bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypical Antipsychotics Use In Eating Disorders. Review
Authors: Hernández Sánchez J.M. , Molina López M.F. , Cancino Botello M.C. , Canseco Navarro M.Á. , Peña Serrano D. 
Published: May 2016

IntroductionEating disorders often have serious medical complications, including the highest mortality rates of any psychiatric disorder. The search for an optimal therapeutic strategy during the last decades has been difficult and it has included antidepressants, antipsychotics, anticonvulsants, benzodiazepines and mood stabilisers.ObjectivesTo review the medical literature related to the treatment of eating disorders with atypical antipsychotics.MethodsMedline search and ulterior review of the related literature. Keywords: “eating disorders”; “anorexia nervosa”; “bulimia nervosa”; “binge eating disorder”; “antypsychotic agents”.ResultsTo the date, most of the studies have been with olanzapine. Olanzapine has shown effects, not only on weight gain, but also on management of other psychological features such as obsessive-compulsive symptoms, depression, aggression, persistence and interpersonal distrust. However, most of these studies have been compared to placebo, and binge-eating behaviour has also been described when using olanzapine (not with aripiprazole or ziprasidone). Recently, Marzola et al, when comparing olanzapine + SSRIs versus aripiprazol + SSRIs, described that aripiprazole (compared to olanzapine) is significantly more effective in reducing purging episodes, eating preoccupations and rituals.ConclusionsSo far, aripiprazol and olanzapine have been proved to be the most effective atypical antypsichotics in eating disorders, especially in anorexia nervosa. However, most of studies were placebo-controlled and in quite small samples. Further investigation is needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Anorexia Nervosa And Dissociative Disorders In Males: a Case Report
Authors: Lázaro Redondo M.D.M. , De la Torre Brasas F. , Duque Domínguez A. , Echeverría Hernández N. , Martín Díaz L. , García Montero C. , Otálora Navarro M. , Mas Villaseñor A. , Bango Suárez J.I. 
Published: May 2016

IntroductionThere is a low prevalence of eating disorders among men. In many cases, the disorder arises as a means of avoiding psychosocial maturation. Various psychiatric comorbidities such as depression or obsessive-compulsive disorder are frequently found in these patients.ObjectivesTo analyze psychiatric symptoms in relation to a case of anorexia nervosa.MethodsPubmed revision on clinical presentation of anorexia nervosa in male. Review of patient medical records.ResultsA 23-years-old male with diagnosis of restricting anorexia nervosa was treated and followed since 2012. In July 2015, the patient, who was clinically stabilized for a year, had decreased gradually intake. Suddenly he showed a decreased consciousness, followed by an absence of response and mutism that motivated hospital admission. The diagnosis was dissociative stupor. A research in women with eating disorders shows a prevalence of pathological dissociation between 4.8 and 48.6%. After recovering a normal consciousness, he presented clinical features of anorexia nervosa according DSM 5 criteria. The patient remained two months until he reached his previous BMI (17) to continue an outcome treatment. Despite of several years of specific treatment for anorexia nervosa, both parents and patient still did not accept the diagnosis. Cultural constructions of eating disorders as a “women's illness” mean that men may fail to recognise their disorder.ConclusionsThere is a delay of diagnosis of anorexia nervosa in men. The lack of research on men's experiences and the cultural construction of anorexia nervosa as a female problem may contribute to underdiagnose eating disorders in men.Disclosure of interestThe authors have not supplied their declaration of competing interest.
“Reflective Learning” In Psychiatric Education: Does It Have Any Merit?
Authors: Adamis D. , McCarthy G. 
Published: May 2016

IntroductionNowadays “reflection” and “reflective practice” is nearly in every curriculum for psychiatric training. Trainees are asked to keep reflection diaries, journals, and participate in “reflection workshops”.AimsTo prove that reflection on or in action does not lead to learning.MethodsUsing epistemological notation.Results/proofsBecause sciences including psychiatry are approximate, evolving and inexact, the classical definition of propositional knowledge becomes: A knows that p if:– (a’) A believes that p is an approximate true;– (b’) p is approximate truth;– (c’) A has reason to claim that p is a better approximation than its rivals on available evidence.Condition (c’) implies that A is not possible at the same time to have two mutually contradictive approximate truths.In reflective learning we need to add two more conditions:– (d’) A knows the outcome of p;– (e’) A is satisfied in believing that p.In cases of reflection in-action, the (e’) remains even the outcome is not favourable. Similarly, in reflection on-action the condition (e’) remains unchanged since this happened in the past. This leads to controversy. Is p better or worse approximation of truth than its’ rival p’? However, p has passed rigorous and different scientific tests and has proved scientifically superior to its rival p’. Therefore subject A cannot change his knowledge despite the unfavourable outcome, but A can tests further the p. Within the former reflecting learning does not occur, within the latter “critical thinking” occurred.ConclusionsReflection does not lead to learning but critical thinking does.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Before And After: Effect Of 4-week Psychiatry Attachment On Medical Students’ Attitude To Psychiatry As a Career Choice
Authors: Adekunte O. , Owen B. , Oliver C. 
Published: May 2016

BackgroundPsychiatry is historically unpopular amongst medical students. The perception that psychiatry is remote from the rest of medicine and not evidence-based has been identified. However, there is evidence that psychiatry placement has positive effects on students. There are reports that medical students experience a positive change of attitude towards psychiatry following their undergraduate psychiatric attachment. There is evidence that medical students experience a positive change of attitude towards psychiatry following their undergraduate psychiatric attachment.AimTo determine the effect of a four-week psychiatry placement on 3rd year medical students’ attitudes towards psychiatry.MethodsPre-and post-attachment questionnaires were administered to four cohorts of 3rd year students. Responses were anonymised and based on Yes/No, free-text, order of preference and Likert scale. Analysis was by basic statistical methods.ResultsA total of 98 pre- and 81 post-placement students responded. Mean positive attitude increased by 6% and the percentage of students choosing psychiatry in their top three career choices increased from 7 to 20%. Ninety percent of students post-attachment thought that psychiatry is relevant to their future jobs, compared to 86% pre-attachment. The percentage of students who think that psychiatry makes little use of medical training decreased from 20% to 16%.ConclusionsThe survey showed a period of 4 weeks psychiatry placement has a positive effect on the attitudes of medical students towards psychiatry. It also increases the number of students wanting to pursue a career in psychiatry.Disclosure of interestThe authors have not supplied their declaration of competing interest.
What Young Adults Know About The Factors That Affect Fertility?
Authors: Carolino N. , Galhardo A. , Moura-Ramos M. , Cunha M. 
Published: May 2016

IntroductionThe literature has shown that young adults reveal lack of knowledge about factors that influence fertility. Given this gap of knowledge regarding fertility, several authors indicate the need for awareness-raising and promotion of attitudes and behaviors that preserve fertility.ObjectiveThis study aimed to assess the knowledge about factors that affect fertility as well as the impact of information transmission on this topic.Materials and methodsFive hundred and fifty-one subjects aged between 18 and 40 years old without children completed an online questionnaire specifically developed for this study. Two assessment moments were considered and participants were randomly assigned to three groups:– video group;– website group;– control group.The video and website groups accessed information on fertility-related factos such as age, weight, exercise, substance abuse, irregular menstrual cycles, pollution, etc. The control group had no access to this information.ResultsMale participants revealed more knowledge about the factors that affect fertility in both moments. Participants in the groups that had access to fertility information (video group and website group) improved their level of expertise. No significant differences were found in the control group.Discussion/conclusionGroups that watched the video or visited the website where information on fertility-related lifestyle and other factors was available increased their level of knowledge, suggesting that education on this subject should be provided to general population. The means used for the information dissemination had no impact on the improvement of knowledge.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Embedded Mixed Methods Evaluation of the Psycho-educational Intervention Impact on People Diagnosed with Schizophrenia and Their Primary Caregivers: Findings From a Randomized Controlled Trial
Authors: Hasan A.A. 
Published: May 2016

BackgroundPsycho-educational interventions for people diagnosed with schizophrenia (PDwS) and their primary caregivers (PC) can improve knowledge about schizophrenia, reduce PCs’ burden of care, PDwSs’ symptoms, and enhance PCs’ quality of life. However, the majority of existing studies have significant methodological weaknesses. Also, little is known about the impact of psycho-educational interventions delivered by booklets and in developing countries like Jordan.ObjectiveThe aim of this study was to examine the effectiveness of psycho-education delivered via a printed booklet for PDwS and their PCs’ in Jordan.MethodsA single blind parallel randomized controlled trial was conducted between September 2012 and September 2013 at four mental outpatient clinics in Amman, Jordan. One hundred and twenty-one PDwS with their PCs were allocated randomly to an experimental (psycho-educational intervention plus treatment as usual in outpatient clinic) group (n = 58) or control (treatment as usual alone) group (n = 63). Outcomes, measured prior randomization (pretest), immediately post-intervention (posttest 1) and at three months after intervention (posttest 2).ResultsParticipants receiving psycho-education and treatment as usual had better knowledge of schizophrenia, reduced positive and negative symptoms and hospitalisation at both follow-up points. PCs had reduced burden of care and experienced a better quality of life.ConclusionPsycho-education delivered via printed booklets improves outcomes for PDwS and their PCs in Jordan better than treatment as usual. Our hypothesis is supported.Disclosure of interestThe author has not supplied his declaration of competing interest.
Use of antidepressants in maintenance phase of patients with bipolar disorder in an outpatient setting
Authors: Peh A. , Tay W.K. 
Published: May 2016

IntroductionGuidelines for the maintenance treatment of bipolar disorder discourage the use of antidepressants chiefly on grounds of unproven efficacy and risk if mania for bipolar I. However, for patients stabilised on an antidepressant, naturalistic data support its continued use.AimThe aim is to describe use of antidepressants in patients with bipolar disorder in remission seen at an outpatient clinic in Singapore.MethodsThe case notes of patients with bipolar disorder in remission, seen by psychiatrist in an outpatient psychiatric clinic in a general hospital unit from December 2014 to March 2015 were studied. Data describing the age, sex, type of bipolar disorder and psychotropic medications prescribed, was obtained.ResultsForty-two patients were included, of which 13 (31%) were male and 29 (69%) were female. The age ranged from 23 to 82, with mean age of 47 years. Of these 17 (40%) had bipolar I and 25 (60%) had bipolar II. Antidepressant use for maintenance treatment was present in 19 out of 42 (45%) of these patients; of these 7 out of 17 (41%) were bipolar 1 and 12 out of 25 (48%) were bipolar II. Eighteen out of the 19 (95%) patients who were prescribed antidepressants were on combination treatment with mood stabilizers. Antidepressant type included SSRI (37%), NDRI (37%), SNRI (10.5%), TCA (10.5%), NASSA (5%).ConclusionAlmost half of patients with bipolar disorder managed in an individual practice were on antidepressants together with mood stabilisers. They remained in remission with combination treatment, which did not seem to jeopardise their condition.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Insight and aggressive Behavior in acute Schizophrenic Patients
Authors: Campi S. , Esposito C. , andreassi P. , Bandinelli P. , Girardi P. , Ducci G. , Cannizzaro C. , Cacciari C. , Spalletta G. 
Published: May 2016

Introductionaggressive behavior in wards is associated to poor treatment compliance and low clinical insight. Most studies focused on the clinical and cognitive dimensions of insight, while the relationship between metacognitive dimension and aggressive behaviors was not investigated. Our aim was to understand what relationship occurs between dimensions of insight (metacognitive, cognitive, clinical), and specific aggressive behaviors in acute patients.Methodswe recruited 75 acute schizophrenic patients using: aQ; MO aS; IS; P aNSS; BCIS.Resultsa positive correlation between the IS score and the hostility, angry and physical aggression sub-scores of the aQ was highlighted, while no correlation between the score of IS and MO aS total score was found. No correlation between the score of the P aNSS G12 item and the aQ scores and MO aS was found, and no correlation between BCIS scores, MO aS and aQ scores was found.Conclusionsin our patients, a higher level of metacognitive insight, but not clinical nor cognitive insight, was associated to higher levels of hostility. we suggest that a higher ability to monitor and appraise one's own altered processes of thought and related discomfort, feeling of destabilization and loss of control, could contribute to enhance resentment and suspiciousness. Findings help develop specific therapeutic strategies to enhance metacognitive and self-monitoring abilities, helping patient's understanding of the illness, improving compliance with treatment, and patient's quality of life. Our results support the multidimensional nature of insight in schizophrenia, confirming that clinical, cognitive and metacognitive dimensions are independent though related facets of the phenomenon of insight in schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Change of Mood in Relation with The Seasons
Authors: de la Mata Hidalgo R. , de la Mata Hidalgo M. , Valriberas Herrera I. , Ana O.E. , Al Chaal Marcos L. , González Soria C. , Sánchez Pernas L. , Exposito Montes C. 
Published: May 2016

IntroductionEmergency situations related to mental disorders represent a significant proportion of all medical emergencies. Over the last years we have been witness to an upturn in the incidence of psychiatry emergency service because to change of mood.ObjectiveTo determine the profile of the patient who requires psychiatric attention with changing of mood in our area in different seasons.MethodologyThis is a prevalence and prospective study in which the dependent variable is taken as change of mood and we also use three more independent variables that are age sex and seasonality. The seasonality (spring period and summer period) will be at the same time the form of divided the population in two groups to compare.ResultsOut of all the consultations for changing of mood in the emergency service during the first period (113 patients), 34% were men and 66% were women. The age range of 36–50 years was more frequent for women and the age range of 51–65 years was more frequent for men. in the second period (with 162 patients), 137 women (86%) and 25 men (14%). in this case, the most common age range was 36–50 years, both for women and for men.ConclusionsThe epidemiological and clinical characteristics of patients with changing of mood assessed by the emergency service are described from a naturalistic approach.Which Chi2 we will discover if the population who has been taken between woman and man is significant and with the median, we will also determine if the age ranges are enough significant to confirm our hypothesis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Physicians’ Burnout: Can We Make a Difference?
Authors: Moreira C.A. , Sobreira G. , Oliveira J.M. , Aleixo M.A. 
Published: May 2016

IntroductionBurnout is a commonly observed syndrome in healthcare workers and it has been defined as a psychological condition involving a continuous exposure to stressful work events leading to adverse consequences both in physical and mental health. Persistent pressure can lead to exhaustion, psychological and/or physical distress and may increase the risk of medical errors and decrease job satisfaction, which incites early retirement.ObjectiveThe authors pretend to make a brief review regarding Physicians’ burnout, its prevention and management.AimsTo understand and to be capable of dealing with physicians’ burnout.MethodsThe review was based in papers published on PubMed using the following terms: “burnout”, “risk factors”, “healthcare professionals” and “physicians coaching”.ResultsTwenty-five to 60% of physicians report burnout across all specialties. Changes in the healthcare environment have created marked and growing external pressures. Numerous studies suggest that the difficulty that physicians face with balancing their personal and professional lives is a major contributor to distress. To reduce stress at work, one should consider two levels of intervention: the individual and the environmental. Multidisciplinary actions that include changes in the work environmental factors along with stress management programs that teach people how to cope better with stressful events showed promising solutions to manage burnout.Discussions/conclusionsBurnout among physicians is a common and serious issue with potentially devastating personal and professional consequences. More interventional research is needed in order to improve psychological well-being, professional career enjoyment as well as the quality of care provided to patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Loneliness And Mortality: a Community-based Prospective Study
Authors: Henriksen J. , Kyle P.R. , Bech P. , Mattisson C. , Andersson N. 
Published: May 2016

IntroductionLoneliness affects up to one in every third individual in the western population, and the prevalence is increasing. The literature suggests an increased mortality risk of about 26% when feeling lonely, and an association to some disorders of physical health.ObjectivesTo assess if loneliness increases the risk of mortality, and if so, if health indicators (hypertension, heart disease, tobacco use, alcoholism, diabetes, obesity, and depression) mediate the association.MethodsThe design is a community-based prospective cohort study using data from the Swedish Lundby Study. Loneliness is measured in 1997 with a singleton question during interview of a psychiatrist. The outcome is death between 1997 and 2011. Survival analysis is used to estimate the relative risk of mortality. Stratification of potential explanatory covariates examines if any of the health indicators mediate the relationship.ResultsSignificant more females, unmarried, unemployed, and childless people feel lonely. Moreover, feeling lonely correlates to being smoker or alcoholic when adjusting for age and gender. The statistical work on the survival analysis is still in progress. However, we expect to find a positive correlation between loneliness and mortality corresponding to previous studies, and perhaps to reveal some of the health indicators to cause the association.ConclusionsWith increasing prevalence, potential health consequences, and a neglected role in the society, loneliness is an important research area.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Analysis of Demand in The First Visit To The Mental Health Unit
Authors: Mata Saenz B. , Lopez Lavela E. , Rodríguez Cano T. , Beato Fernández L. 
Published: May 2016

IntroductionThe first visit is crucial, since it is where a treatment plan is selected and the decision to refer or not the patient to a specialized unit is made. Mental care could be improved through the centralization of demand and the identification of patients’ and psychiatrists’ expectations.ObjectivesAnalyzing patients’ and psychiatrists’ demands and expectations in the first visit to use them as a starting point for the planning and coordination of treatment actions.AimsTo design a record system of the Minimum Basic Data Set of the Centralized Department of our Unit.MethodsThis is an epidemiological, observational, prospective study of patients referred to our department. Following variables were collected:– referral origin;– reason;– demographic data;– diagnosis impression;– destination of referral.The Statistical Package for Social Science version 19.0 was used to analyze the data.ResultsTable 1.ConclusionsThe data obtained are consistent with those reported in the literature for this population. The high rate of wrong referrals reveals the necessity of improving coordination and establishing specific referral criteria. Some initiatives have been designed and will be prospectively evaluated in the future.Table 1Disclosure of interestThe authors have not supplied their declaration of competing interest.
Community Mental Health: Description of the Patients Concerning the Uls Guarda Department of Psychiatry and Mental Health Area
Authors: Nunes J. , Feliz J. , Brigadeiro D. , Ventura Gil T. , Teixeita A.F. , da Costa P. 
Published: May 2016

The World Health Organization (WHO, 2004) stresses the importance of home patient visiting as an answer to the epidemiologic, demographic, social and economic challenges that the world is facing.The severe psychiatric patients are a risk group and often need domicile consultation and visiting. The domicile consultation approach favors the clinical, social and familiar support as well as promotes the integration and the recovering of the patients with mental problems, preventing the relapses and the hospital admissions of these patients.This study, of descriptive nature, is based on the observation and consultation of 287 clinical processes of patients inserted in the domicile consultation program designed by the Department of Psychiatry and Mental Health of Sousa Martins Hospital, ULS Guarda, which covers the 7th biggest district in Portugal (in a universe of 18), between July and September 2015.The main goal of this study is to characterize and analyze the profile of the population, which is followed by the community mental health team of our Department, namely, the socio-demographic and clinic features, in order to improve the assistance practice in the future.Disclosure of interestThe authors have not supplied their declaration of competing interest.