bluuebunny/crossref_metadata_2025_split huggingface dataset:
Catatonia in adolescence: an approach to genetic disorders, autism spectrum and delay of diagnosis
Authors: De Sousa Figueiredo N. 
Published: August 2023

IntroductionCatatonia is a treatable but often undiagnosed condition in children and adolescents. The majority of Pediatric catatonia cases occur at a puberal ages. It is associated with neurodevelopmental disorders. In these cases the diagnosis can be more difficult due to the overlap of symptoms.ObjectivesReport the case of a 11- year - old girl who developed catatonia. She had a previous psychiatry history of intellectual disability, delayed speech and motor slowness. She had a positive Lorazepam challenge test with resolution of the most catatonic symptoms. More studies were completed and according to the clinical history the diagnosis of autistic spectrum disorder was made.Genetic test revealed a Phelan Mc Dermid Syndrom.MethodsA year 11-year-old girl presented to the pediatric emergency department with a 2- days history of worsening anxiety and rigidity, seeming lost and distant. The previous 4 months there was a history of progressive functional and social decline. Her speech was minimal and she required assistance with dressing and feeding. She displayed stereotypias and mannerism. All medical studies were unremarkable. A Lorazepam challenge test (2 mg IV) showed evidence of response. She recovered from catatonia and the basal situation was studied. She was diagnosed of autistic espectrum disorder attending the psychiatric and medical history. Apart from other medical studies, a genetic test showed a mutation in a gene called SHANK 3 according to a Phelan Mc Dermid Syndrom.ResultsPediatric catatonia is associated with neurodevelopmental disorders such as autistic spectrum disorders. There is not always a clear identifiable cause and it is necessary to rule out possible organic causes of pediatric catatonia. The treatment is similar to adults. It is essential to do a complete medical and psychiatric history to an accurate diagnosis such as an autistic spectrum disorder. Genetic testing must be included. In this case, genetics showed a Phelan Mc Dermid Syndrom with a delayed diagnosis. This disorder can cause a wide range of symptoms varying in severity. These symptoms could include global developmental disorders, intellectual disability, delayed speech, autistic spectrum disorders and minor dysmorphic features.ConclusionsIt is crutial to emphasize the high incidence of catatonic symptoms in individuals with Phelan Mc Dermid Syndrome as catatonia often goes unrecognized or undertreated in individuals with developmental disabilities. Significant cognitive and behavioral regression beyond a baseline level of disability has been reported. This case also highlights the relevance of genetic testing in the work of individuals with intellectual disabilities and acute psychiatric illness or regression. Symptoms indicative of catatonia may occur in context of infections, hormonal status and stressful life events. Treatment is centered on the symptoms.Disclosure of InterestNone Declared
Diagnostic stability in adolescents transiting to adult services: exploring the patterns of diagnostic adjustments
Authors: Baldaquí N. , Crucilla C. , Menditto M. G. , Malvini L. , Maltese A. M. , Percudani M. , Barbera S. 
Published: August 2023

IntroductionMost mental illness of adult life begin in late adolescence, affecting young people when they require transition to adult services. In <18 years old patients is more difficult to establish a definitive diagnosis, so diagnoses are often unstable and temporary. In young patients, understanding diagnostic stability may help in clarifying the course, developmental changes, and long-term prognoses of psychiatric disorders. Little research has explored the diagnostic adjustments that occur in child and adolescent mental health services, however previous studies reported that moods disorders and schizophrenia showed more stability than other diagnoses.Understanding diagnostic trajectories is necessary to improve developmental psychopathology, in order to acquire more discrete diagnostic entities, and clinical judgements, regarding risk and prognosis.Objectivesas the evidence of diagnostic stability from childhood (child and adolescent mental health services) to adulthood (adult services) is limited, the aim of this study is to describe the clinical features in patients from child and adolescent mental health services in transition to adult services and to compare the main diagnosis of these patients made in both services.Methodsall individuals, between 18 and 25 years old, admitted to our outpatient clinic specialized in prevention, diagnosis and treatment of mental illness in adolescents (ASST Grande Ospedale Metropolitano Niguarda, Milan), referred to our service between 2021 and 2022. Clinical Diagnosis were establish using ICD-10 criteria.Results
301 new patients were admitted in our outpatients service: 171 in 2021 and 130 in 2022 (until October). The mean age was 21,08. The 30.2% of patients come from child and adolescent mental health services (29,2% in 2021 and 31,5% in 2022). The main diagnosis of these patients were: first reaction to severe stress and adjustment disorders (F43), second specific personality disorders (F60) and thirst eating disorders (F50). The main diagnosis made in our services were: first specific personality disorders (F60), second first reaction to severe stress and adjustment disorders (F43), thirst other anxiety disorders (F41). 56,1% of patients have the same diagnosis in both services and 43.9% have a different diagnosis. There were not differences in sex (60,5% female and 39,5% male). Patients from child and adolescent mental health services were youngers (19,68 vs 21,69), not statistically significant.ConclusionsFurther research is required to understand diagnostic trajectories, especially longitudinal studies in minors during transition period to adult services, in order to find patterns of diagnostic adjustments.Disclosure of InterestNone Declared
PSYCHIATRIC COMORBIDITY IN A SAMPLE OF PATIENTS WITH COGNITIVE-BEHAVIORAL MINORITY DISEASE
Authors: De la Mata R. , Manso-Bazús C. , Pujol S. , Torrent L. , Urraca L. , Vázquez-Tarrio D. , Esteve M. , Fernández E. , Pàmias M. 
Published: August 2023

IntroductionAbout the term cognitive-behavioral minority disease or rare disease are a group of diseases that affect between 6-8% of the populatio. It is estimated that there are more than 7000 in the world, the majority with a genetic basis and affect various organs and systems, they also present psychiactric comorbidities and cause a physical or mental disability. Given its definition, it is difficult to see a large number of these patients in our usual clinical activity, so their management can be complicated.ObjectivesTo evaluate the prevalence of psychiatric comorbidity and the prevalence of psyhcopharmacological treatment in children and adolescents whe present a minority disease.MethodsThis is a descriptive, controlled, retrospective cross-sectional study of a sample obtained by non-probabilistic sampling, which is representative of the study population.The statistical analysis was made using the statistical program SPSS V22 (2013).ResultsWith a sample of 114 patients, of which 26,6% presented fragile X syndrome, secondly 25,3% presented Prader-Willi Syndrome and 48,1% other chromosomal abnormalities.By subgroups (male:female): in Prader-Willi syndrome 6:14 (30%:70%), in Fragile X syndrome 12:9 (57,14%: 42,86%) and in other diseases 25:13 (75,69%: 34,21%).ConclusionsThe creation of clinical expert units makes the possibility to increase knowledge of diseases whose prevalence in the population, thanks to technological advances, is increasing and where scientific knowledge is still limited.These units are also important, in order to be able to offer personalized intensive treatments in order to reduce polypharmacy. There is not a great difference between the minority diagnosis and polypharmacy, although there is less polypharmacy than expected, which may be the result of the success of the most intensive and personal psychotherapeutic intervention in the unit.Disclosure of InterestNone Declared
Treatment of early resistant schizophrenia: a case report
Authors: Benhammou S. , Raissouni M. , Kisra H. 
Published: August 2023

IntroductionEarly-onset schizophrenia begins before the age of 18. Drug treatments are mainly based on antipsychotics, preferably atypical antipsychotics, which have fewer side effects compared to first generation antipsychotics.Resistant schizophrenia is defined as an inadequate response to two different antipsychotic treatments for a sufficient duration and dosage. Clozapine is the only drug treatment currently approved for patients with resistant schizophrenia, for which the risk of aganulocytosis must be monitored.In order to derive a clear benefit, different scientific organizations, recommend the use of Clozapine as early as possible, and they state that there is little evidence to support the use of very high doses of antipsychotics.ObjectivesWe seek to determine the effectiveness of clozapine treatment in the management of early schizophrenia resistant to more than two antipsychotic treatments.MethodsDescription of a case of early resistant schizophrenia , in a 16-year-old girl, put on clozapine in comparison with the data of the literature.Discussion: through articles published on google scholar, pubmed, and science directResultsTreatment with clozapine, showed efficacy in the case of early schizophrenia resistant to several lines of antipsychotics, including disappearance of auditory and visual hallucinations and delusions.ConclusionsThe efficacy of clozapine treatment in early resistant schizophrenia raises the question of its use in first line from the beginning of the schizophrenic disease, however its side effects and its difficulty of follow-up raise questions in relation to its use.Disclosure of InterestNone Declared
Separation-Individuation in Patterns in Turkey: An Investigation of Developmental, Gender and Contextual Differences
Authors: Bildik T. , Şentürk Pilan B. , Özbaran B. , Yüncü Z. , Köse S. 
Published: August 2023

IntroductionThere is still a paucity of studies exploring the impacts of teenage employment on mental health and development. In many developing countries, youths participate intensively in the teenage labor force. The involvement of adolescent in the world of work would promote the development of responsibility and prepare the young person to function more effectively in adult roles.ObjectivesThe purposes of the present study were to examine the adolescent separation-individuation among an understudied and vulnerable population; and to examine the Separation-Individuation Test of Adolescence (SITA) for revealing the differentiation working male group from student male group.MethodsParticipants completed the SITA. The group of study 1 consisted of 618 high school and 252 university students between the ages of 14 and 24, 489 of which were girls and 381 were boys. In Study 2, participants were 269 male adolescents between the ages of 15 and 17, 141 of which were full-time worker and 128 high school students. In study 1, these results were consistent with the rapprochement subphase of the separation-individuation process in adolescence -the striking desires for intimacy and independence.ResultsOur results support the gender specific patterns of identity formation and the argument that connectedness in close relationships plays a central role in the female identity development. Interestingly, there were no significant gender differences in the tendency to view close interpersonal relationships as threatening to their sense of independence and selfhood, and to deny or avoid dependency needs. The reason for this might be the cultural differences between the individualistic and collectivistic cultures. In study 2, working males could be distinguished from student counterparts by their increased tendency to seek close interpersonal ties with caretakers. The finding also suggested that student males reflected characteristics of the traditional view of adolescents’ independence striving. Across both studies it was found that the traditional Turkish child-rearing patterns have been characterized by an emphasis on interpersonal relationships and close ties with family than individualistic culturesConclusionsOur results revealed that the subscales of SITA –especially dependency denial, rejection expectancy, nurturance seeking, engulfment anxiety, and teacher enmeshment- can help clinicians for assessing the adolescent separation-individuation process in a reliable way. We suggested that adolescent employment would lead to the difficulties in developing bonds with parents because of the adolescents’ long work hours, the early involvement with the world of work would lead to the withdrawal from the more dependent, preadultlike student role, and student adolescents would reflect characteristics of the traditional view of adolescents’ independence striving.Disclosure of InterestNone Declared
Prevalence and Comorbidities of Attention Deficit Hyperactivity Disorder Among Adults and Children/Adolescents in Korea
Authors: Bahk W.-M. , Seo J. S. , Sung H.-M. , Park S.-Y. 
Published: August 2023

Introduction: ObjectivesThis study investigated the prevalence and comorbidities of attention deficit hyperactivity disorder (ADHD) among adults and children/adolescents in Korea.MethodsThis study used data from the Korea Health Insurance Review and Assessment Service collected from 2008 to 2018. Study participants comprised patients with at least one diagnosis of ADHD (International Statistical Classification of Diseases and Related Health Provisions, 10th revision code F90.0). Prevalence rates and psychiatric comorbidities were also analyzed.ResultsWe identified 878,996 patients diagnosed with ADHD between 2008 and 2018. The overall prevalence rate of diagnosed ADHD increased steeply from 127.1/100,000 in 2008 to 192.9/100,000 in 2018; it increased 1.47 times in children/adolescents (≤ 18 years) and 10.1 times in adults (> 18 years) during this period. Among children/adolescent and adult ADHD patients, 61.84% (95% confidence interval [95% CI] 61.74−61.93) and 78.72% (95% CI 78.53−78.91) had at least one psychiatric comorbidity, respectively.ConclusionsOur results showed that the prevalence rate of diagnosed ADHD has increased in Korea; however, it is lower than the global average. Further studies are required to identify and treat vulnerable populations appropriately.Disclosure of InterestNone Declared
Kraepelin, the unitary psychosis theory and the classification in psychiatry
Authors: Martínez Jambrina J. J. 
Published: August 2023

IntroductionThe history of psychiatry is the history of the unitary psychosis concept. Recent studies on this subject by prominent authors (Huda, Stanghellini, Broome, etc.) confirm that the problem has not been resolved but that it reappears now with more force from skeptical positions, based above all on the insufficiency of the classification criteria official (ICD-10, DSM-V). This skepticism has led to an attempt to make the line that separates normality from mental illness disappear with the weak argument that isolated psychotic symptoms are detected in the general population.The proposals to stop these movements that border on the denial of mental illness try to provide more information on the contextual and subjective factors of mental illness, thus reinforcing the so-called biopsychosocial model formulated by Engel in 1976, whose conceptual imprecision is largely responsible for the problems before indicated as well as other more serious ones for the organization of psychiatric care.ObjectivesPoint out the insufficiencies of the biopsychosocial model.-Point out the advantages of acquiring a classic evolutionary approach such as the one designed by Iván Pavlov besides the Volga and improved by some followers.-highlight the differences between researching in psychopathology, a true science, or doing it in clinical psychiatry, its practical application. This distinction is essential.MethodsThe works of some authors who have approached this conflict with dedication and rigor will be reviewed.Research lines followed during last hundred years in psychiatry will be contrasted with the results obtained.ResultsNew points of view and new tools need to be incorporated to solve this conflict that confuses experts so much are proposed.Ways of working are indicated that should avoid confusion between psychopathology and clinical psychiatryConclusionsA psychiatric diagnosis must be established on solid conceptual basis that we currently lack.-Both Kraepelin and Kurt Schneider are two key figures to recover and keep current in our daily practice.-The importance of patient’s subjectivity when taking an anamnesis of their problems seems very important. The question is how to manage that subjectivity in order to analyze it from a classical scientific model, Pavlov’s great desire.-A revisiting of Husserlian phenomenology is essential in the training plans of young psychiatrists and in daily psychiatric care. But this is not enough. We need new tools and new conceptual frameworks so that the phenomenological perspective can contribute to put light in problems as important as those generated by the constant change of diagnosis that is carried out with many patients.If we want a scientific psychiatry we cannot handle with tools that have failed since their creation.Disclosure of InterestNone Declared
Psychosis in autism spectrum disorder: a clinical review
Authors: Gomes D. R. , Silveira F. , Freitas R. 
Published: August 2023

IntroductionAutism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by frequent comorbidity including mood, anxiety and psychotic disorders. Psychiatric comorbidity in ASD has been associated with poor prognosis.ObjectivesTo summarize clinical data regarding the relationship between autism spectrum disorder and psychosis comorbidity, namely its epidemiology, diagnosis, treatment and prognosis.MethodsWe conducted a non-systematic review of the literature relevant to the topic published in the PubMed database. Articles were selected based on title and abstract review.ResultsEpidemiological studies report significant rates of comorbidity between ASD and psychosis. According to a recent systematic review, prevalence of non-affective psychosis in ASD has been estimated at 9,56%, despite heterogeneity across included studies.The differential diagnosis of psychosis in a patient with ASD is frequently a challenge and depends on the severity of intellectual and language impairment, medical comorbidities (including epilepsy and associated pharmacological iatrogenic factors), psychiatric comorbidities and substance use. Conversely, establishing the diagnosis of ASD in a patient presenting with psychosis is not always clear, and clinicians must rely on collecting a detailed developmental history.There are no large controlled studies regarding the treatment of psychosis in this specific patient group, but risperidone and aripiprazole have been used based on efficacy in primary psychotic disorders, as well as efficacy and safety profile in other symptomatic clusters of ASD, namely irritability.ASD and psychosis comorbidity has been associated with lower response rates to antipsychotic treatment and negative long-term prognosis.ConclusionsPsychosis is a common and serious comorbidity of ASD, with limited data regarding treatment options. Further research is needed to improve global outcomes.Disclosure of InterestNone Declared
use disorder in patients with autoimmune diseases:sociodemographic profile
Authors: Stati S. 
Published: August 2023

IntroductionAutoimmune diseases are chronic and disabling conditions, especially because of the chronic pain they cause. Substance use disorders are on the rise in these patients, especially the problematic use of prescribed and over-the-counter analgesics.Objectivesto study the socio-demographic profile of patients with comorbidity between substance use disorders and autoimmune diseases, to assess the reasons for admission, the length of hospitalization, and the main psychoactive substances found in these patientsMethodsA retrospective cross-sectional study of the medical records of patients with substance use disorders co-morbid with autoimmune diseases who were hospitalized in the addictology department of the ar-Razi University Psychiatric Hospital in Salé between January 2014 and December 2021.Results10 patients were included in our study, the median age was 42, 76% were male, 41.3% were single, 63% had an average socio-economic level. 43.5% of the patients had a medical history, the main reason for admission was depressive syndrome (50%), the most common autoimmune disease was insulin-dependent diabetes, followed by IBDConclusionsthe comorbidity of autoimmune diseases and substance use disorders suggests the existence of common etiopathogenic mechanisms, the management of this comorbidity requires multidisciplinary collaborationDisclosure of InterestNone Declared
The experience of suicidal patients with inpatient nursing care
Authors: Maes T. 
Published: August 2023

AbstractWorldwide, suicidal patients are treated in residential care. The used interventions and support systems during inpatient care are important in suicide prevention. Nurses are asking for guidelines on how to provide care for suicidal depressed patients. The aim of this study is to explore useful processes during the nursing care for suicidal patients. These processes are identified by exploring the suicidal patient’s experiences with nursing care. We have developed a category system of helpful processes and interventions that are observed in nursing care for suicidal patients. The category system contains four core themes; nurse behavioral interventions, nurse attitudes, and nurse conversational intervention and environment.Disclosure of InterestNone Declared