bluuebunny/crossref_metadata_2025 huggingface dataset:
Case Report of Treatment Issues in the Management of Dementia with Parkinsonism
Authors: Manusheva N. , Bajraktarov S. , Arsova S. , Vujovic V.
Published: June 2017

Background

Parkinsonism as a clinical syndrome needs to be diagnosed multidisciplinary. Cognition problems and behavioural symptoms together with the neurologic symptomatology make the treatment very complicated.

Aims

To emphasize the importance of effective management strategies that may extend quality of life and independence.

Methods

This is a case report of 59 year old male with complicated clinical presentation of dementia with parkinsonism last two years treated with levodopa. Admitted with symptoms of fluctuating cognition, memory problems, visual hallucinations and depression and also generalized rigidity after introduction of atypical antipsychotic. Medical history: epilepsy in the last 15 years, trauma 7 years ago. After admission he was examined clinically and the brain computed tomography (CT) and electroencephalography (EEG) were done.

Results

We analyzed possible etiologies and differential diagnosis of presented symptoms–extrapyramidal signs, mental confusion with hallucinations which are the three most common clinical features of Parkinson's disease dementia (PDD). CT reveals diffuse cortical atrophy with encephalopathy in the white matter combined with dilatation of lateral ventricles. EEG was with theta disrhythmic activity. After consultation with neurologist the patient was given Carbamazepine for epilepsy and Levodopa/Carbidopa to control parkinsonism. Donepezil was introduced. Two weeks after admission the patient was discharged with given advice to be treated in geriatric clinic.

Conclusion

After thorough clinical examination with proper diagnostic procedures with imaging modalities we should try cholinesterase inhibitors because they might improve cognition and can be beneficial for reduction of the hallucinations and behaviour disturbances combined with proper management of the surroundings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychological and Physical Problems in Elderly People with Problems of Falls
Authors: Mentis M. , Gouva M. , Antoniadou E. , Mpourdoulis K. , Kesoudidou I. , Marneras C. , Panagiotopoulos E.
Published: June 2017

Introduction

Falls of the elderly to a degree been associated with poor mental health, poor social support and poor physical health.

Objectives

To investigate the falls of elderly people in relation to their mental and physical healthy.

Aims

To compare the effects of falls in the elderly in the areas of mental and physical health.

Methods

The current study used purposive sampling compromised from 48 people that visited the emergency department at the Patras University Hospital in 2016. The inclusion criterion for participation was age (> 65 years). Data was collected using WHO's questionnaire, the WHOQUOL-BREF. Finally, data was analyzed using the test t test for independent samples.

Results

The sample constituted by 39.6% of male and 61.4% of female. The average age of the sample was M = 75.89 years. In relation to mental health, the average of the elderly with a history of falls found M = 57.26 (SD = ± 22.87), while the other was found M = 74.45 (SD = ± 15.81). The difference between the two groups was statistically significant (P < 0.05), while physical health although again the first group found to have a smaller average (M = 56.65, SD = ± 22.13) relative to the second group (M = 63.78, SD = ± 12.59) no statistical difference was observed.

Discussions

These results demonstrates that falls beyond the physical damage that are immediately visible can as well create significant issues in the psychological state of the elderly exacerbating anxiety, fear and social isolation, which has been associated with depression event.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Study of the Sensitivity of the Organic Psychosyndrome After One Year of the Disease
Authors: Paschalidis K. , Argitis P. , Gatsiou K. , Chatzidai C. , Dalli P.P. , Pantoulas E. , Chaviaras I.
Published: June 2017

Introduction

The delirium of the elderly is defined as an acute confusional state, with variation during the day, characterized by impaired consciousness, orientation, memory, thinking, attention and behavior.

Purpose

The purpose of this research is to investigate whether the organic psychosyndrome of the elderly is a valid indicator of mortality after one year.

Material

It was used material from patients with organic psychosyndrome older than 60 years, who were hospitalized in pathological clinics of the Hospital of Corfu and was diagnosed by the linker portion of the psychiatric clinic.

Methodology

The patients diagnosed with organic psychosyndrome neither suffered from a psychiatric disorder psychotic type in the past, nor previously preceded anaesthesia in the context of physical disease. For the recognition and the criteria of ICD-10 to the exclusion of another psychiatric condition, it was used the delirium rating scale method.

Results

According to the analysis of the data, 8% of patients died during hospitalisation, in the first 3 months after diagnosis, the 28% of the initially hospitalised patients, in 6 months the 42%, while during the year the 48% of the initial total patients died and in the next 12 months only one death was reported.

Conclusions

The analysis of the survey results shows that while the instrument psychosyndrome could be considered as a poor diagnostic marker for the first 12 months, 48% mortality, in the long run it seems to lose its prognostic value with the mortality approaching the mortality index of the hellenic statistical authority for 2015 at ages 60+ (1.2%).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Stress and the Serotonergic System, Observations from Pet Imaging
Authors: Spies M. , Lanzenberger R.
Published: June 2017

Introduction

Stress response and the neuroendocrinologic factors through which it is mediated are disturbed in anxiety and in affective disorders. While acute stress is thought to result in hypothalamus-pituitary-adrenal- (HPA) axis hyperactivity (Varghese 2001), chronic stress may result in decreased HPA-response (Booji 2013). Antidepressant treatment, on the other hand, is thought to realign HPA–axis activity (Schüle 2007).

On the other hand, dysregulation within the serotonergic neurotransmitter system is understood as a central moderator in the pathophysiology of affective and anxiety disorders. Serotonergic transmission both regulates- and is regulated by- glucocortocoids. Cortisol results in an increase in serotonin synthesis and release while serotonergic transmission is thought to downregulate HPA-axis activity (Lanfumey, 2008). Positron emission tomography (PET) studies have demonstrated the link between the serotonergic system and the HPA-axis in humans in vivo. For example, a negative correlation between cortisol and 5HT1A receptor levels in various brain regions has been shown (Lanzenberger, 2010). SERT expression, on the other hand, was shown using PET to be positively related to HPA-axis reactivity (Frokjaer 2013).

Methods

n.a.

Aims

Available literature on interactions between the HPA-axis and the serotonergic system will be discussed with a focus on data acquired via PET studies.

Results

n.a.

Conclusions

The interaction between the serotonergic system and the HPA-axis is likely bilateral and may be understood as a neurobiological link by which stress may foster the development of depression and anxiety.

Disclosure of interest

M. Spies has received travel grants from AOP Orphan Pharmaceuticals AG, Janssen-Cilag Pharma Gmbh, and Eli Lilly, workshop participation from Eli Lilly, and speaker honoraria from Janssen-Cilag Pharma Gmbh. R. Lanzenberger received travel grants and conference speaker honoraria from AstraZeneca, Lundbeck A/S, Roche Austria GmbH, Dr. Willmar Schwabe GmbH & Co. KG, AOP Orphan Pharmaceuticals, and Janssen-Cilag Pharma Gmbh.
Invisible Effects of Chemotherapy
Authors: Brandão D. , Assunção T. , Almeida H.
Published: June 2017

Introduction

Chemotherapy is an essential component in the treatment and alleviation of oncological diseases. To your application are associated, as well as systemic effects, cognitive impairment in patients. These changes have received increasing attention due to the impact on quality of life of cancer survivors.

Objectives

This study aims to evaluate the current evidence on the association between chemotherapy and cognitive impairment in cancer patients, especially in the areas affected cognitive function, possible mechanisms of action and consequences on the quality of life of these patients and the importance of identifying strategies intervention in order to minimize these effects.

Methods

We conducted a literature review from literature articles addressing this topic with use of databases: Medline and Pubmed. The following keywords were used: “chemobrain”, “cognitive dysfunction”, “chemotherapy”.

Results

Although some states have not found differences, several studies have shown that chemotherapy has implications cognitively. Underlying etiology remains unknown, and proposed several mechanisms to explain these changes: neurotoxicity, microvascular damage and inflamamatory response. Cognitive impairment has significant implications in the daily life of patients both personally, socially and labour. The therapeutic approach focuses on the patient and family education, coping strategies, cognitive rehabilitation and cognitive behavioural therapy.

Conclusions

It is vital to educate patients about the possibility of cognitive change as effect of chemotherapy as well as health professionals in the early identification of these changes. It is essential developing specific intervention strategies to improve the quality of life of the oncologic patient during and after treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Changes of Emotional Status and Quality of Life of Early Stomach Cancer Patients After Endoscopic Submucosal Dissection (ESD)
Authors: Lee S. , Lee H. , Oh S.T. , Jeon H.H. , Choi W.J.
Published: June 2017

Introduction

Cancer patients may encounter psychological distress, change of emotional status, and lowered quality of life. It is predicted that similar changes will be shown during the Endoscopic Submucosal Dissection (ESD) of early stomach cancer. The objective of this study is to evaluate changes of emotional status and quality of life over time depending on baseline level of psychological distress.

Method

Ninety-seven patients indicated with ESD who visited National Health Insurance Service Ilsan Hospital in Korea between May 2015 and June 2016 were evaluated. Psychological distress, emotional status, and quality of life were evaluated at the day before ESD. Follow-up evaluations of them were done at the day after ESD, 2 and 10 weeks later.

Result

The group with high psychological distress showed higher female ratio, more depressive and anxiety symptoms than those of the group with low psychological distress. Psychological distress was related to stress level and lowered quality of life. Repeated measures ANOVA analysis showed that significant differences of depression (MADRS), anxiety (HAM-A), level of stress (GARS), and quality of life (EORTC QLQ-C30) were sustained over time, but the decreasing tendency of the differences between the groups was also noticed.

Conclusion

The study revealed that patients who feel more psychological distress may experience more depressive and anxiety symptoms, increased level of stress, and lowered quality of life. We recommend screening of patients with early stomach cancer for psychological distress before ESD, which may improve subjective life satisfaction of patients during ESD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Preliminary Results of USA-European Field Trial on the Use of Patient-reported Measures in a Mobile Application and Potential Uses in Refugee Populations
Authors: Narrow W. , Buwalda V. , McIntyre J.
Published: June 2017

Introduction

The use of patient-reported outcome measures in psychiatric practices in the United States is still in its beginning phases. More research is need to determine the usefulness of such measures and the optimal methods to present them to patients and practitioners in routine care settings.

Objectives

This presentation will describe the research plan for testing a group of patient-reported outcome measures using digital applications. Potential opportunities for use in underserved refugee populations will be presented.

Methods

The outcome measures were selected from those recommended in DSM-5 Section III, including cross-cutting symptom and disability measures. A user-friendly digital application was developed for data collection, synthesis, and presentation. The research plan has three phases: focus groups with patients and clinicians, piloting of methods, and the main study, a pragmatic trial comparing treatment outcomes using outcome measurement versus usual care.

Results

Results of the focus group sessions will be presented, along with changes made to the measures and the digital application in response to these results. Current status of the research project will be discussed.

Conclusions

The results of this research project will bring greater clarity to questions on the role of outcome measurements in improving quality of care and patient outcomes. With ever greater use of smart phones, tablets, and personal computers, digital technology has the potential to facilitate psychiatric assessment and treatment for underserved, difficult-to-reach populations such as refugees.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The compare of early maladaptive schemas, emotion regulation and general health in offender prisoner men and normal group men
Authors: Davoood R. , Ghahari S. , Pirmoradi M.R.
Published: June 2017

Object

The aim of this study was to compare early maladaptive schemas, emotion regulation and general health in offender prisoner men and normal group men.

Methods

The study method was causal – comparative (ex post facto). Participants included two groups: (1) all of offender prisoner men (n = 47) in Fooman jail and (2) normal group men (n = 47) in Fooman. Both groups were matched for age, occupation and education. All of the participants completed Young maladaptive schema questionnaire (Y MSQ), cognitive emotion regulation questionnaire (CERQ-P) and general health questionnaire (GHQ-12) individually. Data were analysed using independent t-test and multivariate analysis of variance (MANOVA).

Finding

There was significant difference between two groups in total score of early maladaptive schema questionnaire and also in its subscales included abandonment, impaired autonomy/performance, impaired limits, other – directedness, over vigilance/inhibition, emotional inhibition (P < 0/01). The general health was different between groups, too. In addition, while groups showed significant difference in total score of emotion regulation and one of the subscales (rumination), no significant difference was explored between groups in self-blame, acceptance, positive refocusing, planning refocusing, positive re-evaluation, perspective taking, catastrophizing and others blame.

Conclusion

Significant differences between the two groups in terms of general health, schema dimensions and emotional regulation dimensions suggest that dysfunctional schemas, maladaptive emotional strategies and low general health could be involved in criminal behaviour.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Political abuse and forensic psychiatry in communist Romania
Authors: Hostiuc S. , Buda O. , Drima E.
Published: June 2017

Psychiatry was often used for political reasons in the second half of the 20th century, especially in the former communist countries. According to the global initiative on psychiatry, political abuse of psychiatry is defined as the incorrect usage of diagnoses, treatments, or psychiatry admissions in order to limits fundamental rights of persons or population groups in certain countries. Most studies regarding political abuse as a repressive measure analysed it in either USSR or China. Romania is one of the countries from the former communist block in which psychiatry was proven to be used as a form of repression against political dissidents. One of the psychiatry “tools” used against political dissidents was the widespread usage of mandatory, non-voluntary admissions. They were seen as preventive measures, whose purpose was to prevent an individual to act antisocially. The purpose of this article is to analyse the characteristics of the patients that were non-voluntarily admitted in psychiatry hospitals, based on studies published by the forensic psychiatry researchers in the communist period. The main conclusions of this study are: (1) the presence of a disproportionate number of patients admitted with schizophrenia, especially the paranoid type; (2) patients that performed acts against the state were more often diagnosed with schizophrenia; (3) patients that performed acts against the state were more often considered to have no judicial responsibility; (4) the non-voluntary admission/treatment were more often removed for crimes against persons, and less often in crimes against the state.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental Health and Social Care Regulation in Ireland: New Ethical Perspectives
Authors: Dodd P.
Published: June 2017

This talk will outline the regulatory framework (both mental health and social care) currently in place in Ireland for people with intellectual disability (I.D.) and mental health problems, in the context of the varied nature of available mental health services. As not all aspects of service are currently under the regulatory system, potential ethical issues arise, and will be discussed.

In addition new legislation regarding the support of people with vulnerable decision making capacity will be outlined (Assisted Decision Making (Capacity) Act, 2015); potential ethical issues that are currently arising from this legislation will be explored and discussed.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Thanatology as a resource in the care of addicts and people with mental disorders
Authors: Färber S. , Färber M.
Published: June 2017

Introduction

The purpose of this research is to present multidisciplinary and relevance of Thanatology in coping of addictions and other mental disorders.

Objective

The aim of this paper is to analyse the scientific connections that thanatology establishes with other knowledge. With this postulate we present the thanatology and its relations with other disciplines, especially psychiatry, considering that addictions and mental disorders often have as triggering events of loss, death and mourning.

Methods

To develop this research we use the systematic literature review, following the process of research, cataloging, careful evaluation and synthesis of the documentation.

Results

Thanatology is multidisciplinary shares and receives information from other sciences or sectors of knowledge without these modified or enriched. It is interdisciplinary because it originated disciplinary specialty of a mother discipline: Anthropology; and it is transdisciplinary, thence its relevance in research on the realities that revolve around mental disorders and addictions (Fig. 1).

Conclusion

It is important to research on thanatology position in the scientific panorama, given the emergence of this reflection and the relevance of research for its interrelationship with other disciplines.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Common Neural Networks Between ocd and Behavioural Addictions: Is ocd a Behavioral Addiction?
Authors: Grassi G. , Pallanti S.
Published: June 2017

The stereotypical portrait of an obsessive–compulsive patient is an excessively self-controlled, risk aversive individual that acts in order to avoid potential loss or punishments. Although this portrait fits well with several clinical studies showing increased harm-avoidance in obsessive–compulsive disorder (OCD), more recent clinical, neuropsychological and neuroimaging studies challenged this idea and described a different portrait of OCD, showing several commonalities between OCD and addictions such as impulsivity, reward dysfunction and impaired decision-making. The results of these studies conflict with the stereotypical OCD portrait of doubtfulness and risk-aversiveness. In fact, these findings are prototypical for addiction and have led some authors in the last years to view OCD as a behavioral addiction. In our recently published article, we investigated the behavioral addiction model of obsessive (OCD), by assessing three core dimensions of addiction in patients with OCD and healthy participants. Similar to the common findings in addiction, OCD patients demonstrated increased impulsivity, risky decision-making, and biased probabilistic reasoning compared to healthy controls. During the presentation we will discuss the behavioral addiction model of OCD by focusing on common neuropsychological and neurobiological circuitries.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
What about the hidden face of Akathisia?
Authors: Jouin L. , Ouali U. , Ouanes S. , Zaouche R. , Jomli R. , Zgueb Y. , Nacef F.
Published: June 2017

Introduction

Akathisia is commonly known for its objective components such as rocking while standing or sitting and lifting feet. However, little is known about its psychiatric impact that can even lead to suicidal attempts.

Objectives

The aim of this study is to investigate the main psychiatric symptoms associated with akathisia in a Tunisian sample of patients under treatment for Schizophrenia, Schizoaffective or Bipolar Disorder.

Methods

Fifteen patients were diagnosed with akathisia using the Barnes Akathisia Scale. Psychiatric symptoms related to akathisia such as mood lability, sadness, anxiety, aggressivity, suicidal ideation, insomnia and social and professional impairment were assessed.

Results

The average age of the sample was 47 years. The average antipsychotic chlorpromazine-equivalent total dosage was 1756 mg. All patients reported at least one psychiatric symptom imputed to akathisia. These were: mood lability (n = 11), inner restlessness (n = 10), anxiety (n = 10), sadness (n = 10), aggressivity (n = 6), and insomnia (n = 12). Eight patients described suicidal ideation and five confessed having committed a suicide attempt. Four and ten said akathisia had professional and social impact respectively. The prevalence of psychiatric symptoms did not differ according to sex, age, diagnosis, illness duration, presence of a comorbid anxiety disorder, the number and types of antipsychotics used, the antipsychotic chlorpromazine-equivalent total dosage or the reported drug compliance.

Conclusions

Psychiatric symptoms resulting from Akathisia remain frequently undetected. Special interest by the clinician is required to elicit these symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Self-esteem links with anxiety and depression at one community adolescent sample
Authors: Kabashaj B. , Avdyl G. , Mustafa S. , Fanaj B. , Melonashi E. , Fanaj N.
Published: June 2017

Introduction

Anxiety and depression is becoming an increasingly important public health issue. The adolescents’ population is among affected seriously.

Objectives

The objectives of the study was to investigate the level of anxiety, depression and self-esteem among adolescents and explore links between.

Methodology

Participants were 99 adolescents randomly selected in school, aged between 12 to 19 years (M = 14.88; SD = 2.09); in terms of gender composition, there were girls 41.1% and boys 58.9%. The measures used included the Albanian versions of depression self-rating scale for children, the revised children's manifest anxiety scale, and the rosenberg self-esteem scale. All data has been analysed by SPSS 21 and Excel 2007.

Results

Results showed that clinical significant levels reported 10.3% of participants for anxiety and 22.4% for depression. With low self-esteem scored 16.3% of participants. Self-esteem is significantly negatively correlated only with depression (r = -.433, P < .00). Mann-Whitney Test didn’t found significant differences in anxiety based on self-esteem levels. Mann-Whitney Test found significant differences in depression levels based on levels of self-esteem (Mdlowself-esteem = 15; n = 16; Mdnormalself-esteem = 10; n = 81) as adolescents with low self-esteem had significantly higher depression as compared to adolescents with normal self-esteem (z = -2.876, P < .004).

Conclusions

Findings suggested that self-esteem and depression links are present but not links self-esteem and anxiety. It is important to investigate these relationships in future research aimed identification/interventions programs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship between the risk of relapse and via of administration of treatment antipsychotic
Authors: Laura L.F. , González Suárez A. , Alonso Huerta A. , Ocio León S. , Gómez Simon M. , Hernández González M.J. , Al Shaban Rodriguez O. Walid Muquebil Ali , Estebanez Suarez M.P. , Lopéz Fernandez J.
Published: June 2017

Introduction

He income hospital represents a rupture in the continuity of life of the patient. It would be advisable to determine those variables that help to reduce them. Some studies are running to a paper protector of the treatment injection in the relapses and number of hospitalizations.

Objectives

Compare the risk of decompensation, measured in terms of income hospital or consultations to emergency, between patients to treatment injection versus oral.

Aims/methods

He is a descriptive study which assesses the number of hospital admissions and consultations to emergency departments in the period of one year (between September 2015 and September 2016) of a sample of 28 patients registered as TMS and the results are compared with the type used for antipsicotivo treatment via.

Results

We start from a sample of 28 patients, of which 17 are still a treatment intramuscular and 11 have all your guideline prescribed in oral. Patients injection treatment group needed to be admitted to a psychiatric inpatient unit at least on one occasionin the past year, 7 patients and 11 patients to oral treatment, only 2 patients wereadmitted and other 2 came once to your referral hospital emergency department.

Conclusions

Of the 17 patients to treatment with injectable ingresason or needed care urgently a 41.18%, facing the 36.36% of those patients to treatment by via oral. These results do not have a protective role of injectable treatment compared with decompensation measures according to need hospitalization or urgent attention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How much does love really hurt? Psychopathology and romantic relationships: A meta-analysis
Authors: Mirsu-Paun A. , Oliver J.A.
Published: June 2017

Introduction

Romantic relationship quality (RRQ) and break-ups (RRB) among young adults have been associated with the onset of a first major depressive episode or suicide attempts. However, the size of these associations varies across studies and the relative weight of RRB versus RRQ needs to be understood.

Objectives

To investigate (1) the size of the association between adolescent RRQ/RRB and psychopathology (i.e., depression, suicide ideation, deliberate self-harm, and suicide attempt); and (2) the role of potential moderators (e.g., gender, age, and nationality).

Methods

A meta-analysis of 20 manuscripts reporting on 21 studies (n = 19623) was conducted, focusing specifically on adolescents and young adults. Studies focused on physically abusive relationships were excluded.

Results

A model combining relationship quality and break-up yielded a highly significant association between relationship measures and depression/self-harm but the strength of this relationship was modest (r = .229). The strength of the association between depression/self-harm and RRQ (r = .279) was statistically different from RRB (r = .145) (P = .006). Location (US vs. Non-US) had no effect. Age was not significant, B = -0.005, 95% CI [-0.026, 0.016], P = .647. Gender was a weak moderator (B = .160, 95% CI [-0.021, 0.340], P = .083).

Conclusions

The association between psychopathology and RRQ/RRB was statistically significant but relatively small. RRQ was a stronger predictor of depression compared to RRB. This association was slightly stronger for women than for men. Implications for practice and future research will be discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Migration, women and education: Iran case study
Authors: Mohammadi M.
Published: June 2017

Short description migration of villagers to cities can be damaging the women's status in social affairs and promotion of family. Long description, one of the most controversial problems of rural dwellers’ migration to big cities, is the occupation of women in low-level jobs. The villagers mostly have little skills and women are deprived of knowledge and skills to cope with the new situation so that they cannot find good jobs to meet the family needs. The low-level jobs and income by men in black market after having migrated to the cities force women to adopt to work in dirty jobs or work as maid at homes to increase the financial capacities of the family and provide educational facilities for children. This can bring about many dangers for the family. First, children are deprived of family interaction most part of the day and most of them become trapped with illegal gangs of drug distribution. Second, women can be exploited with the burglary and shoplifting groups who use low educated and poor women. The destiny of most of these women is prison and being away from the family, which in turn worsens the situation. Vocational skills provided by NGOs have helped women to sustain their life but they are not enough. The factors involving with the situation of these women are the main focus of this paper.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Internet Based Interventions and Patient Generated Bio- and Self-monitoring Data: How to Use them for Self-management in Affective Disorders
Authors: Hegerl U. , Sander C. , Koburger N.
Published: June 2017

Even in developed countries only a small minority of patients with depression and bipolar disorders receives treatment according to guidelines and the treatment gaps are especially pronounced concerning psychotherapy.

A variety of digital and internet based interventions have been developed mainly building on the principles of Cognitive Behavioral Therapy (CBT). A quite consistent finding is superiority compared to control groups with largest effect sizes when compared to waiting list controls, however the evidence provided by such studies is questionable. More support for efficacy is provided by studies showing a comparable efficacy compared to face-to-face CBT, however sufficiently powered non-inferiority studies compared to antidepressants or face-to-face therapy are needed. Such studies are necessary for deciding whether digital intervention should be integrated in the health care system mainly as a self-management tool or as an alternative to regular treatment with psychotherapy or pharmacotherapy.

A dynamic new area of research explores the value for self-management and treatment decision of longitudinal data generated by the patient via self-ratings, wearables and other biosensors as well as the pattern of smartphone use. Within the BMBF-funded study STEADY a platform will be developed which allows the individual patient to securely store and integrate these data and to analyze them using analytic tools involving time series analyses. An overview will be given of similar approaches started in the last years within mental health.

Disclosure of interest

Within the last three years, Prof. Hegerl was an advisory board member for Lundbeck, Takeda Pharmaceuticals, Servier and Otsuka Pharma a consultant for Bayer Pharma and a speaker for Medice Arzneimittel, Novartis and Roche Pharma.
Neuropsychiatric adverse effects of HIV antiviral medication
Authors: Nascimento S. , Mendes M. , Solana C. , Croca M. , Reis J.
Published: June 2017

Introduction

HIV (human immunodeficiency virus) infection is related to several neuropsychiatric complications, such as dementia, encephalopathy, psychosis, as well as, opportunistic infections of the central nervous system (CNS). The discovery of antiretroviral therapy (ART) has limited these conditions and extended the life span of infected patients into a chronic illness, but it is also associated with neuropsychiatric adverse effects.

Objectives

To review the literature on the most common neuropsychiatric complications of the ART, since it can be difficult to distinguish drugs toxicity, the effects of the virus, immune system and psycho-social events.

Methods

The authors have conducted an online search in PubMed with the terms: “Psychiatry”, “HIV”, “adverse effects” and “antiretroviral drugs” from 2011 until 2016. From the outcome were collected, analyzed and summarized the articles considered to be relevant.

Results

The antiretroviral therapy (ART) are associated with a numerous adverse effects on the central and peripheral nervous systems, as well as, metabolic, gastrointestinal, cardiac, and other toxicities. The neuropsychiatric effects are common and highly variable, including depression, cognitive impairment and sleep disturbance. The nucleoside reverse transcriptase inhibitors and the non-nucleoside reverse transcriptase inhibitors are one of the two classes of antiviral drugs most frequently associated with neuropsychiatric complications.

Conclusions

The occurrence of new-onset conditions related to ART makes it difficult to determine the association between psychiatric disorders and ART adverse effects, and given the fact that patients commit to lifelong therapy, as well as, they can diminish quality of life; it makes these assessment important in treating these conditions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
New psychiatric service – fresh nurses experiences
Authors: Pardal A. , Correia N. , Santos C. , Matos Pires A.
Published: June 2017

The year 2015 started a new assistance in the cycle of mental health care ending the gap that existed in the district of Beja in the last twenty years, in this area. The aim of this presentation is to give the data of nursing activity in the first six months inpatient psychiatric service. The population studded was 98 inpatients, 53%male and 47% females aged between 16 and 87-years-old, diagnosed with depression, schizophrenia, personality disorders, bipolar disorders, dementias and others. Descriptive statistic of collected data. We rated the gender, marital status, aged and main disorders as well as the nursing therapeutic activities preformed with the patients. Six different kinds of activities were done. The total of interventions were 148: relaxation, ludic activities, physical activity, art therapy, health education and music therapy. Nursing intervention in the treatment of people with mental disorders improves the compliance to the treatment (adherence, self-care, useful occupation, stress career and insight of the illness) during the hospitalization time, aiming to avoid the worsening situation and the social isolation of the patient, and promote the recovery and quality of life. These objectives begin on hospital stay during the acute crisis. We are aware of the fact that this is just the beginning of this approach and for more and better results we have to have a bigger sample and a longer time of intervention as well as better methodology, namely the use of scales to measure some parameters that can provide more consistent and objective findings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A systematic report review of Ganser syndrome: 118 years of case studies
Authors: Petrykiv S. , De Jonge L. , Sibma W. , Arts M.
Published: June 2017

Introduction

Ganser syndrome was first described by a German psychiatrist Ganser in 1898, in a patient who showed a peculiar twilight state. Ganser syndrome is defined as the presence of approximate answers, somatic conversion symptoms, clouding of consciousness, and pseudo-hallucinations. The etiology of this disease remains a subject of debate. While the DSM-IV-TR classifies Ganser syndrome under the heading of dissociative disorder, it is not listed as a diagnosis in the DSM-V.

Objectives and aims

The purpose of this paper is to review available literature on Ganser syndrome, published in Dutch, English, German, and French for examining the etiological debate, in order to gain insight into the etiology of this disorder.

Methods

The study design was a retrospective case series of all published cases since 1898. For this purpose we used the electronic databases PubMed and Embase.

Results

Over a period of 118 years, we found 79 papers, describing 117 case reports on Ganser syndrome. It generally occurs in patients who are exposed to somatic disorders or to psychological stress, however, often in absence of a psychiatric disorder.

Conclusions

Ganser syndrome remains a controversial disorder in terms of its etiology. Ganser syndrome has been associated with organic disorders, as well as with stressful and intolerable life events. Based on this report, it is noteworthy that this syndrome predominantly occurs in the absence of co-morbid psychiatric disorders and is often associated with stress factors and underlying somatic diseases.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A review about comorbidity between obsessive-compulsive symptoms and huntintong disease and a case report
Authors: Sánchez Blanco L. , Juncal Ruíz M. , Santayana Jenaro G. Pardo de , Goméz Revuelta M. , Landera Rodríguez R. , Porta Olivares O. , Abejas Díez D. , Núñez Morales N.I.
Published: June 2017

Introduction

The concept of obsessive-compulsive disorder (OCD) as a disorder that affects the basal ganglia arising to the phenomenological similarities found between idiopathic OCD and other conditions associated with basal ganglia disease such as Huntington's disease (HD) and Sydenham's chorea. Huntintong's disease is characterized by cognitive, motor and neuropsychiatric symptoms.

Aims

A review of articles published from 1989 to 2016 in Pub-Med and UpToDate about relationship between HD and obsessive-compulsive symptoms.

Methods

Case report of a 56-year-old male who was admitted at the acute unit of psychiatry with obsessive-compulsive symptoms marked by hypochondriac obsessive thoughts. He also had cleaning rituals in relation with meals and we observed an important functional impairment and depressive mood. No previous history except family chorea without cognitive impairment in study by neurology department.

Results

Affective disorders are the most common psychiatric disorders in HD. Less frequently it can be found other psychiatric symptoms as obsessive-compulsive behaviour with prevalences between 10% to 52%. Psychiatric symptoms do not correlate with duration of disease or presence of dementia or motor symptoms.

Conclusions

It is necessary to complete the study of the patient to provide a more appropriate therapeutic option. The neurological signs of basal ganglia disorder should be evaluated when considering OCD diagnosis, especially in atypical presentation ages. Longitudinal studies are needed to determine the pathogenesis, disease progression and future therapeutic options.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Integration of Yoga Theory and Practice into a General Practice of Psychiatry
Authors: Weininger R.
Published: June 2017

Introduction

Yoga is an ancient system of concepts and practices designed to address problems of the mind and body, codified during the few centuries BCE in India. Yoga has become increasingly popular in the West during the past half century, and its practice in various forms is now widespread. Along with mindfulness-based techniques, yoga is increasingly seen as compatible with Western therapeutic methods of approaching physical and mental illness.

Objectives

To introduce the audience to the yoga model of the mind, and to show how it is both compatible with and complementary to Western models, including psychoanalytic and cognitive behavioral.

Aims

We will explore how this ancient system can be introduced into clinical practice, and in what ways it can accelerate the process of psychotherapy and psychological change.

Methods

This talk will include a review of yoga theory, including the causes of suffering and its resolution. We will explore roadblocks in treatment and how daily practices can accelerate the process of growth and change.

Conclusions

Yoga can be a very helpful adjunct to a psychiatric practice, in addition to medications and psychotherapy.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The Study of Relationship Between Personality Traits and Job Satisfaction in Iran Khodro Company Experts in Iran
Authors: Mirabzadeh Ardakani H. , Heidari S. , Sefidgaran B.
Published: June 2017

Job satisfaction among employees is a crucial issue in an organization and employer plays a vital role to fulfill their needs. Keeping job satisfaction high among workers can be of tremendous benefit to any organization, as happy employees will be more likely to produce work effectively. It has been assumed that personality traits can play an important role in people's dealing with the environmental issues such as work situations. By assuming this effectiveness, the main aim of this essay is to study the relationship between personality traits and job satisfaction. Explaining job satisfaction by using personality traits can enlighten weather job satisfaction depends only on type of organization or on some personality traits. In this regard, present study has investigated the relationship between job satisfaction and personality traits among Iran Khodro Company expert staff. To do so personality characteristics were measured by NEO-PI-R scale and job satisfaction was measured by Job Descriptive Index (JDI scale) that filled by experts of “Iran Khodro” company (111 men and women). Pearson correlation used to analyze the data. Results show that, neuroticism/emotional stability was associated with low job satisfaction (r = −0/713, P < 0/01). Also conscientiousness (r = 0/620) and agreeableness (r = 0/476) was significantly correlated with job satisfaction (P < 0/01). But the relationship between extraversion (r = −0/025) and openness to experience (r = 0/061) with job satisfaction was not significant. In addition, the results of this study emphasis on the effective role of age (r = −0/301) and job background (r = −0/330) on job satisfaction. But relationship between sexuality (r = 0/183) and marriage (r = 0/125) with job satisfaction was not significant.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
CBT Waves Through the Lens of Complex Systems Theory: A Tentative Way Toward Integration and Sustainability
Authors: Cheli S.
Published: June 2017

Introduction

In the last 15 years, several new waves have been described within CBT. At the same time, two constraints seem to define the role of psychotherapy: an integrative theoretical trend; an increasing incidence of chronic psychiatric disorders and psychiatric morbidity in chronic conditions.

Objectives

We discuss the viability of a Complex Systems Theory perspective in fostering the theoretical integration of the new wave of CBT and in promoting the healthcare sustainability in facing with chronicity.

Aims

The aims of the present study are to:

– frame a few recurrent and relevant theoretical dimensions in psychotherapy;

– outline a preliminary cost-effectiveness analysis of a Complex Systems Theory approach to psychiatric chronicity.

Methods

We performed a non-systematic review and a meta-synthesis of selected references (identified through a citation analysis per single reference and per single scholar) of the new wave of CBT. We especially focused on theoretical handbooks, meta-analyses and reviews, clinical trials.

Results

Complex Systems Theory describes an approach to theoretical and operational models based on adaptability, interdependency and self-organization. In defining a few integrative trends in psychotherapy, we highlighted the focus on:

– interpretation of events vs. events per se;

– processes vs. contents;

– transdiagnostic vs. pathologized models.

Furthermore, we framed economic, organizational, and educational implications of such an approach in promoting the adaptability of psychotherapy-as-a-system in dealing with the so-called double crisis of welfare state: continuous cutbacks in response to recession; longer-term pressures on health and social care.

Conclusions

Despite further studies are needed, we maintain that psychiatry may benefit from a Complex Systems Theory perspective.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Challenging Patient-doctor Interactions in Psychiatry – Difficult Patient Syndrome
Authors: Roque Pereira M. , Fornelos A. , Figueiredo A.R.
Published: June 2017

Introduction

The factors contributing to a challenging interaction between the roles of patient and physician may come from several sources. Each interrelation has its own modus operandis in which one of the individuals may not condone the persona the other individual is portraying. A mental illness or diagnosis is often stigmatised by the burden of stereotypical bizarre associations. That means the patient is generally not guilty and this is not another label they should carry. Though the mental health professional should be impervious to this, some degree of discomfort may throw some shadow on the clinical mediation of the interview and management of the pathology.

Objective

To provide an overview of what is beyond the label “difficult patient” in mental health care.

Aims

Evaluation of conflicts inside the patient-illness-physician triad.

Methods

Search for articles in Pubmed, Athens, Google Scholar databases, along with the hospital library.

Results

Characteristics of problematic interactions in psychiatric care were described consistently across our references. Causality for these difficulties is vast and surpasses the patient's behaviour. Plus they are not unique in psychiatry. They can be explained by individual, interpersonal, and social factors.

Conclusion

Situational issues, along with patient and physician characteristics, modulate and frame what should potentially be a productive encounter. To become aware of what contributes to difficult clinical encounters and to be prepared to address them while cultivating good interpersonal communication skills is fundamental.

Disclosure of interest

The authors have not supplied their declaration of competing interest.