bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dementia severity among institutionalized elderly: Are there more unmet needs?
Authors: Ferreira A.R. , Martins S. , Dias C.C. , Fernandes L. 
Published: May 2016

IntroductionThe ageing population and the resulting increase in chronic diseases, including dementia, make the evaluation of their emergent needs a crucial step in psychogeriatric care. Unmet needs are found to be important clinical targets that should be followed by active management in order to improve health status and survival.ObjectivesTo analyze the relation between unmet needs and cognition, and explore the nature of these needs across dementia severity stages.MethodsA cross-sectional study was conducted in three nursing homes. Residents were excluded if they were terminally ill, unresponsive or presented delirium. All participants were assessed by Mini-Mental State Examination/MMSE (cognition) and Camberwell Assessment of Need for the Elderly/CANE (needs). Additionally, cognitive decline was staged as: absent (MMSE = 30), questionable (26–29), mild (21–25), moderate (11–20) and severe (≤ 10).ResultsThe study included 175 elderly with a mean age of 80.6 (SD = 10.1) years, of which 58.7% presented cognitive decline. For these, the mean number of unmet needs was greater than for those without (4 vs 3, P < 0.001), and they differed significantly in the domains of daytime activities (P < 0.001), memory (P < 0.001) and psychotic symptoms (P = 0.005). A significant negative correlation was found between MMSE and number of unmet needs (rs = −0.369, P < 0.001). Considering the severity stages, unmet needs also differed: more needs in early stages in daytime activities (73.3%), and in advanced ones in memory (63.9%) and psychotic symptoms (23%).ConclusionsGreater cognitive decline was related with more unmet needs, which agree with previous studies. The different nature of needs across severity stages also suggests that interventions should be tailored comprising this specificity and complexity, when effective care is planned.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Attachment representations in a population of elderly subjects
Authors: Moalla M. , Feki I. , Ktata A. , Sellami R. , Triqui D. , Baati I. , Abida I. , Masmoudi J. 
Published: May 2016

IntroductionAccording to attachment theory, attachment relationships have a lasting impact on the functioning of the individual. If this impact has been much studied in children, few studies have been conducted in the elderly.ObjectivesExplore the representations of attachment in a population of elderly subjects.MethodsThe sample consists of 90 consultants over the age of 65. Each participant filled out demographic questionnaire, Relationship Scale Questionnaire (RSQ): questionnaire of 13 items, each item rated from 1 to 5, a lower score attests a more secure attachment and Adult Attachment Questionnaire: a categorical scale of 3 statements. Statement 1 corresponds to secure attachment style, 2 to avoidant attachment style and 3 to anxious-ambivalent attachment style.ResultsThe age of participants ranged from 65 to 95 years with an average of 68.14. The sex ratio M:F was 0.8. The RSQ Score ranged from 16 to 56 with an average of 37.27. Of the participants, 72.2% have secure attachment style, 24.4% have an avoidant attachment style and 3.3% have an anxious-ambivalent attachment style. The study of correlations showed strong correlation between the two scales (P = 0.00) and the RSQ score was significantly associated with poor satisfaction of married life (P = 0.025), presence of psychological trauma in childhood (P = 0.016) and a separation experience (P = 0.029).ConclusionOur study highlights the importance of early childhood experiences that may impact late adult life. These finding are in accordance with attachment theory.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Dementia in acutely-ill medical elderly patients
Authors: Sá Esteves P. , Loureiro D. , Albuquerque E. , Vieira F. , Lagarto L. , Neves S. , Cerejeira J. 
Published: May 2016

IntroductionDementia is one of the leading causes of disability and burden in Western countries. In Portugal, there is a lack of data regarding dementia prevalence in hospitalized elderly patients and factors associated with in-hospital adverse outcomes of these patients.ObjectivesDetermine dementia prevalence in acutely-ill medical hospitalized elderly patients and its impact in health outcomes.MethodsAll male patients (> 65 years) admitted to a medical ward (> 48 h) between 1.03.2015 to 31.08.2015 were included in the study. Patients were excluded if unable to be assessed due to sensorial deficits, communication problems or severity of the acute medical condition. Baseline evaluation included socio-demographic variables, RASS, NPI, Barthel Index and Confusion Assessment Method.ResultsThe final sample consisted of 270 male subjects with a mean age of 80.9 years, 116 (43%) having prior dementia. Dementia patients were significantly older (83.5 vs 78.9; P < 0.001) and had lower values of Barthel Index (dementia: 34.8 vs non-dementia: 85.8; P < 0.001). Mortality rate (9,3%) and length of hospitalization (11.2 days) were similar between groups (12.1 vs 7.1; P = 0.204 and 11.9 vs 10.6; P = 0.218, respectively). Patients with dementia had higher rates of all neuropsychiatric symptoms except depression, anxiety and mood elation. The level of consciousness (measured by RASS) was impaired in 50% of patients with dementia, which was significantly higher than in non-demented subjects (12.3%; P < 0.001). Delirium rates were 29.5% in dementia compared with 7.1% in controls (P < 0.001).ConclusionsThere is a high prevalence of dementia and an appreciable rate of delirium among these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Intellectual disability among delusional disorder: A case series register
Authors: Carrillo de Albornoz Calahorro C.M. , Guerrero Jiménez M. , Porras Segovia A. , Cervilla Ballesteros J. 
Published: May 2016

IntroductionThe quoted prevalence of intellectual disability (ID) among adults with psychiatric illness varies widely. Some believe that these people are protected from certain intellectual and psychological stress by having ID, and therefore, are less prone to develop psychiatric illness. However, in the past decades, the more prevailing view is that people with ID are more vulnerable to psychosocial stress than people without ID, and therefore, are more likely to develop psychiatric symptomatology. According to various population surveys the probability of suffering a mental disability increase with age. Delusional disorder is as well a disease related to advanced stages of life.Objectives/aimsThe aims of the present study is to establish the prevalence of functional intellectual disability among adults who fulfil DSM 5 delusional disorder criteria.MethodsOur data come from a case register study of delusional disorder in Andalucia (Spanish largest region). By accessing digital health data, we selected 1927 cases, which meet criteria DSM 5 for delusional disorder collecting whether in its history intellectual disability was registered by the referent psychiatrist.ResultsOf our sample, 2.6% had reflected some kind of intellectual disability in their digital clinical record.ConclusionThese percentage has been found to concur with other epidemiological studies linking mental retardation and psychotic spectrum disease although there are no epidemiological data published to the best of our knowledge that correlate delusional disorder specifically and intellectual disability.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Overview of psychiatry in Poland, 2000–2015
Authors: Kiejna A. , Piotrowski P. , Gondek T.M. 
Published: May 2016

At the beginning of the 21st century, psychiatry in Poland was functioning in the model based mostly on the network of large institutions localised outside of the main city centres. Due to Poland's accession to the European Union, it was necessary to change the mental health care system. This need was legally sanctioned when the Law on Protection of Mental Health was passed in 1994. The solutions were included in the National Programme on Mental Health Care (NPOZP). NPOZP comprised the guidelines on the mental health care system shift to community-based health services, including a roadmap for its implementation in 2011–2015. According to the evaluation of the NPOZP, including the information gathered by the Ministry of Health, the programme was implemented to a small extent. The number of large psychiatric institutions and the number of in-patient beds were reduced, the numbers of day wards as well as psychiatric wards in the multidisciplinary hospitals were increased. The training of the staff for the new system beginned. A serious challenge for the continuation of the reforms being carried out is the provision of the sufficient number of mental health professionals, particularly in the face of economic migration. A short duration of the proposed NPOZP implementation period did not allow for a full application of the new mental health care solutions, however the awareness that its implementation may be at risk led to a public and media discourse which definitely will have an impact on the improvement of the execution of the programme.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Gender and immigrant status differences in the treatment of substance use disorders among US Latinos
Authors: Alvarez K. , Cook B. , Montero Bancalero F. , Wang Y. , Rodriguez T. , Noyola N. , Villar A. , Qureshi A. , Alegria M. 
Published: May 2016

US Latinos have higher rates of substance use disorders (SUDs) than Latinas, but Latinas face substantial barriers to treatment and tend to enter care with higher SUD severity. Immigrant Latinas may face greater barriers to care than native-born despite lower overall SUD prevalence. This study aimed to identify how SUD treatment needs of Latinos are addressed depending on patient gender and immigrant status within an urban healthcare system serving a diverse population.MethodsData from electronic health records of adult Latino/a primary care patients (n = 29,887 person-years) were used to identify rates of SUD treatment in primary and specialty care. Treatment characteristics and receipt of adequate care were compared by gender and immigrant status.ResultsTobacco was the most frequently treated substance followed by alcohol and other drugs. Forty-six percent of SUD patients had a comorbid psychiatric condition. Treatment rates ranged from 2.52% (female non-immigrants) to 8.38% (male immigrants). Women had lower treatment rates than men, but male and female immigrants had significantly higher treatment rates than their non-immigrant counterparts. Receipt of minimally adequate outpatient care varied significantly by gender and immigrant status (female non-immigrants 12.5%, immigrants 28.57%; male non-immigrants 13.46%, immigrants 17.09%) in unadjusted and adjusted analyses.DiscussionResults indicate overall low prevalence of SUD treatment in the healthcare system. Low rates of minimally adequate care evidence the challenge of delivering integrated behavioral healthcare for Latinos with SUD. Results also demonstrate gender and immigrant status disparities in an unexpected direction, with immigrant women receiving the highest rates of adequate care.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Clinical features of neurotic disorders in internally displaced persons
Authors: Korostiy V. , Kozhyna H. , Melamud K. , Platyniuk O. 
Published: May 2016

IntroductionAccording to the Guiding Principles on Internal Displacement, internally displaced persons are persons who have been forced or obliged to leave their homes, in particular as a result of extreme situations, and who have not crossed an state border. As of May 21, 2015 UNHCR has information about 1,299,800 IDPs.AimTo study clinical features of neurotic disorders in IDPs.MethodsWe have a complex psychopathological and psychodiagnostic research 97 IDPs in volunteer center, located at the central train station in Kharkiv.ResultsIn total, 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 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. Test results on a scale of quality of life showed no significant differences between men and women. We have developed a medical and psychological support system to correct the neurotic disorders in IDPs.ConclusionsThe majority of people who left the ATO zone have emotional disorders of different severity and require a further correction in the specialized medical institutions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The inattentive and hyperactive brain: Significant links between corpus callosum features and ADHD symptoms in adulthood
Authors: Luders E. , Kurth F. , Das D. , Oyarce D. , Shaw M. , Sachdev P. , Easteal S. , Anstey K. , Cherbuin N. 
Published: May 2016

IntroductionNeuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) have revealed structural deviations of the corpus callosum in children and adolescents. However, little is known about the link between callosal morphology and symptoms of inattention or hyperactivity in adulthood, especially later in life.ObjectiveWe aimed to further expand this understudied field by analyzing a large population-based sample of 280 adults (150 males, 130 females) in their late sixties and early seventies.MethodsWe applied a well-validated approach capturing the thickness of the corpus callosum with a high regional specificity at 100 equidistant points. In addition to correlating point-wise callosal thickness with ADHD symptom measures within the whole sample, we tested for sex interactions.ResultsThere were significant sex interactions with respect to measures of inattention and hyperactivity, with follow-up analyses revealing significant negative correlations in males (see Fig. 1 – Top). In contrast, there were positive correlations with respect to hyperactivity only in females (see Fig. 1 – Bottom).ConclusionA thinner corpus callosum may be associated with fewer fibers or less myelination. Thus, the negative correlations, as observed in males, suggest an impaired inter-hemispheric communication necessary to sustain motor control and attention, which may contribute to symptoms of hyperactivity, impulsivity and/or inattention. The functional relevance and underlying mechanisms of the positive correlations, as detected in females, remain to be resolved.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Differential effects of coping strategies on autogenous and reactive obsessions
Authors: Lee M.S. , Kwon S.M. 
Published: May 2016

IntroductionObsessive thoughts can be categorized into two subtypes, autogenous obsessions and reactive obsessions. Although it has been investigated that each subtype associates with different maladaptive coping strategies, no studies have yet empirically compared the effectiveness of adaptive coping strategies on autogenous and reactive obsessions.ObjectivesIt is hypothesized that acceptance, which is a core therapeutic principle of acceptance-based cognitive therapy (ACT), is more effective on autogenous obsessions, whereas response suppression as a principle of exposure and response prevention (ERP) has a stronger effect on reactive obsessions.AimsTo compare the effectiveness of two coping strategies (acceptance and response suppression) on autogenous and reactive obsessions.MethodsA total of 164 undergraduate students completed questionnaires for obsessional thoughts and coping strategies. According to the most distressing thought, sixty subjects (n = 30 with autogenous obsession, n = 30 with reactive obsession) were randomly assigned to two groups differing in treatment conditions. Individual psychoeducation and practice were performed for four different groups (2 obsessional subtypes × 2 coping strategies).ResultsRepeated measure ANOVA demonstrated that the autogenous obsessional group showed greater distress reduction after acceptance treatment than response suppression treatment, although its effect was not statistically significant. However, the reactive obsessional group did not show the interaction effect between distress reduction and the two coping strategies.ConclusionsThe results suggest that coping strategies have differential effects on distress reduction of obsessional subtypes. Different therapeutic approaches may need to be offered to individuals with autogenous and reactive obsessions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Group cognitive behavioural therapy for outpatients with obsessive-compulsive disorder in a psychiatric service in Italy
Authors: Pozza A. , Domenichetti S. , Tanini A. , Ruggieri E. , Dèttore D. 
Published: May 2016

IntroductionGroup Cognitive Behavioural Therapy (GCBT) is a cost-effective modality of treatment alternative to individual Cognitive Behavioural Therapy (CBT). Despite several well-controlled trials demonstrated the efficacy of GCBT for Obsessive Compulsive Disorder (OCD), few studies evaluated the effectiveness of GCBT on outpatients attending routinary psychiatric services, and in Italy this topic appears understudied.ObjectivesThe current study evaluated the effectiveness of a GCBT protocol on OCD symptoms and comorbid depression and anxiety in a group of outpatients attending a psychiatric service in Italy.MethodTwenty outpatients with a diagnosis of OCD were included in the study and received 20 sessions of GCBT, consisting of psychoeducation on anxiety and OCD, relaxation training, in vivo/imaginal exposure and response prevention, cognitive restructuring for obsessive beliefs, cognitive defusion, and assertiveness training. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI) were administered at pre- and post-treatment.ResultsTwo outpatients had a comorbid bipolar disorder, eight had a concurrent personality disorder. Ten outpatients were on concurrent antidepressants, five on antipsychotics. Three outpatients prematurely dropped out from treatment. Among completers, GCBT produced significant changes on OCD symptoms, anxiety and depression from pre- to post-treatment. The GCBT protocol was feasible and the outpatients reported high satisfaction judgements.ConclusionsFuture studies should investigate clinical predictors of best response after GCBT and assess maintenance of symptom changes at long-term follow-up.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Defence mechanisms and coping skills in oncology patients
Authors: Bredicean C. , Giurgi-Oncu C. , Papava I. , Romosan R. , Jurma A. , Cristanovici M. , Hurmuz M. , Popescu A. 
Published: May 2016

IntroductionOncology-related illnesses have become quite frequent in our lives. Lately, medical progress in the field of oncology has led to an increase in the survival rates of people diagnosed with cancer. The minimisation of disturbances in the lives of these people is done by each on their own, by using defence mechanisms and coping skills.ObjectivesTo identify the coping and defence mechanisms of subjects diagnosed with cancer compared with non-clinical subjects.AimsTo increase quality of life of subjects diagnosed with cancer through psychotherapy interventions.MethodNineteen subjects diagnosed with cancer who were receiving chemotherapy were recruited to the study. For comparison, a control group of non-clinical participants were also recruited. Participants were included into the study according to particular inclusion/exclusion criteria. The evaluation was conducted during 2014 and consisted of the analysis of the following parameters: socio-demographic data, clinical data, defence mechanisms (DSQ-60) and coping mechanisms (COPE scale).ResultsThe group of subjects diagnosed with cancer demonstrated the presence of defence mechanisms of the following type: passive aggressiveness, projection and coping mechanisms that were characterised by an emphasis on social support. The control group had defence mechanisms of the following types: repression, denial and coping mechanisms that focused on emotions.ConclusionsThere are differences in defence and coping mechanisms between subjects with cancer compared to the non-clinical group. It may be that defence and coping mechanisms can be optimized through psychotherapy interventions to increase quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Emotional agility – a new language and paradigm for psychiatry
Authors: Kurz R. 
Published: May 2016

IntroductionEmotional Agility constitutes an alternative to the DSM-5 personality trait model.ObjectiveThe presentation outlines how Emotional Agility is conceptualised and measured through self-report and multi-rater questionnaires.AimsThe paper highlights the development of a short Emotional Agility trait questionnaire and a corresponding behavioural measure with 18 items.MethodData (n = 929) from a substantial personality questionnaire with 161 questions was utilised to create a 54 question ‘short form’ that measures the Big 5 personality factor plus Need for Achievement through 18 facet scales of 3 items each. Data on the same subjects from a 50-item criterion measure was reduced to 18 items that are structurally aligned to the 18-predictor facets.ResultsPredictor reliabilities averaged 0.752 at Factor as well as Facet level. The unit weight sum of the 54 questions achieved an uncorrected validity of 0.28 (n = 929) against external ratings of effectiveness. Joint factor analysis showed good discrimination between the six factors. A ‘positive manifold’ of Emotional Agility scales emerged as expected which could be conceptualised as the opposite of the MMPI2 ‘Demoralisation Factor’.ConclusionThe Emotional Agility approach could ground mental health assessments firmly in positive approaches that use every-day terminology. It seems preferable to vague scales claiming to measure obscure ‘clinical’ constructs through hugely overlapping items that are often not fit for purpose.Disclosure of interestThe author has not supplied his/her declaration of competing interest.