bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors affecting burden of main caregivers in children with epilepsy
Authors: Kim M.D. , Yoon B.H. , Jon D.I. , Lee K. , Kwon Y.J. , Bahk W.M. 
Published: May 2016

ObjectiveThe purpose of the study was to evaluate burden of main caregivers in children with epilepsy and to identify factors associated with caregiver burden.MethodMain caregivers of pediatric patients with epilepsy were enrolled four general hospitals in several cities of Korea. One hundred and twenty-fou caregivers of patients were included in this cross-sectional study. Sociodemograhic/clinical characteristics of patients and sociodemographic characteristics of caregivers were collected. The caregivers were assessed using the Korean version Zarit burden Interview (ZBI), Center for Epidemiological Studies of Depression Scale (CES-D) and social support/conflict scale. Multiple linear regression methods were used to evaluate factors contributing to burden of caregivers.ResultsOf the 124 participants, 98(81.7%) were the mothers. The mean score on the ZBI and CES-D were 23.66 (± 19.15) and 13.87 (± 12.95) points, respectively. Factors affecting of caregiver burden were the number of antiepileptic drugs (AEDs), which patients are taking, and CES-D score by multiple linear regression analysis.ConclusionsHigher number of AEDs prescribed and depression of caregivers are main factors contributing to burden of caregivers in children with epilepsy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Perceived Problem Solving Skill of Iranian Nursing Students: A Cross-Sectional Study
Authors: Moshirabadi Z. , Haghani H. , Borimnejad L. 
Published: May 2016

BackgroundThe ability to solve problems and make decisions creatively has become paramount to new nursing graduates, as these skills assist them with recognizing and evaluating situations that require prompt attention. The purpose of this study was to determine and compare nursing student's perceived levels of own problem solving skills in various years of their 4-year program.MethodsThis is a cross-sectional study. Three hundred and twenty-two undergraduate nursing students in BSc nursing program participated in this study. The study setting was nursing School of Iran university of medical sciences. The Problem solving inventory (PSI) was used to data gathering. The scale was divided into three subscales including: problem-solving confidence (PSC), approaching avoidance style (AAS), and personal control (SC). Students involved in the study signed the study Informed consent.ResultsFindings showed that the mean score of total problem solving skill was 89.52 ± 21.58. The mean score of the 4th year students in PSI was less than other year students (84.18 ± 27.47 vs 89.13 ± 18.71, 91.57 ± 21.87, and 91.52 ± 20.8). This study finding revealed that 4th year students in 3 factors of problem solving (PSC, AAS, PC) considered themselves more successful than others. Meanwhile, when the results are compared according, no significant differences occurred among the student in different years (F: 1.46, P ≤ 0.22).ConclusionEducating should help students to reach the desired levels of problem solving skills by allowing them to acquire and practice these abilities in the field. Nursing students with advanced problem solving skills will be essential for this changing society.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Stigma: Dimensions and Correlates In A Multi-Ethnic Population
Authors: Subramaniam M. , Abdin E. , Picco L. , Pang S. , Shafie S. , Vaingankar J. , Kwok K.W. , Verma K. , Chong S.A. 
Published: May 2016

IntroductionMental health stigma is a multidimensional concept that encompasses many different themes and definitions. Public stigma is defined as the degree to which the general public holds negative views and discriminates against a specific group.ObjectiveTo understand the context and correlates of stigma in multi-ethnic Singapore.AimsThe current study aimed to (i) explore the factor structure of the Depression Stigma Scale and the Social Distance Scale using an exploratory structural equation modelling approach and (ii) examine the correlates of the identified dimensions of stigma in the general population of Singapore.MethodsData for the current study came from a larger nation-wide cross-sectional study of mental health literacy conducted in Singapore. All respondents were administered the Personal and Perceived scales of the Depression Stigma Scale and the Social Distance scale to measure personal stigma and social distance respectively.ResultsThe findings from the factor analysis revealed that personal stigma formed two distinct dimensions comprising “Weak-not-Sick” and “Dangerous/Unpredictable” components while social distance stigma items loaded strongly into a single factor. Those of Malay and Indian ethnicity, lower education, lower income status and those who were administered the depression and alcohol abuse vignette were significantly associated with higher weak-not-sick scores. Those of Indian ethnicity, 6 years of education and below, lower income status and those who were administered the alcohol abuse vignette were significantly associated with higher dangerous/unpredictable scores.ConclusionThere is a need for well-planned and culturally relevant anti-stigma campaigns in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Effectiveness of A School-Based Universal Prevention Program for Enhancing Self-Confiden Considering The Extended Effects Associated With Achievement of The Direct Purposes of The Program
Authors: Yamasaki K. , Murakami Y. , Yokoshima T. , Uchida K. 
Published: May 2016

IntroductionWe have developed a group of school-based universal prevention programs for children's health and adjustment. The programs are characterized by new theories such as the somatic-marker hypothesis and enjoyable methods that utilize animated stories and games. This study adopted one of the programs for the development of self-confidence.ObjectiveThe aim was to examine the effectiveness of the program. In addition to the direct purposes of the program, children's adjustments at school and homeroom class were evaluated as extended effects.MethodsParticipants were third grade children in six public elementary schools in Japan. The final sample included 442 children (219 boys and 223 girls). The program was implemented weekly in one regular 45-minute class over 8 weeks. Participants completed a battery of three questionnaires three times, 1 month before the start of the program (T1), 1 week before the start of the program (T2), and during 1 week after the last class of the program (T3).ResultsResults showed that all of the main endpoints of the program significantly improved in the intervention condition (i.e., changes from T2 to T3), compared to the control condition (i.e., changes from T1 to T2). Moreover, children's adjustment at school and homeroom class increased in the intervention condition, compared to the control condition. However, implicit affect was unchanged.ConclusionThis study suggests that the program is effective for enhancing self-confidence, along with adjustments at school and in class. Future research that examines the sustainability of the effectiveness of the program is planned.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Auditory Hallucinations In A Deaf Patient? – A Clinical Report
Authors: Aleixo M.A. , Moreira C.A. , Sobreira G. , Oliveira J. , Carvalhão Gil L. 
Published: May 2016

IntroductionAccording to some studies, deaf psychiatric inpatients have prevalence rates of psychotic disorders ranging from 20 to 54%. There are descriptions of the paradoxical finding that prelingually deaf patients with psychosis may hear voices.ObjectivesTo present a case report and conduct a database review in order to understand if deaf patients with psychosis can have auditory hallucinations.AimsThe authors’ aim is to describe a case, highlight the clinical and scientific relevance of auditory hallucinations in deaf patients and the difficulties and limitations of this process.MethodsA Pubmed database search using as keywords “auditory hallucinations”, “deaf” and “deafness” and retrieved papers were selected according to their relevance.ResultsThe authors report a case of a 47-year-old female patient apparently suffering from congenital deafness. The patient had no previous psychiatric history until 4 months prior to her admission at our institution, when she started having psychotic symptoms. The patient was admitted into a Neurology ward but because no neurological sign was found psychiatric liaison consultation was requested. Four months later, she had the same symptoms, describing a voice that said to “shut up” and was admitted to a psychiatric hospital. After medication, the symptoms relapsed and now she is followed in an outpatient setting.The presence and nature of auditory hallucinations in deaf patients is not fully elucidated and there are methodological problems in the investigation of this subject.ConclusionsCurrent evidence is still inconclusive and the fact that prelingually deaf patient hear voices needs further research.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Ice Bucket At First…and then? – Psychopathology in Amyotrophic Lateral Sclerosis Patients and their Caregivers, a Review
Authors: Figueiredo A.R. , Espírito Santo V. , Almendra R. , Costa A. 
Published: May 2016

IntroductionAmyotrophic lateral sclerosis (ALS) is a progressive and fatal neurodegenerative disorder that affects motor neurons in the cerebral cortex, brainstem and spinal cord. The progressive loss of motor function creates profound changes on patient's lives and their caregivers.ObjectiveAssessment of eventual existence of psychopathology in ALS patients and their caregivers.MethodsLiterature review using the terms: ALS, Amyotrophic Lateral Sclerosis, psychopathology, psychiatric disorder; depression; anxiety, caregivers.ResultsModerate depressive or anxious symptoms are often observed. The results are not consistent, some studies showing that major depression is less common that in general population, others that is mildly increased. Some studies show that depressive symptoms are related to poorer QoL and with faster disease progression, others suggests no correlations. Coping strategies, cognitive appraisal and social support are important factors to psychological adaptation to ALS. After the diagnosis, high levels of anxiety can be observed. Psychopathological features are observed at this time, and generally depression does not increase as death approaches. Beyond loss of physical functions, it seems that patients’ neurobehavioral symptoms, such as aggressiveness, disinhibition and impulsivity, cognitive impairment, and also lack of social support have a negative effect on caregivers’ mental health. Concordance between patient and caregiver distress was found.ConclusionsIt is important to assess potential psychological distress in ALS patients and their caregivers, given that cope with disease can affect its course. Caregivers’ needs should be addressed, to benefit their well-being and consequently patients’ QoL. There are few studies about psychopharmacotherapy and/or psychotherapy in these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Late Onset Schizophrenia. A Case Report
Authors: Hernández Sánchez J.M. , Cancino Botello M.C. , Molina Lopez M.F. , Muñoz Carril M. , Arnés González S. , Monzó J.A. 
Published: May 2016

IntroductionThe presence of elderly people is more and more common in developed countries. Unlike other medical conditions, late onset psychosis includes organic and mental precipitants in its differential diagnosis.ObjectivesTo present a case of late onset schizophrenia.MethodsMedline search and review of the clinical history and the related literature.ResultsWe present the case of a 71-year-old woman with organic medical history of rectum adenocarcinoma in 2008 that underwent radiotherapy, chemotherapy and surgical resection with successful results. According to the psychiatric history, this patient has needed two admissions to the psychiatry ward, the first of them in 2012, (when the delusional symptoms started), due to deregulated behaviour in relation to persecutory delusions and auditory pseudo-hallucinations. In 2012, she was diagnosed with late onset schizophrenia. Blood tests (hemograme, biochemistry) and brain image were normal. Despite treatment with oral amisulpride and oral paliperidone and due to low compliance, delusional symptoms have remained. We started treatment with long-acting injectable papliperidone 75 mg/28 days having reached clinical stability.ConclusionsLate onset psychosis is due to a wide range of clinical conditions. In this case, our patient had no organic precipitants. The evolution and presentation of delusional symptoms in this patient made us think of late onset schizophrenia as main diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cycloid Psychosis: A Case Report
Authors: Martinez-Ales G. , Louzao I. , Irimia A. , Bravo M.F. , Marin J. 
Published: May 2016

IntroductionEpisodes of time-limited acute psychosis, with full recovery in between, are categorized as acute polymorphic psychotic or brief psychotic disorders. Leonhard described the three forms of cycloid psychosis (CP). Perry considers it a separate entity.Case reportWe report the case of a 54-year-old male, with a 9-year history of brief psychotic disorders. He was admitted to an inpatient unit after a 4-day episode of persecutory delusion, leading to high emotional repercussions and isolation at home. Euthymia was present. Previous admissions, 9 and 5 years before, presented similar clinical pictures. Treatment with low dose paliperidone during 6-month periods had led to the complete resolution of the episodes (restitutio ad integrum: no psychotic manifestations and the ability to run his business). In this episode, 8 days after the reintroduction of 12 mg of paliperidone per day, cessation of the symptoms took place. Careful reconstruction of the clinical history showed no stressors or drug consumption. And immediately previous 5-day phase of insomnia, hyperactivity and expenditure was described by the patient's wife.DiscussionThree inpatient admissions, a careful clinical history and a thorough review of the evidence regarding Perris criteria led to a diagnosis of CP.ConclusionCP, a classical nosological approach, is helpful in a clinical setting, as it might imply different prognosis and treatment. Recognition of CP, not included as an entity by the major diagnostic systems, requires a high index of suspicion.Disclosure of interestThe authors have not supplied their declaration of competing interest.
ADHD-associated risk-taking: The role of benefit and risk perceptions
Authors: Pollak Y. , Aloni H. , Shoham R. 
Published: May 2016

Attention deficit and hyperactivity disorder (ADHD) is associated with increased engagement in risk-taking behaviors. The present study aimed to further our knowledge regarding the extent and the reasons for the association between ADHD symptoms and risk-taking, using a theory-driven behavioral economy theory. The Domain Specific Risk-Taking scale was used, on which 244 adults rated the likelihood of engagement in a range of risky behaviors, across five real life domains, as well as the magnitude of perceived benefit and risk they ascribed to these behaviors. Level of ADHD symptoms was positively correlated with engagement in risky behaviors and benefit perception, but not with risk perception. Mediation analysis confirmed that benefit perception, but not risk perception, mediated the association between ADHD symptoms and engagement in risk-taking behaviors (Fig. 1). These findings emphasize the role of benefit perception in facilitating risk-taking by people with ADHD symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Time-course of treatment-emergent adverse events in a long-term safety study of lisdexamfetamine dimesylate in children and adolescents with ADHD
Authors: Otero I. Hernández , Banaschewski T. , Nagy P. , Soutullo C.A. , Zuddas A. , Caballero B. , Geibel B. , Yan B. , Coghill D.R. 
Published: May 2016

IntroductionThe long-term safety and efficacy of lisdexamfetamine dimesylate (LDX) in children and adolescents with attention deficit/hyperactivity disorder (ADHD) was evaluated in a European 2-year, open-label study (SPD489-404).ObjectiveTo evaluate the time-course of treatment-emergent adverse events (TEAEs) in SPD489-404.MethodsParticipants aged 6–17 years received open-label LDX (30, 50 or 70 mg/day) for 104 weeks (4 weeks dose-optimization; 100 weeks dose-maintenance).ResultsAll enrolled participants (n = 314) were included in the safety population and 191 (60.8%) completed the study. TEAEs occurred in 282 (89.8%) participants; most were mild or moderate. TEAEs considered by the investigators as related to LDX were reported by 232 (73.9%) participants with the following reported for ≥ 10% of participants: decreased appetite (49.4%), weight decreased (18.2%), insomnia (13.1%). TEAEs leading to discontinuation and serious TEAEs occurred in 39 (12.4%) and 28 (8.9%) participants, respectively. The median (range) time to first onset and duration, respectively, of TEAEs identified by the sponsor as being of special interest were: insomnia (insomnia, initial insomnia, middle insomnia, terminal insomnia), 17.0 (1–729) and 42.8 (1–739) days; weight decreased, 29.0 (1–677) and 225.0 (26–724) days; decreased appetite, 13.5 (1–653) and 169.0 (1–749) days; headache, 22.0 (1–718) and 2.0 (1–729) days. Reports of insomnia, weight decreased, decreased appetite and headache were highest in the first 4–12 weeks.ConclusionsTEAEs associated with long-term LDX treatment were characteristic of stimulant medications, with the greatest incidence observed during the first 4–12 weeks.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Antipsychotic polypharmacy at the clinic of psychiatry, clinical centre of Serbia
Authors: Divac N. , Damjanovic A. , Stojanovic R. , Savic Vujovic K. , Letunica B. , Prostran M. 
Published: May 2016

IntroductionAntipsychotic polypharmacy is not supported by current guidelines. However, it is often present in practice. A common reason for this is to gain a greater, faster therapeutic response and reduce the doses of individual drugs, thus reducing the adverse effects.Aims and ObjectivesThe aim of this study is to analyze the prevalence of antipsychotic polypharmacy at the Clinic of Psychiatry, Clinical Centre of Serbia and to compare it with the data from 10 years ago when similar research was conducted.Material and methodsThis is a cross-sectional study conducted in 2015. The data were obtained from the patients’ charts and compared with the results of a more extensive study conducted at the same hospital during 2002–2005 period. Statistics was performed using standard statistical methods.ResultsOf the total number of patients (n = 44), 81.8% (n = 36) were on antipsychotic monotherapy, while in the previous study, which included 198 patients, monotherapy was noted in just 32.3% hospitalizations (n = 64) (Chi = 34.5; P < 0.001). Among patients treated with polypharmacy, the majority was prescribed the combination of a first- and second-generation antipsychotic (n = 7, 87.5%), while just one patient was treated with two first-generation antispychotics (n = 1, 12.5%). In the 2002–2005 period, the combination of two first-generation antipsychotics was dominant (58.9%, n = 79).ConclusionThis study indicates that in Serbian psychiatry there is a strong tendency towards reduction of antipsychotic polypharmacy. However, this is a single-centre study with a relatively small number of participants and more extensive research on the national level is warranted to confirm this trend.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Lithium-induced acute intermittent dystonia in a patient with schizoaffective disorder
Authors: Engel A. , Bilbruck T. , Hossain S. , Leahy R. 
Published: May 2016

While lithium is well known for its neurotoxicity, there are very few publications about lithium-induced acute dystonic reaction. We are presenting a clinical case of lithium-induced acute intermittent dystonic reaction in a patient with schizoaffective disorder (SAD). The patient is a 69-year-old African-American male with a long history of SAD, who was treated for many years with ziprasidone and divalproex and was admitted with SAD exacerbation. Due to increased QTC interval, we switched patient to lurasidone. After 2 weeks, due to increased ammonia level, divalproex was switched to lithium (600 mg loading dose and then 450 mg twice/day). Three days later, patient developed a series of intermittent episodes of acute dystonia, manifested as mutism, dysarthria, upper and lower extremity muscle rigidity, dysphagia, and tremor (Table 1). Dystonic reactions responded to benztropine. Eventually, lithium was discontinued and patient did well on a combination of carbamazepine and olanzapine. In this case, we would like to emphasize not only the intermittent but also the atypical presentation of acute dystonic reactions with involvement of large muscle groups, the resemblance to NMS, and a “spectrum” of dystonic reactions rather than one clear-cut presentation. We can only speculate the role lurasidone played in this presentation but reoccurrence of dysarthria on day 54 after lithium was restarted points to its major role.Table not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.
From Child and Adolescent to Adult Mental Health Services: The Intrepid Journey
Authors: Nascimento M. , Santos C.C. , Bastos Martins G. 
Published: May 2016

BackgroundThe move from Child and Adolescent Mental Health Services (CAMHS) to adults’ services (AMHS) is likely to coincide with other transitions in the adolescents’ life. Barriers affecting this transition have been referred in most countries, but there is a lack of studies on this matter.AimsTo evaluate the transitional process from CAMHS to AMHS in Portugal, focusing on four criteria: continuity of care, parallel care, a transition planning meeting and information transference. The continuity/discontinuity of the diagnosis and therapeutic plan made at CAMHS has also evaluated.MethodsIdentification from a sample of adolescents transferred from Clínica da Juventude (adolescents’ clinic) to 3 major AMHS, collecting information regarding the quality of the transition between these services.ResultsFifty-nine adolescents were discharged in 2014, average of 16.5 years old, after being followed in our clinic for an average of 7.44 months. Ten continued being followed in adult psychiatric services (17.5%), with different disorders: 4 depressive, 2 personality, 1 anxiety, 1 bipolar, 1 addiction to psychoactive substances, and 1 oppositional defiant disorder. Even in those cases the transition was far from optimal, with 4 of those presenting the need to use adult emergency facilities.ConclusionsSeveral barriers between CAMHS and AMHS might account for the ongoing problem with the transition between services. In addition, considering that the onset of severe and recurring mental disorders begins generally before the age of 25, this raises the discussion around the present distinction between child and adolescent mental health services and adult services at 18 years old.Disclosure of interestThe authors have not supplied their declaration of competing interest.