bluuebunny/crossref_metadata_2025_split huggingface dataset:
The birth of Athena – Psychodynamic formulation and case report
Authors: Skokou M. , Assimakopoulos K. , Gourzis P. 
Published: May 2016

IntroductionAthena possesses a special place among the Greek Gods, as she was born from her father, according to an extreme patriarchal model with a marked depreciation of the maternal role. Zeus had swallowed and absorbed the mother of Athena, Mites, because of an oracle that if Mites gave birth to a boy, the boy would take his throne. When the time comes, Zeus commands Hephaestus to cleave his forehead with an axe, and then Athena leaps fully armed and shouting her cry of war, in front of the astonished Gods. The next moment she puts her weapons down, as a token of obedience and devotion. The exceptionally close bond between father and daughter is evident through their uniquely confidential relationship. The ancient myth is paralleled, from a psychodynamic aspect, with the case of a narcissistic patient receiving psychodynamic psychotherapy.MethodsCase report.ResultsA case of a woman with narcissistic personality features and depressive symptoms is described, presenting with the complaints of withdrawal, self-depreciation, passivity, and agoraphobia. Psychodynamic factors defining her pathology are her narcissistic and sexualized relationship with her father, whereas the relationship with her mother has been depreciated. The patient experiences an intrapsychic conflict of reciprocal idealization, against her anger and fear for her father, resulting in the symptoms of agoraphobia and passivity.ConclusionLike Athena, who puts her weapons down, the patient resigns from her will for autonomy and moves to a passive position, as a result of her entrapment in her idealized relationship with the father.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Emotional avoidance process in patients with schizophrenia and bipolar disorder. New module: Emotional body's sensations and meta-cognitive work on the interpretation of delusional thinking
Authors: Suchocka Capuano A. , Karar A. , Ponseti Gaillochon A. , Georgin A. , Bungener C. , Dorard G. , Bouyakoub S. 
Published: May 2016

IntroductionPsychological processes play a mediating role in the development of psycho-pathological disorders depending on the Kinderman's model. Excessive use of emotional avoidance becomes, following the model of Barlow and Allen, the booster of emotional distress at long term. Dysfunctional meta-cognitive processes in turn influence the inadequate interpretations of life experiences.ObjectiveTo improve identification, expression and emotional management in patients with schizophrenia (PWS) and patients with bipolar disorder (PWBD).AimsIntroduction of exposition for the emotional body's sensations. This work on emotional awareness by images and sounds prepare to role-playing and to exposure in real life.MethodsGroups of psychotherapy for adults PWS and PWBD was implemented. The techniques used are those of cognitive behavioral therapy CBT (Beck) and emotional therapies (Barlow): columns Beck tailored, role-playing, psycho-emotional and breathing. Four groups of four patients participated in six therapy sessions.ResultsAn increase in emotional flexibility is observed two weeks after the group work (Wilcoxon P = 0.025). Work on emotional identification facilitates the relaxation of the avoidance process while promoting social skills. The new format includes nine sessions three additional sessions on the emotional body sensations. Meta-cognitive work on the interpretation of the delusional thinking has been inserted.ConclusionThe experience of this pilot study provides encouraging results. The transdiagnostic approach referring to the alterations of this common psychological process finds use with PWS and PWBD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The challenge of Vitamin D deficiency in an inpatient ward
Authors: Adamidou I. , Udo I. 
Published: May 2016

Aims and hypothesisWe set out to determine standards that would enable the identification of persons at risk of Vitamin D (VitD) deficiency in our ward; the prevalence of deficiency in at risk patient group on a 25-bedded ward (Brunswick). Deficiencies were identified, managed according to local guidelines and care plans were updated to reflect this change.BackgroundLow VitD levels have been associated with depression, psychosis, schizophrenia, suicidality, treatment resistance and poor coping. However, serum VitD levels is not a routine investigation on inpatient psychiatric admissions. Factors associated with VitD deficiency include prolonged stay in inpatient units with limited exposure to sun; Inpatients’ diet; Self-neglect and social isolation.MethodsCriteria for identifying patents who may be at increased risk was agreed.These patients were approached, and consented to screening. Results of the investigation were discussed with patients and actioned according to need. Study period May 2015–July 2015.ResultsWe were unable to identify any criteria in use for identifying persons at risk in psychiatric services. The following criteria were agreed: Hospital stay for > 2 months and limited opportunities of leaving the ward (Detention); Transfer from another unit with a total of hospital stay > 2 months; Admission from the community with severe depression or history of social isolation.7 patients (28%) were identified to be at increased risk. Of this, 6 patients (85.7%) were deficient and another 1 (14.3%) had insufficient level. Management was instituted.ConclusionsIf indicated, psychiatrists ought to consider monitoring VitD levels during inpatient stays and managing as appropriate.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Analysis of the elapsed time since a patients’ disease is diagnosed till they come to a rehabilitation center
Authors: Palomo Monge M. , Sandra D.C. , María Fernanda A.L. , María Fernanda T.G. , David G.M. , Silvia S.D.L.P. , Arántzazu D.D. , Rubén O.B. 
Published: May 2016

IntroductionThe elapsed time since a patients’ disease is diagnosed till these patients come to rehabilitation centers is usually long. In this study in our sanitary area, we have checked the average length of time since the patient is diagnosed till they come to the rehabilitation center.ObjectivesTo calculate and analyze the years of evolution of the disease in patients who come to the rehabilitation center in the Talavera area during year 2014. Classify them by sex.MethodsRetrospective cross-sectional descriptive study. We carried out a register of all the patients who come to the Psychosocial and labor Rehabilitation center in 2014. Classified them by sex, and the time lapsed since they were diagnosed until 2014.ResultsFrom all 135 patients: 92 men (68.15%) and 43 women (31.85%). Less than 2 years of evolution: 1 patient (1%) 1 men, 0 women; between 2 and 5 years of evolution: 7 patients (5%) 5 men, 2 women; between 6 and 10 years evolution: 13 patients (10%) 7 men, 6 women; more than 10 years: 114 patients (84%).ConclusionsIt is evident that the number of patients increases proportionally to the number of years since the diagnosis. The majority of patients who come to the center (84%) were diagnosed more than 10 years ago. This leads us to wonder why the patients in our sanitary area with recent diagnosis of diseases such as schizophrenia do not come to the mentioned centers earlier.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Schizencephaly and psychosis: A case report
Authors: Carvalhão Gil L. , Ponte A. 
Published: May 2016

IntroductionSchizencephaly is a rare malformation of the central nervous system, a congenital disorder of cerebral cortical development resulting in the formation of abnormal unilateral or bilateral clefts in the cerebral hemispheres that extends from the pial surface to the ventricle. It often manifests with partial seizures, mental retardation and hemiparesis.ObjectiveTo illustrate a rare case of association between psychosis and schizencephaly and the implication of this association for understanding the biology of the psychosis.MethodsA literature search was performed on PubMed database using the key words schizencephaly, psychosis, brain diseases and retrieved papers were selected according to their relevance. The patient clinical record was reviewed.ResultsThe authors report a case of a 59-year-old male admitted into a psychiatric hospital with insomnia, disorganized behavior probably secondary to auditory hallucinations and mystic delusions. He also reported epilepsy and strabismus in his right eye since his childhood and right facial paresis. A head CT scan revealed a left deep cortico-ventricular parieto-occipital communication corresponding to schizencephaly.ConclusionsConsidering the theory that schizophrenia is associated with abnormal brain development, this case report may provide an example of a neurodevelopment abnormality that manifests as psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
15 years and counting – How are schizophrenic patients with long hospitalization time?
Authors: Duarte M.A. , Lourenço B. , Ponte A. , Caixeiro A. 
Published: May 2016

IntroductionCentro Hospitalar Psiquiátrico de Lisboa (C.H.P.L.), in Lisbon, Portugal, is the biggest psychiatric hospital in Portugal and one of the oldest still working. Along with acute inpatient clinics it has long duration inpatient units with 226 patients.Objectives/aimsCharacterize and improve the therapeutic approaches in patients committed to the long duration inpatient unit with long hospitalization times and the diagnose of schizophrenia.MethodsDuring the month of September 2015 all patients, committed before 2000 who fulfilled the diagnosis criteria ICD 10, F20.X (Schizophrenia) were characterized regarding age, gender, time of hospitalization and were evaluated using the Positive and Negative Symptom Scale (PANSS).ResultsFrom the original sample (n = 226), 31 patients were included in the study. The mean age was 64.4 years (min 50–max 91) and the majority were male (67.7%; n = 21). The mean years of hospitalization were 28.7 years (min 15–max 60). The average total PANSS score was 99.8 (positive symptoms: 25.4; negative symptoms: 29.9; general symptoms: 44.4).ConclusionsAlthough in last decades many psychiatric hospitals were closed and community approaches to treatment of the mentally ill were the direction preconized by several international organizations, some patients still “live” in the hospital. Mostly, as we found in our study, have a severe, refractory disease, sometimes with behaviour changes that unable them to be discharged. With the continuous evolution of psychopharmacological drug treatment, this paradigm may change. Meanwhile other therapeutic approaches should be used to improve the disease symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Feasibility study of culturally adapted cognitive behaviour therapy for psychosis in Pakistan
Authors: Husain N. , Mehmood N. , Husain M.O. , Kiran T. , Naeem F. , Chaudhry I.B. 
Published: May 2016

BackgroundIt is becoming well established that CBT is both effective and cost efficient in the treatment of positive and negative symptoms of schizophrenia. However, there is a need to adapt CBT to the cultural, linguistic, and socioeconomic context of diverse cultural groups. We aimed to establish the feasibility of culturally adaptive cognitive behavior therapy for treatment of psychosis in a low-income country.MethodsThis is a rater-blind, randomized, controlled trial of the use of CBT in patients with psychosis from a low-income country. Patients with a DSM-IV diagnosis of schizophreniform disorder were assessed using Positive and Negative Syndrome Scale for Schizophrenia (PANSS), PSYRATS (Psychotic Symptom Rating Scales), and the Insight Scale. Participants were randomized into the intervention group (n = 18) and TAU group (n = 18). The intervention group received 12 weekly sessions of culturally adapted CBT for psychosis (CaCBTp).ResultsThere were no significant differences between the two groups at baseline. At three months follow-up, there was a statistically significant improvement in the CaCBTp group on PANSS general Psychopathology subscale, PANSS overall score and Insight scale, as compared to the TAU group. The CaCBTp group had lower scores on PANSS positive, PANSS negative sub-scales, and the two subscales of Psychotic Symptom Rating Scale, but differences were not statistically significant.ConclusionCulturally adapted CBT added to pharmacological treatment as usual was acceptable to patients and was helpful in reduction of severity of psychotic symptoms. Adjunctive culturally adapted CBT should be further investigated in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.
LAI versus oral antipsychotic treatment of schizophrenia: A 12-month prospective study on patient's attitude towards treatment and quality of life
Authors: Pietrini F. , Ballerini A. , Burian I. , Campone B. , Chiarello F. , Ciampi E. , Corsi E. , Ferruccio N. , Moneglia M. , Poli L. , Santangelo A. , Spitoni S. , Ricca V. 
Published: May 2016

IntroductionIt is still a matter of debate whether LAI antipsychotics are able to significantly improve patient's attitude towards treatment.ObjectiveThe aim of this 12-month observational study was to investigate the impact of switching antipsychotic treatment from oral to LAI formulation on patient's attitude towards treatment and quality of life.MethodsA total of 41 schizophrenic patients (25 males, mean age 42.10 ± 11.88 years) were recruited. Patients were expected not to need significant changes in concomitant treatments. All patients were under a stabilized therapy with a single oral antipsychotic (either olanzapine or paliperidone) and were switched to the equivalent maintenance regimen with the long-acting formulation of the same antipsychotic (olanzapine pamoate or paliperidone palmitate). Patients were assessed before the switch (T0), and after 6 (T1) and 12 months (T2) of LAI antipsychotic treatment by means of the YMRS, MADRS, PANSS, DAI-10 and SF-36.ResultsOur data evidenced an overall significant improvement of psychopathology, adherence and quality of life over the 12-month period (T0 vs. T2). In particular, while all of the measures significantly improved in the first semester (T0 vs. T1), only YMRS, positive PANSS and DAI-10 improved both in the first and in the second semester (T1 vs. T2), indicating an additional advantage of a prolonged LAI treatment on these clinical dimensions.ConclusionsThe switch from oral to long-acting antipsychotic treatment may provide considerable advantages in improving patient's attitude towards (and therefore adherence to) treatment. Part of this improvement could be related with a better efficacy on psychopathology and quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Impact of vulnerability to stress in the development and course of first psychotic episode
Authors: Rossini Gajsak L. , Celic Ruzic M. , Rojnic Kuzman M. 
Published: May 2016

IntroductionThe stress diathesis hypothesis is one of the leading models of etiology of psychotic disorders. Cortisol is one of the most researched stress hormone; yet its role in first psychotic episode is currently subject of many researches. Psychotic disorder occurs when “enough” stress attacks vulnerable personality. Stress response activates HPA axis that results in cascade effects on several body systems (immune, neuroendocrine and inflammatory). Dysregulation of the HPA axis and increased cortisol levels have been implicated in psychotic as well as in other psychiatric disorders.ObjectiveTo follow treatment response through changes in clinical status and stress biomarkers evaluation in longitudinal 18 months research in drug naive FEP.AimTo assess endocrine and autonomic responses to acute psychosocial stress, their associations with onset of the first psychotic episode and their subsequent remission.MethodsWe studied 17 subjects with FEP and age and gender matched controls who were exposed to the Trier Social Stress Test. Other materials have explored clinical status through standardized clinical psychiatric interview and validated psychiatry scales as well as measured laboratory biomarkers (cortisol, prolactin, insulin).ResultsOur preliminary findings on a sample of 40 participants indicate a differences between patients and controls in terms of response to stress measured by TSST.ConclusionIn our continued longitudinal research, we plan to further explore the role of hypothalamic-pituitary-adrenal activity in onset and course of psychotic disorder and its relation with other biomarkers.Disclosure of interestThe authors have not supplied their declaration of competing interest.
What do we know about treatment-resistant schizophrenia? – A systematic review
Authors: Seppälä A. , Miettunen J. , Hirvonen N. , Isohanni M. , Moilanen J. , Koponen H. , Seppälä J. , Jääskeläinen E. 
Published: May 2016

IntroductionTreatment-resistant schizophrenia (TRS) is a severe form of schizophrenia. From one fifth to one third of all patients with schizophrenia are resistant to treatment.ObjectiveTo determine the knowledge on TRS and to find out the extent and the quality of research on TRS.AimsTo conduct a systematic review of the current literature on TRS.MethodsOriginal studies and reviews on TRS were systematically collected from PubMed and Scopus databases. The following search strategy was used as a title search; (“ultra-resistant” OR “treatment-refractory” OR “treatment-resistant”) AND (schizophrenia). The search was restricted to English language articles.ResultsThe literature search identified 403 studies. After abstract and title review, 324 studies were included. The included studies considered medication (n 213), electroconvulsive therapy and repetitive transcranial magnetic stimulation (15), prognosis (15), genetics (15), studies on neurobiology (15), definitions (14), psychotherapy (12), brain structures and functioning (10), cognition (7) and other miscellaneous studies (6) on TRS. Definitions of TRS varied notably and in most of the non-pharmacological studies, the samples were fairly small. Regarding treatments, clozapine, ECT, and cognitive-behavioral therapy have shown effectiveness, though the quality of research on interventions is limited. Very little is known about risk factors and predictors of outcome in TRS.ConclusionsOur findings suggest TRS is poorly studied and understood condition contrasted to its high prevalence, clinical importance and poor prognosis. There is a lack of studies on epidemiology, for example risk factors of TRS, as well as on outcomes and longitudinal course. Most of the studies considered medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Adults with persistent ADHD: Gender and psychiatric comorbidities – a population-based longitudinal study
Authors: Yoshimasu K. , Barbaresi W.J. , Colligan R.C. , Voigt R.G. , Killian J.M. , Weaver A.L. , Katusic S.K. 
Published: May 2016

ObjectiveTo evaluate in adults the associations between persistent ADHD and comorbid psychiatric disorders and gender differences, among subjects from a population-based birth cohort.MethodSubjects were recruited from a birth cohort of all children born during 1976–1982 who remained in Rochester, MN after five years of age. Participating subjects with research-identified childhood ADHD (n = 232; mean age 27.0 years; 72% men) and non-ADHD controls (n = 335; mean age 28.6 years; 63% men) were administered a structured psychiatric interview (MINI-International Neuropsychiatric Interview) to assess current ADHD status and comorbid psychiatric disorders.ResultsAmong the 232 with research-identified childhood ADHD, 68 (49 men and 19 women) had persistent adult ADHD. Compared to subjects without childhood ADHD, adults with persistent ADHD were significantly more likely to have any (81% vs. 35%, P < 0.001) as well as each of the specific psychiatric comorbidities. The associations retained significance when stratified by gender and there were no significant gender by ADHD interactions on psychiatric disorders except for dysthymia with which ADHD was more strongly associated in women than men. Among subjects with persistent ADHD, externalizing psychiatric disorders were more common in men (73%) and internalizing disorders were more common in women (53%).ConclusionPersistent ADHD is associated with an increased risk of comorbid psychiatric disorders in both adult men and women. Clinicians treating adults with persistent ADHD need to be aware of comorbid psychiatric disorders, especially externalizing disorders for men and internalizing disorders for women.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Clinical characteristics of gender identity disorder
Authors: Pusceddu R. , Bandecchi C. , Pinna F. , Pintore S. , Corda E. , Deiana V. , Oppo A. , Mariotti S. , Argiolas A. , Carpiniello B. 
Published: May 2016

Traditionally, gender identity disorder (GID) is associated with high level of psychiatric comorbidity, particularly psychotic and affective disorders. The aim of this study is to evaluate clinical aspect of GID in a sample of patients in charge of the Operative Unit for Diagnosis and Therapy of GID, Psychiatric Clinic and the Department of Endocrinology, University of Cagliari.Assessment was made by SCID-I, for Axis I comorbidity, GAF, for global functioning, BUT for body discomfort (BUT-A measures different aspects of body image, BUT-B looks at worries about particular body parts).The sample comprised 14 MtF (56%) and 11 FtM (44%), of age between 17–49 years; a diagnosed psychiatric disorder was reported in 32%: 16% mood disorders, 12% anxiety disorders, 4% psychotic disorders. Among subject with GAF < 85, 58.3% were identify to have a Axis I disorder compare to 7,7% patients with GAF ≥ 85 (P = .011), especially for mood disorders (P = .039). Main score of Global Severity Index (GSI) for BUT-A was 2.45 ± 883; all subjects had a score GSI > 1.2 (clinically relevant discomfort index).Regarding BUT-B, MtF have higher scores in PSDI global scale (3.37 ± .577; P = 0.019) and subscale VI (4.38 ± 1.496 vs. .81 ± 1.864; P = 0.006): there are not significant gender differences in the others subscales, although discomfort regards different aspects of both sexes.According to literature, we observed a slightly higher prevalence of Axis I psychiatric disorders compare to general population, with functioning level statistically significant.Generally, GID was not associated with higher level of psychopathology, appearing as specific diagnostic aspect, where the main origin of discomfort is dissatisfaction toward self-body imagine.Disclosure of interestThe authors have not supplied their declaration of competing interest.