bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Clinical Course of Depression: Chronicity is the Rule Rather than the Exception
Authors: Verhoeven J. , Verduijn J. , Milaneschi Y. , Beekman A. , Penninx B. 
Published: June 2017

IntroductionMajor depressive disorder (MDD) is often considered an episodic disorder. However, literature might underestimate the chronicity of MDD since results depend on follow-up duration and the extent to which psychiatric co-morbidity is taken into account.AimTo determine, whether MDD should be considered an episodic or chronic disorder.ObjectiveTo examine the 6 year course of MDD, incorporating data of multiple time points and taking common psychiatric comorbidities into account.MethodsData were from 903 patients with current MDD at baseline in the Netherlands study of depression and anxiety, with subsequent data from 2 year, 4 year and 6 year follow-up. Four course trajectories were created taking all information during follow-up into account classifying patients as (1) recovered, (2) recurrent without chronic episodes, (3) recurrent with chronic episodes or (4) consistently chronic. A chronic episode was defined as having symptoms consistently over 2 years.ResultsThe recovery rate of MDD was 58% at 2 year follow-up but looking at 6 year follow-up and taking into account co-morbid dysthymia, (hypo) mania and anxiety disorders reduced this recovery rate to 17%. Moreover, more than half of the patients experienced chronic episodes.ConclusionsLongitudinal data of this psychiatric cohort study showed that full recovery is the exception rather than the rule. MDD follows a chronic course and, moreover, persons are prone to switch to other psychiatric disorders.
The Impact of Endurance Training on Brain Structure and Function in Multi-episode Schizophrenia
Authors: Malchow B. 
Published: June 2017

Structural and functional brain alterations as well as cognitive deficits are well-documented findings in schizophrenia patients. Cognitive impairments affect the long-term outcome of schizophrenia and are the main contributors to disability. Despite their clinical impact, however, no effective options are available to treat them sufficiently. Aerobic endurance training has been shown to have effects on brain plasticity, gray and white matter volume as well as functional connectivity measures and on cognitive functioning in animal models and healthy humans. However, effects of physical exercise in combination in combination with cognitive remediation are unknown in Schizophrenia. 21 chronic schizophrenia patients and 21 age and gender–matched healthy controls underwent 3 months of aerobic exercise (endurance training, 30 min, 3 times per week). 21 additionally recruited schizophrenia patients played table soccer (known as “foosball” in the USA) over the same period. After 6 weeks of endurance training or table soccer, all participants commenced standardized cognitive training with a computer-assisted training program. We could show that a 3-month endurance-training program combined with CR therapy had positive effects on everyday functioning in multi-episode Schizophrenia patients. Deficits improved from medium to mild as assessed with the GAF. Negative symptoms, short and long-term verbal memory and cognitive flexibility also improved with training. We could demonstrate grey matter volume increase in the left temporal lobe in schizophrenia patients undergoing endurance training. A non-endurance and coordinative training stimulus like playing table soccer led to a clearly distinct pattern of grey matter alterations in Schizophrenia patients.Disclosure of interestThe author declares that he has no competing interest.
Mthfr Allele Distribution in Romanian Schizophrenia Patients
Authors: Nemes B. , Cozman D. 
Published: June 2017

IntroductionCurrently available data on the aetiology of schizophrenia suggests a major involvement of epigenetic mechanisms. One such mechanism could be the alteration of activation and silencing of genes, which involves DNA methylation and de-methylation. The main limiting enzyme involved in the methyl-donor cycle is methylene-tetra-hydro-folate-reductase (MTHFR), and the most frequently observed mutation in the MTHFR gene, altering its activity, is the C677 T mutation.AimIn the present study, we investigated the frequency of MTHFR C677 T mutation and total plasma homocysteine (tHcy) concentrations in a sample of Romanian schizophrenia patients as compared to healthy controls.MethodsSeventy schizophrenia patients (35% females) with a mean age of 38.8 ± 20.5 years and 50 healthy controls (50% females) with a mean age of 36.3 ± 11.6 years were included. MTHFR genotype was determined through polymerase chain reaction and tHcy levels were determined through reversed phase high-pressure liquid chromatography.ResultsSchizophrenia patients, registered higher frequency of the T allele, with the CC genotype observed in 39.4% of them, as compared to a frequency of 60.6% in the control group (P = 0.002–Fisher's exact test). tHcy concentrations did not differ between the two groups (10.7 ± 4.2 vs. 11.2 ± 4.1, P > 0.005–Mann–Whitney U test).ConclusionsRomanian schizophrenia patients have a significantly higher frequency of the MTHFR C677 T mutation, but without significant effect on tHcy concentrations.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Swallowing Disturbances and Psychiatric Profile in Older Adults: The GreatAGE Study
Authors: Lozupone M. , Leo A. , Sardone R. , Veneziani F. , Bonfiglio C. , Galizia I. , Lofano L. , Grasso A. , Tursi M. , Barulli M.R. , Capozzo R. , Tortelli R. , Panza F. , Seripa D. , Osella A.R. , Logroscino G. 
Published: June 2017

IntroductionSeveral studies have reported controversial links between swallowing disturbances (SD) and psychiatric disorders in older age. The available data on the epidemiology of SD in the general population are scarce and often conflicting, because of numerous methodological factors source of possible counfounders.ObjectivesWe aimed to screen the presence of psychiatric and cognitive disorders associated with SD in a random sampling of the general population ≥ 65.MethodsA sample of 1127 elderly individuals collected in a population-based study (GreatAGE) in Castellana Grotte (53,50% males, mean age 74.1 ± 6.3 years), South-East Italy, were mailed a validated self-report questionnaire to assess SD (Eating Assessment Tool-EAT10). Psychiatric disorders and symptoms [assessed with Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders, Geriatric Depression Scale-30 (GDS-30) and Symptom Checklist Revised-90 (SCL-90R)], cognitive functions were assessed with a comprehensive neuropsychological battery, neurological exam, and demographics were compared in participants with and without SD using t-tests and Mann–Whitney U-test.ResultsThe prevalence rates of SD amounted at 5.97%. Psychiatric diagnosis (24.22% of the sample) was statistically significant associated with SD (EAT ≥ 3, P = 0.038), and a trend was found for major depressive disorder and generalized anxiety disorder. Among SCL-90R domains, only anxiety showed a significant association with EAT ≥ 3 (P = 0.006). GDS-30 score was found to be higher in subjects with SD (P = 0.008). Cognitive functions did not differ between the two groups except for an increasing trend for Clinical Dementia Rating Scale in EAT ≥ 3 (P = 0.058).ConclusionsThese preliminary results showed an association between SD in older age and late-life major depression and anxiety disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Long-term rates of remission and late psychotic transition of individuals at risk for psychosis
Authors: Beck K. , Andreou C. , Studerus E. , Egloff L. , Heitz U. , Menghini-Müller S. , Ittig S. , Leanza L. , Uttinger M. , Simon A. , Borgwardt S. , Riecher-Rössler A. 
Published: June 2017

IntroductionIn the growing research field of early psychosis detection in patients with an at risk mental state (ARMS), most studies focus on the transition to frank psychosis. However, the majority of ARMS patients do not go on to develop frank psychosis and reported transition rates are declining. Little is known about the long-term outcome of these non-transitioned patients (ARMS-NT).ObjectivesTo investigate in preliminary analyses the long-term outcome of ARMS-NT patients with respect to persistence of ARMS signs and symptoms and the rates of late psychotic transition.MethodsThe ongoing study “FePsy-BHS-NT” follows up ARMS-NT without transition during at least the first two years for up to 15 years after their initial assessment. ARMS status is ascertained with the Basel Screening Instrument for Psychosis (BSIP). ARMS remission is defined as the absence of attenuated psychotic symptoms or brief limited intermittent psychotic symptoms for at least 12 consecutive months.ResultsIn this preliminary sample of 51 ARMS-NT, the majority of patients (70.6%) have remitted from their at risk mental state, 13.7% remain at risk and 15.7% have made a late psychotic transition during the course of long-term follow up (median = 5.75, range 4–11 years after initial assessment).ConclusionsThe considerable rates of ARMS persistence and late psychotic transition indicate that longer follow-up durations than commonly recommended should be contemplated in ARMS patients. Potential predictors of favorable long-term clinical outcome, as well as psychosocial, neurocognitive and other outcomes of ARMS-NT patients will be further evaluated in the present study.Disclosure of interestThe authors have not supplied their declaration of competing interest.
How is Evaluated Mental Health Recovery?
Authors: Penas P. , Moreno M.C. , Uriarte J.J. , Ridgway P. , Iraurgi I. 
Published: June 2017

IntroductionThere is an increasingly recognition of the concept of recovery in the treatment of mental illness. Recovery defined as living a fulfilling, rewarding life, even in the ongoing presence of a mental illness. Consequently, a number of instruments have been designed to assess recovery-oriented outcomes.ObjectiveThe objective of the study was to conduct a systematic revision of the instruments used to assess recovery with appropriate psychometric properties.MethodA systematic review of the literature has been realized. The adequacy of the instruments utilization, the content validity and psychometrics properties were gathered and analyzed.Results/discussionAfter a systematic review, it has been obtained 25 different instruments for measuring personal recovery and 17 for assessing the orientation of recovery in mental health services. As a consequence of the lack of consensus that exists in the conceptualization of recovery; several instruments have been developed and used to assess the different recovery domains. But it is essential to select scales that match with the recovery model and assess adequately the individual's recovery, and also, the recovery orientation of services. Moreover, those instruments should have appropriate psychometric properties and should be suitable to be introduced in routinely clinical settings.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Ethics and Aesthetics–Philosophical Perspectives
Authors: Poltrum M. 
Published: June 2017

European intellectual history teaches us that beauty is not just an adornment to life but is also a major source of strength for our life. Moreover, the positive aesthetic experience also has healing power. That beauty is a highly effective antidote to life's suffering, i.e. acts as an anti-depressant, has been documented in the tradition of philosophical aesthetics from Plato to Bloch. Beauty reveals truth and goodness (Plato), it shows the harmonious order and the glory of things (Pseudo-Dionysius the Areopagite), it is one of the transcendental names of God (Thomas of Aquinas), in beauty the world appears in its perfection (Baumgarten), beauty is the daughter of freedom (Schiller), it offers a temporary escape from the suffering of existence (Schopenhauer), aesthetic values are the only values that withstand nihilism and the meaninglessness of existence and are thus the actual stimulus of life (Nietzsche), the beautiful is the sensual appearance of the idea (Hegel), beauty is an anti-depressant and Weckamin of being, it tears people out of their forgetfulness of Being (Heidegger), there is a close relationship between the shining forth of the Beautiful and the evidentness of the Understandable (Gadamer), in an artwork and through the aesthetic attitude the Other, foreign, the non-identical that is mangled and mutilated in the administered world is preserved and saved (Adorno). Many more positive affirmative descriptions from the tradition of philosophical aesthetics demonstrate that beauty and the aesthetic have a therapeutic dimension.Disclosure of interestThe author declares that he has no competing interest.
Self-harm and Attachment in Adolescents: What is the Role of Emotion Dysregulation?
Authors: Rogier G. , Petrocchi C. , D’aguanno M. , Velotti P. 
Published: June 2017

IntroductionSelf-harm typically occurs in adolescence and has been conceptualized as a dysfunctional strategy to regulate intense negative emotions. Furthermore, empirical literature outlines that self-harmers are more prone to have an insecure attachment style. Moreover, the link between quality of attachment and capacity to regulate emotions has been theoretically and empirically supported.ObjectiveTo examine the associations between attachment style, self-harm behaviors and emotion dysregulation among a sample of adolescents. The sample consisted of 740 adolescents aged between 13 and 19 years (mean age = 16.70, SD = 0.91).AimsTo explore the nature of different pathways by which insecure attachment leads to self-harm behaviors.ResultsAs expected, insecure attachment and emotion dysregulation were positively associated with self-harm behaviors. Moreover, emotion dysregulation mediated the link between attachment styles and self-harm. Specific pathways between types of insecure attachment dimension of emotion dysregulation and self-harm behaviors emerged.ConclusionsSuch results confirm the theorization of self-harm behaviors as a dysfunctional strategy to regulate emotions. Moreover, such emotion dysregulation in self-harmers seem to be connected to insecure attachment. Depending on the subtype of insecure attachment, specific dimensions of emotion dysregulation seem to be involved in self-harm behavior, suggesting interesting clinical implications.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A Systematic Review and Case Report of the Koro Syndrome in an Intellectually Disabled Caucasian Patient
Authors: Pastor Romero A. , Guillot de Mergelina E. , Borredá Belda L. , Pérez Prieto J.F. 
Published: June 2017

IntroductionKoro syndrome has traditionally been considered a culturally bound syndrome, characterized by the delusional belief that one's genitalia are retracting and the anxiety caused by the perception of imminent death. Although it is widely regarded as an epidemic in South-east Asia, there are some isolated cases in other cultures as well.ObjectivesWe present a Koro case study and a systematic review, focusing on the presentation and its treatment, in order to make visible this syndrome to Western culture and provide the tools to identify it.AimsTo provide an overview of Koro's presentation, phenomenology and treatment. We also want to clarify the nosology classification of this syndrome and its influence in the reported cases.MethodsWe begin describing a new case of Koro syndrome: a Spanish male presented an acute psychosis, the patient had an intellectual disability and a family history of mental illness. A systematic review was done based on articles published in Pubmed following the PRISMA guidelines.ResultsFrom 117 studies, only 29 met the inclusion criteria. Data were analyzed on several epidemiological and clinical characteristics. We found that Koro syndrome is more often presented as a result of intoxication or as a part of a previous known psychotic disorder. Cases involving patients sharing their delusion have been only reported in Asia.ConclusionNo specific data could be obtained about epidemiology and pathogenesis, as our conclusion about Koro syndrome was based mainly on few case studies. Pharmacotherapy and social support may be effective in ameliorating the symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Joint Hypermobility Syndrome and Anxiety Disorder: Structural Brain Correlates
Authors: Eccles J. , Tung J. , Harrison N. , Mathias C. , Critchley H. 
Published: June 2017

IntroductionJoint hypermobility syndrome/Ehlers Danlos III (JHS/EDS III) is a common, connective tissue condition. This group is over-represented in panic/anxiety disorders and exhibits autonomic abnormalities and heightened interoceptive sensibility. Previous neuroimaging in healthy volunteers with hypermobility has observed differences in key emotional brain regions, notably amygdala and insula.Aims and objective To explore, in a clinical population, the structural brain correlates underpinning the association between JHS/EDS III and anxiety.MethodSeventy participants were divided into four experimental groups: (2 × 2 factor design: presence/absence of hypermobility; presence/absence of anxiety). Hypermobility was assessed using Brighton Criteria. All participants underwent brief tests of autonomic function and interoception. Structural images were obtained using a 1.5 T MRI scanner. Results are reported at whole brain uncorrected significance threshold of P < 0.001.ResultsComparison of grey matter volume revealed increased insular volume in anxious patients with JHS/EDS-III compared to anxious patients without (Fig. 1A, B), correlating with initial peak heart rate on standing. Additionally, amygdala volume correlated with hypermobility score in anxious patients, but not in non-anxious individuals (Fig. 1C, D). Amygdala volume correlated with interoceptive accuracy.ConclusionsThis data implicates amygdala and insula as likely neural substrates mediating clinical relationships between hypermobility syndrome and anxiety, demonstrating the relevance of autonomic and interoceptive influences on this relationship. Further work hopes to explore functional and structural connectivity between these regions in JHS/EDS-III.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Efficacy and Safety of Antidepressants as Analgesics in Chronic Pain: A Review
Authors: Fennema J. , Petrykiv S. , de Jonge L. , Arts M. 
Published: June 2017

IntroductionDue to the aging population worldwide, chronic pain is becoming an important public health concern. Chronic pain is bidirectional associated with psychiatric disorders including depression and anxiety. Antidepressants are widely used as adjuvant therapy for the treatment of chronic pain for many disorders.Objectives and aimsTo review available literature on the efficacy and safety of antidepressants for the treatment of chronic pain, including neuropathic pain, fibromyalgia, low back pain, and chronic headache or migraine.MethodsWe performed a detailed literature review through PubMed, EMBASE and Cochrane's Library to assess the efficacy and safety of antidepressants in chronic pain conditions.ResultsIn neuropathic pain, fibromyalgia, low back pain, and chronic headaches/migraine, tricyclic antidepressants (TCAs) showed a significant analgesic effect. Selective serotonin reuptake inhibitors (SSRIs) are not effective for the treatment of low back pain and headaches or migraine. Venlafaxine, a serotonin norepinephrine reuptake inhibitor (SNRI) showed significant improvement of fibromyalgia and neuropathic pain. Duloxetine (SNRI) also reduced the pain in fibromyalgia.ConclusionTCAs are the ‘gold standard’ antidepressant analgesics. However, an electrocardiogram and postural blood pressure should be implemented prior to TCA treatment and TCAs should be initiated at low dosages and subsequently increased to the maximum tolerated dose. One should pay attention to their cardiotoxic potential, especially in the older population. For the treatment of neuropathic pain, SNRIs are second-line agents. Although better tolerated, in most types of chronic pain conditions, the effectiveness of SSRIs is limited. To conclude: start low, go slow, and prescribe with caution.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Electroconvulsive Therapy in Drug-Resistant Paranoid Schizophrenia on Patient with Transplanted Kidney – Case Study
Authors: Zdanowicz A. , Wierzbinski P. 
Published: June 2017

The 22-year-old female patient had her first direct encounter with a psychiatrist in 2009 due to low mood, anxiety, anhedonia, lack of energy and olfactory hallucinations. Diagnosed with delusional depression syndrome, she was treated with SSRI group, and then combined with LLP group. In 2009, she was hospitalized in the Ward of kidney diseases and dialysis due to severe kidney failure, HA affecting the heart and the kidneys and facial nerve paralysis. In May 2012, she had a kidney transplanted from the deceased donor, which led to graft-versus-host disease. She received immunosuppressive therapy. In October 2012, she was diagnosed with paranoid syndrome. She was initially treated with levomepromazine 75 mg/d and amisulpride 800 mg/d (no results), then Olanzapine 20 mg/d and aripiprazole 15 mg/d (no results). After 10 week hospitalization she was discharged in a slightly improved mental state. Three weeks later, she was hospitalized again in a psychiatric institution where she received olanzapine 20 mg/d and haloperidol 6 mg/d (no results). Due to the severe mental condition, she was qualified for electroconvulsive therapy. In the end, the therapy met with the general positive reviews of consultants of different specialties. After 7 (of the 18) treatments the patient reached a significantly improved mental state with almost no sign of psychotic experiences and with a better day-to-day functioning. To the best of the authors’ knowledge, it is the first case of ECT on the patient who was the subject of a kidney transplant, and is one of the very few that have taken place in the entire world.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Mental Disorders are Increasing among Children and Adolescents in Sweden – a Nationwide Study with Focus on Gender Differences
Authors: Salmi P. , Berlin M. 
Published: June 2017

IntroductionAn increasing number of young people in Sweden are diagnosed with mental disorders and there appears to be significant gender differences in disease pattern.ObjectiveTo more thoroughly characterize the increase in mental disorders among young people with focus on gender differences.AimTo increase the knowledge of age and sex-specific trends in incidence and prevalence rates of mental disorders among children and adolescents.MethodData on psychiatric diagnoses for the last 10 years were obtained from Swedish national registers held by the National Board of Health and Welfare in Sweden.ResultsNeuropsychiatric, depressive and anxiety disorders have increased markedly among young people the last decade. In addition, men are increasingly diagnosed with substance-related disorders whereas women with borderline personality disorder.ConclusionThe increase in mental disorders among young people is marked and disease affects men and women differently. Because of greater awareness today, some conditions like ADHD are more frequently diagnosed. However, the increase in depressive and anxiety disorders appears genuine and represents an additional challenge.Disclosure of interestThe authors have not supplied their declaration of competing interest.