bluuebunny/crossref_metadata_2025_split huggingface dataset:
How increasing the effect of rTMS in the treatment of auditory hallucinations in schizophrenia?
Authors: Dollfus S. , Nathou C. , Olivier E. 
Published: May 2016

Repetitive transcranial magnetic stimulation (rTMS) shows a high inter-subjects variability in the efficacy of treatment of auditory verbal hallucinations (AVH) in schizophrenia. The aim of this presentation is to demonstrate the involvement of several factors in the efficacy of rTMS such as the frequency of stimulation, the placebo effect and the brain morphology underlying the target of stimulation.MethodsA meta-analysis was conducted to determine the effect sizes of placebo effect in 21 controlled studies on rTMS in the treatment of AVH in schizophrenia. MRI was also acquired in patients treated by rTMS to evaluate the scalp to cortex distances (SDCs) and the gray matter densities (GMDs) at the target of stimulation. Finally, we evaluated the efficacy of high (20 Hz) frequency stimulation in a controlled placebo study.ResultsWeak or no placebo effect in the control groups led to reveal a superiority of active rTMS over sham rTMS in the treatment of AVH. Clinical efficacy of rTMS was also correlated with the SCD or the GMD at the region of the target stimulation. Finally, we also demonstrated that more responders were observed after 2 weeks in the active group treated by 20 Hz than in the placebo group.ConclusionWe clearly demonstrated that several factors such as high frequency, the placebo effect, anatomical cortical variations can impact on the efficacy of rTMS. These results fundamentally inform the design and the method of further controlled studies, particularly with respect to studies of rTMS in the treatment of AVH.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Value in mental healthcare: The patient aspect
Authors: Cohen Y. 
Published: May 2016

From the patients’ point of view, valued-based mental healthcare is mental healthcare based on a holistic vision of care, according to which patients are actively involved in their treatment to achieve the best possible outcomes. They are invited to collaborate with both mental health care providers such as psychiatrists and primary caregivers to determine what types of treatment are the most effective.GAMIAN-Europe believes that the best package of care includes the following four elements:– medication – antipsychotic medication is consensually regarded as first-line treatment for people with mental health problems;– psychotherapy/counselling – although antipsychotic medications are the mainstay of treatment for mental health problems, pharmacotherapy alone produces only limited improvement in negative symptoms, cognitive function, social functioning and quality of life. Additionally, many patients continue to suffer from persistent positive symptoms and relapses, particularly when they fail to adhere to prescribed medications. These situations emphasize the need for multimodal care, which includes psychosocial therapies as adjuncts to antipsychotic medications in order to alleviate symptoms and to improve social functioning and quality of life;– psycho-education – the more a patient learns about his/her condition the better placed he/she will be to take control of it. Psycho-education embodies this principle by using a clearly-defined therapeutic programme, in which a trained therapist delivers targeted information designed to reduce both the frequency and the severity of symptoms. Psycho-education increases patients’ knowledge and understanding of their illness and treatment options and helps them cope more effectively. Many people find that they benefit not only from the information they receive during psycho-education, but also from the learning process itself. There are several different ways in which psycho-education can be delivered, including one-to-one sessions with a therapist, sessions aimed specifically at carers and family members, group sessions attended by several people coping with mental illness and mixed group sessions attended by people with mental illnesses and family members;– self-help – self-help groups offer patients a voice and an audience with the time and inclination to listen to patients’ concerns and reassure them and ease their anxiety. For example, a self-help group may be able to quell anxiety regarding side effects, to reassure the patient, from first-hand experience, that these side effects are transient, normal and non-threatening and will diminish over time. The real experts on living with a mental disorder are those who are already doing so. Therefore, most support groups are full of people who can share information about how they have managed to cope with their illnesses.Disclosure of interestThe author has not supplied his declaration of competing interest.
The current state of child and adolescent mental health services in Europe: A survey in 28 countries
Authors: de Girolamo G. , Signorini G. , Singh S.P. , Warwick J. 
Published: May 2016

IntroductionTransition to adulthood is the period of onset of most serious mental disorders. The current discontinuity of care between Child and Adolescent Mental Health (CAMHS) and Adult Mental Health (AMHS) Services is a major socioeconomic and societal challenge for the EU.Objectives/aimsIn the framework of the MILESTONE project this study aims to map current services and transitional policies across Europe, highlighting current gaps and the need for innovation in care provision.MethodsAn on-line mapping survey has been conducted across all 28 European countries through the administration of two ad-hoc instruments: the Standardized Assessment Tool for Mental Health Transition (SATMEHT) and the European CAMHS Mapping Questionnaire (ECM-Q). The survey systematically collected data about CAMHS organization and characteristics, with a specific focus on actual national transition policies and practice.ResultsResponse rate was 100%. Despite up to 49% of CAMHS service users need to continue with specialist AMHS care, written policies for managing the interface between these two services are available only in 4/28 countries and transition support services are reported as missing by half of the respondents. Lack of connection between CAMHS and AMHS is reported as the major (82%) difficulty experienced by young service users.ConclusionPreliminary results indicate a marked variability in characteristics of services and in data activity among the 28 European countries, with important missing information at national level about CAMHS and their functioning. All these conclusions warrant an improvement in data collection and service planning and delivery.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Novel psychoactive substances
Authors: Orsolini L. , Papanti D. , Vecchiotti R. , Valchera A. , Corkery J. , Schifano F. 
Published: May 2016

Over the last decade, the “traditional” drug scene has been supplemented – but not replaced – by the emergence of a range of novel psychoactive substances (NPS), which are either newly created or existing drugs, including medications, now being used in novel ways. By the end of 2015, in excess of 700 NPS had been reported by a large number of countries in the world. Most recent data show however that synthetic cathinones; synthetic cannabinoids; and psychedelics/phenethylamines; account for the largest number of NPS. Given the vast range of medical and psychopathological issues associated with the molecules here described, it is crucial for health professionals to be aware of the effects and toxicity of NPS. The “Drugs 2.0.” revolution facilitated the birth and growth of an “Online Drug Culture” which finds its main expression in chats/fora/blogs as well as the diffusion of online drug marketplaces (both in the surface and deep web). The web has progressively modified the drug market from a “street” into a “virtual” one, so by increasing the availability of new drugs/NPS/“legal highs” (“legal alternatives” to the traditional illegal drugs). The rapid pace of change in the NPS online market constitutes a major challenge to the provision of current and reliable scientific knowledge on these substances. The present lecture aims at providing an overview of the NPS phenomenon, also giving an overview of the main clinical and pharmacological issues relating to these most popular NPS categories.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Short-term psychotherapeutic interventions in consultation-liaison psychiatry
Authors: Diefenbacher A. , Burian R. 
Published: May 2016

Due to a reduction in length of hospital stay of general hospital inpatients, CL-psychiatrists find themselves confronted with the problem of “less time to do more”. This presentation will first outline procedural aspects of CL-psychiatry, delineating its development from the “situational approach” do becoming case managers. Then, short-term supportive interventions will be discussed with regard to their applicability and newer disorder specific techniques, such as ACT and DBT will be demonstrated in their usefulness for the medically ill.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Drugs pharmacokinetics interactions with cardiac and renal disease patients in consultation-liaison psychiatry
Authors: Telles D. , Barbosa A. 
Published: May 2016

The prevalence of psychiatric disturbances in patients with cardiovascular disease is elevated. For example the prevalence of major depression can reach 15–20% and of anxiety disturbances 5–20%.When we treat psychiatric symptoms in cardiovascular disease we must have in mind four particular effects of psychiatric drugs: (1) disturbances of atrial-ventricular conduction; (2) QTc interval prolongation that can lead to torsade de pointes and ventricular fibrillation; (3) hypertension; (4) changes in platelet aggregation.On the other hand, there is a great prevalence of psychiatric disease in patients with renal disease. For example, about 5–25% of the patients with advanced renal disease have major depression.Renal disease patients can evidence changes in several pharmacokinetic parameters such as: (1) biodisponibility; (2) distribution; (3) metabolism; (4) excretion. Therefore, when we treat these patients we have to keep in mind the effect of psychiatric drugs over the renal functioning, but also the effect of the deficient renal function in the pharmacokinetics of the drugs.I this presentation we intend to reveal what are the main concerns when we prescribe psychiatric drugs in patients with cardiovascular and renal disease.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A European psychopharmacology curriculum: The young psychiatrist's point of view
Authors: Spies M. , Kasper S. 
Published: May 2016

It goes without saying that psychopharmacologic treatment requires extensive knowledge of topics ranging from pharmacodynamics and efficacy, to pharmacokinetics, side-effects, and toxicity. Knowledge should be supplemented with experience regarding applicability in a clinical setting. It is well accepted that comprehensive psychopharmacologic education is essential to convey necessary knowledge and adequately prepare trainees for independent practice [1]. Currently, a psychopharmacologic curriculum, under the umbrella of the European Psychiatric Association, is in preparation in order to emphasize the importance of psychopharmacologic education in the context of psychiatric training and to foster standardization within the European Union. The aim of this presentation is to discuss psychopharmacologic education and prerequisites for an effective curriculum from the trainee's point of view. We will address challenges facing psychiatric trainees [2] and review existing curricula as well as literature in which they are evaluated. Based on evaluation of the model curriculum by the American Society of Clinical Psychopharmacology, one of the most broadly used psychopharmacologic curricula, it has been emphasized that an effective curriculum should be more than a list of topics. It should also convey pedagogic strategies with a focus on up-to-date technology, and provide a process through which teacher and trainee progress can be assessed [3,4]. Reflection on currently available curricula should aid in the development of an effective and timely EU-wide psychopharmacologic curriculum.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Harmonization of European training
Authors: Oude Voshaar R. 
Published: May 2016

Mental health disorders, especially dementia, mood- and anxiety disorders, are among the most prevalent diseases in later life. Due to a greying European society, numbers are expected to increase over the next decades. Consequently, there is a pressing need for well-trained specialists in geriatric psychiatry across Europe in order to meet the mental health needs and to deliver a high standard of care to the aging population. In the past decades, some countries have set up specific training programs for specializing in geriatric psychiatry, whereas others did not. In order to stimulate the development of high-quality services, harmonizing specialty training across Europe will be a first step forward.The EU stresses the need for standardizing qualifications of medical professionals to enable them to work across the EU. This workshop aims to work towards a consensus on the minimum training level required for geriatric psychiatry. We state that being able to work as an old age psychiatrist requires specific training in geriatric psychiatry and old age over and above general training in psychiatry. Therefore, discussion of opportunities to develop minimal criteria for training and practice across Europe is crucial. Taken the differences between countries into account (many countries do not provide specific training in old age psychiatry), we should finally agree on the minimal level of education and supervision, the minimum level of work experience and finally the minimal level of supervision in peer groups as a starting point.Disclosure of interestThe author has not supplied his declaration of competing interest.
New research in outcome management using apps and DSM-5 measures. Preliminary results
Authors: Buwalda V.J.A. 
Published: May 2016

The presentation is about the use of outcome measurements in combination of a newly developed app that enables psychiatrists and patients track the progress of their treatment process and adjust it if needed in an shared decision fashion.In 2013 the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders was introduced. Around the same time there was the start of a paradigm shift in healthcare which increased the focus on patient involvement in individual health care decision-making and on measuring and improving outcomes of care (Sederer et al., 1997; Sperry, 1997; Hermann, 2005). If outcome measures are psychometrically sound and able to measure clinical change, treatment progress can be made transparent for both patients and clinicians.In this presentation the presenter will update the audience on a research project were the DSM-5 Field Trials, patient-reported dimensional measures and the World Health Organization Disability Assessment Schedule (WHODAS) (Clarke et al., 2013; Narrow et al., 2013; Mościcki et al., 2013) are secured and placed in a newly developed app.Disclosure of interestThe author has not supplied his declaration of competing interest.
Relationships between neurocognition, social cognition and functional outcome in schizophrenia
Authors: Mucci A. , Galderisi S. , Rossi A. , Rocca P. , Bertolino A. , Bucci P. , Maj M. 
Published: May 2016

IntroductionThe inter-relationships of neurocognition, social cognition, residual psychopathology and real-life functioning are poorly understood. A large multicenter study was carried out by the Italian Network for Research on Psychoses to model relationships between neurocognitive deficits, psychopathology and real-life functioning, taking into account the role of functional capacity and social cognition.MethodsA structural equation model was used to investigate direct and indirect effects of neurocognition and psychopathology on real-life functioning. Social cognition and functional capacity were modeled as mediators.ResultsIn 921 patients with schizophrenia, neurocognition had both direct and indirect effects, through functional capacity and social cognition, on real-life functioning. Neurocognition predicted to a large extent social cognition on which depression and disorganization had a modest effect. Social cognition showed a significant direct impact on real-life functioning.ConclusionOur results support a strong link between neurocognition and functional outcome, independent of psychopathology. Social cognition accounted for unique incremental variance in real-life functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Assessment of negative symptoms beyond schizophrenia
Authors: Kaiser S. 
Published: May 2016

IntroductionNegative symptoms have long been recognized as a hallmark of schizophrenia. Newer evidence suggests that negative symptoms can be observed in persons with other disorders or even in non-clinical populations. However, most negative symptom scales are designed to identify clinically relevant symptoms, which might lead to underappreciation of subclinical symptom expression.ObjectivesThe aim of the present study was to establish distributional properties of well-established negative symptom scales in comparison with the newly developed Zurich Negative Symptom Scale, which employs a fully dimensional and continuous approach.MethodsWe included participants with established schizophrenia (n = 65), first-episode psychosis (n = 25), schizotypal personality traits (n = 29) and remitted bipolar disorder (n = 20). Assessment of negative symptoms was conducted with the Zurich Negative Symptom Scale and compared to establish rating scales.ResultsIn this broad sample, measurement of negative symptoms with established negative symptom scales lead to a highly skewed distribution. In other words, established negative symptom scales were able to identify negative symptoms in some participants in the non-schizophrenia spectrum, but a differentiation of negative symptom severity in the subclinical range was not possible. In contrast, the distribution of negative symptoms measured with the Zurich Negative Symptom scale approached normality.ConclusionsNegative symptoms can be observed outside the schizophrenia diagnosis. However, in order to fully explore the continuity of negative symptoms, measurement instruments need to be designed to cover the full range of symptomatology starting at a subclinical level. We propose the newly developed Zurich Negative Symptom Scale as a useful tool in this respect.Disclosure of interestThe author has not supplied his declaration of competing interest.
Efficacy of nalmefene in a sample of patients with alcohol dependence
Authors: Aguado Mañas J.A. , Segurado O. 
Published: May 2016

IntroductionIt is well known the high rate of alcohol abuse and dependence in Spain. Specifically, in Castilla and Léon as a wine region, the risk of developing alcoholism is 1 of 10 men and 1 of 15 women [1].ObjectiveThe aim of the study is to assess the efficacy of nalmefene in reducing alcohol consumption and its complications, in a sample of patients with alcoholism.Materials and methodsIt is an open, naturalistic, observational and descriptive study in a sample of 18 patients with alcohol dependence diagnosis.We collected standard demographic variables, but also living alone, social support and work.In addition, clinical variables as SD (standard drinks) per day, time of illness, concomitant diseases, number of admissions, periods of abstinence, abstinence longer duration, nalmefene doses and other treatments were collected. These variables were reassessed at first, 3th and 6th month.ResultsIn our sample the average profile is a man (75%) with an age of 46, who lives alone (68%), in urban area and with poor social support.Average SD consumed at the beginning was 53, one month later was 26, after three months was 14 and 6 months later was 5, with a total abstinence rate of 65% at the end of the period. Logically there was also a dramatic reduction in somatic and social complications.ConclusionsNalmefene is demonstrated as a useful drug in reducing alcohol consumption and its complications.Nalmefene also proves to be effective for achieving complete alcohol abstinence starting with a reduction plan.Reference not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Prevalence rate, demographic and clinical predictors of substance use disorders in emergency room psychiatric patients of a tertiary hospital in Canada
Authors: Agyapong V. , Juhas M. 
Published: May 2016

BackgroundThere is only a limited body of literature which has examined the factors which can predict the presence of substance use disorders (SUD) in psychiatric patients seeking emergency room (ER) treatment.ObjectiveTo examine the factors that can predict the likelihood that a patient presenting to the emergency room and referred to the liaison psychiatric team will suffer from a SUD.MethodsNineteen independent demographic and clinical factors from data assessment tools for 477 patients assessed by the liaison psychiatric team in the ER over 12 months were compiled and analysed using univariate analyses and logistic regression in SPSS (version 20).ResultsThe 12-month prevalence rate of all SUDs in our clinical sample was 24.7%. Patients who presented to the ER with a chief alcohol and/or drug related complaint (withdrawal or intoxication) were 142 times more likely to fulfill the diagnostic criteria for SUD compared to those who presented with non-SUD related complaints. Male patients or patients with forensic history were both three times more likely to suffer from SUD than female patients or patients with no forensic history, respectively.ConclusionThere is a high prevalence of SUDs among psychiatric patients assessed in the ER. In addition to targeting patients who present to the ER with an alcohol or drug withdrawal/intoxication for brief psycho-educational interventions and referrals to addiction treatment services, patients with forensic history and male patients should be targeted for SUD screening.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Methamphetamine as a risk factor for myopathy
Authors: Azhari A. 
Published: May 2016

IntroductionCardiotoxic effects of methamphetamine have been proposed in many investigations, but the risk of striated muscles involvement among methamphetamine abusers is unknown.MethodsA case-control study has begun in our teaching hospital to examine the association between methamphetamine abuse and myopathy. The study population are adult clients who admit in the electrodiagnostic medicine clinic since January 2015 with complains of weakness. For each subject with myopathy, 2 controls without myopathy are randomly selected from the same population. Self-reported history of methamphetamine abuse is acceptable in both groups.ResultsA total of 56 persons with myopathy and 112 controls have been identified, of whom 5 (9 percent) and 3 (3 percent) had history of methamphetamine abuse, respectively. Persons with history of methamphetamine abuse have about three times greater chance to develop myopathy (95% CI: 1.5–5.1) as compared with controls.ConclusionThere is a misconception among some workers that some illicit drugs such as psycho stimulants can improve their ability to work. In contrast, this study demonstrates that due to harmful effect on the muscles, methamphetamine could diminish the ability to work in long time.Disclosure of interestThe author has not supplied his declaration of competing interest.