We partner with a secure submission system to handle manuscript submissions.
Please note:
You will need an account for the submission system, which is separate to your Cambridge Core account. For login and submission support, please visit the
submission and support pages.
Please review this journal's author instructions, particularly the
preparing your materials
page, before submitting your manuscript.
Click Proceed to submission system to continue to our partner's website.
To save this undefined to your undefined account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your undefined account.
Find out more about saving content to .
To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
One hundred and twelve emergency medical staff are faced with many physical and mental problems due to the deterioration of their sleep-wake cycle and getting out of their usual work and social life.
Objectives
The aim of this study was to examine the effects of anxiety, depression, day time sleepiness on the quality of life in 112 emergency medical staff.
Methods
Target population of this cross-sectional study was the 112 emergency medical staff in the province of Rize. We tried to obtain all the universe (n = 154), so the sample was not selected. One hundred and four people (67%) participated in the study. In the data form, Epworth sleepiness scale, Beck Anxiety Inventory, Beck Depression Inventory and the SF-36 quality of life questionnaire were applied.
Results
The prevalence of pathological sleepiness was 14.4% (n = 15), the prevalence of anxiety was 39,8% (n = 41), the prevalence depression was 20,2% (n = 21), respectively (Table 1).
Conclusion
Based on high levels of anxiety and depression that reduces quality of life compared to the general population in 112 emergency services workers, motivational programs, coping strategies, psychological counseling services are required. Also, against the psychosocial risk factors forming anxiety and depression in the working life, organizational measures must be taken.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Body image dissatisfaction is a risk factor for depression. Research has focused on female adolescents; yet little is known about sex and age differences.
Objectives/aims
The aim of our study was to evaluate the association of body weight dissatisfaction, a component of body image, with depression overall, and for different sex and age-groups independent of body weight.
Methods
We analyzed data of 15,975 individuals from the cross-sectional 2012 Swiss Health Survey. Participants were asked about their weight satisfaction. Patient Health Questionnaire (PHQ-9) was used to ascertain depression. Age was stratified in three groups (≥ 18-29; ≥ 30-59; ≥ 60 years). Body mass index (BMI) was self-reported and categorized into normal weight (BMI: 18.5-24.9 kg/m2), overweight (BMI: 25.0-29.9 kg/m2), and obesity (BMI: ≥ 30 kg/m2). The association between weight dissatisfaction and depression was assessed with logistic regression analyses and adjusted for known confounders (including BMI).
Results
Weight dissatisfaction was associated with depression in the overall group (OR: 2.04, 95% CI: 1.66-2.50) and in men (1.85, 1.34-2.56) and women (2.25, 1.71-2.96) separately, independent of body weight (multivariable adjusted). Stratification by age groups revealed associations of weight dissatisfaction with depression in young (1.78, 1.16-2.74), middle-aged (2.1, 1.61-2.74) and old individuals (2.34, 1.30-4.23) independent of BMI. A sub-analysis in the overall group revealed statistically significant positive associations of weight dissatisfaction with depression in underweight, normal weight, overweight and obese individuals.
Conclusion
Body weight dissatisfaction is associated with depression in men, women, young, middle-aged and old individuals independent of BMI.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Type A behaviour pattern (TABP) is defined as the combination of competitive need for achievement, sense of time urgency, aggressiveness, and hostility. Studies raised evidence for an association between TABP and cardiovascular disease. Recent studies on its association with mortality showed contradicting results and used different methods to measure TABP.
Objectives/aims
Investigating the association between TABP and all-cause, CVD, and all-cancer mortality.
Methods
We used data of the MONICA and the NRP1A studies that were linked with the Swiss National Cohort (SNC) (n = 7997). Essentially, the SNC is an anonymous record linkage of census, migration and mortality data. TABP was measured by the Bortner Scale. To determine the all-cause, CVD, and cancer mortality risk a Cox regression was performed. Following Edwards et al. (1990), we analysed the Bortner Scale in two different ways: all items and its two dimensions (speed and competitiveness) separately.
Results
We found a significant association of the Bortner Scale with all-cause mortality in women (adjusted for sociodemographic factors HR 1.02, 95% CI 1.00–1.03, additionally adjusted for lifestyle factors–smoking, alcohol intake, physical activity, BMI category–1.01, 1.00–1.03). The subscale of competitiveness was associated with all-cause and CVD mortality in women. Interestingly, stratifying for lifestyle variables revealed that the association was only present in those having a healthy lifestyle, e.g. non-smoking or non-hazardous alcohol intake.
Conclusions
The Bortner Scale and its subscale of competitiveness were associated with mortality in women. In those having great health awareness, this might offer potential for further reduction of mortality risk.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Social withdrawal is a major health problem that has been related with higher morbidity and mortality rates. There are few studies about the relationship between suicidal behavior and social isolation.
Aim
To describe the existence of suicidal risk in subjects with social isolation.
Method
Participants were 187 subjects referred to a Crisis Resolution Home Treatment because of social isolation. The inclusion criteria were: home isolation, avoiding of social situations and relationships, for at least 6 months. Suicide risk was assessed by the item of the Severity of Psychiatric Illness, dividing in four groups (from absence to high suicide risk). Socio-demographic and clinical data were also analysed.
Results
Most cases (n = 132, 70.5%) had absence of suicide risk. They were predominantly young males in all groups. There were no statistically significant differences in sociodemographic or clinical variables. The mean age at onset of social isolation was lower in the high suicide risk group, having lower socially withdrawn period. This group had also lower rates of child abuse and suicide attempt history. The more frequent diagnosis in all groups was psychotic, affective and anxiety disorders. Those cases with mild and high suicide risk needed more frequently hospitalization.
Conclusions
Social isolated people attended by CRHT do not have high frequency of suicide risk. Cases with higher suicide risk are younger and have a shorter period of isolation. The absence of child abuse history or previous suicide attempts contrasts with previous suicidal behavior research. These data can be influenced by the characteristics of functioning of CRHT and the small sample size.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Depressive disorders have been related to increased health service utilization, but specific information about associations between health professional-diagnosed depression and the utilization of health care and preventive services in the general population is limited.
Objectives
To compare the use of health care and preventive services among men and women with and without diagnosed depression in the general population in Germany.
Aims
To examine the association of diagnosed depression with the utilization of healthcare and preventive services.
Methods
Cross-sectional analysis of data from the representative telephone survey German Health Update (GEDA) 2009 and 2010 (n = 43.312 residents in private households 18 years and older). We analyzed associations between self-reported health professional-diagnosed depression (past 12 months) and the use of a range of healthcare services and preventive services covered by statutory health insurances using multivariable regressions adjusted for age, socio-economic status, marital status, employment and number of chronic somatic conditions.
Results
Twelve-month diagnosed depression was associated with increased health care service utilization (physician contacts, hospital admissions, rehabilitation) in both sexes. Of the preventive services, diagnosed depression was associated with increased use of general health check-ups, cancer screening and flu vaccination among women, while there was no association with dental check-up and tetanus and pertussis vaccination. Among men, no association of diagnosed depression with any preventive service was found except for cancer screening.
Conclusions
Health professional-diagnosed depression is associated with increased health service utilization independent of somatic comorbidity and socio-demographic confounders. This includes some preventive services in women and only one preventive service in men.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
In deprived environments, mental health problems for both the mother and her stunted child may be related.
Objective
To verify possible association between a child's nutritional and mental health status with common maternal mental disorders (and associated impairment).
Aims
To contribute to management of malnutrition and mental health in low-income populations.
Methods
Case-control study in which 48 malnourished children (aged 48 to 72 months) were compared with 50 eutrophic children. The child's nutritional status, the children's mental health, the maternal mental health, and the associated disability were evaluated by using the WHO criteria, the “Strengths and Difficulties Questionnaire” (SDQ), the “Self-Report Questionnaire”-20 (SRQ-20), and the “Sheehan Disability Scale” (SDS), respectively. In addition, selected socio-economic aspects were considered.
Results
Variables with significant odds ratio (OR) in the univariate analysis were: maternal education (OR: 2.96, 95% CI: 1.30–6.75), number of residents in the household (OR: 0.32, 95% CI: 0.14–0.74), number of children in the household (OR: 0.25, 95% CI: 0.10–0.61), and social class (OR: 2.30, 95% CI: 1.02–5.18). The only SDQ dimension that tended to be associated with malnutrition was conduct problems (P = 0.08). The disability associated with probable common maternal mental disorders (CMD) also showed statistically significant association (P = 0.02). In the logistic regression, child malnutrition remained associated with child conduct problems and disability associated with probable CMD.
Conclusions
Conduct problems in stunted children are positively associated with CMD and related disability. Longitudinal studies are necessary to confirm these hypotheses.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Workforce migration of mental health professionals seems to have a significant impact on mental health services, both in the donor and host countries. Nevertheless, information on migration in junior doctors within Europe is very limited. Therefore, the European Federation of Psychiatric Trainees (EFPT) has conducted the Brain Drain Survey.
Objectives
To identify, in junior doctors training in psychiatry, the impact of international short-term mobility experiences, towards a future workforce migration across countries, exploring its patterns and reasons.
Methods
In this cross-sectional international study, data were collected from 2281 psychiatric trainees in 33 countries. All participants answered to the EFPT Brain Drain Survey reporting their attitudes and experiences on mobility and migration.
Results
Only one-third of the trainees had a short-mobility experience in their lifetime, being education the main purpose for these experiences. Interestingly, the main predictors for future migratory tendency were not only the having a income and being dissatisfied with this income, but having a short-mobility experience. In fact, people that had short-mobility experiences were two times more likely to express a migratory tendency. Trainees that went abroad were predominantly satisfied with their experiences, reporting that these influenced their attitudes towards migration, positively.
Conclusions
These findings show that short-term mobility has a positive impact into future long-term migration, increasing its probability.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Role functioning is key to optimal health and inoculates against life-long inequality. Depression is a leading cause of functional disability. In most cases, improved symptomatology corresponds with improved functioning; however, functioning does not always return to “normal”, despite symptom remission. Furthermore, the relationship between symptom remission and the likelihood of being Not in Employment, Education or Training (NEET) is unknown.
Objectives and aim
To examine the temporal associations between depression course, functioning, and NEET status in young adults with mental health problems.
Methods
A prospective and multisite clinical cohort study of young people aged 15–25 years seeking help from a primary mental health service (n = 448). Participants completed a clinical interview (incl. QIDS-C16) and self-report battery (incl. WHODAS 2.0, employment, education) at baseline which was repeated at 12-month follow-up whilst continuing treatment as usual.
Results
Remitted depression was significantly associated with improved functioning; however, 12 month functioning was still lower than the normative ranges for age-matched peers. Remittance of depression did not change the likelihood of being NEET. Only 10% of those who were NEET had received vocational support during the study.
Conclusion
Remittance of depression was associated with improved functioning but it did not reduce the likelihood of being NEET. This may be explained by economic influences or alternatively, a time lag may exist where improvements in functioning do not immediately correspond with reduced NEET rates. Lastly, there may be a scarring effect of depression such that change in NEET status requires an additional intervention to depression treatment.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
To explore association of family stress with other psychosocial factors in female population aged of 25–64 years in Russia.
Methods
Under the third screening of the WHO “MONICA-psychosocial” program random representative sample of women aged 25–64 years (n = 870) were surveyed in Novosibirsk. Questionnaire “Awareness and attitude towards the health” was used to estimate levels of family stress. Chi-square (χ2) was used for assessment of statistical significance.
Results
The prevalence of high family stress level in women aged 25–64 years was 20.9%.
High family stress was higher in age groups 25–34 years and 45–54 years: 27.6% and 30.5%, respectively. Among women with family stress, 58.7% had high level of trait's anxiety. Women with stress at family had high rate of major depression (11%). There were tendencies of higher prevalence of hostility and vital exhaustion in those with stress (41.1% and 27.4%, respectively). Among those in female population with stress at family, 60.6% had sleep disturbances. Social support like close contacts and social network tended to be lower in women with family stress: 59.1% and 80.3%, respectively. Rates of serious conflicts in family were more often in younger age groups and reached 48.6%. In women aged 25–34 years, 54.9% have no possibilities to have a rest at home after usual working day (P < 0.001).
Conclusions
The prevalence of high stress in family in female population aged 25–64 years is more than 20% in Russia. High family stress closely associated with anxiety, major depression, high hostility and vital exhaustion, poor sleep and low social support.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Pregnancy complications may require admission in a high-risk pregnancy unit (HRPU). A complicated pregnancy and hospital admission might negatively affect the pregnant woman's mental health.
Objectives
To screen for depressive symptoms in pregnant women admitted in a high-risk pregnancy unit due to threatened preterm labour and also to investigate for associated risk factors.
Aims
Early identification of prenatal depression will decrease the risk of pregnancy complications and postnatal depression.
Methods
A prospective study enrolled pregnant women admitted at 324 gestational weeks due to threatened preterm labour in a university hospital HRPU, between 9/2014 and 11/2015. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess depressive symptoms and a cut-off score 313 was considered as indicative of depression. Test results were then correlated with the indication for admission, demographic and socio-economic parameters.
Results
Overall, 80 of the women admitted in the HRPU were eligible for the study and agreed to complete the questionnaire. The mean age was 29.4 ± 6.23 years and the mean gestational week at the admission was 31.6 ± 3.33 weeks. The prevalence of prenatal depression (score 313) was 25% (20/80). In the multivariable model, depression was significantly correlated with the existence of thoughts for pregnancy termination [P = .03 OR = 4.560 95% CI: (1.162–17.892)].
Conclusions
One quarter of pregnant women admitted in the HRPU with the indication of threatened preterm labour may suffer from clinically significant depression. An unwanted pregnancy was found to be independently associated with prenatal depression whereas no association was found with any obstetric parameters.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Studies have demonstrated the high prevalence of depressive disorders amongst elderly people and their underestimation and mistreatment.
Objective
The aim of this study is to describe epidemiological issues in a sample of elderly hospitalized patients, giving special attention on the prevalence of depressive and anxiety disorders and the detection of potential risk factors.
Material and methods
The sample included 168 elderly patients referred for the geriatric unit of a general hospital. Epidemiological and clinical data were collected. Geriatric Depression Scale (GDS), Mini Mental State Examination (MMSE) and Functional Independence Measure (FIM™) were used. Data were analyzed with XLSTAT program.
Results
The 39% of the sample were men and the 61% women, with an age range between 65 and 95 years. Nine percent of patients aged 65–84 had a diagnosis of depressive or anxious-depressive disorder, compared to 13% within the age range 85–95. However, 14% of patients aged 65–85 had a GDS higher than 5 and 19% for the patients aged 85–95, which could confirm the underestimated rate of depression diagnosed in elderly patients. Item “feeling loneliness” was pointed out in 75% and item “feeling bored” in 64% of all GDS higher than 5. Prevalence of dementia was 8% in the whole sample.
Conclusions
High prevalence of depressive and anxious disorders amongst the elderly is to be taken in account. Potential risk factors could be loneliness and lack of daily activity. The development of social primary prevention interventions in order to decrease the prevalence of these pathologies amongst elderly is needed.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Classical work on lethal aggression often viewed suicide and homicide as sharing a common source.
Objective
The present investigation explores the association between measures of social deprivation on the relative incidence of suicide over homicide in Italian provinces.
Methods
Data refer to official government sources on lethal violence rates and measures of social deprivation. The central dependent variable is termed SHR or the suicide rate expressed as a proportion of the sum of the suicide and homicide rates Data were available for the 103 Italian provinces.
Results
The SHR had three significant predictors. The greater the percentage of the population with low education, the lesser the tendency towards suicide. The tendency towards suicide was also predicted by rental housing, the greater the percentage of the population living in rental housing the less the tendency towards suicide. The inverse of the unemployment rate also predicted the SHR. Given that the measure follows an inverse function, the greater the unemployment rate the lesser the tendency towards suicide relative to homicide (SHR). We can interpret the results relative to a homicidal tendency in the SHR: the greater the low education percentage of the population, the greater the homicidal tendency, and the greater the rental housing percentage, the greater the homicidal tendency in the SHR.
Conclusion
The results are consistent with a stream of previous research that connects deprivation with a relatively high probability for disadvantaged populations to direct aggression outwardly in the form of homicide rather than inwardly in the form of suicide.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Interpersonal stressors and social isolation are detrimental for emotional health, but how these factors are related to loneliness and altogether influence risk for mental disorders is not well understood.
Objectives
To examine the mediating role of loneliness in the associations of relationship quality and social networks with depressive symptoms, anxiety, and worry among a sample of Irish men and women in late-life.
Aims
To determine the gender-specific risk for mental disorder associated with poor social relationships and loneliness among older adults.
Methods
Data came from the Irish Longitudinal Study on Ageing (TILDA). Nationally representative data on 6105 community-dwelling adults aged > 50 years were analyzed. Follow-up data was obtained two years after cohort inception. Multivariable linear regressions and mediation analyses were used to assess the associations. Analyses were stratified by gender.
Results
Better spousal relationship quality was protective against depressive symptoms and worry for men. For both genders, support from friends was protective against depressive symptoms, and better relationship quality with children was protective against depressive symptoms and worry. Social network integration was inversely related to depressive symptoms for men. Loneliness significantly mediated most associations (Tables 1–3).
Conclusions
High quality spousal relationships and social integration appear to play a more central role for mental health among men than for women. For both genders, poor social relationships increase feelings of loneliness, which in turn worsens mental health. Interventions to improve relationship quality and social networks, with a focus on reducing loneliness, may be beneficial for the prevention of mental disorders among older adults.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
General hospital-based studies may help towards improving the treatment of psychiatric disorders.
Objectives and aims
Based on five representative studies in general hospital admissions, we will represent a comparative overview of suicidal events due to overdose and of the most common medical comorbidities in psychiatric disorders of ICD-10 classes F1–F4.
Methods
In secondary analysis one-way Anova and Tukey HSD test were used for comparisons of interval variables. Suicidal events and medical comorbidities with prevalences > 10% were compared between studies using the OR and the 95% CI.
Results
Individuals with psychiatric disorders of ICD-10 classes F1–F4 were young (44.7–50.0 years), had an extended length of hospital stay at initial hospitalization (3.8–8.1 vs. 2.9–3.4 days), and significantly more likely suffered of suicidal events due to overdose than controls, contributing from 4.1% (OR = 4,1) to 11,6% (OR = 25.2) to general hospital admissions. Additionally, individuals with schizophrenia (SCH) significantly more likely suffered of type-2 diabetes mellitus (OR = 2.3, 95% CI 1.5–3.6) than individuals with major depressive disorder (MDD), anxiety disorder (ANX), and alcohol dependence (AD), but equal likely as individuals with bipolar disorder (BD). Asthma and hypertension contributed significantly more to hospitalizations in the MDD and ANX samples compared to the SCH, BD, and AD samples. In the AD sample, alcoholic liver disease was more prevalent than in all other samples.
Conclusions
In psychiatric disorders, the frequency of suicidal events due to overdose in general hospitals is significantly determined by the diagnostic class. Additionally, different medical comorbidities contribute more than other medical comorbidities to general hospital admissions in various psychiatric disorders.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The increasing number of dementia is of major public health concern. This study aims to calculate the projected number and prevalence of dementia in Japan, using data from the Toyama Dementia Survey.
Methods
The Toyama Dementia Survey was conducted 6 times in 1983, 1985, 1990, 1996, 2001, and 2014. In the 2014 survey, the subjects were randomly chosen from residents aged 65 or more in Toyama prefecture, with a sampling rate of 0.5%. Of those, 1303 men and women agreed to participate (participation rate: 84.8%). An interview with a screening questionnaire was conducted by public health nurses. Psychiatrists and public health nurses further investigated for the suspected cases of dementia and diagnosed whether the cases had dementia. The 1985–2001 surveys were conducted in a similar way, and, therefore, data from the 1985–2014 surveys were used in the analysis.
Results
The prevalence of dementia in Toyama prefecture increased from 4.7% in 1985 to 15.7% in 2014. Using the age and sex-specific prevalence of dementia in the 2014 survey, the projected number of dementia is approximately 4.8 million (prevalence rate: 14.1%) in 2015, 6.1 million (16.7%) in 2025, and 7.2 million (19.2%) in 2035. Using the age and sex-specific prevalence of dementia as estimated by linear regression models, the projected number of dementia is approximately 4.7 million (13.9%) in 2015, 7.1 million (19.5%) in 2025, and 9.7 million (25.8%) in 2035.
Conclusions
The number of dementia in Japan could double in the next 20 years, which corresponds to 1 in 4 elderly people.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Forensic psychiatric services are costly and highly restrictive for patients. Clinical experience and the limited research available indicate some patients stay for too long in these settings. A proportion of patients may, however, require long-term (potentially life-long) secure forensic psychiatric care but their needs may not be met by existing service provision designed for faster throughput.
Objectives
We conducted a national, multi-centre, cross sectional study exploring the prevalence of long-stay and characteristics of long-stayers in high and medium secure forensic psychiatric care in England.
Aims
(1) Estimate the prevalence of long-stay in secure settings in England (length of stay over 5 years in medium secure care or 10 years in high secure care); (2) describe the characteristics, needs and care pathways of long-stay patients. Develop recommendations following the exploration of international models for this patient group.
Methods
We employed a mixed-methods approach including the analysis of administrative data, case file reviews, patient interviews, consultant questionnaires, interviews with clinicians and commissioners and a Delphi survey.
Results
Twenty-five percent (n = 401) of our sample were experiencing long-stay. This patient group has a heterogeneous set of characteristics and needs relating to their diagnosis, offending history, risk and therapeutic need and have experienced a variety of care pathways through secure care.
Conclusions
We found a greater number of long-stay patients than originally estimated with a set of characteristics and needs that are arguably different to that of the general forensic population, therefore calling for a specific care pathway and service provision for this patient group with a greater focus on autonomy and quality of life.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
There are many studies of HIV-infected patients where have found higher prevalence of substance use disorders than in general population. Moreover some factors, like presence of legal problems, substance abuse and HIV are also frequently related with poorer clinical results.
Objectives/aims
The aim of this study is to analyze the relationship between substance consumption and presence of legal problems among HIV-infected patients.
Methods
Our study is a cross-sectional case-control survey. Cases were defined as HIV-infected patients who referred presence of legal problems in a sociodemographic questionnaire. Controls were defined as HIV-infected patients who denied presence of legal problems. Both groups were interrogated about illegal substance use (cocaine, heroin, cannabis, stimulants or benzodiazepines) and alcohol problematic use during previous year. Logistic regression was employed as statistical analysis. Results were adjusted for age, gender and race.
Results
Our sample was compound by 63 patients: 44 controls and 19 cases. A statistical signification was found between illegal substance use variable and presence of legal problems (P = 0.003) but not with alcohol problematic use. The condition of illegal substance use during previous year increased the risk to have legal problems 5.353 times. Another important result was found in gender, the condition of male increased the risk to have legal problems 2.32 times than female condition.
Conclusions
In our sample, substance use (cocaine, heroin, cannabis, stimulants or benzodiazepines) during previous year was related to have more legal problems. Gender, specifically male condition, also was linked with more risk to have legal problems.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Description through a survey of physical aggressions suffered by Spanish Medical Trainees of all specialties.
Methods
We developed a survey through an online platform that was distributed to all Spanish trainees of all medical specialties. In that survey, we ask residents if they ever have been physically assaulted, for how many times, the year of residence when it occurred, if they have in their hospital an aggression protocol, and if it included a specific topic for trainees. We also asked them about their feelings after they have been assaulted.
Results
We collected 282 answers from the survey. We could observe that 12.9% of respondent trainees had been assaulted as least once. Fifty-one percent of times, it occurs during the first year of residency. Among assaulted residents, 25.5% were psychiatric trainees, and 44.4% were medical trainees, but no psychiatrist. Twenty-three percent were psychiatric trainees, and the 35% of them had been assaulted once. Only 25.2% of the residents knew the aggression protocol of their work center, but the majority (65.5%) did not know it. About how do they feel after being assaulted, most of them responded that they felt anxiety, helplessness, fear and they had even thought of leaving de residency or change it.
Conclusions
Aggressions during the trainee period seems to be prevalent (12,9%). Most trainees don’t even know if there is a aggression protocol in their hospitals, we think that a prevention and supporting guideline should be design for improve this prevalent situation.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Pedophilia is a disorder where sexual preferences of adults are directed towards children. This disorder impacts society with 1–2 out of every 10 children being sexually approached by an adult, often resulting in prolonged negative psychological effects. Prior research reported structural and functional amygdala alterations in pedophilia. As the neurophenomenological model of sexual arousal suggests the importance of the amygdala in the emotional component, we focused on amygdala functional connectivity in pedophilia.
Aims
To investigate amygdala functional connectivity (FC) modulated by expectancy and salient stimuli in pedophilic patients.
Methods
Thirteen pedophilic patients and 13 matched healthy controls underwent a salience expectancy task in a 7T ultra high fMRI study. Subjects perceived pictures of naked adults and children. Half of the pictures were preceded by an expectancy cue. Participants were instructed to actively expect the picture depending on the cue. We conducted psychophysiological analysis (PPI) to examine amygdala FC changes in two amygdala sub-regions for child/adult stimuli during the expectancy period and the visual stimuli consummation period using as seed regions the basolateral (BLA) and central nucleus of the amygdala (CeA).
Results
Healthy controls, relative to patients showed significant stronger left CeA to right post-central gyrus FC during expectancy of adult > child picture. For picture condition (adult > child picture) we found significant stronger left CeA to left dorsolateral prefrontal cortex FC in patients compared to healthy controls.
Conclusion
These findings add to the recent literature by indicating that amygdala dysfunctional connectivity is involved in development of deviant sexual behavior.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Historically, psychopathic individuals have mainly been described as characterized by pervasive callous-unemotional traits, with dramatic implications for clinical and forensic practices – such as the tendency to deem psychopathic individuals as untreatable. However, recent evidence with community samples have highlighted that psychopathic traits may be in fact related to emotion dysregulation rather than being the mere reflection of an underlying ‘unemotionality’. Yet, it is no clear if this association extends to populations with more severe forms of psychopathy (i.e., offenders).
Objectives
We wanted to replicate previous evidence of an association between emotion dysregulation and psychopathic traits in a sample of incarcerated offenders.
Aims
To investigate the associations among emotion dysregulation dimensions and psychopathic traits, exploring similarities and differences between the Interpersonal-Affective and the Antisocial-Lifestyle facets of psychopathy.
Methods
A sample of male offenders incarcerated in Italian jails completed the Self-Report Psychopathy Scale (SRP-4; Paulhus, Neumann, & Hare, 2015) and the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004).
Results
In line with the expectations, emotion dysregulation dimensions did predict higher levels of psychopathic traits. Structural Equation Modelling revealed that selected dimensions of emotion dysregulation were associated with different facets of psychopathy.
Conclusions
Based on our findings, we argue that psychopathic traits may be associated to a certain extent with emotion dysregulation, and thus a focus on improving emotion regulation skills may hold the promise to dampen the therapeutic pessimism when dealing with psychopathic offenders.
Disclosure of interest
The authors have not supplied their declaration of competing interest.