bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risperidone-treated Children and Adolescents with Behavioral Disorders: Do Drug Dose and Patients’ Gender and Age Relate to Drug and Metabolite Plasma Levels?
Authors: Piacentino D. , Grözinger M. , Saria A. , Scolati F. , Arcangeli D. , Girardi P. , Pompili M. , Conca A. 
Published: June 2017

IntroductionBehavioral disorders, such as conduct disorder, influence choice of treatment and its outcome. Less is known about other variables that may have an influence.Objectives/AimsWe aimed to measure the parent drug and metabolite plasma levels in risperidone-treated children and adolescents with behavioral disorders and investigate the role of drug dose and patients’ gender and age.MethodsWe recruited 115 children/adolescents with DSM-5 behavioral disorders (females = 24; age range: 5–18 years) at the Departments of Psychiatry of the Hospitals of Bolzano, Italy, and Innsbruck, Austria. We measured risperidone and its metabolite 9-hydroxyrisperidone plasma levels and the parent drug-to-metabolite ratio in the plasma of all patients by using LC-MS/MS. A subsample of 15 patients had their risperidone doses measured daily. We compared risperidone and 9-hydroxyrisperidone plasma levels, as well as risperidone/9-hydroxyrisperidone ratio, in males vs. females and in younger (≤ 14 years) vs. older (15–18 years) patients by using Mann-Whitney U test. We fitted linear models for the variables “age” and “daily risperidone dose” by using log-transformation, regression analysis and applying the R2 statistic.ResultsFemales had significantly higher median 9-hydroxyrisperidone plasma levels (P = 0.000). Younger patients had a slightly lower median risperidone/9-hydroxyrisperidone ratio (P = 0.052). At the regression analysis, daily risperidone doses and metabolite, rather than parent drug–plasma levels were correlated (R2 = 0.35).ConclusionsGender is significantly associated with plasma levels, with females being slower metabolizers than males. Concerning age, younger patients seem to be rapid metabolizers, possibly due to a higher activity of CYP2D6. R2 suggests a clear-cut elimination of the metabolite.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Grey Matter Volume Patterns in Thalamic Nuclei are Associated with Schizotypy in Healthy Subjects
Authors: Di Carlo P. , Pergola G. , Cariello M. , Bonvino A. , Mancini M. , Taurisano P. , Caforio G. , Bertolino A. , Blasi G. 
Published: June 2017

IntroductionSchizotypy refers to a set of temporally stable traits that are observed in the general population and that resemble, in attenuated form, the symptoms of schizophrenia. In a previous work, we identified volumetric patterns in thalamic subregions which were associated with disease status, and trained a random forests classifier, accounting for such thalamic volumetric patterns, that discriminated healthy controls (HC) from patients with schizophrenia (SCZ) (81% accuracy) [1].Objectivesi) to assess performance of random forests classifier developed by Pergola and coworkers [1], in an independent sample of healthy subjects; ii) to test whether false positives (FP), i.e. HC classified as SCZ based on such classifier would be associated with greater schizotypy compared with true negatives (TN), i.e. HC classified as such.MethodsA total of 167 HC participated in the MRI study and filled the Schizotypal Personality Questionnaire (SPQ). We pre-processed MRI data with SPM8 and DARTEL. Then, we used thalamic grey matter volumes (GMV) as features in the random forests prediction of disease status at the single subject level. Finally, we tested SPQ scores differences between FP and TN with Mann-Whitney test.ResultsThe classification accuracy was 71%. FP had greater SPQ scores compared to TN (P = 0.007).ConclusionsClassification accuracy of our classifier in an independent sample suggests that thalamic GMV patterns are reproducible markers of disease status. Furthermore, the present results also suggest that variability of thalamic GMV patterns in HC may have relevance for subclinical phenotypes related to schizophrenia spectrum.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The burnout's prevalence among Tunisian military consultants in psychiatry
Authors: Belhadj H. , Krir W. , Bencheikh C. , Elkefi H. , Oumaya A. 
Published: June 2017

IntroductionBurnout causes a considerable human cost. Army employees are, in fact, particularly exposed to this risk.ObjectiveTo determinate the prevalence of burnout syndrome among military consultants in psychiatry and to study its socio-familial repercussions.MethodA cross-sectional study was conducted in a military outpatient clinic in Tunis and included 30 military patients with a seniority of more than 15 years. Burnout and major depression were assessed with the instrument Burnout Measure Short version (BMS-10) and the Patient Health Questionnaire “PHQ-9”, respectively.ResultsEighty percent of participants (n = 24) had a very high degree of burnout exposure according to BMS-10. Twenty of these (83.3%) had a moderate to severe depression. All married patients (n = 22) having burnout syndrome reported a conjugopathy and a tendency to physical and verbal aggressiveness against their children.ConclusionMilitary employees are particularly vulnerable to burnout. Detecting burnout in time is therefore essential in order to prevent its undeniable socio-familial repercussions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neuroimaging correlates of insight in obsessive compulsive disorder: A fMRI study
Authors: Gadad A. , Reddy D.Y.C.J. , Venkatasubramanian D.G. , C.N D.J. 
Published: June 2017

Aim of the studyTo study the neural substrates of insight in OCD by comparing patients with good insight, patients with poor insight and matched healthy controls using functional MRI.MethodologySubjects were recruited from among patients attending OCD clinic, adult psychiatry services and psychiatry ward inpatients of National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore. They were further divided into ‘good insight’ (n = 30) and ‘poor insight’ (n = 14) using Brown's assessment of belief's scale. Control subjects (n = 30) were recruited from consenting volunteers. 3 T MRI was used mental rotation task was paradigm used for fMRI and analysis was done by SPM 8.ResultsPoor insight patients and good insight patients comparison revealed differential activation in left superior/medial frontal gyrus (corresponding to the DLPFC). A negative correlation between BABS score and activation of right inferior parietal lobule. Mental rotation task behavioural data results: OCD patients as a group had significantly lower accuracy compared to healthy controls. Poor insight group had significantly decreased accuracy ratio compared to good insight group and healthy controls. A negative correlation was noted between BABS score and accuracy ratio, indicating that poorer the insight, greater the errors during the active task.ConclusionInsight has been important prognostic factor in OCD. Poor insight patients had specific deficits in left medial frontal gyrus and right inferior parietal lobule as compared to good insight patients and healthy controls. Together, these indicate that insight has a strong neurobiological underpinning in OCD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Evaluation of psychological interview before prominent ear reconstruction: Three cases report
Authors: Karatas K.S. , Ercan A.C. , Murat A. , Polat S. , Hocaoglu C. , Bahceci B. 
Published: June 2017

Medical and mental health professionals have long been interested in understanding both the motivations for seeking a change in physical appearance as well as the psychological outcomes of cosmetic surgery. By time to time researchers began to incorporate standardized psychometric tests and psychiatric evaluation into their studies. Psychiatrists have studied the personality characteristics and psychological state of these patients with the hope of identifying patients who may be psychologically inappropriate for surgery or those who are likely to be dissatisfied with a technically successful surgical outcome. There were some degree of congruence in the factors that appeared to be associated with poor outcome, demographic factors like being male, younger age, psychological/psychiatric factors such as history of depression or anxiety, dysmorphophobia, personality disorder as narcissistic or borderline, previous surgical procedure with which the patient was dissatisfied and minimal deformity. As a cosmetic surgery, prominent ear deformity is the most common abnormality of the external ear. We have used both clinical interview and psychometric assessments in three cases who want to go surgery because of their prominent ear. Two of the cases have used cyanoacrylate adhesive to their postauricular skin for camouflage of their prominent ear deformity. We have evaluated the patients’ psychiatric state with psychosocial viewpoint of the deformity.Disclosure of interestThe authors have not supplied their declaration of competing interest.
How painful is this? Idiosyncrasies of attention in irritable Bowel syndrome
Authors: Martin M. , Chapman S. 
Published: June 2017

IntroductionTheoretical controversy surrounds the issue of the extent to which cognitive processes can be identified which are characteristic of patients with irritable Bowel syndrome (IBS). The issue is important because particular patterns of idiosyncrasies would suggest tailored therapeutic interventions.ObjectivesTo map the processing of pain information in IBS and healthy participants in relation to physical and social threat, using latency as well as frequency metrics.MethodsParticipants (20 with IBS and 33 controls) were tested in an extended exogenous cuing paradigm whose derived measures included assessments of bias, engagement and disengagement. They also completed a battery of health and illness activity tests.ResultsThere was a significant interaction between bias in processing of pain (physical threat) and of neutral stimuli, as shown on Fig. 1. Further significant idiosyncrasies were observed in the relations between measures of attention and levels both of symptoms and of illness behaviour.ConclusionsDetailed evidence was obtained of anomalies in attention in IBS. The results may be interpreted in terms of interactive feedback between pain perception in relation to the gut, pain-specific attentional processes, and health behaviour. It will be discussed how mindfulness based cognitive therapy can be used as an intervention to disrupt this feedback.Disclosure of interestThe authors have not supplied their declaration of competing interest.Fig. 1Attentional bias in IBS and healthy groups with pain and neutral stimuli. Target in the same (valid) or different (invalid) position as the cue, bias = (RT invalid − RT valid).
Factors associated with professional stress at the teachers
Authors: Halouani N. , Smaoui F. , Derbel C. , Naoui R. , Alouloi J. , Amami O. 
Published: June 2017

IntroductionTeaching, as a profession, is recognized as demanding and stressful.Objectives(1) Evaluate the professional teacher stress, (2) Identify possible factors associated with it.MethodsThis is a cross-sectional study, descriptive and analytical, conducted among teachers of high school Mahmoud Magdich in Sfax. (Tunisia). Participants were asked to complete the anonymous form detailing the socio-demographic, professional characteristics and any work stressors.The evaluation of occupational stress was evaluated by the scale of “Karasek”.ResultsThirty-six teachers replied to the questionnaires. The sex ratio (M/F) was 0.38. The mean age was 48.77 years. The average number of years of exercise was 23.20 years and the average number of hours worked per week was 16.25 hours. The participants stress profile according to the scale of “Karasek” was: 55.6% stressed, 27.8%, assets, 11.1% liabilities, and 5.6% relaxed. The main stress factors mentioned were respectively: the inadequate salary (58.3%), difficult working conditions (52.8%), problems with students and parents (25%) and lack of organization at work (22.2%). Factors correlated with the profile “stressed” were: female gender (P = 0.026), lack of pastime practice (P = 0.034), teaching high school degree (P = 0.04), feeling that they work “too hard” in their work (P = 0.005), they are “the end” at the end of the working day (P = 0.015) and low social support (P = 0.005).ConclusionThe occupational stress among teachers was quite important. Knowing how to identify factors and taking action would be interesting for the guarantee development for teachers. Students would be the ultimate beneficiaries.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A case report of comorbid Munchausen type factitious disorder with bipolar II disorder
Authors: Kotsi A. , Argitis P. , Chimarios A. , Platari P. , Kittas C. , Karabas A. , Vantzios E. , Paschalidis K. , Mavreas V. 
Published: June 2017

We present an uncommon case of a 46-year-old woman suffering from Munchausen type factitious disorder comorbid with bipolar II disorder.The patient was diagnosed with major depression disorder 4 years ago during her hospitalization in the internal medicine department after a suicide attempt and SSRI was prescribed.Since the onset of the disorder the patient started complaining for physical symptoms, migrating from hospital to hospital seeking pathological and surgical interventions, fabulating her medical history. In the last 3 years, the patient visited the emergency room of university hospital of Ioannina 85 times and she was hospitalized in internal medicine or surgical clinics 16 times, performing 19CR, 11 CT and 4MRI.Many times, she turned to the police suing the treating doctors. During her hospitalizations she refused psychiatric evaluation. Twelve months ago the patient finally visited a psychiatrist, bipolar II disorder was diagnosed and administrated quetiapine with good results to both, mood and ER visits (7 visits in one year and 1 hospitalization).During the analysis of her mood switches, we observed non-euphoric hypomanic episodes and association of the hypomanic phase with the factitious behavior.This case report reinforces the importance of maintaining a clinical suspicion of major psychopathology coexistence with factitious disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Social cognition and bipolar disorder: A preliminary study
Authors: Ponte F.D.R. , Cardoso T.D.A. , Kunz M. , Rosa A.R. 
Published: June 2017

AimTo assess the clinical outcomes associated with social cognition impairment in euthymic patients with bipolar disorder.MethodIt was a cross-sectional study with convenience sample. The diagnose of bipolar disorder was performed by psychiatrist, using DSM-IV criteria, at bipolar disorder program – Hospital de Clinicas de Porto Alegre (Brazil), where the sample was recruited. The social cognition was assessed by psychologists using the Reading the Mind in the Eyes Test.ResultsWe included 46 euthymic BD patients: BD I (n = 39), women (n = 32), age (49.11 ± 13.17), and years of education (10.56 ± 3.80). Patients with social cognition impairment were not different of patients without social cognition impairment regarding socio demographic factors (gender, age, educational level, marital status, and employment status). Patients with social cognitive impairment showed higher rates of BD I patients (P = 0.036) and higher proportion of hospitalization in the first episode (P = 0.033), as compared to patients without social cognition impairment.ConclusionThis is a preliminary study demonstrating that BD patients with social cognition impairment show worse clinical outcomes. Severe BD onset seems to be an important predictor of social cognition impairment. However, more studies are needed investigating social cognition impairment in subjects with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Compassionate Attributes and Action Scale for adolescents: Adaptation and validation
Authors: Cunha M. , Rodrigues C. , Matos M. , Galhardo A. , Couto M. 
Published: June 2017

IntroductionCompassion can be defined as an intentional sensitivity to the suffering, with a motivation and commitment to try to relieve it, which can have a positive impact on individuals’ emotional and psychological well-being. The relevance of compassion focused therapies is well established and this makes the development of reliable instruments for the assessment of the different facets of compassion targeting different age groups crucial for research and clinical practice. The Compassionate Attributes and Actions Scale (CAAS) aims to assess compassion on three directions: self-compassion, compassion for others or compassion received from others. Each of the scales assesses one's compassionate attributes and compassionate actions separately when dealing with difficult or painful situations.Objective/aimThis study aimed to adapt the CAAS for adolescents and to explore its factor structure and psychometric properties in a sample of Portuguese adolescents.MethodsA total of 336 Portuguese adolescents with ages ranging from 12 to 19 years old participated in the study. Several exploratory factor analyses were conducted.ResultsExploratory factor analysis showed that, except for the attributes section of the self-compassion scale (that showed to be bi-factorial), all the other scales (and their sections) presented a single-factor structure. The three scales, and its sections, demonstrated a good reliability and excellent test-retest reliability and good convergent and discriminant validity.ConclusionResults were in line with the factor structure found in the adults’ version. The scales and its sections have shown good psychometric characteristics and constitute a useful instrument to assess and investigate the three directions of the compassion.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Association between depression and alexithymia in adolescents with Acne vulgaris
Authors: Feki R. , Sellami R. , Feki I. , Trigui D. , Turki H. , Masmoudi J. 
Published: June 2017

IntroductionAcne vulgaris is a common skin disease that affects the majority of adolescents. The physical changes of acne may have negative effects on the psychological structure of adolescents such as anxiety and depression. Alexithymia has been suggested to be an important symptom in psychodermatological patients.ObjectiveOur study aims to access depression in adolescents with A. vulgaris and to evaluate its relationship with alexithymia.MethodsThis is a descriptive cross-sectional study regarding 50 adolescents followed in the outpatient dermatology unit of Hédi Chaker University hospital in Sfax (Tunisia). To assess depression, we used a psychometric tool: Beck Depression Inventory (BDI). The Toronto Alexithymia Scale (TAS-20) was used to evaluate alexithymia. The severity of acne was evaluated with the Global Acne Evaluation (GEA) Scale.ResultsThe mean age of adolescents was 15 years 9 months. Almost all of adolescents was female (82%), and live in urban area.The severity of A. vulgaris was mild in 50%, moderate in 32% and severe in 18%.The prevalence of depression was 48%. Twenty-four percent of them have a major depression. Forty-six percent of patients scored positive for alexithymia.The occurrence of depression was significantly associated to alexithymia (P = 0.003).ConclusionThis study showed a positive correlation between alexithymia and depression.These results can be useful in treatment based on processing of emotional information and regulation of emotions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The use of guanfacine (Intuniv XR) in the treatment of disruptive mood dysregulation disorder – Clinical experience from telepsychiatry
Authors: Jain U. 
Published: June 2017

BackgroundDisruptive mood dysregulation disorders (DMDD) is new to DSM-5 and represents children with rage episodes. Medical treatment is critical but few randomized trials. DMDD may be a replacement for the diagnosis of Bipolar Disorder noted in DSM-IV with a heavy use of atypical neuroleptics. DMDD reflects a more moderate treatment of these symptoms.MethodTelepsychiatry referrals 6–9 year old children randomized into n = 12 = group A (11 males/1 female), n = 13 = group B (11 males/2 females). ANOVA not significant (NS) in age and gender. Group A received guanfacine (GUA) titrated to weight between 3–4 mg. Both groups received behavior support. Group B did not receive medications. Analysis by t-test comparison.ResultsGroup A showed significant improvement in frequency but not in intensity of rage episodes (P < 0.05). Major side effects include sedation and gastric irritation. Dropouts from original sample of 22 per group were based on inability to titrate, cost of drug, inability to swallow pills, worsening of symptoms with addition of an atypical neuroleptic.ConclusionGUA is a possible treatment for DMDD but there are limitations requiring further study. Group B did show improvement reflecting the utility of behavioral strategies (future studies require control groups) but GUA may provide a useful alternative to neuroleptics. Cardiovascular issues were not a problem and were assessed. Future studies are warranted.Disclosure of interestThe author has not supplied his declaration of competing interest.
6-months follow up of lisdexanfetamine in adolescent with attention deficit hyperactivity disorder comorbid with severe conduct disorder
Authors: Otero Cuesta S. , Juncal Ruiz M. , Gómez Cancio M.J. , De las Heras M. 
Published: June 2017

IntroductionAdolescents with conduct disorders (CD) often associate symptoms of executive dysfunction and developmental history of attention deficit hyperactivity disorder (ADHD). There is high-quality evidence that psychostimulants have a moderate-to-large effect on conduct problems in youth with ADHD. Lisdexanfetamine (LXD) reduces impulsivity and others ADHD symptoms, has better daylong coverage and less abuse potential than others stimulants.AimsTo evaluate the efficacy of lisdexanfetamine associated to psychological and family interventions in these multi-problem cases.MethodThis work presents for discussion the preliminary measures of the effectiveness and security of LXD (range between 50–70 mg, during 6 months), prescribed to seven boys, ages 15 to 17 with ADHD comorbid with severe conduct disorders. All of them were living in a Young Offender Centre, received intensive psychological and psycho-educational treatment during 6 months before and during the use of LXD. Structured clinical assessment, ADHD and Conduct Disorder Scales were performed before the onset and followed 3 and 6 months.ResultsMeasures of ADHD, and CD symptoms improved at 3 and 6 months comparing to basal measures. Secondary effects were well tolerated and all patients showed a good adherence to treatment except for one of them who was drop out because of increase of anxiety.ConclusionsEvidence indicates that LXD can be beneficial and well tolerate for impulsive and aggressive behaviours in teenagers with ADHD and severe CD. Limitations are the small number of cases and those related to the controlled observation method used.Disclosure of interestThe authors have not supplied their declaration of competing interest.