bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decentering and avoidance: Mechanisms between external shame and depression symptomatology
Authors: Ferreira C. , Mendes A.L. , Marta-Simões J. , Trindade I.A. 
Published: May 2016

It is widely accepted that shame plays a significant role in the development and maintenance psychopathology, namely depressive symptoms. In fact, the experience of shame is highly associated with the adoption of maladaptive strategies to cope with negative feelings, such as experiential avoidance (i.e., the unavailability to accept one's private experiences), and the inability of decenter oneself from unwanted internal events. The present study aims to explore a mediation model that examines whether external shame's effect on depressive symptomatology is mediated through the mechanisms of decentering and experimental avoidance, while controlling for age. Participants were 358 adults of both genders from the general population that completed a battery of self-report scales measuring external shame, decentering, experimental avoidance and depression. The final model explained 33% of depression and revealed excellent model fit indices. Results showed that external shame has a direct effect on depressive symptomatology and simultaneously an indirect effect mediated by the mechanisms of decentering and experiential avoidance. These data seem to support the association between shame and depressive symptomatology. Nevertheless, these findings add to literature by suggesting that when the individual presents higher levels of shame he or she may present lower decentering abilities and tends to engage in experiential avoidance, which amplify the impact of external shame and depression. Furthermore, our findings seem to have important clinical implications, stressing the importance of developing intervention programs in the community that target shame and experimental avoidance and that promote adaptive emotion regulation strategies (e.g., decentering) to deal with adverse experiences.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Escitalopram orally-disintegrating tablets (ODT) in major depression treatment
Authors: Polikowska M. , Łoza B. 
Published: May 2016

IntroductionThe growing rate of depressive disorders causes needs for more effective and more innovative solutions. The modern patients’ challenges make them fail mostly in the treatment compliance. Some reports have described that escitalopram orally disintegrating tablets (ODT) induce faster response and lower dropout rate than oral standard tablets (OST), although both forms have equal bioavailability.AimWe tried to clarify effectiveness rates between escitalopram ODT and OST treatments in depressive patients.MethodAn open-label, 6-month, randomized, flexible-dose study was conducted for direct comparison of the effects of escitalopram ODT (N16) and OST (N15) on dropout rate and clinical outcomes in patients with major depression.ResultsOutcome measures included Hamilton Depression Rating Scale (HDRS), Drug Attitude Inventory-10 (DAI), Clinical Global Improvement Scale (CGI), and Psychological General Well-Being Scale (PGWB). The tolerability was assessed by the UKU scale. No significant difference was found in HDRS, CGI, PGWB and GAF between the two forms of tablets. No significant difference was found in any tolerability rates. However, dropout rate favored escitalopram ODT group (N5, 31.3%) vs escitalopram OST (N7, 47.0%). DAI-10 outcomes, both in patients’ general attitude and subjective feelings, were significantly improved in ODT group (P = 0.000), comparing with OST.DiscussionEscitalopram in its classical form (OST) has become a leader in a group of antidepressants, thanks to safety of use, efficacy and tolerability. In the ODT form, escitalopram can meet additional needs, both clinical and lifestyle. ODT may reduce dropout rate and costs of long-term treatment improving the patients’ compliance.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Randomized controlled trial testing behavioral weight loss versus multi-modal stepped-care treatment for binge eating disorder
Authors: Grilo C. 
Published: May 2016

IntroductionBinge eating disorder (BED) is prevalent, associated with obesity and elevated psychiatric co-morbidity, and represents a treatment challenge.Objective and aimsA controlled comparison of multi-modal, stepped-care versus behavioral-weight-loss (BWL) for BED.MethodsOne hundred and ninety-one patients (71% female, 79% white) with BED and co-morbid obesity (mean BMI 39) were randomly assigned to 6 months of BWL (n = 39) or stepped-care (n = 152). Within stepped-care, patients started BWL for one month; treatment-responders continued BWL while non-responders switched to cognitive-behavioral-therapy (CBT) and all stepped-care patients were additionally randomized to anti-obesity medication or placebo (double-blind) for five months. Independent assessments were performed by research-clinicians at baseline, throughout treatment, and post-treatment (90% assessed) with reliably-administered structured interviews.ResultsIntent-to-treat analyses of remission rates (0 binges/month) revealed BWL and stepped-care did not differ significantly overall (74% vs 64%); within stepped-care, remission rates differed (range 40% - 79%) with medication significantly superior to placebo (P < 0.005) and among initial non-responders switched to CBT (P < 0.002). Mixed-models analyses of binge eating frequency revealed significant time effects but BWL and stepped-care did not differ overall; within stepped-care, medication was significantly superior to placebo overall and among initial non-responders switched to CBT. Mixed models revealed significant weight-loss but BWL and stepped-care did not differ overall; within stepped-care, medication was significantly superior to placebo overall and among both initial responders continued on BWL and non-responders switched to CBT.ConclusionsOverall, BWL and stepped-care treatments produced improvements in binge-eating and weight loss in obese BED patients. Anti-obesity medication enhanced outcomes within a stepped-care model.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Binge-eating disorder and major depressive disorder co-morbidity: Sequence and clinical significance
Authors: Grilo C. , Becker D. 
Published: May 2016

IntroductionBinge-eating disorder (BED) is associated with obesity and with elevated rates of co-occurring major depressive disorder (MDD) but the significance of the diagnostic comorbidity is ambiguous—as is the significance of the onset sequence for MDD and BED.Objective and aimsWe compared eating-disorder psychopathology and psychiatric comorbidity in three subgroups of BED patients: those in whom onset of BED preceded onset of MDD, those with onset of MDD prior to onset of BED, and those without MDD or any psychiatric comorbidity.MethodsA consecutive series of 731 treatment-seeking patients meeting DSM-IV-TR research criteria for BED were assessed reliably by doctoral-clinicians with semi-structured interviews to evaluate lifetime psychiatric disorders (SCID-I/P) and ED psychopathology (EDE Interview).ResultsBased on SCID-I/P, 191 (26%) patients had onset of BED preceding onset of MDD, 114 (16%) had onset of MDD preceding onset of BED, and 426 (58%) had BED without co-occurring disorders. Three groups did not differ with respect to age, ethnicity, or education, but a greater proportion of the group without MDD was male. Three groups did not differ in body-mass-index or binge-eating frequency, but groups differed significantly with respect to eating-disorder psychopathology, with both MDD groups having significantly higher levels than the group without co-occurring disorders. The group having earlier onset of MDD had elevated rates of anxiety disorders compared to the group having earlier onset of BED.ConclusionsMDD in combination with BED—with either order of onset—has a meaningful adverse effect on ED psychopathology and overall psychiatric co-morbidity.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Emotional neglect as the colossus among traumas in patients with eating disorders. A case-control study
Authors: Piacentino D. , Loriedo C. , Biondi M. , Girardi P. , Vanderlinden J. , Pignatelli A.M. 
Published: May 2016

IntroductionIndividuals with eating disorders (EDs) often report a history of early traumatization. Although a great attention has been paid to sexual and physical trauma, less is known about emotional one, especially neglect.Objectives/aimsWe aimed to estimate the prevalence of sexual, physical, and emotional trauma–occurring under 18 years of age–in ED patients vs. healthy controls, focusing on emotional abuse and neglect.MethodsWe consecutively recruited 57 DSM-V ED outpatients (91.2% females; age range = 18–42 years) at the Psychiatric Outpatient Clinic of our University Hospital and 90 healthy controls (78.9% females; age range = 20–39 years). Among ED patients, 43.9% had restrictive anorexia nervosa (AN), 29.8% binge/purging AN, 26.3% bulimia nervosa. Individuals completed the Eating Disorder Inventory-2 (EDI-2) and the Traumatic Experiences Checklist (TEC). We used Mann-Whitney U test and χ2 test for comparisons.ResultsED patients scored significantly higher than controls on all EDI-2 subscales (P-values < 0.05). On the TEC, emotional trauma was more frequent than sexual/physical ones in both ED patients and controls. Emotional trauma, and to a lesser extent physical one, were significantly more frequent in ED patients than controls. Distinguishing between emotional abuse and neglect, the latter had a higher prevalence than the former in both groups. Additionally, ED patients reported significantly more neglect, but not emotional abuse, than controls.ConclusionsOur findings show a high prevalence of emotional trauma in EDs, mainly neglect, i.e., a lack of care and attention potentially contributing to EDs. Thus, it is crucial to investigate emotional neglect in ED patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Professional stress among psychiatrists–a Delphi study
Authors: Dhandapani A. , Armugam S.S. , Chaturvedi S.K. 
Published: May 2016

IntroductionProfessional stress is a misfit between a person's skills and demands of the job. It has been found to be common among psychiatrists and affects their personal and professional life.ObjectivesTo rank order the factors and manifestations of professional stress among Indian psychiatrists.AimsTo determine the factors and manifestations associated with professional stress among Indian psychiatrists.MethodsA qualitative ranking type Delphi study was conducted at National Institute of Mental Health & Neurosciences, Bangalore. The Delphi team comprised of 43 randomly selected Indian psychiatrists with at least 10 years of clinical experience in psychiatry. Questionnaires were mailed & the replies were analyzed and a consolidated list was sent back to rank order them. Agreeability was assessed & the final list of factors and manifestations was shared with the experts.ResultsForty-eight percent of the experts completed all 3 stages of the study, 53% opined that age & gender were not a factor; however 58% & 44% opined that personality attributes & relationship status were significant factors contributing to professional stress (Table 1).ConclusionProfessional stress in Indian psychiatrists is largely secondary to increased workload and inadequate support system. System level changes, like increase in manpower and handling stigma regarding psychiatry, is required.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A new psychiatric society is born: Spanish Society of Psychiatry Residents (SERP)
Authors: Llanes Álvarez C. , San Román Uría A. , Núñez Morales N. , Sevillano Benito I. , Hervías Higueras P. , Gómez-Coronado Suárez de Venegas N. , Puerta Rodríguez S. , Valdés Valdazo J. , Prieto Lorenzo V. , Pimenta V. , Pinto da Costa M. 
Published: May 2016

IntroductionThe European Federation of Psychiatric Trainees (EFPT) is an independent Federation of Psychiatric Trainees and represents the consensus of psychiatric trainee's organizations across European countries and advocates for what training should look like, regardless of the country. Spain was one of the last countries to be part of the Association. Finally, and after months of hard work and networking, on September 2015 the Spanish Society of Psychiatry Trainees(SERP), was founded and Spain became a observer member of the EFPT.ObjectivesOne of the main goals of the SERP, is creating a program of clerkships, in both directions, from other trainees to come to Spain, and for Spanish Trainees to go abroad.MethodsOur idea in this poster is to explain a first look of which Hospitals/Units would be appropriate to make a rotation, and to explain the first steps in order to create a database with information about the nightshifts, possible accommodation and other aspects related to the organization. We want to use this poster to present to Europe our new Association.ResultsOn September 25 at the National Congress of Psychiatry in Santiago de Compostela, a Group of Spanish trainees founded the SERP, organized the first Board and signed the Founding Amendments.ConclusionsAfter two previous failed attempts, finally on 25th September 201; the Spanish Society of Psychiatry Residents (SERP) was founded, an important part of the activity of this company is promoting exchanges between residents of member countries in Spain.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychiatric disorders in mass media and social networks: A media impact study
Authors: Álvarez de mon M.Á. , Sánchez R. , Molero P. 
Published: May 2016

IntroductionEvery year, 1 million people commit suicide in the world. Major Depressive Disorder is the first cause of loss of Disability-Adjusted Life Years (DALYs) in developed countries.ObjectiveTo study the references to psychiatric disorders in the media and to measure their media impact compared with other topics such as politics, sports and tabloids.MethodsWe focused on the top-six journals in terms number of readers in the USA. Our research strategy included the introduction of several terms of interest (ex: “anxiety”) on each journal's Twitter account. The search was restricted to 2014, and yielded a database of 6296 news, which was categorized in four areas: health, politics, sports and tabloids.ResultsSix hundred and eighty-one (10.8%) news dealt with psychiatric disorders. The term with the highest impact in mass media was “suicide”, present in 1 of every 3 Psychiatrics-related news. Anorexia was the psychiatric disorder with the lowest impact (just 1 tweet). We noticed certain peaks-patterns in the number of tweets coincidentally with the suicide of any famous person. Within the total of terms included in our study, suicide ranked the 8th position regarding media impact.ConclusionsSocial networks can be a useful tool for the divulgation of mental disorders and their awareness among the general population. Despite psychiatric disorders are very prevalent and cause high morbidity, they have a relatively low media impact. Despite the WHO recommendation of avoiding specific information regarding the suicide of famous people, for preventive reasons, suicide is the psychiatric disorder with the highest media impact.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The evaluation of the effects of daytime sleepiness, anxiety and depression on the quality of life in 112 emergency medical staff
Authors: Cankaya S. , Topbas M. , Beyhun N.E. , Can G. , Kizilay Cankaya P. 
Published: May 2016

IntroductionOne hundred and twelve emergency medical staff are faced with many physical and mental problems due to the deterioration of their sleep-wake cycle and getting out of their usual work and social life.ObjectivesThe aim of this study was to examine the effects of anxiety, depression, day time sleepiness on the quality of life in 112 emergency medical staff.MethodsTarget population of this cross-sectional study was the 112 emergency medical staff in the province of Rize. We tried to obtain all the universe (n = 154), so the sample was not selected. One hundred and four people (67%) participated in the study. In the data form, Epworth sleepiness scale, Beck Anxiety Inventory, Beck Depression Inventory and the SF-36 quality of life questionnaire were applied.ResultsThe prevalence of pathological sleepiness was 14.4% (n = 15), the prevalence of anxiety was 39,8% (n = 41), the prevalence depression was 20,2% (n = 21), respectively (Table 1).ConclusionBased on high levels of anxiety and depression that reduces quality of life compared to the general population in 112 emergency services workers, motivational programs, coping strategies, psychological counseling services are required. Also, against the psychosocial risk factors forming anxiety and depression in the working life, organizational measures must be taken.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Long-stay in high and medium secure forensic psychiatric care – Prevalence, patient characteristics and pathways in England
Authors: Edworthy R. , Vollm B. 
Published: May 2016

IntroductionForensic psychiatric services are costly and highly restrictive for patients. Clinical experience and the limited research available indicate some patients stay for too long in these settings. A proportion of patients may, however, require long-term (potentially life-long) secure forensic psychiatric care but their needs may not be met by existing service provision designed for faster throughput.ObjectivesWe conducted a national, multi-centre, cross sectional study exploring the prevalence of long-stay and characteristics of long-stayers in high and medium secure forensic psychiatric care in England.Aims(1) Estimate the prevalence of long-stay in secure settings in England (length of stay over 5 years in medium secure care or 10 years in high secure care); (2) describe the characteristics, needs and care pathways of long-stay patients. Develop recommendations following the exploration of international models for this patient group.MethodsWe employed a mixed-methods approach including the analysis of administrative data, case file reviews, patient interviews, consultant questionnaires, interviews with clinicians and commissioners and a Delphi survey.ResultsTwenty-five percent (n = 401) of our sample were experiencing long-stay. This patient group has a heterogeneous set of characteristics and needs relating to their diagnosis, offending history, risk and therapeutic need and have experienced a variety of care pathways through secure care.ConclusionsWe found a greater number of long-stay patients than originally estimated with a set of characteristics and needs that are arguably different to that of the general forensic population, therefore calling for a specific care pathway and service provision for this patient group with a greater focus on autonomy and quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Abnormal amygdala functional connectivity during an fMRI expectancy task in pedophilia
Authors: Ristow I. , Li S. , Demenescu L.R. , Walter H. , Beier K. , Kruger T. , Schiffer B. , Ponseti J. , Walter M. 
Published: May 2016

IntroductionPedophilia is a disorder where sexual preferences of adults are directed towards children. This disorder impacts society with 1–2 out of every 10 children being sexually approached by an adult, often resulting in prolonged negative psychological effects. Prior research reported structural and functional amygdala alterations in pedophilia. As the neurophenomenological model of sexual arousal suggests the importance of the amygdala in the emotional component, we focused on amygdala functional connectivity in pedophilia.AimsTo investigate amygdala functional connectivity (FC) modulated by expectancy and salient stimuli in pedophilic patients.MethodsThirteen pedophilic patients and 13 matched healthy controls underwent a salience expectancy task in a 7T ultra high fMRI study. Subjects perceived pictures of naked adults and children. Half of the pictures were preceded by an expectancy cue. Participants were instructed to actively expect the picture depending on the cue. We conducted psychophysiological analysis (PPI) to examine amygdala FC changes in two amygdala sub-regions for child/adult stimuli during the expectancy period and the visual stimuli consummation period using as seed regions the basolateral (BLA) and central nucleus of the amygdala (CeA).ResultsHealthy controls, relative to patients showed significant stronger left CeA to right post-central gyrus FC during expectancy of adult > child picture. For picture condition (adult > child picture) we found significant stronger left CeA to left dorsolateral prefrontal cortex FC in patients compared to healthy controls.ConclusionThese findings add to the recent literature by indicating that amygdala dysfunctional connectivity is involved in development of deviant sexual behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Not just ‘callous-unemotional’: Psychopathic traits are associated with emotion dysregulation dimensions
Authors: Velotti P. , D’aguanno M. , Garofalo C. , Rogier G. 
Published: May 2016

IntroductionHistorically, psychopathic individuals have mainly been described as characterized by pervasive callous-unemotional traits, with dramatic implications for clinical and forensic practices – such as the tendency to deem psychopathic individuals as untreatable. However, recent evidence with community samples have highlighted that psychopathic traits may be in fact related to emotion dysregulation rather than being the mere reflection of an underlying ‘unemotionality’. Yet, it is no clear if this association extends to populations with more severe forms of psychopathy (i.e., offenders).ObjectivesWe wanted to replicate previous evidence of an association between emotion dysregulation and psychopathic traits in a sample of incarcerated offenders.AimsTo investigate the associations among emotion dysregulation dimensions and psychopathic traits, exploring similarities and differences between the Interpersonal-Affective and the Antisocial-Lifestyle facets of psychopathy.MethodsA sample of male offenders incarcerated in Italian jails completed the Self-Report Psychopathy Scale (SRP-4; Paulhus, Neumann, & Hare, 2015) and the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004).ResultsIn line with the expectations, emotion dysregulation dimensions did predict higher levels of psychopathic traits. Structural Equation Modelling revealed that selected dimensions of emotion dysregulation were associated with different facets of psychopathy.ConclusionsBased on our findings, we argue that psychopathic traits may be associated to a certain extent with emotion dysregulation, and thus a focus on improving emotion regulation skills may hold the promise to dampen the therapeutic pessimism when dealing with psychopathic offenders.Disclosure of interestThe authors have not supplied their declaration of competing interest.