bluuebunny/crossref_metadata_2025_split huggingface dataset:
The reliability of a brief diagnostic interview, the trips, for the assessment of psychiatric disorders according to ICD-10 in primary care and non-psychiatric medical settings
Authors: Berger P. , Sibitz I. , Freidl M. , Topitz A. , Katschnig H. 
Published: May 2011

IntroductionAlthough there are instruments for the assessment of DSM-IV mental disorders in primary care, there is no brief instrument to assess mental disorders in primary care according to the ICD-10.AimsThe aim of the study was to assess the reliability of a new diagnostic interview, the TRIPS, designed for the assessment of anxiety-, mood-, and alcohol related disorders according to ICD-10 by non-mental health professionals.MethodsAt first, all Patients completed a screening questionnaire and were subsequently assessed by the staff of somatic departments of a Vienna General Hospital with the TRIPS. Within a week, patients were re-assessed by psychiatrists of the department of psychiatry with the Composite International Diagnostic Interview (CIDI).ResultsFinally, 290 patients could be assessed with both instruments. With the CIDI, 106 out of 290 patients (37%) got any diagnosis of a mental disorder, 74 (26%) had a mood disorder, 64 (22%) an anxiety disorder and 10 patients (3%) an alcohol-related disorder.Sensitivity of the TRIPS was 88%, specificity was 76% and diagnostic accuracy was 80% for any disorder, and 88%, 83%, and 84% respectively for any mood disorder, 72%, 88%, and 84% for any anxiety disorder, and 60%, 98%, and 97% for alcohol related disorders.ConclusionsThe results show that the TRIPS is a useful instrument with sufficient reliability to detect anxiety disorders and mood disorders in patients with somatic disorders by health professionals without psychiatric training. Due to the low base rate the test criteria for alcohol-related disorders cannot be interpreted sufficiently.
Theoretical considerations and clinical implementations of the somatoform disorders concept
Authors: Bobrova M.A. , Bobrov A.E. 
Published: May 2011

The existing ICD-10 typology of somatoform disorders is often criticized. The alternative approach to pseudo-somatic complaints as an expression of anxiety-affective disorders still deserves much recognition among practicing psychiatrists.To evaluate the validity of these views a group of 53 patients (24 men and 29 women) was studied with the help of clinical interview, symptomatic scales, personality and neuropsychological tests. Results of statistical analysis demonstrate that there are four relatively independent “core” variants of somatoform syndromes, which closely resemble ICD disorders: anxiety-depressive, psychovegenative, dissociative, and paranoid hypochondriac. These variants differ in symptomatology, levels of disturbance and prognosis.The obtained data evidence that differences in clinical features of somatoform disorders are determined by specificity of cognitive styles, changes in sensory levels, dysfunction of brain antinociceptive system, higher integrative brain functions and personality/behavioral patterns. It also means that contradiction between empirically and operationally based approaches to somatoform disorders reflects the consecutive transition from phenomenological to descriptive and then - to bio-psycho-social paradigm in modern psychiatry.
Sleep-related painful erections: pitfall on the interface between neurology and psychiatry
Authors: Buda B.L. , Tóth G.A. 
Published: May 2011

Sleep-related painful erections (SRPE) are characterized by penile pain occurring during nocturnal erections, without apparent penile pathology. Sleep loss caused by the disorder may result in severe anxiety, mood disorders, irritability, and excessive daytime sleepiness. Until now, the phenomenon of SRPE has not been well understood. The rarity of the published cases probably does not reflect the actual prevalence, which is presumably over 1 percent.Because of the bizarre nature of the complaints, patients are often referred to a psychiatrist. The authors present the case of a 69-year-old patient, who, during frequent nocturnal awakenings, experienced hard-to-define burning, tingling sensations in symmetric hypogastric localisation. Sometimes the skin of both legs, and, occasionally, the arms and hands was involved, too. Initially, however, no definite erection-associated penile pain was present. Micturating quite a small amount just after awakening consistently resulted in immediate and complete relief. After two years, painful nocturnal erections reoccurring at stable intervals of 90–120 minutes during sleep developed to be the leading complaint. In default of urological or gastroenterological pathology, the patient has been referred to a psychiatrist. Quite futilely, mianserin and alprazolam, later sertralin and carbamazepine, respectively, were administered. Clozapine has also been tried out; however, it has to be rejected due to some adverse effects.Finally, 10 mg baclofen in the evening resulted in complete and permanent remission. This is consonant with the literature data stating that only clonazepam, baclofen and clozapine are likely to have long term beneficial effects in SRPE.
Munchausen syndrome - diagnostic challenge
Authors: Coutinho B. , Felgueiras P. , Torres M. , Fonte A. 
Published: May 2011

IntroductionThe Munchausen syndrome describes patients with a particular form of factitious disorders: symptoms of illness or injury intentionally produced, for psychological reasons, in order to be hospitalized and even to be submitted to invasive interventions.Clinical caseA 38 years-old woman, firefighter, was admitted, in Medicine Department for a transverse myelitis, (spinal thrombosis D5-D7 secondary to sepsis caused by a central venous catheter infection). Healthy up to 24 years of age, she is diagnosed Webber Syndrome-Christian and treated. Some years after appeared hypochromic microcytic anemia, whose initial cause was considered to be a rectal ulcer, with complete hematologic recovery after surgery. But some time after, there was recurrence of anemia, plenty diagnostic exams were performed and all inconclusive. Since one-year ago, she had the need to blood transfused weekly. Because of poor peripheral vessels, central venous catheter (CVC) was placed, then she developed serial infections by S. aureus with sepsis and is noticed that she got hematological recovered whenever hospitalized, leading the suspicion the catheter was being auto-manipulated. Currently she is paraplegic from D7 and when it was told her, that there was no neurological recovery, paradoxically she happily said “I already knew.” Against her will, the CVC was removed and peripheral accesses reestablished. So, for all of this, it was hypothesized Munchausen Syndrome.DiscussionTreatment of Munchausen syndrome primarily consists in treating the self-induced illness before psychiatric help can be given. Unfortunately most patients refuse psychiatric help and leave hospital even before correct diagnosis is made.
Providing a psychiatry service to a general hospital in the absence of a dedicated liaison psychiatry team
Authors: Doherty A.M. , Rutledge E. 
Published: May 2011

IntroductionThe international literature has clearly set out the importance of having an appropriate consultation liaison psychiatry service in a general hospital. There is limited data available on the quality of psychiatric consultations in those areas which are without dedicated liaison psychiatry teams.ObjectivesTo examine the psychiatric work in a general hospital, and to establish a baseline regarding demographics, type of referral, and management of referrals.AimsTo assess the psychiatric needs of the hopsital with a view to introducing improved evidence-based treatments.MethodsAll referrals from medical and surgical teams and from the accident and emergency department over a 3 month period were prospectively reviewed. As there is no dedicated liaison service, the referrals are seen by the psychiatric registrar on call. The details were entered in a register and reviewed.Results160 referrals were received over the 3 months studied. 90% were from the area served by the psychiatric services based at the psychiatric unit in the hospital. The most common diagnosis was depression (27%). Alcohol was an important factor in 16% overall, and in 26% of referrals from the accident and emergency department.ConclusionIn the absence of a dedicated liaison psychiatry service, the liaison work is done by the team members of the general adult and psychiatry of older age teams. As 31% of the referrals seen were not deemed urgent by the assessing psychiatrist, there may be a role for a liaison nurse in the triage of referrals to this service.
Comparison of depression and anxiety disorders in patients with psoriasis and control group
Authors: Golpour M. , Hosseini S.H. , Khademloo M. , Ghasemi M. , Koohkan F. , Ebadi A. , Shahmohammadi S. 
Published: May 2011

ObjectivePsoriasis is a common, genetically determined inflammatory and proliferative disease of the skin. Psychological stress can also exacerbate the disease. The goal of the present study was to compare depression and anxiety symptom in patients with psoriasis and control group.MethodsOne-hundred patients with psoriasis (case) referred to the dermatology department and 100 patients with Otolaryngology problems and dermatological healthy volunteers (control) who referred to the Otolaryngology department of Bouali Sina hospital in Sari/Iran in 2007 were studied. Demographic characteristics were recorded. Then the Beck Depression Inventory and Spielberger State-Trait Anxiety Scale I-II were administered to the patients in both groups. Data were analyzed using SPSS statistical software and descriptive statistical tests.ResultsFrom 100 patients in each studied group, 44 (45%) were men. Patients with psoriasis and controls had depression scores of 67% and 12%, respectively. The Beck depression scores of patients with psoriasis were significantly higher than scores of the control group (P < 0.05). Based on Spielberger State-Trait Anxiety Scale, anxiety was found in 45% of patients in case group and 18% of controls.ConclusionThe results revealed that Psoriasis patients reported significantly higher degrees of depression and anxiety than controls. In addition, psoriatic women were more depressed than psoriatic men.
The association of the metabolic profile in diabetes mellitus type 2 patients with obsessive compulsive disorder and depression: New insights
Authors: Kontoangelos K. , Raptis A. , Papageorgiou C.C. , Papadimitriou G.N. , Rabavilas A.D. , Dimitriadis G. , Raptis S.A. 
Published: May 2011

IntroductionThe high comorbidity of depression in patients with diabetes mellitus type 2 has been established.ObjectivesThe association between Obsessive Compulsive Disorder (OCD) and diabetes mellitus type 2 is poorly understood.AimsThe aim of the present study was to assess the degree in which diabetes mellitus type 2 is accompanied by OCD.Method131 diabetic patients, 55 female and 76 male were randomly enrolled and during the first assessment was administered in all participants the Zung Self Rating Scale (ZUNG) and the Maudsley O-C Inventory Questionnaire (MOCI). After one year, while an intensive effort to improve the patients’ metabolic profile was performed, the diabetic patients that were initially uncontrolled (n = 31) were re-evaluated by the same psychometric tools. From those 31 patients 10 had managed to control their metabolic profile.ResultsMOCI and the sub-scale of slowness are statistically related with the diabetic profile (controlled-uncontrolled), with uncontrolled patients scoring significantly higher on the overall MOCI score and the factor of slowness of MOCI scale (p = 0.028). Regarding the association between the values of Glycosylated Haemoglobin (HbA1c) and the scores of MOCI it was found that they were significantly positively correlated in overall scores (p = 0,028) and in the subscale of slowness (p = 0,028). The analysis revealed a positive association between depression (p = 0.004) and obsessive compulsive disorder symptomatology (p < 0.001) and thepatient’s metabolic profile.ConclusionsDiabetes mellitus type 2 is associated with obsessive compulsive disorder symptomatology and depression. Improvements in glycaemic control were found to decrease the severity of the symptoms.
Assessment of efficacy of specialized psychiatric assistance for patients with combined mental and somatic pathology
Authors: Lebedeva V.F. , Semke V.Y. 
Published: May 2011

Objective and methodsUse of developed prophylactic and rehabilitative programs based on city primary care unit and psychiatric services of psychiatric institution has allowed improvement of quality of life, high clinical and economic efficacy of treatment of patients with combined mental and somatic pathology.ResultsAccording to data of catamnesis (2–9 years) in group of patients in need for course therapy according to addressing, recovery has been achieved in 46,2% of cases, stable clinical improvement - in 44,1%; in group of patients in need for systematic therapy and dynamic observation, recovery has been achieved in 24,7% of cases, stable clinical improvement - in 65,5%. The most effective measures were at initial stages of mental disorders. Differentiated gradual approach to treatment of combined mental and somatic disorders under conditions of general medical institution and principle of continuum of treatment measures have allowed reducing transient disability in 1,8 times, number of not based addressing and examinations per 1 patient in 2,3 times.ConclusionIntegrative approach to medical assistance rendering for patients with mental disorders, revealed in general medical network is enough effective. Successful interaction of psychiatrists of primary care unit, internists, psychiatrists of dispensary and hospital was contributed by principles: collective character of decision making, continuum in resolution of issues of treatment-prophylactic assistance, observation of principles of medical ethics and deontology oriented at interests of patients, accomplishment of treatment-diagnostic assistance, necessary in such an amount that maximum therapeutic effect was achieved during rational use of medical resources.
Anti-NMDA-receptor encephalitis: aethology of psychiatric symptoms in young women
Authors: Marin Diaz-Guardamino E. , Larrañaga Rementeria L. , Hervella Garces I. , Aldasoro Carcedo T. , Fernandez Bilbao J. , Araluze Iturbe K. , Segarra Echebarria R. , Eguiluz Uruchurtu I. 
Published: May 2011

IntroductionAnti-NMDA-receptor encephalitis is subacute disorder that has been recently described in young women and girls who often present neuropsychiatric symptoms as first clinical features; thus, it is common that they receive an initial assessment, diagnose or even treatment by a specialist in Psychiatry.ObjectivesPresenting a case of Anti-NMDA-receptor encephalitis that was observed at our hospital and the steps taken from its initial assessment by Psychiatry to the final diagnose and treatment by Neurology, our objective is to describe this disorder in order to make it known to the specialists in Psychiatry.MethodsThe case is that of a 14 year old girl who presents altered behavior, bizarre delusions and auditory hallucinations with subacute onset. In psychiatric assessment it is noted that the patient presents fever, slight and language impairment: Medical and Neurological assessment are requested. The steps followed to rule out other disorders are presented. SPECT and the detection of specific anti-NMDA-receptor antibodies in serum were necessary for an accurate diagnose.ResultsThe detection of specific antibodies is necessary for the diagnose of Anti-NMDA-receptor encephalitis. NMDA receptors are ligand-gated cation channels with crucial roles in synaptic transmission and plasticity. Their alteration could be a pathogenic mechanism in disorders such as epilepsy, dementia and schizophrenia.ConclusionsAnti-NMDA-receptor encephalitis is a recently described clinical entity that should be taken in consideration to rule out other causes of subacute onset psychiatric symptoms in young women and girls. Its well-defined set of clinical characteristics should become familiar to the specialists in Psychiatry.
Psychological distress in patients suffering from femoral head osteonecrosis, with and without white matter lesions: clinical characteristics and personality traits
Authors: Mouzas O. , Papaliaga M.N. , Zibis A. , Hadjigeorgiou G. , Angelopoulos N. , Malizos K. 
Published: May 2011

BackgroundThe aim of the present study was to investigate clinical parameters in relation to personality characteristics and psychopathology, in patients with non traumatic osteonecrosis of the femoral head (ONFH), with and without cerebral white matter lesions (WML).MethodsSixty seven patients participated in the study, 48 males and 19 females. The mean age was 37.6 years (SD 10.92, range: 15–61). Seventy five healthy individuals age and sex matched, served as controls. Socio-demographic information, clinical data and brain MRI findings were collected. The following self-report instruments were used: General Health Questionnaire (GHQ-28) and Defense Style Questionnaire (DSQ).ResultsThe odds of being assessed with a psychiatric diagnosis upon interview were three times greater among patients with ONFH compared to healthy controls (p < .006). The presence of cerebral WML and secondary nature of ONFH were associated with intense symptoms of psychological distress and especially with somatic symptoms of depression and social dysfunction (p < .003). A specific personality structure was identified in patients with ONFH.ConclusionsPatients suffering from osteonecrosis of femoral head, especially when white matter lesions are present, often present psychological distress and problematic personality organization. Therefore psychological support and/or psychiatric intervention can be beneficial to these individuals.
Studying the psychosocial adaptation, depression and anxiety leves of patients who experienced myocardial infaction
Authors: Çam O. , Nehir S. 
Published: May 2011

AimThis study was performed to determine psychosocial adaptation, depression and axiety levels of patients who experienced Myocardial Infarction (MI).Materials and methodsA total of 86 patients who were admitted to Coronary Intensive Care Unit of Ege University with MI diagnosis between October and December 2009 and who visited Cardiology Polyclinic as outpatients were comprised the sampling of study. In data collection “Patient Introductory Information Form” involving sociodemographic characteristics of the patients, “Psychosocial Adaptation Scale”, “Beck Depression Inventory” and “Beck Anxiety Inventory” were used.FindingsWhen the sociodemographic characteristics of patients were scrutinized it was identified that their mean age was 57.50 ± 10.43 years. 76.7% were males, 79.1% were married, 40.7% were elementary school graduates, 94% were living with their families. Since patients have experienced MI at early ages, singles or those are living alone, those have less income and those experiencing difficulty in coping with stress had increased mean psychosocail adaptation scores and mean depression scores and the difference was found statistically significant (p < 0.05).In patients who experienced MI, as the depression and anxiety scores increased, also the psychosocial disease-adaptation scores increased. Increased mean anxiety and depression scores will decrease individuals’ adaptation to disease (p < 0.01).ConclusionConsequently, during the process of reducing the negative effects exerted by heart failure, which is a chronic disease, on individual, family and community and increasing patients’ psychosocial disease-adaptation, nurses should consider patients’ individual and disease-related characteristics and provide support for them to develop their psychosocial adaptation.
Psychological status of patients undergone myocardial infarction: presentation of a case myocardial infaction (MI)
Authors: Nehir S. , Çam O. 
Published: May 2011

In myocardial infarction, as well as psychological problems many serious physical problems may appear in individuals who experience a disease which will be a threat for death or bodily image.PresentationMr. H’ cardiac disorder had onset in 2001. When Mr. H. who was discharged after placement of stent due to myocardial infarction has returned to polyclinic for control a psychosocial orientation scale was applied. His compliance to disease was fairly good.There were anxiety, lack of social support, reduced income level and various psychosocial factors which progress up to fear. Mr. H. is a 54-year old married man and he is a secondary school graduate, and is working in a restaurant since his present financial situation is not efficient. He demonstrated behaviors of anxiety, panic, uneasiness, gabbing and restlessness and an increase in tendency toward violence, irritability, isolation from society and timid behaviors were observed. Patient had a history of difficulty in establishing friend-relationships and there was an anxiety caused by gabbing and difficulty in expressing himself. During interview his actions were restless and just like he wanted to leave right away. He had fears of being disgraced in front of strangers. He said he was afraid of being ostracized from public because he was stammering. Nurses taking place in health team to arrange training programs related to issues such as appropriate diet toward MI, regular intake of medications, quitting smoking, reducing weight, increasing social support, coping with stress and anger control facilitate individuals who undergone MI compliance to disease and decrease their anxiety.
Remission of manic disorder in a hepatitis c virus (HCV) infected patient receiving pegylated-interferon (PEGIFN) plus ribavirin (RBV)
Authors: Ortiz Sánchez-Expósito C.L. , Machín Vazquez-Illá M. , Gallego Deike L. , López-Ibor J.J. 
Published: May 2011

IntroductionPegylated-interferon (pegIFN) plus ribavirin (RBV) is for the moment the licensed therapy for chronic hepatitis C. Neuropsychiatric symptoms are frequent side effects due to the treatment with pegIFN, registered in 30 to 80% of instances, with mood rather than psychotic disorders usually observed.ObjectiveA manic profile with psychotic symptoms in a HCV infected patient receiving pegIFN-RBV is presented to discuss management strategies and outcome.MethodsA 47 year-old male patient, former IDU and alcohol abuser, without past psychiatric history, was under therapy for chronic hepatitis C (genotype 1a, HCV-RNA 6.2 log IU/mL, Child A5). After 14 weeks of pegIFN-RBV treatment the patient attends ER with insomnia, uneasiness, expansive mood, irritability, extravagant and disinhibited behaviour, and detrimental and self-referential delusion.ResultsThe patient was admitted at the Psychiatric Unit to receive amisulpride (400 mg/12h) plus lorazepam (1 mg/8h), with psychotic symptoms regressing over following days. It was agreed that psychotropic drugs would be maintained at the same doses until the end pegIFN-RBV therapy, intended for 48 weeks.ConclusionAntipsychotic therapy may be effective and allows VHC infected patients with manic symptoms related to pegIFN-RBV therapy to continue their treatment.