bluuebunny/crossref_metadata_2025_split huggingface dataset:
True story of Bangladeshi women with childhood trauma who heroically faced the trials of life
Authors: Hasan N. 
Published: June 2017

ObjectivesAt the conclusion of this presentation, the participants will be able to know how three women victim of childhood trauma; terribly suffered and tackled their situation. They were born in a developing Muslim country.This paper also intends to aware people about victims of childhood trauma and their need for mental and social support.MethodsPersonal interview with these three subjects who were close persons of the researcher. Description of their suffering and way of tackling it were noted. The words were carefully placed as a story.ResultsTwo of the subjects sexually abused by close relatives in their childhood. The third one was abused for as long time as 17 years. All the subjects suffered severely from headache and flatulence from childhood, insomnia and terrifying dreams, sense of insecurity, depression, PTSD.Despite all the grief and pain, these three became highly educated, holding well position in the society and directly indirectly working for distressed women.ConclusionsThe author concludes that childhood trauma can damage a victim in many ways in her entire life.Social support, sharing the incidents with others, counseling may reduce her pain.Religious acts like prayer, reading Holy Book, remembrance of Allah, serving humanity and helping distressed women may console the victim.These three women's heroic lives may give motivation for women with childhood trauma. Even they may inspire others to act like heroes in hardship of life.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Body shape perception among obese Tunisian women
Authors: Sellami R. , Moalla M. , Affes L. , Feki I. , Mnif F. , Abid M. , Masmoudi J. 
Published: June 2017

IntroductionIn today's societies, pressures from the idea of thinness are omnipresent and lead to a corporal dissatisfaction with an excessive preoccupation of the body's image. Obese persons are often targets of stigmatization and are vulnerable to negative feeling about their physical appearance.AimsTo evaluate the worries towards the weight and the shape of the body among obese women.MethodsOur study was a transversal study, descriptive and analytic. A total of 42 obese women were included. Obesity was defined by body mass index (BMI) ≥ 30 and divided into 3 classes: class I: moderate obesity (30 ≤ BMI ≤ 34.9); class II: severe obesity (35 ≤ BMI ≤ 39.9); class III: morbid obesity (BMI≥40). Patients were studied by mean of body shape questionnaire (BSQ-34) (Considering score BSQ < 80 lack of altered body image perception and score > 140 excessive preoccupation).ResultsThe mean age of participants was 33.6 years. The average BMI was 37.42 kg/m2 (30.45–56.26 kg/m2). Third (35%) of women had a high educational level, 41.4% were inactive, and 70.8% had an average socioeconomic level.The average BSQ score was 108.31 (47–188). The majority of women (78.1%) had excessive preoccupation about their body image. The BSQ score was correlated to morbid obesity (P = 0.014). Women aged between 20 and 3 years were significantly more preoccupied about their body image (P = 0.046).ConclusionMajority of obese women were preoccupied about their body image. Young women and those having morbid obesity seemed more preoccupied about their body image.Disclosure of interestThe authors have not supplied their declaration of competing interest.
When Your Patient Dies by Suicide; Aftermath and Implications
Authors: Sadock B. 
Published: June 2017

Over fifty percent of psychiatrists will have at least one patient die by suicide while in treatment and some will have more than one patient suicide during the course of their career. The impact of patient suicide on the personal and professional lives of those psychiatrists can be profound. Personally, many suffer a grief reaction than can progress to depression in some cases. Almost all experience a sense of shock upon first learning of the event. Feelings of guilt are also common. Professionally, many fear disapproval from peers and may never again treat a suicidal patient. Some psychiatrists leave the field completely or go into administration so that they never have to treat patients again.Surveys of training programs have found that most provide training in the assessment of suicide risk and in the management of the suicidal patient but there is minimal training in how to deal with the aftermath of a patient suicide. There is a need to teach and to help practicing psychiatrists, at whatever stage in their career, cope with the stress that occurs when one of their patients dies by suicide during the course of therapy. Important issues are how and when to contact family members and other survivors, whether or not to attend a funeral or memorial service and what and what not to do regarding discussing the case with others. The risk of litigation also is influenced by how psychiatrists behave after patient suicide occurs. The case of Ernest Hemingway is used as an example to illustrate some of these concepts.Disclosure of interestThe author declares that he has no competing interest.
Comparing the Effects of Cognitive Behavior Therapy or Regular Physical Exercise on Sleep in the Treatment of Patients with Panic Disorder
Authors: Hovland A. , Nordhus I.H. , Martinsen E. , Sjøbø T. , Gjestad B. , Johansen H. , Pallesen S. 
Published: June 2017

IntroductionSeventy percent of patients with panic disorder (PD) have sleep impairment. Cognitive behavior therapy (CBT) effectively treats PD, but the concomitant effect on sleep is understudied. Physical exercise (PE) improves sleep, but this has not been investigated in patients with PD.ObjectiveTo compare the effects of CBT or PE on sleep in PD-patients, and to determine potential mechanisms of action.MethodsThirty-six PD-patients were randomized to either group CBT for PD or regular PE. Sleep was assessed pre/post with the Pittsburgh sleep quality index. Effects were investigated with repeated measures ANOVA and t-tests. Expected mediators were added to the general linear model to assess mediation.ResultsThe effect of time was significant, F(1.33) = 10.11, P = 0.003, but not the interaction (Time × group), F(1.33) = .48, P = 0.49. Symptoms were significantly reduced from pre- to post-treatment: PE, t(16) = 3.03, P = .008, and CBT, t(17) = 2.18, P = 0.044. CBT-patients changed significantly (P < 0.05) on Sleep quality, t(17) = 2.47 and Sleep disturbance, t(17) = 2.38. PE-patients changed significantly on sleep duration, t(16) = 2.58 and sleep disturbance, t(16) = 2.58. A significant interaction with change in fear of bodily symptoms, F(1.16) = 5.53, P = .032, and with change in depression-level, F(1.16) = 12.13, P = 0.003 was only found for CBT. A significant interaction with change in physical fitness, F(1.15) = 5.01, P = .041, was only found for PE.ConclusionBoth interventions improve sleep in PD-patients, but differently. The findings also suggest that these changes are related to different mechanisms for PE and CBT.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Utilization Unspecialized Care of Patients with Anxiety Disorder
Authors: Marachev M. , Avedisova A. 
Published: June 2017

IntroductionThe greatest social and economic burden is divided between the three main anxiety disorders: social phobia (SF), generalized anxiety disorder (GAD) and panic disorder (PD).ObjectivesTo examine the pathways of patients with PD, SF and GAD since the beginning of the first anxiety symptoms and before the first course of a standardized treatment in a specialized mental health facility.AimsTo evaluate the period of delay in seeking specialized care and to identify the main ways of seeking medical/non-medical care.MethodsRetrospective study (n = 80). Structured interview were based on WHO instruments: WHO WMH CIDI and WHO Pathways to care encounter form.ResultsAverage age was 38 years, more females (72.5%). The delay period was 7 years (GAD = 8.7; SF = 8.2, PD = 5.9), during which at least 2 episodes of the disease. The most popular specialists were: neurologists (19%), psychiatrists (17%) (one-time visits to which were not accompanied by the appointment of a standardized course of treatment for an adequate period of time) and therapists (15%). Non-medical care was 10% of all studied (psychologists–5%, healers–3%, priests–2%). SF–psychiatrists (43%), therapists (14%), psychologists (14%); GAD–psychiatrists (22%), neurologists (19%), psychotherapists (11%), ambulance doctor (11%); PD–therapists (22%), neurologists (22%), ambulance doctor (17%), cardiologists (9%).ConclusionsThe findings suggest that patients with anxiety disorders have a long period of delay in receiving specialized care that causes the value of the social and economic burden of anxiety disorders in the community.Disclosure of interestThe authors have not supplied their declaration of competing interest.
First Psychotic Episode and Predictors of Bipolar Disorder Progression
Authors: Halouani N. , Yaich K. , Guermazi F. , Ennaoui R. , Chouayekh S. , Aloulou J. , Amami O. 
Published: June 2017

IntroductionMany studies on the identification and early treatment of psychotic disorders have focussed less on a solution to the issue of the evolution of an acute psychosis.ObjectiveTo identify some predictive elements of an evolution to bipolar disorder during a first psychotic episode.MethodsWe proceed with a retrospective study concerning 55 patients having developed a first psychotic episode and admitted in the psychiatry B department during the period extending between January 2010 and December 2015. Data were collected on a predetermined questionnaire exploring the following items (socio-demographic data, personal and psychiatric family antecedent, prodromes and psychotic episode symptomatology).ResultsOur sample was composed by 55 patients divided into 74% (n = 41) men and 26% (n = 14) women with a mean age of 26.5 ± 6.27 years. The evolution to a bipolar mood disorder concerned 22% of patients. The prodromal phase was always present. Prodromes correlated with progression to bipolar disorder are: thymic symptoms 44.1% of patients (P = 0.001), modification of volition 42.9% (P = 0.05), anger/irritability 66.7% (P = 0.032) and sadness 83.3% of patients (P = 0.05). Psychotic episode's symptoms correlated with the evolution towards a bipolar disorder corresponded to thymic symptoms. The latter was present in 44.1% of patients (P = 0.01).ConclusionThrough our study, we were able to identify some factors positively correlated with a progression towards bipolarity during a first psychotic disorder. So it would be important to monitor closely and to educate our patients and their families about the evolutionary potential of a first psychotic episode.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Treatment with Risperidone vs. Olanzapine in Naturalistic Study of Bipolar Manic Inpatients
Authors: Ibanez Plans I. , Nieto E. , Biel S. 
Published: June 2017

IntroductionThere are very few comparative controlled trials of risperidone versus olanzapine in manic patients. No previous naturalistic study has compared the efficacy of these two antipsychotics in the natural environment of manic inpatients.ObjectiveThe aim of this retrospective and naturalistic study was to evaluate the efficacy of acute treatment with risperidone vs. olanzapine in Bipolar I manic inpatients.Methods(1) Patients: the study includes all the inpatients diagnosed with bipolar I manic episode (DSM-IV) who were admitted during the years 2009 to 2014. Patients treated with risperidone and olanzapine concomitantly (n = 6) and patients not treated with risperidone or olanzapine (n = 129) were excluded.The patients finally included (n = 183) were separated in two groups:– treated with risperidone (n = 89);– treated with olanzapine (n = 94).(2) The Student-T test was used to compare, between the groups, the mean of scores in YMRS and CGI-S scales and the mean of length of stay.ResultsBaseline characteristics were similar between the groups. The majority of patients were also treated with mood stabilizers (46% with lithium and 45% with valproate).The mean decrease in CGI-S scores from baseline to the day of discharge was significantly (P < 0.003) higher in the risperidone group (−2.81 vs. −2.36). The length of stay was significantly (P < 0.004) lower in the olanzapine group (mean of 23.03 days vs. mean of 30.3).Conclusions(1) The CGI-S scores in manic patients treated with risperidone decreased more than in patients treated with olanzapine during admission. (2) The length of stay was significantly lower in patients treated with olanzapine.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Disruptive Behavior Disorders in Childhood and Adolescence: Attachment Models and Post-traumatic Symptomatology
Authors: Bizzi F. 
Published: June 2017

IntroductionIn line with a consistent literature, young patients with disruptive behavior disorders in childhood and adolescence have experienced some traumatic events, such as abuse, rejection and violence assisted. Recent studies are focusing the attention on the role of attachment and post-traumatic symptomatology for a better evaluation of this clinical condition.ObjectiveThis study investigates attachment models and post-traumatic symptomatology in young patients with disruptive behavior disorders.Aim(s)The following objectives are set by the present study: – to evaluate attachment models in a group of children diagnosed with disruptive behavior disorders;– to evaluate their post-traumatic symptomatology;– to test the extent of the association between post-traumatic symptomatology and attachment organization in young patients with disruptive behavior disorders.MethodForty-two Italian patients aged from 8 to 15 previously diagnosed with disruptive behavior disorders are compared to 42 healthy control subjects. We administer the child attachment interview and trauma symptom checklist for children-adolescent.ResultsInsecure attachment are found in more than half of the patients diagnosed with disruptive behavior disorders and disorganization are highly over-represented. Furthermore, low levels of post-traumatic symptoms are found in young patients with disruptive behavior disorders.ConclusionThis study suggests that attachment organization may be a fundamental element to be assessed in the evaluation of disruptive behavior disorders in children and adolescents. Nevertheless, traumatic experiences do not seem expressed through psychic symptoms. The clinical implications are discussed.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Association of Inter-individual Differences in Imaging Markers with Schizophrenia Phenotypes
Authors: Pergola G. , Quarto T. , Papalino M. , Di Carlo P. , Selvaggi P. , Gelao B. , Blasi G. , Bertolino A. 
Published: June 2017

IntroductionNeuroimaging studies have identified several candidate biomarkers of schizophrenia. However, it is unclear whether the considerable variability in these neurobiological correlates between patients can be translated into the clinical setting.ObjectivesWe aimed to identify neuroimaging predictors of clinical course in patients with schizophrenia. Combined with the identification of genetically determined markers of schizophrenia risk, our studies aimed to elucidate the biological basis and the clinical relevance of inter-individual variability between patients.MethodsWe included over 150 patients with schizophrenia and 279 healthy volunteers across five neuroimaging centers in the framework of the IMAGEMEND project [1]. We performed multiple studies on MRI scans using random forests and ROC curves to predict clinical course. Data from healthy controls served to normalize the data from the clinical population and to provide a benchmark for the findings.ResultsWe identified ensembles of neuroimaging markers and of genetic variants predictive of clinical course. Results highlight that (i) brain imaging carries significant clinical information, (ii) clinical information at baseline can considerably increase prediction accuracy.ConclusionThe methodological challenges and the results will be discussed in the context of recent findings from other multi-site studies. We conclude that brain imaging data on their own right are relevant to stratify patients in terms of clinical course; however, complementing these data with other modalities such as genetics and clinical information is necessary to further develop the field towards clinical application of the predictions.Disclosure of interestGiulio Pergola is the academic supervisor of a Hoffmann-La Roche Collaboration grant that partially funds his salary.
Emotional and Behavioral Problems in Early Adolescents and Association with Socio-demographic Risk Factors
Authors: Dostovic Hamidovic L. 
Published: June 2017

AimThe aim is to analyse the frequency emotional and behavioural problems early adolescents and association with socio-demographic risk factors.Subject and methodsWe analysed a group of 240 early adolescents (11–15 years) from the area of Tuzla Canton, Bosnia and Herzegovina, in the general population. For the assessment of children's emotional and behavioural problems, the Strength and Difficulties Questionnaire – SDQ is used. Data were processed by descriptive statistics. For the assessment association between socio-demographic risk factors and emotional and behavioural problems in early adolescents we used Pearson correlation test.ResultsThe result show that the frequency of emotional and behavioural problems are present in 3% of cases, The results of correlation sociodemographic risk factors and emotional and behavioral problems, showed that unemployed mothers have a significant increased risk of developing behavioral disorders in early adolescents (P < 0.05). Low family economic status leads to a significantly higher frequency of emotional symptoms in early adolescents, poor attitude towards society and significantly higher overall difficulties (P < 0.05). Higher levels of parental education was significantly associated with a higher frequency of behavioral problems and illness in the family leads to a much more emotional problems (P < 0.05).ConclusionThe obtained results of this study indicate that early adolescents showed low levels of emotional and behavioral problems. There is a significant correlation between socio-demographic risk factors and emotional and behavioral problems early adolescents.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Growth and Sexual Maturation in a 2-year, Open-label Clinical Study of Lisdexamfetamine Dimesylate in Children and Adolescents with ADHD
Authors: Hernández Otero I. , Banaschewski T. , Johnson M. , Nagy P. , Soutullo C.A. , Zuddas A. , Yan B. , Coghill D.R. 
Published: June 2017

IntroductionIndividuals with attention-deficit/hyperactivity disorder (ADHD) may require long-term medication.ObjectivesTo measure growth and sexual maturation of children and adolescents with ADHD receiving lisdexamfetamine dimesylate (LDX) in a 2-year trial (SPD489-404).AimsTo investigate the impact of long-term LDX treatment on growth and maturation.MethodsParticipants (6–17 years) received dose-optimized, open-label LDX (30–70 mg/day) for 104 weeks. Weight, height and BMI z-scores were derived using the Centers for Disease Control and Prevention norms [1]. Sexual maturation was assessed using the Tanner scale (participant-rated as closest to their stage of development based on standardized drawings).ResultsOf 314 enrolled participants, 191 (60.8%) completed the study. Mean z-scores at baseline and last on-treatment assessment (LOTA) were 0.53 (standard deviation, 0.963) and 0.02 (1.032) for weight, 0.61 (1.124) and 0.37 (1.131) for height, and 0.32 (0.935) and–0.27 (1.052) for BMI. In general, z-scores shifted lower over the first 36 weeks and then stabilized. At LOTA, most participants remained at their baseline Tanner stage or shifted higher, based on development of hair (males, 95.5%; females, 92.1%) or genitalia/breasts (males, 94.7%; females, 98.4%).ConclusionsConsistent with previous studies of stimulants used to treat ADHD [2], z-scores for weight, height and BMI decreased, mostly in the first year, then stabilized. No clinically concerning trends of LDX treatment on sexual maturation or the onset of puberty were observed.Disclosure of interestStudy funded by Shire Development LLC.Dr Isabel Hernández Otero (Alicia Koplowitz Foundation, Eli Lilly, Forest, Janssen-Cilag, Junta de Andalucia, Roche, Shire, Shire Pharmaceuticals Iberica S.L., and Sunovion).
Cortical and Sub–cortical Volumetric Abnormalities in Bipolar Disorder
Authors: Andreassen O. 
Published: June 2017

Previous MRI studies of bipolar disorder (BD) are often limited by small sample sizes and heterogeneity exists with regard to neuroimaging markers. To address these limitations, the ENIGMA Bipolar Disorder Working Group collected the largest BD neuroimaging data set ever studied (n = 6,500). Here, we review findings from sub–cortical volume and cortical thickness and area analyses.ENIGMA harmonized analysis methods were applied to 28 international pooled study samples of MRI data and involved sub–cortical and cortical imaging analyses. We assessed differences between BD and healthy controls (HC) using both mega and meta–analytic multiple linear regression models, adjusting for standard covariates (age, sex, etc.), and correcting for multiple comparisons.Sub–cortical volume analysis revealed we found consistent volumetric reductions in BD patients for hippocampus and thalamus and enlarged lateral ventricles in patients. In BD, cortical gray matter was thinner in frontal, temporal and parietal regions of both brain hemispheres. BD had large general effects on mean gray matter thickness in both left and right brain hemispheres. Further we found that psychopharmacological treatment showed significant associations with cortical thickness and surface area.The ENIGMA pipeline allows for identification of brain MRI abnormalities in BD in the largest analysis ever conducted. The results suggest a pattern of brain structure abnormalities, which provide novel insight in pathophysiology of BD, and potential effects of mood stabilizing agents.Disclosure of interestReceived speaker's honorarium from Lundbeck, Lilly, Otsuka