bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential Susceptibility Properties of the 5HTTLPR Gene in Relation to Depressive Symptoms and Delinquency
Authors: Nilsson K.-W. , Åslund C. 
Published: June 2017

IntroductionThe candidate gene-environment interaction (cG × E) research field in psychiatry has traditionally been dominated by the diathesis–stress framework, where certain genotypes are assumed to confer increased risk for adverse outcomes in a stressful environment. In later years, theories of differential susceptibility or biological sensitivity have been presented, suggesting that cGs that interact with environmental events do not exclusively confer a risk for behavioural or psychiatric disorders but rather seem to alter the sensitivity to both positive and negative environmental influences.AimsThe present study investigates the susceptibility properties of the 5HTTLPR gene in relation to depressive symptoms and delinquency in two separate adolescent community samples: n = 1457, collected in 2006; and n = 191, collected in 2001.ResultsTwo-, three- and four-way interactions between the 5HTTLPR, positive family environment, negative family environment, and sex were found in relation to both depressive symptoms and delinquency. However, the susceptibility properties of the 5HTTLPR gene were distinctly less pronounced in relation to depressive symptoms.ConclusionsIf the assumption that the 5HTTLPR gene induces differential susceptibility to both positive and negative environmental influences is correct, the previous failures to measure and control for positive environmental factors might be a possible explanation for former inconsistent findings within the research field.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A pilot Project Exploring the Utility and Acceptability of a Socially-assistive Robot in an Assessment Unit for People with Neuropsychiatric Symptoms
Authors: Loi S. , Khosla R. , Nguyen K. , Lautenschlager N. , Velakoulis D. 
Published: June 2017

ObjectivesSocially-assistive robots have been used with older adults with cognitive impairment in residential care, and found to improve mood and well-being. However, there is little known about the potential benefits in adults with other neuropsychiatric symptoms.AimsThe aim of this project was explore the utility and acceptability of a socially-assistive robot in engaging adults with a variety of neuropsychiatric symptoms.MethodsBetty, a socially-assistive robot was installed in a unit which specialises in the assessment and diagnosis of adults presenting with neuropsychiatric symptoms. She is 39 cm tall, has a baby-face appearance and has the ability to engage individuals through personalised services which can be programmed according to individuals’ preferences. These include singing songs and playing games. Training for the nursing staff who were responsible for incorporating Betty into the unit activities was provided. The frequency, duration and type of activity which Betty was involved in was recorded. Patients admitted who could provide informed consent were able to be included in the project. These participants completed pre- and post-questionnaires.ResultsEight patients (mean age 54.4 years, SD 13.6) who had diagnoses ranging from depression and schizophrenia participated. Types of activities included singing songs, playing Bingo and reading the news. Participants reported that they were comfortable with Betty and did not feel concerned in her presence. They enjoyed interacting with her.ConclusionsThis pilot project demonstrated that participants found Betty to be acceptable and she was useful in engaging them in activities. Future directions would involve larger sample sizes and different settings.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Nursing consultation and the care to depression in elderly
Authors: Carvalho C.M. , Cardoso Vernaglia T.V. , Correa Sória D. de Assis , da Silva T.D.J. Espirito Santo , Souza S.R. , Mello R. 
Published: June 2017

Depression is a major mental illness affecting the elderly. About 15% of the elderly have some depressive symptoms and about 2% have severe depression. This study was conducted in an Extension Program of the Federal University of the State of Rio de Janeiro (UNIRIO) and the aims are: to identify the prevalence of depression in the elderly attended by the community center “Project Rebirth” in Rio de Janeiro-RJ, and discuss strategies developed in consultation to care the depression.MethodologyThe elderly are registered in the program and accompanied by a multidisciplinary team. In nursing consultations, whose base is in the realization of Nursing Process, there is the application of the Geriatric Depression Scale named Yesavage – reduced version (GDS-15) held by students under the supervision of the teacher. After classification of the patient on the scale, they develop the care plan based in the Nursing Interventions Classification (NIC), and the nursing diagnoses that have among their factors related to depression and its symptoms.Results and conclusionsIn addition to interventions carried out in consultation, involving recovery of self-esteem, encouragement of leisure and recreational activities, and supported self-care, the program staff (psychologists, doctors, nurses and occupational therapists) works in partnership in support group health education, encouraging the integration of the elderly. The well-being and self-esteem of the elderly, thus, reduce the triggers of depression, with the integration of participants, students and professionals.Disclosure of interestThe authors have not supplied their declaration of competing interest.
“Mom, there is a monster in the closet”: The impact of early attachment trauma (EAT) on the development of anxiety disorders and treatment possibilities
Authors: D’Hooghe D. 
Published: June 2017

ObjectivesIn this workshop, I want to broaden the vision on attachment trauma and highlight the importance to acknowledge EAT as a hidden epidemic.The significance of EAT in the development of anxiety symptoms becomes more and more apparent.MethodsRecognizing the effect, that the quality of the attachment relationship has on the development of a secure attachment bond, is important to understand the factors underlying the development of anxiety symptoms.The availability, responsiveness, mentalizing possibilities… of the parent create a secure base from which the child can explore and develop.The absence of those features in the child–parent relationship, causes traumatic stress in the child and impacts his psychological and neurological well-being.ResultsInsecure attachment influences the neurobiology and results in dissociative processes (hyper- and hypo-aroused) expressed in different types of anxiety disorders.Derived from the neurobiology there is a clear link between anxiety, depression and aggression.The internal working model (IWM), rises from insecure attachment, influences adversely the child's capability to regulate and relate.From an intergenerational point of view, an insecure attachment style of the parent implements the absence of affect en stress regulation capabilities and leave the child with the inability to regulate his anxiety.ConclusionThere is a clear link between EAT and different types of anxiety disorders.Treatment strategies should integrate neurobiological, attachment and trauma insights resulting in body oriented therapy, development of affect – and stress – regulation strategies, restructuring the internal working model, the therapeutic relationship as attachment bond…Disclosure of interestThe author has not supplied his declaration of competing interest.
Somatic-type delusional disorder and comorbidity mood disorder
Authors: Martí Garnica V. , Ortega Garcia M.D. , Bernal López M.Á. , Russo De león J.R. , García Marín S. 
Published: June 2017

Chronic delusional disorder encompasses what classical termed as paranoia and paraphrenia. This disorder is characterized by the presence of one or more non-bizarre, permanent and systematized delusions. Cognitive functions of the patient not affected, judgment and reason are not affected if the subject is not addressed delirious. Delusional theme includes life-like experiences, including: persecution – persecutory type –, suffering from a disease – somatic type –, to be loved by someone famous – erotomaniac type –, the partner is unfaithful – jealous type – or having a special quality or gift – megalomaniac type –. Usually, patients lack awareness of mental illness and often prior to contact with mental health, made a pilgrimage by different specialists looking for an organic explanation.The description of a case report of a 47-year-old male who has a delusional belief body deformity secondary to manipulation by a physiotherapist suffering a muscular pain in the lumbar region is performed. Prior to psychiatric diagnosis, begins a long journey by different specialists.As a consequence, somatic-type delusional disorder is a challenge in the diagnosis and treatment in the medical field because it is required a multidisciplinary approach for these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Deep brain stimulation – Is there hope for obsessive compulsive disorder?
Authors: Batista A. , Melim J. , Nunes J. , Carvalho A.R. , Duarte M. , Maia J. 
Published: June 2017

IntroductionDeep brain stimulation (DBS) is a neurosurgical procedure under investigation for a range of psychiatric and neurological disorders. One of them is obsessive compulsive disorder (OCD), which is a neuropsychiatric illness that often develops in childhood, affects 2% of the general population and causes significant impairment across the lifespan. Some cases are refractory to pharmacotherapy and psychotherapy and that is why new treatments have been investigated over the last decades.Objectives/aimsIn this paper, we intent to do a review of the literature about the efficacy of DBS in the treatment of OCD.MethodsWe present a literature review of some scientific articles found on Pubmed search using “deep brain stimulation and obsessive compulsive disorder/DBS and OCD”.ResultsClinical outcome of DBS for OCD shows robust effects in many studies. It appears that most patients regain a normal quality of life after DBS, reporting changes in perception, feeling stronger and more confident, and doing things unreflectively. It seems that DBS is a valid alternative to lesional ablative neurosurgery for severe, therapy-refractory OCD patients, although with partially discrepant results probably related to differences in anatomical targeting and stimulation conditions.ConclusionsDBS seems to be a promising modality for the treatment of some refractory psychiatric disorders such as OCD, but the search for the best target still continues. Randomized studies with larger samples are needed to establish the optimal targeting and stimulation conditions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychogenic nonepileptic seizures
Authors: Queiroga L. , Rodrigues R. , Mesquita Reis J. 
Published: June 2017

IntroductionPsychogenic nonepileptic seizures (PNES) are defined as a somatoform conversion disorder manifesting as paroxysmal events not associated with electroencephalographic (EEG) epileptiform correlates. This entity is poorly understood and often misdiagnosed as epilepsy. It is important to recognize that misdiagnosis leads to inappropriate use of antiepileptic drugs, which may worsen the course of the disease.Recent studies have suggested that the frequency of psychogenic nonepileptic seizures ranges from 10 to 23% of referrals to a pediatric epilepsy center, as well as 60% of children with PNES achieve symptom improvement and event freedom of symptoms following appropriate treatment.ObjectivesThe aim of this study is to conduct a literature review of studies which the purpose was better understand the etiologies, features, and care outcomes of psychogenic nonepileptic seizures (PNESs) in a pediatric setting.ConclusionA early identification of the risk factors for comorbid psychopathology, diagnosis and appropriate care for PNESs reduces inappropriate medical investigation and therapy, expedites rates of remission, and decreases health-care utilization in a pediatric setting.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Emetophobia (a specific phobia of vomiting): A case study
Authors: Roy D. 
Published: June 2017

IntroductionCase presentation of a young woman Ms. A.M., referred by her GP with an eating disorder, who was thereafter diagnosed with an uncommon type of phobia (emetophobia – a specific phobia of vomiting) and treated accordingly.ObjectivesTo highlight the diagnostic dilemma with such uncommon cases, who are often misdiagnosed as having anorexia nervosa or bulimia nervosa or suffering from other anxiety disorders (like OCD or GAD).MethodsA comprehensive mental state examination was conducted including a diagnostic clarification interview. She was followed up by the mental health team on a regular basis with support and also providing appropriate psychotherapy.DiscussionMs. A.M. refused medications and only agreed to non-pharmacological treatment. She was therefore commenced on once weekly psychotherapy (CBT), which she undertook for a period of 4 months. She showed good response to the psychotherapy with significant attenuation of her core symptoms, although she still continued to exhibit some avoidance behaviors.ConclusionsThis particular patient showcases a relatively uncommon and often misdiagnosed specific phobia (emetophobia) and highlights the positive response seen in this case with psychotherapy.Disclosure of interestThe author has not supplied his declaration of competing interest.
Care pathways for patients with bipolar disorders at Psychiatry Clinic Affektiva, Gothenburg: Identifying and solving issues for a more efficient and safe care
Authors: Dellepiane M. , Boldt-Christmas C. , Jungestrand G. , Asplund P. , Ahmed R. , Nordin T. 
Published: June 2017

IntroductionThe Psychiatry Clinic Affektiva has developed a care pathway for patients with bipolar disorder (BD). It consists of one outpatient clinic and two inpatient wards. Clinical observations suggest that patients with BD benefit from treatment in a dedicated unit with tailored care programs and that better outcomes are achieved in terms of reduced average length of stay and safer transitions to outpatient care for this group.AimsThe aim is to improve the care of bipolar patients by increasing bed-availability and overall continuity in the care pathway and monitoring core aspects in the management of outpatients in order to reduce admissions and to facilitate standardized treatment and collaboration between in- and outpatients unit.MethodWe developed a structure to monitor and measure specific outcomes such as readmission within 28 days, relapse within 12 months and the use of lithium in this group. We also developed a standardized care protocol in order to improve the safety and the equality.ResultsAt this stage our preliminary results from our efforts are promising but further monitoring is needed to confirm our hypothesis. More data will be collected during 2017.ConclusionsAffektiva Psychiatry Clinic has developed a model for continuously monitoring several essential aspects in the care of patients with BD and providing a specific care program.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Late-onset bipolar illness: Literature review and case report
Authors: García-Jiménez J. , Porras-Segovia A. , García-López R. , Muñoz-Negro J.E. , Gutiérrez-Rojas L. 
Published: June 2017

IntroductionLate-onset bipolar-illness (LOBI) diagnosis comprises those patients whose first mania episode occurs aged 60 or older. Traditionally, it has been considered as a secondary disorder, accompanying other conditions such as dementia. While this is true for some cases, LOBI is a wider concept, which has its own features and also includes other entities.ObjectivesTo describe the main features of LOBI.MethodsCritical review of the literature and description of the case of a 72-year-old woman diagnosed with LOBI.ResultsWhile only 6–8% of all new cases of bipolar disorder (BD) occur in people older than 60, recent research suggests an increase of first episodes in this age group. LOBI is less associated with family history compared to early onset BD and seems to occur more frequently in women.LOBI presents with better premorbid functioning and atypical psychopathology as compared to early onset. Also, there is a higher prevalence of mixed episodes and a higher frequency of episodes per year, with a great risk of suicide. LOBI patients have more cognitive impairment and higher rates of comorbid psychiatric disorders.These patients show some specific neuroimaging signs, including subcortical hyperintensities.Quetiapine and valproate have proved useful, but the pharmacokinetic and pharmacodynamic characteristics of older patients must be taken into account.ConclusionThe reported case identifies similarities between LOBI and classical BD. However, both this case and the literature review reveal that LOBI has specific features that differentiate it from classical BD. Further research is needed to characterise the condition and improve its management.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Misdiagnose bipolar disorder: About a case report
Authors: Novais C. , Marinho M. , Mota Oliveira M. , Bragança M. , Côrte-Real A. , Fonseca S. 
Published: June 2017

IntroductionEarly stages of bipolar disorder are sometimes misdiagnosed as depressive disorders. This symptomatology can lead to misinterpretation and under diagnosis of bipolar disorders.Objectives/aimsTo describe a patient with a new diagnosis of bipolar disorder after 23 years of psychiatric care.MethodsWe report a case of a 66-year-old man, with a previous psychiatric diagnosis of recurrent depressive disorder for the last 23 years, after a hospitalization in a psychiatric inpatient unit because of a major depressive episode. In subsequent years, he was regularly followed in psychiatric consultation with description of recurrent long periods of depressed mood requiring therapeutic setting, alternating with brief remarks of not valued slightly maladjusted behaviour. At 65, he came to the emergency room presenting with observable expansive and elevated mood, disinhibited behaviour, grandiose ideas and overspending, leading to his hospitalization with the diagnosis of a manic episode. In the inpatient unit care, we performed blood tests, cranial-computed tomography (CT) and a cognitive assessment. His medication has also been adjusted.ResultsLaboratory investigations were unremarkable. Cranial-CT showed some subcortical atrophy of frontotemporal predominance, without corroboration by the neuropsychological evaluation. The patient was posteriorly transferred to a residential unit for stabilization, where he evolved with major depressive symptoms that needed new therapeutic adjustment. Later he was discharged with the diagnosis of bipolar disorder.ConclusionsOur case elucidates the importance of ruling out bipolar disorder in patients presenting with depressive symptoms alternating with non-specific maladjusted behaviour, which sometimes can be a challenging task.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Does gender matter? A comparative study of post-traumatic stress disorder among children and teenager
Authors: Ben Mabrouk N. , Bourgou S. , Staali N. , Hamza M. , Ben Hammouda A. , Charfi F. , Belhadj A. 
Published: June 2017

IntroductionPost-traumatic stress disorder (PTSD) symptomatology seems to depend of many variables like age, exposition to trauma, environment…ObjectivesCompare, basing on gender, socio-demographic and symptomatology of patients with PTSD.MethodsA retrospective and comparative study was conducted at the Child and Adolescent Psychiatry Department of Mongi Slim Hospital (Tunisia) from January 2013 until July 2016. We included all cases of patients followed for PTSD (DSM-5). They were divide into 2 groups according to the gender. Data was collected from patients’ records.ResultsOur study featured 30 patients: 16 boys and 14 girls. The average age was similar for both teams (boys: 8.43 years; girls: 8.53 years). Boys had twice more personal history of somatic, psychiatric illness (70%), and low socioeconomic status (62.5%). The beginning of the facts were significantly later for the female group (P < 0.001). Females were more likely to be a witness, while males tented to be directly exposed to the trauma. Physical abuse was the major aggression for both groups.Female gender was associated to parental trauma exposure (P = 0.023) and to an ongoing event (P = 0.004). Meanwhile, male gender was associated to a maternal history of psychiatric illness (P = 0.012), a single traumatic event (P = 0.010), and to a school located aggression (0.04). Girls have developed more hypervigilance, guilt symptoms and aggressive behaviors. Low self-worth, regression, specific phobia and suicidal ideations occurred more frequently among boys.ConclusionsHealth professionals must be aware of the youth PTSD warning signs in order to have the earlier right intervention.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Reconceptualilzing agitation in autism as primary affective dysregulation: Case report and literature review of use of quetiapine in a patient with Treacher–Collins syndrome and autism
Authors: Cosme R. , Dharmapuri S. 
Published: June 2017

This case report describes the successful use of low dose quetiapine in the treatment of agitation in a patient with Treacher–Collins syndrome (TCS) and suspected autistic spectrum disorder (ASD). Results from this case report found better efficacy in controlling symptoms of agitation in ASD utilizing lower doses of quetiapine. TCS is a genetic disorder that is characterized by a mandibulofacial dysostosis but is not associated with developmental delay, nor is it associated with a high risk of co-morbid autism, and to our knowledge, there are no previous reports of a co-occurrence of TCS and ASD in the extant literature. There are reports of mandibulofacial dysostosis associated with co-morbid developmental delay that are similar but distinct from TCS, however these reports do not comment on the treatment of agitation in this patient population. The results described in this case report demonstrate a reduction of agitation with low dose quetiapine, and offers support for the reconceptualization of agitation in ASD as a primary affective dysregulation which is also in line with evidence from the extant literature regarding the neurobiologic basis of aggression.Disclosure of interestThe authors have not supplied their declaration of competing interest.