bluuebunny/crossref_metadata_2025_split huggingface dataset:
GERD is associated with the outcome of MDD treatment
Authors: Matić K. , Šimunović Filipčić I. , Bajić Ž. , Filipčić I. 
Published: June 2017

IntroductionGastroesophageal reflux disease (GERD) is more prevalent among patients with major depressive disorder (MDD) than in general population, and vice versa. Bidirectional association of GERD and MDD is well documented. Although protective effect for gastric symptoms has been indicated for several antidepressants like trazodone, citalopram, fluoxetine, mirtazapine or fluvoxamine, these findings are sometimes contradictory. Similar may be claimed for antidepressive effect of some proton pump inhibitors. We decided to examine the association of GERD with the long-term efficacy of MDD treatment.ObjectiveTo examine the association of GERD and efficacy of MDD treatment.MethodsThis nested cross-sectional study was done during 2016 at Psychiatric hospital Sveti Ivan, Zagreb, Croatia on the sample of 1008 psychiatric patients. Key outcome was the number of psychiatric rehospitalizations since the first diagnosis of MDD. Predictor was patient-self-declared diagnosis of GERD. Covariates controlled by multivariate analysis of covariance were sex, age, duration of MDD in years, education, marital status, number of household members, work status, clinical global impression scale–severity of MDD at diagnosis, treatment with tricyclic antidepressants (TCA), selective serotonin reuptake inhbitors (SSRI), serotonin-norephinephrine reuptake inhibitors (SNRI), noradrenergic and specific serotonergic (NaSSA) and antipsychotics.ResultsMDD patients with GERD had significantly larger number of psychiatric rehospitalizations (mean = 5.4 (SD 6.82)) than MDD patients with no GERD (mean = 3.1 (SD 4.45)). After adjustment for all covariates, GERD significantly moderated the efficacy of treatment of MDD (P = 0.048; η2 = 0.05) (Figure 1).ConclusionTo treat MDD effectively we should treat GERD as well.Disclosure of interestThe authors have not supplied their declaration of competing interest.
From psychiatric to critical care: Patient profile and predictive transfer elements
Authors: Trabelsi R. , Bram N. , Benromdhan I. , Homri W. , Staali N. , Labbene R. 
Published: June 2017

IntroductionPatients with mental illness have an increased risk of morbidity and mortality from somatic complications, with a reduction in life expectancy of 15 to 30 years. During hospitalization in a psychiatric setting multiple risk factors can combine and contribute to a severe deterioration in the general condition of patients who may require reanimation.AimDescribe the profile of patients admitted to Razi who required transfer to an intensive care setting during hospitalization to more precisely determine the predictors of severe somatic decompensation.MethodologyA descriptive retrospective study of patients transferred from the Razi hospital to the emergency medical assistance center (CAMU) during the period between 1 January 2014 and 31 December 2015.ResultsThe average age of patients was 39.5 years; 64.2% of the patients were men, 60% had a low socio-economic level, 34.7% had a comorbid disease. Forty-one percent (41%) of the patients transferred had been diagnosed with schizophrenia, and 27% had bipolar disorder. Antipsychotics were the most prescribed psychotropic drugs. High doses were used with therapeutic combinations in 85% of the cases. A toxic cause was identified in 58% of cases, including neuroleptic malignant syndrome in 18%. Dehydration and ionic disorders are among the most frequent causes in 27% of cases. Conclusion; Identifying risk factors for deaths in psychiatric hospitals highlights needed changes in psychiatric management strategies taking into account the patient's characteristics as well as the drugs’ safety profile.Disclosure of interestThe authors have not supplied their declaration of competing interest.
When seizures are non-epileptic
Authors: Nogueira J. , Taylor R. 
Published: June 2017

IntroductionNon-epileptic seizures (NES) are a diverse group of disorders, whose paroxysmal events can be mistaken for epilepsy, although they are caused by a mental or psychogenic process rather than a neurological cause.Objectives/methodsWe present a case of a 45-year-old female patient with history of generalized seizures prior to Meningioma resection in August 2015, referred to the Liaison Psychiatry outpatient follow up clinic at the Royal London Hospital after has gone several times to emergency department complaining about flush and hot sensation that proceeded to corners of mouth turning down, teeth chattering, shaking of left arm and torso at first and then legs. During the episodes, she was awake with no consciousness loss. Her mood was low, with clinical evidence of depression and she had very high levels of health anxiety.DiscussionA diagnosis of non-epileptic attacks was made in the sequence of those episodes. A holistic and multidisciplinary approach was made, including pharmacotherapy, cognitive-behavioral therapy and domiciliary support. The clinical response was good regarding both mood, anxiety levels and NES.ConclusionsApproximately 25% of patients who have a previous diagnosis of epilepsy and are not responding to drug therapy are found to be misdiagnosed and it is common that epileptic patients have both epileptic and non-epileptic seizures. Although distinguishing epileptic and non-epileptic seizures is not easy, there are some clinical clues that the physicians should look for, like age of onset, time of the day that episodes occur and presence or absence of postictal confusion.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Report of clinical case: Catatonic symptoms as a result of cerebral venous sinus thrombosis
Authors: Orihuela P. Ortega , Morenilla A.L. Pérez , González C. Hernández 
Published: June 2017

Clinical caseWe present the case of an 18-year-old woman attending the emergency room due to behavioral disorders that appeared 24 hours ago. The clinic was of restlessness, uninhibited behavior, stereotyped movements, global insomnia, semimutism and negativism. Initially she was diagnosed with catatonia, and was admitted to the Mental Health Hospitalization Unit. There were no previous psychopathological antecedents, although relatives reported that she had several stressors. During admission, she had a partial response to benzodiazepine treatment, and a loss of strength in the left upper limb was evidenced, and venous sinus thrombosis was diagnosed. With the anticoagulant treatment, the psychiatric symptomatology presented was markedly improved.Medical examinationNormal vital signs, afebrile. Absence of focal neurological signs. Stereotyped movements, oral-buccal dyskinesia. Negativism, disinhibition and oppositional behaviour. Supplementary tests with results within the normal range. Cranial MRI: Upper, transverse and sigmoid right sagittal sinus thrombosis.ConclusionsNumerous cases of thrombosis have been documented as a result of a catatonic state, mainly due to the immobilization and the risk involved. However, in this case, sudden onset of psychiatric symptoms, absence of psychiatric antecedents, and excellent response to anticoagulant therapy, leads us to conclude that catatonic symptoms could be considered as a consequence of cerebral edema caused by thrombosis. The presentation of catatonia as the sole cause of a somatic disorder is not common, but would be stimulated by certain factors, such as excessive stress and personality disorders, documented as vulnerability factors for such symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
How are personality traits and physical activity involved in colorectal carcinogenesis? A cross-sectional study on patients undergoing colonoscopy
Authors: Marchi M. , Alboni S. , Artoni C. , Galletti M. , Giambalvo N. , Mancini S. , Mariani F. , Mattei G. , Merighi A. , Montardi G. , Pollutri G. , Rioli G. , Saraceni S. , Spiga G. , Visentini C. , Ferrari S. 
Published: June 2017

IntroductionInflammatory state of the large bowel is a key factor for the development of colorectal cancer (CRC). It has multifactorial aetiology, including psychological determinants. Physical activity may have a protective function against CRC via anti-inflammatory properties; on the contrary, personality traits correlate with an unhealthy and dangerous lifestyle.ObjectiveTo measure the association between personality traits, lifestyle and colonoscopy outcome.MethodsCross sectional study. Patients undergoing colonoscopy aged 40 or more, with a negative history for cancer or inflammatory bowel disease, were enrolled. Data collected: colonoscopy outcome, smoke, alcohol, physical activity, presence/absence of Metabolic Syndrome, personality traits assessed by the Temperament & Character Inventory (TCI).ResultsIn a sample of 53 subjects (females = 24, 45.3%), the mean age was 60.66 ± 9.08. At least one adenoma was found to 23 patients (43.3%). Twenty patients were smokers (37.74%), 36 (67.92%) drank alcohol at least weekly; approximately 60% reported regular physical activity. At the multivariate regression, the outcome was associated to: TCI Self Transcendence domain (ST) (OR = 1.36, P = 0.04) and physical activity (OR = 0.14, P = 0.03).ConclusionPeople with ST's characteristic personality traits and sedentary life style are more likely to have precancerous colorectal lesions. This confirms the protective role of physical activity, and suggests to further explore the role of personality in cancerogenesis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Referrals of patients with schizophrenia to a consultation-liaison psychiatry service
Authors: González R. Sánchez , Lázaro E. Baillès , Villanueva S. Herranz , Pérez L. Pintor 
Published: June 2017

BackgroundThere are few studies specifically investigating the acute treatment procedures of patients with schizophrenia in the context of Consultation-liaison psychiatry (CLP).PurposeDescribe the main clinical features of the referrals of patients with schizophrenia, attended by a general hospital CLP service.MethodsLongitudinal observational and descriptive study, assessing adult inpatients with schizophrenia (DSM-IV-TR criteria) admitted to non-psychiatric units of Hospital Clínic of Barcelona (Spain), who were consecutively referred to our CLP service over a 10-year period (from January 1, 2005, through December 31, 2014).ResultsDuring that period, 9.808 psychiatric consultations were requested. 163 of them (1.8%) concerned patients with schizophrenia. These groups of patients were aged 50.9 ± 15.3 years and 65% were male. A 25.9% of patients had history of suicide attempts and 45.6% presented current psychosocial stressors.Characteristics of referrals Referral sources according to medical specialties are shown in Table 1.The major medical conditions for referral according to ICD-10 categories were: external causes of morbidity (21.5%), infectious diseases (13.5%) and diseases of the digestive system (10.4%).The two most frequent reasons for referral were the assessment of psychopharmacological treatment and/or psychopathological state examination (62%) and suicidal risk/attempt assessment (8.6%).ConclusionsIn our sample, only a 1.8% of all patients for whom psychiatric consultation was requested had a diagnosis of schizophrenia. The most common profile of them was: male, 50 years old, coming from general medicine department due external causes of morbidity and referred to the CLP service because of psychiatric state and/or medication review.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Describing the assistance, the basis for improvement
Authors: Sánchez E.J. Pérez , Miranda J.M. Ginés , Romero V. Chavarría , Moreno J. , Palma A. , Pale L. Alba , Leon J. , Bulbena A. , Perez V. 
Published: June 2017

IntroductionConsultation-liaison (CL) psychiatry is a branch of psychiatry that study and treat mental health of patients with other medical or surgical conditions. The assistance between hospitals and health services is heterogeneous.Aims and objectivesFor this reason, the objective of our research is to define the clinical characteristics from our CL service and check out the quality relationship with the applicant service, for improving future assistance.MethodsWe made a descriptive analysis of clinical variables from the patients who received assistance during 2 months by the CL service from the hospital del Mar, Barcelona. We got the frequencies and we used the Chi2 test for the comparison between variables: Diagnosis, appearance in the report and treatment in the report.ResultsTotal of the sample: 42 patients, 61.9% women. Mean age: 55.1 years. Psychiatric diagnosis was present before the assistance on 57.1% of the patients. The most frequent diagnosis was Adjustment Disorder (47.6%) and more than one diagnosis was made in the 14.3%. Near the half of the patients required only primary care assistance after the discharge from the hospital. In the 68.3% of the reports appeared information about CL assistance and the indicated treatment didn’t appear in all the reports. Statistically significant differences weren’t found in the comparisons.ConclusionsAdjustment Disorder is supposed to be the most common psychiatric diagnosis in our CL psychiatry service, as we found in the reviewed literature. The results reveal that relationships between services can be improved. More studies must be done for completing information in this issue.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Exploring sources and types of information about Huntington disease received by affected families
Authors: Vamos M. , Conaghan J. , Lewin T. 
Published: June 2017

IntroductionWhile revealing the presence of Huntington Disease (HD) within the family setting has received considerable research interest, the sources of information and the detail of which aspects of the illness are discussed remains unexplored. This study's primary aim was to identify HD information sources, both professional and family, and to describe the types of information received by members of affected families, with the hypothesis that some aspects of the disorder would be more fully addressed than others.MethodClients drawn from a specialist genetic unit looking after families with HD (n = 46) were engaged in structured interviews and completed standardized questionnaires, including: the psychological adjustment to genetic information scale (PAGIS); and a current psychological distress measure (K10). Participants obtained HD related information from a mean of 4.76 sources (49.3% professional).ResultsAs expected, genetic and neurological symptoms were more frequently described (97.7% and 86.4% respectively) than cognitive and psychological/psychiatric (63.6%; 52.3%). Regression analyses were used to identify potential predictors of current distress, adjustment, and information satisfaction. Rated satisfaction with information received was higher among participants with a gene positive family member. Across the PAGIS sub-scales, there were differential associations with the predictors examined.ConclusionsGiven that HD is a multi-faceted condition affecting the entire family, needs would be better addressed if information provided went beyond discussion of genetic and movement disorders, and extended to the cognitive, psychological and behavioral aspects which are strongly associated with quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Global arginine bioavailability ratio is decreased in patients with major depressive disorder
Authors: Ali-Sisto T. , Tolmunen T. , Viinamäki H. , Mäntyselkä P. , Velagapudi V. , Soili L. 
Published: June 2017

IntroductionThe global arginine bioavailability ratio (GABR) is used to estimate arginine supply. Arginine is precursor to nitric oxide (NO) that has been suggested to play a role in major depressive disorder (MDD). NO also participates in neuronal, inflammatory and cardioprotective functions.ObjectivesTo compare GABR between:– D patients and non-depressed controls;– remitted and non-remitted MDD patients;– baseline and follow-up within remitted and non-remitted MDD groups.AimsTo investigate the role of NO production in MDD.MethodsThe sample comprised 99 MDD patients and 253 non-depressed controls (Beck Depression Inventory scores < 10) aged 20–71 years. Altogether, 78 patients returned for the follow-up; 33 were remitted and 45 non-remitted. GABR was calculated from serum levels of arginine, citrulline and ornithine, which were analysed using ultra-performance liquid chromatography. Differences between the study groups were examined using logistic regression adjusted for age, gender, smoking, alcohol use, physical exercise and glycated haemoglobin. The follow-up regression analyses were adjusted for age, gender and physical exercise.ResultsLowered GABR was associated with belonging to the MDD group (OR 0.13, 95% CI 0.03–0.50). Exclusion of participants using anti-depressants that were associated with measured metabolites did not change the results. Over the follow-up period, the remitted and non-remitted groups both showed an increase in GABR (Z = –.53, P < 0.001 and Z = –3.00, P = 0.003, respectively).ConclusionsDecreased GABR may characterise MDD. This could affect neuronal, immunological and cardioprotective functions of NO.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Clinical predictors of antidepressant response to ketamine in unipolar treatment-resistant depression
Authors: Del Sant L.C. , Magalhães E. , Lucchese A.C. , Alves H.N. Palhares , Sarin L.M. , Del Porto J.A. , Lacerda A.L. Tavares de 
Published: June 2017

IntroductionThe non-competitive N-methyl-d-aspartate glutamate receptor antagonist ketamine has been shown to have rapid antidepressant effects in treatment-resistant depression (TRD). However, only a few studies have investigated which clinical characteristics predict a response to ketamine.ObjectivesTo assess sociodemographic variables and clinical markers that predict response to ketamine in unipolar TRD patients.MethodsSearches of Pubmed, NCBI and Google Scholar were conducted for clinical trials and systematic reviews, through October 2016, using the keywords:ketamine, N-methyl-d-aspartate receptor antagonist, rapid-acting antidepressant, depression, treatment-resistant depression, clinical predictors.ResultsFindings support the following clinical predictors:– sociodemographic variables: positive family history of alcohol abuse disorder in first-degree relative (increased antidepressant response and fewer depressive symptoms for up to 4 weeks post-infusions), higher BMI (improvement in depression severity at 230 minutes and one day post-infusion), negative history of suicide attempt (greater improvement at day 7);– infusion-associated events: greater dissociation during infusion (better antidepressant response at 230 minutes and one week post-infusion); rapid response to first infusion (sustained response to subsequent infusions in one-third responders for up to 83 days);– symptomatology: anxious depression (fewer depression symptoms at day one up to 25 associated with longer time to relapse); neurocognitive performance (lower attention) predicts change in severity of depressive symptoms over six infusions.ConclusionsFindings suggest that specific clinical characteristics are predictors of ketamine response in TRD. Future studies confirming reliable predictors will assist clinicians to implement efficacious and individualized treatment for TRD patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Correlations between doctors’ and patients’ assessment of depression’ severity and efficacy of treatment
Authors: Medvedev V. , Retyunsky K. , Ovchinnikov A. , Barilynik Y. , Shmilovich A. , Antohin E. , Usov G. , Frolova V. 
Published: June 2017

IntroductionData on accordance and clinical significancy of objective (doctor, psychometric scales) and subjective (patient with depression) assessment of severity of depression are almost lacking. Aim of the multicenter study “EMOTION” was to compare prognostic value of doctor's and patient's assessment of depressive symptoms severity as for its grading and treatment outcome.MethodStudy sample consist of 107 depressive patients. The study used clinical and psychometric (HDRS, SHAPS, CGI-S, CGI-I, PGI-S, PGI-I, Visual Analog Scale) methods.ResultsOur data suggest that there's statistically significant (Р ˂ 0.001) discrepancy between doctors’ (CGI-S) and patients’ (PGI-S) assessment of depressive symptoms’ severity at first visit. Concordant opinions were found only in “marked depression” (37.49% of doctors and 36.59% of patients) and in “borderline depression” (4.79% of doctors and 3.79% of patients). Otherwise, doctors’ and patients’ opinions were discordant. Doctors’ scores were more extreme (severe and extremely severe depression); patients’ scores were more “moderate”. We have found inconsistence between HDRS and CGI-S scores. In the course of reduction of depression severity during antidepressive treatment (agomelatine) doctors’ and patients’ scores were more and more in line with each other.ConclusionWe have found leveling of prognostic value of psychometric assessment of depression severity by doctors and patients (in terms of reduction of depressive symptoms severity and treatment outcome) during antidepressive therapy. It is possible that in some HDRS items scores were overestimated.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Frequency of depressive disorders in a representative sample of Nicosia, Cyprus
Authors: Papapetrou I. , Charalambous G. , Sissouras A. , Jelastopulu E. 
Published: June 2017

Introduction“Health Profile” of Nicosia was conducted in 2013–2014, within the framework of the program “Healthy Cities” in order to collect and analyse information on the state of health and health-related behaviors of the citizens of Nicosia in Cyprus.AimsTo estimate the frequency of self-reported depressive disorders and examine burdening as well as factors influencing it.MethodsBased on the 2011 census, a cross-sectional study was carried out on a representative random stratified sample, which was selected to be interviewed, including 477 men and 525 women, from the city area. Participants answered a questionnaire, which required among other items on self-perceived physical and mental health. Participants were also asked the following questions: “Do you have/had in the past depression or/and anxiety?” and “Have you received a medical diagnosis for this disorder?”ResultsApproximately 70% of the sample reported they had experienced anxiety and depression (37% moderate and 33% severe episodes). Diagnosed depression was reported by 4%. Severe depressive disorders were more frequently reported by women (41%, P < 0.001), older aged citizens (70.2%, P < 0.001) widowed/divorced (45.5%, P < 0.001), persons with lower family income (< 1000 €, 79.7%, P < 0.001) and among people with chronic diseases (45.3%, P < 0.001).ConclusionsThe self-reported prevalence of anxiety and depression in the citizens of Nicosia is very high – probably reflecting a negative effect of the economic crisis –, and contrariwise diagnosis of the disorder is rarely provided and consequently therapy rarely offered. Specific population groups, such as women, elderly citizens, patients with chronic diseases are more vulnerable to depressive disorders requiring specialized medical attention.Disclosure of interestThe authors have not supplied their declaration of competing interest.