bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristic distributions of CBF changes in remitted geriatric depression
Authors: Liao W. , Wang Z. , Shu H. , Zhang Z. 
Published: May 2016

BackgroundThe cerebral blood flow (CBF) is an absolute measure that superior to the relative measure of neural activity, blood oxygenation-level-dependent (BOLD). The previous studies have reported CBF abnormalities in the adult depressive patients. However, it is not clear whether the abnormal CBF could be improved in the remitted geriatric depression (RGD).MethodsWe enrolled 82 RGD patients and 90 age and education matched healthy controls. All the subjects underwent 3-T MRI with pseudo arterial spin labeling (pASL), and the pASL data were analysis voxel-by-voxel with control the gray matter volume.ResultsCompared with the healthy controls, the RGD patients demonstrated higher relative CBF value in left inferior temporal gyrus and left precuneus; while lower relative CBF value in right medial temporal and occipital cortex, right insula operculum (including parts of frontal, temporal and parietal cortex) and insula, right medial frontal cortex. When compared with the remitted early onset depression (EOD), the remitted late onset depression (LOD) showed lowed relative CBF value in right angular gyrus. While there was no significantly different relative CBF value between the RGD patients accompany with MCI and RGD patients with cognitive normal.ConclusionThe late life depression persists with CBF abnormalities in the remitted state. And it is implicit that hyperperfusion in the left brain cortex and hypoperfusion in the right brain cortex could be the specific form to RGD patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Prevalence of involuntary hospitalization in patients with depressive disorders
Authors: Palma Conesa Á. , Dinamarca Cáceres F.N. , Grifell Guardia M. , Galingo Guarin L. , González Contreras L. , Campillo Sanz M.T. , Pérez Solà V. 
Published: May 2016

IntroductionDepression is a disabling disorder with a high socio-economic impact. It might require hospitalization for symptom control and/or harm prevention. Other depressive disorders might as well require hospitalization in benefit of the patient. Hospitalization may be involuntary. Hospitalization willfulness in depressive patients has not been systematically studied in recent years.ObjectiveThe aim of this study is to explore the necessity of involuntary hospitalization in patients presenting depressive symptoms at the emergency service that were later diagnosed with a depressive disorder.Materials and methodsFrom all patients visited in the psychiatric emergency service from 2012 to April 2015 those that were hospitalized in the acute mental health unit and diagnosed with a depressive disorder were studied. All those monopolar depression diagnoses were considered, excluding those within the bipolar spectrum. Diagnosis followed CIE-9 criteria. A descriptive cross-sectional study of the samples was then conducted. Statistical analysis was performed using SPSS software (SPSS Inc., Chicago, Ill.).ResultsFrom all 385 depressive disorders, 169 were involuntary admissions (43.9%), 196 were voluntary (50.9%) and 20 were scheduled (5.2%), difference was statistically significant (P < 0.05). Mean age, was 59.52 years for involuntary admissions, 61.7 for voluntary and 63.6 years for scheduled, with a statistically significant difference (P < 0.05). Gender differences were not significant.ConclusionsMost depressive disorders were hospitalized voluntarily. However, a relevant percentage of patients required involuntary hospitalization. Younger patients presented a higher ratio of involuntary hospitalization. Reasons for involuntary hospitalization needs should be further studied.Disclosure of interestThe authors have not supplied their declaration of competing interest. Liliana Galindo is a Rio Hortega fellowship (ISC-III; CM14/00111).
Efficacy Of Lurasidone In Major Depression With Mixed Features: Pattern Of Improvement In Depressive And Manic Symptoms
Authors: Nierenberg A.A. , Tsai J. , Mao Y. , Pikalov A. , Suppes T. , Loebel A. 
Published: May 2016

IntroductionEvidence indicates that manic symptoms, below the threshold for hypomania (mixed features), are common in individuals with major depressive disorder (MDD).Objectives/aimsTo evaluate the effect of lurasidone on specific depressive and manic symptoms, based on Montgomery Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) items, in patients with MDD with mixed features.MethodsPatients meeting DSM-IV-TR criteria for MDD, who presented with 2–3 protocol-specified manic symptoms, were randomized to 6 weeks of double-blind treatment with lurasidone monotherapy 20–60 mg/d (n = 109) or placebo (n = 100). Change from baseline in the MADRS total, MADRS-6 core depression subscale, individual MADRS items, and total and individual items of the YMRS were analyzed by MMRM, and Cohen's d effect sizes (d) were calculated for week 6 change scores.ResultsLurasidone improved depressive symptoms at week 6 in the MADRS total score (–20.5 vs. –13.0; P < 0.0001; d = 0.8) and MADRS-6 core depression score (–13.0 vs. –8.5; P < 0.0001; d = 0.7). Significant improvement on lurasidone was observed at week 6 on all ten MADRS items (d = 0.36–0.78). Effect sizes for the MADRS-6 core depression subscale items ranged from 0.36 to 0.78 at week 6. Treatment with lurasidone was associated with significantly greater week 6 improvement on the YMRS (–7.0 vs. –4.9; P < 0.0001). Effect sizes for the 5 YMRS items with baseline item severity ≥ 2 ranged from 0.32 to 0.48.ConclusionsIn this study of MDD with mixed features, lurasidone was effective in treating the range of depressive and manic symptoms that patients presented with.Sponsored by Sunovion Pharmaceuticals Inc.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Effect Of a Single Nights’ Wake Followed By Bright Light Therapy On Agitation
Authors: Widmark-Jensen M. , Steingrimsson S. , Szabó Z. 
Published: May 2016

IntroductionWake-therapy (or “Sleep deprivation”) has the potential of providing a fast anti-depressive response as add-on treatment to pharmaceutical intervention. Agitation in a depressive state is well known and is often associated with interrupted sleep. Although hypomanic symptoms have been reported following a single nights wake, agitation has not been examined.ObjectiveTo examine if agitation increases among inpatients undergoing wake-therapy compared to treatment as usual (TAU).MethodsAdmitted patients suffering from a depressive episode will be randomized to either wake-therapy combined with bright light therapy in addition to TAU, including medication, or to TAU alone. Before wake-therapy, patients are assessed using PANSS-EC, aimed at measuring only agitation. The day after a single nights wake, the assessment will be repeated. Likewise, agitation will be assessed in the control group directly after randomization as well as the day after.ResultsIn this trial, 50 patients will be randomized for treatment. Results concerning agitation among patients that have undergone the trial will be presented.ConclusionsAgitation as a side effect of wake-therapy has been scarcely investigated and this randomized trial will contribute to the knowledge of agitation following wake-therapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Effectiveness Of Enhanced Cognitive Behavioral Therapy (cbt-e) In The Treatment Of Anorexia Nervosa – a Prospective Multidisciplinary Study
Authors: Danielsen Y. , Rekkedal G. , Frostad S. , Kessler U. 
Published: May 2016

IntroductionAccording to the most widely influential treatment guidelines from the National Institute for Health and Clinical Excellence and the American Psychiatric Association, existing evidence for adult AN treatment is weak, and more treatment studies are needed.Objectives/aimsThe primary objective of this project is to gain knowledge about the effectiveness of CBT-E in the treatment of Anorexia Nervosa (AN). Secondary objectives are to prospectively examine baseline predictors of treatment outcome/drop-out and to examine variables related to treatment process and patient engagement as predictors of outcome/drop-out. Thirdly, in a multidisciplinary approach, to focus on selected pathophysiological mechanisms including disturbed neuropsychological functioning, changes in the gut microbiota, immunological and genetic measures in patients with severe AN in different stages of the disease, and further to investigate to what extent they are related to treatment outcome.MethodsThe sample consists of patients aged ≥ 16 years with AN admitted to outpatient treatment (CBT-E) at Section for Eating Disorders, Haukeland University Hospital, Bergen, Norway. Outcome measures include BMI, self-reported eating disorder symptoms (EDE-Q), depression (BDI), anxiety (BAI) general psychiatric symptomatology (SCL-90-R, M.I.N.I 6.0), health related quality of life (CIA, RAND-36), physical activity (accelerometers) and neuropsychological functioning. The main measurement points are at the start of treatment, 3 months, end of treatment and one year follow-up. Baseline predictors of treatment outcome and drop-out will be examined as well as the association between early adherence, behavioral change, therapeutic alliance and treatment outcome. In addition biochemical, genetic and bacteriological assessments will be conducted.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Attachment Style And Cortisol Response To Psychosocial Stress In Eating Disorder Patients
Authors: Giugliano R. , Monteleone A.M. , De Riso F. , Nigro M. , Monaco F. , Volpe U. , Monteleone P. 
Published: May 2016

IntroductionStress exposure is a risk factor for both the onset and the maintenance of Eating Disorders (EDs). The attachment theory may provide a framework to explain the relationship between social stress and EDs, since secure attachment promotes the seeking for support in order to help people to face stressful events. The endogenous stress response system, including the hypothalamus-pituitary-adrenal (HPA) axis, is likely involved in mediating the role of attachment in the subjects’ coping with stressful situations.Objectives and aimsWe explored cortisol responses to the Trier Social Stress Test (TSST) of patients with EDs in order to evaluate possible associations between subjects’ attachment styles and HPA axis functioning.MethodsTwenty-one adult patients with EDs (7 with secure attachment and 14 with insecure attachment) filled in the Experience in Close Relationship (ECR) questionnaire, which assesses the adult attachment style, and were exposed to the TSST. Saliva samples were collected before and after the stress in order to measure cortisol levels.ResultsAs compared to ED patients with secure attachment, those with insecure attachment showed a significant different pattern of the HPA response to the stress test.DiscussionPresent findings suggest that attachment style may influence the HPA response to stress in patients with EDs and this effect may have relevant implications for the pathophysiology of EDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
‘Dar Kenn Ghal Sahhtek’ – An Effective Therapeutic Intervention
Authors: Falzon Aquilina F. , Grech A. , Zerafa D. , Agius M. , Voon V. 
Published: May 2016

Introduction‘Dar Kenn Ghal Sahhtek’ is a residential service for patients suffering from eating disorders, namely Bulimia Nervosa, Anorexia Nervosa and Obesity (Binge Eating and Non Binge Eating type). The focus will be made on the obesity services.Objectives1. To show that Dar Kenn Ghal Sahhtek has proved to be an effective therapeutic intervention towards obesity (with or without binge eating). 2. To show that from a recruitment of 30 obese subjects a substantial proportion met the DSM-5 criteria for Binge Eating Disorder.Aims1. To show that by means of questionnaires and physical testing a marked improvement was made following the therapeutic interventions offered at DKGS. 2. To highlight the high incidence of binge eating disorder in a sample of 30 obese subjects recruited via DKGS.Methods1. Interviewing the patient for the DSM-5 criteria of binge eating. 2. Comparing scores of questionnaires before admission and prior to discharge. 3. Evaluating the response to various treatment modalities.ResultsOn interviewing the group of 30 patients, 47.6% of the patients were found to be the diagnostic criteria of Binge Eating Disorder according to DSM-5 (Table 1).ConclusionFirstly, a considerable proportions of obese subjects proved to meet the DSM-5 criteria for binge eating while Dar Kenn Ghall Sahhtek has proved to be an effective therapeutic intervention towards obesity (with and without binge eating).Disclosure of interestThe authors have not supplied their declaration of competing interest.
Eating Disorders. Review Of Current Treatment Options For Anorexia Nervosa, Focused On Psychotherapy And Pharmacological Treatment
Authors: Sánchez Sánchez B. , Muñoz-Calero Franco P. , Rodriguez Criado N. , Cruz Fourcade J.F. , Martín Aragón R. , Bravo Herrero S. , García-Poggio Fernández M. , Gil-Eliche Moreno M. , De Cos Milas A. , Chinchurreta de Lora N. 
Published: May 2016

IntroductionAnorexia nervosa is a disorder of eating behavior that is a major health problem on our society. It is characterized by three main criteria: self-induced starvation, desire for thinness or fear of obesity, and the presence of medical signs and symptoms due to improper feeding. This work is focused on its treatment. The biopsychosocial approach allows the design and application of effective therapeutic strategies and a multidisciplinary team collaboration is essential.ObjectivesResearch of current pharmacological and psychotherapy treatments options of the disease.Material and methodsLiterature review based on articles and publications on this topic.ResultsIn anorexia nervosa, it is necessary to establish a therapeutic alliance between doctor and patient. Patient usually feels no motivation to improve. The different treatments options to combine, in terms of the patient status, are: nutritional rehabilitation, cognitive-behavioral, family and interpersonal psychotherapies and pharmacological treatment. It can be carried out at the ambulatory, at the day-hospital or by medical stay, even beyond patient will.ConclusionsNowadays, the nutritional rehabilitation is the best treatment established and it is the core treatment. About the psychotherapies, the cognitive-behavioral is the most used because it has exposed better results in all different studies proved and in clinical practices, followed by the family therapy which is the responsible of the patient family's treatment. Pharmacological treatment should not be used systematically and its exclusive use is not enough to resolve anorexia nervosa as there are needed also other treatments combined.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Differences In The Attitudes Of Clinical And Pre-clinical Medical Students To Mental Illness
Authors: Adekunte O. , Oliver C. , Owen B. 
Published: May 2016

BackgroundThe quality of care provided to psychiatry patients by doctors can be influenced by attitudes towards mental illness. Equally important is the attitude of medical students as future treating doctors towards mental illness. This survey compares the differences in the attitudes of pre-clinical and clinical years student to mental illness.AimsTo compare attitudes of pre-clinical and clinical medical students’ to mental illness.MethodsA cross-sectional survey of 212 clinical students (CS) and pre-clinical students (PS) at Newcastle University. Each responded anonymously to an electronic questionnaire. The responses take the form of: Yes/No, free text, order of preference, and Likert scale. Results were analysed based on basic statistical analysis.ResultsLittle differences exist between the 2 groups in their beliefs that psychiatric patients are not difficult to like, mental illness can be a result of social adversity, psychiatry patients often recover and that people with mental illness should be offered a job with responsibility. However, 54% PS disagreed that mental illness often leads to violence, compared to 66% CS and 87% of PS identified that mental illness can be genetic in origin compared with CS of 91%.ConclusionThis survey did not identify any significant difference between the attitudes of pre-clinical and clinical students in most of the domains. However, a higher percentage of clinical students associate violence with mental illness and are unwilling to consider an elective period in psychiatry.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Simulation Training - Pilot: Psychiatry Higher Trainees’ Mental Health Tribunal Report Writing, Oral Presentation And Cross-examination By Tribunal Panel
Authors: Adekunte O. , Owen B. , Burrell C. 
Published: May 2016

IntroductionSimulation provides a non-judgemental environment where trainees learn skills without compromising patients’ safety or dignity. It also provides safe environment where anxiety-provoking, real-life clinical situations can be recreated and repeatedly practiced. Mental health review tribunal is an anxiety-provoking experience for higher trainees and use of simulation can alleviate this anxiety.AimsTo develop trainees’ skills in writing of tribunal reports and giving oral evidence using simulation technique (ST).ObjectiveTo facilitate trainees’ familiarisation with the process of Mental Health tribunal and improve their skills in completing report and giving oral evidence using ST.MethodsThere are 2 sessions: one half-day session of interactive teaching providing fundamental details on essential elements of the tribunal process, duties and report. This is followed by 4-weeks gap to allow participants to prepare and submit anonymised patients’ reports to the panel. Finally, a second full day of presentation and cross-examination by (real) tribunal panel with 25-minutes of formative feedback.ResultsSix trainees participated in the pilot: A high percentage of participants strongly agreed or agreed that ST is an effective learning experience for tribunal report writing and cross-examination by the panel. Similar proportion agreed that ST helped to facilitate familiarisation with the tribunal process and that it is a satisfactory teaching method. Finally, all participants agreed that ST helped to achieve personal objectives for attending the seminar.ConclusionsSimulation in psychiatry is becoming an effective learning experience. The outcome of this pilot on report writing and cross-examination by tribunal panels how its increasing effectiveness and relevance in psychiatry.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Attitudes Towards Depression Of General Practitioners Can Be Improved By An Educational Program
Authors: Álvarez de Mon M.Á. , Manzanera R. , Lahera G. , Saiz-Ruiz J. , Alvarez de Mon M. 
Published: May 2016

BackgroundContinuous education of physicians is critical for the quality of medical care.ObjectivesTo investigate the attitudes of general practitioners towards depression and to evaluate the short- and long-term impact of a specific designed postgraduate university program in depression.MethodIn this prospective, interventional study participated 1322-certificated Family Practice specialist. They filled out the Depression Attitude Questionnaire (DAQ) Spanish validated version before starting the educational intervention; an official approved 12 ECTS postgraduate university program. The participant refilled the questionnaires at the end of the course and 6 months later.ResultsA total of 885 females and 420 males (mean 48 years) and with a mean clinical experience of 25 years participated in this study. Short-term after training, PGs positively significant (P < 0.05) changed their attitudes in the management of depression in 18 out 20 items of the DAQ. There were not significant changes in only item 1 related to the number of patients presenting depressive symptoms seen in the last 5 years and the knowledge of the underlying biochemical abnormality. In the long-term, the positive effects observed in the short-term did not significantly change. However, in item 1 a significantly increase was observed. The effectiveness of the intervention was related nor to the to the age and sex of the physician nor to the years of medical practice.ConclusionsA specific designed educational program can improve the attitudes in depression of GPs. Years of clinical practice are not a limitation for improving the medical attitudes of General practitioners in mental health.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Educational Project: Learning From The Patient
Authors: Flores P. , Soro M. , Orejas O. , Masferrer C. , Fernandez A. , Renom J. , Negredo M. 
Published: May 2016

IntroductionLearning from the patient presents a pedagogical experience where patients expert in mental health participate as teachers in the teaching-learning processes.This training activity is a pilot aimed to assess the impact and integration in the study plan of the students following the training course in auxiliary nursing care, Barcelona.ObjectivesTo offer a global vision on mental health problems in order to break the stigma, being the persons affected the main actors.Stress the value of the patient voice and its particular way of living and suffering the illness in order to offer a suitable attention.Promote the integration of expert patients as teachers in the education programs.MethodologyThe training activity starts with the evaluation of the previous mental health knowledge and believes of the students.Round table with the participation of:– 2 expert patients explain their history of life and how the illness affects their day-to-day life;– 2 mental health professionals explain how they help patients to recover and empower them.Four groups about the impact of illness on a personal, educational, working and social level.ResultsThe expert patients were very optimistic and reinforced their own self-esteem. The students show a more positive attitude towards mental illness and express that patients’ are first PEOPLE, then patients’ConclusionsThe expert patients collaborating with professionals are ready to become teachers in the health care academic programs and, specifically, in mental health.Taking into account the patient voice and vision improves the technical, personal and social competences of professionals.Disclosure of interestThe authors have not supplied their declaration of competing interest.