bluuebunny/crossref_metadata_2025_split huggingface dataset:
1764 – Case Report: Antidepressant Withdrawal Mania
Authors: Nascimento M. , Graça J. , Palma D. , Trancas B. , Ribeiro R. , Luis A. 
Published: July 2013

IntroductionAntidepressant withdrawal mania is a rare paradoxical event. It was initially reported in unipolar patients but it can also occur in bipolar patients, despite adequate mood-stabilizing treatment. It has been described with all antidepressant classes and may be self-limited or require medical hospitalization. Tapered withdrawal doesn’t seem to prevent the condition, though most reported cases developed after abrupt antidepressant discontinuation. Chronic antidepressant therapy enhances dopaminergic neurotransmission in the mesolimbic system. Noradrenergic hyperactivity and cholinergic overdrive secondary to antidepressant cessation are the most accepted theoretical mechanisms proposed.ObjectivesCase report, discussion and literature review.AimsWe report a case of fluoxetine withdrawal mania and discuss its implications on clinical practice.MethodsCase report and non systematic literature review.ResultsWe present a case of a divorced 59-year-old woman who developed a manic episode shortly after antidepressant discontinuation. She was under antidepressant therapy since 2001, due to an unipolar chronic depressive disorder. She was put on fluoxetine 20 mg q.d. since 2005. On May 2012, she discontinued the antidepressant therapy upon misunderstanding medical advice. Few weeks later, she was involuntarily admitted to our inpatient unit presenting a manic episode with psychotic features. She started valproic acid 1000 mg q.d. and risperidone 4 mg q.d. and a complete remission was quickly obtained.ConclusionsThis case illustrates the potential for mania related to antidepressant discontinuation. Differential diagnosis includes spontaneous mania, antidepressant withdrawal syndrome and antidepressant induced mania. Finally, the authors discuss the adequacy of categorizing this entity in bipolar spectrum disorders.
1776 – Clinical And Cognitive Correlates Of Suicide Attempts In Bipolar Disorder
Authors: Seyller M. , Olié E. , Chaib L. , Henry C. , Courtet P. ,   the BIPADD Group of Face
Published: July 2013

IntroductionBipolar disorder (BD) is strongly associated with suicidal behaviors. Suicidal behavior is based on a stress/vulnerability model. Several factors have been identified, including clinical features (such as impulsivity) and cognitive deficits (such as impaired decision making or problem solving). Identifying specific factors in BD patients is needed to better prevent suicidal behaviors.Objectives1)To identify clinical and cognitive characteristics associated with suicidal behaviors in euthymic BD patients.2)To determine a correlation between neuropsychological variables and the number and characteristics of suicidal attempts.Methods214 euthymic BD patients from the national network of “Centres Experts Bipolaires” were included and divided into two groups based on the personal history of suicide attempts. Socio-demographic and clinical variables were collected and neuropsychological functions were assessed (attention, memory and executive functions).ResultsWe found an association between suicidal behavior and gender, employment status. Suicidal attempters had significantly more mixed episodes and hospitalizations. There was no difference between the two groups concerning neuropsychological measures. The number of suicide attempts and verbal fluency scores were negatively correlated.ConclusionsThe lack of significant differences in neuropsychological scores may be due to a common vulnerability between suicidal behaviors and BD. Further studies, especially prospective ones, are needed in order to characterize high risk BD patients in order to develop effective specific preventive strategies.
1791 – A Case Of Psychosis In a Patient Affected By Beta Thalassemia Major: a Genetic Link?
Authors: Ranieri R. , Demartini B. , Mormandi G. , Scarone S. 
Published: July 2013

A 35-year-old man affected by betathalessemia major was treated at the age of 10 years old by allogeneic bone marrow transplant and then he had a one-year treatment with cyclosporine. In March 2012 he was admitted to our psychiatric department because of delusional thoughts, hallucinations, anxiety and behavioral abnormalities. The insight was absent. His parents reported a progressive social retirement from the age of 16 years old and hallucinations even in the last few years. Furthermore the familial history was positive for psychotic symptoms (brother).During the hospitalization, an antipsychotic therapy based on paliperidone was started. After two weeks at the dosage of 9 mg per day his psychopatological condition slowly improved. He was discharged after one month: delusions, hallucinations and behavioral abnormalities disappeared, anxiety decreased. During the following months the patient was evaluated: no relapse of positive symptoms was observed but his personal, social and working functioning remained significantly impaired. A diagnosis of schizophrenia has not been formulated yet because of the temporalcriterion.Cases where schizophrenia and betathalassemia occurred simultaneously were reported in literature, mostly when psychotic symptoms affected more than one family member. The association maybe suggests a genetic link between these two disorders. Previous studies showed that genetic abnormalities in the short arm of chromosome 11, responsible of betathalassemia, are also known as crucial regions for the genetic susceptibility of schizophrenia.Further studies are needed to better clarify this genetic association in order to verify which abnormalities of chromosome 11 are more associated with the onset of schizophrenia.
1792 – Inpatient Suicide Risk Association With Depression, Anxiety Disorders And Pharmacogenetic Testing
Authors: Lineberry T. , Parsaik A. , Moore K. , Bryan C. 
Published: July 2013

IntroductionNational and international research has shown the association between depression and anxiety disorders with the risk of planned and impulsive suicidal behavior. Patients with depression may have severe anxiety or agitation associated with their depression with or without comorbid additional anxiety disorder diagnoses.Objectives1.Evaluate differences between self rated overall suicide risk of inpatients on a treatment resistant depression unit based on presence or absence of comorbid anxiety disorder.2.Evaluate association of pharmacogenetic testing results with self-ratings of suicide risk.Aims1.To determine if suicide risk of psychiatric inpatients is higher in patients with depression and comorbid anxiety disorder.2.To determine utility of pharmacogenetic testing with suicide risk assessment and patterns of use in patients with treatment resistant depression at a large academic medical center.MethodsThis is a retrospective records review study of a sample of over 700 inpatients on a treatment resistant depression unit at the Mayo Clinic. Patients overall suicide risk self-assessments will be analyzed for differences in suicide risk assessment controlling for diagnoses, age, and sex. Pharmacogenetic testing results, including serotonin transporter and p450 2D6 testing results, will be analyzed for their association with suicide risk.ResultsStatistical analyses results are pending at time of abstract submission.ConclusionsAt a population level, the interplay between anxiety disorders and depressive symptoms is felt to be key to understanding the progression from suicidal ideation to suicidal behavior. Factors complicating this at an individual patient level along with results of research study will be discussed.
1796 – Social Phobia In Non-demented 75- And 85-year Olds. Associated Factors
Authors: Karlsson B. , Skoog I. 
Published: July 2013

IntroductionSocial phobia is one of the most common psychiatric disorders. There is a lack of knowledge on the relationship between social phobia and cognitive functioning among older adults.AimTo examine cognitive functioning, prevalence and psychiatric comorbidity of social phobia in an elderly population.MethodsA general population sample of non-demented 75-year olds (N = 768) and 85-year olds (N = 432) was investigated in 2005-2006 (75-year olds) and 2009-2010 (85-year olds) by psychiatric nurses. The procedure was identical with semistructured psychiatric examinations including the Comprehensive Psychopathological Rating Scale, and the Mini International Neuropsychiatric Interview. Social phobia was diagnosed according to the DSM-IV criteria. Cognitive function was measured with the Mini-Mental State Examination, and eight different psychometric tests measuring short- and long-term memory, nonverbal memory, logical reasoning, visuospatial and executive ability.ResultsThe one-month prevalence of social phobia was 2.5% (N = 30), this was more common among women than among men (3.2% vs. 1.3%). Individuals with social phobia more often had major depression compared to individuals without symptoms of social phobia (33.3% vs. 4.3%). MMSE-score did not differ between individuals with and without social phobia. Individuals with social phobia had worse visuospatial and executive ability measured with Clock Test, compared to individuals with no symptoms of social phobia.ConclusionsOur results indicate that social phobia is not unusual in old age and that comorbidity with depression is common. Social phobia does not have an impact on global cognitive functioning. Social phobia influenced visuospatial and executive ability but not performance on several other cognitive tests.
1800 – Improvement Of Attention Deficit Hyperactivity Disorder Management In The Primary Medical Home Through Psychiatrist-taught Psychopharmacology
Authors: Wegner L. , Humble C. , Domino M. , Stiles A. , Wegner S. , Kratochvil C. , Jensen P. 
Published: July 2013

IntroductionUS primary care clinicians (PCCs) are increasingly assuming the medical management for psychiatric disorders. Clinical practice guidelines (PCGs) remain gold standard for professional care, yet physician adoption is not universal. We sought identification of methods to increase evidence-based mental health practices for the most commonly diagnosed pediatric behavioral condition, attention deficit hyperactivity disorder (ADHD).ObjectiveTest two psychiatric interventions of different intensity levels, both designed to increase primary care clinicians’ use of PCGs for managing ADHD.AimsIncrease PCCs’ use of PCGs for managing ADHD.MethodsParticipants: 70 North Carolina (NC) PCCs ; 70 case managers; 35 to 40 pediatric resident physicians; 420 pediatric government-insured patients ages 6-18 years (chart abstraction only).Procedures: PCCs were randomized to:(1)PCC training and follow-up support only; or(2)PCC, case manager, and office staff training (collaborative) and follow-up support interventions.Differences in knowledge, skills, attitudes, and ADHD assessment and treatment practices assessed by participant selfcompleted surveys at baseline, 6, and 12 months. Six of their patient charts were abstracted to determine the extent they followed American Academy of Pediatrics (AAP) treatment guidelines. NC Medicaid (government insurance) claims for children and adolescents of participating practices and a group of control practices were reviewed for diagnostic documentation.ResultsFor collaborative trained PCCs:(1)increased use of ADHD symptom screeners and greater frequency of F/U visits;(2)greater identification of children with ADHD, but decrease in the probability of receiving an ADHD medication(3)lower rate of prescribing above dosing guidelines.
1820 – Suicide In The Us Army
Authors: Lineberry T. 
Published: July 2013

IntroductionSuicide rates in the United States Army have steadily risen over the past eight years to record levels and continue to rise. The suicide rate now is greater than the general US population even after controlling for sex and age. This change is even more concerning based on the previous steady decreased rate compared to the US general population in the thirty years prior to 2004. In 2012, suicide deaths have outpaced combat deaths year to date.Objectives1. Using epidemiologic surveillance data and new scientific data, describe factors associated with the increase in suicide deaths and potential targets for interventions.AimsProvide overview of factors associated with suicide in military populations and effects of combat on suicide rates.MethodsInformation provided will be based on current published and ongoing research synthesizing the larger suicide research literature.ResultsSuicide in the Army has steadily increased since 2004 along with other surrogate markers of increased psychiatric illness including post deployment surveillance, anonymous surveillance, clinical utilization rates and rates of drug misuse and abuse.ConclusionsIntegrating media and scientific reports on the increased rates of miltary suicide is challenging. However, clinically relevant targets to impact rates along with strategies to research factors associated with suicide and larger prevention efforts hold promise.
1823 – Addiction To High Dose Buprenorphine And Sexually Transmitted Diseases In Tunisia
Authors: Belarbi A. , Ben Ammar H. , Moula O. , Bouasker A. , Ghachem R. 
Published: July 2013

IntroductionHigh dosage buprenorphine (Subutex) is actually the principal treatment for substitution medication. Some misappropriations and wrong uses have been seen; the most frequent and sever being using tablets for injections. Since the introduction in different countries, the high dose buprenorphine as a substitition treatment for opioid drug dependence, the number of overdose deaths and heroin users are significantly declined. But the existence of non-use replacement of this processing, mainly intravenously, was born a new scourge of addiction, especially in Tunisia. Besides the risk of overdose, there is a risk of viral contamination.ObjectivesTo study the sexually transmitted diseases among patients addicted to high dose buprenorphine in Tunisia and followed in the outpatient hospital Razi.Materials and methodsIt is a retrospective study of twenty-three (23) patients (23 men), injection of high dose buprenorphine, having consulted the outpatient clinic of Razi Hospital between January and July of 2012.Results8 patients had a communicable disease: 1HIV, 5 Hepatitis C, 1Hepatitis B, 1 syphilis. 4 patients had infectious complications: 3 cases of skin infections and 1 case of endocarditis. 9 had never been screened. 8 recognized using a used needle.ConclusionThe addiction to high dose buprenorphine is a widespread phenomenon in Tunisia. Lack of information and awareness of companion in Tunisia is at the origin of serious infectious complications. Health professionals have to play an important role in drug addict patients’ education and supervision, to prevent addiction to buprenorphine and related infectious complications.
1826 – State And Trait Anxiety In Young Women With Vasovagal Syncope
Authors: Szewczuk-Boguslawska M. , Zysko D. , Kaczmarek M. , Agrawal A.K. , Rudnicki J. , Gajek J. , Fedorowski A. 
Published: July 2013

ObjectivesThe aim of the study was to assess the state and trait anxiety in women with vasovagal syncope.MethodsThe study group consisted of 50 women referred to tilt testing with finally diagnosis of vasovagal syncope and 166 women from general population: 115 women who have never experienced faints (control negative group), 51 women who reported at least one faint episode (control positive group). All women were aged 21-40 years old. Women filled State and Trait Anxiety Inventory (STAI), the women from study group just before tilt testing after the whole procedure explanation. No one asked woman refused STAI completion or tilt testing. The STAI results were presented as raw results and trichotomized into lower than average, average and higher than average.ResultsThe raw result of STAI as a state was significantly higher in the study group (41.6 ± 9.8) than in the both control groups (37.6 ± 10.6 and 39.8 ± 10.5) p< 0.05. The raw results of STAI as a trait did not differ among groups (respectively 41.3 ± 8.7 vs 40.4 ± 9.4 vs 42.3 ± 8.8 p=NS). The occurrence of lower than average trait anxiety was significantly lower in study (36.0%) and control positive group (37.3%) than in the control negative group (56.5%) p< 0.05. The percentage of women with higher than average trait anxiety did not differ.Conclusions1.High trait anxiety seems not be related to the occurrence of vasovagal syncope.2.Lower than average trait anxiety may play protective function of vasovagal syncope occurrence.
1827 – Prevalence Of Risk Behaviours Among European Young. Preliminary Data From An Italian Sample We-stay Project
Authors: D’Aulerio M. , Carli V. , Iosue M. , Basilico F. , Recchia L. , Apter A. , Balazs J. , Bobes J. , Brunner R. , Cosman D. , Kahn J.P. , Postuvan V. , Saiz P. , Varnik A. , Wasserman C. , Hoven C. , Sarchiapone M. , Wasserman D. 
Published: July 2013

IntroductionTruancy negatively affects almost every aspect in the life, including physical, mental health, social and economical conditions.ObjectivesTo implement and evaluate outcomes of three different kinds of intervention against truancy. A mechanistic intervention to stop truancy will be used as control.AimsTo reduce truancy among European adolescents improving mental health in European high schools.MethodsThe WE- STAY intervention carried out in 6 different European Countries. In Italy a sample of 2265 High school students (mean age 15.6 ± 0,6; 64,4% females) was selected. The students were randomized into one of four different intervention arms. Baseline evaluation of students' lifestyle, coping styles, at-risk truancy, self-harm behaviours and mental health issues was collected using a structured questionnaire.Results6% has been absent from school for 7 days or more without a valid excuse during the past year. 55,0% of the sample has smoked cigarettes; 7,2% drank alcohol 4 or more time during the week (13,9% male and 3,4% female). About the use of drugs, 17,4% of them used drugs at least once in a lifetime. 16% of the students started a fight at least once in a lifetime.ConclusionsTruancy is often related to mental health problems and at-risk behaviours. The truancy has been the focus of a different policy initiatives, often ended in failure. Through the implementation of WE-STAY is possible to acquire more data on truancy prevalence and its correlated psycho-social and psychiatric aspects, as well as information on school and parents attitudes toward this phenomenon.
1830 – The Particularities Of The Long-term Evolution Of Functional Psychoses (the Timisoara Project Of Typology And Evolution Of Functional Psychosis)
Authors: Lazarescu M. , Blajovan J. , Giurgi-Oncu C. , Baranescu R. , Milin M. , Mihalcea R. , Suflea C. , Rosu M. 
Published: July 2013

This study discusses 597 cases of functional psychosis with an average evolution of over 10 years and a stable diagnostic over the last 5 years, found in the outpatient service of Timisoara.The cases are part of the project entitled The Timisoara Project of Typology and Evolution of Functional Psychosis, initiated with a Case Register since 1985 to date.The research team has since remained unaltered and for all the cases there was a permanent record of psychopathological episodes upon admissions, clinical evolution and treatment between episodes, socio-demographic dynamics, as well as other types of evaluation.The assessments were made at 1 year after onset, and respectively after 5, 10 and 15 years. The stability or metamorphosis along time of these diagnostics was evaluated, as well as other clinical parameters from onset to present days. The approach has allowed for the parallel study of the following casuistry (understood both as episode and constant disorder): schizophrenia, persistent delusional disorder, bipolar disorder with or without delusional ideation, major depressive disorder with or without delusional ideation, schizoaffective disorder (with various subtypes). The casuistry has evidenced delusional disorder as being distinct from schizophrenia, both in terms of independent evolution, as well as in association with affective pathology.
1831 – Dnase And Protease Activity Of Immunoglobulins g Of Patients With Schizophrenia
Authors: Smirnova L. , Fattakhov N. , Parshukova D. , Buneva V. , Kornetova E. , Semke A. , Ivanova S. 
Published: July 2013

IntroductionPhenomenon of presence of catalytic properties in immunoglobulins has been actively investigated. Research of catalytic properties of antibodies in schizophrenic patients with various clinical manifestations of the illness has not been carried out previously.ObjectivesTo study DNase and proteolytic activity of immunoglobulins G isolated from serum of blood of patients with schizophrenia.MethodsIgG have been isolated from serum of blood of 34 persons with affine chromatography. DNase activity of antibodies was identified according to degree of hydrolysis of supercoiled form of DNA of plasmid pBluescript per unit of time. Proteolytic activity was assessed according to degree of hydrolysis of basic protein myelin and its peptides. IgG were electrophoretic homogeneity.ResultsWe have identified that IgG of schizophrenic patients possess a higher (0,392 ± 0,19 nM DNA /mgAB/h), than in healthy persons (0,029 ± 0,06 nM DNA /mgAB/h) specific DNAse activity. It has been shown that DNase activity is an own property of antibodies. It has been found that proteolytic hydrolysis of serum of blood of schizophrenic patients is 5 times as high as indices of hydrolysis in healthy persons. It has been revealed that patients with predominant negative symptoms show maximum high percent of protease hydrolysis 66,9%, different from patients with leading positive symptoms (13,9%).ConclusionsIncrease of DNA-hydrolyzing properties of Ig G is likely to be associated with great number of extracellular DNA. Detection of high values of proteolytic activity may be associated with occurring in serum of blood of patients of large number of destructed or damaged proteins.
1833 – Incest: a Traumatic Experience: a Case Report
Authors: Belarbi A. , Ben Ammar H. , Moula O. , Bouasker A. , Ghachem R. 
Published: July 2013

IntroductionIncest may be defined as sexual relations between close blood relatives. It is found in all walks of life and all cultures. Incest is a taboo in all populations. This “secret” lived in childhood raises questions about the future of such a psychological trauma. Father-daughter incest is the most common. It has psychological, social, medical, and legal ramifications. Recently, it was reported that being the victim of paternal incest during childhood might be a significant predictor of a borderline personality disorder and complex posttraumatic stress in adults. Tunisia is among the countries from which incest cases are rarely reported.ObjectivesBrowse the impact of this early trauma on victims to become adult and difficulties the therapeutic approach.Clinical caseWe propose from a clinical case of a family, in which five girls were victims of father-daughter incest.ConclusionThis would suggest that father-daughter incest is the most traumatic experiences which deserves attention and that we cannot afford to ignore. In-depth knowledge of the dynamics and effects of father-daughter incest suggest specific treatment strategies are indeed necessary.