bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uncommon effects of clozapine
Authors: Jerónimo J. , Santos J. , Bastos L. 
Published: May 2016

IntroductionClozapine is the first option for treatment-resistant schizophrenia, affecting about 20–30% of all patients. Weight gain, sedation, hypotension and hypersalivation are common and well-known adverse effects associated with clozapine. However, it is also important to be aware of uncommon adverse effects, like parotitis.ObjectiveWe report a case of clozapine-induced parotitis.MethodsLiterature was accessed through Pudmed, using the search terms parotitis and clozapine.ResultsA 36-year-old male with paranoid schizophrenia, whose psychotic symptoms have responded only slightly to two antipsychotic trial, with both haloperidol and olanzapine. Therefore, he began treatment with clozapine with the dose titrated to 400 mg/day. At first, the only registered adverse effect was hypersalivation. Eventually, after 3 months of treatment, he developed a unilateral swelling of the left parotid gland. Bacterial and viral parotitis were ruled out and the diagnosis of clozapine-induced parotitis was evoked. Patient scored 5 in the Parotitis-Specific Criteria Modified Naranjo Probability Scale. Symptomatic medication was initiated with paracetamol and a non-steroidal anti-inflammatory with a favorable outcome.ConclusionThere are few reports of clozapine-induced parotitis, a very rare and poorly known adverse effect with an unknown pathophysiology. Early recognition and proper management are essential to reduce morbidity associated with the treatment. There is no consensus how to manage these adverse effect, however, generally it is not necessary to discontinue the treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Lamotrigine induced DRESS syndrome in bipolar disorder: Multiple snares behind a potentially life-threatening adverse reaction
Authors: Oriolo G. , Brugués A. , Goikolea J.M. , Pintor L. 
Published: May 2016

BackgroundLamotrigine is widely used to prevent bipolar depression. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a rare, potentially life-threatening adverse effect. The long latency between drug exposure and disease onset, added to the high variability of its clinical presentation, can increase the risk of misdiagnosis lamotrigine withdrawal delay.ObjectiveTo highlight potential risk factors that can be related to a worse clinical onset and evolution of lamotrigine-induced DRESS syndrome.MethodsWe report the case of a 25-year-old-man, with a type I bipolar disorder, treated with lithium and lamotrigine 50 mg per day during the first 13 days of treatment, progressively increase up to 200 mg. Thirty-five days after the treatment initiation, a pruritic rash appeared in his upper arms, and scabies infestation was diagnosed. After 72 hours, the patient required urgent hospitalization due to hemodynamic instability.ResultsOn admission, facial edema and erythrodermia were involving 70 to 80% of the body surface. DRESS diagnosis due to lamotrigine was made following RegiSCAR criteria (Table 1). Psychiatric medication was stopped and DRESS treatment established. Complete recovery without recurrence was achieved after 2 months.ConclusionsThe lamotrigine up titration faster than recommended may have facilitated the DRESS syndrome reaction. Moreover, the latency between lamotrigine introduction and the rash onset could have increased the possibilities of misdiagnosis. In light of this, physicians need to consider at least the last 3 months treatment history when assessing a rash, as the delay of DRESS syndrome diagnosis can fastly lead to a fatal event.Table not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Acute dystonia and dyskinesia progressing in the patient with fibromyalgia upon the use of duloxetine
Authors: Tüz C. 
Published: May 2016

PurposeIn this article, a case who was prescribed duloxetine (30 mg capsule) upon the fibromyalgia diagnosis by a physical therapist and had acute dystonia and dyskinesia after approximately 1.5 hours from duloxetine intake shall be presented.CaseIt was learnt that a married female patient aged 38 consulted a physical therapist with the complaint of back pain and duloxetine (30 mg capsule) was prescribed. It was reported that, the patient applied to our hospital with the compliant of involuntary movements around the mouth, on the lips and neck, spasm, inability to open the mouth completely, spasm in jaw, gritting teeth, mumbling and aphasia after approximately 1.5 hours from her duloxetine intake. The patient was conscious. Her psychomotor activity was natural. As a result of cranial MR, EEG, BT examinations hemogram and the routine biochemistry examinations, any abnormality in zinc and iron levels was not detected. Complaints of the patient regressed after 1 hour from the discontinuance of duloxetine and the administration of biperiden 5 mg/mL ampoule 1000 cm3 in SF. After 72 hours, any symptoms were not found.DiscussionDopamine neurotransmission can be inhibited through the increase in serotonin and norepinephrine. Additionally, dystonia may originate from the prevailing of noradrenaline as a result of the failure of dopaminergic–noradrenergic balance.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Women coping strategies to infertility stress can impact IVF outcome
[EV1356]
Authors: Kitanovic B. , Tulic L. 
Published: May 2016

Infertility is defined as a failure to achieve a pregnancy after a woman has
attempted to get pregnant for more than 12 months. The impact of psychosocial
factors on IVF outcome is a growing field of research. This is the first study
estimating the impact of psychosocial stress and women coping on IVF outcome in
Serbia. The aim of this pilot investigation was to assess the influence of
psychological factors on the outcome of in vitro fertilization in Serbian women.
Psychometric tests were administered at the first visit to 100 women undergoing
IVF treatment at Clinic of Gynecology and Obstetrics, Clinical centre of Serbia,
University of Belgrade, Serbia. We used questionnaire that covered key
demographic and obstetric information and Serbian version of COMPI test,
specially designed test measuring stress in infertility, as well as, Zung
Depression Self-Rating Scale and Beck Anxiety Inventory. Results of pregnant and
non-pregnant group were compared. In the cohort of Serbian women, it has been
remarked that they predominantly use active confronting coping style. We found
statistically significant differences ways of coping styles between pregnant and
non-pregnant group. Women from the pregnant group had significantly lower scores
of marital distress, and significantly higher use of meaningbased coping styles.
It is found that the use of active avoidance coping correlates negatively with
the level of depression and personal, marital and social distress. Clinicians
should be aware that infertility is a stressor itself and that coping strategies
can influence IVF outcome. Therefore, psychosocial assessment should be a part
of an IVF unit.

Disclosure of interest
The authors have not supplied their declaration of competing interest.
Examining the person X situation interactions of internalized traits, state body affect and upward comparison behaviour
Authors: Rogers A. , Lewis V. , Krug I. , Fuller-Tyszkiewicz M. 
Published: May 2016

ObjectiveAlthough the influence of trait internalization and state body satisfaction on appearance comparisons has been well documented, their interactive influence on comparison behaviours is unknown. Therefore, the present study thus tested a person X situation model in which both mood state and trait internalization interacted to predict engagement in upward comparisons.MethodOne hundred and forty-eight women aged 18 to 40 completed baseline measures of trait internalization, and then completed via iPhone app an experience sampling phase in which they reported momentary experiences of mood and comparison behaviours at up to 6 random times daily for 7 days.ResultsMultilevel analyses revealed that although upward comparisons were more likely for individuals who internalized the thin ideal (t = 3.27, P < .001), this effect was minimized in instances when a participant was satisfied with her appearance (t = –1.90, P = .031). Further exploratory analyses showed that state body satisfaction was a stronger predictor than trait internalization of comparison behaviours (R2 = .14 vs. R2 = .11) when the time lag between state body satisfaction and comparison event was less than 2 hours, but this pattern reversed as the time lag between state level predictor and outcome increased beyond 2 hours (R2 = .09 vs. R2 = .12).ConclusionsPresent findings suggest that bolstering one's body satisfaction in the moment may be as clinically important as reducing a client's interest in the thin ideal for alleviating occurrence of unhealthy body comparisons.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychosis due to traumatic brain injury – controversies and diagnoses difficulties
Authors: Amorim A. 
Published: May 2016

IntroductionA traumatic brain injury (TBI) can cause numerous psychiatric complications. Humor and anxious disorders, personality disorders and psychoses are some of those possible problems. The diagnosis of psychosis due to traumatic brain injury (PDTBI), although controversial, has been subject of crescent debate and the idea that a TBI could cause a psychosis is gaining credibility. Diagnosing a PDTBI can be difficult. DSM-5 criteria are rather vague and there are many potential confounding factors due to similarities with other etiological psychosis.Objectives and aimsAlert clinicians to the diagnosis of PDTBI, clarify this clinical entity and define features that may allow them to do the differential diagnosis with other etiologic psychotic disorders.MethodsThe authors performed a research in PubMed using the keywords psychosis and traumatic brain injury and selected the adequate articles to meet the objectives proposed.ResultsDifferential diagnosis of PDTBI should be done with schizophrenia, schizoaffective psychosis, delusional disorder, substance-induced psychosis, psychosis due to other medical condition and with posttraumatic stress disorder. Differentiating PDTBI and schizophrenia can be particularly difficult. Some features have been proposed in the literature as potentially differentiating, namely the presence of negative symptoms (more common in schizophrenia), findings in MRI/CT and EEG.ConclusionsEstablishing PDTBI diagnosis can be difficult. While awaiting new studies, clinicians should, in cases of TBI related psychosis, achieve a meticulous clinical history and mental exam, in order to ensure a correct diagnosis and, therefore, determine an appropriate intervention.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Cyclic vomiting syndrome
Authors: Cano Ruiz P. , Cañas Fraile S. , Gómez Peinado A. , Sánchez García M.D. 
Published: May 2016

IntroductionCyclic vomiting syndrome (SVC) is a functional gastrointestinal disorder characterized by paroxysmal episodes of vomiting, recurrent and cyclical presentation. Although this disorder was first described in children, recently it has increasingly been recognized in adults.ObjectiveTo know the pathogenesis of the syndrome and the optimum approach.MethodTheoretical review and cyclic vomiting syndrome brief statement of a case. This is a man of 51 years for 7 months has repeated episodes of vomiting often than 1 episode for week, with vomiting every 10–15 minutes. The patient is admitted to the neurology department for endless instability and multidirectional nystagmus and right hemispheric deficiency symptoms, with acute renal failure prerenal rehydration and study. While entering data semiotic Wernicke disease are objectified. With replacement therapy meeting evolves favorably at the time of discharge from hospital asymptomatic.DiscussionCVS, in conclusion, is a rare disease in adults whose diagnosis is one of exclusion. The adult presentation usually presents more durable, less frequent episodes. The pathogenesis remains unknown. The optimal treatment is to establish prophylactic migraine medications like amitriptyline. In the prodromal phase, it could be used ketocorolaco or sumatriptan and in the acute phase, ondansetron or lorazepam. Because of the morbidity associated with CVS, in particular the severity of symptoms, it is necessary to conduct more studies in adults.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Boderline versus personality
Authors: Cotta C. , Jesus G. , Vila Nova V. , Moreira C. 
Published: May 2016

IntroductionLatest classifications led to an inflamed debate urging for change or validation in the way personality disorders are classified. The placement in psychiatric classifications of several personality disorders, particularly Borderline Personality Disorder (BPD), is also a matter of discussion.Objectives and aimsThe present work aims to question BPDs place in classification alongside with other personality disorders, rather than focusing on the algorithms used to classify it. The authors review updated literature on core features of the disorder collected from online scientific databases.ResultsStudies reveal that the stability of the diagnosis of BPD over the longer term is less than what standard general definitions of personality disorders would appear to require. It is a chronic and debilitating syndrome with severe functional and psychosocial impairment that remain relevant when comparing to other personality disorders. Additionally, these measures show further declines over time in spite of improvement in psychopathology, in contrast to what happens with other personality disorders. Several misconceptions may have led to the placement of BPD on former axis II, namely being a direct consequence of trauma and merely explained by environmental factors. However, recent research on heritability shows the contrary and several neurobiological markers suggest it has got a nature of its own.ConclusionBPD is probably the most studied and validated personality disorder and has substantially greater empirical basis, clinical significance and public health implications, being both enduring and distinct from other personality disorders. We suggest the placement of BPD as major psychiatric disorder in classifications.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Comorbidity of adult ADHD and obsessive-compulsive disorder
Authors: Duque Domínguez A. , Echeverría Hernández N. , Lázaro Redondo M.D.M. , de la Torre Brasas F. , Otalora Navarro M. , Martín Díaz L. , García Montero C. , Mas Villaseñor A. 
Published: May 2016

IntroductionIn prospective and controlled studies followed up until adult age of patients diagnosed with ADHD in their childhood, the most frequent comorbid disorders were major depressive disorder, personality disorder (borderline and antisocial), substance use disorder and, less frequently, panic disorder and obsessive compulsive disorder.ObjectivesWe report the case of a male patient aged 60, diagnosed with obsessive-compulsive disorder from his adolescence. His psychopathological progress has become aggravated over the years. Nowadays, he presents an important restlessness, which has led him to social isolation and family claudication.MethodologyOur patient is admitted to the Psychiatric Day Hospital with an appropriated treatment for his OCD (sertraline and aripiprazole). After several days under observation, we used the scales ASRS-V1.1 y WURS finding results that suggested adult ADHD. Extended release methylphenidate was prescribed, with a fast improving of our patient's symptoms of restlessness, insecurity and impulsion phobia. He was discharged from the Centre for Psychosocial Rehabilitation showing a good evolution.Results– Anankastic personality disorder (F60.5);– Dependent personality disorder (F60.7);– Hyperkinetic disorders (F90).ConclusionsSeventy-five percent of adults diagnosed with ADHD have comorbid disorders that should be used as severity rates, since they may cover up the ADHD symptoms or complicate the response to treatment. Adults with ADHD present high score on the scales “social maladjustment” and an often concomitant and polymorphic psychiatric pathology, object of varied diagnoses.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A comparative study between the attachment styles of adults who were raised by mothers with schizophrenic disorders, depression, and those raised by mentally healthy mothers
Authors: Hatam S. , Lea Baranovich D. 
Published: May 2016

IntroductionMaternal psychopathology can have a server effect on the ability of mothers to attach to their children.AimTo ascertain the level of attachment of adults between the ages of 18–25 years of age who were raised by mothers who suffer from schizophrenic disorders and depressive spectrum disorders, then compared to adults who were raised by mothers with no formal clinical diagnosis.MethodThis study used the Adult Attachment Questioner (AAQ), by Simpson Rholes Philips (1996) to ascertain the level of attachment of adults between the ages of 18–25 years of age who were raised by mothers who suffer from schizophrenic disorders (n = 30) and depressive spectrum disorders (n = 30). The findings of these two groups were then compared to adults who were raised by mothers with no formal clinical diagnosis (n = 30).ResultThe findings indicated that there is a significant difference between adults who were raised by mothers with the aforementioned mental disorders (schizophrenic and depression), as compared to those who were raised by mentally healthy mothers.ConclusionThe style of attachment in adults who were raised by mothers with the aforementioned clinical diagnosis (schizophrenic and depression) have insecure attachments, while the children who were raised by mentally healthy mothers have almost secure attachment style.Disclosure of interestThe authors have not supplied their declaration of competing interest.
First psychotic episode on the fifth decade? Differential diagnosis of psychotic symptoms, about a case
Authors: Manzur Rojas P. , Botias Cegarra P. , Gonzalez Galdamez A.L. , Ibernon Caballero M.I. , Raposo Hernandez M.R. , Sanchez Bahillo A. , Belmar Simo A. , Carrillo Cordoba M.A. 
Published: May 2016

The postictal psychosis is a psychotic disorder that begins shortly after a crisis. Most often it affects patients with partial epilepsy and especially those with temporal lobe epilepsy. The postictal psychosis according to several publications can occur in up to 25% of patients with epilepsy. The psychotic disorder usually occurs within 24–48 hours after, be transient, with good response to treatment with antipsychotics and complete remission of psychotic symptoms. This case is for a woman of 58 years diagnosed with structural epilepsy after brain abscess left temporal intervened in childhood. The patient is being followed by neurology for complex partial seizures with secondary generalization in anti-epileptic treatment. The patient has previous studies of EEG, video EEG and brain MRI, evidence involvement of temporal lobe and hippocampus. The patient is brought to the emergency room after episode of sensory aphasia, unconsciousness and tonic-clonic limb movements, decreasing with diazepam. The patient, during the stay under observation, has auditory hallucinations, that generate anxiety must initiate being him quetiapina and clonazepam orally, yielding partially psychotic disorder, acute intracranial lesions are discarded and the patient is admitted by neurology. The evolution of psychotic disorder with antipsychotic down in a few weeks remaining asymptomatic. Epileptic psychosis is more common in refractory epilepsy. In all cases, you should make a joint approach between psychiatry and neurology, usually they have good response to antipsychotics.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Burnout and associated factors among Tunisian teachers
Authors: Masmoudi R. , Trigui D. , Ellouze S. , Sellami R. , Baati I. , Feki I. , Masmoudi J. 
Published: May 2016

IntroductionTeachers are confronted with increasing difficulties and demands that make them vulnerable to burnout.AimsTo evaluate burnout among a population of Tunisian teachers and to identify factors that may be involved.MethodsIt was a cross-sectional, descriptive and analytic study, involving 165 teachers working in 10 primary schools and 7 high schools in Sfax, Tunisia. The participants completed a self-questionnaire containing their socio-demographic and professional characteristics. They were explored by the scale of the burnout: Le Maslach Burnout Inventory General Survey (MBI-GS).ResultsThe mean age of teachers was 39.96 years. The sex ratio (M:F) was 1.32. The majority (75.2%) was married. The burnout syndrome was found in 49.7% of teachers. Moderate burnout was found in 43% of cases and severe burnout in 6.7%. The causes of burnout reported by our population were bad working conditions (71.50%), quality of working relationships (65.5%) and overload work (30.3%). Bad working conditions were associated with a high level of emotional exhaustion (P < 0.005) and a low level of professional efficacy (P < 0.001), while poor quality of work relationships and overload work were associated to a high score on cynicism (P < 0.001) and a low score on professional efficacy (P < 0.001).ConclusionAccording to our study, poor working conditions, overload work and bad quality of relationships seem to be risk factors of burnout in teachers. Preventive measures should be instituted against those factors to reduce the constraints of work and improve the professional quality of life of these individuals, essential thing to optimize the educational level in our country.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The treatment of “shell shock” in World War 1: Early attitudes and treatments for post-traumatic stress disorder and combat stress reaction
Authors: Matson H. 
Published: May 2016

Combat stress reaction is a mental health disorder first documented in the latter half of the 19th century. But it was not until World War 1 when men were put through the horrific ordeals of trench warfare that the term, “shell shocked” was coined. Many soldiers with shell shock then developed what is now called post-traumatic stress disorder (though the term was not defined until 1983) or acute stress disorder. The prevailing opinion was that these men who had often not suffered from any physical trauma were sufferers of cowardice. The British army created the PIE (proximity, immediacy, and expectancy) principles to get such men back to the trenches promptly where manpower was always needed. It was rarely regarded as a real psychiatric condition, which had two consequences. Firstly, that many soldiers progressed from shell shock to post-traumatic stress disorder and secondly, over 150 soldiers were executed by the British army for, “displaying cowardice” whilst in the grip of the illness. The diagnosis of “shell shock” was to be made increasingly frequently as wars became larger and more mechanized throughout the 20th century. Psychiatrists’ management of such patients initially was primitive and influenced by the zeitgeist that such servicemen were not ill, having never come across such a widespread prevalence of mental health problems until the Great War. These ranged from prescriptions of milk to lobotomies. Understanding how “shell shock” was understood, treated and learning from the mistakes made then, continues to inform management of our patients today.Disclosure of interestThe author has not supplied his/her declaration of competing interest.