bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Current European Status
Authors: Maric N. , Andric S. , Raballo A. , Kuzman M. Rojnic , Klosterkötter J. , Riecher-Rössler A. 
Published: June 2017

In the last two decades, both early detection (ED) and early intervention (EI) programs and services have gradually become important and innovative components of contemporary mental health care. However, it is unclear whether ED/EI programs have consistently been implemented throughout Europe.Here, we report results of the EPA Survey on ED/EI Programs in Europe in 2016.A 16 item questionnaire was sent to representatives (presidents and secretariats) of 40 EPA National Societies/Associations (NPAs), representing 37 countries. The representatives were also invited to recommend a person for additional information about ED/EI services/programs in the country.The response rate was 59.4% (22 NPAs). Fifteen out of 28 NPAs were from developed, and 7 out of 8 from economies in transition. ED/EI services have been implemented in 54.5% of the included countries, mean duration 10.0 ± 4.9 yrs. Mostly, neither ED were separated from EI, not the adults from adolescents. National plans to develop ED/EI were reported in four countries. Although national guidelines for schizophrenia exist in most of the countries (73.9%), specific chapters focusing on ED/EI and/or at-risk mental states were not included in the majority of them. Duration of untreated psychosis was unknown in 63.6%. In those who gave the estimation it was 12–100 weeks (median in weeks: 33 developed economies; 44 economies in transition).The fields of ED/EI have been unequally developed across Europe. Still, many NPAs are without the development plans. EPA and its Sections should address the identified gaps and suggest how to harmonize services for the full range of assessments and interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Trazodone in treatment of interferon-induced anxiety in persons with viral hepatitis C
Authors: Miljatovic A. 
Published: June 2017

IntroductionThe interferon therapy is associated with numerous adverse psychiatric effects, such as tension, irritability, insomnia, etc.GoalThe goal of this study was to examine the severity and the frequency of anxiety in persons with chronic hepatitis C receiving pegylated interferon alpha combined with ribavirin. We have also tried to assess the efficiency of trazodone in treatment of symptoms of anxiety in patients receiving pegylated interferon.MethodThe total of 36 patients whose diagnosis of chronic hepatitis C has been confirmed both serologically and patohistologically, receiving interferon therapy, ages 22 to 60, participated in this study. The control group consisted of 32 patients, all with same diagnosis, corresponding with those in the study group in terms of gender, age duration of the illness and the level of education. All patients received pegylated interferon alpha 2a, administered subcutaneously once per week, along with oral ribavirin. The research used the following instruments of clinical assessment: structural clinical interview–SCID, ICD–10; Hamilton anxiety rating scale–HAM-A, and the self-report scale for assessment of anxiety–state-trait anxiety inventory–STAI-Form Y. The testing using these instruments was conducted four weeks after the start of the treatment, then after eight weeks, after 12, 24 and 48 weeks, i.e. at the end of the treatment. The patients in the study group received 150–300 mg of trazodone per day, starting at the week 6 of interferon treatment.ResultsThe research showed that in the beginning of the interferon treatment approximately one quarter of the patients exhibited symptoms of anxiety in both groups. The administration of trazodone showed beneficial effects in reduction of anxiety induced by the treatment with pegylated interferon.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Effectiveness of long-acting aripiprazole in schizoaffective disorders: A naturalistic longitudinal study
Authors: Nivoli A. , Antonioli M. , Folini L. , Floris L. , Meli G. , Paolo M. , Lorettu L. 
Published: June 2017

IntroductionIntramuscular paliperidone palmitate (PP) is a long-acting, atypical anti-psychotic for once monthly intramuscular (IM) administration in the treatment of patients with schizophrenia.ObjectiveTo study the effectiveness (efficacy and quality of life) of ARP in the maintenance treatment of schizoaffective disorder.MethodsA non-randomized, prospective naturalistic study was performed in out-patients with schizoaffective disorder unsuccessfully treated with oral anti-psychotics. Efficacy of ARP over time was evaluated by using brief psychiatric rating scale (BPRS 24-items), quality of life was evaluated by using QL-Index, both at T0 and at most recent visit (T1). Data were analyzed with Student's t-tests and Pearson correlations (α value, two tailed). Paired t-test was applied for BPRS and for Ql-Index total scores (T0–T1).ResultsData were available for 8 outpatients consecutively prescribed ARP and naturalistically treated attending at the psychiatric clinic, university of Sassari. Mean time on ARP treatment was 207.14 days (sd 137.2). BPRS mean total score at T0 was 57 (sd 13.2) and at T1 was 39.7 (sd 10.8). QL-Index mean total score was at T0 5.43 (sd 1.6) and at T1 7.14 (sd 2.7). Paired sample test showed a statistically significant difference in decreasing symptoms at BPRS over time (P = 0.001) and QL-Index total score (P = 0.023). The analyses showed a significant improving at the following BPRS sub-items: anxiety (P = 0.005), mood elevation (P = 0.014) conceptual disorganization (P = 0.048), emotional withdrawal (P = 0.05), tension (P = 0.02) and distractibility (P = 0.03).Disclosure of interestThe authors have not supplied their declaration of competing interest.
Changes in the trend of anti-psychotics prescription in elderly patients in a general hospital in Singapore 2005–2013
Authors: Tan L. , Kinson R. 
Published: June 2017

ObjectivesThis was a descriptive study of the prescription trend of anti-psychotics for elderly patients in a general hospital in Singapore.MethodsElderly patients aged >65 who received at least 1 prescription of anti-psychotics during 2005, 2007, 2009, 2011 and 2013 in Tan Tock Seng Hospital, Singapore, were selected. Data was obtained from the hospital computerized prescription records.ResultsThe total number of elderly patients who received anti-psychotics increased from 865 in 2005 to 1990 in 2013. Following the official warning issued by the health sciences authority in 2004 regarding the increased risks of cerebrovascular events in elderly patients taking olanzapine and risperidone, prescriptions for risperidone reduced between 2005 to 2013 (20.74% vs. 11.79%, 95% CI: 0.07–0.10, P < 0.0001). However, the percentage of prescriptions of other atypical anti-psychotics such as quetiapine increased from 27.47% to 58.48% (95% CI: 0.29–0.33, P < 0.0001), in 2005 and 2013 respectively, and prescriptions for olanzapine remained relatively stable at 6.65% in 2005 and 8.94% in 2013 (P > 0.05). With the black box warnings extended to typical anti-psychotics 3 years later, the percentage of prescriptions of typical anti-psychotics decreased between 2005 to 2013, e.g. haloperidol (33.19% vs. 13.39%, 95% CI: 0.17–0.22; P < 0.0001), sulpiride (6.58% vs. 2.83%, 95% CI: 0.03–0.05, P < 0.0001) and chlorpromazine (3.85% vs. 1.85%, 95% CI: 0.01–0.03, P < 0.0001).ConclusionsAfter the first safety warning the percentage of prescriptions for risperidone dropped significantly, and there was a significant increase for quetiapine. The percentage of haloperidol, sulpiride and chlorpromazine prescriptions declined after both warnings. Anti-psychotics use in the elderly continues to be prevalent.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Hyperprolactinemia and anti-psychotics: Prevalence and risk factors
Authors: Walid B. , Marrag I. , Ben Soussia R. , Ellouze F. , Nasr M. 
Published: June 2017

IntroductionHyperprolactinemia is a frequent side effect observed in patients treated with anti-psychotic drugs. The frequency of clinical signs usually correlates with elevated serum prolactin levels.ObjectivesTo estimate the prevalence of hyperprolactinemia among patients treated with a single anti-psychotic and specify the risk factors for its occurrence.MethodsCross-sectional study performed in a period of 6 months in the psychiatric department of Mahdia's hospital, for all patients seen in the consultation and treated with a single anti-psychotic for 12 weeks, with a stable dose, and meeting the inclusion and exclusion criteria of the study. Prolactin blood tests have been performed and confirmed by a second one in case of abnormality objectified in the first lab test results. A magnetic resonance imaging (MRI) was intended for patients with prolactin levels greater than 150 ng/mL.ResultsNinety-two patients were gathered. Prevalence of hyperprolactinemia was 34.8% of which 7.6% had prolactin levels greater than 150 ng/mL. Two macroadenomas’ cases were detected. The analytical study found 7 factors significantly correlated with hyperprolactinemia, which are: female sex, substance use, the presence of side effects, prescription of atypical anti-psychotics, the anti-psychotic treatment prescribed: haloperidol/amisulpride, doses of anti-psychotic greater than 1000 mg equivalent to chlorpromazine and the combination of psychotropic drugs.ConclusionProlactin blood test should be a systematical analysis for all patients treated with anti-psychotics, to prevent the short and long term side effects.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Self-transcendence and excessive TV commercial viewing in senior pupils
Authors: Vasilchenko A. , Tukaiev S. , Havrylets Y. , Rizun V. , Kashpur D. , Pogorilska N. , Radchuk O. , Zyma I. , Abbasova G. , Derevinskaya L. 
Published: June 2017

Self-transcendence is an important component of mental health and emotional well-being, and associates with everyday stress. The aim of this study was to reveal the relationships between excessive TV commercial viewing and self-transcendence. Forty-two healthy senior pupils aged 14–17 years participated in the study. We used the temperament and character inventory by cloninger, cloninger tridimensional personality questionnaire, the school anxiety test by Philips, Maddi Hardiness survey, and the emotional intelligence self-evaluation by Hall. We found that excessive TV commercial viewing has been linked to self-transcendence, which directly correlates with empathy and school anxiety. There was an inverse correlation between self-transcendence and self-directedness. We also found interrelations between self-transcendence and reward dependence, mediated by the noradrenergic brain system. We argue that the propensity for watching TV commercials and self-transcendence may determine the activity of monoaminergic brain systems along with the constitutional traits and personality characteristics.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A systematic review of transcranial magnetic stimulation use for treating autistic spectrum disorders: Preliminary results
Authors: Barahona-Corrêa B. , Chainho A. , Lopes R. 
Published: June 2017

Autistic spectrum disorders (ASD) are a group of neurodevelopmental disorders that manifest as deficits in social communication and interaction, and restricted, repetitive behaviors and interests. ASD affect at least 1% of the population and are associated with lifelong disability and early death. There are no effective biological treatments for ASD, although non-invasive neuromodulation has sparked great interest as a possibly useful therapeutic approach. Here, we present preliminary results of a systematic review on the effectiveness of transcranial magnetic stimulation (TMS) in ASD treatment. Using appropriate syntax we searched Pubmed, Web of Science, Science Direct, and Educational Resources Information Clearinghouse. Following standard PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-analyses) procedures, we selected 12 eligible studies, comprising four controlled and four uncontrolled trials on the effects of TMS on ASD core symptoms, and 9 controlled and three uncontrolled trials on TMS effects on cognitive performance in ASD. The 12 studies totaled 233 subjects. Although combined effect sizes favor TMS in all fours groups of studies, conclusions are limited by the high study heterogeneity. Furthermore, only three of the controlled studies used sham TMS as the control intervention, and only two studies followed up the therapeutic effects after the last TMS session. Side effects, none of them serious, occurred in 6.4% of treated subjects. Our main conclusion is that there is currently little evidence that sustains the commercial offer of TMS for treating ASD. Better-designed studies are badly needed to fully elucidate the role of TMS in the treatment of ASD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
ECT in major recurrent depressive syndrome with Parkinsonism syndrome
Authors: Gómez Alemany T. , Soler Vidal J. , Targa I. , Garcia Alarcon B. , Santoro A. , Alcoverro O. , Sendra Lopez J. 
Published: June 2017

A 71-year-old woman with history of major recurrent depressive syndrome responsive to clomipramine (last episode at 50-year-old) with the following medical records: ischaemic stroke with progressive cognitive impairment to the extent of requiring wheelchair.Current episodeDepressive symptoms, with suicidal thoughts, anxiety, tremor and low food intake in the last month (due to choke phobia) with up to 10 kg of weight loss.DiagnosisMajor recurrent depressive syndrome resistant to treatment with Parkinson syndrome.TreatmentLorazepam 10 mg/day levodopa 150/carbidopa 37.5 mg/day, LART Electroconvulsive therapy (Thymatron SYSTEM IV) was also carried out 3 times a week until 15 sessions were reached.DiscussionThis case illustrates the successful response with LART ECT towards major recurrent depression syndrome associated with a pharmacological parkinsonism maintained over the long-term (one year with ECT). There are sufficient evidences showing that the ECT has an effect in the dopaminergic system at different levels: dopamine release, dopamine neurotransmission and linkage with its receptor, and these effects differ between an acute stimulation and when repeated stimulation is carried out. It must be taken into consideration the fact that concomitant existence of depression and parkinsonism could represent another indication for ECT, since the pharmacological management of these patients is highly complex and could even more if we bear in mind that one of the therapeutical options towards the antidepressant potentiation (atypical anti-psychotics) can worsen the symptomatology.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Electroconvulsive Therapy Management in Benzodiazepine-Resistant Catatonic Syndrome: A Case Report
Authors: Louzao Rojas I.I. , Orosa Duarte Á. , Martínez-Alés García G. , Rubio Zavala I. , Fraga Domingo A. , Sánchez Castro P. , Bonán M.V. , Román Mazuecos E. , Flores Martínez A. , Rodriguez Vega B. , Bravo Ortiz M.F. , Jiménez Sola E. 
Published: June 2017

Catatonia is a rare but potentially lethal neuropsychiatric syndrome. Despite its historical association with schizophrenic disorders, it is more frequent in affective ones, and is currently considered an independent pathological entity. The basis of the treatment, regardless of the cause, is the use of benzodiazepines and electroconvulsive therapy (ECT), without a clear consensus on the combined treatment. Regarding ECT, the frequency and number of effective sessions has not been clearly established. Therefore, clinical evolution is the main factor to be considered in order to determinate the appropriate treatment regimen, although the daily application of ECT is preferred, at least for the first week. We report the case of a 41-year-old patient with paranoid schizophrenia, who presented with a benzodiazepine resistant catatonic syndrome. The clinical picture included stupor, mutism, negativism, severe stiffness, catalepsy, waxy flexibility and diaphoresis, with slight CPK increase but with no other extrapyramidal symptoms, fever more than 39 and hemodynamic instability, which allowed to exclude a neuroleptic malignant syndrome. A blood analysis, lumbar puncture, CT, EEG and viral serologies were performed with inconclusive results. The patient required ICU admission and ECT treatment and we used the Bush-Francis Catatonia Rating Scale to evaluate the evolution of symptoms. Six daily treatments with ECT led to an almost full recovery of the patient. Further case series regarding the clinical management of this syndrome are needed, in order to reach consensus on an effective ECT regimen.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Therapeutic Approach to Complicated Grief–An Example of Group Psychotherapy in Psychiatric Patients
Authors: Soares J. , Azevedo Pinto S.L. , Pinheiro A.C. , Pacheco S. , Curral R. 
Published: June 2017

Introduction.Complicated Grief (CG) affects 7–10% of the grieving individuals in the general population. However, the incidence is much higher in psychiatric patients, reaching 70% in most samples. These individuals present many risk factors for such condition, demanding a particular attention and treatment approach. Most studies have shown that pharmacological treatment may help relieving depressive and anxiety symptoms, although they do not promote a consistent improvement of the grieving scenario. Several meta-analyses have recognized different psychological interventions as effective in dealing with the loss, decreasing psychological suffering and promoting adaptation. It is accepted that the benefits of the intervention overcome any possible harm.Objectives.To evaluate the impact of a group intervention (12 sessions) in pharmacologically stabilized psychiatric patients presenting with CG.Methods.Patient selection was performed through a clinical interview and the fulfilment of the following psychometric tests: Complicated Grief Inventory; the Impact of Events Scale; Beck Depression Inventory; Social Support Scale. These assessment tools were also used to evaluate the impact of the intervention performed.Results.After the psychotherapeutic intervention, there were significant differences in the levels of depressive and post-traumatic stress symptoms.Conclusion.Group intervention in CG has proven effective in this population, specially regarding depression and post-traumatic stress levels.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Evolution of Cognitive Behavioural Therapy – The Third Generation and Its Effectiveness
Authors: Carvalho S. , Martins C.P. , Almeida H.S. , Silva F. 
Published: June 2017

Introduction.First wave cognitive behavioural therapy (CBT) focuses essentially on classical conditioning and operant learning and second wave on information processing. They are based on the premise that certain cognitions, emotions and physiological states lead to dysfunctional behaviour and so, by eliminating the first ones, changes in behaviour will take place. Third wave CBT appeared in an attempt to increase the effectiveness of first and second wave by emphasizing contextual and experiential change strategies.Objectives/Aims.To make a review on the actual state of the art of third wave CBT, focusing on MBSR (Mindfulness-Based Stress Reduction), MCBT (Mindfulness-based Cognitive Behavioural Therapy), DBT (Dialectical Behaviour Therapy), ACT (Acceptance and Commitment Therapy) and CFT (Compassion Focused Therapy).Methods.Research on PubMed using the terms “third wave cognitive behavioural therapy”.Results.Methods and targets differ between MBSR, MCBT, DBT, ACT and CFT. Depression, anxiety and borderline personality disorders are some of those targets. However, a transdiagnostic approach is the hallmark of all third wave therapies: mental processes or emotions transversal to many psychiatric disorders such as shame, self-criticism, experiential avoidance or cognitive fusion are the main focus, emphasizing the context and human experience over any categorical diagnosis.Conclusions.Third wave cognitive behavioural therapy is an emerging approach born from the need to improve and complement first and second waves. Although very promising, it is still a recent approach and data to support its superiority over the conventional therapies is missing.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Object Relations and Self-Esteem in young Adults with Schizophrenia in Long-Term Psychodynamic Group Psychotherapy
Authors: Grah M. , Restek-Petrović B. , Bogović A. , Mayer N. , Handl H. , Filipčić I. 
Published: June 2017

IntroductionPsychodynamic concepts describe object relations deficits in patients with schizophrenia originating from their earliest developmental stage, which is due to reduced ability of direct caregivers to adequately stimulate the child, as well as genetic factors. During psychodynamic group psychotherapy, members through psychotherapy gradually release the old family roles and experiment with new models of behaviour and thus change internalized object representations.AimThe aim of this study was to investigate changes in object relationships and self-esteem in the psychodynamic group psychotherapy in young patients suffering from schizophrenia.Subjects and methodsThe study included a total of 41 patients diagnosed with schizophrenia. Before joining the psychodynamic group therapy and after two years of participation in the treatment, all patients completed a test of object relations and the Rosenberg self-esteem scale.ResultsComparison of the results in two time periods showed downward trend results in all tested dimensions of object relations, a statistically significant difference was found for dimension symbiotic fusion: after two years of participation in the psychodynamic group psychotherapy, patients had significantly expressed less need for symbiotic relationships. Self-esteem was higher in the second period of testing, but without statistical significance.ConclusionTaking into account the limitations of this study, we can conclude that the results are encouraging. During psychodynamic group processes in young patients with schizophrenia there is a trend of positive changes in terms of object relations and self-esteem and a significant reduction in the need for symbiotic merging.Disclosure of interestThe authors have not supplied their declaration of competing interest.