bluuebunny/crossref_metadata_2025_split huggingface dataset:
Five Sessions of in Vivo Exposure Therapy for Post-traumatic Stress Disorder: A Case Report
Authors: Tuvia T. , Rego S. 
Published: June 2017

IntroductionProlonged exposure (PE) is recognized in many guidelines as an effective, evidence based treatment for post-traumatic stress disorder (PTSD), with the active ingredients being in vivo and imaginal exposure. Despite this, patients and clinicians are often reluctant to engage in this form of treatment. Imaginal exposure can be perceived as too anxiety proving, leading to discomfort among both patient and clinician. In vivo exposure alone, however, has also been established as an effective treatment for anxiety disorders that can provide significant results in a rapid manner.MethodsA 31-year-old female with no prior psychiatric history presented to treatment in an acute depressive episode following a motor vehicle accident two years prior. She also met criteria for PTSD. Her Beck Depression Inventory (BDI) and PTSD Checklist for DSM-5 (PCL–5) scores were 42 (severe depression) and 64, respectively. Due to constraints, a modified form of PE was initiated, with five in vivo exposure sessions conducted.ResultsAfter five sessions of in vivo exposure, the patient's PCL–5 score decreased from 64 to 36 and her BDI score decreased from 42 to 13 (minimal depression).ConclusionsThis case report underscores the effectiveness of a modified form of PE, using in vivo exposure alone as a treatment for PTSD. This has significant implications in particular for patients or clinicians who are unable to initiate imaginal exposure (e.g., patient finding it too difficult to tolerate/refusing to engage, language barriers, etc.). In such situations, in vivo exposure appears to be an alternate, effective, short-term treatment option.Disclosure of interestThe authors have not supplied their declaration of competing interest.
CEVUP Program: An Analytical Epidemiological Cohort Study
Authors: Bazziconi P.F. , Lemey C. , Bleton L. , Walter M. 
Published: June 2017

IntroductionOver the past few years, several teams have built programs to detect patient at clinical high-risk state for psychosis and to develop interventions at an early stage of psychiatric troubles. The aim of this study is to provide an overview of the functioning and the results obtained by the specialized program developed in Brest, France (CEVUP).MethodsWe retrospectively analyzed the medical records of patients addressed to the CEVUP between June 2010 and April 2014. Data were double collected by two different investigators and we tested the inter-raters reliability. We included 49 help-seeking patients, aged from 15 to 30 years old, addressed by psychiatrists and general practitioners. The initial evaluation included a clinical evaluation, CAARMS scale, Rorscharch test and neurocognitive tests. Subjects were classified in two groups: not at risk for developing psychosis (NA) or at risk for developing psychosis (AR).ResultsThe main results at initial evaluation showed that 16 (32.7%) patients were AR and 33 (67.3%) NA. Among AR patients, 8 (24%) developed psychosis in two years against 2 (12.5%) for NA patients. These patients have psychiatric comorbidities, essentially depression or anxiety. Secondarily, there are more disturbances of psychomotor and affective development in subjects AR: 14 (41.1%) against 7 (20.5%) in group NA.ConclusionThe present study describes the procedures and the main results established by a specialized program for patient at high risk to develop psychosis. The characteristics of the sample remain consistent with descriptions of such populations worldwide.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Forgiveness and armed conflict in a Colombian Caribbean region: Differences between genders
Authors: Romero Otalvaro A.M. , Munoz M. , Uribe A. , Katia C. , Maria R. 
Published: June 2017

The forgiveness within the framework of social-political conflict is a factor that affects the coexistence and welfare. In the Colombian Caribbean, there are a significant number of people who have been victims of land dispossession and/or forced displacement.The aim of this study is to compare the forgiveness ability between men and women who have been displaced and are in the process of lands restitutions. Displaced and in restitutions process people were participated (n = 38), which 20 of them were women and 18 were men (Mean = 57.81; SD = 13.86). The CAPER Scale, was administered. A cross sectional and comparative design was carried out. The comparison was performed using a t-test for independent samples (Table 1).ConclusionsA greater tendency was observed in women for forgiveness himself, noneless a statistically significant gender difference was not identified. It was a greater tendency in men toward forgiveness to others, however there are no statistical differences between the two groups. In forgiveness situations, a similar trend is evident in gender. As for beliefs, it was observed that men scored higher, this allowed statistically significant differences were observed [F (1, 38) = 6.271; P > 0.05].Table 1Means and SD – Caper Scale1. Women; 2. MennMeanSDStandard error of meanForgiveness himself12028.004.8991.09521826.004.2290.997Forgiveness to others12028.355.4021.20821829.114.1290.973Forgiveness situations12028.005.0161.12221828.003.7570.886Beliefs12011.802.8210.63121813.331.1880.280Disclosure of interestThe authors have not supplied their declaration of competing interest.
Student psychiatry audit and research collaborative (SPARC): A new UK initiative to improve recruitment in psychiatry
Authors: Ellis N. , Quraishy M. , Grubb C.M. , Codling D. , Harrison J. 
Published: June 2017

IntroductionThe UK has longstanding problems with psychiatry recruitment. Various initiatives aim to improve psychiatry's image among medical students, but involve research and none are student-led. Providing opportunities to take part in psychiatry research and quality improvement could increase the number of students who choose to enter the speciality.ObjectivesWe have developed the student psychiatry audit and research collaborative (SPARC), a student-led initiative for nationwide collaboration in high-quality research and audits.MethodsOur model is inspired by the success of the UK Student audit and research in surgery (STARSurg). Area teams, located in medical schools, take part in multi-centre projects. The area teams consist of medical students, who have the main responsibility for collecting data; a junior doctor, to supervise the process; and a consultant, with overall responsibility for patient care. The data collected centrally and analysed by a team of medical students and doctors. Student leads from each site are named authors on resulting papers. All other students are acknowledged and are able to present the work.ResultsWe have completed our first audits in Cardiff and London; other sites will return data in 2017. Student feedback indicated a high level of satisfaction with the project and interest in psychiatry as a future career.ConclusionsThis initiative aims to tackle the recruitment problems in psychiatry by giving students a chance to take part in high quality research and audits.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Concerted action by multidisciplinary stakeholders: The development phase of a complex public health intervention in regards to adolescent self-harm
Authors: Parker R. 
Published: June 2017

Self-harm has a strong prevalence within adolescent populations in Europe, and a potent relationship with suicide. In the UK, adolescent self-harm hospital admissions are rising each year. These statistics reflect the “tip of the iceberg”, with the majority of incidents hidden from public health networks. This invisibility creates barriers to: epidemiological information; the planning and evaluation of evidence-based support; health management within the complexity of adolescent self-harming behaviours to ensure recovery and healthy adolescent trajectories. It is also a serious health risk for this population group, and accidental death from self-harm is one of the common causes of injury-related adolescent death.Within the aforementioned context, this paper describes a UK county-wide complex public health intervention (2013 to 2015) in regards to adolescent self-harm, with concerted action by key stakeholders in health, child welfare, education and social science due to concerns about the increasing self-harm rate within the adolescent population group. As self-harm is a complex behaviour, and the evidence-base for effective interventions is sparse, the development of protective factors within education, health and social care environments were targeted. A synergy of theoretical models from neuroscience and social science informed the intervention's logic model. The intervention's development phase utilised the Medical Research Council's guidance on complex interventions to improve public health, which this paper will exposit.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
A comprehensive training program for professionals working in mental health promotion centers in Hungary
Authors: Toth M.D. , Kallaine Harangi R. , Sumegi A. , Wernigg R. 
Published: June 2017

BackgroundIn a 12 month long mental health promotion pilot programme funded by the Norway Grants, 6 mental health promotion centers (MHPCs) are being set up in various locations in Hungary, employing 2 mental health professionals each, whose main commitment is to develop a local network of key stakeholders. The aim of the project is to enable MHPC professionals to perform network building tasks involving knowledge transfer and attitude changes regarding the following key areas: depression, suicide, dementia, stress and risk assessment.ObjectiveTo measure the effectiveness of the training and education process by using indicators for feedback, knowledge transfer and attitude changes.MethodsThe comprehensive TTT (train the trainers) process of MHPC professionals targets 3 main domains:– improving presentation skills;– knowledge transfer (measured with tests);– elaborative workshops about mental health problems (measured by attitudes at baseline, post-training and 3 months post-training).ResultsThe satisfaction assessment of the initial 3 days long training averaged 4.73 on a 5-point Likert-scale. Altogether, 12 (2/centres) knowledge transfer trainings are being delivered evaluated by attitude change and general satisfaction questionnaires. One elaborating workshop per center has been delivered during the study period. Being a process still underway, the outcome results will only be available by the conference.ConclusionThis procedure enables professionals to disseminate trainings and build networks for mental health promotion in their micro-regions. The optimized version of this pilot program will be delivered on a national level in future projects.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Behavioral disorders: Within the limits of psychiatry or neurology? About a case
Authors: De Jaime Ruiz P. , Fernández Logroño J. 
Published: June 2017

It has been a clinical case of a polimorphic psychotic disorder in a male of 26-year-old, affected by brain palsy, previously with adequate cognitive function, undergoing remarkable confusional fluctuations and a waking state apparently well-preserved. As possible comorbidities or triggers we could count on a tonsillitis and/or a depressive reaction a few days before. Serious consideration must be given to a differential diagnosis with an encephalitis but, despite the presence of an intermittent febricula, it was rejected by both units: internal medicine and neurology, after performing some complementary tests, albeit some more specific tests are still pending. His psychiatric background was also checked, which initially was orientated as a questionable bipolar disorder. At all events, symptoms stopped progressively until, almost complete remittance in the moment he was discharged from the hospital. He recovered his normal functionality. The treatment given was risperidon 2 mL/day, quetiapin 50 mg/8 h and baclofen 10 mg/12 h. This can be used as an example of how many difficulties we usually found to catalogue an acute disorder in first phases, even to encompass the clinical profile within the limits of psychiatry or neurology.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The role of dissociation in patients with a diagnosis of borderline personality disorder and adverse attachment experiences
Authors: Galletta D. , Vangone N. , Califano A.I. , De Simone S. , Suarato V. , Mastrola A.M. 
Published: June 2017

In literature, the link between childhood abuse stories, trauma, unresolved attachment and psychopathological manifestations characterized by the presence of significant dissociative symptoms are well documented. The treatment of this kind of clinical pictures is very problematic because of dysfunctional relational dynamics acted by patients. As we know, borderline personality disorder patients and those with unresolved attachment show poor emotion regulation. About that, a very recent study found an alteration of the neural mechanism involved in the top-down control process of emotional distress both in BPD patients and in those with unresolved attachment. In this context, to make an accurate psychological assessment is essential to define and understand the overall patient functioning and identify the most appropriate therapeutic strategies. In this study, we have selected 22 women characterized by a diagnosis of borderline personality disorder, dissociative experiences and childhood abuse stories. The psycho-diagnostic examination of this sample involved the use of the following tools: Rorschach, MMPI-2, WAIS-R and drawing tests. Consistent with the literature, the outcomes confirmed the presence of response patterns related to trauma, abuse stories and dissociation in both Rorschach and MMPI-2. At the same time, in a significant portion of the sample, we have found an intact cognitive functioning; this aspect, as showed by other authors, highlights the adaptive function of the defensive mechanism of dissociation.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychiatric patients show different coping styles during aggression compared to controls
Authors: Orlando S. , Callovini G. , Altavilla B. , D’Ambrosio L. , Iasevoli F. 
Published: June 2017

IntroductionAggression and violence are common phenomena, potentially experienced by everyone.ObjectivesTo demonstrate that coping patterns to face aggression and violence may exhibit differential group features.AimsTo find differences in coping styles during moments of high aggression in psychiatric patients compared to non-affected controls.MethodsWe evaluated 34 outpatients from the section of psychiatry of university Federico II of Naples by two psychometric scales: AQ to evaluate aggression levels and Brief-COPE for coping patterns. Outcomes were compared with that of 34 non-affected controls, recruited from the university student population. Pearson's correlation was used to find relationships between aggression levels and coping skills in these two groups.ResultsWe found significant differences between groups in multiple scale items and in the correlation measures, e.g. the use of expression was completely reversed in this two samples according to aggression levels.ConclusionsThese results show that aggression is experienced differentially and with different coping styles by psychiatric patients compared to non-affected controls.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Clozapine: Since the very beginning?
Authors: Garcia Ayala L. , Gómez Revuelta M. , Martín Requena C. , Garcia de Acilu E. Saez de Adana , Porta Olivares O. , Juncal Ruiz M. , Nuñez Morales N. , Zubia Martín M. , Laborde Zufiaurre M. , González Hernández B. , Aranzabal Itoiz A. , López Peña M.P. , González-Pinto Arrillaga A.M. 
Published: June 2017

IntroductionPsychosis in childhood and adolescence could be defined as having hallucinations, with the hallucinations occurring in the absence of insight. A broader definition includes symptoms such as delirious thoughts, disorganized speech, disorganized behavior, cognitive and mood symptoms and what is called negative symptoms. Several researches have been done focused in the treatment of first episode of psychosis showing clozapine as a keystone in the treatment of psychosis, especially in refractory first episodes.ObjectivesClozapine has unique efficacy in improving treatment-resistant patients with chronic schizophrenia but the moment of instauration remains unclear. There have always been doubts about the right moment to start clozapine, after two or more previous anti-psychotics or as first option.Materials and methodsWe report a 18-year- old woman with family history of severe psychosis. Her mum reasserted patient's symptoms contributing to a longer period of non-treating psychosis (about 10 months). Auditory hallucinations, incongruent mood and incoherent language appeared for the first time at the age of 17. High doses of two consecutive anti-psychotics were tried without remission and finally clozapine was initiated with clinical improvement.DiscussionIn clinical practice, a subgroup of psychotic patients experience, significant ongoing positive symptoms despite of using first line anti-psychotic medication.ConclusionMost recent research; suggest that clozapine may have an important role in the early treatment of first-episode patients, even becoming a first line option to consider.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Rechallenge clozapine after agranulocytosis in refractory schizophrenia. A case report
Authors: Landera Rodríguez R. , Juncal Ruiz M. , Martín Gutiérrez R. , Gómez Revuelta M. , Río Hortega I. Madrazo del , Sánchez Blanco L. , Santayana Jenaro G. Pardo de , Abejas Díez D. 
Published: June 2017

IntroductionClozapine, is widely prescribed for treatment of refractory schizophrenia, but its use may be limited by potentially serious adverse effects. The most feared complication remains agranulocytosis [absolute neutrophil count (ANC) < 500/mm3], which occurs in 1% of patients. Guidelines recommend immediate cessation until the granulocyte count normalizes, but little is known about the subsequent treatment and the possibility of restoring clozapine.ObjectivesTo know procedures that allow clozapine rechallenge after induced agranulocytosis in refractory schizophrenia.MethodsWe present a clinical case of agranulocytosis and evolution after simple reinstitution of clozapine.ResultsA 38-year-old woman diagnosed refractory schizophrenia. After 10 years with clozapine (300 mg/day), we find neutropenia (ANC 1420/mm3) in a monthly control blood count with progression to agranulocytosis (ANC 460/mm3) in the following month. We suspend clozapine and started olanzapine (20 mg/day) with restoration of haematological values in a period of one month. The patient had psychotic decompensation at two months after the change with lack of response to different psychopharmacological strategies for five months. According to the hematology department we decided to re-introduce clozapine (200 mg/day) in combination with olanzapine with complete clinical remission. Between the 3rd and 9th week after rechallenge we observe a progressive decline in ANC, while remaining within the range of normal. From the 9th week and in the last 6 months neutrophil counts remained stable.ConclusionsAlthough, more research is needed to establish the safety to rechallenge of clozapine after agranulocytosis, it must be an alternative to consider when other treatment strategies fail.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The legacy of Walter Jackson Freeman II (1896–1972): The lobotomist
Authors: Arts M. , Michielsen P. , Petrykiv S. , De Jonge L. 
Published: June 2017

IntroductionWalter Jackson Freeman II was born the grandchild of William Williams Keen, one of world's most renowned surgeons from Philadelphia and the son of an otorhinolaryngist, which may have been contributed to his interest in medicine. Freeman started his medical career in a psychiatric hospital and over the years, he operated thousands of patients. He was a protagonist in American psychosurgery and therefore, he often has been referred as the “lobotomist”.ObjectivesTo present the scientific papers of Walter Jackson Freeman on psychosurgery.AimsTo review available literature and to show evidence that Freeman made a significant though controversial contribution to the development of psychosurgery.MethodsA biography is presented and discussed followed by a literature review.ResultsIn this whole career, “the lobotomist” operated more than 3500 patients and performed mainly operations on the frontal areas. However, he operated human brains without due regard for his patient's mental abilities and emotional well-being after their lobotomy. Despite his work was praised, there was also a lot of criticism on his methods.ConclusionDespite the dubious reputation, Freeman can be remembered as an ambitious doctor who made a significant contribution to the development of psychosurgery. However, unfortunately he crossed medical and legal boundaries.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Intergenerational Transmission of Well Being–Genetic and Epigenetic Mechanisms
Authors: Unternaehrer E. , Greenlaw K. , Hari Dass S. , Chen L.M. , Bouvette-Turcot A.A. , Cost K. , O’Donnell K.J. , Gaudreau H. , McEwen L. , MacIsaac J. , Kobor M.S. , Fleming A.S. , Atkinson L. , Lydon J.E. , Steiner M. , Ciampi A. , Greenwood C.M.T. , Meaney M.J. 
Published: June 2017

IntroductionMaternal mental well being influences offspring development. Research suggests that an interplay between genetic and environmental factors underlies this familial transmission of mental disorders.ObjectivesTo explore an interaction between genetic and environmental factors to predict trajectories of maternal mental well being, and to examine whether these trajectories are associated with epigenetic modifications in mothers and their offspring.MethodWe assessed maternal childhood trauma and rearing experiences, prenatal and postnatal symptoms of depression and stress experience from 6 to 72 months postpartum, and genetic and epigenetic variation in a longitudinal birth-cohort study (n = 262) (Maternal adversity, vulnerability and neurodevelopment project). We used latent class modeling to describe trajectories in maternal depressive symptoms, parenting stress, marital stress and general stress, taking polygenetic risk for major depressive disorder (MDD), a composite score for maternal early life adversities, and prenatal depressive symptoms into account.ResultsGenetic risk for MDD associated with trajectories of maternal well being in the postpartum, conditional on the experience of early life adversities and prenatal symptoms of depression. We will explore whether these trajectories are also linked to DNA methylation patterns in mothers and their offspring. Preliminary analyses suggest that maternal early life adversities associate with offspring DNA methylation age estimates, which is mediated through maternal mental well being and maternal DNA methylation age estimates.ConclusionWe found relevant gene-environment interactions associated with trajectories of maternal well being. Our findings inform research on mechanisms underlying familial transmission of vulnerability for psychopathology and might thus be relevant to prevention and early intervention programs.Disclosure of interestThe authors have not supplied their declaration of competing interest.