bluuebunny/crossref_metadata_2025_split huggingface dataset:
INTERNALIZED STIGMA – HOW WE VIEW OUR MENTAL ILLNESS
Authors: Vieira M. , Fonseca Silva B. , Silva Ribeiro J. 
Published: August 2023

IntroductionStigma in mental health settings is described as a set of negative and unrealistic beliefs about those with mental illness. Authors suggest that stigma is consistently underdefined and overused, leading to resources toward preventing and managing this problem lacking intention and efficiency. Three interacting levels of stigma are defined: social, structural, and internalized or self-stigma. Internalized stigma refers to how people with mental illness see themselves as mentally unwell and, therefore, of lesser value.ObjectivesWe aim to discuss the impact of internalized stigma on psychiatric patients and ways of prevention and stigma resistance.MethodsWe performed a non-systematic literature review from the data base PubMed using the key words “internalized stigma” and “mental illness”.ResultsInternalized stigma is one of the major factors leading to delayed contact with psychiatric care up to two years in outpatients. In psychiatric patients, higher internalized stigma was associated with weakened social support and integration, hopelessness and lower self-esteem and sense of coherence. Low self-esteem is the most significantly associated factor and mediates lower quality of life and higher treatment avoidance. The risk of self-esteem loss seems higher in patients with more insight, especially if they also have a loss of valued social identity. Although some studies suggest higher levels of internalized stigma in female, single and lower educated patients, adjusted statistical analyses do not validate these sociodemographic variations. It is however more prevalent in those with depression and who had been hospitalized because of their mental illness. The impact of internalized stigma is often compared to the levels of the illness burden itself, leading to higher levels of depression and greater psychiatric symptom severity. Additionally, more self-stigma seems to predict suicidal ideation, particularly in young adults.ConclusionsThe internalization of negative stereotypes undermines empowerment and negatively impacts the evolution and recovery of psychiatric patients. There’s strong evidence that general stigma constitutes a risk factor for poor biopsychosocial health outcomes. Programs addressing multiple stigma components seem to be most effective in improving suicide prevention. However, most self-stigma interventions involve groups, which can create barriers for people who are not comfortable disclosing a mental health condition to others. Anti-stigma programs are most effective when they involve people with lived experience of mental health conditions in all aspects of development. Interventions from a younger age should focus on prevention of general stigma by improving understanding of mental illness and reducing self and outwards discrimination. Working on professionals own stigmatizing behaviors is also key to improve the way we communicate and educate populations on how to internally process mental health problems.Disclosure of InterestNone Declared
PSYCHOTIC DISORDER DUE TO PSYCHOSOCIAL STRESS EPISODE. REVIEW OF A CASE.
Authors: Gonzalez-Mota A. , Peso-Navarro I. M. , Garcia-Cerdan C. , Munaiz-Cosio C. , Ligero-Argudo M. , Martin-Gomez C. 
Published: August 2023

IntroductionPsychotic disorder is defined as a loss of contact with reality. Those who suffer from it perceive an altered reality, assuming it to be true.This feeling of unreality generates nervousness, anguish, hypervigilance and even social and emotional isolation.We present the case of a 18-year-old woman who attended the Emergency Department accompanied by the director of her college due to behavioral alterations. The patient reports that since she has moved to Salamanca to study,she has the feeling that her father has hired spies, one of them being her classmate, being able to hear sounds and voices, which she defines as motivating her to go on with her life. She reports that she is in a lower mood in this context and that there have been some days when she has not been able to attend class.ObjectivesThe objectives are to study the severity of the psychotic disorder in a young patient subjected to an episode of stress and to observe the reaction of the patient when it has been properly treated.MethodsWe carry out a review of the clinical history of a 18-year-old female patient with psychotic disorder, admitted to the Psychiatric Brief Hospitalization Unit (PBHU) in Salamanca.ResultsThe patient was treated with Risperidone 2mg/24h. After a few days in the PBHU, total disappearance of the psychotic symptoms was observed and the patient is completely self-critical. Once she was discharged, it was decided that she should return home with her parents for several months and continue treatment with Aripiprazole and Sertraline.ConclusionsOccasionaly, there are ethical dilemmas about beginning to treat young patients with psychotic ideas derived from external situations. Optimal treatment including drugs, psychotherapy and family support are essential. According to the scientific literature,a greater involvement in diagnosis,treatment and follow-up is recommended in patients with psychotic symptomatology derived from stress.Disclosure of InterestNone Declared
Schizophrenia: the announcement of the diagnosis
Authors: Azraf F. , Chtibi M. , Laboudi F. , Ouanass A. 
Published: August 2023

IntroductionFor many years, the question of the announcement of the diagnosis in psychiatry has been controversial. It is the starting point of a management allowing access to psychoeducation and to the patient’s recovery. In the case of schizophrenia, the cognitive impairment and the stigmatizing nature of the pathology jeopardize the announcement of the diagnosis. However, recommendations and legislation emphasize the need to inform the patient about his or her pathology. In Morocco, the law n° 131-13 of February 19, 2015 relating to the practice of medicine has made information about the diagnosis to patients an obligation for doctors and a right for patientsObjectivesThe interest of our work is to try to evaluate the current state of this practice, its ethics and its representations among psychiatrists.MethodsThis is a descriptive study on the announcement of the diagnosis of schizophrenia in a population of psychiatrists. The data collection was carried out by a questionnaire including: Socio-demographic and professional data, opinion on practice and training concerning diagnostic announcement in psychiatry, physicians’ representations concerning announcement: frequency, opinion on the importance of this practice.Results31 participants responded to our questionnaire. More than 9 out of 10 participants would not benefit from training on diagnostic announcement. Only 22.6% of physicians reported being very or somewhat familiar with medical information laws and their content regarding the regulation of diagnostic announcement. All participants considered schizophrenia to be the most difficult pathology to announce, followed by personality disorders and bipolar disorder. 74.2 of the participants considered it “rather” or “completely” essential to inform the patient of his or her psychiatric diagnosis. 77.4% of the participants considered it necessary to announce the diagnosis of schizophrenia and 80.7 often or systematically announce this diagnosis. Three situations considered appropriate to announce a diagnosis of schizophrenia: 74.2% announce it in general when the patient or the family asks for information about the diagnosis, 42% advise the patient when he/she mentions schizophrenia on his/her own. The patient’s functional inability to understand the diagnosis (77.4%) and the fear of negative clinical and therapeutic repercussions (41.9 and 38.7 respectively) were reported to deter physicians from making the announcement. More than half of the participants (64.5%) thought that the announcement of the diagnosis improved therapeutic compliance. Conversely, 35.5% considered that the announcement had no impact on therapeutic compliance.ConclusionsThe announcement of the diagnosis of schizophrenia remains today a complex and evolving subject. Even if great progress has been made to inform patients as well as possible, practices remain disparate from one doctor to another and this information is not well traced.Disclosure of InterestNone Declared
Role of peripheral markers of inflammation in cognitive dysfunction in schizophrenic patients: a systematic review
Authors: Ben Othman F. , Aissa A. , Adouni A. , Yosra Z. , Ouali U. , Jomli R. 
Published: August 2023

IntroductionSchizophrenia (SCZ) is a chronic mental illness characterized by a rich and diverse symptomatology. A generalized cognitive deficit has been widely recognized among the symptoms of this disease. Several authors have studied the relationship between peripheral markers of inflammation and cognitive dysfunctions in order to explain the etiopathogeny of these disorders.ObjectivesThe aim of our study is to better comprehend the nature of the relation between peripheral markers of inflammation and cognitive dysfunctions.MethodsA systematic review of the literature was conducted following the guidelines provided by the PRISMA method. We performed a systematic search focused on two automated bibliographic databases: Pubmed and Google Scholar including the following keywords: “inflammation”, “schizophrenia”, “cognition”ResultsA total of 17 articles were included.Significant relations with cognitive function were reported with IL-6, IL-18, IL-2, IL-8, tumor necrosis factor α (TNF-α ) and chemokines. Memory was the cognitive domain where the most significant relations with cytokines were objectified.BDNF levels were correlated with cognitive tests in 5 studies of SCZ populations. The domains concerned were inhibition, flexibility, verbal fluency, verbal memory, attention, and processing speed.Elevated CRP in patients with SCZ was reported by all studies and a significant relation with cognition in 3 studies. This relations is objectified in the areas of memory, executive functions and processing speed.The relations between CRP, BDNF, cytokines and cognitive functions was inconsistent across studies.ConclusionsThe majority of the results observed during the review were in favor of a significant relation between CRP, BDNF and cytokines. Nevertheless, these results were not constant and heterogeneous. It would be interesting to better explore the nature of this relation through prospective studies in order to establish therapeutic perspectives.Disclosure of InterestNone Declared
Fate of the first Brief Psychotic Disorder in hospitalised patients
Authors: Bouguerra I. , Homri W. , Lagha M. , Ben Romdhan I. , Bram N. , Labben R. 
Published: August 2023

IntroductionBrief Psychotic Disorder (BPD), defined according to the DSM-5 by the presence of delusions and/or hallucinations and/or disorganised speech persisting for at least one day and less than one month, the disturbance not being due to a bipolar disorder or a schizophrenia spectrum disorder or to the effect of a substance. Classically, the prognosis of a BPD is considered to be divided between restitution ad integrum (30%), progression to bipolar disorder (30%), progression to schizophrenia (30%) or repetition of the same form (10%).ObjectivesThe objectives of our study were to evaluate the evolutionary modalities after the first hospitalization for BPD after a follow-up of at least one year and to compare them with the data in the literature.MethodsOur study was retrospective and descriptive. We reviewed the records of patients hospitalised in our department from 1 January 2014 to 31 December 2018 for a first BPD and assessed the subsequent course over a minimum period of one year.ResultsWe included 70 records of patients hospitalized. Twenty-five patients (35.71%) were lost to follow-up after their first hospitalisation. The remaining patients (64.29%) were divided into 3 groups according to the above-mentioned evolutionary modalities (recovery, recurrence of BPD, progression to schizophrenia, progression to bipolarity). Results were in favour of an evolution towards bipolar disorder (35.55%), towards schizophrenia (44.44%), a relapse of the BPD (4.44%), while 13.33% of the BPDs had no future after an aftercare of at least one year. In addition, one case of evolution towards a chronic delusional disorder of the persecution type was observed.ConclusionsIn the present study, our results tend to be in line with the law of one-third described by some authors despite a slight discrepancy partly explained by the limitations of our study. Although, the outcome of BPD remains unpredictable. The minimum five years of evolution are decisive in assessing the subsequent prognosis.Disclosure of InterestNone Declared
A phenomenological approach to the affective core of Delusional Disorder.
Authors: Pellegrini R. , Muñoz Negro J. E. , Ottoni R. , Tonna M. , Cervilla J. A. 
Published: August 2023

Introduction
According to current diagnostic systems, affective symptoms do not represent a fundamental criterion for the diagnosis of DD. However, numerous studies have highlighted frequent comorbidity between DD and Mood Disorders and have elucidated the importance of the affective state in the development and persistence of delusions. Thus, some factor analysis studies have identified the existence of a depressive dimension in DD, suggesting a substantial psychopathological heterogeneity in DD. However, these important affective features have not evaluated from a phenomenological point of view and in their relationship with delusions.ObjectivesThe aim of the present study is to investigate the relationship between personality, trait affectivity and severity of delusions in patients with Delusional Disorder (DD).MethodsThirty-two outpatients affected by DD were administered the Structured Interview for DSM-IV-TR Personality Disorders (SIDP-IV), the Pathological Narcissism Inventory (NPI), the Positive and Negative Affect Schedule (PANAS) and the Psychotic Symptom Rating Scale (PSYRATS). Next, we analysed the prevalence of personality disorder in our sample of patients with DD and studied the correlations between the severity of delusions and the different affective variables. Finally, we obtained a multivariate explanatory model of the severity of the delusions.ResultsThe severity of delusions was directly associated with “Grandiose Fantasy” item of narcissistic personality and inversely related with the feelings of shame, fear and guilt. In the multivariate model, the feeling of shame was the only independent variable capable of accounting for the severity of the delusions, that, in in DD patients, would lie on an affective core of shame.Table 2.Pearson correlation coefficientVARIABLESDRS total scoreGRANDIOSE FANTASYp = 0.045SHAMEp = 0.048GUILTp = 0.016AGITATIONp = 0.049FEARp = 0.041Table 3.Standardized coefficients in linear standard regression (DRS)DRS: total scoreR²βtpStep 10.157---GRANDIOSE FANTASY-0.3961.890.048Step 20.460---GRANDIOSE FANTASY-0.2911.650.116SHAME--0.560-3.170.005ConclusionsThe severity of delusional beliefs in DD patients would lie on an affective core of shame upon predisposing personality traits. These findings could help to develop a psychotherapeutic approach for delusional patients focused in the feeling of shame.Disclosure of InterestNone Declared
Combined Foot and Eye Dominance Scale as a useful tool for the assessment of lateralization
Authors: Akabalieva K. V. 
Published: August 2023

IntroductionLateralization is the functional dominance of one of the dual organs of the body: eyes, arms, legs and even ears, during their spontaneous or purposeful actions. The handedness is influenced by many factors like geographic region, genetic and cultural factors as well as sex. The most used assessment for functional lateralization is hand dominance. When assessing foot and eye dominance, however, we find significantly higher left foot dominance as well as very strong left eye dominance in schizophrenic patients versus controls. We consider the explanation of this results is because in Bulgaria, during the communist regime (before 1990) left hand writing was under cultural pressure. Also handedness itself is influenced by other cultural factors as mentioned already. All of the above made us conclude that foot and eye dominance may assess much better the lateralization than hand dominance.ObjectivesThe aim of the study was to investigate the relaibility (internal consistency) of a combined Foot and Eye Dominance Scale in women- patients with schizophrenia and healthy subjects.MethodsA sample of 94 women- scizophrenia patients and healthy controls were assessed with a Combined afaoot and Eye Dominance Scale. It consisted of two subscales Foot Dominance Subscale and Eye Dominance Subscale. The Foot Dominance Subscale included a modified Chapman & Chapman Foot Dominance Scale and a new Complex Task Scales with four foot tests, reflecting on complex tasks. The Eye Dominance Subscale included three eye tests. Scale reliability statistics (item-scale statistics, summary statistics for the items, Cronbach’s alpha), non-parametric Mann-Whitney test and Spearman’s rank correlation coefficient were used.ResultsConsiderable differences were found in the contribution of the single items to the Combined Foot and Eye Dominance Scale. Some items show greater means than other items (from 0,14 to 0,80), which suggested greater phenogenetic component and consequently greater contribution of these items to the total scale mean. The mean correlation between the items of the Combined Foot and Eye Dominance Scale was positive (0,32), indicating good internal consistency of the scale.ConclusionsThe Combined Foot and Eye Dominance Scale more strongly and objectively reflect leftedness and could be a more useful tool for the assessment of lateralization irrespectively of culture and nation. The Combined Scale allows cross-cultural worldwide equivalence to the different studies in different neuroontogenetic diagnoses with presumed abnormal cerebral asymmetry.Disclosure of InterestNone Declared
The correlation beteen lifestyle and risk of metabolic syndrome in schizophrenia
Authors: Krysta K. , Tredzbor B. , Martyniak E. , Piekarska-Bugiel K. , Koźmin-Burzyńska A. , Cieślik A. , Krzystanek M. 
Published: August 2023

IntroductionPatients suffering from schizophrenia have a higher risk of premature death. An unhealthy lifestyle contributes to increased risk of cardiovascular diseases, metabolic syndromes, suicides among them. In addition to the use of selected therapy with a restriction metabolic risk has become important to influence non-pharmacological factors such as proper diet, introducing the principles of a healthy lifestyle. A diet rich in fiber, the DASH diet, the Mediterranean diet may become beneficial in terms of lowering parameters metabolic, cardiovascular and immune related to premature mortality in schizophrenia.Patients suffering from schizophrenia have a higher risk of premature death. An unhealthy lifestyle contributes to increased risk of cardiovascular diseases, metabolic syndromes, suicides among them. In addition to the use of selected therapy with a restriction metabolic risk has become important to influence non-pharmacological factors such as proper diet, introducing the principles of a healthy lifestyle. A diet rich in fiber, the DASH diet, the Mediterranean diet may become beneficial in terms of lowering parameters metabolic, cardiovascular and immune related to premature mortality in schizophrenia.ObjectivesThe objective of this study was to evaluate the influence of the lifestyle on the metabolic parameters in schizophreniaMethodsIn our study, we assessed the influence of diet, nutritional knowledge and lifestyle on parameters of metabolic syndrome (cholesterol, triglicerydes, glucose) in patients with schizophrenia.ResultsIn the results we have found positive co-relations between unhealthy diet and lifestyle and lack of knowledge on proper nutrition and increased parameters of metabolic syndrome.
Groups
BMI (Std. Dev)
Cholesterol HDL mg/dl
Triglicerides mg/dl
Insuline resistaneceInsuline uU/mlStudy group30,58(4,44)45,63(7,34)177,32(108,76)4,68(4,64)19.77(17,35)Control Group26,00(3,39)54,32(14,07)111,47(57,48)2,1(!,21)9,01(4,97)ConclusionsDietary intervention may become one of the therapeutic goals in schizophrenia.Disclosure of InterestNone Declared
Amantadine augmentation in electroconvulsive therapy-resistant catatonia: a case report.
Authors: Bueno Sanya L. , Andreu Gracia H. , De Juan Viladegut O. , Olivier Mayorga L. 
Published: August 2023

IntroductionCatatonia is a syndrome characterized by physical symptoms ranging from immobility to excessive motor activity. Besides being historically associated mainly with schizophrenia, it is widely known that it can be the expression of different psychiatric, neurological or medical conditions. The treatment of choice is benzodiazepines, indicating electroconvulsive therapy in refractory cases. Amantadine is considered a second-line therapy in setting when electroconvulsive therapy is not available.ObjectivesTo describe the case of a patient with treatment-resistant catatonic schizophrenia. Not having responded to benzodiazepines or electroconvulsive therapy, potentiation with amantadine was subsequently started.MethodsOur patient presented at a psychopathological level; psychomotor inhibition, a perplexing attitude, and mute speech. At the motor level; ambitendency, indecision, automatic obedience, motor stereotypes, and facial grimaces. He did not present other alterations at the neurological level. Regarding complementary explorations, we performed neuroimaging and blood tests, which resulted all anodyne. With an alternative diagnosis, we considered that sequelae of a neuroleptic malignant syndrome could have produced the symptoms that he had suffered. Due to the persistence of the symptoms and their typical characteristics, catatonia was our first diagnostical impression. As treatment with benzodiazepines was ineffective, electroconvulsive therapy was started. No clinical improvement was observed. Given the refractoriness of the case, a review of the existing literature was carried out. We found reports of a good response to amantadine in similar cases. Amantadine was introduced up to a dose of 200mg.ResultsAfter four weeks of treatment with amantadine at a dose of 200mg, the patient showed meager improvement at both psychopathological and motor level.ConclusionsWe find the case of a patient with long-term schizophrenia who is nowadays dependent on all daily living activities and requires sustained care.Disclosure of InterestNone Declared