating disorder. Treatment included standard doses of SSRI. Assessments were performed after 2, 4 and 8 weeks (D14, D30, D60). The level of HAM-D was significantly greater (P < 0.05) in eating disorders group (16.75 ± 2.83 in group 1; 13.04 ± 1.93 in group 2 at screening) and significance was preserved till D60 (9.39 ± 2.54 in group 1; 6.32 ± 1.27 in group 2 at D60). Clinically significant antidepressive effect was revealed faster in group 2 (at D7) compared to group 1 (at D14). Overall score of MoCA was significantly lower (P < 0.05) in eating disorders group (20.33 ± 0.54 in group 1; 23.43 ± 2.32 in group 2 at screening) at all stages of treatment (23.39 ± 0.78 in group 1; 26.96 ± 3.27 in group 2 at D60) and it reached normal range (25 and more) only in group 2 at D60. Significant change from screening was revealed at D30 at group 2 and at D60 at group 1.

Conclusion

Eating disorder have an impact on SSRI treatment efficacy including antidepressive and procognitive effects. It is necessary to reveal eating disorders as a co-morbidity in patients with depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
What do Tunisian General Practitioners Know About Insomnia?
Authors: Yaich K. , Maalej Bouali M. , Charfi N. , Sellami W. , Zouari N. , Zouari L. , Ben Thebet J. , Maalej M.
Published: June 2017

Introduction

Insomnia is the most prevalent sleep disorders and affects 10% of adults worldwide. It has major social and economic consequences. The aim of our study was to evaluate the knowledge of Tunisian general practitioners (GPs) about insomnia.

Methods

A cross-sectional survey was carried out during the month of May 2016. Among the 193 GPs randomly selected from different areas of Sfax, in Tunisia, 127 participated to the study. The latter filled a questionnaire including items related to socio-demographic data and clinical features of insomnia.

Results

Among our participants, 58.3% (n = 74) were men and 41.7% (n = 53) women. The average age was 47.91 ± 10.1 years. They have been working for 17.36 ± 10.7 years on average. Seventy-six of GPs had an individual training and a training by attending conferences or by continuous medical education. Most participants (80.3%) thought that they had some lacuna in the management of insomnia. Specific recommendations for the management and treatment of insomnia were known by 7.2% of the GPs. As for theoretical knowledge about insomnia, 74.8% of participants (n = 95) had a high score of correct answers. The latter was correlated to age (P = 0.013) and to the male gender (P = 0.008). However, it was neither correlated to the seniority of the GPs (P = 0.051) nor to the knowledge of specific recommendations for the management of insomnia (P = 0.11).

Conclusion

Our results showed that the GPs had a rather good theoretical knowledge about insomnia. Yet, an improvement of the continuous medical education and a better knowledge of specific recommendations for the management of insomnia are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Emotion Processing Abnormalities in Eating Disorders: An FMRI Pilot Study
Authors: Zemánková P. , Gajdoš M. , Kašpárek T. , Bareš M.
Published: June 2017

Introduction

Abnormalities in emotional functioning is one of the key features of eating disorders (ED), such as anorexia nervosa (AN) and bulimia nervosa (BN). These patients show increased levels of alexithymia, problems understanding one's own emotion, which has been simultaneously, associated with difficulties in recognizing others emotions.

Objectives

In this study, we were interested in the neuronal mechanism of emotion processing from both, self and others perspective, and we aimed to compare the underlying brain activations in eating disorder patients and healthy controls.

Methods

A sample of 12 women with ED (10 AN, 2 BN) and 11 age and education matched healthy controls (HC) underwent fMRI examination while performing emotion recognition task, which requires either inferring mental states of depicted figures, or assessing participant's own feelings evoked by the pictures.

Results

The task activated superior temporal sulcus bilaterally, left temporo-parietal junction, and medial prefrontal cortex. Those regions have been consistently identified in literature to be active while thinking about other people. Interestingly, group differences analysis revealed that ED patients group showed higher activations in right supramarginal gyrus, compared to HC group. This structure is critical to overcome egocentricity bias in social judgment. Contrary to ED patients, HC group showed greater activations in cingulate gyrus and insula, regions involved in emotion formation and processing.

Conclusion

We hypothesize that ED patients tend to suppress their own perspective while thinking about emotional states of others more strongly than HC, probably due to alexithymia and the lack of awareness of their mental states.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
In-Patient and Post-Discharge Suicides in Tyrol 2004–2011
Authors: Deisenhammer E.A. , Behrndt E.M. , Kemmler G. , Haring C. , Miller C.
Published: June 2017

Introduction

Psychiatric patients constitute a high-risk population for suicide. In-patient status and the period after discharge are of particular interest concerning risk assessment.

Objective

To assess risk factors for in-patient and post-discharge suicides.

Methods

The Tyrol suicide register was linked with the registers of three psychiatric departments/hospitals of the region. Suicides were categorized according to whether the suicide was committed during a hospital stay or within 12 weeks after discharge or whether the suicide subject had not recently been hospitalized. Groups were compared with regard to demographic and clinical variables. Further, case-control comparisons were performed for the in-patient and post-discharge groups.

Results

During the study period (2004–2011) 30 in-patients, 89 post-discharge and 592 not recently hospitalized suicides were identified. Groups differed in terms of gender distribution, history of suicide attempts, warning signals and suicide methods. Compared with controls matched for a number of variables, in-patient suicides were significantly more suicidal and depressed at admission, reported more often a recent life event and showed less often aggressive behavior and plans for the future. Post-discharge suicides had more often a history of attempted suicide, depressive and thought disorder symptomatology, a ward change and an unplanned discharge and less often a scheduled appointment with a non-psychiatric physician.

Conclusions

Suicide victims differ with regard to whether they die during, shortly after or not associated with a hospitalization. Compared to controls there are specific risk factors for those who commit suicide during a hospital stay and within 12 weeks after discharge.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pressure From Superiors and Older Age Increase the Risk of Burnout Syndrome Among Psychiatric Trainees: A Nation-wide Survey in Turkey
Authors: Capraz N. , Ceylan Tufan Ozalp D. , Yalcin M. , Tellioglu Can E. , Alkin T.
Published: June 2017

Introduction

Previous studies reported high burnout rates and indicated significant factors associated with burnout syndrome among psychiatric trainees, such as hard working conditions, lack of supervision and not opting for psychiatry as a first career choice.

Objectives

A substantial amount of variance was reported in psychiatry training across countries. However, there is not sufficient national data regarding the rates and risk factors of burnout syndrome among psychiatric trainees in Turkey.

Aims

To determine the burnout syndrome rates and the risk factors associated with burnout syndrome among psychiatric trainees.

Methods

A questionnaire of occupational, educational and personal factors and Maslach burnout inventory (MBI) were answered by 180 of 450 psychiatric trainees in Turkey. The data was collected from 167 (56% females) trainees who completed the survey material. Converting the scores of three subscales by using MBI manual, a dichotomous variable (severe/non-severe burnout) was obtained for each participant and the data was analyzed using descriptive statistics and regression models.

Results

Mean age was 28.85 ± 2.99-year-old and mean duration of residency was 2.61 ± 1.31 years. Severe burnout was found in 38.3% of the trainees. Logistic regression confirmed that older age (P = 0.02) and pressure from superiors (P = 0.04) are predictive factors associated with severe burnout. The high number of patient visits (P = 0.001), violation of employee personal rights (P = 0.04) and pressure from superiors (P = 0.01) were significantly associated with the “wish working in another institution”.

Conclusions

Pressure from superiors and older age can be described as risk factors associated with burnout syndrome among psychiatric trainees in Turkey.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The EPA Gaining Experience Programme: A Great Experience for Young Professionals
Authors: Oriani M.G. , Beezhold J.
Published: June 2017

Introduction

Mental health services in many European countries are undergoing to changes: it is important that early career psychiatrists (ECPs) have opportunities to broaden their professional horizons and better understand the international context of the upcoming changes: then, they can become aware protagonists of these changes and the future of the mental health system in their countries and in Europe. The gaining experience programme (GEP), offering ECPs observership placements in various psychiatric institutions across the Europe, can boost it.

Aims

We aim to consider how the EPA GEP can provide a unique professional and cultural understanding of the mental health services across the Europe and positively affect the ECPs’ career.

Methods and results

Starting from an experience of the GEP in 2016, we will discuss how it represents a great chance to observe the clinical work of multidisciplinary teams and an opportunity to visit different countries. Many aspects were significant, starting from the different organization of the mental health services, as well as the influence of different cultures on the mental health care system and the patient's expectations.

Conclusions

Attending EPA GEP is an important chance for ECPs to improve their professional and organizational skills as well as a great skill-building opportunity and personal growth experience. The GEP is at his third edition this year and it has having a growing success among young psychiatrists. It gives them a chance to improve mentoring and professional networks among experts and ECPs and to get more involved in the EPA activities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric Trainees: Swiss Penknives for a Cheap Price?
Authors: Sönmez E. , De Picker L. , Ryland H. , Pinto Da Costa M. , Gargot T. , Viltrakyte I. , Grassl R.
Published: June 2017

Introduction

Global trends in the nature of working conditions pose significant threats to the training of medical professionals, as a result of cuts in educational grants and the salaries of professionals in training. Psychiatric trainees are not exempt from these changes.

Objectives

To determine the current working conditions of psychiatric trainees and how they impact on their experience of training.

Methods

A semi-structured survey was distributed to all members of the European forum of psychiatric trainees. Responses were collected online from 34 participating countries. The respondents were representatives of national trainee associations. Data collection was completed between May and July 2016.

Results

Respondents reported that the most important issues affecting postgraduate training were firstly working conditions, then salary, psychotherapy training and supervision, respectively. The average official mandatory working hours for a trainee, including on call duty was reported to be on average 40.16 (± 10.14 hours per week). In reality, the time that trainees report working is more than 20% higher than official working hours (on average 49.08 ± 15 per week). There is an officially recognized minimum vacation period of 20 days in almost all countries, ranging up to a maximum of 40 days (mean: 26.93 ± 4.97, per year). Salaries demonstrate an even greater variation, ranging from 100 Euros (as in the case of Moldova), up to over 5000 Euros (as in the case of Germany or Switzerland) per month.

Conclusion

Psychiatric trainees often work longer than the officially recognized hours and their income varies considerably between countries, which have been identified as the two biggest challenges trainees face.

Disclosure of interest

The authors have not supplied their declaration of competing interest.