bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive fusion: Maladaptive emotion regulation endangering body image appreciation and related eating behaviours
Authors: Marta-Simões M. , Ferreira C. , Mendes A.L. 
Published: June 2017

Body image-related cognitive fusion is described as the perception that undesired and distressing internal events related to body image are reliable representations of reality. This maladaptive emotion regulation process is known for its impact on human suffering, namely eating psychopathology. On the contrary, body appreciation is a positive body image construct, defined as an attitude of acceptance and affection toward one's body image characteristics, despite some level of dissatisfaction. Although body appreciation associates negatively with several pathogenic processes, its relationship with body image-related cognitive fusion is still unexplored. The present study intended to analyse the power of body image related cognitive fusion regarding its impact on body appreciation, and also on the engagement in disordered eating. The study's sample comprised 308 women, aged between 18 and 35. A path model tested the mediator role of body image related cognitive fusion in the relationship between body image dissatisfaction and body appreciation, and eating disorders symptomatology, controlled for the effect of body mass index.The tested model accounted for 67% of the variance of disordered eating. Body image related cognitive fusion appeared as a significant mediator of the association between body dissatisfaction and body appreciation. Body appreciation presented a significant direct effect on eating disorders symptomatology. These findings highlight the disturbing effect of cognitive fusion related to body image on the construction of a positive body image, presenting an impact on the engagement in disordered eating. In this line, cognitive fusion may be a pertinent target in clinical practice and also within eating disorders prevention.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Incidence of dissociative stupor and possession in a private psychiatry clinic
Authors: Dua D. , Dua P. 
Published: June 2017

IntroductionDissociative and conversion disorders are reported to have a present incidence of about 85–100per 1000 by different studies, which are very few. The present research is a part of a longitudinal study of 15 years but here; only 3 years are represented, which could be briefly analyzed.ObjectiveLatest reports suggest a decline in incidence of hysteria (conversion and dissociation) and this research just tries to reconfirm.MethodsAll new patients attending a private psychiatry OPD in a small township of India at Lakhimpur Kheri in Uttar Pradesh, were screened to identify cases of dissociative disorder according to ICD 10, F44.2 and F44.3 from the 1st of January 2016 to 31st of October 2016 (10 months). These screened cases, only those presenting with fits of unconsciousness and possession, were analyzed and compared with the previous years for the same period.ResultsOut of a total of 3671 patients seen, (2122 males and 1549 females) a total of 319 presented with the above mentioned symptoms (58 males and 261 females) about 87 per 1000 of psychiatric patients.ConclusionThe results, when compared with two previous years for the same period were quite similar, 2015 getting incidence of 97 per 1000 and 2014, an incidence of 89 per 1000. The inference thus is that there does not seem to be any decline of incidence and the figure would be much higher if both conversion and dissociative symptoms are included – a really serious situation.Disclosure of InterestThe authors have not supplied their declaration of competing interest.
Services utilization for mental health problems in Portugal during the economic crisis: Preliminary results of the national mental health survey follow-up
Authors: Silva M. , Antunes A. , Frasquilho D. , Cardoso G. , Caldas-de-Almeida J.M. 
Published: June 2017

IntroductionDuring economic crises additional mental health risks emerge and social inequalities in health can widen. In order to ensure universal coverage of mental health care and to reduce the impact of the crisis, it is crucial to assess the needs of the population to be able to reorganize mental health care accordingly.ObjectivesTo analyse the use of services for mental health problems in Portugal during the economic crisis.MethodsIn this follow-up epidemiological study, a probability sub-sample of respondents to the 2008 national mental health survey (n = 911) was re-interviewed in 2015. Socio-demographic variables and treatment patterns were assessed using a structured interview, and psychological distress was measured using the Kessler-10 Scale. Descriptive analysis was conducted to characterize the use of services for mental health problems.ResultsIn total, 27.9% of the respondents sought treatment for mental health problems in the previous 5 years, and GPs were the most contacted professionals. Only 57.7% (n = 119) of the respondents with moderate or severe psychological distress (n = 197) reported recognizing they needed treatment. Among people with moderate or severe psychological distress who recognized their need for treatment, most received treatment (80.5%, n = 105), which was minimally adequate for 74.4% (n = 81). Low perceived need and structural barriers were the main obstacles for access to care.ConclusionsUnder-treatment, low continuity of care and low adequacy of treatment are problems that the Portuguese health system must address in order to meet the mental health challenges of the economic crisis.FundingEEA Grants: Programa Iniciativas em Saúde Pública.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Is a psychiatrist-patient confidentiality relationship subservient to a greater good?
Authors: Berrios G.E. 
Published: June 2017

Before embarking in a fruitless exchange the title question must be unpacked:– is the ‘psychiatrist-patient confidentiality relationship’ a subset of the general doctor-patient confidentiality relationship?– if different, what causes the difference? Is it the nature of mental disorder, for example the fact that some mental disorders may impair ‘mental capacity’ in ways different from general medicine?– given that in addition to psychiatrists, psychologists, nurses, and social workers also enter into ‘confidentiality relationship’ with patients, should all be considered as tokens of the same type or as different types? If the latter, should such differences be considered as intrinsic or extrinsic? Intrinsic differences refer to structural dissimilarities; extrinsic differences to dissimilarities created by the respective legal frames imposed by each profession to its practitioners.– is ‘subservience to a greater good’ an acceptable good way to describe the metier upon which the ethical scrutiny will be applied? Given that it does describe a ‘consequence’ of the process then it would seem that it prematurely opts for utilitarianism, an ethical theory that many may feel is not adequate to the case.The general question and the pre-formulated debating positions are setting up a pseudo-debate. A more useful question should be: “Given the strong political and economic pressures being currently brought to bear upon all confidentiality relationships (held by priests, medics, lawyers, bank workers, etc.), what ethical system may be more convenient to:– justify blatant breaches in confidentiality relationships;– placate our moral conscience?”Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Towards an EU research framework on forensic psychiatric care: Introduction, structure, activities and results of cost action Is1302
Authors: Castelletti L. , Scarpa F. 
Published: June 2017

IntroductionForensic psychiatric care is aimed at improving mental health and reducing the risk of recidivism of mentally ill offenders. For some mentally disordered offenders long forensic psychiatric care is required. Due to different legal framework, policies and resources in member countries, treatment programs and care provided for these subjects may vary substantially across Europe.ObjectivesCOST Action IS1302, a EU project aimed at establishing a European network of researchers, clinicians and service providers about long-term forensic psychiatric care, has involved nineteen European countries for 2013 to set the basis for comparative evaluation and research on effective treatment and the development of best practice in long-term forensic psychiatry in Europe.MethodIt is constituted by three main areas of interest and research. One group works on determination of patient characteristics, looking into prevalence, duration of stay and the most determinant characteristics of long term patients. The second area of research aims at obtaining better understanding of complex external factors that influence the poor progress of patients residing for an above average time in forensic services. Third group of research focuses on knowledge about specific needs brought about by psychiatric symptoms and how these specific needs might optimize the quality of life of patients in long term forensic psychiatric care.Results/conclusionsLaunched four years ago, the action is at its last of activities. We display features, activities and data emerging from the research conducted so far.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Substance use among male forensic patients
Authors: Mezghani M. , Fkih-Romdhane F. , Ghali F. , Jmii G. , Zghal M. , Jouini L. , Ghazeli I. , Ridha R. 
Published: June 2017

There is a widespread use of substances abuse which might cause violence, suicide, interpersonal conflicts, lawsuits, psychiatric commitment, and even crimes. Psychiatrists are under increasing pressure to develop strategies to address the problem of coexisting criminal behaviour, addiction, and mental illness. The aim of this study was to examine the association between demographic profile, psychiatric symptomatology and substance use in forensic psychiatric inpatients, and to consider the treatment needs and opportunities for intervention among the same sample.MethodologyA retrospective study was done on patients admitted to the department for Forensic Psychiatry at the Razi Hospital from 1996 to 2016, initially jailed for detention and drug consumption and judged irresponsible by reason of insanity. Data were collected by record review.ResultsThirty-two patients were included in the study. Mean age was 27.81 years. Thirty-six percent of the participants were illiterate and 45% were single. More than half of the subjects (54%) had personal psychiatric history and 27, 27% had family history of psychiatric problems. About one third (31.81%) of participants had judicial background: 33% were arrested for public drunkenness, 44% were arrested for violence, and 22% were arrested for theft. Concerning the diagnosis, 45% were suffering from schizophrenia, 22.77% were diagnosed with personality disorder and 27.27% of them would not have any mental trouble. About 50% of the patients did not follow up with treatment.ConclusionAddictive disorders are authentic psychopathological disorders. Effective treatment is hindered by the paucity of research on clinical application of treatment models for addictive disorders in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Forensic psychiatric expertise of patients with anti-social personality
Authors: Turki M. , Charfi N. , Maalej Bouali M. , Ben Thabet J. , Zouari N. , Zouari L. , Maalej M. 
Published: June 2017

IntroductionEpidemiological studies in the general population confirm the indisputable link between criminological dangerousness and mental disorders especially anti-social personality, which increase clearly the prevalence of violent behavior.AimTo dress socio-demographic, clinical and medico-legal profile of offenders, with anti-social personality, in forensic psychiatric examination.MethodsIt was a retrospective study of a series of 195 patients with antisocial personality (DSM-IV). They were examined, during the period, from 2009 to 2013, on the occasion of a penal expertise in the department of psychiatry C in the Hedi Chaker university hospital, Sfax, Tunisia.ResultsThe mean age of patients at the offense moment, was 29.58 years, with a sex ratio of 26.85. Among them, 66.2% were single, 49.2% had a primary school level and 41% had no profession. Between the patients, 58.5% lived in urban area and 38.5% in a high crime area. Addictive behaviors were reported in 80% of cases. Self-injury behaviors were noted in 33.8% of offenders. Psychiatric histories were reported in 66.2%, and 25.6% of patients have been already hospitalized in psychiatry department. 64.1% had already committed forensic acts, and 36% had been imprisoned at least once. The current offense was: homicide 16.9%; sexual offense 9.2%; violence 18.5%; theft 30.2%. The offense was related to impulsivity (40%) or utilitarian purpose (39%).ConclusionA young single man with no profession, a limited educational attainment and a history of impulsive behaviors, such is the profile most frequently encountered among offenders with anti-social personality. Interventions for reducing forensic behavior should focus on those social and clinical characteristics.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Criminal insanity and psychiatric diagnoses in Greek penal cases
Authors: Tzeferakos G. , Papaliaga M. , Papageorgiou C. , Bali P. , Douzenis A. 
Published: June 2017

IntroductionTo our knowledge, few studies address the issue of criminal responsibility among psychiatric offenders. In Greece, articles 34 and 36 of the penal code regulate criminal insanity and diminished responsibility, respectively.ObjectivesThe objective of the present study was to provide psychiatric/legal data considering the appeal to articles 34/36 of the Greek penal code.MethodsLegal case files of 100 adult subjects, 90 male/10 female, 88 Greeks/12 foreigners were examined.ResultsAccording to the first degree court, one defendant was found criminally insane, 29 with partial responsibility, while the rest were regarded as fully capable. The decisions of the court of appeal/the supreme court of appeal were 2 criminally insane, 36 partially responsible and 62, fully criminally responsible. The decisions were unanimous in 78% of the cases.The most common diagnoses were schizophrenia spectrum psychosis (18%), antisocial/borderline/mixed personality disorder (15%) and substance use disorder (15%). Court decisions of criminal insanity/diminished responsibility were higher when the perpetrator had an Axis I diagnosis (47.5%), significantly lower in cases of personality disorder (22.2%) and even lower in cases of substance use disorder (16.7%). In patients with prior hospitalizations the percentage of criminal insanity/diminished responsibility was 55.6%, significantly higher than in cases without (24.4%).ConclusionsSchizophrenia is the most common mental disorder correlated with offenders criminally insane/partially responsible, while a history of psychiatric hospitalization is a very strong positive predictive factor for the successful appeal of the aforementioned articles.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Evaluation of serum microRNA expression profile in panic disorder patients
Authors: Çökmüş F.P. , Özmen E. , Alkın T. , Batır M.B. , Çam F.S. 
Published: June 2017

IntroductionEven though it has begun to be investigated in recent years, studies of microRNA (miRNA) in anxiety disorders are limited. Our research is the first miRNA expression study in panic disorder, which excludes of drug use and additional psychiatric disorders.ObjectiveWe aimed to determine the availability of miRNAs as biomarkers in the serum levels of panic disorder and to demonstrate the changing expression of miRNAs.MethodsIn the research, 35 panic disorder patients and 35 healthy controls were administered a socio-demographic and clinical information form, SCID-I, PDSS. 2 tubes of peripheral venous blood were taken from each group for genetic evaluation. miRNA expression analysis was performed in those samples by the RT-PCR method.ResultsCompared with the healthy control group, 8 miRNA expression levels were found different in panic disorder group. Five of them were up-regulated and 3 of them were down-regulated. There was no correlation between the level of miRNA expression and PDSS total score and PDSS sub-items. miR-1297 and miR-4465 expression levels were statistically significant between the two groups. Both miRNAs are also known to arrange the gene regions that affect GABAA receptor subtypes.ConclusionsmiR-1297 and miR-4465 regulate the GABAA gene that is thought to play a role in the etiology of panic disorder (Wong et al., 2014, Wang 2016). In panic disorder group, miR-1297 and miR-4465 expression levels were found to be up-regulated from the healthy control group.Disclosure of interestThe authors have not supplied their declaration of competing interest.
An evidenced based checklist to support anti-dementia medication withdrawal in people with down syndrome (DS), intellectual disability (Id) and dementia
Authors: Shankar R. , Ram S. 
Published: June 2017

DS with aging is associated with greatly increased risk of developing dementia similar to Alzheimer's. Anti-dementia drug discontinuation is recommended when clinical benefit is not determined. In DS it is more complex as medication ill effects of stopping needs to be weighed in balance to extraneous processes such as environment changes, sensory impediments and physical ill health and natural progression of dementia.AimCan identified risk factors extracted from a comprehensive literature review be developed into an evidence based check list to support risk minimized person centered withdrawal of anti-dementia drugs when considered not to be efficacious in DS?MethodA detailed literature review using Medline, PsychInfo, Cinahl and Embase with relevant search terms in various permutations and combinations without any date limit enquiring current evidence base on anti-dementia medication withdrawal was conducted. The review also looked to extract the common risk factors in stopping medication. All risk factors were collated, reviewed by a focus group of experts, developed into a checklist.ResultsThirty abstracts were obtained following the search. Six papers were short-listed. No papers identified a structured approach to medication reduction. An 18-factor checklist was applied prospectively to 30 cases. The checklist was sensitive to identify change to guide clinical decision-making.ConclusionsCurrently, decision to peg medication withdrawal risk is arbitrary and clinical in dementia especially in DS dementia. The evidenced based developed checklist is useful to support and structure clinical decisions. It helps clinicians and patients to focus on promoting safety, reduce harm and guide treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
REMOVED: Psychiatric social work needs of families having children with mental diseases in Turkey
Authors: Arslan E. , Akgül Gök F. , Duyan V. 
Published: June 2017

This has been removed as it was published accidentally. The authors listed wish it to be known that this article was not presented at the conference for which this volume is the proceedings.The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
Interdisciplinarity on the care of a mentally disordered person
Authors: Vasconcelos S.C. , Correia A.S.B. , Gouveia B.G. , Silva I.J. , Mendes M.S.G.C. , Moreira M.A.S.P. , Domingos E.S. , Leal A.S.L.G. 
Published: June 2017

IntroductionBrazilian's humanization policy offers the extended clinic as acting tool in health services, which advocates the use of soft technologies to provide care to its clientele.AimDiscuss the interdisciplinary mental health residents approach to the care of the person with mental disorder.MethodsExperience report, accomplished by experiences of mental health's multidisciplinary residency members, which is in a lato sensu postgraduate linked to the study center of collective health, of the Federal University of Paraíba, Brazil. Structured on two axes: face meetings; and singling out actions in the daily work.ResultsFrom the understanding of the extended clinic as a light technology interdisciplinary approach, in which different professional specialties share knowledge and co-responsible themselves for the mentally disordered patients’ care, Residents have used it as a articulation tool and insertion in the different care scenarios. When developing activities, the residents use guidelines indicated by the extended clinic in order to leverage the work done by the person with mental disorders. Among which stands out: the host, building links, qualified listening, the sensitization for the care co-responsibility, construction of the unique therapeutic project, intersectional actions and sharing care with other services that make up the health system.ConclusionExperiences like these made it possible to perceive the applicability of the National Policy of Humanization through its main tool, which is the extended clinic that contributes to the work process of a health team, promoting interdisciplinarity and raising the prospective to the look of transdisciplinary.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Descriptive Study of Adjustment Disorders in a Mental Health Unit.
Authors: González L. , Pecino B. , Gomez C. , Anibarro M. , Ortigosa C. 
Published: June 2017

IntroductionAdjustment disorders are a common psychiatric disorder in primary care and mental health units, with point prevalence estimates ranging from 0.9% to 2.3%. These disorders have been recently defined as a stress response syndrome in the fifth edition of the DSM, causing emotional and social difficulties and also a large economic burden on society.ObjectivesThe aim of this descriptional study was to analyse the socio-demographic characteristics and treatment of the patients diagnosed with adjustment disorders in the first visit in a mental health unit.MethodsThe study sample consisted of 128 patients admitted for a psychiatric consultation in a mental health unit in Alicante (Spain) from their primary care physician, between February and July 2016. Variables of gender, age, current employment status, diagnosis and treatment were measured. Data analysis was conducted using SPSS software.ResultsThe data from 31 patients who were diagnosed with adjustment disorders meant a 24% of the sample. The median age was 47 years old in the adjustment disorders group. Among those with adjustment disorders, 61% were women, and 52% of them were unemployed. Almost 60% of them had at least one pychotropic prescription and only 22% were derived to psychology.ConclusionsAdjustment disorders are considered as an intermediate category between no mental disorder and affective disorders. Most authors recommend to start with a psychotherapeutic intervention. Despite starting with medication has not proved effectiveness in the studies, most of the patients had at least one psychotropic prescription before the psychiatric evaluation.Disclosure of interestThe authors have not supplied their declaration of competing interest.