bluuebunny/crossref_metadata_2025_split huggingface dataset:
New horizons of dual pathology, report of a case
Authors: Marin S. Garcia , Garcia I. De Haro , Pedrosa N. Martinez , García M.D. Ortega , Garnica V. Marti , Rus S. Galiano , Iborte A. Soler , Borja P. Lucas 
Published: June 2017

IntroductionPathological gambling, as behavioural addiction, is always related with psychosocial important problems. In this case, everything is even more difficult due to grave mental disease associated, Paranoid Schizophrenia. Man, 26 years old, single. He was diagnosed of psychotic disease at the beginning due to his grave addiction to THC and others stimulant drugs. His outpatient treatment was complicated and he needed to be hospitalised once (being diagnosed of Schizophrenia). After that, he improved till he got a standardised job. He was able to have his medical treatment (Aripriprazol 15 mgs per day and Biperidene 4 mgs per day) although he kept his isolation. Then, the patient could talk about his pathological gambling. He suffered from slot machine addiction, and he also suffered from depression symptoms closely related to family and economic problems due to pathological gambling. This patient was in contemplation state and he accepted to start with antidepressant (Mirtazapine 15 mgs per day) and psychological treatment. We agreed to make a record of his gambling uses (with regular self-reports). His salary would be administered by his parents and he only could take a little money every week. The treatment was useful; it increased the capacity of economic self-management and the recovery of depression disease related.ConclusionsIn our opinion, he used gambling as filling a need for activity, and as a way of connecting with society/world. These findings suggest the need for improved prevention and treatment efforts related to problem/pathological gambling in individuals with psychotic disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Gender differences in dual bipolar disorder
Authors: Mateu-Codina G. , Sauras-Quetcuti R. , Farre-Martinez A. , Galindo-Guarín L. , Marti-Bonany J. , Hurtado-Ruiz M.G. , Campillo-Saenz M. , Sanchez-Gonzalez R. , Castillo-Buenaventura C. , Torrens-Melich M. 
Published: June 2017

IntroductionWomen with bipolar disorder are more prone to psychiatric co-morbidity as anxiety, substance use disorders, eating disorders and borderline personality disorder. Nevertheless, substance abuse disorders as co-morbidity in bipolarity are higher in males than females.ObjectivesTo describe differential characteristics of patients admitted to a psychiatric unit referring to gender in a group of patients with bipolar disorder co-morbid with substances disorders (dually diagnosed patients).MethodsSociodemographic, clinical and administrative data of all patients diagnosed with bipolar admitted to a dual diagnosis during a 3-year period were collected. The psychiatric diagnosis was made according to DSM-IV-R criteria.ResultsFrom the whole sample (n = 66), males (84.8%) were prevalent. Mean age were 37.71 ± 11.7 and mean length of admission was 24.94 ± 17.9 days. Cannabis (34.8%) and cocaine (33.3%) were the most frequent SUD diagnosis and main reasons for admittance were conduct disorder (33.3%) and mania (25.8%).Women showed higher length of admission, higher severity scores at admission and greater reduction in severity scores along hospitalisation. No other clinical or sociodemographic differences were found comparing both groups of patients (Tables 1–4).ConclusionsWomen affected by dual bipolar disorder showed higher severity scores at admission but achieved better remission rates during hospitalisation.Table 1Demographic characteristics of both groups.Table 2Clinical and functional variables at admission in both groups.Table 3Historical data about age of drug use in both groups.Table 4Severity Scores for both groups of study.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Benzodiazepines abstinence syndrome with psychotic symptoms: Case report
Authors: Morales N.I. Núñez , Revuelta M. Gómez , Hernández B. González , Zufiaurre M. Laborde , Itoiz A. Aranzabal , Olivares O. Porta , González G. Montero , Martín M. Zubia , Arenaza J. Gaviña , Arrillaga A.M. González Pinto 
Published: June 2017

IntroductionSeveral studies point to the importance that the complex formed by GABA and the benzodiazepine receptor play for cerebral dopaminergic transmission and, hence, to the pathophysiology of psychotic symptoms. The decrease in GABA neuratransmisión or the hypofunction of the system in the hippocampus, cortex and other limbic prefrontal or subcortical regions has consequences as emotional dysregulation, cognitive impairment and development of positive psychotic symptoms.ObjectivesWe intended to show an additional practical example to the limited literature available based on a case linking the emergence of psychotic symptoms due to acute benzodiazepine withdrawal.MethodsWe present the case of a 21 year old man who was sent to the emergency room of our hospital after an episode of aggressiveness on the street. The patient showed a psychotic schizophrenic syndrome with significant emotional and behavioural impact with aggressive and bizarre movements. In parallel, restlessness, sweating, tremor, increased blood pressure and tachycardia were observed. Symptoms had started abruptly two hours earlier. The patient companion explained that he usually took Alprazolam at an of over 40 mg per day. He had decided to give up this consumption abruptly four days earlier.DiscussionGABAergic deficits cause the imbalance between excitatory and inhibitory neurotransmission that may relate the pathophysiology of psychotic symptoms. The dysfunction of the GABAergic cortical interneurons could affect to the modulating response from the association cortex, which, could also relate with the appearance of these symptoms.ConclusionThis case could relate a decrease in GABAergic transmission with the appearance of psychotic symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Hepatic comorbidity in psychiatry. A case report
Authors: Santayana G. Pardo de , Landera R. , Juncal M. , Porta O. , Sánchez L. , Gómez M. , Núñez N. 
Published: June 2017

IntroductionComorbidity between mental and physical illnesses is very common and their possible interactions must always be taken into account. Hepatic disorders in particular, can affect the blood levels of antipsychotic drugs altering their effects on patients. Therefore, it is very important to assess in each case which treatment might be the most beneficial for the patient to avoid iatrogenic complications.AimTo review articles in Pub-Med and UpToDate about the possible iatrogenic complications that can arise using antipsychotic drugs in patients with hepatic disorders.MethodsWe describe the case of a 52-year-old male with Schizophrenia who was diagnosed of HCV infection ten years ago, for which he rejected any kind of treatment due to delirious ideation. In the past he was treated with oral Paliperidone with good tolerance, which he discontinued because of pour insight and stopped attending Psychiatric consultation. In April 2016 the patient was hospitalised suspecting a hepatocellular carcinoma.ResultsDuring hospitalization he began treatment with long-acting injectable formulation of Paliperidone Palmitate that improved his insight. The patient agreed to perform the necessary tests to verify the suspected diagnosis, which was sadly confirmed. He achieved psychopathological stability, but unfortunately the patient died 6 months later because of his hepatocellular carcinoma.ConclusionsPaliperidone is a good therapeutic option in patients with hepatic disorders because it is not metabolised by the liver. It also has a depot formulation that improves adherence in patients with low insight, reducing the danger of future psychotic decompensation and improving the long-term prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Adult ADHD diagnosis and binge eating disorder
Authors: Sevilla Vicente J. , Basurte Villamor I. , Sedano Capdevila A. , Migoya Borja M. , Navarro Jímenez R. , Serrano Marugan L. 
Published: June 2017

The association between attention deficit hyperactivity disorder (ADHD) and eating disorders has not been yet clarified. The presence of ADHD was significantly correlated with more severe binge eating, bulimic behaviors, and depressive symptomatology. The aim of this work is to study the relationship between ADHD subtypes in adults and the risk of food addiction (binge eating disorder).The sample was collected on a specific program for adults with ADHD diagnosis in Madrid (Spain). In total, the sample was 110 patients, and we collected information about socio-demographic factors. All patients met DSM-5 criteria for ADHD in different subtypes. We used the conner's Adult ADHD rating scales and the Barrat impulsiveness scale. Also we used the Shorter Promise Questionnaire. This is a 16 scale self-report instrument to measure an individual's level of addictive tendency.The 36.4% were at high risk of developing a food addiction. For binge eating disorder (BE), no statistically significant differences were found by gender within patients with ADHD.Binge eating was significantly related to the impulsivity and emotional liability subscale of the CAARS (P < 0.05). The risk of develop BE in ADHD was 4.7 (CI 95% 1.8–12.07). Binge eating was significantly related to the total score on the Barrat scale (P < 0.05) Risk of 3,5 (CI 95% 1.5–7.9) and within the subtypes of impulsivity, motor impulsiveness was the one that was significantly related to BE (P < 0.001)There is a clear relationship between impulsiveness symptoms and BE in patients with ADHD. It's important to note that there are no gender differences within ADHA patients to develop a BE disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Sleep disorders associated with interferon in chronic viral hepatitis C
Authors: Aarab C. , Bout A. , Aalouane R. , Rammouz I. 
Published: June 2017

Chronic infection with hepatitis C is a public health problem in Morocco and in the world. The objective of the work screens for sleep problems during the disease and its management to better guide the monitoring and psychiatric interventions.MethodologySixty-eight patients followed for hepatitis C were recruited. The treatment was based on the combination of pegylated IFNa or standard IFNa and ribavirin for 6 to 12 months. The evaluation was done by a questionnaire containing demographic information, medical and psychiatric history, substance use. Sleep assessment was made by Pittsburgh Sleep Quality Index, and measuring the quality of life by SF36. The assessment before starting treatment and at 1 month and 4 months. Statistical analysis by SPSS 21 software read.ResultsFifty-six patients were able to complete the monitoring. 36 women to 20 men. The average age is 59.1years old (standard deviation 9.88). A quarter of patients still gainfully employed. 64.3% of participants live in couple. Seventy-six point eight percent of patients live in the city. Seven percen consume tobacco and single patient use cannabis occasionally. Sleep disorders increased from 37.5% before the start of the treatment to 55.4% after its start. While 44.5% have kept a sleep disturbed to 4 months. At first, the quality of life had more impaired scores on psychological than physical scores. The overall score declined significantly way after initiation of treatment (0.04). A larger decline on the psychological component (0.000) while the physical score did not significantly decrease.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Postictal psychosis – A complex challenge
Authors: Marinho M. , Marques J. , Bragança M. 
Published: June 2017

IntroductionPatients with epilepsy have 6–12 times higher risk of suffering from psychosis, with a prevalence of about 7–8%, and the coexistence of these two conditions is associated with increased morbidity and mortality. The psychosis of epilepsy is generally split into two groups: interictal psychoses and postictal psychosis (PIP), and the latter has been estimated to represent 25% of all types. However, many of these episodes remain under-recognized and/or are often misdiagnosed.ObjectivesTo provide an overview of PIP.MethodsLiterature review based on PubMed/Medline, using the keywords “epilepsy” and “psychosis”.ResultsPIP has been recognized since the 19th century, when Esquirol described postictal “fury”. Although its etiology and pathogenesis remain poorly understood, several risk factors and etiopathogenic mechanisms have been suggested and analysed. An essential step in PIP management is its accurate and early diagnosis. Generally, before the onset of PIP there is a lucid period of one to six days after the seizure(s). PIP frequently has a polymorphic presentation, tends to be affect-laden and symptoms often fluctuate. It is of limited duration and frequently responds very rapidly to low doses of benzodiazepines and antipsychotics. However, the propensity of the antipsychotics to provoke seizures and the risk of pharmacokinetic interaction with anti-epileptics are important considerations. Recurrence rates range 25% to 50%.ConclusionsGiven the negative impact of PIP in morbidity and mortality among these patients, it is crucial that neurologists and psychiatrists are able to adequately recognize and treat this clinical condition.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Impact of classification systems (DSM-5, DSM-IV, CAM and DRS-R98) on outcomes of delirium
Authors: McCarthy G. , Meagher D. , Adamis D. 
Published: June 2017

IntroductionPrevious studies showed different classification systems lead to different case identification and rates of delirium. No one has previously investigated the influence of different classification systems on the outcomes of delirium.Aims and objectivesTo determine the influence of DSM-5 criteria vs. DSM-IV on delirium outcomes (mortality, length of stay, institutionalisation) including DSM-III and DSM-IIR criteria, using CAM and DRS-R98 as proxies.MethodologyProspective, longitudinal, observational study of elderly patients 70+ admitted to acute medical wards in Sligo University Hospital. Participants were assessed within 3 days of admission using DSM-5, and DSM-IV criteria, DRS-R98, and CAM scales.ResultsTwo hundred patients [mean age 81.1 ± 6.5; 50% female]. Rates (prevalence and incidence) of delirium for each diagnostic method were: 20.5% (n = 41) for DSM-5; 22.5% (n = 45) for DSM-IV; 18.5% (n = 37) for DRS-R98 and 22.5%, (n = 45) for CAM. The odds ratio (OR) for mortality (each diagnostic method respectively) were: 3.37, 3.11, 2.42, 2.96. Breslow-Day test on homogeneity of OR was not significant x2= 0.43, df: 3, P = 0.93. Those identified with delirium using the DSM-IV, DRS-R98 and CAM had significantly longer hospital length of stay(los) compared to those without delirium but not with those identified by DSM-5 criteria. Re-institutionalisation, those identified with delirium using DSM-5, DSM-IV and CAM did not have significant differences in discharge destination compared to those without delirium, those identified with delirium using DRS-R98 were more likely discharged to an institution (z = 2.12, P = 0.03)ConclusionAssuming a direct association between delirium and examined outcomes (mortality, los and discharge destination) different classification systems for delirium identify populations with different outcomes.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Evaluating quality of sleep in patients with diagnosis of chronic obstructive pulmonary disease
Authors: Akhan L. Utas 
Published: June 2017

BackgroundMulticenter study showed that sleep disorders was diagnosed in approximately 40% of patients with chronic obstructive pulmonary disease. COPD is a condition that is most widely investigated regarding its relation with sleep.ObjectivesOur study is a complementarily one that is carried out to determine how COPD affects the quality of sleep.MethodsThis study enrolled 300 patients with COPD, who receive treatment in an occupational diseases hospital of ministry of health, Turkey, and control group of 100 healthy volunteers. This definitive, cross-section study was conducted between 01.02.2016–31.04.2016. Socio-demographic details form, epworth sleepiness scale and Pittsburgh sleep quality index are used to gather the study data. Any disease that affects sleep structure (Obstructive sleep apnea syndrome, substance abuse, irritable leg syndrome, depression, anxiety disorder, peptic ulcer) and a treatment that can affect sleep patterns (antidepressant, anxiolytic, diuretic) and to work all patients who were planned to receive Hamilton depression and were assessed with anxiety scale and anxiety, depression those who have high points to think of the reins are not included in the study.ResultsScore obtained from Pittsburgh sleep quality index–A subjective test - was significantly high in the COPD group. Actigraphic sleep parameters that include ‘actual wake time’, ‘actual wake %’, ‘total activation score’ and ‘fragmentation index’ were significantly high in the COPD group comparing to control group. Among actigraphic sleep parameters, ‘actual sleep time’, ‘actual sleep’ and ‘sleep efficiency’ were significantly lower in the COPD group comparing to control group.ConclusionsThe study demonstrates that chronic obstructive pulmonary disease poses negative influence on the quality of sleep and leads to sleep disorders.Disclosure of interestThe author has not supplied his declaration of competing interest.
Long-term validation of the SAD PERSONS scale for prediction of repeat self-harm in A&E patients with and without a prior self-harm history
Authors: Zakaria Y. , Mitchell A. 
Published: June 2017

ObjectiveRepeated self-harm is difficult to predict particularly in the long-term. Scales that help identify risk of repetition are widely used, and the most popular is the modified SAD PERSONS scale (mSPS). We aimed to clarify the accuracy of the mSPS in first time and non-first time patients presenting with self-harm with an extended follow-up period of observation.MethodWe conducted the UK's first long-term prospective risk prediction study of patients to an Accident and Emergency (A&E) department. We followed up 774 patients for a mean period of 7.4 years. At the time of study 429 patients presented with their first episode of self-harm and 345 had a hospital record of past history of self-harm.ResultsDuring 7.4 years of follow-up 54.7% of those who initially presented with self-harm represented with a repeat self-harm episode. Four hundred and twenty-one patients had a mSPS score less than 6 (low risk), 260 had a score between 6 and 8 (moderate risk) and 94 scored 9 or higher usually notated as high risk. The clinical utility of the mSPS was “poor” for predicting future self-harm but at cut-offs ≥7 it was “fair” for predicting non-repetition. Of the individual questions in the mSPS, a positive answer to “stated future wishes” was a true positive in 74.0%.ConclusionsWe found the mSPS was a relatively poor indicator of future self-harm risk in a long term follow-up of patients who self-harmed regardless of hospital record of previous self-harm history. However, mSPS did have modest value in predicting non-repetition.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Gypsies's beliefs about the evil eye in relation to mental illness
Authors: Paralikas T. , Kotrotsiou S. , Kotrotsiou E. , Gouva M. , Hatzoglou C. , Kavadias D. 
Published: June 2017

IntroductionThe focus of Medical Anthropology is, among other things, the study of medicine as an expression of culture and involves the analysis of healing traditions, both “traditional” and biomedical.ObjectivesGreek Gypsies who have their own habitus, language, and culture.Aims The discussion of treatment options that gypsies have or seek in order to address critical life situations outside a biomedical context.MethodsField research with interviews and observation.ResultsUsing Geertz's analytic approach of symbolic interpretation, this paper focuses on the mobilization and transformation of religious symbols in the clinical setting: how these “converse” with biomedicine and how they participate in the process of healing. Painful life experiences drive subjects to seek recourse in remedies outside the biomedical system. At the center of these experiences are thought to be attacks from the “evil eye.” According to the subjects’ worldview, all people are potential victims of the evil eye. A person's glance can provoke the injury, illness, mental illness or even death of another. Consequently, there is a hierarchy of therapeutic choices in which first preference is given to their own means for addressing a situation—only in the case of failure do they turn to specialists.ConclusionsThe beliefs of the subjects are strongly influenced by their worldview, a historically inherited model of health and healing that, unlike the biomedical model, expresses a belief that ailments are successfully cured “wıth God”.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Strategies to reduce the stigma toward people with mental disorders in Iran based on stakeholders view: A qualitative study
Authors: Taghva A. 
Published: June 2017

IntroductionStigma effects on the process of mental disorders and many researchers consider it as the most serious risk factor and inhibitor in promoting mental health.AimsThe aim of this study was to explore the strategies to reduce the stigma toward people with mental disorders in Iran.MethodsThis qualitative study, using content analysis method, was undertaken from 2013 to 2015. All participants were recruited by purposive sampling method. They were stakeholders of mental health in Iran. Data were collected through 16 individual interviews, 2 focus group interviews and 6 written narratives. The data were collected, coded and analyzed simultaneously.ResultsThe major themes were: “Emphasis on education and changing attitudes”, “Changing the culture”, “Promoting services and support coverage”, “Role of various organizations and institutions”, “Integrated reform of structures and policies to improve the performance of custodians”, and “Evidence-based actions”.ConclusionIt seems crucial to adopt strategies that lead to reduce the stigma of mental illnesses and increase awareness among people, scholars and service providers in the field of mental health. Additional studies are needed to evaluate the effectiveness of the emerging strategies to reduce stigma.Disclosure of interestThe author has not supplied his declaration of competing interest.