bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of geographical distribution of referrals to psychiatry from primary care
Authors: Mata Saenz B. , Muñoz Martinez V. , Nuevo Fernández L. , Lopez Lavela E. , Asensio Aguerri L.M. 
Published: June 2017

IntroductionThe distribution of the demand from primary care in the mental health units could be a way of facilitating the coordination and improving the attention to patients. For this reason, in our unit we have made a repartition of the areas among the different psychiatrists.ObjectivesTo analyze if there was a correlation between the geographical origin of the patients or their primary care areas and the referrals, and between them and their attendance.MethodsThis is an epidemiological, analytic, prospective study of patients referred to our department. The following variables were collected: (1) referral protocol, (2) reason, (3) demographic data (origin, gender, age), (4) Primary Care area, (5) attendance to appointment, (6) diagnosis impression and (7) destination of referral. The SPSS 19.0 was used to analyze the data.ResultsA total of 1048 patients were sampled. A statistically significant relationship hasn’t been found between place of residence, primary care area or areas of distribution in the Unit and attendance (Chi2). If we analyze the population of each distribution, we can describe similar percentages depending on the size of these.ConclusionsAlthough a different distribution and a relationship is thought between some areas and the attendance or the number of referrals, we didn’t find out them in our sample.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Who's lost in waiting?
Authors: Ossola P. , Jovanovic N. , McColl H. , Giordano V. , Webber C. Johnston , Steel M. , Ramjaun N. , Andlauer O. 
Published: June 2017

IntroductionEarly intervention services (EIS) can significantly reduce the rate of relapse, risk of suicide and number of hospital admissions for people with first episode of psychosis (FEP). However, care pathways in FEP can be complex, thus extending the period before patients commence appropriate treatment. Recently in the UK, guidelines have set a limit of two-weeks before patients with a FEP receive treatment at EIS.ObjectivesWe explored the impact of this new policy on referrals to an EIS in the area City and Hackney, London, which has one of the highest incidence of psychosis in the UK.MethodsReferrals from 6 months of 2015 have been compared with the data from the same period of 2016, once the waiting standard had been implemented.ResultsWe observed more than a two-fold increase in the monthly number of referrals (9.4 in 2015; 20 in 2016) and this wasn’t due to a rise of inappropriate referrals (2.23% in 2015; 1.53% in 2016). Moreover the number of referrals doubled further when, in addition, the City & Hackney EIS went from a 18–35-year-service to an “ageless” adult service.ConclusionThe recent focus on FEP in the UK might have increased awareness and reduced stigma, leading to the increment in referrals. Also, shortening the waiting time made the service more accessible for those that would have gave up in front of a longer waiting list. Interestingly enough a peak in the number of referrals has been observed from September 2016 when another standard was implemented.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Defensive psychiatry. An ethical perspective
Authors: Riolo A. , Babici F. , Tassi F. 
Published: June 2017

IntroductionThe legal dispute between doctors and patients is increasing. The “frivolous lawsuit” is spreading and the psychiatrist is being dragged to court in the dock. Guidelines and operational protocols become the bastions of the defensive psychiatry. Defensive psychiatry involves, for example, a larger number of hospitalizations, also involuntary admissions, and psycopharmacological prescriptions.ObjectivesWe want to see if the issue of defensive psychiatry is perceived by psychiatrists as a risk in their clinical practices and what consequences may result in the relationship with the patient.MethodsThrough an audit and through a literature review get to define the defensive psychiatry.ConclusionsThough there is much confusions and uncertainty in this field, the defensive psychiatry distorts the relationship with the patients and proposes the questions of social control.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Correlation between socio-demographic factors and profile of the rapist in Bulgaria
Authors: Stoimenova-Popova M. , Tumbev L. , Chumpalova P. , Veleva I. , Todorov A. , Valtchev V. , Popov P. 
Published: June 2017

IntroductionSexual abuse is of great public and high degree of public danger.ObjectivesThe aim of this study was to evaluate the influence of specific socio-demographic factors among sex crime offenders.MaterialThe subjects of study are 66 individuals in total, testified by expert psychiatrist and subsequently charged by law as of December 2010, up until today.MethodsPatient record, providing information about different socio-demographic factors. Retrospective research of the available medical documentation. A statistician conducts data research analysis, using specialised software statistical packages for Statgraphics.ResultsThe highest percentage of the participants are from the age groups between 15–24 and 45–54 years old. Both age groups consist of 18 people (27%). The two groups with the lowest percentage of sex offenders are the ones between 25–34 –6 (9%) and above 64–6 (9%). The biggest share have secondary education–26 (40%), followed by those with elementary education–24 (36%). The smallest percentage are those with higher education – 2 (3%). There is no statistically significant correlation between the research sample and their residence–34 (51%) live in a city and 32 (49%) – In a village. There is also not a significant difference in their ethnical origins. The biggest percentage of sex offenders have been raised by both parents – 54 (82%).ConclusionsSex offenders represent an exceptionally heterogeneous group, our study did not find significant correlation of socio-demographic factors and the profile of the rapist.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Agreement between psychiatric evaluations and court decisions concerning criminal responsibility
Authors: Tzeferakos G. , Papaliaga M. , Papageorgiou C. , Douzenis A. , Bali P. 
Published: June 2017

IntroductionTo our knowledge, a relatively small number of studies address the agreement between psychiatrists and court decisions concerning criminal responsibility among psychiatric offenders.ObjectivesThe objective of the present study was to examine the agreement between psychiatric evaluations and court decisions in Greek penal cases.MethodsLegal case files of 100 adult subjects, 90 male/10 female, 88 Greeks/12 foreigners were studied, and agreement was assessed by the κ (kappa) statistic.ResultsSeventy eight percent of the subjects had had contact with psychiatric services before the commitment of the crime. The most common diagnoses were schizophrenia spectrum psychosis (18%), antisocial/borderline/mixed personality disorder (15%) and substance use disorder (15%). In 30% of the cases criminal insanity/partial responsibility was attributed in the first-degree court. The presence of a psychiatrist (n = 63), attending, defense, prosecution or appointed by the court, significantly increased the possibility of such an attribution (41.3% versus 10.8%).The highest agreement (κ = 0.780) was observed between court's decision and the evaluation of the psychiatrist appointed by the court, in the 35 cases in which such an expert was present (P < 0.001). Very significant agreement (κ = 0.805) was observed between the decisions of second and first-degree courts (P < 0.001). In 91% of the cases, the decisions remained unchanged.ConclusionsCriminal insanity/diminished responsibility, were attributed in 30% of the reviewed cases. The presence of a psychiatrist already at the first-degree court is a prerequisite for such an attribution, especially when, he is appointed by the Court.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Mental health simulation training in psychiatric skills for police and ambulance service personnel
Authors: Attoe C. , Fisher M. , Vishwas A. , Cross S. 
Published: June 2017

IntroductionUK healthcare policy has highlighted a shift in mental health services from hospital to community, stressing the importance of training for professions not traditionally associated with healthcare. Recommendations have been made to introduce training for the police force designed with experts. Similarly, the value of further training for ambulance clinicians in assessing mental health, capacity, and understanding legislation has been highlighted.AimsTo investigate the effect of simulation training on the confidence, knowledge, and human factors skills of police and ambulance service personnel in working with people experiencing mental health conditions.MethodsOn completion of data collection from 14 training courses, approximately 90 police and 90 ambulance personnel (n = 180) will have completed the human factors skills for healthcare instrument, confidence and knowledge self-report measures, and post-course qualitative evaluation forms. A version of the hfshi for non-clinical professions will hopefully be validated following data collection. Results will also be compared by profession.ResultsAnalyses have not been fully completed, although preliminary statistical analyses demonstrate promising findings, with increases post-course for human factors skills, confidence and knowledge. Furthermore, qualitative feedback initially illustrates valuable learning outcomes and interesting findings from comparisons by professions.ConclusionsMental health simulation training appears to have a promising impact on the confidence, knowledge, and human factors skills of police and ambulance personnel for working with people experiencing mental health conditions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychological Effects of Working Night Shifts on Mental Health
Authors: Kchaou A. , Hajjaji M. , Masmoudi R. , Sellami I. , Masmoudi M.L. , Masmoudi J. , Jmal K. Hammami 
Published: June 2017

IntroductionThe medical and scientific communities are continually reporting that night work can increase the risk of certain disorders and have a negative impact on the overall well-being of employees.ObjectivesThis study wanted to examine the impact of night work on physical and psychological well-being of hospital staff.MethodsWe carried out a cross-sectional study about a representative sample of hospital staff. We used validated self-reporting instruments: the Perceived Stress Scale (PSS) and the Subjective Well-being Scale (SWS). Data were analyzed using SPSS-20.ResultsOur study concerned 519 hospital staffs. More than half were male (53%) and 83.1% had worked in the same position for more than two years. More than half of the participants (51. 3%) considered themselves in very good health. Also 41.5% of participants had a well-being index reduced and 26% of personal had high perceived stress. Correlation analysis had shown that more than one guard at week was associated with high levels of perceived stress (P = 0.004) and well-being index reduced (P = 0.000). After adjusting for categories, more than one shift work at week was associated to well-being index reduced with odds ratios of 1.57 (confidence interval 95% [1.07 to 2.30]).ConclusionThere is a clear correlation between night work, perceived stress and subjective well-being of different categories of hospital staff. Shift work interferences on health and well-being are complex and multifaceted in their origins and time manifestations, dealing with several aspects of personal characteristics, and working and living conditions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Comprehensive Care for Inpatients with Mental Disorders: Working Towards Service Developments
Authors: Semenova N. , Kostyk G. 
Published: June 2017

IntroductionOver the past 20 years, considerable progress was made in understanding the multiple and complex needs of patients with mental disorders and ways to organize comprehensive care. However, organizing care in inpatient, pathology-focused settings, where patients were seen increasingly as consumers of ‘inpatient psychiatric’ services is challenging.Objectives and aimsInspired by modern trends, we are more able to integrate recent developments in psychosocial treatments, broadly defined, into progressive treatment framework within inpatient setting.MethodsResults of an audit of our service (psychosocial treatments) over the previous 5 years will be compared to published results of other services with a range of service delivery methods.ResultsExcerpts from mental health care practice in Moscow based Psychiatric Hospital No 3 named after VA Hilyarovsky – are provided. The pathways of care as well as the basic principles governing the treatment (careful attention to referral sources; optimal patient-treatment matching; and psychosocial, rather than medical supremacy) are outlined. Training and development is central to the effective and efficient working of any staff group. As part of the service developments, a number of inductions (on psychosocial treatments) were provided on regular basis to all staff joining the service.ConclusionsThough the opportunity for future reform remains on the horizon, some of the strengths and weaknesses of our current health care practice will be presented.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cognition in Mild and Moderate Depression
Authors: Nešović P. , Simonović M. 
Published: June 2017

IntroductionIt is known that there is a cognitive decline in major depressive disorder. Most studies were performed on patients whose sum on a Montgomery and Asberg depression rating scale was greater than 30.ObjectivesIn our work, we concentrated on mild and moderate depression, MADRS > 30 was not criteria. Patients included were diagnosed with mild to moderate depressive episode.AimsTo determine how depressive episodes affect cognition.MethodsWe included 30 patients diagnosed at the clinic for psychiatry in Nis. We covered the age group between 20 and 40 years, regardless of the gender and educational level. For the assessment of cognition, we used digital symbol substitution test (DSST), Rey audio verbal learning test (RAVLT), trail making test (TMT), stroop color naming test (Stroop), and patients were evaluated with Montgomery and Asberg depression rating scale (MADRS). Tests were conducted on the first visit to a psychiatrist. Patients were compared with the results of the healthy population with the same characteristics, and in the same period (August 2016). Mean values were compared and groups were compared by Student's t-test.ResultsThere was a statistically significant difference in all of the tests, and all of the parts of tests conducted on the patients and the control group.ConclusionsThere is a statistically significant cognitive decline in patients with mild and moderate depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Lurasidone for the Treatment of Major Depressive Disorder with Mixed Features: Do Manic Symptoms Moderate Treatment Response?
Authors: Pikalov A. , Goldberg J. , Mao Y. , Siu C. , Tsai J. , Calabrese J. , Loebel A. 
Published: June 2017

BackgroundThis post-hoc analysis evaluated whether the efficacy of lurasidone in major depressive disorder (MDD) with mixed features is moderated by the number and characteristics of manic symptoms present at study baseline.MethodsPatients meeting DSM-IV-TR criteria for MDD who presented with two or three manic symptoms (consistent with the DSM–5 mixed features specifier) were randomly assigned to 6 weeks of double-blind treatment with either lurasidone 20–60 mg/d (n = 109) or placebo (n = 100). Finite mixture models were applied to identify latent class patterns of the 10 baseline manic symptoms.ResultsThree latent class profiles were identified: 105 (50.5%) patients had manic symptom profile 1 (MIX 1) with mean MADRS 33.0, mean YMRS 9.2, mean number of manic symptoms 3.8; 63 (30.3%) patients had manic symptom profile 2 (MIX 2) with similar baseline mean MADRS (32.4) and YMRS (9.3) and lower number of manic symptoms 3.5; 40 patients had manic symptom profile 3 (MIX 3) with significantly higher severity scores in MADRS (35) and YMRS (14.9) and mean number of manic symptoms 4.6. A significant moderating effect on change in YMRS score was observed for the “decreased need for sleep” symptom, with greater lurasidone effect size (vs. Placebo) found in patients without vs. With this symptom (P < 0.05).ConclusionsIn this post-hoc analysis of a placebo-controlled trial involving MDD patients with mixed features, absence of “decreased need for sleep” was found to be significantly associated with improvement in manic and depressive symptoms and to moderate the treatment effect on manic symptoms.Disclosure of interestI am full time employee of Sunovion pharmaceuticals Inc.
The Major Depressive Disorder Hierarchy: Rasch Analysis of 6 Items of the Hamilton Depression Scale Covering the Continuum of Depressive Syndrome
Authors: Carvalho Alves L. Primo de , Almeida Fleck M. Pio de , Boni A. , Sica da Rocha N. 
Published: June 2017

ObjectivesMelancholic features of depression (MFD) seem to be a unidimensional group of signs and symptoms. However, little importance has been given to the evaluation of what features are related to a more severe disorder. That is, what are the MFD that appear only in the most depressed patients. We aim to demonstrate how each MFD is related to the severity of the major depressive disorder.MethodsWe evaluated both the Hamilton depression rating scale (HDRS-17) and its 6-item melancholic subscale (HAM-D6) in 291 depressed inpatients using Rasch analysis, which computes the severity of each MFD. Overall measures of model fit were mean ( ± SD) of items and persons residual = 0 (± 1); low χ2 value; P > 0.01.ResultsFor the HDRS–17 model fit, mean (± SD) of item residuals = 0.35 (± 1.4); mean (± SD) of person residuals = –0.15 (± 1.09); χ2 = 309.74; P < 0.00001. For the HAM-D6 model fit, mean (± SD) of item residuals = 0.5 (± 0.86); mean (± SD) of person residuals = 0.15 (± 0.91); χ2 = 56.13; P = 0.196. MFD ordered by crescent severity were depressed mood, work and activities, somatic symptoms, psychic anxiety, guilt feelings, and psychomotor retardation.ConclusionsDepressed mood is less severe, while guilt feelings and psychomotor retardation are more severe MFD in a psychiatric hospitalization. Understanding depression, as a continuum of symptoms can improve the understanding of the disorder and may improve its perspective of treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Length of Admission Into Psychiatric Hospitals According to Diagnoses
Authors: Shoka A. , Lazzari C. , Gower Katherine 
Published: June 2017

IntroductionIn recent years, psychiatry in the United Kingdom has faced an important challenge due to the shortage of beds for patients with increased lengths of stay. Available resources have been saturated due to the reduced capability of psychiatric hospitals to provide spaces for patients needing access to psychiatric care.ObjectivesThis research provides a figure of length of stay linked to psychiatric pathology at discharge.AimTo establish the length of admission of psychiatric patients.MethodsThe sample comprised 137 discharges from a general adult psychiatric ward distributed over the first 8 months of 2016. Results were analyzed by descriptive statistics and meta-analysis.ResultsOverall, longer periods of admission were recorded for psychoses and shorter periods for adjustment disorders. Psychoses had a median length of admission of 28 days (range = 3–374); borderline personality disorders, 10 days (range = 1–249); mood disorders, 14 days (range = 2–74); drug addictions, 6 days (range = 1–222); and adjustment disorders, 5 days (range = 1–55). Meta-analysis (Fig. 1) provided a confidence interval estimate for the whole model of 24.314 days (95% CI = 13.00–35.621) with P < .001. Meta-analysis results also provided t2 = 101.061, Cochrane's Q (df = 4) = 14.327, I2 = 72.081, with P = .006.ConclusionsPsychoses are conditions that require longer admissions, whereas adjustment disorders are more transient pathologies. Borderline personality disorder is somewhat of a hybrid condition. Overall, patients remain in hospital for about a month (24 days).Disclosure of interestThe authors have not supplied their declaration of competing interest.
Quality of Life and Anxious-depressive Symptoms in Cancer Patients Undergoing Mindfulness-based Interventions: Feasibility and Preliminary Outcomes on Prospective Single-centre Case-control Study (MIND4ME St.)
Authors: Pontoni G. , Maur M. , Ferrari R. , Guida A. , Poletti S. , Caggia F. , Fontana A. , Gavioli F. , Tarantino V. , Cascinu S. , Ferrari S. 
Published: June 2017

BackgroundMindfulness based interventions (MBIs) have shown efficacy in improving psychological symptoms including depression and anxiety in cancer patients (pts). The study aimed to explore feasibility and reproducibility of MBIs in an Italian Cancer Centre measuring biochemical and psychological parameters.MethodsIn this pilot prospective case-control study, we recruited newly diagnosed pts receiving adjuvant chemotherapy (CT). A MBIs program was designed consisting of 2.5 hours weekly for 8 weeks and, including meditation, yoga and body scan. Material for 45 minutes (mn) home daily practice was provided. Primary endpoint was to evaluate feasibility. Secondary endpoints were assessment of quality of life (QoL), psychological and biochemical outcomes of stress, tested at baseline (W0), W4, W8, W24, W48. PSS (Perceived Stress Reduction), POMS (profile of mood states scores), EuroQoL (EQ-5D-3L) were administered.ResultsTen pts underwent MBIs program arm. We present preliminary results, while data of control arm are being collected. All pts were female, two pts (20%) dropped out. Median age was 56 years. All received adjuvant CT, 5/8 received radiotherapy and hormone therapy. Mean of sessions attending was 6.8 (76%). Median daily practice was 30 mn. EQ-5D item for depression and anxiety showed decreasing trend in mean score from moderate to light (P = 0.15) and significant improvement of auto-perceived QoL was observed comparing W0 and W8 (P = 0.02)ConclusionsIn a sensitive setting such as start CT, we found high pts compliance to MBIs. Improvement in self-perceived QoL after starting program was found and comparing anxious-depressive symptoms outcomes with control arm is still needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.