bluuebunny/crossref_metadata_2025_split huggingface dataset:
Choosing wisely in Germany – adapting an international initiative to a national healthcare agenda
Authors: Klemperer D. 
Published: May 2016

Overuse and underuse in healthcare is a chronic problem in most healthcare systems. Inspired by the North American Choosing Wisely Initiative, the Association of Scientific Medical Societies in Germany (AWMF), which actually counts 173 member organisations, decided to address the problem. The aim of the German “Gemeinsam klug entscheiden” (deciding together wisely)-initiative is to reduce overuse, underuse and misuse of health interventions in areas where recommendations of clinical practice guidelines (CPG) are not adequately implemented or missing. Starting point are the positive and negative recommendations of the CPGs, which the AWMF-member societies have developed for more than 20 years, following the manual and rules set up by AWMF. To identify and select recommendations methodological criteria have been developed by a working group in a consensus-based process. The development of AWMF-CPGs follows a methodology that aims to ensure the full integration of evidence, an interdisciplinary and interprofessional perspective, the prevention of bias as a consequence of conflicts of interest and full transparency of the development process.Disclosure of interestThe author has not supplied his declaration of competing interest.
Quality assessment of mental health rehabilitation services
Authors: Killaspy H. 
Published: May 2016

ObjectivesProviding good quality mental health care is vital to achieve better outcomes but service quality is a complex, multidimensional construct that extends beyond the delivery of specific evidence based treatments and interventions. This makes it difficult to operationalize and measure, particularly at the international level where different socioeconomic and political contexts impact. Mental health rehabilitation services focus on people with severe and complex psychosis. This group are one of the most socially excluded in society and are vulnerable to exploitation and abuse. They are also, be definition, difficult to treat and, historically, have often been institutionalised in hospital or community facilities.AimsThis presentation will report on the development and application of an internationally validated quality assessment tool for longer term mental health care facilities, the Quality Indicator for Rehabilitative Care (QuIRC).MethodsThe content of the QuIRC was derived from a systematic literature review, international Delphi exercise and review of care standards in ten European countries. Its psychometric properties were assessed in over 200 longer-term mental health facilities across Europe involving validation with over 1750 service users. It has subsequently been used in a national programme of research into inpatient mental health rehabilitation services in England which will also be briefly described.ResultsThe QuIRC has excellent inter-rater reliability and validity. Specific aspects of care assessed by the QuIRC have been found to be associated with successful community discharge from inpatient mental health rehabilitation services.ConclusionsThe QuIRC is a free to use, standardised and validated on-line international quality assessment benchmarking and research tool, available in ten European languages.Disclosure of interestThe author has not supplied his declaration of competing interest.
Corollary discharge, auditory hallucinations and schizophrenia – a structural network analysis
Authors: Henze R. , Goch C. , Richter J. , Parzer P. , Brunner R. , Resch F. , Stieltjes B. 
Published: May 2016

IntroductionCorollary discharges (CDs) are the reason most people cannot tickle themselves. They are the brain's way of distinguishing whether a stimulus is associated with one's own actions or something else. In neural terms, CDs are copies of motor plans that are propagated to sensory cortex where they can be compared with inputs. A range of phenomena associated with schizophrenia from auditory hallucinations to visual processing difficulties to the ability of patients to tickle themselves can be explained as pathologies in CD mechanisms. Auditory hallucinations for example involve patients failing to perceive themselves as the author of their own inner speech.Objectives and aimsTo test whether schizophrenia is associated with a structural network disruption that could impair CD signals involved in language processing, adolescents with schizophrenia were examined using magnetic resonance imaging and compared to healthy controls.MethodsA graph theoretical approach was used to analyse the connectivity in networks centered on:– Broca's area;– Wernicke's area.Connectivity information was acquired using diffusion tensor imaging (DTI).ResultsCompared to healthy controls, adolescents with schizophrenia displayed a lower average degree of connectivity with the left inferior frontal gyrus (Broca's area). No significant differences were found in the degree of connectivity with the right inferior frontal gyrus and the superior temporal gyrus bilaterally (Wernicke's area).ConclusionsThe results suggest a link between schizophrenia and impairment to areas where CDs associated with inner speech plausibly originate.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Potential relationship between inflammatory markers, neuroimaging findings and treatment response in depression
Authors: Szulc A. 
Published: May 2016

Pharmacological therapy in mental disorders is usually effective in 60–70%, the treatment reaction is worsening with the disease progression, and proper medication and early treatment regimen choice is crucial. Research showed that specific brain changes (structural and functional) are present in depressed patients. These abnormalities are probably linked to neurodegeneration. There is also an evidence that inflammation contributes to the depression pathophysiology, and both these processes – neurodegeneration and inflammation are related.Novel biological markers allow us to better understand the individual mechanisms of treatment response in depression. Recently, several biological measures have been proposed, amongst them – neuropsychological dysfunction, decreased GABA level in proton magnetic resonance spectroscopy (1H MRS), body weight, genetic factors and peripheral inflammatory markers. Latest research found that brain changes assessed with neuroimaging methods (including 1H MRS, e.g. glutamatergic system abnormalities), correlate with peripheral inflammatory markers. Furthermore, both these factors taken together may serve as one integrated treatment prediction marker in depressed patients.Disclosure of interestThe author has not supplied his declaration of competing interest.
Alcohol and aggression
Authors: Heinz A. , Kluge U. , Schouler-Ocak M. , Beck A. 
Published: May 2016

About half of all murders are committed in Western industrialized countries by subjects under the influence of alcohol. Chronic alcohol use also increases the rate of violent attacks. These findings appear to be due to an interaction between acute and chronic environmental effects (acute alcohol consumption and chronic social isolation stress) on the one hand and limbic processing of aversive stimuli modulated by neurotransmitter systems such as dopamine and serotonin on the other. Animal experiments showed that early social isolation stress can induce serotonin dysfunction and appears to predispose individuals towards increased threat perception. Studies in humans revealed that depending on serotonergic neurotransmission and serotonin transporter genotype, some individuals are prone to show elevated functional activation elicited by aversive and threatening cues. Previous experience with alcohol-related aggression seems to further predispose an individual towards a “fight vs. flight” reaction when confronted with perceived threat during alcohol intake. Together, these findings point to complex gene-environment interactions and a specific role of social isolation stress in the development of alcohol-related aggression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The role of the gut microbiota in mood and behaviour. Whether psychobiotics can become an alternative in therapy in psychiatry?
Authors: Van Hemert S. , Marlicz W. , Szachta P. , Pekelharing E. , Ormel G. , Łoniewski I. , Ostrowska L. , Samochowiec J. 
Published: May 2016

IntroductionNovel research concepts based on therapies aiming to modulate intestinal microbiota are emerging. The evidence is mounting that gut-brain axis plays an important role in the development of mood and depressive disorders [1]. The similarities between blood brain barrier (BBB) and gut vascular barrier (GVB) and their role in chronic diseases have been recently unraveled [2]. Especially convincing data come from animal models, where administration of probiotics and antibiotics in germ and pathogen free mice showed beneficial role in the regulation of behavior, cognition, pain, anxiety and mood.Aims and resultsBased on available data as well as on studies looking at the effect of multispecies probiotics (Ecologic® Barrier containing B.bifidumW23, B.lactisW52, L.acidophilusW37, L.brevisW63, L.caseiW56, L.salivariusW24, L.lactisW19, L.lactisW58) on cognitive reactivity to sad mood in healthy volunteers [3] we designed the human trial aiming to compare microbiome alterations and response to therapy in patients with depression and schizophrenia. Moreover, in vitro and in vivo data support the notion that multispecies probiotics are capable of improving gut barrier function [4] and may alleviate disorders affecting mood and depressive-like behavior. We postulate that therapies modulating the microbiome-gut-brain axis warrant further investigations.ConclusionMultispecies probiotics have the potential to influence the gut-brain axis and alleviate mental disorders. Ongoing clinical study in patients with depression and schizophrenia will help to further unravel the role of gut-brain axis in the treatment of patients with psychiatric disturbances.Disclosure of interestThe authors have not supplied their declaration of competing interest.
E-Mental Health and models of care: The evidence base and feasibility of picking one vs. another?
Authors: Hilty D. 
Published: May 2016

The patient-centered care features quality, affordable, and timely care in a variety of settings – technology is a key part of that – particularly among younger generations and child and adolescent patients. The consumer movement related to new technologies is nearly passing clinicians by, as new ways of communicating with others (text, email, Twitter, Facebook) revolutionizes how we experience life and access healthcare. This paper explores a continuum with healthy, innovative behavior on one end (e.g., social media) and pathological Internet use on the other end–and the range of self-help and e-mental healthcare options being used. Specifically, it focuses on how social media adds to, yet may complicate healthcare delivery, such that clinicians may need to adjust our approach to maintain therapeutic relationships, interpersonal/clinical boundaries, and privacy/confidentiality. We suggest planning ahead to discuss expectations about online communication between doctors and patients as part of the informed consent process, offer other do's and don’ts for patients and clinicians, and review applicable guidelines. More research is needed on consumer and patient use of technology related to healthcare, as is an approach to basic and advanced measurement of outcomes.Disclosure of interestThe author has not supplied his declaration of competing interest.
The acceptability of web-care for patients with major depressive disorder
Authors: Ladea M. , Bran M. 
Published: May 2016

IntroductionWith the extraordinary rate of development of E-health and widespread internet access in Romania, Inomedica decided to create a platform dedicated primarily to the patients and their families: depresiv.ro. According to Internet Live Stats there were 11,178,477 Internet users in Romania (representing 51.66% of the population) in 2014. Inomedica is a non-governmental organization founded by a multidisciplinary team (psychiatrists, sociologists, IT specialists).The platforms provide rigorous and quality online information about depression as well as self-assessment tools and Q&A section.The presentation will explore the development and effects of the first 16 months of operation of a web platform about depression.MethodsThe depresiv.ro platform design is simple and user friendly. Mental health specialists contributed to the development of the content, which is easy to access and understand.The platform also provides access to a self-evaluation tool, the Hospital Anxiety and Depression Scale (HADS), and thus helps the users identify possible problems and encourage them to seek professional help. The web application also included a demographic questionnaire, and a medical history questionnaire. A native iOS version of the application is available to download free on AppStore. The platform is supported by a Google grant program.ResultsThe platform traffic increased from a few users per day at launch to more than 1000 unique visitors per day. Since 1st January 2015, about 178,000 unique visitors accessed the platform. All the metrics improved significantly during the last months: bounce rate (66.3%), average session duration (02:17 minutes), number of pages per session (2.4).About 25,000 users accessed the HADS application since its release, from August 2014 until September 2015, showing the increasing need for free online self-evaluation tools.The Q&A section is one of the most visited on the platform since many users try to find answers for their questions regarding depressive or anxiety symptoms.ConclusionsAs new technologies are introduced and become more accessible, mental health specialists are developing new ways of providing services and collecting data. The traffic data/usage for both the depresiv.ro platform and the app are evidence for the widespread acceptability of web-based delivery methods.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Papageno program: When learners collaborate for a safer coverage of suicide
Authors: Notredame C.E. 
Published: May 2016

Media coverage of suicide has been repeatedly shown to influence suicide rates. The Werther Effect (WE) qualifies the propensity of suicide stories to prompt imitative behaviors. By contrast, the Papageno effect (PE) was more recently identified as a way for journalists to contribute to suicide prevention through their productions. Crucially, both WE and PE depend on the quantitative (audience, redundancies, size of articles, etc.) and qualitative (type of story, editorial style, content, etc.) properties of the coverage.In order to promote the PE and limit the WE, the World Health Organization (WHO) have edited a guideline for media professionals. For instance, journalists are advised to prohibit sensationalism, avoid pictures or details about the suicide method, and show due respect to the bereaved relatives. However, it is now clear that the only chance for these recommendations to be applied is to integrate their diffusion into a more general effort toward collaboration with journalists.Papageno is a French national suicide prevention program that fully relies on learners to rise awareness about suicide and its coverage. It mainly consists in pair-meetings between psychiatry trainees and journalism students. Such an innovative formula breaks with the old top-down knowledge transmission model in order to foster personalized and sustainable sensitization. It aims at growing up a new generation of journalists who would be more aware of their responsibility concerning suicide and would more spontaneously resort to the WHO guidelines. Ultimately, the Papageno program strives for the creation of a new culture where journalists and psychiatrist would collaborate for a safer media coverage of suicide.Disclosure of interestThe author has not supplied his declaration of competing interest.
Longitudinal study of methylome profiles in subjects with psychosis and/or schizophrenia
Authors: Kebir O. , Chaumette B. , Krebs M.O. 
Published: May 2016

BackgroundSchizophrenia is a complex disorder involving both genetic and environmental factors. Epigenetic is a growing theory to explain these interactions at a molecular level. It is well-known that schizophrenia begins with prodromal symptoms and patients undergoing subthreshold symptoms are named ultra-high risk (UHR) subjects. Therapeutic and prognostic attitude remain challenging for this population. According to the model of the gene-environment interactions, the psychotic transition in adolescence could be related to epigenetic changes during the psychotic transition.MethodsWe designed and performed the first longitudinal study about whole-genome DNA methylation changes. Thirty-nine UHR patients were recruited in specialized center C’JAAD - Centre Hospitalier Ste Anne - Paris (France). During follow-up, 14 of them became psychotic (converters) according to the validated scale CAARMS. Initial and final methylation were investigated by Infinium Human Methylation450 BeadChip for 450,000 CpG after bisulfite conversion.ResultsThe psychotic transition was not associated with global methylation changes. Linear models failed to identify CpG and genes significantly associated with psychotic transition after Bonferroni correction. Analyses of the top results provided a cluster, which could classify perfectly converters and non-converters. These genes of interest are over-represented in biological pathways with relevance for psychotic physiopathology. Individual analyses highlighted the biological heterogeneity of the psychotic transition.ConclusionImproving physiopathological understanding of psychotic transition is a current challenge to identify biomarkers and to develop targeted preventive interventions available in clinical practice for UHR subjects. The epigenetic processes and in particular DNA methylation could be interesting factors.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Smartphone based treatment in bipolar disorder
Authors: Faurholt-Jepsen M. , Frost M. , Bardram J.E. , Kessing L.V. 
Published: May 2016

E-mental health technologies are under great development and the use is of these technologies is increasing rapidly.During this symposium, results from a randomized controlled trial investigating the effect of smartphone based electronic self-monitoring on the severity of depressive and manic symptoms will be presented and discussed.Further, we will present and discuss the use of automatically generated objective smartphone data on behavioral activities (e.g. social activities, mobility and physical activity) as electronic biomarkers of illness activity in bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Overview of the EPA guidance paper
Authors: Carrasco M.M. 
Published: May 2016

After several decades of Market Faith in Western societies and the most severe financial crash several generations has known, there has not really been a serious re-examination of the role of markets and money in our society. A market economy may be a valuable and effective tool for organizing productive activity. The problem is whether we have become a “market society”. That is, if the economic values have been transplanted to the whole of society – not only economic life – and we have become a monetized society: a society where just about everything is up for sale. That's to say, a way of life where market relations and market incentives and market values come to dominate all aspects of life. Paradoxically, it is possible that the economic crisis has only increased this trend. Administrations at different levels – European, States, Local… – have demanded tremendous sacrifices from the population intended to save the financial system, but on the way sacrificing a Welfare state that took decades to build. In this presentation, we will review the mental health consequences of the current economic crisis. Also it examines how the change in social values and sweeping assertion of economic values can affect the way we think about Mental Health and Psychiatric Care.Disclosure of interestThe author has not supplied his declaration of competing interest.
Promoting stigma coping and empowerment: Results from the multi-center clinical trial STEM
Authors: Gaebel W. 
Published: May 2016

IntroductionThe stigma of mental illness is still a major challenge for psychiatry. For patients, stigma experiences and self-stigma are associated with reduced quality of life and increased vulnerability to a more chronicle illness course. Nevertheless, there is a scarcity of validated therapeutic approaches addressing strategies for coping with stigma.Objectives and aimsA manualized psycho-educational group therapy for stigma coping and empowerment (STEM) should be tested for efficacy in patients with depression and schizophrenia. The study was funded by a research grant of the Federal Ministry of Education and Research.MethodsA cluster-randomized RCT with two arms including 30 mental health care services (psychiatric inpatient services, day-units, and outpatient services, as well as inpatient psychiatric rehabilitation services) was conducted. The intervention consisted of 8 sessions regular psycho-education group therapy and 3 sessions addressing stigma coping and empowerment. Controls received 11 sessions regular psycho-education. Primary outcome variable was quality of life (WHO-QOL). Assessments were conducted directly before and after the intervention, and at 3, 6 and 12 months follow-ups.ResultsA total of 469 patients participated and more than 300 participants (approx. 65%) completed the 12-month follow-up. First results of the analysis will be presented at the conference.ConclusionsSince the statistical analysis is currently in progress, no conclusions concerning the efficacy of the tested therapeutic approach can be done by now. Nevertheless there is a strong need for supporting patients in developing positive stigma coping strategies. STEM is the first therapeutic approach to our knowledge tested for efficacy in a RCT.Disclosure of interestThe author has not supplied his declaration of competing interest.
Phenomenology of emotions
Authors: Stanghellini G. , Aragona M. , Doerr-Zegers O. , Musalek M. , Madeira L. 
Published: May 2016

This symposium analyses the psychopathological phenomenon “anxiety”, a classical concept, which has returned to be central in the recent psychiatric debate. Some of the most important international phenomenologists will discuss anxiety in the context of major psychopathological areas. Clinical and research insight will be presented in the context of a philosophically deep understanding of the fundamental qualitative features of the psychopathology of anxiety.Disclosure of interestThe authors have not supplied their declaration of competing interest.