bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concordance and Discrepancy Between Subjective and Objective Cognitive Assessment in Bipolar Disorder: What is Influencing this Discrepancy?
Authors: Lima F. , Cardoso T. , Bonnin C. , Martinez-Aran A. , Vieta E. , Rosa A. 
Published: June 2017

IntroductionEvidence has shown that some patients with bipolar disorder have a relatively accurate sense of their cognitive abilities, whereas others may overreported or underreported cognitive difficulties, which causes a discrepancy in this measures.ObjectivesTo investigate concordance and discrepancy between subjective and objective cognitive measures, as well as to identify factors that could influence this discrepancy.MethodsPatients who met DSM IV-TR criteria for bipolar disorder in partial or full remission (HDRS-17 score ≤ 12; YMRS score ≤ 7) were recruited from outpatient clinic at Barcelona and Porto Alegre. Objective cognitive assessment was performed by the Letter-Number Sequencing (LNS-WAIS III). Cognitive Complaints in Bipolar Disorder Rating Scale (COBRA) was used as a subjective cognitive measure.ResultsWere included 179 patients. We found a concordance between COBRA and LNS in 62 cases, and discrepancy in 117 cases (Fig. 1). The incongruent group (COBRA–and LNS + ) have less years of study (8.10 ± 4.01) than the incongruent group (COBRA+ and LNS–) (13.44 ± 4.05, P = 0.001), and than congruent group (COBRA–and NLS–) (13.75 ± 4.04, P = 0.003). Finally, the congruent group (COBRA+ and LNS + ) was the group with higher functioning impairment.ConclusionsA few number of false-negative cases were detected, suggesting that COBRA can be used as a screening instrument. A special attention should be provided for subjects with a few years of study, because possibly these subjects presents more difficulty in express its cognitive difficulties.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Could Soluble Intercellular Adhesion Molecule-1 be Associated with State Affective Symptomatology in Healthy Adults?
Authors: Pantovic M. , Dunjic Kostic B. , Petronijevic N. , Velimirovic M. , Nikolic T. , Jurisic V. , Lackovic M. , Totic S. , Jovanovic A. , Damjanovic A. , Ivkovic M. 
Published: June 2017

IntroductionImmune parameters are frequently associated with mood disorders and affective temperaments. In our study, we investigate the role of soluble intercellular adhesion molecule-1 (sICAM-1) in affective temperaments and mood symptoms in healthy adults.MethodsHealthy adults were screened for psychiatric disorders using the non-patient version of the Structured Clinical Interview for DSM-IV-I and II. Affective temperaments were evaluated with Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A). State mood symptoms were assessed using the Young Mania Rating Scale (YMRS) and Montgomery-Åsberg Depression Rating Scale (MADRS). Serum sICAM-1 levels were measured using enzyme-linked immunosorbent assay.ResultsWe identified no association between sICAM-1 levels and affective temperament scores. We identified correlation between sICAM-1 levels and manic symptoms measured by YMRS. Furthermore, sICAM-1 was a significant predictor of manic symptoms in a linear regression model with age, gender, BMI and smoking habits as confounding variables.ConclusionsOur findings suggest that sICAM-1 could be a relevant immune factor for severity of state affective symptoms and could contribute to better understanding of complexity of affective disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Negative Psychotic Symptoms in 22q11.2 Deletion and Their Association with Neuropsychological Profile
Authors: Pontillo M. , Lin A. , Armando M. , Menghini D. , Alvares G. , Vicari S. 
Published: June 2017

22q11.2 deletion syndrome (22q11.2 DS) is associated with a markedly elevated risk for schizophrenia spectrum disorders. The role of negative symptoms in the pathogenesis of schizophrenia in this population and their link to role, social and cognitive functioning is still unclear. Aims of this study were investigate the association between negative symptoms, social and role functioning and neurocognitive performance in the sample of individuals with 22q11.2DS and compare them to healthy controls. The study was conducted on a sample of 60 individuals with 22q11.2DS (mean age = 14.8; SD = 4.8) and 56 healthy control (HC) participants (mean age = 13.8; SD = 5.4). Individuals with 22q11DS and high level of negative symptoms showed significantly higher level of impairment in several neurocognitive domain (i.e. visuospatial abilities, verbal response inhibition) compared with individuals with 22q11DS and low level of negative symptoms and healthy controls. They showed also lower global functioning, specifically role functioning and not social functioning. Negative symptoms are frequent in 22q11.2DS and are associated with specific cognitive deficit and low role functioning. These results suggest that negative symptoms should be considered an important target in the assessment of risk of conversion to full-blown psychosis and in planning of psychological interventions for this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Childhood Trauma and Cortisol Response to the Trier Social Stress Test in Symptomatic Patients with Eating Disorders
Authors: Marciello F. , Buonomenna V.-M. , Caivano V. , Cascino G. , D’Agostino G. , Nunziata D. , Monteleone P. 
Published: June 2017

IntroductionChildhood trauma exposure is associated with the risk of eating disorders (EDs) in adulthood. The biological basis of this link may involve a persistent dysregulation of the endogenous stress response system, in particular the hypothalamic-pituitary-adrenal (HPA) axis, as a consequence of early life maltreatment.ObjectiveAdult patients with EDs and history of childhood trauma may have a dysregulation of the HPA axis that could be different from EDs patients without childhood trauma exposure.AimsIn order to assess the effects of childhood trauma experiences on HPA-axis activity in EDs, we compared the salivary cortisol response to the Trier Social Stress Test (TSST) of adult patients with EDs according to their history of childhood trauma.MethodTwenty-seven EDs patients and 13 healthy women participated in the study. Salivary cortisol responses during exposure to the TSST was measured. Participants also completed the childhood trauma questionnaire (CTQ) and eating-related psychopathological rating scales.ResultsAccording to CTQ, 15 individuals with EDs reported childhood maltreatment whereas 12 EDs patients and all the healthy women did not experience childhood maltreatment. Compared with the control group, non-maltreated EDs patient group exhibited a slightly enhanced cortisol response to TSST, whereas the group of non-maltreated EDs patients showed a normal cortisol response. Moreover, EDs patients with childhood maltreatment exhibited statistically significant blunting of cortisol compared to non-maltreated ones.ConclusionsThe present findings support the evidence that, in patients with EDs, there is a dysregulation of HPA-axis activity and that childhood trauma exposure may contribute to this dysregulation.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Blood levels of patients with profound refractory OCD who are on supra-normal dosages of sertraline
Authors: Drummond L. , Robert V. 
Published: June 2017

IntroductionPatients with OCD usually require higher dosages of serotonin reuptake inhibiting (SRI) drugs than is used for the treatment of depression. This observation resulted in treatment-refractory patients being occasional prescribed selective SRI drugs above the normal upper limit of prescribing. Previous studies have shown that these high doses are well tolerated.ObjectivesWe decided to investigate the blood levels of patients on dosages of sertraline that were above the normal therapeutic range.MethodSuccessive patients treated by the National Inpatient Service for OCD/BDD who were treatment refractory and prescribed > 200 mg sertraline per day were included. All had previously received 2+ trials of different SRIs for > 3months each as well as been offered augmentation with dopamine blockers and at 2+ trials of exposure and response-prevention. All patients scored in the profoundly ill range of the Yale Brown Obsessive Compulsive Scale.Sertraline was titrated in 50 mg increases every 2–4 weeks up to a maximum of 400 mg. Blood samples were taken after their morning dose. This was after the patients had stabilised for at least 2 weeks on the higher doses.ResultsSeventeen patients were included in the study and received sertraline dosages ranging from 225 mg to 400 mg per day. Blood levels were within therapeutic range or below for all patients. Following treatment within the service, these patients generally showed an improvement of an average of improvement of 43% on the YBOCS.ConclusionsA subgroup of patients with profound refractory OCD seem to either malabsorb or rapidly metabolise sertraline resulting in lower than therapeutic blood levels.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A validation study of the Mood and Feelings Questionnaire, Danish version
Authors: Frøkjær J. Eg , Bilenberg N. , Wesselhoeft R. 
Published: June 2017

IntroductionThe Mood and Feelings Questionnaire (MFQ) was developed to measure depressive symptoms in children and adolescents. It includes a child self-report part and a parent report on child part. The MFQ has been validated and proven clinical useful in several countries.ObjectivesTo validate the MFQ in a population of Danish children and adolescents.AimsThere is a need of a standardized questionnaire for Danish children and adolescents tapping into affective symptoms. Before routine use the MFQ must have been validated in Denmark. This study examines the validity of MFQ in Danish children and adolescents.MethodsThe study included two samples of probands aged 8–18 years. A population-based sample of school children and their parents, and a clinical sample including two subsamples:– patients referred for Child and Adolescent Mental Health Services with depressive symptoms;– in-patients at the paediatric department of a University Hospital.All included probands and their parents filled out the MFQ and the clinical samples in addition answered the depression section of the Beck Youth Inventories, and were interviewed using the depression part of “K-SADS-PL”.ResultsPreliminary results from both samples will be presented at the EPA 2017 in Florence.ConclusionsDepending on the results of this study, the MFQ might be used as a screening instrument and as a clinical tool to monitor depressive symptoms in Danish children and adolescents.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Social and family characteristics of children with stuttering in Tunisia
Authors: Baccouche K. , Walha A. , Hadjkacem I. , Kammoun W. , Hariz I. , Ayadi H. , Moalla Y. , Ghribi F. 
Published: June 2017

IntroductionStuttering constitutes for children a psychological and social disability, in which the environmental context plays an important role in the installation, stabilization and aggravation or attenuation.ObjectiveOur study aims to describe the socio-familial characteristics of children with stuttering.Patients and methodsThis is a descriptive and analytical-retrospective study carried out on 80 children with stuttering and had been followed-up in the child psychiatry department of UMC Hédi Chaker Sfax (Tunisia) for more than 3 years (January 2012 to 31 December 2013).ResultsIn our study, the prevalence of stuttering in child psychiatry consultation department of Sfax is 4%. Most of the patients were either the youngest (36.25% of cases) or seniors (35% of cases).Personal history of speech disorder had been reported in 8 children (10% of cases). Family history of speech disorder was reported in 33.75% of cases. These disorders had been kind of stuttering in 60.66% of cases, speech delay in 18.52% of cases and sound speech disorder in 7.41% of cases.The parent–child relationship is marked by a parental rigidity in 18.6% of cases. The existence of triggering factor was noted in 37.5% of cases: traumatic situation (30% of cases), the birth of a younger sibling (22% case).ConclusionThe emergence and evolution of stuttering depend on predisposing, precipitating and chronicisants factors. Identifying these factors and adopting a favorable parental attitude contribute to the fight against stuttering in children and, at least, avoid aggravation and chronicity of this disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Behavioral problems in Silver–Russell syndrome – Case report
Authors: Karher K. , Banda I. 
Published: June 2017

ObjectivesThe aim of this study is to present two cases of Silver–Russel Syndrome patients with behavioural problems. The male is diagnosed with ADHD, and the female shows antisocial behaviour.BackgroundRussell–Silver syndrome (RSS) is a rare disorder characterized by intrauterine growth retardation and postnatal growth deficiency along with a handful of common physical characteristics and a range of other symptoms.MethodsClinical observation, tests (EEG, psychological tests – IQ scale, JEPQ, Projective techniques) and interviews with the patients and their parents and foster parents.ResultsS.H. (20 years) – is opponent, aggressive, refuses every kind of cooperation with delayed mental development.V.M. (10 years) – premature baby (born in the sixth month) in a 40 years old mother (second pregnancy); blind on right eye and very low vision on the left eye; lost both of his parents at the age of 1.6 in a car accident; had several operations and is always under some treatments. V.M. had low school performance. The foster parent noticed that he has an attention deficit. Besides, he is very aggressive verbally and physically, has low frustration tolerance, borderline intelligence.ConclusionAccording to several studies that claims that patients with Silver–Russel syndrome have behavioural problems and among them, the most common are attention deficit problems; our study improves that hypothesis. Both of our patients have attention deficit problems.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Is bipolar over diagnosed in adolescents?
Authors: Paulino S. , Santos N. , Almeida A.C. , Gonçalves J. 
Published: June 2017

IntroductionSince the mid-1990s, the diagnosis of bipolar disorder has increased significantly: two-fold among adults, four-fold among adolescents and 40-fold among children. Mood instability is a hallmark symptom of many psychiatric disorders but does not imply necessarily a diagnosis of bipolar disorder. Misdiagnosis is not just an academic issue: mood stabilizers have significant adverse effects and expose patients to side effects that range from mild to potentially life-threatening.ObjectivesDiscuss the potential overestimation of bipolar diagnosis in the adolescent population through a statistical analysis of a sample from the adolescence's consultation of Centro Hospitalar Lisboa Norte.MethodsAnalysis of 106 patients taking into account the initial diagnosis and the diagnostic stability over 6 months. Non-systematic review of the literature.ResultsFrom this sample, 39.2% of the adolescents have a diagnose of unipolar affective disorder, 0.02% of bipolar disorder and 0.1% of disruptive mood disorder. These diagnoses did not change over the follow-up period.ConclusionIt is important to try to understand the reasons of this potential discrepancy (influence of pharmaceutical company marketing, of parents’ desire, of doctors’ fear) to reduce controversy and confusion and to adjust treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Access and participation: What factors influence the provision and utilisation of health care services by children with learning disabilities?
Authors: Rebowska A. 
Published: June 2017

AimsThe aim of this literature review is to explore the range of factors that influence the degree of access to health care services by children and young people with learning disabilities.BackgroundChildren with learning disabilities are at increased risk of a wide range of health conditions comparing with their peers. However, recent reports by UK government as well as independent charities working with children and young people with learning disabilities demonstrated that they are at risk of poor health outcomes as a result of barriers preventing them from accessing most appropriate services.MethodsComprehensive searches were conducted in six databases. Articles were also obtained through review of references, a search of the grey literature, and contacting experts in the field. The inclusion criteria were for studies evaluating access to healthcare services, identification and communication of health needs, organisational aspects impacting on access and utilisation, staff attitudes where they impacted on access, barriers, discrimination in patients with intellectual disabilities age 0–18. The literature search identified a sample of 36 papers. The marked heterogeneity of studies excluded conducting a meta-analysis.ResultsBarriers to access included problems with identification of healthcare needs by carers and healthcare professionals, communication difficulties, the inadequacy of facilities, geographical and physical barriers, organisational factors such as inflexible appointment times, attitudes and poor knowledge base of healthcare staff.ConclusionThe factors identified can serve as a guide for managers and clinicians aiming to improve access to their healthcare services for children and young people with intellectual disabilities.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Developing and implementing digital-assisted parent training intervention for disruptive behavior in primary health care
Authors: Sourander A. , Ristkari T. 
Published: June 2017

BackgroundAccording to many epidemiological studies early prevention of mental health problems is essential in childhood. The objectives are:– to determine whether a digital-assisted intervention using whole-population screening that targets the most symptomatic 4-year-old children is effective at 12 months after the start of treatment;– to describe the Finnish Strongest Families intervention model in primary health care.MethodsThe target population was children with high level of DBD symptoms screened from the population of 4-year olds attending annual child health clinic check-ups. The RCT study was conducted in southwest-Finland between 2011 and 2013. In the control group, participants (n = 232) were given access to a parent training website and a telephone call from a coach. Participants (n = 232) in the intervention group received internet and telephone delivered the Finnish Strongest Families program.ResultsDuring the 12-months follow-up results of the intervention showed the behavioural problems of the four-year-old children reduced significantly in the families who participated in the 11-week program compared to the control group. So far, this evidence-based intervention has been implemented in 13 municipalities in Finland and the nationwide implementing process is in progress.ConclusionsTraining parents online and over the telephone significantly decreases preschool children's disruptive behavior. Therefore, it is important to provide low threshold, digitally delivered, family oriented promotion, prevention and early intervention programs in the primary care. More studies are needed to evaluate the long-term effects and cost-effectiveness of digital interventions in preventive mental health care.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Delirium: “The out of the track” of physicians
Authors: Mangas M. , Santos G. Alcobia , Martins Y. , Pires A. Matos 
Published: June 2017

IntroductionDelirium is an acute clinical syndrome with diverse and multi-factorial etiologies. It has high prevalence in hospitalized patients and it is associated with serious adverse outcomes, increasing morbidity and mortality. Delirium requires a differential diagnosis with a wide range of mental disorders.AimTo evaluate cases referred to liaison psychiatry in Hospital José Joaquim Fernandes, in regard to the frequency, cause and misdiagnoses of delirium.MethodsA retrospective analysis of liaison psychiatric referral from January to August 2016.ResultsThe overall referral consisted of a total of 111 cases. Delirium was the second most frequent referral (21.6%), after depression. Half of patients had an advanced age (71–90 years). A total of 44.8% of patients with delirium were misdiagnosed and the referral causes were “depression”, “dementia”, “aggressive behavior”, “agitation” and “schizophrenic psychosis”. The majority of patients were referred by internal medicine. The most frequent underlying conditions were: postoperative (27.6%), respiratory diseases (24.1%) and sepsis (17.2%).Discussion/conclusionDelirium is one of the most frequent diagnoses in liaison psychiatry. This study supports the statement that delirium is often not recognized and that is misdiagnosed as a primary psychiatric illness, mainly, dementia or mood disorder. Although delirium is classified in ICD-10 as a psychiatric diagnosis and clinically manifests with a wide range of neuropsychiatric abnormalities, it is secondary to a medical/surgical disorder that requires urgent approach by the respective specialty.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Alternating intravenous racemic ketamine and electroconvulsive therapy in treatment resistant depression: A case report
Authors: Bartova L. , Weidenauer A. , Dold M. , Naderi-Heiden A. , Kasper S. , Willeit M. , Praschak-Rieder N. 
Published: June 2017

IntroductionTreatment resistant depression (TRD) affecting approximately 10–30% of all depressed patients often remains misdiagnosed and undertreated, leading to a higher risk of relapse and suicide. Electroconvulsive therapy (ECT) and sub-anesthetic ketamine have repeatedly shown to be effective in the TRD population. Administering ketamine as an anesthetic component to augment antidepressant efficacy of ECT has been proven inconclusive, while a combination of alternating ECT and ketamine has not been investigated yet.Case reportWe present a severely depressed and chronically suicidal female inpatient who failed multiple antidepressant treatment attempts, requiring frequent psychiatric admissions. Since available conventional as well as non-conventional antidepressant treatment strategies were nearly exhausted, we employed a combination of ECT (bilateral stimulation up to 150%) 2–3 times/week, while intravenous racemic ketamine (up to 75 mg per infusion) was administered on ECT free days 2–3 times/week. Consequently, robust anti-suicidal and antidepressant effects could be observed already during the first treatment week. The temporarily occurring subjective forgetfulness disappeared after the last ECT. Summarizing, we employed 9 ECT treatments and 7 ketamine infusions leading to a stable psychopathological state even after discharge from psychiatric inpatient care. In order to prevent relapse a maintenance-therapy comprising ECT once monthly and 2 ketamine infusions (up to 100 mg per infusion) administered on the day before and after ECT was established.ConclusionsIn our patient alternating ECT and intravenous racemic ketamine were proven safe and long-term effective after numerous failed antidepressant trials including ECT and ketamine alone. We may hence encourage clinicians to widen their therapeutic armamentarium in severe TRD.Disclosure of interestThe authors have not supplied their declaration of competing interest.