This study examined low episodic memory scores as a potential risk factor for developing depression by using longitudinal data from the PART project in Stockholm, Sweden.

A population-based sample of non-depressed participants (20-64 years) were re-examined three years after the initial screening (n=708). At baseline, a neuropsychological test battery including tests of episodic memory was administered. Also, information about demographic and socioeconomic factors, alcohol use, and anxiety diagnoses was collected. The psychiatric data for depression diagnoses were collected both at baseline and follow-up.

Logistic regressions were conducted on three separate study groups that were defined according to three different assessments of episodic memory (i.e., free + cued recall, free recall or cued recall) among individuals who scored in the 25 lowest or highest percentiles in the memory tests. The results suggest that low episodic memory performance defined as the sum of free and cued recall of organizable words, constitute a risk for depression diagnosis three years later, even after controlling for differences in demographic, socioeconomic, alcohol use and anxiety levels. Also, female gender, low educational level, and financial strain constituted significant risk factors for developing depression.

This study indicates that low episodic memory performance predates depressive diagnosis and might be considered as a premorbid marker of incipient depression.

The objective of this study was to examine the experience and expression of anger in eating disorders (EDs) including bulimia nervosa purging (BN-P) and anorexia nervosa restrictive (AN-R) subtypes, impulsive disorders such as pathological gambling (PG), obsessive-compulsive disorder (OCD) and a non psychiatric healthy control group.

The sample comprised 80 female SODs individuals (20 BN-P, 21 AN-R, 19 PG, 21 TOC) consecutively admitted to our Department and 21 healthy controls. Patients were diagnosed according to DSM-IV-R criteria. We administered the State-Trait Anger Expression Inventory-2 (STAXI-2). in the control group, the GHQ-28 was also employed.

Compared to the healthy control group, elevated Trait Anger scores were revealed for the BN-P (p< .011) and OCD (p< .003) groups. in addition, the OCD group scored higher on this scale than the PG patients (p< .039). as regards to State Anger, higher scores were uncovered for the OCD patients than for the control group (p< .017). Finally, when Anger Expression was assessed, higher scores were found for the OCD (p< .001) and BN (p< .001) individuals when compared to healthy controls. in addition, compared to AN-R, the BN-P and OCD exhibited higher scores on this scale (p< .001 and p< .037, respectively).

Our results indicate that, OCD and BN-P patients may have inadequate anger expressions and deficits in coping with anger and frustration when compared to a healthy control group. Conversely, no significant differences were revealed between AN-R, PG and controls. Finally, some differences across diagnoses were also obtained.

A high prevalence of Self-Injurious Behaviour (SIB) and suicide attempts has been found in patients with Eating Disorders (ED) as well as in patients with a Borderline Personality Disorder (BPD). Since there is a high comorbidity of these two disorders the impact of BPD on the occurrence of self-harm in patients with ED is unclear. This study examined the occurrence and clinical relevance of SIB and suicide attempts in a large sample of 1638 female inpatients with ED, comparing patients with and without a comorbid BPD.

The sample consists of 632 patients with anorexia, 659 with bulimia nervosa and 347 with EDNOS according DSM-IV; 100 had a comorbid BPD. The assessment included the Eating Disorder Questionnaire, the Eating Disorder Inventory, the Self-Harm Behaviour Survey, the Traumatic Life Event Questionnaire, the Dissociative Experience Scale, the Barratt Impulsivity Scale and other.

The lifetime prevalence for the whole sample of SIB and for suicide attempts was 34% and 33% respectively. The risk for SIB doubled with the presence of a comorbid BPD and the risk for suicide attempts increased fivefold. The presence of BPD was associated with significantly severer psychopathology but neither SID nor BPD did compromise the treatment outcome.

SIB and suicidal behaviour are common and important issues in patients with eating disorders. A comorbid BPD increases the risk of SIB and especially of suicide attempts dramatically. This should be taken into account in primary care in order to identify this high risk group.

Bruxism is a syndrome with uncertain etiology but with proposed factors: psychosocial, peripheral and central. Treatment is also controversial and one of the options focuses in GABA theory and regularization of ion channels. Xelox (capecitabine + oxaliplatin) and bevacizumad is indicated for metastatic colorectal cancer, being oxaliplatin the most neurotoxic agent (acute syndrome and/or a chronic sensory neuropathy). Acute neurotoxicity is very frequent and it is a sensory and/or a motor toxicity (as tongue tingling or jaw spams). The proposed pathogenesis – neuronal hyperexcitability due to alterations of voltage-gated ion channels – is supported by mechanism of action of some treatments.

Review different causes of bruxism.

Description of a clinical case.

This is a story of 76-years-old man in treatment for metastatic colon cancer that developed toxicity: nauseas (treated with haloperidol), bruxism and gingival atrophy. He was referred to psycho-oncology by involuntary movements of mouth and trunk. The patient complained of sadness, anhedonia and insomnia since recurrence of cancer and related the movements with CT. At observation he was anxious, tearfulness and agitated. He was treated for a depressive episode, but the doubt remained about involuntary movements: haloperidol was a confounding factor for oxaliplatin acute neurotoxicity, also aggravated by psychic and peripheral factors.

The authors believe that bruxism is linked to CT in a very complex relation that includes psychic, peripheral and central factors. Psychiatrists need to keep attention to the patient as a whole, not being seduced by easy answers like psychosocial factors.

The authors have not supplied their declaration of competing interest.

Neuroleptic malignant syndrome (NMS) requires prompt recognition for effective management, but there are no established diagnostic criteria.

To validate the recently published international expert consensus (IEC) diagnostic criteria for NMS, which assign priority points based on the relative importance of each criterion for diagnosing NMS.

Determine optimal diagnostic cutoff for priority point score.

Data were extracted from 221 archived telephone contact reports of clinician-initiated calls to a national telephone consultation service from 1997–2009; each case was given a total priority point score based on the IEC criteria. DSM-IV-TR research criteria, in original form and modified to accept less than ‘severe’ rigidity, served as the primary diagnostic reference standard. Consultants’ diagnoses served as an additional reference standard. The optimal priority point cutoff score was determined using receiver operating characteristic (ROC) curve analysis.

Area under the ROC curve ranged from 0.715 (95% CI = 0.645–0.785, P < 0.001) for consultant diagnoses to 0.857 (95% CI = 0.808–0.907, P < 0.001) for modified DSM-IV-TR criteria. The latter was associated with 69.6% sensitivity and 90.7% specificity.

Agreement was best between IEC criteria with a cutoff score of 74 and modified DSM-IV-TR criteria (sensitivity 69.6%, specificity 90.7%); this cutoff score demonstrated the highest agreement in all comparisons. Consultant diagnoses showed much better agreement with modified, compared to original, DSM-IV-TR criteria, suggesting that the DSM-IV-TR criterion of “severe” rigidity may be more restrictive than what most knowledgeable clinicians use in practice.

The authors have not supplied their declaration of competing interest.

There has been a rapidly increasing rate of students disclosing specific learning difficulties in higher education- in 2016 dyslexic students accounted for up to 5% of the student population.(Ryder D, Norwich B.)

It is important that provisions for alternative learners are developed in order to increase accessibility to medicine. Podcasts are an inexpensive, accessible and convenient method to both deliver education and interest pieces to a new generation of learners. This poster aims to explore the idea of harnessing the technology available to us to create an accessible, enjoyable platform to improve the experience of students with learning difficulties.

A literature search reviewing the past and present provisions for students with learning difficulties was conducted using a range of databases covering educational, scientific and medical backgrounds. 315 papers were found across the databases, each analysed for relevance and 25 were selected as appropriate.

identified 5 key themes; the lack of awareness and importance of education, the power of audio learning, the practicalities of podcasts, adjustments to examinations specifically and finally additional provisions which accompany audio learning to create an all-inclusive educational experience. Altogether suggesting podcasts have an improved outcome for students with learning difficulties.

It has been evidenced understanding is key to maximising learning potential and highlighted need to increase awareness of dyslexic needs in higher education institutions, generate audio centred provisions in conjunction to traditional materials and be aware of alternative provisions to cater for the spectrum of dyslexic needs.

In clinical practice, insomnia is a common feature in anorexia nervosa (AN). Sleep self-reports in AN suggest that these patients report poor sleep quality and reduced total sleep time. Weight loss, starvation and malnutrition can all affect sleep. Patients with eating disorders who have sleep disturbances have more severe symptomatology.

The authors intend to review sleep disturbances observed in AN, describe possible pathophysiological mechanisms and evaluate the clinical impact of sleep disturbances on the treatment and prognosis of the disease.

In this study, a non-systematic search of published literature from January 1970 and August 2015 was carried out, through PubMed, using the following keywords: ‘sleep’, ‘anorexia nervosa’ and ‘insomnia’.

These patients subjectively report having poor sleep quality, with difficulty falling asleep, interrupted sleep, early morning waking or reduced total sleep time. Sleep disturbances found in AN using polysomnography are: reduction in total sleep time, decrease in slow wave sleep, slow wave activity and reduced sleep efficiency.

Privation of adequate and restful sleep has a negative impact on the quality of life of patients, may contribute to the appearance of comorbidities, such as depression and anxiety, and to a poor prognosis for AN.

The authors have not supplied their declaration of competing interest.

The diagnostic frontiers of social anxiety disorder (SAD) are still controversial, since it could be described as part of a continuum of severity rather than as a disorder based on an arbitrary threshold with qualitative distinctions. The present study aims to investigate possible differences among subjects along the social anxiety spectrum using the Simulated Public Speaking Test (SPST), an experimental model of human anxiety. Afterwards, the anticipatory measures of SPST among groups were correlated with different volume of gray matter areas by MRI using the voxel-based morphometry method.

We evaluated patients with generalized SAD (n=25), subjects with subclinical SAD (with fear of a social situation without avoidance or impairment; n=14) and healthy controls (n=22).

The subjective SPST findings showed that avoidance and functioning impairment were due to a negative self-evaluation in SPST and not to the level of anxiety experienced. When all groups were pooled together, there was a positive correlation between levels of anxiety experienced and the volume of the right amygdala. The negative self-evaluation of performance in the SPST was associated with a reduction in the volume of the anterior cingulated complex (ACC) only in the SAD group.

These results suggest that the association between anxiety and amygdala volume may be a part of a continuum of social anxiety. However, the correlation between self-evaluation of performance with reduced ACC volume only in the SAD group does not support the idea that this association may be also part of a continuum.

Brain tumors (BT) sometimes present with psychiatric symptoms, with or without neurological ones, and BT patients with psychiatric symptoms are sometimes mistakenly oriented towards psychiatric/psychological care. Case studies concluded that atypical psychiatric symptoms should lead to neurological investigation, but no description of such atypical symptoms has been provided.

The present study aims to quantify the prevalence and further describe psychiatric symptoms occurring before a BT diagnosis.

We aim to sensitize physicians to consider more systematically neurological options, and to provide them with a description of atypical pattern of psychiatric symptoms occurring in patients with BT.

Fifty patients with a first diagnosis of BT (21 males and 29 females, aged 25-81 years) completed an anamnestic interview, the Mini International Neuropsychiatric Interview, and the Beck Depression Inventory (BDI-II), in order to investigate and describe current and past psychiatric symptoms. A neuropsychological evaluation was also conducted.

Most patients (45/50) reported at least one psychiatric symptom during the months before the BT diagnosis. About half of them presented anxious or depressive symptoms according to the clinical interviews and the BDI-II. Interestingly, somatic symptoms of depression (tiredness, slower reactions, appetite changes…) were often reported, in contrast to cognitive ones (guilt, self-criticalness…). The influence of the BT characteristics and the neuropsychological profile will be discussed.

The results confirm the frequent occurrence of psychiatric symptoms before a BT diagnosis and provide a first description of these symptoms, as the basis of future recommendations for physicians.