bluuebunny/crossref_metadata_2025_split huggingface dataset:
Between Scylla and Charybdis: Where does the treatment of Addison's disease in late-life depression go first?
Authors: Petrykiv S. , Arts M. , de Jonge L. 
Published: May 2016

IntroductionOlder adults with adrenocortical insufficiency, including Addison's disease (AD), are at an increased risk for developing late-life depression. Treatment of AD with glucocorticoid replacement therapy may exacerbate depressive symptoms and may complicate treatment of late-life depression.ObjectivesTo present a case with algorithm of decision-making in a particular case of glucocorticoid induced depression in patient with syndrome of Addison.AimsTo report a case-study, describing treatment of Addison's disease in LLD.MethodsA case report is presented and discussed, followed by a literature review.ResultsA 77-year-old female, diagnosed with Addison's disease, was referred with persistent fatigue, weakness, weight loss, sleep disturbances, and depressive symptoms over the previous 6 months. She was taken losartan 100 mg/day, zolpidem 10 mg/day, fludrocortisone 100 μg/day, and hydrocortisone 35 mg/day. There was no personal or family history of psychiatric problems. Clinical examination was normal aside from skin hyperpigmentation. After initial minimal dose reduction of glucocorticoids, Addison's disease remained under control. One week later, her depressive symptoms disappeared without administration of antidepressants.ConclusionThe association between glucocorticoid replacement therapy and late-life depression is not well understood. The current case shows that treatment of glucocorticoid-induced depression in subjects with Addison's disease is achievable by minimal adjustments in glucocorticoid regiment. However, collaboration with endocrinology is of vital importance to prevent an Addison's crisis. Pharmacokinetic dose-finding studies are required to find optimal glucocorticoid adjustment strategy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Comorbidity between delusional disorder and depression. Results from the DelirAnda case register
Authors: Porras Segovia A. , Carrillo de Albornoz Calahorro C. , Guerrero Jiménez M. , Cervilla Ballesteros J. 
Published: May 2016

IntroductionComorbidity between two or more mental disorders is highly frequent. Depression is one of the diseases that more often accompanies other conditions.ObjectivesThe objective of this study is to establish the prevalence of depression in patients with delusional disorder and describe the treatment used in these cases.AimsThe aim is to provide useful information regarding this frequent, often disregarded, comorbidity.MethodsOur results proceed from the Andalusian delusional disorder case register. We reviewed 1927 clinical histories of patients diagnosed of delusional disorder. Upon having verified the diagnosis, following DSM-V criteria, we recollected several data, including sociodemographic factors, depression comorbidity and antidepressive treatment.ResultsOne thousand four hundred and fifty-two patients matched DSM-V delusional disorder criteria. 49,8% of our sample were women. Average following period was 9 years and 1 month, with an average of 0,84 hospitalizations. The prevalence of depression in patients with delusional disorders was 31,9%. 67,5% of them received some kind of antidepressive treatment. The antidepressive drugs most frequently used were selective serotonin reuptake inhibitors.ConclusionsDepression is a highly prevalent condition among patients with delusional disorder. Most of them are on antidepressive treatment, the most employed of which is based on selective serotonin reuptake inhibitors. Comorbid depression can have an important impact on the course of delusional disorder. A correct diagnosis and treatment should be made to help improve the prognosis and life quality of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Health-related quality of life in patients with moderate-severe psoriasis: Preliminary results on the role of psychopathology and coping strategies in a cohort of patients
Authors: Fabrazzo M. , De Santis V. , Puca R.V. , Romano F. , Arrigo M. , Cioffi V. , Catapano F. , Schiavo A. Lo 
Published: May 2016

Psoriasis is a multisystem inflammatory disease associated to several comorbidities with a significant impact on interpersonal and social life. Depression, anxiety symptoms and suicidal ideation–due to psychological distress–are frequently reported. The aim of the study was to assess whether psychological factors–psychopathology, perceived health status and coping strategies–together with clinical and sociodemographic factors, were independent predictors of Quality of Life (QoL) in adult psoriatic patients on topical and/or systemic pharmacological therapy. A cohort of 87 patients (53 M and 34 F), whose mean age was 46 ± 22 years, was analyzed. Coping responses were assessed by COPE and general psychopathology by Self-Reported-Symptom Inventory Revised (SCL-90), while HAM-D and HAM-A evaluated depressive and anxiety symptoms. In addition, perceived health status and QoL were analyzed by Short-Form-36 (SF-36) while the disease's burden assessed by PSODISK. Univariate analyses were performed for each variable to explore the relationship with QoL. Preliminary results indicated that, although not severe, anxiety and depressive symptoms were the most reported among patients along with somatization and obsessive-compulsivity. Female patients used more frequently mental disengagement, focus on and venting of emotions, use of instrumental social support and religious coping. Physical pain and mental health, instead, greatly affected QoL of subjects in a negative manner. PSODISK data analysis showed that general health, itching, serenity, shame and degree of extension of the disease on the skin were the most compromised areas. Moreover, correlation analysis indicated that a worse perception of patients’ health status was associated to poor QoL.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychogenic stuttering: A case and review
Authors: Almada A. , Simões R. , Constante M. , Casquinha P. , Heitor M.J. 
Published: May 2016

IntroductionStuttering is a speech disorder characterized by involuntary repetition, prolongation or cessation of a sound. This dysfluency may be developmental or acquired. Acquired dysfluency can be classified as neurogenic or psychogenic.ObjectivesThis case report aims to describe and discuss a case of psychogenic stuttering, providing an updated review on this disorder.MethodsIn and outpatient interviews were performed by Neurology and Psychiatry. Investigation to exclude organic causes included lab exams, electrocardiogram, electroencephalography, computed tomography scan and magnetic resonance imaging. A literature review in Science Direct database, with the keywords “psychogenic stuttering”, was also conducted.ResultsA 63-year-old man was admitted to the Beatriz Ângelo Hospital with an acute stuttering. Speech was characterized by the repetition of initial or stressed syllables, little affected by reading out loud or singing. Comprehension, syntaxes and semantic were not compromised, as weren’t sensory and motor abilities. During admission, stuttering characteristics changed. Multiple somatic complaints and stress prior to the onset and bizarre secondary behaviors were also detected. Work-up didn’t show an organic etiology for that sudden change. An iatrogenic etiology was considered, as sertraline and topiramate were started for depression 1 month before. However, the stuttering pattern, the negative results, the psychological and the social life events suggested a psychogenic etiology.ConclusionsPsychogenic stuttering finds its origin in psychological or emotional problems. It is best classified as a conversion reaction. The differential diagnosis between psychogenic and neurological stuttering can be challenging.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Dynamics of biochemical changes in anxious-depressed patients under treatment with antidepressants with different mechanisms of action on serotonin reuptake
Authors: Uzbekov M. , Maximova N. 
Published: May 2016

ObjectivesPharmacodynamics of serotonergic antidepressants differently influencing on serotonin reuptake receptors is poorly investigated.AimTo compare biochemical profiles at patients with anxious depression under treatment with tianeptine–serotonin reuptake enhancer and sertraline–selective serotonin reuptake inhibitor.MethodsPlatelet monoamine oxidase (MAO) and serum amine oxidase (AO) activities, level of middle mass endotoxic molecules (MMEM) and serum albumin functional properties – effective albumin concentration (EAC) and reserve of albumin binding (RAB) were investigated at 43 patients with anxious depression (F 32.1 and F 33.1). Clinical severity of illness was assessed using Hamilton Depression (21 items) and Hamilton Anxiety Scales. All patients were divided in two groups: group I (21 person) received tianeptine (37, 5 mg/day), group II – sertraline (50 mg/day).ResultsIt was established that patients with anxious depression were characterized by significant increase in MAO activity (by 95%) and the level of MMEM (by 86%) and significant decrease in AO activity (by 28%) and EAC and RAB parameters by 43 and 38%, respectively, in comparison with healthy volunteers. Under tianeptine and sertraline treatment, there were revealed contrary directed changes of all investigated parameters.ConclusionResults of study show that both tianeptine and sertraline are equally effective in treatment of anxious depression. Present biochemical investigation, however, suggest that underlying biochemical changes are more complete following tianeptine treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Burnout in pediatric oncology healthcare providers: Protection and vulnerability
Authors: Araújo C. , Gonçalves R. , Ferreira J.M.V.D. , Pedroso S. , Pinho C. , Silva S. , Brito M.J. 
Published: May 2016

IntroductionBurnout is a condition characterized by emotional exhaustion, depersonalization and reduced personal accomplishment, resulting from the inability to cope with chronic job stress. Healthcare providers at pediatric oncology units, who care for children with life-threatening illnesses, are exposure to high levels of stress, which increases the risk for developing burnout, with consequences in their personal health and quality of patient care.ObjectiveTo assess the prevalence and sources of burnout on a multidisciplinary team of a pediatric oncology unit.MethodsParticipants were a convenience sample of 16 pediatric oncology professionals, including medical, nursing, and related health staff from a Portuguese pediatric oncology center. Participants completed the Portuguese version of the Copenhagen Burnout Inventory.ResultsAll three subscales that compose this Inventory were found to have burnout below normal levels (cut-off ≥ 50 points). However, personal and work-related subscales showed mean values in the superior limit of normality (48 ± 14, 18 points and 49, 48 ± 12, 23 points, respectively). Nevertheless, when analyzed the patient-related subscale, we found low levels of burnout in the majority of responders. These findings are similar to the existing literature, which suggests that patient care and interactions with children are the least stressful aspect of working in this specialty.ConclusionDespite the high levels of stress exposure in pediatric oncology units, results suggest that the majority of professionals are not actually in burnout. However, the obtained values advice for the need of prevention and workplace approaches to staff's well-being and stress reduction, in order to avoid burnout development.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Determining the cut-off for recurrent depressive episode to predict diagnostic conversion from unipolar depression to bipolar disorder: 5-year retrospective study in one university hospital
Authors: Bahk W.M. , Woo Y.S. , Wang H.R. , Yoon B.H. , Jon D.I. , Kwon Y.J. , Lee K.H. , Min K.J. , Lee S.Y. , Kim M.D. 
Published: May 2016

ObjectivesThe aim of this study was to determining the cut-off for recurrent depressive episode to predict diagnostic conversion from unipolar depression to bipolar disorder by means of retrospective reviews of medical records.MethodsThe medical records of 250 patients with a diagnosis of major depressive disorder for at least 5 years were retrospectively reviewed for this study. We reviewed DSM-IV diagnosis and detailed clinical information at the index admission with assessments made every year after discharge to determining the cut-off for recurrent depressive episode to predict diagnostic conversion from unipolar depression to bipolar disorder.ResultsReceiver operating characteristic curve analysis indicated cut-off scores for recurrent depressive episode of more than three times (area under curve = 0.647, sensitivity = 0.435, specificity = 0.819, positive predictive value = 0.351, negative predictive value = 0.865).ConclusionsThese findings suggest that it could predict the best diagnostic conversion from unipolar depression to bipolar disorder when depressive episodes are recurrent more than three times. Based on these findings, it will be able to promote the accuracy of diagnosis and the efficiency of treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Acute hypomania in systemic lupus erythematosus, differential diagnosis. A case report
Authors: Ochoa García D.K. , Chauca Chauca G.M. , Carrión Expósito L. 
Published: May 2016

IntroductionIt is well known that seizures and psychosis are diagnostic criteria for systemic lupus erythematosus (SLE), however, there could be many other neuropsychiatric symptoms. The American College of Rheumatology Nomenclature provides case definitions for 19 neuropsychiatric syndromes seen in SLE (NPSLE), including cognitive impairment, psychosis, mood and anxiety disorders. Lack of specific manifestations difficult diagnosis and treatment.ObjectivesTo address the diagnostic difficulties that involve the appearance of hypomanic symptoms in the course of SLE treated with high doses of corticoids in a patient with a depressive episode history.MethodDescription of case report and literature revision. We report the case of a 22-year-old woman who presented irritable mood, sexual disinhibition, insomnia and inflated self-esteem. The patient was recently diagnosed with SLE and was on treatment with 50 mg/d prednisone. She had familiar history for bipolar disorder and was taking 20 mg/d paroxetine since the last 6 months after being diagnosed with major depressive episode.ResultsWe proposed differential diagnosis between psychiatric symptoms secondary to central nervous system SLE involvement, a comorbid bipolar disorder or prednisone-induced mood symptoms. Fluctuation of hypomanic symptoms during hospitalization, poor relationship with variation in corticosteroid doses, findings on brain MRI compatible with vasculitis and positive antibodies, oriented this case to a neuropsychiatric manifestation of LES.ConclusionsWe should keep in mind that symptoms of neuropsychiatric SLE may vary from more established manifestations of NPSLE to mild diffuses ones. More studies are needed to expand knowledge in the relationship between mood disorders and neuropsychiatric SLE.Disclosure of interestThe authors have not supplied their declaration of competing interest.
First rank symptoms in mania: An indistinct diagnostic strand
Authors: Channa A. , Aleem S. , Mohsin H. 
Published: May 2016

First rank symptoms (FRS) are considered to be pathognomic for schizophrenia. However, FRS is not distinctive feature of schizophrenia. It has also been noticed in affective disorder, albeit not inclusive in diagnostic criteria. Its existence in the first episode of bipolar disorder may be predictor of poor short-term outcome and decompensating course of illness.ObjectiveTo determine the frequency of first rank symptoms in manic patients.MethodThe cross sectional study was done at psychiatric services of Aga Khan University Hospital, Karachi, Pakistan. One hundred and twenty manic patients were recruited from November 2014 to May 2015.FRS was assessed by administration of validated Urdu version of Present State Examination (PSE) tool.ResultThe mean age of the patients was 37.62 + 12.51. The mean number of previous manic episode was 2.17 + 2.23. In total, 11.2% males and 30.6% females had FRS. This association of first rank symptoms with gender in patients of mania was found to be significant with a P value of 0.008. All-inclusive, 19.2% exhibited FRS in their course of illness, 43.5% had thought broadcasting, made feeling, impulses, action and somatic passivity, 39.1% had thought insertion, 30.4% had auditory perceptual distortion, and 17.4% had thought withdrawal. However, none displayed delusional perception.ConclusionThe study confirms the presence of FRS in mania in both male and female, irrespective of the duration of current manic illness or previous number of manic episodes. A substantial difference was established between both the genders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The old concept of psychogenic psychosis revisited from a transcultural approach: A case series
Authors: Gómez-Arnau J. , Puente-García R. , García-Jorge S. , Benítez-Alonso M. , Dolengevich-Segal H. , Correas-Lauffer J. 
Published: May 2016

IntroductionThe concept of psychogenic psychosis was introduced by Wimmer in 1916 and subsequently extended by Strömgren in the mid twentieth century. It typically describes a polymorphic psychotic episode of abrupt onset and which follows a trauma or stressful life situation. The duration of the episode is usually brief and remission occurs ad integrum. In recent decades, the notion has fallen into disuse in clinical psychiatry and international classifications. This could be due to a general improvement in living conditions, with less exposure to traumatic situations.ObjectiveWe intend to study the characteristics of psychogenic psychosis in immigrants. We believe that the condition could be observed better in this population, given their greater vulnerability to trauma. For this purpose, we chose a sample of Romanian patients, who nevertheless have considerable cultural affinity with the Spanish population.MethodsWe collected the clinical and biographical data of four cases of psychogenic psychosis admitted to our clinic between 2012 and 2015.ResultsFour Romanian women aged 25 to 42 were diagnosed with psychogenic psychosis in this period. Mean length of hospitalization was 5, 0 days. All patients reported familiar or occupational stress prior to the onset of symptoms. Psychotic symptoms remitted quickly with low doses of medication, despite being initially intense.ConclusionsReported cases fit remarkably well with the original description of Wimmer. The concept of psychogenic psychosis, along with similar brief psychotic entities, could be useful in describing the psychopathology derived from new social models and crises.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Dreaming the memories of our parents: Understanding neurobiology of transgenerational trauma and the capacities for its healing
Authors: Rozentsvit I. 
Published: May 2016

Selma Freiberg once said that “trauma demands repetition”. What if actual trauma did not happen in real life of one particular person, but he/she feels that it was real, as it is repeated every night – in every dream? Do children and grandchildren of survivors of holocaust and of the pogroms dream the memories of their parents and grandparents? Does their imagination “make them up” or do they have a transgenerational connection to the traumatic past of their parents and grandparents, even if they were protected from knowing and hearing the horrors of what actually happened to their loved ones sometime one or two generations apart? Are these people born with some specific biological markers (e.g., lower cortisol levels)? Can fear be passed along from parents to children by smell? All these questions can be answered positively (see work of Jacek Debiec, Dias and Ressler, and many others), and can be explained on the level of neurobiology and epigenetics (thanks to contributions of Moshe Szyf and Michael Meaney from McGill University, and others). This presentation will offer some neuro-psychoeducational reflections on the topic of transgenerational trauma, its epigenetic transmission and its neuro-psycho-biological constructs, as well as a very personal touch, a personal story of growing up in a very nurturing and cultured, but very small family, and not knowing of the circumstances of “why small?”Disclosure of interestThe author has not supplied his declaration of competing interest.
Associations among immune activation, the clinical characteristics, and the current severity of the “with anxious distress” specifier in patients with depressive disorders
Authors: Bahk W.M. , Shim I.H. , Woo Y.S. , Lee S.Y. , Kwon Y.J. , Jon D.I. , Seo H.J. , Nam B.W. , Seo J.S. 
Published: May 2016

IntroductionThis study assessed the levels of immune factors, demographic and clinical characteristics, and pharmacological treatments of patients with depressive disorders and compared them between patients with mild-to-moderate and moderate/severe-to-severe anxiety.MethodsThis study included 177 patients diagnosed with a depressive disorder who were hospitalized between March 2012 and April 2015. The patients were categorized into mild-to-moderate anxious distress and moderate/severe-to-severe anxious distress groups, based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) based on the “with anxious distress” specifier. The current severity of symptoms was determined using the Hamilton Depression Rating Scale (HAM-D) scores on the Agitation and Anxiety-Psychic subscales. The charts of the patients were reviewed to evaluate immune factors, including C-reactive protein (CRP) and white blood cell (WBC) levels, confounding factors, such as smoking, other general medical disorders, and body mass index (BMI), and demographic and clinical characteristics.ResultsThe moderate–severe to severe anxious distress group tended to have higher CRP and monocyte levels compared with the mild to moderate anxious distress group. However, after adjusting for the total HAM-D scores, there was a significant difference only in monocyte levels. After this adjustment, patients with moderate–severe to severe anxious distress had a significantly greater trend toward significance for suicidality and a higher rate of antipsychotic use.ConclusionsHigh levels of anxiety symptoms may influence various underlying pathophysiological factors and modulate the inflammatory response and course of illness, affecting treatment planning.Disclosure of interestThe authors have not supplied their declaration of competing interest.