bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Adherence to Mediterranean Diet Moderates the Association Between Medical Multi-morbidity and Depressive Symptoms in Elderly Outpatients
Authors: Bersani F.S. , Vicinanza R. , d’Ottavio E. , Biondi M. , Cacciafesta M. , Troisi G. 
Published: June 2017

BackgroundDepressive symptoms in the elderly are related to the advancing of age, loss of life purpose, medical multi-morbidity, cognitive decline and social-economic problems mounting evidence suggests that lifestyle behaviors and certain dietary patterns may improve mood and overall well-being in older adults. In the present study we investigated (i) the association of adherence to Med-Diet with depressive symptoms and multi-morbidity in a cohort of geriatric medical outpatients and (ii) the role of Med-Diet in mediating the association between depressive symptoms and multi-morbidity.MethodsMorbidity was assessed using the severity index of cumulative illness rating scale for geriatrics (CIRSG-SI). Montreal cognitive assessment (MoCA) and geriatric depression scale (GDS) were administrated to evaluate cognitive and depressive symptoms. Adherence to Med-Diet was evaluated using the Med-Diet 14-Item questionnaire (MDQ). Pearson correlation was used to test association between variables. The Preacher and Hayes’ strategy was used to test the mediational model.ResultsOne hundred and forty-three subjects were included in the study. Significant inverse correlations of MDQ with GDS (r = -0.317; P < 0.001) and CIRSG-SI (r = -0.247; P = 0.003) were found, with and without adjustment for potential confounders. A direct correlation between CIRSG-SI and GDS was also observed (r = 0.304; P = 0.001), with this association being moderated by MDQ (b = 0.386; P = 0.047).ConclusionThese findings (i) add to the accumulating evidence that Med-Diet is crucially involved in the regulation of physical and mental health of elderly people, and (ii) suggest that a Mediterranean-style diet may contribute to protect elderly subjects with higher levels of polypathology/multi-morbidity from the development of depressive symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Psycho-geriatric Patient in the Emergency Room (ER) of the Maggiore della Carità Hospital in Novara
Authors: Di Tullio E. , Vecchi C. , Venesia A. , Girardi L. , Molino C. , Camera P. , Chiarelli serra M. , Gramaglia C. , Feggi A. , Zeppegno P. 
Published: June 2017

IntroductionDue to population aging, the health system will face increasing challenges in the next years. Concerning mental disorders, they are major public health issues in late life, with mood and anxiety disorders being some of the most common mental disorder among the elderly. For this reason, increasing attention has to be paid to the evaluation of the elderly in psychiatry emergency settings.ObjectivesTo evaluate the socio-demographic and clinical features of over 65 patients referred to psychiatric consultations in the ER of “Maggiore della Carità” Hospital in Novara, in a 7 years period.AimsThe analysis of the characteristics of the study sample could be potentially useful in resource planning in order to better serve this important segment of the general population.MethodsDeterminants of ER visits for over 65 patients referred to psychiatric evaluation were studied retrospectively from 2008 to 2015.ResultsElderly patients made up 14,7% (n = 458) of all psychiatric evaluation in the ER (n = 3124). About two thirds (65,9%) were females and one third were males (34,1%). The mean age of patients recruited was 75.11 years. The majority of subjects (68.6%) presented without a diagnosis of Axis I according to DSM-IV. The other most frequent diagnosis was “cognitive disorders” (11.4%) and “mood disorders” (10.9%).ConclusionsThe large proportion of patients without a diagnosis of Axis I, could be related to the misunderstanding of the psychosocial aspects of aging. Preliminary results highlight the importance of research on this topic, considering population aging and the impact of mental disorders in late-life.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Evidence of Accelerated Biological Ageing in Post-traumatic Stress Disorder
Authors: Lindqvist D. 
Published: June 2017

Post-traumatic stress disorder (PTSD) is a common and debilitating condition, affecting between 10–20% of soldiers returning from combat zones, and with even higher prevalence rates in Veterans Affairs healthcare settings. PTSD is associated with an increased risk for various medical illnesses, many of which are commonly seen with older age. This raises the possibility that PTSD is associated with accelerated biological aging at the cellular level. Accelerated biological aging occurs when biological age outpaces chronological age, and this process is driven by a number of biological mechanisms including immune activation, oxidative stress, and mitochondrial dysfunction.In this workshop I will present data from our research group and others pertaining to the biological mechanisms underlying accelerated cellular aging in PTSD. Most, but not all, studies have found that PTSD is associated with shorter mean leukocyte telomere length, an indicator of accelerated cellular aging. Mitochondrial dysfunction has been implicated in PTSD and our research group found evidence of a “u-shaped” relationship between PTSD symptom severity and mitochondrial DNA copy number. For what concerns immunity, we have recently found that PTSD subjects have increased blood levels of pro-inflammatory markers, a more senescent and dysfunctional profile of NK cells and impaired synthesis of nitric oxide. Finally, I will discuss the possibility of accelerated epigenetic aging in combat-exposed individuals with and without PTSD, using DNA methylation data.Disclosure of interestThe author has not supplied his declaration of competing interest.
Evolutionism and Involutionism in the Ontogenesis of а Late Age
Authors: Pishchikova L. 
Published: June 2017

Individual human development from birth to death is defined as the ontogenesis. The ability of the human psyche to development and to system acquisition of mental and social functions is called evolutionism. The psyche property, causing a gradual loss in the process of ontogenesis of biological, psychological and social functions is defined as involutionism.Involutivitionism of higher mental functions manifests in their folding in the sequence reverse to the formation. Process of involution is uneven and abrupt. This is caused by their constant interaction with the evolution processes, that are struggling with age-related destruction and disruption and are responsible for the ongoing adaptation, although at a lower ontogenetical level.In the event of critical psycho traumatic situations, which are related to the impact of jet-psychological, somatoneurological factors, there is a failure of adaptation mechanisms, decompensation develops, the action of the involutive mechanisms increases, which leads to a lower level of social functioning. In this interaction biological and social factors act in their unity and predetermine disadaptation options, while the latter, in their turn, determine intensification of involutive processes.Because of the interaction of these processes mental aging unevenly affects higher mental functions with the advent of favorable (adamantix) and unfavorable forms, determined by the development of mental disorders and dementia. Favorable aging can manifest itself by specific quantitative somatoneurological and mental changes that do not lead to the loss of adaptation. Under favorable aging life experience, professional skills, biological, social, adaptive resources are preserved, evolutionary development of the older person continues.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Antipsychotics in Dementia
Authors: Poças A. , Almeida S. 
Published: June 2017

Behaviour disorders and psychosis may represent a greater challenge in patients with dementia. There are evidence-based recommendations to assess psychological and behavioral symptoms of dementia and the practice guidelines of American psychiatric association (APA) reinforce general principles of good clinical care. However, when these patients initiate a psychotropic, the agents often continue to be prescribed for a long time, even after the symptoms disappeared. The recommendation of reduce/stop an antipsychotic medication within 4 months of initiation may seem counterintuitive when the patient is better, with remission of the original symptoms. However, the studies showed that a large amount of patients with dementia can discontinue antipsychotic medication without a return of agitation or psychosis. Older patients are a particularly susceptible population and the risk/benefit of any medication should be carefully considered. For most patients the risk of harm outweighs the profits of continuing treatment and we need a routine evaluation of this factor to identify these cases.It's important to reduce unnecessary medications but agitation and psychosis associated with severe distress also carry serious risks; discontinuing these medications can be dangerous so we need to manage it with caution evaluating each case as an individual one.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Factors associated with job satisfaction among physicians in a university hospital
Authors: Derbel C. , Braham A. , Souilem A. , Ben Romdhane A. , gallala R. , Ben Nasr S. , Bannour A.S. , Ben Hadj Ali B. 
Published: June 2017

IntroductionSeveral professional and personal factors determine the degree of job satisfaction (JS) which is a necessary condition to ensure good quality work, especially for physicians working in university hospitals (UH).AimsTo determine the degree of JS in a population of physicians working in UH and to determine the factors associated with the JS.MethodCross-sectional, descriptive and analytical study involving 96 physicians with different grades in Farhat Hached University Hospital, Sousse, Tunisia. We used Job Satisfaction Scale (JSS) to assess the degree of JS, Hospital Anxiety And Depression Scale to assess anxiety and depression, Maslach Burnout Inventory to determine burnout (BT).ResultsThe average age was 28.15 ± 4.10 years. Doctors with medical specialty were the majority (65.6%). Most doctors were dissatisfied with their work (67.7%). The socio-demographic factor associated with ST was the young age (P = 0.00). Occupational factors associated with JS were: shorter time worked in the department (P = 0.02), lack of outpatient day (P = 0.01), a lower number of outpatient day (P = 0.02), dissatisfaction with the work schedule (P = 0.004), lack of safety (P = 0.00), salary (P = 0.00), non-operating skills (P = 0.00), the distribution of tasks (P = 0.00), the conditions of the guards (P = 0.00), ignorance of the laws governing the department (P = 0.00), BT (P = 0.01) and depression (P = 0.00).ConclusionThe majority of our subjects were dissatisfied with their work. Several factors, especially the professional ones contribute to this state. It is necessary to take steps on these factors to improve the performance of doctors working in university hospitals to provide better care for patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The phenomenon of psychological adaptation to the professional activities of doctors
Authors: Kozhyna A. , Mykhaylov V. , Viyun V. 
Published: June 2017

Disorders of adaptation of young doctors and students to their the professional activities.The study was designed to develop a system of psychological adjustment and psychoprophylactic support during professional training based on a systematic approach to the study of the mechanisms of formation of psychological adaptation to the professional activities of doctors.It was conducted comprehensive examination of 405 interns and of 615 last year's students of medical universities in Ukraine. 211 interns had adaptation disorders. The data demonstrated individual and personal, social and psychological factors, mechanisms and conditions of psychological adaptation to medical work.The necessary components of psychological readiness for independent productive activities on the basis of high value professional identity, a positive attitude to the profession, perception of the patient as a personality in a certain psychological state, choice of interpersonal relationships and the use of ethical and deontological knowledge and skills at different stages of treatment process.The results showed that females have a higher level of disorders of adaptation to professional activity, compared with males. High level of disadaptation, which requires using of emergency measures was founded at 9.2% of men and 12.5% women; moderate level of desadaptation, which requires mandatory intervention of psychologists, conducting rehabilitation programs - 10.3% men, 14.0% women; mild level of desadaptation, in which the useful work of advisory experts - 36.2% and 42.1% respectively.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The reality of domestic violence in the US
Authors: Gonçalves J. , Lima C. 
Published: June 2017

According to the United States department of justice, domestic violence is defined as “a pattern of abusive behaviours in any relationship that are used by one partner to gain or maintain power and control over another intimate partner”. It involves a pattern of coercive behaviour in intimate relationships whereby the behaviour is controlled through humiliation, intimidation, fear, and often intentional physical, emotional or sexual injury. Domestic violence crosses all ethnic, socioeconomic and age groups, and is also prevalent in same sex relationships.Over six million children are severely assaulted by family members every year in the United States; a man beats a woman every twelve seconds; women who leave their batterer are at 75% greater risk of being killed by their batterer than those who stay; and one third of police time is spending on answering domestic violence calls.In domestic violence situations the intervention is frequently in crisis, where the victims “fight” for survival, and it is necessary to give proper answers according to the victim's needs. The professionals that work directly with domestic violence assume that there is a strong bond connecting the domestic violence with mental health. In the United States 90% of domestic violence survivors report extreme emotional distress; 47.5% report having been diagnosed with post-traumatic stress disorder; 14.7% report anxiety; 20% depression. Mental illnesses are frequently observed in domestic violence survivors.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Hydrocephalus and Psychiatric Disorders: About a Clinical Case
Authors: Snene H. 
Published: June 2017

IntroductionHydrocephalus is a neurological disease caused by excessive accumulation of cerebrospinal fluid following an abnormal secretion, circulation and absorption. It is considered the most common reversible cause of dementia but still an underestimated cause of psychiatric disorders.ObjectivesHighlighting the possible association of hydrocephalus in some psychiatric disorders and know how to adapt the management of this co-morbidity.Clinical VignetteHe is Mr O.Y, aged 27, unmarried, his parents divorced, lives with his mother. He had surgery in 2012 to the orthopedic service for disabling scoliosis. No significant psychiatric family history. Discovery of a tri ventricular hydrocephalus in 2011 requiring regular monitoring neurology.Indeed Mr O.Y followed the CMP for a mood disorder requiring antidepressant treatment based. The evolution of disorder was marked by the installation of a hallucinatory and delusional syndrome motivating several hospitalizations and relapses iterative partial response to various therapies.Mr O.Y was received a ventricular shunt within the sound hydrocephalus.The postoperative course was marked a progressive amendment acoustic verbal hallucinations and delusions of persecution.The conduct was to gradually reduce the dose of antipsychotic (Risperdal) to the stop. No recurrence pathological productions.ConclusionsPsychiatric disorders may mark the evolution of hydrocephalus. Share against the indications and side effects of some psychotropic drugs, the management of this co-morbidity may be difficult. Further studies are needed to better elucidate causality for this association and to develop appropriate therapeutic consensus.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Psychopathy and Twins. A Case Report
Authors: Hernandez Dorta A. , González González I. 
Published: June 2017

IntroductionWe are going to explain a case of a patient diagnosed with psychopathy and his twin brother with a normal personality.ObjectivesTo show the controversia about psychopathy and twins.MethodsDescription of a case of psycopathy. We evaluated his psychopatology using the Psychopaty Checklist (PCL).CaseA 18-years-old male teenager admitted to a penitentiary facility for several crimes: drug dealing, violent theft and multiple aggressions.Personal history: early psychological and psychiatric attention for disruptive behaviour as a child: repeated lies, low empathy, defiance to parents and teachers, indifference to punishment, robbery, aggressive behaviour, loitering, escaping from home, cruelty against animals, promiscuity, vandalism and drug abuse. Medium-high class family, well-structured family, none of them with criminal history or mental disorders, his brother is a brilliant student.Personality assessment: We describe 20 features of his personality according to the PCL and we score them from 0 to 2. Zero if it does not apply at all, one if there is a partial match, two if there is a good match.Features: Superficial charm, narcicism, pathological liar, manipulator, absence of guilt, superficial affection, absence of empathy, inability to accept responsibility, need for constant excitation, parasitic life, unrealistic goals, impulsivity, irresponsibility, low self-control, conductual problems since childhood, juvenile delinquency, repeal of conditional freedom, criminal versatility, promiscuity and multiple marriages.ResultsOut of a maximum score of 40, the cut-off for psychopathy is 30.This patient has 34 points so we can conclude he is a psychopath.ConclusionsWe can conclude there is not a clear relationship between twins and psychopathy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Self-esteem in Military Patients with Post-traumatic Stress Disorder
Authors: Ben Zina E. , Krir M.W. , Bel Hadj H. , Lansari R. , El Kefi H. , Ben Cheikh C. , Omaya A. 
Published: June 2017

IntroductionMaintaining self-esteem is a fundamental human motivation. Trauma may lower self-esteem, which contributes to the development and maintenance of Post-Traumatic Stress Disorder (PTSD).ObjectivesAssessment of self-esteem in Tunisian military patients suffering from PTSD. Study of correlation between the severity of the PTSD symptoms and the rate of self-esteem.MethodsTransversal descriptive study of a sample of 22 patients treated for PTSD in the Tunisian Military Hospital during the period between August and October 2016.The PTSD Cheklist for DSM-5 (PCL-5), Hospital Anxiety and Depression scale (HAD), and the Rosenberg Self-Esteem Scale were administered for patients.ResultsAll the patients assessed were male. The mean age of the sample was 29.6 years. Fifty percent of the patients presented with a co-morbid major depression. Based on the score of the Rosenberg Self-Esteem Scale, patients had a self-esteem, which was very low in 45.45% of case, low in 45.45% of cases, average in 4.54% of cases and high in 4.54% of cases. The results also showed that lower levels of self-esteem are significantly correlated to the severity of the PTSD symptoms as measured by the PCL-5 score.ConclusionsThis study highlights the magnitude of self-esteem deficiency among patients suffering from PTSD. It remains unclear as to whether the relationship between trauma and depression is consistently mediated by a negative cognitive schema, such as low self-esteem, or whether trauma influences mood independently of low self-esteem. Further studies are required.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Full and Partial DSM-5 PTSD in Parents of Children with Epilepsy: Exploring Gender Differences
Authors: Carmassi C. , Corsi M. , Gesi C. , Bertelloni C.A. , Faggioni F. , Calderani E. , Massimetti G. , Peroni D. , Bonuccelli A. , Orsini A. , Dell’Osso L. 
Published: June 2017

IntroductionIncreasing literature suggests the need to explore PTSD and post-traumatic stress symptoms among parents and caregivers of children with acute and chronic illnesses but scant data are available on epilepsy.ObjectivesThe aim of this study was to estimate full and partial PTSD rates among parents of children with epilepsy according to DSM-5 criteria. Further, aim of this study was to examine eventual gender differences between mothers and fathers.MethodsOne hundred and thirty-eight parents, 91 mothers (65.9%) and 47 (34.1%) fathers, of children diagnosed with epilepsy were interviewed using the SCID-5.ResultsFull and partial DSM-5 PTSD were reported by 10.4% and 37.3% of patients, respectively. Significant gender differences, with the mother more affected, emerged in the rates of partial A PTSD rates (P = 0.048) and in the endorsement rates of criterion B (intrusion symptoms) (P = 0.047), criterion D (negative alterations in cognitions and mood) (P = 0.010) and criterion E (alterations in arousal and reactivity) (P < 0.001) too.ConclusionsThis is the first study to identify post-traumatic symptoms in caregivers of pediatric patients with epilepsy with the use of current diagnostic criteria and the relevance of the results suggests the need for further studies on this risk population.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Action Plan of the WPA: Action Plan Which Follows the Objectives of the Association Relating to Refugees and Asylum Seekers
Authors: Bhugra D. 
Published: June 2017

Recent mass movement of human beings in various parts of the world has brought several challenges. Not only refugees from Syria and Libya to Europe but also refugees, migrants and asylum seekers in Latin America bring specific set of issues with them. It is critical that clinicians are aware of both the vulnerability of individuals to mental ill health as a result of migratory experiences but equally importantly their resilience. The impact on the mental health of those who may be involved directly or indirectly in delivering care along with those new communities who receive these groups need to be taken into account when planning and delivering psychiatric services. It is essential to recognize that experiences of being a refugee or asylum seeker are heterogeneous. Being an asylum seeker carries with it legal definitions and legal imperatives agreed at international levels.Policymakers and clinicians need to be aware of differential rates of psychiatric disorders in these vulnerable individuals and specific needs related to language, religious values and other cultural factors. Mental health problems may be related to experiencing cultural bereavement where individuals feel that they have lost their cultures, relationships and cultural values. Judicious and careful use of trained culture brokers and mediators should be encouraged as these individuals can inform the team about community needs and inform the community about the team functioning and its principles so that community expectations can be managed appropriately. Such approaches may also help reduce stigma against mental illness.Disclosure of interestThe author has not supplied his declaration of competing interest.