bluuebunny/crossref_metadata_2025 huggingface dataset:
Beliefs about schizophrenia’s causes among family members
Authors: Lajmi I. , Omri S. , Smaoui N. , Feki R. , Thabet J. Ben , Bouali M. Maalej , Zouari L. , Charfi N. , Maalej M.
Published: February 2022

Introduction

Investigating family members’ causal beliefs regarding schizophrenia is an important step in the management of the illness; it may affect adherence to treatment of patients with schizophrenia.

Objectives

To investigate the beliefs about the causes of schizophrenia among families of patients with schizophrenia.

Methods

We led a cross sectional descriptive study involving 32family members of patients suffering from schizophrenia who were followed in the psychiatry department of Hedi Chaker University Hospital in Sfax (Tunisia), between May to September 2019. Data was collected from the medical records and the questionnaire designed to the study.

Results

The mean age of the relatives was 60.8 years, with a sex-ratio of 1.6. The relatives included 20 fathers (62.5%), six wives (18.8%), three mothers (9.4%), and three sisters (9.4%). Among them, 37.5 % were illiterate; 37.5% lived in rural area. Fourteen participants (43.8%) had cited at least two possible causes of schizophrenia. The most frequently cited causes were emotional shock (81%) and god’s will or fate (72%) followed by witchcraft (37.7%). The belief of God’s will and fate was associated with poor compliance to treatment (p=0.06). The belief of supernatural cause was correlated to rural origin (p=0.000) and advanced age of participants (p=0.000).Significant correlation was also found between family history of mental disorders and beliefs on hereditary causes (p=0.000).

Conclusions

These results suggest that family members of patients suffering from schizophrenia need to be better informed about its main causes to improve both compliance to treatment and social integration of this patients.
Electroconvulsive therapy combined with clozapine in the management of ultra-resistant schizophrenia
Authors: Khouadja S. , Charaa O. , Soussia R. Ben , Zarrouk L.
Published: February 2022

Introduction

Although clozapine is the gold standard for treating patients with resistant schizophrenia, clinical symptoms persist in approximately 40-70% of the cases even after a year of treatment with clozapine. Electroconvulsive therapy (ECT) has been tried as augmentation therapy in the management of ultra-resistant schizophrenia.

Objectives

To review recent studies concerning the effectiveness of ECT associated with clozapine in the management of ultra-resistant schizophrenia.

Methods

This is a review of the literature via Medline and Sciences direct. The database was searched using the keyword combination “clozapine” with “ECT”, “resistant schizophrenia” with “ECT and clozapine” and “clozapine resistant schizophrenia” with “ECT” from 2010 to 2020.

Results

We found 4 reviews and meta-analyzes and 6 studies. According to the majority of recent reviews and meta-analyses studied, patients who were resistant to clozapine responded to the combination of clozapine and ECT in 54% of the cases. ECT by increasing the permeability of the blood-brain barrier facilitates the brain transmission of large molecules such as clozapine, thus promoting better efficacy of clozapine. The combination of ECT with clozapine was generally well tolerated in the majority of patients. The most frequently reported adverse reactions in the literature were memory impairment and headache. These effects did not appear to be chronic or persistent, but rather transient and mild. Other rare cases such as prolonged seizures, tachycardia, and confusion have been reported.

Conclusions

ECT associated with clozapine is an effective, relatively safe and tolerable treatment in the majority of cases.
Early career psychiatrists in europe during COVID-19 outbreak: Results of the EPA ECPC-EFPT cross-sectional survey
Authors: Gondek T.
Published: February 2022

The COVID-19 outbreak has left its mark on the work of mental health care staff. Many professionals had to radically change their working conditions or were delegated to work in different facilities, in many cases taking on different responsibilities with little time for training. Many psychiatrists overnight had to partially or fully start working within telemedicine. Due to the lockdown, psychiatric trainees in many countries were not able to complete their training as planned. The measures taken by the governments to limit the impact of the pandemic also affected the capacity to conduct research studies and directions of new research initiatives. Dr. Gondek will present the results of the EPA ECPC-EFPT Cross-sectional survey on the effects of the outbreak on work and wellbeing of Early Career Psychiatrists in Europe.

Disclosure

No significant relationships.
Cognitive impairment associated with psychosis (CIAPS): Validity of clinical criteria to detect cognitive impairment
Authors: Sánchez-Torres A. , Gil-Berrozpe G. , Lorente-Omeñaca R. , Zandio M. , Moreno-Izco L. , Janda L. , Peralta D. , Peralta V. , Cuesta M.
Published: February 2022

Introduction

Even though cognitive impairment is considered a hallmark of schizophrenia, it has not been included as a criterion into major diagnostic systems.

Objectives

To test whether a set of clinical-defined cognitive impairment criteria can have utility in the assessment of psychosis patients in clinical practice.

Methods

We assessed 98 patients with a psychotic disorder, diagnosed using DSM 5 criteria. We developed a set of cognitive impairment associated with psychosis (CIAPs) criteria following the format of current DSM criteria and based on previous literature. The CIAPs criteria include: A) criterion for evidence of cognitive impairment after the beginning of illness; B) cognitive impairment clinically evidenced, affecting functioning in everyday activities in at least two out of six cognitive domains; C) and D) exclusion criterion for either delirium or other neurocognitive disorders, respectively, as causal agents of the cognitive impairment. The psychosis patients dichotomized by the CIAPs criteria were tested regarding the neuropsychological performance in attention, speed of processing, verbal memory, visual memory, working memory, executive function and social cognition tasks. Also a Global Cognitive Index was calculated.

Results

Forty-three patients with psychosis fulfilled the CIAPs criteria (43.9%). MANOVA profile analyses revealed a pattern of statistically significant deficits in all the cognitive dimensions except for social cognition in CIAPs+ patients regarding CIAPS-, with prominent deficits in processing speed and memory functions.

Conclusions

The CIAPs criteria could be an auxiliary method for clinicians to assess cognitive impairment. It may also permit clinical estimation of the influence of cognitive deficits on the ecological functioning of patients.

Conflict of interest

This work was supported by the Government of Navarra (grants 17/31, 18/41, 87/2014) and the Carlos III Health Institute (FEDER Funds) from the Spanish Ministry of Economy and Competitivity (14/01621 and 16/02148). Both had no further role in the study des
What is important for doctor’s drug decision-making for the patient with acute schizophrenia?
Authors: Morozova M. , Rupchev G.
Published: February 2022

Introduction

In spite of the long history of antipsychotic treatment there are still no clear criteria, which can be robust support for drug decision-making.

Objectives

To determine the important hallmarks of patient’s current state, life span and history of illness defining the doctor’s decision about the type of antipsychotic to be chosen.

Methods

The data from the case charts of 275 patients with episodic schizophrenia and rather benign course of the disease were analyzed.

Results

The group included: male 62%, mean age 33 (SD 11), education 10 years 23%, 13 years 27%, 16 years 29%, disability - 51%, number of hospitalizations due to psychotic episodes in the past 7 (SD 6). The symptoms of the current episode varied from patient to patient: delusions and hallucinations, symptoms of disorganization, negative symptoms of different severity were registered Atypical antipsychotics were more often than typical prescribed to the patients with developmental problems: traumatic obstetric complications (p=0,009), poor somatic health in the childhood (p= 0,02), cognitive dysfunction during school years (p=0,04), and quality of first remission – presence of residual symptoms in the first remission (p=0.005). Good compliance in the past was one more important factor for choosing a atypical antipsychotic for a patient (p=0.05). It appeared that the most important for the decision-making was the specific features of the patient’s development and early period of the disease, but not the specific signs of current psychotic state.

Conclusions

Doctor’s decision upon the type of antipsychotics in this category of patients is most probably based on other than current clinical symptoms signs.
Wernicke encephalopathy complicating catatonic schizophrenia
Authors: Rihab C. , Ellouze S. , Messedi N. , Turki M. , Ali F. Ben , Abid W. , Halouani M. , Aloulou J.
Published: February 2022

Introduction

Wernicke’s encephalopathy is a potentially fatal neurological emergency caused by thiamine deficiency. Although it is often associated with chronic alcoholism, it can also occur in all situations that lead to a thiamine deficiency such as undernutrition and exclusive artificial feeding.

Objectives

In this work, we propose to study the clinical and treatment concerns of Wernicke’s encephalopathy complicating catatonic schizophrenia.

Methods

We retrospectively report the case of a patient who developed a Wernicke’s encephalopathy in the aftermath of catatonic schizophrenia.

Results

Mr H.L, a 47-year-old-male has been followed in psychiatric hospital since the age of 27 for catatonic schizophrenia. He has been hospitalized in July 2020 because of oral intake refusal, social isolation and lack of self-care with a poor compliance to treatment. Examination of the patient revealed catalepsy, mutism and negativism. He was treated with antipsychotics drugs, benzodiazepines and parenteral nutrition. About six weeks after his hospitalization, the patient developed horizontal nystagmus and ataxic gait. Magnetic resonance imaging was consistent with Wernicke encephalopathy. Vitamin B1 dosage was 32nmol/l. Parenteral thiamine replacement therapy was initiated with clinical improvement

Conclusions

Catatonic schizophrenia can be associated with severe malnutrition and thus with thiamine deficiency and Wernicke’s encephalopathy. An early intervention by supplying prophylactic thiamine given parenterally in high-risk patients is crucial to avoid Korsakoff syndrome, as well as cardiovascular and neuropsychiatric complications associated with thiamine deficiency.
Preliminary analysis of different tools in emotional competence assessment in patients with schizotypal disorder
Authors: Vinogradova M. , Khokhlova O. , Oleichik I. , Ermusheva A. , Salikhianova N.
Published: February 2022

Introduction

Dysfunctional emotional competence is known as one of the key characteristics of patients with schizotypal disorder. Methods that aim to assess this problem are differently organized and might elicit these deficits differently. Therefore, there is a need in better understanding of scope of problems that might be assessed using different tools in patients with schizotypal disorder.

Objectives

To examine the differences in affective empathy and perception of emotions in normal subjects and patients with schizotypal disorder.

Methods

The sample consisted of 14 patients with schizotypal disorder (F21) (M=19.07, SD=3.17) and 53 healthy individuals (M=22.98, SD=2.77) with equal educational level. Participants were given Affective Responsiveness Test (AR) and Emotional Perspective Taking (ERT) (Derntl et al, 2009) and “Reading the Mind in the Eyes” (RME) Test (Baron-Cohen et al., 2001).

Results

There were significant differences in accuracy of ERT performance between patients with schizotypal disorder (M=80.64, SD=8.17) and healthy individuals (M = 86.62, SD = 8.67), t (65) = -2.32, p = .023. Patients were also found to give less correct answers than healthy controls while carrying out AR, and to need more time for both tasks. However, these differences were not statistically significant. Surprisingly, no significant differences were found for perception of emotions (RME) test, although patients in general gave less correct answers.

Conclusions

It might be assumed that EPT is the most sensitive tool in assessing emotional deficits in patients with schizotypal disorders. Further research is needed to understand the possible reasons for other tests not showing significant results.
COVID-19 and psychiatric education: From postgraduate to continuous medical education
Authors: Dias M. Casanova
Published: February 2022

COVID-19 has impacted psychiatric education at many levels from postgraduate training to Continuous Medical Education (CME). We invited participants at the European Union of Medical Specialists (UEMS) who are national representatives to share how COVID-19 has impacted postgraduate training and Continuous Professional Development (CPD) in their countries. They were asked to report the challenges but also the opportunities created by the pandemic and their answers were analysed. Several themes emerged. Challenges in postgraduate training have been absences caused by COVID, redeployment, reduced interactions and postponement of assessments. The mental health of trainees was affected, including burnout. Interestingly in some places, like Denmark, training was less impacted as psychiatry was designated as ‘critical’ and therefore no redeployment. Exams have moved online and there have been concerns about cheating in the new format. In countries where it is obligatory to be uptodate with CME/CPD to maintain medical registration, the usual requirements were waived. Conferences and live events have moved online and webinars became popular and widely accepted. Some positive developments included rapid adoption of technology, for consultations and training, increased relevance of CPD/CME, emphasis on team cohesion and recognition of the need for self-care and team support. The pandemic also fostered international collaboration, e.g. sharing guidelines for new ways of working. Some of the innovations described, mainly related to the adoption of technology and remote working will likely be taken in the future. However, the sentiment remains that live exchanges are valuable and should be resumed as soon as it is safe.

Disclosure

No significant relationships.
Safety during polypharmacy: A post-hoc analysis examining the safety profile of cariprazine with other antipsychotics in the cross-titration phase
Authors: Vass G. , Barabássy Á. , Laszlovszky I. , Sebe B. , Dombi Z.B. , Szatmári B. , Németh G.
Published: February 2022

Introduction

Although monotherapy is preferable, in every day clinical practice polypharmacy is often unavoidable due to the need of treatment enhancement or cross-titration phases with shorter or longer overlaps of two or more drugs. However, administration of more than one drug treatment is often associated with more side effects.

Objectives

The aim of the present post-hoc analysis was to examine treatment emergent adverse events (TEAEs) during co-administration of cariprazine with other antipsychotics.

Methods

Treatment emergent adverse event data (TEAE) from a randomized, double-blind, parallel-group, active-controlled study (EudraCT Number: 2012-005485-36) in adult patients with schizophrenia having predominant negative symptoms was examined in the first two weeks of the double-blind treatment period, where gradual cross-titration occurred between cariprazine (3-6 mg/day) and other antipsychotics (including amisulpride, aripiprazole, fluphenazine, haloperidol, olanzapine, paliperidone, quetiapine, and sertindole). Thereafter, 24 weeks of cariprazine monotherapy followed.

Results

During the cross-titration period, 17.83% of patients experienced at least one TEAE. The TEAEs were in line with the well-established safety data: nausea (2.61%), insomnia (2.17%), headache (2.17%), akathisia (1.74%) and restlessness (1.3%) were the most common. Most events were mild in severity (66.1% mild, 32.2% moderate, 1.7% severe (insomnia)).

Conclusions

While not definitive, and limited by small sample size, the co-administration of cariprazine with other antipsychotics did not show an unexpected safety profile or overlapping toxicities. This is an important finding, if intermittent or longer co-administration of other antipsychotics are unavoidable with cariprazine treatment.

Conflict of interest

Studies were funded by Gedeon Richter Plc. and Allergan Plc (prior to its acquisition by AbbVie). Dr Vass, Dr Barabássy, Dr Laszlovszky, Dr Sebe, Dombi, Dr Szatmári and Dr Németh are employees of Gedeon Richter Plc.
Multivariate approach to identify electrophysiological markers for diagnosis and prognosis of schizophrenia
Authors: Giuliani L. , Koutsouleris N. , Koenig T. , Mucci A. , Vignapiano A. , Reuf A. , Altamura M. , Bellomo A. , Brugnoli R. , Corrivetti G. , Lorenzo G. Di , Girardi P. , Monteleone P. , Galderisi S. , Maj M.
Published: February 2022

Introduction

Different electrophysiological indices have been investigated to identify diagnostic and prognostic markers of schizophrenia (SCZ). However, these indices have limited use in clinical practice, since both specificity and association with illness outcome remain unclear. In recent years, machine learning techniques, through the combination of multidimensional data, have been used to better characterize SCZ and to predict illness course.

Objectives

The aim of the present study is to identify multimodal electrophysiological biomarkers that could be used in clinical practice in order to improve precision in diagnosis and prognosis of SCZ.

Methods

Illness-related and functioning-related variables were measured at baseline in 113 subjects with SCZ and 57 healthy controls (HC), and after four-year follow-up in 61 SCZ. EEGs were recorded at baseline in resting-state condition and during two auditory tasks (MMN-P3a and N100-P3b). Through a Linear Support Vector Machine, using EEG data as predictors, four models were generated in order to classify SCZ and HC. Then, we combined unimodal classifiers’ scores through a stacking procedure. Pearson’s correlations between classifiers score with illness-related and functioning-related variables, at baseline and follow-up, were performed.

Results

Each EEG model produced significant classification (p < 0.05). Global classifier discriminated SCZ from HC with accuracy of 75.4% (p < 0.01). A significant correlation (r=0.40, p=0.002) between the global classifier scores with negative symptoms at follow-up was found. Within negative symptoms, blunted affect showed the strongest correlation.

Conclusions

Abnormalities in electrophysiological indices might be considered trait markers of schizophrenia. Our results suggest that multimodal electrophysiological markers might have prognostic value for negative symptoms.
Assessment of hospitalizations in schizophrenia patients treated with paliperidone 1-monthly (PP1M), paliperidone 3-monthly (PP3M), aripiprazole once-monthly (AOM) and other oral antipsychotics (OAP) in clinical practice
Authors: Rojas L. Gutiérrez , Alonso S. Sánchez , Dorado M. García , Lopez P.
Published: February 2022

Introduction

It has been shown that long-acting treatments can significantly improve adherence, control symptom, and reduce the risk of relapse compared to oral drugs. However, limited real world evidence is available as to whether there are differences among the various formulations marketed.

Objectives

This study aims to assess the impact on several prognosis variables of PP1M,PP3M,AOM and OAP drugs.

Methods

All adults (≥18 years) with schizophrenia who were initiated on PP1M, PP3M, AOM, or OAP treatment (chlorpromazine,levomepromazine,fluphenazine,haloperidol,ziprasidone,zuclopenthixol,olanzapine,quetiapine,asenapine,amisulpride, risperidone,aripiprazole,paliperidone) between 2017 and 2018 were identified in IQVIA’s database(1.8M of inhabitants from 4 Spanish areas). The rate of hospitalizations, emergency room visits, and treatment persistence was calculated using the Kaplan-Meier method. Survival curves were compared using the log-rank test (Sidak-adjustment),and Cox´s Hazard Ratios (HR) were used for the comparison between groups.

Results

Data from 2275 patients were analyzed (PP1M= 387;PP3M=490;AOM=75;OAP=1323).The mean age of patients was 46.8(14.95) years, and 62.9% were male. The hospitalization rate at 12 months was significantly lower (p<0.01) for PP3M (8.3%) than for AOM (21.2%), PP1M (22.1%),and OAP (29.4%).When compared with PP3M use, the HRs were 2.17 for PP1M, 2.22 for AOM,and 2.90 for OAP. Emergency room visits rate at 12 months was also significantly lower (p<0. 01) for PP3M (23%) than for PP1M (36.9%), OAP (43.5%),and AOM (46.2%). Persistence rates were higher for PP3M (91%) than for any other treatment (p<0.01).

Conclusions

Our results outline that patients treated with PP3M experienced fewer relapses and decompensations compared to all other treatments analyzed, which might help improve the prognosis and quality of life of patients.

Conflict of interest

This study was sponsored by Janssen. M. García and P. López are employees of Janssen.
Determination of cognitive domain involvement in a sample of patients diagnosed with schizophrenia and cardiovascular risk factors
Authors: Eslava J. García , Gutierrez A. Marzán , Molist N. Riera , Llobet S. Escoté , Foguet-Boreu Q.
Published: February 2022

Introduction

Schizophrenia it’s a deteriorating illness, where the cognitive impairment it’s one of the predominant components in this process. Theory of neurodevelopment, the most widely recognized, explains that cognition will depend most of it, on premorbid development. However, other factors explain this impairment, such as the cardiovascular risk factors (CVRF).

Objectives

The purpose of this study is to determine cognitive impairment and the domains affected in a sample of patients who suffered schizophrenia and almost one CVRF.

Methods

Cross-sectional study. Patients diagnosed with schizophrenia and at least one poorly controlled CVRF (diabetes, hypercholesterolemia, arterial hypertension or active smoking) were selected. Screen for Cognitive Impairment in Psychiatry (SCIP) scale was used to evaluate cognitive impairment and the domains affected.

Results

Preliminary data of twenty patients were included (60% men, mean age: 50 years). At CVRF in the sample, no diabetes was found, 75% had hypercholesterolemia, 15% arterial hypertension and 20% active smoking. SCIP scale showed deficits in word learning and delayed learning in 95% of the sample (n=19). The domain less affected was verbal fluency, affected in 55% of the sample (n=11). Additionally, moderate to severe cognitive impairment was observed in 65% of the sample (n=13).

Conclusions

More than half of the patients with schizophrenia and CVRF have a moderate to severe cognitive impairment. Intervention at CVRF could reduce the severity of cognitive impairment, improving functionality in these patients.
Schizoaffective disorder: Nosological controversies and absence of specific treatment guidelines
Authors: García M. Valtueña , Fescina R. Combina , González A. Vázquez , Ludwig C. , Suarez A. González , Fernández J. López , Lora C. Huergo , León S. Ocio , García L. Lago
Published: February 2022

Introduction

Schizoaffective disorder is a psychotic disorder of controversial nosological entity. Affective symptomatology and psychotic features of varying intensity coexist simultaneously in him throughout evolution. The lack of consensus on the existence of this entity determines its diagnostic delay and the absence of specific treatment guidelines.

Objectives

To review the diagnostic criteria for schizoaffective disorder and the published scientific evidence on the efficacy and safety of the different therapeutic options available. To analyze the efficacy of a multidisciplinary treatment plan implemented in an intensive follow-up program, presenting the evolution of a clinical case.

Methods

To review the psychiatric history and psychopathological evolution of a patient diagnosed with schizoaffective disorder from the beginning of an intensive follow-up program in a day center to the present. Review the existing scientific evidence on the usefulness of the treatments used in this nosological entity.

Results

This is a longitudinal and retrospective study of a clinical case in which the areas for improvement are analyzed before implementing a multidisciplinary therapeutic program and the favorable results obtained today. Currently, the patient is euthymic and attenuated and chronic positive and negative symptoms persist that do not interfere with his functionality.

Conclusions

From the implementation of an individualized, personalized and multidisciplinary maintenance treatment plan, an overall improvement in psychopathological stability and functional recovery is observed. Among the psychopharmacological options in this patient, Paliperidone Long Acting Injection (PLAI) stands out for its long-term efficacy and safety.
Symptom-specific assessment of treatment efficacy: The potential of network estimation techniques
Authors: Boschloo L.
Published: February 2022

Abstract Body

Introduction: Most studies on the efficacy of psychiatric treatments consider overall scale scores as outcome measures. A focus on individual symptoms would, however, result in a more precise assessment of treatment efficacy and has potential in improving our understanding of the working mechanisms of treatment. Such an approach may also help in improving the identification of patients who are -based on their pretreatment symptomatology- the most likely to benefit from a particular treatment. Objectives: To show the potential of network estimation techniques in a) unraveling the diverse symptom-specific responses to various depression treatments and b) improving the identification of patients who are the most likely to benefit from these treatments. Methods: First, we combined patient-level data of multiple trials considering various depression treatments, such as antidepressant medication and (internet-based) cognitive-behavioral therapy. Network estimation techniques were used to determine the complex patterns in which symptom-specific responses to treatment were related. Results: Individual clinical symptoms differed substantially in their responses to treatment and these symptom-specific responses were related in a complex manner. Patients suffering from symptoms that were directly affected by a particular treatment were -by definition- the most likely to benefit from that treatment. Conclusions: Network estimation techniques were able to unravel the diverse symptom-specific responses to treatment and could help in improving our understanding of the chain of events leading to a clinical response. Information from the networks could also help in improving the identification of patients who were the most likely to benefit from a particular treatment.

Disclosure

No significant relationships.
Natural catalytic immunoglobulins hydrolyzing histones as a link between inflammation and humoral immunity in schizophrenia
Authors: Ermakov E. , Buneva V. , Nevinsky G.
Published: February 2022

Introduction

Schizophrenia pathogenesis is known to be associated with chronic low-grade inflammation. Inflammation can be caused by extracellular histones that are released from cells due to apoptosis dysfunction. It can also be accompanied by the formation of natural catalytic immunoglobulins that bind and hydrolyze histones.

Objectives

To investigate the ability to hydrolyze various histones by polyclonal IgGs from serum of patients with schizophrenia.

Methods

We recruited 50 patients (28 men and 22 women) with a verified diagnosis of paranoid or simple schizophrenia and 25 healthy individuals (13 men and 12 women) in our study. IgG preparations were obtained by affinity chromatography and analyzed by SDS-PAGE and MALDI MS. Catalytic activity of IgGs were revealed by the degree of hydrolysis of five histones using SDS-PAGE. To prove that antibodies exhibit histone-hydrolyzing activity, we used rigorous generally accepted criteria. Statistical analysis was performed in Origin 2019.

Results

IgGs of patients are shown to bind and hydrolyze various histones with high efficiencies. The IgGs histone-hydrolyzing activity level, depending on the type of histone (H1, H2a, H2b, H3, H4), was statistically significantly 6–20 times higher than that of healthy individuals (Fig. 1). However, only 21% of patients with schizophrenia had IgGs with very high activity. The IgGs activity level correlated with PANSS General scale.

Fig.1. Histone-hydrolyzing activity of IgG.

Conclusions

We suggest that histone-hydrolyzing antibodies may play a compensatory role in schizophrenia because removal of extracellular histones minimizes the inflammatory responses. Therefore, such IgGs may be the link between inflammation and humoral immunity, and also be a promising biomarker.

Conflict of interest

This work was supported by Russian Foundation for Basic Research under grant 20-015-00156. E.A.E. is the recipient of the fellowship of the President of the Russian Federation (SP-2258.2019.4).
Homophobia: Is it a heterosexual “privilege”?
Authors: Kourtesis I.
Published: February 2022

Introduction

The context of stigma, in which many homosexuals live, exposes them to discrimination/stigmatization and promotes the internalization of negative attitudes about sexuality. Battle feelings of rejection and isolation may lead to the development of internalized homophobia (IH).

Objectives

To elucidate the risk factors of IH and how the latter affects mental health.

Methods

Literature review (PubMed).

Results

IH has been associated with lower levels of emotional stability, rejection sensitivity, impairments in emotion regulation and a tendency to turn against the self. Studies have connected IH to depression, poor self/relationship wellbeing, sexual discrimination, addictions, shame, body dissatisfaction, suicidal ideation, binge eating/drinking, partner violence and victimization. Higher levels of attachment anxiety and avoidance, outness, religiosity and internalized stigma were correlated with higher IH levels. The key factors relating to suicide include lack of acceptance by family and/or self, negative feelings about sexuality/gender and appearance dissatisfaction. In traditional/religious societies, heterosexual orientation is a strong norm and homosexuality is considered unacceptable leading LGBT individuals to report higher depressive symptoms and increased levels of IH. Due to heterosexist ideals, IH is a predictor for heterosexual marital intention, protests against LGBT and use of masculinity as a compensatory strategy.

Conclusions

Policies in support of individuals who have recently come out should be improved to reduce the development/effects of IH and take the social and sexual environments of rural gay men into account considering ways to increase service accessibility (e.g internet). Future research is needed to further understand the association between IH and mental health, social and cognitive mechanisms.
A remarkable benefit of group psychotherapies with gender dysphoric adults among a case study
Authors: Can H.N. , Polat A.
Published: February 2022

Introduction

A person who has gender dysphoria can experience some difficulties in his/her/their life (as we can see even in language). These difficulties are mostly because of the binary gender system. Especially in countries like Turkey, homophobia is very common. Because of that, a homosexual person can think that he/she/they is a transgender.

Objectives

At this point, group psychotherapies are worthwhile, especially for differantial diagnosis. These individuals can share their experiences about the process. On this way, they can also explore themselves.

Methods

We have a monthly group psychotherapy for transgender and gender nonconforming adults in our clinic. We accept the individuals who have problems about gender identity. All trans adults who apply to us and are considered to be suitable are directed to the support group.

Results

An individual, aged 20, who defines herself as a FtM trans has joined to the group for 4-5 months. She was in hurry and had decided to go under surgery for gender transition. She was referred to surgery by another clinic which didn’t have a group psychotherapy. So she applied to our clinic. During the group psychotherapy, she realized that she was homosexual and gived up gender transition.

Conclusions

Group psychotherapy is helpful for trans individuals to reduce psychological distress and manage their process. This study shows that it is not the only benefit of group support psychotherapy. It also helps the individuals to explore themselves, like our case. Its benefit can be as major as saving themselves from an irreversible step and its consequences.
Sexual functioning and high sensory processing sensitivity
Authors: Pereira H. , Nave C.
Published: February 2022

Introduction

The concept of Sensory Processing Sensitivity (SPS) was initially introduced by Aron in 1997 and involves complex processing of sensorial information and internal and external sensory stimuli, that is represented as an individual innate difference, as a temperamental property that concerns not only this deep sensorial processing but also to sharper general responsiveness to the environment. Its association with sexual functioning is still to be deeply determined.

Objectives

Through this research we aim to evaluate the levels of High Sensory Processing Sensitivity (HSPS) and to what extent these are related to sexual functioning, in addition to assessing the mediating role of gender in this relationship.

Methods

A total of 1,054 subjects between the ages of 18 and 80 (M age = 29.4; SD age = 11.9) participated in this study. Participants completed a demographic questionnaire, the Portuguese version of The Highly Sensitive Person Scale, and the Portuguese version of the Massachusetts General Hospital – Sexual Functioning Scale. The recruitment of the sample was internet-based.

Results

showed that the Sensitivity Sensory Processing and Sexual Functioning variables are negatively correlated and that there are statistically significant differences in sexual functioning according to gender (t(df)=7.042; p=<.05), males scoring higher; and participants with lower levels of HSPS presented higher levels of sexual functioning (t(df)=3.599; p<.05). Finally, logistic regression showed that Gender is responsible for 6.2% of the total variance of sexual functioning.

Conclusions

When working with highly sensitive people mental health professionals should take into account problems related to their sexual functioning in clinical practice.
Predictors of male sexual dysfunction in post traumatic stress disorder
Authors: Maalej R. , Hamdi G. , Felfel D. , Ammar H. Ben , Maamri A. , Kissi Y. El , Zalila H.
Published: February 2022

Introduction

Post-traumatic stress disorder affects emotional, social and professional functioning. It can also affect physical and sexual health.

Objectives

The aim of this study is to write down the prevalence of sexual dysfunction in men with PTSD and to economize on potential predictors of sexual dysfunction.

Methods

A total of 30 male patients with PTSD were included in this study. We collected socio-demographic and clinical data and we used Post-Traumatic Stress Disorder (PCLS) and International Erectile Function Index (IIEF15) scales.

Results

The mean PTSD severity score was 65.43 ± 2.95. The mean score for revitalization, avoidance, cognitive and mood alteration, and hypervigilance were 15.80 ± 1.44, respectively; 8 ± 0; 24.07 ± 1.20 and 17.57 ± 2.95. The mean IIEF-15 score was 51.16 ± 6.82. The mean sub-scores were 3.93 ± 0.52 for sexual desire; 18.80 ± 5.68 for erectile function; 8.93 ± 8.97 for orgasmic function; 5.13 ± 1.10 for satisfaction with intercourses and 4.13 ± 1.16 for overall satisfaction. The IIEF15-EF score was negatively correlated with the presence of a personal medical history (p = 0.02) and the impairment cognitions and mood score (p = 0.023). The IIEF-OF score was significantly associated with reviviscence, hypervigilance, cognition and mood alterations (p = 0.015; 0.041; 0.045). The IIEF-15 SD score was negatively correlated with altered cognition and mood (p = 0.007).

Conclusions

Our study focused on the importance of assessing sexual function in men followed for PTSD and helps to understand the association of PTSD with different types of sexual dysfunction.
Sexual counselling and sexual therapy in chemsex users in an NGO in spain
Authors: Ramos J. Curto , Azqueta I. , Soriano M.T. Heredia , Solano J.F. Cabrera , Ibarguchi L.
Published: February 2022

Introduction

The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.

Objectives

To describe the sexual health interventions (including sexual counselling and sexual therapy) for patients with chemsex practices in the NGO Apoyo Positivo in Madrid. We describe the main sexual problems.

Methods

Descriptive analysis.

Results

The main sexual problems were dissatisfaction in sexual intercourse without substance and difficulties with sexual desire activation (70%); compulsive sexual behaviour (70%), difficulties with sexual orientation and non normative gender expression, difficulties in erection (34%), premature ejaculation (7%) and delayed ejaculation (10%).

Conclusions

Chemsex is a phenomenon that needs a multidisciplinary approach and mental and sexual health must be taken into account. “Sexo, Drogas y Tu” is a model of collaborative approach which is a pioneering intervention developed by an NGO in Spain.
Sleep disorders among health care workers practicing in emergency department in south tunisia
Authors: Bader S. , Abbes W. , Sellami I. , Falah W. El , Hajjaji M. , Ghanmi L.
Published: February 2022

Introduction

Sleep disorders are the most common health problem among the health care staff, mainly those who perform night shifts.

Objectives

To assess the prevalence of sleep disorders among health care workers in emergency department and to determine its associated factors.

Methods

It was a cross-sectional study, including health care workers assigned to emergency ward and intensive care unit of Hedi Chaker and Habib Bourguiba hospitals in Sfax and regional hospital of Kebili, during the first six months of 2017. We used an anonymous and confidential self-administered questionnaire. We used hospital anxiety and depression scale (HAD) to assess anxiety and depression. Sleep quality was assessed by the Pittsburgh Sleep Quality Index and day time sleepiness by the Epworth Sleepiness Scale.

Results

240 nurses were included. Mean age was 37 years-old, 59.2% were female and 64.2% were married and 79.2% assured night shifts. The prevalence of sleep disorders was 70.4%. Sleep difficulties were significantly correlated with anxiety (p=0.001) and depression (p=0.02). In multivariate study, sleep disorders were related to the absence of leisure activity (OR=0.42 [0.19-0.94]; p=0.035) and anxiety (OR=3 [1.4-6.1]; p=0.002). 40.8% of nurses experienced drowsiness. Sleepiness was significantly correlated with the absence of leisure activities (p=0.04) and with psychiatric family history (p=0.02). In the multivariate study, sleep disorders were correlated with female gender (OR=0.43 [0.19-0.9]; p=0.042) and with no leisure activity (OR=2.6 [1.2-5.6]; p=0.01).

Conclusions

Sleep disorders were common among emergency nurses, in order of that; working conditions should be improved to provide less stressful conditions for nurses.

Conflict of interest

No significant relationships.
Severity of insomnia among counseling patients in psychiatry
Authors: Falfel D. , Krir W. , Kefi H. , Omayya A.
Published: February 2022

Introduction

Insomnia is a frequent reason of consultation in psychiatry. Always it is associates to other psychiatric pathologies.After stabilisation of the main disorder, it can become the only complaint.

Objectives

This study aimed tob assess the prevalence of severe insomnia among patients suffering from different psychiatric disorder, and their sociodemographic profile.

Methods

It is a cross sectional study conducted in February 2020 at the psychiatric ward of the military hospital of Tunis, including 80 patients who responded to the questionnaire of Insomnia Severity Index (ISI).

Results

The study included 80 patients (18 to 66) years old with average age 38.78.The questionnaire showed that 26.92% didn’t have any sleep disorder, 25% had light insomnia, 42,30% had mild insomnia and only 5.76% suffered from severe insomnia.The patients counseling for anxiodepressive disorders were 48%, for PTSD were 17.46% and 17.3% for psychosis. Military population represented 80% of total patients interviewed and the average of years of service was17.7 years. The single patients were 46% th others were married. 70% of the patients were under hypnotic drugs besides the main treatment.

Conclusions

Sleep disorders have a significant impact on cognitive functions and life quality which should be separately studied. Despite of well conducted pharmacotherapy, some patients still suffering from severe insomnia, it can be attributed to the main psychiatric disorder, relapse, treatment resistance, substance abuse…The importance of the psychiatrist involvement in screening and treatment can obviously enhance the prognosis. Other therapeutic alternatives which are non pharmacological such as phytotherapy ans CBT should be proposed to patients.
Family functioning and therapeutic success in detoxification in dual diagnosis patients
Authors: Chorto S. Pombo
Published: February 2022

Introduction

Voluntary dropouts before completion of inpatient psychiatric treatment are common in patients with dual disorders. However, the socioeconomic profile and family structure of patients who undergo a therapeutic program may correlate with their motivation and participation in the treatment received, as well as with their subsequent recovery.

Objectives

To evaluate the family typology of patients with dual diagnosis according to the degree of intrafamily cohesion and adaptability correlated with the prediction of therapeutic success and the risk of voluntary abandonment of hospital detoxification treatment.

Methods

A total of 211 patients admitted to an inpatient psychiatric unit with substance use disorders were studied. Data were obtained from two sources: (1) interview of participants, (2) review of participants’ medical records using the Maudsley Addiction Profile (MAP) and the Family Cohesion and Adaptability Assessment Scale (FACES III).

Results

The 127 subjects who completed the hospital detoxification program had significantly lower MAP and FACES III scores at baseline than the 84 subjects who did not complete the study. Those who did not complete the admission reported greater addictive severity and poorer family functioning. Family cohesion and adaptability measured with FACES III and addictive severity assessed with MAP positively correlated with successful compliance with the hospital treatment program for dual diagnosis patients.

Conclusions

These findings reveal the association of psychosocial and family determinants and addictive severity with treatment completion and subsequent prognostic evolution. Recognizing these predictive characteristics may allow early identification of patients at higher risk of early dropout and prevent it by increasing the intensity of treatment.
Cognitive remediation in the era of new technologies: Applications and innovations
Authors: Wykes T.
Published: February 2022

Most cognitive remediation therapies now involve computer presentation that differ in their level of sophistication and incorporation of gaming technology. But sophistication doesn’t seem to affect the benefits as few outcome differences have been noted. Rather there seems to be a need for some interaction between a therapist and client with two recent meta-analyses reporting this therapist effect. For the large-scale roll-out of cognitive remediation this poses a problem – how do we train these therapists? We know that training or at least educational background is important, so we need clear training packages and supervision. Covid-19 has also given us a greater challenge as it has limited our face-to-face interactions. To remove these two challenges we can use technology. For training we need online processes to increase training availability and for a lack of face to face contact we can provide the bridge with suitable platforms which allow the sharing of screens. Both would ensure that cognitive remediation is available to a wider group, although that requires overcoming the digital divide often experienced by people with a diagnosis of schizophrenia. The tools and the training programme issues are discussed with reference to some initial data.

Disclosure

No significant relationships.
Generalized problematic internet use, use of social networks, and appearance schemas in late adolescence
Authors: Maia B. Rodrigues , Moreira H. , Macedo A. , Pereira A.T.
Published: February 2022

Introduction

Research on the association between internet use and concerns about body image is still scarce.

Objectives

To explore the associations between generalized problematic internet use, number of social networks, and appearance schemas.

Methods

216 Portuguese late adolescents (89.3% females), with a mean age of 18.62 years old (SD = .488, range: 18-19) filled in an internet patterns of use questionnaire, the Generalized Problematic Interne Use Scale 2 (GPIUS2) and The Appearance Schemas Inventory-Revised (ASI-R).

Results

A total of 99.6% of the students use social networks. Subjects were divided into three groups (group1: 1-2 social networks; group 2: 3 social networks, and group 3: >3 social networks). There was a statistically difference in Motivational Salience scores (ASI-R) for the three groups [F (2, 503) = 6.0, p = .003]. Post-hoc comparisons indicated that the mean score for group 3 (M = 28.29, SD = 4.95) was significantly different from group 1 (M = 26.69, SD =4.55), and from group 2, (M = 26.87, SD =4.95). Generalized problematic internet subscales (Mood Regulation, Self-Deficient Regulation, and Negative Consequences) and total score were significantly correlated with both dimensions of ASI-R: Self-Evaluation Salience (coefficients varied from r = .31** to r = .47**) and Motivational Salience (from r = .14*, to r = .31**).

Conclusions

Generalized problematic internet use and the number of social networks are associated with adolescent’s cognitive-behavioural investment in one’s own appearance. Study carried out under the strategic project of the Centre for Philosophical and Humanistic Studies (CEFH) UID/FIL/00683/2019, funded by the FCT.