bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of substance use among Russian, Somali and Kurdish migrants in Finland: A population-based study
Authors: Salama E. , Niemelä S. , Castaneda A. 
Published: May 2016

IntroductionAlthough substance use is a well-known public health risk factor, European population-based studies reporting the substance use among adult migrant populations are scarce.ObjectivesWe aim to: (1) determine the prevalence of alcohol use, cigarette smoking and consumption cannabis and intravenous drugs in Russian, Somali and Kurdish migrants in Finland and compare them to those of the Finnish general population; (2) determine if socio-economic and migration-related factors are associated with substance use in migrants.MethodsWe used data primarily from the Finnish migrant health and well-being study. Alcohol use was measured with the AUDIT-C questionnaire, smoking habits and the lifetime cannabis and intravenous drug use were recorded. Age-adjusted prevalence rates were determined by ethnicity and sex. The associations between background factors and substance use were analysed using logistic regression analysis.ResultsThe prevalence rate of risky drinking is lower and the proportion of abstainers is higher in migrants than in the general population. Current smoking is more common in Russian (31%, P < 0,05) and Kurdish (31%, P < 0,05) migrant men than in the general population (21%). Younger age was associated with risky drinking, socioeconomic disadvantage increased the odd for the daily smoking among migrants, and migration-related factors were associated with substance use.ConclusionsMigrants report less substance use than the general population, but acculturation-related factors seem to be associated with higher levels of substance use among migrants. Substance use seems to be a gendered phenomenon in migrant populations in comparison to the general population, where lately the alcohol and tobacco consumption of women have been growing.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Causes of psychoactive substance use by cannabis users with schizophrenia
Authors: Simonienko K. , Kwiatkowski M. , Cwalina U. , Wygnal N. , Wilczynska K. , Konarzewska B. , Waszkiewicz N. 
Published: May 2016

IntroductionPsychoactive substance use (PSU) in patients with schizophrenia can affect the course of the disease and causes many side effects. There is no clear evidence whether cannabis use can trigger the first episode of schizophrenia. The main causes of cannabis use in patients with schizophrenia are also still not defined.ObjectivesDetermine causes of PSU in cannabis users with schizophrenia.AimsThe aim of this study was to find out the causes of PSU in patients with schizophrenia.MethodsThirty-five cannabis users with schizophrenia (28 males, 7 females) were asked to complete 15-item questionnaire about the reasons of psychoactive substance intake. Eighteen of them used also stimulants. Additional information if PSU or schizophrenia occurred first was also taken.ResultsThe results indicated that regardless of stimulants use PSU occurred before schizophrenia in 83% of patients. Main reasons of substance intake were: need for relaxation (86%) which was more often in marihuana group (100%) than in marihuana and stimulants group (73.7%) and this difference was statistically significant (P = 0.049), curiosity (80%), self-regulation of well-being (74%), shyness, need for altered states of consciousness, expectation that psychoactive substances could help them in problem solving, relationships and sleep disorders (49–54%).ConclusionsPSU usually occur before the first episode of schizophrenia. Anxiety, curiosity and looking for unprofessional help are the most common reasons. The results may indicate an increased need of psychoeducation and social support in many areas of life. Future research should be considered.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Changes in qualified detoxification treatment of inpatients with multiple substance use: Impacts on key figures, a pre-post-study in an open door unit in Saxony, Germany
Authors: Voigtlaender B.S. , Schneider J. , Groß H. , Barth T. 
Published: May 2016

IntroductionDetoxification treatment of adults at younger ages suffering from polysubstance dependence on our department pursues an integrative therapeutic concept. In addition to addiction-specific, topic-centred group and talk therapy orientation also behavioural therapy elements are included: a penalty points system provides negative sign stimuli for undesirable behaviour.ObjectivesSince 2010, both rate of psychotic disorders and number of N-methylamphetamine consumers (P < 0.001) have been growing impressively while the proportion of repeated admissions amounted to > 55%. Dissatisfying trends were identified by longitudinal measurement, e.g. regarding ALOS, kind of discharge, bed occupancy.AimsTargeted changes in treatment were established in the 2nd half of 2014. In particular, the penalty point system was adapted towards less restrictive rules, combined with slightly reduced therapeutic intensity in order to come better on the disorder-related needs of the patients. Staffing level and structure remained stable.MethodsKey figures including quality criteria and performance data such as LOS, kind of admission and discharge, service intensity, and bed occupancy were evaluated by a pre-post study (pre: 1st half of 2014, N = 76/post: 1st half of 2015, N = 77) using descriptive and test statistics.ResultsSocio-demographic patient data remained stable. Regarding selected key figures there were significant changes (LOS > 21 days: P < 0.05; bed occupancy: P < 0.001; therapeutic contacts < 25 min: P < 0.001) and positive trends, e.g. decreased ratio of non-regular discharges.ConclusionsOur data suggest that punishment-oriented interventions impede addressing specific needs of inpatients with multiple substance use whereas more need-oriented interventions may lead to improvements. Further evaluation including patient satisfaction is indispensable.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Relationship between severity of tobacco dependence and personality traits, insomnia and impulsivity in male and female individuals entering alcohol treatment
Authors: Wnorowska A. , Serafin P. , Topolewska-Wochowska A. , Klimkiewicz A. , Jakubczyk A. , Brower K. , Wojnar M. 
Published: May 2016

IntroductionTobacco dependence (TD) often coexists with alcohol dependence. Previous research documented that both biological and environmental factors influence simultaneous development of the two disorders. However, it has not been determined whether the same psychological and psychopathological factors affect TD in alcohol-dependent males and females.AimThe objective of the study was to assess risk factors for high severity of TD in alcohol-dependent individuals considering gender differences.MethodsThe study entailed two groups: male (n = 284) and female (n = 102) subjects entering alcohol addiction treatment programs in Warsaw, Poland. Standardized instruments were used to assess: severity of TD – Fagerstrom Test for Nicotine Dependence, personality traits – NEO-Five Factor Inventory to assess, consequences of drinking – Short Inventory of Problems, impulsivity – Barratt Impulsivity Scale, and Sleep Disorder Questionnaire-7 as a measure of insomnia.ResultsIn the studied sample, current smokers comprised 79.1% (n = 225) of male and 79.4% (n = 81) of female participants. Multivariate regression model showed that high negative consequences of drinking (P = 0.001) and low NEO Openness score (P = 0.009) were associated with high risk of TD in female alcoholics (corr. R2 = 0.223; P < 0.0005). Bivariate analyses showed that TD was associated with impulsivity, openness, agreeableness and neuroticism in male alcohol-dependent subjects. Insomnia was the only significant predictor for high severity of TD in the males (corr. R2 = 0.068; P = 0.002).ConclusionsDifferent factors contribute to severity of tobacco dependence in male and female alcohol-dependent individuals entering addiction treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Anxiety, depression and perceived health status in patients with epilepsy
Authors: Smaoui F. , Turki E. , Halouani N. , Turki M. , Bouchhima I. , Bouzidi N. , Ben Amar M. , Amami O. , Mhiri C. 
Published: May 2016

IntroductionEpilepsy is a chronic disease often disabling, source of stigma and poor quality of life.ObjectivesDetermine the prevalence of anxiety and depression in patients with epilepsy and the associated factors.MethodsWe conducted a prospective, descriptive and analytical study among 20 patients followed for epilepsy in our department of neurology. The study was conducted from February to April 2015. We used a preestablished form to collect the socio-demographic and clinic profile of the patients. The assessment of anxiety and depression was made via the HADS “Hospital Anxiety and Depression Scale” and the perceived health status via GHQ scale “General Health Questionnaire”.ResultsThe average age of our patients was 35.9 years. The average GHQ score was 27.7. It was higher in women without a statistically significant difference. It was positively correlated with the number of attacks during the last 12 months (P = 0.042), poor treatment adherence (P = 0.007), the feeling of disability (P = 0.021) and the feeling of stigma (P = 0.008). Anxiety was estimated in 35% of cases and 45% were depressed. Depression was significantly associated to the celibacy (P = 0.012), the feeling of stigma (P = 0.038) and the GHQ score (P = 0.016). Anxiety was correlated with the absence of hobbies (P = 0.02) and the GHQ score (P = 0.008).ConclusionIt is important to detect these psychiatric disorders and to manage generators factors to ensure a better quality of life and social integration for these patients with epilepsy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Debate: Can suicide be prevented?
Authors: Wasserman D. 
Published: May 2016

Suicidal behaviour is the most common life-threatening psychiatric emergency. Reliable and precise tools to predict suicidal behaviours and to get support in the clinical practice are frequently requested.Several measurement tools for suicide risk assessment, both psychometric and biological have been studied. However, the low precision of the predictions make these tools insufficient from the clinical perspective. To date, the same applies to the search of genetic predictors. The best information is gained in a standard clinical evaluation, which puts focus on the need of acquiring the best possible knowledge and skills by practicing clinicians.The European Psychiatric Association (EPA) issued a guidance paper on suicide treatment and prevention, which was published in the European Psychiatry in 2012 [1]. This guidance paper elucidates the process of systematic evaluation of suicidal risks in the clinical interview, an overview of the best treatment possibilities and strategies for follow-up. As psychiatric patients constitute the majority of people who commit suicide, the adequate treatment of depression, substance use disorders, schizophrenia and other psychiatric diseases is a must.We will probably never be able to have perfect measurements to predict if an individual will or will not commit suicide, due to the complexities of human behaviour. However, with a good clinical praxis, suicide is an unnecessary death [2].Disclosure of interestThe author has not supplied his declaration of competing interest.
The psychological impact of melasma. A report of 30 Tunisian women
Authors: Fatma F. , Baati I. , Mseddi M. , Sallemi R. , Turki H. , Masmoudi J. 
Published: May 2016

IntroductionMelasma is a common disorder of acquired hyperpigmentation characterized by tan or brown macules and patches localized to photo-exposed areas of the face.ObjectiveTo study the psychological impact of melasma on Tunisian women.MethodsWe conducted a cross-sectional study on thirty patients with melasma who attended the dermatology department of the University Hospital in Sfax (Tunisia).The questionnaire included socio-demographic and clinical data. We used four measurement scales:– MELASQOL questionnaire;– Rosenberg Self-Esteem Scale;– Hospital Anxiety and Depression Scale;– Body Image Questionnaire.ResultsThe mean age was 34.6 years. The majority was living in urban areas (90%), was married (56.7%) and had a profession (80%).Sixty percent of patients were anxious and 16.7% were depressed. Both self-esteem and body image were respectively altered in 43.3% and 36.6%. The average score of MELASQOL was 31.77%. It was higher in single woman (36.8 vs. 28.4), younger than 40 years old (31.5 vs. 21.7), having a low socioeconomic status (45.2 vs. 29) and working in private sector (40 vs. 24).The quality of life was more damaged in patients with disease duration less than five years (P = 0.024).Anxious patients had higher MELASQOL scores than non-anxious (38.17 vs. 22.17; P = 0.008), as well as depressed patients (49 vs. 28.32; P = 0.009).High MELASQOL scores were correlated with low self-esteem (P = 0.05) and altered body image (P = 0.04).ConclusionAlthough benign, melasma causes an important psychological impact such as anxiety, depression, low self-esteem and poor body image. These effects should be considered in the care plan.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Burnout and neurotic symptoms among medical students
Authors: Tereszko A. , Drozdowicz K. , Szymura M. , Tuleja A. , Korzeniowski W. , Kozłowska A. , Siwek M. , Dudek D. 
Published: May 2016

IntroductionMedical studies are considered one of the most stressful majors and the medical profession is one of the most at risk of burnout. Some studies indicate the presence of symptoms of burnout already in the early stages of career, or even before it started, i.e. during studies preparing for the profession. Medical studies may be such a case and it can affect the mental health deterioration and cause the occurrence of both burnout and neurotic symptoms.ObjectivesAssessment of the impact of the course of studies on mental health of students and the risk of rapid burnout.AimEstimation of the prevalence and severity of burnout and neurotic symptoms among medical student depending on the year of study.MethodsSeven hundred and eighty-one medical students participated in the study. We used translated version of Maslach Burnout Inventory-Student Survey and Polish questionnaire – Symptom checklist S-III – for neurotic symptoms assessment.ResultsThere was no significant difference in MBI-SS subscales and symptoms checklist between first and last year of studies. Difference turned out to be significant when 1st and 6th year students with 3rd year – in Symptom checklist (P < 0.01 and P < 0.05, respectively), MBI-SS emotional exhaustion subscale (P < 0.01 for both) and depersonalization subscale (P < 0.01, significant only when compared with 1st year students).ConclusionsStudy revealed interesting pattern of burnout and neurotic symptoms, with theirs greatest severity at the beginning and the end of studies.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Severe behavioral disturbances in bipolar disorder: A case report
Authors: Benavente López S. , Salgado Borrego N. , de la Hera Cabero M.I. , Oñoro Carrascal I. , Flores L. , Jiménez Rico R. 
Published: May 2016

IntroductionBehavioral disturbances are common in psychiatric patients. This symptom may be caused by several disorders and clinical status.Case reportWe report the case of a 40 year-old male who was diagnosed of nonspecific psychotic disorder, alcohol dependence, cannabis abuse and intellectual disability. The patient was admitted into a long-stay psychiatric unit because of behavioral disturbances consisted in aggressive in the context of a chronic psychosis consisted in delusions of reference and auditory pseudohallucinations. During his admission the patient received the diagnosis of bipolar disorder type 1, presenting more severe behavioral disturbances during these mood episodes. It was necessary to make diverse pharmacological changes to stabilize the mood of the patient. Finally, the treatment was modified and it was prescribed clozapine (25 mg/24 h), clotiapine (40 mg/8 h), levomepromazine (200 mg/24 h), topiramate (125 mg/12 h), clomipramine (150 mg/24 h) and clorazepate dipotassium (50 mg/24 h). With this treatment, the patient showed a considerable improvement of symptoms, presenting euthymic and without behavioral disturbances.DiscussionIn this case report, we present a patient with severe behavioral disturbances. The inclusion of bipolar disorder in the diagnosis of the patient was very important for the correct treatment and management, because of depressive and manic mood episodes the behavioral disturbances were exacerbated.ConclusionsPatients with behavioral disturbances could present psychotic and affective symptoms as cause of them. It is necessary to explore these symptoms and try different treatments to improve them.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The influence of treatment modality on long-term neurocognitive functioning in treatment resistant bipolar depressed inpatients treated with pharmacotherapy or electroconvulsive therapy
Authors: Bjorke-Bertheussen J. , Auestad B. , Kessler U. , Schoyen H. 
Published: May 2016

IntroductionBipolar depression is difficult to manage, and causes considerable disability and distress for patients and their surroundings. Electroconvulsive therapy (ECT) is an effective treatment, but there are concerns regarding long-term neurocognitive impairment, and in particular autobiographical memory.ObjectivesTo compare the long-term effects of algorithm-based pharmacologic treatment (APT) and ECT in treatment-resistant bipolar depression as measured with standard neurocognitive tests and autobiographical memory interview.AimsTo examine the long-term neurocognitive effects of ECT.MethodsIn this multicenter randomized controlled trial 73 in-patients with treatment resistant bipolar depression were randomized to either APT or unilateral ECT. Patients were assessed at baseline and at 6 months. Neurocognitive functions were assessed with the MATRICS Consensus Cognitive Battery (MCCB), Wechsler Abbreviated Scale of Intelligence (WASI) and the Autobiographical Memory Inventory - Short form (AMI-SF). At 6 months, neurocognitive data were available for 26 patients (APT n = 11, ECT n = 15).ResultsThere were no group-differences at baseline.At 6 months, there was no group-difference in MCCB-score (APT 44.9 vs. ECT 46.0, P-value: 0.707), or WASI total IQ-score (APT 103.9 vs. ECT 107.2, P-value: 0.535). There were indications of (P-value: 0.109) poorer AMI-SF consistency score in the ECT group (APT 72.3% vs. ECT 64.3%).ConclusionsThis study does not find that ECT causes long-term impairment in neurocognitive function as measured with standard neuropsychological tests. We find a trend towards poorer autobiographical memory in the ECT-group, and there needs to be further research regarding this.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Mixed-effects models: Family burden and functionality in patients with bipolar disorder
Authors: Bermúdez-Ampudia C. , García-Alocén A. , Martínez-Cengotitabengoa M. , Alberich S. , González-Ortega I. , Barbeito Resa S. , González-Pinto A. 
Published: May 2016

IntroductionThe bipolar disorder (BD) has an important effect over the lives of patients and families. The attitude of the family is a modifiable factor through specific interventions and it has been related with BD prognosis.ObjectivesStudy a sample of families and patients with BD.AimsCompare between two groups its course of burden of caring for family members with BD. Also, we will see the course of the functionality in patients.MethodsSample of 148 individuals who caring a familiar with BD. Seventy-six of these followed psychoeducation session are going to be experimental group (EG), and the others 72 did not followed any session are going to be control group (CG). There is a follow-up at 6 months and one year. To see the course of the burden and the functionality it will be used mixed models.ResultsAt baseline, there were not significant differences between CG and EG in objective and subjective burden and functionality. But over time there were significant results in the three cases. For objective burden (b = −0.016; P = 0.0001) EG presented a drop (b = −0.014; P = 0.0062), while CG did not show changes (b = 0.002; P = 0.4691). For subjective burden (b = −0.014; P = 0.0058) without significant results for CG (b = −0.352; P = 0.3203) and a significant decrease in EG (b = −0.017; P = 0.003). For the functionality (b = 1.474; P = 0.000) there was a significant increase in EG (b = 1.349; P = 0.000) but not for CG (b = −0.125; P = 0.3828).ConclusionsTwo groups did not differ at baseline however after the psychoeducation sessions appear clear differences, decreasing the burden for EG group and the functionality also improved for EG.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Human rights and mental health care – Can we find a common ground?
Authors: Pūras D. 
Published: May 2016

Future of psychiatry is discussed in the context of modern human rights principles, evidence-based policies and sustainable development goals.After international community agreed on sustainable development goals to be reached by 2030, there is a good opportunity to address mental health as a priority and to substantially invest in promotion of mental health and emotional well-being.Psychiatry, as an influential specialty, needs to reconsider its strategy in this context, and to rethink strengths and weaknesses of its role and image.Protection of dignity and human rights of persons with psychosocial disabilities, in the post-CRPD framework, should become a priority for psychiatry. Common ground for search of a new consensus between different views on non-consensual treatment in psychiatry could be equilibrium within the principles of “first, do no harm”, “right to treatment” and “no hierarchy within human rights”. For mental healthcare practice, this would mean that good intentions to provide evidence-based interventions do not justify the use of force and deprivation of liberty which threatens dignity and universal human rights principles.Psychiatry, while rethinking future directions, should critically reconsider its current focus on neurobiological paradigm and tradition of using force in the name of medicine and social control. These two paradigms, traditionally perceived as strengths of psychiatry and sources of its power, are now too often misused and increasingly discussed as lacking evidence, ignoring human rights and thus threatening image of psychiatry. Instead, psychiatry could consider accepting post-CRPD challenge as a unique opportunity for change, through strengthening strategic alliance with human rights mechanisms, social sciences, general and community medicine, modern public health approach and users’ perspective.Disclosure of interestThe author has not supplied his declaration of competing interest.