bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric Disturbances in a Patient with Melas Syndrome: a Case Report
Authors: Rizza M.C. , Di Marco S. , Delicato C. , Vecchi C. , Gramaglia C. , Prosperini P. , Cantello R. , Zeppegno P. 
Published: May 2016

IntroductionMitochondrial disorders of energetic metabolism (MD) represent a heterogeneous group of diseases manifesting at any age and its one of a number of mitochondria syndromes that share the common characteristics of encephalopathy and myopathy. The clinical expression of MELAS (Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis and Stroke-like episodes) is highly variable and ppsychiatric symptoms are rarely reported in literature even if are more common in MELAS syndrome than in the general population.ObjectiveThe first aim of the study is describing the clinically observed primary psychiatric symptoms in a patient affected by MELAS syndrome admitted to the Psychiatric ward. The second aim is to go back over the diagnostic process, which led, from the uncommon psychiatric symptoms and signs to the final genetic diagnosis of MD.Methods and resultsWe report the case of a 44-year-old male with MELAS in whom psychiatric symptoms preceded the establishment of the clinical diagnosis for several months. Diagnosis was initially based on the neuroimaging and metabolic findings and subsequently confirmed with genetic analysis.ConclusionsIn case of aggressive and paranoid behaviour with delusions of persecution and disorganised behaviour mmitochondrial disorders deserve consideration as part of the differential diagnosis, especially if there is suspected involvement of other organ groups or positive family history of MD. There is no specific consensus approach for treating MELAS syndrome. Management is largely symptomatic and should involve a multidisciplinary team.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Prepulse inhibition in euthymic bipolar disorder patients in comparison with control subjects
Authors: Santos J.L. , Mateo J. , Aparicio A. , Sánchez-Morla E.M. 
Published: May 2016

IntroductionDeficient prepulse inhibition (PPI) of the startle response, indicating sensorimotor gating deficits, has been reported in schizophrenia and other neuropsychiatric disorders.Objectives and aimsThe present study aimed to assess sensorimotor gating deficits in euthymic bipolar patients. Furthermore, we analysed the relationships between PPI and clinical and cognitive measures.MethodPPI was measured in 64 euthymic bipolar patients and in 64 control subjects matched for age, gender, education level and smoking status. Clinical characteristics and level of functioning were assessed in all participants using the Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS) and Functioning Assessment Short Test (FAST). Cognition was evaluated using the MATRICS Consensus Cognitive Battery (MCCB) and the Stroop Test as an additional measure of executive function.ResultsCompared with controls, patients with bipolar disorder exhibited PPI deficits at 60- and 120-milliseconds prepulse-pulse intervals. Among patients with bipolar disorder, PPI was correlated with the social cognition domain of the MCCB. PPI was not significantly correlated with other clinical or neurocognitive variables in either group.ConclusionsOur data suggest that PPI deficit is a neurobiological marker in euthymic bipolar disorder, which is associated with social cognition but not with other clinical, functional or cognitive measures.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Mini-Mental State (MMS) Evaluation of Dementia in Psychiatric Patients Admitted to a Long Stay Ward
Authors: Amel N. , Isabelle L.P. , Aurelie G. , Marc H. , Mohammed A. , Ziad I. 
Published: May 2016

Normal 0 21 false false false FR X-NONE X-NONE MicrosoftInternetExplorer4.MMS scores for 41 psychiatric patients were analyzed at admission and regularly throughout their stay.ResultsTheir average age at admission was 65.7. Thirty-six patients had a diagnosis of chronic psychosis, two with bipolar disorders, one with frontotemportal dementia, two with Korsakoff syndrome.At admission, 21 (51%) patientsshowed mild cognitive deterioration (score = 18–26), 12 (29%) moderate deterioration (12–17), 6 severe deterioration (0–11), 2 had normal scores (27–30). Over the following years, 28 patients were reassessed:– 12 (42%) were stable, 7 (25%) had a fluctuating score, 5 (18%) improved;– 4 (14%) deteriorated over their successive MMS evaluations;– age, socio-cultural level and psychiatric diagnosis were not associated with change in MMS scores;– average change between initial and final assessment was +6.0 points for patients with improved score, –7.75 for those showing deterioration;– 1.28 for those with fluctuating scores, –1.0 for stable patients.AnalysisUnstable psychiatric disorders associated with somatic pathologies influenced MMS scores for all patients, particularly for those with MMS deterioration or fluctuation even if this phenomenon could also be observed to a lesser extent in stable patients. By contrast, patients whose MMS scores improved over time were more mentally stable and had no current somatic problems. Multidisciplinary teamwork is important for patients with deteriorating MMS scores.ConclusionBy illustrating the impact of somatic and psychiatric factors on dementia, the present study underlines the value of multidisciplinary professional care, the role of the family and the importance of long-stay wards.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Comparative Efficacy and Safety of Antidepressive Mono- and Multimodal Therapy with Citicoline in Elderly Patients with Depression in Psychogeriatric Unit
Authors: Kalyn Y. , Gavrilova S. , Safarova T. , Shipilova E. 
Published: May 2016

IntroductionCiticoline is a choline donor involved in the biosynthesis of brain phospholipids and acetylcholine, used for treating neurodegenerative disorders. Several studies have shown its beneficial effects both in degenerative and vascular cognitive decline. Due to its effects on the adrenergic and dopaminergic CNS activity, citicoline can also be used as an adjuvant in depression treatment.Objectives and aimsComparative evaluation of efficacy and safety of a multimodal antidepressive therapy with ceraxone (citicoline) plus one of the antidepressants (venlafaxine, agomelatine, or fluvoxamine) and monotherapy with the same antidepressant for the treatment of depression in the elderly. Two groups of patients were included in the study (21 patients in each group) aged from 60 to 79 years old, comparable to the main clinical characteristics.MethodsFirst group patients were treated with a single antidepressant, patients of the second group – with the same antidepressant and intravenous infusions of ceraxone: 10 infusions (500 mg in 100 mL isotonic sodium chloride solution) during 2 weeks, followed by transfer to the drug in solution at 3 mL per os two times a day for six weeks.ResultsA multimodal therapy with ceraxone leads to more rapid and significant therapeutic response along with the reduction of adverse events compared to antidepressant monotherapy.ConclusionObtained data allows to recommend a multimodal antidepressive therapy with ceraxone (citicoline) for the treatment of elderly depressive patients to reduce the risk of adverse effects of antidepressants and to shorten hospitalization period.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Very Late-onset Schizophrenia-Like Psychosis: Case Report and Current Status of the Issue
Authors: Aragón R. Martín , Rodríguez M. Gutiérrez , Herrero S. Bravo , Menguian C. Moreno , Criado N. Rodríguez , Fourcade J.F. Cruz , Franco P. Muñoz-Calero , Sánchez B. Sánchez 
Published: May 2016

IntroductionSchizophrenia has traditionally been considered to strictly be an early-onset disorder. Current nosologies, including DSMV, are not restrictive with age of onset in schizophrenia and all patients that satisfy diagnostic criteria fall into the same category. Since 1998, International Late-Onset Schizophrenia Group consensus, patients after 60 are classified as very-late onset schizophrenia-like psychosis. Female overrepresentation, low prevalence of formal thought disorder, and a higher prevalence of visual hallucinations are associated with later age at onset. Atypical antipsychotics represent the election treatment because of the reduced likelihood of EPS and tardive dyskinesias, and should be started at very low doses, with slow increases.ObjectiveTo review the current knowledge about very late-onset schizophrenia through systematic review of the literature and the analysis of a case.MethodsCase Report. Review. Literature sources were obtained through electronic search in PubMed database of last fifteen years.ResultsWe present a case of a 86-year-old woman suffering from delusions and hallucinations, diagnosed with very late-onset schizophrenia-like psychosis, after differential diagnosis with other disorders. We analyze ethiology, epidemiology, clinical features and treatment in geriatric patients with schizophrenia.ConclusionsReluctance to diagnose schizophrenia in old people is still present today, probably in relation with the inconsistency in diagnostic systems and nomenclature, and consideration of medical conditions in the diagnosis. Identification of these patients is really important in order to start an appropriate treatment, which can lead to patient clinical stability.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Depression in Geriatric Inpatients: Correlations with Nutritional State and Cognitive Functions
Authors: Bonfitto I. , Moniello G. , Ariano L. , Pascucci M. , Zanasi M.D. , Bellomo A. 
Published: May 2016

BackgroundAlthough the prevalence of malnutrition is relatively low among elderly people, the risk increases significantly among inpatients and even more in those with mental deterioration.AimsTo evaluate the possible association between the severity of depressive symptoms, the nutritional status and the cognitive decline in a sample of geriatric inpatients.MethodsFifty-one geriatric inpatients completed the following tests:– Hamilton Depression Rating Scale (HAM-D), to assess the severity of depressive symptoms;– Mini Nutritional Assessment (MNA), as a nutrition screening and assessment tool;– Mini Mental State Examination (MMSE), to assess the cognitive impairment.ResultsThere is a negative proportional relationship between HAM-D and MMSE scores (P = 0.001) and between HAM-D and MNA scores (P = 0.023). Depressed patients found to have a greater cognitive impairment and a worse nutritional status. Considering a HAM-D cut-off point of 14, distinguishing mild than moderate depression, it shows a significant correlation with the MNA scores (P = 0.008). Patients with HAM-D scores ≥ 14 have an average MNA score of 19.8, while patients with HAM-D scores < 14 have an MNA average score of 23.6. Euthymic or mildly depressed patients are not at risk of malnutrition, while those with moderate or severe depression have an increased risk of malnutrition.ConclusionsOur study shows significant correlations between the severity of depressive symptoms and the risk of malnutrition or cognitive impairment. A mild depression state does not seem to be associated with an increased risk of malnutrition.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neuropsychological and Motivational Factors of Cognitive Efficiency in Elderly Patients with Essential Arterial Hypertension
Authors: Pervichko E. , Zinchenko Y. , Ostroumova O. 
Published: May 2016

IntroductionThe diagnostics of cognitive disorders (CD) in patients with essential arterial hypertension (EAH) is often necessary for the choice of treatment strategy.ObjectiveTo assess the role of neuropsychological and motivational factors in cognitive efficiency of elderly EAH patients.Materials and methodsTwenty-five patients with EAH took part in the study, stage 1–2, mean age was 67.6 ± 6.1. The assessment of cognitive functions embraced a quantitative measurement of intelligence quotient (IQ) with the Wechsler Adult Intelligence Scale (Wechsler, 1955), and investigation into qualitative features of cognitive processes with Luria's neuropsychological assessment scheme (Luria, 1980) and Zeigarnik's procedure of pathopsychological study (Zeigarnik, 1972).ResultsWithin the psychological syndrome structure of CD in EAH patients the leading part is played by the neuro-dynamic factor, manifested in general lability, slowing down, and sudden exhaustion caused by reduction in energy of mental activity. The conclusion is supported by the high frequency of described symptoms among EAH patients and low dynamics of their reduction against the antihypertensive therapy (Pervichko et al., 2014, 2015). However, performance of experimental tasks makes 30% of EAH patients reveal reduced motivation. They would achieve poor results in general scoring, if compared with the group of highly motivated participants. Correlation analysis data show the interconnection between frequency disturbances in motivation and frequency in occurrence of various signs of cognitive decline, such as low efficiency in memorization and delayed recall, as well as low IQ indices.ConclusionsThe data provide a strong argument to support the hypothesis of particular importance of motivational factor of cognitive efficiency in elderly EAH patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A Case of Catatonia, Klebsiella Pneumoniae Lung Infection and Intellectual Disability: Differential Diagnosis
Authors: Ballesteros A. , Montes L. , Jaimes W. , Cortés B. , Inchausti F. , Alex P. , Collantes J. 
Published: May 2016

IntroductionIn DSM-V, catatonia is individualized as a disease of its own. The priority is to look first for organic causes like intoxication. We present a clinical case diagnosed with intellectual disability (ID) and catatonia.ObjectiveTo study a case of catatonia which underwent testing using Bush-Francis Catatonia rating scale (BFCRS) prior/after clinical intervention. We therefore study catatonia's etiology in ID population.AimsTo study the etiology of catatonia (and its clinical complications) in ID.MethodOur patient is 48-year-old female with DI. Considering her clinical features of catatonia (using BFCRS) and clinical examination (fever and hypoxia), the case orientated towards a secondary diagnosis. Work-up tests revealed pneumonia in the lower lobe of the right lung (chest radiography showed opacities and blood tests showed Leuokocytosis with a left shift). The case further received a course oral levofloxacin (500 mg/day) and haloperidol was stopped. Valproic acid was also added to a dose of 600 mg/day, which led to clinical improvement. Remaining psychotropic treatment (duloxetine 60 mg/day, lorazepam 15 mg/day, diazepam 35 mg/day) was not modified.ResultsAfter 1 month, the patient improved according to BFCSR score.ConclusionsWe presented a case of presence of catatonia in other psychiatric conditions and undiagnosed general medical conditions. Haloperidol is contraindicated those circumstances and it may have worsened her clinical state (it should be used cautiously in DI). Other medications (gabaergic drugs) should be considered in such settings and rare causes related to hypoxia cannot be ruled out (Table 1).Disclosure of interestThe authors have not supplied their declaration of competing interest.
Challenging Behaviour in People with Intellectual Disabilities: The Assessment and Intervention Team
Authors: Courtenay K. , Jaydeokar S. 
Published: May 2016

ObjectivesPeople with intellectual disabilities (ID) present with behaviours that challenge community services. Community models of care as alternatives to hospital care exist but are often vary in their function. Certain strategies have been developed to manage challenging behaviour in people with ID. Data from a three-year period on a community-based service for people with ID and challenging behaviour that uses an objective, multi-disciplinary approach is presented.MethodsA case note survey of adults with ID under the care of the Assessment and Intervention Team (AIT), a challenging behaviour service in the London Borough of Haringey.ResultsOver the three-year period, 65 adults were managed by AIT. Forty-four were male and 21 were female. The age range was 21–64 years of age. The level of ID was mild ID 61%, moderate 39%. Diagnoses included psychotic disorder (25%); mood disorder (20%); developmental disorder (40%); dementia (10%); challenging behaviour (45%). Six people (11%) were admitted to hospital during their time with AIT. The length of care under AIT ranged from four to fourteen months.ConclusionsAIT managed effectively people with ID living in the community who presented with complex problems putting their placement at risk. The rate of hospital admission was reduced in this period compared with the previous three years. The length of stay in in-patient services was reduced. The most common reasons for the behaviours included mental illness and ‘challenging behaviour’. People with developmental disorders were a large proportion. Community alternatives are effective with positive benefits to the person.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Comparison of treatment response of typical and atypical antipsychotics in acute mania
Authors: Medici C.R. , Kai L.M. , Kirkedal C. , Straszek S.P.V. 
Published: May 2016

IntroductionThe medical treatment of acute mania today mainly includes atypical and typical antipsychotics, lithium or valproat. Atypical antipsychotics are often used as first-line treatment, while typical antipsychotics come with the risk of severe long-term side effects and less used today. However, typical antipsychotics may lead to a faster reduction in the severity of mania or a faster remission of symptoms.ObjectiveTo investigate whether the acute effect of typical antipsychotics differs from atypical antipsychotics measured by a daily mania rating-scale (MAS-M) and duration of treatment in a real-life clinical setting.AimTo help determine if short-term treatment with typical antipsychotics may still be of benefit in the acute treatment of mania.MethodsThis is a retrospective case record study. Patients admitted to an acute hospital ward with acute mania between 2012 and 2015 were included (n = 100). The daily use of atypical and typical antipsychotics will be compared by daily change in Bech-Rafaelsen Modified Mania Scale (Mas-M) score and time to discharge. The change in mania over time is presented visually using graph curves.ResultsThe data extraction and data handling will be executed in the winter 2015–2016.ConclusionsAny preliminary findings will be presented at EPA 2016.
A Three-Month Follow-Up Study Evaluating Changes in Clinical Profile and Attitudes Towards Involuntary Admission
Authors: Bainbridge E. , Hallahan B. , McGuinness D. , Higgins A. , Murphy K. , Gunning P. , Newell J. , McDonald C. 
Published: May 2016

IntroductionInvoluntary admission and treatment is often a traumatic experience for patients and there is a wide variation in attitudes towards care even when patients are recovered.Objectives/aimsThe purpose of this large prospective study was to identify clinical predictors of attitudes towards care during involuntary admission.MethodsThree hundred and ninety-one consecutively admitted involuntarily patients to three psychiatric inpatient units over a 30-month period were invited to participate in the study. Comprehensive assessments at admission and 3 months after discharge were attained including measures of symptoms, insight, functioning, attitudes towards involuntary admission and coercive experiences. Multiple linear regression modelling was used to determine the optimal explanatory variables for attitudes towards care.ResultsTwo hundred and sixty-three individuals participated at baseline and 156 (59%) successfully completed follow-up assessments. Individuals improved significantly over time clinically and in their attitudes towards their care. At baseline greater insight (P < 0.001) and less symptoms (P = 0.02) were associated with more positive attitudes towards care as was older age (P = 0.001). At follow-up, greater insight (P < 0.001), less symptoms (P = 0.02) and being older (P = 0.04) were associated with more positive attitudes towards care. More positive attitudes towards care at follow-up were associated with greater improvements in insight over time (P < 0.001) and having a diagnosis of an affective psychosis (P = 0.0009).ConclusionsThe best predictors of positive attitudes towards care during and after involuntary admission are illness related factors, such as levels of insight and improvement in insight, rather than service or legislation related factors, such as the use of coercive measures, seclusion and restraint.Disclosure of interestThe authors have not supplied their declaration of competing interest.
An Empirical Study of the Working Conditions in the Drug Prevention Centers of Attika, Greece: New Prospects And Possibilities In An Era Of Uncertainty
Authors: Dritsas I. , Theodoratou M. , Margaris T. , Christodoulidis S. , Valsami O. 
Published: May 2016

IntroductionStudies have documented that drug prevention centers in Greece have been through an era of turmoil and uncertainty (EKTEPN, 2015, Tsounis, 2012, Kiritsi and Tsiotra, 2004) underlining the staff's hard work all over Greece.PurposeThe aim of this study was to investigate the effects of the current fiscal crisis on the operating conditions as described by the staff of the Attica substance prevention centers with the emphasis on main problem areas and solutions.MaterialStatistically reliable questionnaires were used by the research team investigating participants views on the aforementioned areas of enquiry.MethodTwo Questionnaires were administered to 59 psychologists and social workers working at the centers of Attica, Greece during the summer of 2015.ResultsThe majority (85%) of those working at the centers mentioned the main problems as following:– issues concerning the institutional role of the centers, the education and supervision of the staff;– fiscal issues as a result of the economic austerity, which undermine the operation of the centers and the morale of the staff.ConclusionsOur empirical study is actually the first one which delves into the inner workings of the drug prevention centers in Attica, Greece:– the extent the phenomenon of drug dependence in Greece, examining the epidemiology and the influence of the financial crisis, as well as the strategies and action plans developed in a national and EU level;– the most significant innovative and standard European and Greek prevention programs.Finally, research methodological issues are discussed in the light of the main findings of the empirical research.Disclosure of interestThe authors have not supplied their declaration of competing interest.