bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age and pharmacotherapy of suicidal depressed bipolar patients
Authors: Oquendo M.A. , Galfalvy H. 
Published: May 2016

The mortality and morbidity due to suicidal behavior associated with bipolar disorder is the greatest among psychiatric diagnoses. To address this problem, it is essential to find predictors of future risk as well as protective factors. Studies from several international teams have demonstrated that for bipolar disorder, the presence of a depressive episode is the most robust predictor and risk increases as does depression severity. Protective factors such as older age and religious affiliation are also key moderators. The role of pharmacotherapy in suicidal behavior has been studied mostly utilizing data that are either observational and naturalistic, rather than experimental. Only one randomized, double-blind clinical trial has been conducted to date, although another one is underway. The comparison of lithium and valproate in terms of effect on suicidal behavior revealed no differences. Although the trial was not powered to detect small effect sizes, results suggest that the Relative Risk ratio generated from meta-analytic studies (RR∼ 5) is too optimistic. The trial also suggested that younger individuals may respond differently to pharmacotherapy, suggesting opportunities to personalize treatment approaches. Robust pharmacotherapy targeting both mood stabilization and depressive symptoms is essential and may assist in the quest against suicidal behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A systematic review of service transitions in people with ADHD
Authors: McNicholas F. , Tatlow-Golden M. , Gavin B. , Singh S. 
Published: May 2016

BackgroundYoung people (YP) with attention deficit hyperactivity disorder (ADHD) are recognized to be a group who are particularly vulnerable to falling through the gap regarding transitioning from Child and Adolescent Mental health Services (CAMHS) to Adult Mental Health Services (AMHS). This presentation will combine a systematic review of the literature with some clinical examples of the pathway for a number of YP with ADHD who reach the transition boundary (TB).Method(1) Databases (e.g., PubMed, PsycINFO, AMED, CINAHL, EMBASE, Web of Knowledge), and grey literature, were searched systematically with database-specific key words, variants and truncations, to cover six subject areas: ADHD; transition or transfer; age; experiences or views; service development; and policies or protocols. Hand searching of key journals, ancestry and forward searches of references, and expert consultation were conducted. Two reviewers critically evaluated studies using a validated appraisal tool for mixed methodologies and findings were synthesized. (2) Following ethical approval, CAMHS clinicians from 9 clinics in Republic of Ireland identified all cases where a YP with ADHD had reached the TB, and identified referral/service outcomes (n = 20).ResultsThe search yielded 27 studies, covering areas of service review and recommendations (7), guidelines (3), medication (5), case note audit (3), professional's views (5), pilot transition clinics (2). A further set of papers covered the perspective of the young person (4) and parent (2). Overall these highlighted the less than optimum experience by both clinicians and service users of the experience with suggestions for future developments. These findings were mirrored in the review of clinical notes and individual interviews of YP identified through their CAMHS. Of the 20 young people identified, only 1 was directly transferred to AMHS. Eight were retained in CAMHS, on average for over a year. A significant number (7) refused onward referral. A perception from CAMHS clinicians, that AMHS did not accept such cases or lacked relevant service/expertise, may have contributed to the low rate of referral.ConclusionBoth the extant literature and the specific study presented highlight the lack of clear cut consensus about the appropriate management of young people with ADHD have who reach the transition boundary. Low rates of AMHS transfer may come from CAMHS clinicians’ perceptions of AMHS, and preferences of young people and families. Before assuming the very low rate of referral by CAMHS clinicians is poor practice, clinical outcomes need to be identified, young people's reasons for refusing transfer explored and service options identified.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neurostimulation in alcohol dependence: The effect of repetitive transcranial magnetic stimulation on brain function and craving
Authors: Jansen J. , van den Heuvel O. , van der Werf Y. , De Wit S. , Veltman D. , van den Brink W. , Goudriaan A. 
Published: May 2016

BackgroundAlcohol dependence has long been related to impaired processing and handling of negative emotions. This is the first study to compare emotion regulation (ER) at a behavioral and neural level in alcohol dependent patients (ADPs) and healthy controls (HCs). It also examines the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on ER abilities and related craving levels in ADPs.MethodThirty-six ADPs and 32 HCs matched on age, sex, and education, were included in a within-subject fixed-order study with one functional magnetic resonance imaging (fMRI) session and one rTMS plus fMRI session, with high-frequency (10 Hz) rTMS over the right dorsolateral prefrontal cortex (dlPFC). An fMRI emotion regulation task (ERT) was administered during both sessions and craving was measured before and after each ERT.ResultsADPs were impaired in the regulation of negative emotion and showed a higher activation of ER related brain areas compared to HCs. Furthermore, active rTMS improved ER abilities in both ADPs and HCs, but was accompanied by a decrease in anterior cingulate and left dlPFC activity only in ADPs. In addition, the ERT-induced increase in craving levels in ADPs was trend-significantly reduced by active rTMS, with a large effect size.ConclusionsADPs are impaired in the regulation of negative emotion and show enhanced neural activity in the ER brain circuit. High-frequency rTMS improves ER in ADPs and HCs and normalizes neural activity and tends to reduce craving in ADPs. Future studies are needed to test the long-term effects of (multiple session) rTMS on ER, craving, and drinking.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Translational perspectives in addiction psychiatry
Authors: Schellekens A. 
Published: May 2016

BackgroundHeritable factors account for approximately 50–60% of the risk for alcohol dependence. However, which genes confer this risk remains to elucidate. Moreover, genetic association studies are hampered by non-replication. Several strategies can be applied to approach this issue. One option is the application of intermediate phenotypes. Neurobiological measures that are closely related to the addiction phenotype may be more directly related to genetic variation. Intermediate phenotypes related to dopamine function seem particularly suitable, given the strong dopamine hypothesis in addiction. Another strategy is to include environmental factors, such as childhood adverse experience, in genetic association studies. We tested the effect of COMT Val158Met and DRD2 Taq1A genotypes, as modulators of brain dopamine function in the context of self-reported environmental factors, like childhood adverse experience.MethodsAlcohol-dependent patients (n = 110) and healthy controls (n = 99) were genotyped for the COMT Val158Met and DRD2 Taq1A genotypes. Childhood adversity was measured using self-report questionnaires. Dopamine sensitivity was assessed using an apomorphine challenge with cognitive performance and plasma growth hormone levels as main outcome measures.ResultsCOMT genotype modulated the effect of apomorphine on cognitive performance, but was not directly associated with alcohol dependence. Yet, the interaction between childhood adversity and COMT genotype did predict alcohol dependence. DRD2 genotype modulated the effect of apomorphine on plasma growth hormone levels and was also not directly associated with alcohol dependence. Yet, the interaction between parental rule setting and DRD2 genotype did predict alcohol use in a separate population-based sample of adolescents.ConclusionThis study provides evidence for a role of COMT and DRD2 genotypes in alcohol dependence using both the GxE and intermediate phenotype approach. This confirms that both an intermediate phenotype approach and GxE interaction analyses can be useful tools in understanding mechanisms mediating addiction vulnerability. The clinical relevance of dopamine genes and intermediate phenotypes for staging and profiling of alcohol use disorders remains to be investigated.Disclosure of interestThe author has not supplied his declaration of competing interest.
From Griesinger to DSM-V: Do we need the diagnosis of schizophrenia?
Authors: Erfurth A. , Sachs G. 
Published: May 2016

The dichotomy between “dementia praecox” and “manic-depressive insanity” by Emil Kraepelin is one of the milestones of nosology in psychiatry [1].This dichotomy reflects the necessity – particularly in the absence of effective treatment in Kraepelin's time – to differentiate (and to predict) the functional outcome of individual patients. Since Kraepelin's original division particularly the influence of Kurt Schneider has led to a full acknowledgment of the dichotomy in both ICD and DSM.While this division has proven to be clinically useful, alternatives have been proposed covering a large spectrum from the idea of unitary psychosis as in Wilhelm Griesinger and Klaus Conrad to further subdivisions as in Karl Leonhard. Recent research in neuroscience suggests the presence of an overlap between schizophrenia and other psychiatric disorders [2–4].Disclosure of interestThe author has not supplied his declaration of competing interest.
Evolution of negative symptom assessment instruments
Authors: García-Portilla Gonzalez M.P. 
Published: May 2016

In this talk we will review the psychometric evolution of available instruments for assessing the negative syndrome of schizophrenia, describing their strengths and weaknesses.Current instruments were classified into two categories according to their content validity and assessment approach as first- or second-generation instruments. The BPRS, SANS, the SENS and the PANSS belong to the first generation while the BNSS, the CAINS and the MAP-SR belong to the second generation. The NSA can be considered a transitional instrument between the two. First-generation instruments have more content validity problems than second-generation instruments do, as they do not accurately reflect the currently accepted negative syndrome (they do not include all negative symptoms and signs or they include symptoms from other dimensions). They also have more problems relative to the use of behavioral referents instead of internal experiences of deficits when assessing symptoms, which may lead to measuring functioning instead of negative symptoms.Further research needs to be done in this area in order to ensure the evaluation of primary negative symptoms and internal experiences involved in negative symptoms rather than external behaviors.Disclosure of interestThe author has not supplied his declaration of competing interest.
Kleptomania – “it was just a small fragrance in a Chinese store…”
Authors: Almeida M. , Ferreira J. 
Published: May 2016

IntroductionThe idea that some people may not be able to control their stealing impulses emerged in 1838, when Esquirol and Marc coined the term Kleptomanie. Although there are not many studies regarding this issue, becoming therefore difficult to establish epidemiological data, various clinical samples suggest a high prevalence of the disorder. As the problem most likely become chronic when left untreated, the diagnostic approach is very important.AimsLiterature review and discussion about kleptomania, regarding a case report.MethodsClinical interviews and literature review in PUBMED database.Results (case report)Female patient, 62 years, with history of Personality Disorder and Persistent Depressive Disorder, confesses in psychiatric appointment that she had been caught stealing. She says that she has this “addiction to steal” since childhood, always stealing cheap stuff, that she does not need, usually giving it away to other people. She has this behavior as she feels an unexpected and irresistible impulse to steal, with increasing anxiety, which relieves when action is consumed. Afterwards she experiences feelings of shame and guilt. The patient symptoms appear to get worse in depressive relapses.ConclusionsRegarding individual, family and social impact of kleptomania is essential to assess it and to treat it promptly. Most of the patients are ashamed of their behavior, so they may not self-report. There are few and controversial data concerning treatment, but it is widely accepted that co-morbidity with mood disorders or substance use disorders is common and may interfere with treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Elderly-study – treatment for alcohol problems among 60+
Authors: Andersen K. , Bogenschutz M. , Bühringer G. , Behrendt S. , Braun B. , Lizarraga C. , Nielsen A.S. 
Published: May 2016

IntroductionThe western societies have a rapidly aging population and an increasing number of elderly with alcohol use disorders.ObjectiveThe purpose of the elderly study is to develop and test an outpatient behavior therapy program for people with an alcohol use disorders.Aim of this abstractTo investigate the association between ages, gender, drinking pattern and psychology distress.MethodThe study is a randomized study expected to enroll and treat 1000 participants aged 60+ years before April 2017; 200 in USA; 400 in Germany and 400 in Denmark. To be included in the study the participants have to fulfil the DSM-5 criteria for alcohol use disorder. All participants are examined at baseline, and at four follow up interviews. After the baseline interview all participants are randomized to Motivational Enhancement Therapy (MET); or MET followed by 8 weeks of counseling based on the Community Reinforcement Approach (CRA) with a module added to address problems relevants to elderly people.ResultsThe presentation will include baseline characteristics of the Danish participants including demographics, expectations to treatment, history of drinking in the last 90 days before baseline and their psychological distress. We have now enrolled 259 participants in the Danish database. We expect to present results from 320 patients.ConclusionThe data will present information about the profile of 60+ years’ individuals seeking treatment for alcohol use disorder, and thereby provide knowledge about which characteristics that may be important when planning treatment for this age group.Disclosure of interestThe authors have not supplied their declaration of competing interest.
E-cigarettes and tobacco cessation: An online survey of electronic cigarette users in France
Authors: Chevallier C. , Batisse A. , Marillier M. , Djezzar S. 
Published: May 2016

IntroductionE-cigarettes (EC) are widely used in general population and may facilitate smoking cessation. However, efficacy and addictive potential of EC remain insufficiently studied.ObjectivesTo characterize e-cigarette use and its impact on tobacco use/cessation.MethodsOnline survey was available on CEIP website (September 2014–March 2015). Questionnaire assessed smoking status, tobacco and e-cigarette use, including reasons for use, efficacy, adverse effects and dependence (Fagerström test of cigarette dependence [F] and an adapted version to e-cigarette use [Fm]).ResultsOne thousand one hundred and twenty-one EC users answered (1008 ex-smokers, 113 current smokers), with mean age of 39 ± 10 years and 72% female. Ninety-six percent e-cigarette users agreed that vaping is useful for tobacco cessation, 80% succeeded to quit/reduce their smoking. Reasons for EC use are partial/complete alternative to smoking, lower toxicity, less side effects and lower cost. Most of ex-smokers (66%) has no/low dependence to EC (Fm ≤ 4) since current smokers reduced dramatically their tobacco consumption by EC use. Among all EC users, 75% had a craving for EC. Use of EC is described as pleasant as tobacco for 59% ex-smokers and 39% smokers. Eighty-three percent of ex-smokers and 68% of smokers do not intend to stop vaping.ConclusionE-cigarettes are used primarily for smoking cessation and show effectiveness for harm-reduction, but a secondary dependence to nicotine contains in EC can be observed (Figure 1).Disclosure of interestThe authors have not supplied their declaration of competing interest.
The effect of embarrassment on preferences for brand conspicuousness: The roles of self‐esteem and self‐brand connection
Authors: Song Xiaobing , Huang Feifei , Li Xiuping 
Published: May 2016

AbstractThree studies were conducted to examine how embarrassment influences consumer preferences for brand conspicuousness. We predict that consumers with different levels of self‐esteem will have distinct coping strategies when they feel embarrassed, resulting in differences in their preference changes related to brand conspicuousness. The results show that when feeling embarrassed, consumers with low self‐esteem (high self‐esteem) are more likely to have increased motivation to avoid social attention to the self in general (to repair their self‐image). Thus, relatively speaking, consumers with low self‐esteem (high self‐esteem) prefer a more conspicuous product design over a less conspicuous one to a lesser (greater) extent when they are embarrassed than when they are not embarrassed. In addition, we demonstrate that the interaction between self‐esteem and embarrassment is more likely when consumers form a strong connection with the brand.
EFFICIENT ESTIMATION OF ERLANG MIXTURES USING iSCAD PENALTY WITH INSURANCE APPLICATION
Authors: Yin Cuihong , Lin X. Sheldon 
Published: May 2016

AbstractThe Erlang mixture model has been widely used in modeling insurance losses due to its desirable distributional properties. In this paper, we consider the problem of efficient estimation of the Erlang mixture model. We present a new thresholding penalty function and a corresponding EM algorithm to estimate model parameters and to determine the order of the mixture. Using simulation studies and a real data application, we demonstrate the efficiency of the EM algorithm.
Lawyering compliance with international law: Legal advisers in the ‘War on Terror’
Authors: Nuñez-Mietz Fernando G. 
Published: May 2016

AbstractAccording to rationalists and constructivists, compliance with international law occurs to the extent that states see non-compliance as unreasonable or wrong, respectively. An alternative account of compliance points to the practical difficulty of deciding to act contrary to international law. Here non-compliance is blocked rather than morally or instrumentally deterred. This article advances an organisational-process theory of this third kind. The explanatory mechanism lies in the constitutive rules of foreign policymaking, and points to the institutional function of legal advising. Under certain structural conditions (namely, lawyerised decision-making) legal advisers operate as the principal ‘agents of compliance’ within the state, bringing international law into the policymaking process and thus bridging the gap between foreign policy and legal expectations. The theory is applied to the interrogation programme implemented by the United States in the early years of the ‘War on Terror’ (2001–5). While initially violative of international legal standards, the programme eventually shifted towards compliance. Using process tracing, the case study provides fine-grained evidence that corroborates the explanatory power of organisational factors, in general, and legal advising, in particular.
The Value of E-Learning for the Prevention of Healthcare-Associated Infections
Authors: Labeau Sonia O. , Rello Jordi , Dimopoulos George , Lipman Jeffrey , Sarikaya Aklime , Oztürk Candan , Vandijck Dominique M. , Vogelaers Dirk , Vandewoude Koenraad , Blot Stijn I. ,   for the EVIDENCE Research Team
Published: May 2016

BACKGROUNDHealthcare workers (HCWs) lack familiarity with evidence-based guidelines for the prevention of healthcare-associated infections (HAIs). There is good evidence that effective educational interventions help to facilitate guideline implementation, so we investigated whether e-learning could enhance HCW knowledge of HAI prevention guidelines.METHODSWe developed an electronic course (e-course) and tested its usability and content validity. An international sample of voluntary learners submitted to a pretest (T0) that determined their baseline knowledge of guidelines, and they subsequently studied the e-course. Immediately after studying the course, posttest 1 (T1) assessed the immediate learning effect. After 3 months, during which participants had no access to the course, a second posttest (T2) evaluated the residual learning effect.RESULTSA total of 3,587 HCWs representing 79 nationalities enrolled: 2,590 HCWs (72%) completed T0; 1,410 HCWs (39%) completed T1; and 1,011 HCWs (28%) completed T2. The median study time was 193 minutes (interquartile range [IQR], 96–306 minutes)The median scores were 52% (IQR, 44%–62%) for T0, 80% (IQR, 68%–88%) for T1, and 74% (IQR, 64%–84%) for T2. The immediate learning effect (T0 vs T1) was +24% (IQR, 12%–34%;P<.001), and a residual effect (T0 vs T2) of +18% (IQR 8–28) remained (P<.001). A 200-minute study time was associated with a maximum immediate learning effect (28%). A study time >300 minutes yielded the greatest residual effect (24%).CONCLUSIONSModerate time invested in e-learning yielded significant immediate and residual learning effects. Decision makers could consider promoting e-learning as a supporting tool in HAI prevention.Infect Control Hosp Epidemiol2016;37:1052–1059
Exome sequencing identified mutations in CASK and MYBPC3 as the cause of a complex dilated cardiomyopathy phenotype
Authors: REINSTEIN EYAL , TZUR SHAY , BORMANS CONCETTA , BEHAR DORON M. 
Published: May 2016

SummaryWhole-exome sequencing for clinical applications is now an integral part of medical genetics practice. Though most studies are performed in order to establish diagnoses in individuals with rare and clinically unrecognizable disorders, due to the constantly decreasing costs and commercial availability, whole-exome sequencing has gradually become the initial tool to study patients with clinically recognized disorders when more than one gene is responsible for the phenotype or in complex phenotypes, when variants in more than one gene can be the cause for the disease. Here we report a patient presenting with a complex phenotype consisting of severe, adult-onset, dilated cardiomyopathy, hearing loss and developmental delay, in which exome sequencing revealed two genetic variants that are inherited from a healthy mother: a novel missense variant in the CASK gene, mutations in which cause a spectrum of neurocognitive manifestations, and a second variant, in MYBPC3, that is associated with hereditary cardiomyopathy. We conclude that although the potential for co-occurrence of rare diseases is higher when analyzing undefined phenotypes in consanguineous families, it should also be given consideration in the genetic evaluation of complex phenotypes in non-consanguineous families.