bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacological approach of chronic psychosis
Authors: Gago E. , Santos M. , Ribeiro A.E. 
Published: May 2011

IntroductionPsychosis is a mental condition characterized by the presence of hallucinations, delusions, and thought disorders. It spans diagnostic entities that respond to similar therapeutic approaches. Most patients who develop schizophrenia and related psychotic disorders are at very high risk of relapse in the absence of antipsychotic treatment. Yet, chronic psychosis is an entity that has not been well established until today.Evidence indicates that sustained treatment is associated with fewer relapses than is targeted intermittent treatment; however guidelines do not give definite recommendations about treatment duration. Indefinite maintenance antipsychotic medication is recommended for patients who have had multiple prior episodes or two episodes within five years. Adjunctive medications are commonly prescribed for comorbid conditions.AimsThe authors aim to study the therapeutic approach of patients with chronic psychosis.MethodsCross-sectional study and clinical records review of a sample of patients with the diagnosis of schizophrenia and other chronic psychotic disorders.ResultsThe sample consists of 154 psychotic patients, 71% males, with mean age of 45,9 years. 43, 5% of patients are under treatment with more than one antipsychotic agent, and 59% are treated with long-lasting antipsychotic medications (LLA).ConclusionsThe considerable decrease in hospitalization days, and the need to avoid covert non-compliance justifies the increased number of patients under LLA treatment. This sample presents with a high percentage of patients treated with more than one antipsychotic medication, despite the fact that there is minimal evidence supporting this therapeutic option.
Reconceptualizing medication adherence: six phases of dynamic adherence
Authors: Gearing R. , Townsend L. , Mackenzie M. , Charach A. 
Published: May 2011

IntroductionNonadherence is the Achilles heel of effective psychiatric treatment. The meaning of the term “adherence” has evolved over time and is now associated with a variety of definitions and measurement methods. This has resulted in a poorly operationalized and non-standardized term that is often interpreted differently by providers and patients.Objectives/AimsThis abstract aims to: 1) describe changes in the concept of adherence; 2) present a more comprehensive definition of adherence which recognizes the influence of patient-provider transactions; 3) introduce dynamic adherence, a six-phase model, which incorporates the influence of transactional processes and econometrics on patients’ adherence decisions; and 4) provide recommendations for providers to improve their relationships with patients and in turn, medication adherence.MethodsA review of the scientific mental health literature.ResultsDespite the prevalence, seriousness, and costs associated with medication nonadherence, the construct of adherence remains poorly operationalized and lacks cogent standardization. Drawing from psychiatric research, a dynamic model of medication adherence across six phases is presented.ConclusionsThis model of adherence highlights the importance of the patient-provider relationship and the transactional processes that comprise what is a dynamic developmental system. Dynamic adherence is intended to foster movement toward a more coherent and unified set of definitions and clinical strategies that will provide the potential to more fully elucidate the risk and protective mechanisms impacting adherence, and the subsequent development and refinement of best practices in increasing the odds of stable medication adherence.
Pysa syndrome: a case report
Authors: Gutierrez F. , Losada C. , López M. , Rozados C. , Olivares J.M. , Calado M. , Cinos C. 
Published: May 2011

Pisa syndrome is known to be a condition in which there is sustained involuntary flexion of the body and head to one side and slight rotation of the trunk so the person appears to lean like the Leaning Tower of Pisa.The development of Pisa syndrome is most commonly associated with prolonged treatment with antipsychotics. Although less frequently, Pisa syndrome has been reported, in patients who are receiving other medications (such as cholinesterase inhibitors and antiemetics), in those not receiving medication (idiopathic Pisa syndrome) and also patients with neurodegenerative disorders like Alzheimer's disease and multiple system atrophy.We report a case of a 67 year- old male diagnosed with Schizophrenia for 20 years. He has been following a treatment with Clozapine 400 mg/day for 4 years. Amisulpiride was added to the established regimen of antipsychotic and increased during the last month reaching the doses of 600 mg/day. Three weeks later he was observed walking with a tilt toward the right. A first physical examination revealed sustained tonic flexion of the trunk to the right side. No deficits or mental status changes during neurological exploration were shown. We prescribed biperidene hydrochloride therapy. After 24 hour side effects disappeared.As far as we know, no many cases of amisulpride-induced Pisa syndrome in the literature have been reported. This abstract presents a case of amisulpride induced Pisa syndrome.
Psychopharmacotherapy characteristics of alcoholics treated on psychiatry department tuzla from 01.01.2005. to 31.12.2009. with brain comuterized tomography
Authors: Hasanović M. , Pajević I. , Zukić S. , Hamidović J. , Kuldija A. , Delić A. , Kravić N. 
Published: May 2011

IntroductionTreatment of alcoholics is complex and difficult, very often it demands complex psychopharmacotherapy.AimTo investigate characteristics of psychopharmacotherapy of inpatients alcoholics with brain computerized tomography (CT) during hospitalization on Psychiatry Department in Tuzla.MethodologyWe investigated 86 record files of inpatients that were treated from 01.01.2005 to 31.12.2009 year on Psychiatry Department, who had dismissed diagnosis Alcohol dependency F 10.2 according ICD-10, to whom computerized tomography of brain has been done durin hospitalization. Targeted variables were: age, marital status, working status, involvement in war fighting's, CT diagnosis, psychological findings, laboratory findings and characteristics of psychopharmacotherapy.ResultsThe mean age of observed patients was 50.1 ± 6.6 years. Age of inpatients was in positive correlation with duration of work, presence of silent ischemic stroke and brain cortex atrophy. Presence of PTSD was in positive correlation with involvement in the combatants, with cognitive disturbances, with depressiveness and somatic complains. Brain cortex atrophy positively correlated with silent stroke and glucose blood level.There were 72 (83.7%) inpatients that treated with antidepressants, 45 (52.3%) with sedating antipsychotic drugs, 10 (11.7%) atypical antipsychotics 12 (13.0%) with typical antipsychotics, 53 (61.6%) with hypnotics, 37 (43.0%) tranquilizers, 23 (26.7%) vitamin B. There was the most frequent combinations of antidepressants SSRI with promazine in 41 (47.7%), with diazepam 25 (29.1%), with zolpidem 20 (23.3%) and nitrazepam in 17 (19.8%) patients.ConclusionSSRI antidepressants were the most frequent used psychopharmacotherapy drugs, then sedating neuroleptics and hypnotics. The most frequent drug combinations were antidepressants, sedating neuroleptic or tranquillisers and hypnotics.
Meta-analysis: fact or fiction?
Authors: Huf W. , Kalcher K. , Pail G. , Friedrich M.-E. , Filzmoser P. , Kasper S. 
Published: May 2011

IntroductionOver the recent years, meta-analysis has become a very influential tool to synthesize information from multiple primary studies of similar design. Widespread use of increasingly complex statistical methods makes it ever more challenging to adequately assess the results reported and conclusions drawn in meta-analyses of psychopharmacological studies.Objectives/aimsThis study aimed to identify potential fallacies of meta-analytic reporting and interpretation by in-depth examination of recent publications on anti-depressant medication.MethodsPublished meta-analytic datasets were re-analysed and the results and possible interpretations obtained in this way were compared with the published results and interpretations.ResultsSeveral widespread methodological problems were identified in the example studies. As most important among these appear the choice of effect size measures and modeling approaches, as well as the related risk of data dredging. Concerning the level of granularity, two pitfalls encountered were inappropriate aggregation of original data and lack of adequate subgroup analyses. Finally, a low level of transparency regarding data and methodology often hampers re-analysis and cross-checking of reported findings by peers.ConclusionsThe difficulty of replicating meta-analytic results on independent data leads to the often conclusive nature of meta-analytic findings, and therefore a realistic assessment of the limitations of the respective analysis is pertinent. To this end, practically relevant quality criteria for readers to bear in mind when dealing with meta-analytic publications are summarized in a ten point checklist for a rough assessment of the quality of meta-analyses by the reader.
Treatment of ADHD secondary to traumatic brain injury
Authors: Irastorza L.J. 
Published: May 2011

Attention-deficit/hyperactivity disorder secondary to traumatic brain injury (ADHD/TBI) is one of the most common neurobehavioral consequences of TBI, occurring in 20% to 50% of individuals post-injury. Some of the most persistent problems include impairment in memory, attention and concentration, language, executive skills, social judgment, social behavior, and impulsiveness.A female patient is presented with TBI and cognitive symptoms and behavior compatible with ADHD. The treatment with methylphenidate was useful for the behavioral problems. The 23 years old woman suffered 3 years earlier a car accident, causing severe TBI and polytrauma. She was in a coma with a CGS of 4 and 41 days in the intensive care unit. She received rehabilitation and continued to suffer from diplopia and posture alteration, semantic paraphasia, child-like behavior, and neuropsychological problems (reading comprehension, slow mental processing, inhibition control deficit, and memory loss).During her visits to my MHC, she was often euphoric and made inappropriate comments and occasionally became angry. She did not have psychiatric antecedents prior to the TBI. Scales were used to diagnose post-traumatic ADHD. The patient was then treated with methylphenidate. After titration, the dosage reached was 0,3 mg/kg. After 4 months, the child-like behavior disappeared and interpersonal relations became more fluid, with less irritability.Stimulants have frequently been used in the treatment of behavioral and cognitive consequences of TBI in both children and adults. This clinical case demonstrates that the use of methylphenidate is favored for an extended period of time in patients suffering from behavioral and emotional consequences of TBI.
Efficiency of atypical antipsychotic in therapy schizophrenia
Authors: Ivic B.M. 
Published: May 2011

The aim of this report is to show the efficiency of using Clozapine for resistant appearances of schizophrenia with patients who had take two different typical antipsychotic previously, and therapy response was unsatisfying or the endurance was slight.The time of observation was 18(eighteen) months. Daily doses are from 100(a hundred) up to 300(three hundred) mg.Some patients with Clozapine take butirofenonic preparations and some patients have got monotherapy with Clozapine. The result which have been obtained give evidence that Clozapine improve cognitive functions (attention, verbal possibilities, learning, memory, reasoning) it also stimulates the possibility for social integration. It improves social activity and capability to work, and in such a way, it effects on impovent of life quality at all.A combination of Clozapine and intramuscular depo-preparations of butirofenon type has given the exceptional results with “positive syndromes” schizophrenia, while monotherapy has given excellent results with “negative syndrome”.It should be known that Clozapine therapy does not heal patients only in the sense of elimination of symptoms causes because of which they were brought to the hospital, but it also protects them not to become helpless victims who are closed inside institutions, how they would be able to come back in their previous working and social surrounding.
How do european psychiatry trainees prescribe when treating depression, and what influences decision-making? (Survey of the European Federation of Psychiatric Trainees Research Group)
Authors: Jauhar S. , Guloksuz S. , Marques J.G. , Nawka A. , Roventa C. , Psaras R. , Andlauer O. , Lydall G. , De Vriendt N. , Mendonca L. , Van Zanten J. , Dumiterscu I. , Nwachukwu I. , Riese F. ,   European Federation of Psychiatric Trainees Research Group
Published: May 2011

ObjectivesDespite recent recent evidence and subsequent guidelines that have suggested factors such as side-effect profile and cost should be taken into account when prescribing antidepressant medication, relatively little evidence exists on decision-making in clinical practice.Our Pan-European Research Group looked at clinical practice regarding antidepressants amongst Psychiatry trainees, treatments trainees would desire themselves, and factors influencing decision-making.MethodsA semi-structured survey was constructed from recent literature, was piloted, and a homogenous sample size of at least 50 agreed upon from each country, with 50% the minimum response rate. It was distributed via web-link, questioning preference of antidepressant for patients, and factors influencing choice. Trainees were asked for their preference should they develop a moderate to severe depressive episode, and require medication.ResultsTreatment choices are summarised in Table 1. 79% of trainees would prescribe similar antidepressants for themselves as for patients.Factors influencing decision-making mapped onto three main domains: cost, efficacy and side-effect profile (5% other reasons). 86% (n = 548) of those who responded felt efficacy most important, 38% (n = 237) felt side-effect profile most important and 6% (n = 33) considered cost of most importance.ConclusionsSome differences exist in choice of antidepressant for European trainees and their patients, and factors affecting choice conflict with evidence base and guideline suggestions.
Risperidone long-acting injection vs. conventional depot injections
Authors: Jensen S.O.W. , Nielsen J. , Friis R. , Correll C.U. 
Published: May 2011

IntroductionRisperidone long acting injection (RLAI) has in recent years gained widespread use in the treatment of schizophrenia and schizoaffective disorder. It is considered safe, tolerable, and the efficacy has been established in several studies. However, all these studies were funded by the manufacturer of RLAI.ObjectivesTo compare the efficiency of RLAI vs. conventional depot antipsychotics (CAD).MethodsThis study includes 9197 patients with schizophrenia being treated with depot injections in Denmark from January, 1996 until December, 2007. Prescription data were obtained from the national prescription database which contains information of sold defined daily dosages (DDD).Of the 9197 patients 1056 had originally received a CAD treatment (zuclopentixole, haloperidol, perphenazine, fluphenazine or flupenthixol), but where switched to RLAI. The two periods were compared with regard to number of admissions and time spent in hospital. A Cox regression analysis of any-cause-discontinuation was performed on 9105 incident depot antipsychotic periods.ResultsWhen receiving CAD treatment patients had 0.08 (95% CI [0.07; 0.08]) admissions to hospital per month vs. 0.50 (95% CI [0.47; 0.54]) when treated with RLAI. On average the patients spent 33 percent (95% CI [32; 35]) of the time during the CAD-period as admitted to hospital vs. 48 percent (95% CI [46; 50]) during the RLAI-period. Of the 1056 patients 83% where eventually switched back to a CAD.Furthermore the RLAI patients have a higher hazard of discontinuing their treatment than the CAD patients (HR = 2.26, 95% CI [2.05; 2.48]).ConclusionsRLAI was inferior compared to conventional depot antipsychotics.
Children and adolescents with major depressive disorders: are some second generation antidepressants better than others?
Authors: Kaminski A. , Gartlehner G. 
Published: May 2011

IntroductionSince the black box warning of the FDA (Food and Drug Administration) regarding an increased risk of suicidality in children and adolescents treated with antidepressants, cautious prescription of antidepressant drugs in young patients became even more important. In the light of potentially severe side effects the comparative effectiveness and harms of antidepressants should be known to clinicians to provide optimal treatment.ObjectivesTo compare the benefits and harms of second-generation antidepressants for the treatment of Major Depressive Disorder (MDD) in children and adolescents.AimsTo provide an evidence base for clinicians and policymakers when making informed decisions regarding the prescription of Selective Serotonin Reuptake Inhibitors and other newer antidepressants.MethodsWe updated a comparative effectiveness report of the Oregon Drug Effectiveness Review Project searching MEDLINE, Embase, The Cochrane Library, and the International Pharmaceutical Abstracts up to August 2010. Two persons independently reviewed the literature, abstracted data, and rated the risk of bias.ResultsWe could not identify any head-to-head trials. There is insufficient evidence to compare one second-generation antidepressant to another in pediatric outpatients with MDD. Evidence from a systematic review of published and unpublished data indicates, that in children and adolescents only fluoxetine shows a good risk-benefit ratio.ConclusionsTo date, the evidence is insufficient to make any clear inferences about the comparative benefits and harms of second-generation antidepressants for the treatment of MDD in children. Clinicians must be aware of the small benefits and the high potential risks when prescribing antidepressant medications to children and adolescents.
Correlation between lipid profile and different types of aggressive behaviour in combatants
Authors: Kolov S. , Ostapenko A. 
Published: May 2011

ObjectivesAt present there is a discussion whether cholesterol level, aggression and violence are connected for they are characteristic behavioral patterns in combatants suffering particularly from PTSD.MethodWith the help of the Aggressive Behaviour Assessment Scale we examined 337 combatants and 116 healthy people, also we held an additional investigation of serum concentration of lipid profile. Reliability of results was evaluated by the Mann-Whitney U-test. Also the correlation analysis (Spearman rank correlation coefficient) was carried out.ResultsCombatants showed an integrated overall index of aggression twice as much in comparison with the control group (2,44 ± 0,09 and 1,08 ± 0,08, Ð < 0,00001), impulsive aggression was five times greater (2,08 ± 0,12 and 0,39 ± 0,06, Ð < 0,00001), premeditated aggression was 1,7-fold (3,15 ± 0,11 and 1,78 ± 0,13, Ð < 0,00001). The highest points of emotional (impulsive, hostile) aggressive behaviour revealed negative links with concentrations of cholesterol (r = −0,109, Ð < 0,05), LDL total cholesterol (r = −0,109, Ð < 0,05), triglycerides (−0,137 ≥ r ≥ −0,108, Ð < 0,05). Certain positions of premeditated (instrumental) aggression positively correlated with level of total cholesterol (0,140 ≥ r ≥ 0,126, Ð < 0,01), LDL total cholesterol (0,141 ≥ r ≥ 0,161, Ð < 0,01).ConclusionsReduction of cholesterol level and its most atherogenic fractions increases intensity of impulsive aggression and diminishes instrumental aggression of aggressive behaviour whereas increase of lipid profile leads to opposite results. The obtained data can be of great importance for treatment and prophylaxis of cardio-vascular disorders which are so typical for combat veterans.
Bupropion in treatment of depression - patient stopped smoking: case report
Authors: Kozumplik O. , Uzun S. , Jakovljevic M. 
Published: May 2011

AimTo present a case of a patient with depression who stopped smoking during therapy with bupropion.Case reportPatient, 55 years old, diagnosed with depression, was in psychiatric treatment for two year before she discontined her treatment. She decided to discontinue psychiatric treatment and stopped taking antidepressants because she was feeling better and was functioning at work and in her social environment. For the past one year she was taking only lorazepam occasionally. She came again to our hospital when avolition and fatigue intensified, along with depressed mood. She was not able to function at work any more. She smoked about 20 cigarettes daily and tried to stop smoking on several occasions, but unsuccessfully. Because of worsening of symptoms of depression, treatment with bupropion was initiated in daily dosage of 150 mg. After five days of such treatment daily dosage of bupropion was elevated to 300 mg. The patient reported having headache for the first two days of treatment with bupropion, but after the headache stopped. After ten days of treatment she reported feeling better and was smoking less cigarettes (five per day). She said that didn’t have such pleasurable feeling any more when smoking. Also, after smoking she felt mild nausea. At control examination, after one month of treatment with bupropion, the patient reported feeling well, without symptoms of depression and that she stopped smoking. She continued outpatient treatment regularly and was functioning well again at work and in her social environment.
Frequency of sexual dysfunction related to different antidepressants. Results from a multicentric pragmatic study in 2000 patients in spain: the SALSEX-I study
Authors: Majadas S. , Montejo A.L. , Hernandez A.I. , Calama J. ,   SALSEX-I Project Working Group
Published: May 2011

IntroductionAntidepressant-related sexual dysfunction (ADr-SD) is a frequent and underestimated adverse event that may lead to medication non-adherence.Study aimTo explore ADr-SD in regular clinical practice.Objectives1.To stablish the prevalence of sexual dysfunction (SD) in patients following antidepressant treatment.2.To compare ADr-SD between different antidepressants.MethodsCross-sectional multicentric naturalistic study. Patients in antidepressant treatment from at least two months before inclusion without previous SD were included. SD was evaluated with the specific questionnaire PRSexDQ (SALSEX, Montejo 2001).Results1988 out of 2000 patients recruited resulted eligible for the analysis. According to PRSexDQ criteria, most of the antidepressants recorded in the sample (venlafaxine, duloxetine, escitalopram, citalopram, paroxetine, fluoxetine, fluvoxamine, sertraline and clomipramine) were associated to high rates of moderate to severe SD (>70%), with the exception of bupropion (39.6%) and mirtazapine (44.4%). Orgasm delay and reduced libido were the most affected areas of sexual function in all cases. Based on PRSexDQ mean global score bupropion and mirtazapine were associated to a lesser extent of SD vs. the other antidepressants (p < 0.01). Some risk of discontinuing treatment was showed by 8.5%–23.6% of patients presenting SD, depending on the antidepressant.ConclusionsThese results stress the relevance of SD related to most of the antidepressants, showing both bupropion and mirtazapine a better profile regarding this adverse event. Given that ADr-SD may lead to medication non-adherence, individual patient's perception of sexual life and the profile of each antidepressant regarding SD should be considered by clinicians before initiating any antidepressant treatment.