bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric Vulnerability in Adults with Intellectual Disability and Autism: A Literature Review
Authors: Coli S. , Scuticchio D. , Bertelli M. 
Published: June 2017

IntroductionAdults with Intellectual disability (ID) and Autism Spectrum Disorder (ASD) are more vulnerable to mental health problems than the general population.Objectives/aimsThis study investigates presence and rate of psychiatric disorders in comparison with ID or ASD alone, and appropriateness of assessment and diagnostic procedures or tools.MethodsA systematic mapping of the literature was carried out on the basis of the above mentioned issues. The search was conducted using PubMed and ScienceDirect, according to the following keywords: psychiatric comorbidity, psychiatric disorders, autism, ASD, intellectual disability, mental health problems, adults, assessment tools, diagnosis. Twenty-eight papers were selected for pertinence to mapping issues among more than 500.ResultsMany studies show that ASD is an important vulnerability factor for psychiatric co-morbidity and for challenging behaviors (CBs) in adults with ID. Highest rates were reported for psychotic, mood, anxiety, and obsessive-compulsive disorders. Few studies show that the difference between adults with ID plus ASD and adults with only ID are not statistically significant, but for the presence of CBs in those with ID plus ASD. The disagreement of results is based on a variety of factors such as diagnostic over-shadowing, scarcity of specific assessment tools, consideration of the introspective and communication difficulties, incompleteness of medical records, and low reliability of information sources.ConclusionsAlthough low studies concordance, the literature mapping suggests the presence of ASD in ID to be associated with higher rates of psychopathology. Since the relevant implications for prevention and clinical management, further research with high-level evidence is hoped.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Mirtazapine and Trazodone Efficacy on Major Depressive Disorder (MDD) is Moderated by Patients’ Age and Sex: A Randomized, Controlled Trial
Authors: Vilibić M. , Šurina Osmak Ž. , Tomljenović M. , Kolarić B. , Jukić V. 
Published: June 2017

IntroductionNaSSA antidepressant mirtazapine and SARI trazodone has proven efficacy on MDD.AimTo compare differences in mirtazapine and trazodone efficacy on MDD in different age and sex groups.MethodsA consecutive sample of 60 MDD outpatients were randomized to mirtazapine 30 mg/day or trazodone 150 mg/day for a 3 months stable dosing period at the department of biological psychiatry and psychogeriatrics of the university psychiatric hospital Vrapče, Croatia. Outcome was relative lowering of HAMD-17 scale result. The study was single blind: rater was blinded, while patients informed regarding prescribed medication.ResultsOverall efficacy of mirtazapine and trazodone was comparable (84% lowering of HAMD–17 in both cases; difference P = 0.754). After adjustment for MDD baseline severity (CGI–S), education, marital and working status, interaction of age and sex significantly moderated two drugs’ efficacies. In patients older than 47 years, in male patients trazodone was significantly more effective, and in female patients significantly less effective than mirtazapine. This effect was increasing by aging.ConclusionMirtazapine and trazodone efficacy on MDD is moderated by patients’ age and sex.
The Dopaminergic Polymorphisms in Psychomotor Retardation of Depression: A Pathway-based Imaging Genetics Association Study
Authors: Yin Y. , Yuan Y. 
Published: June 2017

IntroductionSeveral lines of evidence implicate dopamine is involved in the psychomotor retardation (PMR) in major depressive disorder (MDD). Besides, abnormal cerebral blood flow (CBF) of PMR was also found in the cortico-basal ganglia-thalamo-cortical (CBTC) circuitry. We hypothesize that the polymorphisms of the dopaminergic pathway should be associated the abnormal CBF in the CBTC circuitry.ObjectiveTo investigate the association of the polymorphisms throughout the dopaminergic pathway with the cerebral blood flow (CBF) of PMR in MDD.MethodsThe blood sample of 63 patients (23 PMR, 40 NPMR) were collected for genotyping the dopaminergic polymorphisms (92 SNPs from10 genes). After quality controlling, 15 SNPs in 8 candidate genes were entered into the mass univariate modeling analysis. For the statistical analysis, patients with unqualified fMRI image and unmatched demographic data were ruled out. Consequently 56 patients (23 PMR, 33 NPMR) were taken into the statistical analysis.ResultsGenotype-by PMR associations with the CBF differences predominately distributed in bilateral prefrontal cortex (PFC), temporal cortex, and striatum, the left thalamus, the right primary motor cortex, insular cortex, fusiform gyri, and lingual gyri. There were significant negative correlation between the CBF of the PFC and the PMR severity. However, the CBF of the striatum and the thalamus were positively correlated with the PMR severity.ConclusionsThe polymorphisms of dopaminergic pathway are associated with not only CSTC circuitry, but also some other brain regions involving in cognition and emotion controlling. While the increased CBF of PFC might suppress PMR, the increased CBF of striatum and thalamus adversely aggravate PMR.
“Tell Me More and Help Me to Decide, Doctor” – Information Seeking Attitudes and Use of Information Resources in Patients with Depression
Authors: Almeida H. , Almeida A.M. Pisco , Figueiredo-Braga M. 
Published: June 2017

IntroductionShared decision-making (SDM) has shown to improve adherence, decrease hospitalization, and enhance knowledge of the illness and satisfaction with mental health services. Eliciting each patient's preferences for information allows tailoring the physician behavior according perspectives and expectations. Patients with depression (PWD) have frequently limited information regarding the availability and efficacy of psychiatric treatments.Aims/objectivesUnveil information seeking attitudes of patients with depression and their a priori use of digital sources of information.MethodsA convenience sample of PWD was submitted to a battery of self-report questionnaires. Standardized instruments were used to measure information seeking attitudes and the accessibility and usage of digital information resources.ResultsThirty-six patients were inquired, with a mean age of 39.8 (13.4) years. Information-seeking preferences were high, with an API-I score of 90.1 (13.8). Preferences for information-seeking behaviors were higher in severely depressed (P = 0.010) and less educated (P = 0.026) patients. Preferences were negatively correlated with length of psychiatric treatment (r = −0.514; P = 0.002). Sixty-one percent had a priori information regarding their psychiatric problem, and 68.8% considered it was influential in the decision-making behavior. Access and use of digital resources were correlated with education level (0.644; P = 0.000 and 0.554; P = 0.003), age (−0.357; P = 0.001 and −0.559; P = 0.007) and illness severity (−0.431; P = 0.04).ConclusionPatients with depression want to be informed about their mental condition and treatment options. Few resources are used and decision mostly relies on health professional's opinion and guidance. Accessible resources seem scarce and future research shall address the acceptance and impact of decisional-aid instruments on this population.
Psychiatric Disorders in Adults with Intellectual Disabilities: A Preliminary Study of Prevalence and Associated Factors
Authors: Görmez A. , İsmet K. 
Published: June 2017

IntroductionStudies have shown that people with Intellectual Disabilities (ID) develop mental illness at rates similar to or higher than general population1.ObjectivesThere is no previous study on mental health of adults with ID in Turkey.AimThe purpose of this study was to investigate the prevalence and associated factors of mental disorders in adults with ID in Turkey.Methods151 participants with ID aged 18 and over were recruited from care homes, rehabilitation centers and from people attending to psychiatry outpatients for the first time. Every participant underwent face to face assessment by a psychiatrist supported by an informant and previous notes. A structured purpose designed socio-demographic form was used. Diagnoses were drawn according to DSM-5. Point prevalence of disorders was calculated and associated factors were investigated.Results63.5% of the participants met criteria for one psychiatric disorder, 21% had more than one disorder. The most common disorders were: challenging behavior (34%), autism spectrum disorders (%13.9), and anxiety disorders (13.9%) and attention deficit hyperactivity disorder (10.6%). Living in a care home and being young were associated with mental ill health (P < 0.05) [1].ConclusionThis study demonstrates high psychiatric comorbidity in adults with ID. Young age and care homes were the associated factors in this sample. These results are important to raise awareness of professionals and service providers about mental health of adults with ID.Disclosure of interestThis project was funded by the Scientific and Technological Research Council of Turkey (TUBITAK) with a project number of BİDEB 115C015. The funding body did not have any involvement with data collection, analysis or writing up.
An Online Survey of the Stigma Attached to Psychiatry and Psychiatrists in India
Authors: Jadhav P. , Dhandapani A. , Hatti S. , Armugam S. , Chaturvedi S. 
Published: June 2017

IntroductionStigma in psychiatry is pervasive, it does not stop at illness and marks all those who are ill, their families across generations, institutions that provide treatment, psychotropics’, and mental health professionals. Stigma directed towards psychiatry as a branch & psychiatrists in particular has not been systematically studied in the Indian context.ObjectivesTo study the Indian psychiatrists perspective of stigma directed towards psychiatry & psychiatrists.MethodsAn online survey containing “The World Psychiatric Association Stigma Questionnaire” was sent to the members of the Indian Psychiatric Society. Two hundred and three Indian psychiatrists filled out the questionnaire which assesses the stigmatization of psychiatry and psychiatrist as perceived by the psychiatrists themselves.ResultsOne hundred and thirty-two psychiatrists completed the survey with a completion rate of 65%, 75% of the respondents were male and most of their clientele was from urban catchment area. Sixty percent of the psychiatrists were either working in a psychiatry hospital or a psychiatry unit in a general hospital setting. More than a third had high-perceived stigma but had a very low stereotype agreement. Discrimination experiences were noted by more than 75% of psychiatrists, however less than 8% had a negative stigma outcome.ConclusionsThough most of the Indian psychiatrists perceive themselves as being stigmatized, the stereotype agreement was found to be low and the discrimination experiences did not have significant impact on job performance. Though this might reflect resilience, we must attempt to improve the image of psychiatry and strive towards achieving a larger public acceptance of mental health services in India.
Perceptions of Residents and Non-residents in Psychiatry on Training Needs and Care of Patients with Intellectual Disability and Mental Health Problems: A Study from Singapore
Authors: Sajith S. , Wong W. , Chiu J. , Chiam P.C. 
Published: June 2017

Background and ObjectivePsychiatric assessment and care of people with Intellectual Disability (ID) is complex due to their cognitive and communication impairments. Demand for further training in this area by trainees in psychiatry has been well documented. The main of aims of this study were to explore the attitudes and perceptions of psychiatry residents and non-residents (non-trainees) with regards to care of patients with ID as well as their knowledge and training in this area.MethodThe study was conducted as an anonymous survey at the Institute of Mental Health, Singapore. A survey questionnaire developed by the study team was sent to residents and non-residents in psychiatry.ResultsForty-eight out of the 76 questionnaires were returned with a response rate of 63.16%. Twenty-eight participants described themselves as non-residents and the rest were residents. All participants responded that postgraduate training was required in the area of ID and mental health and majority reported that available training was inadequate. Ninety percent of respondents believed that people with ID were vulnerable to exploitation by other patients in the inpatient unit and 94% of respondents believed that people with ID should be managed by a specialist team.ConclusionCurrently residents and non-residents in psychiatry see that training in ID and mental health as well as services for people with ID as inadequate. Efforts should be made to include specialist training in psychiatry of ID in the Singapore psychiatry curriculum to enhance the confidence and expertise of psychiatrists in this field.
Spatio-temporal Perception and Boundaries of Self: Evaluation of Peripersonal Space in Schizotypy Traits
Authors: Di Cosmo G. , Fiori F. , Ferri F. , Salone A. , Corbo M. , Costantini M. , Martinotti G. , di Giannantonio M. , Marzetti L. 
Published: June 2017

IntroductionThe peripersonal space is described as that area within the boundary between self and non-self. An accurate judgment of peripersonal space boundaries may depend on the capacity to create an organized and structured mental representation that integrates signals from different sensory modalities and brain regions. Empirical evidence suggests that these functions are altered in schizotypy, which is thought to reflect the subclinical expression of the symptoms of schizophrenia in the general population. A number of clinical studies reported that interpersonal interaction and social stimulation have an impact on the onset and progress of schizophrenia.ObjectivesWe conducted a study on personal space in a sample of student screened for schizotypal traits using a paradigm that was not affected by emotional and social interference.AimsThe aim was to evaluate the relationship between personal space and schizotypy traits.MethodsThirty-four subject recruited for the study completed the Schizotypal Personality Questionnaire (SPQ). According to the SPQ results participants were splitted into two groups (High, Low). Each participant performed a PeriPersonal Space (PPS) task.ResultsOur results show a more extended boundary of the peripersonal space in people with high schizotypy compared to people with low schizotypy even without emotional and social interference.ConclusionsPeople with high traits of schizotypy suffer from a difficulty in social integration because of being unable to adapt the social behavior. A better understanding of the mechanisms for abnormal interactive behavior could provide significant valid guidelines for innovating insertion programs that aims to improve social functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Predictive factors of hospitalization related to the caregiver burden in older adults presenting to the emergency department
Authors: Mattei G. , Goldoni I. , Mariani F. , Casu G. , Boccaletti L. , Ferrari S. , Ligabue L. , Colantoni A. 
Published: June 2017

BackgroundLong-term care for the elderly by their family members represents a serious burden in Italy. The physical and psychological health of informal caregivers is a growing public health issue. Old patients often seek urgent medical attention in the Emergency Department (ED) and hospitalisation is frequent event among the elderly.AimAim of the study was (1) to investigate the burden of care among the caregivers of old patients; (2) to examine the influence of the burden experienced by the caregivers on ED and hospital admissions of the elderly.MethodsWe conducted a descriptive study of patients aged 75 years or older and their caregiver admitted to the ED from 10/1/15 to 6/10/15 (77 patient-caregiver pairs). The caregivers were evaluated using the Caregiver Burden Inventory (CBI). A case manager collected the patient's data.ResultsCBI score is the highest among patients seeking ED evaluation due to caregiver's concern. The majority of the elderly admitted to the ED whose caregiver shows elevated emotional burden at the CBI do not present with serious or urgent medical condition and are not hospitalised. Emotional burden is the highest among the caregivers of demented subjects who share the same house.ConclusionOur findings indicate that the burden experienced by caregiving family members plays a role in elderly people avoidable ED visits.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Risk Factors of Increased Mortality During Hospitalization in Acutely-ill Elderly Patients with Altered State of Consciousness
Authors: Sá Esteves P. , Loureiro D. , Albuquerque E. , Vieira F. , Lagarto L. , Neves S. , Cerejeira J. 
Published: June 2017

IntroductionA significant proportion of acutely ill hospitalised elderly patients have impaired consciousness and this has been associated with increased mortality. It remains unclear which factors underlie this relation. Identification of mortality predictors in this population is important to improve care.ObjectivesDetermine if advanced age, cognitive impairment, high burden of comorbidities and poor functional status are predictors of increased mortality during hospitalisation in acutely-ill medical hospitalised elderly patients with altered state of consciousness.MethodsAll male patients (> 65 years) admitted to a medical ward (> 48 h) between 01/03/2015 to 31/08/2015 with delirium or RASS lower than–2 were included in the study. Patients were excluded if unable to be assessed due to sensorial deficits, communication problems or medical condition precluding the evaluation. Baseline evaluation included socio-demographic variables, RASS, CAM, IQCODE-SF, DSM-IV-TR criteria for dementia, Charlson Comorbidity Index and Barthel Index. The variables were entered in a logistic regression model (significance level < 0.05).ResultsThe final sample consisted of 75 male subjects with altered state of consciousness, 14 of them died during hospitalisation. Dementia and Barthel Index were significantly associated with mortality during hospitalisation (P = 0.01 and P < 0.01, respectively). On the other hand, age and Charlson Co-morbidity Index were not associated significantly with mortality during hospitalisation (P = 0.22 and P = 0.1, respectively).ConclusionsAcutely ill elderly patients with altered state of consciousness at admission have higher risk of death during hospitalisation if they have prior dementia or poor functional status. Health care should be improved to provide better response to this type of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Efficacy of rivastigmine on loss of appetite in patients with Alzheimer's disease
Authors: Tsuno N. , Mori T. , Nakamura Y. 
Published: June 2017

IntroductionIt has been said that nearly 30% of the patients with Alzheimer’ disease (AD) manifest loss of appetite, which might increase cognitive impairments and the incidence of neuropsychiatric symptoms, and malnutrition. As a result, a vicious cycle decreases functionality and quality of life in patients with AD. Cholinesterase inhibitors (ChEIs) is the first-line drugs in the treatment of AD. On the one hand, appetite or weight loss can be seen due to gastrointestinal side effects in the treatment of ChEIs. On the other hand, there are some reports in clinical-settings that patients with AD treated with rivastigmine transdermal patch showed the improvement of appetite loss.ObjectivesTo evaluate the efficacy of rivastigmine transdermal patch in AD patients with poor appetite.MethodsIn this 16-weeks, multicenter prospective study, patients with mild to moderate AD, who manifest loss of appetite and began to receive rivastigmine transdermal patch therapy, were enrolled. The amount of food, total time-eating, body weight, Mini Mental State Examination (MMSE) and Neuropsychiatric Inventory (NPI) were evaluated.ResultsThe amount of food eaten by treated patients significantly increased 10.5% at 8 weeks after the initiation of rivastigmine transdermal patch therapy.CommentsThis preliminary results might show favourable effects of rivastigmine transdermal patch therapy on AD patients with loss of appetite.Disclosure of interestStudy supported by Ono pharmaceutical co.
Icehearts: Sport-based early support program for children at risk
Authors: Appelqvist-Schmidlechner K. , Wessman J. , Kekkonen M. 
Published: June 2017

Icehearts program aims to prevent social exclusion, to promote socio-emotional skills and mental well-being and to provide a secure, long-term adult commitment throughout the child's life using team sport as a tool. The program is facilitated by an Icehearts-mentor providing sports activities as well as support at school and home for a period of 12 years starting at age of 7. Currently, the program is reaching about 500 children in 29 Icehearts teams in Finland. The longitudinal study aims at investigating: (1) the psychosocial well-being and (2) the life course of participating children as well as perceived impact, benefits and challenges of the program. The baseline data was gathered in 2015–2016 by questionnaires and interviews among 7 years old program participants (n = 46) and controls at same age not participating in the program (n = 180), their parents, and teachers. The measures included i.e the Strengths and Difficulties Questionnaire (SDQ). According to the SDQ-scores assessed by the teachers, two of third among program participants had behavioural difficulties. One-fourth had used mental health services. The parents of program participants reported need for more support for their parenting. The results showed that the Icehearts program is reaching out a target group in need for help and support. Further, the study provides valuable information about the role of a NGO organisation offering long-term and intensive support with the help of sport-based intervention program targeted at vulnerable children. In the presentation, the program, study design and the baseline results are presented in more detail.Disclosure of interestThe authors have not supplied their declaration of competing interest.