bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Introduction of Psychotherapy in Psychiatric Outpatients in the Last Four Years in a Greek Hospital
Authors: Lyrakos G. , Menti D. , Spyropoulos I. , Spinaris V. 
Published: June 2017

IntroductionThe use of psychotherapy is an important part of treating psychiatric disorders, in combination with medication taking. However, despite its importance, psychotherapy is still underused from individuals with psychiatric problems in Greece.ObjectivesTo examine the use of psychotherapy, among psychiatric outpatients, in the last four years.AimsTo investigate whether there are differences in the use of psychotherapy, in combination with medications, to treat psychiatric disorders, from 2012 to 2015.MethodsIn this study participated 5,551 patients, 2,760 males (49.7%) and 2,791 females (50.3%). The mean age was 45.54. Convenience sampling method was used and participants were recruited from the General Hospital of Nikaia, ‘Ag. Panteleimon’, in Athens, Greece, from 01/01/2012 to 31/12/2015. SPSS software was used to analyse the data.ResultsThere were significant differences between the four years (2012–2015) with regard to the use of psychotherapy, in combination with medications, from psychiatric patients as χ2 (21): 753.057, P < 0.001. More specifically, only 0.1% of psychiatric patients undertook psychotherapy in addition to taking medications, in 2012, and this increased to 2.7%, in 2013, 13.8% in 2014 and 18.6% in 2015.ConclusionsThere was an increase in the use of psychotherapy, in combination with medication taking, during the four last years, from 2012–2015. However, the percentage of patients undertaking both psychotherapy and taking medications is still low. This has important clinical implications as the use of psychotherapy plays a significant role in achieving optimal health outcomes of psychiatric patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The use of “Pliable Media” in Promoting Symbolization in the Psychoanalytical Psychotherapy of Psychosis
Authors: Solano P. , Quagelli L. 
Published: June 2017

IntroductionIn psychosis, the capacity of symbolization is lost to different extents and patients live in a concrete world of objects. Moreover, the lack of boundaries between self/other, inside/outside severely impairs the capacity of these patients to understand and recognize reality from the delusional dimension.ObjectivesWorking through psychotic concreteness and accessing a first subjectivation of this experience, that leads to the development of a first symbolization.AimsAchieving the possibility to access a first symbolization and begin a delicate process of appropriation of the emotional experience with the establishment of the boundaries between inside/outside.MethodsThe use of “pliable media”, such as drawing, as therapeutic mediation allows a partial defraction of the violent transferential dynamics from the therapist and let unsymbolized material to emerge less destructively in the treatment fostering a first figurability.ResultsThe Squiggle game as “pliable medium” facilitates a first encounter in the therapeutic relationship and represents a primal transitional area that allows a gradual working through process to take place where the establishment of the boundaries between inside/outside could begin.ConclusionsWe suggest that the use of “pliable media” in the early stages of the psychotherapy of psychotics can significantly favor a first encounter between patient and therapist and, at the same time, provides the first experience of a transitional space where a working through process leading to first representations can take place.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Deinstitutionalization and Psychosocial Rehabilitation
Authors: Vidal C. , Melo Vidal L. 
Published: June 2017

IntroductionBarbacena is a Brazilian city with 140,000 inhabitants, which was known as the “city of madmen” because of the excessive number of patients in psychiatric hospitals. In 2000 it began a deinstitutionalization process, and the patients were transferred to assisted residential services.ObjectiveDescribe the process of deinstitutionalization and social rehabilitation of psychiatric patients.MethodologyThe following characteristics were studied: sex, age, medication use, psychiatric diagnosis and the development of social skills.ResultsIn each therapeutic residence (RT) lives eight patients, supervised by upper and mid-level professionals. Since the implementation of RTs about 400 patients leave the psychiatric hospitals. Most had mental retardation (51.0%), followed by schizophrenia (31.0%). More than half (58.5%) were men. The age ranged from 29 to 97 years, with a average of 64.8 ± 12.4. A decrease in the average dose of neuroleptics was seen after deinstitutionalization. Direct observation of patients in the RT, and the reporting of caregivers has shown that patients have developed wide range of social performance, such as dating, started at professional courses, attending exercise classes, travelling and learn how to use money.ConclusionIn despite of difficulties in the psychiatric reform process, the community-based treatment and psychosocial rehabilitation approach are the principal models of psychiatric care presently, and the residential services play an important role in this process. The authors emphasize the importance of community support, professional staff and rehabilitation programs as a condition for good outcomes.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Smoking: A Risk Factor for Suicide
Authors: Aubin H.J. 
Published: June 2017

First demonstrated in 1976, the robust association between smoking and suicide mortality has been established and is dose-dependent, with an estimated increase in suicidal deaths risk of 24% for each increment of 10 cigarettes smoked per day. The statistical association has been shown to exist very soon after smoking initiation, during adolescence, and to withstand adjustments for confounding factors, such as demographics, socio-economic status, somatic and psychiatric comorbidity, and substance use. As the underlying mechanism of the greater suicide risk in smokers is not currently elucidated, we will briefly recapitulate the main hypotheses proposed to date: the toxic effects of nicotine, hypoxemia, monoamine oxidase activity inhibition, the high prevalence of psychiatric comorbidity and consequent suicide risk, and smoking-induced serious physical illness with pain and disability resulting in negative mood response. Smoking could also be an inadequate self-medication for psychological symptoms, themselves causing suicide, and finally the association could be due to a third underlying factor associated with both smoking and suicide.Disclosure of interestHenri-Jean Aubin was member of advisory boards for Pfizer, D&A Pharma, Ethypharm, and Lundbeck, and has received sponsorship to attend scientific meetings, speaker honoraria and consultancy fees from Bioprojet, D&A Pharma, Ethypharm, Lundbeck, Merck-Serono, Novartis, and Pfizer.
The geometrical analysis of handwriting as a new tool to evaluate motor symptoms in psychosis
Authors: Cobo Y. Crespo , Molina A. Ibañez , Parro S. Iglesias , Peña M.F. Soriano , Aznarte J.I. 
Published: June 2017

IntroductionThere is growing evidence about the importance of motor symptoms in psychosis. Motor abnormalities have been observed in naive-drugs, first-episode patients. Clinical assessment of motor abnormalities normally relies upon subjective observer-based ratings. Kinematic analysis of handwriting has proved to be an objective measure of motor symptoms, but it has not been used in clinical settings.ObjectivesIn the present work, the geometrical analysis of handwriting patterns is proposed as a new tool to evaluate motor symptoms in psychosis.MethodOverall, 35 healthy participants and 43 patients with psychosis from San Agustín Hospital (Linares, Spain) participed in the study. Participants were asked to write with a pen on a white paper (see patterns in the Figure 1). In order to analyze the heterogeneity of handwriting pattterns, we employed lacunarity, a nonlinear measure previously used in the analysis of biomedical images. Lacunarity measures the distribution of gap sizes in a geometrical space. A large value implies large gaps and clumping of points, whereas a small value suggests a uniform distribution with shorter gaps.ResultsLacunarity was significantly higher in handwritten patterns from patients than in controls. In addition, we found a higher heterogeneity in patients with motor symptoms in comparison with patients without motor symptoms.ConclusionsOur results suggest that analysis of handwritten patterns can be a valuable method in the evaluation of motor symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychosis and psoriasis, the skin talks the truth
Authors: Marin S. Garcia , García I.M. De Haro , Pedrosa N. Martínez , García M.D. Ortega , Garnica V. Marti 
Published: June 2017

IntroductionIt is well known about relation between skin and mind, not only due to their mutual origin, but also by their illness expression parallelism. We report a case to show that reciprocity.Personal antecedentsWoman, 42-year-old, single. She only suffers from a skin disease; mild psoriasis guttata placed in both elbows and knees. She treated it with local treatment (cortisone cream) during seasonal prutius and the lesions did not grow or expand. She was hospitalized due to psychotic symptoms (paranoid delusions with her colleagues) and started antipsychotics treatment (risperidone 12 mg per day and olanzapine 10 mg per night). By the same time, she suffered a psoriasis crisis. Her psoriatic plaques increased their sizes and her chest and both thighs were affected too. She complained about grave pruritus. All her medical test results were normal. After that, the patient improved her psychotics’ symptoms, but she started with agoraphobic signs and seclusion at home. Psoriasis were even worse than before and she needed metrotexate to treat it. Being introduced to escitalopram 15 mg per day, anxiety and depression symptoms disappeared and her grave psoriasis became the mild one that she knew.ConclusionSchizophrenia was associated with a greater variety of autoimmune diseases than was anticipated. Studies found evidence for a shared genetic etiology between schizophrenia and psoriasis. Despite that, we think that the study of psychopathology can amplify our understanding about the etiopathogenesis of psoriasis and associated mental disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The side effects of risperidone depot in patients with psychotic disorders
Authors: Jupe T. , Elezi F. , Zenelaj B. , Myslimi E. 
Published: June 2017

Background and aimA long-acting form of risperidone is now broadly available for the treatment of schizophrenia and closely related psychiatric conditions. It combines the advantage of previously available depot formulations for first-generation drugs with the favorable characteristics of the modern “atypical” antipsychotics, namely higher efficacy in the treatment of the negative symptoms of schizophrenia and reduced motor disturbances [1].MethodsDuring this study, we observed side effects that appear in patients that are treated with risperidone depot. Patients were observed for a period of 3 months (October–December 2015) and the side effects were evaluated with Glasgow Antipsychotic Side-effect Scale (GASS). The data obtained were analyzed with SPSS, trying to prove the impact of variables such as: gender, age, diagnosis, dose and duration of treatment on the occurrence of side effects.ResultsThrough statistical processing, we reached the conclusion that there is a statistically significant correlation between duration of treatment and side effects (P value was 0.0001). Between two variables has a strong positive correlation (Kendall value was 0.766). Has a statistically significant correlation between the drug dose and side effects (P value was 0.026). Between two variables has a moderate positive correlation (Kendall value was 0.504). No statistically significant correlation between these variables: gender-side effects, diagnose-side effects and age-side effects.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychological resilience and quality of life amongst people with psychotic illnesses
Authors: McCarthy G. , Liston A. , Adamis D. 
Published: June 2017

IntroductionPsychological resilience is defined as an individual's ability to adapt to stress and adversity. People with psychotic illness often experience high levels of distress and difficulties adapting.AimsTo assess the relationship between the resilience of people with psychotic illnesses and their quality of life.MethodologyOutpatients from multiple settings attending Sligo-Leitrim Mental Health Services, aged 18+ years old with a diagnosis of either schizophrenia, bipolar affective disorder or schizoaffective disorder were approached by their treating teams and invited to participate. Other inclusion criteria were having a family member. Drug induced psychoses or no family member were exclusion criteria. The scales used were the Resilience Appraisal Scale and the schizophrenia Quality of Life Scale. This study is part of a larger study looking at family factors and psychosis.ResultsThe study sample was 58 enrolled but only 49 participants completed the 2 assessments, of these 33 were males (67.3%). Data was analysed using SPSS 21. Pearson's correlation coefficient for resilience and quality of life was 0.503, P < 0.001. This shows that higher resilience is associated with better quality of life amongst people with psychotic illnesses. These results could have useful clinical implications. If we can intervene to therapeutically increase resilience, we can eventually improve the quality of life of people with psychoses.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Erotomania: A psychodynamic overview
Authors: Pereira E. , Coutinho F. , Machado A.S. , Reis C. 
Published: June 2017

IntroductionErotomania is a delusional disorder in which one believes to be loved by someone else. Even though its etiology is not known, psychodynamic factors have been proposed as a possible explanation.ObjectivesTo review the psychodynamic etiology of erotomania.MethodsA search of the Medline/Pubmed database was conducted using the terms “erotomania” and “psychodynamic”.ResultsSeveral authors wrote about the psychodynamic etiology of erotomania. Kraepelin describes it as a “compensation for the disappointments of life”. De Clérambault highlights the idea of “sexual pride”: stimulated by the absence of affective and sexual approval, erotomania flourishes as a way of satisfying the individual's pride. Hollender and Callahan explain the disorder as a result of an ego deficit of not feeling attractive enough. According to Segal, the erotomanic delusion meets the patient's need for love and it is related to the idea of it as the ultimate way of approval. Taylor highlights the patients’ isolation, loneliness and extreme dependence on others.ConclusionsAbout every author agrees with the idea that the erotomanic delusion acts as a gratification to the individual's narcissistic needs, when personal experience has failed to do so. Wanting to be loved is the core of human motivation and the delusion most commonly appears in people who feel rejected by society; facing that perceived rejection, it emerges as the fantasy that other human being is in love with them. This is a relevant overview of this disorder with implications in patients’ treatment, since psychotherapy could be important along with drug treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cardiac adipose tissue, intra-abdominal adipose tissue, and risk for cardio-metabolic diseases in patients with schizophrenia
Authors: Ruppert J. , Hartung D. , Gutberlet M. , Westhoff-Bleck M. , Kahl K. 
Published: June 2017

IntroductionSchizophrenia is associated with increased physical morbidity and mortality. In particular, cardio-metabolic diseases are more frequent. Several underlying reasons have been discussed, including adverse lifestyle behaviors, or adverse effects of neuroleptic treatment. However, little is known about changes of cardiac and intra-abdominal adipose tissue, both are risk factors for the development of cardio-metabolic diseases.Objectives/aimsTo compare, cardiac and intra-abdominal adipose tissue between patients with schizophrenia and healthy controls.MethodsTen physically healthy patients with schizophrenia according to DSM-V were included, and compared to healthy control subjects. Cardiac and intra-abdominal adipose tissue was quantified using magnetic resonance tomography. Further factors assessed comprise the metabolic syndrome, physical activity, smoking behavior, and scores for the assessment of cardio-metabolic diseases (FINDRISK score and modified ESC score).ResultsCardiac adipose tissue and intra-abdominal adipose tissue was increased in patients with schizophrenia. Further findings were higher diastolic blood pressure, more smoking, less physical activity, and an increase for diabetes and cardiovascular disease risk according to the modified ESC and FINDRISK score.ConclusionsThe new finding in our study is an increase of cardiac adipose tissue, a risk factor for the development of cardiovascular disorders, in physically healthy patients with schizophrenia. Furthermore, the risk for the development of type-2 diabetes mellitus is increased, indicated by higher amount of intra-abdominal adipose tissue, and the results of the FINDRISK score. We conclude that lifestyle alterations, particularly exercise training that has been shown to reduce cardiac and intra-abdominal adipose tissue, should be recommended in patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Not the same old madness: Evaluating the clinical profile of the “schizophrenia spectrum” disorders
Authors: Russo A. , Verdolini N. , Menculini G. , Moretti P. , Quartesan R. , Tortorella A. 
Published: June 2017

IntroductionThe “schizophrenia spectrum” concept allowed better identifying the psychopathology underpinning disorders including schizophrenia, schizoaffective disorder (SZA) and cluster A personality disorders (PD).AimsTo compare the clinical portrait of the schizophrenia spectrum disorders, focusing on the impact of the affective dimension.MethodsInpatients at the acute psychiatric ward of Perugia (Umbria-Italy) were evaluated with the structured clinical interview for DSM-IV Axis I and Axis II disorders and diagnosed with a “schizophrenia spectrum” disorder according to DSM-IV-TR. The clinical evaluation was conducted using the positive and negative syndrome scale (PANSS). Pearson correlations of the different subscales in the three groups and between the negative scales with the affective symptom “depression” were conducted.ResultsThe sample consisted of 72 inpatients (schizophrenia 55.6%, SZA 20% and cluster A PD 19.4%). The negative and the general psychopathology scales directly correlated at different degrees in the three groups (schizophrenia: r = 0.750; P < 0.001; SZA: r = 0.625, P = 0.006; cluster A PD: r = 0.541, P = 0.046). The symptom “depression” directly correlated with 5 out of 7 negative symptoms: blunted affect (r = 0.616, P < 0.001), emotional withdrawal (r = 0.643, P < 0.001), poor rapport (r = 0.389, P = 0.001), passive/apathetic social withdrawal (r = 0.538, P < 0.001), lack of spontaneity & flow of conversation (r = 0.399, P = 0.001).ConclusionsOur study confirmed the existence of the “schizophrenia spectrum” with combined different disorders lying on a continuum in which negative symptoms mainly correlated with the psychopathological functioning. Noteworthy, the symptoms of the negative scale strongly correlated with the “depression” symptom, underlying the impact of the affective symptoms on the severity of the “schizophrenia spectrum” disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Providing Care for Migrants and Refugees
Authors: Schouler-Ocak M. 
Published: June 2017

With growing globalisation and an increasing number of people on the move across boundaries, it has become vital that service providers, policy makers and mental health professionals are aware of the different needs of the patients they are responsible. One of the most fundamental barriers for migrants, refugees and asylum seekers in accessing health services are inadequate legal entitlement and, mechanisms for ensuring that they are well known and respected in practice. Access to the healthcare system is impeded by language and cultural communication problems. Qualified language and cultural mediators are not widely available, and moreover, are not regularly asked to attend. This can lead to misunderstandings, misdiagnosis and incorrect treatment, with serious consequences for the afflicted. The language barrier represents one of the main barriers to access to the healthcare system for people who do not speak the local language; indeed, language is the main working tool of psychiatry and psychotherapy, without which successful communication is impossible. Additionally, the lack of health literacy among the staff of institutions, which provide care for refugees and asylum seekers means that there is a lack of knowledge about the main symptoms of common mental health problems among these groups. The healthcare services, which are currently available, are not well prepared for these increasing specific groups. In dealing with ethnic minorities, including asylum seekers and refugees, mental healthcare professionals need to be culturally competent.In this talk, main models for providing mental health care for migrants and refugees will be presented and discussed.Disclosure of interestThe author has not supplied his declaration of competing interest.
Schizoaffective disorder and life quality
Authors: Bouali W. , Marrag I. , Ellouze F. , Dekhil A. , Nasr M. 
Published: June 2017

Introductionschizoaffective disorder is a nosographic entity characterized by a combination of symptoms of schizophrenia with mood episodes. The fact that its diagnosis is difficult, and often oscillates between schizophrenia and bipolar disorder raises the problem of its care and the outcome of patients who suffers from it.ObjectiveTo evaluate the quality of life of treated patients with schizoaffective disorder.Materials and methodsThis is a cross-sectional study realized at the psychiatric consultation of Mahdia hospital during a 6month period. Data were collected from patients and from their medical records using a predefined questionnaire.ResultsA total of 52 patients were included, the average age was 38 years. The majority of patients (63.5%) were unemployed. The use of psychoactive substances was noted in 63.5% of patients. Multiple linear regression analysis allowed us to find that 12 factors were more significantly associated with impaired quality of life which were, in descending order of importance: the EAS score > 39, the EGF score ≤ 70, the null or partial adherence, the presence of side effects seriously affecting daily activity, the depressive subtype, the lack of employment, the socio-economic level, the lack of stable budgetary resources, an age > 60years, the widowed and divorced marital status, the PANSS score (≥ 45) and negative symptomatology (PANSS).ConclusionThe diagnosis of schizoaffective disorder has a triple relevance: clinical, prognostic and therapeutic. Identifying a schizoaffective disorder and the risk factors that may affect the quality of life provides a significant practical impact for the patient's benefit.Disclosure of interestThe authors have not supplied their declaration of competing interest.