bluuebunny/crossref_metadata_2025_split huggingface dataset:
Traumatic stress and risk of severe mental illness: A nationwide cohort study
Authors: Okkels N. , Trabjerg B. , Arendt M. , Bøcker Pedersen C. 
Published: May 2016

IntroductionA history of traumatic events is prevalent in people with schizophrenia spectrum disorders and mood disorders. However, little is known about their etiological relationship.ObjectivesTo explore whether patients with acute or posttraumatic stress disorder are at higher risk of developing a schizophrenia spectrum disorder or mood disorder.MethodsIn this prospective cohort study using registers covering the entire Danish population, we used the Danish Psychiatric Central Research Register to identify patients with ICD-10 diagnoses of acute traumatic stress disorder and/or posttraumatic stress disorder. From inpatient and outpatient mental hospitals, we identified 4371 diagnoses with more than 18 million years of follow-up. Main outcomes and measures were relative risks (RR) with 95% confidence intervals (95% CI) of schizophrenia, schizophrenia spectrum disorder, bipolar disorder and mood disorder.ResultsThe incidence of traumatic stress disorder (TSD) has increased steadily from 0.6% in 1996 to 6% in 2012, showed a higher incidence in women and an age distribution with a peak-incidence in early adulthood. We found that diagnoses of TSD increase the risk of schizophrenia (RR 5.85, 95% CI 3.59–8.91), schizophrenia spectrum disorder (RR 3.82, 95% CI 2.38–5.75), bipolar disorder (RR 5.83, 95% CI 3.11–9.83) and mood disorder (RR 4.10, 95% CI 3.15–5.22). Risks were high in the first year after diagnosis of TSD and declined going forward in time.ConclusionsOur findings indicate that acute and posttraumatic stress disorder are etiological risk factors for schizophrenia spectrum disorders and mood disorders. If replicated, this may underline treatment of traumatized patients in prevention of severe mental disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Transcranial direct current stimulation in treatment – resistance unipolar major depressive disorder
Authors: Asadi M. , Mahdavi S. 
Published: May 2016

ObjectiveMDD is a common, chronic and recurrent illness .it is essential to reach full remission in acute treatment. tDCS is a non-invasive brain stimulation that uses direct electrical currents to stimulate specific parts of the brain.AimIs to assess the effectiveness of tDCS in patients with treatment resistance MDD.MethodEighty outpatients of a psychiatric clinic were selected. Subjects meet (DSM-IV) diagnostic criteria for MDD. All patients had failed to respond to at least two standard antidepressant medication, in the current episode. Patients with bipolar depressive disorder, MDD with psychotic and atypical features, other psychiatric disorders, sever medical condition, acute suicidality and pregnancy were excluded. All patients received stable drug regimens for at least two weeks before enrollment and drug dosages remained unchanged throughout the study. They revised 8 stimulation sessions, using a 2 mA current, for 20 minutes, in 8 consecutive days. The anodal electrode was placed over the left DLPFC. Cathode electrode over the right supraorbital region. Mood was evaluated with 21-item Hamilton Rating Depression Scale and the Beck Depression Inventory.We designed a pretest–posttest study and evaluate depression at baseline (pre-intervention), immediately after 8 sessions (post-intervention) and two months after treatment onset (follow-up).ResultsThere is a significant difference between Pre- vs. post-intervention (FBDI = 246.58, P < 0.001; FHRSD = 214.56, P < 0.001) and pre vs. Follow-up intervention (FBDI = 323.10, P < 0.001; FHRSD = 150.96, P < 0.001).ConclusionIt can be said that tDCS had effective and enduring variation (Ppostvs.follow-up > 0.05) in improving the clinical symptoms of MDD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Premorbid social adjustment is better in cannabis-using than non-using psychotic patients across Europe
Authors: Ferraro L. , Capuccio V. , Mulè A. , La Cascia C. , Sideli L. , Tripoli G. , Seminerio F. , Sartorio C. , La Barbera D. , Murray R. , Di Forti M. 
Published: May 2016

IntroductionA number of authors have hypothesized that psychotic patients who consume cannabis constitute a differentiated subgroup of patients that have better cognitive and social skills, necessary to engage in illegal drug consumption, than non-using patients.ObjectivesGiven that the prevalence, and patterns, of cannabis use are culturally driven, we wanted to study first-episode psychosis (FEP) cannabis-using and non-using patients coming from different European countries as part of the EUGEI-STUDY.AimsWe tested the hypothesis of better premorbid social adjustment in cannabis-using FEP patients, by comparing them to FEP non cannabis users and to their respective healthy controls.MethodsA total of 1745 people (746 cases; 999 controls) completed the assessment for premorbid adjustment [Premorbid Adjustment Scale (PAS)] and cannabis use (CEQ-Revised). We first extracted the Premorbid Social Adjustment Factor (PSA) from PAS and then performedlinear mixed models with PSA as dependent variable and cannabis lifetime (Yes/No) and subject status (Cases/Controls) as independent variables. We then considered “Country” as random intercept.ResultsAcross all countries, PSA scores were better in patients who had smoked cannabis in their lifetime than patients who had not (P = 0.009). The difference in PSA score between cannabis users and non-users was significantly greater in cases than controls (P = 0.038). The relationship between PSA, cannabis lifetime (Yes/No) and subject status among nations (random intercept) is shown on Fig. 1.ConclusionsCannabis-using psychotic patients show better premorbid social adjustment than non-using patients, across 5 European countries.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cerebral hemodynamics in schizophrenia during the Trail Making Test: A functional transcranial Doppler sonography study
Authors: Schuepbach D. , Egger S. , Herpertz S.C. 
Published: May 2016

IntroductionSchizophrenia is a severe mental disorder, with complex symptoms involving psychosis, negative symptoms and cognitive impairment. The Trail Making Test (TMT) has been widely used to assess attention and executive function. Functional transcranial Doppler sonography (fTCD) of basal cerebral arteries allows monitoring of aberrant cerebral hemodynamics during cognitive tasks in this patient group.ObjectivesWe assessed cerebral hemodynamics in the middle cerebral arteries (MCA) using fTCD while patients with schizophrenia and healthy subjects performed the TMT and a control task.MethodsFifteen patients with chronic schizophrenia and 15 healthy controls performed the TMT-A and -B during fTCD measurements of the MCA. Dependent measures were performance, mean cerebral blood flow velocity (MFV) and the lateralization.ResultsPatients demonstrated an overall decreased speed of solution (P = 0.002), and there was no significant effect of age. They showed a significantly increased flow pattern for the TMT-B (P = 0.005). There were no lateralization differences between diagnostic groups.ConclusionsThere was a performance deficit in patients with schizophrenia for both TMT-A and -B that fits well with results of existing literature. The aberrant hemodynamic response supports the idea that cognitive performance elicits an aberrant cerebral hemodynamic correlate. It adds to the notion that fTCD is a valuable tool to correlate psychological paradigms with brain perfusion in patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Soluble Fas ligand (sFasL) as a predictor of reduction of general psychopathology in schizophrenia after antipsychotic treatment
Authors: Szymona K. , Karakula-Juchnowicz H. , Zdzisinska B. , Flis M. , Kaławaj K. , Rosa W. , Kandefer-Szerszeń M. 
Published: May 2016

IntroductionDysregulation of the apoptotic process is associated with the etiopathogenesis of schizophrenia, which is observed at the brain and peripheral blood levels. A significant negative correlation between the duration of the disease and serum sFasL concentration was demonstrated by other authors. It was shown that an increased rate of apoptosis is more pronounced in neuroleptic-free patients with the first-episode of schizophrenia than in patients with chronic disease.AimSearch for a predictor of good response to antipsychotic treatment based on the analysis of the sFasL plasma level and its relationship with clinical symptoms.MethodsFifty-three patients with chronic schizophrenia and 46 healthy individuals were enrolled in the study. The concentration of sFasL was measured by ELISA. Clinical assessments (PANSS, SANS, SAPS) and blood analyses were conducted three times: during the active phase of disease (at admission), after 4 weeks of pharmacotherapy, and after reaching remission.ResultsIn the schizophrenia group, non-altered levels of sFasL (P = 0.1; U Mann-Whitney test), compared to the control, were detected at admission. The initial level of sFasL correlated negatively (r = −0.33; P = 0.04; Spearman's rank) with blood leukocyte count. Despite clinical improvement, no significant changes in the level of sFasL were observed. However, the sFasL level correlated negatively with the PANSS general psychopathology reduction after 4 weeks of pharmacotherapy (r = −0.7; P = 0.04) and after remission (r = −0.39; P = 0.026).ConclusionsThe results indicate a possible role of sFasL in apoptosis of blood leukocytes and suggest that the reduction of sFasL level can predict level of PANSS general psychopathology after antipsychotic treatment in schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Efficacy and safety of brexpiprazole in schizophrenia: Meta-analysis of three double-blind, randomized, placebo-controlled phase 3 studies
Authors: Weiss C. , Zhang P. , Hakala M.J. , Skuban A. , Weiller E. 
Published: May 2016

IntroductionBrexpiprazole is a serotonin-dopamine activity modulator that is a partial agonist at 5-HT1A and dopamine D2 receptors at similar potency, and an antagonist at 5-HT2A and noradrenaline alpha1B/2C receptors.ObjectivesTo evaluate the efficacy, safety, and tolerability of brexpiprazole in patients with acute schizophrenia in a meta-analysis of three phase 3 studies with brexpiprazole.AimThe primary endpoint was change from baseline to week 6 in PANSS total score.MethodsData from the 3 clinical studies in patients with acute schizophrenia were combined and analyzed using individual patient data meta-analysis. In two similarly designed studies (NCT01396421; NCT01393613), patients with acute schizophrenia were randomized to fixed-doses of brexpiprazole 2 mg/day, 4 mg/day or placebo (a low-dose treatment group was included in each study [0.25 mg and 1.0 mg]; not included in the meta-analysis). In the third study (NCT01810380), patients were randomized to flexible dosing of brexpiprazole (2 to 4 mg/day), placebo, or an active reference (quetiapine extended release). Changes from baseline for brexpiprazole vs. placebo were analyzed using an MMRM approach.ResultsBrexpiprazole 2–4 mg (n = 868) was superior to placebo (n = 517) in change from baseline in PANSS total score (−20.1 vs. −14.3; estimated treatment difference to placebo: −5.8 [95% CI: −8.0; −3.6]; P < 0.001). The proportions of patients reporting TEAEs were similar between the brexpiprazole and placebo treatment groups (57.9% vs. 57.5%). No unexpected safety concerns were observed.ConclusionThis meta-analysis supports evidence from three individual trials that brexpiprazole is efficacious and safe in treating patients with acute schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The impact of addictive disorders on the HIV and syphilis coinfection
Authors: Chumakov E. , Petrova N. , Smirnova I. 
Published: May 2016

IntroductionOne of the main risk factors for both HIV-infection and syphilis is addictive behavior.The objective of the study was to determine the impact of addictions on the HIV and syphilis coinfection.MethodSixty-five HIV-infected patients with syphilis were examined by a clinical method.ResultsThe sample included 45 men (average age 32.09 ± 9.83) and 20 women (average age 31.7 ± 5.97). All patients were characterized by risky behavior. Seventy-one percent of men belonged to the category of men who have sex with men (MSM). Eighty-five percent of women had drug dependence (as compared to 61% for men who have sex with women (MSW) and 19% for МSМ; P < 0.05). Women were more likely to have opiate dependence (P < 0.001; as compared to men). We revealed a high incidence of drug addiction and alcoholism with the prevalence of dependence on opioids (F11; 55.0%; 7.7%), polysubstance use (F19; 25.0%; 23.1%) and alcoholism (F10; 50.0%; 61.25%) among women and MSW respectively (P < 0.05 as compared to MSM). Only 50% of women and 23% of MSW were in remission. MSM regularly consumed stimulants and cannabinoids without developing dependence.ConclusionsInjecting drug use is typical of women and MSW and plays a leading role in the risk factors for HIV infection and syphilis. Addictive behavior among MSM increases risky sexual behavior and thus influences infection with HIV and syphilis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Assessing Comorbidities and service use among patients with benzodiazepine abuse
Authors: Cook B. , Chavez L. , Carmona R. , Alegria M. 
Published: May 2016

Prior studies have identified that individuals with comorbid substance use disorder and mental health disorder are at a greater risk of benzodiazepine abuse compared to individuals that present with mental health disorder without an accompanying substance use disorder. These studies were conducted in predominantly white populations, and little is known if the same associations are seen in safety net health care networks. Also, the literature is mixed as to whether or not psychiatrists’ prescription of benzodiazepines places individuals at undue risk of benzodiazepine abuse.We use 2013–2015 electronic health record data from a Boston healthcare system. Patients with benzodiazapene abuse were identified if they had received treatment under the ICD-9 code 304.1. Benzodiazepine abuse was compared between patients with only mental illness and patients with existing comorbid substance and mental health disorder, in unadjusted comparisons and adjusted regression models. Covariates in regression models were used to identify subgroups at higher risk of benzodiazepine abuse.Individuals with benzodiazepine abuse had higher rates of emergency room and inpatient use than patients with other mental health and/or substance use disorders. Those with comorbid substance and mental disorder were significantly more likely than individuals with mental or substance use disorder alone to abuse benzodiazepines (P < .01). Among those with benzodiazepine abuse, 93.3% were diagnosed with a mental illness, 75.6% were diagnosed with a substance use disorder (other than benzodiazepine), and 64.4% had comorbid anxiety disorder and substance use disorder. These analyses suggest that patients with benzodiazepine abuse have complex presentations and intensive service use.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Are there more mechanical restraint in patients admitted for substance use disorder?
Authors: Galindo L. , Grifell M. , Peréz E.J. , Dinamarca F. , Chavarria V. , Salgado P. , Pérez V. 
Published: May 2016

Introduction and objectivesMechanical restraint is a therapeutic procedure commonly applied in acute units in response to psychomotor agitation. Its frequency is between 21 and 59% of patients admitted. These patients represent a risk to both themselves and for health workers. There is a myth that patients with substance use disorder (SUD) are more aggressive and require more forceful measures. There are not clinical studies that compared if there are differences of the frequency of mechanical restrain in patients with SUD.The aim of this study is to explore the differences of frequency of mechanical restraint on patients with SUD in the psychiatry acute and dual pathology units and others psychiatric diagnostics.Material and methodsWe reviewed retrospectively the informatics record of all the mechanical restraints made and the total discharges of the three acute care units and dual disorders of Neuropsychiatry and Addictions Institute (INAD) of the Parc de Salut Mar de Barcelona, between January 2012 and January 2015. For every discharge the presence of at least one mechanical restraint and the DSM-IV diagnostic were coded. Then was calculated the frequency and proportion of mechanical retrains in every diagnostic group.ResultsThe number of discharges analyzed was 4659 from which 838 had an episode of mechanical restraint. The 37% of patients with SUD of cocaine had an episode of mechanical restrain. The patients with SUD of alcohol only the 4%, and there no one case on patients with SUD of Cannabis. Thirty percent of patients with schizophrenia and 28% of bipolar disorder.AcknowledgementsL. Galindo is a Rio-Hortega-fellowship-(ISC-III;CM14/00111).Disclosure of interestThe authors have not supplied their declaration of competing interest.
Smoking reduction/cessation and psychiatric patients: What about weight control?
Authors: Ganhao I. , Trigo M. , Paixao A. , Cardoso J. 
Published: May 2016

IntroductionSmoking cessation has long been associated with weight gain and is one of the many reasons that smokers invoke for not giving up smoking. Many psychiatric medications are also associated with increased weight gain and metabolic syndrome. Unhealthy lifestyles reflect symptoms of illness with poor coping strategies and financial and social difficulties.There are many reasons why smoking cessation may be viewed as much more difficult for psychiatric patients and weight gain is one of them.ObjectiveTo study how patients’ weight evolves during smoking reduction and cessation in a smoking reduction/cessation program in a psychiatric hospital.AimsTo demystify weight gain as a significant problem in smoking reduction and cessation in this patient population.MethodsEvery patient entering the smoking reduction/cessation program is evaluated initially with regard to weight and BMI.Patients’ weights are evaluated during the duration of the program for each patient as is smoking status.ResultsWe are still collecting data at this time.ConclusionsThere are three groups of patient according to weight changes during the program: those who gain weight, those who maintain the same weight (± 1 kg) and those who lose weight.Most patients who gain weight end up recuperating their initial weight or are able to lose weight later.Some patients had weight control issues and their fear of gaining weight led them to overcompensate leading to weight loss.We have included interventions on healthy lifestyles that have aided patients in controlling their weight.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Interventions targeting physical health problems in patients with concurrent mental illness and substance use
Authors: Juel A. , Kristiansen C.B. , Povl M.J. , Hjorth P. 
Published: May 2016

IntroductionPhysical comorbidities are common in patients with concurrent mental illness and substance use disorder. Interventional studies addressing health promotion for this group of patients are scarce.AimsTo examine the physical health condition of a non-selected group of patients with substance use disorder comorbid to other psychiatric disorders. Further, to analyze for possible changes in their health condition during a two-year intervention study in relation to physical measures and substance use. Finally, to analyze for possible associations between changes in physical measures and in substance use.MethodsThe patients were enrolled in the project continuously from October 2013 through May 2015. Physical health measures were obtained at the enrolment date and continuously as part of daily clinical practice. Interventions consisted of individual consultations with a research nurse, group sessions and an opportunity to do physical exercise together with the research nurse. Interventions included health promotion activities, i.e. guidance on healthy food intake, smoking cessation and a physically active life.ResultsIn total, 64 patients (mean age 32.7 years, SD 10.7) were included in the study. Patients were mostly diagnosed with psychotic disorders (11%), affective disorders (44%) or developmental disorders (34%). Baseline measures showed that 89% of the patients smoked cigarettes daily, 61% had used cannabis and 20% had used amphetamines within the past month. Further, few patients did moderate or vigorous physical exercise. Further results are in progress.ConclusionsThese interventions seem relevant and manageable in an outpatient setting.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Video game addiction: Providing evidence for Internet gaming disorder through a systematic review of clinical studies
Authors: Lopez-Fernandez O. , Kuss D. , Pontes H. , Griffiths M. 
Published: May 2016

IntroductionThe American Psychiatric Association introduced in Internet Gaming Disorder (IGD) in the appendix as a tentative disorder in the last edition of the Diagnostic and Statistical Manual of Mental Disorders. However, currently no systematic review exists about excessive gaming viewed from a clinical perspective.Objectives and aimsTo review clinical studies on gaming addiction in order to ascertain characteristics of both clinical and research studies to provide retrospective evidence in relation with the proposed IGD classification (including criteria, measures and therapies).MethodsA systematic literature review of studies published from 1980 to 2015 has been conducted using three major psychology databases: Academic Search Complete, PsycInfo, and PsycArticles. A total of 5033 results from peer-reviewed journals were obtained, where 32 were identified as empirical clinical papers focused on gaming addiction.ResultsThe clinical research studies on gaming identified were published between 1998 and 2015, most of which included patient samples. Categorizations identified in the research papers included: (i) patients’ characteristics (e.g., socio-demographics), (ii) criteria and measures used (e.g., scales to diagnose), (iii) types of gaming problems (e.g., game genre), (iv) and treatments (e.g., type of therapy).ConclusionsFindings will be discussed against the background of the controversial IGD diagnostic criteria proposed in the DSM-5 in order to assess the extent to which previously published clinical knowledge matched the current proposal for including gaming addiction as behavioral addiction in the next diagnostic manual.Disclosure of interestThe authors have not supplied their declaration of competing interest.