bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex differences in emotional reactivity to daily life stress in psychosis
Authors: Myin-Germeys I. , Merge G. 
Published: May 2016

BackgroundA recent study did not find clear-cut sex differences in psychotic symptoms. Studies investigating altered stress reactivity more consistently report differences between the sexes, although the results are contradicting in suggesting either men or women to be more stress-sensitive. We assessed self-reported experiences in the context of real-life to more fully understand the nature of sex differences in psychosis.MethodsWe employed the Experience Sampling Method, a structured diary technique, to investigate in real-life:– symptoms;– behavior in context;– underlying mechanisms in 283 healthy controls, 268 subjects at risk for psychosis and 232 patients with psychotic disorder.ResultsMultilevel regression analyses revealed no differences in symptom expression between the sexes. Similarly, men and women did not differ in their level of social interaction and overall activity. However, men at increased risk of psychosis were more often alone and were less involved in goal-directed activities compared to women. Finally, women reported more emotional reactivity to daily life stress then men but women also reported more positive affect when pleasant events had happened.DiscussionThe data thus suggest only minor differences between men and women in psychotic symptoms and actual behavior. However, whenever differences were apparent, they consistently pointed towards more severe symptoms and more deficiencies in men compared to women. In contrast, increased environmental reactivity in women (to both negative and positive environments) in addition to more social contacts may constitute a protective factor for the development of more severe psychopathology.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Exploring full-blown psychotic experiences in ‘non-need for care’ populations: Findings from the UNIQUE Study
Authors: Peters E. , Ward T. , Jackson M. , Morgan C. , Mc Guire P. , Woodruff P. , Garety P. 
Published: May 2016

BackgroundPeople displaying persistent, full-blown psychotic experiences without a need-for-care in the general population are an ideal group to investigate to differentiate those factors that are linked to distress and dysfunction from those that are merely associated with benign anomalous experiences. The UNIQUE study investigated the cognitive and social processes predicted by cognitive models of psychosis to differentiate between benign and pathological outcomes of psychotic experiences (PEs).MethodTwo hundred and fifty-nine individuals were recruited (84 clinical participants with PEs; 92 non-clinical participants with PEs; 83 controls without PEs) from urban (South-East London) and rural (North Wales) UK sites. The three groups were compared on clinical and psychological measures, on reasoning tasks, and on their appraisals of experimental tasks inducing anomalous experiences (of thought interference symptoms and auditory hallucinations).ResultsThe clinical picture demonstrated a distinctive pattern of similarities and differences on PEs between the clinical and non-clinical groups, while their demographic and psychological profiles were markedly different. As predicted, the clinical group showed a ‘jump-to-conclusions’ reasoning style, and endorsed more threatening appraisals ratings of the experimentally-induced anomalous experiences than the non-clinical group, who did not differ from the controls.ConclusionsThe results of this study identified a number of specific factors that may be protective against transition to psychosis in individuals with persistent PEs. They also provide robust experimental evidence for the key role of appraisals in determining outcome, as postulated by cognitive models of psychosis.FundingMedical research Council, UK.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Prevention of psychotic disorders in the general population
Authors: Rössler W. 
Published: May 2016

Subthreshold psychotic experiences are widely reported within otherwise healthy populations. Their phenomenology is broad and very heterogeneous ranging from meaningful coincidences and precognitive dreams over haunting to out-of-body experiences and visual as well as auditory hallucinations.Although creative aspects of these experiences are implied too, a similarity in form and content to positive symptoms in schizophrenia (e.g., delusion, disordered thought, and hallucinations) or schizotypy (e.g. magical thinking, unusual perceptual experiences, ideas of reference or paranoid ideation) seems to be obvious. However, the borderline between normal and pathological experiences and behaviour is unclear.The so called “continuum approach” assumes that schizophrenia or schizotypy are not discrete or categorical illness entities. It implies a gradient in the severity of the symptoms, ranging from healthy population to full-blown schizophrenia. As such, psychotic signs are no longer restricted to formal diagnoses according to DSM or ICD, but would, instead, complete the spectrum of psychological and biological features that characterize individual variations among human beings.Can subthreshold psychotic experiences be integrated in this continuum? Do individuals indicating such experiences lack some social cognitive abilities and are particularly vulnerable to false inferences in their social world. How are these experiences related to increased neural activity or an abnormal dopaminergic neurotransmission?These and similar questions will be discussed in the presentation.Disclosure of interestThe author has not supplied his declaration of competing interest.
Psychotic experiences as precursors in schizophrenia? Findings from a population-based sample in Germany (DEGS1-MH)
Authors: Schmidt-Kraepelin C. 
Published: May 2016

There are only a few studies that have studied the prevalence of psychotic experiences (PEs) in a representative population-based sample and a broad range of age. The association and predictive role of PEs in the context of psychotic and other mental disorders remains a subject of discussion. The Mental Health Module of the German Health Interview and Examination Survey for Adults is the first wave of a German health monitoring survey describing:– the distribution and frequency, the severity and the impairments of a wide range of mental disorders;– risk factors as well as patterns of help-seeking and health care utilization;– associations between mental and somatic disorders.A total of 4483 participants participated in the mental health section of the survey. The Composite International Diagnostic Interview, the Launay-Slade Hallucination Scale and the Peter's Delusion Inventory were used to assess PEs by clinically experienced interviewers. We can confirm and extend previous findings for younger age groups that PEs are very frequent psychopathological expressions in the general population across genders and all age groups. PEs rates were elevated among those with other mental disorders, particularly among possible psychotic disorders, PTSD and affective disorders. This points to the relevant role of PEs as a marker for psychopathology and mental disorders. Future prospective studies will have to focus on specific properties of psychotic experiences such as their appraisal or underlying social influences to determine their significance for the prediction of psychotic and other mental disorders.Disclosure of interestThe author has not supplied his declaration of competing interest.
Clinic risk associated with comorbidity of (subclinical) psychosis, anxiety and depressive symptoms: A case for stratified medicine in psychiatry
Authors: van Nierop M. , Myin-Germeys I. , van Winkel R. 
Published: May 2016

BackgroundMeta-analyses link childhood trauma to depression, mania, anxiety, and psychosis. It is unclear, however, whether these outcomes truly represent distinct disorders following childhood trauma, or that childhood trauma is associated with admixtures of affective, psychotic, anxiety and manic psychopathology throughout life.AimTo investigate the impact of trauma on psychopathological phenotype, functional outcome, and daily life stress reactivity.MethodsWe used data from a representative general population sample (NEMESIS-2; n = 6646), of whom respectively 1577 and 1120 had a lifetime diagnosis of mood or anxiety disorder, as well as from a sample of patients with a diagnosis of schizophrenia (GROUP; n = 825). Multinomial logistic regression was used to assess whether childhood trauma was more strongly associated with isolated affective/psychotic/anxiety/manic symptoms than with their admixture. Additionally, we examined these groups in terms of social functioning, clinical severity, and quality of life. In a separate sample (n = 621), daily life (emotional and cortisol) stress reactivity was assessed, using ambulatory assessment.ResultsIn all samples, childhood trauma was considerably more strongly associated with an admixture of symptoms of depression, anxiety, psychosis, and mania, rather than with these symptoms in isolation. Individuals exposed to childhood trauma, who also had an admixture of symptoms, had a lower quality of life, more help-seeking behaviour, higher prevalence of substance use disorders, and lower social functioning, compared with individuals not exposed to trauma, without an admixture of symptoms, or neither. Furthermore, trauma-exposed individuals with an admixed psychopathological phenotype show a higher daily emotional stress reactivity.ConclusionChildhood trauma increases the likelihood of a specific admixture of affective, anxiety and psychotic symptoms cutting across traditional diagnostic boundaries. Stratifying according to childhood trauma exposure thus identifies an admixed phenotype, possibly induced by continuous daily life stress reactivity, that has important clinical relevance. Identification of functionally meaningful aetiological subgroups may aid clinical practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.
GROUP 6 year outcome data in relation to antipsychotic medication
Authors: Cahn W. ,   for GROUP Investigators
Published: May 2016

ObjectiveGenetic risk and outcome of psychoses (GROUP) is a 6 year longitudinal cohort study that focus on gene–environment vulnerability and resilience in patients with psychotic disorders, their unaffected family members and non-related controls. Its main aim is to elucidate etiological and pathogenetic factors that influence the onset and course of psychotic disorders. In this substudy, we will examine medication use over time, its relation with (the change in) metabolic syndrome status and effects on the brain.MethodsA consortium of four university psychiatric centers and their affiliated mental health care institutions, conducted the GROUP study. At baseline, 1120 patients, 1057 siblings, 919 parents and 590 healthy controls were included. After inclusion, participants, except parents, were evaluated again after three and six years of follow-up. Extensive assessment of genetic factors, environmental factors, medication use, metabolic parameters and outcome were performed. Moreover, brain imaging was performed in a subset of participants, using a 1.5 Tesla MRI scanner.ResultsAt baseline 65% of patients used atypical antipsychotics, 16% used conventional antipsychotics and 19% used clozapine. Siblings and controls used no antipsychotics. Forty-three percent of patients, 21.3% of siblings and 9.1% of controls used antidepressants; 43.9% of patients, 2.1% of siblings and none of the controls used a mood stabilizer. We are currently analyzing the medication data over time in relation to (change in) metabolic syndrome status and the effects on the brain.ConclusionGROUP is a longitudinal cohort study in patients with psychotic disorders, their healthy siblings and controls without psychosis. This naturalistic substudy examines medication use, its association with (change of) metabolic status and effects on the brain in subjects with (high risk of) psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Brain imaging biomarkers in personalizing pharmacotherapy of suicidal depressed patients
Authors: Mann J.J. 
Published: May 2016

BackgroundNew knowledge has emerged about decision-making, mood regulation, social distortions and learning that is relevant for the diathesis for suicidal behavior. All four domains have identified underlying neural circuits and for decision-making and mood regulation also specific neurotransmitter systems.MethodsWe have conducted PET studies of the serotonergic system and CSF studies of the serotonin, norepinephrine and dopamine neurotransmitter systems in patients surviving suicide attempts to determine whether they have neurotransmitter abnormalities that resemble those found in the brain after suicide. We found alterations in the serotonin transporter and the 5-HT1A receptor that are similar to those seen in suicides and moreover the severity of the abnormality in 5-HT1A binding is correlated with the lethality of suicidal behavior. Other studies examining CSF levels of 5-HIAA are consistent with imaging data and extend the findings to the noradrenergic and dopaminergic systems. Finally, we will present data on use of these biomarkers to predict treatment outcome. Abnormal decision-making and mood regulation in suicidal patients is linked to abnormal brain biology and has direct implications for clinical practice in terms of selecting specific types of medication and how these may be best combined with psychotherapies.Disclosure of interestThe author has not supplied his declaration of competing interest.
Value-based mental healthcare: The quality aspect
Authors: Gaebel W. 
Published: May 2016

IntroductionThe goal of value-based healthcare is to improve the quality of care while also lowering healthcare costs. Values may also include societal or research benefits.ObjectivesTo outline the emergence and quality-related concepts of value-based healthcare.AimsTo give a comprehensive overview and critical discussion of quality aspects of value-based mental healthcare including aspects of personal, societal and scientific values.MethodsReview of quality aspects of value-based mental healthcare.ResultsThe quality aspect of value-based healthcare includes the implementation of patient-centered care and may include the assessment of societal values or values for research purposes. Current concepts focus on the reduction of disability-adjusted life years to measure the achievement of values, but may need to be broadened to include benefits to society as a whole or the progress of knowledge about mental disorders in research. Conceptually, addressing such broader value issues may lead to increased benefits and a better appraisal of the value of mental healthcare.ConclusionsThe trend towards value-based mental healthcare aims at creating an efficient care delivery model, that strongly focuses on achieving favorable patient outcomes and may in the future also include creating societal values. It includes the development and implementation of suitable mental health policies and comprehensive quality assessment, plus a broad conceptualization of the value-term and its assessment in value-based mental healthcare.Disclosure of interestThe author has not supplied his declaration of competing interest.
Familiarity, gender and cannabis use determine age of onset in schizophrenia
Authors: Murray R. 
Published: May 2016

There is evidence that certain risk factors for schizophrenia (e.g. copy number variations, obstetric complications) are associated with an earlier age of onset of psychosis. One possible explanation is that in such cases, early neurodevelopmental damage is associated with greater perturbance of critical neural systems and that this leads to the early presentation of psychosis. Less is known about the significance of age of onset for treatment response and outcome though patients presenting in childhood are reported to have a worse outcome than those who present later. We have conducted two large first episode psychosis studies in which we have examined those baseline characteristics which predict later treatment resistance, notably the AESOP and GAP studies. In each of these, early age of onset and also male gender were associated with treatment resistance. Interestingly in approximately three quarters of cases, treatment resistance was present at onset of psychosis and only in the remaining quarter did it develop over the course of the illness. One possibility is that there exists a type of schizophrenia which is associated with neurodevelopmental damage, early age of onset and lack of response to dopamine blockade; this is compatible with our previous finding that patients with treatment resistant schizophrenia do not show the increased synthesis of striatal dopamine which is usually found in actively psychotic individuals.Disclosure of interestThe author has not supplied his declaration of competing interest.
Are psychiatrists an endangered species?
Authors: Katschnig H. 
Published: May 2016

IntroductionRecruitment of young doctors into psychiatry is declining in many countries, which might become a threat to the survival of the profession.ObjectivesTo identify potential reasons for this threat.AimsTo look at psychiatry with concepts used by the sociology of professions.MethodsProfessions are characterized – and these concept will be used for analysis here – by (1) ownership of a specialized body of knowledge and skills, which defines the field of competence and the scope of potential clients, including the demarcation from other professions; (2) holding a high status in society; (3) being granted autonomy by society, e.g. in recruiting and excluding members; and (4) being obliged, in return for the above, to guarantee high quality standards in providing services and following ethical rules.ResultsSix intertwined areas of concern are identified: three of them, the increasing criticism by users and carers, the intrusion of other professions, and psychiatry's negative image in society, can be traced back to problems with the other three concerning the “ownership of a specialized body of knowledge and skills”. With the preparation and advent of DSM-5, discussions about the lack of validity of psychiatric disease entities have gone viral in the time of the internet. The attempts to “carve nature at its joints” have failed, and this is more and more perceived from outside, threatening psychiatry's status in society and potentially turning away to be psychiatrists.ConclusionLooking at psychiatry as a profession may help to better understand its current situation.Disclosure of interestThe author has not supplied his declaration of competing interest.
The negative image psychiatry from a sociological perspective
Authors: Möller-Leimkühler A.M. , Möller H.J. , Maier W. , Gaebel W. , Falkai P. 
Published: May 2016

The negative image of psychiatry is not only due to unfavourable communication with the media, but is basically a problem of self-conceptualization. It results both from unjustified prejudices of the general public, mass media and health care professionals and of own unfavourable coping with external and internal concerns.Issues related to negative stereotypes of psychiatry include overestimation of coercion, associative stigma, lack of public knowledge, need of simplification of complex mental issues, problem of the continuum between normality and psychopathology, competition with medical and non-medical disciplines, and psychopharmacological treatment.Issues related to psychiatry's own contribution to being underestimated include lack of a clear professional identity, lack of biomarkers supporting clinical diagnoses, limited consensus about best treatment options, lack of collaboration with other medical disciplines and low recruitment rates among medical students.Much can be improved to achieve a positive self-concept, however, psychiatry will remain a profession with an exceptional position among the medical disciplines which should be seen as its specific strength.Disclosure of interestThe author has not supplied his declaration of competing interest.
Role of psychopathology in elucidating the underlying neural mechanisms
Authors: Oyebode F. 
Published: May 2016

IntroductionPsychopathology is the systematic study of abnormal subjective experience and behaviour and it aims to give precise description, categorisation and definition of abnormal subjective experiences.AimI aim to demonstrate that the most appropriate approach to elucidating the biological origins of psychiatric disorders is firstly to identify elementary abnormal phenomena and then to relate these to their underlying neural mechanisms. I will exemplify this by drawing attention to studies of Delusional Misidentification Syndromes (DSM).ResultsI will show that there are impairments in face recognition memory in individuals with DSM without impairments in the recognition of emotion and that there are abnormalities of right hemisphere function and of the autonomic recognition pathways that determine sense of familiarity.ConclusionsBasic psychopathological phenomena are more likely to throw light on the basic neural mechanisms that are important in psychiatric disorders than studying disease level categories.Disclosure of interestThe author has not supplied his declaration of competing interest.
The role of cognition in the psychopathology of schizophrenia: Assessment and treatment options
Authors: Sachs G. , Lasser I. , Winklbaur B. , Maihofer E. , Erfurth A. 
Published: May 2016

Cognitive dysfunction is a characteristic feature of patients with schizophrenia. Traditionally, the main distinction between “dementia praecox” and “manic-depressive insanity” was in fact the cognitive outcome during the course of the disease [1].For the assessment of cognitive dysfunction both large, detailed instruments [2] and brief screening scales for quick and multiple use [3,4] are available.Recently, the role of social cognition has been thoroughly examined showing differential effects [5].Treatment of cognitive dysfunction in schizophrenia comprises adherence to a therapy with atypical antipsychotics as well as specific treatment programs for cognitive [6] and social cognitive [7,8] dysfunction.Disclosure of interestThe authors have not supplied their declaration of competing interest.