bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of benzodiazepines and related drugs and the risk of dementia: A review of reviews
Authors: Ferreira P. , Ferreira A.R. , Fernandes L.
Published: February 2022

Introduction

Benzodiazepines (BZDs) and related drugs (BZRDs) are widely used to reduce agitation, anxiety and sleep disturbances in the elderly, despite concerns raised about their modest efficacy for such indications and risk of severe adverse effects, including acute consequences on cognition. Recently, some studies have also raised concerns about the long-term effect of BZDs, suggesting their association with an increased risk of cognitive decline and dementia.

Objectives

To review published synthesis studies on the risk of dementia development due to BZDs/BZRDs use.

Methods

An electronic search was conducted in PubMed. Meta-analysis, systematic and non-systematic reviews examining the association between BZDs/BZRDs and subsequent dementia were included. No language nor publication date restrictions were applied. Search results other than synthesis studies were excluded. Studies were screened for relevance based on predefined inclusion and exclusion criteria.

Results

Overall, 246 results were obtained. After initial screening, nine studies were included. From these, three were systematic reviews with meta-analysis of observational studies (cohort and/or case-control), one was a systematic review from observational studies and five were non-systematic reviews. Most studies found an association between BZDs/BZRDs and subsequent dementia, with meta-analysis studies reporting an increased risk (OR) between 1,38 and 1,78, even after controlling for protopathic bias. However, difficulties in establishing a causal relationship are reported due to the considerable clinical and methodological heterogeneity of the primary studies.

Conclusions

Most studies suggest an association between the use of BZDs/BZRDs and dementia risk, highlighting that their prescription should be cautious, prevented or reduced to attenuate this risk.
The effects of the covid 19 pandemic on the elderly with depression
Authors: Rădulescu I.D. , Sarbu F. , Ciubară A.
Published: February 2022

Introduction

Depression, as a psychiatric entity, has a number of emotional components. These are mainly known among patients over the age of 65: sadness, physical and mental exhaustion, irritability, feeling of emptiness and loneliness.

Objectives

The main objective of this study is to detect if the effects of the Covid 19 pandemic over 65 years of age such as fear, excessive anxiety, lack of motivation, uncertainty and environmental changes, isolation (resulting in sleep disorders, appetite and attention) caused the exacerbation of depression.

Methods

This study included a total number of 126 patients, each over 65, hospitalized at the Psychiatric Hospital “Elisabeta Doamna” in Galati in the context of the COVID-19 pandemic. They were diagnosed with depression, according to ICD-10 and the Hamilton scale.

Results

All data obtained were centralized and used to detect whether, in Galați, the lockdown impacted the number of admissions of people over 65, diagnosed with depression, with an average age of 68,62. There is an increased incidence of female patients (75%), thus reporting an odds ratio of 3:1. The incidence of cases reported during the months of presentation is as follows: January (24%), February (28.8%), March (14.4%), April (3.2%), May (5.6%), June (23.2%).

Conclusions

Environmental factors, unique in this situation, isolation, social distancing and changes in the daily routine, each associated with this global epidemiological crisis determinated a decrease of the number of depressive elderly admissions between March 15th and May 15th.
Antipsychotics use in dementia: How safe are they?
Authors: Lopes C.
Published: February 2022

Introduction

Antipsychotics are frequently used for managing psychiatric and behavioral symptoms of dementia. However, it’s an off-label resource which remains controversial due to significant safety concerns in the elderly population, namely increasing cardiovascular adverse effects.

Objectives

To access antipsychotic safety and potential risks when used in dementia.

Methods

A non-systematic review was carefully conducted on PubMed using the following keywords: “dementia”, “antipsychotics” and “safety.” We selected clinical trials, meta-analysis, randomized controlled trials published in the last 10 years.

Results

A total of 43 articles was obtained, of which 22 were excluded because they didn’t meet our inclusion criteria. Regarding atypical antipsychotics, one study found an incidence of severe events in 23,7% of patients and a OR=2.5 for cerebrovascular side effects. Quetiapine was suspended midway given it had a higher incidence of adverse effects compared to others. There weren’t any significant statistic differences concerning serious events between classes of antipsychotics(p<0,01). No study was found comparing typical and atypical antipsychotics safety in dementia.

Conclusions

Overall, we can conclude that antipsychotics pose a risk of serious adverse effects when used in elderly patients, namely cerebrovascular events. Among atypical antipsychotics, quetiapine, used frequently for controlling neuropsychiatric symptoms in these patients appears a higher risk for severe adverse events compared with other drugs. Their use should be restricted after there aren’t any other options available. New protocols could be developed to control these symptoms, for example, environmental measures before resorting to antipsychotics.
Use of methylphenidate in alzheimer’s dementia: Effect on apathy
Authors: Borralho R. , Oliveira C.
Published: February 2022

Introduction

Alzheimer’s Disease (AD) is associated with neuropsychiatric symptoms such as agitation depression and apathy. It has been proposed that the pathophysiology of apathy, that is defined as quantitative reduction in goal-directed activity compared with previous functioning, in AD is associated with degeneration of prefrontal cortex and dysfunction of dopamine and norepinephrine neurons in the brain. Methylphenidate (MPH) is a dopamine and norepinephrine reuptake inhibitor and its action increase the availability of these neurotransmitters in the extracellular space of striatum and prefrontal cortex. Over the past decade there has been an effort to study the benefit of the use of MPH for treatment of apathy in patients with Alzheimer’s dementia.

Objectives

Study the benefit of methylphenidate in the treatment of apathy in AD.

Methods

Basic literature review collecting data from PubMed (2010-2020) using the words “Methylphenidate”, “Apathy”, “Alzheimer”, “Dementia”.

Results

Clinical trials using 10 to 20mg of MPH per day, for 6 weeks, demonstrated a mitigation in apathy symptoms in one third of patients, with good tolerability. Another clinical trial using the same dosage, for 12 weeks, led to improvement in cognition, functional status, depression and caregiver burden.

Conclusions

New clinical trials with larger groups of patients over a longer period are needed to consolidate the existing results. Although there are still many questions concerning the usefulness of methylphenidate in this population that need to be answered, methylphenidate might be an option to deal with one of the most prevalent neuropsychiatric symptoms, apathy, in some AD patients.
A preliminary study of stroke patients and attention: Exploring the role of spirituality and religiousness on cognition
Authors: Giannouli V. , Giannoulis K.
Published: February 2022

Introduction

Spirituality and religiousness are not so far extensively investigated in patients after stroke.

Objectives

The aim of this preliminary study is to explore whether self-reports in two questionnaires measuring the personal experience of spirituality and religiousness can influence cognition and more specifically performance on neuropsychological tests examining attention.

Methods

Fifteen male stroke patients participated voluntarily one year after their hospitalization. The mean age of the patients was 75.58 years (SD = 7.50, range 61-90), level of education 15.47 years (SD = 3.82). In addition to that, fifteen controls with similar demographics, free of physical and mental diseases, were also examined. Depressive symptoms of the participants were assessed with the 15-item Geriatric Depression Scale. The Daily Spiritual Experience Scale, the Systems of Belief Inventory (SBI-15R) and a number of standardized tests examining attention were administered: Trail Making Test-Part A (TMT-A) time to completion, the Digit Span (WAIS-III) greatest forward span, the Ruff 2 & 7 Selective Attention Test automatic detection speed (ADS) and controlled search speed (CSS).

Results

indicated that there was a statistically significant difference between the control group and the stroke group in attention. No statistically significant difference was found between the two groups regarding the levels of spirituality and religiousness.

Conclusions

Although spirituality and religiousness may be related with quality of life, cognitive functioning such as attention does not seem to be influenced by these variables one year post-stroke. Future research should further investigate the possible influence of the abovementioned factors in post-stroke recovery and rehabilitation.
Pad, psychiatry and stigma
Authors: Kowalinski E. , Huber C.
Published: February 2022

In 2018, the Swiss Academy of Medical Sciences (SAMW) published a new guideline on physician-assisted dying (PAD). In line with the SAMW guideline published in 2004, the patients’ ability to judge, their self-determination, careful consideration and permanence of their wish to die as well as the lack of therapeutic options were set as necessary conditions. However, while the previous wording considered assisted suicide to be ethically justifiable if the patient’s condition is terminal, the new guideline requires that it is unbearable. This difference has been the subject of intense discussion in Swiss healthcare professionals and the population alike. This controversy is particularly important for those affected by mental illness who have a persistent desire to die. This is because mental disorders cannot usually be classified as terminal illnesses, but they can certainly lead to suffering that is perceived as unbearable. Furthermore, it is known that persons with mental illness are subject to stigmatization. It is therefore likely that there is a connection between the stigmatization of mentally ill people and the position on PAD for this group. This talk provides theoretical background on this discusion and proposes a study protocol to investigate the acceptance of PAD in relation to the type of illness as well as the factors of unbearable suffering and terminality. It will furthermore look into the criteria of the 2004 and 2018 guidelines and will explore if there is a connection between stigmatization and the assessment of whether a person should be granted access to assisted suicide.

Disclosure

No significant relationships.
The use of artificial intelligence and machine learning in the care of people with dementia: A literature review
Authors: Belam G. , Nilforooshan R.
Published: February 2022

Introduction

Artificial intelligence and machine learning are increasingly being researched within the field of psychiatry to find out what use it might be. With this review, therefore, we would like to assess what literature, if any, exists that answers the question of whether this technology can be useful for providing dementia care. We also wanted to consider the ethical questions of autonomy, consent and privacy when working with this vulnerable group of patients.

Objectives

To identify and appriase the literature to assess the existing research landscape of the area of machine learning and AI, relating to the care of people with dementia.

Methods

A literature search was conducted, searching the PsychInfo, Medline, PubMed and Embase databases. We assessed the quality of the research and considered what overall findings there were in the existing literature.

Results

619 papers were identified, of which 28 related to the use of AI in the care of people with dementia. The papers were divided into categories to show the utility and effectiveness these technologies may have: 1: to alert caregivers to problems 2: to facilitate activities for people with dementia 3: to help plan care for people with dementia 4: to consider the ethical implications of the use of artificial intelligence and machine learning

Conclusions

Despite a paucity of literature in the area, existing studies show potential, if used well, for technologies to be a useful addition to care of people with dementia. The experience of patients and their carers must be integral to their development and use.
Pad in forensic psychiatry
Authors: Franke I.
Published: February 2022

Introduction

A recent court decision in Germany defined assisted suicide as a basic human right. Consequently, the discussion regarding PAD needs to be extended to people who are in forensic/secure psychiatric hospitals or prisons, sometimes without any prospects of release. Several studies have shown that long-term hospitalization and detention are associated with feelings of hopelessness, depression and suicidal ideations. Moreover, the resources for adequate therapy are often rare. This results in complex moral challenges for mental health care.

Objectives

To review current practices in countries that allow PAD and to discuss ethical conflicts.

Methods

Literature review; international comparison of current regulations.

Results

A majority of the literature on PAD in detention refers to prisoners with terminal medical conditions. Single case reports of PAD-requests of mentally disordered offenders aroused great public interest. The resulting ethical conflicts are similar to those issues regarding PAD and mental disorder in general. However, in secure treatment settings and detention additional aspects such as adverse living conditions and inadequate access to mental health care need to be taken into account.

Conclusions

If unbearable pain is not a precondition for assisted suicide, then mentally disordered and healthy offenders have a right to request PAD, provided they have medical decision-making capacity. Considering the common insufficient mental health care for people in detention, policy and law makers need to ensure that access to PAD will not replace therapy. Professionals involved in PAD evaluations need support by specific guidelines.

Disclosure

No significant relationships.
Burnout and predisposing factors in medical oncology in tunisia
Authors: Daldoul A. , Khechin W. , Krir W. , Ezzairi F. , Kefi H. , Zaied S. , Ahmed S. Ben
Published: February 2022

Introduction

Health care professionals are particularly concerned with burnout

Objectives

This study aimed to evaluate the the factors predisposing to occupational burnout

Methods

This was a cross sectional study including health care professionals in medical oncology working in public hospitals in Tunisia. It was carried out from 15 January 2019 to 15 June 2019. Health profeessionals were asked to answer the Maslach –Burnout Inventory Test.

Results

The mean age was 34 ± 6.7 years [23 - 57]. The sex ratio was 0.22. Our study population included 37 doctors (53%) and 33 nurses (47%). The inappropriate working conditions mentioned by the participants were as follows: The requirementss of patients and their families (91.5%), the lack of resources (87%), overwork found (83%), unsatisfactory effort- salary ratio (83%) and the reduced number of staff (77%). Several Burn-out factors mentioned by the participants were significantly associated with a high emotional exhaustion syndrome: overwork, poor service organization, lack of resources, lack of time, lack of recognition, conflicts with colleagues, lack of communication, unsatisfactory salary - effort ratio, assaults by patients. Several factors were positively and significantly associated with a high depersonalization score: overwork, poor service organization, small number of staff, lack of resources, lack of respect, lack of recognition. The global burnout associating the achievement of the three dimensions was significantly associated with overwork, lack of recognition, conflicts with colleagues and assault by patients.

Conclusions

Burnout has become a major issue in Tunisian medicine. If left untreated, burnout epidemic may continue to worsen, to the detriment of patients and doctors
Maternal cancer and autism spectrum disorder: Analytical cross-sectional study
Authors: Daldoul A. , Moussa R. Ben , Krir W. , Bouslah S. , Kefi H. , Zaied S. , Gaddour N.
Published: February 2022

Introduction

Autism spectrum disorder (ASD) and cancer are two pathologies that appear to be different, but whose multifactorial determinism involves shared genetic and environmental factors.

Objectives

This study aimed to find an association between maternal cancer and ASD in children by comparing the frequencies of ASD between children of mothers followed for cancer and children of mothers free from cancer

Methods

We recruited, between March and August 2018, women divided into 2 groups: G1; women followed for cancer at the oncology consultation of Monastir and Sousse (N1 = 100) and G2; women free from cancer (N2 = 101). We screened their offspring aged 18 months to 11 years for ASD using the C-AQ and the M-CHAT. We confirmed the diagnosis of ASD using ADI-R in children who tested positive.

Results

Nous avons examiné un total de 332 enfants. La fréquence des enfants atteints de TSA chez les mères G1 était de 5,4%, celle des enfants de mères G2 était de 1,2 avec une association significative entre cancer maternel et TSA (p = 0,035), qui est restée significative après analyse multivariée. (p = 0,001) D’autres facteurs que nous avons trouvés associés aux TSA dans notre population sont la présence d’une expérience stressante pendant la grossesse; exposition précoce avant l’âge de 2 ans à la télévision> 2 heures par jour; antécédents psychiatriques de la mère, du père et de la fratrie et dépression post-partum.

Conclusions

Le cancer maternel et les TSA semblent partager des mécanismes étiopathogènes communs
Ethics of pad in mental disorders
Authors: Trachsel M. , Jox R.
Published: February 2022

Involuntary psychiatric hospitalization for suicide prevention and physician assistance in dying (PAD) for patients with severe and persistent mental illness (SPMI) combine to create a moral tension. Switzerland has the longest history of non-medicalized assistance in dying, considered as a civil right even beyond pathological situations. The debate in Switzerland centers on the notion of suffering in the context of PAD. In 2018, the Swiss Academy of Medical Sciences revised their end-of-life policy stipulating intolerable suffering due to severe illness or functional limitations and acknowledged as such by the physician as a core criterion for PAD. However, we argue that suffering is a necessary but insufficient condition for PAD, the other criteria being decision-making capacity (DMC) and refractoriness of the suffering. Moreover, we hold that suffering is a subjective experience that can only be quantified by the patient and cannot be compared between two persons in an objective way. According to this concept, however, some patients with SPMI, refractory suffering, and preserved DMC will meet the criteria for PAD. Therefore, we call for palliative care approaches in psychiatry which includes relief of suffering as much as possible, but also accepting PAD after a conscientious assessment of the criteria.

Disclosure

No significant relationships.
Current pharmacological treatment of fibromyalgia- a literature review
Authors: Vasiliu O.
Published: February 2022

Introduction

Fibromyalgia is a chronic condition, with a high degree of psychiatric comorbidity and an insufficiently explained pathogenesis. Therefore, its therapeutic management is challenging, with both pharmacological and non-pharmacological approaches being suggested as treatment options.

Objectives

To analyze the current level of evidence in favour of pharmacological treatment for fibromyalgia.

Methods

A literature review was performed through the main medical databases using the search paradigm “fibromyalgia” AND “pharmacological therapy” OR “antidepressants” OR “moodstabilizers” OR “anxiolytics”. All papers published between January 2000 and August 2020 were included in the primary analysis.

Results

A gradually increasing interest for the treatment of fibromyalgia has been observed in the last decade, and the number of clinical trials for this indications has almost doubled in this period, when compared to the previous decade. Pregabalin, duloxetine, and milnacipran are the most supported by evidence pharmacological treatments for fibromyalgia, especially for the pain component. Amitriptyline, gabapentin, cyclobenzaprine, and tramadol have also been studied in various clinical trials, but tehre are less evidence to support their use. Cognitive dysfunctions, sleep disorders, and mood disturbances benefit from far less investigation in clinical trials, therefore no clear recommendation can be made regarding the superiority of an agent over another.

Conclusions

The pain component of fibromyalgia benefits from treatment with pregabalin, duloxetine, and milnacipran, while the affective component and the cognitive dimension still need more research from the psychopharmacological perspective.
Therapeutic approaches in chronic fatigue syndrome
Authors: Vasiliu O.
Published: February 2022

Introduction

Chronic fatigue syndrome (CFS) is a complex condition, with an insufficiently known pathophysiology, that raises multiple challenges to the treating physicians. Due to its yet mostly unknown underlying mechanisms, there is no consensus treatment recommendation for CFS. The risk to associate major depression, anxiety disorders or substance use disorders is frequently reported, and this co-morbidity further complicates the evolution of CFS.

Objectives

To search the existing literature for pharmacological and psychotherapeutic recommendations in CFS.

Methods

A literature search was performed using the main electronic databases using the paradigm „chronic fatigue syndrome” AND „psychopharmacological treatment” OR „psychotherapy”. All papers published between January 2000 and August 2020 were included in the primary analysis.

Results

Anti-inflamatory drugs (corticosteroids and non-steroidal drugs), antidepressants, moodstabilizers, anxiolytics, immuno-modulatory drugs, and antivirals have been investigated for CFS, but the trials had low-quality designs, used various definition of CFS, and different criteria for monitoring the efficacy of treatment. Cognitive behavioral therapy (CBT) may be promising for decreasing the fatigue severity, but larger trials are needed. Graded exercise therapy (GET) also may be of some use for improving patients ability to engage in activities, but caution should be in order because of the risk of over-exercising that may exacerbate the core CFS symptoms.

Conclusions

Larger trials are needed in order to validate pharmacological and psychotherapeutic recommendations for CFS. No drug may be considered first line treatment for this indication, while CBT and GET may be useful, although they do not address all the central symptoms of CFS.
Can interoceptive attentiveness modulate the brain correlates of observation of pain in others? A fnirs study
Authors: Angioletti L. , Balconi M.
Published: February 2022

Introduction

Empathizing with others’ pain appears to recruit the whole pain matrix, including a collection of frontal regions involved in the affective, motivational, cognitive, and attentional dimension of pain.

Objectives

This research explored how the modulation of interoceptive attentiveness (IA) can influence the frontal (dorsolateral prefrontal cortex -DLPFC- and somatosensory cortices) activity related to the emotional regulation and sensory response of observing pain in others.

Methods

22 healthy participants were required to observe face versus hand, painful/non-painful stimuli in an individual versus social condition while brain hemodynamic response (oxygenated [O2Hb] and deoxygenated hemoglobin [HHb] components) was measured by functional Near-Infrared Spectroscopy (fNIRS). The sample was divided into experimental (EXP) and control (CNT) groups and the EXP group was explicitly required to focus on its interoceptive correlates while observing the stimuli.

Results

In the individual condition, higher brain responsiveness was detected for painful confronted to non-painful stimuli, and a left/right hemispheric lateralization was found for the individual and social condition, respectively. Besides, both groups showed higher DLPFC activation for face stimuli displayed in the individual condition compared to hand stimuli in the social condition. However, face stimuli activation prevailed for the EXP group, suggesting the direct interoceptive phenomenon has certain features, namely it manifests itself in the individual condition and for pain stimuli.

Conclusions

We can conclude that IA modulation promoted the recruitment of internal adaptive regulatory strategies engaging both DLPFC and somatosensory regions towards emotionally relevant stimuli (painful faces displayed in the individual condition). Therefore IA could be trained for promoting emotion regulation and empathic response.
Pilot study testing the emotional response to physical exercise following a negative emotional induction in adults with borderline personality disorder
Authors: St-Amour S. , Cailhol L. , Bernard P.
Published: February 2022

Introduction

Physical exercise is a well-documented treatment for individuals with mental disorder. It helps improve symptoms and functioning of these individuals. Moreover, recent studies indicated that exercise improve emotional regulation which is one of the main target in borderline personality disorder (BPD) treatment. Therefore, exercise might have important benefits in this population. However, no previous study examined this effect.

Objectives

This pilot study documents the facceptability of a protocol testing the effects of exercise on the response to a negative emotion in adults with BPD.

Methods

28 adults with a diagnosis of BPD have been recruited in a psychiatric hospital. Participants filled several questionnaires then viewed a scene from Silence of the Lambs to induce negative emotions. They were then assigned to 20 minutes of exercise or a neutral video of 20 minutes. Affects were assessed 7 times during the protocol.

Results

In this sample, 9 participants reported at least equal levels of affect after the induction than before. Preliminary results show a tendency of higher response of physical exercise than control on positive affects and no participant had any adverse effect from exercise.

Conclusions

This pilot study was the first to test the effects of exercise on symptoms of BPD. It also informs on the best way to conduct the principal study. First, the mood induction was poor, thus it will be changed for a stronger induction strategy. Then, the control intervention will be a placebo exercise. These modifications will enable a better understanding of the effects of exercise on emotion regulation with BPD population.
Pharmacotherapy for borderline personality disorder: A review
Authors: Lietor M.D.C. Molina , Cuevas I. , Prieto M. Blanco
Published: February 2022

Introduction

Borderline personality disorder (BPD) is characterized by instability of interpersonal relationships, self-image, and emotions, and by impulsivity. Although patients with BPD are misdiagnosed, some of them receive mental health treatment. Even if the first-line treatment of this disorder is psycotherapy, the patients with BPD may be highly symptomatic and are often prescribed multiple medications in a manner unsupported by evidence.

Objectives

The aim of this study is to study the available evidence about the pharmacotherapy for borderline personality disorder.

Methods

A review of the available literature about the management of borderline personality disorder and de pharmacotherapy for personality disorders was performed.

Results

First-line treatment of the personality disorders is psycotherapy. The treatment plan for BPD may include individual and group therapy, medication, self-education, specialized substance use disorder treatment, partial hospitalization, or brief hospitalization during times of crises. Medications are generaly used only as adjuncts to psychotherapy and the adjunctive use of symptom targeted medications has been found to be useful. There is limited information to guide pharmacotherapy; preliminary evidence limits the practice of polypharmacy. Sympton-domain focused medication treatment is recommeded by some guidelines: cognitive-perceptual symtoms (low-dose antipsychotic drugs), impulsive-behavioral dyscontrol (mood stabilizers), affective dysregulation (mood stabilizers and low-dose antipsychotic drugs) and self-harm (omega-3 fatty acids).

Conclusions

BPD cause significant distress and impariment of social, occupational and role functioning. The first-line treatment for BPD is psychotherapy; however symptom-focused, medication treatment of BPD is generally considered to be an adjunct to psychotherapy. The data support the efficacy of low dose antipsychotic drugs and mood stabilizers.
What lies underneath: The genetics and neurobiology of psychopathy
Authors: Lemos M. , Queirós T.
Published: February 2022

Introduction

Psychopathy is a personality disorder characterized by lack of empathy, grandiosity, an impulsive lifestyle and antisociality. Anti-social personality disorder (ASPD) and psychopathy are distinct concepts presenting different criteria. Most people with a diagnosis of psychopathy also meet criteria for ASPD while the reverse is not true. Along the years there has been an increasing interest in investigating genetic and neurobiological factors.

Objectives

To analyze the neurobiological factors involved in psychopathy and anti-social personality disorder according to the scientific knowledge available.

Methods

Review of scientific literature via PubMed search, using the terms “anti-social personality disorder”, “biology or etiology or pathophysiology and psychopathy”.

Results

The strongest evidence base for a genetic pathway is associated with the low-expression variant of the Monoamine Oxidase-A (MAO-A) which is linked to the X chromosome. Other genetic factors involve the 5-HTT gene, dopamine receptor genes (DRD4 and DRD2) and genetic polimorfisms at SNAP25 t-snare protein, OXT gene and the CNR1 and FAAH cannabinoid receptor gene. Structural differences in the brain have been noticed such as reduced gray matter volume in the orbitofrontal cortex, gray matter volume reductions in the mid-anterior insula and left anterior temporal cortex, subtle reductions in gray matter volume across several paralimbic and limbic areas.

Conclusions

There is considerable evidence regarding various possible underlying neurobiological processes in psychopathy although it is insufficient to suggest a single biological etiology and environmental influences cannot be excluded from a complete understanding of this disorder. The neurobiological correlates found hold promise for new research and treatment.
Indirect self-presentation of people with machiavellianism accentuation
Authors: Folomeeva T. , Fedotova S. , Beloglazov I.
Published: February 2022

Introduction

Personal traits influence persons’ perception of the social environment. Therefore analyzing stories with the non-specific plot can enable to distinguish particular characteristics.

Objectives

The aim is to determine the features of verbal self-presentation of people with high and low scores on the Machiavellian scale.

Methods

1. For the selection of particular participants, who have high and low scores, the questionnaire «Dark triad» of Egorova was used. 2. For collection stories of respondents, a series of interviews was carried out with extra stimulus. There were 20 conversations. Age was from 19 to 29 (m = 23; sd = 7,1).

Results

The opportunity to predict personal traits in general stories was proved. There is a confrontation between the person and the world in the speech of the Machiavellians. Their stories usually have a strong hero, other characters are ignored by the main person. Machiavellians want a safe and calm place that allows them to be themselves. We assume that this is a consequence of the fact that they have to dissemble in society. This statement requires further verification Non-Machiavellians are concerned by the opinion of society, that affects their life and behavior. They act for the well-being of the world while their own feelings are being ignored. There is a feeling of guilty in non-Machiavellians’ tales which is connected with failures around them.

Conclusions

The study was piloted interviewing method (with stimulus material) for the study of indirect verbal self-presentation. Differences were found between the people’s self-presentation with an accentuation of Machiavellianism and non-Machiavellianism.
Just try it: A six months protocol for borderline personality disorder impulsivity and symptoms reduction
Authors: Martin S.
Published: February 2022

Introduction

Borderline Personality Disorder is defined from its impulsivity issues regarding relationships, abandonment and rejection issues and emotional regulation problems. This personality disorder issue are hard to treat and often related to poor treatment outcomes. Nonetheless, Dialectical Behavioral Therapy stands as a great therapeutical approach that can be adapted.

Objectives

We tested a 6-month CBT protocol (ECCCLORE)-3 modules respectively working on emotion regulation, distress tolerance and relationships- in a French context to compare its effectiveness to treatment as Usual (TAU).

Methods

We recruited 56 patients suffering from BPD, 34 receiving ECCCLORE treatment and 22 receiving TAU. We assessed BPD traits, impulsivity with UPPS, aggressiveness with AQ12, Suicidal risk with SBQr and Hopelessness with H.

Results

Our results revealed the effectiveness of this 6 months DBT adaptation for decreasing BPD traits and most of clinical dimensions. The dynamic analysis revealed the mediating effect of AQ12.

Conclusions

Shortened treatment protocol are effective for reducing symptoms. Further research is needed to replicate these results.
Ptsd among a sample of french students: A misdiagnosed condition with many implications. preliminary results
Authors: Païs G. , Romo L. , Tarade E. , Vigne S. , Cassé L. , Chaudoye G. , Sweerts S. Julien , Zebdi R. , Fouques D.
Published: February 2022

Introduction

Students often suffer from stress, anxiety and depression (Saleh et al., 2019). However, research on PTSD is scarce among this population.

Objectives

We therefore wanted to explore the presence of PTSD and other psychopathological and psychological variables in this population.

Methods

We recruited 70 students -150 still planned- (22 years old, 70% women, 84.3% in the third year undergraduate) who filled out questionnaires at the university, after ethic committee’s approval.

Results

31.2% show PCL-5 scores in favor of a PTSD. The most frequently mentioned traumatic events (direct exposure) are physical assaults (49.3%), transport accidents (29.4%) and unwanted sexual experiences (23.2%). According to the Mann-Withney U test, if they do not differ from students without PTSD in the number of traumatic events encountered (LEC 5 ns), they show more stress, anxiety and depression (p <.02), more dissociative symptoms (p <.04), less social support available (p = .048), a gap between the importance given to studies as a value and action directed towards this value (p = .002), idem for leisure activities (p =.035), and more rumination (p <.001) and more experiential avoidance (p <. 001). These two latter appear to be powerful processes involved in PTSD, as the PCL5 score is 37% explained by avoidance and rumination, according to linear regression.

Conclusions

These preliminary results tend to show that PTSD should be investigated in students and seems to be linked to higher emotional difficulties, lower academic and social involvement. Rumination and avoidance could be an important therapeutic target.
Post-traumatic stress disorder and professional quality of life among psychiatric staff
Authors: Yaich K. , Omri S. , Smaoui N. , Feki R. , Bouali M. Maalej , Thabet J. Ben , Zouari L. , Charfi N. , Maalej M.
Published: February 2022

Introduction

Psychiatric staff could be exposed to various types of violence that might have potential consequences on their psychological balance.

Objectives

To detect post-traumatic stress disorder (PTSD). To assess the professional quality of life among psychiatric hospital workers.

Methods

A descriptive cross-sectional study was conducted in the psychiatric department of the Hedi Chaker University Hospital in Sfax. The questionnaire study had three major components: the baseline participant characteristics,the post-traumatic stress disorder Checklist (PCL-5) for which a total symptom severity score cutoff of 38 was recommended as the cutoff for a positive screening test and the Professional Quality of Life Scale (ProQOL).

Results

Thirty-one participants completed the questionnaire. The sex-ratio was 0.93. The mean age was 41.5 years. All participants were exposed to physical or verbal assault. Physical aggression was the most traumatic behavior reported by 39.3% of psychiatric professionals. A feeling of insecurity when performing professional tasks was reported by 93.3% of participants. Among participants, 41.9% expressed the desire to change workplace. The mean score on the PCL-5 was 21.6 ± 15.35. Five participants (16.7%) had a PCL-5 score ≥ 38. The Compassion Satisfaction mean score was 37.48 ± 5.64. The burnout mean score was 26.41 ± 7.3 and the mean score at the secondary traumatic stress scale was 27 ±6.7.

Conclusions

PTSD could result from stressful events encountered in the course of managing patients in mental health departments. Attention to post-traumatic event interventions may be useful both to reduce the rate of PTSD and to improve the professional quality of life among psychiatric staff.
Factors associated with post-traumatic stress disorder in family caregivers of psychotic patients
Authors: Daoud M. , Charfi N. , Omri S. , Feki R. , Smaoui N. , Bouali M. Maalej , Zouari L. , Thabet J. Ben , Maalej M.
Published: February 2022

Introduction

An association can be found between patient with psychosis and perpetrating acts of violence. So, the caregiving role can impact negatively on psychosis carer psychological health and wellbeing.

Objectives

The aim of this study was to identify the factors associated with post-traumatic stress disorder (PTSD) in family caregivers of psychotic patients following exposure to aggression.

Methods

This cross-sectional study was carried out involving 95 family caregivers of psychotic patients followed in psychiatry. Data were gathered from caregivers about their experiences in providing care. Sociodemographic and clinical data of patients were collected from medical records.We used the perceptions of prevalence of aggression scale (POPAS) to measure the frequency and severity of aggression directed at the respondent in the past and the Impact of Event Scale-Revised (IES-R) to evaluate PTSD.

Results

The caregivers were male in 51.6% and with low educational level in 46.3% of cases. A rate of 75.8% of caregivers reported experiencing moderate to severe levels of aggression. More than a half of caregivers (54.7%) reported potentially significant levels of PTSD. Decreased contact with patient (p=0.01), male gender (p=0.00), older age (p=0.00), living far from patient (p=0.00), parent relationship of caregivers (p=0.00), diagnosis of schizophrenia or schizoaffective disorder (p=0.00) and poor adherence to treatment (p=0.00) in affected relatives were associated with the presence of PTSD following exposure to moderate to severe aggression.

Conclusions

These findings highlight the need for interventions to promote family psychoeducation and to provide psychosocial support for caregivers of patients in order to prevent the traumatic impact of violence on them.
Prevalence of post traumatic stress disorder in children with mild traumatic brain injury
Authors: Kallianezos P. , Bakola M. , Kitsou K.S. , Petropoulos C. , Sinopidis X. , Gourzis P. , Jelastopulu E.
Published: February 2022

Introduction

Children with traumatic brain injury (TBI) are at risk for post-traumatic stress disorder (PTSD). The vast majority of TBI are of mild severity (MTBI), however, they may develop persistent neurophysiological symptoms.

Objectives

The purpose of this study was to investigate the incidence of PTSD in children with MTBI in Western Greece.

Methods

A one-year prospective study was conducted at the Children Hospital of Patras. A total of 175 children aged 6-14 years screened for risk of PTSD at one-week and one-month post-injury, completing the Child Trauma Screening Questionnaire (CTSQ). The Children’s Revised Impact of Event Scale (CRIES 13) was administered to the parents, to inquire their assessment of PTSD in the children. Statistical analysis was performed with IBM SPSS v.22.0

Results

There were 59 (33.7%) children (27.2% boys, 45.9% girls) whose screen result was at risk. At the rescreening one-month postinjury, 9.9% were still at risk. Parents assessed presence of PTSD in 19% of their children at one-week and in 3.9% at one-month post-injury. There was a positive correlation between parenting and child reporting on symptoms of PTSD in children. However, 23.4% mistakenly estimated their children did not experience stress while in fact they did and 24.2% mistakenly estimated the contrary.

Conclusions

The findings revealed the risk of PTSD even in mild TBI, justifying thus the screening to identify these children for intervention strategies. On the other hand, the rescreening demonstrated that not all at-risk children required intervention, since a natural remission in PTSD symptoms was observed one-month post-injury.
Post-traumatic stress disorder and stroke in the elderly
Authors: Chakroun M. , Ouali R. , Zribi O. , Turki M. , Aribi L. , Aloulou J.
Published: February 2022

Introduction

Posttraumatic stress disorder (PTSD) is common in survivors of acute life-threatening illness, but little is known about the burden of PTSD in survivors of stroke attack.

Objectives

This study estimated the prevalence of PTSD in post-stroke in the elderly and to look for the factors which are correlated with it.

Methods

Participants were outpatients of Psychiatry B department in Hedi chaker University Hospital Center in Tunisia, over the age of 65, hospitalized in psychiatry for a major depressive episode, recruted between 2000 and 2015. The data was collected using a pre-established sheet containing socio-demographic information, the clinical and evolutionary characteristics of the depressive episode and the therapeutic data concerning the depressive episode.

Results

30 patients were included in this study with an average age (69 Y) and sex ratio (0.66). More than half (53.3%, 16 patients) had a history of chronic somatic disease. The average length of hospitalization was 26 days. The most frequent reason for hospitalization is sadness of mood (43.3%) with cognitive impairment as the predominant clinical symptomatology (40%). 93.3% of the population received as treatment an antidepressant mainly Fluoxetine (50%).

Conclusions

clinicians should be mindful that PTSD can be a devastating mental health condition and should consider screening for PTSD in stroke survivors.
Spousal abuse and psychological repercussions
Authors: Kolsi S. , Hentati S. , Baati I. , Masmoudi J.
Published: February 2022

Introduction

Spousal abuse (SA) against women, by its frequency and its consequences on the health of the victims, is a public health issue. For this reason, the role of the physician is essential not only in the care of victims but also in the screening of psychological repercussions.

Objectives

To study the risk factors associated with the development of post-traumatic stress disorder(PTSD) in women victims of spousal abuse(SA).

Methods

Descriptive and analytical cross-sectional study conducted at the National Health Fund of Sfax(CNSS)on 110 women who consulted during the months of October and November2019.The sociodemographic and clinical characteristics of the consultants were collected using a pre established form.We used a 10-item scale,the “Women’s Experience with Battering Scale” (WEBS),to screen women for SA.PTSD was assessed using a PCLS scale(17 items).

Results

(SA)was estimated at 57.3% in our population.The average WEBS score among abused women was 30.92.The prevalence of PTSD in abused women was 63.5% and the average PCLS score was 48.8.The somatic(p=0.049)and psychiatric(p=0.005)histories in the women who had experienced(SA) were related to the development of PTSD.The PCLS score was significantly associated with the WEBS score(p<.0001 and r=.76).The type of violence experienced (physical, psychological, sexual and material) was correlated with the development of PTSD;(p were respectively: <.0001; <.001; 0.02; <.0001).Similarly, repeated violence was strongly related to it(p<0.001).

Conclusions

It seems clear that the(SA)experienced by the women had a psychological impact through the development of PTSD.In addition,several other risk factors inherent to women can be incriminated in this disorder for which systematic screening remains a necessity in order to allow an apdate care.

Conflict of interest

No significant relationships.
A new player in the field: Methylphenidate in post-traumatic stress disorder treatment
Authors: López-Escribano R. , Alvarez M.-J. , Muñoz-Padrós J. , Gutierrez A. Marzán
Published: February 2022

Introduction

Currently available psychotherapies and psychotropic drugs for post-traumatic stress disorder (PTSD) are poorly effective in a substantial proportion of patients. Dopaminergic dysfunction plays a prominent role in the pathophysiology of PTSD: intrusions, avoidance symptoms, anhedonia and emotional numbing. Dopamine reuptake inhibitors can be studied as novel drugs in PTSD treatment.

Objectives

Explore methylphenidate as a promising drug in PTSD treatment.

Methods

Case report presentation based on the review of clinical notes and non-systematic review of the PTSD therapeutics state-of-the-art.

Results

A 72-year-old Portuguese male, a veteran of the Angolan War, sought medical attention four years ago after the death of his brother, which had happened three years before the consultation. The clinical picture consisted of re-experiencing the war and the loss of his brother, flash-backs, nightmares, irritability, a fear of losing control, inner dialogues with occasional intra-psychic voices, emotional numbing with the impossibility of developing loving relationships with his relatives, feelings of unreality, an episode of dissociative fugue and complaints of episodic forgetfulness and time warp. He was diagnosed with PTSD with dissociative symptoms, based on DSM 5 clinical criteria. He was initially treated with SNRIs and risperidone, with little improvement. A year ago, he suffered a flare-up, with suicidal ideation. He was prescribed methylphenidate 36 mg, with progressive improvement, persisting mild PTSD residual symptoms.

Conclusions

There is enough evidence of the dopamine involvement in PTSD, although research on dopaminergic drugs is scarce. Methylphenidate may be promising in the treatment of at least some individuals that haven’t responded to current psychological and medical interventions.