european psychiatry

Background There is a growing number of studies showing interactions between genetic polymorphisms associated with dopaminergic neurotransmission and traumatic life events (TLEs) on a risk of psychotic-like experiences (PLEs). Anomalous self-experiences (ASEs) have been associated both with TLEs as well as with PLEs. However, it remains unknown what is the role of ASEs in the complexity of gene–environment interactions on the emergence of PLEs. Patients and methods We included 445 young adults—university students from three big cities in Poland. We used the Traumatic Events Checklist to assess TLEs, the Inventory of Psychotic-Like anomalous self-experiences in order to measure ASEs, and the Prodromal Questionnaire (PQ16) to record the level of PLEs. The following gene polymorphisms, related to dopaminergic neurotransmission, were determined: the catechol-O-methyltransferase (COMT) rs4680 polymorphism, the dopamine D2 receptor (DRD2) rs6277 polymorphism, and the dopamine transporter ...

SummaryObjectiveDiagnosing personality disorders according to structured expert interviews is time-consuming and costly. For epidemiological studies, self-report instruments have several advantages. The DSM-IV and ICD-10 personality questionnaire (DIP-Q) is a selfreport questionnaire constructed to identify personality disorder according to DSM-IV and ICD-10.MethodsThe DIP-Q is validated vs a structured expert interview in a clinical sample of 138 individuals. In addition, prevalence rates yielded by DIP-Q among 136 healthy volunteers are assessed and compared to expected prevalence.ResultsFor DSM-IV the agreement for any personality disorder as measured by Cohen's Kappa was 0.61 and 0.56 for ICD-10. Overall sensitivity for any personality disorder was for DSM-IV 0.84 and for ICD-10 0.85. However, specificity was lower: 0.77 and 0.70, respectively. When dimensional scores between self-report and interview for each personality disorder were compared, the intraclass correlation fo...

SummaryThis review summarizes the recent literature about personality disorders among substance abusers. First, it will be shown that personality disorders are highly prevalent co-morbid conditions among addicted individuals. Second, it is argued that this co-morbidity is likely to be accounted for by multiple complex etiological relationships. Finally, the clinical relevance of routine assessment of (maladaptive) personality traits in individuals admitting for substance abuse treatment will be discussed.

As COVID-19 has plagued our world, the term “social distancing” has been widely used with the aim to encourage the general population to physically distance themselves from others in order to reduce the spread of the virus. However, this term can have unintended but detrimental effects, as it evokes negative feelings of being ignored, unwelcome, left alone with one's own fears, and even excluded from society. These feelings may be stronger in people with mental illnesses and in socio-economically disadvantaged groups, such as stigmatized minorities, migrants, and homeless persons [1], many of them also having high risk for suicidal behaviors [2]. Mental health disorders are pervasive worldwide; the global burden accounting for approximately 21.2–32.4% of years lived with disability—more than any other group of illnesses [3]. So, the vulnerable group of people with mental health disorders represents a considerable share of the total global population.

Nutritional ketosis, induced via either the classical ketogenic diet or the use of emulsified medium-chain triglycerides, is an established treatment for pharmaceutical resistant epilepsy in children and more recently in adults. In addition, the use of oral ketogenic compounds, fractionated coconut oil, very low carbohydrate intake, or ketone monoester supplementation has been reported to be potentially helpful in mild cognitive impairment, Parkinson’s disease, schizophrenia, bipolar disorder, and autistic spectrum disorder. In these and other neurodegenerative and neuroprogressive disorders, there are detrimental effects of oxidative stress, mitochondrial dysfunction, and neuroinflammation on neuronal function. However, they also adversely impact on neurone–glia interactions, disrupting the role of microglia and astrocytes in central nervous system (CNS) homeostasis. Astrocytes are the main site of CNS fatty acid oxidation; the resulting ketone bodies constitute an important source...

The stress of migration as well as social factors and changes related to the receiving society may lead to the manifestation of psychiatric disorders in vulnerable individuals after migration. The diversity of cultures, ethnicities, races and reasons for migration poses a challenge for those seeking to understand how illness is experienced by immigrants whose backgrounds differ significantly from their clinicians. Cultural competence represents good clinical practice and can be defined as such that a clinician regards each patient in the context of the patient's own culture as well as from the perspective of the clinician's cultural values and prejudices. The EPA Guidance on cultural competence training outlines some of the key issues related to cultural competence and how to deal with these. It points out that cultural competence represents a comprehensive response to the mental health care needs of immigrant patients and requires knowledge, skills and attitudes which can i...

IntroductionAll over the world, there is global emergency when it comes to respecting human rights in providing good mental health services. Morocco as an African and a developing country has always had a mental health policy defined by several glitches and failures, which had not helped him improve its mental health services quality. Nevertheless, huge improvements were achieved through time.ObjectivesThis report, aims to draw attention on how compulsory it is to think and act all together to promote mental health and provide patients with better health services in Morocco.MethodsThe National Human Rights Council conducted an information and investigation mission in Morocco's main mental health hospitals and facilities between March 27 and July 6, 2012.ResultsStructures are insufficient and inadequate in terms of geographical distribution, architecture and equipment. There is a big shortage of medical and paramedical staff and little interest is given to vulnerable groups. Neve...

The Hayling Sentence Competion Test (HSCT) consists of two sections and measures response initiation and inhibitory control. In the first section subjects are instructed to produce a single word to complete a sentence and in the response inhibition condition subjects are instructed to produce a contextually unconnected word. Several studies evidence that these abilities, which are associated with frontal lobe dysfunction and dysexecutive symptoms in evereyday life (Burgess & Shallice, 1996b), are impaired in psychiatric patients particularly in patients with schizophenia and major depression (Gohier et al., 2009; Chan et al., 2010; Joshua et al., 2009). The present study aims to examine the adapted German version of the HSCT by Willinger and Diendorfer (2009) upon a non-clinical sample and its relationship to Stroop-Test. The sample was composed of 74 adults (36 women and 38 men) ranging in age from 19 to 66. Reliability analyses of the HSCT yielded a Cronbachs's alpha of 0.45 (...

Les déficits neuropsychologiques consécutifs à l’alcoolo-dépendance affectent principalement la mémoire épisodique, la mémoire de travail et les capacités visuospatiales, ainsi que les fonctions exécutives et motrices [1,2]. Ces déficits présents notamment en début de sevrage peuvent conduire à un bénéfice limité des ateliers psychothérapeutiques et entraver le maintien de l’abstinence des patients alcoolo-dépendants [3,4]. Ainsi, une évaluation neuropsychologique étendue conduite après sevrage semble essentielle afin d’orienter la prise en charge clinique de ces patients. Cependant, peu de services d’addictologie ont les ressources humaines et financières pour conduire une telle évaluation chez chaque patient. L’objectif de cette étude était donc d’examiner la validité et les qualités psychométriques d’un outil de dépistage : le BEARNI (pour Brief Examination of Alcohol-Related Neuropsychological Impairments). Cet outil a été spécialement développé pour être accessible au personnel soignant non psychologue dans l’objectif de conduire un dépistage rapide des déficits neuropsychologiques consécutifs à l’alcoolo-dépendance. Une batterie neuropsychologique étendue a servi de référence (gold standard) pour déterminer le profil cognitif des patients alcoolo-dépendants et examiner les qualités psychométriques du BEARNI. L’analyse factorielle exploratoire a permis de valider la structure interne de BEARNI en mettant en évidence 5 facteurs expliquant 60 % de la variabilité et reflétant les capacités visuospatiales, les fonctions exécutives, la mémoire verbale et la mémoire de travail verbale. La standardisation de chacun des sub-tests et des scores totaux à BEARNI, conduite par l’intermédiaire de courbes ROC, a mis en évidence que cet outil de dépistage présente une bonne efficacité diagnostique dans le dépistage des atteintes cognitives et motrices présentes chez les patients alcoolo-dépendants après sevrage. Cette étude montre la pertinence de l’utilisation de BEARNI en pratique clinique pour détecter la présence de troubles neuropsychologiques chez les patients alcoolo-dépendants et permettre d’orienter ceux ayant besoin d’une évaluation neuropsychologique étendue.

Stalking may be defined as obsessive following (1) forcibly and continuously invading another's privacy (2)(3); behaviors which: are directed at a particular person; are felt by the object person to be unwanted and invasive; arouse fear and/or concern in the object person. (4) Mester, Birger and Margolin(5) referred to 3 types of interventions in response to stalking: police intervention, legal intervention and medical intervention . They also refer to possible mixed types of intervention strategies. In this presentation we will relate to legal aspects of stalking, taking into account social, clinical and policy related considerations. A focus will be made on the 2001 Israeli law for preventing threatening harassment, and the main tools it provides a subject with: turning to court for an injunction, complaining to the police in case an injunction has been violated. Other legal tools will also be discussed – such as damages claims related to privacy infringements, libel etc. In summary we will inquire whether these legal tools are effective in putting an end to disruptive stalking behaviors and to what extent should those legal possibilities play a part in an anti-stalking action plan for a stalking victim.

The main goal of the conference was to assess the research on useful films made during the first half of the 20th century by neurologists and psychiatrists in Europe for clinical, educational and archival purposes. Long marginalized by the historiography remained in the shadow of the entertainment cinema and the “auteur film”, the useful film refers to a vast set of productions that tackle the cinema through its uses and its performative dimension. Partly escaping commercial theatrical release, useful films are characterized by a large variety of formats, forms and functions, but also a diversity of production, distribution and reception contexts. Their pragmatic and ephemeral nature requires considering the context in which these films are elaborated, but also the discourses that surround them and the practices that determine them.

Drawing on the work of Acland and Wasson, the notion of useful film refers to how institutions conceive and engage with the tool of cinema. “The concept of useful cinema does not so much name a mode of production, a genre, or an exhibition venue as it identifies a disposition, an outlook, and an approach toward a medium on the part of institutions or institutional agents.” (Acland & Wasson 2011, 4). We therefore use this notion as an approach to cinema oriented by the needs of the actors in the field of neurology and psychiatry.

One of the scopes of the conference was to construct, through case studies, a panorama of the practices that are quite diversified (even if film supporting medical research prevails), but also to bring out new approaches or lines of research that are relevant for thinking about this type of audio-visual document. The contributions focused on films made in France (Jean Comandon), Italy (Gaetano Rummo and others), Great Britain (Wellcome collections), Germany (Ludwig Mayer), Belgium (Van Gehuchten and others), the Netherlands (Magnus-Rademaker), Spain (Antonio Subirana) and Switzerland (Walter R. Hess, Ernst Grünthal).

BackgroundPurpose of this study was to assess subjective well-being in schizophrenia inpatients and to find variables predictive for response and remission of subjective well-being.MethodThe subjective well-being under neuroleptic treatment scale (SWN-K) was used in 232 schizophrenia patients within a naturalistic multicenter trial. Early response was defined as a SWN-K total score improvement of 20% and by at least 10 points within the first 2 treatment weeks, response as an improvement in SWN-K total score of at least 20% and by at least 10 points from admission to discharge and remission in subjective well-being as a total score of more or equal to 80 points at discharge. Logistic regression and CART analyses were used to determine valid predictors of subjective well-being outcome.ResultsTwenty-nine percent of the patients were detected to be SWN-K early responders, 40% fulfilled criteria for response in subjective well-being and 66% fulfilled criteria for remission concerning su...

AimOur previous study (Salokangas et al., 2009) suggested that the subjective experience of negative attitude of others (NAO) towards oneself is an early indicator of psychotic development. The aim of this prospective follow-up study was to test this hypothesis.MethodsA total of 55 young psychiatric outpatients assessed as being at current risk of psychosis (CROP) were followed for up to 60 months and rates of transition to psychosis (TTP) identified. CROP was assessed employing the Bonn Scale for assessment of basic symptoms (Schultze-Lutter and Klosterkötter, 2002) and the Structured Interview for prodromal symptoms (Miller et al., 2002). TTP was defined by a psychotic episode lasting for more than one week. Associations between NAO at baseline and TTP were analyzed by a Cox regression survival analysis.ResultsEight (14.5%) TTP were identified: four (57.1%) within seven NAO patients and four (8.7%) within forty-six non-NAO patients. In the multivariate Cox regression analysis, NAO...

SummaryThe objective of this study was to provide a reliable instrument to measure morningness for upcoming studies in French samples, using the Composite Scale of Morningness (CSM), which has been translated into French. Nursing students (n = 356) completed the questionnaire between February and March 1997. The total score obtained was independent of age and gender, and normally distributed. The reliability was high (Cronbach's α = 0.85), and factorial analysis confirmed the unidimensionality of the scale. Evening-type subjects are thought to score under 31, and morning-type subjects are thought to score above 44. As an external validation, morningness was associated, on weekdays and weekends, with early rising times and bedtimes and early peak times of physical and mental performance. In conclusion, we found that the English and the French versions of the Composite Scale of Morningness gave identical results. The scale is reliable and can be used for French-speaking adult samp...

Background Public health measures to curb SARS-CoV-2 transmission rates may have negative psychosocial consequences in youth. Digital interventions may help to mitigate these effects. We investigated the associations between social isolation, COVID-19-related cognitive preoccupation, worries, and anxiety, objective social risk indicators, and psychological distress, as well as use of, and attitude toward, mobile health (mHealth) interventions in youth. Methods Data were collected as part of the “Mental Health And Innovation During COVID-19 Survey”—a cross-sectional panel study including a representative sample of individuals aged 16–25 years (N = 666; Mage = 21.3; assessment period: May 5, 2020 to May 16, 2020). Results Overall, 38% of youth met criteria for moderate or severe psychological distress. Social isolation worries and anxiety, and objective risk indicators were associated with psychological distress, with evidence of dose–response relationships for some of these associati...

The aim of the European Brain Council project "The Value of Treatment" was to provide evidence-based, cost-effective policy recommendations for a patient-centered and sustainable coordinated care model for brain disorders. The first part of schizophrenia study examined the needs and gaps in the patients' care pathway. Descriptive analysis was based on an inventory of needs and treatment opportunities, using focus group sessions, expert interviews, users' input, and literature review. Three patient pathways were selected: indicated prevention, duration of untreated psychosis, and relapse prevention. The analysis identified several critical barriers to optimal treatment. Available health care services often miss or delay detection of symptoms and diagnosis in at-risk individuals. There is a lack of illness awareness among patients, families, and the public; scarcity of information, training and education among primary care providers; stigmatizing beliefs. Early sympt...

IntroductionDepression has sleep disturbances as a key symptom and recently sleep has been suggested as a new area to optimize treatment in depression. Orexin is produced in the hypothalamus and projected throughout the brain innervating a number of structures important in depression. It controls a number of physiological processes including sleep, arousal, cognitive processes and stress, which are affected during depression.ObjectiveThe study examines the possible implications for abnormalities in the orexinergic system in depression. We aim to determine whether treatment targeting this system relieves depressive symptoms.MethodsUsing real-time qPCR and Western blotting optimal sampling time is determined by an assessment of the diurnal variation of orexin expression. Expression of orexin and its receptors are investigated in the hypothalamus, the hippocampus, and the prefrontal cortex of the Flinders Sensitive Line (FSL) and the Chronic Mild Stress model of depression. Behavioral ...

The problem of ethnic degeneration concerned early European psychiatrists of the 19th century and drove somatic investigation into the brain, coupled with concerns with eugenics. Purifying the human population of its dangerous racial defects emerged of course in full bloodied fury within Nazism of the following century. This paper must be viewed alongside John Locke, Slavery and Psychology involving the theme of Western colonisation from the 17th century until the middle of the 20th century as the drive behind the psychological sciences.

IntroductionEugène Minkowski is one of the great authors of structural phenomenological psychiatry. However, it has stressed only its influence on the study of schizophrenia, however, the scope of its investigations is much coarser, while addresses issues that attempt to illuminate the way they are set life and humans.ObjectivesIt is interesting to pose as the author emphasizes the importance of intuition, on more than one level, giving an epistemologically worthy rank in the constitution of the self (soi-même), in psychopathology and even in the ontology.AimsIt is shown that in Minkowski research on intuition it appears as a study of a symptom called autism, as a psychopathological diagnostic method called empathy, and even as an ontological understanding that purpose of the study time.MethodsReconstruction of the uses of the notion of intuition in the work of Minkowski.ResultsThree ways clearly appear in different planes but complementary, pointing not only to a clinical trial, bu...

Objective: Studying stigma in health care professionals may be helpful to address stigma in people with mental illness. The purpose of this study is to assess (stigmatising) attitudes of mental health care professionals (MHC), forensic psychiatric professionals (FP) and general practitioners (GP) in the Netherlands. Method: The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatising attitudes in three different groups of health care professionals. Scores range from 16 (minimum stigma) to 96 (maximum stigma). Additionally, background information was obtained including gender, age, work and personal experience. Results: All three groups of health care professionals had a positive attitude towards psychiatry and patients with a mental health problem. However, the total MICA score differed significantly between the three groups (p<0.001). GP's had the highest score (44) on stigmatising attitudes, followed by the FP's (39) and MH's (34). In our study population 25%-38% had personal experience with having a mental illness. Most stigmatising attitudes were found regarding protection of the public against patients with severe mental illness, telling colleagues about personal experience with mental illness and, appreciating psychiatry as less respectable compared to other medical disciplines. Conclusion: General practitioners showed in comparison to mental health care professionals a significantly higher stigmatising attitude. The scores still represent a mild positive attitude towards psychiatry and psychiatric patients. Although all three groups have a relatively positive attitude, there is still room for improvement.

IntroductionAfter war 1992–1995 in Bosnia and Herzegovina (BH), whole population was highly psych-traumatized. Mental health therapists had no enough capacities to meet needs of population. They are permanently in need to increase their psychotherapy capacities. EMDR is a powerful, state-of-the-art treatment. Its effectiveness and efficacy has been validated by extensive research. National Institute for Clinical Excellence (NICE) recommended it as one of two trauma treatments of choice.AimTo describe non profit, humanitarian approach in sharing skills of Eye Movement Reprocessing and Desensitization (EMDR) to mental health therapists in BH from Humanitarian Assistance Program (HAP) of UK & Ireland.MethodAuthors described educational process considering the history of idea and its realization through training levels and process of supervision.ResultsHighly skilled and internationally approved trainers from HAP UK & Ireland came four times to Psychiatry Department of University Clinic...

IntroductionPeople with a mental disorder are at increased risk for physical illness and therefore their risk of premature death is raised. An unhealthy lifestyle, living conditions, medication side-effects and a lack of physical health monitoring are regarded as the main causes of high somatic morbidity. But up to now only little research has addressed the physical co-morbidity in mentally ill. At present, there are no specific policies to improve the health status of residents in mental health care facilities.Objectives / methodsAgainst this background a multi-disciplinary network of experts from 15 European countries was set up. Working together with researchers, stakeholders, professionals, networks, practitioners, and relevant organizations, the HELPS network developed a “physical health promotion toolkit” for routine application in a wide range of mental health care facilities across Europe. The HELPS toolkit intends to empower patients and staff to identify the most relevant ...