bluuebunny/crossref_metadata_2025_split huggingface dataset:
967 – Cause-specific Mortality Among Patients With Psychosis: Disentangling The Effects Of Age And Duration Since Diagnosis
Authors: Termorshuizen F. , Wierdsma A.I. , Smeets H.M. , Visser E. , Drukker M. , Nijman H. , Sytema S. 
Published: July 2013

IntroductionThere is a large mortality gap between patients with a non-affective psychotic disorder (NAPD) and the general population.ObjectivesTo assess whether mortality risks vary for different death causes according to duration since diagnosis and age in a large sample of NAPD patients.AimsTo get insight into the risk of specific death causes along the treatment trajectory, important for interventions that are tailored to the patients' risk profile.MethodsData of NAPD patients (n=12,580) from three Dutch psychiatric registers were linked to the registers of Statistics Netherlands and compared to personally matched controls (n=124,143). Death rates were analysed by duration since the date of diagnosis of the (matched) patient and age using Poisson regression.ResultsAmong patients, the rates of all-cause death decreased with longer duration. This was explained by lower suicide rates. E.g., among those aged 40-60 years, the rate ratios (RRs) of suicide during 2-5 and >5 years compared to the early years after diagnosis were 0.52 and 0.46 (P=0.002). Compared with controls, patients experienced higher rates of natural death causes during all stages and in all age categories: RRs 2.35-5.04, P < 0.05. No increase in these RRs for patients compared to controls with increasing duration or increasing age was found.ConclusionsThe high risk of natural death causes among NAPD patients is not (only) an effect of accumulating risks induced by the chronic nature of the disorder and/or antipsychotic treatment, but is already present during the early stages of the treatment and at young age.
978 – Involuntary Hospitalization In Psychiatric Hospitals Of Moscow
Authors: Tsygankov B. , Savelyev D. , Yaltonskaya A. 
Published: July 2013

The legislative framework for court-enforced hospitalization of mentally ill individuals was introduced to Russian legal system in 1992. The 29th Article of the Psychiatric Assistance and Civil Rights Act regulates it. The involuntary hospitalization is conducted when mentally ill individuals are at risk of harming themselves or others, unable to fulfill survival needs or are at risk for health and well being without psychiatric care.ObjectivesOf this study were to analyze the frequency of involuntary admission into psychiatric hospitals in Moscow through the Emergency Medical Service during a 2 -year period. As well as distinguish clinical, social and legal particularities associated with compulsory hospitalization.MethodsThe analysis of the database records of Psychiatric Department of the Station of Emergency Medical Service named after A.S. Puchkov for the period from July 2010 till June 2012.ResultsGeneral population of Moscow city consists of 11,5 millions people. 200 thousands individuals receive psychiatric care. Every year about 42,000 mentally ill people get admitted to the psychiatric hospitals in Moscow through emergency medical service. Around 60% (25 000) of the patients went through involuntary hospitalization. 82% of them were due to the autoagressive or aggressive behavior, including suicidal behavior and suicide attempts. 18% of involuntary hospitalization happened due to the psychiatric helplessness and risk for the health and well being of an individual in case of absence of psychiatric help. The numbers of involuntary admission remained stable over the two-year period. The most common entry diagnoses were unspecified schizophrenia and delirium tremens.
984 – Psychopathological Symptoms And Co-morbid Disorders Associated With Internet Addiction And Pathological Gambling: Analyses Of a Clinical Sample
Authors: Müller K.W. , Beutel M.E. , Wölfling K. 
Published: July 2013

IntroductionDespite growing interest in internet addiction (IA), there is still no consensus in perceiving it as a distinct clinical disorder. Proposals of including IA in the DSM-V and possibly also ICD-11 have strengthened the notion that it has a lot of features justifying its nosological classification as a primary disorder.ObjectivesBesides a large number of epidemiological surveys, clinical examinations investigating psychopathological symptoms and co-morbidity in a standardized way are still missing. Hence, clinical data is very important in the research on IA as it might support data gained in representative studies.AimsThe purpose of the study was to provide further clinical characterisation of IA.MethodsA clinical sample from a specialized outpatient clinic in Germany was examined by clinical ratings (GAF; psychiatric co-morbidity) and questionnaires (SCL-90R, PHQ). Two clinical groups were included: Patients meeting criteria for IA (n=80) and patients with pathological gambling (n=80). For further statistical comparison, healthy controls (n=80) were recruited too.ResultsBoth clinical groups scored significantly higher in SCL-90R and PHQ than the controls. Patients with IA showed similar profiles in SCL-90R as pathological gamblers with no significant differences in any sub-scale. Also, scores of GAF were similar. Expert ratings on co-morbidity indicate that depression is associated with both disorders. In IA also social phobia is common.ConclusionsPatients with IA and pathological gamblers display comparable levels of psychopathological symptoms and impairment. IA seems to cause significant psychopathological strain similar to pathological gambling that is accepted as a clinical disorder since the 1980ies.
988 – Coping Strategies Among Primary Caregivers Of Hiv/aids Infected Individuals
Authors: Mathew V.M. 
Published: July 2013

IntroductionCare giving for the HIV/AIDS individual in developing countries has become the responsibility of the family, and an identified primary care giver amongst them, who is subjected to enormous stress in fulfilling that role. Those who adopt healthy coping strategies, render better care to their wards, improving their quality of life.AimsTo study the coping styles among primary caregivers of HIV/AIDS patients.ObjectivesTo assess patterns of coping among primary caregivers of patients infected with HIV/AIDS.MethodsA cross sectional study design was employed. 60 consecutive patients were recruited for the study after consent, from the ART centre of a tertiary care hospital. Socio demographic details were collected, and coping strategies assessed using Active behavioral, Active cognitive and Avoidance coping strategies Scale (Billings & Moos, 1984).ResultsThree patterns of coping were used. Avoidance as a strategy was predominant in older care givers, males, bread winners, influenced by their age, gender and financial independence, respectively. Professionally employed individuals used more coping strategies while those with lower levels of education and employment used fewer strategies, probably an indication of their access to information regarding the illness. Primary carers, for less than a year, used more avoidance; those for more than five years used more cognitive strategies, those between these groups used more behavioral ones.ConclusionIntervention for those primary care givers who employ fewer coping strategies, predominantly avoidance would help improving the quality of care rendered to the afflicted individuals and thereby their quality of life.
996 – Capgras Syndrome In a Three-decades Non-treated Schizophrenia: a Case Report
Authors: Morgado P. , Freitas D. , Carvalho J. , Silva L. , Gonçalves M.M. , Gonçalves J. 
Published: July 2013

IntroductionCapgras syndrome is a misidentification syndrome typically characterized by the delusional belief that a close relative has been replaced by an impostor. This monothematic delusion can be found in numerous disorders such as paranoid schizophrenia, schizoaffective disorder, affective disorders, Alzheimer's disease, Lewy body dementia, head trauma, epilepsy, cerebrovascular disease and dementia, pituitary tumor, multiple myeloma, multiple sclerosis, viral encephalitis, frontal lobe pathology and AIDS. We present a case of a patient that presents Capgras Syndrome at the first psychiatric evaluation in the context of three-decades untreated paranoid schizophrenia.Case reportA 56-year-old woman was brought to the psychiatric department for evaluation for aggressive behavior directed to relatives. She has a history of auditory hallucinations, experiences of self-reference and paranoid delusions with more than 30 years of evolution. More recently, she started becoming aggressive with relatives, saying her real family members had been taken by strangers to an unknown hospital. She also said that her ID photo had been replaced by another person's photo. After detailed psychiatric evaluation, blood analysis and imaging study, the diagnosis of Paranoid Schizophrenia was established. She was treated with olanzapine 20mg/day with behavioral improvement.ConclusionsAlthough Capgras Syndrome is not a psychiatric diagnosis but a feature of several different conditions, psychiatrists should be aware of this syndrome as it can signalize underlying psychiatric disorders and is usually associated with violent behaviors that should be managed.
998 – Can We Still Talk About Paraphrenia? a Case Report
Authors: Freitas D. , Morgado P. , Carvalho J. , Silva L. , Fernandes N. 
Published: July 2013

IntroductionParaphrenia is a disorder similar to paranoid schizophrenia characterized by phantastic, paralogical and extraordinary imaginative delusions, with better-preserved affect and rapport and much less personality and cognitive deterioration. Most affected patients are women, with onset of symptoms in late adulthood. It was firstly systematically described by Kraepelin in 1913 in order to define a group of psychotic patients who exhibited characteristic symptoms of dementia praecox, but with minimal disturbances of emotion and volition, and marked delusions. Later, it was considered to be unfounded and the term paraphrenia was not included in the current DSM-IV-TR and ICD-10 diagnostic criteria. However, several authors suggest that the concept of paraphrenia has not lost its usefulness and it seems to be that some psychiatrists recognize the illness, but labelled it as atypical psychosis or delusional disorder for the lack of a better diagnostic category.Objectives/aimsThe aim of this poster is to underline the modernity of Kraepelin's paraphrenia concept, suggesting that it could be possible to define and recognize the illness if practitioners would be induced to use a viable diagnostic entity.MethodsHerein we report a case of a 51-year-old woman who presented three years ago with a psychotic disorder whose clinical features resemble de classical description of paraphrenia.Results/conclusionVery few systematic studies on paraphrenia have been carried out in the past 70 years. Further research in this field is needed in order to recognize the viability of this diagnosis and provide patients a better care and therapeutic management.
1002 – Sociodemographic And Psychopathological Characteristics In Psychiatry Emergencies: An Observational Study
Authors: Martínez Cortés M. , Pérez Maciá V. , Pecino Esquerdo B. , Serralta Gomis M.J. , Calvo Fernández A. , López Pastor G. , Bernabeu M.J. , Tercelan E. , García Fernández L. , Oliveras Valenzuela M.A. 
Published: July 2013

IntroductionA psichiatric emergency is a situation where disorders of thought, mood or behavior are so disruptive that require immediate assistance.ObjectivesTo analyze clinical and sociodemographic characteristics, predictors of hospitalization, and poli-attendance in patients attended in a reference area psychiatric emergency service.MethodologyAll assistances from 01.12.2011 to 31.01.12 were recorded in a database. Patient poly-attendance was defined by two or more assistances during the study period. Logistic regression analysis was performed to find out hospitalization and poli-attendance predictors.ResultsN = 219. 50.68% male, 49.32% female; 86.75% between 20-64 years. 45.62% finished primary studies. 80.82% owned social support network. 80.73% unemployed. 71.89% voluntary assistances. 58.97% already tracked by mental health, 24.66% first contact. Reason care: anxiety (24.20%), behavioral disorders (22.57%), suicide (20.55%) and psychosis (12.79%). Final diagnoses: psychosis (24.20%), anxiety (15.48%), depression (10.05%), drugs abuse (9.13%), personality disorders (17.35%), mental retardation (8.22%), social issues (16.89%).26.94% were poly-attendance, assisted by: organic mental disorder (OR= 21,10, IC95%), personality disorders (OR=4,313, IC95%), mental retardation (OR=5,545, IC95%), social issues (OR=2,94, IC95%). 24.20% of the patients hospitalized. Factors associated to risk: age range 15-20 (OR 12.10, IC95%); psychosis (OR = 51.03, IC 95%), depression (OR = 14.61, IC95%), bipolar disorder (OR=20,38, IC 95%).ConclusionsMinor diseases, social issues or stables axis II disorders accomplished most attendances. Hospitalitation was associated with severe mental illness and lower age.Poly-attendance is not associated with axis I patology, but it is with axis II and IV disorders.
1004 – Effects Of Internalized Stigma Of Mental Disorder On Quality Of Life And Self-esteem In Schizophrenic Patients
Authors: Batinic B. , Lemonis E. , Opacic G. 
Published: July 2013

Introduction and objectivesResearch suggests that internalized stigma of mental disorder (which reflects the degree to which a person holds internalized stigmatizing beliefs about mental illness) leads to decreased self-esteem, depression, delayed seeking of treatment, prolonged course of illness, poor outcome, social withdrawal, reduced self-efficacy and worsening of quality of life.MethodsOn a sample consisting of 40 outpatients with ICD-10 diagnosis of schizophrenia, with average age of 40.73 (SD= 9.168) and mean illness duration of 15.525 (SD=8.202) years, we administered the Internalized Stigma of Mental Illness Scale, the Rosenberg Self-Esteem Scale, the Manchester Short Assessment of Quality of Life and Beck Depression Inventory II. The questionnaire also included several socio-demographic and clinically-related variables.ResultsSchizophrenic patients showed a moderate level of internalized stigma (M= 40.125, SD= 9.946). Patients with higher levels of internalized stigma had significantly poorer quality of life (r= -0.422) and lower self-esteem (r=-0.318). There was a positive correlation between the level of depressive symptomatology and the level of internalized stigma (r=0.385). Correlation with the duration of illness was not statistically significant (r=-0.145).ConclusionsOur results confirm the data of numerous researches, as well as our earlier findings on the negative effects of internalized stigma of mental disorder on self-esteem and quality of life in panic disorder patients. In order to improve the quality of life of schizophrenic patients, we should increase awareness of the negative effects of internalized stigma and focus interventions on altering stigmatizing attitudes and enhancing coping skills.
1010 – Polydipsia As a First Signal Of Psychosis - a Case Report
Authors: Silva L. , Morgado P. , Freitas D. , Carvalho J. , Silva L. 
Published: July 2013

IntroductionPsychogenic polydipsia associated with hyponatremia is a potentially dangerous and fatal condition observed on patients with psychiatric illness, specially schizophrenia. This results on a peripheral oedema and can lead to cerebral oedema, mental status deterioration and intracranial hypertension if not identified and treated urgently. We present a case of polydipsia as first signal of psychosis.Case report20-year-old man without significant past medical or psychiatric history attended to emergency service presenting exuberant lower limbs oedemas. The analytical study stated an hyponatremia and hipo-osmotic urine. A psychiatric evaluation was made after organic illness exclusion. The patient presented serious behaviour changes, delusions and eating disturbances (“eat raw meat to recover the red cells that they had stolen from him”), polydipsia and auditory hallucinations with 2 weeks of evolution. The patient was compulsory hospitalized, treated with risperidone and lorazepam and discharged 28 days after admission without psychotic symptoms.ConclusionsThe recognition and management of the polydipsia as a first signal of psychosis are difficult because sometimes patients are uncooperative and tend to hide their water intake, but is important to be awhare to this signal to prevent the morbidity and mortality associated with this disease.
1020 – Causal Reattributions In Psychosomatics
Authors: Coremans E.L. 
Published: July 2013

ObjectiveTo measure changes in causal attribution in chronic fatigue syndrome. The cause of chronic fatigue syndrome (CFS) is still unknown. Behavioral, cognitive and affective factors may play a major role in perpetuating fatigue.Method175 patients fulfilling Fukuda CFS criteria participated in a six-month CBT associated with GET based on adaptive pacing strategy, in a group setting. Causal attribution was measured with the Causal Attribution List (CAL). Therapy didn’t aim change in causal attribution. All patients were included in a prospective outcome study at the university outpatient Chronic Fatigue Reference Center (UCL), with multidimensional assessments at baseline and after treatment: Checklist Individual Strength (CIS); Short Form General Health Survey (SF36), Causal Attribution List (CAL).ResultsAt baseline, SFC patients were more likely to attribute their fatigue to physical than psychosocial causes (p< 0.001). After treatment, fatigue severity and behavioural consequences (CIS) and the most factors of health-related quality of live (SF36) improved significantly (p< 0,001). After treatment, patients had more causal attributions (CAL) than at baseline (p< 0,001). Correlation analyses indicated that improvement of subjective fatigue (CIS-severity, SF36-vitality) was not correlated significantly neither with physical or psychosocial causal attributions scores at baseline, nor with individual changes of physical or psychosocial causal attributions after treatment.ConclusionCausal reattribution is not necessary in chronic fatigue syndrome CBT. In our study (n=175) improvement of subjective fatigue is not correlated with changes in causal attribution. The advantages of abstention from causal reattribution in psychosomatics will be discussed.
1023 – Therapeutic Drug-monitoring Of Bupropion For Depression
Authors: Laib K. , Brünen S. , Pfeifer P. , Vincent P. , Hiemke C. 
Published: July 2013

IntroductionTherapeutic Drug-Monitoring (TDM) for bupropion is limited by bupropion's instability at room temperature and by the absence of a well-defined therapeutic reference range. Further it is unclear to what extent bupropion and its metabolites contribute to therapeutic effects, though hydroxybupropion seems to account for the major antidepressant effects.AimThe aim of this examination was to check if measurement of only hydroxybupropion is useful to guide the antidepressant therapy with bupropion.MethodsHydroxybupropion plasma levels were measured by high performance liquid chromatography with ultra violet detection and related to therapeutic effects measured by the Clinical Global Impression Scale for improvement.ResultsThe study included 52 patients (50% female). Patients who were very much improved according to CGI had significantly (p=0.042) higher hydroxybupropion serum levels than patients with moderate or minimal improvement (mean±SD, 1113±576 ng/ml, 825±398 ng/ml and 475±331 ng/ml, respectively). Receiver operating characteristics analysis revealed significant predictive properties of hydroxybupropion serum levels (p=0.002) for improvement with a lower threshold level of 858 ng/ml. Women attained significantly higher serum levels than men and also exhibited a better therapeutic effect (p= 0.018), though they did not receive significantly higher doses.ConclusionsMeasurement of hydroxybupropion plasma levels can be used to optimize the therapeutic outcome of patients treated with bupropion. Plasma levels between 850 and 1500 ng/ml can be regarded as optimal. Potential sex differences in bupropion pharmacokinetics, probably due to differential activities of CYP2B6, should be taken into account.
1025 – The Isle Of Wight Suicide Study: a Case Study Of 68 Suicides Between 2006 And 2009
Authors: Shahpesandy H. , Van Heeswijk A. 
Published: July 2013

BackgroundThe aim of the study was to identify sociodemographic, clinical and service delivery risk factors for suicide in the population of service-users (SUs) and non-service users (NSUs) plus gender-related characteristics of suicidal behaviour; in a limited geographic region.MethodData were collected on 68 cases of suicide (ICD-10 X60-X84) for residents on the Isle of Wight between January 2006 and December 2009.ResultsSignificantly (p=0.0006) more men than women (male/female ratio 3:1) died by suicide. Relatively (p=0.07) more women (56.2%) than men (32.7%), and significantly more (p=0.05) SUs (45.3%) than NSUs (13.3%) were unemployed. Significantly more (p=0.0006) SUs (64%) than NSUs (20%) had a history of suicide and relatively (p=0.06) more (50.9%) SUs than NSUs (20%) had attended the A & E prior to their death. 69% had an adverse life event within a year prior to their suicide. Depression was significantly (p=0.008) more frequent in women (66.6%) than men (23.7%). Suicide by hanging was the commonest cause acounting for death of 71% of men and 50% of women. 57.3% of deaths occurred at their place of residence and 75% of on weekdays. 50% of women died in autumn, compared to 28.8% of men. There were three inpatient deaths (4.4%). Relatively (p=0.08) more women (56.2%) than men (32.7%) have contactacted serivces before their death.Conclusions80% suicides were conducted by people suffering from a mental disorder. Men are at a significant risk of suicide. Anxiety disorders in men and depression in women are the most common mental disorders.
1045 – A Unique Case Of Paraneoplastic Extra-limbic Encephalitis Presenting With Neuropsychiatric Symptoms Subsequent To Biopsy
Authors: Lubarsky K. , Coira D. , Spariosu M. 
Published: July 2013

IntroductionParaneoplastic disorders of the CNS are a heterogeneous group of neurological disorders associated with systemic cancer which cannot be attributed to direct effects of the neoplasm. Although there is extensive literature focusing on the neurological manifestations of these disorders, the initial presentation is psychiatric in many instances and discussion in the psychiatric literature is relatively sparse.Objectives-To bolster recognition and enhanced characterization of paraneoplastic disorders from within the psychiatric community.-To explore temporal aspects of symptom presentation in relation to biopsy.-To identify how psychoneuroimmunological factors may contribute to the development of paraneoplastic disorders.Case descriptionWe report the case of a 48 year-old female with no past psychiatric history who presented with neuropsychiatric symptoms immediately subsequent to biopsy and inflammatory breast cancer diagnosis. Patient was initially admitted to the psychiatric unit for suspected acute stress reaction, yet eventually diagnosed with paraneoplastic extra-limbic encephalitis.Conclusions-As early oncologic treatment and immunotherapies improve outcomes, early diagnosis is paramount for both treating the paraneoplastic syndrome and identifying possible underlying malignancy.-Time course of symptom presentation raises the intriguing possibility that perturbation of tumor tissues during biopsy may accelerate the immune response to onconeuronal auto-antigens and inflammation-mediated neuronal injury.-Given the patient's acute stress state, the rapid time course of symptom onset, and known connection between psychological stress and autoimmunity, we propose that the immune system stress-response may additionally contribute to the paraneoplastic syndrome development. This connection warrants further investigation from within the psychoneuroimmunology community.