bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Insight and Internalized Stigma in Persons With Sever Mental Illness
Authors: Szczesniak D. , Wojciechowska I. , Kłapciński M. , Zwyrtek E. , Rymaszewska J. 
Published: May 2016

IntroductionStigma is a multistage process that makes person marked by the stigma to be perceived as diminished or even as “not fully human”. The internalized stigmatization is seen as one of the levels of stigma to be present in persons with mental illness. A new perspective to mediation models between internalized stigma and illness-related factors is needed.AimTo assess the relationship between insight in mental illness and internalized stigma, as well to verify the knowledge of illness-related factors on the phenomenon of internalized stigma among patients with severe mental illnesses.MethodsA cross-sectional study design conducted among participants of both sexes between 18 years old and 65 years old with diagnosis of psychotic disorders (F20–29) and mood disorders (F30–39), who after reading the information about the study, give their written consent to participate. Among used methods were: a questionnaire of Internalized Stigma of Mental Illness (ISMI) by Ritsher [Boyed] et al. translated into Polish version and self-prepared interviews. Insight into mental illness was assessed using the Positive and Negative Syndrome Scale.ResultsThe preliminary results showed patients with the insight into the mental illness have significantly higher scores on the ISMI scale. Moreover, inpatient participants and those with the diagnosis of depression were characterized by higher level of stereotype endorsement compared with outpatients and psychotic patients.ConclusionsThe obtained results may contribute in the clinical and therapeutic fields, assuming that insight and the type of treatment are strongly linked with the process of recovery and the internalized stigma.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Involuntary Hospitalization in a Mental Health Unit in 2014
Authors: Alvarez Montoya A.M. , Diago Labrador C. , Ruano Hernandez T. 
Published: May 2016

ObjectivesDeliver a detailed analysis of the mental distortions, which led to involuntary hospitalization in a mental health unit in 2014 and their gender distribution.MethodWe analyze the total number of hospitalizations in our mental health hospital unit. From the patient registry, we extract the type of hospitalizations (voluntary or involuntary), the diagnosis and the gender.ResultsIn our analysis, we find a total of 315 hospitalizations. One hundred and fifty-nine (50.48%) of them are voluntary, 150 (47.62%) are involuntary and 6 (1.90%) are a result of a judicial order. From the total involuntary hospitalizations, 81 patients were diagnosed as psychotics disorders (60%), 34 (25.18%) affective disorders, 11 (8.14%) personality disorders, 3 (2.22%) adaptative disorders, 2 (1.48%) mental retardation and 2 (1.48%) autism spectrum disorders.ConclusionsAccording to article 763 of Spanish Procedural Law (Ley 1/2000 de Enjuiciamiento Civil) from the 7th of January: “The hospitalization of a person due to mental disorders who is not in a condition to decide for himself/herself, even should he/she be a subject to parental authority or guardianship, shall require court authorization, which shall be obtained from the court of the place of residence of the person affected by such hospitalization.” For this reason the involuntary admission is considered as an exceptional and necessary measure, which is limited in time.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Ethical Aspects of Involuntary Outpatient Treatment
Authors: Galiano Rus S. , Soler Iborte A. , López Díaz Á. 
Published: May 2016

IntroductionInvoluntary outpatient treatment (IOT) is a type of non-voluntary treatment applied in the community, which tries to ensure the therapeutic compliance of patients that have a severe mental illness.In Spain, a specific legal regulation about this matter does not exist; however, it is a fact in clinical practice. The application of IOT is not without controversy, with advocates, who consider it a way of achieving therapeutic compliance, and detractors, who think it is an infringement of the fundamental rights of a person.Objectives/methodologyAn evaluation of the knowledge on IOT in Spain. Analyze the four ethical principles found in this treatment.ResultsThe protection of the patient is encompassed in the principle of beneficence. And how could we combine this with the principle of autonomy? The answer should be individualized and based on a determined disorder. Starting with non-maleficence, we ask if IOT would provoke a rejection so that the patient would distance himself further from the therapeutic environment. As for the principle of justice, the high cost by patients that do not comply with the treatment would be diminished if we are able to have them follow the treatment with higher effectiveness. This would allow a greater number of patients to access these resources.ConclusionsThe proposal of IOT should be preceded by a deliberative process. This process should include a psychiatric diagnosis that includes not only psychiatric aspects, but psychological, familial and social as well. This would compel us to create a personalized design of the therapeutic needs of each patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Freedom as Theme in Psychotherapy and Cognitive Behavioral Therapy
Authors: Vyskocilova J. , Prasko J. , Slepecky M. , Hruby R. , Grambal A. , Holubova M. , Marackova M. , Jelenova D. , Cinculova A. 
Published: May 2016

BackgroundThe problems that a client presents with to therapy may be associated with his possibility of free choice.MethodReview of psychotherapeutic and cognitive behavioral literature.ResultsFrom a psychological perspective, freedom may be either inner or outer, depending on the nature of obstacles and barriers that limit freedom. Therapy may be understood as a process through which the client is guided to actively increase his freedom. This refers to freedom from destructive habits, self-limiting attitudes, compulsive actions, symptoms etc. When creating the relationship, neither the client nor the therapist is entirely free as they bring past conscious and unconscious experiences into it. From the point of view of CBT, freedom is always relative. The idea of absolute freedom results from cognitive distortions – black and white thinking. CBT does not consider overall freedom but relatively free decision-making in particular situations that the client is in. The therapist helps the client to identify his errors in thinking and to learn a more realistic way to formulate his experiences and to use the new attitude to decide more freely. The change in attitude is realized through rehearsing freer behavior and experiments with it in one's life.ConclusionFreedom may be either inner or outer, depending on the nature of obstacles and barriers that limit freedom. Therapy may be understood as a process through which the client is guided to actively increase his freedom.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Moral Obligation to Acknowledge and Prevent Suicide in Life Sentence Incarcerated Inmates
Authors: Tsopelas C. 
Published: May 2016

IntroductionFor an inmate incarcerated for life we could acknowledge factors contributing to the desire to commit suicide, as social isolation, insensitive discipline, lack of privacy, constant threat of violence, fear, guilt, hopelessness, and depression are prominent in the life imprisonment.AimsTo discuss the ethical issues of prevention suicide in inmates incarcerated for life.MethodsWe performed thorough research of the main medical databases, and web search engines for relevant studies, articles and opinions and reviewed them independently.ResultsPrevalence of mental illness is high among inmates and several common stressors typically herald an inmate's suicide. Suicide is often the single most common cause of death in correctional settings. Even though some suicide victims have consulted a mental health service-provider before their suicide, the majority of suicide victims were not mentally ill. The paradox, particularly for life sentence inmates is that we are trying to persuade an inmate to live within a disciplinary environment, which has as side effect the increase of suicidality of the inmates.ConclusionsPrisons’ inability to protect the health and safety of inmates could raise ethical issues. We have obligation to adequate suicide prevention for all inmates, and we should be more broad minded as the will to die in mentally healthy individuals is beside an free will expression, a sign of serious lack of support and humane living conditions. We should be vigilant not to use the prevention of suicide programs as another way to increase punishment of life long imprisonment.Disclosure of interestThe author has not supplied his declaration of competing interest.
Patterns of Long Acting Injectable Antipsychotic Prescription During Criminal Acts in a Portuguese Psychiatric Hospital
Authors: Duarte M.A. , Vieira F. , Ponte A. 
Published: May 2016

IntroductionUnder the Portuguese law, criminal offenders that are designated as non-criminal responsible – “inimputáveis”, similar those in the United States of America found “not guilty by reason of insanity”, are forced to be committed to inpatient forensic units either in psychiatric hospitals or prison hospitals for mandatory security measures.Objectives/aimsTo evaluate if patients committed in a regional forensic inpatient unit (RFIU) who had a psychiatric history preceding the crime, were under long acting injectable antipsychotic (LAIA) in during the period of the crime.MethodsDuring September/October 2015, patients committed to the RFIU in Centro Hospitalar Psiquiátrico de Lisboa were characterized using medical and court records regarding clinical and demographic variables. The type of crime and previous number of criminal acts were also accounted for.ResultsWe included 33 patients in the study. During time of the crime, 25 patients (75.8%) had history of previous psychiatric appointments, with an average of 3 commitments to the psychiatric inpatient units. The majority (n = 17; 68%) had a diagnose of “schizophrenia, schizotypal and delusional disorders” (F20–29; ICD 10) and committed “crimes against life” (n = 13; 52%). They had an average of 0.8 previous criminal acts. During the crime, 7 patients (28%) were taking LAIA. Those, 16% (n = 4) were doing an unknown antipsychotic and 12% (n = 3) were doing Haloperidol.ConclusionsDespite several studies showing the clinical and rehabilitative benefit of using LAIA early in the disease course, most of the patients in our study, who were already being followed in outpatient psychiatric units, did not benefit from them.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Profile of the Mentally Incompetent Patient of the Local Health Unit of Guarda, Portugal
Authors: Batista P. , Nunes J. , Da Costa P. 
Published: May 2016

Forensic psychiatry, as a specific branch of psychiatry, is the medical science that approaches mental illness and its relation with law enforcement. In this regard, medicine and justice converge in the contact with individuals that, due to the alleged assumption of acting under the effects of a psychiatric disease, have a disturbing behaviour and infringe the laws of Society. The objective of this research project, which has a retrospective nature, is to delineate the profile of the mentally incompetent patients of the Local Health Unit of Guarda, Portugal, resorting to the reports of mental faculty's examinations of, at least, 30 individuals. With this methodology, we will be able to study the characteristics of selected individuals who have committed some sort of criminal offences but are not subject to prosecution, namely with regard to the specific personal and family data, psychiatric background, diagnostic formulations, applied legal concepts, among others. Statistical analysis was carried out using the Microsoft Excel tool. The main goal of the study is to provide to the Psychiatry Department of the Local Health Unit of Guarda an analytical instrument that characterizes the respective mentally incompetent population and may, essentially, contribute positively to the contextualization and accomplishment of the future assessments on mental faculties of the individuals who are involved in judicial proceedings.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Treatment of Charles Bonnet Syndrome with Continuous Positive Airway Pressure in an Older Adult
Authors: Arts M. , Michielsen P. , Petrykiv S. , de Jonge L. , Voshaar R. Oude 
Published: May 2016

IntroductionCharles Bonnet syndrome (CBS) is a disorder in older adults, and is characterized by a triad of recurrent vivid visual hallucinations, ocular pathology causing visual impairment due to lesions in central or peripheral visual pathways, and normal cognitive status. It is often misdiagnosed as a psychosis, early dementia or a drug related condition. Hypoxemia was anecdotally reported as a cause of CBS.ObjectivesWe present an older adult with CBS caused by severe obstructive sleep apnea syndrome.AimsTo report a case study, describing treatment of obstructive sleep apnea syndrome as a cause of CBS.MethodsA case study is presented and discussed.ResultsAn older male adult was admitted to hospital for persistent vivid visual hallucinations. There was no personal or family history of mental illness. Neurological examination was normal, except for visual impairment due to age related macular degeneration. The remainder of his physical examination was normal. Previous treatment with antipsychotics proved not to be effective. Severe hypoxemia (SaO2 79%) was diagnosed with overnight pulse oximetry and subsequent polysomnography revealed an obstructive sleep apnea syndrome. After three nights of nasal continuous positive airway pressure, the vivid hallucinations ceased.ConclusionPhysicians need to understand the underlying causes and mechanisms of CBS. One should be aware of the importance of a full clinical examination and sleep apnea research in elderly persons with visual impairment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Partial Nephrectomy After Oncocytoma Causing Repeated Lithium Poisoning with Normal Renal Function
Authors: Gómez Sánchez-Lafuente C. , Reina Gonzalez R. , Gonzalez Moreno A. , Moreno de Lara F. , Mateos Carrasco E. , De Severac Cano A. 
Published: May 2016

IntroductionLithium has been widely used as mood stabilizer in bipolar disease, despite its narrow therapeutic range and its side effects. Sodium levels and water consumption could affect lithium renal elimination.AimsDescribe a lithium intoxication without risk factors and normal kidney function.MethodsA 71-year-old female, diagnosed with bipolar disorder, current episode euthymic. On treatment with lithium 800 mg/day, 6 months ago she started with hematuria and urologist found a multifocal oncocytoma in left kidney. She was operated with double lumpectomy and partial nephrectomy without complications. Normal preoperative and postoperative renal function. Two months ago, she started with dysarthria, dystonia and coarse tremor, and T wave inversion on the electrocardiogram. In the blood test, lythemia was 1.67 mEQ/L. Creatinine was 0.65 mg/dL. She was admitted to Internal Medicine Unit. She was treated with rehydration by serum. All psychoactive drugs were removed. Twenty days later, lithemia was undetectable in the blood analysis.ResultsTwo weeks ago, the patient was transferred to the mental health unit due to worsening her mood. Lithium was reintroduced 3 days ago, at doses of 200 mg per day. Today, the patient starts again with symptoms of poisoning by lithium. Lithemia was 1.78.ConclusionsOn this occasion, partial nephrectomy due to oncocytoma is the most likely cause two consecutive lithium poisonings. Although creatinine and glomerular filtration are in normal range, patients after partial nephrectomy may have a reduced sodium reabsorption in proximal convoluted tubule, which may cause lithium compensatory resorption. This could cause rising in blood lithium levels.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collaborative Care Between Clinical Pharmacists and General Practitioners in Patients with Alzheimer's Disease in Slovenia
Authors: Stuhec M. , Marusic A. Premus 
Published: May 2016

BackgroundAlzheimer's disease (AD) patients are often treated with inadequate doses of AD's medications, which can lead to harms and additional costs.ObjectiveIn most European countries, there is no data on inappropriate prescribing (IP) in patients with AD in terms of inadequate doses. In Slovenia, the interest for a collaborative care between clinical pharmacists and physicians is increasing, mainly because of payer's interest to reduce several additional costs.AimThe main aim of this paper was to present the benefits of clinical pharmacist interventions in AD patients in community health centres in Eastern Slovenia.MethodsAll included outpatients with AD in 2013 were included, where clinical pharmacists’ interventions were ordered by the general practitioners (GPs). All study data from the patients’ records were obtained from the clinical pharmacists’ reports and patients’ charts. Main outcome measures were obtained from the summary of the patients’ treatments and the questionnaires.ResultsSix hundred and twenty-nine patients were included. Before the clinical pharmacist medications review, 39 patients were treated with AD medications (10 without established AD). In 51.0% of these cases, the suggestions to GPs were provided (mainly dose adjustment). In 70.0% of all cases, the recommendations were accepted by GPs, which led to a total reduction in the number of patients with IP (before 20 and after 6).ConclusionsA clinical pharmacist could help GPs in recognizing IP in patients with AD. These data will guide health system directors and clinical coordinators in allocating resources to establish this cooperation in more European countries.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Assessing Medication Beliefs of Mental Health Professionals: The Portuguese Version of the Medication Alliance Beliefs Questionnaire
Authors: Cardoso A. , Aguiar P. , Byrne M. , Xavier M. 
Published: May 2016

IntroductionClinician's attitudes are an important consideration in implementing adherence strategies and that these attitudes can be successfully improved as a result of training. The 22-item Medication Alliance Beliefs Questionnaire (MABQ; Byrne et al.2008) was used to assess clinician attitudes towards non-adherence. The MABQ contains five subscales reflecting the clinician's self-efficacy (adequacy), the satisfaction (work satisfaction); their appraisal of their self-worth (self-esteem), their outcome expectancies (pessimism) in relation to non-adherent patients, and the extent to which they understand the difficulties patients might experience in trying to adhere to treatment (empathy).Aims/objectivesTo develop the Portuguese version of the MABQ.MethodsThe MABQ was translated and adapted for Portuguese language. The translation was done by the first author (AC). The accuracy of this translation was discussed in a two focus group of experts, providing opinion on face and content validity. After pre-testing, the final version of the Portuguese translation was produced.ResultsA convenience sample of 65 mental health professionals working in a variety of settings is being collected. The average score in MABQ was 80.06 (SD 9.5). The value of internal reliability coefficient α was 0.80. The intraclass correlation coefficient of total MABQ score was 0.35. The t-test showed that there were no statistically significant differences between the mean values of the measurement scale at two different times (80.4 vs.76.2; P = 0.02).ConclusionThe attitudes of mental health professionals may have a predictive relationship with treatment outcomes of patients with mental health disorders. The validation of the Portuguese version of MABQ will provide professionals with a new tool to evaluate crucial issues related to medication beliefs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Decisional Trust and Regret Mediate the HRQL in Work-Related Hand Injury Patients
Authors: Liao H.H. , Cheng S.L. , Chang C.C. , Lin C.H. , Liu F.C. , Cheng C.S. 
Published: May 2016

BackgroundDespite mounting evidence that non-injury-related factors have an important role in recovery from injury; specific variables associated with surgery outcomes are poorly understood. This lack of knowledge complicates efforts to improve the care of work-related hand injury (WRHI) patients. However, substantial research and investigation have still not clarified these underlying relationships, which merit further attention.ObjectiveThe purpose of this study was to evaluate the Health-Related Quality of Life (HRQL) outcome for WRHI patients after the impact of event and to investigate the moderated mediation analysis associated with their decision trust and regret.MethodsA cross sectional study design was used to investigate the impact of event and the associated HRQL in 53 WRHI patients following severe and major hand injury. All consenting patients completed the Impact of Event Scale Revised, the Symptom Checklist-90-Revised, Decisional Trust scale, Decisional Regret scale and Short Form-36.Anticipated achievementIn the result of mediation analysis, patients affected HRQL via decisional trust and decisional regret, respectively. In addition, our data suggest that certain decisional trust and decisional regret (partial) characteristics significantly moderate this association. These findings may aid in the development of clinical interventions to enhance HRQL for WRHI patients. Overall, it is important for clinicians to consider the notion that more decisional trust or less decisional regret may sometimes, but not always, be better.Disclosure of interestThe authors have not supplied their declaration of competing interest.