bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disruptive behaviour's treatment with paliperidone in autistic disorder: Review and case report
Authors: García Moreno M. , De Cós Milas A. , Beatobe Carreño L. , Poza Cano B. 
Published: May 2016

IntroductionAutistic disorder (AD) is a neuropsychiatric disorder that often presents significant disruptive symptoms such as irritability, aggression and self-injury in addition to impairment of social skills and communication. These symptoms interfere both individuals with AD and their families and social environment.ObjectiveShow paliperidone effect in behavioural symptoms in AD.MethodsLiterature review about behavioural symptoms in AD and paliperidone effect in its treatment, followed by a case report of clinical improvement after treatment with paliperidone in a patient with autism. Agitation subscale Aberrant Behavior Checklist (ABC-I) scores was compared prior and 4 weeks after paliperidone treatment, and clinical improvement was assessed with Clinical Global Impression-Improvement Scale (CGI-I).ResultsAlthough risperidone has been one of the most studied atypical antipsychotic to treat this symptoms, its use should be limited in order to avoid extrapyramidal and metabolic symptoms. Paliperidone – the major metabolite of risperidone – has shown effectiveness in the treatment of behavioral symptoms in patients with autism, even in subjects with a prior ineffective trial of risperidone. Our patient, 21-years-old male with AD and significant disruptive symptoms was treated with paliperidone 9 mg/day. We observed a 20-points reduction in ABC-I scores 4 weeks later, with most significant improvement in items like auto-agression, heteroaggressivity, irritability and slams. CGI-I scores showed a much better improvement, and no significant adverse effects appeared.ConclusionsPaliperidone is an effective and safe treatment in behavioral symptoms associated to AD, with reduction in ABC-I subscale scores. More studies are needed to confirm our data.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Mechanical restraint and staffing level in a psychiatric ward
Authors: Kodal J.S. , Kjær J. Nørgaard , Severinsen J. Dahlstrøm , Larsen E. Roj 
Published: May 2016

IntroductionThe use of coercion raises ethical dilemmas, as it deprives patients of their autonomy. In Denmark, the subject has gained political attention, and decreases in the use of coercion are demanded. In the attempt of reducing the use of coercion, it is of interest to obtain more knowledge about the circumstances bound to it.AimThe aim of this study was to investigate a possible correlation between the incidence of mechanical restraint (MR), and staffing level, staff demographics, patient characteristics, type of shift (day/evening/night) and change of shifts.MethodsA naturalistic descriptive method was used to study cases of mechanical restraint in patients admitted to a psychiatric ward. In the study period of one year, 114 cases of MR were carried out. In 66% of cases, the patient was diagnosed with borderline personality disorder. Each case of MR was obtained from Statens Serum Institut's Electronic Reporting System. The care workers from each shift were identified using duty rosters. The statistical package SPSS version 20 was used for data processing, including a logistic regression analysis.ResultsA significant association was found between the use of MR and the presence of male care workers on the ward, OR = 1.639, 95% CI: 1.163–2.311, P = 0.005. The risk of MR is increased during evening shifts, compared to day and night shifts, OR = 1.868, 95% CI: 1.165–2.995, P = 0.009. No significant associations were found between MR and staffing level, age, education, or experience of care workers.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Evidence-based mindfulness
Authors: Maldonado Fernandez M. , Rubio Rodriguez L. , López Fernández J. 
Published: May 2016

IntroductionMindfulness is a form of meditation that cultivates present moment awareness in a non-judging way. It has a Buddhist origin but has been practiced in the last 40 years without relation to any religious belief. It has been proposed as a treatment for a variety of ailments.ObjectivesTo carry out an overview of systematic reviews of the evidence on mindfulness as a therapeutic tool.AimsTo summarize the existing evidence on the efficacy of mindfulness.MethodsWe searched for systematic reviews in the Cochrane Database of Systematic Reviews (Cochrane Library).ResultsWe found nine Cochrane reviews (for fibromyalgia, aggressiveness in intellectually disabled people, mechanical neck disorders, reducing sedentariness at work, anxiety, somatoform disorders, and post-stroke fatigue), two Cochrane review protocols (stress reduction of patients with breast cancer, and substance use disorders), 50 non-Cochrane reviews (29 provisional abstracts and 21 structured abstracts from the Centre for Reviews and Dissemination) on the efficacy of mindfulness. The Cochrane reviews showed a lack of conclusive evidence for fibromyalgia, aggressiveness in intellectually disabled people, anxiety disorders, somatoform disorders and post-stroke fatigue. Mindfulness training induced a non-significant reduction in workplace sitting time. For chronic neck pain, mindfulness exercises minimally improved function but no global effect was perceived at short term.ConclusionsAccording to the existing Cochrane reviews, there is a general lack of evidence mindfulness as an effective treatment. For chronic neck pain, mindfulness exercises minimally improved function. We have detected important areas where high quality clinical trials are needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Autoimmune limbic encephlitis. A rising differential diagnosis between diseases with psychiatric symptoms
Authors: Martín Álvarez C. , Cadenas Extremera F. , Alonso García V. , del Valle Loarte M. , Bravo Arraez M. , Mainar de Paz V. 
Published: May 2016

IntroductionIn psychiatric clinical practice, we can face numerous organic diseases in the differential diagnosis between primary psychiatric disorders. As an example of this, we can see the autoimmune limbic encephalitis(LE), which in a significant percentage of cases begins with psychiatric symptoms. Currently, one of the theories of the origin of the LE is as a idiopathic autoimmune entity, leaving behind the idea of been generated only by a viral or paraneoplastic etiology.ObjectiveTo achieve a better knowledge about this underdiagnosed entity, presenting a case of an anti-LGI1 limbic encephalitis.CaseA 60-year-old Caucasian woman who starts with neuropsychiatric symptoms as: behavioral disorders, manic symptoms, memory impairment and attention deficit.ResultsFinally, the diagnosis was confirmed when the patient had positive results in both serum and CSF samples for anti-LGI1 antibodies. Gastric neuroendocrino tumour type I was discovered. Neither paraneoplasic syndrome nor onconeuronal antibodies were shown. A thin hyperintense signal was identified in the left hippocampus using a brain MRI. Despite the patient had been treated with corticosteroids, immunosuppressants and immunoglobulins, she still showed positive antibodies in CSF samples with poor clinical results, especially psychiatric symptoms. The patient required one psychiatric hospitalization due to reference and persecutory delusions and manic symptoms.ConclusionOur patient had an unsatisfactory evolution with little response to immune treatment. Given the possible underdiagnosis of this condition, the importance of a differential diagnosis and an early treatment, we consider that there is an important need for a greater knowledge and scientific divulgation of this clinical entity.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The chaos involved in Münchausen syndrome and Münchausen syndrome by proxy
Authors: Gherman L.D. , Ciobanu A.M. , Căpraru N. , Mihăilescu A.I. , Gâză L.M. 
Published: May 2016

BackgroundEncountering a patient with Münchausen syndrome (MS) or with MS by proxy is more frequent than it is assumed. Treating this type of patient is indeed a challenge, thus, knowing to depict the signs is important for every doctor. A specific therapeutic approach is needed and sometimes, even law enforcement must be involved.ObjectiveWe plan to highlight the signs and consequences of Münchausen syndrome and Münchausen syndrome by proxy.MethodClinical data were collected during admissions of patients in the psychiatric hospital. A literature review has been performed.ResultsWe report the case of a nurse diagnosed with MS, who had multiple admissions with different diagnostics, before the patient was exposed with the factious disorder diagnosis. We also report the case of a mother diagnosed with MS by proxy and the case of another mother where the obsessive-compulsive elements of her depressive disorder are combined with signs of MS by proxy, both of them inflicting consequences upon the child in care.Discussion and conclusionsPatients suffering from Münchausen syndrome and Münchausen syndrome by proxy can be a burden for society and for themselves. The relationship with them is sabotaged from the start. The diagnostic is difficult to establish. Numerous expensive procedures are being taken and a considerable amount of funds is spent. Most importantly, the abuse of a child with a parent or guardian suffering from this disease is incommensurable and can even lead to death. It is vital to take action as soon as these syndromes are discovered.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neurocognitive mechanisms behind mindfulness
Authors: Perestrelo J. , Teixeira B. 
Published: May 2016

IntroductionClinical applications of mindfulness have become widespread since the introduction of the mindfulness-based stress reduction (MBSR), a treatment program originally developed for the management of chronic pain. Neuroimaging techniques have allowed uncovering the neural mechanisms behind Mindfulness techniques.ObjectiveTo review some of the psychological and neural mechanisms behind mindfulness practice in order to explore the unique factors that account for its positive impact on emotional regulation and health.AimsPsychological and neural mechanisms behind mindfulness practice are reviewed.MethodsA literature review of the theme is surveyed. Several articles were searched on Medline with the keywords “mindfulness”, “meditation”, “neurobiology” and “neurocognitive”.ResultsMindfulness may achieve effective outcomes in the treatment of anxiety, depression, and other psychopathologies through the contribution of emotional regulation. Cognitive reappraisal has been suggested as a core cognitive control skill whereby mindfulness practice may regulate emotions. It seems that a neural circuit comprising the prefrontal cortex (PFC), the anterior cingulate cortex (ACC), the amygdala (A), and the insula (I) are involved in the unique processes of mindful emotion regulation.ConclusionsRecent models of mindfulness allow for more rigorous examination and operationalization of the method to guide research. Increasingly investigators are focusing on the impact that mindfulness has on emotional regulation, which accounts for the effects on mental health.Disclosure of interestThe authors have not supplied their declaration of competing interest.
New data of the theory of self-medication
Authors: Prieto Sánchez I. , Ramírez Domínguez M.D.L.C. , Garrido Torres N. , Fernández León S. , Reina Domínguez M. , Rodríguez Martínez A. , Biedma Martín A.S. , González Macías C. 
Published: May 2016

ObjectiveThe theory of self-medication in patients with severe mental illness has been exposed for years but to date has not been confirmed or ruled out. With this study, we intend to show the latest available evidence regarding this context.MethodsAn exhaustive literature research in Medline and the latest forth in APA 2015.ResultsMore and more evidence refute the veracity of this theory deeply rooted among some professionals.ConclusionThere are theoretical alternatives that relate more sustained manner the relationship between consumption and toxic psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Autistic spectrum disorder masked by mental retardation and impulse control disorder
Authors: Rodríguez Andrés L. , Ballesta Casanova T. , Hernández García M.S. , Noval Canga C. , Gallardo Borge L. , Espina Barrio J.A. 
Published: May 2016

Clinical case reportA 48-year-old male, diagnosed with impulsive control disorder, sex addiction disorder and mental retardation was followed-up by different psychiatrists for the last 20 years. He consults because of presenting depressive symptoms and behavioural disturbances related to the death of his mother two years before. The patient reports to experimenting depressed mood, irritability, insomnia and trends to cry. He has lost motivation for his job and hobbies (he used to show interest in topics such as physics, philosophy, maths, and medicine). He has feelings of loneliness, which make him look for social interaction and support through continuous calls to telephone sex lines. This act has made him spend large amounts of cash, thus, making him be in deep debts. He does not feel integrate in society.Mental status examinationIntrovert, limited social skills, coherent language, echolalic, monotone, tangential speech, depressed mood, feelings of guilt and futility, dysphoria, partial anhedonia, ideas of hopelessness, structured death ideation, unconsciousness of his own acts, with trend to impulsiveness and compulsive behaviour and insomnia.Complementary testWais test: no mental retardation found.DiagnosisAutistic spectrum disorder (F84.0); major depressive disorder (F32.1); bereavement (V62.82).DiscussionThe patient showed classic diagnostic criteria DSM 5 associated with autistic spectrum disorder (Asperger's disorder in DSM-IV); the permanent inability for social interactions and repetitive, restricted and stereotypic behavioural patterns.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Gestchwind syndrome and epileptic psychosis, beyond the schizophrenia frontier
Authors: Rodriguez V. , Gómez C. , Gomis C. , González L. , Tercelán E. , Pérez J. , García L. , Ainbarro M. , Ortigosa C. 
Published: May 2016

During late 19th and early 20th century neuropsychiatrists began to identify common behavioral and cognitive disturbances in epilepsy, but it is not until 1973 that Norman Gestchwind described the basics of what we know as Gestchwind syndrome. This syndrome includes the triada of hyper-religiosity, hypergraphia and hypo/hypersexuality and it was mainly associated with temporal lobe epilepsy. Moreover, it is well known the association between epilepsy and psychotic symptoms, the so-called schizophrenia-like syndrome, which can lead us to a false diagnosis of schizophrenia. We report a 44-year-old man who was brought to the hospital with delusional ideation of prosecution and reference in his work environment with important behavioral disruption, as well as delusional ideation of religious content. He had a diagnosis of schizophrenia since he was 18-years-old and personal history of generalized tonic-clonic convulsions in his twenties. During the admission, he recovered ad integrum very rapidly with low doses of risperidone, but referred recurrence of déjà vu episodes. After reviewing his patobiography and past medical history, we identified the presence of hypergraphia, hypersexuality and a profound religious feeling, fulfilling the criteria for Gestchwind syndrome, in the context of which was later diagnosed as chronic epileptic psychosis. It is very important a careful approach to the patobiography and personal history. Also, we should include classic differential diagnosis such as Gestchwind syndrome, as they can lead us finally to the correct diagnosis, which in this case meant not only a different treatment but also a better prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The influence of social comparisons made on Facebook and sociotropy on bulimia nervosa symptoms: A revised examination of the dual pathway model
Authors: Krug I. , Kalathas F. 
Published: May 2016

BackgroundThe dual pathway model (DPM) attempts to explain the processes that are etiological to the development of Bulimia Nervosa (BN) symptomology by examining both individual and sociocultural risk factors of BN. The DPM, however, is yet to incorporate the sociocultural factor Facebook, which is important given the widespread use of the social media website Facebook. In addition, research has suggested that the personality trait sociotropy may increase vulnerability to developing BN symptoms, however, there is limited evidence examining this factor in the DPM.ObjectiveTo test a revised DPM with the inclusions of social comparisons made on Facebook and sociotropy both (a) cross-sectionally and (b) longitudinally.MethodFour hundred and seventy females participated at baseline (T1). Four weeks later, 274 females completed the follow-up assessment (T2), which assessed a subset of measures from the baseline assessment.ResultsAn acceptable fit for both DM models was obtained through Structural Equation Modeling (SEM) using MPlus (See Figs. 1 and 2).ConclusionsPrevention and early intervention efforts for both depression and BN should focus on addressing appropriate Facebook and social media use and these interventions should be tailored to individuals scoring high on sociotropy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychological factors influence the symptoms of Gastroesophageal Reflux Disease (GERD) and their effect on quality of life in Korean fire fighter
Authors: Lee S.Y. , Jon D.I. , Kyung-Joon M. 
Published: May 2016

ObjectiveThe aim of the study was to investigate the psychological factors influence the symptoms of gastroesophageal reflux disease (GERD) and their effect on quality of life in Korean Fire Fighters.MethodsThis study examined data collected from 1217 fire fighters. Depression and Anxiety were identified using the Patient health questionnaire-9(PHQ-9) and the 7-item Generalized Anxiety Disorder Scale. Occupational stress and Stress coping were identified using the KOSS-26 and the Ways of Coping Checklist-Revised. Self-esteem and quality of life were identified using the Rosenberg's Self-Esteem Scale and World Health Organization quality of life scale abbreviated version (WHOQOL-BREF). The scores for anxiety, depression and QoL of the two groups were analyzed. The correlation between psychological factors and QoL was also analyzed.ResultsCurrent psychological variables were associated with increased odds of concurrent GERD-related symptoms. Current depression, anxiety and stress were associated with increased odds of GERD-related symptoms. According to the WHOQOL-BREF, depression, anxiety, stress, stress coping and self-esteem were significantly correlated with quality of life in patients with GERD. Quality of life was obviously affected by psychological variables in patients with GERD.ConclusionsThese results indicate that psychological symptomatology, depression, anxiety, occupational stress and self-esteem are associated with GERD-related symptoms. Acknowledging this common comorbidity may facilitate recognition and treatment, and opens new questions as to the pathways and mechanisms of the association.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Evaluation of psychomotor/motor disturbances in elderly medical inpatients
Authors: McCarthy G. , Fitzpatrick O. , O’Neill D. , Meagher D. , Adamis D. 
Published: May 2016

IntroductionTraditionally psychomotor subtypes have been investigated in patients with delirium in different settings and it has been found that those with hypoactive type is the largest proportion, often missed and with the worst outcomes.Aims and objectivesWe examined the psychomotor subtypes in an older age inpatients population, the effects that observed clinical variables have on psychomotor subtypes and their association with one year mortality.MethodsProspective study. Participants were assessed using the scales CAM, APACHE II, MoCA, Barthel Index and DRS-R98. Pre-existing dementia was diagnosed according to DSM-IV criteria. Psychomotor subtypes were evaluated using the two relevant items of DRS-R98. Mortality rates were investigated one year after admission day.ResultsThe sample consisted of 200 participants [mean age 81.1 ± 6.5; 50% female; pre-existing cognitive impairment in 126 (63%)]. Thirty-four (17%) were identified with delirium (CAM+). Motor subtypes of the entire sample was: none: 119 (59.5%), hypo: 37 (18.5%), mixed: 15 (7.5%) and hyper: 29 (14.5%). Hypoactive and mixed subtype were significantly more frequent to delirious patients than to those without delirium, and none subtype more often to those without delirium. There was no difference in the hyperactive subtype between those with and without delirium. Hypoactive subtype was significant associated with delirium and lower scores in MoCA (cognition), while mixed was associated mainly with delirium. Predictors for one-year mortality were lower MoCA scores and severity of illness.ConclusionsPsychomotor disturbances are not unique to delirium. Hypoactivity, this “silent epidemic” is also part of a deteriorated cognition.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Case report: Hallucinations as depressive equivalents
Authors: Garcia E. , Vicente I. , Martínez R. 
Published: May 2016

We comment the case of a 12 years old girl who started with visual and auditive hallucinations. Hallucinations are not a common symptom between children. They may also be linked to many conditions, some of them with poor outcome as schizophrenia. Symptoms appeared in a short time, after a previous normal development. She talked about a man who followed her and that was always behind, she also had heard some insults of undeterminated voices. These symptoms were just of one-month duration and made her feel anxious and very afraid. After a normal organical study and a first proposal of medication they asked for our consultation. We found that the patient was alone at home every afternoon. Family, from other country, hadn’t any social support, and the father had had to travel away some days before the child began to suffer hallucinations. Suspecting an affective disorder as the basis of anxious symptoms, and hallucinations as a cultural presentation of them, we started with a social intervention mixed with support therapy. After some sessions the patient could talk about her loneliness and fears, disappearing the other symptoms. We will resume this case and literature about other cultural presentations that may difficult diagnosis or treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.