bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is it Time to Characterize Burnout as a Depressive Syndrome? A Review of Recent Research
Authors: Bianchi R. , Schonfeld I.S. , Laurent E. 
Published: June 2017

IntroductionMore than 40 years after the introduction of the construct in the literature, the status of “burnout” remains unclear. Whether burnout is anything other than a depressive syndrome has been increasingly discussed in recent years.ObjectivesWe examined the extent to which burnout can be considered distinct from depression.MethodsWe reviewed the literature dedicated to burnout-depression overlap over the last decade.ResultsRecent research suggests that burnout and depression overlap in terms of (a) etiology, with (chronic) unresolvable stress a common, key causal factor, (b) clinical picture and course, with burnout and depressive manifestations inextricably linked such that they increase or decrease together over time, (c) cognitive biases, with burnout and depressive symptoms similarly predicting increased attention to negative stimuli and decreased attention to positive stimuli, (d) dispositional correlates (e.g, neuroticism, rumination, pessimism), and (e) allostatic load—an index of the biological cost of adaptation to life adversity. Hypocortisolism has been linked to both burnout and depression with atypical features—a highly prevalent form of depression. The often-invoked argument that burnout is singularized by its job-related character is actually invalid given that (a) depression can also be job-related and (b) the “job-relatedness” of a syndrome is not nosologically discriminant in itself.ConclusionsRobust evidence that burnout overlaps with depression has accumulated in recent years. The burnout construct is unlikely to capture a distinct pathological phenomenon. We propose that burnout be characterized as a depressive syndrome for the sake of conceptual parsimony, theoretical clarity, and effective public health policies.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Antidepressants Augmented with Aripiprazole in the Treatment of Major Depressive Disorder
Authors: Bise S. , Sulejmanpasic G. , Begic D. , Ahmic M. 
Published: June 2017

IntroductionMajor depressive disorder (MDD) does not consistently respond to any single antidepressant (AD) therapy. Adjunctive therapy with atypical antipsychotics (AA) showed higher response rates compared with AD monotherapy. Aripiprazole, an oral quinolinone, is the first AA agent to be approved in the US as adjunctive treatment in adult patients with MDD.Aim The aim was to evaluate the efficacy and safety of adjunctive low-dose aripiprazole combined with AD versus AD monotherapy in patients with MDD with minimal improvement after 4 weeks of prior AD monotherapy.MethodsTen patients with MDD and a history of minimal improvement to 4 weeks of AD monotherapy (escitalopram 10–15 mg/day, sertralin 50–100 mg/day) were included in this study. The patients were randomly assigned to 2 groups: one (n = 5) with AD plus aripiprazole 5–7.5 mg/day and the other (n = 5) with AD alone. After baseline assessment, the subjects were followed up at weeks 2, and 4. The primary efficacy was the mean change in (HAM-D17) and CGI-I.ResultsThe aripiprazole group exhibited significantly better efficacy than the AD group in mean total score changes of HAM-D17 and CGI from the baseline to weeks 2, and 4. The item “work and social activities” of HAM-D 17 showed significant improvement at week 4, and the item “somatic symptoms (GI)” showed significant improvement at week 2.ConclusionsAdjunctive aripiprazole therapy significantly improved depressive symptoms in MDD who didn’t respond to AD monotherapy. Aripiprazole augmentation is an efficacious, well-tolerated and safe treatment for patients with MDD.
Remote Cognitive Behavior Therapy for Obsessive-compulsive Disorder in Egypt: A Randomized Trial
Authors: Aly R. 
Published: June 2017

IntroductionRecently, cognitive behavior therapy has gone from being a promising new treatment to the most well established psychological treatment. In several hundreds of randomized controlled trials, it has shown effectiveness in treating obsessive-compulsive disorder. In addition, CBT is thus a highly promising treatment from a societal cost-effectiveness perspective.ObjectivesSeveral forms of CBT have been developed using remote communication methods, the general idea is that CBT delivered through the Internet or using telephone communication reflects the content of conventional CBT, but is administered as a form of therapist-guided treatment protocol.AimsEstimation of applicability and efficacy of remote cognitive behavior therapy for treating patients suffering from obsessive-compulsive disorder in Egypt.MethodsA group of patients suffering from obsessive-compulsive disorder was randomized into two groups; one received CBT as usual and the intervention group received CBT using telephone and/or the Internet. Both groups were assessed pre– and post treatment using the Yale Brown Scale for OCD symptom severity and Beck depression inventory for symptoms of associated depression. The quality of life scale was also applied to all patients participating in the study.ResultsPre– and post-study measures indicated a statistical and clinically relevant change in patients of two groups.ConclusionsDelivering CBT for patients suffering from OCD in Egypt using remote communication methods appears to be effective in alleviating symptoms and improving the quality of life. Yet some adaptations to the standardized treatment protocol are mandated to render the protocol applicable through remote communication and enhancing cultural reception.
Forensic Psychiatric Assessment of Individuals with Mental and Behavioral Disorders Due to Use of Alcohol, who Committed Homicide
Authors: Survilaite A. 
Published: June 2017

IntroductionThe rate of pure alcohol consumption per capita in Lithuania is reported to be one of the highest in Europe Union. Many studies illustrate the relationship between alcohol and violent crimes. Though dual diagnosis of severe mental disorder and alcohol dependency is common.AimTo evaluate peculiarities of mental status of individuals with mental disorders due to use of alcohol, who had committed homicide.MethodsForensic psychiatry examination reports in alcohol consumption cases and homicide acts (n 110) were taken from archive of national service of forensic psychiatry in Lithuania, 2010–2014.ResultsIn total, 93% (n 91) men and 100% (n 12) women at the time of homicide act were under the influence of alcohol. A total of, 83% (n 91) of cases reported impulsiveness, emotional lability and personality degradation due to long term of alcohol consumption; 52% (n 57) of cases motives for violence remained unclear: offenders indicated they remember nothing because of alcohol intoxication, also possible malingering was evaluated. In total, 100% women (n 12) and 97% men (n 95) were criminally responsible. Only 2 individuals committed homicide as a result of psychosis due to paranoid schizophrenia and 1 individual had significant intellectual deficiency due to moderate mental retardation, which lead them to inability to appreciate the dangerous nature of their acts and to control their behavior. Compulsory medical treatment was recommended to all three of them.ConclusionImpulse control deficiency and emotional lability are prevalent amongst homicide offenders with mental disorders due to use of alcohol. Only 3 individuals were irresponsible for their criminal acts as a result of severe mental disorders.
Facial Emotion Recognition Ability in Psychiatrists, Psychologist and Psychological Counselors
Authors: Dalkiran M. , Yuksek E. , Karamustafalioglu O. 
Published: June 2017

ObjectivesAlthough, emotional cues like facial emotion expressions seem to be important in social interaction, there is limited specific training about emotional cues for psychology professions.AimsHere, we aimed to evaluate psychologist’, psychological counselors’ and psychiatrists’ ability of facial emotion recognition and compare these groups.MethodsOne hundred and forty-one master degree students of clinical psychology and 105 psychiatrists who identified themselves as psychopharmacologists were asked to perform facial emotion recognition test after filling out socio-demographic questionnaire. The facial emotion recognition test was constructed by using a set of photographs (happy, sad, fearful, angry, surprised, disgusted, and neutral faces) from Ekman and Friesen's.ResultsPsychologists were significantly better in recognizing sad facial emotion than psychopharmacologists (6.23 ± 1.08 vs 5.80 ± 1.34 and P = 0.041). Psychological counselors were significantly better in recognizing sad facial emotion than psychopharmacologists (6.24 ± 1.01 vs 5.80 ± 1.34 and P = 0.054). Psychologists were significantly better in recognizing angry facial emotion than psychopharmacologists (6.54 ± 0.73 vs 6.08 ± 1.06 and P = 0.002). Psychological counselors were significantly better in recognizing angry facial emotion than psychopharmacologists (6.48 ± 0.73 vs 6.08 ± 1.06 and P = 0.14).ConclusionWe have revealed that the pyschologist and psychological counselors were more accurate in recognizing sad and angry facial emotions than psychopharmacologists. We considered that more accurate recognition of emotional cues may have important influences on patient doctor relationship. It would be valuable to investigate how these differences or training the ability of facial emotion recognition would affect the quality of patient–clinician interaction.
Deaf Blindness and Mental Health – Prevalence of Mental Disorders of an Upper Austrian Outpatient Service
Authors: Fellinger M. , Sacherer E. , Fellinger J. 
Published: June 2017

IntroductionPeople with deaf blindness are a vulnerable group concerning mental health problems. Due to their constraints in orientation, mobility, access to information and communication they often suffer from a lack of interpersonal relationships and accessibility to health care.AimsTo assess the prevalence of mental disorders in patients with deaf blindness and exam associations with forms of communication.MethodsA retrospective data evaluation of all outpatient charts of patients treated between 2000–2013 in a specialized outpatient unit that provides primary care for all deaf people for the whole catchment area of Upper Austria was conducted. Data were analysed regarding the degree of visual and hearing impairment and the presence of a mental disorder.ResultsForty-seven of 1500 patients were identified as deaf blind including 12 suffering from Usher Syndrome. Of those 29 (61.7%) were at least once diagnosed with a mental disorder, most frequently with a mood disorder (MD) (F30–F39) in 40.4%; an anxiety, stress-related, somatoform disorders (AD) (F40–F49) in 12.8% and a schizophrenia, schizotypal and delusional disorders (F20–F29) in 10.6%. Deaf blind patients suffered compared to deaf patients more often from a MD (40.4% vs.11.3%) however less often from a AD (12.8% vs. 32.6%). No significant association between the form of communication and being diagnosed with a mental disorder could be found.ConclusionPatients with deaf blindness suffer to a high extend from mental disorders, especially MDs. It is of utmost importance to reduce the burden of this population and improve access to specialized services to diminish isolation as major risk factor.
Poor CYP2D6 and Ultrarapid CYP2C19 Metabolizer: Clinical Challenge in Psychiatric Treatment
Authors: Dlugauskas E. , Lengvenyte A. , Strumila R. , Utkus A. 
Published: June 2017

IntroductionFinding the right medication in psychiatry can be very demanding both for the doctor and for the patient. It becomes extremely grueling when the patient has a rare type of metabolizing enzymes, and many drugs may be ineffective or cause side effects.ObjectivesTo highlight the therapeutic difficulties in psychiatric treatment of the patient with complex genetic cytochrome P450 system alterations.AimsTo provide an example on a complicated treatment course of the patient that is poor CYP2D6 and ultrarapid CYP2C19 metabolizer.MethodsLiterature review in scientific database–Pubmed–and case report presentation.ResultsWe report a case of a woman in her early twenties who was repeatedly referred for psychiatric treatment. A diagnosis of paranoid schizophrenia was established, but all treatment rounds were unsuccessful, the illness kept progressing, and major depressive disorder aggravated the clinical picture. The patient became suicidal and injured herself. During the sixth hospitalization in one year the CYP2D6, CYP2C19 and CYP2C9 genotyping was done. CYP2C19 ultrarapid (*1/*17) and CYP2D6 poor metabolizer (*4/*5) profile was discovered. Drugs, that should have been avoided due to the patient's genetic profile, had been prescribed throughout five hospitalizations in a row.ConclusionsAs ultrarapid CYP2C19 metabolizers compose around 3–4% and poor CYP2D6–6–10% of Caucasians, this case presents a rare genetic variant that only 0.18–0.4% of Caucasian population may have. These cases can be extremely clinically challenging and affect healthcare outcomes and costs. Further studies that would include clinical effectivity, drug concentration and genetic testing results are needed.
Help-seeking and psychological distress in university students: Findings from a cross-sectional online survey in the UK
Authors: Wadman R. , Webster L.A.D. , Stain H. 
Published: June 2017

IntroductionWith most mental health disorders emerging in the later teenage years, university students are arguably an at-risk population with increased mental health support needs. This population is characterised by important, life-changing transitions (moving away from home, friends and family) and new potential stressors (including increased academic pressures and relational challenges). Research to examine determinants of mental health help-seeking behaviours in university students is needed to ensure emotional health needs are being met at this critical time.ObjectivesTo examine levels of psychological distress and mental health help-seeking behaviours in a sample of UK university students. By identifying factors associated with help seeking, we can better understand the mental health needs of this population and inform support provision.MethodsThis study draws on data from the social and emotional well-being in university students (SoWise) study, an online survey which aimed to examine risk and resilience for social and emotional well-being in young people attending a UK university.ResultsWhole sample analysis (n = 461) showed help seeking was significantly associated with psychological distress, current life stressors and anxious attachment and not associated with perceived mental health stigma. Sub-group analysis (n = 171) suggests being female and older significantly predicted help seeking in students with mild/moderate psychological distress.ConclusionsYounger males with mild/moderate psychological distress are less likely to seek mental health support and represent an “invisible” at risk group. Results also suggest that global anti-stigma campaigns in universities may not prove effective in encouraging help seeking.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Antipsychotics and Driving Ability
Authors: De las Cuevas C. 
Published: June 2017

Driving a vehicle is an important everyday life skill associated to a psychiatric patient's autonomy and identity. Nevertheless, the right to drive is not a right at all, it is a privilege granted and regulated by rules and restrictions from the States that have also the duty to pull this privilege and deny the ability to legally drive in potentially unsafe drivers. The decision about for whom and when to forbid driving is a difficult matter of judgment that must remain a clinical and professional judgment within the medical encounter. Both antipsychotics as the psychiatric disorders target of these psychoactive drugs produce changes of psychomotor performance that can interfere with the ability to drive safely. Moreover, it is really hard to distinguish between the effects of the disease itself as opposed to the effects of the medication when studying the interaction between antipsychotics and driving ability. Previous results of our research in the field indicate that psychiatric patients who improved clinically after drug treatment also showed improvements in driving ability. So, adequate psychotropic treatment causes a positive effect on driving performance that outweighs the possible deleterious effect of medication. However, it remains essential to supply mental health professionals with new information, which is quantitatively and qualitatively valid, on the role of antipsychotics in driving ability. The purpose of the present lecture is to review research undertaken to-date on the effects of antipsychotic medications on driving ability. A search of various databases, including Medline, Embase and PsycInfo, will be conducted.Disclosure of interestThe author declares that he has no competing interest.
Extrapyramidal side effects and functional remission in schizophrenia
Authors: Ghajati B. , Leila C. , Raja L. , Majda C. 
Published: June 2017

Treating patients with schizophrenia has evolved towards including, as an effective goal, their functional remission. Beyond the discrepancies in this concept definition, a plethora of studies has been conducted trying to identify predictors of functioning in schizophrenia. Among which antipsychotic prescription and related side effects.AimExplore extrapyramidal side effects link with functional prognosis of patients with schizophrenia spectrum disorder.MethodsWe conducted a cross-sectional, retrospective and descriptive study in the psychiatry department “C”, in Razi hospital (Tunis), between October 2014 and March 2015. Sixty patients suffering from schizophrenia spectrum disorder (DSM IV-R) were included. Functional status was explored with the Global Assessment of Functioning Scale (GAF), the Social and Occupational Functioning Assessment Scale (SOFAS) and the Social Autonomy Scale (EAS). Extrapyramidal side effects (EPS) were evaluated using the Simpson and Angus Rating Scale (SAS).ResultsFunctional remission was achieved according to GAF, SOFAS and EAS in respectively: 63,30%, 48,30% and 51,70% of the patients. SAS mean score was 0.898 ± 0.29 (0.4–2). Although SAS showed no significant association with GAF, SOFAS and EAS global scores, patient with less EPS had better autonomy in EAS’ dimension “Relationship with the outside” (P = 0.048).ConclusionEPS may influence functional remission at several levels starting from the neurobiological to the social stigmatization and the treatment adherence levels. Further research in this matter is required.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Functional connectivity of the ventral tegmental area and avolition in schizophrenia: A resting state functional MRI study
Authors: Giordano G.M. , Stanziano M. , Mucci A. , Papa M. , Galderisi S. 
Published: June 2017

IntroductionImpaired motivation is considered a fundamental aspect of the Avolition domain of negative symptoms. The ventral tegmental area (VTA) contains the highest number of DA neurons projecting to the brain areas involved in motivation-related processes.AimThe aim of our study was to investigate by functional MRI the resting-state functional connectivity (RS-FC) of the VTA in patients with schizophrenia and its relationships with real-life motivation and avolition.MethodThe RS-FC was investigated in 22 healthy controls (HC) and in 26 schizophrenia patients (SCZ) treated with second generation antipsychotics only and divided in high (HA = 13) and low avolition (LA = 13) subgroups. We used the Quality of Life Scale and the Schedule for the Deficit Syndrome to assess real-life motivation and avolition, respectively.ResultsHA, as compared to LA and HC, showed a reduced RS-FC of VTA with the right ventrolateral prefrontal cortex (R VLPFC), right posterior insula (R pINS) and right lateral occipital cortex (R LOC). The RS-FC for these regions was positively correlated with motivation in the whole sample and negatively correlated with avolition in schizophrenia patients.ConclusionOur findings demonstrate that motivational deficits in schizophrenia patients are linked to reduced functional connectivity in the DA circuit involved in retrieval of the outcome values of different actions to guide behavior. Further characterization of the factors modulating the functional connectivity in this circuit might foster the development of innovative treatments for avolition.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Adverse Childhood Experiences, Personality Disorders and Addiction: Which Relationship?
Authors: Cerrato F. , Aluisio G. , Casadio P. , Di Girolamo G. , Valente S. , De Ronchi D. , Atti A.R. 
Published: June 2017

IntroductionStressful or traumatic events occurred during childhood do have a role in the genesis of personality disorders. Less is known about this remarkable association in people with addictive behaviors.AimsThis study aims to disentangle the relationship between childhood adverse experiences, personality disorders (PDs) and substance use disorders (SUDs).MethodsA cross-sectional naturalistic study of 320 consecutive SUDs outpatients attending an Italian addiction service. Participants were clinically evaluated by a semi-structured interview, the SCID-II (Structured Clinical Interview for DSM-IV Axis II PD), and the CECA-Q (Childhood Experience of Care and Abuse-questionnaire). Multivariate logistic regression analyses were used to estimate odds ratio (OR) and 95% confidence intervals (95% CI)ResultsThe prevalence rate of PDs in our sample of patients is 62.2%. PDs were associated with a history of physical punishment in childhood (OR = 1.82; CI 95%: 1.05–3.16; P = 0.034). Being exposed to three adverse events increases the risk of Cluster B PD (OR = 5.92; CI 95%: 2.21–15.92; P < 0.001). Heroin addiction increases the risk of Cluster B PD, both as previous (OR = 2.93; CI 95%: 1.49–5.75; P = 0.003) or current (OR = 4.34; IC 95%: 1.97–11.8; P = 0.004) consumption. Childhood institutionalization increases the probability of cluster B PD (OR: 2.15; CI 95%: 1.02–4.54; P = 0.041). Whereas being employed reduces the probability of both PDs and SUDs (OR = 0.54; CI 95%: 0.31–0.93; P = 0.027).ConclusionsPDs occurred in 62% of patients and were related to adverse childhood experiences and SUDs having detrimental effects on both social and occupational functioning. Being employed could be a protective factor on the development of PDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Concentration of the Factors Involved in Trafficking of Stem Cells in Long-Term Treated Bipolar Disorder Patients
Authors: Kucharska-Mazur J. , Reginia A. , Jabłoński M. , Dołęgowska B. , Rybakowski J. , Ratajczak M.Z. , Samochowiec J. 
Published: June 2017

IntroductionAfter analysis of biological and pharmacological data, we formulated the hypothesis that the factors involved in trafficking of stem cells could be engaged in aetiology of bipolar disorder (BP).AimsIn this study, we considered the role of complement cascade proteins, stromal derived factor-1 (SDF-1), and sphingosine-1-phosphate (S1P) in long-term treated BP.MethodsA group of 30 patients with BP, without the history of lithium treatment, was examined in remission and compared with a group of 30 healthy volunteers. In peripheral blood, we have analysed the concentration of stromal derived factor-1 (SDF-1), sphingosine-1-phosphate (S1P), and some proteins of the complement cascade (C3a, C5a, C5b-9).ResultsPeripheral blood concentration of C3a, C5a, C5b-9 and SDF-1 was significantly higher in BP group compared to control group. The concentration of S1P does not distinguish BP patients from controls.ConclusionOur results suggest the possible role of the regeneration system in aetiology of BP.This work was supported by grant POIG.01.01.02-00-109/09.Disclosure of interestThe authors have not supplied their declaration of competing interest.