bluuebunny/crossref_metadata_2025_split huggingface dataset:
Educational level influenced the gold standard diagnosis of late-life depression in the GreatAGE study
Authors: Lozupone M. , Veneziani F. , Lofano L. , Galizia I. , Stella E. , Copetti M. , Arcuti S. , Leo A. , Sardone R. , Grasso A. , Tursi M. , Barulli M.R. , Tortelli R. , Capozzo R. , Panza F. , Seripa D. , Bonfiglio C. , Osella A.R. , Logroscino G. 
Published: June 2017

IntroductionThe validity of the 30-item Geriatric Depression Scale (GDS-30) in detecting late-life depression (LLD) requires a certain level of cognitive functioning. Further research is needed in population-based setting on other socio-demographic and cognitive variables that could potentially influence the accuracy of clinician rated depression.ObjectiveTo compare the diagnostic accuracy of two instruments used to assess depressive disorders [(GDS-30) and the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID)] among three groups with different levels of cognitive functioning (normal, Mild Cognitive Impairment – MCI, Subjective Memory Complain – SMC) in a random sampling of the general population 65+ years.MethodsThe sample, collected in a population-based study (GreatAGE Study) among the older residents of Castellana Grotte, South-East Italy, included 844 subjects (54.50% males). A standardized neuropsychological battery was used to assess MCI, SMC and depressive symptoms (GDS-30). Depressive syndromes were diagnosed through the SCID IV-TR. Socio-demographic and cognitive variables were taken into account in influencing SCID performance.ResultsAccording to the SCID, the rate of depressive disorders was 12.56%. At the optimal cut-off score (≥ 4), GDS-30 had 65.1% sensitivity and 68.4% specificity in diagnosing depressive symptoms. Using a more conservative cut-off (≥ 10), the GDS-30 specificity reached 91.1% while sensitivity dropped to 37,7%. The three cognitive subgroups did not differ in the rate of depression diagnosis. Educational level is the only variable associated to the SCID diagnostic performance (P = 0.015).ConclusionsAt the optimal cut-off, GDS-30 identified lower levels of screening accuracy for subjects with normal cognition rather than for SMC (AUC 0.792 vs. 0.692); educational attainment possibly may modulate diagnostic clinician performance.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychotropic Use in Elderly with Cognitive Impairment Living in Nursing Homes
Authors: Ferreira A.R. , Martins S. , Dias C. , Simões M.R. , Fernandes L. 
Published: June 2017

IntroductionElderly patients in nursing homes (NH) are often prescribed medications for many physical and mental health problems, with polypharmacy. There is a considerable number of studies documenting this extensive prescription of psychotropic medication, despite the raised concerns about their overuse/misuse, due to serious adverse effects, including increased rate of cognitive decline associated with antipsychotics.AimsTo characterize the prescription of psychotropics in elderly sample with cognitive impairment living in NH.MethodsElderly living in three Portuguese NH were included in this cross-sectional study. All residents were eligible, unless they were unwilling or unresponsive. Participants’ medication was obtained from medical records. Guidelines of ATC were used to categorize the drugs. Participants were assessed with MMSE and GDS.ResultsThe sample included 172 elderly, mostly women (90%), with average of 81(sd = 10) years and median lengths of stay of 3 years. Overall, 79.1% used ≥ 1 nervous system-acting drugs. Anxiolytics (54.7%), antidepressants (29.1%) and antipsychotics (23.3%) were the most frequent. The majority (58%) presented cognitive impairment (MMSE). Among those, 46.2% presented depression (GDS) and 79.6% took at least one drug for the CNS and 41.9% ≥ 3. Antipsychotics were received by 26.5%, while 57.1% used anxiolytics, 31.6% antidepressants and 16.3% anti-dementia drugs. No significant relation between GDS and antidepressants was found.ConclusionThis study confirms the high usage of CNS drugs in patients with cognitive impairment in NH. These rates were comparable with previous studies. Antidepressants appear to be under-used, which can be related to the under-recognition of depression. Also, potential harmful psychotropic drugs such as anxiolytics and antipsychotics are overused.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The role of cognitive insight in reduction of positive symptoms in youth with ultra-high risk for psychosis
Authors: Rasskazova E. , Omel’chenko M. , Kaleda V. 
Published: June 2017

IntroductionCognitive insight was shown to be impaired in schizophrenia while its high level predicts improvement of psychotic symptoms. However, later studies demonstrated that in other mental disorders and healthy subjects cognitive insight might play ambiguous role being related to anxiety and lack of self-confidence.ObjectivesDevelopment of clinical criteria for high and ultra-high risk for psychosis allows to study the role of cognitive insight in these patients.AimsThe aim was to examine the role of cognitive insight in different clinical groups of youth with ultra-high risk for psychosis.MethodsSeventy-six male patients 16–25 years old with non-psychotic mental disorders (with preliminary diagnoses of mood disorders – 30, personality disorders – 25, schizotypal disorder – 21 patients) meeting criteria of ultra-high risk for psychosis and 55 healthy male controls filled Beck Cognitive Insight Scale, Symptom Checklist 90-R. The Scale of Prodromal Symptoms was used twice upon hospitalization and after 1-month period.ResultsModeration analysis reveals that in patients with preliminary diagnoses of mood disorders and schizotypal disorder cognitive insight is related to higher anxiety and obsessiveness and to poorer improvement on SOPS and positive symptoms. In patients with symptoms of personality disorders, it predicts better symptoms improvement.ConclusionsResults demonstrate importance of differentiation of the functions of cognitive insight in different patients with ultra-high risk for psychosis both in clinical psychological assessments and CBT.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The split version of Global Assessment of Functioning scale – application and utility in remitted psychotic patients
Authors: Andric S. , Mihaljevic M. , Mirjanic T. , Maric N. 
Published: June 2017

IntroductionCurrent knowledge about the advantages of using split version of GAF scale – having separate Symptom (GAF-S) and Functioning (GAF-F) subscales is insufficient and has number of gaps. Present study analyzed the manner in which young adult remitted psychotic patients with different functional levels vary in their symptom severity and how GAF-F reflects presence/absence of well-known psychosis risk factors.MethodsSample comprised 37 remitted psychotic patients (56.8% male, 29.4 ± 6.1 years), categorized based on GAF-F scores into groups: ‘Moderate remission’ (GAF-F 41–60, n = 19) and “Good remission” (GAF-F > 61, n = 18). Participants were assessed using the GAF-S, WAIS-R, Nottingham Onset Schedule, Premorbid Adjustment and Brief Core Schema scales, childhood trauma and bullying questionnaires. Mann–Whitney and Student's t-tests were used to assess between-group differences.ResultsGroups did not differ in age, sex and education. When compared to “Good remission” group, “Moderate remission” group exhibited earlier illness’ onset (P = 0.01), greater symptom severity (P = 0.00), negative self-evaluation (P = 0.02), more childhood physical abuse (P = 0.01) and bullying (P = 0.01). Moreover, trend-like significances (P = 0.08) were observed for poorer adolescence adjustment and negative evaluation of others. There were no between-group differences regarding IQ and duration of untreated/treated illness.ConclusionsGAF scale is in the continual use since early 1990, however, evidence of further development of the instrument itself is sparse. Present research is demonstrating that GAF-F scores reflect diverse factors related to psychosis risk, the illness’ course and quality of remission. Moreover, the results contribute to surmount some of the gaps in knowledge about the split version of GAF scale.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neurocognitive status in different stages of psychosis: Changes from the first episode psychosis to remission
Authors: Bošnjak D. , Makarić P. , Kekin I. , Sabo T. , Živković M. , Savić A. , Silić A. , Čulo I. , Ostojić D. , Jukić V. , Rojnić Kuzman M. 
Published: June 2017

IntroductionNeurocognitive impairment in schizophrenia is associated with functional disability and poorer quality of life, and is the most resistant of all schizophrenia symptoms to current psychopharmacotherapy.ObjectivesTo compare the differences in neurocognitive status during the acute phase of first psychotic episode and stable symptomatic remission.AimsTo investigate the pattern of neurocognitive impairment in patients with first episode psychosis during acute phase and stable remission phase.MethodsWe performed a longitudinal study, including 150 patients with first episode of psychosis at two time points: during their hospitalization at Zagreb university hospital centre or university psychiatric hospital Vrapče, at acute phase of illness and after 12–18 months, during stable remission. Assessment included detailed clinical interview, clinical rating of neuropsychiatric symptoms using standardized psychiatric scales, self-assessment scales and comprehensive neurocognitive testing.ResultsWhile our preliminary results (n = 40) showed statistically significant improvement in various neurocognitive domains, including visuo-learning abilities, verbal learning, executive functions, attention and processing speed, initial impairment in semantic and phonetic fluency observed in acute psychosis remained unchanged in remission as well.ConclusionsAlthough our results showed improvement in most of cognitive domains during time, language abilities remained unchanged. This further confirms the hypothesis that language impairment is a trait marker of psychotic disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The relationship between theory of mind and social functioning within the schizophrenia spectrum
Authors: Bredicean C. , Papava I. , Giurgi-Oncu C. , Cristanovici M. , Popescu A. , Tuculanu O. 
Published: June 2017

IntroductionCurrent research shows that subjects with disorders belonging to the schizophrenia spectrum have a poor social functioning. There are several factors that can influence social functioning, social cognition being one of them.ObjectivesAssessing the ability to identify emotions and its role in the social functioning of subjects with a schizophrenia spectrum diagnosis.PurposeIncreasing the social functioning of subjects with a schizophrenia spectrum diagnosis.MethodWe evaluated 31 subjects who were at their first admission to the Timisoara psychiatric clinic and who met the diagnostic criteria for a schizophrenia spectrum disorder (a diagnosis of F20, F22 or F25 according to ICD 10). The following parameters were monitored: sociodemographic (gender, age of onset, educational level, marital and professional status), theory of mind (Reading the Mind in the Eyes Test) and social functioning (GAF Scale). The subjects were evaluated during periods of remission. The acquired data was statistically processed.ResultsThe results of the sociodemographic parameters analysis were similar to those in international literature. Most subjects showed a lack of theory of mind (a mean score of 18, standard deviation 5.84). All subjects experienced a decrease in social functioning (a mean score of 64.7 on the GAF Scale). There is a direct correlation between the ability to identify emotions and social functioning (Spearman R = 0.386, P < 0.05).ConclusionsA decreased ability to identify emotions is directly correlated with decreased social functioning in subjects with schizophrenia spectrum disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Patients with severe schizophrenia. functioning improvement after 7-year of comprehensive treatment
Authors: Fernandez-Miranda J.J. , Díaz-Fernández S. , Frías-Ortiz D.F. 
Published: June 2017

IntroductionTo reach not only clinical but also rehabilitation (especially to improve psychosocial functioning) goals in people with schizophrenia is a need.ObjectiveTo know the retention in treatment and functional outcomes of patients with severe schizophrenia enrolled in a specific and comprehensive programme for 7 years.MethodA 7-year prospective, observational study of patients with severe schizophrenia (CGI-S of 5 or over) undergoing comprehensive programme (n = 200). Assessment included at the beginning and after 3, 6, 12, 24, 36 and 84 months: the CGI-S, the Camberwell Assessment of Needs (CAN) and the WHO-DAS. Time in treatment, reasons for discharge, laboratory tests, weight, medications, adverse effects and hospital admissions in the previous six years and during the follow-up were registered.ResultsCGI at baseline was 5.9 (0.7). After seven years, 44% of patients continued under treatment (CGI = 4.3 (0.8); P < 0.01); 36% were medical discharged (CGI = 3.4 (1.5); P < 0.001); WHO-DAS decreased in the four areas (P < 0.005) and also CAN (P < 0.01); 8% were voluntary discharges. Ten patients dead; three of them committed suicide (1.5%). Hospital admission decreased significantly (P < 0.001), and also antipsychotic combinations and antiparkinsonian medications. Fifty-five percent of all of them were treated with atypical long-acting antipsychotics, with good tolerability and few side effects (among them, only 4% were voluntary discharges).ConclusionRetention of patients with schizophrenia with severe symptoms and impairment in a specific and comprehensive programme was really high. Such good treatment adherence helped to get remarkable clinical and functional improvement. Long-acting medication seemed to be useful in improving treatment adherence.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Comorbidities in Patients with an At-risk Mental State and First Episode Psychosis
Authors: Heitz U. , Cherbuin J. , Menghini-Müller S. , Egloff L. , Ittig S. , Beck K. , Andreou C. , Studerus E. , Riecher-Rössler A. 
Published: June 2017

IntroductionNon-psychotic axis I diagnoses are highly prevalent in at-risk mental state (ARMS) and first episode psychosis (FEP) patients, the most common being affective and anxiety disorders. Few studies have examined differences between ARMS and FEP patients or gender effects regarding such diagnoses.ObjectiveTo examine current and lifetime comorbidities in ARMS and FEP patients. Furthermore, to examine gender differences, and differences between patients with (ARMS-T) and without later transition to psychosis (ARMS-NT).MethodsThis study was part of the Früherkennung von Psychosen (FePsy) study. Current and lifetime axis I comorbidities were assessed using the Structured Clinical Interview for DSM-IV (SCID-I).ResultsOne hundred and thirty-two ARMS and 98 FEP patients were included. Current comorbidities were present in 53.1% of FEP and 64.4% of ARMS patients, the most common being affective, anxiety and substance use disorders. Current affective disorders were significantly more common in ARMS than FEP. Lifetime comorbidities were diagnosed in 58.2% of FEP and 69.7% of ARMS patients, with significantly more affective and anxiety disorders in ARMS than FEP. Male FEP patients had more current and lifetime substance use disorders (across all substances) compared to female FEP. No differences emerged between ARMS-T and ARMS-NT.ConclusionsAs expected ARMS patients have many comorbidities, while clearly diagnosed FEP have less comorbidities. There were few gender differences in axis I comorbidities. Moreover, no differences between ARMS-T and NT emerged, suggesting that axis I comorbidities do not improve prediction of transition. Nevertheless, the high comorbidity prevalence is relevant for global functioning and clinical treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Clinical Features and Diagnosis of Alcoholic Hallucinosis
Authors: De Uribe-viloria N. , Alonso Sanchez A. , De Lorenzo Calzon M. , Gomez Garcia M. , Alvarez Astorga A. , Red Gallego H. De La , Hernandez Anton R. , Gomez Sanchez S. , Noval Canga C. , Medina Ojeda G. , Ladron De Cegama F. De Uribe 
Published: June 2017

IntroductionAlcoholic hallucinosis is a rare complication of chronic alcohol abuse, characterized by acoustic verbal hallucinations and delusions, mainly of a menacing content, arising in clear consciousness, that appear during or shortly after a period of heavy alcohol consumption.Objectives and aimsTo outline the key clinical features of alcoholic hallucinosis in order to improve differential diagnosis with other entities.MethodsWe studied the evolution of an outpatient followed in a Mental Health Centre of Valladolid and compared it with present data about the condition, found in a bibliographic search of articles no older than 10 years about the topic.ResultsPartial insight about the experience, along with clear consciousness, was key to discard other psychiatric diagnosis that also present acoustic hallucinations. Neuroimagining and functional tests in our patient showed moderate cognitive impairment and cortical atrophy, which contradicts other studies which claim that an acceptable level of cognition must be present in order to gain the necessary insight to meet the diagnostic criteria.ConclusionsAlcoholic hallucinosis is a rare form of subacute encephalopathy, secondary to an abrupt stop in a previously chronic and heavy alcohol consumption. Its diagnosis is mainly clinical, and neuroleptics are the most used drug, being abstinence essential for an adequate evolution. The course is usually benign, although the acoustic phenomena may not disappear completely.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Ethics in Transcultural Psychiatry
Authors: Schouler-Ocak M. 
Published: June 2017

Global migration and the increasing number of minority groups, including immigrants, asylum seekers, refugees and ethnic minorities, mean that increasingly, psychiatrists and patients may come from different cultural backgrounds. Therefore, cultural differences between patients and clinicians have become a matter of growing importance to mental health care as western societies have become increasingly diverse. This talk will attempt to illustrate how attention to these cultural differences enriches the discussion of ethics in mental health care. This talk will also attempt to underline that cultural competence is able to enhance the ethical treatment of mental health of patients from different cultural backgrounds. Consequently, to be culturally competent, a clinician must be sensitive, knowledgeable, and empathetic about cultural differences. Therefore, cultural competence is a concrete, practical expression of bioethics ideals. According to Hoop et al. in 2008, it is a practical, concrete demonstration of the ethical principles of respect for persons, beneficence (doing good), nonmaleficence (not doing harm), and justice (treating people fairly), the cornerstones of ethical codes for the health professions.In this talk the complex relationship between culture, values, and ethics in mental health care will be analyzed and discussed.Disclosure of interestThe author declares that he has no competing interest.
Early and Late Onset Bipolar Disorders in Older Adults
Authors: Smaoui N. , Zouari L. , Charfi N. , Maâlej-Bouali M. , Zouari N. , Thabet J. Ben , Maâlej M. 
Published: June 2017

IntroductionAge of onset of illness may be useful in explaining the heterogeneity among older bipolar patients.ObjectiveTo examine the relationship of age of onset with clinical, demographic and behavioral variables, in older patients with bipolar disorder.MethodsThis was a cross-sectional, descriptive and analytical study, including 24 patients suffering from bipolar disorders, aged 65 years or more and followed-up in outpatient psychiatry unit at Hedi Chaker university hospital in Sfax in Tunisia. We used a standardized questionnaire including socio-demographic, behavioral and clinical data. Age of onset was split at age 40 years into early-onset (< 40 years; n = 12) and late-onset (≥ 40 years; n = 12) groups.ResultsThe mean age for the entire sample was 68.95 years. The mean age of onset was 39.95 years. The majority (60%) of patients were diagnosed with bipolar I. Few meaningful differences emerged between early-onset and late-onset groups, except that tobacco use was significantly higher in the late-onset group (66.6% vs. 16.6%; P = 0.027). No significant differences between the early-onset and late-onset groups were seen on demographic variables, family history and number of medical diagnoses or presence of psychotic features.ConclusionOur study found few meaningful behavioral differences between early versus late age at onset in older adults with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cultural Variations in Bipolar Disorders in Non-clinical Samples
Authors: Aldos H. , Merey H. , Soliman A. 
Published: June 2017

IntroductionThe prevalence of bipolar disorder (BD) is continuously increasing worldwide. Based on pathophysiological prospective, BD is related to the change in neural circuitry involved in the regulation of emotion. Since there is a cultural variation in emotion expression, it is expected that BD is subject to cultural differences. The literature suggests that the prevalence of BD is influenced by gender, region and ethnicity.ObjectivesExploring the pervasiveness of BD in the Arab cultures.Aims – exploring the pervasiveness of BD in six different but related Arab cultures;– examining the gender differences in BD in the Arab cultural context.MethodsThis study used 327 freshmen university students (42% males and 58% females) from six different Arab universities and administered the Mood Disorder Questionnaire (MDQ). The validity and reliability of the MDQ was measured on 220 Qatari university students.ResultsThe results showed that BD was positively related to age and that males exhibited greater BD symptoms than females. The MDQ scores varied between the Arab subcultures. Sudanese subjects scored the highest on the MDQ, and therefore showed the highest numbers of BD characteristics, followed by Palestinians, Egyptians, Yemenis, Qataris, Jordanians and Tunisians. The Tunisians exhibited the lowest BD symptoms among six Arab cultures.ConclusionsThe findings suggested that it is arguable that BD is sensitive to cultural variations in the Arab world, with males showing a higher number of bipolar symptoms. It is arguable that BD is influenced by cultural openness and socioeconomic status.Disclosure of interestThe authors have not supplied their declaration of competing interest.