bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Culture to Enhance Mental Health in a Northern Canadian Aboriginal Population
Authors: Mainguy B. , Mehl-Madrona L.
Published: June 2017

Introduction

We present three community case studies for how community development and cultural enhancement affected mental health as an epiphenomenon.

Methods

An initiative was undertaken in 3 Northern Canadian aboriginal communities to enhance spiritual and cultural fluency and to provide opportunities to healthy interaction among community members. We began each process with a narrative investigation of the community by eliciting stories about perceived problems in the community. We collected further narratives at the end of the intervention about how it had affected people personally. We reviewed the narratives for commonalities and themes using modified grounded theory and dimensional analysis. We measured numbers of patients presenting to behavioral health services with mental health diagnoses, number of people sent to hospital for mental health treatment, and number of suicide attempts. We collected quality of life data using the My Medical Outcome Profile 2.

Results

Community development and cultural enhancement efforts reduced all of the variables we were tracking. Follow-up interviews revealed common themes of people becoming more present-centered, feeling higher quality in their relationships; feeling more connected to god, creator, nature, or higher power; feeling more peaceful; feeling more accepting of death and change; and having a greater sense of meaning and purpose. As an interesting side effect, people began to eat more traditional diets and to be more active.

Conclusions

Creating opportunities for community interaction and shared community projects and enhancing interactions with spiritual elders resulted in improvement in indices of mental health in three indigenous communities in Northern Canada.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pharmacological and Psychotherapeutic Interventions for Management of Post-stroke Depression: A Bayesian Network Meta-analysis of 27 Randomized Controlled Trials
Authors: Deng L.
Published: June 2017

Background

Post-stroke depression (PSD) constitutes an important complication of stroke, leading to great disability as well as increased mortality. Since which treatment for PSD should be preferred are still matters of controversy, we aimed to compare and rank these treatments.

Methods

We did a network meta-analysis to incorporate both direct and indirect evidence from relevant trials by Bayesian random effects model. We searched PubMed, the Cochrane Library Central Register of Controlled Trials, Scopus, Embase for randomized controlled trials of different PSD treatments. The primary outcomes were efficacy and tolerability. We assessed the quality of evidence using the GRADE framework.

Result

From 1347 citations, 27 randomised trials with a total of 1620 participants were included in this network meta-analysis. In terms of primary outcome, only for reboxetione (standardised mean difference [SMD] −12.84, 95% credible interval [CrI] −23.13 to −2.65) and nortriptyline (SMD −7.95, 95% CrI −14.85 to −1.75) enough evidence existed to support superiority compared with placebo. No significant difference was observed in terms tolerability. Considering patient response rate, repetitive transcranial magnetic stimulation (rTMS) was statistically more effective than sertraline plus nimodipine (Relative risk [RR] 5.53, 95% CrI 1.36 to 23.86) and fluoxetine (RR 10.74, 95% CrI 3.55 to 35.97)

Conclusion

Compared with placebo, reboxetione and nortriptyline offered a clear advantage for PSD patients. rTMS is probably the best option to consider in addition of pharmacological treatment. Nevertheless, doctors need to consider our results together with all known safety and economy information when selecting the strategy for individual patients.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Lists of Demographic Details and Psychiatric Diagnoses of Patients Diagnosed with FMS in Physical Therapy and Rehabilitation Outpatient Clinics
Authors: Tüz C.
Published: June 2017

Objective

In this study, a list of demographic details and a list of psychiatric diagnoses of patients who presented to physical therapy and rehabilitation outpatients clinics of Erenköy state hospital for physical medicine and rehabilitation and were diagnosed with fibromyalgia were investigated.

Method

The study sample included patients who presented to outpatient clinics of the department of physical therapy and rehabilitation and the department of psychiatry in the hospital in 2015 and patients who were diagnosed with fibromyalgia (FMS) in the outpatient clinic of department of physical therapy and rehabilitation and also presented to the outpatients’ clinics of psychiatry department. SCID-Mood Module and HAM-D were used during psychiatric assessment of the patients.

Conclusion

It was determined that a total of 5225 patients diagnosed with fibromyalgia were examined in physical therapy and rehabilitation outpatient clinics in 2015. Of these, 183 patients also presented to the psychiatric outpatients clinic and were diagnosed with a psychiatric diagnoses. In this study, a list of demographic details and a list of psychiatric diagnoses of these 183 patients were made. The results were compared with the literature.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The Correlation between Plasma Brain-derived Neurotrophic Factor and Cognitive Function in Bipolar Disorder is Modulated by the BDNF Val66Met Polymorphism
Authors: Lee S.Y.
Published: June 2017

Objectives

Brain-derived neurotrophic factor (BDNF) may be involved in the pathogenesis of bipolar disorder (BD). The functional BDNF Val66Met polymorphism (rs6265) is associated with secretion of BDNF. The current study aimed to explore the correlation between changes of plasma BDNF and cognitive function after 12 week of treatment, considering the influence of the BDNF val66Met polymorphism. The correlation of changes of plasma BDNF with quality of life (QOL) was explored.

Methods

First diagnosed patients with BD were recruited. Symptom severity, plasma BDNF levels were examined during weeks 0, 1, 2, 4, 8, and 12. QOL, Wisconsin Card Sorting Test (WCST) and the Conners’ Continuous Performance Test (CPT) were assessed at baseline and endpoint. The genotype of the BDNF Val66Met polymorphism was determined. The change of cognitive function and QOL measures over 12 weeks were reduced by factor analysis. Pearson's correlation was used to investigate the association between change of plasma BDNF levels with cognitive function and QOL.

Results

Five hundred and forty-one BP patients were recruited. Three hundred and fifty-five (65.6%) patients completed the 12-week follow-up. A significant negative correlation was found between changes of plasma BDNF level with factor 1 (WCST) (r = −0.25, P < 0.001). After further stratification according to subtypes of BD and the BDNF genotypes, above significant correlation was found only in those with BP-I and the BDNF Val66Met Val/Met genotype (r = −0.54, P < 0.008).

Conclusion

We conclude that changes in plasma BDNF significantly correlated with changes in WCST in patients with BD; such correlation is moderated by the BDNF Val66Met polymorphism and subtype of BD.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Clinical and Sociodemographic Correlates of Suicidality in Bipolar Patients
Authors: Ouali U.
Published: June 2017

Introduction

A major concern in patients with BIPOLAR Disorder (BD) is the high frequency of suicidality. It is important to determine the subgroup of patients particularly exposed to this risk.

Objectives

To explore sociodemographic and clinical characteristics of BD patients with a history of suicide attempts and compare them to those who never attempted suicide.

Methods

This is a retrospective, cross-sectional, descriptive and comparative study on 100 patients followed in our department and diagnosed with BD type I according to DSM 5. Demographic and clinical data was compared across the groups: suicide+ (S + ) and suicide–(S-).

Results

Overall, 77 patients never attempted suicide (S−), whereas 23 had made at least one suicide attempt (S+). Females represented 61,9% of the S+ group. S+ patients had more relatives with psychiatric illness (82,6% vs. 57.1%) and affective illness (43.5% vs. 33,8%). The mean diagnostic delay was 6.61 years in the S+ group vs. 4.58 in the S− group, with 78,3% of S+ patients first receiving another diagnosis than BD. S+ patients had significantly more depressive episodes and manic episodes with mixed features. Quality of intervals was worse in S+ patients. Anxiety comorbidity was significantly higher in the S+ group (52.2% vs. 13%; P = 0,000). Hyperthymic temperament was significantly associated with the S− group.

Conclusions

Depressive polarity, anxiety comorbidity, as well as diagnostic delay seem to elevate the risk for suicidality in bipolar patients. Suicidality should be closely monitored in patients with these characteristics.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Substance Use Disorder among Admitted Patients with Bipolar Disorder in a Psychiatric Service During a Three-year Period
Authors: Fernandes M. , Silva S. , Mota D. , Oliveira A. , Ribeiro J. , Santos V. , Madeira N. , Pissarra C. , Santos Z.
Published: June 2017

Introduction

Bipolar disorder has the highest rates of comorbid substance use disorders. Approximately 60% of patients with bipolar I disorder have a lifetime diagnosis of a substance use disorder (SUD). Excluding tobacco, alcohol is the substance most often abused, followed by cannabis, amphetamines and cocaine.

Objectives

Determine the prevalence and compare sociodemographic and clinical variables in patients with SUD comorbid diagnoses and patients without this comorbidity.

Methods

Charts of all patients with a diagnosis of bipolar disorder admitted in the Coimbra Hospital and Universitary Center over a three-year period (2013–2015) were reviewed to gather data on sociodemographic and clinical data.

Results

During a three-year period, 189 patients were admitted with bipolar disorder, almost half of patients (47,6%) had a SUD comorbid diagnostic. Comorbidity of BD and SUD is characterized by a complicated course with multiple recurrences of bipolar episodes and increased hospitalizations. The risk of suicide attempt is significantly higher when associated with SUD. In addition, BD is associated with pervasive social, family, and employment dysfunction. Poor treatment adherence in this population is also a serious clinical challenge that significantly impacts treatment response and outcome. The authors will analyze all this variables in the population admitted.

Conclusion

According to the most recent literature on SUD and BD, these two problems occur together so frequently that all patients with a bipolar diagnosis should also be assessed for drug and alcohol problems. BD complicated by SUD represents a serious public health problem and a major challenge to treatment providers.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
What Antipsychotic is More Effective? Pafip Three Years Longitudinal Study Comparing Haloperidol, Risperidone, Olanzapine, Quetiapine, Ziprasidone and Aripiprazole
Authors: Revuelta M. Gomez , Alvarez P. Alonso , Egea J.L. Garcia , Ruiz M. Juncal , Olivares O. Porta , Blanco L. Sanchez , Diez D. Abejas , Santayana Jenaro G. Pardo de , Rodriguez R. Landera
Published: June 2017

Introduction

Early stages after a first psychotic episode (FEP) are crucial for the prognosis of the disease. Those patients who drop out of treatment after a FEP show a significant increase in their vulnerability to relapse. Relapses associated a greater risk of neurotoxicity, chronicity, hospitalization, decrease of response to the treatment, increase of burden and functional decline.

Objectives

To determine what antipsychotic is more effective in the prevention of relapse after a first psychotic episode.

Material and methods

PAFIP is an assistance program focused on early intervention in psychosis. Between January 2001 and January 2011, 255 patients were recruited and randomly assigned to treatment with haloperidol (n = 48), olanzapine (n = 41), risperidone (n = 44), quetiapine (n = 34), ziprasidone (n = 38) and aripiprazole (n = 50). We compared the rates of relapse and remission reached by haloperidol, olanzapine, risperidone, aripiprazole, ziprasidone and quetiapine during a 3-year follow-up. All of the patients were antipsychotic naives at the beginning of the treatment.

Results

There were no statistically significant differences in regard to the rate of clinical remission. Patients assigned to the groups of aripiprazole, olanzapine and risperidone presented a solid trend to a significantly inferior rate of discontinuation for any reason since the beginning of the treatment.

Conclusions

These data point to a greater protection against relapse and a likely better prognosis related to the use of aripiprazole, Olanzapine and risperidone.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
5-years Follow-up of Antipsychotic Medication and Hospitalizations After First Episode Hospital-treated Psychosis in a Swedish Nation-wide Cohort
Authors: Strålin P. , Hetta J.
Published: June 2017

Introduction

Outcome after first episode psychosis is heterogeneous, but knowledge about the distribution and predictive factors is limited.

Objective

To investigate medication and rehospitalizations for five years after first episode hospital treated psychosis.

Method

Swedish population registers were used to select a nation-wide cohort of 962 cases (589 or 61% men) with a first hospitalization for psychosis at ages between 16–25 years. Cases were categorized year by year for 5 years after the initial hospitalization with regard to rehospitalizations and dispensations of antipsychotics and other medications.

Results

The 5-years mortality was 4% (n = 39) with suicides in 16 cases (1.6%, 11 of which were men). Additionally, 139 cases (23% of women and 10% of men) had hospitalizations for suicide attempts within 5 years. A bimodal distribution of years with medication was found indicating two different trajectories of outcome. One peak was seen for cases with dispensations of antipsychotics 5 of 5 years (40% of the cohort). Another peak was seen at dispensations during at most 1 of 5 year (30%). During year 5, 514 (56% of 923 cases surviving 5 years) had dispensations of neuroleptics and 257 (28%) were hospitalized, whereas 356 cases (39%) had no dispensation of neuroleptics or hospitalization.

Conclusions

The population of young cases with first episode psychosis is heterogeneous with at least two clearly separable trajectories based on medication and hospitalizations. The high mortality and high incidence of suicide attempts during a five-year period demonstrate a need for careful monitoring of these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Patterns of dissociative (conversion) disorder cases in private psychiatric facility and the effectiveness of an indigene model of psychotherapy
Authors: Hussain M.I.
Published: June 2017

This is descriptive study was carried out on newly diagnosed dissociative (conversion) disorder patients admitted in private health care facility, Iftikhar Psychiatric Hospital Peshawar.

The studied was carried out from January 2012 to December 2012. Cases were diagnosed according to international classification of disease (ICD-10) diagnostic criteria. Subjects were selected through purposive sampling. A total of 139 patients were included in this study. Patterns of and disorder and demographic will be presented in presentation.

Due to sociocultural sensitivity of applying dialectical and CBT an indigenes model of psychotherapy was applied.

Stage 1: admission of conversion disorder cases for four days admission with informed consent, supportive psychotherapy, and brief psycho-education of attendants to avoid reinforcement of the patient's behavior. Parental single dose medication to break the cycle of fits.

Stage 2: it involves exploratory session with the patient and her/his family members focusing on what is the problem with the patient nature of stressors, and the family environment. Meanwhile, we involve the patient in the recreational and occupational therapy to avoid sick role and illness behavior.

Stage 3: psychotherapy session with the patient to give psycho-education and insight of her/his mental problem. Discussing different options, and facilitating the patient to come up with the best possible desirable option. Psychotherapy of the family members involved psycho-education about the patient's mental illness, its association with the prevailing stressors, and avoiding reinforcement. Responses have been 85% improvement in conversion disorder, 90% in sensory symptoms, 98% in motor symptoms, 95% in mixed symptoms.

Disclosure of interest

The author has not supplied his declaration of competing interest.
The correlation between object relationships and attachment style in prostitutes in Iran
Authors: Nouralizade L. , Ghahari S.
Published: June 2017

Objective

Increased statistics of prostitution and reduced age of prostitutes at the world and as a result, prevalence of diseases such as AIDS and other diseases has gained attention of scholars to the problem of prostitution and relevant problems. Hence, the main objective of this study is to analyze the correlation between object relations and attachment style in prostitutes in Iran.

Method

Applied method in this study is correlation. Statistical population in this study consists of prostitutes of Tehran, Mashhad, Kerman, Tabriz and Mazandaran and statistical sample consists of 317 women selected using simple random sampling method in 2015. For purpose of data collection, Bell Object Relations and Reality Testing Inventory (BORRTI) and Hazan and Shaver attachment styles questionnaire are used. The data were analyzed using multivariate regression and Pearson correlation in SPSS-22.

Finding

The results showed that there is significant correlation between object relations and attachment styles in prostitutes (P < 0.01).

Conclusion

Object relations scales (incompetence, self-centeredness and alienation) are correlated to insecure attachment styles in prostitutes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Intramuscular ketamine in depression, suicidal thoughts and anxiety: A report on two cases
Authors: Cigognini M. , Moreno R.
Published: June 2017

Introduction

Several studies have shown that ketamine, an antagonist of NMDA receptors, represents a promising alternative in the treatment of depression. The therapeutic use of ketamine, commonly used at a dose of 0.5 mg/kg, and in a single application IV has been short and requires monitoring in a hospital setting. IM use has been shown to be effective in treating depression and suicide risk, and have low side effect profile.

Methods

Two patients diagnosed with bipolar depression and suicide risk were submitted to ketamine IM application (0.75 mg/kg), receiving one application of ketamine IM every two days, totaling 4 applications. Patients were under medical monitoring for 2 hours after injection verifying vital signs and potential side effects. Responses were measured using BDI, BAI and BSI.

Aim

To evaluate response of ketamine IM injections on depressive, suicidal and anxious symptoms.

Case 1: female, 20 years old, single with three recent suicide attempts, symptomatic for two months. Started lithium 450 mg daily. Side effects of ketamine were nausea, drowsiness and paresthesia. Case 2: female, 24 years old, single with symptoms lasting for six years. Started aripiprazole 5–10 mg and 25 mg lamotrigine concomitantly. Side effects of dry mouth, dizziness and dissociation.

Conclusions

The use of ketamine IM showed reduction of 75.5%–83.3%–85.7% (case 1) and 71.4%–77.2%–60.8% (case 2) in BDI, BAI and BSI, respectively as well as safety and tolerability in use.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Risk factors for suicide behaviors in bipolar disorder: A closer look
Authors: Durães D. , Martins J. , Borralho R.
Published: June 2017

Introduction

Suicide behaviors (suicide acts and suicide attempts) are a major concern for clinicians treating patients with psychiatric disorders. Among them, patients with bipolar disorder (BD) have the highest prevalence of suicide behaviors, accounting for up to one-quarter of all completed suicides. Additionally, suicide remains the leading cause of avoidable death in patients with BD.

Aims

This work aims to review the main risk factors for suicide behaviors in patients with BD.

Methods

The MEDLINE/Pubmed database was searched using the keywords “bipolar disorder” with: “suicide”; “suicide attempt”; and “suicide risk factors”. Articles published in the last 10 years were considered.

Results

It is estimated that 25% to 50% of patients with BD will attempt suicide at least once in their lifetime and, that 10% to 15% will die. The risk factors for suicide behaviors in patients with BD have been widely studied and their knowledge is crucial for identifying patients at risk.

The main risk factors include previous suicide attempts, family history of suicide and hopelessness. Other risk factors have also been identified: depressive polarity of first mood episode; rapid cycling; increasing severity of affective episodes; depressive polarity of the latest mood episode; mixed affective states; early age of onset; and comorbid anxiety disorders, substance use disorders and cluster B personality disorders.

Conclusions

Prevention of suicide behaviors is crucial when treating patients with BD. Therefore, the knowledge of these risk factors is of extreme importance in order to promptly identify patients at risk and adopt the proper preventive therapeutic interventions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The blue-eyed man: A case of Waardenburg syndrome type 1 associated with mania and autistic spectrum disorder
Authors: Francis B. , Jambunathan S.T. , Gill J.S. , Wong S.
Published: June 2017

Waardenburg syndrome (WS) is a rare genetic disorder characterised by varying degrees of sensorineural deafness, dystopia canthorum, musculokeletal defects, pigmentation anomalies such as bright blue iris, greying hair and in some cases intestinal pathology.

A 21-year-old Chinese gentleman, diagnosed with WS type 1 (Figs. 1 and 2) at the age of two, presented at the emergency unit with manic symptoms for the past one month such as irritability, grandiosity, flight of ideas and reduced need for sleep. With regards to social integration, he had features suggestive of autism spectrum disorder (ASD). He often played by himself and was fixated on particular toys. He was eventually admitted to the psychiatric ward for acute management of mania. He was stabilised on olanzapine 10 mg BD and sodium valproate 600 mg BD. His sodium valproate was cross-titrated with lithium in the ward and his manic features gradually subsided. He was discharged well after 2 weeks of admission with lithium 300 mg BD and olanzapine 10 mg BD. WS type 1 has been localised to the locus 2q35 and researchers have identified that a tetranucleotide repeat marker on 2q35 is strongly associated with recurrent mood symptoms.

In conclusion, it is important to note that individuals with WS may be at higher risk to develop ASD and mood disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Research of thinking and memory at persons with the alcoholic dependence complicated by abuse of preparations of sedative and somnolent group
Authors: Jumasheva G.
Published: June 2017

In recent years, abuse of sleeping medicines with the subsequent formation of an inclination and increase of tolerance to preparations of this group has gained distribution in the Republic of Uzbekistan among the persons suffering from alcoholic dependence.

The assessment of thinking and memory functions was carried on by using a pictogram technique at 40 patients with the alcoholic dependence complicated by abuse of a somnolent preparation. Two groups of patients had similar duration of alcohol abuse, but differing in the length of abuse of hypnotic drugs: 20 patients used it not more than 1 year, 20 patients more than 5 years.

Research has shown that with the duration of abuse of somnolent preparation within 1 year patients with alcoholic dependence had no expressed memory violations: by means of pictogram drawings patients could remember all set of words. Twenty-five percent of patients’ drawings had the ordered appearance, steady graphic characteristics; the chosen images were followed by exact, laconic comments. The tendency to prevalence of the concrete images associated with alcoholic situations was found in 75% of patients of this group at a graphic representation of abstract concepts.

Abuse of somnolent preparations more than 5 years at 35% of patients has come to light misunderstanding of sense of the task, 40% of patients – insufficient image differentiation with inability of selection of visions to abstract concepts, 10% of patients – had tendency to the stereotypy and a perseveration. All the patients had a decrease in efficiency of the mediated storing.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Bipolar disorders diagnostics in ambulatory medico-psychological service
Authors: Kornetov N. , Larionova E.
Published: June 2017

Introduction

The difficulties of diagnosis and clinical differentiation of bipolar disorders, schizophrenia and schizoaffective disorder have been repeatedly noted both foreign and Russian authors.

Objectives

Full medico-psychological service clinical documentation research, including bipolar disorder patient records.

Aims

Determination of bipolar disorders in accordance with the DSM-5 criteria among psychiatric outpatients.

Methods

A group of 142 patients with established according to ICD-10 diagnoses: schizophrenia, schizoaffective disorder 137 (96.5%); the average patient's age 50 ± 13 and bipolar disorder and mania episode 5 (3.5%) – 55.4 ± 14.4 has been investigated.

Results

It was found that 18 (12.7%) of all patients meet the DSM-5 bipolar disorder criteria compared with the primary diagnosis (3.5%). Structure of the diagnosis of bipolar disorder was represented as follows: bipolar disorder type I – 11 (61.2%), bipolar disorder type II – 7 (38.8%). Consequently, due to formal application DSM-5 bipolar disorder criteria BD determination 3.5 times more.

Conclusion

Traditionally, the diagnosis of schizophrenia is preferred over bipolar disorder. Manic episode in bipolar disorder can be evidently regarded as an acute schizophrenia manifestation. The diagnostic criteria for DSM-5 are convenient in diagnostics of manic and depressive episodes in case of their combination in I type bipolar disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Antidepressants induced mania in patients with diagnosed unipolar depression: Case report and literature discussion
Authors: Silva M. , Ribeiro M. , Figueredo A.R. , Castelo Branco L.
Published: June 2017

The association of antidepressant therapy with mania in people being treated for unipolar depression reinforces the importance of further clarification of this effect, since it has a huge implication in treatment approach and outcome. With this main objective, authors propose to make retrospective sociodemographic and clinical characterization of a group of patients with antidepressant induced mania in diagnosed unipolar depression, admitted in inpatient unit of Psychiatry and Mental Health Department of Centro Hospitalar de Trás-os-Montes e Alto Douro. Authors also aim to identify features that may increase the risk for mania or hypomania in people who present with an episode of depression, which can guide clinical orientation and improve outcome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prospective predictors of onset, maintenance and cessation of self-injurious behavior during adolescence
Authors: Brunner R. , König J. , Parzer P. , Resch F. , Kaess M.
Published: June 2017

Introduction

Epidemiological studies indicate a high prevalence of self-injurious behavior in adolescents in the general population. So far, there are only very few studies on the course of self-injurious behavior in adolescents and young adults.

Objectives

The aim of the present population-based study was the analysis of prospective predictors of onset, maintenance and cessation self-injurious behavior in adolescents.

Methods

A representative sample of the normal population of adolescents from Germany (initial sample: n = 1444; mean age = 14.7, SD = 0.80, 52% female adolescents) was studied over a two years period on 4 consecutive points of measurement in the context of the European school-based intervention study SEYLE.

Results

There was a high remission rate (70.4%) of self-injurious behaviors at 24-month follow-up investigation. However, there was a substantial rate (29.6%) of adolescents who continued the self-injurious behavior, as well as a group of “new starters”. Self-injurious behavior during the baseline examination proved to be the strongest predictor of self-injurious behavior 2 years later. The extent of depressive symptoms and quality of peer relationships were significantly associated with maintaining self-injurious behavior two years later. Furthermore continued self-injurious behavior over the first 12-month was highly associated with suicide plans/suicide attempts at 24-month follow-up investigation.

Conclusions

While both, onset and maintenance of SIB are prospectively associated with an increased risk for suicidal behaviour in late adolescence, SIB cessation significantly reduces the risk for later suicidal behaviour.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical and psychopathological aspect of electrophysiological abnormalities in adolescents with behavior disorders
Authors: Leshchyna I. , Mozgova T. , Fedorchenko S.
Published: June 2017

Medical and social significance of behavioral disorders in adolescents and their consequences makes the relevance of the study of clinical manifestations and causes the need for early preventive intervention.

Aim

Studying the role of neurophysiological disorders in the formation of behavior disorders in adolescents.

Two hundred and two adolescents aged 11–15 years with behavior disorders were observed. The diagnostic methods included electrophysiological, clinical psychopathological and statistical methods.

In the structure of behavioral disorders, psychopathological syndromes in adolescents have been identified: psychopathic (n = 106), asthenoneurotic (n = 50), asthenoabulic (n = 26) and anxiety-depressive (n = 20).

As a result, it was found that high seizure activity commonly observed in adolescents with anxiety-depressive syndrome (66.67 ± 10.33%); less frequently in adolescents with asthenoneurotic (40.00 ± 6.79%), psychopathic (38.71 ± 4.64%), asthenoabulic (28.57 ± 8.68%) syndromes.

At the same time, diffuse changes with dysregulation of the diencephalic-stem structures were observed in the majority of adolescents with psychopathic (61.29 ± 4.64%), asthenoneurotic (60.00 ± 6.79%), asthenoabulic (57.15 ± 9.51%) syndromes and much less frequently in adolescents with anxiety-depressive symptoms (33.33 ± 10.33%).

Dystonic rheoencephalography type was observed in a third of adolescents with psychopathic (35.48 ± 4.55%), asthenoneurotic (30.00 ± 6.35%) and anxiety-depressive (33.33 ± 10.33%) syndromes, while the hypertensive rheoencephalography type was prevailed in adolescents with astenoabulic symptoms (14.29 ± 6.73%).

Liquor hypertension in adolescents with asthenoneurotic (15.00 ± 4.95%) and psychopathic (9.67 ± 2.81%) syndromes was more common.

The statistical analysis indicated that violations of bioelectric properties of the brain with high seizure activity and dysfunction of the low stem structures and disorders of cerebral hemodynamics by dystonic type are risk factors for the formation of behavioral disorders in adolescents.

Detection of neurophysiological disorders in adolescents is an informative diagnostic method of early signs of behavioral disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Repetitive behavior among autistic children 3–10 years old and a control group in Albania
Authors: Pilika Anita , Maksuti Pasho , Rama Deana , Murati Endri , Guga Greta , Shehu Armand , Simaku Artan
Published: June 2017

Introduction

Autism is a lifelong disability that impairs 3 main areas; communication skills, social interaction and behavioral patterns.

Objectives

To investigate the repetitive behavior in autistic children 3–10 years old.

Aims

Comparison of repetitive behavior between autistic children with a control group of clinically healthy children matched for age and sex.

Methods

Repetitive Behavior Scale (RBS-R) questionnaire was translated, validated and provided to examine children (n = 70) in each group.

Results

Children with autism show significant behavioral problems as compared to healthy children in all subscales and the full RBS-R. Results of the t-test for independent samples indicated a significant difference in mean score for the children with autism of age 3–6 year old (M = 53.1) and for control group (M = 11.9), t = −13.3, P < 0.01. Also, the mean score of children with autism of age 7–10 year old (M = 54.9) is significantly higher, compared to control group (M = 13.7), t = −12.2, P < 0.01.

Conclusion

This comparison provides information on particular forms of repetitive behavior to further our understanding on these important symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Risk factors of problematic video game use among teenagers in Sfax
Authors: Cherif L. , Sahnoun C. , Khemakhem K. , Ayadi H. , Walha A. , Moalla Y. , Hadjkacem I. , Ghribi F.
Published: June 2017

Objective

To identify correlates that might constitute risk factors for problematic video game use (PVU) among urban Tunisian secondary school students.

Methods

This multivariate cross-sectional study was carried out on 587 secondary school students, aged 14 to 20 years. They were randomly selected from seven secondary schools in the urban area of Sfax. The self-administered Fisher's nine-item questionnaire was used in this survey. To identify an associated problematic internet use video game addiction, Young's eight-item questionnaire was used. A self-administered, anonymous questionnaire covered socio-demographic, individual and family data.

Results

The prevalence of PVU was 14.01%. In multivariate logistic regression analysis, we found that the individual risk factors for problematic video game use were anxiety symptoms (P = 0.034) and an associated problematic Internet use (P < 0.001). Playing sport was a protective factor (P = 0.011). The poor relationships within the family (P = 0.001), the lack of parental supervision of time spent on playing video game (P < 0.001) and mother profession as mid-to upper level manager (P = 0.002), predicted PVU.

Conclusion

The identification of risk factors can help to determine individuals at high risk, and alert mental health providers to be careful to screen these patients for PVU. Total avoidance of the Internet is unrealistic and inadvisable; but a sensibilisation outreach for youth, their families and health professionals may help to limit the onset of PVU among young people.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Vintage mode: Expansive paraphrenia
Authors: Landera Rodríguez R. , Gómez Revuelta M. , Juncal Ruíz M. , Santayanda Jenaro G. Pardo de , Sánchez Blanco L. , Porta Olivares O. , Fernández Rodríguez M. , López García E. , Medina Blanco R. , Martín Gutiérrez R.
Published: June 2017

Introduction

Paraphrenia is a poorly defined process whose uncertain origins date back to the German psychiatry mid-nineteenth century. Paraphrenia would be a subtype of schizophrenia characterized by a more benign clinical course in terms of volitional and emotional involvement. Certain types of serious sensoperceptive distortions and paranoid symptoms are characteristics of this clinical variant. Despite its diverse presentation, its chronic development and its presence in the daily lives of the patient, the overall functionality is not deeply affected.

Objectives

To discuss the validity of this and other clinical processes based on classical clinical descriptions for diagnostic approach of our current patients, in contrast to the common use simplified concept (forgetting in ICD-10 or disappeared in American manuals).

Materials and methods

Clinical case a middle-aged woman diagnosed with longstanding paranoid schizophrenia who suffered from a highly systemized delusional and hallucinatory syndrome with chronic evolution after a first relapse due to abandonment of treatment, but keeping high functional performance even during phases of partial remission.

Conclusions

Schizophrenia presents multiple symptomatic and prognostic paths. Classical authors named these different subtypes. Revisiting these subtypes could be useful as a complementary tool for predicting clinical outcome based on their descriptions, especially in the absence of reliable material instruments.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adherence to treatment program in mental health rehabilitation service
Authors: Martí Garnica V. , Ortega Garcia M.D. , García Pérez M.C. , Sánchez Carreño C.
Published: June 2017

Aims

After several years of research to improve the action of antipsychotic medication and to reduce its side effects, we have realized the importance of an accurate intake of antipsychotic medication and because of it we started up a program in our Mental Health Rehabilitation Service. Therefore, we can affirm that outpatients behavior influence their intake medication and also the efficiency of the drug prescription. The main consequence of inadequate treatment compliance is an increase in relapses and hospital admission.

The aim of this program is to improve adherence to pharmacological treatment, to promote the quality of life for a better social integration, to know the use of prescribed medication, to know the health resources of the network to acquire the medication and to acquire skills for greater autonomy in the management and management of medication.

Method

We analyzed a sample of 13 outpatient diagnosed with severe mental disorder that started up into our Program “Adherence to treatment” and their stabilization (less relapses and less admissions) in two years’ time.

Results

One of the patients have completed the aims of the program and he is living on his own, nine of them continue the program without relapses or admissions, one dropped out the program because of relapse and an another one have also completed the program but he died because of somatic disease.

Conclusions

The experience of this program in group format is positive, since patients acquire skills, knowledge and strategies in their own treatment in line with the recovery model in psychosocial rehabilitation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Intellectual developmental disorders, autism, and schizophrenia spectrum: New boundaries in the neurodevelopmental perspective
Authors: Bertelli M. , Salvador-Carulla L. , Keller R. , Bradley E.
Published: June 2017

Background and aim

Recent evidences of clinical overlap, familial co-aggregation, and shared genetic alterations support a neurodevelopmental deviation to represent a probable common vulnerability factor not only for the psychiatric disorders included in the meta-structure of neurodevelopmental disorders, but also for other major psychiatric disorders, including schizophrenia.

The present paper reviews the literature to identify (1) positive and negative implications of the increasing enlargement of the group of neurodevelopmental disorders and (2) most useful clinical aspect for re-defining diagnostic boundaries between syndromic groups.

Methods

The search purpose was reached through a systematic mapping of literature.

Results

The last years’ trend to increasingly enlarge the number of psychiatric features comprised in the autism spectrum should be better evaluated for potential negative impact on research and clinical resources for those autistic syndromes more reliable with Kanner's descriptions or associated with lower personal functioning profiles and different level of ID.

Crucial clinical aspects for the differentiation resulted to be age of onset, interest towards others, main positive symptoms, and anatomical anomalies of the central nervous system.

Conclusions

While on one hand the neurodevelopmental perspective might contribute to a better understanding of the multifactorial aetiopathogenetic mechanisms underlying many psychiatric disorders and provide new intervention strategies, on the other hand it might determine a premature abandonment of the traditional nosology and the appearance of very broad spectrum conditions covering all the range of current psychopathology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The very special way of eating for a man with a very short bowel syndrome and an ileostomy
Authors: Christodoulou I. , Tsiompanou F. , Peitsidis N. , Dounias G. , Tsakiridis I. , Kelesidou V. , Paraskevas A.
Published: June 2017

Aim of this study is to present the extraordinary case of a 45-year-old man with very short bowel syndrome and ileostomy, who is currently engaged in a long hospitalization module of life because of the constant need for parenteral nutrition which he has developed due to Crohn's disease treatments. Case presentation: A Russian young man, with low education, a borderline intellectual functioning and a low socio-economic status, was operated numerous times due to breakouts of Crohn's disease. For the last year, he stays mostly in the hospital. Practically he needs constant intravenous parenteral nutrition due to his very short bowel syndrome, otherwise he cannot live outside the hospital. The patient was advised by his surgeon to eat any kind of food but had the limitation to drink not more than 500 ml of water per day, (the rest of water was taken IV). During the first months, the patient seemed willing to do anything needed, but when he started to get tired, he started to drink more than 2 litres of water per day, ignoring his doctor's advice. One of his main problems was that he was able to see that eggs, meat and other food he was eating were very soon appearing in the ileostomy bag and this led him to think that he would die soon. Neither the patient himself nor his wife and relatives asked for help from supervisory bodies of the National Health System and are not at all aware of his need for transplantation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The relationship between personality disorders and substance abuse disorders
Authors: Goretti S. , Sanchéz M.D.C. Sanchéz , Borja P. Lucas , Rivera G. Bautista , Lara M. Rodríguez
Published: June 2017

Introduction

A frequently observed fact in clinical practice is the relationship between Substance Abuse Disorders and Personality Disorders (PD). Epidemiological investigations have found that diagnoses of PD seem to increase vulnerability to other pathologies, including substance abuse and addiction, and it is possible to speak of comorbidity or dual pathology.

Objective

To describe the comorbidity between PD and substance abuse disorders.

Methods

Systematic review of the literature on the subject. The databases consulted were Dialnet, Pubmed and Cochrane.

Results

The various studies allow estimating that between 65% and 90% of subjects treated for substance abuse or dependence have at least one concomitant PT. Studies show a higher prevalence of Cluster C for alcohol consumption and Histrionic, Narcissistic, Boundary and Antisocial Disorders (Cluster B) for illegal drugs, mainly cocaine. Cluster B is the one that the literature has most related to substance use. It is also the group in which there is a greater predominance of impulsivity, which would be worth remembering its role as a vulnerability factor for addictions.

Conclusions

What the research has shown is that a good deal of the problems that accompany substance use come from dysfunctional patterns of behavior that are maintained over time with high stability and can justify, in part, both the persistence of The addictive behavior as the difficulty of handling the patients who present them. At present, although the high comorbidity between TP and substance use is sufficiently documented, many questions still remain to be solved.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric comorbidities in temporal lobe epilepsy: A case study
Authors: Jouini L. , Ouali U. , Zaouche R. , Jomli R. , Zgueb Y. , Nacef F.
Published: June 2017

Introduction

Psychiatric disorders frequently occur in patients with temporal lobe epilepsy (TLE) (70%). This combination further reduces the quality of life of patients as diagnosis is difficult and therapeutic opportunities are often missed.

Objectives

The aim of this case study is to show the possible association between TLE and psychiatric semiology and its therapeutic implications.

Methods

Presentation of the clinical case of Mr BH who experienced psychosis like symptoms, was finally diagnosed with TLE and put under anti-epileptic drugs.

Results

Mr BH, aged 22, with no family or personal history, was admitted for aggressive behavior, self-harm, pyromania, and depression. Three years prior to onset of psychiatric symptoms, he reports episodes of pulsatile- left-temporal headache followed by hypertonic movements of the neck. Symptoms were intermittently followed by total amnesia or impaired consciousness. The patient explained symptoms by an inner presence that he called “his twin” and to whom he attributed those behaviors contrary to his will. The discovery of bilateral hippocampal atrophy in magnetic resonance imaging with a normal electroencephalography suggested the diagnosis of TLE with post-ictal psychotic disorders. Patient was put initially on diazepam and olanzapine with partial improvement. Association of valproate led to progressive but then complete disappearance of symptoms and so confirmed our diagnosis.

Conclusions

It is often difficult to attach psychiatric symptoms to epilepsy. The diagnosis should be done on a set of clinical, radiological and electrical arguments.

Disclosure of interest

The authors have not supplied their declaration of competing interest.