bluuebunny/crossref_metadata_2025_split huggingface dataset:
How much longer will a patient stay in acute unit if mechanical restraint is required?
Authors: Grifell M. , Galindo L. , Dinamarca F.N. , Chavarría V. , Pérez E. , Salgado P. , Pérez V. 
Published: May 2016

IntroductionMechanical restraint is a therapeutic procedure commonly applied in acute units in response to psychomotor agitation. Its frequency is between 21 and 59% of patients admitted. These patients represent a risk to both themselves and for health workers. In order to implement measures to prevent agitation and therefore mechanical restraint, it is important to quantify the effects and costs of those procedures. The aim of this study is to determine whether the application of mechanical restraint in psychiatry acute unit is related to a longer stay in hospital.Material and methodsWe reviewed retrospectively the informatics record of all the mechanical restraints made and the total discharges of the three acute care units and dual disorders of our institution, between 2012 and 2015. For every discharge, the presence of at least one mechanical restraint was coded, resulting in two groups. The length of stay of the groups was then compared performing a t-test.ResultsThe number of discharges analyzed was 4659 from which 838 had an episode of mechanical restraint associated. There are significant differences between the length of stay of admissions with and without episode of mechanical restraint. The episode of mechanical restraint during an admission is associated with 5 to 9 more days of stay in the unit (P < 0.001).ConclusionsThe performance of a mechanical restraint is associated with a statistically significant and clinically relevant higher length of stay. These results suggest that preventing agitation, and therefore mechanical restraint, would be possible to decrease length of stay, and therefore costs related to hospitalization.Disclosure of interestThe authors have not supplied their declaration of competing interest.
An evaluation of the EOLAS psychoeducation programme for service users: An innovative approach to collaboration between clinicians and ‘experts by experience’
Authors: Gibbons P. , Higgins A. , Hevey D. , Monahan M. , O’Connor C. 
Published: May 2016

IntroductionPsychoeducation for service users has been shown in several recent meta-analyses to improve adherence with treatment, decrease rehospitalization rates and improve various measures of quality of life. The 8-week EOLAS Programme for service users with schizophrenia or bipolar disorder is unique in being designed, co-facilitated and evaluated collaboratively by both clinician and peer representatives. EOLAS forms part of the service plan of the national Health Service in Ireland.Aims and objectivesTo evaluate the impact of the EOLAS programme on participants’ perceived knowledge, confidence, advocacy, recovery attitudes and hope.MethodologyAnonymised questionnaires were administered to participants before and after completion of the EOLAS Programme.All survey participants were invited to attend for interview to examine qualitatively their experience of the programme. Interviews were recorded and subjected to thematic analysis.ResultsForty-five subjects completed pre- and post-programme questionnaires (participation rate = 55%).Significant improvements (P < 0.05) were identified across each of the 5 domains examined (i.e. perceived knowledge, confidence, advocacy, recovery attitudes, hope). Expressed satisfaction with the programme was high (95%).At interview, participants (n = 12) particularly valued:– the opportunity to ask questions of the psychiatrist e.g. about medication;– improving self-care skills e.g. monitoring early warning signs of relapse;– co-facilitation by a peer, which provided extra credibility and inspired hope;– sharing experiences with peers.ConclusionsThe EOLAS programme succeeds in meeting the needs of the participants across the target domains. This success depends on the unique collaboration between clinicians and peer experts on which EOLAS is based.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Attitude toward medication as a predictor of therapeutic adherence. Importance of psychoeducation on treatment
Authors: González Soria C. , Fombellida Velasco C.I. , Fernández Martín L.C. , Sánchez Pernas L. , Al Chaal Marcos L. , Alonso León L. , De La Mata Hidalgo R. , Valriberas Herrero I. 
Published: May 2016

IntroductionBetween 25–50% of psychiatric patients are non-compliant with their pharmacological treatment. When differences between compliant and non-compliant patients were analyzed, differences were found in relation to their beliefs and feelings about medication. The Drug Attitude Inventory (DAI) was created to measure attitudes towards medication in adults. It predicted adherence in schizophrenia and depression studies.ObjectiveDetermine if psychotherapeutic and psychoeducational activities – during a partial hospitalization at the Psychiatric Day Hospital – can improve aspects related to feelings and thoughts about medication.MethodWe gathered retrospectively a sample of 151 patients hospitalized at the Psychiatric Day Hospital, from September 2013 to June 2015. Their thoughts and feelings about medication were measured with the DAI before and after the hospitalization. From the sample of 151 patients, 94 completed both tests, excluding who did not have the final DAI score. Differences between initial and final scores were statistically analyzed with the Wilcoxon test for paired samples.ResultsOf the 94 patients who completed the study, 52 showed an improvement in their DAI score, whereas the remaining 27 showed an equal or decreased final DAI compared to initial evaluation. The difference was statistically significant (P ≤ 0.05).ConclusionIt seems that psychoeducational activities related to medication are important in order to reconsider or modify feelings and thoughts about treatment. Information on medication provided to psychiatric patients (to those who need psychopharmacological treatment), carried out in a group context, which facilitates an open and sincere communication, can be a useful strategy to improve compliance with treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Consumption of medicines for attention deficit hyperactivity disorder treatment per patient in children and adolescents in Slovenia from 2003 to 2012
Authors: Stuhec M. , Vedernjak U. , Igor L. 
Published: May 2016

BackgroundAccording to the attention deficit hyperactivity disorder (ADHD) treatment guidelines, atomoxetine (ATX) is a second line treatment after stimulants and therefore a serious monitoring of ATX prescribing is necessary to avoid inappropriate prescribing.ObjectivesIn most countries in Central Europe, except Germany, there is no data on drug consumption for ADHD medicines (expressed in defined daily dose (DDD)/ADHD patient/year).AimThe main purposes of this study were: calculate and present the pattern and evolution of national consumption in Slovenia expressed in the percentage of DDD/patient/year consumption for the period 2003–2012.MethodsThe national consumption and population data for this period were obtained from Slovenian databases. A DDD/ADHD patient/year was calculated. Only immediate-release methylphenidate (IR-MPH), methylphenidate-osmotic release oral delivery system (OROS-MPH) and ATX have been available and included in this study.ResultsLess than 50% of patients with ADHD are treated with medications in Slovenia. A total consumption rose rapidly from 41.3 in 2003 to 148.5 DDD/ADHD patient/year in 2012. The total consumption for ATX and MPH is almost equal (140.9 for ATX and 150.3 for MPH in 2012). This result is lower as it has been seen in Germany (208 DDD/ADHD patient/year in 2008 for MPH).ConclusionsIn the last decade in Slovenia, the total consumption is increasing rapidly, which indicates a positive trend. This pattern (low total consumption) has not been seen in Germany. After the new drugs have been available on the Slovenian market, the total consumption rose rapidly.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Crisis in the psychiatric patient: A structured illness-management-oriented group intervention
Authors: Fucci G. , Ratti N. , Gattamorta R. , Godoli R. , Randi S. , Riccipetitoni M.P. 
Published: May 2016

IntroductionCrisis prevention and management of the psychiatric patient have obtained a central role in the policies of Mental Health Services. In this context, Mental Health Centre of Ravenna has launched a “Crisis Center”, a rehabilitation group project applied to three types of users: users in an early stage of crisis, users in a post-critical stage and users at high risk of crisis. Intervention was based on the Illness Management and Recovery practice, an evidence-based program which consists in social skills training activities, emotions management, symptom management, coping skills training, psycho-education and, more generally, supporting users in their personal recovery process.ObjectiveObjectives of this project is to prevent crisis and hospitalization and to provide an alternative to institutionalization for mental health users.AimsThe aims of this study was to analyze and show effects and results of the project, in its first three years of life.MethodsThrough the database “Infoclin”, we analyzed data of 94 users who took part in the project between January 2012 and December 2014.ResultsAnalysis showed, primarily, that out of 94 users, 64 (68%) have not needed hospitalization in the following two years after intervention. Furthermore, out of 39 users with a history of one or more hospitalizations at time of entry, 22 (56.4%) have not needed hospitalization in the next two years.ConclusionsDespite the low number of users analyzed, it is believed that this study should be considered a further evidence of the positive effects of the IMR practice within mental health services.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The post-traumatic growth: The wisdom of the mind, its clinical and neuropsychoanalytic vicissitudes
Authors: Rozentsvit I. 
Published: May 2016

The purpose of this symposium is to bring awareness about and to promote knowledge of the phenomenon of posttraumatic growth (PTG) and its neurobiological mechanisms. The other purpose is to explore neuro-psycho-education as an important tool in understanding trauma and in promoting PTG.The idea of PTG was pioneered by Calhoun and Tedeschi (1999), who addressed positive psychological change (as they compared it with the “mind's wisdom”), which occurs in some individuals after trauma. PTG happens in the context of and despite of processing traumatic pain and loss. This phenomenon includes five main factors: relating to others with greater compassion; finding new possibilities, personal strength, spiritual change, and a deeper appreciation of life.Both neuropsychoanalysis and neuro-psycho-education offer us the knowledge of neurobiology and its mechanisms of “action” (such as neuroplasticity, neurointegration, mind-body integration, connectomes, ‘triune brain’, ‘bottom up processing’ and ‘top-down regulation’, etc.) and help modern mental health practitioners to understand their clients from “inside out”: to read the cues of their underlying (and not verbalized) patterns of being; to access their undisclosed, untold, emotional-relational history; to understand how this history shapes the present; to appreciate one's unique personal growth, even in the aftermath of trauma, and to understand mindfulness and mentalization as two powerful healing processes which play significant role in PTG.Both neuropsychoanalysis and neuro-psycho-education also help clinicians to be in touch with and to regulate our own emotions and somatic responses to a “difficult client”, while maintaining “benevolent curiosity” and empathic stance.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Sexuality and affectivity: Two themes in a psychosocial intervention for psychotics inpatients
Authors: Vaccaro A. , Zoppellaro C. , Fusco V. 
Published: May 2016

The aim of this project is about valuing these themes, not only in order to increase physiological genres knowledge or the responsible use of contraceptives, but is mainly about growing sexual psychosocial features awareness. Treating these themes in a psychoeducational intervention means: minimize sexually-transmitted diseases, prevent psychotic patients from quitting psychopharmacological treatment and favour the birth and the development of intimate relationships that may help patients leaving an unhelpful isolation condition.Increase the awareness of different sexual and affection aspects: physiological, anatomic and reproductive, relational and communicative, emotional, social and cultural, playful and pleasant ones.The 18 meetings interventions were done using a psychoeducational model; an active leading group manner (role plays and simulations) was used in order to ease the exchange of views between patients and the group leader.We did a first round of meetings with ten patients who participated actively; we also submitted to them a questionnaire – before and after the intervention – in which we collected knowledge and opinions about different themes (contraceptives, risk awareness, affective relationships etc.).From a qualitative analysis of the results we saw a knowledge-improvement about the dealt themes, and also, in some cases, we identified a modification in some problematic behaviours. The sample it's still too small for statistical analysis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Does clinical change always means the same? Comparison of different perspectives
Authors: Egger S. , Weniger G. , Prinz S. , Vetter S. , Müller M. 
Published: May 2016

IntroductionIn psychiatric practice, the assessment of change from pre- to post-treatment is a key approach for monitoring treatment effects and for the prediction of treatment outcomes. The Health of the Nation Outcome Scales (HoNOS) as a clinician-rated measure and the Brief Symptom Inventory (BSI) as a self-report measure are tools (that are) often incorporated in outcome monitoring. Their usefulness, however, has been questioned by two important issues: their psychometric properties and their lack of concordance.Aims and objectivesThe aim of the study is to evaluate the responsiveness of HoNOS and BSI as well as their interactions to predict clinical meaningful change according to the Global Clinical Impression (CGI) as quasi-gold standard for treatment outcome.MethodsA consecutive sample of patients admitted to a Swiss psychiatric hospital for either alcohol use disorders, schizophrenic psychoses, mood disorders, anxiety and somatoform disorders, or personality disorders was assessed with Brief Symptom Inventory (BSI) at admission and discharge. The HoNOS and the CGI were rated by the responsible clinicians at admission and discharge. Ordinal logistic regressions will be conducted using the CGI categories as ordered categorical outcome. HoNOS and BSI scores as well as their interaction terms will be used as independent variables.Results and conclusionComplete data of admission and discharge is available from approximately 600 cases. Graphical presentations will illustrate the resulting associations.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Validation of BGaze method supporting ADHD diagnosis
Authors: Esposito F. Lorena , Varela P. , Alkan E. Ozan , Morata I. , de la Osa N. , Ezpeleta L. , Crespillo J. Cañete , Super H. 
Published: May 2016

IntroductionEye movement recordings can provide information about higher-level processing of visual information. Recent evidence shows a novel role for eye vergence in orienting attention (Solé Puig et al., 2013). Based on such eye tracking data, the BGaze method (Braingaze; Spain) detects visual attention. The outcomes of the BGaze method have been applied to classify ADHD patients from healthy controls.AimIn this study, we validated the BGaze method.ObjectiveWe therefore recorded eye movements in children while performing a visual detection task.MethodsWe evaluated the BGaze method using 4 types of supervised machine learning algorithms. In total, 138 different trained models were tested. Nineteen ADHD diagnosed patients (children 7–14 years of age) and 19 healthy age matched controls were used to build the 138 models. We performed 30 times repeated random sub-sampling validation. In each repeated random split, training set consisted of 80% of the data and test set of the remaining 20%. Finally, all the 138 models were tested with a validation set consisting of 232 children, including 22 ADHD patients.ResultsAcross all the 138 models, BGaze method showed an average accuracy of 90.84% (minimum 86.21%; maximum, 95.26%) and an average AUC of 0.95 (minimum 0.90; maximum, 0.97). Best models gave accuracies of 92%, AUCs of 0.96 and FN and FP rates of 4.3% and 7.5%, respectively. Mean scores during the training-testing phase averaged 99.63%.ConclusionThe BGaze method is robust, accurate, and can provide an objective tool supporting the clinical diagnosis of ADHD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neurological symptoms in schizophrenia: A case report
Authors: Benavente López S. , Salgado Borrego N. , de la Hera Cabero M.I. , Oñoro Carrascal I. , Flores L. , Jiménez Rico R. 
Published: May 2016

IntroductionPatients with epilepsy and schizophrenia could present atypical clinical presentations with neurological symptoms that are not frequently presented in schizophrenia.Case ReportWe report the case of a 41-year-old male who was diagnosed of schizophrenia and was admitted into a long-stay psychiatric unit. He started at 33 years old with a depressive disorder. After prescribing venlafaxine, symptoms did not remit and the patient started to present apathy, anhedony, impoverished speech, social isolation and blunted affect. Then, the patient started to present behavioral disturbances consisted in regressive behavior, aggressive behavior, inappropriate language, echolalia, sexual disinhibition, impulsivity, worsening of executive functions and soliloquies. A neurological study was made with CT scan and electroencephalography, and no evidences of neurological abnormalities were found. After that, clozapine was prescribed, with an improvement of some symptoms like apathy, anhedony and aggressive behavior, but persisting the impulsivity, regressive behavior, inappropriate language, sexual disinhibition and echolalia.DiscussionPatients with schizophrenia and epilepsy could not respond appropriately to antipsychotic drugs. In this patient, the psychiatric symptoms more frequently seen in schizophrenia responded well to clozapine, but neurological symptoms did not improve with the standard treatment, causing a severe disability to the patient that was the main reason for his prolonged admission.ConclusionsIt is recommended to make a detailed neurological exploration in all psychiatric patients, in order to explore atypical symptoms and comorbidities that could reveal new diagnosis and therapeutic objectives.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Hypergraphia: Illustrating clinical pictures
Authors: Carvalhão Gil L. , Ponte A. , Gama Marques J. 
Published: May 2016

IntroductionHypergraphia is an extensive writing tendency sometimes coupled with hyperreliogiosity and atypical sexuality, completing a syndrome described by Waxman and Geschwind in 1975 during interictal phases of patients with temporal lobe epilepsy. Nevertheless, it may arise from any temporolimbic lesion, usually in the right hemisphere, in contrast to the schizophreniform psychosis more often seen in left-sided lesions.ObjectiveA review on the lateralizing significance of temporolimbic lesions, highlighting the (un)specificity of hypergraphia, after a case report concerning a patient with both hypergraphia and schizophreniform psychosis.MethodsAnalyse patient's clinical records and PubMed review, using hypergraphia, epilepsy and psychosis as keywords.ResultsWe report a 74-year-old male admitted due to aggressiveness. The patient had a traumatic brain injury in his 20s with secondary left temporal epilepsy. He lived in a psychiatric asylum, for almost 40 years, with the diagnosis of schizophrenia, showing fluctuant atypical sexual behavior. After being transinstitutionalized to community nursing-home he developed meningoencephalitis, leading to medication change and behavior relapse. He showed viscosity, circumstantiality, soliloquy, euthymic mood and normal cognition. He wrote profusely, e.g. lists of various categories and letters to eminent clerics and politics. His diary was scanned for illustrative purpose.ConclusionsHypergraphia is an uncommon but easy to find symptom that deserves the full attention of the clinician, especially in the differential diagnosis between schizophreniform psychosis and temporal epilepsy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
An innovative child psychiatry training program using a family-based model for at-risk military families
Authors: Szeftel R. , Pataki C. 
Published: May 2016

IntroductionFew child psychiatrists are well trained in family-based interventions for military families who experience significant trauma, intergenerational posttraumatic stress disorder, substance abuse, depression and high rates of suicide (Ramsawh et al., 2014). The innovative VA/UCLA/LACDMH Child and Adolescent Psychiatry Training program, sponsored jointly by the VA Greater Los Angeles Healthcare System (VA) and the Los Angeles County Department of Mental Health (LAC DMH), will address unmet needs of at-risk military families using a family-focused model also applicable to other families exposed to trauma.ObjectivesTo present the curriculum of the VA/UCLA/LACDMH training program and details of the collaboration between the LA VA and LAC DMH.AimsTo highlight how innovative child psychiatry training programs can be developed through creative institutional collaborations.MethodsThe VA/UCLA/LACDMH program family-based model and FOCUS (Lester et al., 2011) intervention were structured to meet regulatory standards of child psychiatry training programs.ResultsA specialized family-based child training program was created to meet the needs of at-risk military families while providing rigorous child and adolescent psychiatry training. Components Early Intervention Family Clinic for At-Risk Children provides family psychoeducation, and identifies children and adolescents at risk.FocusAn evidence-based early intervention for at-risk military families to enhance resilience and mitigate stress through improved coping, increased problem solving, and effective communication.ConclusionsA successful collaboration between the LA VA and LAC DMH can lead to an innovative family-based child psychiatry training program.Disclosure of interestThe authors have not supplied their declaration of competing interest.