bluuebunny/crossref_metadata_2025_split huggingface dataset:
Persistent genital arousal: Differential diagnosis and management in the emergency room of psychiatry
Authors: Calahorro C.M. , Jiménez M. Guerrero , Serrano B.M. Girela 
Published: June 2017

BackgroundWe describe the case of a 50 years old woman who attended the emergency room for complaints that involves continuous orgasms in the last two months that she describes “as waves”. The woman is a widow and claims not to have had sexual relationships since her husband died four years ago.Main objectivePersistent genital arousal disorder (PGAD) is a relatively unknown clinical condition affecting several women. Moral standards, as well as conservative beliefs regarding sexuality, are believed to be involved in the etiology and maintenance of this syndrome. Nevertheless, there are no consistent data on the content of the beliefs system presented by these women.PGAD It has been identified as a condition of often unprovoked genital arousal associated with a significant level of distress.PGAD is not well understood, and no definitive cause has been determined.Our main objective was to review the literature on PGAD, identify possible causes of the disorder, and provide approaches to the assessment and treatment of the disorder based on the authors’ experience and recent literature.CommentsPGAD is a potentially debilitating disorder of unwanted genital sensation and arousal that is generally spontaneous and unrelenting. Since its first description in 2001, many potential etiologies and management strategies have been suggested. PGAD likely represents a range of conditions manifesting in unwanted genital sensations. Successful treatment requires a multidisciplinary approach and consideration of all reversible causes as well as cognitive therapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Evaluation of depression and anxiety, and their relationship with insomnia, nightmare and demographic variables in medical students
Authors: Haji Seyed Javadi S.A. 
Published: June 2017

IntroductionResearches showed comorbidity of sleep disorders and mental disorders.Objectives and aimsThe current study aimed to evaluate depression and anxiety and their relationship with insomnia, nightmare and demographic variables in the medical students of Qazvin University of Medical Sciences in 2015.MethodThe study population included 253 medical students with the age range of 18–35 years. Data were gathered using Beck depression inventory, Kettle anxiety, and insomnia and nightmare questionnaires and were analyzed by proper statistical methods.ResultsAmong the participants, 126 (49.6%) subjects had depression and 108 (42.5%) anxiety. The prevalence of depression and anxiety among the subjects with lower family income was significantly higher (Chi2 = 6.75, P = 0.03 for depression and Х2 = 27.99, P < 0.05 for anxiety). There was a close relationship between depression with sleep-onset difficulty, difficulty in awakening and daily sleep attacks, and also between anxiety with sleep-onset difficulty and daily tiredness (P < 0.05). In addition, there was a close relationship between depression and anxiety with nightmare; 16.2% of the subjects with depression and 26.5% of the ones with anxiety experienced nightmares.ConclusionResults showed a relationship between nightmare, insomnia and level of family income with increasing depression and anxiety in the medical students; hence, due to the importance of medicine in human life, it is necessary to evaluate the mental health of medical students, identify and solve the relative problems such as anxiety, depression and related symptoms such as insomnia and nightmare in them.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Example of alert and reporting system of scopolamine poisoning among Parisian cocaine users at regional, national and European levels
Authors: Batisse A. , Chevallier C. , Azevedo Correia J. , Martinez M. , Hoizey G. , Chèze M. , Buscail S. , Deveaux M. , Djezzar S. , Sandrine B. , Samira D. 
Published: June 2017

IntroductionIn the literature, few intoxications are related to scopolamine due to its presence in cocaine, heroin or even in counterfeit rohypnol tablets. Nonetheless, during summer 2016, several cases of non-fatal intoxication appeared in the region of Paris.ObjectivesDemonstrate how clinical detection of rare toxic events are fostered by exchanges in close collaboration with different territorial level.AimsImprove the detection of short toxic epidemic.MethodsSuspected cases of scopolamine poisoning notified to Parisian Addictovigilance centre were reported. Information shared through different levels of the alert process contributed to strengthen their assessment.ResultsSeventeen cases of probable scopolamine poisoning among cocaine users were registered between the 6 and 24 of July. In the first 4 cases, toxicological analysis, of blood samples were scopolamine positive, with high concentration between 7 ng/mL and 25 ng/mL (usual therapeutic range: 0.1 to 1.1 ng/mL). A collected sample of this cocaine powder had a purity of 23.2%, with 15.2% of scopolamine. Half time of scopolamine is longer than half time of cocaine (3–8 hours versus 1–2 hours): this could explain why the observed effects lasted over 24 hours (8/17). Main clinical features were mydriasis (15/17), high blood pressure (12/17), tachycardia (13/17), behavioural disorder with agitation (13/17), hallucinations (5/17), and coma (8/17). Practitioner's responsiveness and the extensive information sharing [MM1] between regional and European level were congruent.ConclusionsAdulterated street drugs can lead to short toxic epidemic which could be unnoticed. Emerging event should require careful assessment with linkage between risk assessors and risk managers.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Substance use among youth psychiatric outpatients
Authors: Morais S. , Silva Ribeiro J. , Oliveira P. , Mendes E. , Botelho A. , Godinho H. , Vale L. , Bessa A. , Renca P. , Santos V. , Madeira N. 
Published: June 2017

IntroductionPortuguese young adults (15–34 years old) were more frequent engaged in substance abuse (1.2%) than the general population, according to the Portuguese substance use annual report (2014). Alcohol was the most frequent substance use on youth adults. Cannabis was the most frequent illicit substance used (23.9% of users were considered dependent), with higher prevalence than previously reported. LSD (0.4%) use was also higher among young adults than in previous studies. Cocaine (0.4%), heroine/opiates (0.4%), ecstasy (0.3%), and hallucinogenic mushrooms (1.1%) had their consumption lowered among young adults.Objectives/aimsTo characterize a population of young adult psychiatric outpatients, regarding substance use and associated risk.MethodsSocio-demographic characterization of our young adult unit outpatient users between 1st January 2015–31st July 2016. Substance use was assessed with the Portuguese version of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST).ResultsA total of 255 outpatients were observed during the timeframe; 58 outpatients were assessed with ASSIST: 44 females (75.9%) and 14 males (24.1%), aged between 16–33 years old (average: 20.95; median: 19.50). For tobacco, 3.5% had high risk, 37.9% moderate risk and 58.6% low risk; 22.4% had moderate risk of alcohol, 13.8% moderate risk of cannabis, and 20.7% moderate risk of tranquilizers. For others substances (cocaine, stimulants, inhalants, hallucinogens, and opiates) the risk was low.ConclusionsIn our sample, alcohol and cannabis use had the highest risk, as reported in the National Annual Report; however, we observed a moderate risk for tranquilizers use. In future care planning, youth mental health should address tobacco and alcohol abstinence, and preventive measures regarding anxiolytics should be undertaken, such as banning sale without medical prescription.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Retrospective analysis of a novel community opiate detoxification programme within Bristol specialist drug & alcohol service (BSDAS)
Authors: Paklet L. , Radu I. , Watson B. 
Published: June 2017

IntroductionUntil recently community opiate detoxification strategies have largely been limited to gradual dose reductions in opiate substitute treatment (OST). These detoxes are often lengthy leading to “windows of opportunities” in patients’ motivation to detox being missed. Furthermore, many patients remain on sub-optimal OST doses for long periods of time, during which they are more vulnerable to relapse to illicit opiate use.Within our community service, we adapted and implemented a novel two-week community opiate detoxification programme using buprenorphine front-loading and lofexidine. We worked in partnership with Bristol drugs project (BDP) to offer an 8-week psychosocial intervention alongside the medically assisted detoxification.ObjectivesAssessing the completion rates and clinical safety of this intervention.MethodsData collection was performed through retrospective review of patients’ case notes over a 9-month period.ResultsSeventy-five percent of the patients starting an opiate detox successfully completed the intervention.Lofexidine improved the mean opiate withdrawal scores by 28% at 45 min after the first dose and this was a sustained effect throughout the detox. Mean systolic blood pressure dropped by 6.2 mmHg at 45 min after the first dose of lofexidine and by 16.5 mmHg two days later however this was asymptomatic in all patients. There was no significant change in the heart rate and no adverse events.ConclusionOur team innovatively adapted and tailored a cost-effective community opiate detoxification programme using a multi-agency strategy in a climate of limited funding and staff resources. Our data clearly indicates positive outcomes in terms of completion rates and clinical safety.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Seasonal variation and alcohol consumption: A retrospective observational study
Authors: Colombo R.A. , Preve M. , Bolla E. , Traber R. 
Published: June 2017

IntroductionSeasonal and geographic variations in light exposure influence human mood and behavior, including alcohol consumption. In literature alcohol consumption have a clear seasonal rhythm, with specific differences during the year . Seasonal changes in mood and behavior (seasonality) may be closely related to alcoholism. The aim of our study is to evaluate the relationship between alcohol consumption and seasonal variation.MethodOne hundred and nine inpatient are assessed with: the SCID-P for axis I diagnosis. Inclusion criteria are: (1) acute alcohol intoxication at the admission. All the socio-demographic characteristics are explained.ResultsThe peak period of alcohol admission is in the autumn, the lowest period is in spring in April and May. There is any significant difference related to gender. The 76% of the admission are coerced admission. The rates of co-morbidity are: personality disorders (30.3%), affective disorders (22.9%) and psychotic disorders (12.8%).Discussion and conclusionSome patients with alcoholism have a seasonal pattern to their alcohol misuse. Several lines of evidence suggest that changes in the circadian system are also involved in the development of non-seasonal mood disorders, such as major depression and bipolar disorder. Thus, developmental alcohol exposure produces subtle abnormalities in circadian rhythms that may contribute to the development of seasonal and non-seasonal mood disorders. Further research is warranted to replicate our clinical and qualitative observations and, in general, quantitative studies in large samples followed up over time are needed. Methodological limitations, clinical implications and suggestions for future research directions are considered.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cognitive impairment associated with drug use in old age people
Authors: Ros-Cucurull E. , Cardona-Rubira C. , García-Raboso E. , Palma-Álvarez R.F. , Grau-López L. , Daigre C. , Rodríguez-Cintas L. , Sorribes-Puertas M. , Martínez-Arias R. , Cuautle A. , Ortiz-Medina M.B. , Fadeuilhe C. , Jacas C. , Casas M. , Roncero C. 
Published: June 2017

IntroductionSubstance use disorder is a growing phenomenon among old adults. It is usually significantly undervalued, misidentified, under diagnosed and poorly treated. It has been related to cognitive impairment but there are few studies focused on the elderly.AimTo evaluate the relationship between drug use and cognitive impairment in old adults.MethodsWe conducted a prospective study (basal and 6 month follow up) in 67 patients over 65 years old seeking for treatment for drug misuse (alcohol and prescription drugs, mainly benzodiacepines) in addiction and dual diagnosis unit in Barcelona. A specific protocol was performed to evaluate attention, executive function, working memory, learning capacity, fonetic and visual fluency, decision-making, visual construction and cognitive flexibility (FCT, CPT-II, N-BACK, COWAT FAS, TAP, SDMT, IGT, CVLT, TOL, RFFT, STROOP). Patients were compared with a control group (healthy non drug users) with same characteristics (gender, age range and education status). The protocol consisted in two separated sessions of 90 minutes each one performed by a neuropsychologist.ResultsResults obtained suggested that patients under drug misuse had worse scores in fluency, visual construction, memory and attention compared with controls. After 6 month treatment and achieving abstinence patients improve in cognitive skills as verbal learning, short-term memory and free recall of verbal information. Cognitive impairment profile changes depending on the substance abused (alcohol or benzodiacepines).ConclusionsDrug use can produce deleterious effects in old adults. However, those who achieve abstinence may improve some cognitive functioning as verbal learning, short-term memory and free recall of verbal information.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The application of the attitudes towards suicide questionnaire (ATTS) in Tunisian elderly
Authors: Abbes W. , Manel M. , Kaouthar H. , Nada C. , Nasreddine Z. , Lobna Z. , Jihen B.T. , Mohamed M. 
Published: June 2017

IntroductionAccording to WHO, suicide is a major public health problem and the most affected age group by suicide in Tunisia is that of over 70 years.AimsTo study the perception of the Tunisian elderly of suicide.MethodsA cross-sectional study was conducted during a 3-month period from October to December 2015. Fifty persons aged at least 65 years participated to the study. We used an anonymous questionnaire with a specific scale: “Attitudes Towards Suicide Questionnaire” (ATTS).ResultsThe mean age of our patients was 67.5 years. Sex ratio was 1.27. Most of the participants were married (82%), unemployed (63.2%), with a secondary or high educational level (62%), and low income (73.5%). All participants were believers. As for religious practice, 74.5% of the recruited elderly made the fast and 73.5% were prayers. Among women, 70.8% wore the veil. Concerning the perception of suicide, it was on the dimension of “permissiveness” (M = 1.88) that our participants agreed less. Those who made prayers had lower scores of “permissiveness” (P = 0.032). Women who wore the veil had higher scores on the field of “incomprehensibility” than the unveiled ones (P = 0.047). Furthermore, 68% of our participants believed that suicide is stigmatizing.ConclusionsIt might be time to try to lift the taboo and stigma through information and sensitizing campaigns on suicide. In this direction, studies of perception help to identify, somehow, “automatic thoughts” regarding representations of suicide and to try to develop an “alternative thinking” in the general population.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Algeria, from social issue to self-immolation; autopsy of a “fashionable” suicide
Authors: Pacha N. Ali 
Published: June 2017

IntroductionSelf-immolation has been practised for several centuries in some cultures. Tolerated by Mahayana Buddhism and Hinduism. It is practised for many reasons: Sati (rituals), political protests, devotion and renouncement. In addition, it is also observed in some warrior cultures, like Rajputs.The self-immolation trend began in Tunisia during government protests (“Arab spring” revolution) when a man named Bouazizi set himself on fire and died. Fiery copycat suicides spread throughout other countries. Algeria has also discovered this form of protest and faced a wave of self-immolation considered by some commentators to have reached epidemic proportions.ObjectiveOur goal is to show the kind of support that political and health authorities, with the help of psychiatrists, are trying to set up in order to achieve efficient prevention.MethodsIn a case-control study, 20 consecutive case of deliberate self-inflicted burns admitted to the regional burn centre (Douera Hospital, Algeria) were compared with 20 controls who were selected from the community and matched by sex, age and living area. Diagnostic and statistical manual of mental disorders (DSM IV) Axis I (clinical disorders) and Axis II (personality and mental retardation) diagnoses were assessed via detailed clinical interview.ResultsThere have been 69 cases of self-immolation, with an average age of 26 including 87% of men and from which 13% with a psychiatric history. Unemployment and housing crisis are the most common causes. Here, we will provide specific explanations about our country.ConclusionIt turns out that self-immolation is an extreme form of protest against the social malaise to make things change and does not due in the most cases to mental disease.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Risk factor for suicide attempt in a general hospital
Authors: Mures B. , Lluis N.G. , Luis O.G. , Iñigo A.P. , German M.H. , José R.Q. , Yolanda L.P. 
Published: June 2017

IntroductionA major risk factor for suicide is suicide attempts. The aim of the present study was to assess risk factors for nonfatal suicide attempts. Suicide attempt with high lethality have been interacting with certain clinical and demographic factors such as age, sex, psychopathology and adverse events, among others.MethodsObservational, descriptive and retrospective study of people who was admitted to a general hospital after suicide attempt.AimThe aim of this study was to determinate variable associated to high risk of suicide. Describe and analyze demographic and clinical characteristics associated with serious suicide attempts as well as the methods used.ResultsOf a total of 504, 23 patients was admitted after suicide attempt, 61% male, mean age 54.1; 60% required ICU; the most common method consisted of multiple drug intake 40%, 30% associated with toxic, mostly alcohol. Predominant summer and diagnosis of adjustment disorder.ConclusionAs is the case with suicides prevails male and summer. As to the most common method has been from medication, both men and women. We were surprised diagnosis of the most common reactions to stress. We conclude that the findings could guide a progressive change in the presuicidal pathology.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neurobiological Correlates of the Treatment of Emotion Processing in Schizophrenia
Authors: Sachs G. , Felsberger H. , Furtner J. , Erfurth A. 
Published: June 2017

IntroductionMentalizing ability is impaired in patients with schizophrenia. Most studies in schizophrenia report hypoactivation of the core-mentalizing network including the medial prefrontal cortex (mPFC) and bilateral temporoparietal junction (TPJ). In our study, in patients with first episode schizophrenia treatment as usual with atypical antipsychotics (TAU) was compared to the add-on effect of a mentalization-based treatment program (MBT) on the mentalizing network in the brain.Method12 patients diagnosed with schizophrenia according to DSM-IV-TR criteria participated in the study (6 males, mean age: 30.43, SD = 9.35 years, years of education 13.23, SD =2.45). A modified treatment program for psychoses was used based on the mentalization-based therapy developed by Bateman and Fonagy (2009). Before and after the treatment fMRI analyses (fixed effects analyses) were carried out (3 Tesla, 5 blocks on/off, 36s, TR = 3.62, SPM) using the n-back task.ResultsPreliminary results show single analyses due to the small sample size. Comparing the fMRI scans before and after treatment, increases in the activation patterns were found in first episode patients treated with MBT. In patients with TAU a reduction in the activation patterns was demonstrated (mean changes in the activation clusters in the MBT group was 5.53, SD 12.79, in the TAU group -5.80, SD 6.91).DiscussionMentalization-based treatment is a promising approach in the treatment of schizophrenia and can have an impact on social networks in the brain. Further studies are needed for a better understanding of social cognition and the related neural mechanisms in schizophrenia.Disclosure of interestThe authors declare that they have no competing interest.
Screening for perinatal anxiety disorder in Serbian women
Authors: Kitanovic B. , Milutinovic D. 
Published: June 2017

Perinatal generalized anxiety disorder (GAD) has a high prevalence of 8.5%–10.5% during pregnancy and 4.4%–10.8% postpartum which is higher or as high as in general population. Despite its attendant dysfunction in the patient, this potentially debilitating mental health condition is often underdiagnosed due to difficulty in distinguishing normal versus pathological worry and nonexistent screening tool for perinatal GAD. The maternal dysfunction can potentially impact mother–infant bonding and influence neurodevelopment outcomes in the children.ObjectiveTo screen 100 women for anxiety symptoms during pregnancy and postpartum at the primary health center “Zvezdara”.MethodsOne thousand women were screened for anxiety symptoms using the GAD-7 and DSM-IV. Questionnaire that covered key demographic and obstetric information and GAD-7 and DSM-IV, were administered at the third trimester of pregnancy, and 8 weeks postpartum. Women were identified as at high risk for anxiety, cut-off scores of 5, 10, and 15 were taken as the cut off points for mild, moderate, and severe anxiety, respectively.ResultsTen percent of the sample was screened positive for mild anxiety symptoms during pregnancy. Subsequently, efforts were made to follow-up women with a postnatal GAD-7 and 7.2% percent were screened positive during postpartum.ConclusionClinicians should be aware of the frequency and level of anxiety symptoms during pregnancy and postpartum. Therefore, it is very important to identify women at high risk. Be aware that GAD is one of the risk factors that complicate pregnancy.Disclosure of interestThe authors have not supplied their declaration of competing interest.