bluuebunny/crossref_metadata_2025 huggingface dataset:
Treating Cognitive Impairments in Bipolar Disorders: New Leads in the Cognitive Remediation Field
Authors: Isaac C. , Castillo M.C. , Januel D.
Published: June 2017

Cognitive deficits have been overlooked in bipolar spectrum disorders, despite their significant impact on patients’ quality of life. Indeed, nearly sixty percent of stabilized bipolar patients suffer from major cognitive impairments that impede their everyday life functioning. Without proper care, these impairments remain throughout lifespan and increase with hospitalisations, social isolation or pharmacological treatments. Cognitive remediation is a cost-effective tool well accepted by patients and caregivers that has proven its efficacy for treating cognitive impairments in several disorders such as schizophrenia. However, for bipolar disorders, this psychosocial intervention based on brain plasticity is still in its early stages. After depicting the state of the art on cognitive impairments and cognitive remediation in mood disorders, we will introduce the ECo program that was specifically designed for bipolar disorders. We will then present the preliminary results (n = 18) of a double-blind randomised controlled study that assessed the effect of this program on cognitive impairments and psychosocial functioning, at short term and long term (three and nine months). First results support the hypothesis of a positive impact of the ECo cognitive remediation program on bipolar patients’ neuropsychological functioning, self-efficacy and quality of life. Cognitive remediation may be a promising tool for bipolar disorders that meets the needs of patients, their caregivers and the community.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinico-social Character of Delinquent form of Dissocial (Deviant) Behavior
Authors: Aprasidze T. , Tsirekidze M.
Published: June 2017

Introduction

Among great variety of the manifestations of juvenile deviation of behavior, with its social significance, delinquency draws a special attention, in particular, with its aggressive manifestation.

Objectives

Our task is specification of psychopathological peculiarities of two forms of aggressive behavior of delinquency.

Methods

Fifty delinquent juveniles from 14 to 18 years of age (inclusive) have been examined. Two forms of aggressive manifestations have been picked out: non-pathological: 36 (72%) and pathological: 14 (28%).

Results

Non-pathological aggression basically is conditioned by the influence of micro-social negative conditions and stress situations. The contents of aggressive acts are closely connected with the peculiarities of characterological features; aggressive behavior is characterized with an episodic appearing, less severity and is often manifested in threatening. Marked cruelty, sadism and vandalism are found comparatively seldom. The violation of social adaptation is found in them in stresses, stipulated with negative micro-social factors; they are more manageable and comparatively quickly regress.

The peculiarities of pathological aggression are represented by super valuable and sadistic manifestations, comparatively seldom–with signs of dysphoria. The aggression, stipulated by pathocharacterological reactions is manifested in the form of pathologically super valued and affective situational acts of behavior.

Conclusions

Aggressive behavior of delinquency is chiefly observed in its non-pathological form, which can be explained by the hard social-economical background, visible growth of aggressiveness in an immense part of population, moral and ethic deprivation and frustration. The society itself is a certain indicator of aggressiveness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychoaffectives Repercussions of Autism on Parents
Authors: Ben Soussia R. , Bouallagui A. , Khouadja S. , Marrag I. , Nasr M.
Published: June 2017

Introduction

Caring for a child with autism is a stressful experience for parents. The daily stress of this handicap has a major impact and triggers in the parents a series of adverse psychological reactions.

Aim

To reveal sociodemographic characteristics of parents of autistic children and to estimate the prevalence of anxiety and depressive symptoms among these parents.

Methods

A cross-sectional study conducted among parents of autistic children supported by four of autistic children rehabilitation centers under the Tunisian Association for the Promotion of Mental Health. Data were collected through a questionnaire to explore the sociodemographic data of parents of autistic children. Depressive symptoms were assessed by the Beck scale and anxiety symptoms by the Hamilton scale.

Results

Fifty-two parents were collected. The middle age was 35.73 years. They lived in an urban area in 96% of cases. The majority had an average socioeconomic level (88.4%). The respective rates of depressed or anxious parents as Beck scales and Hamilton were 48% and 23%. The association between depressive and anxious symptoms was found in 19%. In addition, depression was more common in mothers (P < 10−4) and anxiety was also more evident among mothers (P = 0.01).

Conclusion

The presence of an autistic child causes profound changes in families and can be a source of tension and stress. The anxious and depressive impact on parents is important and frequent. The intervention that designs the psychiatrist to help children with autism should necessarily include an action for parents.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Aerobic Exercise Training in Children and Adolescents with Inflammatory Bowel Disease: Influence on psychological Functioning, Sleep and Physical Performance
Authors: Maehlmann L. , Gerber M. , Furlano R.I. , Légeret C. , Kalak N. , Sadeghi Bahmani D. , Holsboer-Trachsler E. , Brand S.
Published: June 2017

Background and aims

Patients with inflammatory bowel disease (IBD) report increased mental health issues, poorer sleep quality and less engagement in physical activity (PA). Standard treatment consists of immune modulating pharmaceuticals, though evidence is growing that aerobic exercise training (AET) might serve as adjuvant option to reduce disease symptoms and improve mental health. The aim of the present study was to investigate possible AET effects on psychological functioning, depressive symptoms, sleep and PA behavior in paediatric patients with IBD.

Methods

Twenty-one paediatric patients with IBD and 23 gender and age-matched healthy controls (HC) were assessed. The IBD group was split into a “remission-group” (IBD-RE; n = 14) and an “active disease group” (IBD-AD; n = 7). All participants completed an 8-week AET exergame intervention reaching 60–80% of maximal heart rate for 5 days per week. At baseline and after 8 weeks, psychological functioning, depressive symptoms, objective sleep EEG, subjective sleep and objective and subjective PA were assessed.

Results

AET significantly improved the exercise capacity of all participants. Self-reported fitness and daily PA behavior significantly increased in IBD-AD, but not in IBD-RE and HC. No improvements were observed for psychological functioning, depressive symptoms and subjective or objective sleep dimensions. Descriptively, the IBD-AD group reported lower psychological functioning and poorer subjective sleep quality.

Conclusions

Results suggest that children and adolescents in an active disease state were at increased risk to descriptively report lower scores of psychological functioning and sleep. Further, an exergaming intervention has the potential to improve exercise capacity, self-reported fitness and daily PA.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Executive Functioning, Response Inhibition and Attentional Process Impairments in Impulsive Children
Authors: Mozaffarinejad F. , Nazarboland N.
Published: June 2017

Impulsivity is a multidimensional concept that incorporates failure of response inhibition, rapid processing of information, novelty seeking, and inability to delay gratification. Aggressive, suicidal and violent behaviors have been shown to be associated with impulsivity and difficulty in inhibiting responses. As explorers of executive function (EF) and impulsivity research areas believe this two are generally considered conceptually distinct, and suggest that they may be antipodes (i.e., widely separated on a common continuum, upon which they are related), We selected subjects with high (n = 25) and low (n = 25) levels of impulsivity among 537 students of ages 8 to 10 years-old, who were measured by Conners Teacher Rating impulsivity Scale. Using computerized versions, response inhibition was examined by their performance in a Go/No Go task, general performance in executive functions (EF) was measured by tower of London Test and continuous performance test (CPT) was used to assess their attentional processes. Using independent t- test and ANOVA, the results revealed that overall performance of executive functions in impulsive children in all three areas were remarkably damaged: they had impaired performance regarding Go/No Go task results; also have consumed more time and committed more errors and a worse general performance; and had more errors and weaker performance in attentional processes. The results of this study along with similar results would be effective in achieving a brighter image of impulsive children's cognitive problems in order to provide efficient treatments focused on improving their executive functions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Families of Children with Autism Spectrum Disorders: Communication and Mental Health
Authors: Fernandes F.D. , Leticia S.
Published: June 2017

Persons with autism need special care during all life and therefore the caretakers need attention too. Parental stress in families with children with autism is significantly higher than the observed in families with children with other disorders or with typical development. Communication is specially affected in autism, is one of parent's first concerns and may increase stress. This study asked if parents of non-verbal children with autism have higher levels of stress than parents of verbal children with autism. The purpose of this study was to assess the stress levels of parents of children with autism and to verify its association with the inability of verbal communication and the relationship to quality of life. Participants were parents of 75 children with autism and 100 parents with no complaints about their children development. They were divided in 3 groups. All participants responded to questionnaires regarding: socio-demographic date, stress level and quality of life. Most parents presented medium level of stress. Presence of speech did not yield to significant differences. More parents of children with autism reported high levels of stress. Associations between the stress level and the quality of life were also observed. It can be concluded that the stress level of parents of children with autism not influenced by their lack of verbal communication.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Early Screening for Autism Spectrum Disorder
Authors: Kamuk C. , Cantio C. , Bilenberg N.
Published: June 2017

Introduction

Most parents to children with Autism Spectrum Disorder (ASD) can report concerns about their child's development within the first year of life. In spite of this, children with ASD are rarely diagnosed before the age of 3–4 years. Early identification allows early intervention, which seems to be substantial for improvement of core behavioural symptoms in children with ASD. The Child Behaviour Checklist for ages 1½ to 5 (CBCL/1½–5) have shown promising utility for early detection of children with ASD.

Objectives

This study will estimate the positive predictive value of CBCL/1½–5 Pervasive Developmental Problems (PDP) scale in a 2 phase screening study. Furthermore, it will analyse the stability of the CBCL/1½–5 PDP-score in pre-school children from 2½ to 5 years.

Aims

The present study aims to validate CBCL/1½–5 for early screening of ASD in a general population sample.

Methods

Parents, enrolled in the Odense Child Cohort (OCC), answered the CBCL/1½–5 when the child reached 27 months of age. Parents with children above the age of four and a raw score ≥5 (90th percentile) on the PDP scale, received the Social Responsiveness Scale (SRS) questionnaire. Children with a high score on the SRS were invited to a clinical examination consisting of ADOS and ADI-R. Children in OCC were re-assessed with CBCL/1½–5 again at age five years.

Results

Results will be presented at the EPA conference 2017 in Florence.

Conclusions

The results may contribute to enhance the outcome of treatment by detecting children with ASD at an earlier age.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship of High PTSD Risk with Severity of ADHD Symptoms While Controlling the Effect of Impulsivity in a Sample of University Students
Authors: Dalbudak E. , Evren C. , Evren B. , Ozen S.
Published: June 2017

Objective

The aim of the present study was to evaluate relationship of high PTSD risk with severity of ADHD symptoms while controlling the effect of impulsivity in a sample of university students.

Method

Participants included 271 volunteered university students. Participants were evaluated with the Short Form Barratt Impulsiveness Scale (BIS-11-SF), the Adult ADHD Self-Report Scale (ASRS) and PTSD Checklist Civilian version (PCL-C).

Results

Age and gender did not differed between those with the high PTSD risk (n = 224, 82.7%) and those without (n = 47, 17.3%). BIS-11-SF and subscale scores, other than non-planning impulsivity (which showed no difference), and ASRS scores were higher among those with the high PTSD risk than those without. Severity of ADHD symptoms, particularly inattentiveness (IN) score, predicted the high risk of PTSD, together with the severity of motor impulsivity in a logistic regression model.

Conclusion

These findings suggest that the severity of ADHD symptoms is related with the high risk of PTSD, while severity of motor impulsivity may have an effect on this relationship among young adults.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Chronic Somatic and Psychiatric Co-morbidities are Associated with Psychiatric Treatment Success; A Nested Cross-sectional Study
Authors: Filipcic I. , Simunovic Filipcic I. , Rojnic Kuzman M. , Vladimir G. , Svrdlin P. , Vuk Pisk S. , Bajic Z.
Published: June 2017

Introduction

A rich body of literature dealt with somatic comorbidities of psychiatric illnesses. However, relatively few explored the association of somatic and psychiatric comorbidities with psychiatric treatment success.

Objective

Objective of this analysis was to explore chronic somatic and psychiatric comorbidities association with the average number of psychiatric re-hospitalisations annually.

Methods

This cross-sectional analysis was done on the baseline data of prospective cohort study “Somatic comorbidities in psychiatric patients” started during 2016 at Psychiatric hospital Sveti Ivan, Zagreb, Croatia. We included 798 patients. Outcome was the average number of psychiatric re-hospitalisations annually since the diagnosis. Predictors were number of chronic somatic and psychiatric comorbidities. Covariates that we controlled were sex, age, BMI, marital status, number of household members, education, work status, duration of primary psychiatric illness, CGI–severity at diagnosis, treatment with antidepressants and antipsychotics.

Results

Interaction of somatic and psychiatric comorbidities was the strongest predictor of the average number of psychiatric re-hospitalisations annually (P < 0.001). Mean number of re-hospitalisations annually adjusted for all covariates, was increasing from 0.60 in patients with no chronic comorbidities, up to 1.10 in patients with ≥ 2 somatic and ≥ 2 psychiatric comorbidities.

Conclusion

Somatic and psychiatric comorbidities are independently associated with the psychiatric treatment success. Further studies should look at possible causal pathways between them, and interdisciplinary treatment of psychiatric patients is urgently needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Short-term Psychological Interventions for Bordeline Personality Disorder–What Works?
Authors: Storebø O.J. , Stoffers-Winterling J. , Mattivi J. , Völlm B. , Kielsholm M.L. , Nielsen S. , Simonsen E. , Lieb K.
Published: June 2017

Introduction

Borderline personality disorder (BPD) is a common and disabling personality disorder associated with difficulties in controlling emotions and impulses, self-injury, feelings of emptiness and abandonment. It is associated with problems in many areas of life, most notably relationships. Psychotherapy is the first-line treatment for people with borderline personality disorder widely used; however, the evidence is not thoroughly investigated. In addition, several specific short-term interventions have been developed during the last decades.

Objectives

We are currently updating this cochrane collaboration review on psychological interventions for BPD. First findings on the up-to-date evidence relating to short-term psychological interventions will be presented.

Methods

We conducted a cochrane systematic review and meta-analysis of randomized controlled trials (RCTs). Any randomized comparisons of psychological interventions versus unspecific control interventions, waitlist or specific psychotherapeutic interventions in adult BPD patients were eligible. Primary outcomes were BPD core pathology as depicted by DSM criteria. Secondary outcomes included depression, anxiety, general psychopathology, dropouts and adverse events. Two independent researchers selected trials, assessed quality and extracted data independently.

Results

The current evidence of short-term psychological interventions in general and the different types of interventions for which RCT evidence is currently available will be evaluated.

Disclosure of interest

The authors declare that they have no competing interest.
The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990–2013
Authors: Charara R. , Mokdad A.
Published: June 2017

The eastern Mediterranean region (EMR) is witnessing an increase in mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the global burden of disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost–YLLs) and nonfatal outcomes (years lived with disability–YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of total disease burden in EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years. The highest proportion of DALYs occurred in the 25–49 age group. The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Depressive disorders accounted for most DALYs, followed by anxiety disorders. Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to global level. Our findings call for EMR health ministries to increase provision of mental health services and to address stigma of mental illness. Our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability.
Qualitative Meta-analysis to Identify Genomic Variants that are Correlated with the Development of Schizophrenia
Authors: Chondrou G. , Patrinos G.P. , Tsermpini E.E.
Published: June 2017

Introduction

Schizophrenia is a devastating and complex disease, which occurs in approximately 1% of the general population. Symptoms include hallucinations, delusions and patients’ social withdrawal. Schizophrenia's etiology remains unclear, however, both patients’ genetic profile and environmental factors play a significant role.

Objectives

Our study's primary objective was to identify genetic variants related with schizophrenia's development in non-Caucasians populations and to explore whether these polymorphisms can be also found in schizophrenia patients of Caucasian origin.

Methods

To achieve that, we screened Science Direct and PubMed medical literature databases to identify research articles correlating genes and variants with the development of schizophrenia. Next step was the categorization of studies according to samples’ origin and the identification of genomic variants that are correlated with schizophrenia (P < 0.001) but have never been studied in Caucasian populations.

Results

In total, 108 and 47 studies, in non-Caucasian and Caucasian populations respectively, were identified, in which 157 (P < 0.05) and 18 (P < 0.001) variants were associated with the development of the disease in non-Caucasian populations.

Conclusions

From our qualitative meta-analysis 18 variants that were correlated with schizophrenia's etiology were identified (P < 0.001), which will be further investigated in a multi-cultural Caucasian cohort.
A systematic review of association between pain and suicidal behavior in elderly people
Authors: Santos J. , Martins S. , Azevedo L.F. , Fernandes L.
Published: June 2017

Introduction

Suicide rates worldwide are highest in elderly people compared to younger ages. The recognition of risk factors for late life suicide may be crucial, since one in four attempts is consummated. In this context, pain has been identified as a major event raising the probability for suicide in elders although very little research has examined this association.

Objective

To conduct a systematic review to examine whether pain is a risk factor for suicidal behaviour (suicide ideation/attempt/suicide) in elderly people.

Methods

The Cochrane Collaboration's guidelines and PRISMA statement were used. The electronic databases considered were MEDLINE, ISI Web of Knowledge, Scopus and PsycARTICLES. Search terms were “pain”, “suicide*” and “elderly”. Studies that assessed the relation between pain and suicidal behavior among people aged ≥ 60 years were included.

Results

Of the 2655 references founded, only 41 articles met the inclusion criteria. Most of the quantitative studies concluded that there is a relationship between pain and late life suicidal ideation, in particular severe and chronic pain. Physical or psychological pain was also reported as the cause of attempting suicide in two studies and was considered an important risk factor for committed suicide in eight of them.

Conclusion

The results suggest that pain is a risk factor for suicidal behaviour in elderly people, especially suffering from severe and chronic pain, which are in accordance with previous reviews in this field. Future studies are needed to clarify this association and highlight about the importance of pain in suicide prevention initiatives for elders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Drug–drug Interactions Between Antibiotics and Psychopharmaceuticals in Slovenian Nursing Homes: A Retrospective Observational Cohort Study from a National Perspective
Authors: Stuhec M. , Ines P. , Stepan D. , Lea U. , Petek Ster M. , Beović B.
Published: June 2017

Background

Drug–drug interactions (DDIs) between antibiotics and psychopharmaceuticals in large national data have not been described yet.

Objectives

In most European countries, there is no national data on DDIs in patients within nursing homes.

Aim

To present the most important DDIs in the Slovenian nursing homes to avoid serious DDIs in the future.

Methods

A retrospective study was carried in 2015 and with 233 patient on antibiotic treatment. All study data from the patients’ records were obtained from the patients’ charts. DDIs were determined by different interaction classes with Lexicomp Online™ 19.0 version and only X (major interactions) and D (minor interactions) were included.

Results

A total of 233 patients (age = 83.5, SD = 9.8) were treated with antibiotics (only 2 without psychopharmaceuticals). The number of patients with at least 1 interaction was: 72 (30.9%) for X and 172 (73.8%) for D and the average number of medication/patient was 10.9 (SD = 3.9). Twenty-seven patients (11.5%) were treated with at least 1 X DDIs s (17 patients ciprofloxacin, 6 moxifloxacin, 3 azithromycin and 1 levofloxacin). Quetiapine and ciprofloxacin was most frequent DDIs occured in 12 patients. Twenty-seven DDIs were pharmacodynamic (QTc prolongation) and 3 pharmacokinetic (ciprofloxacin-tizanidine, ciprofloxacin and duloxetine in 2 patients; n = 3). Quetiapine was most frequent prescribed psychopharmaceutical in X DDIs.

Conclusions

DDIs between these two groups are seen very often. If an antidepressant should be used in these patients, we recommend sertraline instead of escitalopram and venlafaxine instead of duloxetine and mirtazapine instead of quetiapine. We also recommend a use of penicilins instead of ciprofloxacin and azithromycin.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Acute psychotic disorder: Which future?
Authors: Soussia R. Ben , Bouallagui A. , Younes S. , Marrag I. , Nasr M.
Published: June 2017

Introduction

At present, in absence of reliable clinical and evolutionary data, it is difficult to determine what the consequences of an acute psychotic disorder, specifically if it is a mode of entry into schizophrenia, a mood disorder or a short-lived episode.

Aim

The objective of this study was to describe the sociodemographic characteristics and evolutionary modalities of a population of patients with a first psychotic episode.

Methods

This is a retrospective descriptive study, which involved patients admitted to psychiatric ward EPS Mahdia for acute psychotic disorder according to DSM-VI-TR criteria. Data collection was conducted from archived observations and through a predetermined sheet.

Results

One hundred and eleven patients were collected. The average age of the study population was 27 years, a male predominance was noted (59.5%), 52.3% were from urban, 73% of patients were single, 33.3% were from a consanguineous marriage. Among those patients with a first acute psychotic episode, 43 patients (38.7%) progressed to schizophrenia, 15.3% to bipolar disorder, 23, 4% to recovery while 22.5% were lost view.

Conclusion

The long-term evolution of an acute psychotic disorder remains unpredictable. In fact, the severity is related primarily to the risk of developing a schizophrenic disorder or a mood disorder. In this context, attention is paid in recent years to recognize and seek the earliest possible factors associated with this development.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The relationship of emotion recognition with neuropsychological performance in patients with first episode psychosis
Authors: Dardagani A. , Dandi E. , Tsotsi S. , Nazou M. , Lagoudis A. , Bozikas V.P.
Published: June 2017

The relationship between neuropsychological dysfunction and emotion perception has been frequently noted in various studies. Attention, for example, has been found to play an important role in emotion processing and recognition. Not many studies though, have examined this relationship in first psychotic episode patients. The aim of the present study was to explore the nature of the relation between performance in cognitive tests and a test that measures emotion perception. In a sample of 46 first psychotic episode patients (22 male), we administered a comprehensive battery of neuropsychological non-verbal tests and an emotion recognition test. The cognitive domains of attention, memory, working memory, visuospatial ability and executive function were examined, by using specific tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). The emotion recognition assessment comprised a new test that includes 35 coloured pictures of individuals expressing six basic emotions (happiness, sadness, anger, disgust, surprise, fear) and a neutral emotion. We used partial correlation–controlling for the effect of age–and we found a statistically significant relationship between emotion recognition and overall cognitive performance. More specifically, attention, visual memory and visuospatial ability positively correlated with emotion recognition. In regard to specific cognitive domains, attention positively correlated with anger and fear, whereas visual memory correlated with happiness and fear. In conclusion, it seems that the role of underlying visual processes in emotion perception has to be further examined and evaluated in this group of patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Driving Ability and Psychotropic Drugs: Introduction, Epidemiology and General Aspects
Authors: Brunnauer A.
Published: June 2017

Psychiatric illness, psychotropic drugs and driving ability. For most people driving is an important activity in daily life affecting physical, social, and economic well-being. Driving mobility is also an important part of one's self-identity that may influence health status. It could be demonstrated that 67% of psychiatric patients reported to have a valid driver's license and 77% of them referred to regularly use their cars. Closer inspection of data reveals, that road mobility is largely linked to psycho-functional status. In this context a significant issue is the impact of medical conditions and/or psychoactive medicines on road safety. Psychiatric patients, considered as a group, seem to have a moderately elevated risk of being involved in a road traffic accident with high-risk rates especially for organic mental disorders. With respect to pharmacotherapy, within psychotropic medicines an increased road traffic crash risk for benzodiazepines, z-hypnotics and some antidepressants has been well documented. The combination of psychoactive drugs additionally increases risk that is highest when combined with alcohol. However, therapeutic drug use may also lower risk, as the illness itself constitutes a higher risk of road traffic accidents. As many studies did not adequately control for confounding factors, results of epidemiological studies must be interpreted cautiously.

Disclosure of interest

The author declares that he has no competing interest.
The importance of family in the long-term evolution of psychoses
Authors: Dehelean L. , Cornoiu C. , Romosan A.M. , Romosan R.S. , Papava I.
Published: June 2017

Introduction

Adherence and tolerance to treatment are important factors, which may predict the long-term evolution of a psychosis. Family members may influence prognosis by modulating emotional expressivity and treatment supervision.

Objectives

To assess the role of family members in the long-term evolution of psychoses.

Method

The present study is retrospective, conducted on patients with psychosis. Data were obtained from psychiatric records extending for a period of four years. The following parameters were analyzed: socio-demographic data, family relationships (parents, spouses) and clinical/evolutive data (onset age for psychosis, number of recurrences).

Results

We analyzed 71 patients, 42 (59.2%) women and 29 (40.8%) men with a mean age of 30.38 years (SD = 9.33). The subjects were diagnosed according to ICD 10 criteria with acute and transient psychotic disorder (50 patients, 70.4%), schizophrenia (13 patients, 18.3%), and schizoaffective disorder (8 patients, 11.3%). Patients who reported conflicts between parents had significantly more recurrences (t = –2.1, P = 0.04), while those who reported satisfactory relationships in their family of origin had fewer recurrences (t = 2.58, P = 0.01) and a later onset age (t = –2.89, P = 0.006). Unmarried/single subjects had the psychosis onset at a significantly earlier age (t = 4.72, P = 0.0001). In addition, these patients had more conflicts between parents (Z = –2.02, P = 0.04) in comparison with married ones.

Conclusions

Conflicts in the family of origin may predispose to a greater number of recurrences and to an earlier disorder onset. The presence of a spouse may represent a protective factor.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Schizophrenia and major depression: Resilience, coping styles, personality traits, self-esteem and quality of life
Authors: Di Marco S. , Feggi A. , Cammarata E. , Girardi L. , Bert F. , Scaioli G. , Gramaglia C. , Zeppegno P.
Published: June 2017

Introduction

Resilience is commonly defined as positive adaptation to adverse events or as the ability to maintain or regain mental health after exposure to difficulties. According to the bio-psycho-social model, resilience is influenced by self-esteem, coping strategies and personality traits. In schizophrenic patients, resilience seems to affect real-life functioning, while in mood disorders, resilience influences the longitudinal course of the disorder, reducing the frequency of relapses and improving drugs response.

Objectives

The aim of this study is to asses levels of resilience and self-esteem, coping strategies, perceived quality of life and temperament characteristics in a sample composed by patients with major depressive disorder and patients affected by schizophrenia.

Methods

We collected a sample composed by 40 patients with major depressive disorder and 40 patients affected by schizophrenia patients recruited at the “Maggiore della Carità” Hospital in Novara, Italy. The assessment protocol included: Resilience Scale for Adults (RSA), Coping Orientation to Problems Experienced Inventory–Brief (BRIEF–COPE), Rosenberg Self-esteem Scale (RSES), Paykel List Of Stressful Events, Temperamental and Character Inventory (TCI) and Short form 36 (SF-36). Comparison of qualitative data was performed by means of the χ2, a t-test was performed for continuous normal-distribution variables otherwise a non-parametric Mann–Whitney test was performed. Statistical significance was set at P ≤ 0.05.

Conclusions

In patients with major depressive disorder resilience were associated with a good self-perception of physical and mental health, higher self-esteem levels and problem-focused/emotion focused coping strategies. In schizophrenic patients, sample there was no positive correlation between resilience and perceived quality of life. Further implications will be discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Postural control and executive functioning in patients with schizophrenia
Authors: Yildirim M. , Elvan A. , Ercegil G. , Simsek I.E. , Savci S. , Alptekin K.
Published: June 2017

Introduction

Patients with schizophrenia commonly show deficits in executive functioning that allow a person to make plans, solve problems, do many tasks simultaneously and adapt to unexpected conditions. Executive dysfunction is associated with very simple and automatic activities, such as walking in schizophrenia patients. However, no study exists about its relation to postural control in these patients.

Aim

To investigate the effect of executive functioning on postural control using dual task paradigms.

Methods

Fifteen clinically stable schizophrenia outpatients and 15 healthy controls were enrolled in the study. Postural control was assessed with bilateral stance test using the Balance Master system under three different conditions with eyes open and eyes closed (EC): without a task, during a cognitive task (verbal fluency) and during a motor task (holding a cup of water).

Results

Standing on a foam surface with EC resulted in higher postural sway velocities in schizophrenia patients under all conditions (P = 0.009, P = 0.032, P = 0.013). During a cognitive task, both schizophrenia patients and healthy controls showed higher velocities on firm surface with EC in comparison to the condition without a task (P = 0.023). Both schizophrenia patients and healthy controls did not show higher postural sway velocities during the motor task.

Conclusion

The effect of verbal fluency on postural sway shows the relationship between executive functioning and postural control in schizophrenia patients. Foam surface also higher postural sway velocities in schizophrenia patients in EC condition suggesting the difficulties in integrating the proprioceptive information in the absence of visual input.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Concomitant psychotropic medications and functional remission in schizophrenia patients
Authors: Ghajati B. , Leila C. , Raja L. , Majda C.
Published: June 2017

Along with the rise of symptomatic and functional remission concepts in schizophrenia, multiple aspects of the disease treatment have been explored in their link to vocational prognosis. Although antipsychotics are the corner stone treatment, monotherapy is seldom. In fact, concomitant psychotropic medications (CPM) use during treatment of schizophrenia has dramatically increased worldwide.

Aim

To examine whether concomitant psychotropic medications use is associated to functional remission in schizophrenia patients.

Methods

A cross-sectional, retrospective and descriptive study was conducted in the psychiatry department “C”, in Razi hospital (Tunis), between October 2014 and March 2015. Sixty patients suffering from schizophrenia spectrum disorder (DSM IV-R) were included. Functional status was explored with the Global Assessment of Functioning Scale (GAF), the Social and Occupational Functioning Assessment scale and the Social Autonomy Scale (EAS). Sociodemographic and therapeutic characteristics have been collected during a semi-structured interview.

Results

Rates of functional remission were respectively: 63.30% at the GAF scale, 48.30% at the SOFAS and 51.70% at the SAS. Antipsychotics were prescribed alone in more than half patients (56.70%), mood stabilizers in 40% and antidepressants in 1.7% of the cases. Benzodiazepines were prescribed in 40% of the patients. There was no association between CPM use and functional remission, using three scales (GAF: P = 0.091; SOFAS = 0.125; EAS = 0.728).

Conclusion

Largely used, concomitant psychotropic medications can increase side effects, cause drug interactions, escalate treatment costs, and lead to non-adherence. That is said, their therapeutic effectiveness should be thoroughly investigated, aiming to recovery not only symptoms control.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Spanish Adaptation of the Recovery Enhancing Environments (REE) Measure: Preliminary Results
Authors: Penas P. , Uriarte J.J. , Ridgway P. , Moreno M.C. , Iraurgi I.
Published: June 2017

Introduction

During the last decades, the recovery from severe mental illness has shifted from a focus on reducing symptoms to a more holistic approach of emphasizing consumer-centered goals and subjective wellness (Anthony, 1993). The implementation of this controversial new model it has not had an easy path. In that sense, Ridgway (2004, 2011) developed the Recovery Enhancing Environments (REE), an instrument to gather information on personal mental health recovery and the elements that people feel are important to their recovery; staff activities and an organizational climate that encourages resilience.

Objective

To present the preliminary results of the Spanish adaptation.

Method

English to Spanish translation of REE was carried out. The REE interview and Euro-Qol5d, HoNOS, EEAG and CGI scales were completed by 312 patients in Mental Health Services organization of Bizkaia (Spain), 189 men and 123 women (age = 48.89). The interviewers of the REE were service users trained and hired for this task.

Results

The alpha de Cronbach was .98, and for its dimensions: program performance indicators (.97), organizational climate (.92) and recovery markers (.93). The concurrent validity with others scales have resulted in correlations coefficients superiors to r = .35 (P < .001).

Discussion

As the different indicators are adequate and the instrument has a similar structure to other theoretical studies, it can be conclude that Spanish REE is an appropriate measure to fill the gap between the knowledge in the recovery model and what services can do to supports this model. All of this information gathered from people who receive mental health services.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evolutionary Aspects of Psychotic Disorders Induced by Cannabis
Authors: Guermazi F. , Ennaoui R. , Halouani N. , Chouayakh S. , Aloulou J. , Amami O.
Published: June 2017

Introduction

Cannabis is increasingly used by young people. Its several noxious effects on mental health have become a matter of preoccupation. Although cannabis use may be involved in the etiology of acute psychosis, there has been considerable debate about the association observed with chronic psychosis.

Aims

(1) To describe the profile of patients with cannabis use disorders (CUD); (2) to determine the evolutionary aspects.

Methods

We proceed with a retrospective and descriptive study conducted among 16 male patients with CUD and hospitalised for the first time in the psychiatric department at the University Hospital Hedi Chaker during the period from 1 January 2012 to 31 December 2014.

Results

An overwhelming majority of the subjects were single and unemployed. One-third of the users had a stay abroad, the half was incarcerated at least once and one patient was implicated in illegal drugs trade. CUD were associated with specific personality disorders: borderline (18.8%) and antisocial (6.3%) personality. Into at least the 2 years of follow-up, different evolutionary aspects were distinguished. Many of the patients were lost to follow (18.8%). A total restitution of symptoms or a recurrence of the same disorders were observed in 25% of cases. About 56.3% of subjects had a change in diagnosis to either schizophrenia (43.3%) or affective disorder (12.5%).

Conclusion

This study showed that cannabis use can be a cause of the emergence of chronic psychosis. This emphasizes the importance of early screening of the vulnerability to psychotic disorder and identify more effective strategies to improve intervention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosocial Functioning in Injured and Non-injured Athletes with Symptoms of Exercise Addiction
Authors: Lichtenstein M. , Nielsen R.Ø. , Gudex C. , Bojesen A.B. , Hinze C.J. , Jørgensen U.
Published: June 2017

Introduction

Exercise addiction is characterized by compulsive and excessive exercise patterns that eventually can lead to musculoskeletal injury. While exercise leads to increased self-esteem and is a useful tool for emotional regulation, the level of psychosocial distress may be negatively affected by such injuries.

Objectives

The prevalence proportions of post-injury depression and emotional stress in athletes with exercise addiction have not previously been explored and compared to non-addicted athletes.

Aims

We wanted to test the hypothesis that athletes with addiction profiles react to injury with higher levels of emotional and social distress compared to athletes without addiction.

Methods

A cross-sectional survey was employed and a total of 1167 athletes (673 with diagnosed musculoskeletal injuries and 494 without present injury) responded to the following questionnaires: The Exercise Addiction Inventory, The Major Depression Inventory, The Perceived Stress Scale and EQ-5D to assess quality of life.

Results

We found that 26% of the injured athletes with exercise addiction had symptoms of major depression and 53% reported emotional distress. These proportions were significantly greater compared with the injured non-addicted athletes where 11% had symptoms of major depression and 28% reported stress. Quality of life was also significantly reduced in the addiction group.

Conclusions

Injured athletes with exercise addiction report more post-injury psychosocial distress compared with injured non-addicted exercisers. Future trials need to investigate the effect of emotional assessment and support as a complement intervention to somatic injury treatment. Injured athletes should be examined for exercise addiction as they are at risk of depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Platelet and Plasmatic Lipidic Profile as Potential Marker of Bipolar Disorders: Preliminary Findings
Authors: Sideli L. , Mule’ A. , Damiani F. , Corso M. , Montana S. , Caprin M. , Colli G. , Di Giacomo S. , Catalano D. , Greco M. , Di Gaudio F. , La Barbera D.
Published: June 2017

Introduction

Although the diagnosis of bipolar disorder is currently based on clinical criteria, preliminary studies showed that palmitic and arachidonic acid levels are able to discriminate adult patients with major depressive disorder (MDD) from those with bipolar disorder (BD).

Objectives

To replicate and to expand previous findings by investigating the relation between mood disorders and platelet and plasmatic fatty levels.

Aims

To compare the lipidic profile of individuals with different mood disorder (MDD vs. BD) and to investigate the relation with specific clinical features (duration of illness, attempted suicide, psychotic symptoms).

Methods

Potential participants were recruited from the outpatient and inpatient psychiatric units of the university hospital of Palermo (Italy). Diagnosis of DSM IV mood disorders was made using the MINI. Symptom severity was assessed using the HAM-D rating scale and the YMRS. Fatty acid profile was analyzed using mass spectrometry.

Results

Preliminary analyses were performed on 8 patients with MDD and 6 with BD. Groups were similar in terms of demographic variables. Patients with MDD showed highest levels of platelet palmitic acid, stearic acid, and arachidonic acid. Furthermore, plasmatic docosahexaenoic acid was negatively related with manic symptoms severity (Rho = –0.697; P = 0.025) and platelet alpha linolenic acid was positively related with illness duration (Rho = 0.845; P = 0.040).

Conclusions

These preliminary findings suggest that platelet fatty acids may be possible biological markers to improve the diagnosis of BD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.