bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychotherapeutic support peculiarities’ in palliative care structure for cancer patients
Authors: Mykhaylov B. , Postrelko V. , Galachenko O. , Vasilyieva A.
Published: February 2022

Introduction

PPalliative medicine is aimed at achieving the best possible in a particular situation the level of quality of life of the patient.

Objectives

The reaction of grief is one of the strongest and most painful human experiences.

Methods

There were 120 cancer patients observed. The reaction of grief consists of 4 stages: shock and protest - numbness, disbelief and acute dysphoria; absorption - acute longing, search and anger; disorganization - a sense of despair and acceptance of loss and decision.

Results

The initial reaction of grief - shock, emotional numbness and disbelief. The excitement is most pronounced within about two weeks, followed by symptoms of depression, which reach its peak 4-6 weeks. Eventually, the former intense pain of severe loss begins to subside. In addition to the reaction of grief, there is a pathological, which is divided into suppressed (inhibited), delayed (delayed) and chronic. The role of the psychotherapist at this stage is to provide psychological support and assistance to both the patient and his environment to cope with this situation.

Conclusions

The principle of the concept of palliative care is the need to ensure the psychological comfort of the patient.
Feasibility and effectiveness of interpersonal psychotherapy interventions in a collaborative stepped care model between primary care and mental health services
Authors: Mongelli F. , Martino F. , Berardi D. , Colombini N. , Ferrari S. , Menchetti M.
Published: February 2022

Introduction

The NICE guidelines recommend for mild major depression a range of low-intensity psychosocial intervention of proven effectiveness, as Interpersonal Counselling, and a stepped-care approach.

Objectives

To assess feasibility and effectiveness of Interpersonal Psychotherapy interventions for the treatment of depression in a consolidated Collaborative Stepped Care Model between primary care and mental health specialists.

Methods

103 patients were referred by their PCPs to the Consultation-Liaison Service of Bologna and Modena. Of them, 78 were included in the study and administered self-report instruments and interview, including screening depression, anxiety and daily functioning. Patients were asked to choose one of the available treatment: 1) Interpersonal Counseling (IPC) 6-8 weekly meetings for 30 minutes; 2) IPC for Depression in Primary Care 3 sessions of 50 minutes; 3) a guided self-help intervention. Follow-up were planned at 1, 3 and 6 months. Both patients and PCPs provided a feedback about intervention’s satisfactions.

Results

At the baseline, 39.4% of the patients presented a minor depression/major depression mild and the large majority (75.0%) of them chose IPC, while none of them chose the guided self-help intervention. At follow ups the mean PHQ-9 significantly decreased compared to the baseline (p<0.001); daily functioning increased (WSAS: p<0.001) and anxiety traits improved (STAI: p<0.001). Patient’s general satisfaction with the service received was high (GSQ: 85.9±15.0) as well as PCPs, 62.7% of them expressed high satisfaction for the intervention.

Conclusions

The study emphasised that IPC is an effective and feasible treatment very well suited to the primary care setting for an optimal management of depression.
The level of consciousness and mental reactions of children after acute brain injury (interdisciplinary rehabilitation)
Authors: Kamelkova A. , Martyshevskaya D. , Zakrepina A. , Sidneva Y.
Published: February 2022

Introduction

The process of recovery of mental reactions in children after acute traumatic brain injury is determined by complex methods with an interdisciplinary approach. Studies of emotional, communicative and behavioral reactions are based on an assessment by a psychiatrist and a teacher-defectologist.

Objectives

To study mental reactions and identify predictors of positive recovery of consciousness after acute brain injury in children in early rehabilitation.

Methods

48 children (14–36 months) with acute severe traumatic brain injury who were admitted for treatment and rehabilitation (in CRIEPST). Methods: psychiatric and pedagogical examinations; also - neuroimaging data and others.

Results

Three groups of children were identified, depending on the different severity of emotional, communicative and behavioral indicators: Group 1 (11%): The level of consciousness is minimal positive. Reactions: stable gaze fixation; emotional reaction to sound (smile) and the face of an adult; short-term tracking of the gaze of the object; the ability to touch an object and hold it; sits himself. Group 2 (33%): The level of consciousness is minimal positive / negative, with an advantage of positive. Reactions: unstable gaze fixation; emotional reaction and involuntary movements to sound; reflex seizure of an object; sits with support. Group 3 (56%): The level of consciousness is minimal negative. Reactions: no emotional reactions, low motor and sensorimotor activity.

Conclusions

Predictors of emotional-communicative and behavioral indicators of recovery of the level of consciousness were identified: sensory and motor, cognitive and socially-oriented. These predictors are the basis for choosing a rehabilitation program with interdisciplinary support and a treatment strategy.
Successful discharge from a mental health halfway house: A personalized process with integrated approaches
Authors: Chen F.-P.
Published: February 2022

Introduction

In Taiwan, residents of mental health halfway houses (MHHH) receive psychiatric rehabilitation services, aiming for independent living and community integration. Research is yet to investigate how MHHH may effectively assist residents’ discharge in this cultural context.

Objectives

To examine the processes of assessment, preparation, assistance, and appraisal of discharge from MHHH staff’s perspectives.

Methods

Semi-structured in-depth interviews were conducted with 11 halfway house staff members. Verbatim transcripts were analyzed with dimensional analysis procedures of the grounded theory methodology.

Results

Successful discharge is a personalized process with integrated approaches addressing three essential factors: (a) regular community involvement, (b) the residents’ capacity to work, and (c) the family’s acceptance and support. Staff supported individual residents’ community involvement by attending to residents’ personal interests, resource availability, financial concerns, and transportation. Moreover, staff provided rehabilitation trainings to develop work capacity. However, residents’ motivation and functioning as well as job opportunities might affect their employment. Finally, in Taiwan, residents were rarely discharged without their family members’ consent because residents tended to co-reside with their family after discharge or rely on family support while living separately. Staff worked to engage families, which was influenced by family relationship quality, past traumatic events, financial concerns, capacity to assist the resident, and/or the resident’s ability to assist with family affairs.

Conclusions

To achieve successful discharges, MHHH staff need to assist each resident by developing an integrated plan to enhance conditions of the aforementioned factors, including strategies for different familial situations to garner family support in this cultural context.
Conceiving and evaluating novel therapeutic strategies with patients and peer practitioners: The case of urban remediation program
Authors: Empson L. Abrahamyan
Published: February 2022

Introduction

While extensive recent data details risk factors for psychoses in urban milieu, insights regarding recovery processes in cities are scarce. This hampers the translation of promising epidemiological and neuroimagery findings into effective therapeutic strategies. Given the twofold higher incidence of psychoses in cities and the fact that 68% of world population will be urban by 2050, it becomes an urgent matter of psychiatric care.

Objectives

This presentation details specific targets for therapeutic interventions in city context to further discuss a pioneering participatory project with the aim to conceive a novel city specific recovery-oriented program.

Methods

Based on most recent research data, some of which our own, a comprehensive survey of urbanicity studies and an overview of main avenues for developments will be presented.

Results

Urban milieu is a complex dwelling space made of protective and disruptive features. During each life course they may form unique combinations hampering or enhancing psychological well-being. Urban living is not only correlated with higher prevalence of psychoses, but also with better access to health care and lower rates of treatment resistant schizophrenia, pointing to some beneficial aspects of city living on recovery processes. The interplay between personal characteristics, urban resources and supportive social environments seems pivotal to recovery calling for multilevel interventions (CBT interventions, peer-support, go-alongs, resocialization) and integration of different stakeholders (patients, peer-practitioners, community actors).

Conclusions

Participatory approach (design thinking, urban lab etc.) represents an important means of innovation and ensures the best match between patients needs and therapeutic propositions.
Follow-up of patients with delusional disorder in a specialized outpatient clinic over a 2-year period
Authors: González-Rodríguez A. , Guàrdia A. , Pedrero A. Alvarez , Seeman M.V. , Delgado L. , Fucho G.F. , Acebillo S. , Monreal J.A. , Vidal D. Palao , Labad J.
Published: February 2022

Introduction

In order to prevent relapse and increase medication adherence, primary care physicians and psychiatric inpatient units should consider referring patients with delusional disorder (DD) to specialized outpatient clinics for treatment and follow-up.

Objectives

This poster describes a sample of DD patients referred to a specialized unit for DD and documents rates of follow-up care.

Methods

Over a 2-year period, 29 individuals were consecutively referred to the Parc Tauli -Delusional Syndrome Working Group, which provides treatment and clinical care for patients with delusional disorders for a catchment area of nearly 450.000 inhabitants in Sabadell (Barcelona, Spain). Criteria for inclusion in the program are relatively flexible. Referred patients are evaluated at baseline and at 6 months following their first appointment. Treatment and case management are offered by a multidisciplinary team consisting of psychiatric, nursing, and social work personnel. Psychological interventions are also offered.

Results

Of the 29 persons initially referred, 27 attended at least one scheduled appointment. Twenty-one out of the 27 patients received a confirmed diagnosis of DD (14 women,7 men), 2 suffered from schizophrenia and 4 were diagnosed with other psychiatric disorders and referred to other programs: primary care (n=2), affective program (n=1) and addictions unit (n=1). A breakdown of DD subtypes follows: persecutory (n=10,47.6%), jealous (n=4,19%), somatic (n=5,23.81%), mixed (n=2,9.5%). Three patients with DD (14.3%) were lost to follow-up. Attendance rates of the 21 DD patients: 80.4% (Women:77.67%, Men:100%).

Conclusions

For a traditionally difficult-to-engage population, adherence to multidisciplinary clinic appointments was relatively high. Loss to follow-up was lower than would have been expected.

Conflict of interest

AGR has received honoraria, registration for congresses and/or travel costs from Janssen, Lundbeck-Otsuka and Angelini.
Mothers with schizophrenia: Treatment, quality of life and motherhood experience
Authors: Sánchez S. Pérez , Herrero I. Martín , Fernández M.A. Cutillas , Portero A. Crespo , Güimil D. Raya
Published: February 2022

Introduction

Schizophrenia is a chronic disease that deteriorates the functionality of patients, especially when forming a family and taking care of children. We are interested in analyzing the characteristics of mothers with schizophrenia and their degree of global activity when going from oral treatments to injectable treatments.

Objectives

1 To assess the quality of life and functional level of mothers with schizophrenia receiving paliperidone treatment. 2. Compare quality of life and functional level when going from oral treatment to long-term injectables.

Methods

Sample: Mothers, 37-45 years old, diagnosed with schizophrenia in monotherapy with oral paliperidone who started treatment with Paliperidone Palmitate LD IM (200 - 300 mg / month). Retrospective data collection. QLS quality of life scale.

Results

5 patients were included, caregivers of 1 child (80%), 2 children (20%) who met the inclusion criteria and completed the questionnaires. After its application and correction through non-parametric tests (N <30). During oral treatment, scores were observed in the QLS questionnaire of: mean intrapsychic functions 34.2, mean interpersonal relationships 19, mean instrumental role 8, mean daily activities 8. After 12 weeks of treatment with Paliperidone Palmitate IM, scores were obtained: functions Medium intrapsychic 36, medium interpersonal relationships 23, medium instrumental role 15, medium daily activities 11. A better functioning of the patients was observed in the instrumental and daily activities categories.

Conclusions

In our experience, injectable long-acting Paliperidone Palmitate is associated with the perception of better quality of life in mothers with schizophrenia and increases the ease of administration as well as planning in their daily life.
The relationship between combined antipsychotic use and clinical features in schizophrenia spectrum patients treated in inpatient ward: A retrospective study
Authors: Baklaci U.
Published: February 2022

Introduction

The combination of antipsychotics can be seen in up to 70% due to the presence of resistance to treatment, aggression, sleep disorders, and self destructive behavior in psychosis spectrum disorders in clinical practice. More side effects were observed in patients using antipsychotic combinations.

Objectives

The aim of this study is retrospectively investigate the sociodemographic and clinical characteristics differences between antipsychotic combination and monotherapy groups

Methods

The files of 754 cases admitted to the hospital from the first day of January 2013 to the last day of December 2016 were reached. Patients diagnosed as according to DSM-5 “Schizophrenia Spectrum and Other Psychotic Disorders” were included. From the files of these cases, sociodemographic characteristics, disease characteristics and antipsychotic properties (clozapine use, combined antipsychotic and depot antipsychotic use) were used. Pearson chi-square test and student t test were used in data analysis

Results

Age was significantly lower in patients treated with combined antipsychotics than patients receiving monotherapy (t = 2,264, p = 0.026). Age of onset of psychosis was significantly lower in patients treated with combined antipsychotics (t = 2,771, p = 0.007). Education level was also found to be lower in this group (t = 2,333, p = 0.02) The duration of hospitalization was longer in patients treated with combined antipsychotics (t = 3,069, p = 0.002).

Conclusions

There were statistically significant differences between the patients treated with combined antipsychotics compared to the group treated with monotherapy. These are the differences in the age of onset of psychosis, education level and duration of hospitalization.
Working memory and abstract thinking in patients with schizophrenic spectrum disorders
Authors: Popov M. , Pluzhnikov I.
Published: February 2022

Introduction

According to a selective meta-analytical review, weakness of working memory is considered as one of the fundamental disorders in schizophrenia. Some researchers propose identifying this disorder as an endophenotypic marker of schizophrenia diathesis. Many researchers also emphasize violations of “abstract thinking”, that is, the ability of patients to operate with abstract concepts. Many scientists understand the violation of “abstract thinking” as the difficulty of patient in operating with the dominant signs of the concept. Based on these approaches, we assume a dark relationship between working memory and abstract thinking.

Objectives

The aim of this study is to investigate the relationship between working memory and abstract thinking defect in patients with schizophrenic spectrum disorders.

Methods

16 patients with schizophrenic spectrum disorders were studied. To study abstract thinking, the following neuropsychological and psychometric techniques were used: exclusion of objects, D-KEFS understanding of proverbs (latent concepts were recorded). The following techniques were used to study working memory: n-back; Wechsler Test, subtest Digit Repetition.

Results

As a result of preliminary research, the following data was obtained. We found significant differences between the number of irrelevant features (which corresponds to impaired abstract thinking) and the severity of impaired working memory (p = 0.035). The more the memory was impaired, the more the subjects demonstrated the impairment of abstract thinking.

Conclusions

Thus, our results justify our assumption. A relationship between working memory and abstract thinking is founded to be possible. Further studies of this issue requires a wider techniques battery as well as a larger sample.

Conflict of interest

The reported study was funded by RFBR, project number 20-013-00772
Planning impairment in schizophrenia: The possible role of abstract thinking and short-term memory
Authors: Alekseev A. , Morozova M. , Rupchev G.
Published: February 2022

Introduction

The planning impairment is one of the basic aspect of cognitive dysfunction, but its mechanisms in schizophrenia remain unclear.

Objectives

To assess the links between planning and cognitive functioning in schizophrenic patients and in norm.

Methods

50 patients with schizophrenia (age 34.92±8.54; illness duration 8.34±5.87) and 50 healthy volunteers (age 32.42±7.26) were examined. Brief Assessment of Cognition in Schizophrenia, Benton’s test for short-term memory assessment; sub-test Similarity (from WAIS) to assess abstract thinking were used.

Results

Patients showed significantly worse results in all parameters (Tab.1). Table 1: Differences of planning between groups.SchizophreniaNormp-levelTOL-DX92,64±14,48102,52±11,970,00033Similarity16,92±3,9719,76±2,850,00009BVTR Score6,73±1,787,60±1,320,00709

In healthy subjects, significant relationship was found between planning and abstract thinking, and there was no relationship between planning and short-term memory (Tab.2). Table 2: Correlations in the Norm groupSpearman Rp-levelTOL-DX & Similarity0,3925300,004809TOL-DX & BVTR0,1864940,194710

In patients with schizophrenia, the opposite picture was observed (Tab.3). Table 3: Correlations in the Schizophrenia group.Spearman Rp-levelTOL-DX & Similarity0,2623890,071596TOL-DX & BVTR0,3445660,015331

The effectiveness of planning in patients was significantly associated with short-term memory, but not with abstract thinking.

Conclusions

Study results indicate a possible role of basic aspects of mental activity such as short-term memory in planning impairment in patients with schizophrenia. Problem solving and reasoning disorders represent two relatively independent forms of thought disorders in schizophrenia.
Diagnostic change 2 years after a first episode of psychosis
Authors: Aranguren L. , Martinez M. , De Jalón E. García , Fernández A. , Ariz M.C. , Otero M. , Pereda N.
Published: February 2022

Introduction

Psychiatric diagnoses are derived from expert opinion (1). Since no objective tests or markers are on the horizon, clinical psychiatry is anchored to “the patient’s altered experience, expression and existence, associated with suffering in self and/or others”(2). Many studies have examined diagnostic stability over time. In the last years investigators have been reporting prospective and retrospective consistencies of diagnoses between two time points, specially in first episodes of psychosis (3).

Objectives

To examine the prospective and retrospective stability of diagnostic categories 2 years after the first episode of psychosis

Methods

Data were examined from the First Episode Psychosis Program of Navarra (PEPsNA), a prospective observational study of a cohort of patients with first-episode psychosis in Navarra (Spain). Diagnosis was assigned using DSM-IV-TR at baseline and 24 months later. Diagnoses were divided into 5 categories: Affective psychosis, Schizophrenia spectrum psychosis, Schizoaffective disorder, acute psychosis and other diagnoses. Diagnostic change was examined using prospective and retrospective consistency

Results

A total of 78 first-episode psychosis cases with baseline and 24 months follow-up were identified. Table 1 shows the diagnosis movement matrix, and Figure 1 its graphical representation. Of cases, 71.8% (56/78) had the same baseline and 24 months follow-up diagnosis. Prospective and retrospective consistencies are shown in Table 2

Conclusions

The prospective and retrospective consistencies of Schizophrenia spectrum psychosis and acute psychosis were higher than others. Affective psychosis and Schizoaffective disorder show very variable consistencies
Impact of a first psychosis program in functional variables after two years of follow-up
Authors: Martinez M. , Pereda N. , De Jalón E. García , Lizarbe T. , Aquerreta A. , Monclus F. , 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 functional variables: GAF, Occupational State, CGI-CogS, QLS, Sofas and WHODAS II applied to 240 patients during two years of follow-up.

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 GAF scale shows a decline during the first 6 months, but tends to reach and maintain the premorbid levels after a year of treatment. Regarding baseline, patients with normalized jobs or studies are 60.7%. This percentage persists during the next months of follow-up but decline at the 24th month Both the Whodas and Sofas scale show improvement tends. The QLS results show a progresional improvement in every subcale during the whole time of follow-up.

Conclusions

The Early Intervention Services in Psychosis improve, not only psychopatological dimension but also functional areas, what is important for the whole recovery of First Psychotic Patients.
Risk factors for psychotic relapse in chronic schizophrenia after dose-reduction or discontinuation of antipsychotics. A systematic review and meta-analysis
Authors: Bogers J. , Hambarian G. , Vermeulen J. , Dehaan L.
Published: February 2022

Introduction

Patients are often treated with high doses or combinations of antipsychotics, which may hamper recovery. Dose-reduction (DR) or discontinuation of antipsychotic medication in chronic patients carries the risk of psychotic relapse.

Objectives

To identify risk factors of psychotic relapse after DR or discontinuation, we (i) determined the rate of relapse after DR or discontinuation in patients with chronic schizophrenia, and (ii) assessed risk factors for psychotic relapse.

Methods

From studies on dose-reduction from January 1950 through June 2019 we calculated event rates per person-years including 95% confidence intervals. We extracted: (1) patient characteristics (age, percentage of male subjects, setting, duration of illness), (2) dose-reduction/discontinuation characteristics (start-dose, end-dose, dose-reduction in milligrams and percentage of start-dose, time-period of dose-reduction), (3) follow-up characteristics (time after dose-reduction), and (4) study characteristics (blinding, publication-year and relapse definition).

Results

46 unique cohorts, presenting 1677 patients in which doses were reduced/discontinued were included in meta-analysis. We found an overall event rate per person-years on psychotic relapse of 0.55 (CI95% 0.46-0.65;p<0.0001;I2 =79). Most robust event rates for psychotic relapse were seen for discontinuing antipsychotics, and if not discontinuing, dose-reduction till under 5mg haloperidol equivalents daily (HE). Abrupt reduction yielded higher rates than gradual reduction. During short follow-up time more relapses occurred than in studies with long follow-up time.

Conclusions

In patients with chronic schizophrenia discontinuing, and to a lesser extent DR till end-dose<5mgHE, patients who reduce doses abrupt, inpatients, and patients with a short duration of illness carry highest relapse risk. Most relapses occur during the first half year after DR.
Suicide attempts in women with severe mental illness in the perinatal period
Authors: Gressier F. , Sutter-Dallay A.-L.
Published: February 2022

Suicide is one of the leading causes of perinatal maternal mortality (1). Maternal suicidality has a negative impact on the mother-baby relationship and child development. However, little is known about specific risk factors for perinatal suicide attempts in women with severe mental illness. In a sample of 1439 women with severe mental illness in the perinatal period and jointly admitted with their baby in a mother and baby unit, 154 (11.7%) attempted suicide, 49 in pregnancy (3.7%) and 105 (8.0%) in the post-partum period (2). Suicide attempt in pregnancy was related to alcohol use, smoking during pregnancy and a history of miscarriage, and in the post-partum period to major depressive episode or recurrent depression and younger age. Women who attempt suicide either in pregnancy or in the postnatal period could have different psychopathological and environmental profiles. Past obstetric history and addictive behaviours during pregnancy are essential elements to explore. In addition, depressive symptoms should be assessed in all women to treat major depression, as a means of preventing suicide attempt. Special attention to risk of suicide is needed during the perinatal period for women with severe mental illness. For women suffering from an acute psychiatric disorder, or a history of mental illness, multi-disciplinary management should be implemented. 1. Oates M. Suicide: the leading cause of maternal death. Br J Psychiatry. 2003;183:279-81. 2. Gressier F et al. Risk factors for suicide attempt in pregnancy and the post-partum period in women with serious mental illnesses. J Psychiatr Res. 2017;84:284-291.

Disclosure

No significant relationships.
First vs. multiple cannabis-induced psychotic episodes: Is inpatient treatment any different?
Authors: Andrade F. , Covelo V. , Machado A.S.
Published: February 2022

Introduction

Recent studies reported very high cumulative risk for a patient who had cannabis-induced psychosis to be diagnosed with a schizophrenia spectrum disorder.

Objectives

We aim to compare sociodemographic and clinical characteristics, treatment and discharge plan in cannabis-induced first psychosis episode (CI-FEP) vs. multiple cannabis-induced psychotic episodes (CI-MEP) inpatients.

Methods

Retrospective observational study of inpatient episodes with a discharge diagnosis of cannabis-induced psychosis between January 1st, 2018 and December 31st, 2019 in the Psychiatry Service of CHUSJ. Descriptive analysis of the results was performed using the SPSS software, version 26.0.

Results

Our sample included 61 inpatients, 19 (31.1%) with CI-FEP and 42 (68.9%) with CI-MEP. CI-MEP group had a median of 1±0,234 previous hospital admissions. CI-MEP group has 10,0 higher odds of being discharged in outpatient compulsory treatment (CI 95% 1,21-82,50, p=0,013) and 6.0 odds of being treated with long-acting injectable antipsychotics (LAIAP) (CI 95% 1,79-20,31, p=0,002) when compared to CI-FEP group. Having multiple cannabis-induced psychotic episodes was associated with future admissions to psychiatry unit (OR 4,85 (95% CI 1,23-19,15, p=0,018). We found no statistically significant differences regarding the sociodemographic and clinical characteristics, use habits and discharge plan between the two groups.

Conclusions

Patients with multiple psychotic episodes due to cannabis use are more likely to have a LAIAP prescription, be discharged in compulsory outpatient regimen and be readmitted in to psychiatric inpatient unit. Considering the prevalence of CI-MEP and the risk of chronicity, we need integrative treatment programs to address the specificities of these patients.
Ekbom syndrome - a case report
Authors: Nascimento S. , Simião H. , Mendonça T. , Silva M.
Published: February 2022

Introduction

Delusional parasitosis/infestation or Ekbom syndrome is an uncommon psychotic disorder characterized by a false belief that there is a parasitic infestation of the skin - the delusion that insects are crawling underneath the skin.

Objectives

This work aims to summarize and evaluate the currently available evidence regarding Delusional parasitosis, and for this purpose, we will illustrate a case report of a patient admitted in the emergency room.

Methods

The authors have conducted online research in PubMed with the words “Delusional parasitosis” “delusional infestation”, “Ekbom syndrome”, from the outcome, the articles considered to be relevant were collected and analyzed.

Results

Delusional parasitosis can be classified into primary delusional parasitosis without other psychiatric or organic disorders present, secondary – functional (secondary to several mental disorders such as schizophrenia, depression, dementia, anxiety, and phobia), and organic forms (associated with hypothyroidism, anaemia, vitamin B12 deficiency, hepatitis, diabetes, infections (e.g., HIV, syphilis), and cocaine abuse. It is most commonly seen in middle-aged women. The patients became frequently socially isolated, prone to the development of depression symptoms.

Conclusions

This syndrome often presents a high level of psychosocial morbidity. Patients often seek dermatologists help in the first place, although there is no medical evidence. Psychiatrists play a major role in the diagnosis and treatment of these patients. Psychopharmacological therapy is quite challenging because of the patient’s belief that they have a parasitic infestation and not a psychiatric condition.
The impact of social cognition deficits on real life functioning in 22q11.2 deletion syndrome: A comparative study with a large population of patients with schizophrenia
Authors: Accinni T. , Frascarelli M. , Buzzanca A. , Ghezzi F. , Carlone L. , Panzera A. , Moschillo A. , Girardi N. , Fabio F. Di
Published: February 2022

Introduction

22q11.2 Deletion Syndrome (22q11.2DS) represents a congenital syndrome with several clinical features. It entails a 25% risk of psychotic onset in lifespan. 22q11.2DS is a reliable model for biological vulnerability to schizophrenia.

Objectives

With the hypothesis of similar impairments in schizophrenia and 22q11DS, to investigate a possible correlation between Social Cognition (SC) and Interpersonal Functioning (FU).

Methods

Sample consists of 1735 adults: 893 schizophrenic subjects (SCZ); 18 with 22q11.2DS and psychosis (DEL_SCZ); 44 22q11.2DS individuals (DEL); 780 healthy controls (HC). SCZ and HC data come from a multicentric study by Network for Research on Psychoses. SC was assessed with The Awareness of Social Interference Test (TASIT, consisting of three sections: T1= Emotion Recognition; T2=Minimal Social Inference; T3=Social Inference Enriched). The Specific Levels of Functioning (SLOF) interview was employed.

Results

DEL_SCZ (p<0.001) and SCZ (p<0.001) showed impairments in each TASIT sections compared to HC. Significant deficits in interpersonal functioning area were found in SCZ (p<0.001) compared to HC. The interpersonal functioning domain showed a positive correlation with SC in HC (T1: r=0.097; p<0.001; T2: r=0.120; p=0.001; T3: r=0.121; p=0.001); DEL (T1: r=0.380; p=0.024; T2: r=0.466; p=0.005) and SCZ (T1: r=0.113, p=0.001; T2: r=0.110, p=0.001; T3: r=0.134; p<0.001).

Conclusions

SC deficits both in subjects with 22q11.2DS and in people with schizophrenia suggest a role of endophenotypes. SC is directly correlated to interpersonal functioning in 22q11.2DS without psychosis and people with schizophrenia. DEL_SCZ may suffer from deeper cognitive and symptomatic conditions that both impact differently on FU.
Investigation of electrophysiological markers to predict clinical and functional outcome of schizophrenia using sparse partial least square regression
Authors: Giuliani L. , Popovic D. , Koutsouleris N. , Giordano G.M. , Koenig T. , Mucci A. , Vignapiano A. , Altamura M. , Bellomo A. , Brugnoli R. , Corrivetti G. , Lorenzo G. Di , Girardi P. , Monteleone P. , Niolu C. , Galderisi S. , Maj M.
Published: February 2022

Introduction

Despite innovative treatments, the impairment in real-life functioning in subjects with schizophrenia (SCZ) remains an unmet need in the care of these patients. Recently, real-life functioning in SCZ was associated with abnormalities in different electrophysiological indices. It is still not clear whether this relationship is mediated by other variables, and how the combination of different EEG abnormalities influences the complex outcome of schizophrenia.

Objectives

The purpose of the study was to find EEG patterns which can predict the outcome of schizophrenia and identify recovered patients.

Methods

Illness-related and functioning-related variables were measured in 61 SCZ at baseline and after four-years follow-up. EEGs were recorded at the baseline in resting-state condition and during two auditory tasks. We performed Sparse Partial Least Square (SPLS) Regression, using EEG features, age and illness duration to predict clinical and functional features at baseline and follow up. Through a Linear Support Vector Machine (Linear SVM) we used electrophysiological and clinical scores derived from SPLS regression, in order to classify recovered patients at follow-up.

Results

We found one significant latent variable (p<0.01) capturing correlations between independent and dependent variables at follow-up (RHO=0.56). Among individual predictors, age and illness-duration showed the highest scores; however, the score for the combination of the EEG features was higher than all other predictors. Within dependent variables, negative symptoms showed the strongest correlation with predictors. Scores resulting from SPLS Regression classified recovered patients with 90.1% of accuracy.

Conclusions

A combination of electrophysiological markers, age and illness-duration might predict clinical and functional outcome of schizophrenia after 4 years of follow-up.
Reduced prefrontal activity and suicidal behaviour in early schizophrenia
Authors: Grigoriou M. , Reniers R. , Mallikarjun P. , Upthegrove R.
Published: February 2022

Introduction

Approximately, 15- 26% of patients with first-episode psychosis, including schizophrenia, are likely to have attempted suicide by their first treatment contact. Studies of suicidal behavior outside of schizophrenia have indicated grey matter volume loss in the prefrontal and orbitofrontal cortex, and aberrant brain activity in relation to emotional recognition and dysfunction.

Objectives

This study aimed to investigate the functional neural correlates of suicidal behavior in early schizophrenia.

Methods

fMRI faces task was conducted (fearful face versus neutral face) in 8 participants with first-episode schizophrenia together with standardised scales including PANSS and SBQ-R. fMRI activation was compared using a two-sample t-test in participants with low and high suicidal behavior. Extent threshold is 0 voxels and significance level p<0.001 (FWE corrected). Processing of images was carried out using SPM12 and Matlab.

Results

8 participants were recruited; 5 males and 3 females, mean age of 26.5. Results suggest that participants with higher suicidal behaviour showed reduced activation on the anterior-cingulate gyrus and medial frontal gyrus, which are parts of PFC, (p= .005). There was also a significant difference in task response accuracy, where, participants with high suicidal behaviour made more accurate responses compared to low group (t (3) = 3.65, p = .035).

Conclusions

This is an exploratory study, investigated the differences in brain activity in patients with schizophrenia who are at risk of completed suicide and, therefore might provide new insights into the underlying mechanisms. Further work should address how PFC activity changes with risk over time and its potential utility as a biomarker in suicide.
The factors associated with subjective cognitive complaints in schizophrenia
Authors: Bouhamed M. , Sallemi R. , Kolsi S. , Feki I. , Masmoudi J.
Published: February 2022

Introduction

Schizophrenia (SKZ) is a chronic, disabling and incapacitating psychiatric disorder. In addition to the traditional symptomes of schizophrenia, the suffering of this patients can be expressed through a set of cognitive complaints

Objectives

To determe the factors associated with subjective cognitive complaints in schizophrenia

Methods

We conducted a cross-sectional descriptive and analytical study among a sample of of 72 patients followed in psychiatric outpatient of Hefi chaker university hospital in sfax. We used the SSTIC scale to determine subjectif complains ans the PANSS to evalue positif and negatif symptomes

Results

The mean age of our popularion was 46.83± 11.6 years. The patients had a low socio-economic level in 70.1%. They were unemployed in 46.9%, consumed alcohol in 23.6% and consumed tobacco in 58,6% of the cases. the total score on the PANSS scale was 46, distributed as follows: 9 for positive symptoms, 17 for negative symptoms and 22 for total psychopathological assessment. They had an average score of 25 on the total SSTICS score Factors significantly correlated with subjective cognitive complaints were: low socio-economic level (p=0.04), lack of occupation (p=0.001), alcoholism (p=0.001), smoking (p=0.01) and presence of negative symptoms (p=0.00).

Conclusions

This study demonstrates that socio-demographic characteristics and the predominance of negative signs may increase the subjectif cognitif complains in schizophrenia. The recognition of these associations by the psychiatrist can have an important implication in the therapeutic management.
Salience of self-identification of transsexual people in different stages of medical transition
Authors: Kumchenko S. , Tkhostov A. , Rasskazova E.
Published: February 2022

Introduction

Transsexuals are considered to be stable in their identity (White Hughto et al., 2016). Meanwhile, the stages of medical transition affect the mental state of transsexuals differently.

Objectives

The aim was to reveal relationships between salience of self-identification in transsexual people being on different stages of medical transition.

Methods

151 transsexual people: 55 pre-operated Female-to-Male (FtM I), 25 FtM on a hormonal therapy (FtM II), 25 FtM after some surgical operations (FtM III); 12 pre-operated Male-to-Female-Transsexual (MtF I), 16 MtF on a hormonal therapy (MtF II), 18 MtF after some surgical operations (MtF III). The participants filled the modificated Kuhn’s test “Who am I?” (Tkhostov et al., 2014). The modification includes a Likert scale for evaluating one’s self-identifications in terms of salience: “How often do You think or remember this answer?” (Stryker, 2007).

Results

There were differences between identity salience and stages of medical transition (F = 7,177; P < 0,001; η2 = 0,108). Transsexuals before medical transition demonstrated higher levels of identity salience (average score is 7,62 in FtM I and 7,75 in MtF I). Transsexuals on a hormonal therapy demonstrated sharply decreased level of identity salience (6,97 in FtM II and 6,19 in MtF II). Transsexuals after surgical operations reported increased level of salience (7,81 in FtM III and 7,23 in MtF III). There were no statistically significant differences between the groups by gender assigned at birth.

Conclusions

Data suggest that medical transition could change the salience of self-identification. Hormone therapy is associated with a sharp revision of the salience of self-identifications for transsexuals.
The importance of mental and sexual health in addressing people with hiv - the double stigma
Authors: Nascimento S. , Gonçalves M.
Published: February 2022

Introduction

Having a mental disorder is associated with increased vulnerability to the transmission of the Human Immunodeficiency Virus (HIV) and the prevalence of HIV is higher in people with a severe mental disorder. People with psychiatric comorbidities such as bipolar affective disorder and depressive disorder, post-traumatic stress disorder (physical or sexual abuse) and/or psychoactive substance use have a higher risk of HIV infection.

Objectives

This work is intended to expose the importance of integrating mental health care with the care of HIV patients.

Methods

The authors conducted a non-systematic review of the literature, conducting research through Pubmed and Medscape using the keywords ‘Preexposure prophylaxis’, ‘HIV’, ‘Mental health problems’.

Results

Several factors may contribute to the high comorbidity between HIV and Mental Disorders, including socio-demographic factors, weak social and environmental structures, as well as internalized stigma, social and experienced discrimination. Mental health problems may interfere with the care needed for prevention, including regular HIV testing and/or adherence to Preexposure Prophylaxis (PrEP); and influence access to and adherence to antiretroviral treatment.

Conclusions

This compelling evidence makes the necessary contribution of integrating mental health into an assessment and continuous treatment of the HIV patient, on the other hand, the assessment and treatment of mental disorders should address sexual health.
The complexity of vulnerability to psychosis
Authors: Fiorillo A.
Published: February 2022

Schizophrenia is a complex mental disorder, which has been recently conceptualized as a neurodevelopmental disease. This conceptualization has changed the psychopathological approach to schizophrenia, which is now described as lying on a continuum from mild psychotic experiences to frank psychotic episodes. According to this theory, the presence of psychotic symptoms would represent the final pathway of a complex dysregulation and interaction of different genetic and environmental risk factors. As regards genetic liability, recent genome-wide association studies have identified a total of 108 loci containing common risk alleles, and which meet genome-wide significance. As regards environmental factors, higher rates of schizophrenia have been found in ethnic minority groups, in persons who are heavy cannabis smokers, in those who suffered from severe childhood traumas, in persons who have been reared in highly deprived settings. The identification of risk factors associated with vulnerability to psychosis is essential for improving our understanding and early detection of vulnerable individuals, and to propose tailored and timely interventions for sufferers. There is the need for an interdisciplinary approach to schizophrenia which includes screening procedures for individuals reporting specific vulnerabilities and treatment strategies tailored on patients’ needs.

Disclosure

No significant relationships.
Effectiveness of cognitive remediation in schizophrenia: What works and what does not work?
Authors: Vita A. , Deste G. , Ceraso A. , Nibbio G. , Barlati S.
Published: February 2022

Introduction: Cognitive function in schizophrenia is one of the main elements related to functional outcomes. Although there is enough evidence that cognitive remediation (CR) is beneficial, there is still a limited understanding of how the active therapy ingredients contribute to brain changes and translate into improved real-world functioning. Objectives: Identify neurobiological, psychopathological, cognitive, and functional CR response or resistance predictors in schizophrenia, considering both cognitive and functional outcomes. Results: We still lack a precise understanding of how CR produce its effects with different programs, different numbers of sessions, with and without a therapist. CR exerts its maximal benefit when delivered in the context of psychiatric rehabilitation, but it is not yet clear what are the mechanisms of integrated treatment effectiveness. Only a few studies have looked for the relationship between CR response or resistance and the biological, socio-demographic, clinical and cognitive features in schizophrenia. The current knowledge on efficacy predictors of CR is sparse and include: age, illness duration, premorbid adjustment, baseline cognitive performance, intrinsic motivation, hostility, disorganized symptoms, neurobiological reserve, genetic polymorphisms, antipsychotics amount, the type of CR, etc. All of these limitations may have contributed to the poor implementation of CR in national and international guidelines, as well as in clinical practice. Conclusions: It is important that future research shift from studies of group efficacy to individual efficacy of treatments, in the perspective of precision medicine. Issues related to individual effectiveness predictors and interactions between specific pharmacologic, specific CR technique and individual patients’ characteristics should be further addressed.

Disclosure

No significant relationships.
Patterns of alcohol consumption in european pregnant women with alcohol use disorder
Authors: Pereira I. , Nogueira V. , Teixeira J.
Published: February 2022

Introduction

Prenatal alcohol exposure can have a negative impact on a child’s neurocognitive development. Still, about 16% of European women maintain alcohol consumption, even after knowing they are pregnant. Several studies have shown that alcohol use patterns alter drastically during pregnancy. However, little is known about how these change in women with Alcohol Use Disorder (AUD) diagnosis.

Objectives

To understand the impact of pregnancy on alcohol use patterns in women at high risk or with previous AUD diagnosis.

Methods

Bibliographic research was made through the PubMed/NCBI database. No time limit was specified on the search. Pertinent manuscripts were individually reviewed for additional relevant citations.

Results

Several factors influence alcohol consumption during pregnancy, including financial status, educational level, and high levels of psychological stress. Although older age at the onset of pregnancy is deemed a risk factor for alcohol consumption, women of 25 or fewer years of age are at higher risk for AUD, as are those with a history of criminal behaviour and family history of AUD. Pregnancy seems to play a critical role in altering alcohol use patterns, reducing the risk of AUD in about 70%, regardless of pregnancy trimester. This is seen even in women who present high-risk factors for AUD.

Conclusions

Pregnancy presents itself as a behavioural change promoter and should be regarded as a window of opportunity for intervention in women with AUD. However, there are few studies that focus on alcohol consumption patterns specifically in women with AUD, whereby making it necessary to extrapolate the available data.