bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delirium, Hallucinations and Criminal Liability
Authors: Turki M. , Halouani N. , Naoui R. , Gassara I. , Hamza N. , Aloulou J. , Amami O. 
Published: May 2016

IntroductionThe relationship between psychotic motivation and the genesis of medico-legal acts is well documented in the literature. Delirium and hallucinations, in particular, have been widely reported in this context.ObjectiveThe aim was to identify socio-demographic, clinical, and criminological profile of patients hospitalized for forensic acts committed in psychotic context.MethodsWe conducted a descriptive retrospective study, including 7 patients committing a forensic act in psychotic context, selected among all patients hospitalized after a judgement of dismissal (Tunisian law), in psychiatry department, Hedi Chaker university hospital, Sfax, Tunisia. Socio-demographic and clinical data were collected through patients’ observations.ResultsThe mean age was 37.7 years. Sex-ratio (M/F) was 6. The criminological act was an attack in 57.1% and homicide in 42.9% of cases. It was committed on the outside in 42.9% of cases. The tool was a bladed weapon in all cases. The victim was a family member in 71.4% of cases. The context was a delirium in 71.4% (theme: 80% persecution, 20% jealousy; mechanism: 40% hallucinatory, 60% interpretative) and hallucinations in 42.9% of cases. Among our patients, 57.1% were indifferent and 28.6% regretted the act. Psychiatric diagnosis was: schizophrenia 57.1%; delusional disorder 28.5% and brief psychotic disorder 14.2%. Personality disorder was reported in 28.6% of patients.ConclusionThe acting out in a psychotic moment in patients with mental illness remains the most formidable event, causing sometimes the problem of criminal liability. Control of attendance at psychotherapy and psychotropic treatment are preventive and curative necessary measures to avoid crossing the dangerous acts.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neurofarmagen® Testing and Drug Side Effects: An Evaluation of its Use Among a Real-world Case Series
Authors: Oliva F. , Pomeri A. Portigliatti , Nibbio G. , Giuseppe M. 
Published: May 2016

IntroductionVarious pharmacokinetic and pharmacodynamics features have proven to be involved in the development of drug-induced side effects in psychiatry and thus pharmacogenetic profiling should be considered during drug selection to avoid the onset of side effects.AimTo explore the usefulness of Neurofarmagen® testing in clinical practice by evaluating whether the genetic profile given by the tool could properly explain the onset of side effects during antipsychotic treatment.MethodsThe pharmacogenetic profile of ten patients having a history of side effect appeared during to specific a psychopharmacologic treatment was determined by Neurofarmagen® testing tool. The relationship between genetic profile and side effects was evaluated and classified.ResultsSixty percent of the sample showed a genomic alteration related to a increased likelihood of having any side effects, one half of which presented pharmacokinetic alteration (slow or intermediate phenotype for the implicated cytochrome) whereas the other half had a pharmacodynamic gene variant (related to dopamine or serotonin pathway).Conclusionthe Neurofarmagen® testing tool may be useful in the clinical practice in order to avoid drug-induced side effects.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A Case Report of Charles Bonnet Syndrome – The Silent Doubt: Am i Crazy?
Authors: Lopes A. , Sales P. 
Published: May 2016

IntroductionThe Charles Bonnet syndrome refers to symptoms of visual hallucinations that occur in patients with visual acuity or visual field loss. These are often called release hallucinations, reflecting the most widely accepted theory about their pathogenesis. The syndrome is most found in elderly patients, 70–85 years, and this probably reflect the mean age at which the most common underlying conditions are seen. It is probably more common than is thought and because either it is misdiagnosed as psychosis and/or dementia or it is not reported by patients because they fear that the hallucinations represent psychiatric disease.Objective and methodThe authors present the clinical case of a 89-year-old woman, with no previous psychiatric disease, admitted to hospital because of visual hallucinations in form of children and animals. She experienced them during months until she told someone. No psychiatric symptoms were found. The lady had a serious cataract on the left eye with total loss of the visual acuity, as documented by ophthalmologic examination.ResultsThe patient initiated quetiapine 300 mg and will have period appointments with a neurologist. Further future information will be presented.ConclusionsA correct diagnosis is essential to treat these patients and explaining them the meaning of the hallucinations is generally relieving. Many author disagree with antipsychotic agents, while others report benefit.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Paliperidone Palmitate in Psychogeriatric Patients and New Criteria Stopp-start
Authors: Martinez Perez I. , García Sánchez F. , Raposo Hernandez M.R. , Gil Sánchez A. , Gonzalez Galdamez A.L. , Piqueras Acevedo M.D. , Lujan Rico J.M. , Belmar Simo A. , Garcia Briñol C.J. 
Published: May 2016

The treatment of psychosis in the elderly should ensure effectiveness and avoid side effects from combination therapy. Long acting antipsychotic as paliperidone palmitate facilitates this work. Furthermore, STOPP-START criteria, first published in 2008 (in Spanish in 2009), are being adopted as reference criteria throughout Europe. The Spanish version of the new 2014 edition is also recently published [1]. A descriptive study of a total of 53 institutionalized patients in psychogeriatric residence (> 60 to 97 years) with psychotic disorder diagnosis and treatment with various neuroleptics is done. In total, 26.4% of the sample admitted to treatment with three different antipsychotics, and 47.1% with combination of two antipsychotics. Only 26.4% worked with antipsychotic monotherapy. In these patients, treatment with paliperidone palmitate starts or sets the previous dose. A CGI scale is applied after six months of treatment. Antipsychotic monotherapy in 66.66% of patients on neuroleptic combination therapy was achieved, so that 75% of the sample currently maintains monotherapy with paliperidone palmitate. The paliperidone palmitate has shown effectiveness in the symptomatic control and reducing the risk of inapropiate prescribing in older patients with psicosis. The paliperidone palmitate allows antipsychotic monotherapy in the psychogeriatric patient with severe mental illness polymedicated as the STOPP-START criteria recommends.Reference not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cretinism Muscular Hypertrophy: An Unorthodox Reflection
Authors: Mohsin H. , Channa A. 
Published: May 2016

The Kocher Debre Semelaigne Syndrome (KDSS) is also known as cretinism muscular hypertrophy. It is an unusual presentation in intellectually deficit children, commonly associated with congenital or iatrogenic hypothyroidism. The incidence of KDSS is less than 10%. It is more common in males, consanguineous marriage and age range from 18 months to 10 years [4]. The creatinine phosphokinase (CPK) is usually elevated [5]. It might be misdiagnosed particularly when other classical features of hypothyroidism are not dominant at first presentation. We present a case of 15-year-old intellectually deficit female. Her epilepsy had been managed on phenytoin for a decade. She had rigidity, leg cramps, malaise, oliguria, fever, myxedema, delayed deep tendon reflexes, calf muscle hypertrophy and agitation. Her agitation was controlled by haloperidol, which worsened the condition by altering her mental status. The patient was initially managed on line of Neuroleptic Malignant Syndrome due to raised CPK of 40,680 IU/L and mixed presentation. Nevertheless, no significant change was noticed until thyroid profile was done to exclude alternative resources. Thyroid stimulating hormone (TSH) was 74.5 IU, free T3 1.22 ng/dL, and free T4 0.43 ng/dL. Thyroxine was started along with change in anti-epileptic and recovery was observed within five days. This case report highlights the inconsistent finding from previously reported cases of KDSS. The female gender, non-consanguineous marriage, slightly delayed onset with primarily neuromuscular symptoms, and raised CPK is not the frequent demonstration in KDSS. On parallel, thyroid work-up is not routinely done, which can lead to misdiagnosis and mismanagement.References not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Doing More Than Act: The Dutch Fact Model, Flexible Assertive Community Treatment
Authors: Keet R. 
Published: May 2016

Background/objectivesAssertive community treatment (ACT) has become the standard for integrated care for people with severe mental illnesses. Limitations of ACT are the lack of flexibility, the limited feasibility in rural areas, the limited population and the time-unlimited nature. These limitations can be overcome by flexible assertive community treatment (Flexible ACT), developed in the Netherlands and introduced in several European countries.MethodsThree studies were done between 2006 and 2015 on the results of the introduction of Flexible ACT, two in The Netherlands and one in the UK.ResultsThe outcomes in the Netherlands data show the effectiveness of Flexible ACT. Remission of schizophrenia increased form 19% to 31%. Bed use was reduced and quality of life increased. Effectiveness of FACT was also shown in the UK, where total patient time in hospital declined by half, even though the average time service providers spent with patients also declined. Collected data of the digitalized boards show that the board is used in accordance with the FACT model. Transition rate to primary care is 5–10% per year.Discussion/conclusionThe introduction of Flexible ACT has been shown to benefit patients with severe mental illness and indicate the ability of to allocate human resources in mental health care more efficiently. Introduction to other countries will be accompanied by research on the effectiveness and feasibility within other cultures.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Non-Attendance at Initial Appointments in an Outpatient Mental Health Centre
Authors: Perdigues S. Ramos , Llopis S. Gasque , Magaña S. Castillo , Abad Y. Suesta , Martínez M. Forner , Vera M. Gárriz 
Published: May 2016

IntroductionNon-attendance at initial appointments is an important problem in outpatient settings and has consequences, such as decreased efficient use of resources and delayed attention to patients who attend their visits, and that compromises quality of care.ObjectivesTo identify and describe the characteristics of patients who do not attend the first appointment in an adult outpatient mental health center, located in Barcelona.MethodRetrospective study. The sample was made up from all patients who had a first appointment during 2014 in our outpatient mental health centre. Socio-demographic and clinical data (type of first appointment, reason for consultation, origin of derivation, priority, history of mental health problems) were described. The results were analyzed using the SPSS statistical package.ResultsA total of 272 patients were included. Twenty-six per cent did not attend their first appointment; with mean age 39.75 years and 51.4% were male. Most frequent problems were anxiety (41.7%), depression (26.4%) and psycosis and behavioural problems (11.2%). The origin was primary care (83.3%), social services (4.2%) and emergencies (2.8%). Most of them were not preferent or urgent (86.1%). The 51.4% of non-attendees had history or psychiatric problems and 13.9% nowadays are patients of our mental health centre.ConclusionsIt is important to develop mechanisms that can reduce the incidence of first non-attended appointments. In our case, most of them are attended by primary care so we can establish better communication with our colleagues and try to contact to the patients prior to the date of the appointment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Onset of Psychotic Disorders and the Immigration Status – A Look Into A Growing Reality
Authors: Maia L. , Carvalho I. , Silva D. , Carneiro L. 
Published: May 2016

IntroductionRecent studies point for an increased incidence of psychotic disorders among immigrants when compared to nom-immigrant population, with a substantial risk variation being observed among different ethnic minority groups and diverse host countries/societies.ObjectiveThis communication explores the relation between immigration and the onset of psychosis disease, namely the individual and socio-environmental factors implicated in this association.AimsAccessing the implications of immigration in the establishment of psychotic disorders.MethodsThe authors conducted a literary search on Medline and PsychInfo databases regarding the subject immigration and psychotic disorders, elaborating a bibliographic review of the topic.ResultsA greater incidence of psychotic disorders in immigrants (in comparison to nom-immigrant population) has been established. In actuality a range of studies carried out in different socio demographic contexts and with different ethnic groups (of immigrants) identify ethnicity, neighbourhood characteristics (namely level ethnic density), discrimination and refugee status, as some of the probable factors that modulate the rate of psychotic disorder and influence its incidence in immigrants.ConclusionsWith regard to the relationship between immigration and the development of psychosis, much is still to be understood. Future studies with focuses on different individual, social, cultural and demographic aspects need to be developed in order to better understand and addressed this phenomenon.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Keypy – An Open Source Library For EEG Microstate Analysis
Authors: Milz P. 
Published: May 2016

The brain's electric field configuration reflects its momentary, global functional state. The fluctuations of these states can be analyzed at millisecond resolution by the EEG microstate analysis. This analysis reportedly allowed the detection of brain state duration, occurrence, and sequence aberrations in psychiatric disorders such as schizophrenia, dementia, and depression. Several existing software solutions implement the microstate analysis, but they all require extensive user-interaction. This represents a major obstacle to time-efficient automated analyses and parameter exploration of large EEG datasets. Scriptable programming languages such as Python provide a means to efficiently automate such analysis workflows.For this reason, I developed the KEY EEG Python Library keypy. This library implements all steps necessary to compute the microstate analysis based on artefact free segments of EEG. It includes functions to carry out the necessary preprocessing (data loading, filtering, average referencing), modified k-means clustering based microstate identification, principal component based mean computation (across recording runs, conditions, participants, and or participant groups), and to retrieve the microstate class based statistics necessary to compare microstate parameters between groups and/or conditions. Keypy is an open source library and freely available from https://www.github.com/keyinst/keypy.Keypy provides a platform for automated microstate analysis of large-scale EEG datasets from psychiatric patient populations and their comparison to healthy controls. It is easily applicable and allows efficient identification of deviant brain states in clinical conditions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Agenesis of the Corpus Callosum in A Patient With Bipolar Disorder
Authors: Nogueira J. , Ribeiro R. , Vieira J. , Sousa R. , Mendes S. , Ribeiro B. , Salta M. , Barata B. , Gamito A. , Mendes R. 
Published: May 2016

BackgroundThe corpus callosum (CC) is the largest white matter structure in the brain, which plays a crucial role in interhemispheric communication. Agenesis of the CC is a rare development anomaly, with unknown cause. It could be asymptomatic or associated with mental retardation and neurologic symptoms. Some case reports, post-mortem studies and image studies have linked thickness reduction and agenesis of CC with psychotic symptoms, mainly in schizophrenia patients. Lately, anatomical abnormalities in the CC have been reported in patients with Bipolar Disorder (BD).Case reportA 52-year-old woman was brought to the emergency room by the authorities after being physically aggressive to her 13-year-old daughter and inappropriate behavior in public. At the emergency department her mood was elevated with emotional lability, dispersible attention, slight increase of motor activity, pressured and difficult to interrupt speech, grandious and self-referent delusional ideas.Her past history revealed hippomaniac episodes characterized by periods of excessive shopping and hyperphagia. In 2008, she had a major depressive episode.Head CT-SCAN revealed agenesia of CC. She received the diagnosis of Manic Episode with mixed features and was treated with valproic acid, flurazepam and olanzapine.ConclusionThis case reinforces the fact that changes in CC, probably due to deficiency in myelination, could have a crucial importance in the pathophysiology of Bipolar Disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Dual Target Repetitive Transcranial Magnetic Stimulation In The Treatment Of Comorbid Obsessive-Compulsive Disorder In Patients With Anorexia Nervosa: Preliminary Results Of Two Case Reports
Authors: De Schryver N. , Lemmens G.M.D. , Baeken C. , Van den Abbeele D. 
Published: May 2016

IntroductionObsessive-compulsive disorder (OCD) is a frequently reported comorbid disorder (20–30%) in patients with anorexia nervosa (AN). Increasing evidence suggests that repetitive transcranial magnetic stimulation (r-TMS) may be effective in the treatment of refractory OCD and to a lesser extent in AN. Hereby, different target areas: supplemental motor area (SMA) and orbitofrontal cortex (OFC) and dorsolateral prefrontal cortex in AN. We report two patients with enduring AN and comorbid treatment resistant OCD treated with r-TMS.MethodsBoth female patients (34 and 26 years respectively) were hospitalized at the Eating Disorder Unit at the Ghent University Hospital. Treatment responses were evaluated with Yale Brown Obsessive Compulsive Scale (Y-BOCS) and weight gain. Inhibitory continuous thetaburst stimulation (cTBS) of the SMA followed by cTBS of the OFC was conducted during 20 sessions, 5 sessions a week, during 4 weeks. Stimulation intensity was respectively 100% and 80% of the motor treshold.ResultsAfter cTBS treatment Y-BOCS score of both patients decreased (31 to 24 and 31 to 23 respectively). Only one patient showed a 10% increase of weight. The treatment was well tolerated. No significant side effects were reported.ConclusionTreatment resistant comorbid OCD in patients with AN may be succesfully treated with cTBS.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Exploring the Role of Dissociation Dimensions in Obsessive Compulsive Disorder
Authors: Pozza A. , Giaquinta N. , Dèttore D. 
Published: May 2016

IntroductionIn the last decade, accumulating evidence has been produced on the role of dissociation in Obsessive Compulsive Disorder (OCD). Understanding which dissociation dimensions are specific to OCD could suggest the integration of therapeutic strategies for dissociation in the treatment of patients with OCD.ObjectivesThe current study explored the role of dissociation in a sample of patients with OCD, patients with anxiety disorders and healthy controls with the aim to understand which dissociation dimensions could be specific to OCD.MethodOne hundred seventy-one participants were included in the study (56% females, mean age = 35.96, SD = 12.61), of which 52 were patients with primary OCD, 59 were patients with Anxiety Disorders (AD), and 60 were healthy controls. The Dissociative Experiences Scale (DES), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Yale-Brown Obsessive Compulsive Scale (Y-BOCS) were administered.ResultsPatients with OCD had significantly higher dissociative amnesia symptoms than patients with AD and health controls (F = 6.08, P < 0.01) and higher depersonalization/derealization symptoms than healthy controls but not than patients with AD. Patients with OCD did not report significantly higher dissociative absorption than healthy controls and patients with AD.ConclusionsStrategies targeting dissociative amnesia and depersonalization/derealization symptoms in OCD are discussed. Future studies should examine which OCD subtypes are more strongly associated to dissociation dimensions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Pain Management in Context of Emotionally Unstable Personality Disorder
Authors: Dobrzynska E. , Clementi N. 
Published: May 2016

IntroductionEmotionally unstable personality disorder (EUPD) is characterised by Pain Paradox. The response for acute, self-induced pain seems to be attenuated while chronic, endogenous pain is usually intolerable. Pain management of this group of patients poses many difficulties, including discrepancies between subjective and objective pain assessment, patients’ demands for strong analgesics and impact on relationship with other professionals.Objectives and aimsThe purpose of the study was to review pain management options for persons diagnosed with EUPD and complaining of chronic pain.MethodsMEDLINE and PsycINFO databases were searched for all English-language articles containing the keywords “chronic pain”, “pain management”, “borderline personality disorder”, and “emotionally unstable personality disorder”.ResultsSeventeen relevant papers were identified. Suggested first step in pain management was ongoing clarification with EUPD patients that analgesics are unlikely to fully treat their pain and support of non-pharmacological approaches to pain, including cognitive-behavioural strategies. Regarding pharmacology, liberal use of non-addicting analgesics was recommended with highly conservative use of opioid analgesics. Importance of evaluation and treatment of any underlying mood and/or anxiety syndromes was stressed as well as liaison with other professionals (e.g. psychologists, neurologists, orthopaedics, and physiotherapists).ConclusionsPatients with EUPD often report chronic pain, which can only be managed by close collaboration of professionals from different disciplines.Disclosure of interestThe authors have not supplied their declaration of competing interest.