bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mydriasis caused by ESCITALOPRAM: A case report
Authors: Bouattour N. , Bouattour W. , Messedi N. , Charfeddine F. , Aribi L. , Aloulou J. 
Published: August 2023

IntroductionSerotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants thanks to the overall safety and tolerability spectrum. However, they can cause different side effects that not all of them are well identified.ObjectivesWe intend to clarify the clinical presentation of mydriasis caused by Escitalopram.MethodsReporting the case of a patient suffering a major depressive disorder, that presented a mydriasis after adjusting her antidepressant medication. Then, we conducted a literature review using “PubMed” database and keywords “Mydriasis”, “escitalopram”, “SSRI”,” side effects”.ResultsA 29-year-old female with no past clinical history, presented in May 2021 a severe depression requiring an antidepressant treatment. Under 10 mg per day of escitalopram there was a partial remission of the symptoms, leading to increase the dose by another 10 mg. One month after taking 20 mg/day, she consults before the appointment suffering from a blurry vision and photophobia. Ophthalmologic examination showed a bilateral reactive half-mydriasis, eye pressure was 14 mmHg and fundus examination was normal. Iatrogenic origin of mydriasis was suspected. A gradual interruption of the medication lead to disappearance of the latter. A pharmacological investigation concluded to the suspension of escitalopram and to be vigilant if an antidepressant medication would be needed.ConclusionsMydriasis is an uncommon side effect caused by SSRI that needs to be kept in mind by clinicians. Therapeutic patient education can help to detect abnormal side effects and treat them if needed.Disclosure of InterestNone Declared
Psychotherapy program as an additional treatment method for patients with rheumatoid arthritis, multidisciplinary approach
Authors: Matic A. , Gudelj Gračanin A. , Tonković I. , Mužinić Marinić L. , Morović-Vergles J. 
Published: August 2023

IntroductionChronic diseases, with the development of medicine, the extension of life expectancy and the reduction of dying from infectious diseases, have become a leading public health problem. Rheumatoid arthritis (RA) is a chronic, progressive, multifactorial, autoimmune, systemic inflammatory disease of connective tissue, and sufferers are at greater risk of developing psychological disorders, depression and anxiety being the most common. Optimal treatment of RA should include periodic screening of somatic and psychological comorbid disorders and diseases with a multidisciplinary approach to treatment.ObjectivesPresenting a psychotherapy program as an additional method of treating patients with rheumatoid arthritis.MethodsIn University Hospital Dubrava, a psychotherapy program was organized for patients with rheumatoid arthritis, which took place once a week for 12 weeks, and consisted of autogenic training, education about the disease and group psychotherapy. The program would begin with autogenic training held by a clinical psychologist, and the main goal was to achieve psychophysical relaxation. This was followed by an education on rheumatoid arthritis, in which a clinical rheumatologist was involved, and the goal was to provide basic information about the disease, thereby achieving better cooperation with health care personnel and a more active role in their own treatment. In the end, there would be a time-limited dynamic group psychotherapy conducted by a psychiatrist/psychotherapist with the basic therapeutic effects of group therapy.Results
As a result of a 12-week psychotherapy program for somatic patients, which was held in a clinical hospital, patients’ anxiety and depression decreased, the experience of pain decreased, and there were positive changes in the perception of the quality of life.ConclusionsA multidisciplinary approach is recommended in treating patients with rheumatoid arthritis and psychotherapy progam can be used as an additonal way of treatment.Disclosure of InterestNone Declared
Psychosomatics and mentalization
Authors: Delgado Campos A. M. , Alcindor Huelva P. , Alvarez Astorga A. , Rubio Corgo S. , Pérez Vicente E. , Arrieta Pey M. , Diaz Gordillo C. , Del Sol Calderón P. , Martín Martín A. C. 
Published: August 2023

IntroductionWe have investigated the relationship between the Psychosomatic Classification method (Marty) and the Rorschach Test, with respect to the diagnosis of psychosomatic disorders, within the framework of the degree of mentalization measured by both.ObjectivesA) To verify statistical coincidence with respect to the degree of mentalization (risk of generating psychosomatic disorders in a subject) between the Rorschach Test and the diagnostic technique Psychosomatic Classification, by P. Marty. B) To test the hypothesis: Patients diagnosed with infertility, whose degree of mentalization is good, will have a greater probability of achieving a successful pregnancy throught Assisted Reproduction Techniques.MethodsTwo evaluation tools were used: a) Psychosomatic Classification based on the criteria established by this diagnostic method; b) The Rorschach test (based on the evaluation of 29 indicators, selected according to their greater relevance in the generation of somatic symptoms).A sample of 120 patients (women) diagnosed infertility at the Assisted Reproduction Unit (U.R.A.) at Hospital Universitario 12 de Octubre in Madrid was recruited. The method of ‘statistical correlation of coincidence’ between the results of the two diagnostic instruments used was used. Once both tests had been assessed by the “inter-judge” method and the quantitative values of the selected items had been weighted, the KAPPA statistical method was applied to establish the “correlation of coincidence” between the results of the two assessment instruments.ResultsConsidering that the KAPPA method takes values between “0" and ”1" and that between 0.6 and 0.8 the agreement or coincidence is considered good, and above 0.8 very good, the result applied to the hypothesis is 0’76 (’good’).ConclusionsA) Using the Rorschach Test and P. Marty’s Psychosomatic Classification in a complementary manner, these two instruments together provide high reliability, with respect to the degree of mentalization (a subject’s risk of suffering psychosomatic disorders). B) The degree of mentalization has a significant impact on the success or failure in the application of Assisted Reproduction Techniques in infertile women.Disclosure of InterestNone Declared
The concept of love in the patchwork family and it’s use in psychotherapy
Authors: Miętkiewicz R. , Kałaczyńska-Miętkiewicz M. 
Published: August 2023

IntroductionThe authors - both active psychotherapists and at the same time happily married couple - present bravely a unique case study : theirs own patchwork family. The dwelve deeply into family systems dynamic, analyze the relationship between grandparents, parents and children. The standard roles of father and mother are taken into examination, especially after the youngest baby is born. With wit and humor, the authors define the new working paradigm of patchowork love.ObjectivesDefine the new concept of love in patchwork family and redefine the traditional roles.MethodsCase study.ResultsThe result - the new concept of a fully functioning patchwork family with redefined love concept and new roles - enables better understanding and richer life.ConclusionsWe should always seek for love in the families, which come to psychotherapy / psychiatry office for help. Understanding the dynamic of love in the patchwork family is crucial to providing high quality help.Disclosure of InterestNone Declared
Online versus in-person Eating Disorder Examination for adolescents with eating disorders: Empirical verification of data equivalency
Authors: Besse-Fluetsch N. , Mayr L. , Smigielski L. , Buehlmann C. , Pauli D. 
Published: August 2023

IntroductionIn the last ten to fifteen years, it has become common for researchers to collect both quantitative (Sue & Ritter, 2012) and qualitative data (Jowett, Peel, & Shaw, 2011) online. The Covid-19 pandemic has increased the importance of this process and accelerated it in many disciplines (Torrentira, 2022).In addition to convenience, recent work suggests that online data collection may be more valid than face-to-face data collection for some populations. This would mean that online data collection may be the most valid and effective for this age group (Barratt, 2012).ObjectivesAdolescents with an eating disorder tend to be more open about their symptoms via impersonal online data collection than they are in a face-to-face conversation. Symptom underrating has been documented in face-to-face interviews, because “of feelings of shame elicited by the loss of anonymity during face to-face interviews” leading to face-to-face denial, whereas a self-report questionnaire allows for more privacy and hence honesty while answering questions (Berg et al. 2011). This is especially key in the diagnosis of Anorexia Nervosa (AN), as AN patients minimize, deny, and/or fail to recognize their symptoms (Passi, Bryson and Lock 2003).Given the benefits of collecting data online for both researchers and participants, it is important to determine the quality of the data collected online to guide its use and interpretation. More evidence is needed to confirm the equivalence of online and face-to-face interview data. The current study examines the equivalence of semi-structured interview data collected online versus original face-to-face interviews.MethodsThe Eating Disorder Examination (EDE), assessing psychopathology of eating disorders, was administered to 49 adolescents meeting ICD 10 criteria for anorexia nervosa or atypical anorexia nervosa. The same diagnostic interview was administered twice, once via face-to-face and once as an online version, within a week. Method order was counterbalanced among participants and temporal stability was controlled. The Eating Disorder Inventory-2 (EDI-2) was used as a control variable.ResultsBoth the equivalence test and the null hypothesis test were significant for the sum score of the EDE. Measures of psychopathology in eating disorders demonstrated equivalence across face-to-face and online format of the EDE.ConclusionsThe aim was to examine the equivalence of face-to-face and online methodologies, controlling for temporal change in the variable under investigation over one week and order of administration. Results demonstrate equivalence across face-to-face and online format of the EDE. These findings suggest that data obtained using EDE online can be interpreted in comparison with normative data obtained in the face-to-face Interview and that corrections trough transformations are not necessary.Disclosure of InterestNone Declared
GnRh agonists as precipitating components of psychiatric pathology. A case report.
Authors: Guerrero Medina A. , García Eslava J. S. , Martín Rodriguez A. C. , Martinez Salvador L. , Alvarez Alonso M. J. , Aubareda Magriña M. 
Published: August 2023

IntroductionGnRh agonists are drugs used in various gynecological pathologies, among which is endometriosis. They act by stimulating GnRh receptors in the pituitary gland. This sustained and continuous stimulation of GnRh, will initially generate an increase in the release of luteinizing hormones and follicle-stimulating hormones, subsequently losing sensitivity to the receptors, internalizing them, and thus suppressing the release of these hormones, which would entail an ovarian suppression, thereby inhibiting the release of estrogens and progesterone. Psychiatric adverse effects have been described. Gonzalez-Rodriguez et al (Front Psychiatry 2020; 11:479), described this association with changes in mood, and the presence of a series of cases where the link between GnRh agonist and the possibility of presenting psychotic symptoms is observed. Wieck (Curr Top Behav Neurosci 2011;8:173-87), Frokjaer (J Neurosci Res 2020;98(7):1283-1292), Brzezinski-Sinai et al (Front Psychiatry 2020;11:693) reported that this association could be related with the relationship of the hypothalamic-pituitary-gonadal axis, hormonal fluctuation and its relationship with the dopaminergic regulation, a genetic component that would increase the predisposition to trigger psychiatric pathology in patients with greater sensitivity to hormonal fluctuations, and the loss of neuroprotection generated by the decrease of estrogens in the central nervous system. All of this in the context of multiple environmental and genetic factors that participate together in the appearance of the disease.ObjectivesTo describe the importance of detecting the risk factors that can precipitate a psychotic episode, including the use of certain drugs, such as GnRh agonists.MethodsWe describe a case of a 45 year old patient with endometriosis with multiple organ involvement who went to the emergency room due to behavioral changes in the context of a brief psychotic disorder with “ad-integrum” recovery.ResultsA retrospective analysis of the case is conducted, observing an association between the introduction of GnRh agonists and the presentation of a first psychotic episode.ConclusionsThe importance of this case lies in the limited evidence of this association in the literature, and the implication of these drugs in the triggering of psychiatric pathology, being an aspect to be considered by psychiatrists in their patient’s follow-up.Disclosure of InterestNone Declared
Stigma and self-stigma in patients with delusional disorder: a systematic review.
Authors: González- Rodríguez A. , Alvarez A. , Román E. , Guàrdia A. , Natividad M. , Alberto Marcus M. , Calvo E. , Labad J. , Monreal J. A. 
Published: August 2023

IntroductionThe association between insight, stigma and self-concept has been considered as a potential predictor of poor clinical outcomes and global functioning in psychosis. In patients with delusional disorder (DD), the effects of stigma and self-stigma have been poorly explored.ObjectivesOur main goal was to systematically review studies addressing stigma and self-stigma in DD to assess whether these phenomena have an impact on clinical symptoms.MethodsA systematic review was conducted through PubMed and Google Scholar databases from inception to 2022 (PRISMA guidelines). Search terms: (Stigma OR self-stigma) AND (“delusional disorder” OR psychosis OR paranoia). Studies were considered eligible if they included patients with DD.ResultsA total of 875 records were retrieved, from which 18 were included.Stigma: (1) Stigma is associated with poor quality of life, poor adherence to medications and acceptation of diagnosis. (2) Support at workplaces would improve stigma and discrimination in DD. (3) Poor interpersonal competence may increase stigma experience in DD.Self-stigma: (1) Women show higher level of self-stigma than men. (2) Higher rates of psychiatric hospitalizations and higher severity of symptoms associated with greater degree of self-stigma. (3) Suicidal ideation was associated with negative self-schema but not self-stigma, particularly in patients with persecutory delusions. (4) Self-stigmatization negatively associated with quality of life. (5) Depressive symptoms associated with higher levels of self-stigma. (6) Promotion interventions should address self-stigma content.ConclusionsFurther longitudinal studies are needed to test the influence of stigma and self-stigma on adherence to follow-up and specific interventions to improve them.Disclosure of InterestNone Declared
Post Cerebrovascular Stroke Catatonic Psychosis: A Case Report
Authors: Hasan H. , Abdo M. , Rabei S. 
Published: August 2023

IntroductionCatatonia due to cerebrovascular stroke is a rare condition that needs further observation and research.ObjectivesTo review the opinions of psychotic disorders experts worldwide as to this issue based on evidence and clinical experience and to consider strategies for future investigations.MethodsThis case shows a 64 years old female who suddenly developed wish for isolation, followed 10 days later by discontinuity of ideas, hallucinatory behavior and food refusal. She had verbal and physical aggression due to a fixed belief that family members are conspiring somehow to harm her.ResultsOn examination she was mute with waxy flexibility and negativism. Extensor plantar reflex was evident. MRI Brain showed small vessel disease and right basal ganglia acute ischemic infarction. On IV midazolam 7.5 mg, patient’s mutism, negativism and waxy flexibility improved. Lower limb Venous Duplex revealed acute right popliteal and left soleal veins thrombosis. CT angiography showed Bilateral pulmonary embolism with no pulmonary infarction. D dimer was positive.ConclusionsEarly diagnosis and intervention improves outcome if psychiatric teams gives attention and has enough awareness with warning symptoms and prompt necessary interventions.Disclosure of InterestNone Declared
Brexpiprazole augmentation in a clozapine-resistant young schizophrenic patient: a successful case report.
Authors: Martiadis V. , Raffone F. , Russo M. 
Published: August 2023

IntroductionAlthough clozapine is considered the most effective drug for Treatment Resistant Schizophrenia (TRS), only 40% of patients treated will meet clinical response. Literature reviews and meta-analytic data offer no definite conclusions about the most effective clozapine augmentation strategies. Nevertheless, it has been suggested that the lack of evidence should not discourage clinicians from trying out new strategies in individual patients. Brexpiprazole is a novel 5-HT and DA modulator antipsychotic that exhibits partial agonism to D2/D3 and 5HT1A receptors, antagonism to 5HT2A and α-1B/2C receptors and represents a promising new drug in the pharmacotherapy of schizophrenia for both acute and maintenance treatment. In current literature there is no evidence of experiences in brexpiprazole augmentation for clozapine resistant patients.ObjectivesThis case report describes a successful clinical experience of brexpiprazole augmentation in a complicated case of clozapine resistant paranoid schizophrenia with consistent negative symptoms, the clinical evolution and metabolic improvement consequent to this therapy combination.MethodsIn a 27 male TRS patient, sequentially treated with adequate doses of risperidone, cariprazine, aripiprazole and olanzapine monotherapy, prescribed for adequate time, clozapine treatment was started, with a gradual titration from 25 to 300 mg/day, without significant clinical response on both positive and negative symptoms. Successively was introduced fluoxetine, from 10 to 30 mg/day, with no relevant clinical improvement. After 2 months of pharmacological stabilization with clozapine and fluoxetine described dosages, brexpiprazole was introduced starting from 1 mg/day and rapidly increasing till 4 mg/day.ResultsAfter 6 weeks of treatment, PANSS positive and negative subscales showed a significant decrease, respectively from 28 to 17 and from 42 to 20, while general psychopathology subscale decreased from 66 to 34. Negative sub-items with major improvement were those regarding blunted affect, emotional withdrawal, poor rapport, and passive/apathetic social withdrawal. Brexpiprazole augmentation also allowed to slowly decrease (in 6 months) clozapine dose till actual 150 mg/day, with a significant improvement in general tolerability and a slow decline in metabolic parameters (BMI from 36.5 to 30.3; fasting glucose from 112 to 92 mg/dL; total cholesterol from 248 to 182 mg/dL; total triglycerides from 392 to 198 mg/dL).ConclusionsIn this case report brexpiprazole augmentation in a clozapine resistant young schizophrenic patient was an effective strategy with significant symptoms improvement, in particular in PANSS general psychopathology and PANSS negative subscales. The consequent clozapine dose reduction contribute to the slow decrease in metabolic parameters considered.Disclosure of InterestNone Declared
The manifestation of anxiety in patients undergoing elective coronary angiography
Authors: Kokalj Palandacic A. , Ucman S. , Novak Sarotar B. , Lainscak M. 
Published: August 2023

IntroductionPrevalence of anxiety disorders in coronary artery disease reaches up to 15% and about half of patients with coronary artery disease have anxiety or depression comorbidity. Prevalence of anxiety in patients undergoing percutaneous coronary intervention ranges from 24% to 72%. Anxiety can be the source of distress and is associated with poor prognosis, impaired health-related quality of life and can cause cardiac dysfunction.ObjectivesWe aimed to determine the prevalence of anxiety and its association to coping strategies and personality traits in non-depressed patients undergoing elective coronary angiography, a diagnostic procedure for coronary artery disease. We also aimed to determine the correlation of state anxiety to elective coronary angiography finding and its expression over time.MethodsThis was a single-center, cross-sectional, prospective study. Anxiety was evaluated at four-time points using self-rating questionnaires: 14 days prior to and 2–4h before procedure; 24h after procedure and 6 weeks after discharge. The association between anxiety and psychological variables was assessed by multiple linear regression and by linear mixed effect model.ResultsA total of 259 non-depressed patients were included in the final analysis (median age 65, 32% were female). Prevalence of anxiety was 35% and was higher in patients with avoidance-oriented coping style (p<0.001), meanwhile low neuroticism (p<0.001) and extrovertive personality trait (p=0.032) were protective factors. Patients that had no intervention (p=0.022) or had percutaneous coronary intervention (p=0.010) during elective coronary angiography, had lower anxiety than patients in need for coronary artery bypass graft surgery.ConclusionsPersonality traits emotional stability and extroversion are protective factors against anxiety. More than one third of patients experienced clinically significant anxiety before procedure. Our results suggest that recognising anxiety in patients undergoing elective coronary angiography is important. Further on, application of effective interventions for reducing/treating anxiety before or after procedure is needed.Disclosure of InterestNone Declared
Daytime sleepiness among health workers affected by COVID-19 during the “OMICRON” wave
Authors: Athimni Z. , Mersni M. , Ben Said H. , Bahri G. , Brahim D. , Mechergui N. , Yousssef I. , Ernez S. , Ladhari N. 
Published: August 2023

IntroductionExcessive daytime sleepiness is a frequent symptom in the general population. It may be fleeting, due to transient circumstances, or it may be related to certain pathologies. Indeed, following their infection with SARS-COV2, several healthcare workers (HCWs) have complained of excessive daytime sleepiness.ObjectivesThis study was conducted to assess excessive daytime sleepiness in the SARS-COV2-affected HCWs during the “OMICRON” wave.MethodsCross-sectional descriptive study, conducted among the HCWs of Charles Nicolle Hospital with COVID-19 during the period from 22 December 2021 to 31 January 2022. Sleepiness was assessed using the Epworth Sleepiness Scale administered during the return to work medical visit.ResultsDuring the “OMICRON” wave, 58 HCWs joined our study. The average age was 39 +/- 10 years. The sex ratio (M/F) was 0.2. The participants had no previous history of sleep disorders. Excessive daytime sleepiness was found in 21 participants (36% of cases). Excessive daytime sleepiness was mild in 81% of cases, moderate in 14%, and severe in 5%. The category most affected was senior technicians in 57% of cases. Most of the HCWs suffering from daytime sleepiness were working in the gynecology department (19%) and the neurology department (19%).ConclusionsEarly and systematic screening for sleep disorders after any SARS-COV2 infection is necessary to ensure the good health of the HCWs and to reduce accidents and errors in professional procedures.Disclosure of InterestNone Declared