bluuebunny/crossref_metadata_2025_split huggingface dataset:
About a case suicide attempt as a trigger of remission in obsessive and compulsive disorder
Authors: Garcés J.M. Got. , Lopez R. García , Segovia A. Porras , Negro J.E. Muñoz , Jiménez J. García , Rojas L. Gutierrez 
Published: June 2017

IntroductionThis is the case of a 73 year old woman with a late onset, severe and refractory obsessive-compulsive disorder who experimented a sudden remission after a frustrated suicide attempt.ObjectiveOur target is to make a reflection about the relation between traumatic closeness to own death and neurosis spontaneous remission.MethodPatient has been interviewed and her medical record studied.ResultsPatient's psychiatric history shows major depressive disorder, recurrent (ICD 10 CM-F33). Patient is a housewife with primary education. In her psychobiography distinguish a conflictive relationship which probably acted as a trigger for obsessive-compulsive symptoms. These symptoms include obsessive thoughts of contamination, ritual hand washing and avoid contact with others people. In the course of the last 10 years, since the OCD (ICD 10 CM-F42.2) diagnose, the patient has been through a wide therapeutic arsenal, from cognitive-behavioural psychotherapeutic interventions to psychopharmacological treatment, resulting with limited effectiveness. The last treatment was fluoxetine 200 mg (0–0–1) and pregabalin 300 mg (1–0–1). Subsequently, the patient underwent a failed suicide attempt by hanging. After physical recovery, all OCD symptoms had subsided.ConclusionsTraditionally, literature and philosophy considered catharsis as a purifying experience, and Breuer and Freud introduced this concept in modern psychology as a therapeutic method. More recent authors as Yalom have correlated the closeness to death as a stress factor with radical change in life's perspective and attitude. Although current research presents contradicting data about healing effectiveness through a catharsis processes, this case exposes a clear example of positive outcomes in this assumption.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neuroleptic-induced Parkinsonism in Patient with Obsessive Compulsive Disorder: A Case Report
Authors: Nunes J. , Brigadeiro D. , Andrade J. , Costa A. Pissarra da 
Published: June 2017

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder characterized by either obsessions (recurrent unwanted thoughts, images or impulses) or compulsions (repetitive behaviors often performed to relieve anxiety or distress). In some cases, it is considered antipsychotic enhancement. However, in high doses, it can exacerbate OCD symptoms and cause extrapyramidal effects such as neuroleptic-induced Parkinsonism.Here, the authors present a clinic case of a single male patient with 50 years old, in which with the age of 42, started with a obsessive-compulsive framework about the developed task at the work place (production of fabric) followed by several verifications of the assembled pieces, which interfered with his work performance. This patient was admitted to the psychiatric hospital due to the deterioration of the symptoms with obsessive ideas of HIV contamination resulting in rigid cleaning rituals. He was medicated with several OCD medications including Clozapine 50 mg.In the following years and complaining of insomnia, the clozapine dose was increased by the patient reaching the dose of 200 mg. In 2016 he started secondary Parkinsonism framework to antipsychotics, characterized by akinesia, facial hypomimia, stiff, coarse tremor and stooped posture. Therapeutic setting was made with a reduction of clozapine at doses of 50 mg occurring fading of extrapyramidal symptoms and decrease the symptoms of OCD.The authors intend with this presented case to highlight the importance of surveillance of patients receiving antipsychotics for OCD to avoid worsening of symptoms and the development of extrapyramidal effects, which deeply contribute to the decrease of quality life of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Visual Hallucinations in Elderly People: Early Dementia, Psychosis or Charles Bonnet Syndrome? Review and Case Report
Authors: García Moreno M. , De Cos Milas A. , Poza Cano B. , Beatobe Carreño L. 
Published: June 2017

IntroductionCharles Bonnet Syndrome (CBS) is an uncommon disease that involves visual hallucinations in visually impaired individuals, in absence of cognitive impairment or psychiatric illness, although some authors propose CBS as an early maker of dementia.ObjectivesShow the importance of differential diagnosis in individuals with presence of visual hallucinations, with distinction of CBS from others psychiatric or organic disorders such as hypnogogic and hypnopompic hallucinations, epileptic phenomenon, Parkinson disease, dementia, delirum tremens or late-onset psychosis.MethodsLiterature review about visual hallucinations in people with psychiatric illness, dementia or in absence of these status, followed by a case report of a patient who met criteria for CBS.ResultsEighty one-years-old female with no previous psychiatric illness, experience suddenly visual hallucinations (animals, insects) with secondary anxiety, fear and insomnia as well as disruptive behaviour (throw lye to kill the animals) and delusional interpretations of the hallucinations considering them as a divine proof. Clinical exam, neuroimaging tests and SPECT confirmed just a minimal cognitive impairment nor suggestive of dementia. She had personal history of cataracts and macular degeneration, with no other medical condition. Olanzapine was prescribed but it was withdrew because of adverse effects. Later, haloperidol was introduced with well tolerance and symptom's recovery ad integrum.ConclusionsCharles Bonnet syndrome is a rare condition that may sometimes be the beginning of a dementia. Medical evaluation and complementary tests help differential diagnosis in order to reject others psychiatric/somatic disorders. Neuroleptic and anti-epileptic treatment should be useful to control symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Mistreatment of Alzheimer's Patients: Predictive Factors
Authors: Ghal F. , El Karoui M. , Robbana L. , Beji R. , Jmii G. , Zghal M. , Ben Ghzaeil I. , Jouini L. , Rafrafi R. 
Published: June 2017

IntroductionViolence against elderly persons is an intricate social, legal and ethic issue. Alzheimer's patients are the most vulnerable individuals to mistreatment and neglect. The aggressor can be even the main helper of the patient. We noticed a wide underestimation of this phenomenon, which remains taboo subject in our society.Objectives and methods– The aim of our study is to identify predictive factors of mistreatment of Alzheimer's patients through a prospective and descriptive study, within patients following in the department of neurology in Razi's hospital.– we evaluate cognitive function (MMSE) and the importance of behavioural disorders.– we explored helper's socio-demographic characteristics and the quality of aid relationship.– anger and hostility within relationship were estimated through family attitude scale.ResultsOur sample accounts 60 informal caregivers predominately female (91.7%) with an average age of 49.67 years, mostly are married (71.66%) and jobless (38.88%):– in 78.3% of cases, caregivers spent about 12 to 24 hours per day with Alzheimer's patient.– the average score of FAS was about 52.4% with an important emotional charge (score >60).– twenty-five caregivers wished the death of the patient and 42 others admitted being sarcastic with him.– We noticed a correlation between mistreatment and both cognitive function and behavioural disorders.ConclusionOur results support the fact that mistreatment of people with dementia is closely related with the exhausting situation of the main caregiver.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Depression in Elderly Patients with Schizophrenia
Authors: Feki I. , Mdhaffar K. , Hentati S. , Sallemi R. , Masmoudi J. 
Published: June 2017

BackgroundThe presence of depressive symptoms impacts negatively the lives of patients suffering from schizophrenia-spectrum disorders. Likewise, the treatment poses many challenges for clinicians.ObjectivesTo specify the profile of elderly with schizophrenia and to evaluate the prevalence of depression and its related factors.MethodsA descriptive and analytic study involved 40 elderly patients aged 65 and over with DSM-5 diagnoses of schizophrenia or schizoaffective disorder, followed to the outpatient psychiatry department of Hedi Chaker University Hospital, in Sfax, Tunisia, during the two months of September and October 2015. Positive and negative syndrome scale (PANSS) and Calgary depression scales were used to assess respectively the symptoms of schizophrenia dimensionally and depression.ResultsThe majority of our patients was male (62.5%), single (55%), with low school and socioeconomic level. The mean duration of disease was 45 ± 6.02 years and patients were mostly (90%) in classical neuroleptics. The scale of PANSS showed the predominance of negative symptoms (67.5% of cases). In addition, according to Calgary scale, depression was found in 25% of patients. Factors positively correlated to depression were: the female sex among single (P = 0.043), absence of family support (P = 0.001), treatment with conventional neuroleptics (P = 0.039) and negative symptoms (P = 0.001).ConclusionDepression in patients with schizophrenia is far from exceptional. It is often difficult to diagnose due to the recovery of other symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Antipsychotic Prescribing Practices Amongst the Elderly of St. James's Hospital (SJH), Dublin
Authors: Power C. , McCarthy B. , Lawlor B.A. , Greene E. 
Published: June 2017

IntroductionPsychotic symptoms arise commonly in the context of behavioural and psychological symptoms of dementia (BPSD) in the elderly. While non-pharmacological interventions are preferable to manage such symptoms, antipsychotic medications are frequently used. This is largely unlicensed and associated with significant risks, particularly in dementia (1).ObjectivesTo examine antipsychotic prescribing practices in SJH.MethodsOn 23rd February 2016 all inpatients aged over 65 who were prescribed antipsychotic medications were identified. Demographic and medical data were collected from medical and electronic notes and medication kardexes.ResultsComplete data were available for 53 of 59 identified cases. The cohort had a mean age of 80 (range 65–99) and 62% were male. Seventy-four percent (n = 39) had documented cognitive impairment or dementia. Fifty-eight percent (n = 31) were newly prescribed an antipsychotic following admission. The commonest indications for antipsychotics were: delirium (53%) and BPSD (25%). Haloperidol (56%), quetiapine (19%) and risperidone (8%) were prescribed most frequently. Non-pharmacological interventions were documented in 50% however in many cases it is not clear what these interventions were. Antipsychotic use was discussed with patients and/or next of kin in less than 25% of cases. Adverse effects were noted in 6/36 (17%) with equal incidence of falls, EPSEs and ECG changes.ConclusionPositive and negative aspects of current antipsychotic prescribing practices are highlighted. Antipsychotics were prescribed for a small number of patients for appropriate indications. However, there was poor consideration of non-pharmacological interventions and a lack of consultation with the patient/NOK. This may reflect, in part, inadequate medical documentation. A guideline needs to specifically address these areas of concern to improve safety and promote best practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Mild Cognitive Impairments and Whole-body Cryotherapy – Placebo Control Study
Authors: Urbańska K. , Stańczykiewicz B. , Szcześniak D. , Trypka E. , Zabłocka A. , Rymaszewska J. 
Published: June 2017

IntroductionCognitive impairment is considered to be a result of oxidative stress and disturbances in inflammatory status. Whole-body cryotherapy (WBC), which is a short exposure to extremely low temperatures, probably regulates the release of cytokines and nitric oxide. The hypothesis is that WBC may be useful in the therapy of mild cognitive impairments (MCI).AimsThe effect of the whole-body cryotherapy (WBC) on cognitive impairments was investigated.ObjectivesIn this study the observation of several biological factors and cognitive functions were conducted to analyse the WBC influence on cognitive deficits.MethodsPeople with MCI participated in 10 WBC sessions divided for experimental group (−110 °C till −160 °C) or control group (−10 °C till −20 °C). The MoCa test (scores 26 and lower) was used for inclusion criteria. Cognitive functions were measured with: TYM, DemTect and SLUMS at baseline and in follow-up. Biological factors (cytokines, BDNF, NO) were also assessed.ResultsIt was shown that memory domains in experimental group improved after WBC sessions. Also modulatory effect on inflammatory mediators in plasma was shown. The results of this study consist of the comparison of experimental and control groups regarding to cognitive functions as well as biological factors.ConclusionsWhole-body cryotherapy may be supposed to improve cognitive functions in MCI patients. The modulatory effect of WBC on immunological response may be considered as one of possible mechanisms of its action. However, there is no confirmation how long the effects resist so further investigations are needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Effect of a Sleep-hygiene Education and Sleeping Pill Reduction Program for Hospitalized Cancer Patients at a General Hospital
Authors: Youn S. , Park B. , Lee S. , Kim C. , Chung S. 
Published: June 2017

ObjectivesSleep disturbances are common among cancer patients. Especially during hospitalization, not only adverse medical conditions but also ward environments can affect sleep. We have developed a program of sleep-hygiene education and sleeping pill reduction for inpatients (the i-sleep program) and applied it to cancer patients. This study aimed to explore the effect of the program.MethodsIn a general hospital with 2,715 beds, we estimated the proportion of inpatients prescribed hypnotics at admission to and discharge from the department of oncology before (2014) and after (2015) the program. In addition, we estimated the proportion of inpatients prescribed hypnotics among all inpatients in the department of oncology on the first day of each month of 2014 and 2015.ResultsA total of 12,382 patients (2014, before) and 12,313 patients (2015, after) were admitted to oncology department of Asan Medical Center. The proportion of inpatients prescribed hypnotics as discharge medication among inpatients who had been prescribed them at the time of admission decreased significantly, from 76.0% (2014) to 69.8% (2015), after the program (RR = 0.92, 95% CI: 0.87–0.98). The proportion of inpatients newly prescribed sleeping pills after admission to the hospital did not significantly decrease (4.03% to 3.98%; RR = 0.99, 95% CI: 0.87–1.12). The mean prescription rate of sleeping pills per day was 10.02% in 2014 and 7.99% in 2015 (P = 0.03).ConclusionsAlthough the i-sleep program did not reduce the prescription rate of sleeping pills per day, it effectively reduced the proportion of cancer patients who continued to take sleeping pills from admission until discharge.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Screening for Cognitive Disorders in Elderly Diabetics
Authors: Baat I. , Abida I. , Omri S. , Ellouze S. , Hadj Kacem F. , Affes L. , Abid M. , Masmoudi J. 
Published: June 2017

IntroductionOld people with diabetes are more likely to develop cognitive impairment, Alzheimer's disease and vascular dementia. However, the determinants of the association between diabetes and cognitive impairments are only partially known.ObjectivesTo evaluate cognitive disorders in elderly diabetic patients and to identify risk factors of cognitive impairment in this population.MethodsIt was a cross-sectional study. It involved outpatients aged 65 and older, who were followed for diabetes in the endocrinology department at the Hedi Chaker University Hospital in Sfax (Tunisia), from October 1 to December 31, 2015. For each patient, we collected sociodemographic, clinical and therapeutic data. We used the Montreal Cognitive Assessment (MoCA) to identify mild cognitive decline (score < 26/30).ResultsWe identified 70 patients, all with type 2 diabetes. The average age was 66.8 years. The sex ratio (M: F) was 0.7. The mean duration of diabetes was 14.76 years. The average MoCA score was 20.68 ± 6. Forty patients (57%) had cognitive decline. The cognitive impairment was statistically correlated with female sex (P = 0.02), low level of education (P = 0.00), high levels of glycated hemoglobin (Hb A1c ≥ 7%) (P = 0.00), presence of hypoglycemic episodes (P = 0.05) and presence of dyslipidemia (P = 0.00).ConclusionOur study confirmed the high rate of cognitive decline in older type 2 diabetes patients. The profile of subjects at risk was consistent with the literature: poorly controlled diabetes, severe recurrent hypoglycaemia and associated dyslipidemia. Acting on these risk factors would prevent cognitive decline and therefore progression to dementia.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Neurocognitive Profile Among Omani Who have Sustained Traumatic Brain Injury with Post-concussion Syndrome
Authors: Albalushi M. 
Published: June 2017

BackgroundNeurocognitive disorders, previously not featured in the psychiatric nomenclature such as the Diagnostic and Statistical Manual of Mental Disorders (DSM), have now been included in the latest, fifth edition of the DSM. There is a dearth of studies on neurocognitive disorders among non-western population.AimsThe aim of this study is to compare neuropsychological functioning measured by tests of executive function and cognition among patients marked by apathy and impulsivity following a traumatic brain injury in a non-Western population, Oman.MethodsComparing the performance of various neurocognitive indices including negativistic features and disinhibition, which were identified using the symptom checklists Apathy Evaluation Scale and Disinhibited Evaluation Scale. Comparative neurocognitive measures included tapping verbal reasoning ability (Raven's Standard Progressive Matrices), working memory (Digit Span–Digit Forward–Digit Backward); Buschke Reminding Test, planning/goal-directed (Controlled Oral Word Association Test–verbal fluency, Tower of London(–planning time–number solved), (Wisconsin Card Sorting Test–perseverative errors, and–number of categories solved), and affective ranges (Hospital Anxiety and Depression Scale).ResultAnalysis showed that those participants who scored highly at Apathy Evaluation Scale and Disinhibited Evaluation Scale did not differ on indices measuring working memory/attention and affective ranges except for one measure: Digit span-Digit Forward. In the measures operationalized here to tap planning/goal-directed behaviour, the two cohorts differ on all indices except for Tower of London-Number Solved.ConclusionThis study lays ground for further scrutiny in delineating the different characteristics of what previously labelled as frontal dysexecutive phenotype. It indicates that apathetic and disinhibited temperaments marked with specific neuropsychological performance.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
The Theme of Violence and the Teaching Strategies Used by Teachers of Nursing Undergraduate Courses
Authors: Scherer Z. , Scherer E. , Baragatti D. 
Published: June 2017

IntroductionUnderstanding violence as a public health problem brings as required its inclusion in the curricula of undergraduate courses in health.ObjectiveTo describe the approach to the topic of violence and the teaching strategies used by teachers of undergraduate courses in nursing of two public higher education institutions of the State of São Paulo, Brazil.AimsKnowing the approach to the topic of violence in two nursing under graduation courses.MethodDescriptive, exploratory qualitative study. For data collection, semi-structured interview was used; were subject of the study, 15 teachers of the institutions studied that ministered courses whose programs contained the word “violence” or related. The data were subjected to analysis of the “collective subject discourse”.ResultsThe results referred to speeches about the importance of addressing violence in theory and practical course, the experience of violence in the everyday practice and pedagogical strategies in the theoretical and practical learning. Teachers recognize the importance of violence be crafted at graduation, describing that, although not always appear in the formal curriculum, the subject appears in an informal way in academic training. Recognize, however, that there is a fragmentation in the approach of the theme, because teachers are divided between theoretical and practical classes and not all of them study the subject.ConclusionIt is essential that there should be more discussions on violence among teachers as well as be designed strategies to better approach the theme at graduation.Disclosure of interestThe authors have not supplied their declaration of competing interest.
“It is safer to sell marihuana than heroin or cocaine and you make more money” qualitative study about drug traffic and consumption in Girona (eastern sector)
Authors: Calvo F. , Giralt C. 
Published: June 2017

IntroductionFont de la Pólvora is a neighbourhood located on Catalonia, which has been one of the most important points of sale of heroin and cocaine in the country. The sale of drugs was also affected by the economic crisis, changing the behaviour pattern of patients with drug dependence.ObjectiveTo describe the changes in drug trafficking in this region and how these influence their consumption.MethodsThe investigation is carried out by the harm reduction outreach team, who selected, with a non-probabilistic method, a sample of 6 drug users. An in-depth semi-structured interview was conducted.ResultsFrom 2006 to 2012, there existed up to 19 points of drug sale of heroin and cocaine. There are currently 2. The reasons behind the decrease are:–the demand for cocaine decreases;–the sporadic consumption of heroin decreases;–with the decrease in demand, drugs lose quality.With the housing bubble in Spain and the rise in foreclosures on behalf of banks, empty flats proliferated in the area, which were eventually occupied illegally. This fact prompts the production of cannabis.ConclusionMany of the strictly punitive actions in the control of narcotics lead to the dealers coming up with new ideas and new patterns of consumption which complicate the intervention of the teams working in the territory.Disclosure of interestThe authors have not supplied their declaration of competing interest.