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International journal of adhesion and adhesives 98, 102473 (2020). doi:10.1016/j.ijadhadh.2019.102473, Published by Elsevier, New York, NY [u.a.]

BACKGROUND From an evolutionary perspective it is remarkable that psychotic disorders, mostly occurring during fertile age and decreasing fecundity, maintain in the human population. AIM To argue the hypothesis that psychotic symptoms may not be viewed as an illness but as an adaptation phenomenon. METHOD Philosophical consideration and literature study. RESULTS Until now, biomedical research has not unraveled the definitive etiology of psychotic disorders. Findings are inconsistent and show non-specific brain anomalies and genetic variation with small effect sizes. However, compelling evidence was found for a relation between psychosis and stressful environmental factors, particularly those influencing social interaction. Psychotic symptoms may be explained as a natural defense mechanism or protective response to stressful environments. This is in line with the fact that psychotic symptoms most often develop during adolescence. In this phase of life, it is important for an individual’s development to leave the familiar and safe home environment, and to build new social networks. This could cause symptoms of ‘hyperconsciousness’ and calls on the capacity for social adaptation. This mechanism can become out of control due to different underlying brain vulnerabilities and external stressors, leading to social exclusion. CONCLUSIONS There is theoretical ground to consider psychotic symptoms as an evolutionary maintained phenomenon. Research investigating psychotic disorders may benefit from a focus on underlying general brain vulnerabilities or prevention of social exclusion, instead of regarding psychotic symptoms as abnormal phenomena.

Identification of patient subgroups is an important process for supporting clinical care in many medical specialties. In psychiatry, patient stratification is mainly done using a psychiatric diagnosis following the Diagnostic and Statistical Manual of Mental Disorders (DSM). Diagnostic categories in the DSM are however heterogeneous, and many symptoms cut across several diagnoses, leading to criticism of this approach. Data-driven approaches using clustering algorithms have recently been proposed, but have suffered from subjectivity in choosing a number of clusters and a clustering algorithm. We therefore propose to apply cluster ensemble techniques to the problem of identifying subgroups of psychiatric patients, which have previously been shown to overcome drawbacks of individual clustering algorithms. We first introduce a process guide for modelling and evaluating cluster ensembles in the form of a Meta Algorithmic Model. Then, we apply cluster ensembles to a novel cross-diagnostic dataset from the Psychiatry Department of the University Medical Center Utrecht in the Netherlands. We finally describe the clusters that are identified, and their relations to several clinically relevant variables.

Advances in commercial wearable devices are increasingly facilitating the collection and analysis of everyday physiological data. This article discusses the theoretical and practical aspects of using such ambulatory devices for the detection of episodic changes in physiological signals as a marker for mental state in outdoor environments. A pilot study was conducted to evaluate the feasibility of using commercial wearables in combination with location tracking technologies. The study measured physiological signals for fifteen participants, including heart rate, heart rate variability, and skin conductance. Participants’ signals were recorded during an outdoor walk that was tracked using a Global Positioning System logger. The walk was designed to pass through various types of environments including green, blue, and urban spaces, as well as a more stressful road crossing. The data that were obtained were used to demonstrate how biosensor information can be contextualized and enriched using location information. Significant episodic changes in physiological signals under real-world conditions were detectable in the stressful road crossing but not in the other types of environments. The article concludes that despite challenges and limitations of current off-the-shelf wearables, the utilization of these devices offers novel opportunities for evaluating episodic changes in physiological signals as a marker for mental state during everyday activities including in outdoor environments. Key Words: electrodermal activity, GPS, mental state, stress, wearable.

BACKGROUND: The information society is digitalising at a fast pace. New technology enables the collection of real life and real time information from sources that were inaccessible before. This creates an inordinate amount of dynamic data and, consequently, opportunities to introduce new insights and improvement of treatment in the field of psychiatry. AIM: To clarify the definition of big data and how a big data approach can reform care into a data driven, patient oriented dynamic system which is constantly learning. METHOD: Brief description of a pilot effected at the UMC Utrecht where the Cross Industry Standard Process for Interactive Data Mining (CRISP-IDM) was performed and description of applications in the future. RESULTS: The described approach and examples from literature show that there are possibilities to realise quick improvements in practice and implement new insights from existing data sources. CONCLUSION: Introduction of data science in psychiatric practice offers new prospects.

BACKGROUND: The information society is digitalising at a fast pace. New technology enables the collection of real life and real time information from sources that were inaccessible before. This creates an inordinate amount of dynamic data and, consequently, opportunities to introduce new insights and improvement of treatment in the field of psychiatry. AIM: To clarify the definition of big data and how a big data approach can reform care into a data driven, patient oriented dynamic system which is constantly learning. METHOD: Brief description of a pilot effected at the UMC Utrecht where the Cross Industry Standard Process for Interactive Data Mining (CRISP-IDM) was performed and description of applications in the future. RESULTS: The described approach and examples from literature show that there are possibilities to realise quick improvements in practice and implement new insights from existing data sources. CONCLUSION: Introduction of data science in psychiatric practice offers new prospects.

Mental health is reportedly influenced by the presence of green and blue space in residential areas, but scientific evidence of a relation to psychotic disorders is scant. We put two hypotheses to the test: first, compared to the general population, psychiatric patients live in neighborhoods with less green and blue space, second, the amount of green and blue space is negatively associated with the duration of hospital admission. The study population consisted of 623 patients with psychotic disorders who had been admitted to the psychiatric ward of an academic hospital in Utrecht, The Netherlands from 2008 to 2016. Recovery was measured by length of stay. Structured patient data was linked to socio-economic status and the amount of green and blue space in the residential area. Associations were assessed by means of regression models controlling for confounding factors. Compared to the general population, psychiatric patients had a significantly lower amount of green space in their neighborhood. This result was not confirmed for blue space. Furthermore, no significant associations were found between green and blue space and the duration of hospital stay. In conclusion, previous studies focusing on other mental disorders, like anxiety or depression, found positive mental health effects of green and blue space in the neighborhood. We were not able to confirm significant effects among our study population on duration of admission, however. Future research focusing on psychotic patients could investigate the influence of exposure to green and blue space on other influences and outcomes on mental health.

BACKGROUND: Psychotic symptoms can occur during normal development, but they can also indicate the presence of or an increased risk of a psychotic disorder. By studying children who are at risk of developing a psychotic disorder we can obtain information that will help to distinguish more accurately between developmental phenomena and psychopathology AIM: To present the current state of our knowledge about the development of psychotic symptoms and psychotic disorders and to discuss the importance of continuing research into subpopulations of children who are at risk of developing a psychotic disorder. METHOD: We give an epidemiological and clinical description of psychosis in childhood and we report on recent Dutch and international studies about children with an increased risk of developing psychotic disorders. RESULTS: Results so far indicate that these children tend to have an increased risk of developing not only psychotic disorders but also a wide range of psychopathological conditions in later life. The degree of risk depends on the nature and number of risk factors involved. CONCLUSION: More research is needed to follow the development of children with an increased risk of psychotic disorders.

Background Structural abnormalities in first episode psychosis (FEP) tend to be subtle and widespread. Most studies investigating structural abnormalities in this clinical population have used small samples, and therefore may be under-powered. In addition, most studies have examined participants at a single research site, and therefore the results may be specific to the local sample investigated. Consequently, findings from existing studies have often been heterogeneous. This study aimed to overcome these issues by testing for neuroanatomical abnormalities in individuals with FEP relative to healthy controls that are expressed consistently across five independent datasets. Methods Structural Magnetic Resonance Imaging data were acquired from a total of 572 patients with FEP and 502 age and gender comparable healthy controls (HC) at five sites - London (UK), Utrecht (Netherlands), Chengdu (China) and two independent sites at Santander (Spain). Voxel-based morphometry (VBM) as implemented in Statistical Parametric Mapping software (SPM12) was used to investigate differences in gray matter volume (GMV) between the two groups. The statistical analysis was carried out using an analysis of variance (ANCOVA), with diagnostic group and scanning site as factors, and age and gender as covariates of no interest. Neuroanatomical alterations in patients with FEP relative to HC common to the five datasets were identified by comparing the total FEP group against the total HC group, and then using the inclusive masking option (at p

The cost of mental health care has possibly risen more than costs in other sectors of health care in the Netherlands. In an attempt to control the rising costs, new policies have been implemented that include the introduction of selective financial penalties for those in need of mental health care as well as the start of performance-based mental health care reimbursement. In order to achieve the latter goal, a nation-wide large-scale data collection was introduced based on clinical routine outcome monitoring (ROM) data, with a view to using these data for benchmarking.Closer inspection of the benchmarking efforts in terms of scientific validity.Qualitative review and analysis.Analysis shows that the type of ROM data that is collected in the Netherlands is valid for tracking the outcomes of individual patients, but unsuitable for performance comparisons between institutions for reasons of case-mix, instrument-mix, bias and lack of sensitivity.Attempts to introduce benchmarking based on rom will probably have a negative impact on the practice of mental health care in the Netherlands. More input from mental health professionals and scientists is required in order to identify more rational and efficient ways of spending scarce resources.

De ontwerpen van Kracht van Koeien en het Cowel model laten zien dat dierenwelzijn op melkveebedrijven veel beter kan en ook hoe dat gerealiseerd kan worden in de praktijk. En dat dat niet tegenstrijdig hoeft te zijn met de economie van de veehouder, het milieu en de wensen van de burger

BACKGROUND: Antipsychotics are effective drugs that are prescribed frequently for a large group of patients. However, they also have many side-effects which can lead ultimately to serious somatic complications. These complications fall into various categories: metabolic, cardiovascular, neurobiological, haematological, gastro-intestinal and urogenital. AIM: To make an inventory of the side-effects and advise on ways of monitoring and preventing them. method The multidisciplinary working group on somatic complications arising from the use of antipsychotics (Werkgroep Somatische Complicaties) has collected literature on the subject and has discussed it at a number of consensus meetings. results The most frequent somatic complications are described on the basis of specific risk profiles and advice is given on how to identify these complications and on how to treat them when necessary. It is essential to monitor, systematically and regularly, somatic complications arising from the use of antipsychotics; furthermore, polypharmacy should be avoided. The person ultimately responsible for this is the doctor who has prescribed the antipsychotics. In addition, it is important to draw patients' attention to the general rules for a healthy lifestyle: no smoking, a balanced diet and adequate exercise. CONCLUSION: It is very important that somatic complications should be monitored carefully and accurately. So far, the Netherlands has no official guidelines on ways to identify and treat somatic complications