bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment with intramuscular paliperidone palmitate in schizoaffective disorder
Authors: Maroto Martin L. , Hervías Higueras P. 
Published: May 2016

IntroductionInjectable formulations of long acting antipsychotic are a valuable treatment option for patients with psychotic disorders. Schizoaffective Disorder (SAD) is a complex disease; the optimal treatment is not well established yet.ObjectiveAnswer the question about the effectiveness offered by intramuscular Paliperidone Palmitate in SAD versus other injectable antipsychotics. Keywords: schizoaffective disorder; paliperidone palmitate injection.MethodsA case report of a 35-year-old male diagnosed with Schizoaffective Disorder six years ago and with personal history of multiple manic decompensation after treatment discontinuation. Throughout his life he has been treated with intramuscular Risperidone 87.5 mg (50 + 37.5) every 14 days, Olanzapine flas 20 mg/day, Risperidone flas 3 mg, Amisulpride 600 mg/day, Valproic acid 1500 mg/day Clonazepam 2 mg/day and Lormetazepam 1 mg. In the last admission one year ago, he started treatment with intramuscular paliperidone palmitate up to 200 mg a month. Currently he receives a monthly dose of 100 mg and concomitant lithium 800 mg/day.DiscussionThe use of intramuscular paliperidone palmitate in SAD and its effectiveness against other injectable antipsychotic is discussed.ConclusionsThe use of intramuscular paliperidone palmitate appears to constitute an employment opportunity in the treatment of intramuscular maintenance in SAD. It could be effective in stabilizing episodes of acute exacerbation and remissions of psychotic, manic and depressive symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Catatonic schizophrenia vs anti-NMDA receptor encephalitis – A video case report
Authors: Ponte A. , Gama Marques J. , Carvalhão Gil L. , Nobrega C. , Pinheiro S. , Brito A. 
Published: May 2016

IntroductionAnti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a treatable autoimmune disease of the CNS with prominent neuropsychiatric features that primarily affects young adults and children.ObjectiveTo present the diagnosis course of a case of anti-NMDAR encephalitis in a patient with previous diagnosis of Schizophrenia.MethodsAnalysis of the patient's clinical records and of a PubMed database review, using “anti-NMDAR encephalitis” as keywords.ResultsWe report a single case of a 33-year-old man diagnosed with Paranoid Schizophrenia in 2009 that after 1 year of treatment abandoned follow-up. Six years later, the patient presented to the psychiatric emergency department with persistent headaches, abnormal behavior and loss of motor skill. He was admitted to the psychiatric ward with a presumptive diagnosis of “Catatonic Schizophrenia” and began to manifest fluctuating catatonic symptoms (captured in video). Neuroleptics and benzodiazepines were tried without success. There was a clinical deterioration with autonomic dysfunction, breathing instability and seizures. Complementary exams revealed: EEG with slow base activity; brain MRI with right temporal pole and right frontobasal lesions compatible with head trauma; CSF with pleocytosis; and positive anti-NMDAR antibodies. Occult neoplasm was excluded. Treatment with high-dose steroids, intravenous immunoglobulins, followed by cyclophosphamide resulted in relevant clinical improvement.ConclusionsAs early detection of antibodies may allow for earlier treatment of anti-NMDAR encephalitis, which is associated with better outcomes, we believe the present case underscores the importance of clinicians maintaining vigilance for neuropsychiatric symptoms that have not adequately responded to therapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Awareness of illness and psychosis
Authors: Remesal Cobreros R. , Alonso Díaz R. , Cortázar Alonso E. , Andrés Villa M. 
Published: May 2016

IntroductionOne of the characteristics of Karl Jaspers approach to clinical practice was the importance he gave to the subjective experience by the patient. Patient's self-observation is one of the most important sources of knowledge of the psychic life of the patient. The lack of awareness of illness is quite common in psychotic spectrum.AimThe aim of this paper was to examine and compare a group of patients diagnosed with psychosis disorder with another group with other mental disorders, in relation to their mental and emotional suffering,SampleThe sample was composed by 118 subjects with both sexes. It was divided into two groups: patients with a diagnosis of psychotic disorder and another one with other mental disorders.InstrumentInventory SCL-90-R, which evaluating a wide range of psychological and psychopathological symptoms was used.Statistics analysisTwo groups were compared with respect to perceived psychopathological symptoms.ResultsStatistically significant differences were observed between both groups. Patients with psychotic disorders showed lower scores in most clinical scales. It reflects less emotional suffering and psychological distress perceived in this group against the other. It could be related to the lack of awareness of illness by psychotic patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The aetiology of schizophrenia as outlined in a treatment-resistant case
Authors: Vella Fondacaro D. , Falzon Aquilina F. 
Published: May 2016

IntroductionThe development of treatment-resistant schizophrenia in a 16-year-old Maltese girl was analyzed in terms of its biopsychosocial model of disease.ObjectivesTo highlight the presentation of treatment-resistant schizophrenia.To investigate the etiology of treatment-resistant schizophrenia.AimsTo utilize the biopsychosocial model of disease in order to investigate the aetiology of treatment-resistant schizophrenia.To highlight the treatment modalities utilized in this case of treatment-resistant schizophrenia.MethodsInterviewing the patient.Analyzing all investigations and documentation made during her admission in an acute psychiatric hospital.Evaluating the response to various treatment modalities.Carrying out literature reviews.ResultsImage attached.ConclusionsAlthough the aetiology of treatment-resistant schizophrenia remains somewhat unclear even after many years of study, the biopsychosocial model is nevertheless useful in understanding the development of this condition. The treatment modalities to which the patient was resistant were also identified.Figure not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Sexuality in mental health: Brazilian science production review (2001–2014)
Authors: Boaes R. , Silva M.B.B. , Russi J.A. 
Published: May 2016

Aiming at analyzing mental health and sexuality studies, specifically in papers published in Brazil, this dissertation brings a review of the literature carried out in two databases. It can be noticed that studies on sex, gender and sexuality show the complexity of the understanding of human sexual life going from essentialist to constructivist perspectives, conceiving sexuality in several manners. However, studies on madness, mental health and psychosocial care point to different conceptions of mental sickening process, mental health being at the same time a science field and a psychological well-being value to be achieved. Surveys in nursery homes show that institution agents represent the sexuality of a mentally suffering person (MSP) as abnormal or non-existing. The review of academic production on the subject, has put together 685 publications, 43 of them in both, with only 109 from Brazil, these ones having been systematized by title and abstract, only eleven were selected and studied thoroughly. Results show that the analyzed science production is scarce, being the theme just at its beginning in collective health, with the predominance of biomedical approaches focusing in on sexual behavior, with special attention to the vulnerability to IST/HIV/AIDS, the absence of sexual education and gaps in the training to work with sexuality. The conclusion is that the studied Brazilian science production on sexuality in the field of mental health is not centered on sexual and reproductive rights of MSP, while user sexual practices and the representations of professionals come to the fore in the analyses.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Radiotherapy and treatment of cervical cancer – sexuality implications
Authors: Fornelos A. , Macedo P. , Nunes S. , Figueiredo A. , Silva M. , Viseu M. 
Published: May 2016

IntroductionCancer of the uterine cervix represents 10% of malignant tumors affecting women. Despite occupying fifth place in the global mortality rate it is described with the highest healing potential. One of the most used treatments is radiotherapy, which has a particularly significant impact on women's quality of life, especially in their sexuality. Biological and psychic factors are suggested as possible etiologies for sexual dysfunction situations. Changes in body image may arouse feelings of shame and low self-esteem. In what concerns biology, vaginal stenosis is referred as a cause of vaginism and vaginal bleeding, with consequent decrease in libido and pleasure.ObjectiveDescribe the implications in the sexuality of women with cancer of the uterine cervix after radiotherapy.MethodsA literature search using the PubMed and Scielo databases of scientific articles published in the last 10 years.ResultsIn the literature, there are significant changes in sexual behavior in women with cervical cancer in the period after radiotherapy. A large percentage reveals sexual abstinence and an equally significant part presents sexual dysfunction caused by lack of lubrication, arousal and orgasm. Moreover, it is reported decreased libido and sexual pleasure, vaginal bleeding and vaginism. On the other hand, there is a small account of cases in which it is mentioned increase libido and pleasure.ConclusionDespite the high probability of healing this disease, the patients’ quality of life after advanced stages of radiotherapy, should be a source of concern, especially with regard to sexuality.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Autolytic behavior in acute psychiatric hospitalization
Authors: Hervías Higueras P. , Maroto Martín L. , Raffo Moncloa S. , Jiménez de los Galanes Marchán P. 
Published: May 2016

The aim of the study was to identify inpatients due to autolytic behavior in the acute psychiatric hospitalization of Dr. R. Lafora Hospital. It is an observational, descriptive and retrospective study. We collected information about patients aged 18 to 64 who were hospitalized during the month of January of 2015 in the acute psychiatric hospitalization by Selene software. The results were analyzed by SPSS software; 53.3% of patients diagnosed with schizophrenia spectrum and other psychotic disorders were hospitalized for acute exacerbation of paranoid schizophrenia; 57.1% of personality disorders for suicide attempts, 28.6% autolytic ideation; 28.6% of bipolar disorders due to mania, 28.6% depression, 28.6% mixed clinical and 14.29% suicide attempts; 60% of alcohol use disorders for autolytic ideation, 20% intoxication; 100% of substance-related and addictive disorders due to autolytic ideation; 100% of feeding and eating disorders for autolytic ideation; 50% of obsessive-compulsive and related disorders due to autolytic ideation; 100% of adjustment disorders with depressed mood due to drug over-eating; 100% of adjustment disorders with mixed anxiety and depressed mood for mixed clinic; 16.7% of depressive disorders due to dysthymia, 16.7% due to major depressive episode, 16.7% for moderate depressive episode, 16.7% for mild depressive episode with mixed nature, 16.7% for drug over-eating, 16.7% for autolytic ideation. It would be important to focus on patients with a diagnosis of adjustment disorders, personality disorders, alcohol use disorders, obsessive-compulsive and related disorders and bipolar disorders, providing community care and avoiding the risks associated psychiatric hospitalization.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Economic impact of suicidality in manic patients with depressive features
Authors: Ösby U. , Jonas E. , Hällgren J. , Pompili M. 
Published: May 2016

IntroductionThere is limited information published on the specific financial costs of completed and/or attempted suicide in bipolar patients. In the last 15 years, only 6 studies were published. Their results vary considerably due to differences in methods used. Also, information on cost for pure manic versus mixed episodes is lacking. This is surprising, since studies have shown that suicidal behaviour is more common among patients with depressive symptoms than with pure mania, and this difference increases considerably when the mixed-features specifier is applied.ObjectivesWe conducted a registry study with the aim to expand the epidemiological information on suicidal behaviour by episode type in bipolar disorder, and its associated costs.MethodsHealth data were retrieved from the Swedish Patient Register. Data covered the period 1990–2014 and included the number of discharged patients with bipolar diagnosis, hospital re-admissions, and attempted and/or completed suicides. Moreover, we retrieved data on suicide and cause of death from the Swedish Cause of Death register. Analyses were done for the whole sample and stratified by subtypes (mania, depression and mixed forms).ResultsFirst results will be presented at the EPA meeting.ConclusionsThis is a nation-wide Swedish study of completed and attempted suicide in bipolar patients. The hypothesis we will test is that there is a substantial variation between different bipolar disorder subtypes, and that most of the expenditures due to suicidal behaviour in bipolar disorder are linked to mixed forms, mania in combination with depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Suicidal behavior in old age: Special considerations
Authors: Ramirez Dominguez M.D.L.C. , Ramirez Dominguez A. , Prieto Sánchez I. , Gonzalez Macias C. 
Published: May 2016

IntroductionSuicide in the elderly is a growing problem in Western society, despite which there are no large studies examining this issue, nor specific protocols to address them.ObjectiveTo raise awareness of the importance of suicidal behavior in elderly both its prevalence and special features that presents need a different performance plan from other fractions old.MethodsComprehensive literature review of all published in the last two years, as well as the specific features.ConclusionSuicidal behavior in the elderly has very specific characteristics that we must know in order to develop therapeutic strategies adapted to the present conditions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Over, but not out-recognition and preventing aircraft-assisted murder-suicide by Aircrew
Authors: Saxena A. , Sharma V. , Walia A. , Sharma P. 
Published: May 2016

Context and introductionThe recent crash of Germanwings Flight 4U9525 appears to be the latest act of aircraft-assisted murder-suicide. The psychiatric preventive aspects of the murder-suicide need to be discussed, and effective measures for recognition and prevention of this murder-suicide are needed. Aircrew health is biased towards the physical ailments, and evaluation manuals have not discussed the mental health aspects, especially preventive strategies. These strategies involve multifactorial interventions, their applicability and usefulness are not globally validated.Objectives and methodsThanatology has since long, focused on early detection of mental distress and elucidating behavioural and psychological factors that predispose towards attempts at self-harm. Aircrew forms a different group from the general population. The recognition and preventive strategies in this special group, must, therefore, be tailored to this group with its special characteristics.Data sources, study selection and data synthesis publications were identified via electronic searches using multiple search terms related to suicide prevention. The available effective preventive measures were juxtaposed on the current concepts in aerospace psychiatry.ConclusionsMurder-suicide by aircrew is an event that is the culmination of undetected, ignored or even condoned discrete events that gradually progress and insidiously escalate. The importance of psychological factors in this catastrophic event needs to be disseminated amongst psychiatrists, and aircrew medical examiners. Ascertaining which components of suicide prevention programmes are effective in early recognition of aircrew who may attempt or complete the murder-suicide and putting into practice these to optimize the use of limited resources, is therefore essential and necessary.Disclosure of interestThe authors have not supplied their declaration of competing interest.
A new evidence-based neuropsychological model of suicidal propensity and suicide based in depression
Authors: Thorell L.-H. 
Published: May 2016

IntroductionObjectively validated models of the depressed suicide are lacking. Early observations that electrodermal hyporeactivity was strongly related to suicide in depression required an untraditional statistical approach that was applied on materials from published materials with between themselves totally confirming results.ObjectivesA plausible explanation model of the relationship had to be developed.AimsThe aims were to investigate the nature of electrodermal hyporeactivity and its possible causes and connections to other suicide relevant factors and to formulate a coherent model of the depressed suicide.MethodsPublished materials with in- and outpatients (in total > 900 patients) comprising follow-up of suicide and tests of habituation of the electrodermal response were analysed. Symptomatology, gender, age and other variables were considered and so were knowledge and theories from other scientists.ResultsThe apparent loss of or considerably reduced specific electrodermal orienting (curiosity) responses in future depressed suicide victims showed clear relationships to and clear independence of considered important suicidal factors.ConclusionsLoss of specific orienting responses indicates loss of hippocampal CA3 plasticity. CA3 areas are early and centrally positioned in the information processing of neocortical sensory input supporting the hypothesis of a particular neuropsychological dysfunction disabling normal cognitive and emotional curiosity reactions to everyday events. It is proposed that this dysfunction may make the depressed person ready to leave the everyday life and fearless of imminent pain – a loss of two important barriers against suicide.It seems righteous to propose this basically objectively validated model as a plausible explanation of the depressed suicide.Disclosure of interestThe author has not supplied his declaration of competing interest.
ApTiC: A feasibility trial of a communication method using mobile technology to improve assessment within an early intervention service
Authors: Riley M. , Lovell M. , Gire N. , Lane S. , Taylor P.J. , Fitzsimmons M. , Chaudhry I.B. , Bee P. , Lovell K. , Husain N. 
Published: May 2016

IntroductionThe early intervention service (EIS) approach is based on therapeutic interactions, which promote service user recovery from first episode psychosis. Collaborative therapeutic work between the service user and case manager depends on good communication. This can be a challenge for people with psychosis as the process of thought can be disrupted or stimulus misinterpreted leading to communication errors.ObjectiveThe objective is to develop an interactive tool that can assist service user's communication of distress, whilst employing a psychoeducational approach to the use of an informal therapeutic measurement scale; subjective units of distress (SUDs) and early warning signs (EWS). The ApTiC mobile intervention will include ten numerically graded emoticons from low to extreme distress. Each emoticon is associated with specific individualised service user descriptors and linked to an individually agreed action plan and level of response to be offered by a staff member.AimThe aim of the present study will be to examine the feasibility and acceptability of the ApTic mobile intervention in preparation for a larger randomised controlled trial.MethodsPhase one: qualitative research to inform the development of the complimentary tool and mobile app (qualitative). Phase two: a 12-week rater-blinded randomized control trial of ApTiC compared to routine EIS case management (quantitative).ResultsThe qualitative data will be presented.ConclusionsIt is expected that once validated, the SUDs based ApTiC will enhance rapport and understanding thus improving the recovery approach to well-being and hopefully preventing relapse or the involvement of the crisis team or hospital admissions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
mHealth in mental health: What do the users think about it?
Authors: Sengelen J.M. , Banea I.C. 
Published: May 2016

There is currently a major trend for e-health and the first mental health applications for smartphones are now released. Patients and health care professionals are still struggling to position themselves in relation to these new approaches. So, we wanted to know more about the involvement of mental health users and their care providers in mobile health (mHealth) technologies. We needed to understand their expectations and their reluctances. For achieving this purpose, we carried out an online survey for mental health users (n = 108). It turns out that people who responded to this survey are well equipped with smartphones and are experienced in using mobile apps. They expect from professionals an advisory role in relation to e-health. The major interest lies in practical, concrete applications and the main reluctance is about management, transit and storage of data. It is necessary to involve mental health users and health care professionals together in order to develop these new tools. To achieve this, health care professionals must continue to invest themselves in the use and understanding of m-Health tools.Disclosure of interestThe authors have not supplied their declaration of competing interest.
It is possible to change clozapine by another neuroleptic
Authors: Fluvia F.X. , Pastor R. 
Published: May 2016

It is well known that when we have a schizophrenic patient who do not respond to two batches of neuroleptics at full dosage for more than six month, it may be wise to try with clozpine which is believed to be one of the best neuroleptics we have but with two main handicaps: it can produce leucopenia which can be fatal and epileptic seizures as well. We do think that in many cases, clozapine has been used too soon in the treatment of the schizophrenic patient, before we can really talk of a resistant patient. To prove that we have changed the clozapine treatment of four chronically ill schizophrenic patients admitted to a home for the chronically mentally ill. Two patients were changed from clozapine 400 mg/day to paliperidone 15 mg/day along two months time. They both improved in mental clarity and ability of thinking. Another patient were changed from 600 mg/day to 27 mg/day of paliperidone. That patient worsened a little bit mainly with hostility and social avoidance but it was mandatory to change neuroleptic because he had had two seizures and had low levels of platelets and therefore he was at risk of developing leukopenia. The fourth one was taking 300 mg of clozapine and was changed to 12 mg of paliperidone. We got no change in the clinical outcome.DiscussionWe discuss the different explanations for the results we got.Disclosure of interestThe authors have not supplied their declaration of competing interest.