bluuebunny/crossref_metadata_2025_split huggingface dataset:
The psychiatric emergency service in the Netherlands
Authors: Streitz S. 
Published: June 2017

Every region in The Netherlands has got an emergency service. This is a team of people that immediately goes to see the psychiatric patient after an instruction of for instance the general practitioner or the police. This special team works 24 hours a day, 7 days a week. The patient is then visited by members of the team, a social worker accompanied by a psychiatrist, or the patient will go to the ambulant unit (the polyclinic) directly. This is a very effective procedure, because behind the two people that visit the psychiatric patient, is a whole team of people who have the opportunity to start an ambulant treatment the day after. Through this team we have the opportunity to treat patients intensively without a needed admission in the clinic. The basis of this team are social-nurse-therapists who are very skilled. These people take lead in the treatment and have a psychiatrist as a back-up. Suicidal patients are through a special procedure included in a clinic upon a juridical decision. If it is expected that the patient is dangerous, the police will accompany the emergency teams. If psychiatric medication is needed, the treatment will start directly. Other forms of treatment are psychotherapy, a short treatment by conducting 5 meetings with the patient, or intensive ambulant treatment. In my opinion it is a very good example of how ambulant treatment of psychiatric patients works and is effective for everybody involved.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
The impact of the economic crisis on the use of psychotropic medication in Portugal: Preliminary results of the national mental health survey follow-up
Authors: Silva M. , Antunes A. , Frasquilho D. , Cardoso G. , Caldas-de-Almeida J.M. 
Published: June 2017

IntroductionEconomic crises can contribute to a worsening of mental health problems and, consequently, to a possible increase of the use of psychotropic medication.ObjectivesTo assess the use of psychotropic medication in Portugal before and after the onset of the economic crisis, and to better understand the impact of the economic crisis in this highly hit country.MethodsThis 2015 follow-up epidemiological study re-interviewed a probability sub-sample of respondents to the 2008 national mental health survey, the first nationally representative study of psychiatric morbidity and treatment patterns in Portugal. Socio-demographic and clinical variables were assessed using a structured interview in 2008 (n = 2060) and 2015 (n = 911). All participants were questioned about the last 12 month use of psychotropic medication for mental health problems. Descriptive analysis was conducted to assess the use of psychotropic medication by group and gender in 2008 and 2015.ResultsBetween 2008 and 2015 there was an overall increase in the use of the main groups of psychotropic medication (22.5% to 28.6%), with a particularly relevant increase in the consumption of anti-depressants and anxiolytics. The use of psychotropic medication was higher among women in 2008 and 2015 (31.1% and 36.7%) compared to men. However, the increase in consumption was more relevant in men (13.3% to 20.0%), particularly in relation to anxiolytics (6.0% to 11.6%).ConclusionsThe economic crisis was associated with a substantial increase of psychotropic medication's use in Portugal, consistent with the increased prevalence of mental health problems that this study also found.FundingEEA Grants Programa Iniciativas em Saúde Pública.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A biopsychosocial look on the violence in Colombia. Understanding violence to understand the role of psychiatrist in the post-peace agreement era
Authors: Suelt M.J. 
Published: June 2017

IntroductionThe armed Colombian conflict is one of the bloodiest and most extensive in the contemporary history of Latin America, with multiple factors and causes implicated.ObjectivesDetermine the factors involved in the emergence of Colombian political violence from neurobiological, anthropological, social and psychoanalytic models.MethodsWe revised the report Basta Ya! of The National Center for Historical Memory, which approximates the casualties and victims of the armed conflict in Colombia. In addition, we conducted a rigorous review of current scientific and clinical literature on the neurobiology of violent behavior, social psychiatry and psychoanalytic papers about war, death, and survival instincts.ResultsViolent behavior can be explained by the neurobiological model of aggressive response as an imbalance between the prefrontal cortex and the limbic system. There is evidence to support a geographically-based violence in Colombia with a fragmentation of the territory, the State, and the Colombian identity. Moreover, we found the psychological component raised by Freud and in psychoanalysis, about war, and life and death instinct, as antagonistic manifestations of life-present in acts of violence.ConclusionsThe violence from the armed Colombian conflict has been one of the longest in modern history, determining its causality has been complex. However, understanding violence multifactorially allows us to improve social psychiatry and our role as clinicians in this new post-agreement era, in order to better establish mental health policies for victims and perpetrators in future reparation.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Demographic and criminal data among psychiatric patients in Greece
Authors: Tzeferakos G. , Papagaliaga M. , Papageorgiou C. , Bali P. , Douzenis A. 
Published: June 2017

IntroductionTo our knowledge, a limited number of studies address criminality among psychiatric patients as depicted in legal files.ObjectivesThe objective of the present study was to provide demographic, psychiatric, legal/criminal data about psychiatric patients in Greece.MethodsLegal case files of 100 adult subjects, 90 male/10 female, 88 Greeks/12 foreigners were reviewed.ResultsSeventy eight percent of the subjects had at least one psychiatric evaluation prior to the commitment of the crime. The main diagnoses at the time of the criminal act were: schizophrenia spectrum psychosis (18%), anti-social/borderline/mixed personality disorder (15%), substance use disorder (15%), alcohol use disorder (10%), depressive affective disorder (6%), mixed anxiety/depressive disorder (6%), bipolar disorder (5%), anti-social personality disorder/substance use disorder (5%), schizophrenia/substance use disorder (3%). In 11% the diagnosis was unknown. Eighty four percent of the crimes committed were homicides/attempted homicides, 6% assaults/(attempted) homicides, 3% property crimes/(attempted) homicides and below 3% assaults, property crimes, sexual offences, drug crimes. The weapon used was a knife/sharp object (42%) or a gun (40%). Perpetrator and victim were strangers in 25% of the cases, just acquaintances in 14%, had a professional relationship in 7%, their relationship was conjugal (15%), they were partners (13%) or relatives (7%). In persons with schizophrenia spectrum psychosis the victims were relatives/spouses in 41.2%, while in other diagnoses the respective percentage was 21.5% (P = 0.044).ConclusionsIn accordance to the international literature, there is a vast need for further research in order to improve forensic psychiatric services and prevent criminality among psychiatric patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Descriptive study of people, with intellectual disability, presenting with challenging behavior in north London, UK
Authors: Perera B. , Courtenay K. 
Published: June 2017

Prevalence of intellectual disability (ID) ranges from 0.05 to 1.55%. A total of 10–15% of the people with ID present with challenging behaviour (CB). This causes a significant strain on mental health services. People with ID often end up staying in psychiatric inpatient units for longer periods. Most people with ID move out of their family home to various care settings due to severity of their behavioural difficulties. This descriptive study shows characteristic features of people with ID and CB and financial costs to look after them in the community. This study highlights the importance to improve services to manage challenging behaviour, which may lead to better quality of life to the person with CB and reduction in financial pressures.Disclosure of interestCOI: Bhathika Perera has received grants to attend conferences and speak at ADHD conferences by pharmaceutical companies.
Adapting the assertive community treatment (ACT) for the needs of different communities: A comparative case study of KUINA ACT Japan and Mt. Sinai ACT Canada
Authors: Chow W. , Shiida M. , Andermann L. 
Published: June 2017

In this workshop, we will present the assertive community treatment (ACT) model in both Japan and Toronto, Canada. We will compare the adaptations of ACT models in both teams in order to serve their target populations efficiently and effectively.We will also compare the demographic data, clinical data and the outcomes of both ACT teams by analysing the hospitalisation days, number of emergency admission and the number of admissions into hospitals. We will also highlight differences in the mental health systems in Japan and Canada in an attempt to formulate guidelines to ensure the effectiveness of ACT Teams in both countries. We would also like to open up discussion with the audiences and incorporate their ideas and suggestions in an attempt to formulate a competent mental health system which would effectively cater to the needs of people suffering severe mental health symptoms to ensure successful integration into the community.Learning objectives:– To explore adaptation in implementation of ACT in Japan and Canada;– to develop a framework or model for assessing issues critical in establishing ACT in different countries;– to develop guidelines to establish programs which will continuously be revised implementation based on needs, systems and feedback from the field.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neighbourhood Ethnic Density and Incidence of Psychosis – First and Second Generation Migrants Compared
Authors: Schofield P. , Das-Munshi J. , Becares L. , Agerbo E. 
Published: June 2017

IntroductionLiving in an area with few people from the same ethnic background has been associated with increased incidence of psychosis (the ethnic density effect).ObjectivesCompare associations between neighbourhood ethnic density and incidence of non-affective psychosis for first and second generation migrants.MethodsPopulation based cohort (2.2 million) of all those born 1st January 1965 or later and living in Denmark on their 15th birthday. We looked at a total of 106,000 migrants, including 62% first generation migrants. Ethnic density was determined at age 15 and we adjusted for age, gender, calendar period, parental psychiatric history and parental income at age 15.ResultsFor the first generation, we found no evidence that rates of non-affective psychosis were related to neighbourhood ethnic density for migrants from Africa (comparing lowest and highest quintiles): IRR 1.02 (95% CI 0.6–1.73), and the Middle East: IRR 0.96 (CI 0.68–1.35) and only weak evidence for migrants from Europe (excluding Scandinavia): IRR 1.35 (CI 0.98–1.84). Conversely, for the second generation rates of non-affective psychosis were increased for migrants from Africa in lower ethnic density neighbourhoods (comparing lowest and highest quintiles): IRR 3.97 (95% CI 1.81–8.69), Europe (excluding Scandinavia): IRR 1.82 (CI 1.28–2.59) and the Middle East: IRR 2.42 (CI 1.18–4.99).ConclusionsThere is strong evidence for an area ethnic density effect on psychosis incidence for second generation migrants, but not for first generation migrants. This could reflect a greater resilience among the latter group to the adverse effects of minority status.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Personality Traits and Disorders Among Adult ADHD Patients: Is Borderline Personality Disorder as Common as we Expect?
Authors: Oliva F. , Bramante S. , Portigliatti Pomeri A. , Carezana C. , Nibbio G. , Mangiapane C. , Maina G. 
Published: June 2017

IntroductionPatients with Attention Deficit/Hyperactivity Disorder (ADHD) have shown a high risk to develop a DSM cluster B (i.e., Borderline, OR = 13.16; Antisocial, OR = 3.03; Narcissistic, OR = 8.69) and DSM Avoidant personality disorder (OR = 9.77). Similarly, higher rates of DSM cluster B personality disorder were found among adult ADHD patients (6-25%) than general population. Although some authors investigated the prevalence of personality traits and disorders among adult ADHD patients, no studies have been yet reported about the assessment of Millon's Evolution-Based Personality profiles in adult ADHD patients.AimsTo explore the prevalence of personality traits and disorders among adult ADHD patients.MethodsMillon's personality traits and disorders were assessed in a consecutive sample of 35 adult ADHD outpatients accessing the Service for Adult ADHD of the AOU San Luigi Gonzaga (Orbassano, TO) using the Millon Clinical Multiaxial Inventory–III (MCMI-III).ResultsAccording to the MCMI-III manual, ADHD patients in our sample showed more frequently both Cluster C and Cluster A traits and disorders, with a high prevalence of avoidant/depressive (8.6%/14.3%) and negativistic/self-defeating (20%/5.7%) personality disorders. Conversely, we found a low prevalence of Narcissistic (5.7%) and Histrionic (5.7%) traits, and no patient showed Borderline personality traits or disorder.ConclusionsUnexpectedly, the dimensional assessment of adult ADHD personality reveals a high prevalence of cluster C and cluster A personality traits and disorders, and a low prevalence of cluster B personality disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Results of Using Micronutrients as Adjunctive Treatment for Psychotic Disorders
Authors: Mehl-Madrona L. , Mainguy B. 
Published: June 2017

ObjectiveTo evaluate the use of micronutrients (minerals and vitamins) as adjunctive therapies for psychosis when added to conventional medications.Setting/locationsRural primary care and psychiatry clinic in Northern New England, USA.SubjectsPeople over age 18 diagnosed with a psychotic disorder on medications.InterventionFifty consecutive clients during one month's time were invited to participate; 19 completed a one-month open-label phase of the addition of a micronutrient to their medication regimen; all 19 then withdrew rather than risk randomization to a placebo. We then compared the response of those 19 over 24 months of micronutrients + medication to the 31 people who declined participation enriched by an additional 28 consecutive patients recruited over the second month of the study for a total of 59 who received medication without micronutrients.Outcome measuresAll clients were evaluated with the Positive and Negative Symptom Scale and the Clinical Global Impression scale at study baseline and after 3, 6, 9, 12, 15, 18, and 24 months. Psychosis was confirmed with clinical interview using DSM IV-TR criteria. All participants had normal physical examinations and laboratory studies.ResultsOutcomes were similar for both groups until 15 months, though the micronutrient group used significantly less antipsychotic medication throughout that time (P < 0.001). At 15 months, the micronutrients + medication group exhibited significantly fewer symptoms than the medication only group, a difference that was even stronger at 24 months.ConclusionsMicronutrients may be a beneficial long-term, adjunctive strategy for people with psychotic disorders, allowing for smaller doses of antipsychotic medications.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Executive Function Assessment in Young Hospitalized Schizophrenic Patients with the “CANTAB Schizophrenia Battery” (Russian Sample)
Authors: Rupchev G. , Alekseev A. , Morozova M. , Kaleda V. , Tkhostov A. , Tikhonov D. , Listova A. 
Published: June 2017

IntroductionImpairment of executive function is the fundamental feature of the cognitive dysfunction in schizophrenia has to be measured throughout the illness regularly. Computerized technologies for assessment of cognitive dysfunction are widely used. However, their applicability in hospitalized schizophrenic patients setting should be specially examined.ObjectiveExecutive function in schizophrenia.AimsTo test the applicability of “CANTAB” neurocognitive battery for measurement of executive function in young hospitalized schizophrenic patients in Russian sample.MethodsFifteen inpatients diagnosed with schizophrenia according to ICD-10 (F 20.хх), 13 males and 2 females, aged 23.5(SD 3.2), disease duration is 5(SD 1.6) years and 16 healthy individuals, 7 males and 9 females, aged 21.3(SD 0.7). Spatial Working Memory (SWM) (Mnemonic Executive function), Stockings of Cambridge (OTS) (Planning Executive function), Intra/Extra-Dimensional Shift (IED) (Cognitive flexibility) were administered.ResultsThe majority of patients and controls easily understood the test instructions. Both groups did not have any difficulties with the touchpad. The “CANTAB” demonstrated sensitivity to the impairments of executive function. As a group, patients with schizophrenia performed significantly worse than controls on almost all tests: SWM–Between errors (P = 0.028), Total errors (P = 0.019), Strategy (P = 0.03), Mean time to last response (P = 0.001); OTS–Mean choices to correct (P = 0.044), Problems solved on first choice (P = 0.009), Probability of error given correct (P = 0.021); IED–Total errors (P = 0.015), Total trials (P = 0.002).ConclusionThe “CANTAB” is an applicable instrument for assessment of the executive function in young hospitalized schizophrenic patients. It can be used both for experimental and clinical needs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Outcomes in a Group of 7–8-Year-Old Children in a Developmental-Based Intervention in Autism Spectrum Disorder
Authors: Sindelar M.T. , Furland N. 
Published: June 2017

Healthy parent-child interaction is essential for child development. Parents play a central role in the acquisition of social and communicative skills, both in typical and atypical children. Increased support for parent-mediated intervention in autism has been demonstrated. Developmental approaches for ASD are based in establishing strong interpersonal relationships through natural play to foster developmental capacities. This work reports outcomes from an intensive approach based on a developmental, individual difference, home-based intervention program with children with severe ASD. Parents were trained with DIR approach by a specialist. An individual intensive rehabilitation program was set up for each child and implemented at school, home and rehabilitation center. The intervention program also focused on semi-structured activities to promote problem solving, and meliorate sensory dysfunction. Standardized scales were administered pre– and post-intervention, with ABC). The Childhood Autism Rating Scale (CARS), the Social Communication Questionnaire (SCQ) and Vineland Adaptive Behaviours Scales.ResultsBefore initiating the intervention all children presented severe difficulties in communication, social interaction, lack of language, and gestures of communication, auto– and hetero-aggressive behaviors. After 6 months, children showed significant changes in mean scores for emotional functioning, communication, and daily living skills and diminution of aggressive behaviors. The present results provide strong support for the effectiveness of a developmental-based intervention, specifically in the domains of social skills behavior, social responsiveness, in a group of children with severe autism. These results highlight the positive effects of a rehabilitative approach that works in harmony with the family, school and professional team.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Exome Sequencing Detection of Genetic Markers for Thai Autism Spectrum Disorder
Authors: Sukasem C. 
Published: June 2017

BackgroundAutism spectrum disorders (ASD) are neurodevelopmental disorders characterized by abnormalities in 3 domains; social interaction, communication/language, and restricted and repetitive behavior. The study of ASD prevalence in Thailand showed that it is approximately 9.9 children per 10,000 population for children 1–5 years old. ASD has a strong genetic basis, although the genetics of autism are complex and it is unclear. The objective of this study was to identify the genetic markers of Thai ASD.MethodsExome sequencing was performed with twelve unrelated ASD affected individuals from twelve families. Each sample was sequenced on SOLiD 5500xl genetic analyzer, and the resulting data was processed and analyzed on LifeScope Genomic Analysis software. Exome sequencing with two additional samples was performed Ion Proton System and the data was processed on Ion Reporter server. Tertiary data analysis with all fourteen exome sequencing data were performed by using Golden Helix software. In filtering process, data were annotated to various databases including UCSC KnownGenes for non-coding and synonymous variants filter, 1000 Genomes Project for high frequency variants filter, and dbNSFP for functional prediction.ResultsThe genetic markers were identified for Thai ASD associated variants (c.2014G > A in EIF2AK3, c.2951G > A in FGD6, and c.6119A > G in CHD8).Conclusionsthese genetic markers were the most possible of causing variants Thai. We also demonstrated a potential of exome sequencing and bioinformatics pipeline to identify the possible causative variants of ASD, which could by applied in the case that unable to identified variants by other technique.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Hyperuricemia and Metabolic Adverse Effect in Children and Adolescents with Autism Spectrum Disorder Treated with Risperidone
Authors: Sukasem C. 
Published: June 2017

BackgroundAtypical anti-psychotics have been found to be associated with hyperuricemia. The aims of this study were to determine the prevalence of hyperuricemia and metabolic adverse events in children and adolescents with ASD treated with risperidone.MethodsIn this cross-sectional study, we recruited 127 Thai ASD children and adolescents aged 3–20 years receiving risperidone for more than 4 weeks. The clinical data and laboratory data were obtained and analyzed. Hyperuricemia was defined as serum uric acid > 5.5 mg/dL.ResultsHyperuricemia was present in 57.48% of total ASD patients treated with risperidone. Uric acid levels were significantly higher in adolescents as compared to children. Uric acid levels correlated with risperidone dose (P = 0.01), duration of treatment (P < 0.0001), BMI (P < 0.0001), waist circumference (P = 0.003), triglyceride (TG; P < 0.0001), triglycerides/high-density lipoprotein cholesterol ratio (TG/HDL-C; P < 0.0001), insulin (P = 0.04), homeostatic model assessment index (HOMA-IR; P = 0.03), high-sensitivity CRP (hs-CRP; P < 0.0001), and leptin levels (P < 0.0001). HDL-C and adiponectin levels were negatively correlated with uric acid levels (P < 0.0001). In multiple regressions analysis, age, BMI, TG/HDL-C, and adiponectin level remained significantly associated with uric acid levels (P < 0.0001).ConclusionHyperuricemia may play a role in metabolic adverse effects in children and adolescents with ASD receiving high dose and/or long-term treatment with risperidone.Disclosure of interestThe author has not supplied his/her declaration of competing interest.