bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of switching to long-acting injectable (LAI) aripiprazole on long-lasting antipsychotic-induced hyperprolactinemia: A report of two cases
Authors: Juncal Ruiz M. , Fernández-Abascal Puente B. , Landera Rodríguez R. 
Published: May 2016

IntroductionAntipsychotic-induced hyperprolactinemia (> 29 ng/ml in women) is associated with relevant side-effects.AimWe describe the case of two women aged 50 and 54 years, respectively, diagnosed with schizophrenia who were receiving outpatient treatment with paliperidone depot 100 mg/month and risperidone depot 50 mg/2 weeks, respectively and complained of oligoamenorrhoea and amenorrhoea for at least 6 months.MethodsRoutine blood tests showed hyperprolactinemia of 203.5 ng/ml and 306.2 ng/ml, respectively. The patients were evaluated by the Endocrinology unit and an MRI was performed discarding the presence of any primary brain condition. Both patients were switched to LAI aripiprazole due to its partial agonism of D2-brain receptors. At the time of switching both patients were stable in terms of psychopathology.ResultsChanges in prolactin levels 3 months after switching are shown in the Fig. 1. Two months after switching, both patients regained cyclic menstrual function. After 6 months, they still showed psycopathological stability.ConclusionsSeveral studies have described an improvement of drug-induced hyperprolactinemia after switching to or adding oral aripiprazole. In these two cases, the normalization of prolactin levels and the resolution of oligoamenorrhoea/amenorrhoea were observed as soon as 2–3 months after switching to LAI aripiprazole. These findings suggest that switching to LAI aripiprazole may be an effective alternative for managing antipsychotic-induced hyperprolactinemia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The cremation of care ritual: Burning of effigies or human sacrifice murder? The importance of differentiating complex trauma from schizophrenia in extreme abuse settings
Authors: Kurz R. 
Published: May 2016

IntroductionThis session explores Human Sacrifice killings in extreme abuse cult settings disclosure of which often leads to a misdiagnosis of ‘Schizophrenia’.ObjectivesThe purpose of the paper is to raise awareness and signpost professional development resources regarding extreme abuse ‘Death Cults’ that operate largely with impunity across the world.AimsCase study materials and documentary evidence will be utilised to illustrate criminal practices and the impact on survivors.MethodAccounts of extreme abuse and ritual violence were identified in the context of an adult survivor assessment intervention.ResultsThere are supporters of abuse survivors who bore witness to and believe disclosures of extreme abuse and ritual violence, and ‘False Memory’ adherents who consider Ritual Abuse an unfounded ‘moral panic’. Survivors provide chilling accounts of ritual killings in Scott (2001), Becker, Karriker, Overkamp and Rutz (2008) and Epstein, Schwartz and Schwartz (2011). In the wake of institutional abuse enquiries and the ‘unbelievable’ child abuse perpetrated by celebrities like Jimmy Saville and Ian Watkins, a ‘new reality’ is setting in that child abuse is pervasive and knows no limits. Reports of elaborate rituals with ‘mock’ human sacrifices at the highly secretive annual ‘Bohemian Grove’ summer festival point towards a pervasive interest in the occult in high society.ConclusionMental health professionals have a ‘duty of care’ towards their service users. Unless clear and irrefutable counter-evidence is available it is inappropriate to claim that disclosures of extreme abuse and/or human sacrifice rituals are ‘delusions’ and indicative of Schizophrenia.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Comparison of defence mechanisms in adolescent patients with deliberate self-harm behaviour and without it
Authors: Vuk A. , Razic Pavicic A. , Santric L. , Tomac A. 
Published: May 2016

IntroductionTwenty percent of children and adolescent population are suffering from psychiatric disorders, according to World Health Organization. Above that, clinical work and previous published reports point to increase of self-harm behaviour incidence and prevalence in many countries, including Croatia.AimsTo compare defence mechanisms in adolescent patients with deliberate self-harm behaviour and without it.ObjectivesTo explore differences in adaptive and maladaptive defence mechanisms in adolescent patients with self-harm behaviour and without this behaviour; to gain better insight in possible perception and functioning patterns in these two patient subgroups. To assess the effect of possible differences on early diagnostic procedure and therapeutic plan.MethodsDefence Style Questionnaire (DSQ) was administered to 150 patients aged between 14 and 18 years on their first visit to child and adolescent psychiatrist. Sevety-nine patients had history of self-harm behaviour and 81 patients had negative anamnestic data on such behaviour.ResultsComparison of defence mechanisms in these two patient subgroups showed a statistically relevant difference in using defence mechanisms.ConclusionResults of this study showed significant difference between patients with self-harm behaviour and without such behaviour regarding used defence mechanisms. Awareness of specific mental patterns in patients with self-harm behaviour provides better assessment of suicidal risk and optimal individual approach planning.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Schizophrenia and sexual desinhibition
Authors: Palomo Monge M. , David G.M. , Arántzazu D.D. , Maria Fernanda A.L. , Maria Fernanda T.G. , Gemma M.M. , Sandra D.C. 
Published: May 2016

IntroductionSexual disinhibition is uncommon in patients with schizophrenia and are included within the behavioral disorders along with others such as agitation, aggression, sleep disorders and circadian rhythm, due to multiple reasons: isolation, rejection, difficulty in personal relationships.ObjectivesWe report the case of a male patient aged 58 with multiple previous admissions for behavioral alteration symptoms, including exhibitionism. He is referred as irritable, uninhibited and sleeping disorders. There is a risk of flight as he is difficult to be held so it is feared that he can be run over by a car. He shows a marked self-referentiality.MethodologyThe patient is admitted. He properly gets used to the rules of the Ward. Pharmacological adjustment is performed. During his admittance he shows no behavior disorders neither episodes of self or hetero aggression and poor impulse. He properly makes comments of what happened during his stay. He responds well to treatment prescribed. Sleep pattern is restored.ResultsSchizophrenia (undifferentiated) 295.90 (F.20.3); intellectual disability mild 317 (F70); neurocognitive disorder (possible).ConclusionsThis is unusual case because it is normal that the sexual function of such patients is adversely affected, not finding numerous cases of disinhibition in our medical consultation. This is due to the different aspects that are affected, biological (drugs), psychological and social levels. We have different therapeutic alternatives to address this problem. However, they may hinder sociability and patient rehabilitation.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Pruritic urticarial papules and plaques of gestation in perinatal depression
Authors: Hassan F. , Azaaibi M. , Shahid S. , Saimwala T.S. , Kalar N. , Mughal M.T. , Wahab A. , Wahab G. , Haider F. , Azam A. , Shahid N. , Mujeeb E. , Kalar M.U. 
Published: May 2016

IntroductionThe cutaneous polymorphic eruption of pregnancy (PEP) is presented by skin lesions usually in the third trimester of gestation and about 13% of women also suffer from perinatal depression.ObjectiveTo determine the frequency of pruritic urticarial papules of gestation with and without perinatal depression.AimTo assess the maternal causes for polymorphic eruption of pregnancy (PEP) in patients with and without perinatal depression.MethodsCases and controls were matched on the grounds of maternal weight gain in gestation, hormonal changes, deficit in iron and zinc, dysregulation of hypothalamic pituitary axis, pre-maturity, pre-eclampsia, pre-term labour. Univariate and multivariate analysis, adjusting for important demographic factors and comorbodities was conducted to assess the relationship of PEP with and without perinatal depression in reduced and full models of ANOVA in regression analysis. (Reduced model Y = β0 + β1X1 + … and the full model Y = β0 + β1X1 + β2X2 + β3X3 + β4X4 + β5X5 + β6X6 + …)ResultsPolymorphic eruption of pregnancy with perinatal depression was statistically significant in maternal weight gain in gestation [odds ratio (OR) 1.20; 95% (CI): 1.15–1.30], hormonal changes [(OR) 2.78; 95% (CI): 2.52–2.82], deficit in iron and zinc [(OR) 2.18; 95% (CI): 2.04–2.38], dysregulation of hypothalamic pituitary axis [(OR) 1.37; 95% (CI): 1.18–1.49] and was not statistically significant in pre-maturity, pre-eclampsia and pre-term labour in cases and controls.ConclusionPruritic urticarial papules and plaques of gestation are commonly associated in patients with perinatal derpession.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Preventable schizophrenia
Authors: Silvia C.F. , Gómez Peinado A. , Cano Ruiz P. 
Published: May 2016

IntroductionSchizophrenia is a psychiatric disorder with multiple causes, including genetic, immune, environmental causes of various kinds, which all increase the vulnerability and predisposition to the disorder. Among them stand out prenatal infections, thus being a preventable risk potential factor in our daily clinical practice.ObjectivesTo analyze the relation between prenatal infections and schizophrenia.MethodsReview of the subject and recent articles on schizophrenia in psychiatric guides and magazines.ResultsAfter analyzing several studies, it have shown that prenatal infections, where the nervous system is not yet fully developed, may be a risk factor for the development of schizophrenia in adults, in relation with genetically predisposed individuals. Infections such as influenza, especially during the first quarter of gestation; rubella, toxoplasma and herpes simplex virus-type 2 are related to potentially increase risk of suffer schizophrenia.ConclusionsPrenatal infections, especially in the first quarter and the periconceptional period, constitute a risk factor in individuals with vulnerability to develop schizophrenia. Awareness and prevention is important in the pregnant population of the influence of these infections on the possible origin of psychotic episodes.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Medication adherence in schizophrenia
Authors: Fatma F. , Baati I. , Omri S. , Sallemi R. , Masmoudi J. 
Published: May 2016

IntroductionCompliance is a major issue in the treatment of schizophrenia. Many studies have attempted to identify factors that influence it.ObjectiveTo assess treatment adherence in patients with schizophrenia. To identify factors correlated with poor adherence.MethodsIt was a cross-sectional, descriptive and analytical study, involving 37 outpatients with DSM-IV diagnosis of schizophrenia, followed in the psychiatry department at the Hédi Chaker University Hospital of Sfax (Tunisia). The questionnaire included socio-demographic, clinical and therapeutic data. We also used the Medication Adherence Rating Scale “MARS”, the Insight Scale “IS” and the Stigma Scale (9 items).ResultsThe average age was 36.4 years. The majority of patients was male (68.8%), did not exceed the level of secondary education (89.2%) and had a low socioeconomic level (84.4%).Paranoid schizophrenia was the most frequent type of schizophrenia (54.1%). Atypical antipsychotic were prescribed in 40.5% of cases.Patients were non-adherent to treatment in 56.8% of cases. The factors correlated with poor adherence were: psychoactive substance use (P = 0.036), sexual dysfunction (P = 0.036), complexity of treatment (P = 0.036), poor insight according to the subscale “awareness of the need for treatment” of the IS (P = 0.047) and high score on the subscale “discrimination” of the Stigma Scale (P = 0.008).ConclusionTunisian schizophrenic patients have a poor adherence to treatment. Acting on risk factors (such as substance use, sexual side effects, poor insight and discrimination perception) would improve patient compliance and management of schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Biomarkers of response to transcranial magnetic stimulation in youth with treatment resistant major depression
Authors: Wilkes T. , Jasaui Y. , Kirton A. , Langevin L.M. , Sembo M. , MacMaster F. 
Published: May 2016

BackgroundMajor depressive disorder (MDD) affects approximately 15% of youth, half of who do not respond to standard treatment. One promising intervention is repetitive transcranial magnetic stimulation (rTMS). However, response is limited, highlighting the need to focus on biomarkers to predict treatment response.ObjectivesTo explore baseline biomarkers of response associated with rTMS treatment in adolescent MDD.AimsTo determine the association between dorsolateral prefrontal cortex (DLPFC) glutamate levels, cortical thickness, and cerebral blood flow (CBF) with MDD symptomatology decrease after rTMS intervention.MethodsTwenty-four MDD youth underwent 3 weeks of rTMS, baseline and post-intervention magnetic resonance imaging scans, and short echo proton magnetic resonance spectroscopy. Response was determined by a 50% reduction of depression scores.ResultsDepressive symptoms decreased with rTMS (t = 8.304, P = 0.00). Glutamate levels differed significantly between responders and non-responders (t = 2.24, P = 0.0039), where higher glutamate changes were associated with a better response (r = 0.416, P = 0.038). Responders also exhibited thinner DLPFC (r = –0.797, P = 0.000) and lower CBF levels.ConclusionsThe development of biomarkers for rTMS represents a novel and encouraging technique for a personalized and effective treatment while reducing ineffective treatment costs and personal burden in adolescent MDD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A journey across perversions history – from Middle Age to DSM
Authors: Amaral A. , Ferraz I. , Mota M. 
Published: May 2016

IntroductionPsychiatry's viewpoint of sexual deviance has waved between the normal and the pathological. “Normal” is not determined by nature but by the values of a specific society.AimsTo review the main landmarks in paraphilias history and the importance of social and cultural dimensions to it.MethodsPubMed database was searched using the keywords perversion, sexual deviance, paraphilia, culture and society.ResultsThroughout Middle Age and Renaissance any sexual act that differed from the natural/divine law was considered a vice. Unnatural vices (masturbation, sodomy, bestiality) were the most severely punished, as they could not result in conception. In 1886, Krafft-Ebing stated perversions were functional diseases of the sexual instinct caused by “hereditary taintedness” in the family pedigree and worsened by excessive masturbation. Proper perversions were sadism, masochism, antipathic sexuality (homosexuality, transvestism, transsexuality) and fetishism. Later, Havelock Ellis and Hirschfeld claimed sexual interest in the population followed a statistical norm, opposed the idea that masturbation led to diseases and demanded the decriminalization of homosexuality. Freud believed the “perverse disposition” to be universal in the childhood giving rise to healthy and pathological adult behaviors. In 1950's, Albert Kinsey surprised America when he proved many supposedly deviant sexual practices were quite common. The first Diagnostic and Statistical Manual (1952) was mainly psychoanalytic. Later, by 1973, homosexuality was removed from classifications. Recently, DSM-5 distinguishes between paraphilias and paraphilic disorders.ConclusionA progress in the paraphilic instincts’ acceptance has occurred. We hypothesize, in the future, paraphilias will follow homosexuality out of the diseases’ classifications.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Primary and secondary transsexualism, really?
Authors: Jurysta F. , Hladki G. 
Published: May 2016

IntroductionTranssexualism suffers from several definitions that evolve across time. Therefore, some discrepancies appear progressively in regard of evidence-based medicine and psychological approaches as sexo-analysis.ObjectivesIn our present study, we test if “primary” or “secondary” transsexualism defines in accordance with sexo-analysis definitions will be reliable with the pathology course.AimsClarify the definition of transsexualism to obtain a better understanding of this trouble and perhaps to change psychological approaches of gender disorders.MethodsNine transsexual male-to-female (MtF) aged between 25 to 65 were voluntary recruited. They were diagnosed by a psychiatrist. We adapted the GID scale to measure the lifetime process. Descriptive statistics were reported. Results are expressed as mean ± standard deviation.ResultsAge of the group is 41 ± 12. All subjects were treated by hormone therapy. One of them was surgical reassigned. All subjects reported a persistent feeling to be a woman across their entire life. None showed a decreased female feeling during a part of their life or a brutal apparition of this trouble during the adult period.ConclusionsIn regards of our preliminary results, we concluded that secondary transsexualism should be redefined and was probably induced by sociocultural aspects. Our results are limited by amount of subjects and should be confirmed by a large population included MtF and FtM people.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Controversy diagnosing sex addition
Authors: Palomo Monge M. , David G.M. , Arántzazu D.D. , Sandra D.C. , María Fernanda T.G. , Silvia S.D.L.P. , Maria Fernanda A.L. , Rubén O.B. 
Published: May 2016

IntroductionThe sexual compulsive behavior also known as sex addition is the repetitive and intense sexual behavior of the individual. Although the few studies carried out, the prevailing rates vary between the 2% and the 20%.ObjectivesWe present the case of a 46-year-old male with psychiatric treatment records since he was 17 and a personality disorder group B diagnosis and depressive reactions reactive to environmental frustrations. Several short-, medium- and long-term hospitalizations. Currently he is admitted after having expressed some autolytic ideas.MethodologyThe patient started a treatment in the Unit of Addictive Behaviors. He says he started to frequent the brothels 10 years ago to satisfy his sexual needs, but gradually increased the frequency. Later, he started to have sex online, also in fee-paying web pages. This has had a negative influence in the different aspects of his life, leading him to economic stress and endless debts.ResultsBorderline personality disorder. 301.83 (F60.3).Other specified disruptive, impulse-control, and conduct disorder (sex). 312.89 (F91.8).Pathological gambling. 312.31 (F63.0).Persistent depressive disorder. 300.4 (F34.1).ConclusionsIt is clear that the compulsive sexual behavior is a disorder that includes repetitive, intrusive and distressing thoughts and leads to behaviors that affect negatively several aspects of the lives of people suffering such disorder, so that is why it is associated with other psychiatric disorders. Even though it has been described and discussed for years in literature, it is difficult to classify within psychiatric nosology and nowadays its categorization is still a challenge within the mental health.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Premature ejaculation – how to treat?
Authors: Fornelos A. , Macedo P. , Veríssimo F. , Viseu M. 
Published: May 2016

IntroductionPremature ejaculation (PE) corresponds to “a persistent or recurring ejaculation pattern that occurs during sexual activity with a partner approximately 1 minute after vaginal penetration and before the person wishes to”. It affects 5–20% of men, having its origin in psychological factors and with important biological contribution. It is considered generalised, when not confined to certain patterns of stimulation, situations, or partners, or may be situational. It may occur soon after the onset of sexual activity (primary) or after a normal sexual functioning (acquired). Primary EP is associated with the hyposensitivity 5-HT2C receptors and/or hypersensitivity 5-HT1A receptors. High performance anxiety levels are related to acquired EP. Increasing this physiological knowledge has enabled significant advances in treatment.ObjectiveApproach the therapeutic options of EP and its peculiarities.MethodsLiterature review of articles published in the last five years, using the PubMed and Scielo databases.ResultsAt present, the approaches include psychosexual counseling, behavioral and pharmacotherapy. Among the most popular drugs, antidepressants stand out, particularly dapoxetine, the first medication specifically approved. Local anesthetics, phosphodiesterase-5 inhibitors and tramadol are also used. Acupuncture is suggested as a useful therapeutic, but needs more research.ConclusionThe behavioral therapies are referred to as first-line treatment in the long-term, associated or not with medication. Dapoxetine is the preferred symptomatic treatment. However, a holistic approach, including psychotherapy and sex therapy, is the most beneficial modality for sexual and marital relationship.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Depression and suicide ideation in medical students
Authors: Alonso Sanchez A. , Alvarez Astorga A. , De la Red Gallego H. , Hernandez Antón R. , Gómez Sanchez S. , Noval Canga C. , Sevillano Benitez I. , Isidro García G. , Hernandez García M. , De Uribe Ladrón de Cegama F. 
Published: May 2016

BackgroundMedical students have higher levels of depressive symptoms than the general population. Additionally, depressed students are more likely to commit suicide. Recent studies find up to 10% of medical students experiment depression and suicidal ideation, which is meaningfully higher than general population of similar age (5–8%). However, little is known about depression and suicidal ideation in medical students in Spain.ObjectiveThis study aims to create a self-administered questionnaire to investigate the prevalence and factors involved in depression and suicidal behaviour in medical students from a Spanish University.MethodsWe evaluated the main risk factors leaning to suicide in students. In addition, we selected an appropriate scale to assess depression among the existing ones. The evaluated items included demographic reports, academic information (academic course, unfinished subjects and accomplishment) and sanitary data (psychiatric family history, psychiatric personal history, psychotropic drug consumption, distress emotional events in the last twelve months and drugs consumption). Furthermore, we selected the 9-item Patient Health Questionnaire (PHQ-9) because of its rapidly implementation and proven efficacy.ConclusionsRates of depression and suicidal ideation are high in medical students. Currently, there is no program to detect and prevent depression neither suicide in students. For that reason, we consider that creating a new instrument to evaluate mental health in student is useful in order to offer early detection and treatment at medical school.Disclosure of interestThe authors have not supplied their declaration of competing interest.