bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gynecomastia induced by trazodone: A case report
Authors: Sánchez García M.D. , Gómez Peinado A. , Cano Ruiz P. , Cañas Fraile S. 
Published: May 2016

IntroductionTrazodone is a heterocyclic antidepressant that exerts its effect via the inhibition of selective serotonin reuptake and the antagonism of 5-HT2A and 5-HT2 C receptors. Antidepressant-induced gynecomastia and galactorrhea and increases in prolactin levels have rarely been reported.Case reportA 73-year-old man presented to the psychiatric clinic with depressive symptoms and insomnia that was the reason that his GP introduced paroxetine 20 mg/day three months before. One month later because the insomnia persisted, trazodone (100 mg/day) was added to the treatment. At a 2-month follow-up, the patient reported improvement in depressive symptoms but also presented gynecomastia on the left side that is non-tender on palpation. No other medications were noted. Laboratory testing was within normal limits, with the exception of on elevated prolactin level (38.2 ng/mL). Ultrasonography indicated normal results. Treatment included the tapering and discontinuation of trazodone with continued paroxetine therapy. Lorazepam was initiated for the treatment of insomnia. Two weeks later, the prolactin level was 13.1 ng/mL and gynecomastia was practically resolved. Lorazepam was initiated for the treatment of insomnia.ConclusionsEffects of trazodone on PRL are unclear, there is one study reported that trazodone increases the PRL level, and another one reported that trazodone reduces them, in our case, the trazodone use led to hyperprolactinemia via hypothalamic postsynaptic receptor stimulation and it should be remembered that gynecomastia and galactorrhea may appear as a rare side effect of trazodone.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Group therapy based on mindfulness in a mental health center
Authors: Uría de los Ojos A. , Ballesteros López J. , Rico García P. , González Palacios A.B. , Domínguez García C. 
Published: May 2016

IntroductionMindfulness is defined as the ability of paying attention to the present moment with intentionality, moment to moment without making judgments of value.ObjectivesTo describe the effectiveness of group therapy performed in our mental health center according to the results in the SOFI scale of patients. This scale is designed to assess different qualities, which evolve through training in meditation practice based on mindfulness.MethodsGroup therapy consisted of 12 weekly sessions of an hour and a half. A total of 11 patients, 7 of which having completed therapy. The questionnaires were answered in the first and final session of therapy.ResultsThe questionnaire items were divided before and after treatment, into four categories with the following results: positive (friendly, happy, acceptance, compassion) to himself: 1.86 (0.54)/2.75 (0.78) and to others 3.57 (0.86)/3.89 (0.54); negative (hate, angry, cruel, bad) to himself: 2.92 (0.54)/2 (0.23); and to others: 2.28 (0.41)/1.96 (0.36)ConclusionsIn keeping with similar studies, the scale shows effectiveness of therapy in all sets of items, highlighting the variation of the aspects related to himself.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Comorbidity between delusional disorder and chronic physical conditions. Results from the Deliranda case register
Authors: Porras Segovia A. , Carrillo de Albornoz Calahorro C. , Guerrero Jiménez M. , Cervilla Ballesteros J. 
Published: May 2016

IntroductionMental disorders are often comorbid with chronic physical conditions. This relationship has been looked into in some mental disorders, such as depression or schizophrenia. However, very few studies have explored this comorbidity in the delusional disorder.ObjectivesThe objective of this study is to establish the prevalence of common chronic medical conditions across delusional disorder.AimsThe aim is to provide useful information regarding this frequent, often disregarded, comorbidity.MethodsOur results proceed from the Andalusian delusional disorder case-register (DelirAnda). We reviewed 1927 clinical histories of patients diagnosed of delusional disorder. Upon having verified the diagnosis following DSM-5 criteria, we recollected data on the prevalence of 10 different medical conditions, which were defined based on clinical diagnosis.ResultsOne thousand four hundred and fifty-two patients matched DSM-5 delusional disorder criteria. Among them, 49.8% of our sample were women. The overall prevalence of medical conditions was 66%. Thirty-one percent of the patients with delusional disorder had only one comorbid physical condition, 20% of them suffered from two conditions, and 15% of them had three or more chronic conditions. The most prevalent physical condition among delusional disorder patients was diabetes, affecting 16% of these patients.ConclusionsChronic physical conditions are highly prevalent among patients with delusional disorder. Comorbid physical conditions may have an important impact on the course of delusional disorder. A correct diagnosis and treatment of this comorbidity should be made to help improve the prognosis and life quality of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Parkinson disease psychosis – A case report
Authors: Ferreira M.D.C. , Varanda S. , Carneiro G. , Santos B. , Machado Á. 
Published: May 2016

IntroductionPsychosis is one of the most prevalent non-motor complications in Parkinson's disease (PD). Risk factors for PD psychosis are advancing age, longer disease duration, severe motor symptoms, presence of dementia, sleep disorders, depression and autonomic dysfunction. Treatment is challenging in this setting because antipsychotic medications are known to worse motor symptoms.ObjectivesTo highlight the therapeutic difficulties in PD-related psychosis.MethodsCase description and literature review.ResultsWe report a case of a 74-year-old woman with a 9-year history of PD, who presented a complex psychotic disorder consisting in auditory, olfactory and visual (gulliverian and lilliputian) hallucinations, persecutory and sexual delusions. Additionally, the patient presented euthymic mood, without evidence of cognitive impairment or impulse-control disorder. These symptoms began after dopamine agonist therapy (ropinirole 4 mg/day). Other medical conditions that could justify these symptoms were excluded. Initially, ropinirole was removed, but without psychotic remission. Then, she was treated with antipsychotic medication (clozapine 25 mg/day) with full psychotic remission and without significant worsening of motor symptoms.ConclusionsClozapine treatment is frequently delayed, mainly for fear of its side effects, particularly agranulocytosis. However, this antipsychotic drug presents many benefits regarding the management of PD-related psychosis, namely few motor effects and even improvement of motor fluctuations.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychiatric symptoms as a presentation of central nervous system involvement in Chagas disease, a case report
Authors: Martinez-Ales G. , Fraga A. , Bonan V. , Roman E. , Palao A. , Rodriguez-Vega B. , Bravo M.F. 
Published: May 2016

IntroductionPsychiatric symptoms set forth brain dysfunction at several levels. Behavioral disturbances, although frequently associated to primary psychiatric disorders, call for a previous discard of neurologic treatable causes.Case reportWe report the case of a 30-year-old gentleman, receiving outpatient psychological treatment and follow-up for a 3-month history of low mood, abulia, apathy, generalized malaise, weight loss and insomnia. Non-structured jealous delusions were also present. No neurological deficit was found. After CT of the brain, a space occupying lesion, suggestive of glioblastoma multiforme, was found. Further studies, including biopsy and a MR, led to the diagnosis of central nervous system Chagas, related to a previously unknown HIV infection in AIDS status, and conditioning a secondary central hipothyroidism. Careful treatment of the etiological factors, along with symptomatic relieve with low dose paliperidone, led to the resolution of the symptoms.DiscussionThe majority of patients suffering from neurologic diseases develop psychiatric symptoms over the course of their illness, with or without the presence of classical disturbances, such as weakness, sensory loss or seizures. Modern psychiatry uses a complex disease model, therefore necessarily integrating anatomy, biochemistry and function during every diagnostic approach.ConclusionIt is necessary to rule out frequent treatable causes, thus involving both psychopatological and neuroscientific approach to psychiatric disturbances. However, while underlying causes are often difficult to treat, psychiatric symptoms respond to existing pharmacologic and nonpharmacologic therapies.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychotic symptoms in a patient diagnosed with temporal lobe epilepsy and schizoaffective disorder
Authors: Martinez-Ales G. , Baena V. , Rubio I. , Rodriguez-Vega B. , Bonan V. , Roman E. , Bravo M.F. 
Published: May 2016

IntroductionEpilepsy is considered a complex neurological disorder, and its clinical picture can resemble many different cerebral dysfunctions, including those associated to major psychiatric disorders.Case reportWe report the case of a 52-year-old gentleman, with a 30-year history of schizoaffective disorder and of complex partial epilepsy with secondary generalization. He was admitted to an emergency room due to a voluntary overdose with 8 mg of clonazepam. The patient explained how he had recently experienced visual hallucinations and insomnia, symptoms that originally led to the psychotic diagnosis. He had previously presented these symptoms, along with stupor, delusions and lability, as a prodrome of complex motor epileptic decompensations. Thus, he took the overdose not to suffer seizures. After carefully reconstructing the clinical history, psychiatric admissions had shown seizures, and periods of clinical stability had been achieved by regulating antiepileptic medication. Eslicarbazepine and lamotrigine reintroduction, and quetiapine withdrawal, led to symptomatic remission.DiscussionEpilepsy and major psychiatric disorders show a high comorbidity. There has been an effort to even include epilepsy and psychosis in a unique diagnosis (alternant psychosis). Furthermore, polimorphism and restitutio ad integrum may resemble classic cycloid psychosis. In this case, chronological study showed all symptoms could be explained by one disorder.ConclusionEpilepsy includes a variety of neuropsychiatric symptoms. It can be difficult to withdraw psychiatric diagnoses from patients after years of follow-up. However, a carefully taken medical history clarifies temporal criteria.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Psychological mechanisms of the formation of non-psychotic mental disorders in patients with hyperthyroidism
Authors: Pityk O. , Pityk M. , Kuzhda I. 
Published: May 2016

The application of a comprehensive, integrative, systemic approach to the examination of patients with abnormal thyroid gland has to lie in the basis of planning strategies and tactics of medical programs such patients. On this point of view we consider that non- psychotic mental disorders are developing on the basis of both organic and adaptation levels. Population researches showed that the majority of patients with endocrinological pathology suffer from one of the three DCPR syndromes: irritant mood, demoralization thrown in (desperation), persistant somatization. The task of our work was to investigate mechanisms of psychological defense in patients with hyperthyroidism with non-psychotic mental disorders. One hundred and twenty-five patients were examined. Non-psychotic mental disorders with different syndromologic structure were found in 76% of patients (study group), among which anxious-asthenic (38.95%), anxiety and depression (23.16%) were dominant. The method of Robert Plutchik for assessment of the mechanisms of defense was used. In asthenic syndrome we found excessive functioning of negation and regression, inadequate functioning of intellectualization. In patients with astheno-anxious syndrome inadequate functioning of negation, intellectualization, compensation, and excessive repression contributed to the formation of the sensations of anxiety. Excessive compensation, projection, reactive formation generally affected the structure of the asteno-depressive syndrome. The lack of displacing of reactive formation, repression and excessive intellectualization in a complex influenced to the structuring of anxious-depressive syndrome. In hypochondrical syndrome projection, regression and negation were the basis of the formation of clinical picture. Thus, meaningful relationships between intrapsychic level of functioning and syndromological structure of non-psychotic disorders were installed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The experience and impact of stigma in Saudi people with a mood disorder
Authors: Alateeq D. , AlDaoud A. , AlHadi A. , AlKhalaf H. 
Published: May 2016

IntroductionSelf-stigma plays a powerful role in attitudes toward mental illness and seeking psychological services. Assessing stigma from the perspective of people with mood disorders is important as they were ranked as major causes of disability.ObjectivesTo determine the extent and the impact of stigma experience in Saudi patients with mood disorder and compare them between depression and bipolar disorder patients. To test if stigma is a universal experience and has similar psychosocial impact across cultures.AimIt's a part of multicenter international study comparing its results to the universal experiences inthe perspectives of individuals with mood disorder.MethodologyWe randomly interviewed 94 individuals with mood disorder at King Khalid University Hospital using valid reliable tool, Inventory of Stigmatizing Experiences (ISE), which has two components: Stigma Experiences Scale (SES) and Stigma Impact Scale (SIS).ResultsISE was validated in a population of Saudi patients with mood disorder. There were no significant differences in stigma between patients with bipolar or depressive disorder on SES or SIS. However, over 50% of all respondents tried to hide their mental illness from the others, and to avoid situations that might lead them to be stigmatized. In comparison with the Canadian population, Saudi participants scored lower on both SES and SIS, which may be due to cultural differences.ConclusionStigma associated with mood disorder is serious and pervasive. It's important first to understand how patients perceive stigma in order to conduct successful anti-stigma programs. The ISE is a highly reliable instrument among cultures.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Can somebody listen to me?
Authors: Cortázar Alonso E. , Guillén Rodrigo H. , Remesal Cobreros R. , Alonso Díaz R. 
Published: May 2016

Given the increase in depressive symptoms, as a mental disorder combined with an organic disease, we suggest a therapeutic approach based on group therapy. The effectivity of this kind of therapy has been confirmed by multiple studies as a way to decrease the pressure in mental health units. The results reached in various studies confirm at least an equal effectivity as individual psychotherapy, thereby it optimizes the increasingly limited public health resources. The objective of the group therapy is to promote an active attitude in the patients and make them responsible of their condition and their treatment process too. The program is aimed to female patients with various kinds of clinical depression, ranging from 40 to 60, who come to the USMC Hospital Vazquez Diaz in Huelva. The group had 12 participants, it was led by a Clinical Psychologist with the help of the Clinical Psychology residents. The program consisted in 8 bimonthly sessions of 90 minutes with an assessment test/retest at the beginning and end of it. The work in the group therapy was based on the constructivist orientation. Different areas were treated as: identification and adaptive expression of emotions, strengthening self-esteem and providing adaptive coping strategies to the psychological distress. As a conclusion we can see how the individual changes in the patients go socializing and enhancing the change in the rest of the participants in a mutual support that promote a more active role that take the patients away of the initial passivity.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Apathy and depression: Which clinical specificities?
Authors: Palaric J. 
Published: May 2016

IntroductionApathy is a transnosographical symptom that is often described in psychiatric and neurological illness. The most known definition, proposed by Marin (1991), is a lack of goal-directed voluntary behavior. Apathy and depression may be present together but they are clinically independent. The confusion between signs of apathy and those of depression might reveal diagnostic and treatment issue. Our aim is to define a clinical profile of apathetic patients (Ap) with depression, hypothesizing there is a different clinic profile than non-apathetic patients (NAp).MethodSeventy adults diagnosed with depression were included in a comparative, non-randomized and open cohort, since November 2014. Clinical assessments targeted clinical scale evaluations (MINI, AES, MADRS, STAI, SHAPS). Patients were separated in two groups, Ap VS NAp, using a 42 points cut-off at AES score.ResultsAp represent 30%; n(Ap)= 21, n(NAp)= 49. Depressive severity scores (MADRS) are lower in the Ap group; W-test= 672, P= 0,044. State anxiety scores (STAI-A) are lower in Ap group; W-test= 739, P = 0,004. Anhedonia scores (SHAPS) are lower in Ap group; W-test= 412, P= 0,004. Pearson test show negative correlation between AES/STAI-A (r = -0,27; P= 0,02); AES/SHAPS (r= -0,45; P= 0,001).ConclusionApathetic patients suffering from depression seem to present different clinical pattern in term of anxiety and anhedonia. These results are high of interest for therapeutic and further studies focus on pathophysiological issues.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
The role of augmentation treatment with second-generation antipsychotics in major depression disorder–current evidence in the literature
Authors: Pereira E. , Coutinho F. , Marinho M. , Hipólito-Reis C. 
Published: May 2016

IntroductionMajor depressive disorder (MDD) is a chronic mental illness with a considerable lifetime prevalence in adult men and women. Only a third of MDD patients remit following adequate antidepressant treatment, while most suffer from significant core depressive or residual symptoms during their clinical course. Augmentation treatment with second-generation antipsychotics (SGAs) has been one of the suggested approaches to overcome this shortage of efficacy of antidepressant therapy.ObjectivesTo review the role of SGAs as an augmentation strategy to antidepressant therapy in MDD.MethodsA search of the MEDLINE/Pubmed database was conducted for articles from 2010 to 2015, using the MeSH terms “antypsichotics”, “depression” and “treatment”.ResultsThere is a general consensus in the literature that antidepressant augmentation treatment with SGAs is more effective than placebo in the management of patients with MDD who failed to respond adequately to antidepressant therapy alone. The majority of studies found no significant differences between the different studied drugs (namely, aripiprazole, quetiapine, olanzapine and risperidone). On the other hand, discontinuation rates due to adverse effects are also higher with SGAs versus placebo. However, it remains unclear if augmentation with SGAs is more effective than other therapeutic strategies, such as combination or switching to other antidepressant or augmentation with other psychotropics.ConclusionsThere is strong evidence that SGAs augmentation is an effective and generally safe therapeutic approach to patients with MDD who respond poorly to antidepressants. Nevertheless, more studies are needed to understand the efficacy of this treatment comparing other therapeutic approaches.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Differential profile amongst patients with depressive disorder (DD) and adjustment disorder (AD)
Authors: Martínez Arnaiz J. , Vallejo-Sánchez B. , Garcia Blanco C. , Pérez-García A.M. 
Published: May 2016

IntroductionAdjustment disorder (AD) is a condition that includes both emotional or/and behavioral symptoms and occurs when individual is unable to cope with stress. It is a common diagnosis but few studies have been done due to controversial diagnosis related to their diagnostic criteria definition. It is often difficult to establish differential diagnosis with condition such as depressive and anxiety disorders or even normal reaction to stressful situations. There are limited tools to evaluate such condition and its definition is focused or based on lack of severity.ObjectivesStudy objective target is to analyse the differences between two groups, a first group with AD and another one with Major Depressive Disorder (MDD) (with different sociodemographic, clinical and triggering individual factors such as vulnerability or copying management).AimsWe try to have a better comprehension and management of depressive conditions.MethodsTwo groups that belongs to Mental Health Community Team are compared. The first one with a diagnosis of AD, and another group with the diagnosis of MD. They have been diagnosed through a structured clinical interview and standard questionnaires to evaluate personality copying management. Other pathologies (such as psychotic, organic,…) were excluded through a structured clinical interview. We analyzed variables considered through variance analysis.ResultsSignificant differences between groups were found in some of the variables considered.ConclusionsThis study have important implications regarding evaluation, differential diagnosis and psychotherapeutic approach to patients with AD and MD.Disclosure of interestThe authors have not supplied their declaration of competing interest.