bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Makoki”: A view of electroconvulsive therapy in a Spanish comic of the early 80s
Authors: Pavez F. , Alcántara A. , Saura E. , Marset P. 
Published: May 2016

IntroductionAnalysis from cultural products has been previously reported in psychiatry field. This approach provides an understanding of the social imaginary about psychiatry and its work over a determined period of time.ObjectivesTo describe the representations of ECT and insanity in an Spanish underground comic of the early 80s.MethodsWe performed an analysis of complete production (1979–1994) of “Makoki”, comic by Gallardo and Mediavilla, looking for the aspects related with our interest scope (Fig. 1).ResultsThe comic analyzed is inscribed in the field of provocation and insolence. This is comprehensible in the historical context of Spanish transition, if we attend to almost forty years of cultural confinement as a result of a dictatorial regime. This cultural product could be seen as “politically incorrect” from the current perspective, given that reproduces some stigmatizing topics regarding mental illness, glorifying its alleged associations with violence and drug use, in addition to a negative view of ECT, represented as a sadistic instrument of punishment, control and subjugation (see Fig. 1).ConclusionsThe material analyzed reproduces the prevailing social stigma in its epoch about psychiatry and mental illness. The analysis of cultural products that reflect and built the speeches about the psychiatry and its action field, can be a useful strategy to understand the views of the general population in a given era.Disclosure of interestThe authors have not supplied their declaration of competing interest.
N–methyl–D–aspartate antagonists in depression–15 years after the first ketamine clinical study what has changed?
Authors: Ribeiro J. , Mota D. , Rosa L. 
Published: May 2016

IntroductionIn the last decades, multiple studies have suggested evidences of disturbances within the glutamate system in depressed patients. The first clinical study using ketamine in depression treatment was conduct fifteen years ago. Since then several studies tried to understand the mechanisms underlying the antidepressant effects of ketamine, as well as discover new drugs with better pharmacodynamic profiles.Objectives/aimsReview the literature on the role of glutamate system in depression and novel approaches with glutamate N–methyl–D–aspartate receptor antagonists in depression.MethodsSearch and review of scientific literature on PubMed database with the keywords.“major depressive disorder”, “depression”, “ketamine”, “glutamate”, “NMDA”, “neuroplasticity”.ResultsAbnormalities of the glutamate clearance at synaptic space and astrocytic dysfunction associated with glutamate metabolism have been associated with depressive symptomatology. In depressed patients, reduced levels of glutamate have been described by magnetic resonance spectroscopy in multiple cortical areas, amygdala and hippocampus, supportting the hypothesis of glutamate system involvement in the neurobiology of depression. Indeed, in the last 15 years, multiple clinical studies using ketamine provided some evidence that glutamate N–methyl–D–aspartate receptor antagonism could be an approach for refractory forms of depression. However, regardless all of the evidences, no drug targeting specifically the glutamate system has been approved for depression treatment.ConclusionsThe glutaminergic system plays a role in the pathophysiology of depression, why it's a possible therapeutic target. So, it's of utmost importance that future studies keep the focus in this area, looking for new drugs active in this system.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Disturbance of serum albumin conformation in patients with melancholic depression
Authors: Uzbekov M. , Syrejshchikova T. , Smolina N. , Brilliantova V. , Dobretsov G. , Krujkov V. , Emel’yanova I. , Krasnov V. 
Published: May 2016

IntroductionThe last years it is became clear that disturbances in molecular processes in pathological conditions can be connected with conformational changes in protein structure.AimInvestigation of blood albumin conformation in patients with melancholic depression.Material and methodsThere were investigated 19 patients with melancholic depression (12 women and 7 men) and 25 health volunteers. Patient's state according to ICD-10 criteria was defined as a depressive episode in the frame of bipolar depressive disorder (type 2) (F32) and in the structure of recurrent depressive disorder (F33). Subnanosecond laser time resolved fluorescence spectroscopy (SLTRFS) (subnanosecond diapason) with K-35 fluorescent probe was used for the investigation of albumin conformation.Results and discussionThere were revealed 3 binding sites in albumin molecule with fluorescent decay time of 1, 3 and 9 nanoseconds (A1, A3 and A9 sites, respectively) in healthy volunteers using SLTRFS approach. There were found significant differences between albumin binding sites of volunteers and patients with melancholic depression, respectively, А1–117 ± 7 и 142 ± 10; А3–358 ± 14 и 420 ± 26; А9–371 ± 16 и 433 ± 29.ConclusionThese findings point out that melancholic depression is followed by conformational changes of albumin molecule that can affect its functional properties. We can hypothesized that albumin binding properties can serve as a biomarker of the efficacy of psychopharmacotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Anhedonic brain while attending sexual and emotional pictures
Authors: Von Duering F. 
Published: May 2016

Anhedonia is defined as the inability to gain pleasure from normally pleasurable experiences and reduced sexual desire. Rees et al. (2007) showed that limbic and paralimbic areas are responsible for sexual arousal and that anhedonia is associated with frontolimbic inhibition. In major depression, reduced ventral striatum and increased ventral prefrontal cortex areas was associated with anhedonia(Gorwood, 2009). Walter et al. (2009) indicated that there is a deviation in the neuronal activation pattern of the pregenual anterior cingulate cortex in anhedonic depression which is related to a glutamergic deficit. Glutamate was suggested to play a relevant role in reward system (Birgner et al., 2005). ACC is a key involved in affective state and glutamate mediates ACC activation to sexual attraction(Wu et al., 2009). Thus, a glutamatergic deficit might be related to reduced hedonic effect specific to major depression. Using an attention modulation of emotional and sexual pictures, we investigate the role of anhedonia on the ventral and dorsal systems in healthy volunteers and patients with major depression. They undergo an expectancy task in a 7 T scanner and passively view sexual and emotional photographs and are asked to expect either high salient pictures or high erotic pictures. Half of these pictures are announced by an expectancy cue, whereas the other half are preceded by a fixation cross. Snaith-Hamilton-Pleasure-Scale and Hamilton Depression Rating Scale are employed to assess anhedonia and depressive symptom severity. Brain metabolites in the dorsal and pgACC are measured using MRS. We will show how anhedonia modulates the neural response to sexual arousal.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Childhood trauma and cortisol awakening response in eating disorders: A dose-dependent trauma effect
Authors: Monaco F. , Monteleone A.M. , Pellegrino F. , De Riso F. , Patriciello G. , Cimino M. , Calvanese M. , Volpe U. , Monteleone P. 
Published: May 2016

IntroductionA role for the hypothalamus-pituitary-adrenal (HPA) axis has been suggested in the pathophysiology of anorexia nervosa (AN) and bulimia nervosa (BN), and childhood trauma experiences have been detected frequently in patients with AN and BN. Since trauma exposure in the childhood may persistently affect HPA axis functioning, we explored HPA axis activity in AN and BN patients with and without childhood trauma history.Objectives and aimsWe aimed to examine possible associations between childhood traumatic experiences and HPA axis functioning, as assessed by the cortisol awakening response (CAR), in adult patients with AN or BN as compared to adult healthy controls.MethodsSaliva samples were collected by 41 patients with symptomatic AN, 32 with symptomatic BN and 45 healthy controls at wakening and after 15, 30 and 60 min. They filled in the Childhood Trauma Questionnaire (CTQ), which assesses five specific types of childhood trauma.ResultsAs compared to the control group, the no-maltreated AN patient group exhibited an enhanced CAR whereas the no-maltreated BN patient group showed a similar CAR. On the contrary, both AN and BN patients with a positive history of childhood maltreatment exhibited statistically significant blunted CAR as compared to no-maltreated patients. Moreover, in maltreated ED patients the CAR tended to decrease when the number of trauma types increased.DiscussionPresent findings confirm a dysregulation of the HPA axis activity in symptomatic patients with AN and BN and suggest a dose-dependent effect of childhood adverse experiences on the CAR of adult ED patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The European trainees’ perspective on psychiatric postgraduate education: An EFPT survey
Authors: Giurgiuca A. , Mogren T. , Tomori S. , Berze L. , Munjiza A. , Pinto da Costa M. ,   E.F.P.T. TEO-PC Research WG
Published: May 2016

IntroductionDespite efforts to unify psychiatric education among European member countries, there are still considerable variations between national training programmes. To ensure equivalence of training standards the current tendency of recommended guidelines and reports is steering psychiatric training towards becoming more competency focused.ObjectivesThe research group of the European Federation of Psychiatric Trainees (EFPT) conducted a multi-national study on postgraduate psychiatry training. The aims are to assess the psychiatric trainees’ experiences and opinions on their national training and assessment methods in respect to the Union européenne des médecins spécialistes (UEMS) 2009 competencies framework.MethodsThis study surveyed 745 psychiatric trainees from 10 EFPT member countries using a questionnaire designed specifically for assessing this issue.ResultsIn this sample, the majority are aware of having a competency based training programme but 86.5% are poorly acquainted with the UEMS competencies framework. All key competencies were rated as being important but not all as being relevant in the assessment process. One's level of preparedness and the degree of education one's receives during their training differs from one competency to another. Trainees who aren’t satisfied with their national training would be in favour of taking an end of training Pan-European exam which differs from the one's that are satisfied and wouldn’t be interested in undergoing this assessment method.ConclusionsThis sample isn’t fully acquainted with the competency-based concept for postgraduate training. The ones satisfied with their postgraduate psychiatric education seem to be less inclined to take an end of training Pan European exam.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Indicators in psychiatric assessments; an evidence-based practice
Authors: Rumalean Y. , Parfitt C. 
Published: May 2016

There are subtle signs and symptoms that can function as strong, significant and evidence-based indicators to improve upon diagnosis of mental illness as a primary clinical issue. With the well-being of patients at stake and services experiencing mounting pressure on their time and resources, the accuracy of such a diagnosis is critical. The data used in this study was obtained from the Hampshire Police of individuals arrested under Section 136 of the Mental Health Act 1983 (Amended 2007). Documented observations by the arresting officers were transferred onto a list of signs and symptoms, adapted for clinicians and non-clinicians. Answers to all 23 indicator questions were assigned a binary coding and became the input data. A logistic regression model (LRM), sensitivity and specificity analysis, analysis of maximum likelihood estimates, and confusion matrix, were applied. Three significant evidence-based indicators for primary mental illness diagnosis: “fixed stare/looking (possibly) confused” (perplexed), “calm/seemingly calm”, and “poor attention and concentration, not able to follow instructions easily” (distracted). There was suggestion that when all three identified indicators are absent within the same assessment period, primary mental illness should not be diagnosed. A correlation was observed between the presence of one, two, or all three indicators and the increased chance of patients suffering from moderate-to-severe primary mental illness. The indicators would very likely be particularly helpful in cases where signs and symptoms of primary mental illness are less obvious and made more complex by actual underlying problems of drugs/alcohol, difficult personality traits, and/or criminal behaviour.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Detection and management of agitation in psychiatry: A Delphi expert consensus study
Authors: Garriga M. , Pacchiarotti I. , Hidalgo D. , Bernardo M. , Vieta E. 
Published: May 2016

IntroductionThe assessment and management of psychomotor agitation may result in the use of coercive or sedative treatments. In the absence of conclusive evidence, the consensus of experts can guide clinical decisions.ObjectivesTo seek consensus recommendations on the assessment and management of psychomotor agitation.MethodsAn international expert task force in this field developed consensus using the Delphi method. Twenty-seven experts were invited to participate and 91% of them agreed. Initial survey items were gathered from the content of literature search (systematic review). This included open-ended questions inviting participants to add suggestions by e-mail correspondence. After this initial first round, the Delphi study was conducted online using Google Forms. Survey items were rated on a 5-point scale. Items rated by at least 80% of experts as essential or important were included. Items rated as essential or important by 65–79% of experts were included in the next survey for re-rating. Items with consensus below to 65% were rejected and excluded.ResultsThe initial survey included 52 items. The second web-based survey included 33 items. The briefer third survey consisted of 6 items that needed rerating. Twenty-two of the initial 33 items were endorsed and formed the clinical recommendations on the assessment and management of the psychomotor agitation. The endorsed items were categorized into 5 domains forming the clinical recommendations.ConclusionsThe panel expert generated 22 recommendations on the assessment and management of agitation. The Delphi method is a suitable formal iterative process for reaching consensus on relevant and controversial issues.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Recognizing high-risk behavioural patterns in emergency psychiatry: From surveillance to technical assistance, insights into an innovative project* from the point of view of potential users
Authors: Voigtlaender B.S. , Schölzel D. , Schönherr A. , Schloßhauer J. , Barth T. 
Published: May 2016

IntroductionAfter legal restrictions regarding coerced medication in Saxony, we monitored significant increases in aggressive behaviour and regarding the use of physical restraints at our closed psychiatric ward. Alternative measures for managing dangerous behaviour were discussed.ObjectivesThere are limitations regarding the use of treatment interventions in emergency psychiatry, e.g. the use of constant observation is limited in its efficiency generally and video surveillance is prohibited by law in high-risk areas (e.g. bathroom).AimsTo find appropriate solutions for patient safety improvement in emergency psychiatry including high-risk areas, prospects of the field of “technical assistance” entered the limelight of interest.MethodsIn 2014, a cooperation of Chemnitz University of Technology, Intenta GmbH, Eckstein Design and the affiliated partner Klinikum Chemnitz started a project*, which focuses on the development of a technical assistance system for recognizing high-risk behavioural patterns (e.g. suicide attempt) in risk areas in emergency psychiatry. The system is based on a smart-sensor technology and waives a recording and storing of sound and vision.ResultsIn the 1st half of the project technical development and the design of the system were the focus of attention. Special requirements regarding use cases, user acceptance, data protection and ethical concerns were processed by our psychiatric department. Testing and further development of the system in clinical settings are planned.ConclusionsThe development of the system must be seen as a big challenge in many regards. Further research is indispensable.*Sponsored by the Central Innovation Program Mittelstand of the Federal Ministry for Economic Affairs and Energy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Health related quality of life in adults with ADHD symptoms: A population survey using 15D and AAQoL
Authors: Alaheino L. , Leppämäki S. , Partonen T. , Sainio M. 
Published: May 2016

IntroductionHealth related quality of life (HRQoL) can be measured and compared, to give us an understanding of the impact different diseases have on health. The diagnostic tests for attention-deficit/hyperactive disorder (ADHD) in adulthood fail to catch the diversity of ways the condition affects one's life. Disease-specific quality-of-life scales try to reach beyond the typical symptoms of the condition, to find those specific difficulties a person subjectively grades as challenging.ObjectivesTo assess the levels of general and disease-specific HRQoL in adults with ADHD-like symptoms.AimsTo understand the impact ADHD-like symptoms have on adults’ HRQoL.MethodsA random, nationwide sample of 3000 Finnish speaking citizens (aged 18-44 years) was drawn from the national population register. A subsample of 171 people, 57 screener (Adult ADHD Self-Report Scale [ASRS]) positive cases and two age- and sex-matched controls for each case, participated in a telephone interview. General HRQoL was measured with 15D, and disease-specific HRQoL with Adult ADHD Quality-of-Life (AAQoL) scale.ResultsThe 15D score was 0.866 for the screener positives, 0.943 for the controls, and 0.945 for the Finnish population reference. The difference between the screener positives and controls was significant (P < 0.001). The AAQoL sum score was worse for the screener positives than controls (61.9 vs. 82.1, P < 0.001), and all the subscales were affected accordingly.ConclusionsAdults with ADHD-like symptoms have a lower quality of life, as measured both on the general and on the condition-specific quality of life scales.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Characterizing rare mis-sense variations of CACNA1I identified in a Swedish schizophrenia cohort
Authors: Pan J. , Allen A. , huang L. , Daez D. 
Published: May 2016

CACNA1I (hCaV3.3) encodes the α1 pore-forming subunit of human voltage-gated T-type calcium channels. CaV3.3 is expressed in a limited subset of neurons including GABAergic neurons of the thalamic reticular nucleus (TRN) where they support oscillatory activity essential for sleep spindle generation. CACNA1I is implicated in schizophrenia risk by emerging genetics including genome-wide association studies (PGC, 2014), and exome sequencing of trio samples (Gulsuner et al., 2013). In order to understand the impact of disease-associated sequence variation on the function of CaV3.3, we set out to analyze a complete set of rare mis-sense coding variations in CACNA1I in a Swedish cohort, including 15 variations identified in patients, 20 identified in control subjects, and 23 in both. We established a heterologous expression system of isogenic cell lines, each carrying single-copy inducible cDNA variants of hCaV3.3, and evaluated their functional impact on channel function by electrophysiology, calcium imaging, and biochemistry. We found at least five coding variations impaired overall channel protein abundance, as well as whole cell current density. In addition, we identified hCaV3.3 variants with altered voltage-dependence of channel activation and inactivation. Overall, we found that reduced calcium influx through hCaV3.3 is associated with the group of variants identified in patients, compared to those in both patients and controls. Our findings suggest that patient-specific rare variations of CACNA1I may influence channel-dependent functions, including rebound bursting in TRN neurons, with potential implications for schizophrenia pathophysiology.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Screening for metabolic syndrome in older patients with severe mental illness: Two-years observational study
Authors: Franza F. , Aquino K. , Calabrese L. , Cervone A. , Fiorentino N. , De Guglielmo S. , Iandoli M. , Soddu A. , Solomita B. , Fasano V. 
Published: May 2016

IntroductionPatients with serious psychiatric illness (SMI) have a reduced quality of life and life expectancy than the general population. Metabolic syndrome (MS) is a clinical aspect determining who should be considered to reduce the risk of serious and chronic organic factors, even more significant in the elderly.ObjectivesTo evaluate metabolic screening of elderly patients with severe mental illness (SMI).AimsTo evaluate the importance of routine screening of metabolic parameters in elderly guests of residential facilities with or without SMI; metabolic screening at baseline and after two of hospitalization.MethodsElderly inpatients (44 Tot) with Severe Mental Illness (SMI: bipolar disorder: 34%; schizophrenia: 46%; other: 20%) vs elderly inpatients (78 Tot). Data collected at baseline: psychiatric diagnosis; any previous diagnosis of hypertension, diabetes, dyslipidemia; ECG. At baseline and for two years were administered following scale: BPRS; PANSS; Qli; MMSE, ADL.ResultsAfter two years metabolic screening has recorded at least one of the new interactions between the five factors of MS (ATP III) in 50% of patients with: one (34%); two (21%); three (11%); four (3%) new altered parameters. In MS inpatients, 53% of new metabolic alterations were recorded in 53% (MS inpatients) vs 23% without MS after two years.ConclusionsOur results showed a higher frequency of MS in patients with SMI than comparison subjects. Haloperidol was the antipsychotic medication that caused minor impact on the development of metabolic disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.