bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex and age factors in neuroleptic malignant syndrome diagnosis frequency
Authors: Gurrera R. 
Published: June 2017

IntroductionIt is not known whether sex and age are risk factors for neuroleptic malignant syndrome (NMS).ObjectivesTo examine sex and age distributions in NMS patients based on a systematic review of the literature.AimsEstimate the sex-specific relative risk of an NMS diagnosis.MethodsEMBASE and PubMed databases were searched in November 2014 using broad, unrestricted criteria to identify any published observation of NMS. Any physically (online or hard copy) accessible and interpretable (using language translation software) report published from January 1, 1998 through November 1, 2014 was considered for inclusion. Secondary sources (e.g., reviews) were included when primary sources could not be accessed. All cases for which the patient's sex or the sample's sex distribution was provided were included, except for redundant reports and cases in which NMS was not the most likely clinical diagnosis. Sex ratio and age distributions were examined using standard graphical techniques and measures of association.ResultsTwenty-eight independent NMS sex ratio estimates were included. Most sex ratio estimates (75%) indicated male preponderance, with a median of 1.47 (95% CI: 1.20–1.80). NMS incidence peaked at age 20–25 years and declined steadily thereafter; males consistently outnumbered females at all age intervals. Major study limitations are the heterogeneity of case ascertainment procedures and the potential for publication bias.ConclusionsNMS patients are 50% more likely to be males, and NMS is most likely to occur in young adulthood. Men, and all young adults, appear to be at increased risk for NMS.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Amisulpride-induced agranulocytosis: A case report
Authors: Maatallah H. , Ben Ammar H. , AIssa A. , Nefzi R. , Said M. , El Hechmi Z. 
Published: June 2017

IntroductionAgranulocytosis is a potentially life-threatening haematological side effect induced by typical and atypical neuroleptic. When agranulocytosis is associated with a specific anti-psychotic, the medication should be discontinued. This severe side effect is troublesome.Case reportWe report the case of a 60-year-old man, treated with amisulpride for schizophrenia, who developed an agranulocytosis. This patient had been treated with first and second generation anti-psychotic drugs during his life and had already been exposed to many neuroleptics without any signs of toxicity. However, after three days of the introduction of amisulpride he presented a rapid onset agranulocytosis (leukocytes 1.2 G/L and neutrophils 0.4 G/L). After discontinuation of amisulpride, blood count returned to normal. The favorable evolution after discontinuation of treatment: the normality of biological and cytological examinations is in favor of a causal relationship between this severe neutropenia al introduction of amisulpride.ConclusionThis case report highlights the risk of amisulpride in inducing agranulocytosis, a risk underestimated in regard of the clozapine risk to induce agranulocytosis or neutropenia. For this reason, it seems reasonable to recommend performing a blood count before introduction and during the treatment by anti-psychotics.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Benefits of the functional ensemble of temperament framework in assessment of mental disorders: Examples
Authors: Trofimova I. 
Published: June 2017

IntroductionAn integration between psychiatry, neurochemistry and differential psychology gives an evidence-based framework for the diagnosis of mental illness rooted both in modern neurophysiology and clinical observations.ObjectivesTo investigate whether, a neurochemical model of temperament might (FET) provide a better discrimination between major depression (MD), anxiety (GAD), co-morbid depression and anxiety and delusional disorders than existing emotionality-based temperament models.MethodsThree studies compared the profiles on temperament and personality disorder inventories in patients who were diagnosed and treated for named disorders across four adult age groups (17–24, 25–45, 46–65, 66–84).ResultsThe FET distinguished between MD and GAD in line with the DSM descriptors and showed significant differences for the traits of motor endurance and motor tempo (much lower values in MD), and neuroticism (much higher value in GAD). The results showed benefits of differentiation between physical and social types of fatigue as a symptom of MD and that high impulsivity and low plasticity can be also considered symptoms differentiating between mental disorders. Moreover, high sociability appeared as a symptom associated with high dominance–mania tendencies. The FET framework appeared to be sensitive to age and sex differences: higher anxiety and anti-social symptoms appeared to be more prominent in the younger age (unlike depression symptoms), and declined with age.ConclusionsThis study suggest the utility of using a functional approach to both taxonomy of temperament and classification of mental disorders and the benefits of systemic differentiating between 12 functional aspects of behavior, with special attention to non-emotionality-related aspects of behavior.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Manic switch in bipolar patients treated with electroconvulsive therapy for treatment-resistant depression: The experience at the mood disorder unit of Milan (Italy)
Authors: Delmonte D. , Brioschi S. , Barbini B. , Zanardi R. , Colombo C. 
Published: June 2017

IntroductionDespite appropriate treatment, 30–40% of depressed patients, both unipolar and bipolar, do not achieve improvement, with high morbidity and mortality. For bipolar patients another risk is the switch into mania due to antidepressant treatment. The concern about the switch, suggests to administer antidepressants at lower doses, in combination with mood stabilizers and second generation anti-psychotics.ObjectivesWe performed an observational study on a sample of 23 bipolar patients treated with ECT for severe TRD in last 3 years, in order to evaluate the risk of switch.MethodsTwenty-three bipolar inpatients, undergoing bitemporal ECT twice/week, with MECTA spectrum device. Main demographic and clinical data collected. Hamilton rating scale for depression (HAM-D). Clinical response defined as 50% reduction of HAM-D score at the endpoint from baseline; remission as HAM-D score at the endpoint < 8. Young Mania rating scale (YMRS) weekly in order to assess switch into mania.ResultsThirteen (56.5%) females, 10 (43.5%) males, mean age 60.1 ± 10.3 years. Mean age at onset 35.5 ± 13.6 years. Mean number of episodes: 7.1 ± 3.6. Mean duration of current episode: 33.4 ± 24.9 weeks. Mean HAM-D basal score: 30.0 ± 5. Each patient underwent a cycle of ECT (mean No. 6.7 ± 3.3). Pharmacological treatment was administered upon clinical need. Response rate 87%, remission rate 43.5%. Three out of 23 (13.04%) patients had transient hypomanic switch, spontaneous recovery within 7 days after the last ECT.ConclusionsOur experience confirms that ECT is a powerful antidepressant, especially in patients with severe long-lasting depression, refractory to treatment. ECT is also a safe procedure: no adverse effects were reported. The manic switch rate is comparable with antidepressant drugs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Bilateral continuous theta burst stimulation (cTBS) for treatment resistant auditory hallucinations and synesthesia in schizophrenia – A case report
Authors: Jakhar J. , Mehta D.U. 
Published: June 2017

IntroductionWhile 1–Hz repetitive transcranial magnetic stimulation (rTMS) has been found to be effective in reducing auditory hallucinations (AH), its effects are transient. cTBS, a patterned-rTMS technique induces sustained long-term-depression-like effects. Here, we demonstrate efficacy of twice daily, bilateral-cTBS in a patient with treatment-resistant AH, reflex hallucinations and vision-touch synesthesia.MethodA 25-year-old male with 5 years history of treatment-resistant AH (2nd/3rd person), vision-touch synesthesia and reflex hallucinations. He was on a combination of 200 mg clozapine and 300 mg amisulpride for the last 6 months with no improvement. He received two-weeks of twice daily, bilateral-cTBS [40,1 s-trains (bursts of 3-pulses at 50 Hz every 200 ms) given continuously at 90% motor threshold] over the temporoparietal junctions located using the International 10/20 system. Amisulpride was stopped and clozapine was increased to 300 mg/day. Change in AH and synesthesiae were assessed using auditory hallucination rating scale (AHRS) and clinical interview.ResultAHRS scores reduced from 35/41 to 0/41 at the end of 2 weeks, with substantial improvement being noticed at the end of the fifth day. Synesthesiae and reflex hallucinations also showed similar trends in improvement. No serious adverse events.DiscussionIntegration of auditory, visual and tactile perceptions is an important function of the temporoparietal junction. administering cTBS to this region bilaterally reduced our patient's perceptual abnormalities. Increasing dose of clozapine could be a confounding factor, however, the rapidity of treatment response enables us to attribute part of the improvement to cTBS.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The New Aspect of Psychotherapy in our Clinical Psychiatric Unit: The Effort it Took to Make it work; and the First Results
Authors: Goujon D. , Berenguer L. , Romann F. 
Published: June 2017

IntroductionOur two units take care of a rather big number of people (about 170 000). Various activities are proposed for outpatients and the idea was expressed to initiate art therapy.ObjectivesWe first analysed the possibility of starting this new mediation equally in the two units. A team was formed: a clinical psychiatrist and two registered nurses, one being an art therapist as well. We started this activity with a small group of out patients in April 2016.AimsThe registered nurse – art therapist was provided with appropriate space, art material and furniture by hospital sources. The other unit will send the nurse for training in art – therapy: leave and grant are provided by the hospital. Her project is different and yet complementary.MethodsThe group was validated and evaluated by the art therapist and the psychiatrist. The organization of the activity is left to the art therapist. A questionnaire was filled out by art therapist before beginning the art therapy and at regular intervals.ResultsPatients are engaged by this therapy and come on regular basis. They chose painting to express themselves and leave their productions in the room after they are finished.ConclusionsThe newly opened psychotherapy – art therapy has brought many positive changes in our hospital for working staff as well as for the patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.AcknowledgementsWe want to thank the Chiefs of our Department of Psychiatry, Grandin Pascal, MD and Benzaken-Charlier Catherine MD for their acceptance and support of this project.
The Use of Art Therapy in Complex Treatment on the Quality of Remission in Patients with Melancholy in Major Depressive Disorder
Authors: Kozhyna H. , Korostiy V. , Hmain S. , Mykhaylov V. 
Published: June 2017

IntroductionAccording to studies done in recent years regarding the treatment of patients with melancholy in major depressive disorder, a shift of interest from studies evaluating the effectiveness of therapy to the study of remission is seen. Despite significant progress in the development of pharmacotherapy of depressive disorders, difficulty in achieving rapid reduction in depressive symptoms and stable remission in patients with melancholic depression necessitated the search for new approaches to the treatment of this pathology.AimsEvaluating the effectiveness of art therapy in treatment in patients with melancholy in major depressive disorder on the quality of remission.MethodsThe study involved 135 patients – 60 male and 75 female patients aged from 18 to 30 years old. The main group of patients apart the combined treatment also participated in group art therapy with the use of drawing techniques, while the control group – statutory standard therapy.ResultsThe results of the use of art therapy in complex treatment in patients with major depressive disorder is detected primarily in reducing of the level of anxiety at the early stages of treatment (60% of patients have noticed decreasing of melancholic state), as well as improving the quality of life in remission period.ConclusionThese results support the use of art therapy in treatment in patients with melancholy in major depressive disorder during period of active treatment, and after achieving clinical remission contributes to achieving and maintaining high-quality and stable remission with full restoration of quality of life and social functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Attempting Reconciliation with Cross-Examination in Couple Therapy
Authors: Latecki B. 
Published: June 2017

Many traps and conflicts can be encountered by the therapist trying to facilitate communication and to promote agreement between couples or between an angry teenager and his/her parent. The cross-examination technique is a useful tool in such situations. It involves humour but it is also confrontational, it shifts the burden of initiating and continuation of the dialog onto the parties involved, it teaches responsibility, respect and sensitivity to the other's points of view and, after exposing the “sore points”, it leaves the couple in a position to discuss possible solutions. Elements of other psychotherapeutic approaches (mirror technique, paradoxical intentions, empty chair technique, Ericksonian approach) are included as well. Elements of logic aimed at recognizing the fallacies and assumptions between the couple are also used.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Roll of the Third Wave Therapies in the Treatment of Schizophrenia
Authors: Asensio Aguerri L. , Nuevo L. , Mata B. , Segura E. , Lopez E. , García F. 
Published: June 2017

IntroductionThe schizophrenia is a frequent mental disorder. The symptoms affect the emotions, cognition, perception and other aspects of the behaviour. In the last years have been developed different interventions and psychological treatments in order to improve the personal and social functioning of these patients. Among the new proposals is the called “third wave”.ObjectivesDetermine the efficacy of third generation therapies in the treatment of schizophrenia.MethodsWe have performed a systematic review of the existing bibliography in PubMed/Medline, Cochrane and Dialnet, using the combination of different keywords “acceptance and commitment therapy, mindfulness, psychosis, schizophrenia, third wave of therapies, based cognitive therapy”.ResultsThe based cognitive therapy for the psychosis (CBT) was designed for the treatment of the residual symptoms of schizophrenia, however in the present there are over 30 randomized trial publications were is evaluated the efficacy of CBT in psychosis, on positive and negative symptoms, functionality and affectivity. It is most effective in acute episodes.ConclusionsThe treatment with the third generation therapies reduces the positive symptoms of schizophrenia and improves depressive and anxiety symptoms. The CBT and the mindfulness are the most studied. There are scientifically therapeutic options for the treatment of patients with schizophrenia in combination with pharmacotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Interoceptive Exposure at the Heart of Emotional Identification work in Psychotherapy
Authors: Suchocka Capuano A. , Karar A. , Georgin A. , Allek R. , Dupuy C. , Bouyakoub S. 
Published: June 2017

IntroductionEmotional avoidance is a target process, offered by modern psychotherapies. Emotional exposure is often difficult to put in place when there is a major cognitive and behavioral avoidance. Education on emotional processes is necessary but often insufficient during individual follow-up.ObjectivesThe longitudinal study seeks to verify whether work on exposure and emotional identification influences the decreased level of anxiety and depression.AimsIntroduction of interoceptive exposition in psychotherapy decreases the frequency of emotional avoidance.MethodGroup psychotherapy composed of two modules: interoceptive exposure and emotional identification was proposed to patients with anxiety and depressive disorders. A group of 6 participants was evaluated at three times: T0 before the start of the group, T1 post-module 1 and T2 post-group. Assessments of HAMA anxiety, MADRS depression, QEC cognitive avoidance, UPPS impulsivity, MCQ-30 metacognition and emotional regulation REQ-21 have been proposed.ResultsSignificant differences were observed between pre- and post-intervention scores (Friedman test). The HAMA anxiety rate (P = 0.006) and the MADRS depression (P = 0.047) decreased. Participants in the group were less likely to use QEC thought substitution (P = 0.009) and urgency in their UPPS reactions (P = 0.03). Moreover, their external dysfunction REQ. 21 decreases (P = 0.03).ConclusionFaced with emotional avoidance, work on emotional identification requires prior interoceptive exposure. It is a first stage of work that involves sensitizing to the presence of emotional bodily sensations. Group work facilitates exposure to emotion and its identification; decentration leading to emotional intensity decrease. The work on the interoceptive exhibition facilitates the emotional exposure while participating in the deactivation of the associative emotional network.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cognitive Behavioral Therapy in Internet Addiction – A Case Series
Authors: Vasile D. , Vasiliu O. , Vasiliu D.G. , Vasile F. 
Published: June 2017

Internet use increased significantly in the last decade through the development of portable technologies, like laptops, smart-phones, tablets etc. Time spent on Internet could became a problem for many users, some of them reporting a sense of control loss, as they begin to stay more on-line than they initially wanted. Gaming, shopping, gambling, social networking, visiting pornographic sites, e-mailing, all these activities could transform an apparently inoffensive mean of communication into the trigger of a behavioral addiction. We applied individual cognitive-behavioral therapy (CBT) in three cases of Internet addiction, with cognitive re-structuring based on a diary of dysfunctional thoughts, relaxation techniques, and coping skills training, with good results. CBT was structured in bi-weekly sessions, of 30 minutes duration, for 6 weeks. Time spent on-line and daily functioning were the main variables monitored. A very important issue is to address all potential factors that could maintain the disorder, like social skills deficits, personality disorders, other co-morbid addictions, anxiety or depressive symptoms etc. Elements of motivational interview could be helpful especially at first visit, but also during therapy, when danger of relapse surfaces. Cue exposure with prevention of response is another technique that had proven itself useful in several sessions, when automatic thoughts challenge appeared to have reached a dead point. An informant like a close relative of the patient should be involved in the therapy whenever possible, due to the fact that Internet addiction therapy, like any other addiction therapy, need a third party to offer feed-back regarding patient's changes under treatment.Disclosure of interestThe presenting author was speaker for Astra Zeneca, Bristol Myers Squibb, CSC Pharmaceuticals, Eli Lilly, Janssen Cilag, Lundbeck, Organon, Pfizer, Servier, Sanofi Aventis 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, Servier.
Parental stress in autistic parents: The counseling effects
Authors: Ferrara R. , Esposito M. 
Published: June 2017

IntroductionIn parents of autistic children there are high levels of stress. For parents, counseling can help them face the world of autism through the many stressors they experiment.ObjectivesTo evidence a possible effect of the counseling intervention on parental stress.MethodsThe sample consisted of 24 parents (mean age = 38.7) of children diagnosed with autism spectrum disorder related to the treatment centre “Una breccia nel muro”. Parents’ group was randomly divided into two subgroups, the first (EG experimental group) consists in 12 parents, which were included in a counseling treatment of six months (one meeting of 2 hours every 15 days), while the other subgroup parents, (CG control group) were not included. We used parenting stress index–short form (PSI-SF) before counseling intervention (T0) and after (T1) with every parent. PSI values stress level in following scales: parental distress (PD), parent-child dysfunctional interaction (PCDI) and difficult child characteristics (DC). Figure 1 shows all the variables in each group at T0 and T1.ResultsThen a 2-tail t-test was separately carried out for each group (Counseling Yes; Counseling No). Counseling Yes: PD (t22 = .70, P = .49); PCDI (t22 = .72, P = .47); DC (t22 = 2.23, P = .03); Tot Stress (t22 = 1.04, P = .3). Counseling No: PD (t22 = .82, P = .42); PCDI (t22 = 1.7, P = .09); DC (t22 = .59, P = .56); Tot Stress (t22 = .72, P = .48)ConclusionsOur data confirm the positive effects of counseling especially on the difficulties related to children (DC scale).Disclosure of interestThe authors have not supplied their declaration of competing interest.
Early Signs of Crisis in the Perception of Users and their Family
Authors: Fucci G. , Ratti N. , Ignarra R. 
Published: June 2017

The identification of the early signs of crisis is globally considered one of the fundamental elements in the illness management practice of the psychiatric user. For this reason the mental health center of the city of Ravenna wanted to offer a personalized questionnaire to a 15 random-selected users and their families, with the aim of evaluating and analyzing the alarm signals in the participant's perception. The questionnaire has been created on the basis of other tests in the literature. It is divided in two parts, a “symptomatic”, related to the early signs of crisis, and an “environmental”, focalized on the potentially stressing situations for the individual. The administration took place within the individual and the family talks at the center. This project was implemented not only as a psycho-educational activity for the users and their family's, but also to amplify the knowledge of the staff on these signs. The results have shown how often there are points of difference in the perceptions of the early signs of crisis of the users and their families and it is believed this could turn out to be an important factor to be worked on within the projects of psycho-education of the mental health center.Disclosure of interestThe authors have not supplied their declaration of competing interest.