bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dropout in the treatment for anorexia nervosa and bulimia: A systematic review from the international databases
Authors: Seidinger F.M. , Garcia C. , Böttcher-Luiz F. , Turato E.R. 
Published: May 2011

IntroductionAnorexia nervosa and bulimia have the highest mortality rates among psychiatric disorders. High dropout rates 30 to 50% stand obstacle to outcomes.ObjectivesTo search and to analyze articles based on studies about inpatients and outpatients dropout in AN and BN.MethodsThe search was conducted through PubMed/Medline, Lilacs, PsycINFO and Cochrane databases. The selection included all the articles about AN/BN focused on dropout. Furthermore, cited articles were included when related. The articles were fully summarized, classified and submitted to categorization.ResultsMost of the articles came from Europe; scarce results from Latin America. dropout-rates are not significantly different between inpatients and outpatients; lower rates among adolescents. Emerging categories are discussed: socio-demographic, clinical and psychological characteristics; family; therapeutic alliance. Impulsive/compulsive behaviour is the strongest predictor explaining the higher dropout rate for AN purging-subtype. The correlation with lower educational level and family background are also supported. The correlation between depression and lower dropout risk founded by some studies was not confirmed by others. Age, previous hospitalizations, length of illness, symptoms severity, weight/BMI are emerging as not consistent predictors. Dropout is not always a negative outcome.ConclusionsThe common discrepant results are attributed to the difficulty in composing adequate samples and to the lack of standardization of the term “dropout”. The focus on patient characteristics in research was questioned; this tendency is changing toward to take into account the answer to treatment process. Highlights: patient's difficulty in intrapersonal relationships, the therapeutic alliance and its management to adherence and continuation of treatment.
Bioethics in psychiatry
Authors: Gomez Juanes R. , Herbera Gonzalez P. 
Published: May 2011

IntroductionBioethics in psychiatry is a research area that is gaining more relevance each year. To understand what bioethics is we need to clarify some concepts.Morals are the rules that govern the behaviour of humans being in relation to society and themselves but that does not imply alone the concept of good or bad.Ethics consider what is moral, how to rationally justify a moral system and how it is applied then to different areas of our social life. We therefore conclude that bioethics is responsible for studying what is moral in the field of human behavior.ObjectivesWe provide a historical review of bioethics in psychiatry from the Middle Ages to the present day.MethodologyHaving reviewed documents we will cover the key historical events which changed the course of bioethics in psychiatry as well as in other areas of medicine.ResultsIn our field, Psychiatry, Bioethics is a relatively new discipline which has changed over the centuries to find a model based on patient autonomy and beneficence. These two basic ethical principles were specially established since the Belmont Report was published in the 70s.ConclusionsDespite the changes and evolution through the history, bioethics is a subject that still requires more research and analysis. There are still few professionals who have an adequate training in bioethics.
Lipid monitoring of patients taking clozapine in a high secure forensic hospital
Authors: Ahmed U. , Brown A. 
Published: May 2011

AimsTo review current practice of lipid monitoring for patients prescribed colzapine and to improve the health of patients taking clozapine.MethodologyThis was a retrospective audit targeting all patients who were taking Clozapine from May 2008 to April 2009 inclusive. Data was collected from pharmacy records, the heath centre records and patients’ personal care records. Current practice within the hospital was then compared with the standards proposed by the Maudsley Guidelines.ResultsThe total number of patients who were prescribed clozapine between May 2008 to April 2009 was 65. Of these patients 54 met the identified standards. We identified two patient groups; 56 patients were taking clozpaine for more than one year and nine patients were taking clozapine for less than one year. Out of those patients who were taking clozapine for more than one year, standards were met for 89% of patient (n = 50) compared to only 44% (n = 9) of those patients who were taking it for less than 1 year. Also, of those patients who had been taking clozapine for less than one year and do not meet the standard, none of them had lipid monitoring at three monthly intervals.ConclusionAlthough the vast majority of patients in the hospital who were prescribed Clozapine had their lipids monitored appropriately, a small percentage did not. Monitoring of lipid levels was particularly lacking in the first year of treatment.
Punitive incarceration or corrective seclusion: a critical review of the state of nigerian juvenile justice system
Authors: Atilola O. 
Published: May 2011

IntroductionNigeria has a predominantly youthful population living in an adverse social environment created by a combination of factors, which creates a situation for a large number of children to be exposed to life of want, danger, abuse and social isolation. Such children are known to have a higher risk of coming into contact with the juvenile justice system (JJS). An ideal JJS should provide statutory guardianship for children in need of care, protection or reformation. There are reports that Nigerian JJS may have some shortcomings.ObjectivesTo review internationally accepted standards of care for children within the JJS and compare this with the current practices in Nigeria with a view to make recommendations for improvement.AimsTo examine the level of compliance of the Nigerian JJS with international standards.MethodsInformation and data on the history, structure, facilities, current practices and enabling laws of the Nigerian JJS were obtained by review of literatures, perusal of available records, on-site visits and direct interview of officials of the Nigerian JJS.ResultsThe Nigerian JJS was modelled after the British system, with few modifications to accommodate local customs. The current state may have deviated beyond customary differences to include systematic ones. For instance, incarcerating forms of custodian care is the norm in Nigeria as non-incarcerating methods are not well developed. These facilities are also in deplorable states. Furthermore, the current enabling laws are obsolete.ConclusionsNigerian JJS currently have major shortcomings that may preclude serving its intended purpose. Recommendations were made.
Organic personality disorder in forensic psychiatric juvenile practice
Authors: Bulatowa M. 
Published: May 2011

TopicalityDiagnostic category “ganic Personality Disorder”OPD) is widely used in forensic psychiatric practice for juveniles. Clinical pattern of psychopathological disturbances, masked in the OPD structure, is polymorphous; its shaping is influenced by polyetiological factors, organism compensatory facilities, pathoplastic mechanism of pubertal period.ObjectiveTo single out structural syndromic, etiological pathogenetic and clinical dynamic components of a juvenile OPD.MethodsClinical psychopathological with psychological, neurological and paraclinical data; clinical statistic.Object80 male juvenile delinquents diagnosed OPD (in accordance with ICD-10: F07.00; F07.08; F07.09). Among law infringements prevailed personal crimes notable for extreme gravity.ResultsWhile correlating clinical manifestations and statistical data processing, there were singled out 3 groups designated as Organic Disorders Models.Model 1 - cerebral asthenic syndrome with vegetative dysfunction;Model 2 - syndrome of organic cognitive and organic emotional volitional immaturity; Model 3 - encephalopathical (oligophrenia-like) syndrome.Etiological factors analysis proved exogenous influence prevalence in Model 3 juveniles.Clinical dynamics study demonstrated: most patients suffered from mental manifestations of organic disorder in the way of volitional regulation derangement and cognitive dysfunctions during preschool period.The above-mentioned diagnostic models are taken into account by experts during conducting forensic psychiatric evaluations.ConclusionsThe results may be used in forensic psychiatric practice to work out criteria of OPD expert evaluation, and in general psychiatry under the framework of early prevention of criminal activity. Timely adjustment of early manifestations of behavioural and cognitive disorders contributes to full compensation of organic disorder and mental disturbances arresting.
Differences in clinical and needs assessment between inmates with high versus low risk of suicide
Authors: Cardoso A.M. , Talina M. , Fortes F. , Leal T. , Caldas de Almeida J.M. , Xavier M. 
Published: May 2011

IntroductionDrugs addiction, suicide and mental health disorders are the major problems of inmates health. In Portugal the suicide is the second cause of death and is increasing in a panorama of general decreased mortality in prisons.ObjectivesTo characterize and compare the inmate population with high versus low risk of suicidality, according several variables including the needs for care.MethodsA descriptive study of a non-probabilistic sample constituted by all male inmates referenced to a forensic psychiatric clinic in Lisbon region, during a year (April 2009–2010), was performed. The data was collect from user and professional interviews and user file. The instruments, besides a specific questionnaire, includes MINI; BPRS and the Camberwell Assessment of Need, Forensic Version (CANFOR). The suicide risk was defined by C section from MINI and defined as a dichotomic variable: null/low or moderate/high suicide risk.ResultsThe sample was composed of seventy nine inmates (median age 36). Major depression was the only diagnostic significantly associated with suicide risk. There was a significant association between moderate/high risk of suicide and the unmet needs rated by users in psychological distress, safety to self, drugs and company domains and unmet needs rated by staff in daytime activities, psychological distress, safety to self and drugs domains.ConclusionThe suicide prevention is a crucial issue in prisons. The assessment of suicide risk, psychiatric care and care delivery in unmet needs domains may have a positive impact in self harm and suicide incidence.
Understanding violence: a qualitative study of violence and types of violence in neuropsychiatry practice
Authors: Faruqui R. , Tajer A. , Moffat B. 
Published: May 2011

IntroductionPatients with acquired brain injury and other neuropsychiatric conditions may present with a significant risk of violence.ObjectivesTo conduct a qualitative evaluation of violence to inform risk assessment, patient management, service planning, and workforce training in neuropsychiatryAimsTo provide thematic or qualitative categories based exploration of violence to enhance understanding of risk factors and risk presentations while clarifying the nature and types of violence in this patient population.MethodsA service evaluation exercise was conducted using routinely collected clinical information for patient group admitted at a neuropsychiatric service. Data files were converted in word format and transferred on qualitative analysis software NVIV0-8. This software was used for further qualitative analysis through creating free nodes in order to generate qualitative themes or categories of violence in this patient population.Results65 Male and 23 Female patients were admitted at the time of this review (working age adults). The qualitative data analysis using NVIVO-8 generated qualitative categories of violence in this patient population1.Violent Offending: Wounding, murder, criminal damage, sexual offending, arson2.Institutional violence: Directed towards patients and staff included, scratching, biting, slapping, punching, kicking, grabbing, groping.3.Sexual Violence: Stalking, rubbing, groping, exposing, masturbating, person directed sexual threats.4.Types of Violence: Impulsive violence, instrumental violence, grudges based violence, opportunistic violence, predatory violence, erotic violenceConclusionsQualitative categorisation of violence amongst a neuropsychiatric population is feasible and provides supportive evidence for further clinical practice and guideline development in violence risk assessment for this patient population.
The current status of forensic psychiatry in japan
Authors: Fujii R. , Fujimoto M. , Kuga M. , Kudo Y. , Suzuki H. , Haki K. , Nishimon S. , Nakane J. 
Published: May 2011

In 2005, the Medical Treatment and Supervision (MTS) Act was enacted in Japan to hospitalize the criminally insane and to promote a self-supporting lifestyle after deinstitutionalization. As of October 2010, 490 patients remain hospitalized in 23 highly secure forensic hospitals. Most patients are diagnosed with chronic schizophrenia and exhibit symptoms of drug resistance. Battering is the most common criminal act they have committed.The increased prevalence of the combination of criminal insanity with drug dependence is a common problem in other countries as well. It is a serious problem that diversity in prison medical care has not been achieved.A characteristic feature of care for criminally insane patients in Japan is that they must live in a residential district where a public health center is located and close to forensic hospitals after deinstitutionalization. Although there may be concerns about social prejudice against psychiatric disorders, this limited area would help support rehabilitation of patients because medical staff can easily know the whereabouts, psychiatric condition and aspects, of daily life for each patient through frequent reports obtained from home-visiting nurses. As a result, patients who have been successfully deinstitutionalized lead a self-supporting lifestyle without treatment interruption or repetition of similar criminal acts.In this presentation, we will show the current status of forensic care in Japan, analyze its characteristics and problems described above, and make suggestions for the treatment of the criminally insane in countries with a small national land area such as Japan.
Personality disorders and insanity
Authors: Gorinov V. 
Published: May 2011

One of the pressing problems of Forensic Science is to define criteria for assessing Personality Disorders (PD)with a view of Article 21 of the Russian Federation Criminal Code. Forty cases with paranoid, schizoid and mixed types of Personality Disorders were studied for the purpose of passing judgment on their inability, during the acts of aggression, to be recognize the true character and the societal danger of their actions and to control themselves.Half of the cases demonstrated situational development, with marked exacerbation of suspiciousness and a bend towards forming extremely valuable ideas, followed by pronounced depressive conditions, persistent adjustment disorders, and impaired ability for critical judgment and prognosis. Twenty-five per cent of the cases showed pathological (constitutional) personality development. Delirious ideas of jealousy and anger (litigiousness) were systemic, deeply and heavily loaded emotionally, they developed in the “self-development” mode, with loss of content of the emotion and with psychogenic reactions. In 17.5% of cases our conclusions were based on the assertion that during the criminal act, “acute reaction to stress” was experienced, with deep emotional involvement, impaired consciousness, loss of ability to adequately assess the obtaining situation, and general disorientation.Thus, the main prerequisite for inability to appreciate the factual character and societal danger of one's actions or to control them is the statement of reactions of psychotic level, or of pathological development with the presence of pathologically overvalued or maniac ideas of interpretative nature, transforming into a paranoid system.
Prevalence of violent committed acts by inpatients in forensic setting department of psychiatry -in kosova
Authors: Ibishi N. , Musliu N.R. 
Published: May 2011

The aimIn this study we evaluated the prevalence of committed acts in the group of male inpatients in forensic setting with major mental disorder and past history of aggressive behavior in community.MethodologyIn the study we included 80 male inpatients, 41 of them have meet DSM-IV criteria for Personality Disorder, 28 were psychotic, 11 were Drug/alcohol abusers. Past aggressive history was collected from patient interviews and reviews of clinicalforensic records and collateral source of documents.ResultsThe inpatients were adults with mean age 35,22±10,50 in Schizophrenia spectrum disorders group and the mean duration of the illness was 11,7±9,48, Personality disorders group with mean age 31,35±9,85 and mean duration of illness 10,70±8,34, Drug/alcohol abusers with mean age 19,1±8,6 and mean duration of illness 4,5±2,6.Personality disorder and Drug/alcohol abuser group of inpatients offenders were more prevalent on homicide acts 40%, and threatening 35%, while Schizophrenia spectrum disorder inpatients were more prevalent in domestic violence 49,2%, threatening acts committing with 33,3% and homicide prevalence 7,9%.ConclusionThe studies until now showed that the prevalence of Schizophrenia in the homicide offenders is around 6%. Despite this, the prevalence of Personality disorder or of Drug/alcohol abuse is higher: 10% to 38% respectively. Our results showed the same results with prevalence of Schizophrenia spectrum disorder in homicide with 7,9%, and respectively Personality disorder with homicide prevalence 40%.
Differencial diagnosing of schizotypal personality disorder
Authors: Klembovskaya E. , Fastovtsov G. , Pechenkina O. 
Published: May 2011

Background and aimClinical definitions and differencial diagnosis criteria of «Schizotypal personality disorder» is not enough investigated yet, especially how it differs from schizoid personality disorder and continuous sluggish schizophrenia. It is impossible to consider diagnostic indications (that the symptoms of schizophrenia couldn’t be observed before and during actual examination) sufficient to explain the special place of this mental disorder. Some criteria of diagnosis of schizotypal disorders (for example, suspiciousness and paranoid ideas, episodes of quazi- psychotic disorders) are not applicable.With the aim to define the clinical features of schizotypal personality disorder 58 patients were examined. All patients were characterized by mainly personality disorders.Results-Schizotypal personality disorder is similar to deficit states, observed at schizophrenia, clinically limited to personality sphere, without the signs of flow of endogenous process and psychotic disorders.-Schizotypal personality disorder on the clinical content reminds schizoid, but insignificant ideatory disorders are rather typical. Dymamic of psychopathy - disposition to decompensation - is never observed.-Schizotypal personality disorder can be diagnosed as latent, prodromal schizophrenia, because the clinical picture of these states is very similar. The special value acquires a dynamic aspect, allowing to find the signs of «flow» and dynamics typical of the endogenous process.ConclusionThus, the main differencial diagnosing criteria of schizotypal personality disorder are the dynamic aspects and changing of clinical features.
Xq28 duplication in a boy with mental retardation, hyperkinesia and dysmorphic features - a case report
Authors: Budisteanu B. , Arghir A. , Tutulan-Cunita A. , Chirieac S.M. , Budisteanu M. , Lungeanu A. 
Published: May 2011

IntroductionX-linked mental retardation (XLMR) is a common, clinically complex and genetically heterogeneous disease arising from many mutations along the X chromosome. Although research during the past decade has identified >90 XLMR genes, many more remain uncharacterized. In XY males, duplication of any part of the X chromosome leads to functional disomy of the corresponding genes.ObjectiveIn this paper we present the case of a boy with a syndrome of Xq28 duplication. Methods: We present a 6 years old boy, admitted in the Department of Pediatric Psychiatry for evaluation. He presented sever mental retardation, autistic features, speech delay, hyperkinesia, and dysmorphic features (high forehead, partial palpebral ptosis, small nose, carp-shaped open mouth, micrognathia), recurrent infections. Cerebral MRI was normal. Genetic investigations, including katyotype with GTG banding and array-CGH, were performed.ResultsArray-CGH indicated a dup(X)(q28) of less than 1.5 Mb. There were 15 duplicated genes, including MECP2 gene, which is involved in autism and mental retardation.ConclusionsDuplications at Xq28 are often associated with autistic features/non-syndromic MR; alterations in MECP2 gene (duplicated in our patient) are described in Rett syndrome or as a specific phenotype. The alteration occurring at Xq28 band is responsible for the patient’s phenotype. Clinical manifestation of this child will be compared with those of other patients with the same duplication previously described to further delineate this syndrome.
Klinefelter's Syndrome and psychiatric pathology: a case report
Authors: Isasi M. , Arroita A. , Periañez N. , Ugarte K. 
Published: May 2011

IntroductionThe presence of an extra X-chromosome, also known as Klinefelter's Syndrome, occurs in approximately 1 in 500 live male births. Epidemiological studies have reported an increased vulnerability to psychiatric disturbances in this group of patients and suggest that the X chromosome may be involved in the aetiology.Material and MethodsComprehensive review of the scientific literature (Medline, Ovid) on Psychiatric pathology in Klinefelter's Syndrome published over the last 20 years.ResultsThis is a case report of a 27 year-old-male with Klinefelter's Syndrome confirmed by karyotyping (XXY), suffering from different neuropsychiatric disorders, such as mental retardation, dyslexia, ADHD and social dysfunctioning. Since the age of 16 he has required multiple psychiatric hospitalizations due to his impulse control difficulties and exaggerated mood swings.This case raises the question of whether Klinefelter's syndrome patients are predisposed to psychiatric pathology (including Schizophrenia, Bipolar Disorder, Anorexia Nervosa or social-emotional processing) at a genetic level.ConclusionsReviews of the neuropsychiatric problems associated with Klinefelter's Syndrome confirm an association between disorders in this area and the chromosomal abnormality. Further studies are needed to identify involvement of X-linked epigenetic influence and susceptibility to several psychiatric diseases.