bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population pharmacokinetic modeling and simulations of dopamine Dd2 receptor occupancy of long-acting intramuscular risperidone-ISM
Authors: Llaudó J. , Anta L. , Ayani I. , Martínez-González J. , Gutierro I. , Faelens R. , Winkler J. , Snoeck E. 
Published: May 2016

IntroductionRisperidone-ISM is a new long-acting intramuscular formulation intended to achieve sustained plasma concentrations over 4 weeks without oral supplementation. The clinical efficacy to risperidone has been associated with 65–80% occupancy of dopamine D2 receptor (D2RO) and a mean Cmax between 7.5 ng/mL and 80 ng/mL.AimUse a population PK/PD model to predict the PK and the D2RO for Risperidone-ISM in schizophrenic patients and to characterize the relationship among doses, in order to guide dose selection for a future Phase-III trial.MethodsA population PK/PD analysis for Risperidone-ISM using Monolix software was conducted based on 6641 plasma samples from two Phase-I studies (17 healthy subjects and 31 schizophrenic subjects, respectively) and 1 Phase-II study (60 schizophrenic subjects). Simulations were subsequently undertaken predicting the steady state PK and D2RO after multiple Risperidone-ISM doses administered every 28 days for 12 weeks.ResultsDoses of 75 and 100 mg, administered either in gluteal or deltoid muscle, were predicted to result in median Cmax and Ctrough that stayed between 7.5 ng/mL and 80 ng/mL. At steady state 75 mg and 100 mg dose (gluteal) achieved a D2RO average [min–max] of 70.8% [61.4–80.4] and 74.3% [66.2–82.1], respectively; a 75-mg and 100-mg dose (deltoid) achieved a D2RO average [min–max] of 69.3% [56.5–80.3] and 73.0% [61.8–82.1], respectively. The model estimated that the 65% D2RO occurs within first 8 h after treatment.ConclusionsSimulations were carried out supporting doses of 75 mg and 100 mg Risperidone-ISM to show the greatest efficacy and safety potential to be assessed in the future Phase-III trial.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Treatment of schizophrenia with aripiprazole may contribute to improved functions
Authors: Björner A. , Erixon-Lindroth N. , Öberg Jansdotter S. , Flatla A. 
Published: May 2016

IntroductionThe goals with modern treatment of schizophrenia are to achieve remission of clinical symptoms, prevent relapse, and to restore the patients’ functions.Objectives/aimsThe objective of this study was to investigate the impact of treatment with the partial dopamine agonist aripiprazole on functions, measured as time spent for work or studies, in patients with schizophrenia or schizoaffective disorder.MethodsRetrospective data on employment and study activities were collected for all patients between 18–65 years with schizophrenia or schizoaffective disorder at an open care psychosis clinic in Sweden (n = 104). Possible impact of treatment with aripiprazole and of other variables, such as age, gender, and disease severity, was analysed.ResultsAmong patients who worked or studied at Day of admission (n = 36), the probability of maintaining or increasing time for work or studies was significantly higher in patients treated with aripiprazole compared with patients who were not (88% versus 53%; P = 0.020). This difference remained significant after controlling for severity of symptoms, age and sex. A secondary analysis, including all patients (independent of work or study status at Day of admission) also showed a significant difference in favour of aripiprazole (53% versus 26%, P = 0.005).ConclusionsThe results indicate that patients treated with aripiprazole (monotherapy or add-on) have higher probability of maintaining functional capacity. A plausible explanation might be aripiprazole's favourable effect on cognitive functions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Specifics of communication with schizophrenic patient
Authors: Manojlovic S. , Nikolic-Popovic J. 
Published: May 2016

The precondition of communication with schizophrenics is knowing and understanding of their fragmented and chaotic world. Communication with the schizophrenics should respect their fear of fusion and disintegration, as well as the fear of abandoning. In communication with the schizophrenic two facts are important: the real support is accepting the bizarre existence of the patient, and the other side of the support is the capacity of the psychiatrist to understand and withstand the patient. This capacity is determined through the consistency of therapist's behavior, possibility to accept the patient's right on regression, but also the ability to offer the constancy of himself, too. The therapist is the representative of the reality whose consequence and constant presence enables him to grow up from the internal mixture of the mental presentations into an authentic, independent person, dedicated to the patient. The therapist is expected to tolerate the patient's alienation due to the fears from fusion or disintegration. A constant activity of reestablishing of contact and respect of a specific cognitive style are needed. Communication with the schizophrenics implies an explicit calling to a verbal communication that has to be understandable, and searching for the conceptual framework, which provides understanding. Basic characteristics of the adequate communication are persistence, consequence and simplicity of instructions with the norm of behavior control, as well as the clarity of the “here-and-now” situation. The therapist's understanding of the schizophrenics justifies his actions and allows taking the psychotherapeutic attitude.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A pilot early psychosis intervention programme in Bolivia
Authors: Rivera Arroyo G. 
Published: May 2016

The problemLess than half of the more than 250 adolescents and young adults who are estimated to experience a first episode of psychosis in the city of Santa Cruz each year are ever diagnosed and receive treatment.Of those patients who are eventually diagnosed, the average duration of their symptoms of psychosis prior to receiving treatment is estimated to be over 2 years.The opportunityMultiple psychosocial variables, such as the reaction of patients and their families to symptoms of psychosis, which play a vital role in determining long-term outcomes, demonstrate their highest degree of flexibility during the period of early psychosis. Psychological, social and evidence-based pharmacological interventions undertaken during this time frame can have a profound impact on the life-course of an individual with psychosis.Our solutionWe propose to establish a pilot early psychosis intervention program that will provide age appropriate biopsychosocial treatment and support for 15–25 years old with first episode psychosis and their families in Santa Cruz. This will improve short and long-term outcomes for those with psychosis, increase speed of recovery, decrease the need for hospitalization, reduce family disruption and decrease rates of relapse.By utilizing a mobile, multidisciplinary treatment team that emphasizes the roles of trained case managers focused on providing intensive individual and family support in the home, this program will provide culturally appropriate care that will leverage contributions from a limited supply of psychiatrists and shift dependence away from a fragmented medical system.Disclosure of interestThe author has not supplied his declaration of competing interest.
Factors associated with schizophrenic evolution after a first episode psychosis
Authors: Turki M. , Halouani N. , Naoui R. , Gassara I. , Hamza N. , Aloulou J. , Amami O. 
Published: May 2016

IntroductionThe evolution of a first episode psychosis is a fundamental question, despite its unpredictability. It affects the type of management and drug treatment. In this context, schizophrenia, a disabling psychiatric disease, remains the most formidable evolution.ObjectiveAssess the frequency and factors associated with schizophrenic evolution after a first episode psychosis.MethodsWe conducted a retrospective, descriptive and analytic study including 55 patients hospitalized in psychiatry department, Hédi Chaker Hospital, Sfax, Tunisia, during 7 years (from 2007 to 2013), then managed in the outpatient department. We collected socio-demographic, clinical and evolutive data from clinical observations.ResultsThe mean age was 26.5 years. Sex ratio (M/F) was 2.9. Among our patients, 74.5% were single and 49.1% had no profession. A trigger factor of this episode was noted in 43.6% and a break with the previous functioning in 63.6% of cases. A schizoid personality was reported in 74.5% of the population. All patients presented positive symptoms, 96.4% had negative symptoms and 61.8% presented mood symptoms.Schizophrenic evolution was reported in 38.2% of patients. Factors associated with this evolution were: masculine gender (P = 0.004), social isolation (P = 0.009); absence of mood symptoms (P < 0.001) and mental automatism (P = 0.043).ConclusionOur study shows some factors associated with schizophrenic evolution after a first episode psychosis. The identification of these factors, as well as other factors reported in the literature is essential to allow early and adequate support, and ensure a better social integration.Disclosure of interestThe authors have not supplied their declaration of competing interest.
About an exhibitionism clinical case: Entity's review and state of the art exposure
Authors: Varregoso M.I. , Coelho S. , Borges G. , Xavier R. 
Published: May 2016

IntroductionExhibitionistic disorder may be present when there is sexual arousal from the exposure of one's genitals to an unsuspecting and nonconsenting person. This disorder prevalence is unknown but we know it is highly unusual in females. It generally starts at adolescence and its course is likely to vary with age. There are temperamental and environmental risk factors.Most of what we know about exhibitionistic disorder is largely based on research with individuals convicted for criminal acts involving genital exposure, and this may represent an important bias. From a clinical case of exhibitionism, the authors intend to review this type of paraphilia from an historical, conceptual and etiologic point of view.ObjectiveTo review the concept behind this diagnosis and its evolution, the comprehensive theories that attempt to justify and frame it, as well as the type of intervention currently considered to be the state of the art.MethodsPatient's observation and assessment, along with an extensive review of the relevant literature.ConclusionsStarting from a real clinical case, the authors present a general theoretical review on the subject.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Emerging treatments options for narcolepsy throughout a case
Authors: Alvarez Astorga A. , Gallardo Borge L. , de la Red Gallego H. , Alonso Sánchez A. , Gómez Sánchez S. , Noval Canga C. , Mayor Toranzo E. , Cepedello Pérez S. , Rodriguez Andrés L. , Ballesta Casanova T. 
Published: May 2016

BackgroundNarcolepsy is a neurological disorder characterized by disturbances in REM sleep. The symptoms that the patient could present are excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucinations and disrupted nocturnal sleep. Its etiology is unknown. Currently, there is established pharmacotherapy for symptomatic treatment, which are often unsatisfactory.ObjectiveReview of new treatments for narcolepsy based on recent advances about its ethiopathogenesis.MethodSeventy-five year-old female with a personal history of arterial hypertension and obstructive sleep apnea syndrome. The patient presented several episodes of abrupt muscular weakness, nightmares, sleep paralysis and excessive daytime sleepiness. Diagnosed of narcolepsy and treated with methylphenidate immediate-release (IR) 10 mg, alprazolam 1 mg, and trazodone 100 mg with good response.ResultsDue to persistent symptoms, treatment was modified to osmotic-release oral system (OROS) – methylphenidate resulting on a substantial weight loss (12 kg) and persistence of symptoms. Another methylphenidate preparations were unsuccessfully tested. Currently she continues treatment based on methylphenidate release-release and she improved significantly though she sometimes presented daytime sleepiness.DiscussionRecent studies have shown that a loss of the hypothalamic neuropeptide hypocretin causes Narcolepsy with cataplexy and that an autoimmune mechanism may be responsible for this loss (related to HLA DQB*0602). Pathophysiology of narcolepsy without cataplexy is less understood.Although amphetamines and its derivatives are the mainstay of management, therapies that involve hypocretine seems to be hopeful (intranasal, peripherical or hipocretin cell transplantation). Monotherapy with GHB, H3 antagonist receptors, TRH analogs and immunotherapy are also being studied.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Gender differences in suicide ideation among college students in Kuwait
Authors: Alsalman R. 
Published: May 2016

IntroductionThe Beck Scale for Suicide ideation (BSS) has consistently been regarded as a strong tool for measuring cognitive and somatic aspects of suicide ideation symptomatology in both clinical and non-clinical population. There is no study until this date that examines the BSS within Kuwaiti College students.ObjectiveThe present study aims at identifying impact of gender (male/female) on suicide ideation.MethodsThe sample was consisted of (584) undergraduates students (284 of males and 300 females). The study applies Beck Scale for Suicide ideation (BSS) and suicide Ideation Questionnaire (SIQ).ResultsTable 1 descriptive statistics for two standardized self-report measures means and standard deviations for these measures were within the expected ranges for college samples. The mean (BSS) score was 5.2 for males and 7.0 for females. The mean (SIQ) score was 11.3 for males and 13.7 for females.ConclusionBSS revealed significant gender differences in score indicated that females obtained higher scores than males on suicide Ideation although the magnitude of the difference was small.Table not available.Disclosure of interestThe author has not supplied his declaration of competing interest.
In a period of economical crisis who is at risk for attempted suicide?
Authors: Coppola I. , Marangon D. , Gramaglia C. , Delicato C. , Di Marco S. , Gattoni E. , Venesia A. , Avanzi G.C. , Castello L. , Bert F. , Gualano M.R. , Siliquini R. , Torre E. , Zeppegno P. 
Published: May 2016

IntroductionAccording to Durkheim's theory, suicide attempts increase during periods of rapid economic changes and decrease again when stability is achieved, due to the social integration in the community guaranteed by occupational status. Since 2009 in Europe, it was observed an increase in the suicide rates, in line with the increase of unemployment. Although unemployment is considered a risk factor for suicide, it was observed a noticeable increase in suicide rates among Italian employed men during the last years, probably related to the specific economic scenario and to emerging difficulties in keeping an income to adequately maintain one's own family standard of living.AimTo study attempted suicides with a specific focus and attention on the current Italian economic scenario.MethodsDeterminants of emergency room visits for psychiatric reasons in patients aged > 16 years were studied prospectively from 2008 to 2015 at the AOU Maggiore della Carità Hospital, Novara, Italy. Each patient was assessed by an experienced psychiatrist with a clinical interview and socio-demographic and clinical features were gathered. Statistical significance was set at P ≤ 0.05.ResultsPreliminary results suggest an increase in suicide attempts according to the rise of the unemployment rate in Novara. Although in absolute figures most attempters are unemployed, it seems that suicide attempts are more frequent in the group of employed subjects, which includes also people under redundancy fund. This subgroup may be considered halfway between employed and unemployed attempters.ConclusionsData collection and statistical analyses are still ongoing. Implications for clinical practice will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychiatric consultations in the emergency room: Focus on suicide attempters with and without longitudinal psychiatric disorders
Authors: Delicato C. , Di Marco S. , Gattoni E. , Coppola I. , Venesia A. , Marangon D. , Avanzi G. , Castello L.M. , Gramaglia C. , Zeppegno P. 
Published: May 2016

IntroductionThe role of mental illness in the pathway leading to suicide is widely discussed in the literature. Nonetheless, the debate about this issue is open, both from a clinical and philosophical point of view.AimsThe purpose of the present study was to compare suicide attempters with and without a history of psychiatric disorder, in order to highlight the possible differences between the two groups, with a specific focus on intent to die and methods of the attempt.MethodsData from all ER referrals undergoing a psychiatric consultation in the period 2008–2015 at the Maggiore della Carità Hospital, Novara, Italy, were gathered. Comparison of qualitative data was performed by means of the Chi2 test. Statistical significance was set at P ≤ 0.05.ResultsWe have already gathered data from more than 2000 ER psychiatric consultations, including 495 suicide attempters. Preliminary results suggest that these kinds of behaviours are more common in subjects without psychiatric disorders but with clinical history of previous contact with mental health services and in psychopharmacological therapy. Reasons for self-harming are associated with relational problems rather than psychiatric symptoms. Among Axis II diagnoses, almost half of cases are affected by histrionic personality disorder.ConclusionsThe results described above should be considered as preliminary, as data collection and statistical analyses are still ongoing. Anyway, the observed correlation between previous contact with mental health services, socio-relational issues and suicide attempt, and the significant frequency of attempts in histrionic personality disorders seem to be particularly interesting. Implications will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Suicide risk assessment and early recognition of risk factors
Authors: Fricchione Parise V. , Addeo L. , Balletta G. 
Published: May 2016

Suicide is a common cause of death in people with mental health problems. No specific patient stereotype nor single risk factor can be used to easily identify which person or patient will attempt suicide. Mental health professionals often have to assess or manage suicide risk and this is challenging by reason of accurate methods of predicting remain elusive. Presence of multiple risk factors often suggest the need for additional evaluation for suicidal ideation, but an impending suicide attempt is not always recognized, even after evaluation by healthcare provider. More half of suicidals have seen a psychiatrist or psychologist or other healthcare provider within one month beforehand. The presentation of possible warning signs can be subtle and experience is required. Service provision for suicidal patients is often substandard, particularly at times of highest need such as after discharge from hospital or emergency department. As many as 75% or more of people who die by suicide have a diagnosable mental health disorder at the time of their death. The most common are bipolar disorder and schizophrenia over major depression. Between 25% and 50% of bipolar patients will attempt suicide at least once, and 5% to 20% will die by suicide. In schizophrenia diagnosis, 20% to 40% of patients will attempt suicide and more than 10% will die by suicide. Additional risk factors: alcohol misuse, family history, illegal substance use. The way in which suicide is broached and discussed with patient plays a significant role. Here, a focus on clinical management of suicide risk.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Suicide attempters: Clinical characteristics and management
Authors: Gattoni E. , Feggi A. , Gramaglia C. , Bergamasco P. , Coppola I. , Di Marco S. , Delicato C. , Venesia A. , Marangon D. , Zeppegno P. 
Published: May 2016

BackgroundSuicide attempts, defined as self-inflicted, potentially injurious behaviors with a nonfatal outcome, and with evidence of intent to die are extremely prevalent. Literature suggests that suicide is more common among males, while attempted suicide is more frequent among females. Depression, mental disorders, substance use disorders and history of suicidal behavior are important risk factors for suicide: the risk of suicide attempt is 3 to 12 times higher in psychiatric patients than in the general population.AimThe aim of our study was to compare severity of depressive symptoms in a sample of suicide attempters with a diagnosis of bipolar and related disorders or depressive disorders and in a sample of sex- and diagnosis-matched patients who do not commit a suicide attempt. The severity of attempted suicide and the suicidal risk in the hospital will be assessed as well.Material and methodsWe collected a sample of inpatients who committed a suicide attempt during 2015. For each attempter, we selected another sex- and diagnosis-matched patient with no history of attempted suicide. Socio-demographic and clinical characteristics of the sample were gathered. Assessment included: Montgomery-Asberg Depression Rating Scale (MADRS) for severity of depressive symptoms in both groups, Suicide Intent Scale (SIS) for the severity of attempted suicide and the suicidal risk with a nurse assessment for suicide.ResultsData collecting is still ongoing. We expected to find more severe symptoms in patients who attempted suicide. Clinical implication will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Who is a survivor of suicide loss? A systematic review
Authors: Gili S. , Delicato C. , Feggi A. , Gramaglia C. , Zeppegno P. 
Published: May 2016

IntroductionDeath by suicide stuns with soul-crushing surprise, leaving family and friends not only grieving the unexpected death, but confused and lost by this haunting loss. The underlying structure of grief for survivors of suicide loss appears complicated.AimsThe purpose of this study consists in reviewing literature data about survivors of suicide, especially exploring the few informations emerged by researches on the role of psychiatrist as “survivor”.MethodsA PubMed search was conducted using combinations of the following keywords: survivors suicide or bereavement suicide or suicide psychiatrists and randomized.The search was conducted through September 10, 2015, and no conference proceedings were included.ResultsBereavement following suicide is complicated by the psychological impact of the act on those close to the victim. It is further complicated by the societal perception that the act of suicide is a failure by the victim and the family to deal with some emotional issue and ultimately society affixes blame for the loss on the survivors. This individual or societal stigma introduces a unique stress on the bereavement process that in some cases requires clinical intervention.ConclusionsSuicide bereavement seems to be different from natural loss. Clinicians may react to a patient's suicide both on a personal and professional level, with emotions such as loss of self-esteem or blame. This grief somehow nullifies the core of a helping relationship and may imply a more conservative management of future patients or even avoiding to accept suicidal patients for treatment. Support interventions have been proposed.Disclosure of interestThe authors have not supplied their declaration of competing interest.