bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demonstrating the methodology of a pilot programme for establishing a system for mental health promotion in Hungary
Authors: Wernigg R. , Toth M.D. , Sumegi A. 
Published: June 2017

IntroductionA 12 month long mental health promotion pilot programme in Hungary, funded by the Norway Grants, will finish on 30th April 2017.AimsTo launch six community mental health promotion centers (MHPCs) located in various economic environments, supervised by one Methodological Center plus expert teams and carrying out studies on the effectiveness of the launch of the system. The final recommendations will constitute a basis for setting up a national network for mental health promotion.ObjectivesTo develop a sustainable model for establishing a national network of MHPCs; to map and record the mental health problems and the stakeholders of the area; to find and assess the local best practices; and to raise public awareness in the following mental health problems: depression, suicide, stress and dementia.Methods(1) Models for inducing changes in the knowledge and attitudes upon mental health in the communities were reviewed in a systematic literature search. (2) Based on the results, a model of mental health promotion centers was outlined for problem identification, stakeholder mapping, assessing local best practices, organizing and supporting local networking activities for synergistic effects. (3) In the new MHPCs, on-site TTT education programme and organisational development have been in place. (4) The activities of the MHPCs have been monitored for knowledge transfer and attitude changes in the local networks. (5) Based on the results, recommendations are being made for the national extension of the model.Results and conclusionsThe first data ready for analysis will be available by April 2017.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A rare instance of tardive dyskinesia with SSRI use: A case study
Authors: Roy D. 
Published: June 2017

IntroductionCase presentation of a middle aged lady Mrs. C.K., who developed tardive dyskinesia (TD) after a trial of an SSRI.Case reportA 49-year-old Australian aboriginal lady, presented with involuntary movement of her face (bucco-linguo masticatory), movements after a 3 months trial of sertraline (maximum dose of 100 mg daily) for her depressive illness. There was no history of trials with anti-psychotics or any other medications, which may have caused the oral dyskinesias. Routine examinations including cognitive testing, EEG and MRI revealed no pathological findings. Her sertraline was ceased and she was commenced on mirtazapine 15 mg at night, which was hiked to 30 mg after 1 week and continued on this dose over the next 3 months. She exhibited good improvement in her depressive symptoms and a significant attenuation of her TD's. Involuntary movement scale rating: she was rated on the abnormal involuntary movement scale (AIMS) and showed gradual improvement in the severity of her orofacial dyskinetic movement. Her scores were–initial presentation (scored 22/36); at 4 weeks (9/36); 8 weeks (6/36) and at 16 weeks (4/36).DiscussionAlthough TD's are seen in approximately 1 to 5% of mental health patients treated with anti-psychotics (and some other medications like Levodopa, Metochlorpromide, etc.), research studies on SSRI's causing TD's are rare and few (Leo et al., 1996; Gerber et al., 1998).ConclusionsTo alert and educate clinicians about a relatively rare adverse-effect of SSRI producing an involuntary movement disorder.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
Psychotherapeutic Iinterventions in Transition Unit
Authors: Asensio L. , Estefania S. , Nuevo L. , Gomez I. , Rodriguez C. , Muñoz V. 
Published: June 2017

Introduction.The In-patient units are very closed and highly controlled healthcare resource and then patients have to join the community rapidly, and in sometimes feeling unprotected and with their needs non covered. We created a transition unit with a program of psychotherapeutic intervention, to offer an adequate transition between the acute episode and the incorporation to the community.Objective.We describe the characteristics of the psychotherapeutic group, the aims and the results of the interventions.Methods.Psychotherapeutic transition unit was created to offer intensive attention and control demand that is not possible to control in the community. The objects are to prevent re-admissions and relapse because of abandonment of treatment in patient with personality disorder and suicide attempts, and first episode, affective or psychotic. Patients are selected from the in-patients unit with inclusion criteria, and start going from the unit before discharge. The intervention is once per week, with a duration between 60–90 minutes. There is not a number of sessions, and we have approximately 10 patients per sessions.Results.Since the beginning of the psychotherapeutic interventions, re-admissions have been decreased in patients with diagnosis of personality disorder (most histrionic and borderline disorder) with multiple admissions because of suicide attempt, some had been discharged. In another group of patient we have prevented relapses.Conclusions.Psychotherapeutic interventions will be effective in patients with high risk of re-admissions and relapses. It is early to have solid conclusions, but the preliminary results encourage the continuation of the program.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cognitive Analytic Therapy and Mentalizing Function
Authors: Gimeno E. , Chiclana C. 
Published: June 2017

IntroductionCognitive-Analytic Therapy (CAT) has settled as an integrative approach from Ryle and Kerr's model in the 70's widely accepted in England and Australia, although increasingly European countries have decided to include this model in their public mental health services. Even though its formulation allows the treatment of almost any pathology ensuring good results, it has been traditionally applied to the treatment of personality and eating disorders. Some authors seem to link this efficacy with training in mental states and reciprocal role procedures identification, justifying the improvement through the increase of the reflexive function.Aim and objectivesThe aim of this study is to determine the effect of CAT in mentalizing ability and social functioning in patients attending consultation.MethodsFor this purpose a CAT intervention was performed in 6 adults, administering the Inventory of Interpersonal Problems (IIP-64) and the Mindful Awareness Assessment Scale (MAAS) before and after treatment.ResultsThe results show a statistically significant reduction in interpersonal problems, as well as a non-significant increase in the mentalizing ability.ConclusionsCognitive Analytic Therapy has shown being effective in increasing social functioning, however we have not been able to demonstrate significantly its efficacy in the reflexive function.DiscussionImplications in the clinical setting are discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Academic Stress and Emotion Regulation in the Iranian Female Students with High and Low Academic Performance
Authors: Piryaei S. , Mohebbi M. , Khademi Ashkzari M. , Khademi Ashkezari E. 
Published: June 2017

IntroductionThis paper examines the similarities and differences between academic stress and emotion regulation and investigates that the association between emotion regulation and academic stress may be explained the level of academic success among female students.ObjectivesThis research suggests that students vary in their ability to regulate emotions and cope with academic stress, and these abilities may differ across the level of student's academic success. Identifying the academic stress and quality of emotion regulation strategies will lead to practical implications for promoting student's with low or high academic success.AimsThe present study aims to compare academic stress and emotion regulation in the female students with high and low academic performance.MethodsA total of 162 high school students (mean age = 15.26) were selected by cluster random sampling method. They were categorized as students with high (87 students) and low (75 students) academic performance by average of their academic performance. Emotion regulation questionnaire, educational stress scale for adolescents and academic performance were administered. One-way MANOVA was conducted on academic stress and emotion regulation.ResultsThe results of analysis were significant only for emotion regulation, F (5, 156) = 5.34, P = .001. Mean score of students with low academic performance in the emotion regulation was significantly lower than students with high academic performance.ConclusionsThe extent to which variation in emotion regulation and coping with stress can be considered as a key factor of academic failure/success in educational settings.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Vitamin B12 deficiency induced psychosis – a case report
Authors: Carvalho A.R. , Vacas S. , Klut C. 
Published: June 2017

Vitamin B12 is one of the most essential vitamins affecting various systems of the body. Cases of neuropsychiatry disorders due to its deficiency are more common in elderly patients with prevalence of 10–20%. The most common psychiatry symptoms reported in the literature associated with vitamin B12 deficiency was depression, mania, psychotic symptoms, cognitive impairment and delirium. Here, we report a case of vitamin B12 deficiency in a 52-year-old male who presented with psychotic features: persecutory delusions, tactile and auditory hallucinations. Patient had neither recorded psychiatry history nor any drug abuse. Medical history includes hypertension, diabetes mellitus and glaucoma. The patient was not a vegetarian. All relevant laboratory evaluations and head CT were normal except vitamin B12. The patient was treated with antipsychotics (risperidone 3 mg/day) and intramuscular vitamin B12. One week after, there was total remission of psychotic symptoms. In the follow-up during the next four months, psychiatry symptoms did not recur at any time. This case reports a rare case of vitamin B12 deficiency induced psychosis. Although there was concurrent administration of an antipsychotic along with vitamin B12, it underlines the importation of evaluation of vitamin B12 and other potential reversible causes of psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Rechallenge of clozapine in a low secure setting following pericardial effusion
Authors: Mohandas A. , McCarthy J. , Hartley A. , Fatima E. , Shearman L. 
Published: June 2017

IntroductionClozapine is licensed for treatment-resistant schizophrenia and when clozapine is not able to be used, less evidence based practices may be required. Full remission may require combinations or high doses of psychotropic medications having greater potential for interactions and side effects. If this is not successful, symptoms may persist and long-term disability may occur.AimsTo explore safety and efficacy of a rechallenge of clozapine in a patient with treatment resistant schizoaffective disorder, who previously developed pericardial effusion. Collateral history reported best improvement with clozapine compared to other medications.ObjectivesTo improve level of functioning and reduce need for less evidence based choices of medication.MethodsInitial consultation with clozapine monitoring service over prospects of rechallenge. Full medication history and review. Consultation with a cardiologist regarding validity of local monitoring strategy. Obtain consent from the patient and his family. Titrate clozapine slowly. Once clozapine initiated, measure temperature, blood pressure, pulse rate and monitoring of symptoms of pericarditis including chest pain, cough and dyspnoea daily. ECG and echocardiography at baseline and 2 and 4 weeks after initiation of the rechallenge. ECGs monthly thereafter, with a further echocardiogram at 3 months. Weekly troponin and CRP for three months to monitor developing myocarditis and pericarditis.ResultsSuccessful rechallenge of clozapine with significant reduction in psychopathology, improvement in functioning and no adverse events reported. Reduction of risk enabled transfer to open ward conditions.ConclusionsThere is increasing evidence of successful rechallenges of clozapine however, further research is necessary to aid such clinical decisions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Seroprevalence of toxoplasma gondii in Romanian psychiatric patients
Authors: Olariu T.R. , Capraru I.D. , Papava I. , Romosan R. , Dehelean L. , Lupu M.A. 
Published: June 2017

IntroductionToxoplasma gondii infection has been recently associated with schizophrenia and other psychiatric disorders.AimThe aim of the present study was to evaluate the prevalence of T. gondii antibodies among acute psychiatric patients from Western Romania.MethodsThis study included 214 consecutive patients admitted at the psychiatric clinic, Country Clinical Emergency Hospital in Timisoara, Romania, between 30.06.2011 and 12.01.2012. Clinical and laboratory investigations were performed in these hospitalized patients, including serologic tests for T. gondii IgG and IgM antibodies.ResultsThe 214 patients aged 19 to 71 years (mean = 42.5), 64.9% were females. T. gondii antibodies were detected in 117 (54.7%) of 214 psychiatric patients. When the data were analyzed by diagnostic groups, T. gondii antibodies were demonstrated in 30 (50.84%) of 59 patients with schizophrenia, in 28 (59.57%) of 47 with persistent delusional disorder, 10 (31.25%) of 32 with acute and transient psychotic disorder, 13 (54.16%) of 24 with schizoaffective disorder and 35 (70%) of 50 with bipolar disorder. A high prevalence of T. gondii antibodies was found among patients with bipolar disorder compared to those with schizophrenia (P = 0.043) acute and transient psychotic disorder (P < 0.0001) and healthy controls (P < 0.0001). Of the 18 patients with schizophrenia and a BPRS score <51, T. gondii antibodies were detected in 13 (72.2%) compared to 17 (41.4%) of 41 in whom BPRS score was >51 (P = 0.03).ConclusionThese findings suggest that T. gondii infection may be associated with several psychiatric disorders. A high seroprevalence of T. gondii was demonstrated in patients with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Ultra-resistant schizophrenia and potentiation strategies
Authors: Khouadja S. , Ben Soussia R. , Younes S. , Bouallagui A. , Marrag I. , Nasr M. 
Published: June 2017

IntroductionTreatment resistance to clozapine is estimated at 40–70% of the treated population. Several clozapine potentiation strategies have come into clinical practice although often without evidence-based support.ObjectiveThe aim of our work was to identify the potentiation strategies in ultra-resistant schizophrenia depending on the subtype of schizophrenia.MethodologyThis is a prospective study conducted on patients with the diagnosis of schizophrenia, based on DSM-IV-TR criteria, and hospitalized in the psychiatric department of the university hospital in Mahdia, Tunisia. The study sample consisted of patients meeting the resistant schizophrenia criteria as defined by national institute for clinical excellence (NICE), and the prescription of clozapine for 6 to 8 weeks was shown without significant improvement.Resultswe have collected 10 patients. The mean serum level of clozapine was 462.25 mg/L. The potentiation strategies were different depending on the subtype of schizophrenia. For the undifferentiated schizophrenia, we have chosen ECT sessions. For the disorganized schizophrenia, we opted for amisulpiride and aripiprazole. For the paranoid forms, we have chosen the association of risperidone and ECT. A psychometric improvement was noted in BPRS ranging from 34 to 40%.ConclusionEvery potentiation strategy entails a cost, whether it is an additional monetary cost, adverse effects or greater stress to caregivers. The cost/benefit equation should be thoroughly evaluated and discussed before commencing a strategy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Predictors of transition to psychosis in individuals at clinical high-risk for psychosis
Authors: Skuhareuskaya M. , Skugarevsky O. 
Published: June 2017

ObjectiveClinical high risk (CHR) for psychosis state is characterized by presence of potentially prodromal for schizophrenia symptoms. The aim of this study was to assess the predictors of transition to first psychotic episode.MethodsThe study included 123 CHR subjects. All the subjects were characterized by the presence of one of the group of criteria: (1) UHR criteria, (2) basic symptoms criteria and (3) negative symptoms and formal thought disorders (FTD). The presence of FTD in clinical high-risk individuals was assessed with methods of experimental pathopsychology. The mean length of follow-up was 26 months (SD 18). All subjects were males, mean age = 20.2 (SD: 2.1). We examined the subjects’ performance using the Cambridge automated neuropsychological test battery. We applied survival analyses to determine associations between a transition to psychosis and sociodemographic, clinical and neurocognitive parameters. To determine which items are the best predictors, Cox regression analyses were applied.ResultsThe psychosis developed in 39 subjects (31.7%). Global assessment of functioning, positive symptoms, blunted affect, social isolation, impaired role function, disorganizing/stigmatizing behavior, basic symptoms (thought pressure, unstable ideas of reference), neurocognitive parameters (visual memory and new learning, decision making, executive function) significantly influenced the transition to psychosis. A prediction model was developed and included unusual thought content (Wald = 12.386, P < 0.0001, HR = 2.996), perceptual abnormalities (Wald = 4.777, P = 0.029, HR = 1.43) and impaired role function (Wald = 1.425, P < 0.028, HR = 4.157).ConclusionClinical measures are important predictors for transition to psychosis in high-risk individuals.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Delayed post-hypoxic leukoencephalopathy: Case report
Authors: Arimany M. Solerdelcoll , Garriga M. , Parellada E. 
Published: June 2017

IntroductionDelayed post-hypoxic leukoencephalopathy (DPHL) is an underrecognized syndrome of delayed demyelination, where patients manifest neuropsychiatric symptoms after a period of 2–40 days of apparent recovery from a cerebral hypo-oxygenation episode.ObjectivesWe report a case of a patient who successfully recovered from an overdose of heroin, but then suffered a delayed abrupt neurological deterioration.AimsTo improve assessment and recognition of DPHL.MethodsAn adequate retrospective collection of clinical data and nonsystematic review of the literature was performed.ResultsA 43-year-old male with schizoaffective disorder who attempted suicide with an overdose of heroin, was successfully revived and return to his previously mental status, but 3 weeks after, he abruptly developed progressive cognitive impairment with akinetic mutism and ataxia. He was admitted to our acute psychiatric unit after brain CT and chemistry analyses were unremarkable. Brain MRI showed diffusely symmetric hyperintensity in the white matter (WM), pronominally the periventricular WM, on FLAIR and T2 weighted sequences. At 16 weeks postoverdose, he presented improvement both cognitive and motor symptoms, lasting deficits in frontal-executive functions.DiscussionDPHL is characterized by similar clinical and neuroimaging features regardless of the initial insult. The mean lucid interval coincides with the replacement half-life for myelin related lipids and proteins. Prolonged mild-to-moderate hypo-oxygenation of WM is thought to disrupt myelin turnover. It appears probable that these were responsible for DPHL in our patient rather than a direct toxicity.ConclusionDPHL can be diagnosed when clinical history, laboratory assessments and MRI findings are concordant. DPHL requires extensive support care and carries a relatively good prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
“Pseudoneurotic Schizophrenia” Revisited: The role of obsessive-compulsive symptoms in low-level disorganization psychosishosiser
Authors: Tonna M. , Ottoni R. , Paglia F. , De Panfilis C. , marchesi C. 
Published: June 2017

ObjectiveRecent research has suggested a dual impact of obsessive-compulsive dimension on functioning in schizophrenia with a gradual transition from an improving to a worsening effect depending on obsessive-compulsive symptom (OCS) severity (from mild to moderate-severe). Aim of the present study was to investigate whether this varying effect of OCS on functioning might be mediated or moderated by schizophrenia symptom dimensions or occur independently.MethodSeventy-five patients affected by schizophrenia were administered the SCID-IV, the PANSS, the YBOCS and the SOFAS.The sample was divided into two groups according to the severity of OCS (absent/mild and moderate/high).ResultsIn both groups, a significant interaction between OCS and disorganization dimension was found: the dual effect of OCS on functioning occurred only among patients with low disorganization symptoms while it was no more apparent at higher levels of disorganization (Figure 1).ConclusionData suggest that in patients with schizophrenia, functioning at least in part depends on the interaction between disorganization and OCS. Particularly, mild OCS contributes to higher levels of functioning in patients with psychosis at low levels of disorganization. In keeping with the historical concept of “pseudoneurotic schizophrenia”, we speculate that obsessive dimension might have a pathoplastic influence in milder forms of schizophrenia spectrum disorders, balancing the effect of underlying low disorganization symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Impact of postpartum depression on quality of life
Authors: Feki R. , Feki I. , Trigui D. , Baâti I. , Sallemi R. , Masmoudi J. 
Published: June 2017

IntroductionWomen during the postpartum period experience many physiological, psychological, and social changes. Quality of life (QOL) is a sense of well-being and arises from satisfaction or dissatisfaction with various aspects of life including health, employment, socioeconomic state, psychological-emotional state, and family.ObjectivesThe purpose of this study was to identify influence of childbirth experience and postpartum depression on QOL.MethodsThis is a descriptive cross-sectional study regarding 150 postpartum women receiving cares in the hospital of Sfax and examined during the first and the sixth week post-delivery. Data collection tools in this study were demographic questionnaire, Edinburgh Postnatal Depression Scale (EPDS), and world health organization quality of life-bref (WHOQOL-bref). Data were analyzed using SPSS.ResultsThe mean age of our sample (n = 150) was 29.61 years. During the sixth week study period, 126 of 150 were examined.A personal psychiatric history of depression was found in 9.3% of cases.The current pregnancy was undesired in 15.3% of cases.The prevalence of postpartum depression in the first week was 14.7% and 19.8% in the sixth week after delivery.The mean score of quality of life was 81.62 ± 9.09.Scores of quality of life and all its dimensions were significantly lower in depressive women.ConclusionBecause enormous changes develop in postpartum women, we suggest supportive measures for mother by her mother-in-law family, and caregivers to improve the QOL and health status of the mother and her child and to prevent postpartum depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.