bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cortisol, life events and cognition in non-demented subjects: A population-based study
Authors: Ouanes S. , Castelao E. , Von Gunten A. , Preisig M. , Popp J. 
Published: May 2016

BackgroundOlder people are particularly exposed to stressful events, known to activate the hypothalamus-pituitary-adrenal axis. Many studies highlighted the possible deleterious effects of elevated cortisol on cognition, assuming a likely role of stressful events. Yet, very few studies actually examined these assumed links between life events, cortisol and cognition.ObjectiveTo examine associations between salivary cortisol, cognition and life events in a population of non-demented old individuals.MethodsA cross-sectional analysis was conducted using data from Colaus/PsyColaus, a longitudinal population-based study involving 6733 Lausanne residents. Salivary cortisol samples (upon waking, 30 minutes after waking, at 11 am and at 8 pm) were obtained from 799 non-demented participants aged at least 60.Life events, activities of daily life along with depressive symptoms were assessed using a standardized questionnaire. A comprehensive neuropsychological test battery was used to determine the Clinical Dementia Rating (CDR).For multiple comparisons, P values were adjusted (P′) according to Holm-Bonferroni's method.ResultsCortisol at 11 am and cortisol area under the curve (AUC) were positively correlated with CDR sum of boxes (CDRSOB) scores (P′ = 0.035; Rho = 0.097 and P′ = 0.024; Rho = 0.110, respectively). The association between cortisol AUC and CDRSOB remained significant after controlling for age, sex, body mass index, education, smoking and depression (P = 0.001; β = 0.001; R2 change = 0.016).The number and the total impact of life events were associated neither with cortisol nor with CDRSOB.ConclusionsElevated cortisol was associated with poorer cognitive functioning yet independently of life events. This suggests that the increased cortisol associated with poorer cognition might be not a mere reflection of stressful events but rather explained by other factors, yet to be elucidated.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Clinical features in insulin-treated diabetes with comorbid diabulimia, disordered eating behaviors and eating disorders
Authors: Deiana V. , Diana E. , Pinna F. , Atzeni M.G. , Medda F. , Manca D. , Mascia E. , Farci F. , Ghiani M. , Cau R. , Tuveri M. , Cossu E. , Elena L. , Mariotti S. , Carpiniello B. 
Published: May 2016

Adherence to self-management and medication regimens is required to achieve blood glucose control in diabetic patients. Therefore, diabulimia, the deliberate insulin restriction/omission to lose weight, and other disordered eating behaviors (DEBs) or eating disorders (EDs), place these patients at risk of complications.We aimed to establish the frequency of diabulimia, DEBs and EDs among patients with type 1 and 2 diabetes (T1DM and T2DM) and their association with other clinical features.A total of 211 insulin-treated diabetic patients (13–55 years old) answered the Diabetes Eating Problem Survey-Revised (DEPS-R), a diabetes-specific screening tool for DEBs, and the Eating Disorders Inventory-3 (EDI-3). SCID-I modified according to DSM-5 criteria was used to diagnose EDs.At the DEPS-R, 20.8% of the sample scored above the cutoff, more frequently females (P = 0.005), patients with T1DM (P = 0.045), with a diagnosis of ED (P < 0.001), positive to the EDI-3 (P ≤ 0.001), with physical comorbidities (P = 0.003), with HbA1c > 7% (P = 0.020). Combining data from the interview with the results at the DEPS-R, 60.2% of the sample presented diabulimia. Dividing the sample by gender, we found that diabulimic females more frequently used diet pills (P = 0.006), had significantly higher HbA1c (P = 0.019) and STAI-Y1 scores (P = 0.004). Other DEBs comprised dietary restraint (51.8% of the sample), binge eating (42.2%), vomiting (6.2%), diet pills (7.1%) or laxatives (1.9%) or diuretics use (4.3%). Overall, 21.8% of the sample, mostly females (P < 0.001) met criteria for at least one DSM-5 diagnosis of ED.Diabetic patients, especially women, should be carefully monitored for the presence of diabulimia, BEDs and EDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Peripheral sub-inflammation is associated with antidepressant consumption in schizophrenia. Results from the multi-center FACE-SZ dataset
Authors: Fond G. , Godin O. , Llorca P.M. , Leboyer M. 
Published: May 2016

ObjectivesThe relation between C-reactive protein (CRP), depression and antidepressant consumption has been well explored in major depressive disorders but not in schizophrenia, which has a high rate of depression comorbidity. The objectives of this study were:– to determine the prevalence of abnormal CRP levels, depression and antidepressant consumption in a multi-center community-dwelling sample of subjects with schizophrenia;– to determine the association between abnormal CRP levels, depression and antidepressant consumption in schizophrenia.MethodTwo hundred and nineteen stable patients with schizophrenia (mean age = 31.6 years, 75.3% male gender) were systematically included in the multicentre network of FondaMental Expert Center for schizophrenia (FACE-SZ) and assessed with Calgary Depression Scale for depression. High sensitivity CRP (hs-CRP) was measured with an assay using nephelometry (Dade Behring). Abnormal CRP level was defined by levels > 3 mg/L. Current medication was recorded.ResultsOverall, 63 subjects (28.8%) were found to have abnormal CRP levels, 43 (20.1%) received a diagnosis of comorbid current depression, and 51 (31.9%) had ongoing antidepressant treatment. In univariate analysis, abnormal CRP levels were found to be significantly associated with metabolic syndrome (P = 0.0011) and with antidepressant consumption (P = 0.01), while depression, psychotic symptomatology, age of onset, illness duration, sociodemographic characteristics, current tobacco or cannabis status were not (all P > 0.05).In a multivariate model, abnormal CRP was highly associated with antidepressant consumption independently of other confounding variables (adjusted odd ratio = 2.9, 95% confidence interval 1.2–6.8).ConclusionAbnormal CRP levels in schizophrenia were found to be associated with antidepressant consumption, but not with depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Substance use disorders: Baclofen as a promising drug
Authors: Gomes da Costa S. , Yanina Pasini O. , Maside Oliete B. , Balcells Olivero M.M. 
Published: May 2016

IntroductionBaclofen, a drug currently used in the treatment of spasticity, has been reported to be useful in reducing the intensity of withdrawal symptoms of substance use disorders of alcohol or other psychotropic drugs.ObjectivesWith our clinical case we aim to demonstrate that baclofen reduces severe withdrawal symptoms and also helps to achieve and maintain abstinence in severe cases, in agreement with the current literature.Aims/methodsWe present a clinical case of a 68 year-old patient with alcohol use disorder since his childhood, with familiar antecedents, multiples relapses and associated organic pathology such as alcoholic polyneuropathy and Wernicke syndrome. We used to high doses of baclofen to reduce the craving and withdrawal symptoms. Additionally, we searched in PubMed for more case reports and for a systematic review of the efficacy and tolerability of baclofen.ResultsWe were able to demonstrate that high doses of baclofen can be useful in resistant cases of substance use disorders like alcoholism. For our case study, we obtained positive results with a large remission, in comparison with the previous detoxications, with doses up to 150 mg/day.ConclusionsWe conclude that baclofen is an interesting alternative for resistant cases, with a good outcome and tolerability, in complicated patients, with important organic repercussions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The effects of the last global economic crisis on the suicide rate in Europe
Authors: Dumitru M.M. , Constantin B.S. 
Published: May 2016

IntroductionSince 1897, Émile Durkheim noted that suicides occur more often during the economic changes that disrupt the social structure of society.Objective and aimsThe objective of this study is to analyze the consequences of last global economic crisis on mortality by suicide in the EU countries in period 2007–2012.Material and methodWe extracted data on mortality from the WHO database and unemployment trends from the EUROSTAT database. We had used this data to calculate the effect of unemployment on suicide rate, in pre-2004 and post-2004 EU countries.ResultsIf the number of suicides from 2007 was maintained in 2008–2012 period, EU 27 countries would have registered with 16,572 fewer suicides. The increase of suicides is based on the increasing number of suicides in men. The small increase in the suicide rate was recorded in Austria, France, Hungary and Slovenia. Luxembourg was the only country where the number of suicides was lower compared to 2007. In 2008, we can notice a slight decrease in the unemployment rate compared to 2007 and an increase in suicide by 3% in both groups of countries, followed by increasing suicide only in the post-2004 EU, where reach 10% in 2010, followed by a slight decrease in the coming years, while the unemployment rate gradually increases to 46% compared with 2007.ConclusionsIn European Union countries, suicides have increased both before and during the crisis, in periods in which unemployment rose. States that joined the EU after 2004 are more vulnerable in times of crisis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
What triggers help-seeking behaviour in “early stage” alcohol-dependent drinkers
Authors: Ponizovskiy P. , Gofman A. 
Published: May 2016

AbstractIn early stages of alcohol addiction negative effects of alcohol often remain invisible to the patient or underestimated and considered “normal” by him. However, there is a cohort of alcohol drinkers who seek outpatient treatment in early stages of addiction.The study was conducted in order to investigate the triggers for seeking therapy in early stages of alcohol dependence when compulsive drinking, impaired control and increased alcohol tolerance are developed, but withdrawal symptoms followed by relief drinking are not yet observed. Fourty-six out-patients (31 men and 15 women, mean age 38 ± 7 years) were studied by means of audit and clinical interview.The average duration of alcohol abuse was 8,7 ± 5 years, the mean daily dose of alcohol was 10 ± 4 standard drinks. Most of the patients were drinking alcohol from several times a week to several times a month.The decision to seek treatment in most cases was pushed by patients’ family members because of the recurrent interpersonal problems caused or exacerbated by the effects of alcohol – 70% (n = 32). Other triggers included: job instability – 35% (n = 16); alcohol blackouts – 26% (n = 12); exacerbations of symptoms of existing physical conditions – 24% (n = 11); legal problems – 7% (n = 3).Alcohol consumption in early stages of alcohol addiction can affect nearly every aspect of a patient's life. The triggers which promote treatment-seeking behaviour should be addressed in the course of the treatment in order to encourage recovery and prevent transition to more severe stages of the disease.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Related factors with substance use in old adults
Authors: Ros-Cucurull E. , Daigre C. , Grau-Lopez L. , Barral C. , Abad A.C. , Ortiz M.B. , Martinez-Arias R. , Garcia E. , Cardona C. , Jacas C. , Casas M. , Roncero C. 
Published: May 2016

IntroSubstance use disorder is a growing phenomenon among the elderly. It is undervalued, misidentified, underdiagnosed and poorly treated.AimStudy prevalence, characteristics and risk factors associated with drug use among the elderly.MethodA 6-month prospective study of substance use in elderly patients (65+) who attended the addiction and dual diagnosis unit, Vall d’Hebron University Hospital.ResultsFifty-nine patients evaluated, mean age 70.04 years, 60% men. A total of 49.1% are married, 35.8% divorced and 53.8% live with a partner and/or children. A total of 67.3% have basic studies and 78.8% are pensioners. A total of 82.7% have no criminal record.Medical comorbidity presents in 90.4% of the sample, psychiatric and addictive family background in 42.3% and 37.3%. A total of 67.3% have comorbid Axis I (mainly affective disorders) and 25% Axis II (cluster B most). A total of 7.7% attempted suicide at least once.The main substance is alcohol (76.9%), followed by prescription drugs (19.3%). A total of 28.8% are multi-drug users. A total of 67.3% have used tobacco in their life and 63.5% are currently dependent. The average age of onset for a disorder for any substance consumption is 28.19, being lower for alcohol and illegal substances and higher for prescription drugs.A total of 61.5% have gone through treatment before but only 32.7% has been admitted because of addiction. The adherence rate is 90.4% and the relapse rate 8.3% at first month and 13% at 6 months.ConclusionsOld adults present differences compared to overall drug user population: prevalence by gender is almost equal, lower Axis II, less multi-drug consumption and both dropout and relapse rate are drastically lower.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Dissociative disorder – unraveling the mystery
Authors: Sousa L. , Antunes A. , Oliveira S. 
Published: May 2016

IntroductionDissociative disorders are among the most enigmatic and controversial psychiatric pathologies. In the last decades, great interest has emerged in understanding its pathophysiology, nonetheless, problems in recognition and management of these disorders are still challenging the psychiatric community.ObjectivesWe describe a paradigmatic case of a dissociative disorder illustrating the “choice” of dissociation as a strategy for coping with a traumatic reality.AimCall attention to problems that interfere with the recognition, diagnosis and management of dissociative disorders.MethodsBibliographic research was conducted through the PubMed in the Medline library and clinical information was obtained through medical records and clinical interviews with the patient.ResultsA 51-year-old Brazilian woman with no psychiatric history presented to the psychiatric outpatient care with apparent dissociative symptoms, these consisted of amnesia for episodes of agitation and aggressive behavior that occurred mainly at bed time. She had been previously on general practice and neurology consultations but none organic diagnose was made. Already in psychiatry, it was recognized that those symptoms developed together after a car accident and the beginning of a romantic relationship. It was also recognized that she has sexual dysfunction and a history of sexual abuse by a family member during her childhood, a known risk factor to dissociative disorders.ConclusionsSkepticism and lack of understanding might be the reason for late psychiatric referral after the realization of various expensive and time-consuming medical exams. Improving the recognition of dissociative disorders will conduce not only to better clinical outcomes but also improve cost effectivity of medical interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Predictors for readmission within one year after discharge from an alcohol rehabilitation program
Authors: Müller M. , Weniger G. , Prinz S. , Vetter S. , Egger S. 
Published: May 2016

IntroductionAlcohol use disorders have been associated with an increased risk of frequent readmissions. This study aimed to examine factors that contribute to the risk for readmission within one year after discharge from an alcohol rehabilitation program.MethodsRehospitalization status was assessed for all patients with an alcohol use disorder as primary diagnosis (n = 468) admitted to our inpatient unit between July 1, 2012, and June 30, 2014. All patients were followed up for one year after their first hospitalization (index hospitalization) within this period. Time to readmission within one year after discharge was measured using the Kaplan–Meier method. Risk factors for readmission were examined using Cox proportional hazard regression models. Three set of variables were selected to be included in the analyses:– demographic features at time of admission of index hospitalization;– comorbid conditions at time of admission of index hospitalization;– treatment-related variables in relation to the index hospitalization including observer-rated outcome measures.ResultsReadmissions within one year after discharge from an alcohol rehabilitation program as well as the corresponding time to readmission were linked to higher numbers of previous hospitalizations and the presence of comorbid opioid use disorders.ConclusionHigher numbers of past treatments for AUD are indicators for a chronic course of the disorder, which, in turn, increase the risk of further relapses. Our findings further confirmed previous findings suggesting high rates of comorbidity among alcohol and opioid use disorders, and their link with poorer clinical outcomes.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Frontotemporal dementia and psychosis: Literature review
Authors: Brandão D. , Massano J. 
Published: May 2016

IntroductionFrontotemporal dementia (FTD) is a progressive neurodegenerative disease especially sporadic. About 30–40% have positive family history, with an identifiable genetic mutation in a percentage of cases increasing. Although the FTD psychosis has been recognized for many years, it is not included in the clinical criteria.ObjectivesTo assess the prevalence and characteristics of psychotic symptoms in FTD, compare the presence of psychosis in FTD C9+ versus C9− and analyze the occurrence of wrong diagnoses in FTD with psychosis.MethodsLiterature review, using computerized databases (Pubmed®). Articles were selected based on the content of their abstract and their relevance.ResultsIt is frequently the presence of psychotic symptoms in FTD associated with C9+ versus C9−. These may arise as initial symptom often leading to a psychiatric diagnosis years before obtaining diagnosis of FTD. There is no conclusive evidence about the anatomical correlation of psychotic features in the FTD, although there is the possible association with the right brain degeneration.ConclusionsThe existence of psychotic symptoms do not argues against the diagnosis of FTD verifying a high frequency of psychosis in FTD – C9+. As can be the first symptom in FTD is critical to differentiate psychiatric disorders. Further studies are needed in order to obtain a better characterization of psychotic symptoms in FTD – C9+.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The relationship between language deficit, severity and structure of cognitive decline and BPSD in patients with dementia and MCI
Authors: Kralova M. , Meszaros Hideghety B. , Markova J. , Csefalvay Z. , Hajduk M. 
Published: May 2016

IntroductionComprehensive language testing shows a strong relationship between overall severity of cognitive decline and language deficit. Moreover, the language performance can be affected also by neuropsychiatric symptoms of dementia.AimTo detect the language deficits in sentence comprehension in patients with MCI and dementia and to determine the relationship between them, the severity and the structure of cognitive impairment and independently between them and BPSD.MethodIn the sample of 46 cognitively declined patients (MCI and dementia, majority of them with Alzheimer's disease), we evaluated the severity and the structure of cognitive impairment by means of MoCA instrument, language deficits by our own sentence comprehension test and BPSD by means of NPI-Q.ResultsThe average performance in the sentence comprehension test was about 90% of normal in the group of MCI patients, about 75% in mild, about 60% in moderate and only about 20% in the group of severe dementias. According to individual cognitive domains, their impact on language performance was different. We found a strong correlation between the overall severity of BPSD and the language performance, too.ConclusionAt earlier stages of cognitive disorders/dementias, the language specific test should be used to discover comprehension deficits, because at the simple level of word the language skills are preserved. BPSD are also associated with language deficits even when the severity of dementia is controlled for. Identification of these communication disturbances can help to detect cognitive decline earlier and to start preserving treatment in time.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The advantage of fear stimuli in accessing visual awareness
Authors: Gomes N. , Silva S. , Silva C. , Azevedo J. , Soares S. 
Published: May 2016

IntroductionSeveral studies have shown that evolutionary relevant fear stimuli hold a privileged access to the fear module, an independent behavioral, psychophysiological and neural system that is automatically and selectively activated, and is relatively encapsulated from more advanced human cognition. However, to the best of our knowledge no study has yet directly assessed whether such stimuli are granted a facilitated access to visual awareness, compared to stimuli without such evolutionary relevance.ObjectiveIn the present study we used an interocular suppression technique, the Continuous Flash Suppression, known to reduce the activity along the geniculostriate pathway and to strongly suppress processing in the visual cortex.AimOur goal was to investigate whether ecologically relevant fear stimuli (snakes and spiders) overcame suppression and accessed awareness to a larger extent than non-evolutionary relevant animal stimuli (birds).MethodThirty university students volunteered to participate. Participants were asked to identify the screen quadrant in which the stimulus was presented in order to ensure that there was indeed a conscious processing.ResultsThe results confirmed our hypothesis by showing an advantage of fear stimuli (snakes and spiders) over the control stimulus (birds) in emerging from suppression into awareness, which was evidenced by significantly shorter response times.ConclusionsOur findings support the notion that evolutionary relevant stimuli hold a privileged access into awareness, most likely involving a direct brainstem-thalamic route to the amygdala. Importantly, they contribute to elucidate the functions and mechanisms of the fear system and may have important implications for understanding emotional disorders, since many of these involve the fear system.Disclosure of interestThe authors have not supplied their declaration of competing interest.