GLOBAL PSYCHIATRY ARCHIVES2754-93801220181101Pharmacotherapy prescribing patterns in the treatment of bipolar disorder in a South African outpatient population3951138210.52095/gpa.2020.1382ENEleanor Mari HolzapfelDepartment of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, South AfricaChristopher Paul SzaboDepartment of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, South AfricaJournal Article20201103Objectives<br /> To describe the range and frequency of psychotropics used in the management of bipolar disorder in a specific setting as well as describe the nature and frequency of monotherapy versus polypharmacy use. Specifically to determine congruence with recommended standard of care that might inform a review and refinement of prescribing within this context.<br /> <br /> Methods<br /> The study was a retrospective file review for patients with bipolar disorder (ICD 10 and or DSM IV TR diagnostic criteria) attending the outpatient clinic of a specialised psychiatric hospital (Tara Hospital) affiliated to the Department of Psychiatry (University of the Witwatersrand) in Johannesburg, South Africa. Data were presented both descriptively (continuous, discrete and categorical data) and with a range of appropriate statistical tests used for associations between categorical data (Chi Square; Fisher’s exact test; Cramer’s V and the phi coefficient).<br /> <br /> Results<br /> The majority of patients (93.8%) were prescribed polypharmacy, with 3.2 as the mean number of psychotropic medications prescribed per patient (as determined from the last prescription written during the period of review, i.e. one year). There was a notable variety in the combinations used with no particular combination being prescribed in the majority of patients, noting, however, that 47% of the combinations used included a standard mood stabiliser prescribed together with an antipsychotic.<br /> <br /> Conclusions<br /> The current study provides data on the prescribing patterns for bipolar disorder in a specialist psychiatric clinic within an academic complex in South Africa. The findings reflect international studies and highlight polypharmacy and combination treatment as common in such settings. Where polypharmacy is prescribed, the variation in combinations prescribed indicate that whilst treatment guidelines may provide a best practice approach, studies determining the most useful combinations are few and ultimately clinical requirements for individual patients will dictate treatment.GLOBAL PSYCHIATRY ARCHIVES2754-93801220181101Facial emotion recognition performance influences executive control impairment in Anorexia Nervosa: an exploratory study5360138310.52095/gpa.2020.1383ENGiuseppe CarràDepartment of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 - Monza, Italy.
Division of Psychiatry, University College London. 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.Giulia BrambillaDepartment of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 - Monza, ItalyManuela CasliniDepartment of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 - Monza, ItalyFrancesca ParmaDepartment of Psychology, University of Milano Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 - Milano, ItalyAlessandro ChinelloDepartment of Psychology, University of Milano Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 - Milano, ItalyFrancesco BartoliDepartment of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 - Monza, ItalyCristina CrocamoDepartment of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 - Monza, ItalyLuigi ZappaDepartment of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 - Monza, ItalyCostanza PapagnoDepartment of Psychology, University of Milano Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 - Milano, Italy.
CIMeC and CERIN, University of Trento, Via Matteo del Ben, 5/b, 38068 - Rovereto, ItalyJournal Article20201103Objectives<br /> Since evidence on executive control among women with Anorexia or Bulimia Nervosa (AN/BN) are somehow inconclusive, we aimed to explore whether performance in set-shifting in AN/BN might be influenced by Facial Emotion Recognition (FER).<br /> <br /> <br /> Methods<br /> We randomly recruited women with a diagnosis of AN or BN, from an Eating Disorders Outpatient Clinic in Italy, as well as healthy controls (HCs). We evaluated with established tools: diagnosis (Eating Disorder Examination- EDE-17.0), executive control (Intra-Extra Dimensional Set Shift-IED) and FER (Ekman 60 Faces Test-EK-60F). Univariate distributions by diagnostic subgroups were assessed on sociodemographic and clinical variables, which were selected for subsequent multiple linear regression analyses.<br /> <br /> <br /> Results<br /> Women with AN performed significantly worse than HCs on IED adjusted total errors. HCs scored significantly better than AN and BN on EK-60F fear subscale. Although IED set shifting was associated (p = 0.008) with AN, after controlling for age, EK-60F fear subscale, alexithymia and depression (i.e., clinically relevant covariates identified a priori from the literature, or associated with AN/BN at univariate level), this association could not be confirmed.<br /> <br /> <br /> Conclusions<br /> Impaired executive control may not be a distinctive feature in women with AN, since several clinical characteristics, including fear recognition ability, are likely to have an important role. This has significant implications for relevant interventions in AN, which should aim at also improving socio-emotional processing.GLOBAL PSYCHIATRY ARCHIVES2754-93801220181101Increased Risk of Attempted and Completed Suicide in Obsessive Compulsive Disorder: A Systematic Review of Follow-up Studies6170138410.52095/gpa.2020.1384ENReinhard HeunUniversity of Bonn, GermanyJournal Article20201103Obsessive compulsive disorder (OCD) is a severe, often long-term mental disorder. It may be independent from, or comorbid with other mental disorders, especially depression and anxiety disorders. Suicidal thoughts, ideations and ruminations are prevalent in subjects with OCD, but it is not yet clear if the incidences of attempted and completed suicides have increased in comparison with the general population and with other psychiatric disorders.<br /> <br /> Methods<br /> We conducted a systematic literature search on the incidence of suicide attempts and completed suicides in subjects with OCD. Search terms for Pubmed and Medline were OCD and suicide. We selected papers providing follow-up data on the incidence of attempted and completed suicide in OCD.<br /> <br /> Results<br /> 404 papers were initially identified. Only 8 papers covering six studies provided prospective data on attempted or completed suicide over a defined period in subjects with OCD, four studies included control subjects. Two studies providing follow-up data were limited to high-risk samples and did not provide enough data on the incidence of suicide in comparison with the general population. The conclusion that there is an increased risk of attempted and completed suicides in OCD can only be based on one large Swedish National Registry sample with an up to 44 year follow up. Psychiatric comorbidity is the most relevant risk factor for suicide.<br /> <br /> Conclusions<br /> Even though some studies report an increased incidence of attempted and completed suicides in OCD patients from selected high risk samples, the evidence from population based studies is mostly based on one large Swedish study. More long-term studies in the general population with a reduced risk of subject attrition are needed. Using a clear definition and assessment of suicidal behaviour and a common time-frame would improve the comparability of future studies.GLOBAL PSYCHIATRY ARCHIVES2754-93801220181101Quality Assurance in Psychiatric Occupational Therapy by Treatment Manuals: Patients’ Perceptions of Resistance- and Regeneration-specific Occupational Therapy7194138510.52095/gpa.2020.1385ENJenny HufenreuterResearch Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, Berlin, GermanyJosephine OttoResearch Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, Berlin, GermanyMichael LindenResearch Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, Berlin, GermanyJournal Article20201103Objectives<br /> Training, treatment and quality assurance in occupational therapy need guidelines and manuals. Two manuals and corresponding manual adherence checklists were developed for resistance- and regeneration-oriented treatment strategies, which are standard in occupational therapy. The hypothesis is that occupational therapists can apply different treatments and that this can be measured.<br /> <br /> <br /> Methods<br /> In a psychiatric-psychosomatic rehabilitation hospital, 108 patients were randomly assigned to the regeneration group and 113 to the resistance group. Patients were asked to indicate on a manual adherence checklist which interventions they had experienced during treatment. Additionally, a convenience sample of 124 patients who had not participated in the special groups but only in routine occupational therapy was interviewed at the end of the hospital stay.<br /> <br /> <br /> Results<br /> Resistance-oriented interventions were significantly more often reported in the resistance group and regeneration-oriented intervention was reported in the regeneration group.<br /> <br /> <br /> Conclusions<br /> The study demonstrates that the occupational therapy can be standardised according to treatment manuals and that protocol adherence can be ascertained, similar to that in other psychotherapies. This is important for training, practice, research and quality control, as manual guided and monitored treatment allows transparency in regard to what should and what has been done in therapy.GLOBAL PSYCHIATRY ARCHIVES2754-93801220181101Validation of Bangla parenting style and dimension questionnaire95108138610.52095/gpa.2020.1386ENS. M. Yasir ArafatDepartment of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, BangladeshJournal Article20201103Objectives<br /> There has been a plethora of studies conducted on different aspects of parenting and how it affects children. However, assessment of parenting style and dimension is untouched in Bangladesh. The Parenting Style and Dimension Questionnaire (PSDQ) is a self-reporting questionnaire responded by parents regarding their parenting practices, which assesses the three categories of parenting styles, namely, authoritative, authoritarian, and permissive. It was aimed to adapt and validate PSDQ in Bangla which is the mother tongue of the people of Bangladesh.<br /> <br /> <br /> Methods<br /> The validation study was conducted from January 2017 to June 2018 in three schools of Dhaka city with the self-reporting semi-structured Bangla version of PSDQ. The adaptation of PSDQ to Bangla was performed according to the state-of-the-art procedure of forward–backward translation. Parents having children aged 6–16 years were approached through schools to participate in the study. Data were collected from 349 parents and analyzed using Statistical Package for the Social Science version 16.0 software.<br /> <br /> <br /> Results<br /> Cronbach’s alpha of PSDQ Bangla was 0.84, which signifies a good internal consistency. Cronbach’s alpha of authoritative domain was 0.95, authoritarian domain 0.88, and permissive domain 0.78. A total of three factors were extracted using exploratory factor analysis with varimax rotation after discarding four items that had poor correlation and factor loading values. The three extracted factors were authoritative, authoritarian, and permissive; these are similar with the initial three dimensions of PSDQ.<br /> <br /> <br /> Conclusions<br /> Current study resulted in PSDQ Bangla, which retains 35 items in 3 domains with distribution of 20 items in authoritative domain, 9 items in authoritarian domain, and 6 items in permissive domain. The 35-item PSDQ Bangla can be a psychometrically reliable and valid tool to use in clinical setting of psychiatric practices in Bangladesh, especially to deal with child psychiatric disorders.