bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brain networks sub-serving self-referential processing in depression
Authors: Wagner G. , Schachtzabel C. , Peikert G. , Bär K.J. 
Published: May 2016

IntroductionPersistent pondering over negative self-related thoughts is a central feature of depressive psychopathology.ObjectivesIn the present study, we sought to investigate the neural correlates of abnormal negative self-referential processing (SRP) in patients with major depressive disorder (MDD) and its impact on subsequent cognitive control-related neuronal activation.AimsWe hypothesized aberrant activation dynamics during the period of negative and neutral SRP in the rostral anterior cingulate cortex (rACC) and in the amygdala in patients with MDD. We assumed abnormal activation in the fronto-cingulate network during Stroop task execution.MethodsNineteen depressed patients and 20 healthy controls participated in the study. Using an event-related fMRI design, negative, positive and neutral self-referential statements were displayed for 6.5s and followed by incongruent or congruent Stroop conditions.ResultsIn contrast to controls, patients did not exhibit valence-dependent rACC activation differences during SRP. A novel finding was the significant activation of the amygdala and the reward-processing network during presentation of neutral self-referential stimuli relative to baseline and to affective stimuli in patients. The fMRI analysis of the Stroop task revealed a reduced BOLD activation in the right frontoparietal network of patients in the incongruent condition after negative SRP only.ConclusionsThus, the inflexible activation in the rACC may correspond to the inability of depressed patients to shift their attention away from negative self-related stimuli. The accompanying negative affect and task-irrelevant emotional processing may compete for neuronal resources with cognitive control processes and lead thereby to deficient cognitive performance associated with decreased frontoparietal activation.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The relationship between social anxiety, shyness and blushing
Authors: Pelissolo A. , Moukheiber A. 
Published: May 2016

The diagnosis of social anxiety disorder (SAD) has seen substantial changes in the last 35 years from its first appearance in the DSM-III in 1980 up to the most recent ones in the DSM-5. Throughout all these changes, this disorder, previously called social phobia, is still considered one homogenous entity with only one specifier (“performance only”) introduced in the DSM-5 revision with specific fears or associated personality profiles not being considered relevant clinical markers to define SAD subtypes. However, our therapeutic experience suggested substantial particularities associated with the fear of blushing in patients with SAD. Some patients presenting this profile, historically called “erythrophobia”, seem to have a very specific type of social anxiety that does not include shyness and other characteristics of classical SAD. In a study conducted in a sample of 450 new consecutive outpatients seeking treatment for SAD, we compared 142 subjects with fear of blushing without other social fears, 97 subjects with fear of blushing with other associated social fears and 190 SAD subjects without fear of blushing. The group with pure fear of blushing presented a different profile when compared with the two other groups: later age of onset, less comorbidity, lower behavioral and temperamental inhibition, i.e. less shyness, and higher self-esteem. Furthermore, from a therapeutic point of view, some specific strategies such as the Task Concentration Training have shown to be particularly effective in fear of blushing. We will further argue the validity of a possible “fear of blushing” subtype of SAD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Emotional instability and bipolar disorder
Authors: Frangou S. 
Published: May 2016

BackgroundAffective dysregulation is a core feature of bipolar disorder (BD) and a significant predictor of clinical and functional outcome. Affective dysregulation can arise from abnormalities in multiple processes. This study addresses the knowledge gap regarding the precise nature of the processes that may be dysregulated in BD and their relationship to the clinical expression of the disorder.MethodsPatients with BD (n = 45) who were either in remission or in a depressive or manic state and healthy individuals (n = 101) were compared in terms of the intensity, duration and physiological response (measured using inter-beat intervals and skin conductance) to affective and neutral pictures during passive viewing and during experiential suppression.ResultsCompared to healthy individuals, patients with BD evidenced increased affective reactivity to neutral pictures and reduced maintenance of subjective affective responses to all pictures. This pattern was present irrespective of clinical state but was more pronounced in symptomatic patients, regardless of polarity. Patients, regardless of symptomatic status, were comparable to healthy individuals in terms of physiological arousal and voluntary control of affective responses.ConclusionOur study demonstrates that increased affective reactivity to neutral stimuli and decreased maintenance of affective responses are key dimensions of affective dysregulation in BD.Disclosure of interestThe author has not supplied his declaration of competing interest.
Value-based mental healthcare: The cost aspect
Authors: Knapp M. 
Published: May 2016

Economic hardship can be a factor in the incidence and exacerbation of mental health problems, and economic constraints have always constrained availability of resources. But examining the economic case – whether treatment or longer-term preventive strategies are cost-effective – can actually provide strong support for investing more in them. This presentation will provide illustrations of how economic evidence has helped decision-makers (in government and in funding bodies) to recognise the enormous contributions often generated by prevention, treatment and care.Disclosure of interestThe author has not supplied his declaration of competing interest.
Age of onset of bipolar disorders: A systematic review and meta-analysis
Authors: de Girolamo G. , Bani M. , Dagani J. , Ferrari C. , Pastore A. , Signorini G. 
Published: May 2016

IntroductionAlthough the onset of bipolar disorder (BD) is usually estimated in early adulthood (Burke et al., 1990; Kessler et al., 1997), it is still not clear which age-specific triggering factors may contribute to the underlying vulnerability.Objectives/aimsThe present meta-analysis attempts to clarify the number of untreated years of BD, from first symptoms appearance, to first actions carried out by health services (first diagnosis, treatment and hospitalization).MethodsA literature search of three databases PubMed, Web of Science and Psychology and Behavioral Sciences Collection was performed, looking for peer-reviewed publications in English, French, German and Italian language that reported the AOO of BD; the search string adopted was “bipolar and onset”. Standardized mean differences were calculated between (i) mean AOO, operationally defined as onset of first symptoms/episodes, and (ii) mean AOO, operationally defined according to four criteria: first contact with services, date of the diagnosis, first pharmacological treatment, or first hospitalization.ResultsThe searches yielded 8710 articles; 2424 of these articles met the inclusion criteria. A final set of 19 studies presenting multiple definitions of AOO has been analyzed, revealing an overall effect size of 6.96 of untreated years (Cohen's d = 0.65)ConclusionTo our knowledge, this is the first meta-analysis that addresses the definition and the modulation of the AOO in bipolar disorder. Identifying the time-frame of untreated illness is very important for the best planning of timely interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Anticipation of age at onset in anorexia nervosa
Authors: Favaro A. , Santonastaso P. 
Published: May 2016

It is a common clinical observation that early-onset cases of anorexia nervosa (AN) are increasing. In a previous study in a large cohort, we found that age of onset in both AN and bulimia nervosa was significantly decreasing in younger generations. We now present data about cohort effects in a sample of more than 3000 patients with eating disorders.MethodsThe sample is composed of 2200 AN subjects and 900 BN subjects without previous AN consecutively referred to our outpatient Unit in the period between 1985 and 2014. Time trends have been analysed according to the year of birth of subjects. All diagnoses were reviewed according to DSM-5 criteria.ResultsAge of onset in AN showed a significant decrease according to year of birth. A regression model showed a significant independent effect of socio-economic status, age at menarche and number of siblings in predicting age of onset. A second analysis including a subsample representative of the general population confirmed the effect in AN. In BN, although the age of onset showed a decrease in new generations, the effect is not significant.ConclusionAge of onset of AN continues to decrease in younger generations. The implications of our findings in terms of long-term outcome remain to be understood. Biological and socio-cultural factors explaining this phenomenon need to be explored by future studies. It is important to acknowledge the clinical implications of this cohort effect.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychopharmacological treatments strategies in consultation-liaison psychiatry: Clinical vignette and pros and cons
Authors: Mattei G. , Colombini N. , Ferrari S. , Galeazzi G.M. 
Published: May 2016

IntroductionMultimorbidity and polipharmacotherapy are crucial features influencing the psychiatrist's prescription in the consultation-liaison psychiatry (CLP) setting.Aimsto provide an example of computer-assisted decision-making in psychotropic prescriptions and to provide hints for developing pharmacological treatment strategies in the CLP setting.MethodsCase report. A clinical vignette is presented, followed by a review of available online computer-assisted prescription software.ResultsA woman in her seventies was repeatedly referred for psychiatric consultation. Eleven different medications were administered daily, because of multimorbidity. A diagnosis of distymia was established, with comorbid mixed pain (partly fulfilling the criteria of somatic symptom disorder) and substance use disorder (opioids). After the first assessment, six follow-up visits were needed during hospitalization. Mirtazapine and benzodiazepines were introduced. Beside the pharmacological intervention, conflict mediation was performed in the relationship with the patient, her relatives, the ward personnel and the GP, to develop a long-term rehabilitation project. Pros and cons of online computer-assisted prescription software were discussed together with the ward personnel, as well.ConclusionsComputer-assisted decision-making in psychotropic prescription is becoming more common and feasible. The use of available software may contribute to safety, effectiveness and cost-effectiveness of clinical decision-making. Risks are also possible: depending for example from regional differences in prescription indications, different guidelines, pharmacogenomics, frequency with which databases are updated, sponsorships, possible conflicts of interest, and real clinical significance of highlighted interactions – all issues the clinician willing to benefit from this modern tools should pay attention to.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Proposal for a model psychopharmacology curriculum for psychiatric residents in Germany
Authors: Laux G. 
Published: May 2016

All German societies of medicine have been ordered by the Federal Association of Physicians (Bundesärztekammer) to propose new revised regulations for the education of residents. The German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) is offering a broad extension of education in psychotherapy while education in pharmacotherapy is still rather small and limited. The working group Biological Psychiatry of the German Association of Psychiatric Hospitals (Bundesdirektorenkonferenz, BDK) suggests a detailed proposal of a psychopharmacology curriculum based on a Delphi method consent of medical directors involved in the education of the majority of German psychiatric residents. Issues include general pharmacology, neurobiological principles, clinical pharmacology of different classes of psychotropics (antidepressants, antipsychotics, mood stabilizers, anxiolytics, hypnotics, stimulants etc.), special aspects (e.g. pregnancy, geriatric patients) as well as ethical, legal and economic aspects. About 160 hours of theoretical education are proposed, clinical teaching should be interactive, with vignettes and supervision covering about 300 hours.Disclosure of interestThe author has not supplied his declaration of competing interest.
New technologies for detecting suicidal risk of psychiatric patients
Authors: Lopez-Castroman J. 
Published: May 2016

Suicide is a major health issue with considerable human and economic costs. There have been many attempts to develop techniques capable of predicting future suicidal behavior, but known risk factors are insufficiently specific. However, during the last decades, technical developments have made possible the use of new technologies to assess potential clinical markers for psychiatric patients. In many cases the technologies are affordable, wearable and interconnected, multiplying the wealth of data resulting from their use. Quite logically, psychiatrists from all over the world are investing in recently developed devices for their research projects and have consequently started to collaborate with engineering and pattern recognition groups in the study of potential clinical markers. These groups provide the expertise and computational methods required to process this wealth of data, and can improve the classification accuracy to predict a certain condition using data mining techniques. In the field of suicidal behavior, new devices that capture promising predictors such as electrodermal response activity, some facial expressions or speech properties have been developed and are being tested. In view of these facts, during the workshop we will review some of the new methodologies that can be used for the assessment of suicidal risk and how can multidisciplinary and complementary approaches be implemented.Disclosure of interestThe author has not supplied his declaration of competing interest.
Self-assessment instruments: Development and validation
Authors: Dollfus S. 
Published: May 2016

IntroductionNegative symptoms are found in many patients with schizophrenia, but their assessment remains delicate. Standardized assessments are therefore needed to facilitate their identification. Many tools have been developed but most of them are assessments based on observer rating. Nevertheless, patient subjective evaluation can provide an additional outcome measure and allow patients to be more engaged in their treatment. Therefore, the aim of this study is to present past and recent tools assessing the subjective experience of negative symptoms; we will particularly focus on a novel tool, the Self-evaluation of Negative Symptoms (SNS).MethodsForty-nine patients with schizophrenia and schizoaffective disorders (DSMIV) were evaluated in order to demonstrate three components of the scale's validity: face and content validities and reliability.ResultsCronbach's coefficient showed good internal consistency. Factor analysis extracted 2 factors (apathy and emotional). SNS was significantly correlated with the Scale of Assessment of Negative Symptoms and the Clinician Global Impression on severity of negative symptoms supporting good convergent validity. SNS scores were not correlated with level of insight, Parkinsonism, or with BPRS positive sub-scores in favor of good discriminant validity. Intra-subject reliability of SNS revealed excellent intraclass correlation coefficients.ConclusionThis study shows good psychometric properties of SNS as well as quite satisfactory acceptance by patients. It also demonstrates the ability of patients with schizophrenia to accurately report their own experience. Self-assessments of negative symptoms should be used more in clinical practice since they might allow patients with schizophrenia to develop appropriate coping strategies.Disclosure of interestThe author has not supplied his declaration of competing interest.
LGBT adolescents in America: Depression, discrimination and suicide
Authors: Ahuja A. 
Published: May 2016

IntroductionThe mental health of Adolescents in America is a major concern for the field of psychiatry. In particular, Lesbian, Gay, Bisexual and Transgender (LGBT) adolescents are at higher risk of adverse mental health outcomes. This is largely attributed to “minority stress” and from outright bullying and discrimination. In this presentation, this link between bullying and depression will be explored.ObjectivesBy the end of this presentation, the audience will be able to better understand the link between anti-LGBT bullying and mental illness and identify the ways to help their patients.MethodsThis presentation is informed by a literature search from PubMed In addition, it is informed by a symposium previously done at the American Psychiatric Association (APA) annual meeting in 2014.ResultsThere is clear evidence in the literature that bullying of LGBT adolescents is pervasive. In addition, LGBT people are more likely to be depressed than their heterosexual counterparts. This combination has led to 4-5 times higher rates of attempted suicide by LGBT adolescents. Having Gay-Straight Alliances in schools, supportive teachers and school administrators, and broader anti-discrimination legislation has a protective effect on this.ConclusionLGBT adolescents are exposed to more stress by being a minority in society and by being explicitly bullied and discriminated against. This can lead to depression in some of these adolescents, and can also lead to suicide in the most vulnerable among them. There are proven ways to reduce these risks, and psychiatrists have a role to play in advocating for these reforms.Disclosure of interestThe author has not supplied his declaration of competing interest.
Cultural variations in LGBT issues
Authors: Bhugra D. 
Published: May 2016

Culturally determined gender roles influence relationships between different-sex partners, and cultural values affect attitudes towards sexual variation. LGBT patients face stigma, discrimination and prejudice and have specific issues related to a number of factors, in addition to the nature of sexuality. These factors affect help-seeking and also cause delays in pathways to care. In specific instances, gay, lesbian and transgender individuals show higher than expected levels of psychopathology. The clinician's attitudes affect therapeutic adherence and therapeutic alliance. LGBT patients may also have specific issues related to “coming out” and this may influence their relationships directly and indirectly. Furthermore, they may experience a reluctance to share their sexual orientation. Matching of therapists may offer one way forward but this is not always possible, and may not work due to a number of reasons.Disclosure of interestThe author has not supplied his declaration of competing interest.
The association of bullying with suicide ideation and attempt among adolescents with different dimensions of sexual orientation
Authors: Montoro R. , Igartua K. , Thombs B.D. 
Published: May 2016

IntroductionSexual minority youth are at increased risk for bullying and suicide, but they are heterogeneous in their sexual orientation dimensions (attraction, behavior and identity).ObjectiveTo compare the association of bullying and suicide parameters between (1) heterosexually identified students without same-sex attractions or behaviors (2) heterosexually identified students with same-sex attractions or behaviors and (3) non-heterosexually identified students.MethodsThe Quebec Youth Risk Behavior Survey was a self-report questionnaire given to 1852 students 14–18 years old.ResultsThe heterosexually identified students without same-sex attraction or behavior, and no bullying, was our reference group. When these students had bullying, the likelihood of suicidal ideation was double, but their likelihood of suicide attempts was the same. For non-heterosexually identified students, those with no bullying were twice as likely, and those with bullying were four times as likely to have suicidal ideation. When these students had no bullying, they were not more likely to have suicide attempts, but they were almost three times as likely when they had bullying. Heterosexually identified students with same-sex attraction or behavior were never more likely on any of the suicide measures.ConclusionThis study was the first to show that adolescents with a non-heterosexual identity will have a disproportionately greater likelihood in their suicide parameters when subject to bullying, than heterosexually identified students with or without same-sex attraction or behavior, suggesting that these latter two dimensions were non-contributory to suicide risk. The significance of identity as a predictor of suicidal ideation and behavior will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Risk factors for accidents among cocaine-dependent patient seeking treatment
Authors: Roncero C. , Rodriguez-Cintas L. , Daigre C. , Alvarez J. , Barral C. , Abad A. , Nina V. , Herrero-Fernandez A. , Grau-López L. , Barral C. , Pérez-Pazos J. , Ros-Cucurrull E. , Rodriguez-Martos L. , Casas M. 
Published: May 2016

IntroductionAccident rate have a high social cost. Cocaine consumption increases the risk of traffic crashes (Monras, 2011; Fierro, 2011). However, there is not extensively studies in addicts.ObjectiveCompare and analyze the history of accidents and risk behaviors while driving in cocaine dependent patients (DC) and of other substances (OtherD).MethodsOne hundred and eighty-two patients seeking treatment since January 2014 to September 2015. Sociodemographic and accident-related variables were collected, also administered the MDBQ. Descriptive analysis and bivariate analysis using Chi-square test for categorical variables and Student t test was performed for quantitative.ResultsOf women, 30.3%, and 69.7% men, mean age 43.67 years (SD = 13). 65.6% currently driving or above. 45.2% DC vs. 54.8 DOther (35.6% alcohol, cannabis 8.3%, 5.8% opioid and 5.1% other drugs).Comparing accident rate on the DC is a tendency to have suffered more accidents (χ2: 2.62 P=.072). Patients addicted to cocaine referred further potentially dangerous activities both under the influence of consumption (65.9% vs. 33.3%) and abstinence (41.7% vs. 12%).As for the results of MDBQ, it has been detected that cocaine addicts show more errors and traffic violations. No differences in the lapses identified by patients of different groups.ConclusionPatients with cocaine dependence have more accidents, reduced risk perception and recognize more mistakes and traffic violations. Cocaine implies a high risk of road accidents and exposure to high-risk situations compared to the use of other substances.References not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.