bluuebunny/crossref_metadata_2025 huggingface dataset:
Dementia or Mania
Authors: Gomez C. , Rodriguez V.
Published: June 2017

Background

In the clinical practice we encounter different clinical situations that require precise differential diagnosis and special treatment. This poster reviews the diagnosis and pharmacotherapy of two cases that points out how likely is to confuse the diagnosis of two apparently different pathologies, as are bipolar disorder and frontotemporal dementia. We study and compare two cases that were hospitalised in the psychiatric ward of Sant Joan's Hospital. Following their treatment and evolution. The first case is a 75-years-old man that presented behavioural changes, hypomania, and insomnia without previous known psychiatric history other than alcoholism. The family explained a history of episodes of mood changes going from depression to mania, compatible with a bipolar diagnosis never diagnosed, and the neuropsychological exam that was performed did not show any cognitive impairment finally receiving a diagnosis of bipolar disorder after the good response to the lithium treatment. In the second case we have a 58-years-old man with behavioural disturbances and mood fluctuation that changes from short periods of hypomania with disinhibition and insomnia to a predominance of hypothymia, apathy and self-care negligence, which received at the beginning a diagnosis of bipolar disorder and that after the proper complementary tests was shown to be a frontotemporal dementia.

Conclusions

When facing behavioural and mood changes in advance age in the absence of psychiatric history we should take into account the considerable percentage of patients with a final diagnosis of frontotemporal dementia that received previously a mistaken diagnosis of bipolar disorder and vice versa.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive Symptoms: The Border Between Dementia and Depression, a Report of One Case
Authors: Juncal Ruiz M. , Porta Olivares O. , Blanco Sánchez L. , Landera Rodríguez R. , Gómez Revuelta M. , Santayana Jenaro G. Pardo de , Núñez Morales N.I. , Martín Gutiérrez R. , Pérez Santos A.B. , Fernández-Abascal Puente B.
Published: June 2017

Introduction

Twenty percent of people aged over 80 have a serious dementia. Cognition disturbances are present both in depressive disorder and dementia. Vortioxetine is a new antidepressant with a multi-modal mechanism of action, being one of the antidepressant with more procholinergic action.

Aims

to know the efficacy of vortioxetine in elder people with cognitive disturbances due to both pathologies: depression and dementia.

Methods

It is described the result of using vortioxetine in one elder woman with dementia and affective symptoms with no clinical improvement after using two classical antidepressants.

Results

Woman aged 82 without psychiatric history came to our consultation in April 2016. She had been diagnosed with dementia last year by a neurologist and she had started treatment with Donepezile 10 mg/d. Six months after this diagnosis she complained of depressive mood and faster deterioration of her previous cognition disturbances in terms of functionality level and autonomy, so her neurologist prescribed escitalopram until 10 mg/d and mirtazapine until 30 mg/d without clinical improvement. After first exploration, we decided starting treatment with vortioxetine 10 mg/d and withdraw previous antidepressants. Next week she complained of nausea and vomiting so we reduced the dose to 5 mg/d with good tolerance after that moment. Six months later her depressive mood had improved and her family remarked she had a little more autonomy and more desire to do things.

Conclusions

Vortioixetine might be an effective and safe option in elder people who have cognitive disturbances due to mood disorder and/or dementia, probably because of its procholinergic action.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Elderly Diabetic Patients: Depression and Adherence to Treatment
Authors: Mendes R. , Martins S. , Fernandes L.
Published: June 2017

Introduction

Demographic changes with the aging of the worldwide population imply an increase in prevalence of chronic diseases, such as diabetes mellitus. Many studies have suggested that depression is higher in diabetic patients, and that this association often contributes to under-recognition of the illness, limiting adequate metabolic control.

Aims

To study the association between depression and adherence to treatment in elderly diabetic patients.

Methods

A cross-sectional study was conducted with elderly outpatients (≥65 years) from the Internal Medicine Department in São João Hospital (CHSJ, Porto). Patients unable to communicate were excluded. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale/HADS, and adherence to treatment with a clinical interview and from medical records.

Results

The final sample included 78 patients, with an average of 75.3 (sd = 6.75) years. They were mostly female (80%), married (66.7%) and with low education level (62.8%). The mean number of comorbidities was 5.76 (sd = 1.6) and 98.7% took ≥5 drugs. In this sample, 23.1% had cognitive impairment, 16.7% depression and 24.4% anxiety. Patients not adhering to treatment presented a higher depression score, when compared with adherents (median 6vs3), even without statistical significance (P = 0.56).

Conclusions

Diabetic patients not adhering to treatment tend to present more depression, in spite of the lack of statistical significance. These results suggest that depression can limit the adherence to treatment, which is in line with previous studies. In this context, the early diagnosis and treatment of depression seems to be an important target in the management of diabetes, particularly in elderly patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Review of Association Between Delirium and Dementia in Elderly People
Authors: Pereira R. , Martins S. , Fernandes L.
Published: June 2017

Delirium is a neuropsychiatric syndrome, characterized by an acute change in mental status with a fluctuating course of symptoms, that affects almost 50% of people aged 65 years or older, admitted to hospital. Delirium is associated with negative outcomes, including increased risk of mortality, cognitive and functional decline. In 50% of the cases, the cause of delirium is multifactorial, resulting from a complex inter-relationship between several predisposing factors (e.g. advanced age, dementia) in highly vulnerable patients that are exposed to precipitating factors (e.g. infections). In this context, cognitive impairment and dementia are important risk factors for delirium, increasing its risk by two to five times, associated with worse outcomes. The underlying brain vulnerability of these patients with dementia may predispose to the development of delirium, as a consequence of insults related to the acute medical disease, medication or environmental factors. On the other hand, delirium may cause permanent neuronal damage, which may lead to the development or worsening of a pre-existing dementia. As a result, delirium and dementia frequently coexist and overlap, challenging differential diagnosis.

The identification of risk factors for delirium, specifically pre-existing cognitive impairment or dementia, in elderly people admitted to hospital is essential to the implementation of preventive strategies that may contribute to the decrease of delirium rates. The present literature review aims to highlight the association between delirium and dementia in elderly people, focusing on diagnosis, pathophysiology, prevention, and management.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Attitudes and Practices of General Practitioners Towards Elderly Patients with Cognitive Deficits
Authors: Masmoudi R. , Feki I. , Trigui D. , Baati I. , Sellami R. , Masmoudi J.
Published: June 2017

Background

Tunisia has experienced a considerable increase in degenerative diseases associated with aging including in particular dementia and Alzheimer's disease.

Objectives

To evaluate the diagnostic procedures of cognitive impairments in general medicine and to identify obstacles concerning the early diagnosis of dementia in these patients.

Methods

An email questionnaire was sent to a sample of general practitioners (GPs) working in the Sfax region, Tunisia.

Results

We received 55 answers. When facing a mnesic complaint, 20% of GPs perform a screening of cognitive disorders. Among reasons leading to early identification, memory complaints (76.4%) was the most mentioned by GPs surveyed. the Mini Mental State was the most used (34.5%) by general practitioners. Twenty-nine point one percent (29.1%) of physicians conducted a comparative assessment 6 to 12 months later if the initial evaluation was normal and 83.6% send the patient to a specialist in case of a detected disorder. For GPs, in 58.2% of the cases, the major impediment is the lack of time, in 32.7% of the cases it is patient's and family's denial and in 23.6% of the cases it is the absence of effective medical treatment. A cross analysis shows that GPs who have had further training in geriatrics have a better approach.

Conclusion

Our study shows a lack in the early identification of cognitive impairment in the elderly by GPs. Develop simple cognitive tests, reinforce training of doctors and promote research to develop new drugs would improve early diagnosis and management of dementia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Girls Spend More Time to be Generous in First Offer
Authors: Aarabi Sobhan , Brazegar Ebrahim , Shayetehfar Monir
Published: June 2017

Introduction

Fairness is a fundamental factor for prosocial behaviors and have a crucial role in social interaction. Examining fairness during maturation can shed light on different questions and hypothesis about the development of prosociality across life span.

Objectives

The purpose of this study was to investigate the development of strategic planning in children and adolescents.

Methods

A total of 288 healthy students between ages 7 and 18 from four community schools participated in a one-shut run game which the participants were proposed and should set a package of offers concluded six suggestions.

Results

Among 288 students, 128 (44.44%) participants were male and 160 (55.56%) participants were female. In first offer, 29.7% of boys suggested an unfair offer but girls with 23% were more generous. However, in last suggestion in comparison with girls (73% unfair), boys showed more generosity (64% unfair). Notably, girls in average, spent 135.78 seconds (SD = 86) to set their offers while boys needed less time to prepare their suggestions (117.16s, SD = 119.7)

Conclusion

According to the findings it seems that both genders start more generous offers and end up with less generous offers. In comparison with boys, girls need more time in economic decision-making and interestingly more fair options at the start of game.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Use of a Telemedicine Model and its Logistics to Reach as Many European Refugees as Possible
Authors: Mucic D.
Published: June 2017

Current refugee crisis challenges mental health care systems all over the Europe. There is a number of research describing difficulties in dealing with cross-cultural patients. Access to relevant care as well as its availability are often limited due to: a) lack of respective qualified resources b) linguistically, cultural and even racial barriers in addressing of mental health care needs of cross-cultural patient population. By use of various e-Mental health applications, primarily videoconference, we may improve assessment and/or treatment of refugees and asylum seekers on distance e.g. Arabic speaking psychiatrist located in Sweden would be able to assess and/or treat refugees from Syria located in Germany). Specialized centers for treatment of refugees would also be able to get second-opinion service from remote experts and use it in order to confirm or re-consider diagnosis as well as the treatment options. Establishment of international network of cross-cultural experts enables to:

– Improve the mental health care across national boundaries by providing psychiatric consultations to other countries within EU

– Conduct International Treatment Team with Select Skills (e.g. Sign Language and Many Foreign Languages Staff)

– Provide Distance Supervision and Staff Consultation

– Provide Psycho Education of caregivers

– Improve Distance Learning via Case Conferencing and Best Practice Demonstration Across the National Boundaries

– Create Data Base over cross-cultural and other select skills professionals within EU

Disclosure of interest

The author has not supplied his declaration of competing interest.
Mental Health of Roofless and Squatter Population in North Catalonia
Authors: Calvo F. , Giralt C. , Carbonell X.
Published: June 2017

Introduction

Homelessness is a phenomenon, which is hard to limit, as it contemplates different situations including roofless and squatters.

Objective

To determine the presence of these homeless categories in the city of Girona and examine the prevalence of diagnosed mental pathology and its principal socio-demographic characteristics.

Methods

Transversal, observational and analytic study of the population of roofless people and squatters. The registers of the outreach street work team, the local police and the public shelter were used in order to detect the cases and their basic socio-demographic characteristics. The clinical record of the mental health and addiction public network was accessed to determine their diagnosis.

Results

During the 6 years of registers, 781 cases of people in situation of roofless and squatters were detected. In total, 83.2% (n = 630) of the cases were men and 16.8% (n = 131) women. The average age was 44.8 (ED = 11.2) and no differences were found regarding gender (Men = 45.3, ED = 11.0 vs. Women = 42.9, ED = 12.2; t = 1.7, df = 405, P = 09). However differences were found regarding origin (Immigrants = 42.2 years, ED = 10.3 vs. Natives = 46.8 years, ED = 11.4; t = -4.2, df = 402, P < .001). A total of, 52.9% of the cases (n = 412) displayed diagnosed mental pathology and 15.8 (n = 123), dual pathology.

Conclusion

Mental pathology is more prevalent among this typology of homeless people than in general population, as other studies prove.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychogenic polydipsia: A case report
Authors: Erzin G. , ozdel K. , Karadağ H.
Published: June 2017

Introduction

Psychogenic or primary polydipsia characterized by excessive thirst and compulsive water drinking is a common problem among psychiatric populations, affecting 6% to 20% of patients. It is frequent in chronic psychiatric diseases, particularly schizophrenia. We report a patient with excessive thirst and diagnosed as PIP syndrome.

Case

A 54-year-old, married, female patient had normal vital signs. She has excessive water intake (10–12 L/day). She did not have edema, signs of dehydration or fever. The neurological examination, CT, MRI, and EEG was normal. The laboratory tests were normal. She had started using sertraline 100 mg, 7 months ago due to anxiety disorder. There is not any disease except the anxiety disorder, which is in remission due to the treatment. A total of, 2 μg desmopressin I.M. is applied in fluid restriction test. The urine density is determined as 1.008 mg/dL initially, 1.011 mg/dL one hour later, and 1.013 mg/dL two hours later in the urinary test. The diagnosis is psychogenic polydipsia (primary) according to patient history, the clinical examination, and the test results. The patient is recommended to continue the sertraline 100 mg treatment, and also assigned with fluid restriction behaviour.

Conclusion

Since excess water intake periods are correlated with psychotic exacerbations; psychosis and polydipsia might have similar physiopathologic mechanisms. Polydipsia might be due to anti-cholinergic side effect of some psychiatric drugs. The physiopathology of the polydipsia and polyuria is not totally enlightened in the psychiatric disorders. In some cases, the fluid intake occurs completely voluntary. Therefore, we decided to present this case.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental flexibility and problem solving in adult patients who present non-suicidal self-injury
Authors: Garreto A.K. , Giusti J. , Oliveira M. , Tavares H. , Rossini D. , Scivoletto S.
Published: June 2017

Introduction

Non-Suicidal Self-Injury (NSSI) is considered a dysfunctional way of dealing with problem situations.

Objective

This study aimed to investigate the problem solving capacity in adults with NSSI compared to controls.

Methods

Thirty-three patients who sought treatment for NSSI (NSSI group) were compared with 33 individuals without psychiatric disorder (control group). We also investigated Axis I disorders, executive functions and problem solving capacity.

Results

In both groups, the majority were women (77.25%) with a mean age of 30 years, and the beginning of NSSI behavior of 16 years. The most common NSSI behaviour was skin cutting, and the most common reason given for engaging in that behaviour was “to stop negative feelings”. The most common psychiatric comorbidities were major depressive disorder (60.6%). Compared to controls, the group with NSSI showed lower results in relation to problem solving capacity (P = 0.000) and mental flexibility (P = 0.007). Deficits in problem solving capacity may be a reflection of low mental flexibility of adults with NSSI. This may be a risk factor for the beginning of NSSI and the persistence of it in adulthood.

Conclusion

Early identification and treatment focused on problem solving capacity during the adolescence may prevent the chronicity of NSSI.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Academic burnout and personality traits in Korean medical students
Authors: Chae H. , Lee S.J.
Published: June 2017

Objectives

Personality was shown to play an important role for well being under academic stress. The purpose of the present study was to evaluate how temperament and character traits predict academic burnout in Korean medical students.

Methods

One hundred and seventy-eight Korean medical students completed the Cloninger's temperament and character inventory (TCI) at the beginning of semester and Maslach burnout inventory-student survey (MBI-SS) was also measured around the final exam when academic stress and burnout is at the highest. The correlation between TCI and MBI-SS was examined and stepwise regression analysis was performed to measure how well personality traits predict academic burnout level.

Results

The MBI-SS total burnout score was correlated positively with harm-avoidance (r = 0.247, P < 0.05) and negatively with self-directedness (r = -0.296, P < 0.001) and Cooperativeness (r = -0.169, P < 0.05) scores. The regression analysis showed that the harm-avoidance (β = 0.269, P < 0.001) accounted for exhaustion score and the self-directedness explained the Total burnout score (β = -0.296, P < 0.001) and Inefficacy score (β = -0.284, P < 0.001). The Cynicism score was accounted for high Novelty-Seeking (β = 0.150, P < 0.05) and low Cooperativeness (β = -0.182, P < 0.05).

Conclusion

This study showed that the Cloninger's temperament and character might explain the burnout level from the stressful medical education. The temperament of novelty-seeking and harm-avoidance could provide the susceptibility to the academic burnout and the character of self-directedness and cooperativeness might determine the resilience to the negative influence of academic stress.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Women's personal and political identities in selected Middle East countries
Authors: Lu S.F.
Published: June 2017

Introduction

Women's personal and political identities are significant in defining their roles and eventual contribution to society in contemporary society both in the private and public spheres.

Objectives

This research study focuses on the effect of Islam on women's personal and political identities.

Aims

This research aims to highlight the existing ideology relating to women's treatment in regards their identities and public roles, and hence to contribute to women's emancipation.

Methods

This study utilizes quantitative and qualitative methods in analysing women in eight Muslim-majority countries, namely, Iran, Turkey, Egypt, Saudi Arabia, Jordan, Yemen, Cyprus and Kuwait, in the Middle East. For the quantitative data, statistical dataset was culled from Inter-university consortium for political and social research of the university of Michigan.

Results

The overall results show that historical constructions of gender spheres are still palpable in the Islamic landscape. Woman's question is identified as a complex personal and social problem, and cannot be rejected as a valid search for gender sameness or equality. This study also shows the interpolation of Islam with other factors such as patriarchy, modernization, and state formations. Some Muslim scholars argue that Quran's fundamental mooring is geared towards equality between men and women, and women's enhanced status, and it is patriarchy that has confined women to the domestic sphere.

Conclusion

Gender is embedded within culture, and structures of power in families, communities, and states, which have gender in itself, as an organizing principle.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The evaluation of emotional labor and emotional self-efficacy on burnout among nurses
Authors: akgün B. mala. , Öz F.
Published: June 2017

Introduction

Nurses are required to manage their emotions, like being empathetic. Emotion management requires emotional self-efficacy and emotion labour, because learning how to it takes effort. If emotional labor is not managed effectively by nurses, burnout will occur among nurses.

Objectives

To evaluate the emotional labor, emotional self-efficacy and burnout levels of nurses.

Methods

Clinic nurses of Hacettepe university hospitals constituted the population of this study. Nursing information form, emotional self-efficacy scale, emotional labour Scale and Maslach Burnout Scale were applied to participating 350 nurses.

Results

It was found out that nurses went through high level “emotional exhaustion”, medium level “depersonalization”, low level “personal accomplishment” and had medium level emotional self-efficacy sense. It was determined that there was a positively relationship between emotional labor and its sub-dimensions surface acting and emotional effort and depersonalization levels, also there was same relationship between surface acting and emotional exhaustion. There was a negative relationship between emotional self-efficacy sense and emotional exhaustion and depersonalization but there was a positive relationship in personal accomplishments. There was a positive relationship between emotional self-efficacy sense between deep acting, emotional effort and suppression of real emotions. Additionally, discrepancies were found in burnout levels of nurses according to sociodemographic, their working and choice of profession characteristics (P < .05).

Conclusions

To prevent and cope with burnout; it has been proposed that awareness training programmes and course contents about emotional management, emotional self-efficacy and emotional labour should be arranged.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Socio-demographic and clinic characterization in youth psychiatric outpatients: An observational study
Authors: Morais S. , Silva Ribeiro J. , Oliveira P. , Mendes E. , Botelho A. , Godinho H. , Vale L. , Bessa A. , Renca P. , Santos V. , Madeira N.
Published: June 2017

Introduction

Most mental disorders begin during adolescence and early adulthood (18–24-years-old), highlighting the importance of understanding the onset and progression of mental disorders among youths. Although progress has been made, namely by creating youth mental health transition services, gaps continue to exist. Locally, our recently constituted young adults unit aimed to minimize discontinuities in care.

Objectives/aims

To characterize a population of young adult psychiatric outpatients, regarding socio-demographic and clinic variables.

Methods

Socio-demographic and clinic characterization of young adult psychiatric outpatients observed during 1st January 2015–30th July 2016.

Results

Two hundred and fifty-five outpatients were observed: 64.3% females and 35.7% males, average age 20.56-years-old (median 20). Most lived in urban areas (59.4%), with their parents (27.8%), were students (80.4%), attending secondary school (36.1%). A total of, 27.5% were referenced by an emergency department, and adjustment disorders (ICD-10 F43.2) were the most frequent diagnosis (21.6%). Regarding suicidal behaviours and self-harm, 9.8% did self-cutting. A vast majority did not have previous psychiatric hospitalizations–only 5.9% outpatients had at least one. In total, 39.8% were medicated with antidepressants (1/3 of which in association with other drugs), and about 38.8% received cognitive-behavioural interventions. About 2/3 of patients (66.3%) remained in care and only about 1/6 (15.7%) were discharged.

Conclusions

Our typical youth psychiatric outpatient was of female gender, student, living with its parents. Adjustment disorders were the most frequent diagnosis, and antidepressants were the main psychopharmacologic option, often combined with other psychotropic drugs. In the future, psychotherapy interventions should be more widely available, namely group psychotherapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Descriptive study of the first consultations in a mental health unit
Authors: Bobadilla E. , Quiroga C.
Published: June 2017

The profile of patients cared for in a mental health unit is diverse. However, there are recurring features. In this study, a total of 100 patients were evaluated for 2 months. This study describes the socio-demographic aspects, the reason for the consultation, the psychiatric history, the diagnoses, the previous treatments and the presence of previous admissions in a psychiatric hospitalization unit. Knowledge of the patient profile will improve service delivery.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personality traits and emotion recognition abilities in two samples of Romanian medical students
Authors: Romosan A.M. , Dehelean L. , Romosan R.S. , Manea M.O.
Published: June 2017

Introduction

Personality traits and social cognition are important predictors for the future performance, success, adjustment and mental health of medical students.

Objectives

The purpose of the study was to assess and compare personality traits and emotion recognition abilities of two medical student samples: general medicine (GM) and general nursing (GN) students.

Methods

The study was conducted between 2015–2016 on 173 Romanian medical undergraduates from the Timisoara “Victor Babes” university of medicine and pharmacy: sixth-year GM students (n = 96) and fourth-year GN students (n = 83). Personality traits were evaluated with the 60-item NEO five-factor inventory (NEO-FFI). Emotion recognition abilities were assessed with the revised version of the “reading the mind in the eyes” test.

Results

The GM sample consisted of 31 (32.3%) males and 65 (67.7%) females, with a mean age of 24.65 years (SD = 1.81). The GN sample was comprised of 13 (15.7%) males and 70 (84.3%) females, with a mean age of 23.84 years (SD = 2.12). Overall, compared with female students, males gave considerably less correct answers in the “eyes test” (P = 0.002) and had lower mean scores in “agreeableness” (P = 0.005). GM students scored significantly higher than GN students in “neuroticism” (P = 0.01), obtained lower mean scores in “agreeableness” (P = 0.015) and had poorer emotion recognition abilities (P = 0.03) than their GN colleagues.

Conclusions

GN students appear to be more emotionally stable and with better emotion recognition abilities than GM students. Results of the present study represent a starting point for other studies that may use larger and diverse student samples.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Which one is the best anaesthetic agent for Ect?
Authors: Garcia H. Saiz , Reula L. Montes , Fernandez A. Portilla , Sanchez V. Pereira , Lopez N. Olmo , Heredero E. Mancha , Enriquez A.S. Rosero , Parreño M.E. Martinez
Published: June 2017

Introduction

The most frequently used anesthesiologic agents are methohexital, thiopental, etomidate, propofol, ketamine, and sevoflurane. The objective is to clarify the differences on recovery, cardiovascular variables, cognitive functions, and response to treatment showed by these drugs.

Methods

A review was conducted aiming to clarify the differences between anaesthetic agnets used in ECT. The literature search was conducted in PubMed data reviewing articles dating between 2015 and 2016.

Results

– Propofol seems to have better hemodynamic effects in comparison with etomidate in patients with schizophrenia and depression;

– The seizure duration was significantly shorter with propofol, but this did not cause a difference regarding clinical improvement;

– The seizure duration was longer with etomidate in many studies. It did not decrease in a dose-dependent fashion with etomidate in a study comparing methohexital, etomidate, and propofol;

– The most frequently observed adverse effects were arrhythmias and nausea and they occurred more frequently in patients who were given thiopental. The pain at the injection site was more frequent in patients who were given propofol;

– Etomidate seems to have better clinical improvement than thiopental. Thiopental seems to have better results than propofol, which has an anticonvulsant feature effects.

Conclusions

In order to figure out which anaesthetic agent was the most indicated for undergoing ECT, we found that both EEG-based seizure duration and motor seizure duration showed the sequence etomidatemethohexical>thio- pental>propofol. These items are directly related with clinical improvement. When a drug is chosen, It is important to individualize the treatment according to the patients’ comobidity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Demographic Characteristics of Personality Disorders in an Emergency Department
Authors: Gomez C. , González L. , Anibarro M. , Rodriguez V. , Ortigosa C. , Gomis C.
Published: June 2017

Objective

The aim of our study is to outline the demographic characteristics of the patients with a diagnosis of personality disorder that come to the ED. A second objective is to find specific risk factor for this type of patients.

Methods

We selected patients that came to the ED with the diagnosis of personality disorder, between October 2015 and February 2016. Data analysis was conducted using SPSS software. Chi2 test and t-Test were used as appropriate. A P-value < 0.05 was considered statistically significant.

Results

Sixty-eight of the 402 patients that were attended in the ED met the criteria of personality disorder; 44.92% of these patients presented with suicidal ideation or attempt. We found in the use of drugs, statistically significant differences between men and women, using drugs all the men with a personality disorder that came to the ED except one. The most frequent reason for consult were anxiety, conduct alterations, suicidal ideation, and suicidal attempt, being these consultations the 77%.

Conclusion

Anxiety and suicide risk are the most common reasons for a personality disorder patient to go to an ED. We have to be even more careful due to the high rate of suicide conducts in these patients. Also, it is important to think of drug use and dual pathology when assessing these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personality, Psychopathological Symptoms and Illness Perception in Mental Disorders: Results from Russian MMPI-2 Validation Study
Authors: Kovyazina M. , Rasskazova E. , Varako N. , Palatov S.
Published: June 2017

Introduction

According to common-sense model illness representation regulates her coping both in somatic and mental illnesses.

Objectives

As a personal reaction illness representation should partially depend not only on diagnosis and symptoms but also on personality. Aim is to identify direct and indirect effects of personality and psychopathological complaints in illness representation in mental disorders.

Methods

Eighty patients (20 males) from MMPI-2 validation sample (Butcher et al., 2001) filled revised version of Illness Perception Questionnaire and Symptom Checklist 90-R. Eleven patients met ICD-10 criteria for addictions, 28 – for mood disorders, 20 – for schizophrenia and schizotypal disorder, 21 – for acute stress reactions.

Results

According to moderation analysis, illness-related beliefs in mental disorders are relatively independent on clinical diagnosis and specific symptoms, but are associated with the overall level of psychopathological complaints. Regardless of the clinical group and complaints, depressive traits are associated with negative and emotional appraisal of illness. Social introversion and hypomanic activation serve as moderators of the relationship between complaints, illness duration and emotional representations.

Conclusions

Personality and overall level of psychopathological symptoms could be stronger predictor of illness-related beliefs than specific clinical factors in mental illness. Preliminary diagnostics of personality in mental illnesses could be used to reveal high-risk group for poor insight and non-compliance due to unrealistic beliefs. Research supported by the grant of President of the Russian Federation for the state support for young Russian scientists, project MK2193.2017.6.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessment of Chronic Pain in Military Patients with PTSD
Authors: Ben Zina E. , Krir M.W. , Bel Hadj H. , Tajmout A. , Ben Cheikh C. , El Kefi H. , Omaya A.
Published: June 2017

Introduction

Patients with post-traumatic stress disorder (PTSD) presents often with several concomitant physical and mental health problems. Recent evidence suggests that pain is one of the most commonly reported symptoms in patients with PTSD, regardless of the nature of their traumatic experience.

Aim of the study

To evaluate chronic pain in patients with PTSD in a Tunisian military sample.

Methods

Transversal descriptive study of a sample of 22 patients treated for PTSD in the Principal Military Hospital of Instruction of Tunis during the period between August and October 2016.

The PTSD Checklist for DSM-5 (PCL-5), Hospital Anxiety and Depression scale (HAD), and the Brief Pain Inventory Short Form (BPI-SF) were administered for patients.

Results

All the patients of the study were male. The mean age of the sample was 29.6 years. Fifty percent presented with a co-morbid major depression and 59.1% with chronic pain symptoms. Locations of chronic pain were as follow: limb pain (69.23%), back pain (38.46%), headache (30.76%) and torso pain (7.69%). Sequelae from combat-related trauma were present in 31.8% of cases.

Conclusion

The results of this study illustrate a high rate of chronic pain symptoms among PTSD patients. This suggests that closer attention should be given to the interaction of medical problems, especially pain, with PTSD symptomatology in clinical management and in future research.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
DSM-5 PTSD and Post-Traumatic Stress Disorder Spectrum in Patients with Fibromyalgia: Possible Correlations with Subthreshold Autism Spectrum?
Authors: Carmassi C. , Manni C. , Cipollone G. , Tagliarini C. , Avella M.T. , Portulano C. , Massimetti G. , Conversano C. , Bazzichi L. , Gesi C. , Dell’Osso L.
Published: June 2017

Introduction

PTSD is extremely common in patients with fibromyalgia (FM) with rates up to 57%, and it often correlates with increased severity of the disease.

Objectives

The aim of this study was to investigate the presence of PTSD, diagnosed according to DSM-5 criteria, and of Post-Traumatic Stress Spectrum symptoms in a sample of patients with FM.

Methods

Sixty-one patients, 7 males and 54 females, with FM, diagnosed according to American College of Rheumatology (ACR) at the Unit of Rheumatology of A.O.U.P clinics, were assessed by: SCID-5; Trauma and Loss Spectrum Self-Report (TALS-SR); Adult Autism Subthreshold Spectrum (AdAS Spectrum).

Results

Patients with FM with full and partial PTSD reported a significantly higher number of losses and potentially traumatic events in the TALS-SR than patients without PTSD. Significantly, higher AdAS Spectrum scores in almost all domains were reported in patients with PTSD with respect to those with partial or without PTSD. Moderate to good correlations were highlighted amongst most of the TALS-SR and ADAS-Spectrum domains.

Conclusions

Significant DSM-5 PTSD rates emerged in our sample of patients with FM. Significant correlations were found between Adult Subthreshold Autism Spectrum and Post-Traumatic Stress Spectrum, corroborating recent hypotheses that indicate autism spectrum symptoms as vulnerability factors for PTSD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The benefits of physical activities in patients with dual diagnosis
Authors: Jaber J. , Verissimo J. , Cardozo J. , Halabi A. , Carvalho S. , Hollanda A. , Reys B.
Published: June 2017

Introduction

The work describes the benefits of physical activities in patients with dual diagnosis in a psychiatric clinic of Rio de Janeiro city, Brazil.

Objectives

Present the benefits of physical activities inside the hospital space. Evaluate the impact of the introduction of regular physical activity practice in patients having dual diagnosis in hospitalization environment.

Aims

Demonstrates the decrease of the resistance to treatment in hospitalization regime, the behavioral and social improvement of patients, as well as the physical and mental capacities and the wellness promotion during and after the treatment.

Methods

Forty-five patients carrying the dual diagnosis, hospitalized in the clinic for the period of 1 year, were monitored. All the patients were assessed by a general practitioner, a psychiatrist and a physiotherapist, before starting the physical activity, being the classification of mental disorders ICD-10 used for the diagnosis. The patients were treated with psychotropics, according to the diagnosis and the signs and symptoms presented. The therapeutic project offered physical and psychological treatment, promoting the recovery possibility through aerobic and anaerobic ludic physical activities inside the therapeutic environment.

Results

All the patients presented improvement in the physical and mental capacities and in socializing. In the physical activities, the patients participated respecting their limitations, respecting the next and having a higher body perception.

Conclusions

Through the development of the activities, the patients demonstrated excellent involvement and interaction with the treatment, favoring their psychological and behavioral recovery and impacting positively their response to the treatment of various mental disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The relationship between job satisfaction with marital satisfaction and mental health: The specific case of female employees
Authors: Ashkzari M. Khademi , Piryaei S. , Brojerdian N. , Ashkezari E. Khademi
Published: June 2017

Introduction

As a component of personal characteristics, mental health has always been associated with marital satisfaction. Mental disorders associated with depression and anxiety are common in the workplace. Many studies have found a close link between job satisfaction and these two factors.

Objectives

The present study investigated the relationship of the level of job satisfaction, with mental health indicators and marital satisfaction in women.

Aims

This study aimed to explain the relationships of job satisfaction (as an organizational key factor) with mental health and marital satisfaction of women at the workplace considering the practical implications for promoting mental health.

Methods

To achieve the goal of research, a sample of 100 married women who worked at least for 5 years were selected by randomized sampling method in an organizational setting in Iran. Enrich Marital Inventory, Brayfield and Rothe's job satisfaction scale, and General Health Questionnaire were used for data gathering. Data was analyzed by utilizing hierarchical regression.

Results

Findings indicated that most respondents were satisfied with their jobs. In general, subjects with more severe psychological distress and lower level of marital satisfaction reported lower levels of job satisfaction.

Conclusions

Factors related to organizational attitudes such as job satisfaction were especially important in overall mental health and severity of psychological distress. Improving job attitudes is a key factor for promoting marital satisfaction and mental health in women.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The impact of animal-assisted therapy in the context of pediatric oncology: Results of an experimental study
Authors: Osório F.L. , Silva N.B.
Published: June 2017

Introduction

The use of animals as a therapeutic resource has increased over the past years, especially for patients suffering from chronic conditions associated with high levels of distress, and animal-assisted therapy (AAT) stands out in this scenario.

Objective

To assess the impact of an AAT program for children outpatients in oncological treatment according to psychological, physiological, and quality of life indicators.

Methods

Children aged 6–12 years attended an AAT program (weekly open group with a duration of three meetings). The activities followed a pre-established script and children were assessed before and after the intervention with instruments that measure stress, pain, mood, and quality of life, in addition to heart rate and blood pressure records. Two trained therapy dogs were used and the program followed the “Guidelines for animal assisted interventions in health care facilities”.

Results

Ten children completed the intervention (70% females, 50% with Ewing's sarcoma/neuroblastoma). There was a significant reduction in anxiety and depression indicators after the intervention (effect size = -0.73 e – 1.27) and a tendency to stress reduction.

Conclusion

Despite the small sample size, the partial analyses already provided favorable results regarding the use of AAT in the oncological context. We highlight the total absence of adverse events during the intervention, which speaks in favor of its safety. The expansion of the sample will probably strengthen the results found so far, suggesting that the technique can be an important ally in the management of emotional conditions associated with oncological treatment in childhood.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A pharmacologic option to reduce hospital admissions and relapses of patients with severe mental illness
Authors: Gomez-Coronado N. , Blanco P. , Martinez I.
Published: June 2017

Introduction

Some diseases relapses involve functional impairment that sometimes takes years to recover. We present our experience using long-acting aripiprazole as maintenance therapy in patients diagnosed with psychotic episode, acute mania (bipolar disorder) or personality disorder, who were previously treated with another anti-psychotic.

Aims

Analyze what treatment were they taking before aripiprazole depot. Determine the number of hospital admissions and relapses before and after long-acting aripiprazole treatment.

Methods

Descriptive analysis based on a sample of 37 patients, aged 18–65 years, treated during one year with anti-psychotics at two community mental health units.

Results

Reduction of hospitalization average: 0.59/year with non-long-acting-aripiprazol anti-psychotic, 0.18/year with long-acting aripiprazol (66.6%).

Conclusion

Long-acting aripiprazole appears to reduce the number of hospitalizations and relapses compared to other anti-psychotics. However, the sample size is small and more studies are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sex and age factors in neuroleptic malignant syndrome diagnosis frequency
Authors: Gurrera R.
Published: June 2017

Introduction

It is not known whether sex and age are risk factors for neuroleptic malignant syndrome (NMS).

Objectives

To examine sex and age distributions in NMS patients based on a systematic review of the literature.

Aims

Estimate the sex-specific relative risk of an NMS diagnosis.

Methods

EMBASE and PubMed databases were searched in November 2014 using broad, unrestricted criteria to identify any published observation of NMS. Any physically (online or hard copy) accessible and interpretable (using language translation software) report published from January 1, 1998 through November 1, 2014 was considered for inclusion. Secondary sources (e.g., reviews) were included when primary sources could not be accessed. All cases for which the patient's sex or the sample's sex distribution was provided were included, except for redundant reports and cases in which NMS was not the most likely clinical diagnosis. Sex ratio and age distributions were examined using standard graphical techniques and measures of association.

Results

Twenty-eight independent NMS sex ratio estimates were included. Most sex ratio estimates (75%) indicated male preponderance, with a median of 1.47 (95% CI: 1.20–1.80). NMS incidence peaked at age 20–25 years and declined steadily thereafter; males consistently outnumbered females at all age intervals. Major study limitations are the heterogeneity of case ascertainment procedures and the potential for publication bias.

Conclusions

NMS patients are 50% more likely to be males, and NMS is most likely to occur in young adulthood. Men, and all young adults, appear to be at increased risk for NMS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.