bluuebunny/crossref_metadata_2025 huggingface dataset:
A Qualitative Research to Examine Experiences of Turkish Women with Breast Cancer
Authors: Yastibaş C. , Dirik G. , Yilmaz-Karaman İ.G.
Published: September 2022

Introduction

Breast cancer is a serious public health problem and one out of every 4 women diagnosed with cancer is breast cancer. Although the survival rate has increased due to advances in diagnosis and treatment, getting a cancer diagnosis is a highly stressful life event and seriously affects the lives of patients.

Objectives

Therefore, the aim of this qualitative study is to explore the experiences of women with breast cancer.

Methods

Data were gathered using semi-structured forms, in-depth interviews with 7 patients aged between 29 and 64 who had been diagnosed with breast cancer in 2017 and after. All interviews were tape-recorded and the themes have resulted in analyzing the content of the recorded data.

Results

It has been determined that women have difficulties in getting information from healthcare professionals, emotional supports from their partners and family members, dealing with losses in roles and femininity, and coping with intrusive thoughts. However, it has been highlighted that women have experienced some positive changes in certain areas such as deeper interpersonal relationships with others, appreciating health and life.

Conclusions

As a result of the study, it has been thought that it is important to reduce the distress level of women with breast cancer related to their needs and difficulties and to encourage their positive changes. Besides, working in cooperation with healthcare professionals responsible for their treatment will be beneficial to reduce the distress level of the women.

Disclosure

No significant relationships.
“Let’s face it… it’s futile”: Experiences of futility among nurses who provide care to patients with borderline personality disorder
Authors: Papathanasiou C. , Stylianidis S.
Published: September 2022

Introduction

Research studies suggest that mental health nurses hold negative attitudes towards patients diagnosed with borderline personality disorder (BPD).

Objectives

The aim of this study was to explore mental health nurses’ experiences and attitudes towards BPD patients in Greece, using a qualitative approach.

Methods

Data were collected through two audio-recorded focus group discussions. The participants were twelve nurses who work in two General Hospital Psychiatric Units –one in Athens and one regional– and have direct clinical experience with BPD patients. The audio recordings were transcribed verbatim and analysed using thematic analysis in the context of grounded theory.

Results

One overarching theme and three main themes were identified. The overarching theme that emerged was: “Futility”, which refers to feelings that the provision of nursing care to BPD patients is devoid of purpose and meaning. The main themes were: “Uncertainty”, which refers to the absence of valid causal explanations for mental disorders and on the perplexity of the BPD psychopathology; “Frustration”, which refers to challenges and barriers to providing care to BPD patients; “Unsupportiveness”, which refers to a complex mental health system, where there is a lack of guidance and goal orientation. Of significance are the nurses’ feelings of frustration and futility creating a sense of being burdened and leading to negative attitudes and behaviours towards BPD patients.

Conclusions

Understanding treatment goals from the recovery model perspective and developing guidelines to help nurses revisit the concept of medical futility, may improve care to BPD patients.

Disclosure

No significant relationships.
Borderline personality disorder and decision-making capacity
Authors: Garcia Lazaro F.
Published: September 2022

Introduction

Borderline personality disorder is characterized by a pattern in which instability in interpersonal relationships, self-image and affections prevails, and intense impulsivity present in the early stages of adulthood and with altered functionality in several contexts.

Objectives

Establish what functions may be altered in crisis situations in borderline personality disorder.

Point out what legal tools we have available in situations in which the will is altered in borderline personality disorder.

Reflect on borderline personality disorder and its relationship with substance use.

Methods

Regarding a clinical case with a 25-year-old patient with a diagnosis of Borderline Personality Disorder and a history of use in a pattern of dependence (opioids, cannabis, cocaine) who is admitted to a hospital for diagnostic and therapeutic procedures secondary to pathology to which it is denied, determining the absence of the capacity to give consent. A systematic review of the existing bibliography on borderline personality disorder, substance use disorder and decision-making capacity has been carried out using as key words: borderline personality disorder decision-making capacity.

Results

The presence of anxious symptoms, affective instability, feelings of emptiness and hopelessness as well as impulsivity can give rise to scenarios in which the decision-making capacity is impaired, being necessary to resort to legal means that allow us to prioritize the well-being of the patient.

Conclusions

The decision-making capacity can be altered in crisis situations in borderline personality disorder, having legal tools at hand that allow us to carry out actions to preserve the physical state of patients.

Disclosure

No significant relationships.
Traumatic brain injury, antisocial personality disorder and alcohol
Authors: De Andrés Lobo C. , Jiménez Aparicio T. , Vallecillo Adame C. , Queipo De Llano De La Viuda M. , Gonzaga Ramírez A. , Guerra Valera G. , Santos Carrasco I. , Gonçalves Cerejeira J. , Fernández Lozano M. , Rodríguez Rodríguez B. , Navarro Barriga N. , Mateos Sexmero M.J. , De Uribe Viloria N. , Medina Ojeda G.
Published: September 2022

Introduction

Traumatic brain injury (TBI) can cause changes in the personality and behaviors. History of TBI has been associated with violent behavior and substance abuse.

Objectives

Presentation of a clinical case of a patient with antisocial personality traits who suffered a TBI and abuses alcohol.

Methods

We conducted a bibliographic review by searching for articles published the last 5 years in Pubmed

Results

We present the case of a 48-year-old male patient with a history of myoclonic epilepsy, who suffered a TBI in a car crash. During his stay at ICU antisocial and borderline personality traits were found. When he came to consultations, he presented signs of alcohol intoxication (verbiage with hasty and dysarthric speech, and psychomotor incoordination). He acknowledges daily alcohol intake, although he minimizes it. During the interview he is irritable, prone to anger when contradicted and boasts of episodes of heteroaggressiveness and violence that he has carried out in the past. He reports morning sickness and tremors, but does not accept that they may be due to alcohol withdrawal. There is no motivation for change.

Conclusions

It has been determined that history of TBI is more frequent in individuals with antisocial personality. TBI has been linked to violent behaviors, poor inhibitory control, engaging in illegal acts and higher rates of substance abuse. However, the causal relationship between antisocial behavior and TBI has yet to be clarified, as the available evidence does not show which comes first. More research is needed in the future that takes into account the temporal sequence of events.

Disclosure

No significant relationships.
Antisocial personality disorder: what else can be done?
Authors: Falcao V. , Pinto C. , Heitor M.J.
Published: September 2022

Introduction

Antisocial personality disorder (ASPD) is an under-researched mental disorder, and these patients are often excluded from mental healthcare and thus from studies. The consequences of antisocial behavior result in great burden for the patients, victims, family members and for society, and it is associated with criminality, substance use and relationship difficulties.

Objectives

The aim of this abstract is to review the current possibilities of treatment, and its efficacy.

Methods

We present a revision of the state of the art on treatment of ASPD, drawing from PubMed and using the keywords “Antisocial personality disorder” and “treatment”, in a time period ranging from 2011 to 2021, inclusive.

Results

There is little evidence of effective treatments for patients with ASPD and no intervention has been established as the treatment of choice for this disorder. Recent studies, found benefits from Mentalization-based treatment (MBT), that specifically targets the ability to recognise and understand the mental states of oneself and others, an ability compromised in these patients. Specifically, reduction of anger, hostility, paranoia, and frequency of self-harm and suicide attempts, as well as the improvement of negative mood, general psychiatric symptoms, interpersonal problems, and social adjustment were found.

Conclusions

ASPD is a condition that incurs substantial societal and individual costs. Although proper treatment is yet being discussed, MBT is a psychotherapeutic treatment that has shown some promising preliminary results. Thus, we believe that guidelines on the treatment of ASPD and possibilities for more systematical research, with prevention programs, is urgently needed.

Disclosure

No significant relationships.
Antisocial personality disorder in women: a cross-sectional study about 20 cases
Authors: Karoui M. , Khanfir S. , Amri G. , Kammoun R. , Nefzi H. , Ellouz F.
Published: September 2022

Introduction

Antisocial personality disorder (ASPD) is characterized by a long term pattern of disregard for, or violation of the rights of others that occurs in childhood or early adolescence and continues into adulthood. This disorder remains unknown in women.

Objectives

The aim of this study was to describe socio-demographic, clinical, psychometric and therapeutic characteristics of women with ASPD hospitalized in psychiatric ward.

Methods

A cross-sectional and descriptive study was conducted in G psychiatry department, in Razi hospital. It included 20 women with ASPD and hospitalized in psychiatric ward. Socio-demographic, clinical and therapeutic characteristics were assessed. A psychometric evaluation was carried out by the application of six scales: BIS 11, HCR 20, VRAG, PCL-R, ENFP and PID5-BF.

Results

The mean age of the patients was 34 ± 9 years. Patients with a personal history of suicide attempt accounted for 45% of the study population. Patients with a criminal history accounted for 67.5% of the study population. A substance-related disorder was found in 85% of the patients. Adjustment Disorder was retained in 42.5% of the patients and Psychotic Disorder was diagnosed in 32.5% of the population. The average score at VRAG was 6.18 ± 5.8. The mean score at PCL R was 24 ± 4.2. High impulsivity scores were found.

Conclusions

ASPD represents a major concern for clinicians in psychiatric wards. A better knowledge of the characteristics of this trouble in women could improve their quality of care.

Disclosure

No significant relationships.
The concept of Evil in Psychiatry: Philosophy, neurobiology and clinical implications
Authors: Maia A. , Nascimento S.
Published: September 2022

Introduction

Although difficult to define, the concept of evil is widely used and implicitly influences psychiatric judgements and diagnosis. Most definitions of evil rely on classical philosophical concepts, but it remains controversial if evil is a concept by itself or rather a dysfunction on the ability to experience goodness. Also, it is unclear if there is a neurobiological basis for evil or if it is entirely dependent on socio-cultural beliefs.

Objectives

In this work, we intend to systematize evidence on the philosophical definitions and neurobiological correlates of evil, and reflect on its implications in clinical psychiatry.

Methods

Literature review.

Results

The concept of evil has been a theme of debate since the ancient Greek, where Plato argued that evil was a result of ignorance and Aristoteles saw morality as a guide for education and politics. Nietzsche claimed that evil was a dangerous concept that was created by the church, while Hannah Arendt underlined the banality of evil by highlighting “thoughtlessness” that frequently justify evil acts. From a neurobiological perspective, studies assessing individuals with neuro-psychiatric conditions associated with evil-related behavioral abnormalities have been suggesting a potential role of frontal and limbic structures, as well as of the serotonergic system. However, several of these studies assessed presumed correlates of evil, such as antisocial personality disorder or impulsive-aggressive behavior.

Conclusions

Despite the polemic frontier between neurosciences and morality, a conceptual insight over the definition of evil is vital to guide comprehensiveness and clinical approach when dealing with deviant evil-like behaviors.

Disclosure

No significant relationships.
Transcranial magnetic stimulation and post-traumatic stress disorder
Authors: Moura N. , Fraga A. , Facucho-Oliveira J. , Azevedo F. , Laginhas C. , Esteves-Sousa D.
Published: September 2022

Introduction

Post-traumatic stress disorder (PTSD) is a psychiatric disorder characterized by symptoms from four clusters after exposure to a traumatic event: re-experiencing symptoms including flashbacks and nightmares, hyperarousal, avoidance of internal and external stimuli related to trauma, and negative alterations in mood and cognition. As a noninvasive intervention that uses induction of electromagnetic fields to modulate cortical circuitry, TMS has a substantial body of literature demonstrating safety, tolerability, and efficacy in depression and potentially PTSD.

Objectives

Our aim is to perform a non-systematic review of the literature regarding TMS and PTSD

Methods

A semi-structured review was conducted on Pubmed concerning TMS and PTSD

Results

The majority of studies utilize repetitive TMS targeted to the right dorsolateral prefrontal cortex (DLPFC) at low frequency (1 Hz) or high frequency (10 or 20 Hz), however others have used alternative frequencies, targeted other regions, or trialed different stimulation protocols utilizing newer TMS modalities such as theta-burst TMS (TBS). It is encouraging that were positive outcomes have been shown, and often sustained for up to -3 months, nevertheless there is a paucity of long-term studies directly comparing available approaches.

Conclusions

TMS appears safe and effective for PTSD, although important steps are needed to operationalize optimal approaches for patients.

Disclosure

No significant relationships.
The role of Effortful Control and Executive Attention in Mood Disorders
Authors: Ossola P.
Published: September 2022

In the first part of the talk I will show that using a computational approach, namely the Drift Diffusion Model, the efficiency of executive attention (EA) is associated with effortful control, the self-regulatory aspect of temperament in a sample of n=427 healthy subjects. Then I will demonstrate how, applying the same model, EA measured through the same conflict resolution task predicts longitudinally a sooner relapse in a sample of n=64 subjects with bipolar and depressive disorders. Lastly I will discuss how EA is associated with obsessive compulsive symptoms in the same clinical population and how they interact in predicting the course of illness. Altogether these results suggest that there is an association between self-reported effortful control and EA and that treatments targeting executive functions could be crucial in preventing relapses in subjects with mood disorders experiencing obsessive compulsive-symptoms.

Disclosure

No significant relationships.
Clinical effects of Cariprazine and their relationship with polymorphisms of dopamine and serotonin receptors: preliminary results from a prospective study on schizophrenia and bipolar disorder
Authors: De Pieri M. , Dyrmishi E. , Bolla E. , Preve M. , Colombo R.A. , Traber R.
Published: September 2022

Introduction

Cariprazine (CAR) is a D2, D3, 5HT1A receptor partial agonist and a 5HT2A, 5HT2B antagonist, used to treat Schizophrenia and Bipolar disorder. Interindividual variability in therapeutic and side effects of antipsychotics is difficult to predict, due to non-genetic and genetic factors. Single nucleotide polymorphisms (SNPs) are the main source of genetic variability, the ones in dopamine and serotonin receptors to which CAR binds are indeed likely to determine response to treatment.

Objectives

The aim of the study is to define a relationship between CAR clinical efficacy and SNPs in dopamine and serotonin receptors genes of patients affected by schizophrenia and bipolar disorder.

Methods

We recruited 16 patients starting a monotherapy with CAR, evaluated at baseline and after 2, 4 and 8 weeks through BPRS rating scale. We selected a panel of SNPs in DR2, DR3, 5HT1A and 5HT2A receptors, with a frequency higher that 10% in Caucasians and functionally characterized. Cut-off for response to treatment was a 50% reduction of BPRS score. Statistical analysis was performed with one-way ANOVA followed by the test for linear trend between columns.

Results

All subjects achieved response after 8 weeks of treatment, but 6 patients after 4 weeks. Early responders have a genetic profile associated with increased dopamine and serotonin receptor expression and/or binding affinity for their specific ligands. The association don’t reach statistical significance, probably due to low number of patients.

Conclusions

Preliminary results suggest that an array of dopamine and serotonin receptors SNPs could predict time to respond to CAR in schizophrenia and bipolar disorder.

Disclosure

The study is founded by Recordati AG, that commercialize the drug under study (Cariprazine) in Switzerland. Funding covers the costs for genetic analysis and other procedures of the study, no financial compensation is planned for investigators/authors.
The role of Effortful Control in Pychopathology Amongst Older Psychiatric Patients
Authors: Brancart X. , Dierckx E. , Rossi G. , De Raedt R.
Published: September 2022

Background and aim: Based upon a person-centred approach, there is a growing interest in neurobiological transdiagnostic factors, such as reactive temperament (Behavioral Inhibition (BIS) and Behavioral Activation Systems (BAS)) and regulatory processes (Effortful Control (EC)). Three temperament-based personality types (Resilient, Undercontrolled and Overcontrolled type (RUO)) have been replicated in adolescents and younger adults with several clinical problems; with the resilient type (highest scores on EC) consistently showing less psychological symptoms. However, these RUO types have not been studied yet in older adults with mental disorders. Therefore, the current study investigates (1) whether these RUO types can be replicated based on the aforementioned reactive and regulative temperamental factors in older inpatients and (2) whether a higher EC is related to the presence of less psychopathology. Methods: The EC, BIS/BAS, SCL-90-R and ADP-IV questionnaires were administered to 96 older patients (<= 60 years) admitted to a psychiatric hospital. Results: Cluster analysis resulted in a solution of three atypical types: a Resilient type (low BIS, mean BAS, high EC), a Dysregulated type (high BIS, high BAS, low EC) and an “Apathic” type (mean BIS, low BAS, mean EC). Comparison of means revealed that the Resilient type has the highest scores on EC and shows less clinical symptoms and maladaptive personality traits. Discussion: Of the 3 RUO types, only the Resilient type was fully replicated in older psychiatric patients. Strengthening EC might be useful as an additional therapy in order to reduce clinical symptoms, possibly leading to a better treatment outcome.

Disclosure

No significant relationships.
Correlation between psychotic risk and depressive “cognitive” symptoms in adolescence
Authors: Maffucci A. , Cesario S. , Mammarella V. , Colafrancesco G. , Ferrara M. , Raballo A. , Monducci E.
Published: September 2022

Introduction

Prevention of disorders has become a central element of psychiatric research and clinic. Currently, Ultra High Risk (UHR) criteria are internationally recognized for psychiatric risk assessment. Self Disorders (SD) aroused particular interest because they were found to be specific to schizophrenic spectrum disorders and a marker of vulnerability for psychotic onset.

Objectives

To evaluate the correlation between psychotic risk and depressive symptoms in at-risk adolescent population.

Methods

We collected data from 80 patients, aged 14-18, with sufficient skills in the Italian language and an IQ ≥70, excluding patients with disorders related to direct effects of a general medical condition or substance. Psychodiagnostic evaluation included K-SADS-PL, SIPS/SOPS, EASE (for the assessment of SDs) and the CDSS (for the assessment of Depression).

Results

35 subjects have UHR criteria, while 45 do not have a psychotic risk syndrome or psychotic features. Between the two groups there is a significant difference in the total SCORE of EASE, in domains 1, 2 and 5. In addition, a positive correlation between SDs and depressive symptoms emerged, in particular with pathological guilt and with reference ideas of guilt.

Conclusions

The results confirm the validity of SDs for early detection of psychosis. Depressive features appear to be associated with the presence of abnormalities of experience. This results suggest a close care and monitoring of depressive symptoms in adolescence, because they can mask disorders of different nature, particularly pathological guilt and guilty ideas of reference that are depressive “cognitive” symptoms more correlate with psychotic risk.

Disclosure

No significant relationships.
Interrelations of love of life with psychosocial factors in university students
Authors: Nikolaev E. , Petunova S.
Published: September 2022

Introduction

Love of life as a positive evaluation of one‘s own life plays an important role in developing a person’s positive outlook on their own wellbeing.

Objectives

Our goal is to define the nature of interrelations between manifestations of love of life and some psychosocial factors of health in university students.

Methods

Using the English version of the Love of Life Scale (Ahmed M. Abdel-Khalek) and the Sociocultural Health Questionnaire (E. Nikolaev), we carried out an online survey of 136 university students of both genders. A correlation analysis helped to define the interrelations.

Results

We established that a high level of the overall rate of Love of Life, on the one hand, corresponds to high self-evaluation of a person’s health (r=.31, p<.05) and happiness (r=.47, p<.05). On the other hand, it correlates with a high level of anti-suicidal barrier (r=.20, p<.05) and low frequency of headaches (r=-.18, p<.05). Students’ desire for a long life, which would enable to achieve everything they have been dreaming of, correlates with low weight (r=-.18, p<.05). A low level of stress is connected with a greater feeling of love in life (r=-.22, p<.05) and its perception as something beautiful and fascinating (r=-.29, p<.05). Better understanding of life correlates with lower frequency of smoking (r=-.19, p<.05).

Conclusions

A psychological construct of Love of life, due to its negative correlations with the health risk factors has a great positive potential for a personality development and their health. It can serve as a target for a psychological impact in interventions.

Disclosure

No significant relationships.
Inventory of Sources of Stress During Medical Education - Further Validation
Authors: Carneiro M. , Macedo A. , Loureiro E. , Dias M. , Carvalho F. , Telles Correia D. , Novais F. , Barreto Carvalho C. , Cabacos C. , Pereira D. , Vitória P. , Araújo A. , Pereira A.T.
Published: September 2022

Introduction

The Inventory of Academic Sources of Stress in Medical Education (IASSME) evaluates the presence and intensity of the main sources of academic stress for Portuguese Medicine students in five dimensions: Course demands/CD, Human demands/HD, Lifestyle/LS, Academic competition/AC, and Academic adjustment/AA.

Objectives

To further validate the ISSME using Confirmatory Factor Analysis and to analyze the psychometric properties of a new version including additional sources of stress.

Methods

Participants were 666 Portuguese medicine (82.6%) and dentistry (17.4%) students (81.8% girls); they answered an online survey including the ISSME and other validated questionnaires: Maslach Burnout Inventory – Students Survey (MBI-SS) and Depression Anxiety and Stress Scales (DASS).

Results

Confirmatory Factor Analysis showed that the second order model composed of five factors (the original structure by Loureiro et al. 2008), but excluding item 11 (loading=.371), presented good fit indexes (χ2/df=3.274; RMSEA=.0581, p<.001; CFI=.917; TLI=.904, GFI=.919). The Cronbach’s alfas were α=.897 for the total and from α=.669 (F2-HD) to α=.859 (F1-CD) for the dimensions. The expanded version, including two additional items related to lack of interest in medicine/dentistry (F6, α=.543) and two additional COVID-19 stress-related-items (F7, α=.744) also showed acceptable fit indexes (χ2/df=3.513; RMSEA=.061, p<.001; CFI=.88.; TLI=.866, GFI=.892). This new version’s α was of .896. Pearson correlations between ISSME and the other measures were significant (p<.01) and high: >.55 with DASS and >.50 with MBI-SS. Girls presented significantly higher ISSME scores. F6 score was significantly higher in dentistry students.

Conclusions

This further validation study underlines that IASSME presents good validity (construct and convergent) and reliability.

Disclosure

No significant relationships.
Feasibility of fNIRS in Children with Developmental Coordination Disorder
Authors: Johnson C. , Klingels K. , Verbecque E. , Meyns P. , Hallemans A.
Published: September 2022

Introduction

Balance deficits are heterogeneous among children with Developmental Coordination Disorder (DCD). Balance performance depends on different balance domains, each associated with specific underlying neurological systems. In DCD, any of these domains can be affected, but the control mechanisms are poorly understood. The mirror neuron system (MNS) seems to play a key-role in DCD-related deficits. To understand the role of MNS as a control mechanism underlying the balance deficits, simultaneous registration of cortical MNS activity while performing balance tasks is imperative. Therefore, a protocol for combining real-time registration of cortical MNS activity during functional balance tasks in children with DCD, CP and TD is introduced. Methods: Children with DCD, CP and TD (n=108) aged 5-10yr perform preselected tasks of the Kids-BESTest, representing specific balance domains (mixed design): leaning with eyes closed (stability limits/verticality), single-leg-stance, alternate stair touching (anticipatory balance), in-place response, compensatory stepping backward (reactive balance) and walking over obstacles (gait stability). Simultaneously, functional Near-Infrared Spectroscopy (fNIRS) monitors cortical activity involving the MNS: premotor, inferior and superior parietal cortex and supplementary motor area. An 8-8-optode bundle, making 22 channels, targets this region of interest. Outcome measures are: (de)oxygenated hemoglobin concentration changes per task per channel. Results: In this ongoing research, the protocol was already feasible in 19 children (7.52±1.19). Conclusion: Simultaneous registration of cortical MNS activity (fNIRS) and Kids-BESTest scores will help increase the understanding of the control mechanisms underlying the heterogeneous balance problems in DCD. Consequently, first steps are made to confirm whether DCD shows deviant or delayed development.

Disclosure

No significant relationships.
The Effectiveness of Motivational counseling in improving Psychological vitality of Teachers in Dhofar Region Schools - Sultanate of Oman
Authors: Abdelrasheed N. , Khalaf M.
Published: September 2022

Introduction

Psychological vitality has a significant relationship with self-realization, mental health, positive emotions and self-motivation, life satisfaction, and optimism. Additionally, it reduces the possibility of exposure to anxiety, depression and stress. In the same line, work pressures drive teachers to suffer from some negative emotions such as anger and lack of motivation, which in turn influence their vitality, social relations with colleagues.

Objectives

The present study designed a motivational counseling-based program to improve psychological vitality among teachers in Dhofar region schools

Methods

Participants were 60 teachers obtained the lowest degrees on the psychological vitality questionnaire. They were divided randomly into two groups: experimental and control. Qusai-experimental method with two groups design was adopted. The given program consists of 18 counseling sessions at the rate of 3 sessions per week ranging from 60 to 75 minutes.

Results

indicated that statistically significant differences at 0.01 level were found between mean scores of both groups groups on the posttest of psychological vitality favoring the experimental group. Also, statistically significant differences at 0.01 level were detected between the pre-test and post-test (experimental group) mean scores favoring the post-test. Taken together those findings confirm the effectiveness of the counseling program in improving psychological vitality Posttest and follow up test did not significantly differ which prove the continuity of program effectiveness.

Conclusions

To conclude, motivational counseling plays an important role in enhancing psychological vitality of teachers. Further research might use the program in alleviating other psychological disorders.

Disclosure

No significant relationships.
Comparing the role of neuronal versus non-neuronal cells in the pathophysiology of delirium: a systematic review
Authors: Mcadam H.
Published: September 2022

Introduction

Delirium is a condition which impacts nearly half of older adults during hospital admission. It presents with a wide range of neuropsychiatric symptoms leading to increased morbidity and mortality. Despite this, specialised knowledge and ownership of the condition remain unclear.

Objectives

To compare evidence surrounding the roles of neuronal and non-neuronal cells in the overall pathophysiology of delirium and consider the impact this could have in practice.

Methods

Using PRISMA systematic review guidelines, five medical research databases were screened for papers discussing the role of neuronal and/or non-neuronal cells in the pathophysiology of delirium between 2011 and 2021.

Results

Fifteen papers which met the inclusion criteria were then categorised into discussing neuronal (n=2), non-neuronal (n=4) or both (n=9) types of cells’ roles in the pathophysiology of delirium. Delirium was often caused by a homeostatic imbalance secondary to acute illness leading to deterioration of neural synapses and therefore signal transmission. However, it was also argued that activated non-neuronal cells, particularly microglia and astrocytes, played a significant role through disruption of the blood brain barrier. This was likely to play a role in the more severe clinical presentations of delirium.

Conclusions

The pathophysiology of delirium is multifactorial with neuronal and non-neuronal cells implicated in neurological disruption. There is no clear agreement on how these mechanisms vary according to aetiology and, ultimately, the severity of delirium. Further research will help refine these theories, which will support the pharmacological and clinical management of the condition.

Disclosure

No significant relationships.
Psychopathological descriptive model of hallucinogenic/psychedelic drugs effect in the treatment of depression and addictions
Authors: Girala N.
Published: September 2022

Introduction

There is a growing and renewed interest in the use of hallucinogenic drugs in the treatment of psychiatric disorders, especially since the FDA approval of ketamine treatment for resistant depression. The response to hallucinogenic psychedelic substances (ayahuasca, psilocybin, LSD, ketamine) in the treatment of depression and addictions calls for a theoretical explanatory model.

Objectives

Provide a descriptive / explanatory psychopathological model of the response to treatment with hallucinogenic drugs based on the descriptions of the subjects and the comparison with other extreme life experiences.

Methods

Relevant published literature on subjective experiences in treatment with hallucinogenic drugs for depression and addictions is reviewed. It is compared with subjective experiences in life changing experiences.

Results

Intense emotional states, mystical-type experiences including feelings of oneness, transcendence, ineffability, and the complex emotion of awe seem to be consistently presented as psychic elements related to the efficacy of these treatments. The genetic and cultural (memetic) evolutionary value of these emotions in the cohesiveness of human groups and the genesis of affective symptoms, and in the recalibration of cognitions and emotions, is discussed.

Conclusions

The efficacy of hallucinogenic drugs used in the treatment of depression and addictions is accompanied by complex and varied emotions but with common psychopathological elements that could mediate their action.

Disclosure

No significant relationships.
Comparison of toxic effects of lead and copper and protective power of glutathione on oxidative stress parameters
Authors: Jovanovic Mirkovic J. , Kocic G. , Alexopoulos C. , Jurinjak Z.
Published: September 2022

Introduction

Lead as an industrial pollutant can be detected at all stages of the working and living environment. Lead, based on its properties, solubility and mobility, accumulates in the soil, so that the average concentrations of oil in the soil are between 15 and 25 mg/kg (Radojević at all., 1999). Due to increased human activity, the amount of copper in the air, soil and water has increased. Glutathione (GSH) is an essential cofactor of many enzymes, such as: formaldehyde dehydrogenase, glyoxalase, prostaglandin endoperoxide isomerase, dehydrochlorinase and others. GSH is a biological redox in the metabolism of erythrocytes, it also plays a role in the transport of amino acids. Reactive forms of oxygen cause oxidative biomolecules (lipids, proteins, DNA) (Freidovich, 1999; Massaad i Klann, 2010).

Objectives

The aim of this research was to examine the protective role of supplements GSH in conditions of chronic intoxication with sublethal doses of lead acetate and copper II sulfate.

Methods

The preparation of biomaterials for testing and making homogenates of brain tissue of albino rats of Wistar strain was performed and the activity of acid and alkaline DNase was measured spectrophotometrically (Kocić i sar., 1998).

Results

Lead otherwise “as soft Lewis acid” has a pronounced affinity for interaction with “soft bases” such as S-atoms of the thiol group in antioxidants, natural biomolecules and supplements in this case in glutathione.

Conclusions

It can be said that GSH is a desirable supplement and antioxidant in the detoxification of reactive oxygen species in rats exposed to lead poisoning.

Disclosure

No significant relationships.
Pseudologia Fantastica: a case report
Authors: Sneep S. , De Jong I.
Published: September 2022

Introduction

Pseudologia fantastica is a psychiatric phenomenon that occurs equally in men and women (1). The condition was first described in 1891 and contains fantasized events (2). Most of the time the fantasized events are not entirely unbelievable. They are based upon blurred fantasy and reality and are stable over time (1,3).

Objectives

We present a case of possible pseudologia fantastica to raise awareness about this phenomenon and possible treatment.

Methods

A literature search in English was performed using Pubmed with the following MeSh terms ‘pseudologia fantastica’.

Results

We present a 20-year old women diagnosed with an intellectual disability (IQ=80) and a post traumatic stress disorder. She received treatment in an outpatient setting for a couple of years. The patient was treated by EMDR therapy and individual therapy sessions. She rejected other forms of therapy or any medication. During the treatment her symptoms were getting worse. The symptoms contained an increase of nightmares and moments of dissociation. The patient was telling she wasn’t able to eat, sleep and function on a daily basis. In individual sessions she reported life-events which worsened over time including; being a victim of rape, seeing her rapist in the subway, being touched and chased by a stranger on her bicycle. Literature search shows that confrontation is one of the treatment methods for this phenomenom.

Conclusions

The treatment of a patient with pseudologia fantastica requires attention for details and acknowledging the possibility of fantasized events, confronting techniques and maintaining an alliance between patient and therapist (2,4).

Disclosure

No significant relationships.
Management of antipsychotic-related sexual dysfunction
Authors: Rodrigues C.
Published: September 2022

Introduction

Sexual dysfunction (SD) can often be a side-effect of treatment with antipsychotics (APS). It often jeopardizes long-term adherence to treatment, while deeply affecting the patient’s quality of life. The pathogenic mechanisms may be associated with postsynaptic dopamine antagonism, a1-antagonism and prolactin elevation. APS-induced hyperprolactinemia has been linked to the occurrence of galactorrhea, gynecomastia, amenorrhea and SD.

Objectives

To synthesize the available evidence on the management of APS-related sexual dysfunction, with a main focus on the second-generation antipsychotics.

Methods

A search for randomized controlled trials (RCT) published between 2021 and 2011 on PubMed was made using the keywords “sexual”; “dysfunction”; “antipsychotic” and “treatment”, from which resulted sixteen articles. Only six of those were considered relevant for the study’s objectives.

Results

Three studies focused on the comparison between different APS and prolactin levels and SD occurrence, showing that treatment with aripiprazole is mostly related to prolactin levels with the normal range and a lower incidence of sexual dysfunction. Addition of aripiprazole to previous APS may be associated with normalization of sexual function and pose as a possible management option. Adjunctive treatment with tadalafil showed no significant effect on its primary outcome.

Conclusions

There seems to be a general consensus that patients treated with first-generation antipsychotics (FGA), along with risperidone, paliperidone and amissulpride show higher prolactin levels and incidence of SD. Whether there is a causal relationship between these two variables still remains a question. Larger and more prolonged trials are still needed to evaluate APS-related sexual dysfunction and its management.

Disclosure

No significant relationships.
A case report of eosinophilia associated with risperidone withdrawl in a patient with schizophrenia
Authors: Giourou E. , Theodoropoulou A. , Batzikosta P. , Prodromaki O. , Georgila E. , Gourzis P.
Published: September 2022

Introduction

Risperidone, a second generation antipsychotic, shows high affinity with serotoninergic and dopaminergic D2 receptors, but also adrenergic and H1 histaminergic receptors. Previous studies have shown an increase in eosinophile count associated with the second-generation antipsychotics through the histaminergic path.

Objectives

The presentation of a case in which eosinophilia was associated with risperidone withdrawl which has not been described so far.

Methods

A 46-year-old woman with schizophrenia diagnosed at the age of 22 was admitted in our inpatient psychiatric clinic with psychotic symptoms relapse after she voluntarily discontinued risperidone. The patient was fully evaluated with full laboratory tests, a brain CT scan, EEG and her medical and psychiatric histories were recorded.

Results

Risperidone was reinitiated but due to the persistence of symptoms it was switched to clozapine which lead to full remission. It was observed though, that while gradually decreasing risperidone dosage (Figure 1.), eosinophile count was raising and it was normalized after complete discontinuation. Eosinophilia was also present in other instances that the patient discontinued taking risperidone according to her personal history. Other causes of eosinophilia (allergic, inflammatory) were fully excluded.

Conclusions

Risperidone discontinuation could lead to an elevated eosinophile count. There is limited research in this topic and it is yet to be clarified whether the elevation is due to stopping one antipsychotic or switching between two different antipsychotics. It is important to run laboratory tests regularly with every treatment modification.

Disclosure

No significant relationships.
Clozapine induced pneumonia: A case report of diagnostic difficulties in the time of Covid-19
Authors: Softic R. , Tahirovic A. , Sulejmanpasic G. , Memic Serdarevic A. , Cesir A. , Becarevic N.
Published: September 2022

Introduction

Clozapine is a drug that can cause several side effects. Among the less commonly described is a drug-induced lung disease. Due to its non-specific clinical presentation, it represents a diagnostic challenge. The diagnosis is made based on: 1. Association of exposure to the agent and development of symptoms, 2. Pulmonary infiltration, 3. Exclusion of other causes, 4. Withdrawal of symptoms when the agent is excluded from therapy. To date, there have been only a few descriptions of this condition.

Objectives

Case report of rare side effect of clozapine.

Methods

Case report

Results

Case report: male patient (37) with schizophrenia, was hospitalized after a brutal suicide attempt. The PCR test for COVID-19 that was routinely performed on admission was negative. After the introduction of clozapine into therapy, the patient became febrile. There was a drop in oxygen saturation, a Lung CT scan showed inflammatory changes („ground-glass opacities“),
and COVID-19 pneumonia was suspected. Due to the worsening of the mental state, the dose of clozapine was increased. The physical condition further deteriorated: febrile, sO2 declining. After repeated PCR tests for COVID-19 (all negative), interstitial pneumonia caused by clozapine was suspected, and clozapine was excluded from therapy. The physical condition started to improve. Quetiapine was introduced, and occasional episodes of agitation were relieved with intramuscular diazepam. In the following days, the patient’s mental state improved and he was discharged.

Conclusions

Despite its superiority over other antipsychotics, clozapine was with good rationale ranked third in treatment guidelines for schizophrenia.

Disclosure

No significant relationships.
Incidence of clozapine-induced hematological side effects in a Tunisian population
Authors: Shiri M. , Ouertani A. , Madouri S. , Ouali U.
Published: September 2022

Introduction

Clozapine is commonly associated with adverse hematological outcomes. However, incidence of blood dyscrasias in the north African population is scarce.

Objectives

The aim of this study was to assess the incidence of hematological side effects in a Tunisian sample of clozapine treated patients.

Methods

We conducted a retrospective longitudinal chart review of 64 patients on clozapine enrolled in our clozapine consultation between January 1, 2000 and September 2020.

Results

Our sample consisted of 15 women (23.5%) and 49 men (76.5%), mean age was 41.34 ±9.32 years. Patients were diagnosed with schizophrenia in 70.3% of the cases, 7 (10.9%) had a bipolar disorder and 12 (18.8%) had a schizoaffective disorder.We found blood dyscrasias in 21 patients (32.8%). Hematological abnormalities were as follow: 2 cases of agranulocytosis, 8 cases of neutropenia, 13 cases of thrombocytopenia, 5 cases of leukocytosis, 5 cases of eosinophilia and 3 cases of anemia. The incidence rate of hematological side effects was 0.1 case/year- person. The mean clozapine dose at the time of onset of the hematological side effect was 309.52 mg/day(range 25-600 mg/day).The median duration of clozapine treatment prior to developing hematological side effects was 119.71±126.52 days.Clozapine discontinuation was decided in 11 cases due to hematological side effects and reintroduced in 9 cases after normalization of blood count.

Conclusions

This study emphasis on the importance of a regular long-term monitoring of blood count to ensure early detection of hematological side effects.

Disclosure

No significant relationships.
Hipersexuality in aripiprazole treatment : A case report
Authors: López Rodrigo M.V. , Palomo Monge M. , Padilla Romero P. , Osca Oliver A. , Pérez Fominaya M.
Published: September 2022

Introduction

Aripiprazole is an antipsychotic that differs from the group in that it is a partial agonist of the D2 receptor, being also a partial agonist of 5HT1A and an antagonist of 5HT2A.Most antipsychotics cause a decrease in libido, affecting both sexual desire and function. According to the literature, D2 partial agonists can cause the appearance of compulsive behaviors as an adverse effect in 6-24% of patients. Among these behaviors you can find hypersexuality. In most cases, it subsides when treatment is stopped. We describe the case of a patient with bipolar disorder who develops hypersexual behaviors following the aripiprazole treatment. This is a 61-year-old bipolar patient receiving valproate and risperidone. It requires hospital admission due to manic symptoms where dysfunctional tremor is observed. Change from risperidone to aripiprazole. Subsequently, hypersexual behaviors appear, increased libido, obsession with sexual activities (compulsive masturbation with TV programs, mobile applications, cartoons) as well as delusional ideas about “receiving sexual gazes” with no other maniac symptomps.

Objectives

To determine the possibility that hypersexuality was induced by treatment with aripiprazole.

Methods

The appearance in the time line of hypersexuality after the change of treatment would be indicative of causality.

Results

After switching back to risperidone, compulsive sexual behaviors disappear but not the delusional idea of being the focus of sexual gazes by everyone.

Conclusions

Although it is not a common adverse effect, hypersexuality is listed in the literature as a rare adverse effect.

Disclosure

No significant relationships.