bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethnic Immigrant suicide in a Canadian psychiatric service: A case series from 1966–1997
Authors: Husain N. , Martin B. , Husain M. , Duddu V. , Sakinofsky I. , Beiser M. 
Published: May 2016

IntroductionSuicide is a major public-health problem in Canada. Data from ‘Statistics Canada’ suggests that there was a 10% increase in suicide rate between the years 1997 and 1999. Studies have found substantial differences in suicide rates (and patterns) amongst ethnic immigrants compared to Canadian-born individuals.AimThe aim of the study was to investigate whether ethnic-immigrant patients differed from Canadian-born patients in their social, demographic, psychiatric and historical associations.MethodsAll registered patients (n = 276) known to have completed suicide from 1966–1997 constituted the study sample. Data were extracted from the written case audits, autopsy and toxicology reports, and medical records.ResultsOf the 276 known cases of suicide, 11 were Afro-Caribbean, 24 were Eastern European, 14 were Asian and 215 were Canadian-born patients. The ethnic-immigrant groups were broadly comparable to the Canadian-born group in terms of the social, demographic, psychiatric and background historical factors (except that the latter had a higher prevalence of alcohol and substance misuse). There were no significant differences between different ethnic immigrant groups themselves.ConclusionsThe most salient implication of the findings are that social, psychiatric and historical associations of mentally ill patients who complete suicide are common across different ethnic immigrant groups, and as such a universal approach to mental health promotion, early identification and treatment would be similarly applicable to patients belonging to all groups.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Association between immigration status and inpatient psychiatric admission after attempted suicide: Results from a hospital-based observational study
Authors: Martinez-Ales G. , Jimenez E. , Roman E. , Sanchez-Castro P. , Suarez A. , Rodriguez-Vega B. , De Dios C. , Bravo M.F. 
Published: May 2016

IntroductionAcute suicidality or a condition after attempted suicide frequently leads patients to both voluntary or involuntary inpatient admission. Emergency room psychiatrists decide whether such patients can be treated on an outpatient basis.ObjectivesTo identify if immigration status is associated with the decision whether a patient needs a hospital admission.AimsTo detect social determinants of hospital-based health resource uses.MethodsA cross-sectional study including data from 323 patients treated in a general hospital's emergency room after a suicidal attempt during year 2014.ResultsSeventy-six patients were admitted to the hospital (23.5%). Hospitalization frequencies for immigrant and non-immigrant individuals were 6.3% and 26.5% (P = 0.002). No significant association was found between psychiatric admission and history of a diagnosed psychiatric disorder, previous suicidal attempts, previous emergency room care use, family support or current drug use. A subgroup of patients (n = 37; 9%) answered Beck's suicidal intent scale (SIS), a measure of risk in suicidal attempters. Mean SIS was found to be higher among hospitalized than discharged patients (8.5 vs. 16.5; P = 0.01). No significant difference was found in mean SIS between immigrant and non-immigrant patients (9.3 vs. 9.1; P = 0.3).ConclusionsThese preliminary results call for consideration. The highly significant lower rate of psychiatric admission among immigrant patients, without significant differences in mean SIS score in regard to non-immigrants, needs further study.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Suicidal ideation and organic diseases in acute female psychiatric patients
Authors: Solano P. , Ustulin M. , Vecchio R. , Rreshketa A. , Pizzorno E. , Serafini G. , Amore M. 
Published: May 2016

IntroductionPhysical illness has been recognized as a major risk factor for suicidal behaviours, especially among females. A higher number of physical comorbidities has been associated with higher suicide- risk, thus having a greater burden among the elderly.Objectivesinvestigate this evidence to be able to estimate the load of physical illness on suicidality among psychiatric females of different age.AimsEvaluate the association between suicidal ideation, age, depression and physical comorbidities in a sample of acute females psychiatric in-patients.Methods81 psychiatric female in-patients were evaluated during their first day of hospitalization through MADRS, SSI and the presence of organic comorbidity has been collected together with demographic data. All the evaluations were carried out at the Psychiatric Clinic, University of Genova, Italy.ResultsMean age 48 (age–range value: 74, high variability). Pearson's Chi-squared test showed: significant association between SSI and MADRS (P = 0,027; α = 0,05); no association between SSI and age (P = 0,194; α=0,05); no association between SSI and presence medical illness (P = 0,132; α = 0,05); no association between SSI and number of medical illness (P = 0,186; α = 0,05).ConclusionsOur results show that the levels of suicidal ideation in psychiatric females are independent from age, presence and number of physical comorbidities. Suicidal ideation appears to be associated only with levels of depression. Our results challenge evidence from a large number of current studies and, if confirmed by further research, would lead to reconsider major suicide risk factors. Further research to investigate these associations on larger samples is needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Development and psychometric testing of the triggers of suicidal ideation inventory for assessing older outpatients in primary care settings
Authors: Tsai Y.F. , Lee S.H. , Wang Y.W. , Chen Y.J. 
Published: May 2016

IntroductionOlder adults with depression resist accepting depression screening and seeking treatment due to stigmatization of mental disorders and little knowledge about depression. This study was undertaken to develop and determine the psychometrics of an instrument for assessing triggers of suicidal ideation among older outpatients.MethodParticipants were recruited from older outpatients of two hospitals in northern Taiwan. An initial 32-item Triggers of Suicidal Ideation Inventory (TSII) was developed, and its items were validated by experts in two runs of Delphi technique survey. After this TSII was pre-tested in 200 elderly outpatients, 12 items were retained. The 12-item TSII was examined by criterion validity, construct validity, internal consistency reliability, and test-retest reliability.ResultsTSII scores were significantly and positively correlated with the Beck Scale for Suicide Ideation (r = 0.45, P < 0.01), and UCLA Loneliness scores (r = 0.55, P < 0.01), indicating satisfied criterion validity. Participants with depressive tendency tended to have higher TSII scores than participants with no depressive tendency (t = 8.62, P < 0.01), indicating good construct validity. Cronbach's α and the intraclass correlation coefficient for the TSII were 0.70 and 0.99 respectively, indicating acceptable internal consistency reliability and excellent test-retest reliability. Receiver operating characteristic analysis revealed that the area under the curve was 0.83, indicating excellent ability to detect triggers of suicidal ideation. With a cutoff point of 2, the sensitivity and specify were 0.86 and 0.67, respectively.ConclusionsThe TSII can be completed in 5 minutes and is perceived as easy to complete. Moreover, the inventory yielded highly acceptable parameters of validity and reliability.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Online destigmatization of schizophrenia: A Romanian experience
Authors: Ladea M. , Bran M. , Marcel Claudiu S. 
Published: May 2016

IntroductionMental illness stigma existed long before psychiatry, although sometimes the institution of psychiatry has not helped enough in reducing either stereotyping or discriminatory practices. Stigma of mental illness involves problems with knowledge, attitudes, and behavior and has important negative consequences for patients and their families. As new technologies become more reliable and accessible, mental health specialists are developing new and innovative methods through which they may provide services. Internet has an important role in the delivery of information because of its ability to reach a large number of people in a cost-effective manner.ObjectivesIn order to reduce stigma an online platform with relevant information about schizophrenia was developed. Simultaneously a social media campaign to increase awareness was launched.MethodsA multidisciplinary team of psychiatrists, web-developers, IT specialists and designers developed the platform www.schizophrenia.ro. The platform is intended to be simple and with a great visual impact and it gathers general information about schizophrenia. The social media campaign used emotional messages like “Diagnosis is not the end of the road” or “I’m a person not a diagnosis” combined with high impact images.ResultsFrom 1st January to end of September 2015 the platform had about 22,500 users and about 70,500 page views. The social media campaign had a reach of approximately 9700 people in just 2 months.ConclusionsThe World Wide Web is increasingly recognized as a powerful tool for prevention and intervention programs and could also play an important role in destigmatization campaigns.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Antipsychotic monotherapy versus combination in schizophrenia: Are there differences in cognition?
Authors: Ruiz A. , Brañas A. , Vicens M. , Orozco A. , Lahera G. 
Published: May 2016

IntroductionInfluential protocols in the treatment of schizophrenia recommend the use of antipsychotics in monotherapy, although combination is common in clinical practice.Objectives/aimsTo compare cognitive performance of patients with schizophrenia treated by antipsychotic monotherapy or polytherapy; secondly, to analyze clinical and sociodemographic differences.MethodsNinety-eight outpatients between 18 and 65 years, diagnosed with schizophrenia, based on the DSM-V were recruited. Seventy were in monotherapy and 28 in antipsychotic combination. Patients with comorbidity, moderate to severe motor impregnation, abuse-substance dependence or serious somatic illness were excluded. Both groups were compared in sociodemographic, clinical and cognitive measures: PANSS scale, short Akathisia Scale Simpson-Angus Scale, State-Trait Anxiety Inventory (STAI), face emotion recognition (FEIT) and global Functioning (GAF), speed processing - through the Trail Making Test, parte A, subtest of symbol coding of the Brief Assessment of Cognition in Schizophrenia (BACS) and Verbal fluency (animals)- and sustained attention (SA)–through the Continuous Performance Test (CPT).ResultsBoth groups showed similar age, gender, number of hospitalizations, score in STAI-Trait, STAI-State, ANGUS, GAF, TMT-A, verbal fluency and face emotion recognition. Patients in politherapy had more years of evolution (P 0.047), higher score in positive PANSS (P 0.007), negative PANSS (P 0.008), general PANSS (P 0.001); they showed more detection errors in the CPT (P 0008), and a trend towards less processing speed through the symbol coding (P 0.063), compared to patients in monotherapy.ConclusionsAntipsychotic polipharmacy is associated with an impairment in sustained attention in patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Exploratory randomized controlled trial of a group psychological intervention for postnatal depression in British mothers of South Asian origin
Authors: Husain N. , Lovell K. , lunat F. , Atif N. , Bhokari A. , Bhojani I. , Tomenson B. , Waheed W. , Rahman A. , Chaudhry N. 
Published: May 2016

IntroductionThe rates of postnatal depression (PND) in British South Asian (BSA) women are higher than the general population. PND is known to cause disability and suffering in women and negative consequences for their infants and their family with huge costs to society. Due to linguistic and cultural barriers, BSA women do not access health care services.ObjectivesTo conduct an exploratory trial to test the feasibility and acceptability of a culturally adapted group Cognitive Behavioural Therapy (CBT) intervention (Positive Health Programme (PHP).AimWe aimed to determine if depressed BSA women receiving the PHP intervention will show significant improvements in terms of severity of depression, marital support, and social support as compared to the control group.MethodsWe used a two-arm pragmatic single-blind randomised controlled design. Women meeting the inclusion criteria were randomised either to the experimental group receiving PHP or treatment as usual (TAU) that is standard care usually provided by the GP.ResultsA total of 615 mothers were screened for participation in the trial, of these 137 were assessed further to determine eligibility. Eighty-three mothers were randomized to receive either PHP (n = 42) or treatment as usual (TAU) (n = 41). Mothers found the intervention to be acceptable and felt an overall positive change in their attitudes, behaviour and confidence level.ConclusionThe recruitment and retention figures (70%) highlight the ability of the research team to engage with the population. The findings suggest the acceptability of the culturally adapted PHP intervention for British South Asian women with postnatal depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Are there clinical and care differences in real care intensity among patients in general hospitals suffering from psychiatric comorbidity?
Authors: Valdes-Stauber J. , Bachthaler S. 
Published: May 2016

BackgroundAccording to literature, about 30–40% of individuals admitted in general hospitals suffer from psychiatric comorbidity. Consultation-liaison services (CLS) cover internationally 1–10% of admissions and are able to improve care quality, treatment adherence and to reduce length of stay.ObjectivesTo assess possible clinical and care differences between individuals with and without psychiatric comorbidity as well as differences among principal diagnostic groups.AimsTo find out, whether individuals suffering from specific psychiatric diagnoses show a higher degree of care needs held by a CLS.MethodRetrospective, ethical approved full-survey assessment (n = 2940) over three years (2012–2014). ICD-10 diagnoses, clinical factors and care variables were considered. Group differences were calculated by means of chi-square and ANOVA as well as Scheffé post-hoc estimation. Associations were conducted by means of multivariate regression as well as logistic regression models.ResultsIndividuals suffering from psychiatric comorbidity (48% of sample) were seldom primarily oncologic patients (30%), they showed more distress (DT = 6.5), more performance limitations (ECOG = 1.38), and less functionality (GAF = 59.6). They received more contacts by CLS (1.95), more cumulative treatment time (89.7 min), and more psychopharmacological interventions (30.6%). People suffering from recurrent depressive and somatoform disorders received much more contacts and treatment time than other diagnostic groups. Age was negatively associated with care intensity.ConclusionsCLS services are able to offer differentiated psychiatric care depending on diagnoses. Individuals suffering from classical psychiatric disorders received rather treatment as usual, oncologic patients more psychotherapeutic interventions. Depressive as well as somatoform patients seem to need more time and personal resources.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Making mental health part of the solution for reducing the negative impact of austerity – a perspective from England
Authors: Bailey S. 
Published: May 2016

This paper will describe four initiatives in England to protect the mental health of the population.1. Lobbying government – presenting the evidence about how mental health services can reduce the impact of austerity on families and communities.2. Building psychosocial resilience in schools through well being programmes and through “enabling environments” in the workplace.3. Delivering sustainability in mental and physical healthcare:– prevention – don’t get ill in the first place;– patient empowerment – if unwell patient to self manage where possible;– lean service design – if healthcare services necessary, these should be efficient and high value;– low carbon – reducing carbon footprint and waste.4. Working across medicine – choosing wisely:– promoting conversations between doctors and patients to choose care that is:– supported by evidence,– not duplicative of other tests of procedures already received,– free from harm,– truly necessary.Disclosure of interestThe author has not supplied his declaration of competing interest.
Internally displaced persons in Ukraine
Authors: Korostiy V. 
Published: May 2016

As of May 21, 2015 UNHCR has information about 1,299,800 IDPs, the data provided by the Ministry of Social Policy of Ukraine. Since the process of establishing a centralized system for registration is still pending, the actual number of persons displaced within the country may be higher.We have a complex psychopathological and clinical research psychodiagnostic 97 internally displaced people in volunteer center, located at the central train station in Kharkiv to study the clinical features of neurotic disorders.The results showed that 75.9% of IDPs observed have violations of adaptation: long-term depressive reaction (F 43.21) and predominant disturbance of other emotions (F 43.23). The clinical picture is dominated by the depression, anxiety, inner tension, inability to relax, asthenic symptoms, various fears and paroxysmal autonomic instability.The results of the diagnostic psychological studies have found that men reactive alarm indicators (average – 37,7 ± 3,0) were higher than trait anxiety (average – 32,6 ± 2,9). On the contrary, women figures trait anxiety (average – 38,6 ± 2,9) were higher than reactive anxiety (average – 34,7 ± 3,0). Severity of depressive symptoms also slightly prevailed in women. The mean score on the Hamilton scale for men was 17,0 ± 2,3 points, women – 18,0 ± 2,3 points.Disclosure of interestThe author has not supplied his declaration of competing interest.
Can ecstasy treat the agony of PTSD?
Authors: Mithoefer M. 
Published: May 2016

IntroductionTwo serotonin reuptake inhibitors (SSRIs) have received FDA indication for treatment of PTSD, however the effectiveness of pharmacotherapy for PTSD is limited. Psychotherapy, including several well established evidence based methods, is the mainstay of PTSD treatment. Despite advances in this area, a significant percentage of PTSD patients are refractory to existing treatments. Recent research has explored the possibility that certain drugs could increase the effectiveness of psychotherapy when administered intermittently in conjunction with psychotherapy sessions. The most robust published. Results to date using this approach have been in early clinical trials of ± 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. These studies primarily involved civilians with treatment-resistant, crime-related PTSD. A more recent phase 2 trial, completed in 2015 yielded equally promising. Results in a cohort of military veterans, police officers and firefighters, mostly veterans from the wars in Iraq and Afghanistan.MethodologyIn these double blind controlled trials subjects with PTSD refractory to prior treatment are randomized to an active dose of MDMA or an active or inactive placebo administered to each individual on only two or three occasions during eight-hour psychotherapy sessions one month apart, in conjunction with preparatory and follow-up psychotherapy sessions. Outcome measures are repeated one or two months after the second MDMA-assisted session before the blind is broken. Subjects who were randomized to full dose MDMA are then eligible for one additional, open label, MDMA-assisted session. Those randomized to placebo or a lower dose of MDMA are eligible for three open-label full dose sessions. Outcome measures are repeated two months following the third MDMA-assisted session. The primary outcome measure is the Clinician Administered PTSD Scale (CAPS). Additional measures include the Beck Depression Inventory-II (BDI-II), Global Assessment of Functioning (GAF), Pittsburgh Sleep Quality Index (PSQI) and Posttraumatic Growth Inventory (PTGI).ResultsIn the original study comparing MDMA with inactive placebo along with the same psychotherapy PTSD was resolved in 83% of the MDMA group vs. 25% of the placebo group receiving the same therapy. Improvement was maintained for at least 74% of subjects at long-term follow-up a mean of 45 months later. In a more recent, unpublished, study both the high dose and the medium dose of MDMA showed large effect sizes in reducing CAPS scores, and improvements in secondary measures: and BDI-II, PSQI, GAF and PTGI.ConclusionEvidence in phase II trials suggest that MDMA-assisted psychotherapy is effective in treating PTSD in both civilians and veterans who have not responded to established treatments. Phase III trials are necessary to definitively establish safety and efficacy of MDMA-assisted psychotherapy for PTSD.Disclosure of interestThe author has not supplied his declaration of competing interest.
How EFPT trainee-led cross-national research can change training in psychiatry
Authors: De Picker L. , Mogren T. , Tomori S. 
Published: May 2016

Established in 2008, the Research Working Group of the European Federation of Psychiatric Trainees (EFPT) creates a platform for trainee-led collaborative studies. Several large-scale transnational studies on training-related subjects have been initiated and carried out, driven by psychiatry trainees. Examples of recent and ongoing projects are the Brain Drain study, which investigated migratory experiences and attitudes among trainees in Europe, and the TEO-PC project, which aims to raise awareness on UEMS Psychiatric competencies as well as to compile data on trainees’ experiences and satisfaction with their national training programs.Earlier projects leading to publications have looked into drug prescription habits of trainees [1,2] and the interactions trainees with pharmaceutical industry [3]. Besides these projects, EFPT yearly gathers reports from the representatives of the national trainees associations on the structure, content and conditions of psychiatry training in all member countries. The information obtained through these channels is used actively to guide and influence policy related to psychiatry training, through collaboration with relevant organizations involved in the creation of guidelines, and through the EFPT statements, which serve to empower trainees themselves.Disclosure of interestThe authors have not supplied their declaration of competing interest.