bluuebunny/crossref_metadata_2025 huggingface dataset:
Low Income Deteriorates Quality of Life in Early Breast Cancer Survivors
Authors: Ristevska G. , Rajchanovska D. , Jovanovska T. , Dejanova B.
Published: June 2017

Background

Patients who have survived cancer and have lower socio-economic status, are more likely to leave the workforce. Financial problems are widespread among many of the breast cancer survivors, but their effect on the quality of life are not sufficiently explored. The aim of this study is to assess the effect of low income onto quality of life in early breast cancer survivors.

Methods

In this study, 214 consecutive early female breast cancer patients, with mean age of 60 years (range 30–90), were interviewed for psycho-social aspects, depression (MINI) and quality of life (EORTC QLQ-Core 30 and BR-23). All patients were cancer free at the moment of interview and all initial oncological treatments were completed. Monthly net family income distribution was: ≤150 euro 58 patients (27.1%); income between 150–500 euro 116 patients (54.2%); ≥500 euro 40 patients (18.7%).

Results

Patients with income ≤150 euro, compared to patients with income ≥500 euro, had statistically significant worse global health status (60.2 ± 27.9 vs. 80.2 ± 19.2; P = 0.0007); worse physical functioning (80.3 vs. 69.1; P < 0.001); worse role functioning (92.9 vs. 78.7; P = 0.009); worse sexual functioning (P = 0.019); more severe fatigue (38 vs. 23; P = 0.01), nausea/vomitus (P = 0.041), appetite loss (18.4 ± 7.5). Major depression was diagnosed in 35 patients. Depressed patients have less income than not depressed patients (23.3% vs. 14.41%), but the difference did not reach statistical significance.

Conclusions

Lower income negatively affects many aspects of quality of life. Specific interventions are needed for cancer survivors with lower socio-economic status to preserve and improve the quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relations of Post-traumatic Growth and Resilience in Cancer Experience
Authors: Uzar Ozcetin Y.S. , Hicdurmaz D.
Published: June 2017

Introduction

Each individual experience cancer in a different way. While some perceive cancer as a complex and traumatic experience by developing some psychosocial and additional physical problems, others overcome cancer-related difficulties by gaining benefits such as post-traumatic growth (PTG) owing to their resilience. Resilience and PTG that are very valuable concepts in human life to adapt positively to cancer process have relations which need to be better understood.

Objectives

We aimed to provide a better understanding of relations between resilience and PTG and relations of these two concepts with cancer experience.

Methods

Literature review.

Results

Successful adjustment to life-threatening illnesses such as cancer, require resilience. On the other hand, resilience provides a barrier toward stressors by helping improvement of PTG and so, is an antecedent factor of PTG. PTG ensures a deeper perspective and strength to people after traumatic events. Hence, individuals having higher levels of PTG feel powerful enough to handle the problems in their life and can easily adapt to cancer process by focusing on the positive outcomes of trauma, having improved coping mechanisms and an improved psychological well-being.

Conclusions

Resilience and PTG have strong mutual relations and this phenomenon should be considered for a qualified cancer care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depression and anxiety among Tunisian medical students “binge viewers”
Authors: Boudali M. , Hamza M. , Bourgou S. , Jouini L. , Charfi F. , Belhadj A.
Published: June 2017

Introduction

Since the advent of online streaming television, a new behavioural phenomenon have emerged among millennial, named “binge watching” that is viewing more than two episodes of a TV show in the same sitting. Whether or not this behaviour reflects emotional difficulties has been poorly studied.

Aims

Describe the phenomenon and search a possible link with depression and anxiety.

Methods

Fifty medical students were recruited. A questionnaire exploring the circumstances, the purpose and the outcome of the binge viewing was fulfilled. The Beck depressive inventory and the state-trait anxiety inventory were passed for the assessment of depression and anxiety.

Results

Among the 50 students questioned, 68% met the criteria of binge viewers and 64.7% of them adopted this behaviour at least once a week with an overall average of screen exposure of 3.8 hours in one sitting. Before the binge watching, 35.3% reported excitement and 29.4% boredom and have used it mostly to pass time (47.1%) and for fun (44.1%). Participants have felt more relaxed and happier after the viewing. Mild depression was found in 10 cases and moderate depression in 5 cases. Anxiety scores averaged 35.38 for state anxiety and 40.32 for trait anxiety. An inverse relationship was found between depression and anxiety scores and the frequency of the binge watching and its exposure duration. The correlation was hover non significant.

Conclusions

Could it be that the binge watching is a means of fighting against anxiety and depression rather than an evidence of emotional difficulties? Further studies are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personality Dark Triad: Portuguese Validation of the Dirty Dozen
Authors: Macedo A. , Araújo A.I. , Cabaços C. , Brito M.J. , Mendonça L. , Pereira A.T.
Published: June 2017

Introduction

The Dark Triad is a term used to describe a constellation of three socially undesirable personality traits: narcissism, psychopathy, and Machiavellianism. Contrary to Altruism (the desire to help others with no personal reward or gain), these traits are harmful to others. Given the increased scientific interest on the dark triad, Jonason and Webster developed a shorter questionnaire to evaluate these three independent-yet-related constructs with only 12 items – Dirty Dozen (D12).

Objective

To investigate the psychometric properties of the Portuguese version of the Dirty Dozen.

Methods

A community sample composed of 286 university students (69.2% females; mean age = 21.09 ± 2.133; range: 17–33) answered the Portuguese preliminary versions of the Dirty Dozen and of the Altruism dimension from HEXACO-100. To study the temporal stability, 30 participants (66.7% females) answered the D12 again after six weeks.

Results

The EA Cronbach alpha was “very good” (a = 0.72). Following Kaiser and Cattel Scree Plot criteria, three meaningful factors were extracted which explained variance (EV) was of 54.64%: F1 Machiavellianism (EV 32.07%; a = 0.73), F2 Narcissism (13.665%; a = 0.74), F3 Psychopathy (8.90%; a = 0.64). The test-retest correlation coefficients were high, positive and significant for the total D12 and its dimensions (r > 0.70; P < 0.001). Pearson correlations of D12 total and dimensional scores and Altruism were negative, moderate and significant (r@ − 0.30).

Conclusions

The Portuguese version of Dirty Dozen has good reliability and validity. It could be very useful both in clinical and research contexts, namely in an ongoing project on the relationship between dark triad and perfectionism traits.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Impact of Parental Schizophrenia in the Development of Behavioral Disorders and Mental Illness in Children
Authors: Alves M. , Rodrigues A.R. , Moreira A.M. , Queirós O.
Published: June 2017

Introduction

Parental schizophrenia will potentially cause dysfunction in mother-child relationships, and it will also cause difficulty in adapting to motherhood.

Objectives

We aim to study the implications of the relationship between mothers with schizophrenia and their children. The psychosocial environment and the impact of dysfunctional relationship in social skills development may cause behavioral disorders in children and further development of severe mental illness taking into account genetic factors and biopsychosocial factors.

Methods

Non systematic literature review, through the Pubmed and Medline database, with time constraints.

Results

The development of schizophrenia is related to genetic and environmental factors. Children of parents with schizophrenia are at increased risk of developing psychiatric disorder compared to the general population. It was found early behavioral disorders, starting between 5 and 8 years old and the difficulties in social interaction may arise at this age and remain until adulthood.

Conclusions

It is important to assess the level of acquisition of social skills in children and families when there is a direct relationship with schizophrenia. It may be important in the future, monitorize the development of these children, as well as be aware of the surrounding social and family environment, to identify and manage early in the presence of behavioral disorders and possible development of serious mental illness. An early intervention at the level of social deficits in children can be a preventive intervention of later schizophrenia development.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Demonstrating the methodology of a pilot programme for establishing a system for mental health promotion in Hungary
Authors: Wernigg R. , Toth M.D. , Sumegi A.
Published: June 2017

Introduction

A 12 month long mental health promotion pilot programme in Hungary, funded by the Norway Grants, will finish on 30th April 2017.

Aims

To launch six community mental health promotion centers (MHPCs) located in various economic environments, supervised by one Methodological Center plus expert teams and carrying out studies on the effectiveness of the launch of the system. The final recommendations will constitute a basis for setting up a national network for mental health promotion.

Objectives

To develop a sustainable model for establishing a national network of MHPCs; to map and record the mental health problems and the stakeholders of the area; to find and assess the local best practices; and to raise public awareness in the following mental health problems: depression, suicide, stress and dementia.

Methods

(1) Models for inducing changes in the knowledge and attitudes upon mental health in the communities were reviewed in a systematic literature search. (2) Based on the results, a model of mental health promotion centers was outlined for problem identification, stakeholder mapping, assessing local best practices, organizing and supporting local networking activities for synergistic effects. (3) In the new MHPCs, on-site TTT education programme and organisational development have been in place. (4) The activities of the MHPCs have been monitored for knowledge transfer and attitude changes in the local networks. (5) Based on the results, recommendations are being made for the national extension of the model.

Results and conclusions

The first data ready for analysis will be available by April 2017.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A rare instance of tardive dyskinesia with SSRI use: A case study
Authors: Roy D.
Published: June 2017

Introduction

Case presentation of a middle aged lady Mrs. C.K., who developed tardive dyskinesia (TD) after a trial of an SSRI.

Case report

A 49-year-old Australian aboriginal lady, presented with involuntary movement of her face (bucco-linguo masticatory), movements after a 3 months trial of sertraline (maximum dose of 100 mg daily) for her depressive illness. There was no history of trials with anti-psychotics or any other medications, which may have caused the oral dyskinesias. Routine examinations including cognitive testing, EEG and MRI revealed no pathological findings. Her sertraline was ceased and she was commenced on mirtazapine 15 mg at night, which was hiked to 30 mg after 1 week and continued on this dose over the next 3 months. She exhibited good improvement in her depressive symptoms and a significant attenuation of her TD's. Involuntary movement scale rating: she was rated on the abnormal involuntary movement scale (AIMS) and showed gradual improvement in the severity of her orofacial dyskinetic movement. Her scores were–initial presentation (scored 22/36); at 4 weeks (9/36); 8 weeks (6/36) and at 16 weeks (4/36).

Discussion

Although TD's are seen in approximately 1 to 5% of mental health patients treated with anti-psychotics (and some other medications like Levodopa, Metochlorpromide, etc.), research studies on SSRI's causing TD's are rare and few (Leo et al., 1996; Gerber et al., 1998).

Conclusions

To alert and educate clinicians about a relatively rare adverse-effect of SSRI producing an involuntary movement disorder.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Psychotherapeutic Iinterventions in Transition Unit
Authors: Asensio L. , Estefania S. , Nuevo L. , Gomez I. , Rodriguez C. , Muñoz V.
Published: June 2017

Introduction.

The In-patient units are very closed and highly controlled healthcare resource and then patients have to join the community rapidly, and in sometimes feeling unprotected and with their needs non covered. We created a transition unit with a program of psychotherapeutic intervention, to offer an adequate transition between the acute episode and the incorporation to the community.

Objective.

We describe the characteristics of the psychotherapeutic group, the aims and the results of the interventions.

Methods.

Psychotherapeutic transition unit was created to offer intensive attention and control demand that is not possible to control in the community. The objects are to prevent re-admissions and relapse because of abandonment of treatment in patient with personality disorder and suicide attempts, and first episode, affective or psychotic. Patients are selected from the in-patients unit with inclusion criteria, and start going from the unit before discharge. The intervention is once per week, with a duration between 60–90 minutes. There is not a number of sessions, and we have approximately 10 patients per sessions.

Results.

Since the beginning of the psychotherapeutic interventions, re-admissions have been decreased in patients with diagnosis of personality disorder (most histrionic and borderline disorder) with multiple admissions because of suicide attempt, some had been discharged. In another group of patient we have prevented relapses.

Conclusions.

Psychotherapeutic interventions will be effective in patients with high risk of re-admissions and relapses. It is early to have solid conclusions, but the preliminary results encourage the continuation of the program.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive Analytic Therapy and Mentalizing Function
Authors: Gimeno E. , Chiclana C.
Published: June 2017

Introduction

Cognitive-Analytic Therapy (CAT) has settled as an integrative approach from Ryle and Kerr's model in the 70's widely accepted in England and Australia, although increasingly European countries have decided to include this model in their public mental health services. Even though its formulation allows the treatment of almost any pathology ensuring good results, it has been traditionally applied to the treatment of personality and eating disorders. Some authors seem to link this efficacy with training in mental states and reciprocal role procedures identification, justifying the improvement through the increase of the reflexive function.

Aim and objectives

The aim of this study is to determine the effect of CAT in mentalizing ability and social functioning in patients attending consultation.

Methods

For this purpose a CAT intervention was performed in 6 adults, administering the Inventory of Interpersonal Problems (IIP-64) and the Mindful Awareness Assessment Scale (MAAS) before and after treatment.

Results

The results show a statistically significant reduction in interpersonal problems, as well as a non-significant increase in the mentalizing ability.

Conclusions

Cognitive Analytic Therapy has shown being effective in increasing social functioning, however we have not been able to demonstrate significantly its efficacy in the reflexive function.

Discussion

Implications in the clinical setting are discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Academic Stress and Emotion Regulation in the Iranian Female Students with High and Low Academic Performance
Authors: Piryaei S. , Mohebbi M. , Khademi Ashkzari M. , Khademi Ashkezari E.
Published: June 2017

Introduction

This paper examines the similarities and differences between academic stress and emotion regulation and investigates that the association between emotion regulation and academic stress may be explained the level of academic success among female students.

Objectives

This research suggests that students vary in their ability to regulate emotions and cope with academic stress, and these abilities may differ across the level of student's academic success. Identifying the academic stress and quality of emotion regulation strategies will lead to practical implications for promoting student's with low or high academic success.

Aims

The present study aims to compare academic stress and emotion regulation in the female students with high and low academic performance.

Methods

A total of 162 high school students (mean age = 15.26) were selected by cluster random sampling method. They were categorized as students with high (87 students) and low (75 students) academic performance by average of their academic performance. Emotion regulation questionnaire, educational stress scale for adolescents and academic performance were administered. One-way MANOVA was conducted on academic stress and emotion regulation.

Results

The results of analysis were significant only for emotion regulation, F (5, 156) = 5.34, P = .001. Mean score of students with low academic performance in the emotion regulation was significantly lower than students with high academic performance.

Conclusions

The extent to which variation in emotion regulation and coping with stress can be considered as a key factor of academic failure/success in educational settings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Vitamin B12 deficiency induced psychosis – a case report
Authors: Carvalho A.R. , Vacas S. , Klut C.
Published: June 2017

Vitamin B12 is one of the most essential vitamins affecting various systems of the body. Cases of neuropsychiatry disorders due to its deficiency are more common in elderly patients with prevalence of 10–20%. The most common psychiatry symptoms reported in the literature associated with vitamin B12 deficiency was depression, mania, psychotic symptoms, cognitive impairment and delirium. Here, we report a case of vitamin B12 deficiency in a 52-year-old male who presented with psychotic features: persecutory delusions, tactile and auditory hallucinations. Patient had neither recorded psychiatry history nor any drug abuse. Medical history includes hypertension, diabetes mellitus and glaucoma. The patient was not a vegetarian. All relevant laboratory evaluations and head CT were normal except vitamin B12. The patient was treated with antipsychotics (risperidone 3 mg/day) and intramuscular vitamin B12. One week after, there was total remission of psychotic symptoms. In the follow-up during the next four months, psychiatry symptoms did not recur at any time. This case reports a rare case of vitamin B12 deficiency induced psychosis. Although there was concurrent administration of an antipsychotic along with vitamin B12, it underlines the importation of evaluation of vitamin B12 and other potential reversible causes of psychosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Rechallenge of clozapine in a low secure setting following pericardial effusion
Authors: Mohandas A. , McCarthy J. , Hartley A. , Fatima E. , Shearman L.
Published: June 2017

Introduction

Clozapine is licensed for treatment-resistant schizophrenia and when clozapine is not able to be used, less evidence based practices may be required. Full remission may require combinations or high doses of psychotropic medications having greater potential for interactions and side effects. If this is not successful, symptoms may persist and long-term disability may occur.

Aims

To explore safety and efficacy of a rechallenge of clozapine in a patient with treatment resistant schizoaffective disorder, who previously developed pericardial effusion. Collateral history reported best improvement with clozapine compared to other medications.

Objectives

To improve level of functioning and reduce need for less evidence based choices of medication.

Methods

Initial consultation with clozapine monitoring service over prospects of rechallenge. Full medication history and review. Consultation with a cardiologist regarding validity of local monitoring strategy. Obtain consent from the patient and his family. Titrate clozapine slowly. Once clozapine initiated, measure temperature, blood pressure, pulse rate and monitoring of symptoms of pericarditis including chest pain, cough and dyspnoea daily. ECG and echocardiography at baseline and 2 and 4 weeks after initiation of the rechallenge. ECGs monthly thereafter, with a further echocardiogram at 3 months. Weekly troponin and CRP for three months to monitor developing myocarditis and pericarditis.

Results

Successful rechallenge of clozapine with significant reduction in psychopathology, improvement in functioning and no adverse events reported. Reduction of risk enabled transfer to open ward conditions.

Conclusions

There is increasing evidence of successful rechallenges of clozapine however, further research is necessary to aid such clinical decisions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Seroprevalence of toxoplasma gondii in Romanian psychiatric patients
Authors: Olariu T.R. , Capraru I.D. , Papava I. , Romosan R. , Dehelean L. , Lupu M.A.
Published: June 2017

Introduction

Toxoplasma gondii infection has been recently associated with schizophrenia and other psychiatric disorders.

Aim

The aim of the present study was to evaluate the prevalence of T. gondii antibodies among acute psychiatric patients from Western Romania.

Methods

This study included 214 consecutive patients admitted at the psychiatric clinic, Country Clinical Emergency Hospital in Timisoara, Romania, between 30.06.2011 and 12.01.2012. Clinical and laboratory investigations were performed in these hospitalized patients, including serologic tests for T. gondii IgG and IgM antibodies.

Results

The 214 patients aged 19 to 71 years (mean = 42.5), 64.9% were females. T. gondii antibodies were detected in 117 (54.7%) of 214 psychiatric patients. When the data were analyzed by diagnostic groups, T. gondii antibodies were demonstrated in 30 (50.84%) of 59 patients with schizophrenia, in 28 (59.57%) of 47 with persistent delusional disorder, 10 (31.25%) of 32 with acute and transient psychotic disorder, 13 (54.16%) of 24 with schizoaffective disorder and 35 (70%) of 50 with bipolar disorder. A high prevalence of T. gondii antibodies was found among patients with bipolar disorder compared to those with schizophrenia (P = 0.043) acute and transient psychotic disorder (P < 0.0001) and healthy controls (P < 0.0001). Of the 18 patients with schizophrenia and a BPRS score <51, T. gondii antibodies were detected in 13 (72.2%) compared to 17 (41.4%) of 41 in whom BPRS score was >51 (P = 0.03).

Conclusion

These findings suggest that T. gondii infection may be associated with several psychiatric disorders. A high seroprevalence of T. gondii was demonstrated in patients with bipolar disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Ultra-resistant schizophrenia and potentiation strategies
Authors: Khouadja S. , Ben Soussia R. , Younes S. , Bouallagui A. , Marrag I. , Nasr M.
Published: June 2017

Introduction

Treatment resistance to clozapine is estimated at 40–70% of the treated population. Several clozapine potentiation strategies have come into clinical practice although often without evidence-based support.

Objective

The aim of our work was to identify the potentiation strategies in ultra-resistant schizophrenia depending on the subtype of schizophrenia.

Methodology

This is a prospective study conducted on patients with the diagnosis of schizophrenia, based on DSM-IV-TR criteria, and hospitalized in the psychiatric department of the university hospital in Mahdia, Tunisia. The study sample consisted of patients meeting the resistant schizophrenia criteria as defined by national institute for clinical excellence (NICE), and the prescription of clozapine for 6 to 8 weeks was shown without significant improvement.

Results

we have collected 10 patients. The mean serum level of clozapine was 462.25 mg/L. The potentiation strategies were different depending on the subtype of schizophrenia. For the undifferentiated schizophrenia, we have chosen ECT sessions. For the disorganized schizophrenia, we opted for amisulpiride and aripiprazole. For the paranoid forms, we have chosen the association of risperidone and ECT. A psychometric improvement was noted in BPRS ranging from 34 to 40%.

Conclusion

Every potentiation strategy entails a cost, whether it is an additional monetary cost, adverse effects or greater stress to caregivers. The cost/benefit equation should be thoroughly evaluated and discussed before commencing a strategy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Predictors of transition to psychosis in individuals at clinical high-risk for psychosis
Authors: Skuhareuskaya M. , Skugarevsky O.
Published: June 2017

Objective

Clinical high risk (CHR) for psychosis state is characterized by presence of potentially prodromal for schizophrenia symptoms. The aim of this study was to assess the predictors of transition to first psychotic episode.

Methods

The study included 123 CHR subjects. All the subjects were characterized by the presence of one of the group of criteria: (1) UHR criteria, (2) basic symptoms criteria and (3) negative symptoms and formal thought disorders (FTD). The presence of FTD in clinical high-risk individuals was assessed with methods of experimental pathopsychology. The mean length of follow-up was 26 months (SD 18). All subjects were males, mean age = 20.2 (SD: 2.1). We examined the subjects’ performance using the Cambridge automated neuropsychological test battery. We applied survival analyses to determine associations between a transition to psychosis and sociodemographic, clinical and neurocognitive parameters. To determine which items are the best predictors, Cox regression analyses were applied.

Results

The psychosis developed in 39 subjects (31.7%). Global assessment of functioning, positive symptoms, blunted affect, social isolation, impaired role function, disorganizing/stigmatizing behavior, basic symptoms (thought pressure, unstable ideas of reference), neurocognitive parameters (visual memory and new learning, decision making, executive function) significantly influenced the transition to psychosis. A prediction model was developed and included unusual thought content (Wald = 12.386, P < 0.0001, HR = 2.996), perceptual abnormalities (Wald = 4.777, P = 0.029, HR = 1.43) and impaired role function (Wald = 1.425, P < 0.028, HR = 4.157).

Conclusion

Clinical measures are important predictors for transition to psychosis in high-risk individuals.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Delayed post-hypoxic leukoencephalopathy: Case report
Authors: Arimany M. Solerdelcoll , Garriga M. , Parellada E.
Published: June 2017

Introduction

Delayed post-hypoxic leukoencephalopathy (DPHL) is an underrecognized syndrome of delayed demyelination, where patients manifest neuropsychiatric symptoms after a period of 2–40 days of apparent recovery from a cerebral hypo-oxygenation episode.

Objectives

We report a case of a patient who successfully recovered from an overdose of heroin, but then suffered a delayed abrupt neurological deterioration.

Aims

To improve assessment and recognition of DPHL.

Methods

An adequate retrospective collection of clinical data and nonsystematic review of the literature was performed.

Results

A 43-year-old male with schizoaffective disorder who attempted suicide with an overdose of heroin, was successfully revived and return to his previously mental status, but 3 weeks after, he abruptly developed progressive cognitive impairment with akinetic mutism and ataxia. He was admitted to our acute psychiatric unit after brain CT and chemistry analyses were unremarkable. Brain MRI showed diffusely symmetric hyperintensity in the white matter (WM), pronominally the periventricular WM, on FLAIR and T2 weighted sequences. At 16 weeks postoverdose, he presented improvement both cognitive and motor symptoms, lasting deficits in frontal-executive functions.

Discussion

DPHL is characterized by similar clinical and neuroimaging features regardless of the initial insult. The mean lucid interval coincides with the replacement half-life for myelin related lipids and proteins. Prolonged mild-to-moderate hypo-oxygenation of WM is thought to disrupt myelin turnover. It appears probable that these were responsible for DPHL in our patient rather than a direct toxicity.

Conclusion

DPHL can be diagnosed when clinical history, laboratory assessments and MRI findings are concordant. DPHL requires extensive support care and carries a relatively good prognosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
“Pseudoneurotic Schizophrenia” Revisited: The role of obsessive-compulsive symptoms in low-level disorganization psychosishosiser
Authors: Tonna M. , Ottoni R. , Paglia F. , De Panfilis C. , marchesi C.
Published: June 2017

Objective

Recent research has suggested a dual impact of obsessive-compulsive dimension on functioning in schizophrenia with a gradual transition from an improving to a worsening effect depending on obsessive-compulsive symptom (OCS) severity (from mild to moderate-severe). Aim of the present study was to investigate whether this varying effect of OCS on functioning might be mediated or moderated by schizophrenia symptom dimensions or occur independently.

Method

Seventy-five patients affected by schizophrenia were administered the SCID-IV, the PANSS, the YBOCS and the SOFAS.

The sample was divided into two groups according to the severity of OCS (absent/mild and moderate/high).

Results

In both groups, a significant interaction between OCS and disorganization dimension was found: the dual effect of OCS on functioning occurred only among patients with low disorganization symptoms while it was no more apparent at higher levels of disorganization (Figure 1).

Conclusion

Data suggest that in patients with schizophrenia, functioning at least in part depends on the interaction between disorganization and OCS. Particularly, mild OCS contributes to higher levels of functioning in patients with psychosis at low levels of disorganization. In keeping with the historical concept of “pseudoneurotic schizophrenia”, we speculate that obsessive dimension might have a pathoplastic influence in milder forms of schizophrenia spectrum disorders, balancing the effect of underlying low disorganization symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impact of postpartum depression on quality of life
Authors: Feki R. , Feki I. , Trigui D. , Baâti I. , Sallemi R. , Masmoudi J.
Published: June 2017

Introduction

Women during the postpartum period experience many physiological, psychological, and social changes. Quality of life (QOL) is a sense of well-being and arises from satisfaction or dissatisfaction with various aspects of life including health, employment, socioeconomic state, psychological-emotional state, and family.

Objectives

The purpose of this study was to identify influence of childbirth experience and postpartum depression on QOL.

Methods

This is a descriptive cross-sectional study regarding 150 postpartum women receiving cares in the hospital of Sfax and examined during the first and the sixth week post-delivery. Data collection tools in this study were demographic questionnaire, Edinburgh Postnatal Depression Scale (EPDS), and world health organization quality of life-bref (WHOQOL-bref). Data were analyzed using SPSS.

Results

The mean age of our sample (n = 150) was 29.61 years. During the sixth week study period, 126 of 150 were examined.

A personal psychiatric history of depression was found in 9.3% of cases.

The current pregnancy was undesired in 15.3% of cases.

The prevalence of postpartum depression in the first week was 14.7% and 19.8% in the sixth week after delivery.

The mean score of quality of life was 81.62 ± 9.09.

Scores of quality of life and all its dimensions were significantly lower in depressive women.

Conclusion

Because enormous changes develop in postpartum women, we suggest supportive measures for mother by her mother-in-law family, and caregivers to improve the QOL and health status of the mother and her child and to prevent postpartum depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Metabolic Syndrome in Patients with Bipolar Disorder Treated with Atypical Antipsychotics, their First-degree Relatives and Control Group
Authors: Arya S. , Ahmadkhaniha H. , Arya B.
Published: June 2017

Introduction and objective

Patients with serious mental illness have lower life expectancy and higher prevalence of metabolic syndrome compared to normal population. Although, we have little evidence about their first-degree relatives.

Aims

To compare metabolic syndrome in patients with bipolar disorder treated with atypical antipsychotics, their first degree relatives and healthy subjects in two age groups: under and over 40.

Methods

This cross-sectional study was conducted on 100 patients with bipolar disorder treated with atypical antipsychotics, 50 first degree relatives and 135 healthy subjects. The prevalence of metabolic syndrome was assessed based on National Cholesterol Education Program (NCEP).

Results

Under the age of 40, the prevalence of metabolic syndrome was 15.4% in patients with Bipolar disorder, 17.6% in first degree relatives and 7% in healthy subjects. Systolic blood pressure was significantly higher in bipolar disorder patients (P = 0.004). In those over 40, the prevalence of metabolic syndrome was 31.8% in patients with bipolar disorder, 33.3% in first-degree relatives and 32.8% in healthy subjects. Serum levels of HDL were significantly lower in bipolar disorder patients (P = 0.002).

Conclusion

Patients with bipolar disorder and their first-degree relatives have greater chance for cardiovascular disease due to higher metabolic syndrome. Further investigations are needed for evaluating serious mental illness patients and their relatives.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association Between HbA1c and Number of Episodes in Individuals with Bipolar Disorder
Authors: Fellendorf F.
Published: June 2017

Introduction

Bipolar disorder (BD) is associated with an impaired glucose metabolism (IGM) leading to diabetes mellitus Type II (DM). DM influences the medical state of BD individuals and leads to increased mortality. However, there is evidence that IGM is associated with psychiatric symptoms, as well.

Aim

The study aimed to investigate the association between IGM and number of episodes and their ratio in individuals with BD, separated for gender.

Methods

HbA1c levels from fasting blood were measured of 162 individuals (46% females) with BD. Furthermore, clinical parameters e.g. number of depressive and (hypo)manic episodes were gathered.

Results

After adjustment for illness duration and BMI there was a positive correlation in male individuals between HbA1c and number of depressive (M = 13.86, SD = 14.67; r = .308, P < 0.05) as well as (hypo)manic episodes (M = 17.23, SD = 24.24; r = 0.263, P < 0.05). There was no association in females as well as between HbA1c levels and ratio of episodes.

Conclusion

Associations between HbA1c and number of episodes in male individuals with BD were found. As there are correlations between IGM and somatic comorbidities as well as the course of illness the treatment of glucose metabolism is important in BD. However, number of episodes might have an impact on the glucose metabolism due to inflammation processes, but further investigations have to focus on the direction of the found correlation. As gender differences are known in different pathways, they should be considered in research, diagnosis and therapy.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
E-Mental Health Interventions for the Treatment of Gambling
Authors: Dom G. , Snippe L. , Willemen R. , Wiers R. , Boffo M.
Published: June 2017

Gambling Disorder (GD) is a complex psychopathological phenomenon, characterized by the interaction of multiple etiological factors and a very heterogeneous symptomatological expression. Currently many questions remain concerning the best way of treating GD. Indeed, the traditional used (cognitive) behavioral interventions have at best a modest effect size. In addiction, there remains a large treatment gap, i.e. less than 10% of pathological gamblers ever seek help and enter treatment. E-health interventions could potentially help to close this gap. Cognitive bias modification (CBM) refers to a class of cognitive training paradigms that target specific automatic attentional, behavioral or evaluative biases triggered by addiction-related cues. These biases have repeatedly been shown to play an important role in addiction. Recently a number of studies have shown that modifying these biases has been effective in the treatment of different types of addictions, e.g. alcohol use disorders. An online Approach Bias Modification program, testing both Attention Bias Modification (ABM) and Approach Bias Modification (AppBM), is currently tested with Belgian and Dutch problem and disordered gamblers. Personalized motivational feedback has been added to the training program, to increase training adherence and prevent dropout. The same research group is also launching a second web-based study combining online AppBM with an online standard, protocoled, cognitive behavioral Therapy (CBT) program with guidance of a trained therapist. Participants receive nine CBT sessions through online chat with the therapist and, concurrently, nine sessions of AppBM. Preliminary results will be discussed.

Disclosure of interest

Member Advisory board Lundbeck-Belgium.

Received grant from LOTTO- Belgium to conduct behavioural study that will be discussed in presentation
Emotional Face Recognition in Bipolar Disorder
Authors: Homorogan C. , Adam R. , Barboianu R. , Popovici Z. , Bredicean C. , Ienciu M.
Published: June 2017

Introduction

Emotional face recognition is significant for social communication. This is impaired in mood disorders, such as bipolar disorder. Individuals with bipolar disorder lack the ability to perceive facial expressions.

Objectives

To analyse the capacity of emotional face recognition in subjects diagnosed with bipolar disorder.

Aims

To establish a correlation between emotion recognition ability and the evolution of bipolar disease.

Methods

A sample of 24 subjects were analysed in this trial, diagnosed with bipolar disorder (according to ICD-10 criteria), who were hospitalised in the Psychiatry Clinic of Timisoara and monitored in outpatients clinic. Subjects were introduced in the trial based on inclusion/exclusion criteria. The analysed parameters were: socio-demographic (age, gender, education level), the number of relapses, the predominance of manic or depressive episodes, and the ability of identifying emotions (Reading the Mind in the Eyes Test).

Results

Most of the subjects (79.16%) had a low ability to identify emotions, 20.83% had a normal capacity to recognise emotions, and none of them had a high emotion recognition capacity. The positive emotions (love, joy, surprise) were easier recognised, by 75% of the subjects, than the negative ones (anger, sadness, fear). There was no evident difference in emotional face recognition between the individuals with predominance of manic episodes than the ones who had mostly depressive episodes, and between the number of relapses.

Conclusions

The individuals with bipolar disorder have difficulties in identifying facial emotions, but with no obvious correlation between the analysed parameters.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Burden of care of the caregivers of Alzheimer's disease patients and relationship with burnout syndromes
Authors: Yildizhan E. , Ören N. , Erdoğan A.
Published: June 2017

Introduction

Increased caregiver burden and burn out in Alzheimer disease is associated with a spectrum of problems, like depression or anxiety.

Objectives

To examine the relationship between the burden of care and burnout level of professional staff dealing with Alzheimer's disease patients in geriatric inpatient centers in Turkey.

Methods

Zarit Caregiver Burden Scale to measure the level of burden of care, and Maslach Burnout Inventory were used to measure the level of burnout. Relationships between the socio-demographic data of the sample group, burden of care and burnout level were investigated. Sample group was consisting of 203 caregivers working in 8 geriatric care centers in Istanbul.

Results

The surveyed caregivers’ “burden of care giving” level was low (35.3 ± 9.9); “emotional exhaustion” level was weak (2.3 ± 0.8); “depersonalization” level was weak (1.9 ± 0.6); “a feeling of low personal accomplishment” level was weak (2.5 ± 0.8); “general burnout” level was weak (2.3 ± 0.5). There was positive correlation between caregiver burden and burnout level. According to the sociodemographic data, married women with children were especially in increased risk for burnout. Low level of education was associated with increased caregiver burden and burnout. Caregiver burden and depersonalization points were also higher with increasing age.

Conclusions

Supportive interventions are needed to decrease the burnout and caregiver burden especially for the caregivers with increased risk.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Improving recruitment in psychiatry: The impact of a psychiatry summer school on attitudes towards psychiatry in medical students and foundation doctors
Authors: O’Prey C. , Hyland D. , O’Flaherty C. , Bramham G.
Published: June 2017

Introduction

In 2011, the Royal College of Psychiatrists in UK published a five-year plan to boost recruitment to a 95% fill rate for core training posts. Psychiatric summer schools were one of the methods outlined to improve recruitment. These are 3-day courses allowing attendees to explore different subspecialties and showcase inspiring psychiatrists who are leaders in their field.

Aims

To evaluate whether attending a Psychiatry Summer School improves scores on the attitudes towards Psychiatry Scale (ATP-30) in Medical Students (MS) and Junior Doctors (JD).

Methods

Two free courses were held; one for MS in August 2016 and one for JD in November 2015. These involved interactive talks from consultant psychiatrists in various sub-specialties and a day in a forensic setting. All attendees were asked to complete ATP-30 before and immediately after attendance. A higher ATP-30 score indicates a more positive the attitude the minimum score is 30 and the maximum is 50. Paired scores were analysed using a paired t-test.

Results

Thirty-three out of 45 attendees completed ATP-30 MS (n = 20/24) and JD (n = 13/21) before and after the course. The mean ATP30 score was 116 before attendance and 128 after the course, the mean difference was +12. When the two samples were compared using a paired t-test, there was a significant positive difference P < 0.0005.

Conclusions

Psychiatry summer schools can improve attitudes towards psychiatry in medical students and junior doctors.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Efficacy and safety of MIN-101: A new drug for the treatment of negative symptoms in schizophrenia a 12-week randomized, double blind, placebo-controlled trial
Authors: Luthringer R.
Published: June 2017

Objective

To compare the efficacy, safety, and tolerability of MIN-101, a compound with high affinities for sigma 2 and 5-HT 2A receptors, to placebo in treating negative symptoms, in stabilized patients with schizophrenia.

Methods

This multi-national phase 2b trial enrolled 244 patients with schizophrenia who were symptomatically stable for ≥ 3 months prior to entering the trial and had scores ≥ 20 negative subscale of the PANSS. Patients were randomized to monotherapy with MIN-101 32 mg/day, MIN-101 64 mg/day or placebo in a 1:1:1 ratio. The primary endpoint was the PANSS negative symptom score based on the five factors (pentagonal) model.

Results

Statistically significant reduction in the primary endpoint score was demonstrated for MIN-101 32 mg and 64 mg compared to placebo (P ≤ 0.022, ES 0.45 and ≤ 0.003, ES 0.58, respectively). This was supported by similar effects on most of the secondary measurements including: the PANSS three factors negative symptoms subscale, PANSS total score, CGI, BACS, CDSS, and PSP. There were no statistically significant differences in PANSS positive subscale scores between MIN-101 and placebo. No weight gain or clinically significant changes in vital sings, prolactin levels, routine laboratory values, metabolic indices and extrapyramidal symptom scores (EPS) were observed.

Conclusions

Since positive symptoms and EPS did not change, the improvement in negative symptoms was not secondary to improvement in positive symptoms or EPS, suggesting that MIN-101 might be the first specific treatment to have a direct effect on negative symptoms.

Disclosure of interest

I have received consultant fees from Minerva Neuroscience the sponsor of this trial and own stock of Minerva Neuroscience