bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of insomnia management in the elderly by general practitioners
Authors: Turki M. , Aloulou J. , Halouani N. , Ennaoui R. , Amami O. 
Published: June 2017

IntroductionInsomnia is the most common sleep disorder in the elderly. Its management must take into account the physiological changes associated with age, a higher frequency of comorbidities and polypharmacy.AimTo evaluate the management of insomnia in the elderly patients by general practitioners and to compare it with international recommendations.MethodsWe conducted a cross-sectional and descriptive study among general practitioners in Sfax over a period of two months (January and February 2016). We proposed to these doctors to participate in our study by sending to them a questionnaire in their emails, which they fill anonymously.ResultsA total of 32 doctors responded to the questionnaire. Among them, 62.5% reported that they often or very often receive elderly consulting for insomnia. Before prescribing hypnotic drugs, 65.6% of practitioners reported that they often advise lifestyle and dietary rules. The most prescribed hypnotic classes were: benzodiazepines (BZD) 59.37%; antihistamines 59.37% and homeopathic treatments 56.25%. In the last prescription, the treatment period exceeded 30 days in 18.75%. As for the prescription of BZD, molecules with long half-life were used in 37.48% of cases, and the dosage was identical to adult in 34.4% of cases.ConclusionThe prescription of hypnotic treatment in the elderly meets a logical approach to care, after an accurate diagnosis, taking into account psychiatric and somatic comorbidities, the precautions and contraindications. In this context, we have identified several shortcomings in the management of insomnia in the elderly in general practice. A multiplication of training on this subject is needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychometric evaluation of the Slovenian translation of the Circumstances, Motivation and Readiness Scales
Authors: Delic M. , Kajdiz K. , Pregelj P. 
Published: June 2017

IntroductionAccording to the available data, treatment motivation and readiness are closely linked to retention. There are instruments for measuring the stages of motivation and readiness, and predicting treatment retention and outcome.AimThis study describes psychometric properties, while focusing on the reliability of the Slovenian version of the Circumstances, Motivation and Readiness (CMR) scales.MethodsWe included 109 male and female patients with opioid addiction at the Centre for Treatment of Drug Addiction, Ljubljana. The CMR was translated into Slovenian by using the “forward-backward” procedure by our team and its author. Data analysis addressed psychometric properties of the CMR. Internal consistency was examined by applying exploratory and confirmatory factor analysis, while reliability was examined with Cronbach's coefficient alpha.ResultsCronbach alpha coefficients of reliability were calculated for each of the three CMR subscales and for the total score. The total alpha was 0.842. Alpha for Motivation was 0.860, for Circumstances 0.372 and for Readiness 0.818. Exploratory factor analysis extracted a 3-factor solution with 56% explained total variance. The factors do not provide an exact match with the dimensions C, M and R.ConclusionOn the basis of these results we can conclude that the Slovenian translation of the CMR is a valid instrument for evaluating patients’ motivation and readiness for treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Alcoholic hallucinosis after chronic alcohol abuse: A case report
Authors: Fernandez Miranda J.J. , Frías Ortiz D.F. , Maria Francina F.C. , Rossi P. , Shaban Rodríguez O.W. Muquebil Ali Al 
Published: June 2017

IntroductionAlcoholic hallucinosis is a rare complication of chronic alcohol abuse and a prevalence of 0.6–0.7% in alcoholics has been reported.Case reportA 54-year-old Indian immigrant in Barcelona was referred for psychiatric evaluation in April 2016 by due of his behavioral alterations. Evaluation revealed that he was apparently asymptomatic when he come to Spain, 18 years ago. He had been consuming alcohol since 1974 and gradually the frequency and quantity increased to 600 mL of rum daily by 1996. He complained of hearing voices of family members, being irritable even when he was alone and in catatonic phases. He was found to be gloomy, reclusive, not sleeping and talking to oneself. He used to have sleep disturbances; irritability and tremors when temporarily stopped alcohol consumption. He presented a clinical abstinence syndrome, with pharmacological resistance to benzodiazepine perfusion: it was necessary to use dexmedetomidine an Alpha2-agonist with sedative and analgesic properties. After 12 days of medical treatment on UCI, he recovered from abstinence syndrome and was transferred to psychiatry ward. Blood analysis showed raised aspartate amino transferase and alanine amino transferase. Computed tomography and magnetic resonance imaging brain revealed bilateral lateral ventricle enlargement with narrowing of lower end of Aqueduct of Sylvius. He was treated with oral paliperidone. The dose was gradually increased to 18 mg/day and he responded quickly. In the follow-up, he was abstinent from alcohol, compliant with treatment and free from all kinds of hallucinations after medication adherence and psychotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Addictive behaviors among psychiatric outpatients
Authors: Ghanmi L. , Zitoun K. , Hachaichi I. , Hamrouni S. , Salem O. , Zouari L. , Maalej M. 
Published: June 2017

IntroductionLittle is known about the epidemiology of smoking and substance use disorders (SUD) among psychiatric outpatients in south of Tunisia.ObjectiveExamine the prevalence of smoking and SUD among adult psychiatric outpatients at the regional hospital of Gabes.MethodA survey was conducted to assess the extent of alcohol abuse, drug abuse and smoking among adult psychiatric outpatients (n = 115), with different psychiatric diagnoses (DSM−5), aged over 18 years, following the psychiatric department of the regional hospital of Gabes. Data collection was done through a semi-structured interview with the patient and a family member + review of medical records. SUD was defined as an abuse or dependence to alcohol or drug.ResultsSmokers account for 29.6% of the patients. Smoking was significantly higher in male patients (97.1% vs. 43.2%, P < 10−3). Compared to nonsmokers, smokers patients had significantly more the diagnosis of schizophrenia (64.7% vs. 35.3%, P = 0.004), a higher level of education (52.9% vs. 32.1%, P = 0.03), a higher rate of alcohol (14.7% vs. 1.2%, P = 0.008) and drug use disorders (8.8% vs. 0%, P = 0.02), and a higher rate of relapses (3.5 vs. 2, P = 0.004). Alcohol use was noted in 6% of patients and cannabis in 4%. Patients with a SUD had significantly more the diagnosis of schizophrenia (100% vs. 36.2%, P = 0.05), a higher rate of smoking (100% vs. 27.7%, P = 0.02). Financial situation, education, marital status and age of onset of the disease were not associated with SUD.ConclusionAddictive behaviors are prevalent among psychiatric outpatients. This has implications in treatment and management of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Role of Psychiatrists in Memory Clinics
Authors: Verhey F. 
Published: June 2017

Memory clinics (MCs) are multidisciplinary teams involved with early diagnosis and treatment of people with dementia. In this presentation, we will discuss several trends of the role of psychiatrists over the last twenty years, on the basis of five questionnaires that were sent to MCs every 5 years in the Netherlands.MCs have developed in Europe using a range of service models but providing similar functions, which include assessment, information, treatment monitoring, education, training and research. MCs may vary among each other, and across countries. Psychiatrists used to play a coordinating role in most MCs, but there is now a tendency that MCs are more frequently led by other specialists, notably neurologists. In 1998 in the Netherlands, only a small minority of the MCs had a structural cooperation with local service providers, but 10 years later, most of them were collaborating with other regional care organizations. In most cases, the collaborating partner was a community mental health team or a long-term care facility.Disclosure of interestThe author has not supplied his declaration of competing interest.
Elevated neutrophil lymphocyte ratio in patients with substance use disorders
Authors: Ozkan N. , Sonmez M.B. , Tas Durmus P. , Gorgulu Y. , Kose Cınar R. , Vardar M.E. 
Published: June 2017

IntroductionDisturbances in inflammatory processes may play a role in the pathophysiology of psychiatric disorders. The neutrophil lymphocyte ratio (NLR) and C-reactive protein (CRP) are indicators of the systemic inflammatory response.ObjectivesThe current study was prepared based on the assumption that dysregulated immune function and elevated inflammation markers may be seen in substance use disorders.AimsOur aim was to investigate whether NLR and CRP are higher in patients diagnosed with substance use disorders than in healthy subjects.MethodsThe participants in the study included 115 male inpatients diagnosed with alcohol (n = 41), heroin (n = 46), or synthetic cannabinoid (n = 28) dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR), and 32 healthy male volunteers. We used NLR and CRP as measures of systemic inflammation. Blood samples were taken on the next morning of admission for detoxification. Addiction severity was assessed using the Addiction Profile Index (API).ResultsThe difference between the groups with respect to NLR was statistically significant (P = 0.014). Patients diagnosed with alcohol, heroin or synthetic cannabinoid dependence had similar NLR. Patients with alcohol or synthetic cannabinoid dependence had significantly higher NLR than healthy controls (P = 0.001 and P = 0.029, respectively). Patients with heroin dependence trended towards statistically significantly higher NLR compared to healthy controls (P = 0.067). CRP levels did not differ significantly between the patient and control groups. NLR and CRP were not significantly correlated with API scores.ConclusionsOur findings suggest that NLR is elevated in patients with substance use disorders in comparison to healthy controls.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The prevalence of psychiatric comorbidities and relapses in males treated for alcohol dependence syndrome – Prospective study from tertiary de-addiction care unit in Kerala, India
Authors: Soman S. , Vr A. 
Published: June 2017

Kerala has high percapita consumption of alcohol among the other Indian states.ObjectivesPrevalence of psychiatric comorbidities in alcohol dependence syndrome and association of severity of alcohol dependence, personality dimensions, motivation and short delay relapses.MethodsA prospective study in 91 male alcoholic patients for 2 months.ResultsTwo groups not relapsed (NR = 48) and Relapsed (R = 43) were comparable in age, SADQ severity score, average units of alcohol consumption and years of alcohol use. Average consumption was 17 units/day (500 mL spirits), age of onset before 25 years 87%, mean age 40 and severe alcohol dependence was in 57% of study population. Co-morbid nicotine use was 80.2% and in equal numbers in the relapsers and non-relapsers group.ConclusionsBipolar disorder was the most prevalent (19.8%) in the study population. About 53.8% had alcohol dependence as the primary diagnosis with no associated psychiatric comorbidities. Anxiety disorders (12%) and personality disorders (19.7%) were found more in the relapsers group. Anxiety symptoms seemed to be a risk factor for relapsing compared to other comorbidities in bivariate analysis (Pearson Chi2 5.998, P = 0.014). Psychoticism among relapsers were high (Pearson Chi2 4.901, P value 0.027, OR: 3.782, 95% CI: 1.103–12.958). Co-morbidities were not statistically significant in multivariate (Pearson Chi2 1.765, P = 0.184, OR: 1.755, 95% CI: 0.763–4.037). Severity of alcohol dependence in relapsers was not significant (Pearson Chi2 0.650, P = 0.722). Motivation levels of 62.8% of relapsers were low, 32.6% medium and only 4.7% reported high motivation (Pearson Chi2 11.846, P = 0.003). Poor motivation proved to be a risk factor for future relapse (P = 0.008, 95% CI: 1.266–4.648, SE.332).Disclosure of interestThe authors have not supplied their declaration of competing interest.
Central nervous system grey matter decreases in volume in smokers impacting cognitive abilities: A systematic review
Authors: Vnukova M. , Ptacek R. , Raboch J. , Stefano G. 
Published: June 2017

BackgroundEven though cigarette smoking is a leading cause of preventable mortality, worldwide tobacco is consumed by approximately 22% of population. Smoking is also one of the risk factors for cardiovascular disease and it impacts our brain processing as well as being one of the recognised risk factors for Alzheimer's disease. The tobacco toxins may cause these disorders, e.g., nicotine at high levels, which are inhaled, resulting in preclinical brain changes. Researchers suggest that there are differences in brain volume between smokers and non-smokers. This review examines these differences on the brain grey matter volume (GMV).Material/methodsIn March/April 2015: MedLine, Embasse and PsycInfo were searched using terms: “grey matter”, “voxel based”, “smoking” and “cigarette”.ResultsStudies found brain GMV decreases in smokers compared to non-smokers. Furthermore, gender specific differences were found, while thalamus and cerebellum was affected in both genders decrease in olfactory gyrus was found only in male smokers. Age group differences were also found and these may suggest pre-existing abnormalities that lead to nicotine dependence in younger individuals. Only one study found positive correlation between number of pack-years and GMV.ConclusionSmoking decreases the volume of grey matter in most brain areas. This decrease may be responsible for the cognitive impairment and difficulties with emotional regulation in smokers compared with non-smokers.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Socio-demographic, clinical and therapeutic features of patients treated for schizoaffective disorder using cannabis
Authors: Walid B. , Marrag I. , Ellouze F. , Nasr M. 
Published: June 2017

IntroductionPsychotic disorders were formerly associated with cannabis use. It could accelerate the course of the illness and thus, constitutes a severity factor in terms of prognosis.ObjectivesTo define the socio-demographic, clinical and therapeutic profiles of patients suffering from schizoaffective disorder (ASD) and who are consuming cannabis.MethodsA retrospective study of 16 patients diagnosed with ASD, who were hospitalized at the psychiatric department of Tahar Sfar Mahdia's hospital, and whose toxicology test results during the hospitalization came back positive for tetrahydrocannabinol.ResultsSixteen patients were gathered, all male, the average age was 26 years. The average age of first hospitalization was 25 years, 41.9% were unemployed; 76.3% of our sample were single. Three quarters of patients were hospitalized without consent. The average hospital stay was 30.33 days. Our patients had required during their stay an average dosage of antipsychotic, equivalent to chlorpromazine, of 752.42 ± 342.79 mg. The average scores of psychometric scales were: BPRS = 55.72 ± 14.11, SAPS = 41.5 ± 14.80 and 42.11 ± 18.88.ConclusionCurrently, it is recognized that prolonged use of cannabis is an exogenous risk factor. The association between cannabis and schizoaffective disorder may amend the treatment modalities. It requires, thereby, an integrated and simultaneous treatment of schizophrenia and addictive behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Disorganization and Social Cognition: Data from the Italian Network of Research on Psychoses
Authors: Rocca P. 
Published: June 2017

Social cognition (SC) refers broadly to the domains of cognitive functions that are employed in socially relevant situations. These disturbances have been found to be strongly related to disorganized and negative symptoms in schizophrenia. Each of the disorganization symptoms suggests a diminishment or absence of organization. There seems to be a loss of the ability to be directed toward or committed to a particular focal topic or goal. Such conditions are likely to impact patients’ drives or motivations to initiate goal-directed activities that could yield pleasurable opportunities. Moreover, it has been suggested that disorganized symptoms are an integral link in cognitive pathways, with connections between cognitive processes weakening as disorganized symptoms increase. Thus, it seems that when disorganized symptoms are present, people with schizophrenia are no longer able to effectively utilize the neurocognitive abilities necessary for performing social cognitive or metacognitive tasks. It is also in line with models of disorganization in schizophrenia (Bleuler, 1911) that a “loosening of associations”—similar to current conceptualizations of disorganized symptoms—is at the core of these cognitive disruptions. Previous research has linked disorganization to cognition (neurocognition and SC) and cognition to social functioning, although in separate studies. The present study was conducted to explore a model, where disorganization predicted social functioning both directly both through indirect effects on other determinants (neurocognition, SC and negative symptoms) in a large, and well-characterized sample of patients with schizophrenia recruited in the context of a multi-center study of the Italian Network for Research on Psychoses (NIRP).Disclosure of interestThe author declares that he has no competing interest.
Characteristics of suicide attempters with a high lethality means
Authors: Lee C.T. , Lee S.Y. , Lee K.U. , Lee H.K. , Kweon Y.S. 
Published: June 2017

IntroductionSuicide attempts with higher lethality increase the likelihood of suicide completion. Accumulating knowledge on risk factors contributing to higher suicide lethality may help clinicians to allocate their limited resources to more endangered people.ObjectivesTo explore the factors associated with higher lethality in suicide attempts.MethodsAll suicide attempters, who visited the emergency department of Uijeongbu St. Mary's hospital from January 2014 to December 2015, were reviewed retrospectively. We compared between the high vs. the low lethality group, of which had been recorded based on clinical judgment using t-test or Chi2/Fisher's exact test with two-sided P-value of 0.05.ResultsAmong the 753 suicide attempters, the assessed lethality was recorded in 736 cases. Low and highly lethal attempters were 426 (57.9%) and 310 (42.1%), respectively. For demographic variables, the high lethality attempters were significantly more likely to be older (48.3 vs. 44.78; P = 0.009), unemployed (61.0% vs. 56.5%; P = 0.042, without religion (90.9% vs. 84.9%; P = 0.017). For clinical variables, the high lethality attempters were significantly more likely have hopelessness (67.7% vs. 58.2%; P = 0.013) and a history of schizophrenia (4.5% vs. 1.4%; P = 0.023, while they did display any difference for mood disorders. The low lethality suicide attempts were more frequent in patients with comorbid personality disorders (9.2% vs. 4.9%; P = 0.031).ConclusionsThese results are in line with literatures reporting higher suicide risk in people, who are old, unemployed, not having a religion, psychotic and hopeless. These may have been moderated by committing a higher lethal means of suicide at least in part and warrants additional investigations.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Suicides in the Kyrgyz Republic: Discrepancies in different types of official statistics
Authors: Molchanova E. , Galako T. 
Published: June 2017

In order to develop the “prevention of suicides” component of the state program on mental health protection of the Kyrgyz Republic population for 2017–2030 years, a suicide situation in the country over the past 10 years was investigated. During collecting, processing and statistical analysis of data from different sources, a significant discrepancy was revealed between them.According to the national statistics committee (NSC), in 2015 the level of prevalence of suicide was 6.93% per 100,000 of population, whereas, according to the information from the republican medical information center it was 4.82%. Over the last 10 years in the Kyrgyz Republic, a level of suicidal behavior among children, teenagers and young adults has still been rather high and 22.63% of suicide attempts were committed by persons aged between 18 and 22 years. A significant difference was revealed in the indexes of suicides among these age categories provided by NSC and the ministry of Inner affairs.Due to religious and national traditions, suicide is a very sensitive topic in Kyrgyzstan. In a lot of cases, death from suicide is not registered or is disguised as accidents and other causes of death, so the figures may be considered reliable.Thus, despite the relative standardization of suicides accounting by the separate departments, the further work is needed for coordination and harmonization of the data collection, as well as for development and implementation of inter-agency action plan to prevent suicides at the national level, taking into account the regional, cultural and ethnic characteristics.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Temperament and character traits among suicidal patients during depressive episode of bipolar disorder
Authors: Petek Eric A. , Eric I. , Dodig-Curkovic K. , Kralik K. , Filakovic P. 
Published: June 2017

IntroductionBoth suicide and mood disorders represent current and future global burden on public health system. Bipolar disorder (BD), part of a diagnostic group of mood disorders, is characterized by manic, depressive and mixed episodes with life-expectancy much shorter than in general population. Patients with BD have 30 times higher suicide rate than the general population and 25–50% of these patients attempts suicide. About 15% of patients who attempted suicide eventually end their lives with completed suicide.AimThe aim of our research was to distinguish personality features among bipolar patients with current depressive episode (BD-D) who attempted suicide.Materials and methodsThe research was conducted among patients with depressive episode of BD (according to diagnostic criteria of ICD–10) who attempted suicide and had been admitted for hospital psychiatric treatment. For assessment of personality, we used the Temperament and Character Inventory (TCI, Cloninger R.) upon admittance. Our sample consisted of 31 (n = 31) patient who met the above mentioned criteria. All patients given their written informed consent. The statistical analysis was performed using SPSS 17.0.ResultsIn our sample, we found, higher scores on harm-avoidance (HA), significantly higher scores on novelty seeking (NS) with significantly lower scores on persistence (P), self-directedness (SD) and cooperativeness (C) scales of the TCI. The Mann–Whitney-U test was used to compare samples.ConclusionIn our sample, suicide attempts are associated with temperament and character dimensions. These results confirmed our initial hypotheses on existence of specific personality features among that group of suicidal patients with BD–D.Disclosure of interestThe authors have not supplied their declaration of competing interest.