bluuebunny/crossref_metadata_2025_split huggingface dataset:
Major depressive disorder: Recurrence risk factors
Authors: Ellouze F. , Bouali W. , Marrag I. , Chaabouni A. , Soussia R. Ben , Nasr M. 
Published: June 2017

IntroductionDespite the frequency and the severity of depressive episodes, the major depressive disorder (MDD) is today inadequately diagnosed and treated, and the risk factors for its recurrence are not well elaborated. The objectives of this study were to describe the sociodemographic, clinical evolutionary and therapeutic features of this disorder and to identify the factors involved in the risk of its recurrence.MethodsThis is a retrospective, descriptive and analytical study, involving 150 patients with MDD, isolated episode or recurrent major depressive disorder (RMDD) with a follow-up for at least two years. Data collection was performed using two pre-established questionnaires for the MDD isolated episode and for the RMDD respectively with 51 and 92 items. A study of the recurrence period was performed by Kaplan–Meier method. The Cox-test was used to determine the survival curves and to look for the risk factors significantly associated with MDD recurrence.ResultsA total of 150 patients was gathered, predominantly female, married and from urban origin. The average age at the beginning of the disorder was 35 years. The recurrence period was 109 months and the factors associated with recurrence were the early age of onset of the disorder, family history of mood disorders, the severity of MDE index, residual symptoms and discontinuation of treatment.ConclusionThe study of factors involved in MDD recurrence is of a particular importance since it allows not only to know the group of patients at risk but also to improve their therapeutic care.Disclosure of interestThe authors have not supplied their declaration of competing interest.
An expressive group approach to borderline personality disorder in patients with bulimia nervosa: A clinical case
Authors: Martín I. Baños , Gómez E. Guerra , Itúbide K. Eaton , Conde B. Unzeta , Besteiro P. Vilariño , Franco C. Pérez , Jorge P. García 
Published: June 2017

IntroductionIt is widely known comorbid Bulimia Nervosa (BN) with Borderline personality disorders (BPD). This is associated with worse prognosis and resistance to pharmacological and psychotherapeutic treatments. In integrated treatment, both disorders are addressed, not being frequent psychotherapy groups that address only the personality traits. Some studies have proposed the brain basis of psychodrama intervention in both pathologies.ObjectivesTo highlight the clinical effectiveness of adding a nonverbal orientation (psychodrama) to the treatment of BN patients; to specifically address personality traits, by presenting a clinical case. We rely on studies.MethodsClinical case: 42-year-old woman patient with BN (DSM-5) severe degree, BITE: Symptoms scale = 28; S. Severity = 13; and BPD (7 DSM-V); MCMI-III: BPD = 115 She is incorporated into a day hospital with integrated and multidisciplinary approach: psychotropic drugs, individual, group and family psychotherapy. This patient is added to an open psychodrama group; where he works exclusively personality pathology, during one year.ResultsImprovement was observed in BN (she switched to intermediate grade); BITE: Symptom scale = 23, S. Severity = 8; also improves BPD criteria of DSM-V = 4 (minimum = 5) MCMI-III: BPD = 104.Conclusions(1) Psychodrama psychotherapy groups to treat Bulimia and BPD could provide an added clinical improvement in both pathologies.(2) Insufficient RCTs compared to other models of psychotherapy (mentalizing, interpersonal, dialectical behavior) do not allow to speak even scientific evidence of psychodrama.Disclosure of interestThe authors have not supplied their declaration of competing interest.
New technologies as risk factor for eating disorders
Authors: Rojo S. Fernandez , Mora F. , Banzo C. , Quintero J. 
Published: June 2017

IntroductionEating disorders (ED) have a significant prevalence in children and adolescents. The use of new technologies allows to access to a big amount of information. Excessive use of these technologies at this stage of life decreases social and family relationships and provides access to online content in favor of these disorders, which can affect to the development of an ED. The aim of this study is to analyze the relationship between the use of new technologies and the risk of developing an ED.Material and methodWe have selected a sample of 500 patients who were in the 2nd year of secondary school to which has been applied a battery of scales, including the EAT-26 scale for ED; and has been collected socio-demographic data, including the use of internet and mobile phone. We used SPSS to analyze the relationship between these variables.ResultsWe have analyzed clinical and socio-demographic characteristics of the sample. In relation to the risk of developing an eating disorder we have found that high frequencies of use of the Internet and high frequencies of use of mobile phones (especially more than 4 hours a day) increases significantly the score in EAT-26 scale for ED (P < 0.05).ConclusionsRegarding the results, we can say that, in our sample, the use of Internet and/or mobile phone more than 4 hours a day significantly increases the probability of having a high score on the scale for ED. This data can be essential when planning treatment or establishing a preventive strategy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Reconceptualization of recovery from anorexia nervosa: Patients’ perspective
Authors: Jarrige M. 
Published: June 2017

Outcome research has not found a consistent definition of recovery from anorexia nervosa by consensus of experts, or by empirical validation. Therefore, medical criterion of recovery varies between studies and results are not comparable. This poster refers to a study of 44 participants treated for anorexia nervosa and who believe they have recovered. The purpose of this study is to reconceptualize recovery from patients’ perspective. The Free Association about Recovery – Questionnaire (FAR-Q) is a new tool by which to explore and understand the anorexic's account of recovery. Content analysis reveals four subjective definitions of recovery: (1). Return to the social normality; (2). Cohabit with eating disorder; (3). Self-acceptance; (4). Rebirth. This study assesses patients’ stages of recovery process and gives recommendations to health professionals.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Eating disorders in Malays in Singapore
Authors: Kwok V. , Lee H.Y. , Tan S.M. , Chee W.S.A. , Ann K. , Binte Kamaruzaman N.R. 
Published: June 2017

IntroductionThe prevalence of eating disorders has been increasing in the Asian countries. Malays in Singapore are at the crossroads because they are largely traditional in practice and almost all are Muslim, but are exposed to western culture. Studies found that Malays at increased risk of eating disorders but yet those that present for treatment are very small, and this study aims to study Malays with eating disorders to unveil this contradiction.MethodsAll Malay patients presenting to Singapore General Hospital (SGH), which hosts the only specialized eating disorder programme in Singapore, between 2003 and 2014 were identified and medical records studied retrospectively.ResultsMalays constitute only 42 out of 1340 patients treated in the same period. The mean age at presentation is 18.81 years (SD = 5.54) and the majority are students (78.6%). A total of 92.9% are single. There are more cases of bulimia nervosa than anorexia nervosa (45.2% vs. 26.2%). In total, 54.8% have psychiatric comorbidities, the most common is depression (31.0%), 38.1% have a history of deliberate self-harm and 21.4% attempted suicide. A total of 52.4% reported teasing as a trigger, while 16.7% were triggered by being overweight.DiscussionThere is only a small number of Malays that presented. Fasting is commonly which may be confused with restriction. Other factors could be lack of awareness. The higher prevalence of bulimia nervosa suggests that purging is recognized as abnormal. High prevalence of comorbidities suggests that family members recognize comorbidities better. Outreach programs for Malay will help increase awareness.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Prenatal stress exposure as a risk factor for anorexia nervosa: A controlled study
Authors: Michelon S. , Tenconi E. , Bonello E. , Degortes D. , De Toffol M. , Favaro A. , Santonastaso P. , Nassuato M. 
Published: June 2017

IntroductionPrenatal risk factors, such as gestational complications and exposure to stress during pregnancy, may have a role in the development of many psychiatric disorders including eating disorders.AimTo investigate the impact of prenatal stress exposure on the development and clinical features of anorexia nervosa.MethodsOne hundred and nine patients with a lifetime diagnosis of anorexia nervosa and 118 healthy controls underwent a clinical assessment, which included interviews, questionnaires and a neuropsychological battery. The mothers of the patients and controls underwent a specific interview focused on stressful life events, which occurred during pregnancy. Obstetric and neonatal records were consulted.ResultsThe mothers of patients experienced more severe stressful episodes during pregnancy than the mothers of controls and the perceived distress showed significant positive correlation with both total number of obstetrical complications and placental weight. In patients, the severity of stressful events was strongly associated to cognitive rigidity and perseverance.ConclusionsPrenatal stress exposure might be a risk factor for the development of anorexia nervosa and it is associated with cognitive traits of rigidity and perseverance.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cortisol awakening response in binge-purging and restrictive anorexia nervosa
Authors: Nigro M. , Monteleone A.M. , Pellegrino F. , Cimino M. , Di Maso V. , Volpe U. , Monteleone P. 
Published: June 2017

IntroductionAnorexia nervosa (AN) is a complex psychiatric disorder characterized by severe restriction of food intake and aberrant behaviours. The endogenous stress response system, including the hypothalamus-pituitary-adrenal (HPA) axis, may have a role in the pathophysiology of AN.ObjectivesIt has been shown that specific clinical traits of AN, such as binge-purging behaviours, may be associated with higher psychopathology and poorer outcomes. Therefore, the HPA axis functioning could differ between patients with restrictive AN (ANR) and those with binge-purging AN (ANBP).AimsIn order to evaluate whether HPA axis functioning differs between the two subtypes of AN, we assessed the cortisol awakening response (CAR) of symptomatic ANR and ANBP patients.MethodsOur sample included 17 ANBP and 18 ANR patients, and 42 healthy women. All of them filled in the Eating Disorder Inventory-2 (EDI-2). For CAR assessment, participants collected saliva samples at home. Saliva cortisol concentrations were measured by an enzyme immunoassay method.ResultsANR and ANBP patients exhibited a CAR significantly higher than healthy women. Furthermore, the CAR of ANBP women was higher than that of ANR women and positively correlated with the bulimia subitem score of the EDI-2.ConclusionsPresent findings show, for the first time, differences in the CAR between ANBP and ANR subtypes supporting the idea that binge-purging behaviours may have a specific connection with HPA axis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Eating problems and body image among Finnish adolescents
Authors: Sourander A. , Maezono J. 
Published: June 2017

ObjectiveTo study prevalence of self-reported body image and eating distress symptoms among Finnish adolescents, and to study associations between psychopathology, body image and eating distress.DesignCross-sectional population-based, survey subjects, 7th to 9th grade students aged 13–15: 3154 in Finland in 2014.MethodsData were collected by student self-reported questionnaire including scale designed for evaluating attitudes and behaviors towards body shape and eating, and Strengths and Difficulties Questionnaire (SDQ) for assessing emotional and behavioral problems.ResultsThe female adolescents reported much more dissatisfaction and concerns with their bodies than the males, high levels of distress with body emotional, behavioral and peer problems measured with SDQ. Body image and eating problems were higher in Finnish than Japanese females with peer problems.ConclusionThe finding was in accordance with previous studies that found that body image and eating distress are associated with to gender and wide range of psychiatric problems.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Bulimia nervosa in Singapore: Clinical profile, comorbidity and gender comparisons
Authors: Zainal K.A. , Ng K.W. , Lee H.Y. 
Published: June 2017

IntroductionThough eating disorder cases have been on the rise in Asia, little is known about them. Bulimia nervosa (BN) has been associated with poor treatment outcome and high mortality risk, and is the second most commonly diagnosed eating disorders in Singapore, after anorexia nervosa (AN), yet no report thus far has explored this condition.ObjectivesThe current study seeks to describe the clinical population diagnosed with BN in our hospital treatment program, as well as to compare their clinical characteristics with a previously published local study on patients with AN.MethodRetrospective medical records review was carried out for patients diagnosed with BN in our hospital's eating disorders treatment program. Patient records from 2003 to 2013 were retrieved and analyzed. We also further compared presenting characteristics across genders and with AN patients.ResultsBetween 2003 and 2013, 348 patients were diagnosed with BN by psychiatrists based on the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR). BN patients presented with high rate of self-harm behaviors (37.1%), previous suicide attempts (19.0%) and psychiatric comorbidities (67.5%), many of which require inpatient treatment. Significant differences were found between genders and in comparison with the AN patients.ConclusionOur results suggest that many patients with BN present with severe psychiatric comorbidities, in some aspects more severe than the AN population. The current study appeals for the development of more effective detection and treatment of vulnerable populations in Singapore. We further discuss about the potential roles of mental health literacy and stigmatization in influencing treatment-seeking behaviors.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neuroleptic malignant syndrome: A rare, life-threatening and not fully understood condition
Authors: Cabral Barata P. , Melo J.C. , Maia T. 
Published: June 2017

IntroductionNeuroleptic Malignant Syndrome (NMS) is a rare life-threatening idiosyncratic reaction associated with the use of neuroleptics. It is characterized by delirium, muscular rigidity, fever and autonomic nervous system dysregulation. Its diagnosis represents a significant challenge for clinicians and many aspects regarding its epidemiology, etiopathology and nosology remain controversial.ObjectivesSummarize current knowledge to facilitate NMS diagnosis and allow a fast onset of therapeutic and life-saving interventions.MethodsNon-systematic review of the literature–scientific publications from Pubmed and a Psychiatry Textbook.ResultsNMS typically develops during the first week after the neuroleptic is introduced, although it may also appear after years of treatment. Its incidence is of 0.02 to 3% in patients taking antipsychotics; the mean age of its patients is 50 years. Typical symptoms are muscle rigidity and temperature greater than 38hC in a patient on antipsychotic; however, recent reports indicate that these core symptoms may not always be present. Several risk factors have also been identified and must be addressed. NMS may be fatal in 10 to 20% of cases or may produce residual sequelae, like cognitive dysfunction or neurological deficits. NMS must be managed by aggressive use of supportive measures, as well as specific interventions. It recurs in 30% of patients, which can be diminished by specific measures.DiscussionNMS requires timely and accurate diagnosis and treatment. Antipsychotics should be used cautiously in patients at increased risk. When recognizing this condition, prompt withdrawal of the offending agent is the most important step. Wise approaches can diminish morbidity, mortality and recurrence.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Reducing restraint with clozapine in involuntarily admitted patients with schizophrenia
Authors: Ifteni P. , Teodorescu A. 
Published: June 2017

IntroductionIn the entire world, restraint and seclusion are common interventions in psychiatric in-patient settings due to aggressive behavior.ObjectivesOur objective was to test for the immediate anti-aggressive property of clozapine compared to other antipsychotic treatments in an enriched cohort with high rates of restraint during early hospitalization.MethodsWe present a retrospective chart review in all involuntary admissions with schizophrenia during 2011–2014 in Psychiatry and Neurology Hospital, Brasov, Romania. Timing and number of restraints in addition to clinical, demographic and treatment characteristics were extracted. Based on our earlier observation of clinical efficacy of early, fast titration of clozapine, we tested the hypothesis that clozapine treatment was associated with reduced use of restraint, and with longer restraint-free periods.ResultsIn 115 patients with schizophrenia (age = 39.7 ± 11.1 years; male = 59%) involuntarily admitted due to externalized (74.78%) or self-directed violence (25.22%), restraint was used in 89.6%; with a median duration of 3 hours until restraint past admission. Antipsychotics used immediately after hospitalization included haloperidol (70.4%), clozapine (11.3%), olanzapine (10.4%) and other second-generation antipsychotics (7.9%). Comparison of restraint characteristics favored immediate clozapine use with highly reduced rates of restraint (38.5% vs.95.6%. P < 0.001) and significantly extended hours until restraint ([118 h,24 h, 426 h] vs.[3 h,0.25 h, 48 h]; median; 25th, 75th percentile; P < 0.001) relative to the remaining cohort. These effects remained highly significant after controlling for potential moderators of restraint use in multivariate models.ConclusionsThese retrospective data suggest an early anti-aggressive effect of clozapine during the immediate use of clozapine in highly problematic patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Screening for mental health problems as indicator for evaluation of needs for mental health services
Authors: Fanaj N. , Mustafa S. , Shkëmbi F. , Kabashaj B. , Fanaj B. 
Published: June 2017

BackgroundScreening questionnaires for mental health problems are useful tools for research and clinical practice.ObjectivesTo identify mental health problems and overall emotional functioning among general population samples in Kosovo as indicators for evaluation of needs for mental health services.MethodsIt is cross-sectional quantitative study. Participants from two samples: students (filled-out directly) and online respondents (n = 540; mean age = 24.84; SD = 8.29) were included in this study. All participants were asked to complete the Albanian translation of Mental Health Inventory (MHI-38). Data processing was done with SPSS 21.0 and Microsoft Excel 2007.ResultsIn total 11.2% of participants ranged at low level of mental health index. Regarding anxiety the high level is found at 51.3% and regarding depression high level is found at 24.5% of participants. A significant gender difference is found whereas females show greater depression (P = .022, r = .09), greater psychological distress (P = .000, r = .17) and lover mental health index (P = .000, r = .17), than males. A significant difference between samples is found whereas online sample show greater psychological distress (P = .000, r = .18), less anxiety (P = .001, r = .13) and lower mental health index (P = .000, r = .22) than direct sample.ConclusionsThe findings are quite intriguing. Future research is needed to find out more understanding on gender, anxiety, depression, psychological distress and mental health. Socio-cultural aspects can be of great importance to be examined. Despite this, needs for mental health services are inevitably and must be addressed properly.Disclosure of InterestThe authors have not supplied their declaration of competing interest.
Attitude to and social distance from schizophrenic patients as forms of stigmatization, investigated by a group of medical professionals and a group of non-professional subjects
Authors: Grbesa G. , Simonovic M. , Stankovic M. 
Published: June 2017

IntroductionThe attitude to schizophrenic patients has always been considered a significant indicator of stigmatization of mental patients. The social aspect of stigmatization involves the social distance when speaking about the attitudes towards mental patients. The social distance is defined as “a various degree of understanding and feelings existing among the groups”.ObjectivesThe investigation included 120 participants divided into two groups. The first group included 60 participants; psychiatrists (38) directly involved in treating schizophrenia and 28 nurses working in wards where schizophrenic patients were treated. The second group of 60 participants included non-professionals divided according to age and gender to match the experiment group.AimsInvestigating the correlation between the proclaimed attitudes to and social distance from schizophrenic patients: medical professionals and non-professional subjects.MethodsSemantic differential scale was used to examine the personal attitudes towards a stigmatized group. To examine social distance, the modified Bogardus Social was used.ResultsThe results obtained using the Semantic differential scale to examine the attitudes did not show statistically significant score difference between the two groups of patients Bogardus Social Distance Scale score showed statistically significant difference (P > 0.03). A significant score on the scale of social distance can be recognized in both psychiatry professionals and non-professionals.ConclusionStratification of items on the social distance scale shows a great social distance in the sphere of intimacy and slightly lower score on the level of social relations. The group having competent knowledge concerning the disease shows sophisticated way of hiding behind professional reasons.Disclosure of InterestThe authors have not supplied their declaration of competing interest.