bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biochemical and genetic markers in patients with alcohol dependence and affective disorders and their correlation with alcohol intake
Authors: Preuss U. , Wurst F. 
Published: May 2016

Rates of comorbid affective disorders in alcohol-dependent individuals are significant. Biomarkers of alcohol use may support the diagnosis of high and frequent alcohol use in these individuals. The aim of these analyses of the WHO-ISBRA Study on State and Trait Markers of Alcohol Use and Dependence is to compare biomarkers of alcohol use across individuals with and without comorbid alcohol dependence and affective disorders. Significantly, higher values of these biomarkers are hypothesized in individuals with comorbid disorders compared to alcohol dependence only. Assessment of Alcohol dependence and comorbid depression and bipolar disorders were conducted using an adapted version of the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS). Altogether, n = 1863 individuals were included into the analyses, of whom n = 299 had a lifetime history of depression and n = 20 a bipolar disorder. Clinical characteristics like mean alcohol intake last month and biomarkers including ASAT, GGT, CDT, 5-HTOL/5-HIAA ratio and MAO-Activity were included into the analyses. Results indicate that AD only subjects had higher measures of all biomarkers compared to comorbid bipolar and depression subjects, while the latter had a higher alcohol intake during last month.Since this is a cross-sectional study, conducted in emergency rooms of several countries, this allegedly divergent result in alcohol intake in comorbid subjects compared to higher biomarkers in AD only subjects may indicate that drinking is more frequent in alcohol-dependent individuals while bipolar and depressed subjects may have more episodic pattern of alcohol intake. The latter may lead to shorter periods of intake compared to the chronic and frequent use of this substance in alcohol-dependent individuals and higher biomarkers of alcohol use.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Implementing the clinical standards of the National Institute for Health and Care Excellence (NICE) bipolar clinical guideline
Authors: Tremblay M. , Palin S. 
Published: May 2016

In the UK, the National Institute for Health and Care Excellence (NICE) sets standards for interventions to drive improvement in the quality of services delivered. The actual update of clinical guidelines remains patchy and difficult to ascertain.NICE most recent guideline on the management of bipolar disorder in adults will be reviewed. A concept tool to facilitate adherence to NICE clinical standards will be presented along with detailed outcomes of its pilot application in a naturalistic treatment setting, which drove the average concordance from 32% for a team providing treatment as usual, to 92% for a team supporting their practice with the tool. This presentation will also address additional impacts of its use including allowing drawing key clinical characteristics of an index population of individuals suffering from bipolar disorder, supporting education and auditing the actual service delivery.The usefulness of the tool to shape clinical practice according to NICE evidence-based standards will be outlined. Its versatility and limitations will be debated. The discussion of the findings will include epidemiological considerations as well as implications for mental and physical well-being.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Multi-morbidity: Psychosis early childhood adversity and substance use within homeless people
Authors: Krausz M. 
Published: May 2016

Homelessness is the most visible indicator for social marginalization and vulnerability. It is a risk factor for subsequent health threats and especially individuals with a history of trauma, substance use and severe persistent mental illness are at high risk to loose their homes, jobs and social networks.The Canadian At Home/Chez Soi study aimed to better understand the entanglement of homelessness and mental illness and possible strategies to provide care to the most vulnerable. In 5 Canadian centers, over 2000 patients were included and randomized to different intervention arms based on a housing first approach.Early trauma and foster care were as rampant as poly substance use, which explains a significant increase in mortality too.Disclosure of interestThe author has not supplied his declaration of competing interest.
The role of IgG hypersensitivity and changes in gut microbiota in the pathogenesis and therapy of depressive disorders
Authors: Karakula-Juchnowicz H. , Szachta P. , Juchnowicz D. , Grochowski S. , Gałęcka M. 
Published: May 2016

Depression is a complex, heterogeneous psychiatric disorder with multifactorial aetiology. Substantial evidence indicates that depressive episodes are associated not only with changes in neurotransmission in the central nervous system (CNS), but also may lead to structural changes in the brain through neuroendocrine, inflammatory, and immunological mechanisms. Among the factors deserving special attention connected with developing systematic inflammation are altered intestinal permeability, IgG food intolerance, and changes in gut microbiota.We present a possible scenario of the development of depression, linking elevated zonulin production, loosening of the tight junction barrier, an increase in permeability of the gut wall, and the passage of macromolecules, normally staying the gut, into the bloodstream, with the immuno-inflammatory cascade and induction of IgG-dependent food sensitivity. Alterations in bidirectional signaling between the gastrointestinal tract and the brain, so called “microbiota–gut–brain axis”, may be normalized by dietary immunomodulating factors, including prebiotics and probiotics. In the case of increased IgG concentrations, the implementation of an elimination–rotation diet may prove to be an effective method of reducing inflammation and, in this way, alleviating depressive symptoms.Given complexity and variety of mood disorders, it is necessary to develop improved integration models. Preliminary study results raise hope that the new methods mentioned above, i.e. psychobiotics, prebiotics, an elimination-rotation diet, may be an important addition to the psychiatrist's armamentarium as therapeutic agents improving the efficacy of the treatment for affective disorders [1–3].Disclosure of interestThe authors have not supplied their declaration of competing interest.
Treatment of schizophrenia using tablet and smartphone based applications (Polish Study)
Authors: Krzystanek M. , Krzeszowski D. , Jagoda K. , Radzio B. , Krysta K. 
Published: May 2016

Relapses, deterioration of cognitive functioning, negative symptoms, neuroleptic resistance are the examples of many consequences of noncompliance in schizophrenia. In order to improve the compliance, schizophrenic patients treated in an outpatient department in a traditional way have been given an additional possibility of contacting their doctors with the use of a special application on a portable electronic device. Other functions of this application are possibilities of PANSS, Calgary and CGI measurements and cognitive trainings for the patients. This type of a remote contact with patients can be an effective tool in the work in an outpatient setting. The compliance was assessed using a telepsychiatric system, sending reminders: 1 hour before the planned dose to remind them that drug intake is approaching, and at the moment of intake to check if they took the drug. In general the compliance in the group of schizophrenic patients in remission is very low, however the telemedicine system improves the compliance in this group of patients, in which the compliance is the worst.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The impact of E-Mental Health on prevention and early detection of illness
Authors: Hilty D. 
Published: May 2016

Our current healthcare system in the United States is characterized by problems with access to timely and evidence-based care, particularly for mental disorders. Telemental health improves access to care regardless of the point-of-service or barriers involved. Its effectiveness across age, population and disorders is as good as in-person care, though adjustments for some populations in the approach is necessary. Early intervention is an example of “Cadillac” care or a best evidence-based approach that is easier to distribute via telemedicine. Cadillac care delivered via TMH has the potential to bring evidence-based early intervention modalities to very young children and their families. However, early access to care is also critical for all populations, particularly those with cultural or medical disadvantages. It appears that telemental health may be preferable or better than in-person care in some instances.Disclosure of interestThe author has not supplied his declaration of competing interest.
Youth leadership in mental health: Views from EFPT and IFMSA
Authors: Pinto da Costa M. , Silva D. , Essafi S. , Frau E. , Berquist V. , Maceviciute K. 
Published: May 2016

The world today is more challenging than ever before. Discrimination, stigma, and ever-changing lifestyles are just a few examples of elements that have a profound impact on the mental health status of our global population. Even though the burden of mental illness is well documented and increasing, mental health remains a neglected area of health worldwide.Youth Associations, like the International Federation of Medical Students’ Associations (IFMSA) and the European Federation of Psychiatric Trainees (EFPT) recognize the importance of tackling this problem, taking an active role on promoting education in our communities, tackling stigma and advocating for more action. Medical students worldwide, from Slovenia, Australia, Lebanon, Brazil, Quebec and Grenada – among at least 42 other countries, organise expansive, creative and engaging mental health projects.With particular interest we can mention the winner of the last Rex Crossley Award, attributed to a Slovenian project ‘in Reflection’: a suicide prevention project, which tackles the different factors associated with vulnerable groups through a series of workshops and campaigns that seek to destigmatize the mental health problems and offer the opportunity to high school students to get the help they need.This talk will give an insight into strengths, weaknesses and challenges faced by youth in tackling mental health, specially in the role of the IFMSA, displaying some of our most interesting and innovative projects from future mental health leaders around the world, together with the initiatives of EFPT.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Whole-genome epigenetic changes genome regarding childhood maltreatment in patients with borderline personality disorder or depression
Authors: Prados J. , Stenz L. , Courtet P. , Prada P. , Nicastro R. , Wafae A. , Guillaume S. , Olié E. , Aubry J.M. , Dayer A. , perroud N. 
Published: May 2016

Early life adversity plays a critical role in the emergence of borderline personality disorder (BPD) and this could occur through epigenetic programming. In this perspective, we aimed to determine whether childhood maltreatment could durably modify epigenetic processes by the means of a whole-genome methylation scan of BPD subjects. Using the Illumina Infinium® Human Methylation450 BeadChip, global methylation status of DNA extracted from peripheral blood leucocytes was correlated to the severity of childhood maltreatment in 96 BPD subjects suffering from a high level of child adversity and 93 subjects suffering from major depressive disorder (MDD) and reporting a low rate of child maltreatment. Several CpGs within or near the following genes (IL17RA, miR124-3, KCNQ2, EFNB1, OCA2, MFAP2, RPH3AL, WDR60, CST9L, EP400, A2ML1, NT5DC2, FAM163A and SPSB2) were found to be differently methylated, either in BPD compared with MDD or in relation to the severity of childhood maltreatment. A highly relevant biological result was observed for cg04927004 close to miR124-3 that was significantly associated with BPD and severity of childhood maltreatment. miR124-3 codes for a microRNA (miRNA) targeting several genes previously found to be associated with BPD such as NR3C1. Our results highlight the potentially important role played by miRNAs in the etiology of neuropsychiatric disorders such as BPD and the usefulness of using methylome-wide association studies to uncover such candidate genes. Moreover, they offer new understanding of the impact of maltreatments on biological processes leading to diseases and may ultimately result in the identification of relevant biomarkers.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Fronto-thalamic dysconnectivity and cognitive control in schizophrenia
Authors: Wagner G. , De la Cruz F. , Güllmar D. , Schultz C.C. , Koch K. , Bär K.J. 
Published: May 2016

IntroductionSeveral lines of evidence suggest that cognitive deficits represent a core feature of schizophrenia.ObjectivesThe concept of “cognitive dysmetria” has been introduced to characterize disintegration at the system level of frontal-thalamic-cerebellar circuitry which has been regarded as a key network for a wide range of neuropsychological symptoms in schizophrenia.AimsThe present multimodal study aimed at investigating effective and structural connectivity of the frontal-thalamic circuitry in schizophrenia.MethodsUnivariate fMRI data analysis and effective connectivity analysis using dynamic causal modeling (DCM) were combined to examine cognitive control processes in 40 patients with schizophrenia and 40 matched healthy controls. BOLD signal and parameters of effective connectivity were related to parameters of corresponding white matter integrity assessed with diffusion tensor imaging (DTI).ResultsIn the DTI analysis, significantly decreased fractional anisotropy (FA) was detected in patients in the right anterior limb of the internal capsule (ALIC), the right thalamus and the right corpus callosum. During Stroop task performance patients demonstrated significantly lower activation relative to healthy controls in a predominantly right lateralized frontal-thalamic-cerebellar network. An abnormal effective connectivity was observed in the right lateralized connections between thalamus, anterior cingulate and dorsolateral prefrontal cortex. FA in the right ALIC was significantly correlated with the fronto-thalamic BOLD signal, effective connectivity and cognitive performance in patients.ConclusionsPresent data provide evidence for the notion of a structural and functional defect in the prefrontal-thalamic-cerebellar circuitry, which seems to be the basis of the cognitive control deficits in schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Treatment-resistant schizophrenia during life span : Epidemiology, outcomes and innovative M-Health treatments within M-RESIST Project
Authors: Rubinstein K. 
Published: May 2016

Treatment-resistant symptoms of schizophrenia (TRS) complicate the clinical course of the illness, and a large proportion of patients do not reach functional recovery (Englisch and Zink, 2012). Out of the estimated 5 million people (0.2–2.6 %) suffering from psychotic disorders in the European Union, 30-50 % can be considered resistant to treatment, and 10–20 % ultra-resistant (Essock et al., 1996 ; Juarez-Reyes et al., 1995). The complexity of standard intervention within this population, along with the presence of persistent positive symptomatology, extensive periods of hospital care and greater risk of multi-morbidity, lead to a high degrees of suffering for the patients, family and social environment, and a high proportion of costs to the healthcare system (Kennedy et al., 2014).At present, a uniform definition of treatment resistance in the pharmacotherapy of schizophrenia is not available (Suzuki et al., 2011), as well as generally recommendable evidence-based treatment methods (Dold and Leucht, 2014).A recent systematic review on the topic showed that TRS is poorly a studied and understood condition, contrasted to its high prevalence, clinical importance and poor prognosis. There is lack of studies on epidemiology and risk factors of this disorder, as well as on outcomes and longitudinal course. Most of the available literature focuses on medication treatments, while very few examine efficacy of adjunctive therapeutic options (Seppala et al., in preparation).Treatments based on information and communication technology (ICT) present novel possibilities to improve the outcomes of schizophrenia. Previous studies have indicated suitability and promising results of such intervention techniques (Granholm et al., 2012 ; Ben-Zeev et al., 2013). m-RESIST is an innovative project aimed to empower patients with resistant schizophrenia, to personalize treatment by integrating pharmacological and psychosocial approaches, and to further develop knowledge related to the illness using predictive models designed to exploit historical and real-time data based on environmental factors and treatment outcomes.Disclosure of interestThe author has not supplied his declaration of competing interest.
Discussant: Ethical challenges
Authors: Kastrup M. 
Published: May 2016

Europe has undergone considerable economic changes that have an impact on mental health of its citizens; have consequences for the organization of mental health services; and raise ethical issues, such as the distribution of wealth, and equity in access to care. Furthermore, Europe is current undergoing serious economic problems that will produce adverse effects on the mental health of its citizens, among them increase in substance abuse related disorders as well as an increase in suicide.The consequences that economic changes have on mental health relate to the conditions of the particular country, as countries with better health security nets would be less likely to experience adverse effects. Different policy measures may reduce the impact on mental health not only within the health sector, but other sectors of society have to be engaged in the process.The symposium will consider these problems from different selected perspectives.An overview of the impact of economic policies on health services will be followed by a presentation of the important role of international organizations like EPA in outlining the problem and finally a presentation of the initiative Choosing Wisely that focuses on communication between health professionals and patients with recommendations of decisions about the most appropriate care based on the patient's individual situation.Disclosure of interestThe author has not supplied his declaration of competing interest.
Treating chronically psychotic patients in nursing homes
Authors: Gauillard J. 
Published: May 2016

The increase of aging patients with schizophrenia becomes a public health issue. The exponential demography of the elderly, the improvement of cares associated with better physical follow-up directly impact the number of old patients with chronic psychiatric disease. Deinstitutionalization associated with a dramatic enhancement of ambulatory and community cares has led to a reduction of beds in psychiatric hospitals. When dependency occurs, due to physical comorbid illness or a worsening of the negative symptoms, psychiatric teams should find appropriate housing and no longer the psychiatric hospital. Nursing home and sheltered housing for the elderly dependent persons become a solution, but geriatric staffs are not always prepared to receive resident with schizophrenia and other psychotic disorders. They often are at a loss when faced with the expression of psychiatric symptoms or with the specificity of caring for often-younger patients whose behavior is different from older people with neurodegenerative disorders.How psychiatric teams could long-term assist the sheltered housing and nursing home and bring a psychiatric know-how within staffs often reluctant to deal with psychotic patients who could burden caregivers. How could they be trained to cope with complex cognitive functions impairments of schizophrenia, far from cognitive impairments of Alzheimer dementia? How to change the representation of psychiatric illness, which often leads to a double stigmatization (old age and madness)? Improving the quality of life of aging patients with severe chronic mental illness in homes for seniors is a great challenge for psychiatric teams in collaboration with geriatric caregivers.Disclosure of interestThe author has not supplied his declaration of competing interest.
From genes to treatment: The effect of polymorphisms in neurotransmitter systems on addictive behaviour, neural response and relapse
Authors: Bach P. , Vollstädt-Klein S. , Kirsch M. , Hoffmann S. , Jorde A. , Frank J. , Charlet K. , Beck A. , Heinz A. , Walter H. , Rietschel M. , Kiefer F. 
Published: May 2016

IntroductionThe development and maintenance of an alcohol addiction is a complex interaction between genetic and environmental factors. Genetic effects seem to contribute substantially to the risk of developing an addiction, but also to its course and patients’ responses to different treatments. Recent studies identified associations between polymorphisms in the genes of glutamate and μ-opioid receptors and addiction risk. Those receptors are of special interest, because they are targets of therapeutic agents, such as acamprosate and topiramate.Objectives and aimsSeveral studies were conducted, in order to further determine the effects of genetic polymorphisms in glutamate and opioid receptor genes on addictive behavior, neural response to alcohol cues and relapse risk.MethodsGenetic effects were investigated in samples of alcohol-dependent patients using functional imaging techniques, neuropsychological tests and follow-up investigation after standard clinical treatment. Data on clinical parameters, neuronal response to alcohol cues, functional neuronal connectivity and relapse risk were collected and analyzed.ResultsResults demonstrate effects of genetic polymorphisms in glutamate and opioid receptors on neuronal response to alcohol cues in frontal and mesolimbic brain areas, subjective craving and time to first relapse. Current findings will be discussed in the light of existing evidence on the contribution of genetic effects to treatment outcome and patient stratification.ConclusionsThe investigation of genetic risk factors and mechanisms by which they affect addiction related phenotypes seems to be a promising tool to identify molecular treatment targets and predictors for successful treatment strategies.Disclosure of interestThe authors have not supplied their declaration of competing interest.