bluuebunny/crossref_metadata_2025 huggingface dataset:
The traps of the internet in the covid era
Authors: Rădulescu I.D. , Luca L. , Bokolas V. , Mărineanu V.D. , Rawat S. , Ciubară A.B. , Piotrowski A. , Vashdi E. , Ciubară A.
Published: February 2022

Introduction

The paper presents the results of one international study due by our team in the period of restrictions imposed by Covid-19, between March and June 2020.

Objectives

To inform the population about the risks concerning the excessiv use of internet To prevent the effects of those behaviors which affects the global functioning of individuals

Methods

Questionnaire applied to a number of 549 subjects, 18 to 60 years old, 217 from Romania and 332 from other European and Asian countries

Results

The results allowed us to verify the assumption that there is a change in communications needs of individuals, as well gender and age differences in terms of time spent on the internet during the covid period.

Conclusions

The issue of psycho-education regarding the awareness of dangers and the traps of the virtual era remain relevant.
Impulse control disorders and dopamine agonists
Authors: Martins D. , Faria R. , Pinho M. , Rodrigues S.
Published: February 2022

Introduction

Impulse control disorders (ICDs) are an adverse effect of dopamine agonists (DAAs) that affects the quality of life and can lead to legal, criminal and familiar problems.

Objectives

Presenting a review of the mechanisms, prevalence and factors associated with the development of an ICD due to DAA use.

Methods

Search on Pubmed database with combination of the following keywords were used: “Impulse control disorders”, “dopamine agonist” or “therapy”. We focused on data from studies published between 2015 and 2020. The articles were selected by the author according to their relevance.

Results

DAAs are mainly indicated in the treatment of Parkinson’s Disease (PD), and are also used on symptoms of restless legs syndrome (RLS) and prolactinoma or lactation inhibition. Dopamine replacement therapy act on dopamine receptors in the nigrostriatal and the reward pathways, which plays a role in addictive behavior. The prevalence of ICDs ranged from 2.6 to 34.8% in PD patients and a lower prevalence in RLS patients. Some of the ICDs reported were pathological gambling, hypersexuality, compulsive shopping, obsessive hobbying, punding, and compulsive medication use. The factors associated with the development include the type of DAAs, dosage, male gender, younger age, history of psychiatric symptoms, earlier onset of disease, longer disease duration, and motor complications in PD.

Conclusions

Further studies are needed to clarify the pathophysiology of the ICD in DAA therapy and determinate premorbid risk factors. The percentage of patients with ICDs is underrated, so it’s important to improve the patient’s evaluation, using validated and consensual assessment tools.
Clinical case of animal hoarding – characterization and management of a new disorder
Authors: Lopes L. , Certo A. , Pereira S. , Venâncio Â.
Published: February 2022

Introduction

Animal hoarding is characterized by hoarding of a large number of animals without providing minimum conditions of nutrition and sanitation, accompanied by lack of insight for the behavior and by social isolation. Despite studies detecting an increasing incidence, the behavior is still poorly understood.

Objectives

To review clinical evidence on animal hoarding and to report a clinical case.

Methods

We report a clinical case based on patient’s history and clinical data, along with a review of the literature on animal hoarding. The terms “Noah syndrome” and “animal hoarding disorder” were searched on PubMed® database.

Results

We present the case of a 51-years-old woman, living alone, with higher education. His first contact with psychiatry was in August 2019 upon aggravated self-neglect and behavioral disorganization. She was living with around 40 cats, her home was extremely deteriorated. In December 2019 she was admitted to a psychiatric unit. A schizophrenia diagnosis was established and pharmacological treatment was initiated. She was discharged to a chronic psychiatric institution. Studies found out that animal hoarders are typically middle age/older women living alone in squalid conditions. Animal hoarding is characterized by a chronic course and intense emotional attachment to animals. It seems to be associated with traumatic situations, as well as mental disorders such as schizophrenia or dementia. Published data on intervention and treatment is still limited.

Conclusions

Animal hoarding phenomenon requires further investigation, regarding developmental risk factors and co-morbid mental disorders. Comprehensive approaches to clinical intervention and management strategies in animal hoarding are necessary.
Clinical features, effectiveness of therapy and quality of life of patients with type 2 diabetes and comorbid schizophrenia
Authors: Artemieva M. , Varnakova T. , Danilin I. , Lazukova A. , Suleimanov R. , Sokolov V.
Published: February 2022

Introduction

According to previous studies, about 8,8-14,5% cases of schizophrenia is comorbid to type 2 diabetes. The focus of the study was the evaluation and dynamics of positive and negative symptoms in case of combination of the diseases.

Objectives

100 patients were divided in two groups: 48 patients was assigned to receive a monotherapy treatment with antipsychotic; 52 patients received the combination of antipsychotics, nootropics and antioxidants. The efficiency criterion was the dynamics of the questionnaire The quality of life of patients SF- 36, Hamilton’s scale of Depression and anxiety, overall score on a scale for evaluation positive and negative symptoms (PANSS).

Methods

After treatment the physical component of health is 41,38% in the first group and 56,34% in the second group (p≤ 0,05). The psychical component of health is 39,79% in the first group and 50,8% in the second group (p≤ 0,05). Also statistically confirmed (p≤ 0,05) in the patients of the second group the improvement on the Hamilton’s scale of Depression and anxiety questionnaire and PANSS.

Results

After treatment the physical component of health is 41,38% in the first group and 56,34% in the second group (p≤ 0,05). The psychical component of health is 39,79% in the first group and 50,8% in the second group (p≤ 0,05). Also statistically confirmed (p≤ 0,05) in the patients of the second group the improvement on the Hamilton’s scale of Depression and anxiety questionnaire and PANSS.

Conclusions

According to Quality of Life questionnaire combination of antipsychotic, nootropic, antioxidant is significant more effective than treatment only with antipsychotic.
Benzodiazepines prescribing in insomnia : Between practice and guidelines
Authors: Lagha M. , Ouali U. , Nacef F.
Published: February 2022

Introduction

Benzodiazepines (BZD) are psychotropic drugs prescribed in psychiatry for their anxiolytic, hypnotic and sedative properties. Several guidelines aimed to limit the chronic use of BZDs. However, BZDs prescribing that does not comply with international recommendations remains widespread, estimated in France at 20% for hypnotic BZDs.

Objectives

The aims of our study were to evaluate BZDs prescribing practices in the treatment of insomnia and to assess their compliance with international recommendations.

Methods

This is a cross-sectional study conducted through a Google-forms self-administered questionnaire,intended for psychiatrists and psychiatric residents, over a period of two months, from April 1 to May 31, 2019.

Results

One hundred physicians practicing in psychiatry answered our questionnaire. The response rate was 28%. Four BZDs are recommended for the treatment of insomnia, none of which is available in Tunisia. Almost the third of the participants did not systematically look for signs of sleep apnea syndrome before treating an insomnia (30.5%). For treating insomnia, the majority of the participants began by indicating hygieno-dietetic rules (64%), 4% prescribed directly a BZD. Cognitive behavioral therapy was not indicated at all by the particiants. The maximum duration of prescribing BZDs in insomnia was 4 weeks in 20% of cases, and more than 4 weeks in 38% of cases. Among the participants, 41% prescribed BZDs for the treatment of chronic insomnia.

Conclusions

Insomnia appear to be badly managed and early drug prescribing is frequent. These practices do not comply with the recommendations of good practice and increase the risk of dependance and other side effects.
Use of botulinum toxin type a in psychiatry - new perspectives and future potential
Authors: Viegas F. Gonçalves , Figueiredo I. , Ferreira F. , Lourenço A.
Published: February 2022

Introduction

For almost three decades, botulinum toxin type A (BT-A) has been used for medical purposes. Evidence of the potential use of BT-A is emerging for psychiatric disorders, like unipolar and bipolar depression, borderline personality disorder (BPD), late dyskinesia, amongst others. This may represent a new role of BT-A treatment and could expand the therapeutic arsenal in psychiatry.

Objectives

The goal is to review current evidence regarding BT-A and psychiatry disorders.

Methods

Literature review of BT-A use in psychiatric conditions using Medline database.

Results

There’s evidence supporting the use of BT-A in resistant unipolar depression, with studies showing an 8 and 4 times higher response and remission rates comparing with placebo. Beneficial effects were also found in bipolar depression. Preliminary data suggest that BT-A therapy may also be effective in the treatment of mental disorders characterized by an excess of negative emotions, such as BPD. The underlying mechanism might be the “facial feedback hypothesis”. Hyperhidrosis is a common comorbidity in social anxiety disorder and may itself give rise to depressive or anxiety symptoms. BT-A has proved to be a safe and effective treatment for hyperhidrosis. BT-A can also be safely used for dystonia secondary to the use of psychiatric medication, when there’s an inadequate response to anticholinergic medication. Also, BT-A injections in the salivary glands have been investigated for treating clozapine-induced sialorrhea and studies reported successful reduction in hypersalivation.

Conclusions

Although more studies are needed to evaluate the potential of BT-A in psychiatry, there is growing evidence of its potential use for some psychiatric conditions.
How to manage antipsychotic-induced akathisia
Authors: Moura N. , Esteves-Sousa D. , Facucho-Oliveira J. , Laginhas C. , Quintão A.
Published: February 2022

Introduction

Akathisia is a relatively common adverse effect of antipsychotics although some second-generation antipsychotics are known to have a lower liability for the condition. The core feature of akathisia is mental unease characterized by a sense of agitation, usually accompanied by motor restlessness, which can cause patients to pace up and down and be unable to stay seated for more than a short time. An association between this discomfiting subjective experience and suicidal ideation has been postulated but remains uncertain.

Objectives

Our aim is to perform a non-systematic review of the literature regarding the current understanding of antipsychotic-induced akathisia and its management.

Methods

A semi-structured review was conducted on Pubmed concerning the relationship between akathisia and antipsychotics.

Results

All antipsychotics drugs can cause akathisia. The management of antipsychotic-induced akathisia should include a dose reduction of the antipsychotic treatment or a switch to quetiapine or olanzapine. If ineffective, a trial with propranolol may be useful as well as the addition of a 5-HT2A antagonist like mirtazapine or mianserine. At last the inclusion of a benzodiazepine may be helpful albeit the risk of dependence and anticholinergics mainly when other extrapyramidal symptoms are present.

Conclusions

High‐dose antipsychotic medication, antipsychotic polypharmacy and rapid increase in antipsychotic dosage should be avoided to prevent akathisia. There is limited evidence for any pharmacological treatment for akathisia such as switching to an antipsychotic medication with a lower liability for the condition, or adding a beta‐adrenergic blocker, a 5‐HT2A antagonist or an anticholinergic agent although some patients may benefit from such interventions.
Lithium monitoring in clinical practice
Authors: Sciberras E. , Bellizzi A. , Rapa L. , Vassallo C. , Grech A.
Published: February 2022

Introduction

Lithium is widely used for the treatment of bipolar disorder. Owing to its narrow therapeutic index and side-effect profile, regular monitoring is recommended by all major guidelines on lithium use.

Objectives

The aim of this study was to determine whether routine lithium monitoring practice at the local mental hospital in Malta reaches the standard set by the most recent NICE guidelines (NICE, 2014a).

Methods

All patients on lithium maintenance treatment for bipolar disorder at the local Mental Hospital were included. Blood tests within the last one year were collected using iSOFT clinical manager (iCM). After the first audit cycle, a lithium monitoring sheet was created in accordance with the NICE guideline and after 6 months of implementation, the second audit cycle was conducuted.

Results

In the first cycle, 28 patients met the NICE criteria for increased risk of toxicity and have a recommended testing frequency for lithium levels of every 3 months. However, only 1 patient was observed to meet this criteria. When assessing the last lithium level only 35.7% were within 0.4-0.8 mmol/L. In the second audit cycle, 28 patients met the NICE criteria for increased risk of toxicity and have a recommended testing frequency for lithium levels of every 3 months. Almost half of the patients (12 patients, 42%) were to observed to meet this criteria. When assessing the last lithium level, 50% were within 0.4-0.8 mmol/L

Conclusions

After the introduction of the lithium monitoring sheet, monitoring improved substantially especially in high risk patients. Moreover, the majority of test results for lithium levels were within the therapeutic range.
Benzodiazepine prescribing in tunisia: A study about psychiatrists prescribing habits
Authors: Lagha M. , Ouali U. , Nacef F.
Published: February 2022

Introduction

Benzodiazepines (BZDs) are psychotropic drugs that are predominantly prescribed in psychiatry and that can have serious side effects. BZDs prescribing is well codified by several guidelines, yet the epidemiological data on their prescribing remains alarming.

Objectives

Our study aimed to evaluate the general modalities of BZDs prescribing in psychiatry in Tunisia.

Methods

This is a descriptive cross-sectional study conducted through a Google-forms self-administered questionnaire, intended for psychiatrists and psychiatric residents, over a period of two months, from April 1 to May 31, 2019.

Results

One hundred physicians practicing in psychiatry answered our questionnaire. The response rate was 28%. The purpose of treatment with BZDs was explained to the patient at its initiation in 98.2% of cases and the risks associated with it in 87.7% of cases. Special precautions were taken in elderly patients (96.5%), at risk of respiratory failure (94.7%), and in cases of personality disorders (80.7%). Only three quarters of physicians took precautions before prescribing BZDs to a pregnant woman (77.9%). In cases of rebellious or refractory symptoms, 14.4% of the participants stated that they combine two BZDs. Before reproducing/repeating a BZD prescription, 18.4% of the participants indicated that they did not systematically and regularly assess its necessity.

Conclusions

The severity of the side effects associated with BZDs, especially those of tolerance and dependence, are at the origin of strict prescribing rules, dictated by several guidelines. According to the results of our study and to the literature data, the prescribing practices of these molecules remain nonetheless in many cases non-compliant with the recommendations.
On psychiatry and psychology
Authors: Neu E. , Michailov M. , Welscher U. , Schratz M. , Weber G.
Published: February 2022

Introduction

Psychiatry is fundamental interdisciplinary medical science with essential importance for enormous health-problems of humanity. Creation of integrative-psychiary in context of multidimensional&holistic medicine, founded by HIPPOCRATES-GALENUS-HUA T’UA-AVICENA-PARACELSUS is necessary to counteract disastrous human health-situation. Psychiatry needs new integrative therapy-models considering application of psychopharmacotherapy as well as practices of psycho-somatic (Th.v.UEXKÜLL) and somato-psychic theories (Y.IKEMI). Emperor AKIHITO during Opening-Ceremony of ICPM-2005-Kobe appointed to consider “total symptoms of mind-body, seeking ways of holistic care”.

Objectives

REFERENCES. PSYCHIATRY: EPA-2020-virtual/Madrid, Eur.Psychiatry 63S, EPP0834/5+EPV0581/1470; EPA-2019-Warsaw, Eur. Psychiatry 56S,S689; EPA-2018-Nice, Eur.Psychiatry 48/S1, S623&567&662. WPA-2019-Lisbon, E-Poster WCP19-2137, -1822, -1839; 2018-Mexico-City, Abs.-Book WCP18-0584/-0625/-0643/-0654. 2011-Buenos-Aires,AB:PO1.200. PSYCHOLOGY: EFPA-2019-Moscow, Abs.-Book 1529,1530,1549. IUPsyS-2012-Cape-Town, IntJPsychol 47:407; -2008-Berlin, 43/3-4:154, 248,615,799; -2004-Beijing, AB:49,587. PSYCHOSOMATICS: ICPM-2017-Beijing, AB:ID: 648493,648895,648749,648878; -2005-Kobe, J.Psychosom.Res. 58:85-86.

Methods

Evaluation of psychic-“polar-attitude-list”/physiological-parameters: heart-rate, blood-pressure,etc. from patients/probands after training by occidental/oriental practices (Music-/Yogatherapy/others) (ref.).

Results

Observations demonstrate strong positive influence after music[1], respiratory[2], hatha-yoga[3] therapies. Items of psycho-physiological (relaxed), emotional (tranquil/happy), cognitive (few/ordered thoughts), voluntary (active/spontaneous), social (open/assertive), consciousness (clear/sleepy) categories are significantly positive changed 25-50%. The 3-therapies have specific psychic-effects,e.g. items “relaxed/tranquil” after respiratory- (+45/50%) and music- (+20/5%), also item “open” after music-therapy (+25%) are positive, but negative after respiratory-therapy (-20%). Psychic-effects are correlated with positive physiological-ones,e.g. heart/respiratory-frequency decreased 25-30%, voluntary-apnoea prolonged 55%. Mountain-altitude (>2000-3000m), hypothermia (<20 to 0°C) influenced positively psychic/physiological-parameters,e.g. heart-rate/blood-pressure decrease (n=125,P<0.05-0.01).

Conclusions

Different methods of integrative psychiatric therapy are with preference,e.g. for depression is suitable respiratory/physical-training, also hypothermia&high-mountain therapy (activation-euphoria), for mania:music-therapy (inhibitory-effect). Systematically research about single/combined therapies is necessary,e.g. for epilepsy: Respiratory-therapy/hypothermia,etc. could help patients (hypo-/hypercapnia: inhibitory/excitatory effects on CNS-structures).
Insights from electronic health record data to improve mental health service delivery during the COVID-19 pandemic
Authors: Patel R. , Irving J. , Brinn A. , Broadbent M. , Shetty H. , Pritchard M. , Downs J. , Stewart R. , Harland R.
Published: February 2022

Background

Remote consultation technology has been rapidly adopted due to the COVID-19 pandemic. However, some healthcare settings have faced barriers in implementation. We present a study to investigate changes in rates of remote consultation during the pandemic using a large electronic health record (EHR) dataset.

Methods

The Clinical Record Interactive Search tool (CRIS) was used to examine de-identified EHR data of people receiving mental healthcare in South London, UK. Data from around 37,500 patients were analysed for each week from 7th January 2019 and 20th September 2020 using linear regression and locally estimated scatterplot smoothing (LOESS) to investigate changes in the number of clinical contacts (in-person, remote or non-attended) with mental healthcare professionals and prescribing of antipsychotics and mood stabilisers. The data are presented in an interactive dashboard: http://rpatel.co.uk/TelepsychiatryDashboard.

Results

The frequency of in-person contacts was substantially reduced following the onset of the pandemic (β coefficient: -5829.6 contacts, 95% CI -6919.5 to -4739.6, p<0.001), while the frequency of remote contacts increased significantly (β coefficient: 3338.5 contacts, 95% CI 3074.4 to 3602.7, p<0.001). Rates of remote consultation were lower in older adults than in working age adults, children and adolescents. Despite the increase in remote contact, antipsychotic and mood stabiliser prescribing remained at similar levels.

Conclusions

The COVID-19 pandemic has been associated with a marked increase in remote consultation, particularly among younger patients. However, there was no evidence that this has led to changes in prescribing. Further work is needed to support older patients in accessing remote mental healthcare.

Disclosure

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: RS has received funding from Janssen, GSK and Takeda outside the submitted work. RP has received funding from Janssen, Induction Healthcare and H
Transcranial magnetic stimulation in the management of autism spectrum disorder: Narrative review
Authors: Adnan M. , Zafar M. , Trivedi C. , Beg U.
Published: February 2022

Introduction

Fifty years ago, the estimated prevalence of autism was 30-60 per 10,000; now, it has increased to 18.5 per 1,000. Autism disorders are 4.3 times as prevalent among boys as among girls.

Objectives

This systematic review provides an overview of the management of AD with Transcranial Magnetic Stimulation.

Methods

A systematic review was conducted using (“Autism spectrum disorder” AND “Repetitive Transcranial Magnetic stimulation” AND “RTMS” OR “Children and adolescent”) in PubMed, Embase, and PsycINFO, resulted in 453 hits and finally qualified 18 studies.

Results

We found 18 eligible studies, 8 randomize controlled clinical trials, 10 non-controlled clinical trials comparing TMS effects with waiting-list controls (n = 6), sham-treatment (n = 8) and no control group (n=4). There was a significant reduction of repetitive, stereotyped behaviors, irritability, social behavior, and executive function improvements with a medium-size effect. Eleven studies in this review had a moderate to high risk of bias due to small sample size, lack of blinding to treatment, and inadequate follow-up period. Four studies reported the stability of these gains in clinical outcomes for more than six months with no clarification after that.

Conclusions

The data encourages the potential safety and efficacy; it provides significant evidence to support TMS’s efficacy in symptom severity reductions and improved clinical outcomes in children with autism. Therefore, future large-scale randomized controlled trials are required to conclude intervention efficacy in a larger sample size further.
Personality and psychophysiological self-regulation influence individual efficacy of neurofeedback in tension-type headache
Authors: Arina G. , Dobrushina O. , Shvetsova E. , Meshkov G. , Martunov S. , Fyodorova E.
Published: February 2022

Introduction

Due to limited efficacy and side effects of pharmacological therapy in tension-type headache (TTH), alternative approaches are feasible. Neurofeedback is a noninvasive neuromodulation technique increasingly used in practice, but, however, there is limited research on its efficacy.

Objectives

To evaluate the efficacy of neurofeedback in TTH and to reveal the factors moderating treatment effects.

Methods

We analyzed the data from a pilot phase of an ongoing single case design cross-over sham-controlled study. Four females with TTH underwent 10 sessions of neurofeedback and 10 sessions of sham-neurofeedback in a randomized order. Participants filled a detailed headache diary 3 weeks before, during and 3 weeks after the treatment. At enrollment, we evaluated the personality factors with the MMPI, and performed a specially developed test on psychophysiological regulation of breath.

Results

Significant reduction of headache frequency and intensity was observed in 2 of 4 participants (responders). The responders were characterized by normal MMPI profile and, the same time, by lower baseline abilities for psychophysiological self-regulation. The non-responders had high MMPI profile (accentuation) and also higher abilities for psychophysiological self-regulation.

Conclusions

On the base of preliminary data, we suggest that neurofeedback may be feasible in TTH patients with lowered abilities for in psychophysiological self-regulation. Accentuation of personality traits may interfere with the efficacy of neurofeedback.
Effects of repetitive transcranial magnetic stimulation in the treatment of attention-deficit hyperactivity disorser: A case study
Authors: Asimoglou E. , Tsakiri A. , Gkikas P. , Kalimeris S. , Karampoutakis G.
Published: February 2022

Introduction

Although there are very effective treatment approaches for Attention Deficit Hyperactivity Disorder (ADHD) available, the clinical management has its limits making new treatment modalities a necessity. Evidence suggests that low frequency repetitive transcranial magnetic stimulation (rTMS), improves hyperactivity, impulsivity, and attention deficit of individuals with ADHD.

Objectives

The aim of this case study is to present the effectiveness of rTMS on hyperactivity, impulsivity, and attention deficit of an individual with ADHD.

Methods

This is a case study of a 22 year old male diagnosed with ADHD. The protocol applied was 2 weeks of daily rTMS sessions. This involved repetitive TMS to the right dorsomedial prefrontal cortex (10 Hz, 3.000 pulses, 120% motor threshold) to treat attention deficit, hyperactivity and impulsivity. Assessments were conducted using Adult ADHD Questionnaires, the Jasper and Goldberg questionnaire and WHO self- reported scale at baseline, 1 month and up to 3 months follow up.

Results

The patient showed overall improvement in scores in both ADHD scales with scores dropping more than 50 % in both scales from pre treatment to 3 months follow up. No side effects were recorded during therapy

Conclusions

Our findings suggest that the use of rTMS therapy in individuals with ADHD, is an efficacious and safe therapeutic treatment option.
Digital psychiatry and COVID-19: a potential recruitment opportunity
Authors: Rigby D.
Published: February 2022

Psychiatry has long been battling with a recruitment crisis in the UK which is also reflected across much of Europe. Covid-19 has brought about widespread changes to our ways of working, as well as driving technological developments, which provides potential opportunities for the profession to draw people into the speciality. Covid-19 has brought interest in digital psychiatry from the peripheries to the mainstream. Mental health professionals are currently using sophisticated technologies such as Virtual Reality, Artificial Intelligence and Natural Language Processing in the diagnosis and treatment of mental health disorders. Highlighting the ways in which our profession is at the cutting edge of innovation to junior doctors offers a fruitful avenue to improve recruitment into the speciality. Many outpatient clinics have made the move to online service delivery during the pandemic to varying degrees. For many clinicians this has allowed more flexible and efficient ways of working. Psychiatry is better placed than most other medical disciplines to retain online patient contact in future clinical practice, post pandemic and may provide an attractive proposition for future psychiatrists. This talk will review some of the ways in which developments in digital psychiatry have been used to help generate interest for recruitment into the discipline as well as evaluating the benefits and challenges of the shift to telepsychiatry during Covid-19 and will offer some suggestions what the profession can learn from this to help future recruitment.

Disclosure

No significant relationships.
An existential model of addiction
Authors: Grech G.
Published: February 2022

Introduction

Despite existentialism positing that existential concerns are universal, research into the existential issues related to addiction remains scarce. An existential model of addiction is lacking.

Objectives

This research aims to develop an existential model of addiction, conceptualising the development of addiction through to authenticity.

Methods

A scoping literature review was carried out using PUBMED, reference lists and internet websites.

Results

Psychopathology, from an existential point of view, occurs as a result of the avoidance of the existential givens which are death, freedom, existential isolation and meaninglessness. In this model, addiction is positioned as a coping mechanism to deal with the existential or neurotic anxiety which arises from facing or avoiding the existential givens. Addiction is defined as being-with-drug; a state in which our inherent relation to others is replaced by a relation with a substance. This state is understood from the ontological, axiological, ethical and praxeological levels, shedding light on the phenomenological experience of addiction. The existential dilemmas around meaning, loneliness, death, freedom, guilt and control while living with addiction are discussed. Finally, existential crises, boundary situations and secondary suffering are seen as the main motivators to overcome addiction.

Conclusions

Phenomenological and existential research support the fact that existential issues are relevant to addiction. This model explains the relationships between existential concepts and addiction, while providing a framework for clinicians to explore and address these issues with patients.
Acceptance commitment therapy for preschool children : A pilot study
Authors: Brahim T. , Bouzgarrou S. , Guedria A.
Published: February 2022

Introduction

Emotion regulation is a key world to understand many human behaviors. Preschool children can exhibite disturbing behaviors that could interfeer with their integration, development and learning abilities. One way to understand these behaviors is their “immature” emotional regulation process. Helping children acquiring this ability can help to solve these disturbances’, which can lead to mental health problems.

Objectives

To experiment with a new acceptance and committment therapy protocol in preschool children

Methods

It is a qualitative interventional study that relies on issues to enable the recognition and regulation of emotions. a protocol was implemented which consists of activities and techniques useful to help children recognize, regulate and accept their emotions, with the support of the educator.

Results

All six selected children accepted to undergo the therapy till the end of the eight sessions. at fisrt, they were enable to recognise some emtions. it was the most difficult for them to recognise body expression of emotion. they had also difficulties find the different worlds to express them and to enact them.Throw different activities, we tried to help children visualize their emotions, imagine them under different faces and play with them. Children were introduced to mindfulness and emotional regulation technics. After One month of the intervention, children were still able to recognize emotions and to propose technics to regulate them. their score on the CBCL were below 70 one month after the intervention.

Conclusions

Even at an early age of 4 years, ACT seems to be possible and helpful for children.
4Ds: Documenting delirium diagnosis in discharge summary
Authors: Azvee Z. , Khair I. , Barry N. , Sheehan J.
Published: February 2022

Introduction

Hospital discharge is a significant transitional phase with varying levels of needs and risks to be managed as lapses in communication commonly happen between secondary/tertiary and primary care.

Objectives

Our aim was to look at inclusion of delirium diagnosis in discharge summaries based on standards set by: 1. Health Information and Quality Authority (HIQA) National Standard for Patient Discharge Summary Information 2. NICE Guidelines on Delirium: prevention, diagnosis and management (CG 103)

Methods

All inpatients referred to Liaison Psychiatry from 9thJuly 2019 till 5th January 2020 were included, n = 729. Compared discharge summaries diagnoses to the internal Liaison Psychiatry ICD 10 consensus diagnosis and also HIPE coded diagnosis specifically for delirium.

Results

Delirium diagnoses and inclusion of delirium-specific information on discharge summarynProportion (n=112*) (%)Q1 Any F05 diagnosis coded by Liaison Psychiatry117100Q2 F10.4 diagnosis coded by Liaison Psychiatry00Q3 F1x.4 diagnosis coded by Liaison Psychiatry00Q4 Any F05, F10.4 and F1x.4 diagnosis coded in discharge summary on patient centre2320.5Q5 Was the word delirium or its synonym such as acute confusional state mentioned in the body of the discharge summary?6255.4HIPE Code Diagnosis6658.9

Conclusions

Hospital discharge summaries are essentially the main communication link between hospitalists and general practitioners to ensure continuity and future care of patients. Delirium diagnosis is not always recorded in discharge summaries. This is a risk to be managed. Education is vital to ensure awareness, prevention, early recognition and to ensure recording of diagnosis of delirium.
Therapeutic isolation in psychiatry
Authors: Kefi H. El , Kabtni W. , Boughalmi S. , Gafsi I. , Baatout A. , Krir W. , Oumaya A.
Published: February 2022

Introduction

Therapeutic seclusion, consist of locking a patient alone in a room dedicated to this type of care. It poses real questions about respect for fundamental rights, in particular the right to liberty.

Objectives

The objectives of our work were to evaluate the practices of psychiatric doctors and nurses in seclusion.

Methods

Our study is descriptive-based. Using a self-questionnaire, a set of questions about the decision of seclusion, its prescription, its means, its surveillance, the information of the patient and his relatives as well as the characteristic of the seclusion room, were asked. Our target population consisted of medical and paramedical staff working in the HMPIT Psychiatry Department.

Results

Our study covered eleven doctors and fourteen nurses. The average age was 35 years with 52% having more than 5 years of psychiatric experience. Fifty-two percent used seclusion while 72% had no specific training. Twelve (12%) percent felt that no accidents could occur in seclusion. Twenty percent (20%) did not find it necessary to transcribe the monitoring parameters on the medical file.

Conclusions

Our study showed that the psychiatric staff lack sufficient exposure to in the area of therapeutic seclusion. A seclusion protocol has been drawn up to guarantee patient safety.
Study of 18 months of follow up dir floortime intervention in preschool children with autism spectrum disorder (ASD)
Authors: Pacheco P. , Pacheco M. , Molini-Avejonas D.
Published: February 2022

Introduction

Children in Autism Spectrum Disorder (ASD) have a qualitative deficit in social interaction. The DIR/Floortime (Stanley Greenspan and Serena Wieder) is based on the Child’s Functional Development, Individual Differences and Relationships (D for development, I for individuality or individual differences and R for relationship), aiming at building the foundations for social, emotional and intellectual skills of children.

Objectives

To determine the results of 18 months DIR/Floortime™ parent training for an additional benefit in encouraging children with ASD climbing the developmental “ladder”.

Methods

The participants are 15 children with ASD aged between 2 and 6 years-old. The follow-up occurs in two private DIR Floortime Model service centers in Brazil. Protocols: Functional Emotional Assessment Scale – FEAS and Functional Emotional Developmental Questionnaire – FEDQ. The participants were followed-up one on one every four months.

Results

At the first month of assessment the children showed lack of self regulation, social interaction and engagement with their parents in a symbolic, sensory and motor play setting. At the following evaluations, they showed increase of social interaction and engagement in the same play setting. Besides the high affect of the parents during the play time promoted a two way purpose communication and behavioral organization.

Conclusions

Children showed a good development of functional and emotional capacities during the study period, demonstrating the effectiveness of the DIR/Floortime model in the intervention.
Predictors of real-life functioning in subjects with schizophrenia: A 4-year follow-up study
Authors: Galderisi S. , Mucci A. , Gibertoni D. , Rossi A. , Rocca P. , Bertolino A. , Maj M.
Published: February 2022

In a cross-sectional study, the Italian Network for Research on Psychoses (INReP) found that variables relevant to the disease, personal resources and social context explain 53.8% of real-life functioning variance in a large sample of community dwelling people with schizophrenia. In a longitudinal study, the INReP aimed to identify baseline predictors of main domains of real-life functioning, i.e. work skills, interpersonal relationships and everyday life skills, at 4-year follow-up. We assessed psychopathology, social and non-social cognition, functional capacity, personal resources, and context-related factors, as well as real-life functioning as the main outcome. We used structural equation modeling (SEM) and latent change score (LCS) model to identify predictors of real-life functioning domains at follow-up and changes from baseline in the same domains. Six-hundred-eighteen subjects took part in the study. Neurocognition predicted everyday life and work skills; avolition predicted interpersonal relationships; positive symptoms work skills, and social cognition work skills and interpersonal functioning. Higher neurocognitive abilities predicted the improvement of everyday life and work skills, as well as of social cognition and functional capacity; better baseline social cognition predicted the improvement of work skills and interpersonal functioning, and better baseline everyday life skills predicted the improvement of work skills. Several variables which predict important aspects of functional outcome of people with schizophrenia are not routinely assessed and are not systematically targeted by intervention programs in community mental health services. A larger dissemination of practices such as cognitive training and personalized psychosocial interventions should be promoted in mental health care.

Disclosure

No significant relationships.
Modern system approach to the diagnosis, therapy and rehabilitation of mental disorders
Authors: Mitikhin V. , Solokhina T. , Tiumenkova G.
Published: February 2022

Introduction

The current stage of research on mental disorders is associated with the use of system approaches to the development of the scientific foundations of psychiatric care.

Objectives

Approach to solving problems that arise in the diagnosis of psychopathological conditions, assessing their severity, as well as evaluating the effectiveness of psychosocial treatment and rehabilitation.

Methods

Clinical, psychometric, system analysis methods and algorithms of the Analytical Hierarchy Process (AHP) [1] were used.

Results

When assessing a patient’s condition and behavior, it is necessary to make decisions (diagnosis, development of treatment and rehabilitation plans) based on heterogeneous information (genetic, neuronal and environmental, involving individual characteristics, as well as family and social context). This information is hierarchically organized and includes quantitative and qualitative data. Exposure at each of these different levels can affect the onset and course of the disease, and therefore should be considered in primary prevention and subsequent psychosocial therapy and rehabilitation of patients. Analysis of the problems of assessing psychopathological states and related psychosocial problems shows that these problems can be presented in the form of appropriate hierarchies, the structure of which must be taken into account when processing the initial information. The main advantages of the AHP include the use of the relationship scale (fundamental scale) for processing heterogeneous data based on expert, clinical information.

Conclusions

The approach provides correct integration of heterogeneous characteristics when considering diagnostic procedures, psychosocial therapy and rehabilitation.1. Mitikhin V.G., Solokhina T.A. S.S. Korsakov Journal of Neurology and Psychiatry, 2019, 2: 49-54. doi:10.17116/jnevro201911902149
Objective risk assessment using a driving computer game
Authors: Delgado-Gomez D. , Sujar A. , Ardoy-Cuadros J. , Moana S. , Peñuelas-Calvo I. , Aguado D. , Blasco-Fontecilla H.
Published: February 2022

Introduction

Accurate and objective risk assessment is important in the evaluation of many mental disorders and behaviours. For example, in the evaluation of suicidal behaviour or the assessment of accidents in ADHD. Video games could contribute to improve the assessment and increase engagement.

Objectives

Our hypothesis is that the proposed videogame can precisely evaluate risk. In addition, the developed game is able to indirectly assess the risk. This feature is useful in setups where patients are prone to lie.

Methods

We have developed a car driving video game where users are told that they should drive near to the border but not too much. We record distance to the border and each key pulsation every 0.1 seconds.

Results

It has been observed that the median of recorded distance positively correlated with the score obtained by Self-report of Risk-taking Behaviors (SRB). In addition, the interquartile range significant correlates with the global score obtained in this questionnaire.

Conclusions

The proposed videogame is able of performing an accurate risk assessment. Our game takes seven minutes and it does not need complicated nor expensive hardware and could be deployed online. Results obtained open up new possibilities of creating video games which make an objective assessment risk.
Eye-movements deficits in schizophrenia: A metanalysis of evidence
Authors: Orsoni M. , Col S. Dal , Ruscelli C. , Sant’Angelo R. , Benassi M.
Published: February 2022

Introduction

Although eye-movement disorders are one of the most replicated deficits in the psychiatric literature, the strong heterogeneity of results is still an unexplained issue that could be effectively addressed with a quantitative review of evidence.

Objectives

For this reason, a large-scale metanalytic study comprising more than 200 studies was conducted to analyse the presence of eye-movement deficits in schizophrenia patients, as compared to healthy controls.

Methods

To this aim, saccadic eye movements were grouped based on the type of task required (e.g., standard, predictive) and the quantification method used (e.g., number, duration, amplitude). For each sub-group separate meta-analysis were computed. Cohen’s d was used as measure of effect size. Risk of bias within and between studies and heterogeneity were also analysed.

Results

indicated low Cohen’s d with the exception of the number of correct antisaccades – where schizophrenia patients reportedless correct anti-saccadesthan healthy controls - and antisaccades error rate – where schizophrenia patients reported a higher number of errors than healthy controls.

Conclusions

Antisaccades emerged as better suited to differentiate between patients and healthy controls, thus making them the most promising candidate as a possible biomarker for schizophrenia.
Sexual disfunction in adolescents with antipsychotics. evaluation and suitability of the treatment
Authors: Sánchez S. Pérez , Herrero I. Martín , Fernández M.A. Cutillas , Güimil D. Raya , Portero A. Crespo
Published: February 2022

Introduction

Problems in sexual function associated with psychotropic drugs in adolescents with psychotic disorders are common in clinical practice. However, they are usually not taken into account in follow-up and are rarely reported by patients.

Objectives

1. To analyze if there is sexual dysfunction in adolencents with antipsychotic treatment. 2. To assess the degree of sexual dysfunction.

Methods

Descriptive study in psychiatric outpatient clinics involving 14 men (aged 16 to 19) with antipsychotic treatment. Record prospectively through interviews between 2 and 4 months from the start of treatment. Sexual function was evaluated with the questionnaire SALSEX Informed consent.

Results

Initially, no sexual dysfunction scores are obtained. At 4 months, records of sexual dysfunction were observed in 67% of the patients with less impact in those with aripiprazole as antipsychotic treatment, with a moderate intensity (mean score 8.2; SD 4.7). 33% of cases report the problem spontaneously. Breaking down the reasons for sexual dysfunction: 50% decrease in libido, 20% delay in ejaculation and 7% impotence. The global tolerance to sexual dysfunction was poor, 45% with ideas to abandon treatment.

Conclusions

In our experience, sexual dysfunction is one of the main causes that make young patients abandon treatment and even follow-up. For what we consider, it is very relevant to systematically evaluate and be able to quantify this vital aspect of our patients, which on many occasions is not addressed in the consultation. Likewise, it will be necessary in future studies to describe in detail the psychotropic drugs associated with sexual dysfunction for better management and dose adjustment.
Epilepsy and psychosis– where are we now?
Authors: Pereira I. , Nogueira V. , Teixeira J.
Published: February 2022

Introduction

Epilepsy has long been considered a risk factor for psychosis, and studies estimate that up to 80% of patients with epilepsy will experience a psychotic episode at some point in the course of their disease. However, data on the treatment of psychotic disorders in epilepsy is limited and the management of these problems is still founded on individual clinical experience.

Objectives

To assess evidence pertaining psychosis related to epilepsy, especially its risks factors and treatment approaches available.

Methods

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

Results

Recent literature shows a prevalence in psychotic disorders of 5.6%, and up to 7% in patients with epilepsy. So far, mechanisms of psychosis in epileptic patients remain unknown. Risk factors are earlier age of epilepsy onset, more frequent seizures, longer duration of epilepsy, high number of relatives with epilepsy and long-term antiepileptic drugs therapy. Psychiatric manifestations may include both positive and negative symptoms, including auditory hallucinations, paranoid delusions, and disorganized thought and/or behaviour. Poor adherence to treatment with oral antipsychotics occurs in more than 40% of patients; long-acting injectable medication should be considered, bearing in mind interactions with anti-epileptic medication and possibility of increased side effects.

Conclusions

Our findings emphasize the importance of early recognition and management of psychosis in epileptic patients. Unfortunately, there is lack of evidence for the use of antipsychotic medication in epileptic patients, since available studies pertain to populations with primary psychiatric disorders.