bluuebunny/crossref_metadata_2025_split huggingface dataset:
Portuguese Version of Delirium Experience Questionnaire (DEQ): Feasibility Study
Authors: Martins S. , Pinho E. , Correia R. , Fernandes L. 
Published: June 2017

IntroductionDelirium is a frequent and serious acute neuropsychiatric syndrome, namely in elderly hospitalised patients, described as a psychologically traumatic experience by patients, family/caregivers and health professionals(HPs). In this context, the Delirium Experience Questionnaire (DEQ) was developed as a face-valid instrument assessing the delirium experience recall and the degree of distress related to delirium episodes in patients, family/caregivers, and HPs.AimTo present the translation and cultural adaptation of the Portuguese version of DEQ (DEQ-PT).MethodsThe translation process followed ISPOR guidelines. After preparation, forward translation, reconciliation, back translation, back translation review, harmonization and cognitive debriefing (involving experts’ consensus), the DEQ-PT was tested (pre-test) in a group of elderly patients with delirium(≥ 65 years) in two Intermediate Care Units (Intensive Care Medicine Service-CHSJ, Porto). Exclusion criteria were: brain injury, blindness/deafness, unable to communicate, and Glasgow Coma Scale ≤ 11. Their families were also assessed, as well as the HPs (physicians/nurse) in charge of patients during hospitalisation.ResultsAfter obtaining permission to use the instrument, the DEQ was successfully translated into Portuguese, with harmonization of all new translations. Pre-test included a group of 5 patients, 5 families and 5 nurses. This version revealed good cognitive equivalence with the original English version and also a good level of comprehensibility.ConclusionThe DEQ-PT showed good feasibility, being suitable, quick and easy to use in the assessment of delirium experience in intermediate care units. These findings will be further developed by an ongoing validation study.AcknowledgementThis work was supported by foundation for science and technology (SFRH/BPD/103306/2014).Disclosure of interestThe authors have not supplied their declaration of competing interest.
Effects of the Person-centered Environment Program (Belmont Village's Memory Care) on Behavioral and Emotional Problems in Mexican Senior Living Residents, Six Week Trial
Authors: Mesa Rios F.J. 
Published: June 2017

Behavioural and psychological symptoms of dementia include agitation, depression, apathy, repetitive questioning, psychosis, aggression, sleep problems, wandering, and a variety of inappropriate behaviors. One or more of these symptoms will affect nearly all people with dementia over the course of their illness. These symptoms are among the most complex, stressful, and costly aspects of care, and they lead to a myriad of poor patient health outcomes, healthcare problems, and income loss for family caregivers. The complexity of these symptoms means that there is no “one size fits all solution, and approaches tailored to the patient and the caregiver are needed”. Non-pharmacologic approaches should be used first line, although several exceptions are discussed.The current pilot study examined the effects of the Person-Centered Environment Program (Memory Care®, developed by Belmont Village Senior Living) on agitation, cognition, stress, pain, sleep, and activities of daily living for Mexican senior living residents with dementia. Thirty individuals participated in the study. Memory Care® included sensitive, cognitive and affective stimulation, based on participants’ preferences and needs. memory care sessions were held daily (7 days per week, 8 hours) and a total of 6 weeks were performed at the first Belmont Village Community in Mexico City. Findings showed that agitation and pain improved with the Memory Care® Program (t = 2.91, P < 0.02; t = 4.51, P < 0.002, respectively). Findings suggested that a better study design, repeated with a bigger sample size, must be considered, but promissory results are shown.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
First Neuropsychiatric Symptoms and Neurocognitive Correlates of Behavioral Variant Frontotemporal Dementia
Authors: Santamaría García H. , Reyes P. , Santacruz-Escudero J.M. , Matallana D. , Ibañez A. 
Published: June 2017

Previous works highlight the neurocognitive differences between apathetic and disinhibited clinical presentations of the behavioral variant frontotemporal dementia (bvFTD). However, little is known regarding how the early presentation (i.e., first symptom) is associated to the neurocognitive correlates of the disease's clinical presentation at future stages of disease. We analyzed the neurocognitive correlates of patients with bvFTD who debuted with apathy or disinhibition as first symptom of disease. We evaluated the neuropsychological, clinical and neuroanatomical (3 T structural images) correlates in a group of healthy controls (n = 30) and two groups of bvFTD patients (presented with apathy [AbvFTD, n = 18] or disinhibition [DbvFTD, n = 16]). To differentiate groups according to first symptoms, we used multivariate analyses. The first symptom in patients described the evolution of the disease. AbvFTD and DbvFTD patients showed increased brain atrophy and increased levels of disinhibition and apathy, respectively. Whole brain analyzes in AbvFTD revealed atrophy in the frontal, insular and temporal areas. DbvFTD, in turn, presented atrophy in the prefrontal regions, temporoparietal junction, insula and temporoparietal region. Increased atrophy in DbvFTD patients (compared to AbvFTD) was observed in frontotemporal regions. Multivariate analyses confirmed that a set of brain areas including right orbitofrontal, right dorsolateral prefrontal and left caudate were enough to distinguish the patients’ subgroups. First symptom in bvFTD patients described the neurocognitive impairments after around three years of disease, playing an important role in the early detection, disease tracking, and neuroanatomical specification of bvFTD, as well as in future research on potential disease-modifying treatments.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Suicide Risk in Cancer Patients – Are We Prepared?
Authors: Alves M. , Tavares A. 
Published: June 2017

IntroductionIndividuals with cancer are at increased risk for suicidal ideation and behaviour when compared to the general population. Suicidal thoughts are sometimes minimized and considered by clinicians as a normal reaction to diagnosis of oncological disease. Less severe forms of suicidal ideation, such a fleeting wish to die may happen in all stages of the disease.ObjectivesWe aim to highlight the cases of cancer patients that present an imminent suicide risk and its related psychopathological aspects, psychosocial and physical risk factors that may increase the probability of suicidal attempt.MethodsNon systematic literature review through the Medline and Clinical Key databases, with time constraints.ResultsIndividuals with cancer have twice the risk of suicide compared to the general population. It was found that suicidal thoughts are more common in patients with advanced disease, in hospital or in palliative care settings or in those who are experiencing severe pain, depression, cognitive impairment or delirium. The first months following the diagnosis are the period of greatest risk and the highest suicide risk occurs in men with respiratory cancers. Death by suicide occurs more often in cancer patients in the advanced stages of disease.ConclusionsAn appropriate therapeutic response should include empathy, active listening, management of realistic expectations and permission to discuss psychological distress. The first intervention should focus on determining imminent risk of suicidal behaviour and act for patient safety.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Association of Stress Hormone System, Epigenetics and Imaging
Authors: Frodl T. , Tozzi L. , Farrell C. , Doolin K. , O’Keane V. , Pomares F. , Carballedo A. , Booij L. 
Published: June 2017

IntroductionMajor depressive disorder (MDD) is a common psychiatric condition, affecting up to 350 million people worldwide. Its pathogenesis seems to involve dysregulation of the hypothalamic-pituitary (HPA) axis and inflammation as key elements of the condition. Stressful life events and in particular early life adversity seem to play an important role as risk factors for MDD. Epigenetic, which has been found to impact in the transcription of genes, seem to be associated with brain structure and function. Aim of the research was to provide an overview about neuroimaging (epi)-genetics in MDD.MethodsFunctional MRI, epigenetic and genetic information was obtained in a cohort of patients with MDD and healthy controls. Associations between, early life adversity, methylation of FKBP5 and SLC6A4, genetic variants and brain function and connectivity have been analysed.ResultsHigher methylation of SLC6A4 gene was associated with higher BOLD response during emotion processing and lower BOLD response during higher order cognitive processes. Healthy participants with higher SLC6A4 methylation involved prefrontal cortical regions to a greater extent than the participants with lower SLC6A4 methylation, when trying to switch attention away from negative emotional stimuli (Frodl et al., 2015). Moreover, FKBP5 methylation was association with HPA axis functioning and amygdala brain function in patients with MDD. FKBP5 methylation also was related to grey matter volume.ConclusionsOur study provides further support to the hypothesis that DNA methylation plays a role. Particular peripheral DNA methylation states of MDD candidate genes are associated with brain function during emotion processing in patients with MDD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychological Effect of Semi-permanent Tattooing Rehabilitation in Patients with Mastectomy in 12 Months Period
Authors: Argitis P. , Platari P. , Gatsiou K. , Chatzidai C. , Paschalidis K. 
Published: June 2017

IntroductionBreast cancer is the most common cancer type in Greek women as more than 4000 new cases are diagnosed every year. Seventy percent of those patents performs a type mastectomy. The breast has a societal and social connotation of femininity, motherhood, and sexuality.BackgroundSeveral studies support the existence of the relationship between psychological problems and mastectomy surgery. Body image and feminine self-concept also seems to influence quality of life of those women, considering the breast association of femininity, motherhood, and sexuality. During this study, we try to investigate how a non-psychiatric intervention might influence the mental state and the quality of life of those women.MaterialA clinical interview was performed in 53 women with partial or total mastectomy before 3 and 52 weeks after the rehabilitation with the method of semi-permanent tattooing.MethodsData were collected during the personal interviews, using Hamilton anxiety rating scale (Ham-A), body image scale and sexual activity questionnaire.ResultsModerate levels of anxiety were identified before the rehabilitation, associated with poor body image scale scores and sexual difficulties. Both Ham-A and body image score ameliorated after 3 weeks with unchanged sexual behaviour. One year after rehabilitation, anxiety scale score raises close to initial values, body image remains unchanged, comparing with the 3rd week interview and significant improvement noticed in sexual activity.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Mental Disorders in Patients Breast Cancer: Differentiated Approach to the Study Nozogeny
Authors: Shushpanova O. 
Published: June 2017

ObjectiveThe problem of mental disorders in patients with breast cancer is relevant due to the high prevalence of pathological changes in the mental health patients, insufficient development of clinical typology of psychosomatic correlations of the contribution of constitutional features.MethodsNozogeny disorders are clinically heterogeneous and are represented by two nosologic categories: reaction and nosogenic patho-characterological personal development. The basic method of work was a clinical follow-up and statistical research methods (method using contingency tables and Fechner coefficient method using the χ2 – test).ResultsThe manifestation of a nozogeny reaction is closely correlated with his premorbid personality characteristics. Anxious-depressive nozogeny reaction was recorded in 17 patients of the first sample with high direct correlation (coefficient Fechner F = 0.76, P < 0.01) with respect to accentuation of personality in the alarm type, and the weak direct link to the personal characteristics of the affective (bipolar) range (F = 0.22, P < 0.01). Anxious-nozogeny dissociative response was detected in 9 patients with hysterical (55.5%) and expansive schizotypal (vershrobene) (44.4%) lung cancer with a significant (F = 0.65, P < 0.01) a direct correlation with constitutional hyperthymia, anxiety-hypomanic nozogeny response was observed in patients c schizotypal RL (n = 4) paired with symptoms of persistent hyperthymia (F = 0.39, P = 0.012).ConclusionPatho-characterological development of personality are formed on the remote catamnestic stage breast cancer and show the clinical heterogeneity of differentiation into 4 types: (1) the type of hypochondriacal dysthymia, (2) the type of “paranoia struggle”, (3) in an “aberrant hypochondria” and (4) the type of “new life”.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Huntington disease, to have or not to have: That is the question – the importance of psychiatric symptoms
Authors: Carvalhão Gil L. , Lázaro M. , Queiroz L. 
Published: June 2017

IntroductionHuntington's disease (HD) is an autosomal dominant inherited neurodegenerative disorder, beginning in adulthood. HD represents the majority of patients who present the triad of motor, cognitive and psychiatric symptoms. The last two may be early manifestations, but the clinical diagnosis is based on motor symptoms and a positive genetic test for CAG repeat extension. The remaining patients that are negative for the HD genetic mutation may have HD phenocopies.ObjectivesIllustrate the role of psychiatric assessment, discuss the psychiatric and behavioural manifestations, and management.AimsIllustrate the challenge of diagnosing HD in psychiatry.MethodsA literature search was performed on PubMed database. The patient clinical record was reviewed.ResultsWe report a case of a 49-year-old male with a family history of HD (mother, uncle, cousin). He was diagnosed with a psychotic disorder fifteen years ago, hospitalised twice and thereafter treated as an outpatient with fluphenazine long-acting injection. He was a symptomatic for ten years. During the last year, he started showing dysphoria, marked irritability, stammering, inappropriate behaviour, poorly structured paranoid delusions, mild cognitive impairment and lack of insight. This was correlated with the beginning of functional impairment, both professionally and socially. Further assessment was performed: neurological evaluation, head CT scan and the genetic test was negative. He is clinically stable under haloperidol long-acting injection.ConclusionsHD is a rare condition which is frequently under diagnosed, especially in early stages, due to lack of recognition of psychiatric symptoms. HD-like disorders should be considered if the clinical picture is obvious, but HD gene test result is negative.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Protagonist-patient and servant-doctor: A medicine for the sick doctor-patient relationship
Authors: Ferraz I. , Guedes A. 
Published: June 2017

The doctor-patient relationship (DPR) is very ill; it is in need of emergency assistance. Although there have been change in this relationship, no current model is satisfying. In 1972, Robert Veatch defined some models of DPR. Likewise, Pierloot, in 1983, and Balint, in 1975 and ultimately, Mead and Bower, 2000 with the model of Person-center-care (PCC) medicine.ObjectiveEvaluate the different kinds of DPR described in the literature and propose an abduction-based model of the Servant DPR, in which patients are protagonists in their treatment.MethodsPubmed literature review of the last forty years with the keyword ‘physician-patient relations’.DiscussionWhile nursing care advanced in its professional efficacy through Watson's human care and through the leader servant model, the DPR models demonstrated that the doctors are lost in their posture, even feeling as abused heroes. Models that include the patient in decision-making and that value the patient as a person (PCC) promise a revolution in the medical realm. Nevertheless, the PCC model is not enough to heal the DPR itself, because the role of the doctor must be changed to adapt to the relationship, otherwise, the PCC by itself can increase the burden upon the doctor. Doctors with a role of remunerated servant (not slave), like any other professional who delivers a service with excellence, focusing in the main actor, the patient, can heal the DPR.ConclusionThe Servant DPR gives a positive counter transference, increasing the doctor's motivation and giving him back the sense of purpose in medicine, increasing the health system's effectiveness.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Work memory and inhibition in abused children
Authors: Martinez M.C. Jimenez 
Published: June 2017

IntroductionIt has been shown that children with a history of abuse tend to have a deficit in both their academic and cognitive abilities. Mesa-Gresa, P., & Moya-Albiol, L. (2011) [1]. This study aimed to identify the relationship between abuse (psychological, neglect, custody and abandonment) and the performance of executive functions of memory of verbal work and inhibition.MethodThe Executive Function battery (Gonzalez, M., & Ostrosky, F., 2012) [2] was applied to 38 preschoolers 4–5 year olds who have experience abuse and to 36 preschoolers who have not. Data was analysed using the test t for independent samples and the Chi-cuadrado from Pearson.ResultsInhibition was affected in children with psychological abuse and negligence. It means that children presented difficulty in controlling their behaviour. Children victim of abandonment showed lower performance of executive functions of memory of verbal work. Such function allows them to carry on daily activities efficiently. Conversely, children without previous history of abuse showed higher performance in both tests especially in inhibition.ConclusionFindings suggest that child abuse in preschoolers can influence the performance in their executive functions without difference in gender.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Alexithymia and coping strategies among medical students
Authors: Messedi N. , Feki I. , Saguem B.N. , Masmoudi R. , Masmoudi J. 
Published: June 2017

IntroductionUniversity life is stressful for the student, which is characterized by disturbed emotional regulation or alexithymia. To face these stressful events he must use certain coping strategies.ObjectivesStudying the prevalence of alexithymia and exploring coping strategies among medical students, and establish the relationship between these parameters.MethodsIt was a cross-sectional study of 97 students in Sfax university medicine (Tunisia). We used:– a questionnaire containing demographic and clinical data;– Toronto alexithymia Scale (TAS-20): a score ≥61 indicates alexithymia;– WCC (Ways of Coping Checklist-r Folkman) with 3 factors: problem-focused, emotion-focused and social support coping.ResultsThe average age of participants was 24.07 years (±2.71); the sex ratio (M/W) was 0.4. They were smoking in 36.1% and sedentary in 43.3% of case. They had a nibbling activity in 57.7%. The average score of TAS-20 was 50. 92 10.46 and alexithymia was found in 16.5% of students. Alexithymia was significantly correlated with smoking (P = 0.003) and physical inactivity (P = 0.025). Most students (72.2%) opted for problem-focused ways of coping with a highest score at WCC = 29.21. A significant correlation was found between alexithymia and coping strategy with emotion-focused (P = 0.02). The TAS score was significantly higher among students who resort to this ways of coping = 26.11. (P = 0.002).ConclusionThis study explored the role of alexithymia in stress management ubiquitous in university life. A high level of alexithymia could be a detrimental factor in stress management. Psychological support aimed specifically alexithymic dimension is indispensable.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The relevance of Paraphrenia: Case report
Authors: Peixoto M. , Oliveira M.M. , Bragança M. 
Published: June 2017

IntroductionParaphrenia is a chronic psychotic disorder with a better-preserved affect and minimal disturbances of emotion and volition and a much less cognitive deterioration and personality changes.Objectives/aimsTo report a case with probable Paraphrenia and to highlight the importance of the differential diagnosis in a first psychotic episode.MethodsCase report and systematic review of the literature.ResultsWe report a case of a 41-year-old man without a past psychiatry history that was led to the psychiatry emergency department (PED), by officers, because of strange behaviour and aggressiveness towards his family. In the PED the patient said that his real father was his father-in-law and that his ex-wife was his sister. His mental exam revealed disinhibition, disorganized speech with slightly mood elation, persecutory, mystic and influential delusions with various delusional interpretations. After being admitted to the psychiatric ward, in compulsatory care, he began treatment and a medical work up was completed. According to the family the patient had begun this strange behaviour four years prior. During the hospitalization it became clear that the patient was experiencing imaginative-confabulatoric multi-thematic delusions, sometimes interviewer guided, without showing cognitive deterioration and retaining his personality.ConclusionsThe diagnosis of atypical psychosis or psychosis not otherwise specified is not satisfactory since it agglutinates different conditions together. Paraphrenia is a well-established concept and should be used in order to define a group of psychotic patients who exhibited characteristic symptoms of schizophrenia, minus personality impairment and slower cognitive decline.Disclosure of interestThe authors have not supplied their declaration of competing interest.