bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-esteem and emotional distress in a population of unemployed persons
Authors: Medhaffar K. , Feki I. , Sellami R. , Baati I. , Trigui D. , Abida I. , Masmoudi J. 
Published: May 2016

IntroductionFor most individuals, basic life requirements are met through employment. It can satisfy creative urges, promote self-esteem, and provide an avenue for achievement and self-realization.ObjectiveTo assess the level of depression, anxiety and self-esteem in a population of unemployed persons.MethodIt was a cross-sectional study involving unemployed people we met in the office of employment of Sfax in Tunisia. The level of anxiety and depression was assessed by the Beck depression and anxiety inventories. The self-esteem Rosenberg scale allowed us to evaluate the level of self-esteem of our population.ResultsThe average age of oursubjects was 33 years six months. The average duration of unemployment of our population was 4 years 7 months and 38.2% of them had never worked before. The anxiety level was moderate in 38.2%, while moderate to severe depression was found in 47%. Self-esteem was low to very low in 47.1%. A low level of depression was positively correlated with a low socioeconomic level (P = 0.000), a low level of anxiety (P = 0.000) and a high self-esteem level (P = 0.000).ConclusionPeople with strong support systems and greater self-esteem seemed to experience less unemployment stress. Identifying those who are at high risk for psychological and physical problems and finding ways of preventing them from suffering the adverse effect of unemployment are important areas for further study.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Antidepressant-induced hyponatremia
Authors: Rodríguez Andrés L. , Gómez Sánchez S. , Rodríguez Campos A. , Hernández Antón R. , Gallardo Borge L. , Álvarez Astorga A. 
Published: May 2016

IntroductionHyponatremia is one of the electrolytic disorders most comonly observed among general hospitalized populations (2% of hospitalized patients). A form of hyponatremia is the syndrome of inappropriate antidiuretic hormone secrection (SIADH). One of its diverse causes is medication. Selective serotonine reuptake inhibitors (ISRSs) can cause hyponatremia due to SIADH, particularly among elderly population.Clinical case reportA 81-year-old female treated with paroxetine 20 mg/day because of depression. Two weeks later she starts feeling nausea, somnolence and motor inhibition. The sodium level previous to the onset of treatment was normal but after two weeks it has decreased to 121 mEq/L, pointing to SIADH induced by ISRSs.DiscussionThe incidence of hyponatremia among elderly patients treated with antidepressants of ISRSs class has increased. The prevalence varies between 0.5 and 25%. Although half of the patients are asymptomatic, the mortality is rate may reach 25%. It generally develops during the first month of treatment and is reversible between 2 and 28 days after the suspension of the ISRSs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Attachment style and salivary cortisol awakening response in eating disorders
Authors: De Riso F. , Giugliano R. , Monteleone A.M. , Nigro M. , Pellegrino F. , Calvanese M. , Patriciello G. , De Stefano V. , Volpe U. , Monteleone P. 
Published: May 2016

IntroductionEarly life experiences can influence hypotalamus-pituitary-adrenal (HPA) axis regulation and adult attachment styles. Furthermore, several studies showed that in patients with eating disorders (EDs) there is a prevalence of insecure attachment. However, the relationship between adult attachment style, HPA axis functioning and onset of EDs is largely unknown.Objectives and aimsIn order to evaluate possible associations between attachment styles and HPA axis functioning in EDs, we investigated Cortisol Awakening Response (CAR) in ED patients with different attachment styles.MethodsTwenty adult patients with EDs were classified in three groups, according to the Experience in Close Relationship questionnaire (6 with secure attachment, 6 with anxious attachment and 8 with avoidant attachment). Saliva samples were collected at awakening and 15, 30 and 60 minutes after.ResultsThere was a significant difference among the groups in both awakening and post-awakening cortisol concentrations. In particular, compared to secure and avoidant groups, the anxious group exhibited lower cortisol concentrations at awakening and post-awakening with a preservation of the timing of the CAR.DiscussionPresent findings demonstrate that anxious attachment style is linked to flattened CAR in EDs. This pattern has been associated with other psychiatric disorders. Therefore, attachment style could influence the HPA functioning and it could play, although not specifically, a role in pathophysiology of EDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Changes in the electrical properties of the tissues in patients with anorexia nervosa measured by bioelectrical impedance analysis
Authors: Karakula-Juchnowicz H. , Teter M. , Kozak G. , Makarewicz A. , Kalinowska J. , Małecka-Massalska T. 
Published: May 2016

IntroductionMonitoring patient with anorexia nervosa (AN) include clinical, biological and psychological factors. In recent years many researchers criticize the BMI as useful measure for controlling evolution of AN.ObjectivesBioelectrical impedance analysis (BIA) is one of the main methods for nutritional status assessment.AimsThe aim of this study was the assessment of the nutrition status in a group of patients with anorexia nervosa in comparison to healthy population (HP).MethodsThe study involved 37 participants: 21 patients with AN and 16 healthy volunteers constituting the control group (HP). The patients were divided into two groups according a BMI: I group 14 < BMI < 15,5 (n = 11; age 18.0 ± 4.37) and II group: 15,5 < BMI < 17,5 (n = 10; age 17.82 ± 3.68). The mean age of HP was 17.68 ± 1.57 and BMI 20.56 ± 1.16 kg/m2. BIA was performed by using ImpediMed bioimpedance analysis SFB7 BioImp. The parameters: phase angle (PA), TBW%, ECW, ICW, ECW/ICW were analyzed.ResultsPA was decreased significantly in the I (4.5°±0,6) and II group (4.7°±0,6) of AN patients’ in comparison with HP (5.6°±0,7). TBW was 9% higher in I group and ECW was increased 6% in the both AN groups compared with HP (P < 0.01). Additionally ECW/ICW ratio indicated the higher transfer of water into the extracellular compartment in AN group (P < 0.01).ConclusionsBIA is accurate tool to indicate the valuable indicators of detecting malnutrition in AN. Further studies are needed to validate the significance of these parameters for the full identification of the nutrition status of AN patients’.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Current and emerging drugs treatment for night eating syndrome
Authors: Martellini M. , Barchiesi M. , Oriani M.G. , Nardi B. 
Published: May 2016

IntroductionThe night eating syndrome (NES) is a categorized in the diagnostic and statistic manual (DSM-5) as an “Other Specified Feeding or Eating Disorder” and it is characterized by a reduced feeding during the day, evening hyperphagia accompagned by frequent nocturnal awakenings associated with conscious episodes of compulsive ingestion of food and abnormal circadian rhythms of food and other neuroendocrine factors. Frequently it is associated with obesity and depressed mood.ObjectivesThe purpose of this review is to investigate the state of art concerning the psychopharmacological treatment of NES.MethodsA Medline enquiry of published articles from 2005 to October 2015 was performed using the following keywords: “NES, pharmacological treatment, SSRI, antidepressants, antipsychotic, sertraline, citalopram, escitalopram, duloxetine, venlafaxine, paroxetine, fluoxetine, fluvoxamine, topiramate”. Reviews, single case studies and RCT were also analyzed.ResultsOnly few studies met the selection criteria. A recent 8-week double-blind placebo controlled study, in 34 patients with NES, has confirmed the efficacy of sertraline. Sertraline was associated with significantly greater improvement than placebo in overall symptomatology.ConclusionsSSRIs should be considered the drug of choice for the treatment of NES not only because of evidence in the literature but also since they display the best pharmacological profiles with fewer adverse events. More evidence of efficacy is shown for some SSRIs such us paroxetine, fluvoxamine and especially sertraline. Topiramate should be reserved for cases resistant to treatment with SSRIs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Perfectionism in eating disorders: Temperament or character? Does perfectionism improve on treatment outcome?
Authors: Rodriguez Cano T. , Beato Fernandez L. , Mata Saenz B. , Rojo Moreno L. , Vaz Leal F.J. 
Published: May 2016

IntroductionPerfectionism is considered a risk factor and is very close related to Eating Disorders (EDs). It estimates heritability of 29-42%. However, it has also been related to psychosocial factors such as the insecure attachment style.ObjectivesTo study the relationship of perfectionism with personality dimensions, its likelihood of improvement and its treatment.AimsTo analyze if Perfectionism is associated with dimensions of Temperament or dimensions of Character and therefore more psychosocial.MethodsParticipants were 151 female outpatients who consecutively started treatment at the Eating Disorders Unit (Ciudad Real University General Hospital). Personality was assessed by using the Temperament and Character Inventory (TCI). Perfectionism was assessed by using the Edinburg Investigatory Test (EDI-2) subscale (t0). One year later, patients were re-assessed with the EDI-2 (t1).ResultsThe scores on Perfectionism significantly improved from t0 to t1, (repeated measures ANOVA, F = 6.6, P < 0.01). At baseline, Perfectionism was related to any of the Temperament dimensions, but the Character variable Purposefulness (SD2) (β = .25 95% CI .17, 98), 2.7% of variance). Responsibility (SD1) and Self-Aceptance (SD4) were inversely associated with Perfectionism. At t1, Responsibility still was a protective factor for Perfectionism, regardless the effect of Perfectionism at t0.ConclusionsPerfectionism is also related to psychosocial and developmental factors. People with an internal locus of control tend to take responsibility for their own actions and are resourceful in solving problems. Thus, Self-directedness, mainly Responsibility for their own actions, is a protective factor for Perfectionism in EDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Suicide attempts in emergency department
Authors: Hajji K. , Marrag I. , Ben soussia R. , Zarrouk L. , Younes S. , Nasr M. 
Published: May 2016

IntroductionThe suicide attempt is a real challenge for the clinician who works at the emergency department in order to identify and propose an adequate care.AimsTo estimate the prevalence of the suicide attempts, to describe the sociodemographic and clinical characteristics and to identify the predictors of recurrence.MethodsOur cross-sectional study was conducted at the medical emergency department of the university hospital of Mahdia and lasted for 12 months. Data were collected using a questionnaire of 51 items exploring the general and clinical characteristics and providing information of the treatment.ResultsAmong the 513 consultants, 90 had attempted suicide (17,5%). We found an average age of 26 years old, a sex-ratio (M/F) of 0,3, a secondary education level (53,3%), an unemployment and a single status (38,9% and 75,6%). The presence of psychiatric personal history and/or suicide attempts was found in 31,1% and 33,3% of cases. Suicide attempts were taken place in all cases at home, between 18 and midnight (43,3%), without premeditation (82,2%), in the presence of triggering factor (95,6%), during the last 3 months of the year (34,4%). In 70,2% of cases, the type of the suicide attempts was a drug intoxication. 67,8% of the suicide attempters regretted and criticized their acts.ConclusionA good assessment of the suicide risk determines the type of intervention that should be established and allows an adequate care.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Ensuring patient safety: Physical health monitoring in rapid tranquillisation for aggression and violence of adult acute inpatients
Authors: Talukdar R. , Ludlam M. , Pout L. , Lekka N.P. 
Published: May 2016

IntroductionIntramuscular (IM) medications used in rapid tranquillisation (RT) to manage violent/aggressive behaviour can cause serious physical side effects including sudden death, therefore comprehensive physical health monitoring is advised.ObjectivesTo assess whether physical health monitoring of patients who received IM medication for RT was completed as per the Aggression/Violence NICE-guideline based local Policy.MethodsAll patients that received IM benzodiazepines or antipsychotics for RT were identified amongst 822 discharges from February 2014 to February 2015. Demographics, diagnoses, non-pharmacological interventions, types/doses of medication, and associated seclusion/restraint episodes were recorded. Notes were examined to determine whether physical health monitoring protocols involving blood pressure, pulse, temperature, oxygen saturation, respiratory rate and level of consciousness were followed.ResultsThere were a total of 218 episodes where these medications were used, in which only 19 (8.8%) had any physical observations completed; only one case (0.5%) was completed fully as per the protocol. Of the cases that did not have observations taken, in 12 (5.5%) cases observations were attempted but the patient was too agitated/aggressive. A doctor was contacted in only 53 (24.3%) cases and an ECG was completed in 120 (55%) cases, of which only 11 were completed within 24 hours.ConclusionsThe results show poor compliance (or at least recording) with the guidance, demonstrating the need for further education of nursing and medical staff on the potential dangers of RT and for better physical health monitoring of patients on RT. To improve patient safety, staff training and well-timed recording of physical observations on electronic tablets will commence.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Incidence and management of agitation in emergency medical services in Spain – “SOSEGA” Study
Authors: Rodriguez Calzada R. , Suarez Fuentes M.A. , Roset Arisso P. ,   S.G.O.R. Sosega Group Of Researchers
Published: May 2016

IntroductionAgitation is a frequent and complex emergency. Its early detection and adequate treatment are crucial to ensure the best outcomes. Pre-hospital management of agitation requires appropriate measures to preserve patients’ safety, stabilize the patient and alleviate suffering, and transfer to the hospital psychiatric services, including involuntary admission if needed.ObjectivesTo describe the management of agitation by the Emergency Medical Services (EMS) in Spain.MethodsObservational retrospective survey on the protocols and procedures used, the number of in-calls received and the resources dedicated to attend emergencies in 2013.ResultsSeven out of the seventeen EMS in Spain provided information. All of them registered in a database in-calls and actions taken. Four of them had a specific protocol to attend psychiatric emergencies and agitation in-calls, and five coded the initial diagnostic with ICD-9. Paramedics attending emergencies register the diagnostic in 3/7 EMS. Nursing and Medical staff code the final diagnostic with ICD-9 in all. Emergency Coordination Centres received 4,437,388 in-calls (209/1000 inhabitants); 2.6% classified as psychiatric (6.2/1000 inhab.). Healthcare teams attended 2,028,467 emergencies, 84,933 (4.2%) were psychiatric (4.0/1000 inhab.) and 37,951 (1.9%) were patients with agitation (2.0/1000 inhab.). General practitioners attended 17% of all psychiatric emergencies, while ambulances attended 61%.ConclusionsThe incidence of acute agitation accounts for almost half of the total psychiatric emergencies in the pre-hospital setting. Since there are different healthcare providers in charge, specific protocols as well as treatment procedures are needed to provide the most adequate management, in order to ensure the best Psychiatric Emergency Chain.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Psychiatry consultation in primary health care setting at an Oporto Area: Sociodemographic and clinical data
Authors: Dias Amaral A. , Peixoto M.J. , Cortiñas A. , Fonseca S. , Curral R. 
Published: May 2016

IntroductionThe Psychiatry consultation is a collaborative approach between primary health care services and community mental health teams. Our clinic provides support to three Oporto areas (Bonfim/Paranhos, Campanhã and Maia/Valongo) corresponding to a population of 350,000 inhabitants.ObjectivesTo analyze and collect Psychiatry consultation data of the first semester of 2015 in Maia/Valongo region. We aim to describe our population's sociodemographic characteristics, the most common referral motive, diagnosis and therapeutics, and orientation.MethodsPsychiatry consultation data of the first semester of 2015 were collected and analyzed using SPSS software (version 20).ResultsOne hundred and sixty-one patients were evaluated. A total of 26.09% were male and 73.91% were female. The mean age was 51.61 years old. The most frequent referral motives were depressive (47.82%) and anxiety (23.60%) symptoms. The two most common diagnostic groups according to the International Classification of Diseases (version 10) were F30-F39–Mood affective disorders (57.76%) and F40-F48–Neurotic, stress-related and somatoform disorders (18.63%). 22.36% of the patients were referred without medication, but only four were discharged drug-free, corresponding to bereavement situations. 34.16% of our population were previously prescribed two or more psychotropic drugs, increasing to 63.98% after assessment. Only 18.63% met criteria to hospital referral.ConclusionsThe Psychiatry consultation selects the most severe patients and allows a faster evaluation of mentally ill patients awaiting hospital consultation, thus preventing unnecessary access to the emergency room. Authors consider that all the patients referred to a hospital consultation should be previously evaluated by a consultant psychiatrist on a primary health care setting.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Unemployment and the rate of new contacts with mental health services in South London
Authors: Bhavsar V. , Hotopf M. , Boydell J. , Hatch S. ,   SELCOH Investigators
Published: May 2016

IntroductionUnemployment is a risk factor for later development of mental health problems, but characterisation of this in real world clinical data is limited. This study aimed to investigate the association between employment status and time-to-first-contact with mental health services using survey data linked to electronic health records(EHR).MethodsSELCoH (n = 1698, 2008–2010) was a representative population survey of South East London, with a 71.9% household participation rate. Anonymised survey data for participants was linked with EHR, generating survival data for time-to-first-contact. Cox regression was used to assess associations between unemployment and time to first contact with mental health services.ResultsThe rate in the unemployed was 22.84 contacts per 1000 person-years, and in those not unemployed, it was 10 contacts per 1000 person-years. The crude (age-adjusted) hazard ratio (HR) for unemployment was 3.09 (95% CI: 1.66–5.75). The HR for contact for unemployment, after adjusting for age, gender, ethnicity and education, was 2.8 (95% CI: 1.44–5.47). On addition of symptoms of common mental disorder, post-traumatic stress, psychosis and suicide attempts, to the model, unemployed participants remained at elevated risk (HR:2.65, 95% CI: 1.33–5.27). Finally, illicit drugs and alcohol had minimal influence on estimates, giving a fully-adjusted estimate for the association between unemployment and rate of contact of 2.6 (95% CI: 1.31–5.14).ConclusionsUnemployment was associated with a greater than two-fold increase in risk of accessing mental health care for the first time within the observation time, after adjustment for sociodemographic confounders, psychopathology, and substance use. Explanations for this association could include unobserved confounding, health behaviours associated with unemployment or effects of unemployment on stress processing.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Should I stay or should I go? Mobility and migration among psychiatric trainees in Europe – EFPT Brain Drain Survey
Authors: Pinto da Costa M. , Biskup E. , Giurgiuca A. , Kaaja J. , Kilic Ö. , Mogren T. , Stoyanova M. , Banjac V. , Tomori S. ,   E. European Federation of Psychiatric Trainees
Published: May 2016

IntroductionWorkforce migration of mental health professionals seems to have a significant impact on mental health services, both in the donor and host countries. Nevertheless, information on migration in junior doctors within Europe is very limited. Therefore, the European Federation of Psychiatric Trainees (EFPT) has conducted the Brain Drain Survey.ObjectivesTo identify, in junior doctors training in psychiatry, the impact of international short-term mobility experiences, towards a future workforce migration across countries, exploring its patterns and reasons.MethodsIn this cross-sectional international study, data were collected from 2281 psychiatric trainees in 33 countries. All participants answered to the EFPT Brain Drain Survey reporting their attitudes and experiences on mobility and migration.ResultsOnly one-third of the trainees had a short-mobility experience in their lifetime, being education the main purpose for these experiences. Interestingly, the main predictors for future migratory tendency were not only the having a income and being dissatisfied with this income, but having a short-mobility experience. In fact, people that had short-mobility experiences were two times more likely to express a migratory tendency. Trainees that went abroad were predominantly satisfied with their experiences, reporting that these influenced their attitudes towards migration, positively.ConclusionsThese findings show that short-term mobility has a positive impact into future long-term migration, increasing its probability.Disclosure of interestThe authors have not supplied their declaration of competing interest.