bluuebunny/crossref_metadata_2025_split huggingface dataset:
Irreversible silent
Authors: Azvee Z. 
Published: June 2017

ObjectivesLithium is a well-known substance used in treatment of mood disorders. It has a narrow therapeutic index with recognised adverse effects on renal and thyroid function. Clinical guidelines published by the national institute for health and clinical excellence in the United Kingdom (NICE) recommend renal and thyroid function checks before lithium is prescribed, as well as ongoing monitoring of renal function, thyroid function and serum lithium levels. Lithium-induced drug toxicity is frequently seen in clinical practice. While the ongoing monitoring serves to monitor reversible side effects of Lithium provided its discontinued, rarely patients develop a persistent neurological side effect known as a syndrome of irreversible lithium-effectuated neurotoxicity (SILENT).MethodThis is a case report on a patient where the patient developed SILENT syndrome after being treated with Lithium, long term for bipolar disorder.ResultsThis case supports the biological mechanism of SILENT syndrome. It also caused a huge implication in the patient's care.ConclusionsAs clinicians, we are well aware of following treatment guidelines for Lithium. This case report was written to raise awareness regarding a “SILENT” albeit significantly debilitating syndrome of Lithium use.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Neurosyphilis presenting with affective psychosis and Parkinsonism: A case report
Authors: Butt H.S. , Hopkins C.W.P. 
Published: June 2017

IntroductionA 38-year-old gentleman was admitted to an inpatient psychiatric unit with a first episode of fluctuating affective psychosis. He initially presented as manic although subsequently evolved a severe depressive episode, with prominent bizarre, affect-incongruent delusions throughout this period. Upon admission, anisocoria was evident, although this was attributed to a past head injury. Over the course of his admission he developed emergent Parkinsonism, initially ascribed to prescription of aripiprazole. Given his anisocoria and worsening Parkinsonism, further investigation was undertaken. While his MRI brain scan was unremarkable, his serum and CSF specimens tested positive for Treponema pallidum serology, and he was diagnosed with neurosyphilis. He was treated with a single dose of intramuscular penicillin, but experienced marked deterioration of neurological symptoms (paraparesis and truncal ataxia) and was transferred to the general hospital for an extended 14 day course of intravenous penicillin. Following this extended course of antibiotic therapy, resolution of neurological symptoms was seen, but no sustained improvement in residual psychotic symptoms has been seen.ConclusionsThis case demonstrates the potential neuropsychiatric consequences of neurosyphilis, and serves as a reminder of its potential to imitate other psychiatric presentations. This gentleman, and many like him, continue to experience severe and enduring psychopathology despite penicillin treatment when cases are detected late. Given the potential consequences of this, we would advocate assertive screening for syphilis in patients admitted to psychiatric units.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Experimental intervention program in psychosomatic pathology
Authors: Coutinho A. , Silva D. , Carvalho I. , Silva R. Ribeiro , Ribeiro L. 
Published: June 2017

IntroductionThe work of Bion, developing the psychoanalytic theories of Freud and Klein on the origins of anxiety in childhood, includes the hypothesis of a protomental system as a matrix in the human organism in which physical and mental are at first undifferentiated. He defends that the continuing experience by the infant of parental containment of its anxieties, through a process of projection and introjection, develops its capacity for thinking about frustration rather than evading it. This conception was extended to psychosomatic illness, by the hypothesis that, without this experience, frustration may lead to basic assumption mentality and psychosomatic illness rather than emotions and thought.ObjectivesThis work aims to describe an experimental technique of group psychotherapy, inspired in Bion's principles combined with relaxation techniques, in the context of psychosomatic diseases.AimsThe authors pretend to identify improvement in clinical symptomatology, quality of life, identification and expression of emotions, in the group submitted to this method, compared to controls.MethodsIt was performed a weekly group psychotherapeutic session and a weekly relaxation session (using Jacobson's method), along two months. The patients were randomly selected and submitted to psychological evaluation with scales and questionnaires, in the beginning and at the end of the study.ResultsAt the time of submission of this work, the results of the intervention were in analysis.ConclusionsThis paper describes an experimental method of psychotherapeutic intervention in the field of psychosomatic disease, using a transdisciplinary perspective.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cognitive behavioral therapy for chronic migraine
Authors: Onur O. , Ertem D.H. , Uludüz D. , Karşıdağ Ç. 
Published: June 2017

AimAlthough current standard treatment for migraine headache is medication, high levels of psychological comorbidity has led to migraine influencing by cognitive, emotional and environmental factors, as well as biological. Viewing migraine in a biopsychosocial framework introduces the possible utilisation of psychological treatment options, such as cognitive behavioural therapy (CBT). The aim of this study was to evaluate the efficacy of CBT for chronic migraine.MethodologyThirty-five participants diagnosed as chronic migraine were recruited from Headache Clinic. According to inclusion criteria 14 participants, underwent bi-weekly lasting 30 minutes CBT sessions for 6 months, were administered Hamilton Anxiety Scale, Hamilton Depression Scale, Visual Analog Scale (VAS) and the Migraine Disability Assessment Scale (MİDAS) before and after CBT.FindingsNine of the participants were female and 5 male. Mean age of group was 34.35 ± 8.17. Duration of illness was 13.07 ± 7.18 and 12 of participants had the history of a psychiatry illness whose diagnoses were depression (7), anxiety disorder (4) and post-traumatic stress disorder (1). Nine of the patients had prophylactic migraine treatment. There were statistically significant difference in Hamilton Depression scores between before CBT (29.07 ± 7.74) and after CBT (14.21 ± 7.7); in Hamilton Anxiety scores before CBT (26.8 ± 11.7) and after CBT (11.7 ± 2.6); in VAS scores before CBT (8.07± 0.91) and after CBT (3.71 ± 1.32); in frequency of migraine attacks between before CBT (10.85 ± 3.50 day) and after CBT (4.92 ± 2.70 day) and in MİDAS before CBT (55.5 ± 20.4) and after CBT (20.12 ± 16.6) (P < 0.05).ConclusionCBT might reduce the severity of symptoms in migraine patients especially with the comorbidity of psychiatric illness.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Polydipsia and intermittent hyponatremia
Authors: Ramos-Perdigues S. , Gordillo M.J. , Caballero C. , Latorre S. , Boned S.V. , Miriam G. , Torres P. , De Almuedo M. , Sanchez M.T. , Contreras E. , Gomez E. , Sanchez E. , Segura M. , Torres C. , Gemma G. , Tur M. , Fernandez A. , Merino C. 
Published: June 2017

IntroductionHyponatraemia occurs in 4% of schizophrenic patients. Dilutional hyponatraemia, due to inappropriate retention of water and excretion of sodium, occurs with different psychotropic medications and could lead to hippocampal dysfunction. This complication is usually asymptomatic but can cause severe problems, as lethargy and confusion, difficult to diagnose in mentally ill patients.ObjectivesTo describe a case of a patient with psychotropic poli-therapy, admitted three times due to hyponatremia and the pharmacological changes that improved his condition.AimsTo broadcast the intermittent hyponatraemia and polydipsia (PIP), a not rare condition, suffered by treated schizophrenic patients and discuss its physiopathology and treatment thorough a case report.MethodsA 56-year schizophrenic male was admitted for presenting disorganized behavior, agitation, auditory hallucinations, disorientation, ataxia, vomits and urinary retention. He was on clomipramine, haloperidol and clotiapine (recently added), quetiapine, fluphenazine and clonazepam. After water restriction his symptoms improved and he was discharged. Twenty-five days later, he was readmitted for presenting the same symptoms and after water restriction, he was discharged. Five days later, he was again admitted and transferred to the psychiatric ward.ResultsHaloperidol, fluphenazine and clomipramine were replaced by clozapine. These changes lead him to normalize the hypoosmolality and reduce his water-voracity. Endocrinology team did not label this episode of SIADH due to its borderline blood and urine parameters.ConclusionsHyponatremia is frequent in schizophrenic patients and may have severe consequences. Therefore, a prompt recognition and treatment is warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Clozapine induced diarrhea
Authors: Ramos-Perdigues S. , Gordillo M.J. , Caballero C. , Latorre S. , Boned S.V. , Sanchez M.T. , Torres P. , Guisado M. , Contreras E. , De Almuedo M. , Esmeralda E. , Sanchez E. , Segura M. , Fernandez A. , Torres C. , Herrero G. , Tur M. , Merino C. 
Published: June 2017

IntroductionClozapine (CZP) is the only antipsychotic approved for resistant schizophrenia 1. Due to its side effects, CZP is not the first therapeutic option in a psychotic episode. Its anticholinergic effects often cause constipation, however, diarrhea have also been described in literature.ObjectivesWe describe a patient with two episodes of severe diarrhea after clozapine initiation, which lead to CZP discontinuation.AimsDiscuss about the differential diagnosis of diarrhea in CZP patients and the needing of a further studies for clarify the more appropriate management in CZP induced diarrhea.MethodsWe present a case report of a 46 years man diagnosed with schizoaffective disorder who presented two episodes of severe diarrhea with fever, which forced his transfer to internal medicine and UCI after CZP initiation.ResultsAt the first episode analytical, radiological and histological findings led to Crohn's disease diagnosis, which required budesonide and mesalazine treatment. In the second episode, the digestive team concluded that the episode was due to clozapine toxicity despite the controversial findings (clostridium toxin and Crohn's compatible biopsies)ConclusionsDiarrhea caused by CZP has been controversial in the literature. However due to the severity of digestive episodes and the paucity of alternative treatments further studies for a better understanding of its physiopathology are warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Which are the possibilities of psychiatric liaison-consultation in dentistry? By the way a qualitative study on symbolic meanings reported by dentists on handling of dental-caries
Authors: Leme P.A.T. , Bastos R.A. , Vedovello S.A.S. , Turato E.R. , Meneghim M.C. 
Published: June 2017

Dental caries is the main oral disease and there is a possible psychological resistance from dentists to change clinical practice towards in sense of health promotion as opposite to invasive mechanical practice. We hypothesized that the discussion of their practice with mental health professionals, highlighting the humanist view in approaching patients, would imply reviewing usually invasive practices.ObjectiveTo understand the psychological meanings attributed by dentists to the treatment of dental caries considering the frequent invasive treatment.MethodClinical-qualitative method derived from qualitative designs proper to human sciences and applied in assistance settings. Sample composed of all available dentists (ten participants) within an area of basic health units of Piracicaba, Săo Paulo state. Semi-directed interview with open-ended questions, in-depth, was used. After full transcription of the interviews, qualitative content analysis was carried out, including floating readings to emerge core of meanings with consequent categorization for discussion.ResultsTwo categories show conflicts in the interpersonal relationship: psychological discomfort due to a perspective of care different from patient and presence of an ideologically vertical relationship. One category showed a successful approach: the patient through openness.ConclusionsThere were feelings of impotence in face of difficulties in interpersonal communication. It was possible to observe the influence of bio-power that weakens the possibility of empowering patients. In this way, a mechanical way of practice “saves” professionals from thinking about these human dilemmas. On the other hand, the liaison-consultation psychiatry, at primary care, allows dental professionals to have a personal affective support to rethink approaches on use of technology.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The impact of shame and cultural beliefs on mental illness and treatment adherence: A case report
Authors: Albassam A. , Ameen A. , Chiappetta V. , Hanif A. , Gonzalez L. 
Published: June 2017

IntroductionShame, especially when enmeshed in cultural beliefs about mental illness and cultural roles, could be a detrimental factor in psychiatric illness in context of adherence to treatment and continuation of care. Shame is defined as a painful experience which embodies multiple components including: collapse of self esteem, feeling of humiliation, rupture of self continuity, sense of isolation, and feeling of being watched by critical others.ObjectiveUnderstanding the psychodynamics of shame, in a particular cultural milieu and its components which could impact psychiatric treatment and care.MethodHere we present a case report of a 41-years-old Arab male patient from Yemen, with a history of paranoid schizophrenia who was admitted to inpatient psychiatric service for bizarre and aggressive behavior.ResultsInitially the depth of patient's delusions and psychotic symptoms were not fully appreciated due to the cultural gap between the patient and the treatment team. He was then re-valuated through the implementation of the cultural formulation interview (CFI) by clinicians from same cultural background. This team was able to elucidate the deep feelings of shame and inadequacy in patient's presentation and provide a culturally tailored treatment plan.ConclusionsEvaluation of psychiatric patients in a different cultural setting where western values do not apply might not be sufficient to assess the breadth of psychotic symptoms especially when an underlying feeling of shame contribute to presenting symptoms. Treatment of those patients with neuroleptics without assessing the cultural dynamics might result in poor adherence to medication and follow up.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Hikikomori goes global: A Portuguese case
Authors: Macedo P. , Pimenta V. , Alves M. , San Roman Uria A. , Salgado H. 
Published: June 2017

IntroductionHikikomori, a form of severe social isolation, once characterized as a Japanese cultural-bond behavior with social and economic consequences, it is now being described in other countries. Its presentation mimics some clinical features of various classified mental diseases, such as prodromal phase of schizophrenia, personality disorders, Internet dependence, social phobia or depression, without fulfilling their defining criteria.Objectives/methodThis work aimed to do a brief review of this subject, describing one case that is probably the first ever reported in Portugal, comparing it with similar cases around the world.ResultsThe patient was a 22-year-old male, taken to psychiatry evaluation after 4 years of social withdrawal, avoiding or blocking any contact even with family members, which resulted in work and school impairment. He spent most of his days locked at his room, investing his time in particular interests and Internet use, only leaving to eat or do his basic hygiene. At that time, he presented no affective or psychotic symptoms and perceived his behavior as egosintonic. After six appointments with psychotherapeutic approach, he was able to get a job and improved his communication with the others, especially with family.Discussion/conclusionThis case fits most of the reports found on literature, in its presentation and clinical management. Hikikomori is not considered yet a disorder and further documentation of these cases is still needed to define its place in psychiatric nosology.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychometric of questionnaire about cultural factors comorbidity of obsessions and major depressive disorders in Iranian samples
Authors: Nikpour G. , Homayouni A. 
Published: June 2017

Background and purposeCultural signs may be found among people that speak a local dialect or live in a specific region or historical period. These cultural signs could influence psychopathology. The aim of this study was to design and validate a questionnaire that could evaluate the cultural factors causing concurrent obsessions and major depressive disorders in Iran.Materials and methodsTo design the questionnaire, 10 psychologists and psychiatrists who were members of academic boards were questioned by an open questionnaire. Then, the answers to the questions were classified and based on exploratory factor analysis the questionnaire containing 11 factors and 79 questions was confirmed. Internal homogeneity was analyzed by Cronbach's alpha.ResultsThe results of Cronbach's alpha for all factors showed that the highest reliability was 0.90 and the lowest was 0.42. In exploratory factor analysis using Varimax rotation 11 factors were extracted that predict 47.3% of the scale variance. 25 factors were extracted of which14 had less than three items, therefore they were omitted because of not being able to acquire reliability as sub factors. Accordingly, a questionnaire containing 11 factors and 79 questions was constructed.ConclusionThe findings showed that the instrument could identify the cultural factors that cause concurrent obsession and major depressive disorders in Iran.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Between creativity and death: Abstract expressionists and alcohol use disorders
Authors: Vasiliu O. , Vasile D. , Androne F. , Patrascu M. , Morariu E. 
Published: June 2017

American Expressionists were a group of American artists who valued free expression of unconscious elements, combining emotional intense expressions with anti-figurative abstract style. Their main place of creative debates was Cedar Tavern in New York City, considered by art critics an important incubator of the Abstract Expressionism. Jackson Pollock, one of the most prominent figures of this movement, suspected of having bipolar disorder, abused alcohol during long periods of his life, for which he even underwent psychotherapy. Unfortunately, he died in a car accident while driving under influence, after decades of innovative work, during which he created a new painting method and produced compositions which are nowadays between the most expensive works of art. Mark Rothko also had periods of heavy drinking, and finally he died by cutting his arms with a razor. He is considered a genius, who created a completely new perspective over painting, and his works are also between the most expensive paintings in the world. Willem de Kooning was affected by alcoholism since his early years, and developed dementia, at least partially induced by abusive drinking. Although affected by neurocognitive disorder, he continued to produce amazingly creative paintings until his final years and in 2016 one of his works obtained the record for the most expensive painting ever sold. Using alcohol as a tool for increasing creativity risks to expose the creator to severe disorders or even death, the subject walking on a narrow line between sublimation of unconscious impulses and tragic resignation before them.Disclosure of interestThe presenting author was speaker for Bristol Myers Squibb and Servier, and participated in clinical research funded by Janssen Cilag, Astra Zeneca, Eli Lilly, Sanofi Aventis, Schering Plough, Organon, Bioline Rx, Forenap, Wyeth, Otsuka Pharmaceuticals, Dainippon Sumitomo.
Correlation between depression and happiness among Kuwait university students
Authors: Baqer G. 
Published: June 2017

BackgroundThe Beck Depression Inventory (BDI-II) has become one of the most widely used instruments for evaluating the severity of depressive symptoms in psychiatric patients and in normal populations. The Oxford Happiness Questionnaire (OHQ) has been derived from the Oxford Happiness Inventory (OHI). The OHI follows the design and format of BDI-II, which provided, when reversed, a set of 20 multiple-choice items relevant to subjective well being. Further items were added to cover aspects of happiness and 29 items were retained in the final scale. OHQ was translated into Arabic for the first time in the present study. The aim of the study is to examine the correlation between depression and happiness.Materials and methodsBDI-II (alpha .87) and the Arabic version of OHQ (alpha .92) were completed by a sample of (380) Kuwait university students (180) males and (200) females with mean age of 22.19 ± 2.8 years old. Pearson correlations were calculated.ResultsSignificant (P > 0.01) reverse correlation was found between depression and happiness (r = –54).ConclusionAlthough significant negative relationship existed between BDI-II and OHQ, the coefficient for determination of this correlation shows that nearly only half of depression changes are described and assessed with happiness score! It seems that the two psychometric tools do not completely stand against each other. However, further evaluation of this relationship is needed.Disclosure of interestThe author has not supplied his/her declaration of competing interest.