bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychiatric Presentations of Central Nervous System Tumors
Authors: Maia L. , Sofia Coutinho A. , Irina G.C. , Carneiro L.
Published: May 2016

Introduction

For the most part, central nervous system (CNS) tumors present themselves with focal neurologic sing or manifestations resulting from increased intracranial pressure. However, in particular cases, these tumors may present exclusively psychiatric symptoms.

Objective

This communication explores importance of CNS tumors as differential diagnosis of various psychiatric disorders.

Aims

Highlight the need of acknowledging this important differential diagnosis (CNS tumors) in current psychiatry practice, while presenting a clinical case as an example of the subject.

Methods

It is exposed a bibliographic review of the topic, followed by the description of a clinical case regarding a patient with pituitary adenoma and simultaneous installation of psychotic symptoms namely delusional paranoid ideation.

Results

The authors present a case report of a 66-year-old patient admitted compulsively in a Psychiatric ward in the context of behavioral changes associated with delusional ideation of paranoid content. Multidisciplinary assessed by specialties of Psychiatry, Neurology, Neurosurgery, Endocrinology and Psychology, concluded by the presence of nonfunctioning pituitary adenoma associated with cognitive major disturbance.

Conclusions

The tumors of the CNS can be associated with a whole variety of psychiatric symptoms such as psychosis, anxiety, depression or cognitive impairment, even in the absence of organic/neurological symptoms. Its role in the genesis of psychiatric symptomatology makes these neoplasias an important differential diagnosis, whose clinical approach should include different medical specialties integrated as a multidisciplinary team.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Duloxetine Added to Tramadol in Chronic Pain Syndrome
Authors: Domijan M. , Lončar Z. , Udovičić S.
Published: May 2016

Introduction

About 15–20% of the population suffering from the chronic pain. Over time, chronic pain can result in different emotional problems, social isolation, sleep disturbances, which reduce the quality of life. Chronic pain syndrome (CPS) indicates persistent pain, subjective symptoms in excess of objective findings, associated dysfunctional pain behavious and self-limitation in activities of daily living. Duloxetine is a potent antidepressant approved by the Food and Drug Administration for the chronic musculoskeletal disorder, diabetic neuropathic pain, fibromyalgia, generallized anxiety disorder and major depressive disorder.

Objective

To determine the effect of duloxetine on the reduction of pain and psychosocial suffering.

Aims

The goal of the treatment should be to effectively reduce pain while improving function and reducing psychosocial suffering.

Methods

Thirty-six adult, nondepressed patients, already on tramadol therapy were included. Patients with VAS (visual analogue scale) ≥ 4were treated with duloxetine for 13 weeks. We measured pain intensity with the McGill Pain Questionnaire-Short Form (MPQ-SF) and compared VAS before starting the treatment with duloxetine and weekly for 13 weeks.

Results

Pain response was defined as a 30%decrease in the MPQ-SF. A total of 62.5% of the sample met these criteria for response. Among them, 13.8% of patients were discontinued because of adverse effects. Duloxetine significantly improved functioning and the quality of life in patients with CPS.

Conclusions

Because of it is analgesic properties, duloxetine in the lower antidepressant doses (60 mg taken ones daily) combined with tramadol (another analgesic agent) can be useful in CPS for patients who do not respond satisfactory to monotherapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Distinct Subgroups Derived By Cluster Analysis Based on Pain Characteristics and Anxiety-Depression Symptoms in Swedish Older Adults With Chronic Pain (Pains65+)
Authors: Dragioti E. , Gerdle B. , Larsson B. , Bernfort L. , Levin L.Å.
Published: May 2016

Introduction

There is a lack of research on subtypes of chronic pain (CP) characteristics in the elderly.

Objective

To scrutinize major subgroups based on pain aspects and psychological factors on an elderly population.

Aims

To determine possible differences between the derived subgroups with respect to pain aspects and anxiety-depression symptoms, health aspects and health care costs.

Methods

A cross-sectional study was implemented. A large sample of 2300 individuals (M = 75.9 years, SD = 7.4) participated. Self-reported postal measurements regarding pain intensity, spreading of pain, anxiety and depression (General well-being schedule [GWBS]), and pain catastrophizing [PCS]) were used as classification variables. A two-step cluster analysis was employed. We further investigated whether the derived subgroups experienced different quality of life and general health. Calculations regarding health care costs were also performed.

Results

Two major subgroups were identified: one low symptom severity subgroup (Cluster 1; n = 1326; 58%) and one high symptom severity subgroup (Cluster 2; n = 974; 42%). There were statistical significant differences on pain intensity, spreading of pain, anxiety, depression and pain catastrophizing between the two subgroups (P < 0.001). Significant lower levels for quality of life and general health (P < 0.001) were found for the high symptom severity subgroup. Health care costs in the high symptom severity subgroup were significantly higher than those of the low symptom severity subgroup (P < 0.001).

Conclusions

Our findings exhibit the necessity for subgroup-specific treatment services for improving pain management and reducing health care costs in the elderly.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Ziconotide and Amnesia: a Case Report
Authors: Marini S. , Lalli V. , Costantini A. , Gambi F.
Published: May 2016

Introduction

Ziconotide is a new class of non-opioid analgesic that selectively blocks the neuron-specific (N-type), voltage-gated calcium channels, preventing the release of substance P and calcitonin gene-related peptide.

Methods

A literature search was conducted in September 2015 using Pubmed and Scopus databases. No articles speaking about the direct correlation between ziconotide and amnesia were found.

Discussion

A 56-year-old female patient, in treatment with ziconotide for chronic phantom pain syndrome, reported amnesia and dysgeusia symptoms. No psychiatric pathologies were diagnosed except for the high anxiety state correlated to the amnesia for recent events. The ziconotide treatment was reduced from 2,4 μg/day to 1,5 μg/day. Clonazepam was prescribed to treat the anxiety state. The subject clinical conditions did not require hospitalization.

Conclusions

It is recommended that patients in treatment with ziconotide be monitored for changes in mood, suicidality ideation, thoughts or consciousness. Ziconotide could have serious neurological or psychiatric signs/symptoms (Table 1). Amnesia is a rare side effect of intrathecal administration of ziconotide. Severe psychiatric adverse effects may require ziconotide discontinuation, treatment with psychotropic agents and/or acute hospitalization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Recurrent Depression Over An Schizoid Personality. Case Report
Authors: Cancino Botello M.C. , Molina López F. , Hernández Sánchez J.M. , Peña Serrano A. , Canseco Navarro M.D.L.A.
Published: May 2016

Introduction

According to Millon, personality is a “complex pattern of psychological factors, which are mostly unconscious and express themselves automatically in almost every functional dimension of the subject”. It has been described how personality traits can modify the expression of other mental diseases, leading to confusion in diagnosis and treatment of the patient.

Method

Systematic review of the literature in English (PubMed) and clinical history of the patient. Keywords: “recurrent depression disorder”; “schizoid personality”.

Objective

To highlight the importance of making an accurate and detailed diagnostic formulation, in patients with both mental and personality disorders.

Case

Sixty-seven-year-old woman, with many psychiatric hospitalizations, secondary to a recurrent depression disorder with psychotic symptoms and schizoid personality disorder. Both psychiatric monitoring and pharmacological treatment have been erratic. Initially, depressive episodes were considered as symptoms of her personality disorder. However, over the years, it was possible to make a more accurate diagnosis and a better treatment adjustment. In this case, lack of adherence is probably due to multiple factors, but no awareness of illness and personality disorder itself are the most important ones. This fact makes the patient less concerned about her personal care, leading to irregular treatment.

Conclusions

People with schizoid, schizotypal or paranoid personality traits usually have a worse outcome, and they interfere with the functionality of the patient. This explains the importance of making an accurate and detailed diagnostic formulation, in order to benefit the course of the underlying mental disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Borderline Personality Disorder in Adolescence. Prevention and Early Intervention From a Cognitive Analytic Approach
Authors: Gimeno E. , Chiclana C.
Published: May 2016

Introduction

Borderline personality disorder begins in adolescence, however, its diagnosis is subject to some controversy and tends to be underdiagnosed. Stigma associated with its diagnosis, comorbidity with other axis I disorders or the changeable sense of identity during adolescence are some of the elements that obscure the diagnosis. Increasingly, recent studies have shown the utility of prevention programs as well as instituting early intervention in adolescents, with very hopeful outcomes.

Objectives

The aim of this study is to review the benefits derived from early prevention and intervention programs in adolescents with borderline symptoms from a cognitive analytic approach.

Methods

A systematic review for scientific articles extracted from research databases including Dialnet, EBSCO, Pubmed, Unika and Scholar Google was conducted. Other high-impact studies in the field were also included.

Results

Evidence reported by reviewed articles supports Cognitive analytical therapy as one of the most successful approaches, the same as Mentalization based therapy, in the treatment of Borderline personality disorder. From this approach, prevention and early intervention have shown their effectiveness in reducing borderline symptoms and risk factors besides they contribute to interpersonal functioning improvement.

Conclusions

Prevention and early intervention constitute the main pillars to prevent the potential development of Borderline personality disorder or its evolution in more complex and irreversible forms. But this intervention must be carried not only in young already diagnosed, but also in those who are on the diagnostic threshold, presenting risk factors for further development.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anger in Personality Disorders – Catalyser of Violence – Bio-Psycho-Social Mechanisms
Authors: Ciubară A. , Săcuiu I. , Untu R.A. , Radu D.A. , Untu I. , Poroh V. , Ştefănescu C.
Published: May 2016

Introduction

Personality disorders designate a series of personality traits involving a behavioural pattern characterized by the recurrent violation of social norms, the importance of medico-legal implications associated to personality disorders being incontestable.

Objective

This study aims to obtain a clear image regarding the particularities of violent behaviour, and also the mechanisms of anger in personality disorders, in relation with the legal implications of those reactions.

Methods

The present study is a synthesis of recent literature (2012-2014) regarding the role of anger in violent behaviour with legal implications, in personality disorders. The research was made on PubMed, by the following keywords: personality disorder; violence in personality disorders; anger.

Results

The core element that determines violent behaviour is anger. The physical effects of anger include increased heart rate and blood pressure, as well as an increase in the level of epinephrine and norepinephrine. Therefore, anger can be considered an integrant part of the response to a potential aggression or a potentially dangerous environment. Several general circumstances can activate anger. A strong example in supporting this theory is the bidirectional relation between anger within personality disorders and the use of alcohol and psychoactive substances. The individual gets extra stimulation, including through their psychopharmacological properties, thus exacerbating anger.

Conclusions

In conclusion, it is necessary to conduct future studies focusing on the underlying causes of violence in personality disorders, as well as on the warning signs of potential violent acts, considering that personality disorders alone often cannot explain criminality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
On Becoming Ill: An Exploration of the Concept of “Transition” to a Mental Disorder
Authors: Moura B.
Published: May 2016

Introduction

As a general problem in nosology, the moment when one becomes ill may be hard to define. In Psychiatry, the boundaries of disease may be more difficult to establish. In the last decade, we’ve been observing a growing interest in early diagnosis in this field, and the concept of “transition” to a mental illness became an important topic of discussion with implications in clinical practice.

Objective

To review different author's models of evolution of symptoms and transition to mental illness and discuss their advantages and limitations in the actual context of Psychiatry research and clinical practice.

Aim

To increase understanding on the different paradigms of becoming ill and their relevance to present and future psychiatric practice.

Methods

Non-systematic review of literature devoted to the creation of models that describe the establishment of a mental disorder.

Results

One of the first accounts of becoming mentally ill was developed by K. Jaspers within a phenomenological life-history analysis. Nonetheless, a cross-sectional approach to diagnosis has dominated Psychiatry for most of the time. With the advent of early intervention studies, longitudinal models of disease have been emphasized. The concept of a transition to disease was then operationalized but also highly criticized. Recently, McGorry proposed a staging model for psychiatric disorders in continuum with the non-clinical population. Finally, a dynamic systems approach to diagnosis in Psychiatry will be discussed.

Conclusion

Driven by research in early phases of mental illnesses, current models of disease propose a longitudinal approach that emphasizes the complex and non-linear course of symptom clusters.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Wittengstein's Private Language Argument: Does it Pass the Schizophrenic Mind Challenge?
Authors: Santos G.
Published: May 2016

Introduction

The private language argument was introduced by Ludwig Wittengstein in his Philosophical Investigations (1953). For Wittengstein, language is a rule-governed activity and a language in principle unintelligible to anyone but its originating user is impossible, as even the originator would fail to establish meanings for its putative signs. The private language argument is of paramount significance in modern debates about the nature of language and mind and continues to be disputed. Language disorder has been described since the first accounts of Schizophrenia. Multiple studies have reported anomalies at multiple levels of language processing, from lexical and syntactic particularities to the discourse field, as well as structural and functional abnormalities in brain regions that are involved with language perception and processing.

Objectives and aims

We aim to critically assess the Wittengstein's argument in the light of recent developments in neuroscience of language.

Results and conclusions

We conclude that in some patients diagnosed with schizophrenia, presenting a significant language impairment, one can infer a dysfunctional process, in which the language becomes progressively more private and the meaning of utterances harder to ascertain in the realm of interpersonal communication. The privatization of language might contribute to the social cognition deficits and the so-called negative symptomatology of these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence of Post-Traumatic Stress Disorder and Associated Events in Adults Victim of Displacement in the Colombian Caribbean
Authors: Cabas-Hoyos K. , Ospina-Buelvas J. , Lopez-Sierra M.A. , Ochoa-Reyes A. , Uribe-Urzola A. , Villamil-Benitez I. , Otero-Suarez C. , Cardenas-Lopez G.
Published: May 2016

The forced displacement in Montería, a region from the Colombian Caribbean could become a risk factor for the existence of Post-Traumatic Stress Disorder (PTSD), nevertheless, there isn’t data of the prevalence of this disorder.

Aim

To identify the prevalence of the PTSD and associated events in adults victims of the displacement in the city of Montería.

Method

Transversal and explorative study, 117 adults (M: 40,41; SD: 13,14). The PTSD was verified with the checklist for PTSD (Weathers, Litz, herman, Huska & Keane, 1993) and according to criteria of DSM-5 (APA, 2014). The 3 factors associated with the disorder were analyzed according to age groups. To evaluate the events associated to the disorder was used the checklist of events (Blake, Weathers & Nagy, 1990). Occurred and witnessed by the subject events were analyzed. Descriptive were used to determinate the existence of the PTSD and an ANOVA to contrast the symptomatology of the PTSD by age groups.

Results

The 26,49% (n = 31) of the sample had the clinic criteria of PTSD. An ANOVA of a factor evidenced that the activation was present in a biggest proportion in the range of 53-59 years old (M = 18.73); intrusion and avoidance was shown mostly in the range of 60-71 years old (intrusion M = 14.00; avoidance M = 14.85). In relation to the associated events occurred to the subjects, there was found that the highest incidence were: natural disasters (42.7%) and unexpected death (35.9%); the witnessed events with higher percentage where: unexpected death (19.70%) and traffic accidents (15.4%).

References not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive Behavioral Therapy in a Group of Militaries With Posttraumatic Stress Disorder
Authors: El Kefi H. , Abdelghaffar W. , Baatout A. , Bechikh Brahim C. , Krir W. , Eddif S. , Oumaya A.
Published: May 2016

Introduction

Posttraumatic stress disorder (PTSD) has a high prevalence and severe impact in military populations. Cognitive behavioral therapy (CBT) is indicated in this condition but it is a structured therapy that requires patients’ motivation and doctors’ availability.

Objectives and aims

Assess feasibility and effectiveness of CBT in a military group with PTSD.

Methods

A group of six militaries that witnessed the same traumatic event (an armed attack) and were diagnosed with PTSD were involved in a structured individual session CBT with one therapist. An assessment using the PTSD checklist for DSM (PCL) was performed initially and in halfway therapy. The therapy included an education about PTSD, a cognitive restructuring, a behavioral approach via home tasks and relaxation techniques.

Results

The initial PCL scores varied from 25 to 55. All patients were initially on sick leave. Five patients had adjunctive antidepressant medications and one patient was only on therapy. Three patients showed no motivation and were excluded after 3 sessions. Two patients have had 7 weekly sessions and were able to return to work in the same place. One patient with severe PTSD had 2 sessions monthly, he had slight clinical improvement and could not come back to military work. The three patients who are still in therapy have improved PCL scores.

Conclusions

CBT can be effective in PTSD. The outcome depends on initial severity of PTSD and assiduity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adaptation Skill Improvement Through Communication Skills Analysis of Individuals With Over-Adaptation
Authors: Aida Y.
Published: May 2016

Japanese society, which culturally focuses more on harmony rather than individuals, tends to promote making society members to have over-adaptation, one of the psychological characteristics. The research embraced the definition of over-adaptation, as “the tendency to lose the authority due to one's excessive efforts to meet others’ expectations rather than their own needs”. Individuals with over-adaptation have higher risks for suffering depression, violent behaviors, and psychosomatic disorders, potentially creates risks for suicide and death from over-work.

The recent Japanese studies mostly focused on examining the methods that balance internal adaptation by lowering external adaptation. However, this method has risks such as inducing resistance and coincidentally making professional helps more difficult. Our research focused on one of the internal maladjustment, self-inhibition, which is the necessary communication skill.

The research focused on individuals with over-adaptation, and set the objectives to reveal their imbalance of communication skills including self-inhibition. It farther aimed to examine the preventing methods the over-adaptation, which induce people to have another psychological maladjustments.

The research conducted a questioner to students in a university and high school. It suggested that individuals with over-adaptation tendency were less skillful in representation and self-assertion, and that they had stronger skill in other areas, such as capability for others, empathy, internal relationship adjustment skill, and self-control. Since these skills were high, they coincidentally made total balance worth. Additionally, their bad physical conditions were noted.

The research suggested the effectiveness of the self-expression and assertion training to improve adaptation, which coincidentally prevents physical problems.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Understanding Discrepancies in the Prediction of Mental Health, Substance Use and Dual Disorders. Implications From a Multi-Site International Study
Authors: Carmona Camacho R. , Chavez L. , Villar A. , Vidal C. , Polo R. , Baca-García E. , Alegria M.
Published: May 2016

Introduction

The use of valid and practical screening scales might ease the burden for greatly needed universal testing for mental health, substance use and dual disorders, but do they work well with all populations? Do they miss correct identification of certain groups?

Objective

To understand discrepancies in diagnostic prediction using the AC-OK screen in conjunction with other standardized assessment scales.

Methods

Two hundred and twenty-six Latino participants were recruited from primary care and community clinics in Madrid, Barcelona and Boston and assessed with standardized mental health and substance abuse measures including the AC-OK screen and with a Computerized adaptive test for mental health (CAT-MH). A measure of frequency of discrepancies and an adjusted and unadjusted comparison of results and demographic characteristics or respondents were made for mental health, substance abuse or for discrepancies in both categories.

Results

35.4% of cases were discrepant in mental health (AC-OK-Mental Health vs. Patient Health Questionnaire-9, Generalized Anxiety Disorder 7 or PTSD Checklist) and 14.2% in substance abuse (AC-OK-substance abuse vs. drug abuse screening test or Alcohol use disorders identification test). When CAT-MH scale was incorporated, discrepant results were found in 24.3% and 14.2%, respectively. No association was found between substance abuse discrepancies and patient demographics. In logit regressions being from Barcelona, of younger age and male were significant predictors of discrepancies.

Conclusions

Discrepancies were observed in the diagnostic prediction, with differences detected for site and sociodemographic characteristics of participants suggesting the importance of testing screeners for site and population differences. Evidence for the misclassification of young males is discussed. Caution is warranted in the implementation of screeners for at risk populations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Emotional Regulation of Mothers Bringing Up Children With Burn Injury
Authors: Dovbysh D.
Published: May 2016

Introduction

Burn injuries occupy 11th place in the list of causes of infant mortality and 5th in the list of the most common non-fatal childhood injuries (WHO, 2014). The situation of getting a burn injury, prolonged hospitalization, painful medical procedures, the threat of a child's life results in mother's unusual and heavy emotional experience. Adequate processing of this experience will be an important factor in her future mental health. The study involved 35 mothers hospitalized with their children because of burn trauma.

Objectives

The aim of the study was to describe the characteristics of emotional regulation and emotional response of mothers bringing up children with burn injury.

Goals

(1) Describe the phenomenа of emotional regulation, found in mothers whose children have experienced a burn injury; (2) determine factors that cause appearance of special emotional phenomena among these mothers.

Methods

Сlinical interview, Beck Depression Inventory, State Trait Anxiety Inventor, Cognitive Emotion Regulation Questionnaire (CERQ).

Results

A significant numbers of mothers shows a high level of anxiety and depression, which may be predictive of the development of PTSD. The main cognitive strategies of emotion regulation – self-blame and disasterization are maladaptive. An important role played by unconscious strategy of emotion regulation, basically – situation selection and attentional deployment, as well as the social regulation of emotions: the availability of a good support from family members with adaptive strategies of emotional regulation, adequate reactions of other mothers in hospital associated with less emotional distress above mothers. There is no correlation between the severity of burn injury and the emotional response of the mother.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Preventing Attachment Disorder (Ad): Attachment-Focused Dyadic Group Therapy With Borderline Personality Disorder – and Former Ad – Mothers
Authors: Compés C. , Iniesta A. , Pereira V. , Martínez C. , Justo C. , Herrero M.E.
Published: May 2016

Children with mothers with Borderline Personality Disorder (BPD) have a high risk of developing attachment difficulties, and this risk is like to grow when their mothers experienced severe neglect and/or abuse in their childhood and early adolescence. Our objective was to clinically assess and lend support to a small group of young mothers at risk. We recruited mothers aged 18-25, with 1-12 month-old children. None was married, had a stable residence and sexual partner, and most were unemployed. All had early diagnosis of AD, had at present BPD, and had received extended global and residential psychiatric treatment in our Therapeutic Community (SIRIO Project) along their adolescence. We conducted six consecutive 4 h weekly sessions, which were attended by mothers with their babies in the familiar setting of the Community. The explicit aim proposed to them was: “to come to be listened and accompanied and to share their motherhood experiences” with members of our multidisciplinary team (nurse, social worker, therapeutic educator, psychologist and psychiatrist), who were known to them.

Fears, somatizations, more-or-less concealed rejection of her baby, apathy, sadness, suspiciousness, jealousy, relational difficulties with their couples and family figures… were common findings that were addressed in the sessions.

Main conclusion

Minor but positive changes occurred in the dyadic mother-baby relationship. This was more patent concerning breastfeeding, relationships with their couple and extended family and pediatricians, and attitudes toward job seeking. In addition, the frequent contact with these mothers elicited markedly positive reactions in the 8-9 children/adolescents currently residing in our community.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sub-Types of Childhood Trauma Predicts Depressive and Anxiety Symptoms in the General Population
Authors: Maric N. , Andric S. , Mihaljevic M. , Mirjanic T. , Pavlovic Z.
Published: May 2016

Background

Ubiquitous negative emotional states such as depression, anxiety and stress in adulthood are related to individual life scenario, particularly influenced by exposure to environmental risk factors. Here, we investigated if sub-threshold negative emotional states in general population can be predicted by experience of trauma in the childhood.

Method

A sample of 106 healthy young adult participants from Belgrade and surroundings (43.4% male, age 29.2 ± 6.6 years, mean IQ 106.4 ± 15.9) fulfilled Childhood Trauma Questionnaire (CTQ) to identify emotional or physical abuse/neglect or sexual abuse. Present level of negative affectivity was measured by Depression Anxiety Stress Scale (DASS). Hierarchical linear regression analysis was conducted to identify subtypes of trauma as predictors of the negative affectivity.

Results

Mean CTQ and DASS scores were 31.2 ± 6.7 and 16.4 ± 16.8, respectively. An exposure to given risk factors in the past correlated significantly with intensity of the present negative affective states (r = 0.290, P = 0.004). For the prediction of anxiety, the most important traumatism subtypes were emotional abuse, emotional neglect and physical abuse (P = 0.001; 0.028; and 0.041, respectively). Depressive symptoms were predicted only by the emotional abuse in the past (P = 0.008).

Conclusion

Based on clinical samples, findings from the literature yielded greater risk for mood and anxiety disorders after exposure to emotional, in comparison to the physical trauma. We confirmed the same pattern of correlations in the healthy subject's sample, who had no history mental disorders. Evaluation of the interaction effects among emotional trauma and genotype is strongly recommended in the identification of subjects at risk and for the prevention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Applications of Classical and Traditional Folk Music in Psychiatric Settings
Authors: Giannouli V. , Syrmos N.
Published: May 2016

Introduction

Although there is an augmenting interest for the applications of classical music in psychiatry, traditional folk music is not properly highlighted in the literature.

Objective

In this paper, we examine the possible benefits that psychiatric patients who attend music therapy in psychiatric settings may have when traditional folk music and/or classical music are used in the process of rehabilitation.

Method

A literature search of the electronic databases was performed to identify relevant studies published before June 2015.

Results

A meta-analysis of the existing research revealed the positive influence of passive and active music listening on different groups of neurological and psychiatric patients’ anxiety, pain, tension and stress, and a series of cognitive and emotional changes that occur due to music interventions on patients and doctors alike. A general finding from the 700 diverse retrieved articles is that classical music has a positive influence on psychiatric patients. In contrast to that, there is scarce research for traditional music in psychiatric settings.

Conclusions

Music has a strong influence on psychiatric patients. Future research should focus on different questions such as how the knowledge of the varieties of the different types of (folk) music can enrich the music therapy in psychiatric settings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Factors Influencing Attitudes Towards Seeking Professional Psychological Help: Findings From A Multi-Ethnic Asian Population-Based Study
Authors: Picco L. , Abdin E. , Chong S.A. , Pang S. , Shafie S. , Vaingankar J. , Subramaniam M.
Published: May 2016

Introduction

Various socio-demographic variables have been shown to influence attitudes towards seeking professional psychological help (ATSPPH), while negative ATSPPH can act as a barrier to mental healthcare, resulting in under-utilization of psychological services.

Aims and objectives

To explore the factor structure of the ATSPPH scale and determine whether any significant socio-demographic differences exist in relation to ATSPPH among a nationally representative sample.

Methods

Data was extracted from a population-based, cross-sectional survey conducted between March 2014 and March 2015 among Singapore Residents aged 18-65 years (n = 3006). Respondents completed the 10-item ATSPPH scale and also provided socio-demographic information. Exploratory factor analysis (EFA) was performed to establish the factor structure of the ATSPPH scale. Multivariable linear regression analyses were conducted to examine socio-demographic factors associated with ATSPPH.

Results

EFA revealed that the ATSPPH scale formed three distinct dimensions comprising “Openness to seeking professional help”, “Value in seeking professional help” and “Preference to cope on your own”. Higher “Openness to seeking professional help” scores were significantly associated with 18-34-year-olds and unmarried respondents, whilst Malay ethnicity and lower education were significantly associated with lower openness scores. Malays, Indians and lower education were significantly associated with lower “Value in seeking professional help” scores, whereas higher “Preference to cope on your own” scores were significantly associated with lower education.

Conclusion

Population subgroups including those with lower educational levels and different ethnic groups have more negative ATSPPH. Tailored, culturally appropriate educational interventions which reduce negative ATSPPH are needed, which effectively target these populations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dermatologists, Acne and Psychological Counseling
Authors: Rebelo-Neves C. , Amaral Dias C. , Torgal J.
Published: May 2016

Introduction

In psychotherapeutic clinic, patients without visible marks of acne report this experience with great emotional charge, even when it occurred many years before.

Objectives

This observation arose the interest in investigating the psychological impact of acne, which led us to find out what acneic subjects think of their disease, how they deal with it and, simultaneously, evaluate the beliefs of dermatologists on it. The present work is part of an investigation whose aim is to develop a program for the promotion of skills to deal with acne and its effects.

Methods

The inventory of beliefs, behaviours and treatment of acne – ICA – was developed through the content analysis of non-structured interviews to health care professionals and to patients with acne and/or who had it. This inventory was applied to a convenience sample (n = 367), to a university sample (n = 1666) and to a sample of 95 dermatologists – the 16 questions related to the beliefs on acne.

Results

We found general agreement with some statements. Most respondents agree with a group of statements, though opinions are divided. Most respondents “disagree” or “disagree more than agree” with “…ingestion of chocolates or dairy products would cause acne”. Finally, there is no consensus about “…caused by the combination of psychological and hormonal factors”.

Conclusions

Further studies are needed, on the impact of acne in patient's quality of life. We also found great interest of promoting a close collaboration between dermatologists and psychology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Positive Mental Health In Individuals With Mental Disorders
Authors: Vaingankar J. , Subramaniam M. , Abdin E. , Sambasivam R. , Jeyagurunathan A. , Seow E. , Pang S. , Picco L. , Chong S.A.
Published: May 2016

Introduction

Given the emphasis on inclusion of well-being interventions in the treatment and rehabilitation of individuals with mental disorders, it is important to understand the level and determinants of positive mental health (PMH) among them.

Objective

To conduct a cross-sectional study among patients with schizophrenia, depression and anxiety spectrum disorders to estimate PMH.

Aims

(i) To estimate the level of PMH among patients with mental disorders and compare these with the established general population estimates; (ii) to identify socio-demographic and clinical determinants of PMH.

Methods

Following ethics approval, 353 patients aged 21-65 years, receiving treatment at a psychiatric hospital in Singapore for schizophrenia, depression or anxiety spectrum disorders were included. Patients provided socio-demographic information and completed the multidimensional PMH instrument that provides total and domain-specific scores ranging from 1 to 6; higher scores indicate better PMH. Functioning was assessed with the Global Assessment of Functioning (GAF) scale and clinical data were obtained from administrative databases.

Results

Sample comprised 142, 139 and 72 patients with schizophrenia, depression and anxiety spectrum disorders respectively, with a mean age of 39.2 years. Mean total PMH scores among them were 4.2, 3.7 and 3.8 respectively which were significantly lower than the general population mean of 4.5 (P < 0.001). Patients of Chinese ethnicity, with lower education, depression or anxiety, and lower GAF scores were more likely to have lower PMH.

Conclusions

This study identified patient subgroups that are likely to have poorer PMH. Interventions facilitating PMH among these patient groups would be beneficial and are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
To The Question of Destigmatization of Psychiatry and Mentally III Persons In The Modern Society
Authors: Vladimirova S. , Lebedeva V. , Gutkevich E. , Semke A. , Bokhan N. , Garganeeva N.
Published: May 2016

In recent decades, new medications have been developed that entailed possibility of rehabilitation and socialization of mentally ill persons.

Purpose

To consider a phenomenon of destigmatization of mentally ill persons on the example of the analysis of screening-questioning in mental health service.

Methods

Randomized screening-questioning of participants of Open Doors Day in the clinics of Mental Health Research Institute (Tomsk, Russia) in connection with World Mental Health Day in October, 2015.

Results

One hundred and forty-six residents of Tomsk and inhabitants of the Tomsk Region as well as other cities visited Mental Health Research Institute. 76,5% of them visited mental health service for the first time. More than a half of visitors (51%) was the most able-bodied age group – 20-50 years old; elderly people – 20%. According to many-year observation of authors of the work, there is a gradual destigmatization of people with mental health problems. Process of destigmatization will develop further, and mass media should also be engaged in it. One more moment should be emphasized – reduction of self-stigmatization. Though people do not still aim to seek for psychiatric help at the appropriate institutions (they prefer to visit the psychiatrist of the catchment area policlinic), they after all started recognizing presence of the problem, understanding the need of its overcoming, and possibility of its correction.

Conclusion

The attitude of society towards people with mental health problems and towards psychiatry reasonably changes, and this promotes further development in the field of help to patients and their relatives.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Phenotype Of Resiliency? Cross-Sectional Psychobiological Differences Between Caregivers Who Are Vulnerable vs. Resilient To Depression, And Controls
Authors: Bersani F.S. , Wolkowitz O. , Epel E.
Published: May 2016

Introduction

Being a caregiver of chronically ill children is a source of chronic-psychological stress affecting general physical and mental health. However, there is tremendous variance among caregivers: some may develop stress-related depression, whereas others are more “resilient”. The objective of the study was to phenotypically differentiate on psychobiology caregivers who developed depressive symptoms (“vulnerable”) vs. those who did not (“resilient”) from each other and from age-matched controls.

Methods

Forty-five mothers of chronically-ill children and 18 controls have been examined. Caregivers were divided via a median split of Center for Epidemiological Studies Depression Scale scores in “resilient” (RCs) and “vulnerable” (VCs). We assessed cognitive, affective, metabolic, neuroendocrine and oxidative markers at rest and in response to a laboratory social stressor. ANCOVAs and Bonferroni post-hoc tests were used to examine between-group differences.

Results

Although RCs compared to VCs had similar levels of objective parenting-related burden (P = 0.51), they had lower subjective distress (P < 0.01) and higher levels of positive affect (P = 0.04). Although RCs compared to controls had higher levels of objective parenting-related burden (P = 0.04), they had greater cortisol suppression post-dexamethasone (P = 0.05), lower F2-isoprostanes/vitamin E ratio (P < 0.01) and lower fasting insulin levels (P = 0.06).

Discussion

Our results suggest that caregivers with higher resiliency demonstrate more salutary stress-related functioning in comparison with less resilient caregivers and, more surprisingly, non-caregiver controls. These findings might be interpreted in the spirit of Nietzsche's quote “What does not kill me, makes me stronger” and of the idea that successfully overcoming adversity may be more psychobiologically beneficial than not having been exposed to any adversity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric Symptoms As Onset of Anti-Nmdar Encephalitis
Authors: Cancino Botello M.C. , Cercos López A. , Chavarria Romero V. , Sugranyes Ernest G.
Published: May 2016

Introduction

Every more often, there is evidence that shows a relationship between psychiatric symptoms and autoimmune disorders. Such is the case of anti-NMDAR encephalitis, in which it has been recently described the development of psychotic symptoms. Anti-NMDAR encephalitis is an autoimmune disorder that involves IgG autoantibodies against the NMDA receptor subunit GluN1. This last fact could support the relationship with the glutamatergic model of schizophrenia.

Objective

To conduct a current review to deepen the detection and management of anti-NMDAR encephalitis, due to the frequent existence of psychiatric symptoms at onset, which have contributed to the difficulty of diagnose.

Method

Systematic review of the literature in English (PubMed), with the following keywords: “Autoimmune encephalitis”, “psychosis”, and “NMDA receptor”.

Results

Autoimmune encephalitis appears more frequently in children and young adults and it is characterized by a prodromal period, in which there usually are non-specific symptoms of headaches or fever. Next, it could progress to cognitive deficits, seizures, catatonic symptoms and psychosis. However, sometimes in the rarest clinical presentations, there is nothing but psychiatric symptoms at the onset of encephalitis, which leads to misdiagnose and lack of proper treatment. This fact has stimulated the curiosity of the psychiatry scientific community, since the anti-NMDAR encephalitis may mimic the glutamatergic model of schizophrenia.

Conclusions

To make an accurate and detailed diagnostic formulation in people with psychiatric symptoms as onset of any disorder is essential to determine whether it is a primary psychiatric disorder or symptoms associated to another disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Possible Anti-Inflammatory Role of Perivascular Macrophages In A Model of Depression Induced By Chronic Mild Stress In Rats
Authors: Sayd A. , MacDowell K. , Monteagudo L. , Martin D. , Madrigal J.L. , Leza J.C. , Caso J.R. , Orio L. , Garcia-Bueno B.
Published: May 2016

Perivascular macrophages (PVM) are hematopoyetic cells that migrate to the brain perivascular space modulating the interactions between the immune and central nervous systems (CNS). Previously, their depletion with the icv administration of the pro-apoptotic drug clodronate encapsulated in liposomes increased the vascular production of the proinflammatory prostaglandin E2 (PGE2), the release of ACTH, corticosterone and fever, induced by the intravenous administration of Lipopolysaccharide (LPS). Further studies also demonstrated a decrease in the synthesis of the anti-inflammatory prostaglandin 15d-PGJ2.

With this background, we decide to deeper explore the mechanisms involved in the anti-inflammatory profile of PVM by depleting them in a model of depression induced by chronic mild stress (CMS) exposure in rats.

Our results showed an increase of the proinflammatory cytokines TNFα, IL-1 and IL-6 at mRNA levels in the prefrontal cortex of the groups of animals where the PVM were depleted, as well as in the protein levels of the pro-inflammatory nuclear factor NF-κB, the enzymatic pro-inflammatory enzymatic sources iNOS, COX-2 and m-PGES-1 and their product PGE2. A concomitant decrease of the 15d-PGJ2 mediator was also observed. In addition, we also checked whether the depletion of PVMs could regulate the expression of molecules implicated in the leukocyte traffic and infiltration in the CNS in our CMS model. Thus, the mRNA levels of the chemokines MCP-1, fractalkine and the adhesion molecule VCAM appeared increased in the animals without PVMs.

In summary, our results could suggest a potential anti-inflammatory role for PVMs in a depression model chronic stress-induced as CMS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.