bluuebunny/crossref_metadata_2025 huggingface dataset:
Using causal interventionist models to examine the relationship between social anxiety and paranoia: A 3-month follow-up cross-cultural survey conducted in thailand and the united kingdom
Authors: Aunjitsakul W. , Mcleod H. , Gumley A.
Published: February 2022

Introduction

The continuum of social threat ranges from anxiety to paranoia. Examining the factors that predict and mediate the relationship between social anxiety and persecutory paranoia will help with the development of interventionist-causal theories that can guide the development of new treatments.

Objectives

To investigate mediators between social anxiety and persecutory paranoia in a prospective cross-cultural analogue sample.

Methods

A 3-month follow-up online survey included participants aged ≥18-years-old in Thailand and the UK. Recruitment was via advertisements on websites and social media. Participants completed questionnaires at baseline (T1) and 3-month follow-up (T2) measuring social anxiety, paranoia, depression. Mediators were: stigma; internal and external shame; social rank; self-esteem; and safety behaviours. We used linear regression to examine predictors of paranoia and mediation analysis to test indirect effects. Estimating the indirect effects was calculated by 10,000 bootstrapping bias-corrected 95% confidence intervals.

Results

At follow-up, 186 (70.4%female; mean age 34.9±9.1) Thai and 236 (81.4%female; 35.7±12.7) UK respondents completed the survey. Regarding change scores (T2-T1), higher paranoia was significantly predicted by higher social anxiety and external shame controlling for age, gender, depression. A simple mediation model controlling for depression showed significant indirect effects for external shame (ab=0.06, 95%CI=0.018 to 0.105) and safety behaviours (ab=0.06, 95%CI=0.002 to 0.127). A multiple mediation model found external shame was a significant mediator (ab=0.06, 95%CI=0.020 to 0.110).

Conclusions

These cross-cultural data suggest that external shame may mediate the prospective relationship between social anxiety and paranoia. These data suggest the potential for treatment of persecutory fears and social anxiety in psychosis by targeting shame-related cognitions.
Cognitive impairment in treatment-refractory schizophrenia and type i diabetes. A case
Authors: Rodriguez L. Soldado , Sánchez Rus S.S. , Martinez G.M. Ruiz , Dafonte A. Alvarado
Published: February 2022

Introduction

Even when sharing etiologic factors, the incidence of DM-1 is low in patients with schizophrenia. Both diseases can lead to cognitive impairment, but its difficult to define its origin. 33 years old male, with DM-1 and schizophrenia referred to Therapeutic Community for psychotic symptomatology control, cannabis consumption withdrawal, improvement of self-care and hipoglycemia control reach

Objectives

Nowadays toxic abstinent and adequate consciousness of disorder. Remarkable persistence of hallucinations both auditive and visual, mostly shown as delirium, pharmacologic treatment-refractary. During last months, he shows excessive absent-mindedness, recent memory failure and verbal declarative memory and psychomotor slowdown Analysis: unbalance glycosylated hemoglobin. MR: cortical-subcortical atrophy, very shocking his age. Endocrinology follow up it was decided to stablish an insulin pump, so metrics were regulated.

Methods

Neurological profile of the patient (deficit and slowdown attention capability) aggravation of symptoms according to glycaemia and disturbances in image test could lead to vascular origin. Attention deficit and excessive focus are symptoms of schizophrenia, but they are shown in the beginning, they tend to stabilize during years. Verbal declarative memory disruptions can be produced in both disorders

Results

Better glycemic control and changed to Lurasidone 37mg and Cariprazine 3mg objecting higher reactivity and less absent-mindednes

Conclusions

Cognitive impairment in DM is frequent in adults with severe and long evolving hypoglycemic episodes Regardless of its origin, the cognitive impairment in schizophrenia leads to serious impact in functional and pragmatic areas Further investigation will allow us to quantify the magnitude of cognitive effect in metabolic control so according strategies could be developed
A network analysis of executive deficits in patients with psychosis and their healthy siblings
Authors: Gil-Berrozpe G. , Sánchez-Torres A. , Lorente-Omeñaca R. , Moreno-Izco L. , De Jalón E. García , Anton R. Hernandez , Peralta V. , Cuesta M.
Published: February 2022

Introduction

Psychopathological symptoms and cognitive impairment are core features of patients with psychotic disorders. Executive dysfunctions are within the most commonly observed deficits and the Wisconsin Card Sorting Test (WCST) is the test most extensively used for their assessment. Yet, the structure of executive deficits remains unclear, as there may be different underlying processes.

Objectives

The study’s aims were to explore and compare the network structure of the WCST measures in psychosis and their unaffected siblings.

Methods

Subjects were 298 patients with a DSM 5 diagnosis of psychotic disorder and 89 of their healthy siblings. The dimensionality and network structure of the 13 WCST measures were examined by means of the Exploratory Graph Analysis (EGA) and centrality parameters.

Results

The WCST network structure comprised 4 dimensions: Perseveration (PER), Inefficient sorting (IS), Failure to maintain set (FMS) and Learning (LNG). Patient and sibling groups showed a similar network structure and in both cases the network structure was reliably estimated.

Conclusions

Perseveration measures reflect the inability to switch sorting rules when necessary. Scores for the IS dimension can occur when the subject ineffectively tries to test different sorting hypotheses, changing at random the response. FMS reflects the subject’s strategy when he/she is able to find out the sorting rule, but is unable to keep applying that rule long enough. LNG comprised conceptual ability and learning items. The lack of significant difference between network structures is in keeping with results from exploratory and confirmatory studies demonstrating an invariant cognitive factor structure between schizophrenia patients and their unaffected siblings.
Reality–fantasy collapse in schizophrenia vs. neurocognitive impairment during Rorschach’s III card responding
Authors: Gornushenkov I. , Pluzhnikov I. , Sorokin S.
Published: February 2022

Introduction

Adaptive thinking demands a balance between manifestations of intrapsychic activity and reliance on requirements of the outer reality. Features of responses to Rorschach’s III card could provide information about subject’s ability to preserve the dialectical tension between the two poles of external and internal realities during solving tasks related to interpersonal relationships.

Objectives

To compare reality-fantasy relations during Rorschach’s III card responding in patients with schizophrenia, neurocognitive impairment and normal subjects.

Methods

Participants were 12 young adult inpatients with schizophrenia, 14 students without mental disorders and 12 inpatients with neurodegenerative diseases of old age. Reality-Fantasy Scale (RFS) was applied to assess responses to Rorschach’s III card. RFS scale ranges from –5 (reality collapse into fantasy) to 5 (fantasy collapse into reality) (Tibon-Czopp et al., 2015).

Results

Patients with schizophrenia (M= –3,38, SD= 1,9) demonstrated tendency to fantasy domination (and reality collapse) if compared with the students (M= –1,47, SD= 2,0, p<0,05). Patients with neurodegenerative diseases (M= 0,75, SD= 2,1), conversely, had difficulties to apply fantasy during solving Rorschach task (p<0,01).

Conclusions

Express Rorschach testing using III card could be useful to provide screening data of thinking tendencies related to situations of social interaction. Also it provides a mental pabulum regarding role of cognitive impairment in schizophrenia in relation to significance of affective dependence of their thinking process.

Conflict of interest

The reported study was funded by RFBR, project number 20-013-00772
Productivity of the performance of visual perceptual tasks and symptom severity in patients with schizotypal disorder
Authors: Vinogradova M. , Chepeliuk A. , Dorofeeva O.
Published: February 2022

Introduction

The experimental research of visual perceptual processes in schizophrenia could shed a light on the psychological mechanisms of development of the illness.

Objectives

To research the performance of visual perceptual tasks and its correlation with the symptom severity in patients with schizotypal disorder (SD).

Methods

40 patients with SD in ICD-10 (mean age 29.8±8.3 years) were enrolled to the study. The Positive and Negative Symptoms Scale (PANSS) and two series of visual-perceptual tasks (Figures of Witkin and Goldstein) were applied. In series I subject should make a decision whether a complex figure contains a simple one without any feedback from the experimenter (all 96 trials). In series II each trial included two complex figures presented simultaneously (all 96 trials) that increased the visual-perceptual load. Statistical significance was ascertained by Spearman’s rank correlation.

Results

Negative correlations were established between the number of right answers in series II of visual perceptual tasks and emotional withdrawal (r=-0.78, p≤0.01), passive/apathetic social withdrawal (r=-0.53, p≤0.05). Time of performance of series I and series II had negative correlations with preoccupation (r=-0.55 and r=-0.53, p≤0.05, respectively).

Conclusions

The decrease in the productivity of visual perceptual tasks performance in case of additional load relates with reduced social and emotional dimensions of symptoms (social initiation, passivity, lack of sociality and inattention in daily activity, etc.) of patients with SD. Impulsivity in solutions (reduction of decision-making time) is associated with the increase of preoccupation with feelings, thoughts and autistic fantasies that lead to social and daily life disadaptation.
Relationship of abstract thinking to mentalization in schizophrenia
Authors: Sokolova E. , Andreyuk K. , Ryzhov A.
Published: February 2022

Introduction

The formation of thinking in ontogenesis follows the line of progressive differentiation and integration of the representations of objects, events, and relationships. The same is true for the development of mentalization ability, conceived as a thought process in the area of social interactions.

Objectives

The purpose of the study was to compare the particularities of thought processes when dealing with different types of material: physical objects (operational thinking) and social situations (mentalization).

Methods

40 inpatients with schizotypal personality disorder, 40 inpatients with paranoid schizophrenia and 40 controls took part in the study. The Objects Sorting Test was used to assess operational thinking. The mentalization ability was assessed using two SCOR-S scales for Thematic Apperception Test: Complexity of representations of people and Understanding of social causality.

Results

The results of correlation analysis support the existence of the reverse links between the impairments of operational thinking and both the complexity of representations of people (r=-.36, р<.001) and the understanding of social causality (r=-.38, р<.001). It is supported by the qualitative analysis, where inpatients with thought distortions, characterized by arbitrary generalizations, are inclined to make similar errors in the reasoning about the mental states, ignoring the conventional explanations and relying on their own emotional impression and etc.

Conclusions

The limitations of the operational thinking as reflected in the inability to form adequate generalizations on the basis of socially predefined attributes of meaning are closely related to the ability of differentiation, integration and causal explanation of meaningful aspects or social situations.
Improvement of conventional perception in stable patients with schizophrenia by add-on treatment with ipidacrine
Authors: Morozova M. , Potanin S. , Rupchev G. , Burminskiy D. , Lepilkina T. , Beniashvili A.
Published: February 2022

Introduction

Impairment of conventional perception is one of the key dysfunction in patients with schizophrenia even in absence of psychotic symptoms.

Objectives

Possibility of improvement of conventional perception by add-on treatment with ipidacrine in patients with schizophrenia in long-term remission.

Methods

26 (13 females) patients, mean age 40.4 (SD 11.7) with episodic schizophrenia in remission more than one year, receiving stable antipsychotic therapy were included into the open label study. As add-on treatment ipidacrine was administered once per day in dosage 20 mg for two months. Positive and Negative Symptoms Scale (PANSS) was used to assess clinical symptoms and projective psychological method (Rorschach Test) was used to assess conventional perception.

Results

The study showed that ipidacrine in a low dosage, added to standard antipsychotic treatment, was effective in relation to negative symptoms (PANSS negative subscale score before 22,4 (SD4,7) and after beginning of the study 19,7 (4,5), p=0, 001). Of all the indicators of the Rorschach test, there was significant improvement in the index X+%, which is responsible for the degree of conventionality in reality recognition. The decrease in conventionality was associated with both high individualism and perceptual disorders. The value of of X+ % did not reach the standard one (70%) to the end of the study, but the improvement showed the switching from severe (52,4 (SD 12,2) to moderate (60,6 (SD10,4) impairment level (p=0,039).

Conclusions

Ipidacrine in a low dosage as add-on treatment has positive effect on conventional perception of stable patients with schizophrenia even in short-term trial.
A systematic review of cognition and functionality in delusional disorder
Authors: De Diego Ruiz H. , González M. González , Díaz-Caneja C. Martínez
Published: February 2022

Introduction

Current definitions for delusional disorder (DD) state that no cognitive or functional impairment is present. However, this assumption lacks empirical validation and has been questioned by numerous authors over the years. Through systematic search we collected articles that compare patients with DD with either healthy controls or patients with schizophrenia on the basis of their cognitive symptoms and their functional outcomes.

Objectives

Our aim is to draw conclusions from the available evidence on neurocognitive and functional affectation of DD.

Methods

Systematic electronic search was performed using Pubmed and Embase databases. Inclusion criteria included that selected articles must be original studies, must be published in peer-reviewed journals, must contain a sample of DD patients that is compared with a sample of healthy controls and/or patients with schizophrenia and that samples must be compared on the basis of cognitive and/or functionality parameters. A qualitative synthesis was performed due to heterogeneity in data.

Results

According to the information collected through our systematic review, DD patients tend to perform worse than healthy control in tests assessing cognitive functions. Results are not as conclusive regarding comparison between DD and schizophrenia, with mixed outcomes. When it comes to functionality, results are not conclusive either, with some degree of evidence pointing towards a better functioning in patients with DD in comparison to patients with schizophrenia.

Conclusions

Results agree with many authors who consider both conditions as part of a psychosis spectrum. Cognitive interventions, such as cognitive remediation, must be studied for their potential role in the treatment of patients with DD.
Impact of a first psychosis program in clinical variables after two years of follow-up
Authors: Martinez M. , De Jalón E. García , Pereda N. , Fernández A. , Ariz M.C. , Azcárate L. , Otero M.
Published: February 2022

Introduction

Early Intervention Services for Early-Phase Psychosis have shown efficacy and effectiveness (Correl C, JAMA). In Pamplona, Spain, there is an Early Intervention Program that has been providing multiprofesional assistance for First Psychotic Patients for the last two years.

Objectives

The aim of this study is to analize the longitudinal effects of the different interventions in several clinical variables applied to 240 patients during two years of follow-up : CASH dimensions, substance abuse, antipsychotic type and dosage, remission rates, re-hospitalization rates and DSM 5 diagnoses.

Methods

We apply an standard evaluation protocol to every patient at different times: premorbid, initial time and at months 6, 12, 18 and 24. We analyse the data with the SPSS statistical program to see the results in these variables.

Results

The positive and disorganized dimensions show an evident decline during the treatment. The doses of antipsychotic drugs are low and tend to decline. 87% of patients are in monotherapy. The most frequent DSM 5 basal diagnosis is Brief Psychotic Episode, but during de follow-up the Diagnosis of Schizophrenia increase from 14,6% at baseline up to 46,2% at month 24. The remission rates are about 65% after 24 months.

Conclusions

Early Intervention Services improve psychopathological dimensions, prevents from re-hospitalization, allows the use of lower doses of Antipsychotic Drugs and improve the rates of remission. However, the diagnosis of Schizophrenia is high, so there is no evidence that these programs prevents from chronicity, but provide a better quality of life.
Symptoms of psychosis, depression, and suicide ideation among individuals in a first episode of psychosis: The mechanistic role of clinical insight and cognitive functioning
Authors: Bornheimer L. , Wojtalik J. , Li J. , Cobia D. , Smith M.
Published: February 2022

Introduction

First-episode psychosis (FEP) is a particularly high-risk period in which risk for suicide death is elevated by 60% as compared to individuals in later stages of psychotic illness. Clinical insight and cognition have been studied in schizophrenia in relation to suicide ideation and attempt, yet, less is understood within the context of early-phase of illness and FEP.

Objectives

This study examined whether clinical insight and cognitive functioning served as a mechanism in the relationships between depression, positive symptoms, negative symptoms, and suicide ideation over time among individuals in FEP.

Methods

Data were obtained from the Recovery After an Initial Schizophrenia Episode (RAISE) project. Participants (n=404) included adults in FEP between ages 15 and 40. Structural equation modeling was used in Mplus8 to examine the proposed mediation model.

Results

Clinical insight and working memory functioned as mechanisms in the relationships between depression, positive symptoms, negative symptoms, and suicide ideation. As depression decreased and positive and negative symptoms increased, clinical insight was shown to be poorer, which in turn related to decreased suicide ideation. As positive symptoms increased and negative symptoms decreased, working memory was shown to be stronger, which in turn related to decreased suicide ideation.

Conclusions

Implications surround the importance of cognitive testing and approaches aiming to strengthen cognitive functioning given the relationships between cognition and suicide ideation in FEP. Also, of importance, it is imperative practitioners have awareness of the insight paradox given the complex and dynamic relationships between clinical insight and suicide thoughts and behaviors.
Green space and schizophrenia: A review
Authors: Freitas R. Mota , Valadas M.T.
Published: February 2022

Introduction

Urban living has consistently been associated with higher risk of developing schizophrenia when compared to rural living. Exposure to green space has been associated with better mental health outcomes and, more recently, childhood exposure to green space has been linked with lower rates of schizophrenia. The reasons for these findings remain unknown, although lower levels of pollution and psychological factors may play a role.

Objectives

We aim to review the literature regarding exposure to green space and its relationship with the risk of developing schizophrenia.

Methods

We performed an updated review in the PubMed database using the terms “green space” and “schizophrenia”. The included articles were selected by title and abstract.

Results

Growing up surrounded by non-urban environments is associated with lower schizophrenia rates. Upbringing in urban areas is associated with higher schizophrenia rates when compared with non-built-up areas. Schizophrenia risk seems to decrease with vegetation density in a dose-response relationship for urban and agricultural areas. Risk of schizophrenia has been found to be associated additively with green space exposure and genetic liability. No evidence for gene-environment interaction has been reported so far in this regard.

Conclusions

Exposure to green space during childhood appears to lower the risk of developing schizophrenia later in life and can be a preventive strategy. Further research in this area is needed.
Hopelessness in patients with schizophrenia
Authors: Laginhas C. , Jeremias D. , Rodrigues D. , Medinas R. , Moura N. , Pereira C.
Published: February 2022

Introduction

Individuals with schizophrenia have a shortened average life expectancy, with a lifetime risk of suicide around 5%.

Objectives

Here we present a case of a patient diagnosed with schizophrenia who developed depressive symptoms with suicidal ideation, reactive to psychotic symptoms. Considering this specific case, the factors that contribute to the increased risk of suicide in these patients are reviewed.

Methods

Relevant clinical information was extracted from the patient’s clinical process. In addition, we searched PubmedR database with the terms “Schizophrenia”, “Hopelessness” and “Suicide”.

Results

A 40-year-old male patient, single and unemployed presents a progressive psychotic condition, with 20 years of evolution, with an impact on social and work behaviour. As a background he has a history of depressive episodes with suicidal ideation at the age of 36, following psychotic symptoms. This is a patient with preserved cognitive functioning combined with a high level of education, who understands the impact of his reality on his functioning. In this context, he develops feelings of hopelessness, that are the risk factor for suicide, most consistently reported in patients with schizophrenia.

Conclusions

This case assesses a patient with schizophrenia who has several factors, that contribute to an increased risk of suicide, focusing on hopelessness. In the future, it may be interesting to study in more detail the individual weight of each factor, so that it is possible to accurately predict the individual risk of each patient and, consequently, it is possible to implement preventive strategies.
Should we monitor psychotropic drug levels in pregnancy and the postpartum period to reduce risks of recurrence?
Authors: Wieck A.
Published: February 2022

Pregnancy is associated with profound changes in pharmacokinetic processes. This is an important - and until recently neglected - area of research since the majority of women take drugs during pregnancy in addition to vitamin and dietary supplements. Recent evidence has emerged that the changes do not only include absorption, distribution and excretion but also drug metabolism, such as modifications in the regulation of hepatic metabolism and conjugation. Oestradiol is known to have an important role in the expression of cytochrome P450 isoenzymes and glucuronosyltransferase that are involved in the metabolism of psychotropic drugs. Recent studies of different psychotropic drug classes have shown that this can result in profound changes of plasma concentrations that commence early in pregnancy and gradually increase towards delivery. In this presentation pregnancy-induced metabolic changes that have been found so far for several psychotropic drugs will be discussed and the question addressed whether and how we should monitor plasma levels in our pregnant patients.

Disclosure

No significant relationships.
Quality of life in patients with the first-episode psychosis
Authors: Usova A. , Khalikova A.
Published: February 2022

Introduction

The use of a modern biopsychosocial model of care for patients with schizophrenia dictates the need for a dynamic assessment of the quality of life of patients at different stages of the disease to identify targets for treatment and rehabilitation measures. It is especially important to determine the available targets in the early stages of the disease in order to select effective complex therapy and improve the clinical and social prognosis.

Objectives

To determine the socio-biological and clinical factors that have a significant impact on the quality of life of patients with first-episode psychosis.

Methods

The sample consisted of patients diagnosed with schizophrenia (n=58). The following research methods were used: 1) clinical-psychopathological; 2) quality of life assessment; 3) clinical-laboratory and functional research methods; 4) statistical. The QL-100 questionnaire was used as a tool for studying the quality of life. The PANSS scale was used to assess the severity of positive and negative syndromes.

Results

The most significant adverse impact on the quality of life indicators are the absence of family, lack of work, low material wealth, active consumption of psychoactive substances, the predominance of negative symptoms and the presence of concomitant somatic disease in the acute phase.

Conclusions

Early identification of problematic aspects of the quality of life in patients with the first-episode psychosis allows us to conduct effective treatment and rehabilitation measures for these patients.
The effect of cariprazine on patient engagement: Post-hoc analysis of a phase 3 study in patients with predominant negative symptoms of schizophrenia
Authors: Laszlovszky I. , Dombi Z.B. , Balogh Á. , Barabássy Á. , Vass G. , Szatmári B. , Németh G.
Published: February 2022

Introduction

Motivation deficit is a significant aspect of lack of improvement in patients with schizophrenia especially with predominant negative symptoms (PNS). Therefore, improvement depends not only on symptoms reduction and better social functioning but also on patient engagement which is a key but less investigated aspect of successful treatment.

Objectives

To investigate and compare patient engagement in PNS patients after cariprazine and risperidone treatment characterized by the 11 items of the Positive and Negative Syndrome Scale (PANSS-11).

Methods

In this phase 3 study patients suffering from PNS of schizophrenia (PANSS-FSNS≥24) were randomized to 26 weeks of treatment with either cariprazine or risperidone (target dose 4.5 and 4 mg/day, respectively). To compare the effects of the two drugs on patient engagement the PANSS-11 scale was used. Change from baseline (CfB) on the selected items and PANSS-11 total score were analyzed using mixed model of repeated measures approach without correction for multiplicity.

Results

PANSS-11 total score mean CfB were -11.20 (SD=0.43) for cariprazine-, and -9.44 (SD=0.45) for risperidone-treated patients with a -1.79 (95% CI=-3.01, -0.56) mean difference (p=0.004) in favor of cariprazine. Most item differences were statistically significant (N1, N2, N3, N4, N5, G16) or numerically higher (N6, G7, G13) for cariprazine versus risperidone.

Conclusions

Cariprazine significantly improved patient engagement in patients with PNS of schizophrenia compared to risperidone based on the PANSS-11 post-hoc analysis. These results suggest that cariprazine treatment may improve not only the symptoms and everyday functioning of PNS patients but their engagement with life.

Conflict of interest

Studies were funded by Gedeon Richter Plc. and Allergan Plc (prior to its acquisition by AbbVie). Dr. Laszlovszky, Dombi, Balogh, Dr Barabassy, Dr Vass, Dr. Szatmári and Dr. Németh are employees of Gedeon Richter Plc.
Quality of life assessment in patients with negative symptoms
Authors: Norbutaitė B. , Adomaitienė V. , Leskauskas D. , Butkutė-Šliuožienė K. , Montvidas J.
Published: February 2022

Introduction

One or more negative symptoms are present in 57,6% of patients with schizophrenia spectrum disorder [Bobes et al, 2010]. These symptoms are responsible for impaired social functioning and have impact on the quality of life. There are no epidemiological studies that analyse the prevalence of negative symptoms and their impact on life quality in Lithuania.

Objectives

To evaluate the impact of negative symptoms on quality of life in patients with schizophrenia spectrum disorder.

Methods

Participants were 48 adults with schizophrenia (n=36) or schizoaffective disorders (n=12). All participants provided informed consent. All participants were administered a sociodemographic data form, Brief Psychiatric Rating Scale (BPRS), Mini-International Neuropsychiatric Interview (MINI). Negative symptoms were assessed by the Self-evaluation of Negative Symptoms (SNS). The Short-Form Health Survey (SF-36) was used to measure health-related quality of life.

Results

The results of SF-36 scales significantly correlated with SNS subscales. All SNS subscales correlated with general health result, vitality, social functioning and emotional well-being as well as in overal quality of life. Signifficant correlations were observed between the total scores of SNS and physical activity (r=-0,404, p=0,004), general health (r=-0,626, p<0,001), vitality (r=-0,683, p=0,004), social functioning (r=-0,53, p<0,001), role limitations (r=0,354, p=0,014), emotional well-being (r=-0,662, p<0,001) in SF-36 scales.

Conclusions

Negative symptoms of schizophrenia such as social withdrawal, diminished emotional range, alogia, avolition and anhedonia are associated with impaired quality of life. We found a strong relation between negative symptoms and quality of life, however further studies can support this point of view.
Follie a deux: Psychopathology in a pandemic
Authors: Da Costa I. Soares , Vieira A. , Amaral A. , Coutinho F.
Published: February 2022

Introduction

Follie a deux is a rare syndrome characterized by the transference of delusions from a primary subject to a secondary one. This rare condition, and frequently forgotten in psychiatry pratice, is more frequent in feedlots, particularly in situations alike we face nowadays because of the pandemic.

Objectives

To describe a clinical case and to discuss and highlight some clinical aspects of this entity.

Methods

Present a clinical case report and respective non systematic literature review

Results

This clinical vignete describes a case of shared delusion between a mother and a son. The son suffers from an intelectual disability and shared with his mother a persecutory and prejudice delusion. Both live in the same house and because of the pandemic they spend all the time together. This situation was probably the main factor influencing the course of the symptoms.

Conclusions

It is highlighted the importance of a social isolation and close contact between the pair mother/son, more important in context of a global pandemic, viewed as an obstacle to promote the separation of both.
Matricide in psychotic patients: About 3 case reports
Authors: Kolsi S. , Hentati S. , Baati I.
Published: February 2022

Introduction

Matricide is the murder of the mother and it is one the rarest reported homicides with rates varying between 1% and 4% of all murders. In our country, few studies have focused on this issue.

Objectives

To precise circumstances of matricide in psychotic patients and the offender and victim’s profiles.

Methods

We report three clinical cases who were hospitalized in the department of Psychiatry “A” at the Hedi Chaker university hospital in Sfax, Tunisia, because of non-judicial proceedings for dementia during the year of 2019.

Results

Among 3 cases, two patients were male and they were aged respectively 26 and 48 years old. The third was female. All of them had very low educational and income levels and they lived with the victim. In 2 cases, the victim-offender relationship was conflictive and there was already exhibited violent behavior towards victim.Two patients had a psychiatric follow-up and many hospitalizations. The diagnoses were schizophrenia and schizoaffective disorder. However, it was a poor compliance and an interruption of treatment. In the third case, the medicolegal procedure was inaugural. His diagnosis was schizophrenia.All the victims were illiterate and unemployed. Their middle age was 64 years.In all cases, the crime was not premeditated, motivated by persecution delusions including the mother. It was committed in the family house while using a blunt object. The post homicide reaction was marked by coldness.

Conclusions

Matricide has always been considered one of the most abhorrent crimes. Regular evaluation of psychotic patients’ dangerousness signals is needed to reduce the acting out.

Conflict of interest

No significant relationships.
Resting-state functional connectivity of the ventral tegmental area and negative symptom domains in subjects with schizophrenia
Authors: Pezzella P. , Giordano G.M. , Perrottelli A. , Cascino G. , Marciello F. , Blasi G. , Fazio L. , Mucci A. , Galderisi S.
Published: February 2022

Introduction

Negative symptoms (NS) represent a core aspect of schizophrenia with a huge impact on real life functioning. Dysfunctions within the dopaminergic cortico-striatal circuits have been documented in subjects with schizophrenia (SCZ) and hypothesized as possible neurobiological mechanisms underlying some domains of NS.

Objectives

We investigated relationships between the resting-state functional connectivity (RS-FC) of the ventro-tegmental area (VTA) and NS.

Methods

Resting-state fMRI data were recorded in 35 SCZ, recruited within the Italian Network for Research on Psychoses. We performed partial correlations between RS-FC and NS (evaluated with the Brief Negative Symptom Scale) controlling for possible sources of secondary negative symptoms.

Results

We found that the experiential domain correlated with the RS-FC of the VTA with the left ventro-lateral prefrontal cortex (lVLPFC) (r=0.372, p=0.039), while the Expressive deficit domain correlated with the RS-FC of the VTA with the left dorso-lateral prefrontal cortex (lDLPFC) (r= 0.470, p .008). Looking at subdomains, only the avolition (r= 0.418, p=0.019) and the blunted affect (r= 0.465, p=.008) showed the same correlations of the domains to which they belong.

Conclusions

According to our findings, separate dysfunctional neuronal circuits could underpin distinct negative symptom subdomains. A better understanding of neurobiological dysfunctions underlying NS could help to design new treatments, targeting different NS subdomains.
Covid 19, lockdown and brief psychotic disorders
Authors: Cerejeira J. Gonçalves , Carrasco I. Santos , Meseguer C. Capella , Vázquez E. Rodríguez , Óscar M. , De Llano M. Queipo , Valera G. Guerra , Ramírez A. Gonzaga
Published: February 2022

Introduction

Acute and transient psychotic disorders are a rare condition entity as the sudden appearance of affective, confusional symptoms and paranoia triggered by some psychological trauma. The current pandemic caused by COVID-19 is an important psychological stressor that could favor the appearance of acute psychotic disorders. Several studies have been recently published proposing that the multifactorial stress associated with lockdown could function as a catalyst for acute psychotic disorders.

Objectives

To present a case of a brief psychotic disorder during the national lockdown in Spain and to review the literature about the relationship between the current pandemic and psychosis.

Methods

We will present a case report and a literature review.

Results

We report a case of a 27-year-old woman, with no previous psychiatric history. Three weeks after the start of Spain lockdown sudden symptoms appeared with psychomotor restlessness, confused speech, emotional lability, thought blocking and persecutory and referential delusions. Physical exam, blood analysis and cerebral CT scan with no alterations. Treatment was performed with aripiprazole 10 mg and lorazepam 1 mg daily with clinical improvement in one weeks. She was diagnosed of Acute transient psychotic disorder.

Conclusions

Stressful life events that can trigger psychosis in vulnerable individuals and the current pandemic and lockdown context could favor the appearance of acute psychotic disorders. The case reported here is in line with other current studies that show a preliminary intuition of this trend.
Catatonia induced by abrupt discontinuation of clozapine - case report
Authors: Oliveira C. , Caldas F. , Gonçalves M.
Published: February 2022

Introduction

Catatonia is characterized by a bizarre and severe psychomotor change. According to DSM-5, the presence of three or more symptoms is necessary to affirm the diagnosis: stupor, catalepsy, brain flexibility, mutism, negativism, posturing, mannerisms, stereotypes, agitation not influenced by external stimuli, grimaces, echolalia or echopraxia. The association between first- and second-generation antipsychotics (AP) and the onset of catatonia is well established in the literature. In contrast, clozapine is one of the second-generation APs that is recognized for its effectiveness in treating catatonia, rather than inducing it. However, it has been documented that abrupt discontinuation of clozapine can induce rapid clinical deterioration with multiple presentations including: psychoses, cholinergic rebound states, serotonergic syndromes and catatonia.

Objectives

Review the literature on catatonia associated with abrupt interruption of clozapine. Describe a clinical case.

Methods

Observation of the patient and consultation the clinical file. Non-systematic literature review on catatonia, clozapine, side effects associated with rapid discontinuation and respective treatment.

Results

34-year-old man, with the diagnosis of Schizoaffective Disorder. Admitted due to an acute decompensation with psychotic symptoms resistant to treatment requiring the introduction of clozapine. In the absence of a clinical response, clozapine was suspended, with the consequent appearance of catatonia resistant to benzodiazepines in high doses.

Conclusions

Its already well established that the abrupt discontinuation of clozapine can trigger catatonia. This clinical case and literature review suits to emphasize the importance of educating psychiatrists on the adverse effects of psychiatric drugs and, in this case, the cautious discontinuation of clozapine in order to avoid its rebound effects.
Quality of life in patients with schizophrenia
Authors: Hentati S. , Abdallah M. Ben , Daoud M. , Bouhamed M. , Baati I. , Sallemi R. , Feki I. , Masmoudi J.
Published: February 2022

Introduction

Schizophrenia, with its high prevalence, chronic progression and social impact, is a major challenge for health professionals. For this reason it is important to assess the impact of this disease on these patients, mainly on their quality of life.

Objectives

To study the quality of life in patients with schizophrenia and determine the factors correlated with it.

Methods

A cross-sectional, descriptive and analytical study of 28 patients with schizophrenia followed up at the psychiatric consultation in Hédi Chaker University Hospital of Sfax. Data collection was performed using a sheet exploring socio-demographic and clinical data. We used the Quality of Life Scale (Q-LES-Q-SF).

Results

The average age of our patients was 40.61±6.27 years. The sex ratio (M/F) was1.15. The socioeconomic level was low in 71.4%. The average number of relapses was 3.04±1.4. Follow-up and compliance were good in 28.6% of cases. The average number of hospitalizations was 3.04±1.4. The average of quality of life in patients with schizophrenia was 21±5.74. The quality of life was affected with age (p=0.023), with the high number of relapses and with a higher number of hospitalizations in psychiatric hospital (p=0.008). Quality of life was improved with regular follow-up and good adherence to the treatment (p=0.000).

Conclusions

The quality of life in mental disorders was impaired mainly in schizophrenics, hence the need to evaluate in a codified way the quality of life of our patients in order to raise awareness among general practitioners as well as psychiatrists to improve the therapeutic and social care of patients.
First-rank symptoms: Past, present and future
Authors: Jorge B. , Fernandes C. Pedro , Mangas M. Duarte , Carvalho J.
Published: February 2022

Introduction

Conceptualising Schneider’s first-rank symptoms (FRS) as a diagnostic test whose performance can be measured in terms of sensitivity and specificity involves some issues that require reflection. The first formal proposal was contained in a 1939 monograph Schneider wrote, but little is known of their prehistory. In recent years there has been renewed interest in their clinical value.

Objectives

This work aims to review the the diagnostic the evolution and diagnostic accuracy of FRS.

Methods

A non-systematic review was performed, searching Pubmed/MEDLINE for articles using the keywords “schizophrenia” and “first rank symptoms”.

Results

From the beginning of Western descriptive psychopathology in the early 19th century, symptoms have been observed later described as first-rank by Schneider. When FRS are conceived as simple clinical indicators at a low level of inference, the results of the meta-analytic estimate of their diagnostic accuracy can be considered as a valid appraisal of their performance and usefulness. However, when FRS are conceptualised from a psychopathological perspective as strange and incomprehensible experiences that cannot be reduced merely to their propositional content and require substantial expertise and skill to be properly evaluated, the meta-analytic estimates can hardly be seen as a valid evaluation of their diagnostic significance, considering that some FRS are extremely difficult to assess properly.

Conclusions

The descriptions of these symptoms present substantial temporal and geographical continuity, over two centuries and in many countries. There is contradictory information concerning the validity of FRS as a clinical indicator. Phenomenologically informed studies are needed to address this research gap.
The effects of the age of male early life circumcision on sexual functions later in life
Authors: Esen E.C. , Özer S. , Yıldırım Ö. , Hasırcı E. , Şah C. , Şahin B. , Duran B. , Çınar Ö. , Cihan A. , Kazaz İ. , Gül Ü. , Deliktaş H. , Kızılkan Y. , Altınkol A. , Kurt H. , Tosun Ç. , Güdeloğlu A. , Üre İ. , Tutuş A. , Alkış O. , Bozkurt O. , Turunç T. , Akkuş K.
Published: February 2022

Introduction

According to psychoanalytic theory performing circumcision on a boy in phallic phase may aggravate this fear and cause sexual dysfunctions later in life. However this hypothesis is an unverified common-view rather than a scientifically proven conclusion.

Objectives

We hypothesized that being circumcised during phallic phase is not a risk factor for sexual dysfunction. We also took a peak at how the experience of circumcision is being perceived and its psychological effects. Our secondary hypothesis was, sexual dysfunctions are more frequent among men who had a traumatic circumcision experience.

Methods

For this cross-sectional study, a total of 2768 sexually active, circumcised and voluntary men were recruited from 20 different urology outpatient clinics around Turkey.

Results

There was no significant difference for PEDT and IIEF scores between participants who were circumcised at different ages (Graph-1,2). When participants were divided into 3 groups according to their circumcision age in accordance with psychoanalytic theory (before, after and during phallic phase) mean IIEF and PEDT scores did not differ. PEDT scores did not differ either by which emotion the participant describe their experience of circumcision or how vividly he remembered it. However participants who remembered their circumcision experience more vividly and had who describe their circumcision experience with fear/anxiety had a higher IIEF score (Graph-3).

Conclusions

The age of circumcision does not affect the risk of PE. This is one of the very few studies that challenges psychoanalytic theory with a scientific method. Remembering the circumcision experience with fear or anxiety did not increase the risk of sexual dysfunctions.
Sexual assault in the mahdia region : Epidemiological peculiarities of victims
Authors: Brahim S. , Mosrati M.A. , Bouali W. , Kacem M. , Sellami S. , Abid A. , Frej S. Ben , Henia M. , Chabbouh M. , Zarrouk L.
Published: February 2022

Introduction

Women around the world are still victims of violence and discrimination in many areas. In Tunisia, discrimination against women remains a reality, and they are often more vulnerable to violence, especially sexual violence, compared to men.

Objectives

To describe the epidemiological characteristics of victims of sexual assault in the Mahdia region in Tunisia

Methods

This is a descriptive and retrospective study of 110 sexual assault cases examined at the legal medecin department of Mahdia University Hospital between January 2016 and August 2018.

Results

The majority of victims were female (80 %). All genders, 77% were under the age of 25 years old. The median age of the men was 11.5 years. The median age of women was 18. The urban origin was more common (55.5%). Only 8.1% were married compared to 87.4% single. Only 2.7% said they were divorced and only one woman was a widow. 41.8% of the sample said they were still in school and almost 29,1% of the cases were out of work. 3.6% reported a history of sexual assault. The sexual act was the same in all situations. The perpetrator was unique in 73.6% of cases, male (100%), known to his victim (57%) or even a member of the family circle (14%). Sexual assault by penetration was mostly reported (51%), and it was almost exclusively penile(98.2%).

Conclusions

Sexual violence remains under-reported. The statistical data do not allow to know the phenomenon of its whole, because the majority of acts remain unknown, due to the absence of complaints or medical consultations.
Effect of childhood trauma on patients with schizophrenia
Authors: Ouali R. , Sellami R. , Cheffi N. , Elleuch S. , Cherif F. , Masmoudi R. , Masmoudi J.
Published: February 2022

Introduction

Recent research shows that exposure to trauma, such as child abuse, may result in a heightened risk of developing schizophrenia and worsening of positive symptoms in schizophrenic patient.

Objectives

The objective of this study was to examine the relation between childhood abuse and psychotic symptoms in patients with schizophrenia.

Methods

Participants were outpatients of Hedi chaker University Hospital Center in sfax, Tunisia, recruited between January and July of 2019, diagnosed with schizophrenia or schizoaffective disorder. The Childhood Trauma Questionnaire (CTQ-SF), the Positive and Negative Syndrome Scale (PANSS) were administered in this study to evaluate respectively childhood trauma and psychotic symptoms

Results

44 patients were included in this study with an average age 39,81 ±9,7. The rate of emotional abuse was 15.9%, physical abuse 31.8%, sexual abuse 15.8%, emotional neglect 6.8% and physical neglect 18.2%. PANS positive score (r=0,59 ; p< 10-3 ), PANS negative score (r=0,55 ; p< 10-3 ) and PANS psychopathology score(r =0,45, p<0,002) were higher in patients who had a history of childhood trauma in comparison with those who did not report experiencing this.

Conclusions

This study confirms that a history of Childhood trauma may have a serious impact in patients with schizophrenia.