bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship of Severity of ADHD Symptoms with the Presence of Psychological Trauma While Controlling the Effect of Impulsivity in a Sample of University Students
Authors: Dalbudak E. , Evren C. , Evren B. , Ozen S. 
Published: June 2017

ObjectiveThe aim of the present study was to evaluate relationship of severity of ADHD symptoms with the presence of psychological trauma while controlling the effect of impulsivity in a sample of university students.MethodParticipants included 321 volunteered university students. Participants were evaluated with the Short Form Barratt Impulsiveness Scale (BIS-11-SF), the Adult ADHD Self-Report Scale (ASRS) and the Traumatic Experiences Checklist (TEC).ResultsAge and gender did not differed between those with the history of psychological trauma (n = 271, 84.4%) and those without (n = 50, 15.6%). BIS-11-SF and subscale scores did not differ between groups, other than motor impulsivity, which was higher among those with the history of psychological trauma. ASRS score, inattentiveness and hyperactivity/impulsivity subscale scores were higher among those with the history of psychological trauma than those without. Severity of ADHD symptoms, particularly inattentiveness score, predicted the presence of psychological trauma, together with the severity of motor and attentional impulsivities in a logistic regression model.ConclusionThese findings suggest that the severity of ADHD symptoms may be related with the presence of psychological trauma, while severity of motor and attentional impulsivities may have an effect on this relationship among young adults.Disclosure of interestThe authors have not supplied their declaration of competing interest.
From (Psycho) Pathology to Diagnosis: Psychiatry Nosology Beyond Dichotomy
Authors: Erfurth A. , Sachs G. 
Published: June 2017

As in all medical disciplines, diagnosis in clinical psychiatry should be reached in a step-wise approach: after assessing the chief complaint of the patient, a careful examination of the psychopathology follows e.g. by using the AMDP system [1] to preliminarily conclude the process with a syndromal classification [2]. This syndromal classification is of great importance as it guides the initiation of therapy in daily life practice. After gaining additional information (e.g. investigation in the course of the disease, brain imaging, thorough assessment of cognitive function, exclusion of organic causes) a final diagnosis is possible. Unfortunately, a premature jumping to diagnosis is not uncommon (with the potential consequence of incorrect therapies).In addition to these difficulties, recent neurobiological research has shown that nosologic assignments through conventional diagnostic classifications are far less specific than assumed, revealing a large overlap between diagnostic categories [3,4], e.g. between Schizophrenia and affective disorders. Consequences of this finding are discussed both for the construction of future classification systems and for therapy.Disclosure of interestThe authors declare that they have no competing interest.
Major Depressive Disorder: Recurrence Risk Factors
Authors: Ben Soussia R. , Khouadja S. , Marrag I. , Younes S. , Nasr M. 
Published: June 2017

IntroductionIn spite of the frequency and the gravity of the depressive episodes, the major depressive disorder (MDD) is diagnosed and treated today insufficiently and the risk factors of its recurrence are little approached.Aims of the studyDescribe the socio–demographic, clinical and therapeutic characteristics of patients with MDD and identify the factors involved in the recurrence risk.MethodologyThis is a retrospective study carried out in the university hospital of Mahdia, Tunisia during two years. We have included patients with a follow up for at least two years and diagnosed with MDD, isolated episode or MDD, recurrent episode according to the DSM-IV-TR criteria. Data collection was performed using two pre-established questionnaires respectively with 51 and 92 items. We have estimated the time to recurrence with the Kaplan-Meier estimator.ResultsWe have collected 150 patients. The time to recurrence was 109 months. Five factors were associated with recurrence: early age at onset of the disorder, family history of mood disorders, severity of the index major depressive episode, persistent residual symptoms and ceasing treatment.ConclusionDepression is a very common mental illness that is highly recurrent in individuals. There is great interest in the development of strategies that might reduce the recurrence of depression.
Psychosis and Autism Spectrum Disorders
Authors: Kyriakopoulos M. 
Published: June 2017

Autism spectrum disorders (ASD) and schizophrenia were separated into different diagnostic categories in the late 1970's (DSM-III) having previously been considered as related diagnostic entities. Since then, several lines of evidence have indicated that these disorders show clinical and cognitive overlaps as well as some common neurobiological characteristics. Furthermore, there is a group of patients presenting with ASD and psychotic experiences who pose particular diagnostic and management challenges and may represent a subgroup of ASD more closely linked to psychosis. Evidence from a study of the first empirically derived classification of children with ASD in relation to psychosis based on three underlying symptom dimensions, anxiety, social deﬁcits and thought disorder, will be presented. Further phenomenological, genetic and neuroimaging research on the clinical boundaries and overlapping pathophysiology of ASD and psychosis may help better define their relationship and lead to more effective interventions. Understanding this relationship will also provide a framework of working with patients with mixed clinical presentations.Disclosure of interestThe author declares that he has no competing interest.
Neurobiology of Autism Spectrum Disorders
Authors: Sheldrick-Michel T.M. , Morten B.T. , Niels B. , Mirolyuba I. 
Published: June 2017

Autism Spectrum Disorders (ASD) is a group of neurodevelopmental disorders with heterogeneous etiology characterized by deficits in social cognition, communication, and behavioral flexibility. Disturbances on molecular and cellular level in early brain development incl. intercellular communication, an unbalanced ratio between certain neuronal populations and maturation/differentiation process, oxidative stress, happening in embryonal stages, might be promising candidates to explain the development of autistic symptoms.In order to get a deeper understanding of these processes, valid “disease models” are pivotal. A new cutting edge technique, named brain organoids, has been highlighted as a promising candidate for obtaining a better “disease model”.Brain organoids derived from patients induced pluripotent stem cells (iPSC) follow in vivo timeline development; they also have the ability to recreate the right complexity of the brains, developmental stages. On the cellular and gene expression level, organoids demonstrate a high similarity to the developing brain in vivo and can therefore recapitulate early stages of the neurogenesis. To date organoids are the most relevant cellular in vitro platform for the understanding of the mechanisms behind ADS pathology. Investigations of “mini brains” at different time points in their development will give a wider and more detailed picture of the disease dynamic and thus the development of therapeutic and prevention strategies. It is a tool that can be used for effective high throughput screening of chemical compounds as potential drugs (“in sphero” drug testing). Organoids are a good modeling system for elucidating the role of epigenetic and environmental factors for development of ASD.Disclosure of interestThe authors declare that they have no competing interest.
New Technologies in Suicide Prevention
Authors: Pompili M. 
Published: June 2017

IntroductionThe use of new technologies is beginning to be embraced by volunteers and professionals, from crisis lines, suicide prevention centers, mental health centers, researchers and politicians.ObjectivesNew technologies have entered the field of suicide prevention with high expectations for the future, despite a relatively slow start. Internet, smartphones, apps, social networks and self-help computer programs have a strong potential to achieve, sustain and help people at risk of suicide, their families, teachers, health professionals and for the survivors.AimsTo provide comprehensive overview on the role of new technologies in suicide prevention.MethodsGiven the relatively early and underdeveloped state of this area of inquiry, the author viewed his task as gathering and critically appraising the available research relevant to the topic, with the aim of formulating a hypothesis to be tested with further research.ResultsNew cheaper services will soon be available to effectively reach and assist the most vulnerable people and prevent suicides. The potential to help vulnerable people who do not use conventional mental health services and people in regions with inadequate psychiatric facilities represents an attractive target with favourable perspectives for suicide prevention Smartphone, apps, websites, avatar coach, and virtual suicidal subjects are important for both delivering help as well as to educate mental health professionals as in the case of role playing.ConclusionsShadows and lights are emerging through the use of new technologies. If more people can be reached there are however concern for improper use of social network and pro-suicide websites.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
How Involuntary Admission Might Have Been Avoided: An Interview Study of Referring General Practitioners
Authors: Røtvold K. , Wynn R. 
Published: June 2017

IntroductionThe legal criteria for involuntary admission in Norway are that the patient has a serious psychiatric disorder (i.e. psychosis) and is in need of admission to secure needed treatment or that there is a risk of danger. While there have been some studies focusing on coercion in hospitals, less is known about the processes leading up to involuntary admission and the reasoning of referring doctors. In Norway, it is primarily general practitioners (GPs) that refer patients.AimsTo study which factors that GPs who had recently referred patients to involuntary admission thought might have made their latest referral unnecessary.MethodsSeventy-four GPs were interviewed by phone. They had all recently referred patients involuntarily to a major Norwegian university psychiatric hospital. One central question concerned how their latest involuntary referral might have been avoided.ResultsThese are the main factors that the GPs thought could have been of importance in avoiding involuntary referral of their patients:– that the patient took the prescribed medication (28%);– that they personally had the opportunity to closely follow up the patient in the following days (22%);– that other health care staff could follow up the patient closely in the patient's own home (i.e. home care nursing, etc.) (19%);– that a family member of the patient could help the patient (8%).ConclusionsThe GPs suggested that an increased availability of resources and more assistance from other parts of the health service were some of the factors that could be of importance in reducing involuntary admissions.
Assessments of Need for Treatment and Danger in Decisions About Community Treatment Orders
Authors: Stuen H.K. , Landheim A. , Rugkåsa J. , Wynn R. 
Published: June 2017

BackgroundA total of, 14 Norwegian assertive community treatment (ACT) teams have been established. During the teams’ first year of operation, approximately 35% of the enrolled patients were subjected to community treatment orders (CTOs) at intake. CTOs are a legal mechanism to secure treatment adherence, and may be used in Norway when severely mentally ill patients refuse necessary treatment (‘treatment criterion’) or when they are considered a danger to themselves or others (‘danger criterion’). Even if the use of CTOs seems to increase in Norway, few have examined in detail how and why these decisions are made. The purpose of the present study was to explore assessments of need for treatment and danger in decisions about CTOs.MethodSemi-structured interviews with eight responsible clinicians and four focus-group interviews with 20 ACT providers were recorded and transcribed. We also read case files and observed selected treatment planning meetings. The data were analyzed with a modified grounded theory approach.ResultsThe ACT teams provided high-intensive services over longer periods of time, which gave the teams important knowledge about the patients, reduced clinical uncertainty, and allowed for well-informed decisions about the need for coercive interventions. The treatment criterion was typically used to justify the need for CTOs. However, the danger criterion was in some cases used when patients had to be readmitted to hospital.ConclusionsAccording to the clinicians that were interviewed, patients’ need for treatment was most often used to justify the CTOs in the Norwegian ACT teams.
QuIQ (Quick Instrument for Quality of Life): A New Instrument for a Rapid Assessment of Generic Quality of Life
Authors: Bianco A. , Scuticchio D. , Piva Merli M. , Bertelli M.O. 
Published: June 2017

IntroductionRecently, new patient-oriented outcome measures have emerged in mental health research and practice. Among these, generic quality of life (GQoL) has gained a central place and has come to represent a valid endpoint in most settings, from basic care programs to clinical trials, especially for the field of intellectual disability (ID). However, most studies still refer to health-related QoL, and the tools for the assessment of GQoL present many issues related to the structure complexity and administration time.AimThe purposes is to evaluate psychometric properties of a new rapid tool for the GQoL assessment named QuIQ (quick instrument for quality of life), originally constructed for use for people with ID.MethodsTwo hundred and ten persons with ID were consecutively administered with the QuIQ. A part of them were also assessed with the BASIQ, the Italian adaptation of the quality of life instrument package. QuIQ has the same conceptual framework and refers to the same areas of the BASIQ, but include a low number of dimensions (only attribution of importance and perception of satisfaction) and a factor way of score attribution such as visual analogue scale and graphic geometrical mean calculation.ResultsQuIQ showed good internal coherence (Cronbach's α = 0.92), inter-rater reliability (Cohen's K > 0.93), and concurrent validity (> 0.8) with BASIQ.ConclusionThese findings seem to display for the QuIQ good psychometric characteristics. They also suggest that it could be possible to apply rapid QoL assessment to all the range of people with ID. This could have very important implications for future massive use in different settings.
Behavioural Equivalents as Predictors of Psychiatric Disorder in People with Intellectual Disability
Authors: Rossi M. , scuticchio D. , bertelli M.O. 
Published: June 2017

IntroductionThe last decades’ considerable advances of the psychiatric assessment in People with Intellectual Disability (PwID) do not include the ability to identify Behavioural Equivalents (BE) of psychiatric symptoms and their relationship with different psychiatric syndromes. Recent reports have found BE to be differentially associated with one or more specific Psychiatric Disorders (PD).AimsThe present study was aimed at evaluating the correlations between BE and DSM-5 syndromic groups of symptoms, in a wide multicentric sample of PwID.MethodsAn observational cross-sectional analysis was performed for a sample of 843 adults with ID, randomly or consecutively recruited among those living in residential facilities of the National Healthcare System, or in private institutes of care, or those attending psychiatric outpatient clinics. The total sample was administered with the SPAID-G (Psychiatric Instrument for Intellectual Disabled Adult - General version), which is a checklist for the detection of significant behavioural changes from the baseline. The items of the checklist represents BE of the symptoms of the main psychiatric disorders included in the DSM-5.ResultsMany significant correlations were found, some of the most relevant were for mood disorders. Psychomotor agitation, aggressivity, disorganised behaviour and distractibility were most pronounced in bipolar patients; for depressed patients, irritability and weight loss had higher correlations than in other diagnostic groups.ConclusionsAlthough not diagnostically specific, some BE seem to be more strongly related with specific PD. This line of research could improve the definition of the specific expression and clustering of psychiatric symptoms in PwID.
Does a Bespoke Intellectual Disability (ID) Epilepsy Service Reduce Mortality? A 11 Year Study of Sudden Unexpected Death in Epilepsy (SUDEP) in Cornwall UK
Authors: Shankar R. 
Published: June 2017

AimEpilepsy is the second most common cause of premorbid mortality in the ID population. Rates of SUDEP are considered up to 9 times higher in the ID population. Cornwall UK (population 600.000 i.e. 1% of UK) runs a specialist ID epilepsy community service for adults with ID. It delivers reasonable adjustments and person centered care to this population. We measured how service outcomes on SUDEP compared to regional and national averages.MethodsData of all Cornwall epilepsy deaths 2004–2015 using the Cornwall Coroner's database and the Public Health Cornwall was reviewed systemically. We identified patients with and without ID.ResultsThere were 113 epilepsy deaths of which 57 were SUDEPs of which 3 were identified to have a clinical diagnosis of ID. In another 2 cases it was not evident if they had an ID or not. None of the 5 was known to the ID Epilepsy service. Mean and 95% confidence intervals were calculated using a binomial calculation, making no prior assumptions about the population distribution.ConclusionCornwall's specialist ID epilepsy service is a rarity in the UK. A recent study using the Leicestershire ID Register revealed 26 people with ID of the total deaths of 83 SUDEP. This contrasts greatly with Cornwall only 5.26% of SUDEP deaths had ID compared to 23.4% in Leicestershire and similarly when compared to neighboring Plymouth (population 300.000) which had 26% ID deaths in its SUDEPs between 2004–2012. It is possible that having an ID dedicated epilepsy service saves lives.
CYP450 Enzymes Genetic Polymorphism Influence on Treatment of Affective Disorders
Authors: Lengvenytė A. , Strumila R. , Dlugauskas E. , Utkus A. 
Published: June 2017

IntroductionIndividualized treatment decisions in psychiatry may be important, since substantial part of first choice drugs are ineffective or cause side effects. Polymorphic variants of genes that code CYP450 enzymes cause differences in their activity and therefore in efficacy and safety of drugs that are metabolized by them.Aim of the studyDetermine whether pharmacogenetic testing of CYP2D6, CYP2C19 and CYP2C9 polymorphism would have had influence on selected patients’ treatment courses.MethodsFive patients that were diagnosed for treament-resistant mood disorders in Vilnius university hospital Santariskiu clinics centre of neurology, department of psychiatry were invited to give blood samples for genetic testing retrospectively. Patients’ CYP2C19, CYP2D6 and CYP2C9 enzymes genetic polymorphism results were compared with previous empirical pharmacological treatment courses of these patients.ResultsIn four out of five cases significant polymorphism of CYP2C19 enzyme allele was detected. In all of these cases 1*/2* variant, that conditions intermediate metabolizer phenotype, was identified. Alterations in CYP2D6 and CYP2C19 regions were not found. In three cases the presence of varied genetic variant could have been clinically relevant. In two of these cases Sertraline and valproates, that are both metabolized by CYP2C19 enzyme, were taken by patients and side effects were observed. Unsuccessful treatment was repeated without effect, both in clinical and outpatient environment. Continuous rehospitalization took place until appropriate empirical treatments were established.ConclusionsPharmacogenetic testing could have had influence on treatment choices for three out of five selected patients leading to less side effects and rehospitalizations.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Biological Correlates of the Effects of Cognitive Remediation in the Psychoses
Authors: Penades R. 
Published: June 2017

Cognitive Remediation Therapy (CRT) deals with the cognitive impairment, which is one of the most disabling symptoms of schizophrenia. Unfortunately, the understanding of its neurobiological correlates is far from complete. Neuroimaging studies have shown that CRT is able to induce neurobiological changes although the results have not always been enough replicated. The most commonly reported changes were those that involved the prefrontal and thalamic regions. Additionally, structural changes were described in both the grey and white matter, suggesting a neuroprotective effect of cognitive remediation. Neuroimaging studies of cognitive remediation in patients with schizophrenia suggest a positive effect on brain functioning in terms of the functional reorganisation of neural networks. From a different perspective, some changes in serum levels of Brain derived neurotrophic factor (BDNF) have been described. However, our replication of this trial has not been able to find any significant differences. So, nowadays the status of BDNF as a biomarker of cognitive recovery is possibly premature. One possible explanation can be the role of genetics and their different polymorphisms. COMT and BDNF polymorphisms could be accounting for the different outcomes of CRT. Moreover, some studies suggested a role of genes affecting dopamine modulation on outcomes of cognitive remediation.Disclosure of interestThe author declares that he has no competing interest.
Impact of Cognitive Remediation on the Use of Psychiatric Services and Patterns of Care of Patients With Psychoses
Authors: Vita A. 
Published: June 2017

Cognitive remediation (CR) has proved to be effective in improving cognition, symptoms and psychosocial functioning in schizophrenia and other psychoses, but its impact on the use of psychiatric services and patterns of care of patients suffering from these diseases is still scarcely known. In fact, it would be particularly relevant to know if such intervention may have any modifying effect on use of services and costs of treatments. There is preliminary evidence that such an impact does exist, with possible reduction of number and duration of hospitalizations and of long-term residential stays and consequent reduced costs of inpatient treatment. On the other hand, community treatment costs could be increased as an effect of a shift of psychiatric and psychosocial interventions from inpatient to outpatient activities. A critical review of the existing literature on the issue will be provided, together with a discussion of the impact of this shift towards the attainment of increased functional and social recovery in the individual patient.Disclosure of interestThe author declares that he has no competing interest.