bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive response factors of repetitive transcranial magnetic stimulation in treatment-resistant depression
Authors: Calvet B. , Gardère O. , Girard M. , Clément J.P. 
Published: June 2017

IntroductionRepetitive transcranial magnetic stimulation (rTMS) is a neurostimulation technique used in many indications, especially in psychiatry in the treatment of mood disorders. Although its efficacy in this treatment has been demonstrated, the study of predictive response factors currently remains a major challenge.MethodWe conducted a retrospective study from the cohort of treatment-resistant depressed patients that received rTMS treatment in Esquirol Hospital in Limoges in order to identify response predictors at three months. Of the 416 patients treated between January 2007 and November 2015, 107 subjects have been included. The clinical characteristics of responders and nonresponders at three months after treatment, but also at the end of treatment and after one month were compared. Predictors of clinical improvement objectified by the Hamilton Depression Rating Scale (HDRS) were identified using a logistic regression model.ResultsIn our cohort, the response rates were 52% at the end of treatment, 61% at 1 month and 57% at 3 months. Psychiatric family history and the recurrence of thymic episodes were found to be negative predictors of response to rTMS treatment. Similarly, high subscore of depression core symptoms in HDRS could also predict a poorer response.ConclusionOur data from a naturalistic cohort tended to prove that a number of clinical features should be taken into account in determining the profile of the treatment-resistant depressed patients that could respond to rTMS treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A systematic review and meta-analysis of the mortality rate of electroconvulsive therapy (ECT)
Authors: Torring N. , Sanghani S.N. , Petrides G. , Kellner C.H. , Ostergaard S.D. 
Published: June 2017

IntroductionElectroconvulsive therapy (ECT) is an efficacious treatment for many mental disorders, but is underutilized because of fears of adverse effects, including the risk of death.Objectives and aimsTo provide a full picture of the magnitude of ECT-related mortality worldwide.MethodsWe performed a systematic review and meta-analysis (PubMed and Embase) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Only publications reporting on a specific number of ECT treatments as well as specific number of ECT-related deaths were included in our analysis. The ECT-related mortality rate was calculated by dividing the total number of ECT-related deaths by the total number of ECT treatments. The 95% confidence interval (95% CI) of this estimate was calculated using Bernoullis principle of distribution.ResultsFourteen studies with data from 32 countries reporting on a total of 757,662 ECT treatments met the predefined inclusion criteria. Fifteen cases of ECT-related death were reported – yielding an ECT-related mortality rate of 2.0 per 100,000 treatments (95% CI: 1.0–3.0). In the eight studies published after 2001 (covering 406,229 treatments), no ECT-related deaths were reported.ConclusionsThe ECT-related mortality rate was estimated at 2 per 100,000 treatments. For comparison, a recent meta-analysis on the mortality of general anaesthesia in relation to surgical procedures reported a mortality rate of 3.4 per 100,000. Thus, our systematic review and meta-analysis documents that death caused by ECT is extremely rare. This information can be used to reassure patients in need of ECT.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Predictive biomarkers in clozapine-treated patients: Assessment of the evidences and suggestion for research methodology
Authors: Cerrato F. , Guizzaro L. , Scudellari P. , Atti A.R. , De Ronchi D. 
Published: June 2017

IntroductionPredictive biomarkers are tools that identify a subpopulation of patients who are most likely to respond to a given therapy. In order to identify them a strict methodology is necessary (RCT's studies). In consideration of its cost in economic and medical terms, predictive biomarkers would be useful to distinguish clozapine-resistant patients before its administration.AimsThe evidence concerning genetic biomarkers was reviewed with the aim of assessing whether there is enough evidence to claim for predictive biomarkers useful in practice. Secondary aims were the assessment of the evidence concerning genetic prognostic biomarkers and predictors of side effects in clozapine-treated schizophrenic patients.MethodsOne hundred and twenty-eight studies, searched on the Pubmed database or referenced in other studies, were included in this review. Sixty-five papers were related to clozapine efficacy and explored 167 genetic variants.ResultsFifty-four variants were supported as prognostic biomarkers, three were successfully replicated: rs6280, rs6314 and rs4680; 49 papers were related to clozapine weight gain and explored 216 different genetic variants. Forty-five of which were positively related to weight gain during clozapine treatment. Among these 45 variants, only two, Rs3813929 and Rs779039, were successfully replicated.Fourteen studies explored 111 genetic variants potentially correlated to Clozapine-induced agranulocytosis. Thirty-four variants were found to be associated with agranulocytosis. Five variants had positive results, successfully replicated. In particular, HLA B38.ConclusionsTo date there is no evidence to support a modification of clinical practice towards predictive medicine. The research could ideally progress with RCTs involving the prognostic factors found in association studies.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Loss of motivation and frustration for visitor surgeons in provincial health centers or psychiatric hospitals in Greece
Authors: Christodoulou I. , Pogonidou E. , Pogonidis C. , Charalambous C. 
Published: June 2017

IntroductionThe core workplace for a surgeon is the operating theatre. Secondary duties may include visits to small health centers for outpatient examinations and visitor work to psychiatric hospitals.ObjectiveThe objective of our study is to highlight the mistakes of management that lead to half-empty provincial health centers and psychiatric hospitals.MethodsPresentation of the 2-year-experience of a surgeon visitor in provincial health centers and in a large psychiatric hospital in Greece.ResultsThe provincial health center of Lagada needs at least 4 surgeons to serve; too many patients to be examined or/and operated in 2–3 hours only. Subsequently problems arise, as simultaneously in the emergencies department a surgical eye for an abdominal pain or a bad looking leg is needed every 15 minutes. The health center of Koufalia needs 3 hours of driving per day for 3–8 surgical patients only. The psychiatric hospital offered work for 3 surgeons 5 days a week for a long period of time. During 2012–2014, only one surgeon visited the hospital once a week. The work needed to be done may kill the surgeon or force him to receive antidepressants in order to keep his functions alive.ConclusionsNot a hint of scientific motivation for two years is a strong reason for a surgeon to avoid the duty to provincial health centers and psychiatric hospitals which is obligatory according to our national health system Laws until two years are completed for newly appointed surgeons. Managers might encourage surgeons if some balancing convenience was offered.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Clozapine augmented with risperidone in treatment-resistant schizophrenia
Authors: Sulejmanpasic G. , Bise S. 
Published: June 2017

IntroductionThe evolution of various pharmacological therapies for schizophrenia has given rise to several pharmacological models for the neuroreceptor targets of antipsychotics and the influence of various neuroreceptors on specific symptoms and side effects.ObjectivesExperience in clinical practice affirms clozapine's position as the treatment of choice for patients with treatment-refractory schizophrenia. Unlike clozapine, risperidone has a more targeted profile of neurotransmitter binding, with particular predilection for dopamine and serotonin receptors. Risperidone is, to date, the most extensively documented clozapine augmentation agent.AimThe aim was to evaluate clinical efficacy, safety and tolerability of augmenting clozapine with risperidone in patients with treatment-resistant schizophrenia.MethodsIn a randomized, double-blind, placebo-controlled 8-week trial, 10 patients unresponsive or partially responsive to 300 mg/day of clozapine monotherapy (n = 5) received a steady dose of 450 mg/day clozapine combined with or up to 4 mg/day of risperidone (n = 5). Patient psychopathology was assessed at 2-week intervals with the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS) and Clinical Global Impression (CGI) improvement scale.ResultsFrom baseline to week 4 and week 8, mean BPRS total and positive symptom subscale scores were reduced significantly in both groups, but the reductions were significantly greater with clozapine/risperidone treatment. Reductions in SANS scores were also significantly greater with clozapine/risperidone treatment than with clozapine monotherapy group. Clozapine/risperidone treatment did not induce additional weight gain or agranulocytosis compared with clozapine monotherapy treatment.ConclusionsClozapine augmentation with risperidone appears to be well tolerated, safe and may provide additional clinical benefit for patients who are nonresponsive or only partially responsive to clozapine alone.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Differentiated psychopharmacological treatment in three genetic subtypes of 22q11.2 deletion syndrome
Authors: Verhoeven W.M.A. , Egger J.I.M. , de Leeuw N. 
Published: June 2017

IntroductionThe 22q11.2 deletion syndrome (22q11DS), mostly caused by the common deletion including the TBX- and COMT-genes (LCR22A-D), is highly associated with somatic anomalies. The distal deletion (distal of LCR22D) comprises the MAPK1-gene and is associated with specific heart defects. The rare central deletion (LCR22B-D) encompasses the CRKL-gene and shows predominantly urogenital anomalies. 22q11DS also differs in its neuropsychiatric profile: common deletion accompanied by schizophrenia-like psychoses and autism spectrum disorders, distal deletion by anxiety disorders, and central deletion by autistic-like behaviours.ObjectivesInvestigating genetic subtypes of 22q11DS.AimsAchieving a targeted pharmacological treatment based on genetic sub-typing.MethodsThirty-two patients with genetically proven 22q11DS, referred for detailed neuropsychiatric analysis.ResultsApart from two patients with distal deletion and one with central deletion, common 22q11.2 deletion was detected in 29 patients. Those with the common deletion were typified by a history of relapsing schizophrenia-like psychoses and partial non-response to conventional antipsychotics. In most patients, anxieties and mood instability were also manifest. The two patients with a distal deletion predominantly showed anxiety symptoms, while the behaviour of the patient with a central deletion was characterized by symptoms from the autism spectrum. Most patients with a common deletion could successfully be treated with clozapine or quetiapine, often combined with valproic acid. One patient with a distal deletion showed full remission upon treatment with citalopram (the second refused such a pharmacological intervention). The behaviour of the patient with central deletion improved upon contextual measures only.ConclusionsThe genetic subtype of 22q11DS enables targeting of treatment strategy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Smoking and tardive dyskinesia in patients with schizophrenia
Authors: Zouari L. , Smaoui N. , Abida I. , Charfi N. , Maâlej M. , Zouari N. , Ben Thabet J. , Maâlej M. 
Published: June 2017

IntroductionTardive dyskinesia (TD) is a drug-induced movement disorder that arises with antipsychotics. These drugs are the mainstay of treatment for schizophrenia. Epidemiological studies have shown mixed results on smoking's association with TD.ObjectiveTo study the association between smoking and TD induced by antipsychotics in outpatients with schizophrenia.MethodsThis was a cross-sectional study. It involved 89 patients suffering from schizophrenia, followed-up in outpatient psychiatry unit at Hédi Chaker university hospital in Sfax in Tunisia, between April and May 2016. We looked for TD in according to DSM-IV-R criteria. The intensity of TD was assessed with the Abnormal Involuntary Movement Scale (AIMS) and the level of nicotine dependence with the Fagerström Test for Nicotine Dependence (FTND).ResultsThe prevalence of smoking in patients with schizophrenia was 69.6%. Of these, 54.8% had a high or very high degree of nicotine dependence. The prevalence of TD was 33.7%. The AIMS average score was 12.13 ± 5.6 with extremes ranging from 3 to 26. TD was correlated with tobacco consumption (P = 0.003), the average number of smoked cigarettes (43.7 vs. 33.8; P = 0.004) and the Fagerström average score (7.2 vs. 6.1; P = 0.012).ConclusionThe results of this study showed a correlation between the amount of smoking and severity of TD in patients with schizophrenia. The nature of the relationship between smoking and TD needs to be clarified through an experimental study.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Attachment styles and severity of pathological gambling: Preliminary evaluations
Authors: Testa R. , Grandinetti P. , Pascucci M. , Bruschi A. , Parente P. , Pozzi G. , Janiri L. 
Published: June 2017

IntroductionThe addictive behaviors can be seen as attachment disorders. To our knowledge, the literature on the relationship between pathological gambling (PG) and attachment styles is still poorly represented. However, in addicted patients, the identification of secure or insecure attachment styles seems to have serious implications for the therapeutic alliance and the treatment.ObjectivesTo examine the clinical role of attachment styles in the PG patients.AimsTo study the relationships between the different attachment styles and PG and the severity of PG.MaterialsWe recruited 33 patients with GP according to DSM-IV-TR criteria; all patients were abstinent from addictive behaviors at least since one month, the experiences in close relationships (ECR) was administered to investigate attachment styles, the South Oaks Gambling Screen (SOGS) to investigate the severity of gambling.ResultsThe subjects showed the following attachment styles (Table 1). Ambivalent attachment style correlates with high scores to the SOGS (P < 0.001), and with a shorter period of abstinence from PG (P = 0.022). Patients with ambivalent attachment style have increased severity of PG at SOGS, correlating with higher raw score on the anxiety factor of ECR and lower raw score on avoidance factor (for both P = 0.036).ConclusionsPatients showed ambivalent attachment, and anxiety factor correlates with a greater severity of PG. Attachment style could be a severity index of PG. Our findings need to be replicated in larger groups, also widening the target of other addictions both chemical and behavioral.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Incidence of Internet addiction in adult attention deficit hyperactivity disorder
Authors: Tuzun Mutluer B. , Yener Orum T.G. , Sertcelik S. 
Published: June 2017

ObjectiveIn this study, it was aimed to determine the internet use properties of Adult Attention Deficit Hyperactivity Disorder (ADHD) patients who were followed-up at Haydarpasa Numune Research and Training Hospital, Psychiatry Department; ADHD Outpatient Clinic.MethodThirty participants who were diagnosed with adult ADHD aged between 18–31 years rated their ADHD symptoms in childhood retrospectively, using Wender Utah Rating Scale. Patients rated current adult ADHD symptoms with the Adult ADHD DSM-IV-Based Diagnostic Screening and Rating Scale (DSRS) and severity of symptoms measured by Adult ADHD Self-Report Scale (ASRS). Internet addiction (IA) was assessed with Young's Internet Addiction Scale (IAS). It was determined that, none of 30 Adult ADHD patients have been diagnosed with IA.29 of patient have moderate internet use although 1 of patients have risky internet use. The results revealed that total ASRS score (P = 0.020), total Adult ADHD DSM-IV-Based DSRS score (P = 0.036) and the Attention Deficit related properties subscale total score (P = 0.042) were significantly correlated with the IAS total score. Subscale of the self-report scales including; failing to finish schoolworks, chores, or duties at workplace, difficulty of following through on instructions (P = 0.017), restiveness; impaired inhibitory performance (P = 0.017), feeling not confident (P = 0.017), difficulty of managing time (P = 0.047), failing to give close attention to details or making careless mistakes (P = 0.037) are closely relevant to IAS total score.ResultIn conclusion, clinical features, which are characteristic of Adult ADHD could have same shared etiology with IA. Furthermore, ADHD patients are more likely to have an IA diagnosis. However, it was thought that this result had to be supported with studies including larger samples.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The burden of attempted suicide: The attitude of emergency services workers
Authors: Cuoghi G. , Venuta M. , Mattei G. , Sacchetti A. , Ferrari S. 
Published: June 2017

IntroductionThe great global burden of suicide requires specific preventive strategies focused on emergency services (ES) workers, providing first aid after attempted suicide.ObjectivesTo investigate the approach of ES workers toward attempted suicides, and to assess work-related stress and teamwork attitude as variables likely to influence suicide risk perception.MethodsA total of 265 ES workers (73 medical doctors, 130 nurses, 62 health and social care workers) from 3 hospitals in the area of Modena (Northern Italy) were involved. In a group setting, titles from local newspapers reporting about suicides were read, and ES workers were asked to fill in 3 psychometric scale questionnaires (SUIATT, MBI and SAQ).ResultsThe questionnaires returned were 88 (33%), 47% (n = 42) were filled by women, median age was 40 years. Doctors group had the highest response rate (60%). Burnout levels were intermediate at the Emotional Exhaustion subscale, severe at the Depersonalization subscale and mild at the Professional Efficacy subscale. Eighteen percent recorded a good team perception, 33% had a good perception of their work conditions. SUIATT subscales showed a restrictive attitude toward suicide, regardless of hospital and task.DiscussionNo associations emerged among SUIATT, MBI and SAQ subscales; male sex alone correlated to the SUIATT factor “rationality/mental alteration”, suggesting more “tolerance” of suicidal behaviour.ConclusionsIt is crucial to raise awareness among ES workers on this issue, since those workers considering suicide as “more acceptable” are more likely to recognise its signs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The impact of trait emotional intelligence and resilience on suicidal behavior in university students
Authors: Sojer P. , Kainbacher S. , Kemmler G. , Freudenthaler H. , Deisenhammer E. 
Published: June 2017

IntroductionSuicidal ideation has repeatedly been reported as a predecessor of suicidal behavior. Several neuropsychological parameters have been associated with suicidal ideation. Emotional intelligence (EI) and resilience, which play an important role in the emergence of psychiatric disorders may also be related with suicidality.ObjectivesThe main objective of this study was to investigate the relationship of trait EI and resilience with suicidal ideation. Moreover, we hypothesized that EI and resilience would be correlated with each other and that they were moderating variables between stressful life events and suicidal ideation.MethodsA total of 277 male and female students without current psychiatric diseases were recruited per online questionnaire asking for lifetime and 4-weeks suicidal ideation and demographic data and containing the Resilience Scale of Wagnild and Young, the Connor Davidson Resilience Scale and, for the measurement of trait EI, the Self-Report Emotional Ability Scale. Additionally, we applied the Social Readjustment Rating Scale to assess stressful life events.ResultsWe found significant negative correlations between lifetime and in part 4-weeks suicidal ideation and intrapersonal trait EI as well as resilience. Trait EI and resilience were interrelated. There was no significant moderating effect of trait EI or resilience on the relationship between SRRS score and suicidality.ConclusionAssessing EI and resilience as trait factors might be helpful in the prospective identification of suicidal individuals.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Who Learns More in Interprofessional Mental Health Simulation Training? A Study Comparing Learning Outcomes of Different Professionals who Work in Mental and Physical Health Care Settings
Authors: Valdearenas L. , Attoe C. , Cross S. 
Published: June 2017

IntroductionSimulation training has the potential to develop communication and teamwork skills, as well as technical knowledge and competency. Mental health simulation training aims to promote awareness of mental health conditions and to enhance human factors (or non-technical) skills that will enable professionals that work in mental and physical healthcare settings to improve their collaborative and patient-centered clinical practice. This study explored the differences in learning outcomes after a mental health simulation course between different professionals–nursing staff, medical staff, and allied health professionals.Aims and objectives This project examined the different learning outcomes of human factors, confidence and knowledge, for nursing, medical and allied health professionals following mental health simulation training.MethodsCourse-specific measures of confidence and knowledge were administered pre- and post-training to all participants, in addition to The Human Factors Skills for Healthcare Instrument (HFSHI). A post-course evaluation for with free-text responses to open questions regarding the impact of the training was utilised to collect qualitative data.ResultsWith data collection ongoing, preliminary results indicate differences in learning outcome depending on professional background, both in terms of quantitative measures and qualitative findings.ConclusionsLearning outcomes may differ for different professionals despite receiving the same simulation training focusing on mental and physical health, evidencing the importance of sharing individual learning experiences in simulation using a debrief model.Disclosure of interestThe authors have not supplied their declaration of competing interest.