bluuebunny/crossref_metadata_2025_split huggingface dataset:
Portuguese Junior Doctors Exchanging in the Uk – Reflections From the Experience
Authors: Salgado H. , Pinto da Costa M. , Walker H. , Powell J. , Potter L. , Ryland H. , Kjellstenius A. , Feteanu C. 
Published: May 2016

IntroductionThe interest in experiencing training abroad has grown and its benefits have been progressively recognized. For these reasons, several psychiatric trainees seek to extend their competencies, skills and knowledge through these exchange opportunities, such as the European Federation of Psychiatric Trainees (EFPT) Exchange Programme.ObjectivesWith this work we intend to describe these international experiences of being acquainted with a different health system and psychiatry training programme.AimsReflect on the impact of these experiences, considering on how these can be used to benefit the patient care provided across countries, further to the professional and personal individual benefits that colleagues gain.MethodsPresenting the testimonials of junior doctors from abroad that have had the opportunity to observe and collaborate in the current system of the United Kingdom.ResultsThe EFPT Exchange Programme is an excellent opportunity for psychiatry trainees to share experiences, knowledge and good practices. The cultural and social framework of psychiatry certainly has an impact on the approach to mental health problems, and being knowledgeable of these differences can provide benefits not only to the junior doctors who complete these exchanges abroad, but also to their colleagues working at their hosting institutions that become acquainted with different realities through their presence and feedback.ConclusionsThe benefits of these exchange mobility experiences are unequivocal. Therefore, it is fundamental to share these experiences and promote these opportunities.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Where to Be in 5 Years? Brain Drain of Psychiatric Trainees – Case of Albania
Authors: Tomori S. , Pinto da Costa M. ,   European Federation of Psychiatric Trainees
Published: May 2016

IntroductionThe brain drain of psychiatrists is considered as a mental health care damaging phenomenon in low- and middle-income countries. Albania currently has one of the world's highest emigration rates, relative to its population and a total emigrant population of more than 1.25 millions in 2014. More than 50% of the lecturers and researchers in Albania left the country during 1991–2005. Nevertheless, the data on healthcare workers migration is very limited.ObjectivesAssessing the migration profile and migratory trends of psychiatry trainees in Albania as part of EFPT Brain Drain study in Europe.MethodsData collection was accomplished by an anonymous online survey and hard-copy questionnaire in University Hospital Center “Mother Teresa”, to all psychiatric residents in Psychiatric Clinic in Tirana, during May–October 2013.ResultsMore than 2/3 respondents are very dissatisfied with their income but the main reasons for leaving the country are personal and family composition. A minority did have a short term or long term experience abroad respectively 8,3% and 16.7% during which 50% of them considered to have the same opportunities as the locals. A total of 66% of residents consider leaving the country after the residency training.ConclusionsLosing large numbers of skilled psychiatrists contributes to decreasing of quality of mental health services. Since it can be considered “brain waste” in terms of a loss of investment into human resource development, Albania needs to establish policies to promote returnees.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A Brief Exploration of the Psychological Support Available for Cancer Victims/Survivors and Relatives in Health System in Riga, Latvia
Authors: Kumar S. , Stengrevica E. 
Published: May 2016

IntroductionIn Riga, Latvia, people who have been diagnosed with cancer at various stages, are not offered any group or individual psychological intervention. This applies for the immediate relatives as well.AimThe aim of the study was to collate a homogenous understanding of the resources and standards of extant practice in psychological needs of patients and their family diagnosed with cancer. Further aims include to identify any deficiencies in the service delivery and make appropriate recommendations.MethodThe collective survey tool is devised to reflect the psychological needs of the aforementioned patients were devised by the authors, one a practicing psychiatrist in UK and the other with background in group work and support in Riga. The tool extended to ask coping skills, understanding, impact on relationship, work and general well-being of patients and carers and their family members alike. The collated survey was distributed and results collated.DiscussionThe results of the survey indicate number of deficiencies in the organization and service delivery. There is also a huge lack of psychological support to family members who have been affected by a diagnosis of cancer or loss to cancer in the family. We also discuss means of improving service delivery in groups for this sample.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Assessment of cognitive profile (WISC-IV), autistic symptomatology and pragmatic disorders in high intellectual potential compared with autism spectrum disorder
Authors: Boschi A. , Planche P. , Philippe A. , Vaivre-douret L. 
Published: May 2016

IntroductionAn overlap between autism spectrum disorder (ASD), in particular Asperger Syndrome (AS), and high intellectual potential (HIP–Total IQ > 2 SD) is often discussed.ObjectivesExplore differences between homogeneous and heterogeneous Wisc-profiles among HIP children, and between HIP and ASD children, on cognitive and clinical assessments.MethodsForty-nine participants (mean age 11.2 years) were divided in 4 groups: High Functioning Autism (HFA), AS, Homogenous HIP and Heterogeneous HIP. Data of WISC-IV and questionnaires – Autism Quotient (AQ), Empathy Quotient (EQ), Systemizing Quotient (SQ), Children's Communication Checklist (CCC) – were compared.(Preliminary) ResultsOn the WISC-IV, the Z scores curves follow similar trajectories but highlight quantitative differences between AS and heterogeneous HIP: verbal comprehension is the highest index (+1,6 SD in AS; +3,1 SD in heterogeneous HIP) followed by perceptual reasoning, working memory, and processing speed indexes (–1,2 SD in AS; +0,5 SD in heterogeneous HIP), respectively. The questionnaires show that scores of Homogenous HIP children are all in the average. Heterogeneous HIP children score 2,1 SD above average on the AQ (+1,6 SD on “Social Skills” and +1,3 SD on “Local Detail” subscales), whereas ASD children score 4 SD above average on the AQ. In addition, heterogeneous HIP children show pragmatic difficulties (–2,4 SD on the CCC, with a peak on “Area of Interest” subscale), also present in ASD children (–4 SD).ConclusionsAS and heterogeneous HIP children show similar cognitive profiles on the WISC-IV. Furthermore, heterogeneous HIP children exhibit high scores on the AQ and have pragmatic difficulties.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Sedation Could Consist in a Therapeutic Strategy in Advanced Cancer Conditions
Authors: Tamarindo A. , Vogel C. , Hida G. , Malheiros D. , Ropero J. , Taniguchi S. 
Published: May 2016

IntroductionThe sedation could consist in a therapeutic strategy in advanced cancer conditions.ObjectiveTo study the drugs administered to patients under Palliative Care Sedation (PCS) audits effects on vital signs.MethodsOur retrospective study included 101 oncological patients with mean age of 66.5 ± 13.4 years old and mean weight of 48.5 ± 3.36 kg, under PCS. The data were analysed applying the test of Wilcoxon.ResultsThe drugs administered to these patients under PCS were morphine 55 mg/kg/day associated to midazolam 52.5 mg/kg/day (Morph/Midazo) or the association of morphine 55 mg/kg/day, midazolam 52.5 mg/kg/day and neuroleptics such as chlorpromazine 54.5 mg/kg/day or haloperidol 13.25 mg/kg/day (Morph/Midazo/Neurol). The values of vital signs of these patients when the sedation was initiated were: systolic blood pressure 116.55 ± 16.98 mmHg, diastolic bloodpressure73.17 ± 10.55 mmHg, heart rate 83.41 ± 16.25bpm, respiratory rate 19.39 ± 3.97 rpm and body temperature 35.91 ± 0.57 °C. No significant differences between these groups were observed. Vital signs measures were collected 48 hours before the patient's death. Significant reduction in systolic blood pressure 77.5 mmHg, diastolic blood pressure 43.3 mmHg were observed in the group (Morph/Benzo/Neurol). The Wilcoxon test for independent samples to a significance level of 5% we obtain a P-value of 0.01. The sedation period was 2.56 ± 0.23 days.ConclusionNeuroleptic, a central nervous system (CNS) depressant drug, when associated to other two depressants (morphine/midazolam), conducted to the patient's vital signs reduction.Considering the short period of time between the beginning of sedation and the patients’ death; and that palliative sedation should not include the hastening of patients’ death, we suggest a better drug association criteria.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Differentiating Between Bipolar Affective Disorder (Bd) and Borderline Personality Disorder (BPD) – a Clinical Case
Authors: Ballesteros A. , Petcu A. , Cortés B. , Montes L. , Inchausti F. , Jaimes W. , Collantes J. , Zubizarreta B. 
Published: May 2016

IntroductionRecent studies suggest that Borderline Personality Disorder (BPD) could be regarded as an affective disorder within the Bipolar Affective Disorder (BP) spectrum. This is supported by evidence suggesting a clinical/neurobiological overlap between these two disorders. The Temperament and Character Inventory Revised (TCI-R) may help differentiate between the two disorders and orientate the clinical approach, considering the evidence of the medium-term temporal stability of TCI-R in a clinical population.ObjectiveWe present a clinical case diagnosed with BD which underwent testing using TCI-R. TCI-R orientated towards a secondary diagnosis of BPD and the case further received a course of Dialectical Behavior Therapy (DBT) which led to clinical improvement. We therefore study the usefulness of TCI-R in this clinical setting.AimsTo study whether TCI-R may help differentiate between BD and BPD in mood stabilized patients.MethodOur patient is a 52-year-old married male diagnosed with BD. Considering his clinical features of impulsivity/instability of behaviors and pathological interpersonal relationships, patient was started on individual DBT (fortnightly, 4 months). Psychotropic treatment (paroxetine 30 mg/day, lithium 1000 mg/day, aripiprazole 15 mg/day) was not modified.ResultsTCI-R scores: harm avoidance (100%), novelty seeking (53%), reward dependence (20%), persistence (18%), self-directedness (1%), cooperativeness (2%) and self-transcendence (48%). After 4 months of therapy, the patient improved in distress tolerance, acceptance, behavioral activation and assertiveness.ConclusionsTCI-R is an inventory for personality traits in which character scores differ markedly between PD and non-PD patients. It is a useful tool in BPD patients orientating the clinician in the differential diagnosis and the treatment approach.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Influence of Temperamental and Character Traits on Antidepressant Response in Patients Affected by Major Depressive Disorder
Authors: Prisco V. , Di Puorto C. , Fabrazzo M. 
Published: May 2016

Several studies have been conducted to evaluate personality characteristics in patients affected by major depressive disorder. Temperamental and character traits may help clinicians to identify responders to antidepressive therapy. The aim of our study was to evaluate these characteristics as possible predictive indices of response to SSRIs or SNRIs. A cohort of 41 patients was included (30 F and 11 M), whose diagnosis was made according to DSM-IV criteria. Subjects were interviewed using the HAM-D and the HAM-A scale in basal condition (T0) and after 4 weeks (T1) of antidepressive treatment. Patients with a ≥ 50% reduction of HAM-D and HAM-A score, have been considered as responders, when compared to basal conditions. All subjects were in monotherapy and evaluated using the TCI-R scale. In patients affected by major depressive disorder, personality assessment was characterised, from a temperamental point of view, by high levels of Persistence and Reward Dependence and, from a character one, by high levels of Self Directiveness and Cooperativity. After 4 weeks of antidepressive treatment, responders to HAM-D had higher levels of Responsibility versus Guilt, which could be considered as a predictor of positive response to SSRIs or SNRIs. Conversely, responders to HAM-A showed higher values of Responsibility versus Guilt and of Safety versus Fear of uncertainty. These values were predictive of a recovery of anxious sintomatology associated with depressive disorder. Our results are in line with those reported in the literature, indicating that character dimensions “Self Directiveness” and “Cooperativity” could be important predictors of response to antidepressants.Disclosure of interestThe authors have not supplied their declaration of competing interest.
On The Carlos Castilla Del Pino “Axiom of Behavioral Significance” and Its Relevance in Philosophy of Psychiatry: The Unification of Clinical Neuroscience
Authors: Vargas M. 
Published: May 2016

Carlos Castilla del Pino (1922-2009) was a Spanish psychiatrist and essayist with a wide work ranging from neuropsychiatry to social psychiatry. His essays include interesting psychopathological, anthropological and semiotic ideas.The “axiom of behavioural significance” proposes that human behaviour is not an objective event but a meaningful act. As the objective of human behaviour is relation between human beings, it must be studied only under this communicative perspective.Based in this axiomatic approach of Castilla del Pino, some arguments of interest to philosophy of psychiatry will be exposed:– Mind is based in language and language is a communicative acts system in need of a dialogic community, namely, in need of a group of interacting brains. So, referring to the “brains-mind problem” is proposed to be preferred instead of referring to the “brain-mind problem”. Mind is a language-based emergent property of the social group, not a property of a single brain.– The intention of human behaviour and the content of mental subjective phenomena should not be taken as a sign of any brain disease. Human behavior and mental representations always refers to a social group and a social context, not to a single brain. The only disease indicators we can take as disease signs are the formal aspects of behaviour and mind contents, as disexecutive syndrome or mental automatism are.– As a corollary, it is proposed that neurology and psychiatry do not have any epistemic difference, leading to defence the unification of clinical neuroscience.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Metamorphosing Histories: The Narrative as a Tool for Psychological Trauma's Recovery
Authors: Becker J. 
Published: May 2016

Considering psychological traumatism as a subject in constant discussion, this study approaches the recovery of the patients that suffered violent events. Based on studies about the reflection of disasters and wars, we present trauma as a consequence of the unexpected event from where is originated intense fear. Trauma is a violation, an abruption, which disorganizes and incapacitates the victim. When a violence situation is experienced, the physical and verbal abuses are not alone as the elements that interfere in the trauma's establishment, but also their representations. Thereby, the event that produces trauma is imposed, although its meaning depends of the history and beliefs of the subject. Understanding that the accident's representation is the cause of the trauma's establishment, we introduce the narrative as tool for psychological trauma's recovery, because it allows the victims relive their past and reframe their feelings. Regarding it, we highlight the relevance of the sociocultural context – before, during and after the trauma –, once it has direct influence over the way the person deals with adversities, as it can stimulate or stop a resilience process. This study takes in consideration that resilience is not something static, a faculty that the subject has or not, but a process that can be developed, improved or reduced. Thus, the narrative is presented as essential to initiate a resilience process, empowering the victims to confront the trauma and to rewrite their history and their return to life.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Image of Psychiatric Hospitals Among General Population in 2015, Views From Four Countries
Authors: Fontaine A. 
Published: May 2016

IntroductionIn recent years, numerous studies about the image of psychiatry have been conducted. However, to our knowledge, a significant part of psychiatry has been very little explored: the vision of psychiatric hospitals (PsH). For instance, “PsH” on google images reveals a long list of frightening pictures of ravaged places.Objectives/AimsWith such an image spread by the medias, we wanted to evaluate the vision of PsH and treatment modalities among general population in 2015, in 4 countries: France, Spain, England, and Brazil.MethodsAn online survey in 4 languages has been sent via facebook and emails. Two hundred and fifteen responses were collected during September 2015: 178 French, 11 Spanish, 17 Brazilians, 9 English.ResultsThirty-nine percent of participants consider PsH as a place of care, and 16% as an asylum. There were differences among countries: for example, asylum is more represented in France than Spain. Regarding patients admitted in PsH, they are not all dangerous (90%), nor all irresponsible (94%) and have specifics rights (66%). Concerning diseases: delirium, bipolar disorders, and perversity are to be treated in PsH, while depression, addiction, and autism are to be cured in psychiatric structures other than hospital. Moreover, 2% of participants believe abuses are common practice, whereas a majority consider therapeutic activities instead.ConclusionsThese results are quite different from the studies based on the perception of mental illness and patients. Here, on the overall, they are quite encouraging. So, PsH could lead the path on the improvement of the image of psychiatry.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Acceptability and Feasibility of the Mindfulness Based Program for Infertility (PBMI)
Authors: Galhardo A. , Cunha M. , Pinto-Gouveia J. 
Published: May 2016

IntroductionInfertility is described as a low-control stressor that may induce psychopathological symptoms. The Mindfulness Based Program for Infertility (MBPI) is a structured intervention targeting infertile women that aims to cultivate mindfulness and acceptance skills. The MBPI efficacy was tested in 55 infertile women who completed the program and 37 women in a control group. By the end of the MBPI, women who attended the program revealed a significant decrease in depressive symptoms, internal and external shame, entrapment and defeat. Inversely, they showed significant improvement in mindfulness skills and self-efficacy to deal with infertility.AimsDetermine the MBPI feasibility and acceptability.MethodsThe MBPI includes 10 weekly sessions, in a group format, with the duration of about 2 hours each. Participants’ recruitment was supported by the Portuguese Fertility Association. Fifty-five female participants with an infertility diagnosis who were pursuing medical treatment for infertility completed a questionnaire specifically developed to address the acceptability and satisfaction with the MBPI at the end of the 10th session.ResultsParticipants scored as “very useful” most of the MBPI components (mindfulness practice, acceptance skills, values clarification, psychoeducation on stress and fertility-related lifestyle factors), except for the yoga component. The same pattern was found for the utility information, group support, small group exercises, contact with the therapist, progress notes and MBPI materials. The mean score for satisfaction with the therapist knowledge/competence was 9.55 (maximum: 10), the MBPI quality 8.91 and the MBPI global utility 8.95.ConclusionsThe MBPI showed to be feasible and well accepted by participants.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Development of Headucate in Mental Health Awareness
Authors: Patel A. , Soundararajan V. , Beezhold J. 
Published: May 2016

IntroductionHeaducate is a pioneering student-led society at the University of East Anglia (UEA), founded in 2012. Mental health stigma exists widely and is a well-known barrier to accessing support. This presents a need for education and raising awareness about mental illness.ObjectivesThe goal is to spread mental health awareness locally, measured by school outreach and events organised. This is achievable through Headucate's collaboration with the university and schools to convey the message each year.AimsHeaducate aims to raise mental health awareness and tackle stigma, with the intention of reaching the university, schools locally and communities nationally.MethodsHeaducate delivers workshops for secondary schools. This involves interactive sessions to stimulate discussions about mental health and illness, and where to find help. Additionally, there are university-held talks from a variety of guest speakers who are experts in this field.ResultsIt has expanded beyond medical students to involve the whole university, with a shared interest in mental health awareness. Research conducted by Headucate in 2014-2015 has indicated there is a statistically significant (P < 0.001) increase in the knowledge about mental illness and knowing where to get help following school workshops.ConclusionsThe success has transformed from starting as an idea into one of UEA's largest student societies which will continue to expand. Future goals include a mental health awareness campaign and collaborating with student groups at the university, to host events that link mental health to other causes. Furthermore, Headucate is hoping to expand outreach to the elderly community.Disclosure of interestThe authors have not supplied their declaration of competing interest.