bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Importance of Recognition, Validation and Certification of Competences System in Promoting Mental Health
Authors: Sa M. , Ferreira J. 
Published: May 2011

In Portugal, Recognition, Validation and Certification of Competences (RVCC) allows adults to achieve recognition of competences acquired by formal and informal learning using a Competences Reference System. By creating a portfolio describing their life story, adults may explore and question their own living experiences.This communication aims at promoting deep consideration on the importance of an RVCC process in promoting adult mental health. It analyses the relation between mental health and the RVCC process, and its benefits to prevention and rehabilitation. Methods include my experience as a psychologist at a Centra de Novas Oportunidades (New Opportunities Centre) and scientific literature on the subject. Adults are involved in activities which contribute to developing their social competences. They increase self-confidence and self-esteem, control over life choices and accountability for their actions. In Portugal, this process also involves patients with mental disorders and offers appropriate Key Competences Reference Systems. Adults suffering from mental disorder and undergoing a RVCC process re-establish their self-confidence, self-esteem, self-efficacy and gain a positive hope for the future. Empowerment leads them to cooperate more actively with mental health professionals in their own treatment and rehabilitation plan.Despite being highly criticized as a system which only validates competences, such criticisms to this process are clearly reductive.
N-3 Fatty Acid Supplementation Influences Membrane Fatty Acids and Phospholipase A2 Activity in Patients at Risk to Develop Psychosis
Authors: Smesny S. , Milleit B. , Schäfer M. , Milleit C. , Otto M. , Hipler U.-C. , Berger G. , Sauer H. , Amminger P. 
Published: May 2011

IntroductionDecreased levels of polyunsaturated membrane fatty acids (PUFA) and increased activity of cytosolic phospholipase A2 (PLA2) enzymes (key regulating enzymes of membrane remodelling and PUFA availability) are supporting pillars of the “membrane phospholipids concept of schizophrenia”. Assuming that membrane PUFA profile and PLA2 activity are altered during the at risk phase of disorder and influenced by fatty acid supplementation, we investigated PUFA profiles and PLA2 activity simultaneously in ultra high-risk (UHR) subjects before and after (n-3) fatty acids supplementation.MethodIn 81 UHR patients (aged between 13 and 25 years) PUFA levels were assessed in erythrocyte membranes using gas chromatography, and cytosolic PLA2 activity was measured in blood serum using a fluorometric HPTLC-based assay. Measurements were performed before and after a 6 month interval of placebo-controlled supplementation with n-3 fatty acids.ResultsAt baseline significant associations were found between (n-9) and (n-6)-PUFA levels and psychopathology (especially in negative symptoms) assessed by the PANSS according to PACE criteria. (n-3)-PUFA supplementation caused significant changes in (n-3)- and (n-6)-PUFA levels and a significant decrease of PLA2 activity.ConclusionOur results support associations between membrane biochemistry and psychopathology (especially negative symptoms) in people at risk to develop psychosis. Supplementation of n-3 PUFA increases PUFA availability at membrane level and modulates membrane repair and remodelling processes. Assuming that PLA2 activity reflects neuronal damage, PUFA supplementation might unfold neuroprotective effects.
Predictors of Subjective Perception of Quality of Life Among Medical Students
Authors: Stojkovic T. , Ralic T. , Latas M. , Milovanovic S. 
Published: May 2011

IntroductionMedical education could contribute to the lower appraisal of quality of life in student population.ObjectiveThe aim of the study was to estimate the predictors of higher subjective perception of quality of life among medical students, i.e., to identify association between certain sociodemographic and academic characteristics of students and quality of life.MethodSample consisted of 310 medical students of Belgrade University. We used sociodemographic questionnaire and Flanagan Quality of Life Scale (QOLS) for assessment of the subjective perception of quality of life across five categories and fifteen scale items.ResultsIn medical students’ population, the predictor variable of worse perception of quality of life was a failed year (F = 2,30, p < 0,05). The other features of study participants (gender, age, grade year, average grade, marital status, parenthood and place of living) were not in a correlation with quality of life.ConclusionThere is a need for maintenance and improvement of quality of life among medical students in order to create competent physicians.
Electroconvulsive Therapy in Treatment-Resistant Schizophrenia: a Case Report
Authors: Barrau V.M. , Salinas M. , Yelmo S. , Santana E. , Montiano F. , Gallego N. , Bello G. , Gracia R. 
Published: May 2011

Electroconvulsive therapy (ECT) is born as we know it in the first half of the twentieth century. Although initially introduced as a treatment for schizophrenia, soon proved more effective in affective disorders.Currently this therapy is second choice in the treatment of schizophrenia, representing only 10–20% of ECT treatments.We present a 55 years-old-woman diagnosed with Paranoid Schizophrenia in the adolescence, with several hospital admissions who was sent from sub-acute unit to receive ECT, given the null response to several pharmacological trials. The last, 1,200 mg amisulpride, 650 mg clozapine and 1,000 mg valproate per day, and Zuclopenthixol ampoule every 14 days. She verbalizes poorly structured persecutory, megalomaniac and nihilist delusional ideas, as well as auditory hallucinations which she does not clarify, and thought broadcasting phenomena. After withdrawing this medication and starting treatment with 30 mg haloperidol and 550 mg quetiapine, 14 bifrontotemporal ECT sessions were given.Given the disappearance of persecutory delusional ideas, and the decrease of auditory hallucinations, which she criticizes, the patient was discharged. After 4 months, she is still psychopathologically stable, and receiving maintenance ECT biweekly.ECT, either alone or in combination with conventional antipsychotic drugs, has been shown effective in a certain percentage of patients with acute schizophrenia, particularly in the catatonic subtype and also in schizoaffective disorder. The use and efficacy of ECT in chronic schizophrenia is a more controversial topic.Research should also focus on the determination of optimal number of ECT, the predictors of response and the efficacy of continuation and maintenance ECT.
Treatment of Primary Insomnia: Effect of Repetitive Transcranial Magnetic Stimulation with and Without Field Modulation Based on the Normal Sleep EEG
Authors: He M. , Wang X. , Shi H. 
Published: May 2011

Background and objectiveAside from medications, no effective physical methods of treatment for insomnia have been reported. The purpose of this study is to evaluate the effect on primary insomnia of sleep electroencephalogram modulated repetitive transcranial-magnetic stimulation (SEM-rTMS) compared with the effect of routine repetitive transcranial magnetic stimulation (R-rTMS).MethodsThe 126 patients who volunteered for this study were diagnosed by DSM-IV criteria. Patients were divided randomly into an SEM-rTMS group (44 cases), an R-rTMS group (42 cases), and a sham therapy group (40 cases). Each case was treated for 10d with consecutive rTMS for 30 min once a day with both patient and therapist being blind to conditions. The Krakow sleep score, electroencephalogram, and blood pressure were recorded before treatment, after the 10d treatment, and 30 days after treatment.ResultsDuring therapy with rTMS, a portion of the patients felt sleepy and their EEG pattern showed signs of sleep. The efficiency of producing sleep signs in the SEM-rTMS group was 79.5% and in the R-rTMS group was 45.2%, with the former being significantly higher (c2 = 9.4065, P = 0.0022). At 30d after completion of therapy, the efficiency of sleep production in the SEM-rTMS group was still higher than in the R-rTMS group (c2 = 16.7998, P = 0.0000). No obvious side effects were observed in any of the three groups during the observation period.ConclusionSEM-rTMS therapy for insomnia appears to be more effective and more stable than routine rTMS therapy and appears to be a safe treatment for primary insomnia.
Double dissociation of deficits in visuospatial memory and executive function in patients with major depression with and without ECT referral
Authors: Oulis P. , Kalogerakou S. , Papakosta V.-M. , Kontis D. , Theochari E. , Koutroumpi M. , Anyfandi E. , Michopoulos I. , Poulopoulou C. , Tsaltas E. 
Published: May 2011

IntroductionThe pretreatment neuropsychological profile of drug-resistant patients with major depressive disorder (MDD) referred for electroconvulsive therapy (ECT) may differ from that of their drug-respondent MDD counterparts. Such differences could help in identifying distinct MDD subtypes, thus offering insights into the neuropathology underlying differential treatment responses.MethodDepressed patients with ECT referral (ECTs), depressed patients with no ECT referral (NECTs) and nonpsychiatric Controls (matched groups, n = 15) were assessed with memory and executive function tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB).ResultsECTs scored significantly lower than NECTs in the Mini-Mental State Examination (MMSE; p = 0.01). NECTs performed worse than Controls in the Paired Associates Learning (PAL) task (p < 0.03 ; Control/NECT p < 0.01) and the Spatial Recognition Memory (SRM) task (p < 0.05 ; Controls/NECTs p < 0.05) ; ECTs performed between Controls and NECTs, not differing from either. In the Intra/Extradimensional (IED) set-shifting task, ECTs performed worse that Controls and NECTS (IED: p < 0.01 ; Controls/ECTs p < 0.01), particularly in the shift phases, which suggests reduced attentional flexibility. In Stockings of Cambridge (SOC), ECTs abandoned the test early more often than Controls and NECTs (H = 11, p < 0.01) but ECTs who completed SOC performed comparably to the other two groups.ConclusionsA double dissociation emerged from the comparison of cognitive profiles of ECT and NECT patients. ECTs showed executive deficits, particularly in attentional flexibility, but mild deficits in tests of visuospatial memory. NECTs presented the opposite pattern. This suggests predominantly frontostriatal involvement in ECT versus temporal involvement in NECT dépressives.
Brain-derived neurotrophic factor and electroconvulsive therapy in a schizoaffective patient with treatment-resistant paranoid-hallucinatory symptoms
Authors: Martinotti G. , Ricci V. , Di Nicola M. , Caltagirone C. , Bria P. , Martinotti A. , Angelucci F. 
Published: May 2011

It has been proposed that deficits in the production and the utilization of brain-derived neurotrophic factor (BDNF) may contribute to the pathogenesis of schizophrenia. At the same time, electroconvulsive therapy (ECT) has been shown to induce a robust increase of BDNF protein in animal models. These findings suggest that one putative mechanism of action of ECT is the regulation of BDNF and/or related neurotrophins. In this case report a 54-year-old man with severe treatment-resistant schizophrenic symptoms was treated with ECT. In order to evaluate the effect of ECT on BDNF serum levels, we collected a blood sample before each ECT session. During the course of ECT treatment the paranoid and hallucinatory symptoms gradually improved while BDNF levels increased over time. In addition, there was a general improvement of its positive and negative schizophrenic symptoms and depressive state.In conclusion, this case report further validates the therapeutic efficacy of ECT in schizophrenic patients with inadequate or poor response to traditional treatments. Moreover, ECT therapeutic effect is associated with an increase in BDNF serum levels. Further studies are needed to characterize the relationship between BDNF and ECT in patients with schizophrenia symptoms.
Transcranial direct current stimulation (TDCS) of the prefrontal cortex in therapy-resistant depression: A double-blind, placebo-controlled study
Authors: Palm U. , Schiller C. , Fintescu Z. , Obermeier M. , Keeser D. , Reisinger E. , Pogarell O. , Nitsche M. , Möller H.-J. , Padberg F. 
Published: May 2011

BackgroundTDCS for modulating neurophysiology is known since the 1960s. tDCS trials in patients with depression showed promising results.Methods22 patients with therapy resistant major depression (DSM-IV criteria) were included in a four week cross-over trial, 10 received 1 mA tDCS, 12 received 2 mA tDCS, 2 dropped out. Patients received add-on tDCS under a stable antidepressant treatment over 3 weeks and were randomized to active or sham tDCS treatment. The sham condition was evaluated in 10 healthy volunteers and was indistinguishable.Both, active (1 mA resp. 2 mA) and placebo tDCS were applied for 20 min per day and for two weeks and then switched to the other condition. The anode was positioned over F3 and the cathode over the contralateral supraorbital region. For placebo tDCS a novel sham device (neuroConn, llmenau, Germany) was used which is indistinguishable for the applying person. Severity of depression was assessed by HAMD, BDI, CGI and CORE scales and raters were blind to treatment conditions.ResultsMean HAMD decreased by 25% in the whole population after four weeks of tDCS. Active tDCS performed significantly better (p = 0.0492) than the control treatment. However this positive association was restricted to the first study phase as there was also a significant (p = 0.0271) influence of the study phase in the cross-over design and an almost significant (p = 0.0864) interaction between treatment and study phase.ConclusionThough active tDCS was not superior to sham treatment, we observed hangover effects in weeks 3 and 4 depending on the first condition.
Analysis of treatment results in the electroconvulsive therapy unit of centro hospitalar psiquiatrico de lisboa (CHPL)
Authors: Silva-Carvalho F. , Moutinho A. , Mendonça L. , Cunha I. 
Published: May 2011

IntroductionElectroconvulsive therapy is widely used for treatment-resistant psychiatric patients, with remission rates close to 50% and response rates between 60–70%. Post ictal suppression index (PISI) has been positively correlated with clinical outcome.ObjectivesCharacterize the treatment results of the electroconvulsive therapy unit of CHPL; find a correlation between improvement on HAM-D, PANSS and PSAS and PISI.MethodsThe patient data was collected and divided according to ICD-10 diagnosis. Evaluation scales were applied at the beginning and end of treatment: depressed patients (F31.3–5; F33; F20.4; F25.1) - HAM-D; schizophrenic/ schizoaffective/ bipolar-manic or mixed patients (F20.X, F25.X, F31.0, F31.6) - PANSS; with any of these diagnosis - PSAS. A correlation between the points of improvement on each scale and PISI was investigated using the Pearson product-moment correlation coefficient.ResultsOf 101 depressed patients, 33,7% showed remission and 49,5% showed response, over 11 sessions (average). The reduction on HAM-D score was significantly greater for patients with initial HAM-D score > 18 versus HAM-D ≤ 18 (52,9% versus 37,75%). Patients with unipolar depression (N = 72) and bipolar depression (N = 22) showed comparable results (response:47,2% versus 52,4%; remission: 30,6% versus 40,1%). Schizophrenic patients (N = 43) had higher response rates: 88%. No correlation was found between PISI and HAM-D, PANSS or PSAS improvement (r = -0,1;-0,01;-0,07).ConclusionResponse and remission rates in depressed patients were inferior to other ECT studies, except in patients with higher severity. Those rates were comparable for schizophrenic patients. PISI did not correlate with clinical outcome.
Study on organic hallucinosis: The charles-bonet syndrome
Authors: Campos Mangas M.C. , Ruiz Feliu M.A. 
Published: May 2011

IntroductionIn 1890 Ball defined hallucinations as perceptions without real object with sharp features and embodiment of that approach actual sensory perceptions.Objective and methodsWe present the case of an elderly woman with cataract. Previously we maked a review of the literature and its controversies.ResultsAn 82 year old woman was referred to psychiatry for primary care physician for evaluation of visual hallucinations of 3 ½ months of evolution. Among somatic background are collected: arterial hypertension, cataracts and increased intraocular tension.The detection of the picture is casual, for the comments that the patient makes to his daughter. She says that she sees her husband died 6 years ago, on the stairs. Reported to have a house full of people describing in detail the number of people and the characteristics of them. She claims that under the bed see rats and dogs.She was conscious and oriented. No significant objective emotional impact of visual hallucinations. Is euthymic and without anxiety clinic. Complex visual hallucinations are objectified. The content of thought has developed a delusional elaboration of hallucinations with partial insight.The primary care physician began treatment with haloperidol, the patient presenting extrapyramidal symptoms, so it was discontinued and olanzapine was started up to 10 mg. The clinical picture resolved completely within a few days.ConclusionsCharles Bonnet described in the 1760s. Morsier is the first called the Charles Bonnet syndrome as a persistent or recurrent visual hallucinosis in older people with serious visual impairment and psychically healthy.
Early intervention program for psychosis: Experience and results in a mental health center
Authors: Campos Mangas M.C. , Ruiz Feliu M.A. 
Published: May 2011

IntroductionThis program aims to assist young people aged 16 to 35 years at risk for or who have a severe mental disorder, a psychosis both affected and unaffected, according to the principles of early intervention and assertive community treatment.ObjectivesAssisting young people with psychosis in order to achieve symptomatic and functional recovery, return to provide standardized environment and prevent deterioration.MethodsInitial assessment is made and individualized plan of work.Inclusion criteria1.Diagnosis: substance-induced psychotic disorder, schizophrenia and other psychotic disorders, bipolar disorder and mood disorders with psychotic symptoms2.age: 16–35 years3.Informed consentEvaluation ToolsPANSS, SCIP, CDS, CGI-S, PAS, CAN, EU, SFS, GAF, WHOQUOL-BREF, IEQ-EU, UKU, HoNOS, CGI-IP, CGI-ICResultsThe sample consisted of 22 patients. 45.5% men and 54.5% women. Mean age 24 (SD = 4.74). Diagnosis: schizophrenia 54.5%, 27.3% acute psychotic disorder, 4.5% and 13.6% schizoaffective disorder manic episode with psychotic symptoms. Clinical stage at the beginning of the program: 45.5% stage 2, 4.5% stage 3a; 22.7% stage 3b, 3c stage 22.7% and 4.5% stage 4.ConclusionsIt is necessary to implement such programs to establish the treatment as soon as possible to the onset of the disease and improve prognosis.
Therapeutic compliance in patients with psychosis in an outpatient setting
Authors: Ruiz Feliu M.A. , Campos Mangas M.C. 
Published: May 2011

IntroductionNumerous studies show that patients with psychotic disorders have low rates of adherence, which is the main cause of relapses and hospital admissions. It is fundamental to long-term drug treatment in the management of patients with psychosis, both in preventing relapses and the consequences that flow from them (hospital admissions, clinical deterioration, loss of functionality and quality of life of patients)ObjectivesAssess the benefits to be derived from the use of extended-release injectable antipsychotics in regard to adherence to treatment, the persistent improvement of psychotic symptoms and reducing the number of hospital admissionsMethodsDescriptive study. Sample: 40 patients diagnosed with schizophrenia or schizoaffective disorder treated at a mental health center. Patients are divided into two treatment groups: 20 patients are treated with risperidone in prolonged release of more than one year duration and the other group treated with oral antipsychotics.ResultsAdherence to treatment is higher in the group treated with injectable antipsychotics (90%) than with oral (50%). The age range from 20 to 61 years. The average hospitalization was greater for the group treated with antipsychotic injections in the period prior to treatment (17) compared to post-injection treatment outcome (5). In patients with oral antipsychotics were 20 hospitalizations in total.ConclusionsConfirms the results on adherence and hospitalizations compared to other similar studies. There is a clinical and functional improvement, fewer hospitalizations, shorter average stays and higher outpatient adherence in patients with extended-release injectable antipsychotics compared with the group of patients with oral antipsychotics.
Autism comorbidities and social deficits in children aged 7–14
Authors: Mirfazeli F.S. , Memari A. , Kordi R. 
Published: May 2011

IntroductionAlong with other neurodevelopmental disorders, recently, interest in studying the comorbidities of autism spectrum disorders (ASDs) has grown. According to previous findings many ASD children often do experience a number of comorbid medical conditions and about 60–70% of them present with additional neuropsychiatric Disorders.AimWe aimed to examine the comorbidities of autistic children and identify whether or not the comorbidities affect their social and behavioral profile.MethodsOne hundred and seven children with ASD were surveyed. For all subjects, their parents were asked to complete three forms as the ATEC (autism treatment evaluation checklist), Vineland Social Maturity and a checklist for general and biomedical information.We then compared the subjects as two groups with and without comorbidities.ResultsFifty one (44.3 %) of subjects had at least one comorbid condition, and thirty six (31.3%) had at least one additional neuropsychiatric condition. Children with comorbidities showed significant lower score in social quotient against the others without comorbidities (p < 0.05, CI 1.6: 20.5). There was a significant correlation between number of comorbidites and physical-behavioral profile of children (r = 0.172, p < 0.05). Comparison of means between two groups showed a trend of higher severity in all dimensions of ATEC in Children with comorbidities but not significantly.ConclusionOur results extended the autism literature in association of comorbidities with lower performance in social and behavioral issues.