bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyponatremia associated with selective serotonin-reuptake inhibitors
Authors: Petrykiv S. , De Jonge L. , Arts M. 
Published: June 2017

IntroductionPsychotropic agents have been implicated in the cause of hyponatremia, including the majority of selective serotonin reuptake inhibitors (SSRIs). The reported incidence of hyponatremia caused by SSRIs varies widely up to 40%. Important risk factors are older age and concomitant use of diuretics. Though there are numerous retrospective studies available, an update of current knowledge SSRI induced hyponatremia is warranted.Objectives and aimsTo review the incidence, risk factors, mechanism, times of onset and resolution, and treatment of hyponatremia associated with selective serotonin-reuptake inhibitors (SSRIs).MethodsAn English language literature search was conducted using Pubmed, EMBASE and Cochrane library (December 1980–December 2015) using the search terms selective serotonin-reuptake inhibitor, hyponatremia, syndrome of inappropriate secretion of antidiuretic hormone, citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline.ResultsNumerous case reports, observational studies, and case-controlled studies, as well as one prospective clinical trial, have reported hyponatremia associated with SSRI use, with an incidence of 15%. Risk factors for the development of hyponatremia with SSRIs include older age, female gender, and concomitant use of diuretics, low body weight, and lower baseline serum sodium concentration. Predisposing factors, such as volume status, diuretic use, or concomitant use of other agents known to cause SIADH, may predispose to the development of hyponatremia. In published reports, hyponatremia developed within the first few weeks of treatment and resolved within 2 weeks after therapy was discontinued.ConclusionPractitioners should be on the alert for this potentially life-threatening adverse event, especially in older adults.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Aripiprazole once monthly outpatient experience
Authors: Sánchez Páez P. , Gómez Cano J.L. , Sánchez Flores L. , González Lucas R. , Artieda Urrutia P. 
Published: June 2017

IntroductionAripiprazole once monthly (AOM) is one of the most recently introduced antipsychotics with a different mechanism of action, which seems to bring clinical and tolerability implications [1].ObjectivesWe describe the patient profile that may benefit from AOM treatment.MethodsThis is a single-centre, retrospective, one year follow-up study of 13 cases of ambulatory AOM use. We analyze clinical and functional evolution, and the tolerability profile of patients in a real clinical practice basis.ResultsMean age was 53.69; 53.8% were males and 46.2% females. The most frequent diagnosis was Schizophrenia and other chronic psychosis (69.3%). Only 7.7% had co-morbidity with substance use disorder (cocaine); 61.6% were on previous treatment with other injectable anti-psychotics; 84,6% of the sample received AOM as monotherapy. Reasons for switching to AOM are shown on Fig. 1. Events during switching are shown on Fig. 2. Outcomes with AOM long-term treatment were positive in 84.61% of cases and are shown on Fig. 3.ConclusionsSwitching to AOM could be considered as a good strategy to improve tolerability, functionality and ultimately adherence to treatment in patients in middle age of life with a chronic psychotic disorder [2].Fig. 1Reasons for switching.Fig. 2Events during switching.Fig. 3Outcomes with AOM.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Treating bipolar disorder in pregnancy
Authors: Solana C. , Nascimento S. , Mendes M. , Duarte M. 
Published: June 2017

IntroductionBipolar disorder is a chronic psychiatric illnesses characterized by alternating episodes of mania/hypomania and major depression, or with mixed features. Acute exacerbations and maintenance treatment with appropriate pharmacotherapy are mandatory. Long-term treatment with mood-stabilizing medications is typically required. The incidence of bipolar disorders in women during the primary reproductive years is very high, and the episodes of mania or depression are thought to occur in an estimated 25%–30% of women with bipolar disorder during pregnancy.ObjectivesProvide a clinically focused review of the available information on the effectiveness and safety of the different pharmacotherapies in the treatment of bipolar disorder during pregnancy.MethodsA bibliographic review is made of the pregnancy in bipolar disorder, based on the data published in PubMed.ResultsClinical decision making about the use of mood stabilizers and atypical anti-psychotics by pregnant women can be conceptualized as balancing the competing risks imposed by withholding or stopping pharmacotherapeutic treatment against that of continuing or initiating pharmacotherapy during pregnancy. Some of the most effective pharmacotherapies have been associated with the occurrence of congenital malformations or other adverse neonatal effects in offspring. There is few information about the safety profile and clinical effectiveness of atypical anti-psychotic drugs when used to treat bipolar disorder during pregnancy.ConclusionsTreating women with bipolar disorders during pregnancy is a challenge. There are no uniformly effective or risk-free treatment options. Fully informed decision-making requires the review of the risks of both untreated maternal bipolar disorder and risks associated with potentials interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychiatrists’ opinions on long-acting anti-psychotics drugs: Perceived differences and identification of the ideal patient for each of these medications
Authors: Verdino V. , Fagiolini A. 
Published: June 2017

IntroductionLong-acting anti-psychotic drugs (LAI) are increasingly used in clinical practice, owing to their ability to improve adherence.Objectives and aimsTo understand the variables that inform treatment choice, within the LAI anti-psychotics, in the daily clinical practice.MethodsFifteen attending psychiatrists from the university clinic of Siena and the community mental health service USL 7 Siena and Val d’Elsa were asked to answer a questionnaire comprising 4 questions, and asking for their clinical experience regarding olanzapine, risperidone, haloperidol, zuchlopentixol, paliperidone and aripiprazole LAISs.In particular, they were asked to indicate:– which LAI has been their mostly used;– what have been the most relevant side effects;– an efficacy score ranging from 0 to 5;– who the ideal patient for each of these medications could be.The answers were statistically assessed and the final results described as a percentage of the total.ResultsThe results are shown by the Tables 1 and 2.ConclusionsLAI are still heterogeneously used in the daily clinical practice: their actual use depends on the individual experience with a specific drug as well as on their costs and the availability of resources within the medical service. The most used LAI resulted to be risperidone, although haloperidol LAI is still considered to be the most effective one. Those psychiatrists interviewed had an overall good opinion about the most recent LAI such as paliperidone and aripiprazole. This is due to their good tolerability, which allows them to be administered more safely to the youngest, in order to preserve their good functioning.Table 1Table 2Disclosure of interestThe authors have not supplied their declaration of competing interest.
Clozapine treatment of adolescent refractory emergent emotionally unstable personality disorder: Challenges in diagnostics and therapeutics
Authors: Whitaker S. , Mathe M. 
Published: June 2017

Despite recent advances precision diagnostic criteria on how best to diagnose and treat EUPD remains debated. Therapeutic indication and appropriate use of anti-psychotics including clozapine in this patient group remains unclear. It is debated about personality disorder being diagnosed in children and adolescents, overall it is much more acceptable for adolescents to be given a diagnosis of ‘emerging’ personality disorder if they exhibit clinical features of such. Clozapine has been used (as an off-license treatment) in adults diagnosed with personality disorder improving psychopathology and quality of life. These patients have been tried on numerous other treatments. In a secure unit for adolescent girls who meet the criteria for a diagnosis of emergent personality disorder who posed serious risks to themselves and others three were given a trial of clozapine The off license use of clozapine was tried in all three patients showed a reduction in incidents, reduced need for polypharmacy and improvement in their qualities of life. One cannot account for these changes being the result of clozapine alone; however, these cases add to the growing body of evidence of the benefits of clozapine in patients with emergent personality disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Modified Electroconvulsive Therapy in Pseudocholinesterase Deficiency: A Case Report
Authors: Yildizhan E. , Tomruk N.B. , Dereli M. , Özdemir A. , Yıldırım H. , Canbek Ö. 
Published: June 2017

Introduction.Pseudocholinesterase (PCHE) deficiency is an inherited condition, in which recovery from anesthetic agents like succinylcholine and mivacurium is slow and complicated with prolonged paralysis of respiratory muscles in susceptible patients. Succinylcholine is used very frequently as a muscle relaxant during the procedure.Objectives.In Bakirkoy research and training hospital for psychiatric and neurological diseases, 24.310 patients were hospitalized for acute conditions and 3490 of these patients were treated with electroconvulsive therapy (ECT) in 3 years. We present a very rare case that we encountered in our practice; a severe PCHE deficiency case that could have complicated the modified ECT procedure unless necessary precautions were taken.Aims.Detection of PCHE levels of all patients eligible for ECT is part of our pre-ECT assessments procedure, and the case presented here shows the benefits of this method.Methods.The patient is a 29-year-old woman, with a 15 year history of schizophrenia. She was hospitalized for homicidal risk and refusal of treatment. Inadequate clinical response with pharmacological interventions and continuous aggressive excitations directed us to consider ECT.Results.After the detection of PCHE deficiency (PCHE level: 126 U/L), we performed the modified ECT with propophol and rocuronium instead of succinylcholine as usual. Sugammadex 100 mg was used for fastening the recovery. Response to treatment, which is recorded with positive and negative syndrome scale, was good and we completed 9 ECT sessions without complication.Conclusions.Screening for PCHE levels in the pre-ECT assessments is efficacious in order to decrease the complications of the ECT procedure.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Pollyanna Syndrome in Psychotherapy-or Pseudotherapy. Counseling, Consoling or Counterfeiting?
Authors: Latecki B. 
Published: June 2017

Pollyanna syndrome, the name being taken from a book of the same title, means “an excessively or blindly optimistic person.” The occurrence and danger of such attitudes in psychotherapy is discussed. Such attitudes may occur both in patients and their therapists. Either of them may say “things will not be so bad...” attempting to console not him/himself but the other party. The main aim of psychotherapy is to facilitate taking responsibility and decisions. But there are also other aims, identical to those attributed to philosophy in ancient times, namely, “to treat the soul” or, clinically speaking, to provide consolation. This is usually achieved by attributing meaning and purpose to suffering and set-backs. In the paper, I discuss how the therapist could avoid the trap of being and coercing the patient to be “optimistic, positive, and strong” when the situation does not necessarily warrant such an attitude. Philosophy may be of help here. One may apply theodicy, that is, the philosophical attempt to explain and justify the evil existing in God's world. Another possibility is Ericksonian approach of utilization, paradoxical intervention, using metaphors and hypnotic techniques in order to let the patient come up with his own, intimate resources facilitating recovery. Logotherapy, which is an existential approach is recommended, either as such or as a part of REBT. In short, the difference between an ineffective and an effective approach is the difference between being optimistic and being realistic.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Borderline Personality Disorder – Dilemmas and Therapeutic Challenges
Authors: Tasic G. , Anakiev S. 
Published: June 2017

Treatment of borderline personality disorder has some specifics relative to other disorders, which are deriving from nature and structure of those people. Treatment is very slow, often with interruptions, and it presents a special challenge for contratransferal feelings but at the same time offers a possibility of continuous learning, for the patient and the therapist. Main characteristics of this personality disorder are the diffusion of identity, primitive defence mechanisms concentrated around the cleft and relatively preserved ability to rest reality. As classical psychoanalysis and psychoanalytical psychotherapy did not give results in therapy of this disorder, Otto Kernberg took its basic techniques but used them adjusted for borderline personality disorder, developing so called transfer focused psychotherapy. This paper will present the main principles of this modification, applied in practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Brief Family Psycho-Education Program for Caregivers of Inpatients with Severe Mental Illness
Authors: Lima F. , Selau T. , Menegalli V. , Magalhães P. , Rosa A. 
Published: June 2017

IntroductionFamily psycho-education is an essential part of the treatment for people with severe mental illness (SMI), however this relevant intervention is underutilized. Shortened variations of family psycho-education have been described in attempts to make it more attractive, efficient, and feasible.Objectives/aimsConsidering the lack of manualized intervention for families in Brazil, our study comes up with a proposal to implement and to evaluate the feasibility of brief family psycho-education program (BFPP) during inpatient psychiatric treatment.MethodsAn extensive review using a combination of the words: “family psychoeducation”; “severe mental illness”; “schizophrenia”; “bipolar disorder” was conducted in PubMed/Medline with the aim to select reports of multifamily group psycho-educational programs. Studies involving adults with severe mental illness published until March 2016 were included.ResultsAfter the review of literature and meeting with experts in SMI, the BFPP was developed collaboratively by bipolar disorders’ team at Hospital de Clínicas de Porto Alegre (HCPA). The standard BFPP consists of four sessions: (1) causes, symptoms, course, prognosis and stigma of severe mental disorder; (2) treatment; (3) community resources, communication skills and importance of healthy and regular habits; and (4) problem-solving strategies: preventing relapses and establishing plans for crisis. Each session will occur weekly, lasting 90 min, with 8–12 caregivers. The patients did not attend the group.ConclusionWe purposed a standard, brief, cheap and simple intervention to apply. We believe that BFPP is highly suitable for caregivers of patients with SMI. We hope that this program demonstrates feasibility among participants and become a useful and effective intervention.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Is Social Frustration Typical of Multiple Sclerosis Patients?
Authors: Nikolaev E. , Vasil’eva N. 
Published: June 2017

IntroductionPsychological problems of multiple sclerosis patients are often studied in context of distress and depression or quality of life concept. However, analysis of social frustration still has not been an object of research interest. Whereas ignoring patients’ feelings of frustration and social worry may worsen the prognosis of treatment.Objectives and aimsTo study if the social frustration prevalent among multiple sclerosis patients.MethodsWe studied 104 multiple sclerosis patients during in-patient treatment in neurological unit. Male and female patients aged between 19 and 64 years were diagnosed relapsing-remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS). Psychological indicators of social frustration were assessed by using “The level of social frustration” questionnaire.ResultsLack of social frustration was revealed only in 5% of multiple sclerosis patients. The most frequent area of social frustration in the patients was the sphere of health and labor activity (45%). The second area of social frustration was dissatisfaction with the socio-economic status (37%), the third – the social status (26%). Both male and female patients were equally dissatisfied with their physical condition. Men were more frustrated with their material condition, women – with their inability to work. Some differences were also defined in clinical groups. RRMS patients were more frustrated in need for their status in the society, SPMS patients with their psychological and emotional state.ConclusionsThe directions of typical social frustration in multiple sclerosis patients, associations with clinical and gender factors may be considered in system of treatment and rehabilitation.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Genetic Methods for Drug-Resistant Epilepsy
Authors: Salohiddinov M. 
Published: June 2017

ActualityMechanisms of underlying pharmacoresistance have been explored insufficiently. Enzymes of a system for biotransformation of xenobiotic and transporters for drugs are the key participants in the systems of metabolism of antiepileptic drugs (AEDs). Among proteins-transporters, glycoprotein P encoded by MDR1 gene plays an essential role in the processes of uptake, distribution and excretion of AEDs.ObjectiveThe work initiated to study gene MDR1 C3435 T polymorphism and to assess its association with pharmacoresistance formation in patients with epilepsy receiving antiepileptic drugs (AEDs).MaterialsStudy involved 89 patients with localization-related epilepsy and 55 unrelated healthy subjects.ResultsDistribution of 3435 T/C polymorphism in NDR1 gene was analyzed in the patients with the localization-related epilepsy and nominally healthy donors. The distribution of frequencies of gene alleles was found to correspond to the Hardy-Weinberg equilibrium (Р > 0.05). Incidence of genotypic variants of the polymorphism was as follows, СС was found in 18.6%, СТ and TT were observed in 55.9% and 25.4% of cases. In the controls СС was found in 60.0%, СТ and TT were observed in 33.3% and 6.6% of cases, respectively. The findings are the evidence for significant effect of functionally weak variants in C3435 T polymorphism of MDR1 gene on efficacy of antiepileptic therapy.Conclusionpresence of T-allele of C3435 T polymorphism of MDR1 gene increases risk of pharmacoresistance in the patients with epilepsy and is a significant and predicting criterion of efficacy and feasibility of the antiepileptic therapy conducted.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The comprehensive Icf core set for schizophrenia from the perspective of psychiatrists: A content-validity study using the Delphi technique
Authors: Nuño L. , Barrios M. , Rojo E. , Gomez-Benito J. , Guilera G. 
Published: June 2017

IntroductionSchizophrenia is a chronic mental illness associated with several functional impairments. There has been an increasing interest in the impact of schizophrenia on functioning. The development of the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for schizophrenia, a shortlist of 97 ICF categories that are relevant for describing functioning and disability of people living with schizophrenia, has derived from this interest.ObjectivesThis study aims to explore the content validity of this core set from the perspective of psychiatrists.MethodsIn a 3-round Delphi survey, psychiatrists experienced in schizophrenia treatment were asked about patients’ problems, resources and environmental factors they treat in patients with schizophrenia.ResultsA total of 352 psychiatrists from 65 countries representing all six World Health Organization regions completed the first round questionnaire. The response rate at the third round was 86%. Answers were linked to 422 ICF categories. Of all these, 109 ICF categories reached consensus (≥ 75% agreement) at the third round. Eighty-seven out of the 97 ICF categories that form the comprehensive ICF core set for schizophrenia were represented in this list. All the comprehensive ICF core set for schizophrenia categories reached consensus except five categories.ConclusionsThe content validity of the comprehensive ICF core set for schizophrenia from the perspective of psychiatrists was largely supported. However, further research is needed including other health professionals (e.g., psychologists, nurses and occupational therapists) to further obtain new content validity evidences.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Peripersonal space and schizophrenia: Looking for the self boundaries
Authors: Corbo M. , Di Cosmo G. , Ferri F. , Salone A. , Carlesi D. , Centofanti M. , Cipollone F. , Costantini M. , Di Iorio G. , Martinotti G. , di Giannantonio M. 
Published: June 2017

IntroductionPeripersonal space has been defined as the area immediately surrounding the body in which interactions with a person or an object can occur. Larger peripersonal space may reflect discomfort in close interpersonal situation or cognitive deficit. Individuals with schizophrenia are more sensitive to social stimulation. The capacity to provide accurate judgments of peripersonal space boundaries depend on the capacity to create an organized and structured mental representation that integrates signals from different sensory modalities and brain regions.ObjectivesWe conducted a study on personal space in patients with schizophrenia using a paradigm that was not affected by emotional and social interference.AimsWe aimed to investigate the characteristics of personal space in patients with schizophrenia.MethodsWe recruited 20 schizophrenic patients according to DSM-V criterion and 20 healthy volunteers, matched by gender and age. Schizophrenic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Participants performed the peripersonal space (PPS) task. Collected data underwent statistical analyses.ResultsSchizophrenic patients demonstrate a stronger/weaker need for personal space, than the comparison group, depending on the score of negative and positive symptom, as assessed by using the PANSS even without emotional and social interference.ConclusionsInterpersonal interactions between the individual with schizophrenia and people in their immediate environment can lead to increased symptomatology. Social isolation is one of the most primary causes of poor quality of life in mental illnesses. Better understanding of the mechanisms for abnormal interactive behavior could provide significant valid guidelines for innovating intervention programs.Disclosure of interestThe authors have not supplied their declaration of competing interest.