bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in Baseline Demographics, Presentation, Pathways to Care and Duration of Untreated Psychosis (DUP) in the Ethnically Diverse Population of Lancashire, UK
Authors: Damle V. , Husain D.N. 
Published: June 2017

IntroductionDUP is the time from the emergence of first psychotic symptom to the commencement of adequate antipsychotic treatment. Psychopathological and sociocultural factors influence patient's treatment seeking behavior. Better understanding of DUP could help in development of improved therapeutic strategies and public health initiatives. Emphasis on early detection of psychosis and reduction of DUP has led to a huge interest in pathways to care.ObjectivesTo understand the differences in baseline demographics, presentation, care-pathways and DUP in ethnically diverse population of Lancashire, UK.MethodsOur cross-sectional study involved a subset analysis of National EDEN data for Blackburn and Preston in Lancashire.ResultsOf the 183 patients, 78% were Whites and rest belonged to BME population. Median DUP was 188 days. Whites were significantly younger at onset of both non-specific symptoms and psychosis and at acceptance into EIS. Whites were significantly less likely than non-whites to be married, more likely to be in paid work and to have used illicit drugs. There were no significant differences with respect to other demographics/delays in help seeking or DUP. Non-White group had shorter DUP of 95 days (but not statistically significant, P = 0.060).ConclusionsBetter understanding of mental illness and local services in White patients could have led to early help seeking. Having a supportive family may have promoted early help seeking and thus shorter DUP in BME group. Further studies are needed exploring socioenvironmental variables, substance misuse and knowledge of local psychiatric services amongst the BME population and the influence of these variables on DUP.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Differential Effect of Childhood Trauma Subtypes on Fatigue and Physical Functioning in Chronic Fatigue Syndrome
Authors: De Venter M. , Illegems J. , Van Royen R. , Sabbe B. , Moorkens G. , Van Den Eede F. 
Published: June 2017

ObjectiveThere is a large consensus concerning the important aetiological role of childhood trauma in chronic fatigue syndrome (CFS). In the current study, we examine the differential effect of childhood trauma subtypes on fatigue and physical functioning in patients with CFS.MethodsOne hundred and fifty-five participants receiving treatment at the outpatient clinic for CFS of the Antwerp University Hospital in Belgium were included in this study. Stepwise regression analyses were conducted with the outcomes of the total score of the Checklist Individual Strength (CIS) measuring fatigue and the physical functioning subscale of the medical outcomes short form-36 health status survey (SF-36) as the dependent variables, and the scores on the five Traumatic Experiences Checklist (TEC) subscales as the independent variables.ResultsFatigue and physical functioning scores in CFS patients were significantly predicted by sexual harassment only. A significant effect of emotional neglect, emotional abuse and bodily threat during childhood on elevated fatigue or reduced physical functioning levels could not be found.ConclusionThere is a differential effect of childhood trauma subtypes on fatigue and physical functioning in CFS patients. Sexual harassment emerged as the most important predictor variable. Therefore, childhood (sexual) trauma has to be taken into account in assessment and treatment of chronic fatigue syndrome.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychosis Induced by Interferon-α–A Limitation of Treatment
Authors: Marinho M. , Mota-Oliveira M. , Marques J. , Bragança M. 
Published: June 2017

IntroductionPsychosis is an uncommon but serious complication of treatment with interferon-α, a cytokine frequently used to treat several infectious and malignant diseases.ObjectivesTo provide an overview of interferon-α-induced psychosis.MethodsLiterature review based on PubMed/MEDLINE, using the keywords “interferon-α” and “psychosis”.ResultsPsychotic symptoms usually emerge between 6 to 46 weeks and on average 3 months after the start of interferon-α treatment, occurring most frequently in the form of persecutory, guilt or grandeur delusions and auditory hallucinations. Often they are accompanied by mood symptoms, anxiety, attention disturbances and insomnia. Many factors are known to increase the risk of psychiatric effects as a whole associated with interferon-α. Pathogenesis of interferon-induced psychosis remains unclear, however several theories have been discussed, namely the overlap influence of biological vulnerability and the cytokine's action on the brain. Dopaminergic, opioid, serotoninergic and glutaminergic pathways as well as hypothalamic-pituitary-adrenal axis hypersensitivity are some of the hypotheses raised about the underlying cause of that susceptibility. Psychosis management usually includes stopping interferon-α and introducing antipsychotics with minimal antidopaminergic effects and at the lowest possible dose, due to the increased risk of extrapyramidal reactions in these patients.ConclusionThe decision to use interferon-based treatments in psychiatric patients should be highly individualized. Early recognition and adequate treatment of interferon-induced psychosis might prevent subsequent emergence of serious debilitating symptoms. Thus, it is very important that medical and psychiatric treatment teams work closely together and are familiar with this important subject.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Reasons for Acute Psychiatric Admissions and Psychological Interventions for Patients with Borderline Personality Disorder
Authors: Lekka N.P. , Carr G. , Gilpin T. , Eyo B. 
Published: June 2017

IntroductionNICE guidelines advise to consider admission for patients with borderline personality disorder (BPD) for the management of crises involving significant risk to self or others. Furthermore, to consider structured psychological interventions of greater than three months’ duration and twice-weekly sessions according to patients’ needs and wishes.ObjectivesWe aimed to assess reasons for admission and access to psychological interventions in an acute inpatient BPD population.MethodsCase notes of patients with a diagnosis of BPD (ICD-10 F60.3 and F60.31), discharged from four acute general adult wards in Sheffield during a period of twelve months were studied retrospectively, using a structured questionnaire based on BPD NICE guidance.ResultsOf the 83 identified BPD patients, seventy-eight percent were female and 82% between 16–45 years old. Eleven patients had four or more admissions. Eighty percent reported suicidal ideation at admission, with 50% having acted on it (70% by overdose, 50% cutting, 10% hanging). Of this cohort, 58% reported they intended to die. Psychosocial factors at admission were identified in 59 cases, including relationship breakdown (47.5%), alcohol/drug use (30.5%) and accommodation issues (17%). Disturbed/aggressive behaviour was documented in 27.1% of these cases. Sixty-eight percent of patients had psychology input in the 5 years preadmission: 38% (21 patients) received structured therapy, whilst 62% received only one assessment or advise to teams.ConclusionsPatients were mainly admitted for risk management. A high proportion received unstructured psychological interventions. Services offering structured psychological interventions should be supported, as hospitalisations only temporarily address BPD patients’ suicidality and psychosocial difficulties.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Thyroid Profile and its Relationship with Response to Treatment with Lithium in Bipolar Mood Disorder Patients
Authors: Avinash P. , Pathak K. 
Published: June 2017

IntroductionThere is substantial evidence that even minor perturbation of thyroid function plays a significant role in clinical course and treatment outcome in depressive disorder; however the same is not yet clear in bipolar disorders.Aims and objectivesTo study the relationship between pretreatment thyroid profile and response to treatment with lithium along with other predictors of response to treatment with lithium in cases of bipolar mood disorder.MethodsThis study was conducted in the indoor facilities of a regional Institute of Mental Health, Tezpur, India in the year of 2012. Forty-five consecutive indoor patients diagnosed with bipolar mood disorder using DSM-IV-TR criteria were selected. On day 1, blood was collected for thyroid profile and BPRS 24 item scale version 4.0 was applied. They were started on lithium monotherapy and only lorazepam was used on S.O.S basis. On day 30, the BPRS was applied again to check the response to treatment, statistical analysis was done using SPSS version 16.ResultsThe mean percentage fall of the BPRS score was 40%, with the maximum fall in the subscale of grandiosity and minimum for depression. Age, illness duration, substance use, family history second or later episodes were negatively correlated with treatment response. Pretreatment T4 level was positively correlated, while pretreatment TSH level was negatively correlated with the treatment response.ConclusionLithium monotherapy proved to be a good agent for first episode of bipolar Mood disorder patients with manic symptoms and pretreatment T4 and TSH level were predictors of treatment response.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Impulsivity and Brain Volume in Patients with Bipolar Disorder type I and Bipolar Disorder Type II
Authors: Janiri D. , Giuseppin G. , Spinazzola E. , Maggiora M. , Sani G. 
Published: June 2017

IntroductionImpulsivity is a key feature of both bipolar disorder (BD) type I (BDI) and type II (BDII).ObjectiveStructural neuroimaging studies help clarifying brain mechanisms underpinning the regulation of impulsivity in BDI and BDII.AimsTo address the question whether grey matter (GM) alterations relate differently with impulsivity in BDI and BDII.MethodsWe assessed 54 euthymic outpatients, diagnosed with BDI (n = 28) or BDII (n = 26) according to DSM-IV-TR criteria. They underwent a 3 T magnetic resonance imaging (MRI) investigation. GM brain volumes were analyzed on a voxel-by-voxel basis using Statistical Parametric Mapping 8. The Barratt Impulsiveness Scale (BIS), version 11A, was used to assess trait impulsivity.ResultsBDI and BDII patients present an inverse relationship between impulsivity and GM volume in two cerebral areas: the right cerebellum (right crus I) and the interface between the left angular gyrus and the left inferior parietal cortex (Brodmann Area 39, 7, 40). More specifically, a negative relationship for BPI and a positive relationship for BPII were found in both areas.ConclusionsResults suggest that the different diagnosis between BDI and BDII could have a significant effect on GM changes according to impulsivity severity and point up the importance of considering the BP subtype distinction in neuroimaging studies on this topic.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Early Childcare and Trajectories of Behavioral Difficulties in Children: The EDEN Mother–Child Cohort Study
Authors: Melchior M. 
Published: June 2017

BackgroundThere is no consensus of the relationship between early childcare and later psychological development.MethodsWe studied 1428 children participating in the French EDEN cohort. Childcare was reported prospectively between ages 4 months and 3 years: childminder, collective care, informal care. Children's behavior was assessed by mother-reported strength and difficulty questionnaire (SDQ) scores at ages 3.5, 5.5 and 8 years. Trajectories of children's behavioral difficulties (emotional difficulties, behavioral problems, peer-relations difficulties, symptoms of hyperactivity and inattention, prosocial behavior) were identified using group-based trajectory modelling (PROC TRAJ, SAS). To control for selection and confounding factors, we used propensity scores based on over 30 covariates, included in multinomial regression models as inverse probability weights of exposure.ResultsCompared to children in informal care, those who were cared for by a childminder or in collective care were less likely to have peer problems (respectively, ORs for the intermediate level trajectory = 0.67 [95% IC: 0.47–0.95] and 0.49 [95% IC: 0.34–0.72]; ORs for the high level trajectory = 0.47 [0.27–0.82] and 0.33 [0.17–0.62]). Collective care was also associated with a reduced likelihood of intermediate (OR = 0.71 [0.52–0.98]) and high trajectories of hyperactivity and inattention (OR = 0.50 [0.35–0.81]), intermediate (OR = 0.58 [0.39–0.88]) and high trajectories of emotional symptoms (OR = 0.54 [0.32–0.92]) and intermediate (OR = 0.72 [0.51–1.01]) and high behavioral problems trajectories (OR = 0.54 [0.34–0.85]).ConclusionChildcare attendance prior to school entry – particularly collective childcare – may have beneficial effects for children's psychological development and peer relations.Disclosure of interestThe author has not supplied his declaration of competing interest.
The Different Effect of Childhood Trauma on Amygdala and Hippocampus in Patients with Bipolar Disorder and Healthy Controls
Authors: Janiri D. , De Rossi P. , Simonetti A. , Spalletta G. , Sani G. 
Published: June 2017

IntroductionChildhood trauma (CT) is a relevant environmental stressor for bipolar disorder (BP). Amygdala and hippocampus are key areas involved both in the pathophysiology of BP and in mediating the biological response to stress.ObjectivesStructural neuroimaging studies help clarifying neural correlates of the relationship between BP diagnosis and CT.AimsTo verify the impact of CT on amygdala and hippocampus and hippocampal subfields volumes in BP patients and healthy control (HC).MethodsWe assessed 105 outpatients, diagnosed with BPI or BPII according to DSM-IV-TR criteria, and 113 HC subjects. History of CT was obtained using the childhood trauma questionnaire (CTQ). High-resolution magnetic resonance imaging was performed on all subjects and volumes of amygdala, hippocampus, nucleus accumbens, caudate, pallidum, putamen, thalamus and hippocampal subfields were measured through FreeSurfer.ResultsAll deep gray matter structures were smaller in BP than HC. CT modulated the impact of the diagnosis on bilateral amygdala and hippocampus, in particular on subiculum, presubiculum and cornu ammonis CA1. It was associated with bilateral decreased volumes in HC and increased volumes in patients with BP.ConclusionsChildhood trauma impacts on the amygdala and hippocampus, brain areas involved in response to stress and emotion processing, and specifically on the hippocampal subfields most implicated in learning trough positive/negative reinforcement.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychological treatment of trihotillomania: A case study
Authors: Sarmiento Luque T. , Sanchez J.M. 
Published: June 2017

This paper presents a clinical case of trichotillomania. Therefore, the aim of this study is to present in detail the procedure followed in a case of trichotillomania in a public health context, using cognitive-behavioral techniques, in order to deepen the knowledge of the efficacy of these treatment procedures and demonstrate the feasibility of implementation.The results obtained show significant improvements in different clinical aspects: first, the hair pulling behavior disappeared completely; moreover, anxiety diminished significantly and mood normalized. All these results allow us to conclude that the intervention was successful.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Personal and pathopsychological features of patients with somatoform disorders in primary care
Authors: Tsygankov B. , Kulichenko A. 
Published: June 2017

IntroductionSomatoform disorders are a therapeutic challenge for primary care physicians. Various studies show low efficacy of psychotherapy for these patients, and the need for differentiated approach to their treatment.ObjectiveExplore the differences between pathopsychological, personal characteristics of patients with somatoform disorders.MethodsIt was carried out psychometric evaluation of 108 patients with different clinical variants of somatoform disorders, using SCL-90-r, Leonhard questionnaire.ResultsPatient with somatization disorder (SD) had maximum values on the “somatization”, “depression”, “hostile”, “paranoid” scales; a high level of anxiety. Singularity personality structure of these patients defining feature of exaltation, excitability, emotivity. Patients with undifferentiated somatoform disorder (USD) also showed high levels of somatization, anxiety and obsessive-compulsive, interpersonal sensitivity, phobic anxiety. Patients with stable somatoform pain disorder (SPD), had high levels of depression, obsessive-compulsive. SPD formed in individuals with features of anxiety, seizing, high emotivity. The maximum values for the scales of anxiety (ANX, PHOB) recorded in patients with somatoform dysfunction of the autonomic nervous system (SDANS). Evaluation of coping strategies showed a preferential use of the “avoidance” strategy by patients with SD, USD, a rare use of social support strategies, responsibility. Patients with somatoform pain disorder often resorted to seek social support.ConclusionThe use of the questionnaire SCL-90-r has identified a number of clinical features of patients with different variants of the SFD. Typologically in all samples of patients revealed moderate accentuation on emotivity trait.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A broken heart
Authors: Gordillo Montaño M.J. , Ramos Perdigues S. , Latorre S. , de Amuedo Rincon M. , Torres Llorens P. , Boned Torres S.V. , Segura Valencia M. , Guisado Rico M. , Merino del Villar C. 
Published: June 2017

IntroductionWithin the various cultures and throughout the centuries has observed the relationship between emotional states and heart function, colloquially calling him “heartbroken”. Also in the medical literature are references to cardiac alterations induced by stress.ObjectiveTakotsubo is a rare cardiac syndrome that occurs most frequently in postmenopausal women after an acute episode of severe physical or emotional stress. In the text that concerns us, we describe a case related to an exacerbation of psychiatric illness, an episode maniform.MethodWoman 71 years old with a history of bipolar I disorder diagnosed at age 20. Throughout her life, she suffered several depressive episodes as both manic episodes with psychotic symptoms. Carbamazepine treatment performed and venlafaxine. He previously performed treatment with lithium, which had to be suspended due to the impact on thyroid hormones and renal function, and is currently in pre-dialysis situation.She requires significant adjustment treatment, not only removal of antidepressants, but introduction of high doses of antipsychotic and mood stabilizer change of partial responders. In the transcurso income, abrupt change in the physical condition of the patient suffers loss of consciousness, respiratory distress, drop in blood pressure, confusion, making involving several specialists. EEG was performed with abnormal activity, cranial CT, where no changes were observed, and after finally being Echocardiography and coronary angiography performed when diagnosed Takotsubo.Results/conclusionsIn this case and with the available literature, we can conclude that the state of acute mania should be added to the list of psychosocial/stressors that can trigger this condition.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Bipolar versus schizoaffective disorder: Clinical profiles
Authors: Romosan A.M. , Dehelean L. , Romosan R.S. , Papava I. , Drut I. 
Published: June 2017

IntroductionDifferentiating between bipolar (BD) and schizoaffective disorder (SAD) can be challenging, especially during early stages of the illness.ObjectivesComparing clinical profiles and socio-demographic characteristics of patients diagnosed with BD and SAD.MethodsThe study, conducted between 2014–2016, included 67 inpatients from the Timisoara Psychiatric Clinic, diagnosed with either BD (n = 35) or SAD (n = 32), according to ICD-10 criteria. The following parameters were analyzed: number of episodes, number of times hospitalized, onset age, frequency and nature of psychotic symptoms, family history of psychiatric disorders and socio-demographic characteristics (age, sex, marital status). Data were obtained by direct interview and patient files. Symptom severity was measured with Brief Psychiatric Rating Scale (BPRS).ResultsThere were no significant differences between the two samples regarding age or sex distribution. Schizoaffective patients were more frequent unmarried (P = 0.007). Onset age was significantly lower in SAD patients (22.41 years for SAD, 28.36 years for BD). SAD patients had the highest number of episodes and needed more frequent hospitalization. Bipolar patients had higher percentage of family history of affective disorders when compared to schizoaffective patients (41% versus 36%). Hallucinations were more frequently found in schizoaffective patients than in bipolar patients (P = 0.004). We found no significant differences between the two samples regarding the presence or the type of delusions. The SAD sample had significantly higher BPRS total scores than bipolar patients (P = 0.035).ConclusionsAlthough this study revealed numerous similarities between BD and SAD, it also identified differences that may be helpful in establishing the correct diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Temporality in mania: Phenomenological, neurobiological and therapeutic consequences
Authors: Schwartz M. , Moskalewicz M. , Schwartz E. , Wiggins O. 
Published: June 2017

Manic disturbances of temporality are underemphasized in present-day accounts. For example, they are not included among criteria for manic episodes in DSM or ICD. Nonetheless, as already claimed by Binswanger (1964), aberrant temporality is core to the disorder. Persons with mania live almost exclusively in the present and hardly into the future. Especially in the larger scheme of things, their future is already here. There is no “advancing, developing or maturing,” anticipations have been achieved, all that I strive for is present – if you will just get out of my way! A half century ago, Binswanger spelled out this temporal foundation for mania and summed up consequences. The manic self, not living into the future, “is not, to borrow a word, an existential self.”This presentation will describe phenomenological characteristics of such a manic self and then present correlating findings from contemporary neuroscience. Importantly, such findings clarify present and future therapeutic interventions. Of critical importance is manic chronobiology: clocks in our brains afford receptor sites for the lithium ion. At these sites, lithium potently inhibits the circadian rhythm regulator glycogen synthase kinase 3 and alters the biological cascade that follows. By taking a close look, we can comprehend implications for mania as well as for treatment with lithium: Neurobiologically, lithium disrupts manic rhythm dysregulation and restores a more “normalized” temporality. The consequence is no less than the return of the existential self.A receptor mechanism of action for lithium additionally portends future specific and safer treatment options “after lithium.”Disclosure of interestThe authors have not supplied their declaration of competing interest.