bluuebunny/crossref_metadata_2025 huggingface dataset:
Learning disorders and ADHD
Authors: Cortázar Alonso E. , Guillén Rodrigo H. , Alonso Diaz R.
Published: May 2016

The term learning disorders alludes to problems in reading, calculate, writing and spelling. The prevalence of these disorders ranges from 5 to 15 percent of all the children in school age. As for sex distribution, men tend to have these problems often than women.

This summary is about a 9-year-old male with multiple eye tics and suspected of having ADHD. He was referred by her general pediatrician. The patient did not have a history of mental illness, although he had a diagnosis of migraines.

J. is an only child, who lives with his parents in a district of the city of Huelva, where he was born. His psychomotor and social developments are within normal limits. His parents define him as an introverted child, sensitive, with low self-esteem and very attached to his mother.

The patient has a history of underperforming at school since he was in third grade, without being associated with external factors. He is going to support classes since then. He was evaluated by the guidance team from his school and they decided to do a curricular adaptation for him. Currently, he is repeating 4th year and he is going to educational support.

The patient's assessment consisted in clinical interviews with the patient and their parents and the implementation of additional tests like WISC-IV, D2, CDI, TALE, SNAP IV and a review of his clinical report.

The results showed us a specific development disorder comorbid with a deficit of attention so we decided to start with the psychopharmacological treatment and psychotherapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Affective symptoms and emerging psychotic disorder in adolescents
Authors: Benarous X.
Published: May 2016

Depressive symptoms are frequently reported during the period preceding the onset of schizophrenia in adolescents when such symptoms can be mistaken for those of mood disorder. However, it is unclear which emotional symptoms should be considered predictive of schizophrenia onset.

The types of emotional disturbances that may precede schizophrenic disorder were sought through a review of historical descriptive studies and seminal works using a phenomenological approach. Five main types of emotional disturbances have been found as prodromal symptoms of a schizophrenic disorder: (1) increased sensitivity to stress, (2) poor or incomplete expression of emotions, (3) reduced emotion sharing, (4) emotional detachment, and (5) disconnection between the perception and expression of emotions. Studies based on phenomenological views of schizophrenic disorders stressed the chronological sequence of these symptoms in the same person. For example, the term “delusional mood” (Wahnstimmung) coined to describe changes in the perceived atmosphere encompass mood disturbances from subtle emotional overreactivity to more severe symptoms that could evoke athymhormia.

Analysis of recent studies among subjects at high-risk for psychotic transition showed that the presence of mood symptoms at a very early stage of the disorder is common. While these symptoms predict a lower level of general functioning, they were not associated with a higher risk of developing a schizophrenic disorder at follow-up.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Wernicke-Korsakoff syndrome with psychotic symptoms in a severe case of anorexia nervosa: A case report
Authors: Brigadeiro D. , Ferreira C. , Magalhães J. , Nunes J. , Santos P. , Santos E. , Pissarra A.
Published: May 2016

Introduction

The Wernicke-Korsakoff syndrome comprises a complex of symptoms including Wernicke's encephalopathy and the Korsakoff's syndrome. While the former is characterized by a classic clinical triad of ataxia, ophtalmoplegia and a global confusional state; the Korsakoff's syndrome is characterized by memory impairment and confabulation. These two entities are now considered as a clinical spectrum of a same disease caused by deficiency of thiamine (vitamin B1).

Objective

To describe a case of Wernicke-Korsakoff Syndrome with psychotic symptoms in a 13-year-old female patient with anorexia nervosa.

Method

The patient and family were interviewed. Literature relevant to the case was reviewed.

Results

A 13-year-old Caucasian female was admitted to the emergency department with bradycardia (38 bpm) and a two-month history of weight loss totaling 6 kg. This loss of weight was a result of dietary restriction and over-exercise because she “felt too fat”. On admission she has a body mass index of 12.17. She was diagnosed with anorexia nervosa and was hospitalized. On day 11 after hospitalization, patient initiated alteration in behavior, fluctuating mental state with periods of lucidity and periods of confusion, memory impairment and psychotic symptoms, with paranoid delusions and auditory hallucinations. The classic triad of Wernicke's encephalopathy was not present. The treatment with thiamine was initiated and the symptoms including psychotic symptoms improved.

Conclusion

Wernicke-Korsakoff syndrome should be considered in cases of anorexia nervosa with a confusional state and memory impairment even if the classic symptoms are not present.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric antiepileptics side effects: A case report
Authors: Moreira C.A. , Soares A.R. , Maia G.
Published: May 2016

Introduction

Psychiatric disorders in epilepsy have a multifactorial etiology, being pharmacotherapy only one of many risk factors, which can be both biological and psychosocial. The adverse effects of antiepileptics (AEDs) embrace all categories of psychiatric symptomatology, including disturbances of consciousness, psychotic state, neurotic state, behaviour and character disorder. In fact, Psychotropic effects of AEDs require further research because many relevant parameters related to pathological mechanisms, frequency, psychopathology, and prognosis are not well understood.

Objectives

The authors aim to present a case of an adolescent with epilepsy who has developed secondary psychiatric symptoms.

Aims

To understand and deal with the most common Psychiatric side effects of AEDs.

Methods

A non-systematic review of English scientific literature was conducted using keywords “Epilepsy” and “antiepileptic side effects”.

Discussion

A 14-year-old female adolescent with history of seven years of Epilepsy (usual medication: carabamazepine 45 mg/kg/day, Lamotrigine 8 mg/kg/day; pregabaline 8 mg/kg/day) was admitted in the paediatric ward due to behaviour disorder characterized by agitation, anxiety and seizures-like symptoms. A therapeutic adjust was made (Fenetoíne and Levetiracetam). After this medication change, the adolescent presented psychotic symptoms namely auditory and tactile hallucinations. A complete clinical investigation was performed and the hypothesis of drugs side effects was considered. After AEDs reduction, a total remission of the symptoms was obtained.

Conclusion

Psychiatric disorders in epilepsy have a multifactorial etiology and are not yet well understood. Behavioural side-effect profiles of AEDs (both negative and positive effects) should be considered in the choice of the optimal drug for each patient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety and loss experiences during pregnancy and postpartum and anxious children
Authors: Güerre M.J. , Santesteban O. , Hernandez L. , Rentero D.
Published: May 2016

Anxiety disorders in children are very prevalent in youth. They are associated with poor psychosocial functioning and predict later psychopathology in individuals. Environmental and genetic factors and their interaction are involved in the genesis of anxiety disorders.

Stress, depression or anxiety during pregnancy are considered risk factors for development of psychopathology in children. We aimed to know its relationship whit anxiety disorders in young people.

Patients recruited for this study were the participants of our CBT group based in the coping cat model of treatment. All of them were children between 8 and 13 years old and meet criteria for Generalized Anxiety Disorder, Separation Anxiety Disorder or Social Phobia. Children and their parents assessed different anxiety and socio-demographic questionnaires. For this study we only analyzed the risk factors of pregnancy, delivery and breastfeeding of the socio-demographic interview. SPSS v-21 was the statistical instrument.

We found out that mothers of our patients had reported anxiety symptoms, loss experiences or stress during pregnancy or postpartum period more than we expected.

Stress, anxiety or depression during pregnancy is related with anxiety disorders in children. Helping mothers to cope with stressors during pregnancy and postpartum period will contribute to a better mental health in their children. The findings of this study match with previous researches.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Symbolic development in TD, DS and ASD
Authors: Szabó M. Kékes
Published: May 2016

This study is about symbolic processes in atypical populations, which is presumed to lead to a deeper understanding of the ontogenesis of normal symbolic development. Exactly, we aimed to explore the emergence of symbolic play in children with Down syndrome (DS) and in children with autism spectrum disorder (ASD). A typically developing (TD) control group was also involved in the study. Fundamentally, we applied the qualitative method and focused on the replica play of the children that could be observed during their dyadic interaction with their parents. The activity of the individuals was recorded on video. The data were analysed with Noldus Observer XT 8.0 program software. The results confirmed atypical patterns of replica play in DS and ASD. Although both of these children groups demonstrated impairments in representational abilities, the autistic children seemed to have a basic cognitive defect. While children with DS were more often able to demonstrate coherent play activity, children with ASD could not use replica toys in the appropriate context verifying impairments in the social-communicative system. However, further studies are needed to cover the characterizations of psychopathological-specific disorders, to plan new diagnostic tools and more effective interventions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The possible role of mothers’ thrombophilic predisposition as a risk factor mental and motor delay in toddlers
Authors: Baranov D. , Lvova O.
Published: May 2016

Introduction

Inherited thrombophilia is described as a risk factor for burdened obstetrical history. But the relashionships between mothers’ thrombophilic predisposion (MTP) and mental status in their children is not investigated thoroughly.

Objectives

To investigate the mental and motor neonates’ status, born from MTP.

Methods

Case-control study. Thirty-seven children born from MTP were assessed at 1, 3, 6 and 12-month (1st group). MTP carried more than 5 thrombophilic single nucleotide polymorphisms and had burdened obstetrical history; 47 neonates with clear mothers’ obstetrical history and 2 and less SNPs (2nd group); informed consent form. The quantity of term and preterm neonates were equal in groups.

Results

We found the neonates from both group were comparable under the 6-month age (table). But in year-old children mental and/or motor delays were more frequent in 1st group despite on comparable level of paresis and brain ultrasound data. There were no thrombotic episodes in children in 1st group.

Conclusions

There were no direct link between MTP and neurological outcomes in children: paresis and ischemic lesions in brain were not differ in groups. Confirmed MTP can cause mental and motor delays to year-old period, milestones must be supervised thoroughly until 3 y.o.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Autism-plus spectrum disorders: Interfaces with psychosis
Authors: Peixoto I. , Velasco Rodrigues R. , Marques C.
Published: May 2016

Introduction

Despite categorical differentiation, autistic and psychotic disorders are historically related diagnostic entities and there is still much controversy regarding their limits and developmental course. Particularly in children, the presence of idiosyncratic fears, difficulties in the social sphere and thought disorder are important factors in the differential diagnosis. There are some research-derived clinical constructs that operationalize symptomatology aiming to highlight the interfaces and the overlap between such disorders. Their clinical implications can be extremely relevant in the face of the limits of current nosology.

Objetives

To phenomenologically describe differentiating parameters and high-risk clinical profiles for the development of psychosis in children with autism spectrum disorder.

Methods

Selective review of the literature in PubMed (MEDLINE). Illustration with a clinical case vignette.

Results

The clinical case reflects well the difficulties posed in the differential diagnosis due to the multiple interfaces between autism and psychosis. Constructs such as “multiple complex developmental disorder” or “multidimensionally impaired syndrome” allow a clearer and more practice-friendly characterization of such individuals.

Conclusion

The constelation of symptoms identified in these criteria may become useful through the definition of subgroups of autism spectrum disorder individuals with complex psychopathology. Studies in this regard are still scarce, but the validation and reproduction of the positive results observed in the near future can help optimize the clinical approaches in these children.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Emotion regulation strategies in adolescents with mitral valve prolapse
Authors: Pervichko E. , Zinchenko Y.
Published: May 2016

Introduction

Two thirds of adolescents with mitral valve prolapse (MVP) show signs of anxiety disorders. They display difficulty in emotion regulation (Van Der Ham et al., 2003; Scordo, 2007).

Objective

To investigate into emotion regulation strategies in MVP adolescents.

Methods

A projective study of emotion regulation was undertaken with our modified version of Rosenzweig Picture-Frustration Test (Zinchenko, Pervichko, 2014). Thirty-six adolescents with MVP (mean age was 17.1 ± 0.8 years) and 40 healthy adolescents (mean age was 16.7 ± 0.6 years) took part in the study.

Results

MVP adolescents significantly more frequently (P < 0.001) would mark Rosenzweig's situations as potentially traumatizing. Ego-defence (E-D) and extrapunitive (E) reactions appear to be significantly (P < 0.05) more frequent among MVP adolescents. MVP adolescents are more than healthy subjects prone to avoid open verbal revelations of their thoughts and feelings that emerge in the situation of frustration. Content analysis of responses conditioned by cognitive control (when the task was to taper off arbitrarily the traumatizing effect of the situation) revealed that suppression of emotions was displayed by MVP adolescents in 52% of answers, and for healthy participants - 29% of answers (P < 0.001). Cognitive reappraisal strategy was displayed by MVP adolescents in 27% of answers, and for healthy participants – 38% of answers (P < 0.05). Twenty-one percent of answers of MVP adolescents and 33% of answers of healthy participants suggested cognitive transformation of emotional experience and actualization of new meanings in traumatic situations (P < 0.05).

Conclusions

MVP adolescents appear to be more sensitive of frustrations and differ from healthy peers in more frequent use of the strategy of suppression of emotions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
ADHD complex correction in children
Authors: Pityk O. , Pityk M. , Kuzhda I.
Published: May 2016

About a third of children are described as overactive by their parents, and up to a fifth of schoolchildren are described in this way by their teachers. Diagnosis of ADHD can be exhibited in 3–7% of children reached school age. It is not surprising that in children with ADHD as a result of such symptoms develop low self-esteem and emotional problems, often observed a variety of neurotic symptoms and behavioral disorders. The aim of our work was to investigate effectiveness of GABA-ergic medications in complex correction of ADHD children. It is investigated and treated 69 children with ADHD in age from 6 to 12 years. All the children were assigned GABA-ergic medications in doses that depended on the age of the child within three months. Besides medication, parents with their children carried out psychological adjustment, first of all it was a psychological training of parents based on system model of psychotherapy and appropriate recommendations for changes in behavioral strategies in relation to children. After treatment 100% of parents noted improvement of children's state. However, symptoms significantly smoothed in 51 children, children were more attentive, calmer, and more reflective. It was made significant changes in the relationships of parents with children that manifested itself in improving mutual understanding, increased positive reinforcement, reducing cases of different methods of punishment and expression of dissatisfaction with the behavior of children. Therefore, GABA-ergic medications can be successfully used in complex correction in children with ADHD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Methylone consumption characterized through samples handled by users
Authors: Sadurní L. Martínez , Grifell M. , Galindo L. , Ezquiaga I. , Quintana P. , Ventura M. , Fornís I. , Palma Á. , Angelats M. , Ribera E. , Torrens M. , Farré M.
Published: May 2016

Introduction

In recent years, the increasing use tendency of NPS has motivated both awareness and concern about their identification and potential harmfulness. Synthetic cathinones represent a significant proportion of the NPS available and methylone is one of the most frequently found in Europe.

Objectives

The aim of the present study is to determine methylone presence and characteristics from the samples analyzed by Energy Control between the years 2009 and 2015 in Spain.

Methods

From all 21,198 samples analyzed from august 2009 to august 2015, only those in which methylone was found are studied (n = 140). The samples have been analyzed by Energy Control, a spanish harm-reduction NGO that offers to users the possibility of analyzing the substances they intend to consume. The analysis is done by gas chromatography–mass spectrometry.

Results

From the 140 samples containing methylone, 87 were handled as methylone, 20 as MDMA, 8 as other synthetic cathinones and 25 as other substances. The peak of consume was registered in 2011 with 41 samples then the number decreased until 10 samples in 2015.

Conclusions

Results suggest that methylone is most frequently handled as methylone or as MDMA and that its consumption could be decreasing. Further pharmacokinetic, pharmacodynamic, clinical and epidemiological studies should be conducted to enhance the knowledge not only about methylone consumption, but also about synthetic cathinones in general in order to assess their potential risk and study the complications and its management.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Ganser syndrome: Review and case report
Authors: Faria R. , Brandão D. , Novo T. , Quintela L. , Fonte A.
Published: May 2016

Introduction

First described by Sigbert Ganser in 1987, Ganser syndrome consists in a rare condition, characterized by the following four clinical features: approximate answers, dulling of consciousness, conversion symptoms and hallucinations.

Objectives

To present a case suggestive of Ganser Syndrome and to review the literature with particular regard to the aetiology of this condition.

Methods

Literature review, using computerized databases (MEDLINE®, Medscape®). Articles were selected based on the content of their abstract and their relevance.

Results

A 58-year-old woman was admitted to a Psychiatric Unit of a General Hospital for presenting behavioural abnormalities of acute onset. During hospitalization, the patient displayed indifference, incoherent speech with approximate answers, motor abnormalities and auditory psedudohallucinations. The patient was evaluated by a neurologist and various exams were performed (blood tests, CT, MRI, EEG) that showed no significant abnormalities. Pharmacological treatment consisted of antidepressant and antipsychotic medications. During the follow-up, there was a slow but gradual improvement of symptoms. Six months after hospitalization the patient decide to end up the follow-up.

Conclusions

Little is still known about Ganser Syndrome. The four aetiological perspectives consider: hysterical origin, malingering or factitious disorder, psychotic origin and organic origin. The lack of reports and information about Ganser syndrome made it worthwhile reporting this case.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship between emotional intelligence and neurocognition in severe mental disorders
Authors: Chapela E. , Morales I. , Quintero J. , Félix-Alcántara M. , Correas J. , Gómez-Arnau J.
Published: May 2016

Introduction

The severe mental disorders are the subject of growing research in the area of emotional intelligence because of his relationship with psychosocial functionality loss. Despite treatment advances, patients continue to experience high levels of social, professional and personal disabilities, related to the presence of deficits in cognition. These changes are manifested in two areas: the neurocognitive and social cognition.

Objectives

To better understand the relationship between neuro- and sociocognition in schizophrenia and bipolar disorder.

Aims

The aim of this research is to study the factors related to emotional intelligence, with particular interest in neurocognitive deficits.

Methods

A total of 75 adult patients with schizophrenia and bipolar disorder type I were evaluated. The assessment protocol consisted of a questionnaire on socio-demographic and clinical-care data, and a battery of clinical and cognitive scales, including MSCEIT, WAIS-IV, TMT and Rey Figure.

Results

MSCEIT was negatively correlated with age, the severity of the clinical symptoms (BPRS, CGI-S), the TMT-A and the Test of Complex Figure, and positively with the intelligence quotient.

Conclusions

The deficits in emotional intelligence are part of a set of cognitive, social and non-social skills, which are altered in these severe mental disorders. Emotional intelligence worsens with the deterioration of cognitive functioning, executive dysfunction and severity of psychiatric disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Inconsistent decline of executive functions in patients with early and late Huntington's disease
Authors: Mörkl S. , Blesl C. , Tmava A. , Wurm W. , Holl A. , Painold A.
Published: May 2016

Background

Huntington's disease (HD) is characterized by executive dysfunctions like problems with planning, accuracy, inhibition and impulsivity. During the course of the disease executive function worsens with ongoing pathological changes in the basal ganglia. However, it is not clear whether cognitive dysfunction develops gradually or not during the course of the disease.

Methods

We assessed the development of executive dysfunction in 23 patients with early HD and 29 patients with late HD on the Tower of London (ToL) for the number of solved problems, planning time and number of breaks.

Results

HD patients showed a linear decrease of accuracy (as assessed by number of solved problems) during the course of the disease. Controls scored significantly higher than early stage HD patients and early stage HD patients scored significantly higher than late stage HD patients. In planning time and number of breaks a non-linear decrease was found.

Conclusion

Executive dysfunctions in HD are not alone connected to degenerative changes in the striatum as they do not develop gradually and linear during the course of the disease. Obviously, executive function could not be seen as a single component, but as a combination of different abilities, which show a non-linear and non-parallel decline.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neuropsychiatric manifestations of vitamin B12 and folate deficiencies: Data from an inpatient psychiatric department
Authors: Mota A. , Lázaro M. , Alves R. , Moreira A. , Nobre M.
Published: May 2016

Introduction

The prevalence of vitamin B12 and folate deficiency is significant in the psychiatric population. These deficiencies may be associated with varied neuropsychiatric signs and symptoms, caused by different pathophysiological mechanisms.

Objectives

Characterize the main neuropsychiatric signs and symptoms associated with vitamin B12 and folate deficiencies. Evaluate the prevalence of these vitamins deficiencies in an acute inpatient psychiatric department, dedicated to Affective Disorders.

Aims

To review the clinical significance of vitamin B12 and folate deficiencies in psychiatric disorders and reflect on the importance of routine screening in mental health care.

Material and methods

Observational, retrospective and descriptive study, with analysis of clinical and blood tests data concerning the total number of inpatient episodes in 2015. Non-systematic review of the scientific literature.

Results

A small case series of the patients that had folate or B12 deficiency detected is presented. The prevalence of vitamin B12 and folate deficiencies found in our study is in accordance with the data found in the literature.

Conclusions

Vitamin B12 and folate deficiencies should be considered in the approach to the psychiatric patient as its neuropsychiatric manifestations are varied, can be severe, and may constitute a potentially treatable cause of mental disorder. Our data shows that folate and B12 deficiencies are significant in inpatients and we believe it justifies routine screening at admission.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
From clinical cases to clinical research: Neurocognition and social cognition in schizophrenia
Authors: Gurovich I. , Papsuev O. , Shmukler A. , Movina L. , Storozhakova Y.
Published: May 2016

Introduction

Neurocognition and social cognition are the core deficits influencing social outcomes in patients with schizophrenia. These deficits are present in prodromal phase and throughout the illness, in first-degree relatives and are considered in the framework of neurodevelopmental or neurodegenerative models.

Method

Four clinical cases with patients reflecting different cognitive profiles were chosen to demonstrate heterogeneity of cognitive biases and their influence on the social function en vivo. The patients have undergone a number of neurocognitive and social cognitive measures.

Results

In these four patients, we would like to highlight the dissociation of neurocognitive deficits, clinical manifestations and social functioning. Social cognitive measures revealed heterogeneity of biases in different domains. As a result of our observation, we can hypothesize that better social functioning was achieved by patients with better abilities to discriminate negative emotions and states of mind in others.

Conclusion

Despite certain limitations of case-report studies, it is hard not to point out heterogeneity and incoherence of social and neurocognition. We assume that intact domains of Processing of Emotions and Theory of Mind predispose to better social functioning, while it's hard to trace this connection to neurocognition. This result needs to be challenged on large samples in future research, concerning emotionality in Theory of Mind and capacity for empathy and its’ role in social functioning.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Characteristics of selected cognitive functions in patients with systemic lupus erythematosus using Cambridge neuropsychological test automated battery
Authors: Bogaczewicz A. , Kowalski J. , Ząbek J. , Wożniacka A. , Bogaczewicz J. , Sobow T.
Published: May 2016

Introduction

Cognitive dysfunction in patients with systemic lupus erythematosus affects 10–36% of them.

Objective

To determine a profile of selected cognitive functions in systemic lupus erythematosus.

The aim

To investigate and characterize selected cognitive parameters in patients with systemic lupus erythematosus (SLE) using a standardized, comparable and reproducible computer-based method.

Material and methods

The study included 25 patients with SLE. For neuropsychological assessment, the Cambridge Neuropsychological Test Automated Battery was used. Following parameters were investigated: mean latency and mean error in motor screening (MOTML, MOTME), big little circle (BLC), paired associated learning (PAL), problems solved in minimum moves in stockings of Cambridge (SOC PSMM) and graded naming test (GNT). Results were referred automatically to determined ranges of norms matched according to age and gender.

Results

In patients with SLE results displayed by median and upper and lower quartiles were as follows: MOTML = 1.1 (0.9–1.34), MOTME = 0.41 (0.31–0.52), BLC = 0.16 (0.16–0.18), PAL = −0.43 (−1.28; −0.18), SOCPSMM = −0.62 (−1.19–0.04), and GNT = −0.8 (−1.6; −0.32).

MOTML correlated negatively with MOTME (r = −0.51), MOTME correlated with SOCPSMM (r = 0.41), and PAL correlated with GNT (r = 0.48) (P < 0.05).

Conclusions

In our study, predominant abnormalities were those related to lexical and semantic memory, revealed by the GNT, spatial planning and spatial working memory, assessed by the SOC, together with visual memory and new learning, assessed with the PAL.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosis, cause or consequence of substance use disorder
Authors: Cancino Botello M.C. , Canseco Navarro M.D.L.A. , Peña Serrano A. , Molina López F. , Hernández Sánchez J.M.
Published: May 2016

Introduction

The use of psychostimulants, such as amphetamines and cocaine in psychotic patients is 4 times more frequent than non-psychotic ones. It is believed that people with psychosis may use substances as a self-treatment for negative symptoms. However, early onset of substance use disorder can develop psychotic and/or negative symptoms, leading to confusion between primary or secondary psychosis.

Method

Systematic review of the literature in English (PubMed) and patient's clinical record. Keywords: “Substance use disorder”; “psychosis”.

Objectives

to highlight the importance of an adequate characterization of psychotic symptoms in patients with substance use disorder.

Case

A 29-year-old man, with psychostimulants and cannabis abuse since adolescence and very short abstinence episodes. Later on, he developed paranoia symptoms that slightly improved once he decreased drugs dosage, but they were still present even on complete abstinence. Over the last year he has showed negative and psychotic symptoms that have been worsening with aggressive behavior during the last months, so he had to be hospitalized. During this period, he has been treated successfully with aripiprazol depot once monthly. His evolution has been positive, it has disappeared psychotic symptoms and paranoia, and after discharge he has managed to remain abstinent to psychostimulants.

Conclusions

Adequate characterization of patients with psychotic symptoms and substance abuse is essential to determine whether the psychotic disorder is associated with primary or induced TUS. Therefore, it is essential a thorough clinical evaluation to make an accurate diagnosis and to draw an individualized treatment plan.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric disorders among asthmatic patients: Literature review
Authors: Moreira C.A. , Marinho A.M. , Gil L.C. , Bairrão M. , Queiroz L.
Published: May 2016

Introduction

Asthma is a major public health problem and its prevalence has increased in both developed and developing countries during the last few years. Once it is a chronic illness, it has also revealed psychological consequences. Moreover, recent studies have suggested an association between asthma (especially of severe grade) and mental disorders.

Objectives

The authors pretend to make a brief review concerning psychiatric disorders among asthmatic patients.

Aims

To understand and to be able to deal with the psychiatric disorders among chronic asthmatic patients.

Methods

The review was based on scientific documentation published in PubMed database, using the following terms as keywords: “asthma”, “depression”, “anxiety” and “panic disorder”.

Results

Compared to the general population, both anxiety and mood disorders rates are at least two times those observed in asthmatic patients. Moreover, certain psychiatric disorders rates, including panic disorder (PD) and major depressive disorder, are as much as six times more prevalent among asthmatics when compared to the general population. The association between psychiatric disorders and poor asthma control and asthma-related quality of life could occur through several pathways, such as behavioural pathways; cognitive or perceptual pathways; or through the direct physiological effects of depression and anxiety on the autonomic nervous system (ANS) and immune systems which increase asthma symptomatology.

Discussions/Conclusions

There is a close correlation between anxiety, PD and depression, and a poor controlled asthma. A better understanding of this association may have major clinical implications, mainly in patients with poor controlled asthma in whom the presence of anxiety and depression should be investigated.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence of problematic alcohol consumption in patients with anxiety of depressive disorders
Authors: García Mahía M.D.C. , Fernández Quintana Á.
Published: May 2016

Introduction

Depression and alcohol problems are common in psychiatric outpatients, but there are few studies including patients with anxiety disorders.

Aims

To study the prevalence of problematic alcohol consumption in a sample of patients diagnosed of anxiety or depressive disorder and treated in a mental health clinic and to analyze clinical and sociodemographic variables associated to alcohol consumption.

Methods

The sample studied included 194 outpatients (31.9% men and 68.1% women) treated in an outpatient clinic and diagnosed of any anxiety or depressive disorder included in DSM-IVTR as main diagnose. Instruments used were Beck Depression Inventory (BDI), and the Alcohol Use Identification Test (AUDIT). Other variables studied included age, civil status, level of studies, and specific psychiatric diagnoses.

Results

A total of 64.9% were diagnosed of anxiety disorder and 35.1% were diagnosed of depressive disorder. The prevalence of problematic alcohol consumption was 7.8%, being more frequent in men, especially in men and in middle ages. Problematic alcohol consumption was found with more frequency in patients with generalized anxiety disorder and major depression, in this order. Patients with other comorbidity disorders in Axis II presented the highest prevalences of problematic alcohol consumption.

Conclusions

Problematic alcohol consumption presents high prevalence in patients with anxiety or depressive disorders and dual diagnose usually is associated with poor prognosis. It is necessary to make efforts to detect alcohol problematic consumption in psychiatric patients and develop specific treatment programs directed to this group of patients in both primary and specialized care units.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental disturbances in patients with acute medical condition
Authors: Fedak B.
Published: May 2016

Contemporary remains understudied health issue - the psychological aspect of the acute therapeutic diseases problem. Among the most common diseases - coronary heart disease (CHD), myocardial infarction (MI), crisis states in patients with arterial hypertension (AH), transient ischemic attack (TIA) and acute stroke (AS), gastric ulcer and duodenal ulcer (GU&DU). Clinical features of the structure, dynamics, current and immediate link with the medical conditions is not fully understood. The basis of our research, the purpose of which, was to identify mental disturbances in patients with acute therapeutic diseases. One hundred and eighty-seven patients were examined, 34 CHD patients, 37–MI, 38 - TIA, 39–AH, 39 - GU&DU, 65% male and 35% female aged 20 to 60 years. The main research method was clinical and psychopathological. A high-level affective and neurotic disorders in these patients was observed. Structured analysis allowed identifying four main options disturbances: nosogenic neurotic reaction–68 patients; somatogenic asthenic syndrome–46 patients; reaction psychological maladjustment–34 patients; acute stress reactions–39 patients. Stratification of structure psychopathological syndroms allowed systematizing them in 4 different groups: asthenic–24%; anxiety - 46%; subdepressive - 11%; somatoform - 19%. That was the basis for the determination early psychotherapeutic correction program, formed by integrative model. The high efficacy was shown in 74% patients, middle range–in 15%, low–in 11% patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety and depression in haemodialysis patients in relation to dialysis adequacy and nutritional status
Authors: Cui Xi L. , Michael G. , Chen Z. , Anuar N.H.M. , Yong K.H.M. , Tagore R.
Published: May 2016

Introduction

Anxiety and depression are distinct clinical entities associated with mortality in haemodialysis (HD) patients.

Aims

This study aims to identify the prevalence of anxiety and depression in HD patients and uncover the association of anxiety and depression in relation to the dialysis adequacy and nutritional status.

Objective

This would help reinforce early detection and treatment to improve quality of life and patient's outcome in HD treatment.

Method

Forty HD patients were assessed for anxiety and depression with the Generalised Anxiety Disorder Assessment (GAD-7 and Patient Health Questionaire [PHQ-9]). The scores of GAD-7 and PHQ-9 were correlated with the demographic, clinical and laboratory variables and nutritional status assessed by a dietician through the Subjective Global Assessment (SGA).

Results

Out of the 40 HD patients, 7 (17.5%) were anxious and 15 (37.5%) were depressed. Patients were more anxious and less depressed with better nutrition. They were less anxious and depressed with increasing albumin levels, Charlston comorbidity index based on combined condition and age-related score and Kt/V. The univariate logistic regression analysis showed only a significant inverse correlation between depression and albumin level (P = 0.041, OR = 0.88 [95% CI = 0.78 to 0.99]) and Kt/V (P = 0.054, OR = 0.03 [95% CI = 0.01 to 1.07]).

Conclusion

Depression is more prevalent than anxiety in HD patients. The risk of depression also increases with poorer dialysis adequacy and nutritional status. Thus, by improving dialysis adequacy and nutritional status, we can reduce the incidence of depression. However, a significant correlation cannot be drawn for anxiety.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosocial outcomes 3 years after facial transplantation of a blind patient
Authors: Lemmens G. , Hendrickx H. , Poppe C. , Roche N. , Peeters P. , Vermeersch H. , Rogiers X. , Van Lierde K. , Blondeel P.
Published: May 2016

Background

To date, psychosocial outcomes after facial transplantation are promising although long-term consequences, outcome of blind patients and the impact on family members are less well investigated. The aim of this study was to examine the long-term psychosocial of a blind patient and his partner 2 and 3 years after facial transplantation.

Methods

Depressive and anxiety symptoms, hopelessness, coping, resilience, illness cognitions, marital support, dyadic adjustment, family functioning and quality of life of the patient and the partner were assessed before and 2 and 3 years after transplantation. Reliable change index (RCI) was further calculated to evaluate the magnitude of change.

Results

Most psychological, marital and family scores of both the patient and the partner remained within a normative and healthy range at follow-up. Resilience (RCI: 2.5 & 3.4 respectively), affective responsiveness (RCI: −4.1 & −3.2 respectively), physical quality of life (RCI: 8.7 & 7.2 respectively) and helplessness (RCI: −2.2 & −2.9 respectively) of the patient improved at 2 and 3 years follow-up. Further, dyadic cohesion (RCI: 2.4) of the patient improved at 2 years whereas marital depth (RCI: −2.0) of the partner decreased at 3 years.

Conclusions

The results of this study point to positive long-term psychosocial outcomes of a blind patient and his partner after facial transplantation. Further, they may underscore the importance of patient selection, social support and involvement of family members in treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Incapacity to decide in liaison psychiatry: Analysis of sample of patients admitted in somatic departments of a general hospital
Authors: Nascimento M. , Vicente F. , Oliveira C. , Silva N. , Vieira C. , Luís A. , Maia T.
Published: May 2016

Introduction

Decision capacity (DC) is a complex construct, whose assessment poses huge challenges to Liaison Psychiatrist (LP).

Objectives/aims

Assess factors related to DC in patients with somatic disorders admitted in medical and surgical departments of a general hospital.

Methods

Clinical records of patients who were submitted to a DC assessment at Hospital Fernando Fonseca (Portugal), from 1st January 2012 to 31st December 2014 were retrospectively analysed. Collected data were statistically analysed with SPSS®. Univariable analysis was performed, in order to determine factors related to DC.

Results

Data from 35 patients subject to DC evaluation were considered, of whom 42.4% were considered unable to give consent to medical and/or surgical procedures. Most of these assessments were related to patients who refused treatment. Patients unable to decide were predominantly male and mainly affected by organic mental or neurocognitive disorders (P < 0.05). There were no statistical significant differences in the age of those considered able or unable to decide. After PL intervention, 40% of those considered unable to decide changed their decision. However, it was not significantly related to the ability to give consent.

Conclusions

Neurocognitive disorders are common diagnosis found in patients admitted in somatic departments with no DC. Frequent change in decision after LP intervention may reflect not only cognitive fluctuations, but also a possible influence of LP intervention on patients’ choices. Appropriate standardized measures are useful tools in assessing patients with cognitive impairment, reducing evaluation differences between professionals, and in order to increase LP decisions credibility.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric comorbidity and suicide risk in patients with psoriasis
Authors: Pompili M. , Innamorati M. , Erbuto D. , Costanzo A.
Published: May 2016

Introduction

Psoriasis has a significant impact on the mental and emotional functioning.

Objective

It has been reported that the risk of psychiatric comorbidity increases with the severity of the disorder, and the most frequent associations appear to be those with depression and anxiety.

Aims

To analyze the association between psoriasis, mental disorders and suicidal ideation in a sample of patients affected by psoriasis. To investigate the differences between psoriasis patients and patients with other dermatologic diseases.

Methods

Participants were 242 consecutive patients (142 women and 100 men), 112 patients with psoriasis (46.3%), 77 with melanoma (31.8%) and 53 with allergy (21.0%). All patients were administered a structured sociodemographic interview and the following measures: the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety (HAM-A). We also assessed current and previous suicidal ideation and previous suicide attempts.

Results

Patients with psoriasis (compared to other groups of patients) more frequently had a comorbid mood disorder (16.1% vs 3.9% and 0.0%, respectively for patients with melanoma and patients with allergy; χ22 = 14.98; P < 0.001), past suicidal ideation (33.9% vs 15.6% and 18.9%, respectively for patients with melanoma and patients with allergy; χ22 = 2.05; P < 0.01) and attempts (6.3% vs 0.0% and 0.0%, for the other groups of patients; χ22 = 8.37; P < 0.05). Patients with psoriasis reported higher HAM-D scores than melanoma patients.

Conclusions

The clinical evaluation of patients with psoriasis should include the assessment of psychiatric comorbidities and the routinely assessment of suicide risk.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cultural explanations of sleep paralysis: The spiritual phenomena
Authors: Carvalho I. , Maia L. , Coutinho A. , Silva D. , Guimarães G.
Published: May 2016

Introduction

Sleep paralysis (SP) is relatively frequent condition, occurring either at sleep onset or sleep offset. It occurs at least once in a lifetime in 40–50% of normal subjects. During SP, the patient experiences gross motor paralysis, while the sensory system is clear. Hypnogogic and hypnopompic hallucinations are common. This experience might be interpreted as a spiritual phenomenon in several cultures, each one with different interpretations and attributions.

Objective

The authors revisit the clinical presentation of sleep paralysis and how this sleep disorder is seen from a cultural perspective.

Aims

To describe several cultural interpretations of SP.

Methods

A literature review of the theme is shortly surveyed.

Results

It is very common during an episode of SP sensing the presence of menacing intruders in one's bedroom. Supernatural accounts of this hallucinated intruder are common across cultures. It has been traditionally labeled “ghost oppression” among the Chinese. In the Abruzzo region (Italy), the supernatural interpretation of the phenomena is called the Pandafeche attack. One study found that nearly half (48%) of the participants from the general Egyptian population believed their SP to be caused by the Jinn, a spirit-like creature. In Southwest Nigeria, Ogun Oru is a traditional explanation for nocturnal neuropsychiatric disturbances. The characteristics of the ‘a dead body climbed on top of me’ phenomenon suggest that is identical to sleep paralysis and a frequent experience among Mexican adolescents.

Conclusions

Depending on the etiological interpretations of SP, which is largely culturally determined, patients react to the event in specific ways.

Disclosure of interest

The authors have not supplied their declaration of competing interest.