bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression in the Elderly with Chronic Medical Illness
Authors: Ghanm L. , Sghaier S. , Toumi R. , Zitoun K. , Zouari L. , Maalej M. 
Published: June 2017

BackgroundThere is a bi-directional relationship between depression and chronic medical disorders.AimsThe objectives of our study were to measure the prevalence of depression in the elderly with chronic medical illness in primary care and to determine the socio-demographic and clinical factors related to depression.MethodsWe conducted a descriptive and analytical cross-sectional study of patients aged over 65, followed at the outpatient chronic diseases in Oudhref's district hospital (south of Tunisia) during the month of September 2014. We used two instruments: the activity of daily living (ADL) to determine the degree of autonomy and the geriatric depression scale (GDS) validated in Tunisia.ResultsAt the end of our investigation, 100 chronic disease patients met inclusion criteria. The average age of our population was 75 years. Prevalence of depression was 48%. The most frequent chronic pathology was hypertension (79%), followed by diabetes (70%). In analytical study, we noted no correlation between depression and socio-demographic variables such as age, sex and marital status. Regarding clinical variables, depression was significantly more frequent in patients with sensory impairments (82% vs 18%, P = 0.017), dependent (80% vs 20%, P = 0.002). Regarding chronic disease, depression was significantly more frequent in patients with respiratory disease (80% vs 20%, P = 0.033), a higher number of comorbidities (P = 0.005), who were hospitalised at least once (P = 0.015).ConclusionDepression is common in elderly with a chronic disease. Using screening instruments for major depression by primary care clinicians will help to detect depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Dementia or Mania
Authors: Gomez C. , Rodriguez V. 
Published: June 2017

BackgroundIn the clinical practice we encounter different clinical situations that require precise differential diagnosis and special treatment. This poster reviews the diagnosis and pharmacotherapy of two cases that points out how likely is to confuse the diagnosis of two apparently different pathologies, as are bipolar disorder and frontotemporal dementia. We study and compare two cases that were hospitalised in the psychiatric ward of Sant Joan's Hospital. Following their treatment and evolution. The first case is a 75-years-old man that presented behavioural changes, hypomania, and insomnia without previous known psychiatric history other than alcoholism. The family explained a history of episodes of mood changes going from depression to mania, compatible with a bipolar diagnosis never diagnosed, and the neuropsychological exam that was performed did not show any cognitive impairment finally receiving a diagnosis of bipolar disorder after the good response to the lithium treatment. In the second case we have a 58-years-old man with behavioural disturbances and mood fluctuation that changes from short periods of hypomania with disinhibition and insomnia to a predominance of hypothymia, apathy and self-care negligence, which received at the beginning a diagnosis of bipolar disorder and that after the proper complementary tests was shown to be a frontotemporal dementia.ConclusionsWhen facing behavioural and mood changes in advance age in the absence of psychiatric history we should take into account the considerable percentage of patients with a final diagnosis of frontotemporal dementia that received previously a mistaken diagnosis of bipolar disorder and vice versa.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cognitive Symptoms: The Border Between Dementia and Depression, a Report of One Case
Authors: Juncal Ruiz M. , Porta Olivares O. , Blanco Sánchez L. , Landera Rodríguez R. , Gómez Revuelta M. , Santayana Jenaro G. Pardo de , Núñez Morales N.I. , Martín Gutiérrez R. , Pérez Santos A.B. , Fernández-Abascal Puente B. 
Published: June 2017

IntroductionTwenty percent of people aged over 80 have a serious dementia. Cognition disturbances are present both in depressive disorder and dementia. Vortioxetine is a new antidepressant with a multi-modal mechanism of action, being one of the antidepressant with more procholinergic action.Aimsto know the efficacy of vortioxetine in elder people with cognitive disturbances due to both pathologies: depression and dementia.MethodsIt is described the result of using vortioxetine in one elder woman with dementia and affective symptoms with no clinical improvement after using two classical antidepressants.ResultsWoman aged 82 without psychiatric history came to our consultation in April 2016. She had been diagnosed with dementia last year by a neurologist and she had started treatment with Donepezile 10 mg/d. Six months after this diagnosis she complained of depressive mood and faster deterioration of her previous cognition disturbances in terms of functionality level and autonomy, so her neurologist prescribed escitalopram until 10 mg/d and mirtazapine until 30 mg/d without clinical improvement. After first exploration, we decided starting treatment with vortioxetine 10 mg/d and withdraw previous antidepressants. Next week she complained of nausea and vomiting so we reduced the dose to 5 mg/d with good tolerance after that moment. Six months later her depressive mood had improved and her family remarked she had a little more autonomy and more desire to do things.ConclusionsVortioixetine might be an effective and safe option in elder people who have cognitive disturbances due to mood disorder and/or dementia, probably because of its procholinergic action.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Elderly Diabetic Patients: Depression and Adherence to Treatment
Authors: Mendes R. , Martins S. , Fernandes L. 
Published: June 2017

IntroductionDemographic changes with the aging of the worldwide population imply an increase in prevalence of chronic diseases, such as diabetes mellitus. Many studies have suggested that depression is higher in diabetic patients, and that this association often contributes to under-recognition of the illness, limiting adequate metabolic control.AimsTo study the association between depression and adherence to treatment in elderly diabetic patients.MethodsA cross-sectional study was conducted with elderly outpatients (≥65 years) from the Internal Medicine Department in São João Hospital (CHSJ, Porto). Patients unable to communicate were excluded. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale/HADS, and adherence to treatment with a clinical interview and from medical records.ResultsThe final sample included 78 patients, with an average of 75.3 (sd = 6.75) years. They were mostly female (80%), married (66.7%) and with low education level (62.8%). The mean number of comorbidities was 5.76 (sd = 1.6) and 98.7% took ≥5 drugs. In this sample, 23.1% had cognitive impairment, 16.7% depression and 24.4% anxiety. Patients not adhering to treatment presented a higher depression score, when compared with adherents (median 6vs3), even without statistical significance (P = 0.56).ConclusionsDiabetic patients not adhering to treatment tend to present more depression, in spite of the lack of statistical significance. These results suggest that depression can limit the adherence to treatment, which is in line with previous studies. In this context, the early diagnosis and treatment of depression seems to be an important target in the management of diabetes, particularly in elderly patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Review of Association Between Delirium and Dementia in Elderly People
Authors: Pereira R. , Martins S. , Fernandes L. 
Published: June 2017

Delirium is a neuropsychiatric syndrome, characterized by an acute change in mental status with a fluctuating course of symptoms, that affects almost 50% of people aged 65 years or older, admitted to hospital. Delirium is associated with negative outcomes, including increased risk of mortality, cognitive and functional decline. In 50% of the cases, the cause of delirium is multifactorial, resulting from a complex inter-relationship between several predisposing factors (e.g. advanced age, dementia) in highly vulnerable patients that are exposed to precipitating factors (e.g. infections). In this context, cognitive impairment and dementia are important risk factors for delirium, increasing its risk by two to five times, associated with worse outcomes. The underlying brain vulnerability of these patients with dementia may predispose to the development of delirium, as a consequence of insults related to the acute medical disease, medication or environmental factors. On the other hand, delirium may cause permanent neuronal damage, which may lead to the development or worsening of a pre-existing dementia. As a result, delirium and dementia frequently coexist and overlap, challenging differential diagnosis.The identification of risk factors for delirium, specifically pre-existing cognitive impairment or dementia, in elderly people admitted to hospital is essential to the implementation of preventive strategies that may contribute to the decrease of delirium rates. The present literature review aims to highlight the association between delirium and dementia in elderly people, focusing on diagnosis, pathophysiology, prevention, and management.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Attitudes and Practices of General Practitioners Towards Elderly Patients with Cognitive Deficits
Authors: Masmoudi R. , Feki I. , Trigui D. , Baati I. , Sellami R. , Masmoudi J. 
Published: June 2017

BackgroundTunisia has experienced a considerable increase in degenerative diseases associated with aging including in particular dementia and Alzheimer's disease.ObjectivesTo evaluate the diagnostic procedures of cognitive impairments in general medicine and to identify obstacles concerning the early diagnosis of dementia in these patients.MethodsAn email questionnaire was sent to a sample of general practitioners (GPs) working in the Sfax region, Tunisia.ResultsWe received 55 answers. When facing a mnesic complaint, 20% of GPs perform a screening of cognitive disorders. Among reasons leading to early identification, memory complaints (76.4%) was the most mentioned by GPs surveyed. the Mini Mental State was the most used (34.5%) by general practitioners. Twenty-nine point one percent (29.1%) of physicians conducted a comparative assessment 6 to 12 months later if the initial evaluation was normal and 83.6% send the patient to a specialist in case of a detected disorder. For GPs, in 58.2% of the cases, the major impediment is the lack of time, in 32.7% of the cases it is patient's and family's denial and in 23.6% of the cases it is the absence of effective medical treatment. A cross analysis shows that GPs who have had further training in geriatrics have a better approach.ConclusionOur study shows a lack in the early identification of cognitive impairment in the elderly by GPs. Develop simple cognitive tests, reinforce training of doctors and promote research to develop new drugs would improve early diagnosis and management of dementia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Girls Spend More Time to be Generous in First Offer
Authors: Aarabi Sobhan , Brazegar Ebrahim , Shayetehfar Monir 
Published: June 2017

IntroductionFairness is a fundamental factor for prosocial behaviors and have a crucial role in social interaction. Examining fairness during maturation can shed light on different questions and hypothesis about the development of prosociality across life span.ObjectivesThe purpose of this study was to investigate the development of strategic planning in children and adolescents.MethodsA total of 288 healthy students between ages 7 and 18 from four community schools participated in a one-shut run game which the participants were proposed and should set a package of offers concluded six suggestions.ResultsAmong 288 students, 128 (44.44%) participants were male and 160 (55.56%) participants were female. In first offer, 29.7% of boys suggested an unfair offer but girls with 23% were more generous. However, in last suggestion in comparison with girls (73% unfair), boys showed more generosity (64% unfair). Notably, girls in average, spent 135.78 seconds (SD = 86) to set their offers while boys needed less time to prepare their suggestions (117.16s, SD = 119.7)ConclusionAccording to the findings it seems that both genders start more generous offers and end up with less generous offers. In comparison with boys, girls need more time in economic decision-making and interestingly more fair options at the start of game.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Use of a Telemedicine Model and its Logistics to Reach as Many European Refugees as Possible
Authors: Mucic D. 
Published: June 2017

Current refugee crisis challenges mental health care systems all over the Europe. There is a number of research describing difficulties in dealing with cross-cultural patients. Access to relevant care as well as its availability are often limited due to: a) lack of respective qualified resources b) linguistically, cultural and even racial barriers in addressing of mental health care needs of cross-cultural patient population. By use of various e-Mental health applications, primarily videoconference, we may improve assessment and/or treatment of refugees and asylum seekers on distance e.g. Arabic speaking psychiatrist located in Sweden would be able to assess and/or treat refugees from Syria located in Germany). Specialized centers for treatment of refugees would also be able to get second-opinion service from remote experts and use it in order to confirm or re-consider diagnosis as well as the treatment options. Establishment of international network of cross-cultural experts enables to:– Improve the mental health care across national boundaries by providing psychiatric consultations to other countries within EU– Conduct International Treatment Team with Select Skills (e.g. Sign Language and Many Foreign Languages Staff)– Provide Distance Supervision and Staff Consultation– Provide Psycho Education of caregivers– Improve Distance Learning via Case Conferencing and Best Practice Demonstration Across the National Boundaries– Create Data Base over cross-cultural and other select skills professionals within EUDisclosure of interestThe author has not supplied his declaration of competing interest.
Mental Health of Roofless and Squatter Population in North Catalonia
Authors: Calvo F. , Giralt C. , Carbonell X. 
Published: June 2017

IntroductionHomelessness is a phenomenon, which is hard to limit, as it contemplates different situations including roofless and squatters.ObjectiveTo determine the presence of these homeless categories in the city of Girona and examine the prevalence of diagnosed mental pathology and its principal socio-demographic characteristics.MethodsTransversal, observational and analytic study of the population of roofless people and squatters. The registers of the outreach street work team, the local police and the public shelter were used in order to detect the cases and their basic socio-demographic characteristics. The clinical record of the mental health and addiction public network was accessed to determine their diagnosis.ResultsDuring the 6 years of registers, 781 cases of people in situation of roofless and squatters were detected. In total, 83.2% (n = 630) of the cases were men and 16.8% (n = 131) women. The average age was 44.8 (ED = 11.2) and no differences were found regarding gender (Men = 45.3, ED = 11.0 vs. Women = 42.9, ED = 12.2; t = 1.7, df = 405, P = 09). However differences were found regarding origin (Immigrants = 42.2 years, ED = 10.3 vs. Natives = 46.8 years, ED = 11.4; t = -4.2, df = 402, P < .001). A total of, 52.9% of the cases (n = 412) displayed diagnosed mental pathology and 15.8 (n = 123), dual pathology.ConclusionMental pathology is more prevalent among this typology of homeless people than in general population, as other studies prove.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychogenic polydipsia: A case report
Authors: Erzin G. , ozdel K. , Karadağ H. 
Published: June 2017

IntroductionPsychogenic or primary polydipsia characterized by excessive thirst and compulsive water drinking is a common problem among psychiatric populations, affecting 6% to 20% of patients. It is frequent in chronic psychiatric diseases, particularly schizophrenia. We report a patient with excessive thirst and diagnosed as PIP syndrome.CaseA 54-year-old, married, female patient had normal vital signs. She has excessive water intake (10–12 L/day). She did not have edema, signs of dehydration or fever. The neurological examination, CT, MRI, and EEG was normal. The laboratory tests were normal. She had started using sertraline 100 mg, 7 months ago due to anxiety disorder. There is not any disease except the anxiety disorder, which is in remission due to the treatment. A total of, 2 μg desmopressin I.M. is applied in fluid restriction test. The urine density is determined as 1.008 mg/dL initially, 1.011 mg/dL one hour later, and 1.013 mg/dL two hours later in the urinary test. The diagnosis is psychogenic polydipsia (primary) according to patient history, the clinical examination, and the test results. The patient is recommended to continue the sertraline 100 mg treatment, and also assigned with fluid restriction behaviour.ConclusionSince excess water intake periods are correlated with psychotic exacerbations; psychosis and polydipsia might have similar physiopathologic mechanisms. Polydipsia might be due to anti-cholinergic side effect of some psychiatric drugs. The physiopathology of the polydipsia and polyuria is not totally enlightened in the psychiatric disorders. In some cases, the fluid intake occurs completely voluntary. Therefore, we decided to present this case.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Mental flexibility and problem solving in adult patients who present non-suicidal self-injury
Authors: Garreto A.K. , Giusti J. , Oliveira M. , Tavares H. , Rossini D. , Scivoletto S. 
Published: June 2017

IntroductionNon-Suicidal Self-Injury (NSSI) is considered a dysfunctional way of dealing with problem situations.ObjectiveThis study aimed to investigate the problem solving capacity in adults with NSSI compared to controls.MethodsThirty-three patients who sought treatment for NSSI (NSSI group) were compared with 33 individuals without psychiatric disorder (control group). We also investigated Axis I disorders, executive functions and problem solving capacity.ResultsIn both groups, the majority were women (77.25%) with a mean age of 30 years, and the beginning of NSSI behavior of 16 years. The most common NSSI behaviour was skin cutting, and the most common reason given for engaging in that behaviour was “to stop negative feelings”. The most common psychiatric comorbidities were major depressive disorder (60.6%). Compared to controls, the group with NSSI showed lower results in relation to problem solving capacity (P = 0.000) and mental flexibility (P = 0.007). Deficits in problem solving capacity may be a reflection of low mental flexibility of adults with NSSI. This may be a risk factor for the beginning of NSSI and the persistence of it in adulthood.ConclusionEarly identification and treatment focused on problem solving capacity during the adolescence may prevent the chronicity of NSSI.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Academic burnout and personality traits in Korean medical students
Authors: Chae H. , Lee S.J. 
Published: June 2017

ObjectivesPersonality was shown to play an important role for well being under academic stress. The purpose of the present study was to evaluate how temperament and character traits predict academic burnout in Korean medical students.MethodsOne hundred and seventy-eight Korean medical students completed the Cloninger's temperament and character inventory (TCI) at the beginning of semester and Maslach burnout inventory-student survey (MBI-SS) was also measured around the final exam when academic stress and burnout is at the highest. The correlation between TCI and MBI-SS was examined and stepwise regression analysis was performed to measure how well personality traits predict academic burnout level.ResultsThe MBI-SS total burnout score was correlated positively with harm-avoidance (r = 0.247, P < 0.05) and negatively with self-directedness (r = -0.296, P < 0.001) and Cooperativeness (r = -0.169, P < 0.05) scores. The regression analysis showed that the harm-avoidance (β = 0.269, P < 0.001) accounted for exhaustion score and the self-directedness explained the Total burnout score (β = -0.296, P < 0.001) and Inefficacy score (β = -0.284, P < 0.001). The Cynicism score was accounted for high Novelty-Seeking (β = 0.150, P < 0.05) and low Cooperativeness (β = -0.182, P < 0.05).ConclusionThis study showed that the Cloninger's temperament and character might explain the burnout level from the stressful medical education. The temperament of novelty-seeking and harm-avoidance could provide the susceptibility to the academic burnout and the character of self-directedness and cooperativeness might determine the resilience to the negative influence of academic stress.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Women's personal and political identities in selected Middle East countries
Authors: Lu S.F. 
Published: June 2017

IntroductionWomen's personal and political identities are significant in defining their roles and eventual contribution to society in contemporary society both in the private and public spheres.ObjectivesThis research study focuses on the effect of Islam on women's personal and political identities.AimsThis research aims to highlight the existing ideology relating to women's treatment in regards their identities and public roles, and hence to contribute to women's emancipation.MethodsThis study utilizes quantitative and qualitative methods in analysing women in eight Muslim-majority countries, namely, Iran, Turkey, Egypt, Saudi Arabia, Jordan, Yemen, Cyprus and Kuwait, in the Middle East. For the quantitative data, statistical dataset was culled from Inter-university consortium for political and social research of the university of Michigan.ResultsThe overall results show that historical constructions of gender spheres are still palpable in the Islamic landscape. Woman's question is identified as a complex personal and social problem, and cannot be rejected as a valid search for gender sameness or equality. This study also shows the interpolation of Islam with other factors such as patriarchy, modernization, and state formations. Some Muslim scholars argue that Quran's fundamental mooring is geared towards equality between men and women, and women's enhanced status, and it is patriarchy that has confined women to the domestic sphere.ConclusionGender is embedded within culture, and structures of power in families, communities, and states, which have gender in itself, as an organizing principle.Disclosure of interestThe author has not supplied his/her declaration of competing interest.