bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Insights in the Pharmacotherapy of Psychosis: The Example of Parkinson's Disease Psychosis
Authors: Fontaine A. , Radu G. 
Published: June 2017

IntroductionWith 10 million of patients across the world, Parkinson's disease is the second most common form of neurodegeneration, after Alzheimer's. Among half of patients develop psychotic symptoms, such as visual hallucinations and delusions, which are correlated with higher rate of placement in nursing home, are difficult to treat and severely affect quality of life, making Parkinson's disease psychosis (PDP) a major public health issue.ObjectivesThe aim of this study is to identify treatment options that could be used to treat PDP and clarify underlying pathophysiology.MethodWe conducted a literature review on Pubmed, Goggle scholar and Cochrane library, using a combination of the following: “Parkinson's disease Psychosis” “visual hallucinations” “Pimavanserin” “Clozapine” “atypical anti-psychotics” 120 articles were screened.ResultsConsidering that hallucinations arise from overactivation of dopaminergic receptors, treatment options include reducing the dopaminergic drugs used to control motor symptoms; using atypical anti-psychotics such as Risperidone, Olanzapine, Quetiapine, which often results in the worsening of extra-pyramidal symptoms. Another option is the use of low doses of Clozapine, which has been proven efficient with no worsening of non-motor symptoms, suggesting the implication of other pathways, such as serotonin. Finally, Pimavanserin, a 5-HT2A receptor inverse agonist, without any dopaminergic activity, has been demonstrated to be effective in the treatment of PDP, well tolerated and easy to use.ConclusionSerotonin inverse agonists represent a major breakthrough in the pharmacotherapy of PDP, and may lead the way to changes in the treatment of schizophrenia and other psychotic disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Burden of Caregivers of Patients with Alzheimer
Authors: Jmi G. , Robbana L. , Ghali F. , Zghal M. , Mezghani M. , Lamia J. , Rafrafi R. 
Published: June 2017

IntroductionThe Alzheimer's patient assistance relationship is a morally painful experience, most frequently discussed in terms of “burden” in the literature, especially as professionals and institutional intermediaries are underdeveloped in Tunisia.GoalIt is intended to assess the level of burden among caregivers of patients with Alzheimer's disease and to search factors associated with a high level of burden.MethodologyThis is a retrospective descriptive study. Patients were recruited from neurology department of Razi hospital, which were hospitalised between the months of December 2012 and March 2013. The burden was measured using the Zarit inventory.Results and discussionThirty patients were included. The majority female, most caregivers are descendants (60%), then, daughters in law (33%), and finally the spouses (23%). 80% of caregivers lived in the same home as patients. Caregivers were asked about all the items of the grid Zarit. The average burden in our sample is 59.9 + 16 3. We observed that 33% have absent to light burden (score <21), 10% have a light to moderate burden (between 21 and 40), 36, 66% have moderate to severe burden (between 41 and 60) and 50% have a severe burden (>60), according to the classification proposed by Zarit. Sex, kinship and cohabitation with the patient were not associated with a higher burden.ConclusionThe study of factors correlated with high levels of burden aims at finding ways of intervention and support to fight against the isolation of caregivers and the occurrence of anxiodepressive complications.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Behavioral and Psychological Symptoms: A Contribution for their Understanding Based on the Unmet Needs Model
Authors: Ferreira A.R. , Martins S. , Dias C. , Simões M.R. , Fernandes L. 
Published: June 2017

IntroductionBehavioural and psychological symptoms (BPSD) are frequent in dementia and their contribution to poor health outcomes is well recognized. Four major frameworks attempt an explanation their aetiology: biological, behavioural, environmental vulnerability and unmet needs models. The latter states that BPSD are symptoms of needs that are not being met due to patients’ decreased ability to communicate/fulfil them. This model also implies that if needs were met, BPSD would improve.AimsTo explore the relation between needs and BPSD, and describe which unmet needs were contributing to BPSD in an elderly sample.MethodsA cross-sectional study was conducted in three Portuguese nursing homes. All residents were considered eligible. However, those unwilling or unable to participate were excluded. For each elderly patient, needs were assessed with camberwell assessment of need for the elderly/cane and BPSD with European Portuguese neuropsychiatric inventory/NPI.ResultsThe final sample included 166 elderly with an average of 80.9(sd = 10.2) years. Significant correlations between NPI and unmet and global needs were found (rs = 0.181,P = 0.020; rs = 0.254,P = 0.001, respectively). Additionally, the unmet needs of daytime activities (P = 0.019), company (P = 0.028) and behaviour (P = 0.001), presented significant correlations with NPI.ConclusionIn this sample, a high number of unmet needs were found. The absence of daytime activities, company and behaviour contributed to the identified BPSD, which is in line with other studies also highlighting the importance of these needs in nursing homes. This not only provides a framework for understanding BPSD, but also points to the identification of unmet needs as pivotal in prevention and treatment of these symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Acute Catatonic Syndrome Associated with Hyponatraemia
Authors: McGuire E. , Yohanathan D.M. , Lally D.L. , McCarthy D.G. 
Published: June 2017

IntroductionA 71 year old gentleman presented with two discrete episodes of delirium with prominent psychotic features and catatonia, over a 3-year period. Symptomatically, he was suffering from fluctuating consciousness, paranoid ideation and both auditory and visual hallucinations. He went on to develop catatonia, demonstrating negativism and mutism and he also exhibited pseudoseizures. His symptoms resolved entirely after three weeks. He re-presented 3 years later with profound psychosis and hyponatraemia. On this occasion, he exhibited catalepsy, negativism, echolalia and mutism, which resolved when his sodium was corrected.Objectives/aimsTo illustrate 2 episodes of acute catatonia temporally associated with hyponatraemia in an otherwise healthy elderly gentleman.MethodsThis is a case study. Consent was sought from the patient to write up his case and distribute it for educational purposes. His medical inpatient notes, psychiatric inpatient notes, correspondence and bloods pertaining to both admissions were reviewed and analysed. A literature review was carried out using Pubmed.ResultsLow sodium levels were a common factor in his presentations and normal sodium levels were associated with a return to normal consciousness.ConclusionsWhile medical issues confounded his first presentation of hyponatraemia associated catatonia, his second presentation was directly related to hyponatraemia. Given the coincidence of hyponatraemia during his first admission, it would strongly suggest that low sodium levels were an important factor in this gentleman's presentation. Importantly, this is the first case in the literature to demonstrate catatonia related to hyponatraemia on two separate occasions in the same individual.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Evaluation of Dependence Among Benzodiazepines in Population of Elderly Subjects Followed in Psychiatric Service in Sfax
Authors: Messedi N. , Feki I. , Baati I. , Sellami R. , Trigui D. , Masmoudi J. 
Published: June 2017

IntroductionBenzodiazepines (BZD) are the most consumed psychotropic drugs by the elders. This prescription can lead to the dependence which is a major public health problem particularly in this population.ObjectivesTo study the prevalence of dependence of the (BZD) in elderly subjects followed as outpatients and to identify the factors associated with it.MethodsIt was a cross-sectional study of 60 patients aged 65 years and older followed at the psychiatric consultation of the UH Hédi Chaker of Sfax; for 3 months. We used:– Questionnaire containing demographic and clinical data.– The cognitive scale of attachment to benzodiazepines (ECAB), a score ≥ 6 indicates dependence.ResultsThe average age of patients was 67.78 years, with a sex-ratio M/W = 0.46. They were smoking in 58.3% of cases. The most frequent psychiatric disorders were mood disorders (40%) followed by anxiety disorders (13.3%). The absence of diagnosis was observed in 23.3% of cases. A psychotropic drugs were associated with BZD in 86.7%. The most prescripted BZD was lorazépam (90%). Withdrawal signs were present in 90% of cases. The prevalence of BZD dependence has been estimated at 80%.BZD dependence was significantly correlated with smoking (P = 0.00), with psychotropics association (P = 0.04) and with signs of withdrawal (P = 0.001).ConclusionIt appears from our study the importance of BZD dependence in the elderly what it is a source of withdrawal difficulty. So we need make more effort to comply with recommendations regarding the prescription of these molecules.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Parkinson Psychosis: A Complex Interaction of Disease and Medication Related Factors
Authors: Petrykiv S. , de Jonge L. , Arts M. 
Published: June 2017

IntroductionPsychotic symptoms are the most important non-motoric symptoms of the Parkinson disease (PD). The quality of life of those patients can be significantly improved with an appropriate therapy. In this article we provide evidence about the etiology, differential diagnosis and therapeutic possibilities with a work-up for the clinics.Objectives & aimsTo provide a case report of patient with PD who developed a paranoid psychosis after administration of levodopa/carbidopa, followed by a literature review on psychotic symptoms evoked by psychotropic medication by patients with PD.MethodsAn English-language literature search was conducted using Pubmed, EMBASE searching for case reports and observational studies reporting iatrogenic psychotic symptoms by patients with PD.ResultsMs. C. was a 65-year old woman with PD who was observed in a polyclinic setting and who used a levodopa/carbidopa combination. She developed paranoid psychosis with a following admission to the psychiatric ward. We have gradually lowered the dose of anti-Parkinson medication. Subsequently, treatment with clozapine was initiated and the psychotic symptoms resolved within five months.ConclusionParkinson psychosis is due to a complex interaction of neurodegenerative changes and pharmacological therapy. Therefore, the role of iatrogenic factors must be always carefully assessed. Psychosis inducting agents should be lowered or stopped before the treatment with antipsychotic medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Strategy to Combat Dementia in Russia
Authors: Pishchikova L. 
Published: June 2017

The 139th Executive Committee WHO was held in May 2016. The Russian delegation took part in its work. The main issue on the agenda was the report on “Dementia”. It was noted that each year dementia develops in 8 million people in the world. It is expected that this figure will increase to 145 million by 2050. In Russia the national plan to combat dementia is missing. In the resulting meeting, all the WHO country-members voted for immediate action on the adoption of the strategy for the fight against dementia by 2017. We developed a strategy for dementia, which includes the following tasks;– The need of epidemiological research in the field of dementia;– Research on etiology, prevention, early diagnosis and treatment of dementia;– The expansion of the network of specialized stationary and nonstationarny facilities for patients with dementia;– Development of programs of psychological care to patients with dementia and to caregivers;– Development of palliative care for patients with dementia;– Cross-sectoral cooperation and multidisciplinary approach in assistance to patients with dementia;– Training in the field of geriatric psychiatry, denomination of the specialty of geriatric psychiatrist;– Fighting stigma of patients with dementia, protection of their rights, including in psychiatry and forensic psychiatry.The solution of these objectives requires foundation of the Russian observatory on dementia, the WHO cooperating center. The tasks of such an Observatory will be: centralization and coordination of actions concerning strategic planning, implementation of mechanisms of a multispectral cooperation, assessment of services, monitoring and providing reports on dementia issues in Russia.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Risperidone Induce Recurrence of Severe Acute Respiratory Distress in a Patient with Psychotic Disorders
Authors: Amel N. , Hadjadj M. , Maoudh W. 
Published: June 2017

Mrs. R, 61-years-old was admitted into the department on July 2015 with a history of major paranoid psychosis. Notion of asthma was indicated in the medical file without any specific treatment. At the admission she received risperidone 4 mg/day and duloxetine since one year. Between October 2015 and June 2016, the patient presented 19 episodes of respiratory decompensation, six of them required transfer in the emergency unit, and 3 in the intensive care unit (ICU) with the assistance of mechanical ventilation. During the last episode, transfer in the intensive care unit was refused by the ICU physician because of the high frequency of recurrence and the difficulty to extube the patient. “End of life” was therefore considered. Nevertheless, medical physician in charge of the patient decided to continue symptomatic treatment and to stop all anti-psychotic drugs susceptible to deteriorate respiratory disease. On the first day we observed a dramatic improvement and no recurrence occurred since now 3 months without any treatment. Between the admission and the occurrence of respiratory decompensation, hypereosinophilia (1610/mL) was observed with recovery in normal value after interruption of risperidone. We also noted an improvement of functional respiratory test. In conclusion, risperidone is an anti-psychotic drug largely used. Severe side effect may endanger life-threatening as described in this case. The recurrence of severe acute respiratory distress without induced factors founded needs to discuss the potential role of this drug.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Social Phobia and Co-morbid States-diagnostics and Importance
Authors: Anakiev S. , Tasic G. 
Published: June 2017

IntroductionThe roots of social phobia, lay in the social nature of human beings who fulfil their basic needs in social relations. By the definition, it is the fear of witnessing the negative judgement and the criticism of other people, which is so intense that, is followed by reactions of avoidance of phobic situations and doings, followed by intense vegetative symptoms.AimIntroduce social phobia as an important social and medical problem with common co-morbidity and exceptional risk of suicide. At the same time it gives special accent to the diagnostic procedures and differential diagnosis.MethodAnalysis of the information from literature and practice and coming to conclusions with the inductive method.ResultsSocial phobia is a chronicle illness, equally present in both sexes. The central position is taken by all-the-time present intense irrational fear. Alcoholism, misuse of sedatives, depression, and panic with agoraphobia, OCD are common followers of social phobia. Differential diagnosis witch eliminates panic with agoraphobia, or just the lack of social skills allows the right therapeutic approach.ConclusionSocial phobia, alone or combined with other disorders, has a huge medical and social value. Coming back to regular life tracks depends on the right diagnosis and the right time to go into the healing process.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Development of a preliminary tool to assess care-giving practices by family members with Schizophrenia: A report from India
Authors: Das S. 
Published: June 2017

IntroductionCare-giving practices by family members have inherent value and importance in the provision of care for patients with schizophrenia. There is dearth of assessment tools that focus on practices followed by caregivers’ while dealing with their relatives with schizophrenia, especially from India.ObjectiveTo develop a tool for the assessment of ‘care-giving practices’ followed by family members while caring for their patients with schizophrenia.Aims(a) To construct a reliable and valid tool on ‘care-giving practices’ followed by family members while caring for their patients with schizophrenia; (b) To determine the various ‘good’ and ‘bad’ practices within this tool.MethodsInitial detailed literature (Pubmed, Goggle search with input by the caregivers generated a list of 24 commonly used practices; which was shortened to 17 statements whose face validity was tested by 14 mental health professionals. Hindi translation with ‘test-retest’ reliability was conducted. Finally, ‘Consensus based approach’ was adopted by the mental health professionals to arrive at objective (b) i.e. statements reflecting ‘good’ or ‘bad’ practice.ResultsFinal questionnaire comprised 15 statements with adequate face and content validity and high test-retest reliability (Cronbach's alpha = 0.747). 6 items reflected ‘good’ and 9 reflected ‘poor’ practice respectively with maximum score of 15; and categorization from ‘very poor’ to ‘very good’ practices.ConclusionThis preliminary yet simple and easy to use tool will give better understanding about how family members provide ‘care-giving’ practices for patients with schizophrenia. However, this needs further validation, replicability, and possible modifications in a multi-cultural, multi-linguistic country like India.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Can psychopathy be treated?
Authors: Durães D. , Borralho R. 
Published: June 2017

IntroductionPsychopaths are incapable of feeling empathy and guilt, being responsible for most violent crimes. To date, confinement has been the option of choice to minimize the harm they inflict. However, a deeper understanding of the neurobiology of psychopathy may lead to new insight on possible treatment approaches.AimsThis work aims to review the current knowledge in psychopathy treatment.MethodsA literature search of MEDLINE (2000-present) was conducted using the search terms “psychopathy” + “treatment” and “drug therapy”.ResultsDefects in the amygdala and the prefrontal cortex have been implicated in the pathological basis of psychopathy. The most affected areas are the ventromedial prefrontal cortex (VMPC) and the associated anterior cingulated cortex. Alterations in connectivity between the amygdala and the VMPC with other areas of the brain have been demonstrated and seem to be responsible for the non-empathetic, unemotional, and amoral features of psychopaths. Also, they present an increase in dopamine turnover and metabolism and a serotonin dysregulation.As not all individuals with the biological substrate for psychopathy become violent, it seems that plasticity in forebrain circuits may allow the development of more prosocial responses, especially in youth. Some authors emphasize the need to address other behaviours that can be responsible for violent actions, namely, impulsive aggression. Some drugs have shown efficacy in controlling impulsive aggression.ConclusionsPharmacological approaches to treating psychopathy have been disappointing. A more reasonable goal would be to focus on impulsive aggression, for which treatment effectiveness has been demonstrated. Additional research is needed if we hope to design rational therapeutic strategies for this disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A case for considering differences between organic and psychogenic amnesia
Authors: García López R. , Gota Garcés J.M. , García Jiménez J. , Muñoz Negro J.E. , Gutiérrez-Rojas L. 
Published: June 2017

IntroductionMedical record, general examination, laboratory findings, neuropsychological interview and multidisciplinary consideration are essential to establish differencial diagnosis and correct approach in amnesic episodes.AimTo describe differences between organic and psychogenic anterograde amnesia.MethodsSingle case report and literature review.ResultsA 51-year-old man with only diagnosis of DM I, single, a good relationship with his family, without any personal or familiar psychiatric or neurological history, came to the hospital emergency department brought by his sisters referring disorientation, acute memory loss and mood changes, prevailing indifference to the situation for the last three days. After general exploration, including psychopatological examination and higher brain functions study, we arrived to the conclusion that the patient suffered from anterograde short-term severe amnesia as the only symptom, with evident conservation of autobiographic memory. The family referred as a possible stressor factor his mother's recent transfer to a different city, which had caused constant repeated questions about her location. Given the questionable presentation and trigger we shared the case with the neurologist, who ordered an array of tests to rule out any organic cause (LP, CT, MRI…), obtaining as a final result a diagnosis of limbic encephalitis, treated and effectively solved in two weeks with high-dose glucocorticoids.ConclusionCertain features of the symptoms exploration in amnesic episodes such as reiterative questioning about a specific topic, a non-modified autobiography or the absence of a clear traumatic precipitant factor, are essential for a correct approach and may lead the clinic to an organic evaluation.Disclosure of interestThe authors have not supplied their declaration of competing interest.