bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case study: Bipolar disease in treatment with asenapine
Authors: Alvarez Montoya A.M. , Diago Labrador C. , Ruano Hernandez T. 
Published: May 2016

ObjectivesAnalysis of the treatment alternatives for patients diagnosed with a bipolar disorder of torpid evolution. Revision of the possible adverse effects of lithium and its impact on the adherence to treatment.MethodsWe revise the clinical evolution of a patient diagnosed with Bipolar disorder type I, with the following characteristics: at least two maniac episodes per year, consumption of toxic substances and high sensibility to antipsychotics and euthymics.ResultsWe will describe the case of a 23-years-old patient diagnosed with bipolar disorder type I. During the course of the illness, benign intracranial hypertension is diagnosed and the treatment with lithium must be stopped. We replace lithium treatment by Asenapine monotherapy. The evolution of the patient was very positive. Taking account of the adverse effects of lithium and reducing them can facilitate the adherence to treatment and also benefit early remission and less deterioration in each episode.ConclusionsIt is fundamental to promote a comprehensive approach to each patient, including psychotherapy, psychoeducation as well as appropriate medication. The knowledge of the described effects helps us to determinate the appropriate medication for each patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Manic episode associated with interferon alpha therapy: A case report
Authors: González L. , Gomis C. , Rodriguez V. , Gomez C. , tercelan E. , Ortigosa C. , Anibarro M. , Garcia L. 
Published: May 2016

Interferon alpha is a cytokine with antiviral and antineoplastic action, which is commonly used for treatment of Hepatitis C and B, malignant melanoma, Kaposi's sarcoma, kidney cancer and certain hematologic diseases. It is well-known some of its neuropsychiatric symptoms such as depressive symptoms, cognitive impairment, chronic fatigue, dysphoria and anxiety, but there are also other less common like mania, psychotic symptoms and suicide risk that have been reported. These symptoms interfere in the quality of life very significantly, which at the end can affect treatment adherence.We report a case of a 33-year-old man who was taken to the emergency department by his family referring nervousness, irritability, verbose, and insomnia during the last 5 days. The patient had not psychiatric history. He was diagnosed with a malignant melanoma stage III A a year ago which required to start interferon alpha treatment.Patient and family tell that symptoms began after forgetting last interferon dose. In the psychopathology exploration, we could observe mood lability, delusion ideas of prosecution, which includes his entire family and autorreferentiality. In the emergency room the blood test, urine drug test and CT were normal.During the admission, and in collaboration with the Oncology service, it was agreed the reintroduction and maintenance of interferon combined with olanzapine up to 30 mg/day and clonazepam up to 6 mg/day, which resulted in the resolution of symptoms in two weeks.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Decrease in prolactine levels after treatment with aripiprazole during a maniac episode: A case report
Authors: Coll J.M. , Martínez-Alés G. , Salgado N. 
Published: May 2016

IntroductionHyperprolactinemia can produce clinical symptoms affecting the patient's quality of life and therefore limiting therapeutic approaches to bipolar disorder.Case reportWe report a case of a 46-year-old woman, with a 10 year history of type I bipolar disorder and a microprolactinoma, who was admitted to a psychiatry inpatient unit due to a maniac episode. Current symptoms at the moment of admission included hyperthymia, verbiage, flight of ideas and insomnia. Menstrual changes and galactorrea had been present previously. Aripiprazole was introduced, reaching a dose of 30 mg/day, in addition to her usual treatment with lithium and gabapentin. Response to treatment was good and euthymia was reached within 10 days. Moreover, gabapentin was substituted by Valproic acid, and the patient was discharged once therapeutic levels were attained. Prolactin levels were measured at the moment of admission (128.75 ng/mL) and after 11 days of treatment (92.93 ng/mL).DiscussionChoosing an adequate antipsychotic agent can reduce the risk of iatrogenesis and thus enhance adherence to treatment and quality of life. Aripiprazole had previously shown a high potential at decreasing levels of prolactine. In this case, clinical practice supports scientific evidence.ConclusionsAripiprazole is an effective treatment for type I bipolar disorder. Especially, it can be a treatment of choice in patients suffering from symptoms related to high levels of prolactine, even using a high dosage.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Clinical and socio-demographic profile of bipolar I disorder patients
Authors: Khemakhem R. , Homri W. , Karoui D. , Belhadj H. , Mouelhi L. , Bram N. , Ben Romdhane I. , Labbene R. 
Published: May 2016

IntroductionThe bipolar disorder (BD) is a chronic and severe disease which diagnosis and treatment are still raising the issues.AimsTo show a potential clinical and socio-demographic profile in BD patients.ObjectiveWe hypothesized that BD patients have a particular clinical and socio-demographic characteristics.MethodsThis was a descriptive and retrospective study which assesses 49 BD's outpatients. The diagnosis was accorded to DSM-IV criteria. The enrollment was conducted from January 2010 to August 2015. The socio-demographic and clinical data were collected by a preestablished railing.ResultsThe mean age was 39.7 years with a sex ratio of 1.33. Six patients (12.2%) lived in urban zones and 61% (n = 30) patients have a lowly socioeconomic conditions. Celibacy was the prevailing civil status in 57.1% (n = 28) among which 17 lived in family home. Thirty-four (69.4%) patients were unemployed.A primary school level was found in 34.7% of the cases (n = 17). Nineteen patients (38.8%) were schooled until the secondary level and 9 patients (18.4%) followed a university program.Addiction to smoking was found at 26 patients (53%) whose half of them had moreover an alcoholic poisoning. The mean age at the diagnosis was 35.6 years with an inaugural manic episode in 63.4% (n = 31) of the cases. The average number of relapse was 1.23 and the mean duration of follow-up was 3.2 years.ConclusionThe knowledge of the profile of the consultants, their socio-demographic and clinical characteristics would allow to adapt the offer of care to the request.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The role of medical condition in perplexity inside psychotic mixed states in bipolar disorder: Case series and literature review
Authors: Preve M. , Bolla E. , Godio M. , Suardi N.E. , Traber R. , Colombo R.A. 
Published: May 2016

IntroductionIn literature Leonard introduce, after Wernike (1900) and Kleist (1928), the concept of cycloid psychoses, and he gives again a weight to the mixed forms in affective disorders [1–4]. A lot of different medical conditions cause pychiatric problems, like hyperammonemia, hyponatiremia, thyroid disfunction, urinary infections and still others. The aim of our study is to evaluate the role of a medical condition in perplexity inside psychotic mixed states in bipolar disorder (BD). We propouse three different cases and literature review.MethodThree patients with perplexity in BD were assessed with: the SCID-P for axis I diagnosis, HRSD, YMRS, internistical examination, blood test exams and urinanalysis, and first level brain imagin (CT and/or MRI). We conducted a systematic review of the literature (PubMed, Embase, PsychInfo), using the terms “bipolar disorder”, “mixed states”, “perplexity” and “medical condition”.ResultsAll our patients present: hyperammonemia, reduction of TSH and presence of infection at the urinanalysis, and a resolution of perplexity with the normalization of the blood test and urinanalysis.Discussion and conclusionTo our knowledge there are not studies that confirm the relationship between thyroid and epatic dysfunction, and urinary infection with perplexity in psychotic mixed states in BD, and the resolution with the normalization of blood and urinary exams. Further research is warranted to replicate our clinical observations and to confirm our results.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Adherence to rehabilitation treatment in HIV-positive and HIV-negative opioid-addicted patients with psychiatric comorbidity
Authors: Bereza Z. 
Published: May 2016

IntroductionEarly diagnostics and treatment of comorbid disorders in drug addicts is an integral part of the rehabilitation process and a critical factor in the success of rehabilitation measures as a whole.SubjectsOne hundred and thirty-three patient of inpatient rehabilitation department. The inclusion criteria in the study were: age above 18 years, withdrawal status, diagnosis (F 11.20 ICD-10). They were divided into two groups: HIV positive (n = 38) and HIV negative (n = 95).AimsTo estimate the prevalence of HIV infection and comorbid mental disorders in substance abuse patients and the impact of comorbidities disorders on the compliance.MethodsClinico-anamnestic method, clinical-psychopathological method (criteria ICD-10 and clinical diagnostic scales: PANSS, HADS, MMPI). All participants also had serological blood test for antibodies to HIV.ResultsAccording to our data, the incidence of comorbid mental disorders among HIV negative patients is 65%. The research also showed a correlation (P < 0.05) between HIV infection and mental disorders. So, mental disorders were diagnosed in 82% of HIV infected patients. Patients who stopped their treatment early (n = 42) significantly (P < 0.05) more often had specific personality disorders (17%). Most of them suffered from dissocial personality disorder (9%) and borderline personality disorder (18%).ConclusionsThis analysis showed that HIV is not significant factor (P > 0.05) of early rehabilitation treatment interruption. But comorbid personality disorders in both groups are a significant factor (P < 0.05) of the treatment interruption, while the endogenous, neurotic or affective mental disorders are not.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Prevalence of insulin resistance and diabetes mellitus type II in bipolar disorders
Authors: Steardo L. , Tortorella A. , Fabrazzo M. , Del Buono G. , Ambrosio S. , Monteleone P. 
Published: May 2016

IntroductionBipolar disorder (BD) is associated with high morbidity and mortality. Patients are symptomatic almost half of their lives and experience significant disability. One subtype of BD is associated with a more chronic course, refractoriness to treatment and poor outcome. Diabetes mellitus type 2 (T2D) and insulin resistance (IR) have been identified as risk factors for this more severe form of BD.Objectives and aimsWe investigated the rates of IR and T2D in patients with BD and whether this comorbidity is associated with specific clinical features of BD such as rapid cycling or treatment resistance.MethodsIR and T2D were screened in patients with BD types I or II, who were on stable treatment with mood stabilizers. The response to treatment was assessed by means of the Alda scale.ResultsIn a preliminary sample, we made a new diagnosis of IR in 40% of patients. The 1% of this sample had a diagnosis of T2D. The treatment response was worse in BD patients with comorbid IR or T2D as compared to those without metabolic abnormalities.ConclusionsThese findings show that IR and T2D have high prevalence in BD patients and have negative impact on treatment response.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Acute psychosis in an adolescent with cerebral palsy
Authors: Moreira C.A. , Soares A.R. , Maia G. 
Published: May 2016

IntroductionCerebral Palsy is a movement, posture or muscle toning disorder caused by an insult to the immature, developing brain, most often before birth. It is a leading cause for serious disabilities in childhood and a risk factor for the development of psychiatric disorders, particularly in adolescents. Moreover, according to DSM-5, a Brief psychotic disorder is a short-term illness with psychotic symptoms, which arise suddenly, but last for less than one month, after which the person recovers completely.Objectives/AimsThe authors aim to present a case of an adolescent with cerebral palsy who has developed secondary psychotic symptoms, a rare and sparsely understood phenomenon.MethodsA non-systematic review of English scientific literature was conducted through research in the PubMed search engine, using the keywords “Cerebral Palsy” and “Brief Psychotic Disorder”.ResultsA 16-year-old female adolescent with history of Cerebral Palsy (due to neonatal anoxia) was admitted in the paediatric ward due to behaviour disorder characterized by incoherent speech, full insomnia, agitation and auto/alo-aggression. A complete clinical investigation was performed, in which trauma, organic brain injury, degenerative and inflammatory diseases, infection or toxic ingestion were all excluded. The hypothesis of an acute psychotic disorder was considered and after antipsychotic treatment, a total remission of the symptoms was obtained.ConclusionsAlthough rare, the association between cerebral palsy and psychotic disorders should be considered in the diagnostic investigation of behavioural changes. Early identification allows a proper therapeutic intervention and a better quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Conversion disorder in adolescents: A review and case report
Authors: De Cos Milas A. , Garcia Moreno M. , Gómez Macías V. , Chinchurreta de Lora N.E. , Rodríguez Criado N. , Sánchez Sánchez B. 
Published: May 2016

IntroductionConversion disorder (CD) is an uncommon but highly disabling condition. Affected children and adolescents are often severely impaired and at risk of serious long-term physical and psychosocial complications. Despite the enormous personal suffering and health resource implications of CD, little research has been done.ObjectivesTo update our knowledge about CD in adolescents, with a comprehensive review of the literature with special focus in prevalence, psychosocial factors, diagnosis, treatment and outcome.AimsTo present the most relevant data of our review with a clinical illustration that provides a practical vision of this disorder.MethodsA systematic literature review was performed in MEDLINE, with particular interest in papers published in the last 10 years. Clinical illustration is provided by a case selected from an outpatient child and adolescent mental health service.ResultsFew reliable prevalence data are available; the range goes from 0.2 in a German study to 31% in non-western clinical settings. Diagnosis is based on a constellation of features and treatment should involve several heath care professionals. CD has a favourable outcome in children and adolescents. However, mood and/or anxiety disorders are encountered at a considerable rate even after recovery from conversion symptoms. Long clinical follow-up seems appropriate.ConclusionsThe expression of emotional distress in the form of physical complaints is common in children. Nevertheless, the most severe presentation of physical symptoms is not a common topic in literature. More research should be done to improve our understanding of this disabling disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Is lithium implicated in tobacco addiction?
Authors: Houas I. , Haj Mouhamed D. , Gallelo G. , Douki W. , Gaha L. , Cervera M.L. , De la Guardia M. 
Published: May 2016

IntroductionTobacco is a source of mineral elements that can affect human health in various ways, such as lithium, which is used as a psychiatric medication. Lithium salts are used as mood-stabilizing drugs and indicated in the treatment of manic-depressive psychosis.ObjectiveStudying the lithium content in tobacco over the smokers’plasma content and evaluate the potential role of lithium in tobacco addiction.MethodsA total of 18 different tobacco products (cigarettes, smokeless and water pipe tobacco) and 125 plasma samples (45 from smokers, 10 from ex-smokers and 70 from non-smokers) were collected to determinate the lithium content. Tobacco samples were digested with nitric acid and lithium concentration was measured by inductively coupled plasma-optical emission. The collected plasma samples were diluted 1/10 with a nitric acid solution and the lithium level was measured by inductively coupled plasma-mass spectrometry.ResultsThe average concentration of lithium in the cigarettes (16.59 ± 0.59 μg/g) was higher compared to those in the smokeless tobacco (8.39 ± 4.44 μg/g) and in the water pipe tobacco (6.13 ± 6.32 μg/g) but with no significant difference (P = 0.182). For plasma lithium levels, there was no significant difference (P = 0.186) between smokers and non-smokers (6.20 ± 6.24 vs. 4.98 ± 6.20 μg/g). However, a significant negative correlation was noted between plasma and the lithium content in tobacco products (r = –0.435; P = 0.04). The lithium plasma level was significantly and negatively correlated with the dependence score (r = –0.316; P = 0.031).ConclusionThe correlation between plasmatic lithium and dependence score in smokers suggests that lithium would be involved in tobacco addiction probably through his regulating action of mood.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The other 25%: Autistic girls and women
Authors: Gill M. 
Published: May 2016

Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by impairments in social and communicative abilities, along with the presence of ritualistic and/or repetitive behaviors. One of the under-researched areas in the ASD literature is the large gender difference in the diagnosis rates. On average, the male to female ratio stands at 4.3:1, increasing to 9:1 in the absence of comorbid intellectual impairment. It has been evidenced that compared to boys, ASD is diagnosed later in cognitively able girls, despite there being no difference in the number of visits to a health-care professional during the diagnostic process and the age at which parents first express concern. The suboptimal identification of the disorder in cognitively able girls causes a large magnitude of gender discrepancy. These statistics may not be accurate since females may camouflage their difficulties and may be undetected due to their ability to disguise their symptoms better than males. The other hypothesis of under diagnosing ASD in girls is how we quantify and diagnose it. It is based on a male-centric presentation, which does not accurately reflect the disorder in girls. Altogether, these differences may make it more challenging for medical professionals and clinicians to identify potential early signs of the disorder in girls. Hence, there is a need to develop programs to mentor girls and women on the autism spectrum in schools, colleges and industry. And there should be an insistence on inclusion of females on the autism spectrum in pharmacological research and other research projects.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Fears in anxious children
Authors: Hernandez Arroyo L. , Santesteban Echarri O. , Güerre Lobera M.J. , Espin Jaime J.C. , Jimenez-Arriero M.Á. 
Published: May 2016

IntroductionFear is a distressing emotion aroused by a risk or a damage, real or imaginary. Fears have a warning function against dangers. Nevertheless, fear can also become in one of the most limiting elements of a person's life.ObjectivesTo characterize the profile of fears presented in a sample of 19 children, aged between 8 and 13 years old, who had previously been diagnosed with one of the following: Generalized Anxiety Disorder, Separation Anxiety Disorder or Social Phobia.Material and methodsThe sample was taken from patients who participated in a cognitive-behavioral group therapy. The Spanish version of the Fear Survey Schedule for Children-Revised (FSSC-R) questionnaire was employed. The FSSC-R asks children to indicate on a 3-point scale (‘none’, ‘some’, ‘a lot’) how much they fear 80 specific stimuli or situations. Five basic categories of fears can be stablished: failure and criticism (17 items); the unknown (17 items); minor injury and small animals (13 items); danger and death (16 items); medical fears (5 items).ResultsThe sample includes 19 children: 12 boys (63.2%) and 7 girls (36.8%). The median age is 10.74 years. The sample shows 15 excessive fears on average (those scored as ‘a lot’). Girls show higher rates of excessive fears than boys: 19 versus 13. The most common fears were ‘being hit by a car or truck’, ‘bombing attacks. Being invaded’, ‘a burglar breaking into our house’ and ‘falling from high places’.ConclusionsMost common excessive fears belong to danger and death category. Females report more fears than males.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Differential diagnosis of recurrent hypersomnia. Case report of primary narcolepsy and acute transient psychotic attack
Authors: Kıyak J. , Köse S. , Özbaran B. 
Published: May 2016

IntroductionWe report a case of 17-year-old boy with excessive daytime sleepiness.ObjectivesCase presented in our study is an example of atypical narcolepsy with coexistence of psychotic symptoms that were especially prominent during the first attack. Excessive daytime sleepiness period was followed by psychotic symptoms including delusions of reference and persecution, as well as visual and acoustic hallucinations. However, during the second attack, negative psychotic symptoms were more prominent.AimsClinicians should not forget that child and adolescent patients, which demonstrate psychotic symptoms and excessive daytime sleepiness component, should be evaluated for a diagnosis of primary hypersomnia.MethodPatient did not exhibit any comorbidities that would match with secondary hypersomnia. The initial sleep study did however reveal increased REM sleep latency (43% of total sleep time). The result of polysomnographic study was abnormal and suggestive of narcolepsy. In multi-sleep latency test mean REM latency was 1.7 min, sleep-onset REM (SOREM) was observed 3 times. Between the tests he had no episodes of cataplexy.ResultPatient was diagnosed with primary hypersomnia-narcolepsy without cataplexy. We found that mixed symptoms of narcolepsy and psychotic attack improved with anti-psychotic agent treatment.ConclusionChild and adolescent patients, which demonstrate psychotic symptoms and excessive daytime sleepiness component, should be evaluated for a diagnosis of primary hypersomnia following a multidisciplinary cooperation of neurologists, pediatricians and psychiatrists.Disclosure of interestThe authors have not supplied their declaration of competing interest.