bluuebunny/crossref_metadata_2025_split huggingface dataset:
Core Competencies for Health Professionals in Global Health
Authors: Dias M. Casanova , Ryland H. 
Published: June 2017

IntroductionThe world is becoming increasingly globalised and this has a major impact on the delivery of healthcare. Issues such as conflict, migration, climate change and technological advances all contribute to this. But are we equipped to deal with the challenges of Global Health?ObjectivesTo discuss the core competencies that health professionals should have in Global Health.MethodsThe UK's Global Health Curriculum Group (GHCG), a group of healthcare professionals, was commissioned by the Academy of Medical Royal Colleges to lead a consultation on global health competencies. The consultation took the form of a modified Policy Delphi which involved an online survey and face-to-face and telephone interviews over three rounds. Over 250 stakeholders participated, including doctors, other health professionals, policymakers and members of the public from all continents of the world.ResultsThis study demonstrated broad agreement that global health competence is essential for postgraduate doctors and other health professionals. It identified five core competencies, relevant to the UK and applicable to other parts of the world: (1) diversity, human rights and ethics; (2) environmental, social and economic determinants of health; (3) global epidemiology; (4) global health governance; and (5) health systems and health professionals.ConclusionsThis framework of five core competencies aims to equip psychiatrists and other doctors with the skills, knowledge and attitudes necessary to practice in a globalised world.In the workshop we will harness the international nature of the delegates attending the congress to enable a lively debate about the meaning of global mental health and the skills psychiatrists need.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Auditory Cortex Characteristics in Early Onset Psychosis and its Associations with Auditory Hallucinations: A Structural MRI Study
Authors: Smelror R.E. , Lonning V. , Mørch-Johnsen L. , Nerland S. , Gurholt T. , Agartz I. 
Published: June 2017

IntroductionSmaller auditory cortex volume in schizophrenia patients with auditory hallucinations (AH) may be a result of reduced cortical surface area and/or cortical thickness. A neuro–imaging study from our group demonstrated that adult schizophrenia spectrum patients with AH had significantly thinner cortex in the left side Heschl's gyrus (HG), compared to patients without AH, and healthy controls (HC).ObjectivesThis study aims to investigate if adolescents with early-onset psychosis (EOP) and AH demonstrate thinner cortices in HG, as found in Mørch-Johnsen et al. in 2016, compared to EOP patients without AH, and HC.MethodsEOP patients (schizophrenia spectrum, psychotic disorder not otherwise specified) (n = 29) underwent MRI. Mean volume, cortical thickness and surface area in auditory cortex regions (HG, superior temporal gyrus [STG]) were compared between patients with AH (n = 20) and without AH (n = 9), measured with item P3 from the Positive And Negative Syndrome Scale (PANSS), and 48 HC.ResultsPreliminary results show no significant differences between patients with and without AH and HC in mean volume, cortical thickness, or surface area in HG or STG. There were no significant side differences across hemispheres for these structures.ConclusionsAH in EOP were not related to smaller volume, thinner cortex or reduced surface area in auditory cortex regions. To overcome the limitation of having a relatively small sample size, the sample will be expanded with other EOP cohorts. Investigations into HG structure variation in relation to AH in EOP will also be conducted.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Forensic care in Germany
Authors: Dressing H. , Salize H.J. 
Published: June 2017

Although the idea that offenders suffering from a mental disorder must primarily be considered as ill and should therefore be exempted from punishment is of considerable antiquity legal frameworks and key concepts, which are applied in this field, differ widely in European Union member States. The respective legal regulations and epidemiological data of Germany will be presented.In German penal law the question of the guilt of an offender is of central significance. Legal regulations on the placement and treatment of mentally ill offenders in a forensic psychiatric hospital are subsumed under the section “Measures on improvement and safety”. Section 63 of the German penal law provides for the temporally unlimited commitment to a forensic- psychiatric hospital.In accordance with section 64 of the German penal law addicted offenders can be committed to a detoxification center for a period of up to two years. The available epidemiological data show a clear increase in the admissions to forensic psychiatric hospitals and to detoxification centers since beginnings of the 1990s. Recently the German parliament passed a new law. The aim of the new law is to strengthen patients’ rights and to diminish the number of forensic patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychiatric Training in Perinatal Mental Health Across European Countries
Authors: Casanova Dias M. , Sonmez E. , Baessler F. , Kanellopoulos A. , Naughton S. , Pinto Da Costa M. , Ryland H. , De Picker L. 
Published: June 2017

IntroductionThe aim of postgraduate psychiatric training is to prepare psychiatrists to practice independently. The quality of care provided will depend on the training they received. Pregnancy and childbirth (usually called the perinatal period) are a high-risk period for many women with psychiatric problems. An illness episode at that time can have a devastating effect on women and the whole family, including the child's development.ObjectivesTo understand how perinatal mental health training is organized within Europe and how it fits in the training curricula.MethodsThe European Federation of Psychiatric Trainees conducts an annual survey of all member country organizations. We have asked respondents if they received training in perinatal psychiatry, whether that was optional or mandatory and what was its duration. Where training in perinatal psychiatry was not available we asked if they felt it should be.ResultsData will be presented from the 35 countries that responded in the 2016 survey. Six countries reported that training in perinatal mental health is available. But it is mandatory in only one, with the others offering a mix of theoretical and practical optional training. Of the 29 countries that do not offer perinatal psychiatry training, the majority reported it should be offered and mandatory.ConclusionThere is a gap in the expectations of psychiatrists treating women in pregnancy and after birth, and a widespread lack of training for them to be able to do so effectively.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Trauma and Migration in First Episode Psychosis
Authors: Tosato S. , Bonetto C. , Tarricone I. , Ruggeri M. , Tomassi S. , Morgan C. , Eugei G. 
Published: June 2017

IntroductionResearches show that the period of migration, or the migration process itself, may confer an increased risk for psychosis. Some studies have addressed whether the high rates of psychosis found in migrants could be due to higher genetic or environmental risk factors. Facing severe or chronic stress such as trauma, social isolation, low socio-economic status, late-life social adversity may result in long term, sometimes permanent, alterations of the biological stress response system, leading to the onset of psychosis.ObjectivesThis study aims to examine, in a large sample of first episode psychosis patients, whether negative social experiences like stressful life events and difficulties, trauma and isolation have significantly higher frequencies in migrants with respect to natives.MethodsThe present study is conducted within the framework of the EUGEI (European Network of National Schizophrenia Networks Studying Gene Environment Interactions) study, a Europe-wide incidence and case–control study of psychosis conducted in 12 centers chosen to include areas with large first and subsequent generation migrant populations.Data about age, gender, migration history, trauma, life events, ethnicity, social class and family history of mental disorders have been collected.ResultsPreliminary data on the relationship between trauma and migration in first episode psychosis will be presented.ConclusionsSince migration is an important stressful life event, and difficulties in integration in host countries may remain chronic, it is important to identify in each context the most vulnerable minority groups in order to implement targeted prevention interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Migration History and the Onset of Psychotic Disorders
Authors: Tarricone I. , Lastrina O. , Tosato S. , Di Forti M. , Murray R.M. , Domenico B. , Morgan C. 
Published: June 2017

IntroductionResearch has established that there are high rates of first episode psychosis (FEP) in immigrant populations. These findings could indicate that socio-environmental risk factors, such as individual social class, social capital, early trauma, life events, neighborhood deprivation could be relevant in explaining the differences in incidence rates observed between migrants and natives, following the socio-developmental model of Morgan et al. (2010). Some preliminary results also indicate that migration history itself versus ethnicity could implicate higher risk of the onset of psychotic disorders.AimsTo present preliminary findings from the EUGEI European Network of National Schizophrenia Networks Studying Gene Environment Interactions study.MethodsPopulation based FEP incidence/case control study. Comparison of the incidence rate of FEP and of the distribution of several risk factors (e.g. substance abuse, neighborhood deprivation, urbanicity and trauma) in natives and migrants in different countries across Europe.ResultsPreliminary results of the EUGEI study will be discussed in comparison with previous evidences.ConclusionThe EUGEI study allows a deeper understanding of the excess of FEP found among migrants in Europe.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Evolution of Negative Symptom Constructs
Authors: Mucci A. , Galderisi S. 
Published: June 2017

IntroductionNegative symptoms represent a separate dimension of schizophrenia psychopathology, distinct from positive symptoms, disorganization and cognitive impairment. It is increasingly acknowledged that negative symptoms are associated with poor functional outcome and represent an unmet need in schizophrenia treatment. Improvement in definition of their phenomenology, assessment instruments and experimental models are needed in order to improve schizophrenia prognosis.AimsThe presentation will review key aspects of the evolution of negative symptom constructs. In particular, findings concerning phenomenology, clinical assessment, association with functional outcome and brain imaging correlates will be presented.MethodsWe searched PubMed for English full-text publications with the keywordsSchizophrenia AND “negative symptoms”/“primary negative symptoms”/“deficit schizophrenia”/“persistent negative symptoms”/“affective flattening”/alogia/“expressive deficit”/apathy/asociality/“social withdrawal”/anhedonia/“anticipatory anhedonia”/avolition/neuroimaging.ResultsThe distinction between secondary negative symptoms (i.e., those due to identifiable factors, such as drug effects, psychotic symptoms or depression), and primary or persistent negative symptoms (i.e., those etiologically related to the core pathophysiology of schizophrenia) is grounded on solid research evidence and might have major implications for both treatment development and clinical care. The evidence that negative symptoms cluster in motivation- and expressive-related domains is founded on large consensus and empirical evidence and will foster pathophysiological modeling. The motivation-related domain is a stronger predictor of functional outcome than the expressive one.ConclusionsAn improved definition and assessment of negative symptoms needs to translate in large-scale studies to advance knowledge. In the short-term, the improved identification of treatable causes of secondary negative symptoms can translate into better care for people with schizophrenia.Disclosure of interestAM received honoraria or advisory board/consulting fees from the following companies: Janssen Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre.SG received honoraria or advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter.
Helping Abused Children from Various Minorities in the Greek Context
Authors: Kanellopoulos A. , Dionysopoulou K. , Antoniou X. , Marini E. , Nikolaidis G. 
Published: June 2017

IntroductionChildren's abuse and neglect is widely studied as a major risk factor for emotional and behavioural disorders, various somatic and psychiatric problems during adulthood.ObjectiveMental health is fundamental to health. Mental illnesses are real, disabling conditions affecting all populations regardless of race or ethnicity but disparities in mental health services exist for racial and ethnic minorities, and thus, mental illnesses exact a greater toll on their overall health and productivity.AimThe most important aim when working with ethnic minorities is to better understand the roles of culture, race and ethnicity, and overcome obstacles that would keep anyone with mental health problems from seeking or receiving effective treatment.MethodsThe Day Centre “The House of the Child” is a community unit which provides customized clinical mental health services for therapeutic treatment and psychosocial rehabilitation of children victims of abuse, neglect or domestic violence. The Day Centre was founded by the non-profit voluntary organization “THE SMILE OF THE CHILD”. The services are based on the bio-psycho-social model approach and treatment, which aim at early detection, and treatment of possible mental disorders and the overall psychosocial rehabilitation of victims of abuse/neglect and the support of their carers.ResultsBy identifying the many barriers to quality care faced by racial and ethnic minorities, the Day Center provides mental health services also to children who come from minority populations.ConclusionsDifferent case studies highlight challenges and various levels of difficulties in this specific scheme of cooperation aiming to open an interesting dialogue on the topic.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Evidence-based Medicine - A Critical Review
Authors: Gaebe W. 
Published: June 2017

Evidence-based medicine is a method to establish best practice recommendations based on graded recommendations for diagnostic and therapeutic issues in health care. In mental healthcare, evidence-based medicine has shown that the therapeutic procedures are efficient and can help to not only ameliorate the symptoms of mental disorders, but also to improve the quality of life of those affected by mental disorders. Evidence-based medicine is not, however, cookbook medicine. While evidence is mostly generated in larger group trials and should be applicable to the majority of cases, aspects of the personal situation, social support systems and legal boundaries all affect mental healthcare and may modulate the interpretation of the findings of evidence-based medicine. A human-based psychiatry will therefore need to use the methods of evidence-based medicine as a basis for diagnostic and therapeutic recommendations, but will also need to extend into the acknowledgements of personal accounts, traditions and the cultural framework, in which mental healthcare is provided. This presentation will highlight some of the issues associated with the questions of the roles of evidence-based medicine in mental healthcare, and in a human-based approach towards mental healthcare.Disclosure of interestUnterstützung bei Symposien/Symposia Support.Janssen-Cilag GmbH, Neuss.Aristo Pharma GmbH, Berlin.Lilly Deutschland GmbH, Bad Homburg.Servier Deutschland GmbH, München.Fakultätsmitglied/Faculty Member.Lundbeck International Neuroscience Foundation (LINF), Dänemark.
Psychosis and Schizencephaly – A Case Report and Systematic Review
Authors: Gunturu S. , Schmalz L. , Zebelian J. , Gonzalez L. , Drazinic C. , Korenis P. 
Published: June 2017

Psychotic symptoms have been reported in association with a wide array of brain abnormalities. Few published reports have examined the association between schizencephaly and psychiatric illness. Originally defined by Wilmarth and later by Yakolev and Wadsworth – Schizencephaly is an uncommon congenital disorder of cerebral cortical development, defined as a grey matter-lined cleft extending from the pial surface to the ventricle. The nosology is based on neuroradiologic findings and confirmed by neuropathology when available. The Clinical presentation and neurodevelopmental outcomes of the disorder vary and are usually related to the extent/areas of the brain involved. In this article we review the medical literature around Schizencephaly paying particular attention to the pathophysiology, etiology and diagnosis of such patients. We then present a case of Schizencephaly and first episode psychosis in a 16-year-old adolescent who was admitted to our inpatient psychiatric service. Lastly, we present the findings of a systematic review from PubMed whereby we summarize 10 cases of Schizencephaly with associated psychiatric symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Glutamatergic Synaptic Plasticity in the Periaqueductal Gray Governs Fear-induced Depression-like Behavior in Rats
Authors: Ho Y.C. , Hsieh M.C. , Lai C.Y. , Peng H.Y. 
Published: June 2017

IntroductionMajor depressive disorder affecting more than 110 million people worldwide every year is a heterogeneous illness influenced by a variety of factors, including repeated stressful factors. Despite widely research during the past several decades, the pathophysiology and neurobiological mechanisms of depressive disorders remain unclear. Ventrolateral periaqueductal gray (vlPAG), a midbrain nucleus, has been considered as an important part of the circuitry that involves in stress-induced depression-like behaviors. Dysregulation of glutamatergic neurotransmission in depressed patients suggests that glutamate-mediated excitatory system is critical involved in the depressive disorders.ObjectivesIt is still unclear that whether vlPAG involves in fear condition-elicited depression-like behavior.AimsWe investigated the synaptic transmission in the vlPAG to examine whether vlPAG participates in fear-induced depression-like behavior in rats.MethodsDepression-like behaviors, in the rats, were induced by learned helplessness procedure. The synaptic transmission was conducted by whole-cell patch-clamp recording in the rat brain slices containing periaqueductal gray.ResultsRats receiving learned helplessness procedure displayed high failure rate in the escapable foot-shock test compared to control group. Both amplitude and frequency of miniature excitatory postsynaptic currents were significant reduced compared to control group, suggesting reduced presynaptic glutamate release and postsynaptic responses were involved in the learned helplessness procedure-induced depression behavior in rats.ConclusionsReduced glutamatergic transmission in the vlPAG contributes to learned helplessness procedure-induced depression-like behavior in rats through pre – and post-synaptic mechanisms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Plastic Surgery Treatment of Post-bariatric Patients Cannot Remain “brainless”
Authors: Pavan C. , Vindigni V. , Vallesi A. 
Published: June 2017

IntroductionThe aim of this study was to investigate the presence of executive difficulties due to a lack of the management of cognitive conflict, inhibition, and cognitive flexibility in this group of patients. If executive difficulties are at the basis of uncontrolled alimentary behavior, these will be present also after a dramatic weight loss and could led to a poor compliance of the patient after plastic surgery procedures.Materials and methodsWe enrolled 21 consecutive post-bariatric patients. This clinical population was compared with a control group (n = 21) from the general population sharing the same clinical and demographic features. Psychiatric evaluation was performed. Executive difficulties were investigated through electroencephalography using the stroop task, sustained attention to response task, and task switching tests.ResultsThe patient group reported more frequently psychiatric disorders than control group. Patients had higher prevalence of lifetime major depression (58.3% vs. 14.3%), of lifetime panic disorder (36.1% vs. 4.8%) and generalized anxiety disorder (16.75% vs. 0%). Finally, patients were more frequently affected by body dismorphic disorder (chi2 = 8.867, P = .003). Electroencephalography confirmed the presence of executive difficulties sustained by a lack of the control of cognitive conflict and cognitive flexibility, and a difficulty of the inhibitory control in the patient group.ConclusionElectroencephalography confirmed for the first time the high prevalence of psychological/psychiatric problems in post-bariatric patients. Patients showing high values of executive difficulties will need a psychological/psychiatric support to sustain a positive outcome after post-bariatric plastic surgery.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Knowledge Takes up Space, a Family Affair
Authors: Garcia Ayala L. , Gomez Revuelta M. , Martin Requena C. , Juncal Ruiz M. , Olivares O. Porta , Garcia de Acilu E. Saez de Adana , Itoiz A. Aranzabal , Hernandez B. Gonzalez , Laborde Zufiaurre M. , Lopez Peña M.P. , Nuñez Morales N. , Zubia Martin M. , Gonzalez-Pinto Arrillaga A.M. 
Published: June 2017

IntroductionPrevious research suggests that hoarding aggregates in families and is associated with health, safety risks and family problems. Hoarding symptoms appear to be more common among first-degree relatives of people who hoard. A predominance of shared hoarding disorder has been observed among female relatives.ObjectivesWe present an atypical case report describing hoarding symptoms among first-degree male relatives who present two different subtypes of hoarding disorder.Materials and methodsWe report the case of a 38 years old male patient, attended for the first time by the mental health services at the age of 22, and being diagnosed of severe OCD at that moment. In the home visit paid by the social services, an excessive object hoarding was observed, including the presence of over 40,000 books.Moreover, they found a 38 years old man looking severely deteriorated; when they ask him about it, the patient's father admits to having been isolated in the house for almost 14 years. Hoarding history was gathered, through the acquisition of various objects by the patient's father, dating back to over 30 years ago.DiscussionThe harmonic coexistence for over a decade between two patients affected with a hoarding disorder with two different clinical setting subtypes was only made possible by the complementary nature of their symptoms.ConclusionThe hoarding disorders amongst more than one person living under the same roof are uncommon, can present themselves in both genders and can exhibit different symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.