bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression Among Tunisian Young Mothers
Authors: Zerriaa O. , Moula O. , Ben Saadi S. , Chebli S. , Ghachem R. 
Published: June 2017

IntroductionIn the Tunisian cultural context, the mother is in charge of childcare, housekeeping and the well-being of the whole family, which can lead to exhaustion and depression.ObjectiveTo estimate the frequency of depression among mothers aged between 20 and 40 years, its consequences and the possible solutions.MethodTransversal study using an anonymous questionnaire of 26 questions published through social media sites to mother with young aged children.ResultsThree hundred and twenty-seven mothers participated in the study: 20% of them aged between 20 and 30 years and 80% between 30 and 40. Ninety-seven percent of the participants were married; 96% of them had university education. Seventy-nine percent of them were working mothers and 50% of them did not get any help in childcare. Forty-two percent of the participants had only 1 child, 49% had 2 children, 8% 3 children and only 1 mother had 4 children. Depressive symptoms were present in 73% of the participants and were significantly higher among mothers aged between 30 and 40. However, depression was certain in only 36% of them and there was no significant difference between the two age groups. Eighteen percent of the participants noticed an increase in consummation of cigarettes, 31% resorted to tranquilizers, 25% needed sick leaves, and 2% resorted to alcohol use. Less working hours was suggested as a solution in 36% cases, sharing house chores in 30% cases.ConclusionDepression among young mother is a public health problem in Tunisia. It is underestimated and not always treated, which can have a serious impact on the whole family well-being.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Increased Prevalence of Major Depressive Disorder in Patients who Get Admitted with Atrial Fibrillation with Worse Outcomes
Authors: Mansuri Z. , Patel S. , Patel P. , Jayeola O. , Das A. , Shah J. , Gul M.H. , Ganti A. , Karnik K. , Patel R. 
Published: June 2017

ObjectiveTo determine trends and impact on outcomes of atrial fibrillation (AF) in patients with pre-existing major depressive disorder(MDD).BackgroundWhile post-AF MDD has been extensively studied, contemporary studies including temporal trends on impact of pre-AF MDD on AF and post-AF outcomes are lacking.MethodsWe used Nationwide Inpatient Sample (NIS) from Healthcare Cost and Utilization Project (HCUP) from 2002 to 2012. We identified AF and MDD as primary and secondary diagnosis respectively using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD9CM) codes, and used Cochrane-Armitage trend test and multivariate regression to generate adjusted odds ratios (aOR).ResultsWe analyzed total of 3,887,827 AF hospital admissions from 2002 to 2012 of which 6.78% had MDD. Proportion of hospitalizations with MDD increased from 4.93% to 14.19% (P-trend < 0.001). Utilization of atrial cardioversion was lower in patients with MDD (34.37% vs. 40.52%, P < 0.001). In-hospital mortality was significantly lower in patients with MDD (aOR0.749; 95% CI 0.664–0.846; P < 0.001) but discharge to specialty care was higher (aOR 1.695; 95%CI 1.650–1.741; P < 0.001). In addition, median length of hospitalization (2.5 vs. 2.13 days; P < 0.001) and median cost of hospitalization (28,246 vs. 22,663; P < 0.001) was higher in hospitalizations with MDD.ConclusionsOur study displayed an increasing proportion of patients with MDD admitted due to AF in the last decade with lower mortality but higher morbidity post-AF. In addition, there was significantly less utilization of atrial cardioversion in this population along with higher median length and cost of hospitalization. There is a need to explore the reasons behind this disparity in outcomes and atrial cardioversion utilization in order to improve post-AF outcomes in this vulnerable population.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Temporal Trends in Drug Abuse in Adults with Acute Myocardial Infarction Show Worse Outcomes
Authors: Mansuri Z. , Patel S. , Patel P. , Jayeola O. , Das A. , Shah J. , Gul M.H. , Karnik K. , Ganti A. , Patel R. 
Published: June 2017

ObjectiveTo determine temporal trends, invasive treatment utilization and impact on outcomes of pre-infarction drug abuse (DA) on acute myocardial infarction (AMI) in adults.BackgroundDA is important risk factor for AMI. However, temporal trends in drug abuse on AMI hospitalization outcomes in adults are lacking.MethodsWe used Nationwide Inpatient Sample (NIS) from Healthcare Cost and Utilization Project (HCUP) from 2002 to 2012. We identified AMI and DA as primary and secondary diagnosis respectively using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD9CM) codes, and used the CochraneArmitage trend test and multivariate regression to generate adjusted odds ratios (aOR).ResultsWe analyzed total of 7,174,274 AMI hospital admissions from 2002 to 2012 of which 1.67% had DA. Proportion of hospitalizations with DA increased from 5.63% to 12.08% (P trend < 0.001). Utilization of coronary artery bypass grafting (CABG) was lower in patients with DA (7.83% vs. 9.18%, P < 0.001). In-hospital mortality was significantly lower in patients with DA (aOR 0.811; 95% CI 0.693–0.735; P < 0.001) but discharge to specialty care was higher (aOR 1.076; 95% CI 1.025–1.128; P < 0.001). The median cost of hospitalization (40,834 vs. 37,253; P < 0.001) was higher in hospitalizations with DA.ConclusionsWe demonstrate an increasing proportion of adults admitted with AMI have DA over the decade. However, DA has paradoxical association with mortality in adults. DA is associated with lower CABG utilization and higher discharge to specialty care, with a higher mean cost of hospitalization. The reasons for the paradoxical association of DA with mortality and worse morbidity outcomes need to be explored in greater detail.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Intensive Case Management (ICM) Project in Eastern Lower Austria: A Description
Authors: Ramirez Gaite M. , Gundendorfer-Mag. FH E. , Hrubos W. 
Published: June 2017

IntroductionOur ICM Project was implemented in 2012, with the primary objective of preventing hospitalizations and unburdening services. Here, we present a description.ObjectivesICM is a type of multi-professional assertive community treatment (ACT) and case management, although our concept has a stronger focus on social work than ACT and uses less resources. It aims at patient's stabilization at home, better life quality, less inpatient/residential treatments, and more access to crisis intervention.MethodsPresently we have 118 spots. Target groups are persons with severe psychiatric conditions at high risk for institutionalization or already institutionalized, including heavy users of mental health services. An initial eligibility assessment is required. At least 3 workers are providing a minimum of 2 h face-to-face contact per week per person. Care is offered predominantly at home environment and anchored in: careful distance-closeness ratio, structured and restructuring, autonomy enhancing, respectful, non-judgmental, confidential, regularity and commitment. Each treatment plan is individualized and based on two axes: intensive assistance and day-structure. It comprises comprehensive psychiatric treatment, counselling, assistance in everyday life, support groups, crisis management and interdisciplinary organizational meetings.ResultsThe program was evaluated in 2014 using the CANSAS and FLZ scales and its effectiveness was validated. Most significant improvements were found in day-structure, housing, social contacts and performance, nutrition, and psycho-education. Life satisfaction improvement was found mostly in areas of general health, performance, relaxation and autonomy.ConclusionsSince its implementation ICM has steadily expanded. Further research tools are currently being developed. Results will be presented in future publications.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Association Between ADHD and Psychopathology Among Prison Inmates
Authors: Machado A. , Rafaela D. , Silva T. , Cerejeira J. 
Published: June 2017

IntroductionSeveral studies showed that among people with ADHD, the prevalence of psychiatric comorbidities is the rule, both in general population and in perpetrators.ObjectivesTo analyze the relationship between ADHD and other psychiatric symptoms among prison inmates from a high security male prison in Portugal.MethodsA total of 101 subjects aged 18–65, with at least 4 years of formal education, were interviewed for socio-demographic data and completed the ASRS-v1.1 (Adult ADHD Self-Report Scale) and the BSI (Brief Symptom Inventory). Subjects were divided into ADHD positive or negative according to their score on ASRS-v1.1, and then compared regarding BSI scores using Student's t-test.ResultsSeventeen subjects scored positive for ADHD. They significantly differed from the non-ADHD group in the total BSI score (t = −4.27, P < 0.001). When looking into the different subscales of BSI, the groups differed in the subscales of obsessions/compulsions (t = −4.05, P < 0.001), interpersonal sensibility (t = −3.47, P 0.001), hostility (t = −6.71, P < 0.001), paranoia (t = −3.17, P 0.002) and psychotism (t = −3.20, P 0.002), with the ADHD group scoring higher in all the mentioned subscales. No significant differences were found between the groups in the subscales regarding anxiety, depression or somatization.ConclusionsIn line with previous work, our study showed a higher prevalence of psychopathology in prison inmates with ADHD, then in non-ADHD subjects. However, while higher prevalence of depressive and anxiety symptoms in ADHD subjects is mentioned in other studies, we found no differences between the two groups concerning those subscales. The subscales that significantly differed, point to higher prevalence of disfunctional relationships and a higher tendency for violent behaviour in the ADHD group.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Risk Factors Related to Homicide in Moroccan Patients with Schizophrenia
Authors: Kachouchi A. , Majda D.S. , Said D.S. , Imane P.A. , Fatiha P.M. , Mohamed P.A. , Fatima P.A. 
Published: June 2017

BackgroundThe relationship between schizophrenia and homicide is complex and cannot be reduced to a simple causal link.ObjectivesThe objectives of this study were to describe the characteristics of homicide in Moroccan patients suffering from schizophrenia and to determine the correlated socio-demographic, clinical and toxic variables.MethodsThe study included two groups of patients with a DSM-IV diagnosis of schizophrenia who attended the “Ibn Nafis” university psychiatric hospital of Marrakech in Morocco. The first group was composed of 30 patients hospitalized for homicide in the forensic unit between the first January 2005 and the 31st of August 2015. The second group included 90 patients without any criminal record. These two groups have been matched according to age and gender. Demographic, clinical and therapeutic variables were analyzed and compared between the two groups.ResultsThe mean of age in the first group was 37.03 and in the second group was 31.4. No significant difference was found between the two groups regarding the different socio-demographic variables and the age of onset of disease. Significant difference was found between the two groups regarding: personal antecedents of attempt of homicide a (P < 0.003), personal antecedents of attempt of suicide (P < 0.001), a history of previous violence (P = 0.005), untreated psychosis before the act (P < 0.001) poor medication compliance and a low familial support (P < 0.001), antisocial behavior (P < 0.001), addictive behavior (P = 0.007).ConclusionAwareness of these factors will allow us to provide improved prevention of violence within schizophrenic subjects.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Eating Disorders in Schizophrenia
Authors: Sallemi R. , Hentati S. , Feki I. , Masmoudi J. , Moala M. 
Published: June 2017

BackgroundDue to their frequency and negative impact on quality of life, eating disorders in schizophrenia need to be considered and highlighting.ObjectiveTo identify the risk of eating disorders (ED) and its correlates among mental patients.MethodsIt was a descriptive and analytic study. It included 53 inpatients with DSM-5 diagnoses of schizophrenia or schizoaffective disorder, followed in the department of Psychiatry at the Hedi Chaker University Hospital of Sfax in Tunisia, during the three months of August, September and October 2016. Data collections were conducted using questionnaire exploring sociodemographic and medical data. The SCOFF (sick, control, one, fat, food) Questionnaire was used to screen ED. A total score of ≥ 2 was used as a cutoff point to select persons at risk of ED.ResultsThe average age of our patients was 30.47 ± 9.5 years old. The majority of our patients was male (71.7%) and single (71%). The mean of extra Body mass was 27.9. The mean duration of disease was 9.9 ± 8.1 years and patients were mostly (54%) in atypical neuroleptics. According to the SCOFF Questionnaire, 35.8% had a risk of ED. Female gender and treatment with atypical neuroleptics were significantly associated to ED risk with respectively P = 0.02 and P = 0.038.ConclusionEating disorders remain underestimated among patients suffering from schizophrenia. Yet, its screening prevention and management are crucial and must be multidisciplinary for optimal care.Disclosure of interestThe authors have not supplied their declaration of competing interest.
How Dissociation, Temperament and Character Influence at the Eating Disorders
Authors: Muñoz Martínez V. , Rodriguez Cano T. , Beato Fernández L. , Jimenez Londoño G.A. , Mata Saenz B. , Asensio L. , Nuevo Fernandez L. , Mella L. 
Published: June 2017

ObjectivesDissociation has been related to emotional dysregulation and eating psychopathology. Dissociation may interfere with the learning process, affecting at the therapy negatively. The aim of the study is to analyse if at the eating disorders (ED), dissociation is linked to temperamental traits or also to character traits, which are susceptible to be modulated during the therapeutic process.MethodsWe studied 119 females that started an outpatient program for their ED. We used the Dissociative Experience Scale (DES), Temperament and Character Inventory (TCI), Eating Attitudes Test (EAT-40), and the State Trait Anxiety Inventory (STAI). We used multiple regression analysis.ResultsDissociation was associated with high scores on the EAT-40, even controlling the effect of anxiety traits, which also was related to dissociation. The temperament dimension “searching for novelty”, has been related in an opposite way to the DES. Also, the “dimension of transcendence “character and “self determination” influenced on the DES.ConclusionsThis study confirms the importance of improving Self Determination levels at ED therapy, which influence on a lot of prognostic aspects, such as protecting from dissociation, which is related to anxiety and alimentary psychopathology and can interfere with the therapeutic progress.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Microstructural Changes in Patients with Parkinson's Diseases and REM Sleep Behavior Disorder: Depressive Symptoms Versus Non-Depressed
Authors: Mohammadi Jooyandeh S. , Aarabi M.H. , Rahmani F. 
Published: June 2017

IntroductionREM sleep behaviour disorder (RBD) is associated with psychiatric symptoms, such as anxiety and depression. RBD is characterized by loss of normal skeletal muscle atonia during rapid eye movement (REM) sleep with prominent motor activity and dreaming and is a usual symptom of the early stages of Parkinson's disease (PD). Diffusion MRI connectometry was used to carry out group analysis between age and gender matched PD patients with RBD in with and without depression to characterize possible depression-related white matter microstructural changes in the Parkinson patients with RBD.MethodDWI images were obtained for 15 PD-RBD with depression and 27 PD-RBD without depression. This dataset was acquired on a 3 Tesla Siemens scanner, producing 64 DWI at b = 1000 s/mm2 and one b0 image. Diffusion MRI data were corrected for subject motion, eddy current distortions, and susceptibility artefacts due to the magnetic field inhomogeneity. Diffusion MRI connectometry was conducted in a total of 27 subjects using percentage measurement.ResultsPD-RBD Patients with depressive symptoms showed decreased anisotropy (FDR < 0.05) in the fornix bilaterally, right cingulum, inferior longitudinal fasciculus bilaterally, right corticospinal tract and Genu of corpus callosum compared to PD-RBD patients without depression.ConclusionSince RBD is considered to be an early symptom of PD and also a marker of progression to PD, these results might PD-RBD patients with depression may progress dementing processes and visuospatial dysfunction earlier since fornix, cingulum and ILF have proven to be associated with these cognitive dysfunctions respectively.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Light as an Aid for Recovery in Psychiatric Inpatients: A Randomized Controlled Effectiveness Pilot Trial
Authors: Okkels N. , Jensen L.G. , Arendt R. , Blicker A.B. , Hjortdal J. , Jennum P. , Straszek S. 
Published: June 2017

IntroductionElectric indoor lighting can disturb sleep and increase depressive symptoms; both common complaints in psychiatric inpatients.AimsTo improve quality of sleep in patients using an indoor hospital lighting environment simulating nature in intensity, color, and circadian timing.MethodsInvestigator-blinded parallel group randomized controlled effectiveness trial supplied with qualitative interviews in an inpatient psychiatric ward with fully automatic and adjustable lighting. Admitted patients received a room with a naturalistic lighting environment (intervention group) or lighting as usual (control group). The primary outcome was the Pittsburg Sleep Quality Index and secondary outcomes included the Major Depression Inventory and WHO-five Well- Being Index.ResultsIn this ongoing trial, we included 28 patients (16 treated and 12 controls). Patients in the intervention group reported higher subjective sleep quality and sleep efficiency, lower use of sleep medication (mean difference, 4.68 mg; 95% CI, 0.54; 53.5), fewer depressive symptoms (mean difference, 5; 95% CI,–2; 13), but lower well-being (difference,–4 percentage points; 95% CI,–20; 16), compared with the control group. At discharge, fewer patients in the intervention group had experienced use of involuntary treatment. Qualitative data indicated no side effects apart from issues in performing indoor leisure activities in dim light.ConclusionsA naturalistic lighting environment was safe and improved sleep and mood in our small patient sample. The trial integrated well with routine clinical care and our sample reflected the heterogeneity of the target population (Funded by Region Midtjylland and others; Clinicaltrials.gov number, NCT02653040)Disclosure of interestThe authors have not supplied their declaration of competing interest.
Risk of Suicide Mortality Among Cancer Patients: A Meta-Analysis of Observational Studies
Authors: Calati R. , Di Mattei V. , Courtet P. 
Published: June 2017

IntroductionSuicide rates among patients with cancer are higher than ones in the general population.ObjectiveThis meta-analysis aims to estimate the suicide risk in patients with cancer.MethodsWe searched Medline, PsycINFO, and the Cochrane library to identify articles published before July 1, 2016, examining the association between suicide [death (SD), attempt (SA), ideation (SI)] and any form of diagnosed cancer.ResultsWe initially identified 4880 records and after unsuitable studies were removed, our search yielded 102 publications of which 14 were used in the meta-analyses. Patients with cancer had higher risk of SD (seven studies, 247.869 participants; odds ratio [OR] = 1.52, 95% CI = 1.22–1.89, P = 0.0002) compared with those without cancer (among case-control studies focused on SD versus living controls). Among studies focused on SD versus other deaths, patients with cancer had higher risk of SD (two studies, 23.839 participants; OR = 1.53, 95% CI = 1.03–2.27, P = 0.03). No difference has been detected for risk of SA (four studies, 8.147.762 participants) and for SI (two studies, 37.879 participants).Since publication bias was detected, the “trim and fill” method was applied. The majority of the included studies have a high quality at the STROBE statement.ConclusionThe assessment of suicide risk in this population is crucial.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Workplace Assessment in Crisis? – The Way Forward
Authors: Al-Taiar H. 
Published: June 2017

IntroductionA recent Royal College of Physicians’ (RCP) study on assessment raises serious questions for workplace assessment. To address these, a system that bridges the gap from competence to performance and integrates supervised learning events (SLEs) that are formative in purpose with summative assessment of performance by entrustable professional activities (EPAs) is recommended.Aims and objectivesAs a working group on assessment in psychiatry, we were interested in the RCP findings which represent a significant milestone in studies of workplace assessment. The RCP aims were to evaluate the feasibility, validity and educational value of using existing WPBA tools but for different assessment purposes and processes.ResultsThese were based on the General Medical Council (GMC) working party on assessment. The RCP revised its assessment processes to differentiate between assessments of development and performance. The former are formative and aim to identify a trainee's areas of strength and development; the latter are summative and aim to determine fitness to progress. Of note is that the same workplace based assessment (WPBA) tool can be used for each type of assessment; the assessment's purpose is the discriminating factor.ConclusionsInitial design of the requisite EPAs requires value judgments by trainers and trainees alike on what represent core units of work. EPAs can contribute directly and more meaningfully to ARCP progression decisions.RecommendationsInclusion of the required level of supervision as part of SLE feedback enables future decisions on meeting performance standards.Trainee/trainerInteraction in this educational process.Disclosure of interestThe author has not supplied his/her declaration of competing interest.