The diagnoses of autism spectrum disorders (ASDs) are based on a phenotype, characterized by impaired social interaction and communication and by repetitive and restricted interests. However, this might not represent a single clinical entity, but a behavioral manifestation of different neurodevelopmental deficits with a multifactorial etiology. Small studies have shown elevated levels of oxidative stress and lower levels of anti-oxidants in patients with ASD, and correlations with the severity of ASD. Therapies targeting oxidative stress have shown improvements regarding behavior, social interaction and verbal communication in patients with ASD, supporting the oxidative stress theory.

To evaluate the importance of oxidative stress in the neurobiology of adults with ASD.

There is a need to understand the neurobiology of ASD, therefore this study analyzes the level of oxidative stress in a larger cohort of patients with ASD and compares to controls.

The study includes 350 patients over 18 years of age diagnosed with ICD-10 diagnoses F84.0, F84.1, F84.5 or F84.8 and compared to gender and age matched neurotypical controls. The included probands will have their serum and plasma analyzed for levels of oxidative stress (superoxide dismutase 1 and 2, catalase, glutathioneperoxidase, malonialdehyde, thiobarbituric acid reactive substances and xanthinoxidase).

The preliminary results will be presented at the EPA in March 2016 in Madrid.

With this study we aim to elucidate some of the neurobiology in ASD. This could lead to new potential targets for treatment and prevention of the disorders.

The authors have not supplied their declaration of competing interest.

Micro-RNAs (miRs) are involved in processes associated with MDD such as neural plasticity, neurogenesis, synaptogenesis and stress response. MiRs are detectable in biological fluids; however, no data is available regarding the use of plasma circulating miRs as markers of MDD, only whole blood or serum being reported so far.

We investigated plasma miR profiles as potential markers for MDD in patients treated with antidepressants.

To detect and characterize differentially expressed miRs in the plasma of MDD patients, before and after treatment with escitalopram.

Blood was collected from patients with MDD before and after 12 weeks of treatment. Plasma profiles of 1008 miRs were measured by real time PCR. The fold change of expression between time points was calculated and a paired t test was used for statistical significance. Gene targets and pathways were assessed in miRWalk2.0.

From 222 plasma miRs expressed, 40 were significantly different after treatment. Upregulated miRs (23) belonged to 43 pathways, down-regulated miRs (17) belonged to 46 pathways; the top 5 significant pathways identified being pathways in cancer, Wnt signalling, endocytosis, axon guidance and MAPK signalling. Six of these miRs are common to all five pathways: miR-146a-5p, miR-146b-5p, miR-221-3p, miR-24-3p, miR-26a-5p.

Our analysis of significant changes in plasma miRs after escitalopram treatment of MDD might open new avenues for the understanding of its mode of action and its side effects. To our knowledge, this is the first study to assess miRs affected by antidepressant treatment in plasma of MDD patients.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

To study the association gene of candidate NPSR1 rs324981 with sleep disorders in the open population of men 45–64 years of Novosibirsk.

The study of the association candidate gene polymorphisms with sleep disorders was carried out during the examination of a random representative sample of men 45–69 years (n = 1770). The response rate was 61%. The median age is 56.5 year. Every 12 a man was selected for genotyping (n = 147). To assess the level of sleep was used a questionnaire which was filled with self-test. Statistical analysis was performed using SPSS-11.5.

The level of sleep disorders in the male population of 45–64 years was 79.9%. The frequency of homozygous C/C genotype of neuropeptide S (gene NPSR1 rs324981) was 19.4%, T/T genotype occurs in 27.8%, C/T genotype −52.8%. Men dominated the T allele of −54.2%, and the C allele −45.8% growth trend Fnd dissatisfaction with the quality of their sleep among men. Men T-allele carriers, most evaluated their sleep as “satisfactory” in 69% of cases, (χ2 = 15,713 df = 8, P < 0.05).

Association found men carrier T-allele of neuropeptide S (gene NPSR1 rs324981), a sleep disorder.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

There is substantial evidence suggesting that individual variability in antipsychotic treatment response could be genetically determined. Disrupted-in-Schizophrenia 1 (DISC1) gene has been previously associated to the illness and to treatment response in a sample of patients suffering from psychosis. However, there is a lack of studies on the effect of DISC1 on treatment response in samples of first episode psychosis.

The aim of this study was to explore the relation between variations in DISC1 gene and treatment response to antipsychotics in a sample of drug-naïve patients with a first episode of psychosis.

Two hundred and twenty Caucasian drug-naive patients experiencing a first episode of non-affective psychosis were genotyped for rs821616 (Ser704Cys), rs6675281 (Leu607Phe) and rs1000731. Early (6 weeks) response to antipsychotic treatment was assessed with the Brief Psychiatric Rating Scale, the Scale for the Assessment of Positive Symptoms, and the Scale for the Assessment of Negative Symptoms. Other clinical and socio-demographic variables were recorded to eliminate potential confounding effects.

We found a significant association between rs1000731 and treatment response. Thus, those patients homozygous for the G allele of rs1000731 were more frequently non-responders, measured with SANS, after 6 weeks of treatment, than those carrying the A allele (X2 = 4.019; P = 0.032). Moreover, when analysing the clinical improvement longitudinally, we observed that those patients carrying the A allele for the rs1000731 presented a greater improvement in positive symptoms dimension (F = 8.905; P = 0.003).

Our results suggest a minor contribution to antipsychotic drug response of genetic alterations in the DISC1 gene.

The authors have not supplied their declaration of competing interest.

Both MMSE and MoCA are two widely used cognitive screening test. Comparison of the two tests has been done in specific populations (Parkinson) but not in general elderly psychiatric populations. In research, equating methodologies has been used to compare results among studies that use different scales, which measure the same construct.

To explore their level of agreement within a particular clinical setting.

(a) To find MoCA and MMSE agreement. (b) To derive a conversion formula between the two scales and test it in a random population of similar setting.

Prospective study of consecutive community dwelling older patients who attend outpatient clinic or day hospital. Both tests were administered from the same researcher the same day in random order.

The total sample (n = 135) was randomly divided in two. One from where the equating rule derived (n = 70) and a second (n = 65) in which the derived conversion was tested. Agreement of the two scales (Pearson's r) was 0.86 (P < 0.001), and Lin's Concordance Correlation Coefficient (CCC) was 0.57 (95% CI 0.45–0.66). In the second sample, we convert the MoCA scores to MMSE scores according to equating rule from the first sample and after we examined the agreement between the converted MMSE scores and the originals. The Pearson's r was 0.89 (n = 65, P < 0.001) and the CCC 0.88 (95% CI 0.82–0.92).

Although the two scales overlap considerably, the agreement is modest. The conversion rule derived showed promising accuracy in this population but need further testing in other populations.

The authors have not supplied their declaration of competing interest.

Providing care to people with dementia is a stressful experience and has been associated with high burden of care. Such issue has been under-researched in Arabic/Islamic parts of the world.

The aim of this study is to determine the degree of burden of care among caregivers of people with dementia attending the Old-Age clinic, Sultan Qaboos University Hospital, Oman.

Fifty patients with dementia and their primary care caregivers were included in the study. The diagnosis of dementia was based on DSM 5 criteria and the severity was rated according to the Global Deterioration Scale for Assessment of Primary Degenerative Dementia and Clinical Dementia Rating. Level of dependency was measured using the Katz Index of Independence in Activities of Daily Living (ADL) and Lawton Instrumental Activities of Daily Living (IADL) Scale. For the caregivers, burden of care was determined by Zarit Burden Interview (ZBI).

The majority of caregivers were adult children (90%) who are supported by other relatives. Overall, 70% of caregivers demonstrated high degree of burden as quantified by ZBI. Factors such as patient's age, duration and severity of dementia, level of dependency and female gender of the caregiver were associated with higher burden.

Burden is common among dementia caregivers and several factors interplay to influence the perceived stress. As increased burden was evidenced to be associated with higher incidence of mental disorders, screening and early intervention will impact positively on the caregiver as well as the patient.

The authors have not supplied their declaration of competing interest.

Medical assistance for elderly people with mental health problems increases at the same time that life expectancy does.

The aim of this work is to describe several demographic and clinical characteristics of elderly patients admitted for the first time to an acute inpatient psychiatry unit.

Observational, descriptive, and retrospective study from June 2013 to May 2015, where it is analysed patients older than 65 years admitted to the acute psychiatric ward of Hospital de Getafe in that period without psychiatric hospitalization in their personal background.

Seventeen patients were included of a total of 428 patients admitted in that period (3.97%). Mean age: 70.7 ± 4.7. A total of 10 male (58.9%). The average stay in the studied group was 18.5 days, slightly lower than general average stay in that period (19.2 days). No psychiatric background was found in 4 patients. The most common diagnoses was depressive episode (5 patients) followed by manic episode (4 patients) and delusional disorder. Every of them but one, were taking at least one antipsychotic drug at discharge.

Elderly patients represent a low percentage of the total of patients admitted to an acute inpatient psychiatry unit. Many of them, despite having long-term ambulatory psychiatric follow-up, require a first psychiatric hospitalization after 65 years, as well as other patients begin their treatment in the mental health services in that hospitalization. It is noteworthy that antipsychotic drugs are used very commonly in those patients.

The authors have not supplied their declaration of competing interest.

Frail individuals are highly vulnerable to minor stressful events, presenting a higher risk for adverse health outcomes (e.g. falls, disability, hospitalization), which can lead to a decline in quality of life (QoL). In this context, an early screening of elderly frailty is of crucial importance.

To compare how the Frailty Phenotype (FP) and the Tilburg Frailty Indicator (TFI) predict QoL in a two-year follow-up.

A longitudinal study was designed recruiting 110 community-dwelling elderly (≥ 65 years). The presence of frailty was assessed at baseline (FP ≥ 3 and TFI ≥ 6), whereas QoL was measured two years later with two different scales: the WHOQOL-OLD and the EUROHIS-QOL-8. Hierarchical regressions were conducted.

The mean age of the participants at baseline was 77.7 ± 6.9 years, and most were women (75.5%). According to FP, 33.6% of the participants were classified as frail, while the TFI detected frailty in 50% of the elderly. After adjusting for age and gender, the TFI significantly predicted QoL (WHOQOL-OLD: β = −18.9, t(106) = −6.97, P < 0.001; EUROHIS-QOL-8: β = −6.1, t(106) = −6.71, P < 0.001), whereas the effect of the FP on the outcome measures was non-significant.

Frailty at baseline was associated with a lower QoL at follow-up. A multidimensional frailty operationalization (TFI) showed a stronger predictive validity than an exclusively physical one (FP). The option of which frailty measure to use in a clinical setting should take into account its ability to predict specific adverse outcomes, conducing to targeted and effective interventions.

The authors have not supplied their declaration of competing interest.

Patients with serious psychiatric illness (SMI) have a reduced quality of life and life expectancy than the general population. Metabolic syndrome (MS) is a clinical aspect determining who should be considered to reduce the risk of serious and chronic organic factors, even more significant in the elderly.

To evaluate metabolic screening of elderly patients with severe mental illness (SMI).

To evaluate the importance of routine screening of metabolic parameters in elderly guests of residential facilities with or without SMI; metabolic screening at baseline and after two of hospitalization.

Elderly inpatients (44 Tot) with Severe Mental Illness (SMI: bipolar disorder: 34%; schizophrenia: 46%; other: 20%) vs elderly inpatients (78 Tot). Data collected at baseline: psychiatric diagnosis; any previous diagnosis of hypertension, diabetes, dyslipidemia; ECG. At baseline and for two years were administered following scale: BPRS; PANSS; Qli; MMSE, ADL.

After two years metabolic screening has recorded at least one of the new interactions between the five factors of MS (ATP III) in 50% of patients with: one (34%); two (21%); three (11%); four (3%) new altered parameters. In MS inpatients, 53% of new metabolic alterations were recorded in 53% (MS inpatients) vs 23% without MS after two years.

Our results showed a higher frequency of MS in patients with SMI than comparison subjects. Haloperidol was the antipsychotic medication that caused minor impact on the development of metabolic disorders.

The authors have not supplied their declaration of competing interest.

Depression is a prevalent illness in elderly people. Cognitive deterioration associated to depressive symptoms is frequently considered as Dementia, especially in primary care. The study of the relation between both pathologies is necessary to correct treatment of mental illness in elderly people.

The aim of this study is to investigate whether depressive symptoms are related to certain areas of cognitive decline in elderly people.

The sample included community people older than 65 years (n = 927), mean age 72.9; 55.1% were women and 44,9% men. Instruments used were Beck Depression Inventory (BDI), Blessed Dementia Scale (BDS), Mini Mental State Examination (MMSE), verbal fluency test, clock drawing task, Wechsler digit substitution test and Wechsler similarity test.

Of the sample, 15,2% presented cognitive deterioration in Blessed Dementia Scale, with statistical significance in relation between growing age, female sex and cognitive deterioration (P < 0.005). Twenty-eight percent of the sample present cognitive decline, finding the same relation between sex, age and cognitive condition. Of the sample, 33.5% presented mild depression, 9.1% moderate depression and 1.4% presented severe depression using BDI. Correlations between depression and cognitive tests were analyzed. In demographic factors, social support was significantly correlated with depression but marital status, occupation and education were not correlated.

There is a high prevalence of depressive symptoms and cognitive deterioration in elderly people. High levels of depressive symptoms are associated with cognitive deterioration, especially in comprehension and judgment, delayed recall, verbal memory and visuospacial coordination in elderly people.

The authors have not supplied their declaration of competing interest.

Older patients with psychiatric conditions often have other disorders that include different levels of cognitive impairment, modifying the presentation of psychiatric symptoms and requiring treatment adaptations [1].

To describe clinical profile of hospitalized patients > 65 years, and its relationship with the presence of cognitive impairment and the length of hospital stay.

Descriptive and comparative study. Sample: 71 inpatients > 65 years (mean ± SD Age: 72.42 ± 5.96), admitted to “Hospital Universitario Central de Asturias”(Spain) from August 2014 to June 2015. Age, length of hospitalization, diagnosis, cognitive impairment and treatment data were collected (Table 1).

Days of hospital stay (mean ± SD) = 15.89 ± 11.53. No variable showed significant relation except number of antipsychotics taken (r = 0.307, P = 0.009). Cognitive impairment was significantly more frequent in men than women (45.5/15.8%; χ2 = 7.46; P = 0.006). No other variable showed significant differences.

A high percentage of psychiatric inpatients > 65 years present a cognitive impairment (29.6%) which was more frequent in males (45.5%). The length of hospital stay seems to be similar than in the rest of patients and not being affected by any of studied variables. More studies should be carried on to compare those results with similar variables in younger population and to analyze if there are differences between subgroups (65–75 vs > 75) [1].

The authors have not supplied their declaration of competing interest.

It was a complex examination of 60 elderly persons (72.40 ± 1.35 years) with mild stage of AD and VD. The effectiveness of response to (20 mg/day) memantine intake was studied during the first 3 months of treatment. Efficacy of short-term treatment was determined by MMSE and the numbers of positive statistically significant changes ADAS-cog subtests. Genetic ApoE polymorphism was investigated too (using the of the PCR technique). Statistical Anova analysis was done.

After 3 months of treatment significant changes in the overall score of Adas-cog was observed in both groups with some differences in subscale profiles. For AD patients, statistically positive changes (P < 0.05) were found in comprehension of spoken language, naming objects, commands, ideational praxis and delayed recall subtests. For VaD patients, statistically positive changes (P < 0.05) were found in comprehension of spoken language, naming objects, word finding difficulty and delayed recall subtests. There was established a significant prevalence of individuals with genotype ɛ4/ɛ4 among patients with AD compared with patients with VD. The main differences, according to the memantine efficacy treatment in carriers ApoE3 and ApoE4 genotypes, were in remembering test instructions subtest.

The memantine treatment efficacy in AD and VaD patients in mild stage of dementia was not significantly associated with an existing of Apo-E genotype polymorphism.

The authors have not supplied their declaration of competing interest.

Widowhood in old age increases mortality and adverse health effects, particularly depression and need for psychiatric care. The causes of this are poorly understood. To study risk factors and mechanisms, theories about what to study are needed. A qualitatively approach to widowhood from the widow/widower's perspective may uncover important knowledge.

To investigate risk factors of the adverse health effects associated with widowhood in old age from the perspective of the widower/widowers and to test the generalisability of the theories quantitatively.

This is a cross-country mixed methods study combining narrative interviews with Danish widows/widowers and a 50-year follow-up study from Sweden – The Lundby Study. Widows/widowers above 65 years of age referred to in- or outpatient treatment at the Department of Psychiatry at Odense or Aarhus University Hospital are included. Narrative interviews are conducted and analysed according to grounded theory. The qualitatively developed theories will then be tested quantitatively through the Lundby Study by comparing widows/widowers above 65 years with age-matched controls, who are still married.

In the Lundby Study, 597 persons above 65 years were identified in the latest follow-up: 176 (29.5%) were widow/widowers, 421 (70.5%) were married/cohabitating. Depending on the theories developed a total of 384 possible variables regarding physical health, mental health and general living circumstances are tested. Further results will be presented.

The causes of adverse health effects in widowhood are poorly understood. This study will potentially contribute to unravelling these by identifying possible risk factors.

The authors have not supplied their declaration of competing interest.

Although recent studies have found that there is significant association between anticholinergic and cognitive impairment, especially in the elderly population, there seems to be minimal emphasis on anticholinergic burden (ACB) when prescribing medications to the inpatient psychogeriatric population.

To evaluate the prescribing patterns in Older Person Mental Health Inpatient Unit (OPMHU), whether the ACB Score on admission has been reviewed for lowest possible ACB while maintaining therapeutic effects. A protocol will be developed to ensure that ACB is reviewed for future admissions and discharges.

Fifty patients admitted and discharged from OPMHU are recruited retrospectively from 30th September 2015, excluding outliers and deceased patients. For those who had multiple admissions during that period, only the most recent admission would be included for evaluation. Individual ACB score is calculated on admission and discharge based on pharmacist final medication summary. Their mental health records are also audited for any documented ACB review by the treating team, while making note for any pre-existing cognitive impairment.

ACB has not been taken into consideration in all patients by the treating team on admission as well as when prescribing medications on discharge. Hence, it is unsurprising that the ACB score showed an increment of 30% on discharge (3.25) when compared to the admission score (2.5).

The study found that although ACB poses significant risks on cognitive impairment, this knowledge has not been employed pragmatically. A protocol should be developed to ensure that ACB is evaluated and managed accordingly.

The authors have not supplied their declaration of competing interest.

Delirium is a common neuropsychiatric syndrome, particularly in elderly hospitalized patients, and is associated with an increase in morbidity and mortality. Although these negative consequences are well documented, only a few studies describe the experience of delirium from the families’ perspective.

To analyze studies regarding the experience and distress caused by delirium in the families/caregivers of adult/elderly hospitalized patients.

A non-systematic review of published articles until October 2015 in the database PubMed was carried out. The keyword “Delirium” was combined with: “experience”, “distress”, “anxiety” and “family”, “carer” and “relatives”. Inclusion criteria were: standardized diagnosis of delirium, systematic/prospective assessment of distress level. Clinical cases were excluded.

Sixteen studies met the inclusion criteria for analysis. In most of them, family members (mostly younger) showed high levels of distress, even higher than health care professionals and patients. Several predictors of family distress were found, including poor functional status, psychomotor agitation, delusions, emotional lability, incoherent speech, inattention and disorientation. Higher distress was associated with long-term consequences (e.g. generalized anxiety). In the qualitative research, family members interpreted delirium as a sign of approaching death, result of pain/discomfort or an effect of medication. In addition, distress was associated with rapid and unexpected changes or unable to recognize the loved ones.

Delirium in patients was associated with significant distress in family members. These findings underline the importance of providing information and the development of appropriate supportive and psychoeducational interventions in order to help families throughout this process and reduce the associated distress. This work is supported by FCT (SFRH/BPD/103306/2014).

The authors have not supplied their declaration of competing interest.

The ageing population and the resulting increase in chronic diseases, including dementia, make the evaluation of their emergent needs a crucial step in psychogeriatric care. Unmet needs are found to be important clinical targets that should be followed by active management in order to improve health status and survival.

To analyze the relation between unmet needs and cognition, and explore the nature of these needs across dementia severity stages.

A cross-sectional study was conducted in three nursing homes. Residents were excluded if they were terminally ill, unresponsive or presented delirium. All participants were assessed by Mini-Mental State Examination/MMSE (cognition) and Camberwell Assessment of Need for the Elderly/CANE (needs). Additionally, cognitive decline was staged as: absent (MMSE = 30), questionable (26–29), mild (21–25), moderate (11–20) and severe (≤ 10).

The study included 175 elderly with a mean age of 80.6 (SD = 10.1) years, of which 58.7% presented cognitive decline. For these, the mean number of unmet needs was greater than for those without (4 vs 3, P < 0.001), and they differed significantly in the domains of daytime activities (P < 0.001), memory (P < 0.001) and psychotic symptoms (P = 0.005). A significant negative correlation was found between MMSE and number of unmet needs (rs = −0.369, P < 0.001). Considering the severity stages, unmet needs also differed: more needs in early stages in daytime activities (73.3%), and in advanced ones in memory (63.9%) and psychotic symptoms (23%).

Greater cognitive decline was related with more unmet needs, which agree with previous studies. The different nature of needs across severity stages also suggests that interventions should be tailored comprising this specificity and complexity, when effective care is planned.

The authors have not supplied their declaration of competing interest.

Research has shown that approximately 67% of carers experience extreme mental tiredness, a decrease in their quality of life and a deterioration in their physical health since taking on a care-giving role.

This study aims to identify factors that influence carer burden and in doing so, identify the sub-populations of carers who are most susceptible to burden.

In northwest Ireland, 53 informal carers referred to the Carers Association, Sligo were contacted and met for a face-to-face interview. Measurements used included demographic data, the Neuropsychiatric Inventory, Zarit Burden Interview, Social Network Index and Brown's Locus of Control Scale.

Of the 53 carers, 43 were females and 10 males (age range: 32–81 years, mean age of 64.5 years). Of the corresponding 53 patients, 21 were females and 32 males (age range: 17–92 years, mean age of 72.1 years). Multiple linear regression analysis showed that sex of carer, marital status and the patient's behavioural problems were statistically significant independent factors, which influenced carer burden (p < 0.01). Female sex and greater patient behavioural problems increased susceptibility to burden and being married increased resilience towards burden.

The ability to predict which carers are more susceptible to burden allows physicians to more quickly identify “higher risk” carers, facilitating routine check-ups by physicians and carer support services. Further research should explore why female and unmarried carers are more susceptible to burden and whether it is possible to tailor support services to their individual needs.

The authors have not supplied their declaration of competing interest.

According to attachment theory, attachment relationships have a lasting impact on the functioning of the individual. If this impact has been much studied in children, few studies have been conducted in the elderly.

Explore the representations of attachment in a population of elderly subjects.

The sample consists of 90 consultants over the age of 65. Each participant filled out demographic questionnaire, Relationship Scale Questionnaire (RSQ): questionnaire of 13 items, each item rated from 1 to 5, a lower score attests a more secure attachment and Adult Attachment Questionnaire: a categorical scale of 3 statements. Statement 1 corresponds to secure attachment style, 2 to avoidant attachment style and 3 to anxious-ambivalent attachment style.

The age of participants ranged from 65 to 95 years with an average of 68.14. The sex ratio M:F was 0.8. The RSQ Score ranged from 16 to 56 with an average of 37.27. Of the participants, 72.2% have secure attachment style, 24.4% have an avoidant attachment style and 3.3% have an anxious-ambivalent attachment style. The study of correlations showed strong correlation between the two scales (P = 0.00) and the RSQ score was significantly associated with poor satisfaction of married life (P = 0.025), presence of psychological trauma in childhood (P = 0.016) and a separation experience (P = 0.029).

Our study highlights the importance of early childhood experiences that may impact late adult life. These finding are in accordance with attachment theory.

The authors have not supplied their declaration of competing interest.