bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Theory of Mind in Psychopathology: a Scoping Review
Authors: de la Higuera-Gonzalez P. , Galvez-Merlin A. , Rodríguez-Toscano E. , Andreo-Jover J. , Lopez-Soto T. , de la Torre-Luque A. 
Published: August 2023

IntroductionTheory of Mind (ToM) is defined as the cognitive ability that infers other’s mental states (Premack & Woodruff. J Behav Brain Sci 1978; 1 515-526).The interest in the study of ToM distinguishing its affective and cognitive components has been growing. Its study in psychopathology has been evolved from its original studies in autism spectrum disorders (ASD), schizophrenia (SCZ) and, borderline personality disorder (BPD), to other mental disorders like major depressive disorder (MDD), bipolar disorder (BP), anorexia nervosa (AN) and social anxiety disorder (SAD).Objectives1) review the most commonly used instruments for ToM assessment; 2) to compile the evidence on ToM deficits across mental disorders. For both objectives, target disorders are previously mentioned.MethodsThe search was carried out on the PubMed, PsycInfo and Scopus databases, using the terms “Theory of mind”, “Mentalization” and the previously mentioned mental disorders and pertinent thesaurus. Articles in English, published since 2010 were considered. A 2-step strategy (first, article screening and full reading) was followed to select articles of interest.ResultsReading the Mind in the Eyes (Baron-Cohen et al., J Child Psychol Psychiatry 2001; 42 241-251) and Movie for the Assessment of Social Cognition (Dziobeck et al. J Autism Dev Disord 2006; 36 623-636) were the most commonly used tasks to assess ToM. Regarding mental disorders, studies showed deficits in cognitive and affective ToM skills in ASD, SCZ, BPD, MDD and BP. Hypomentalization was mainly observed in ASD and MDD, while BPD and SCZ were featured by errors associated with hypermentalization. Studies in AN and SAD are scarce, but they mainly highlight a cognitive ToM deficit, with hypomentalization in AN and hypermentalization in ASD. In all of them, depressive symptomatology seems to be a critical moderator of ToM performance.ConclusionsAlthough ToM impairments are well described for some mental disorders, more research is needed to reach solid conclusions for others. The use of different and heterogeneous ToM assessment instruments can strongly influence the results of studies. The study of ToM is essential to gain a better understanding of the diseases and to develop effective treatments targeting specific ToM deficits.Disclosure of InterestNone Declared
Lithium: Managing Cognitive Impairment and Sexual Problems
Authors: Petta J. , Falcão A. L. , Soares G. , Lourenço A. 
Published: August 2023

IntroductionPatients taking lithium complain of cognitive impairment. This was assumed to be real by expert clinicians for years until relatively recent objective neuropsychological studies have failed to verify much impairment.Second and perhaps underemphasized side effect from lithium is sexual dysfunction.ObjectivesThe objective of this review is to highlight for the cognitive and sexual problems, which are two very important areas for discussion with patients. It should be brought up right when beginning to prescribe.MethodsData was obtained through an internet-based literature review, using the research platform PubMed and the World Health Organization website. Eight articles from the last five years were included.ResultsDue to the lack of evidence in neuropsychological studies, what was considered to be impaired cognitive function in the past has been recently considered a loss of sharp thinking in manic states or mild persisting depressions.About sexual dysfunction it is important eliminating other possible causes, lowering lithium dose, timing sex, and taking sildenafil and 240 mg/day of aspirin may help.ConclusionsCognitive impairment and sexual problems are two important subjects that involve the issues of dosing, of managing and dealing with people’s willingness to take lithium.Providing psychoeducation about these possible effects can head off abrupt discontinuation impulses.Disclosure of InterestNone Declared
Aripriprazole induced severe oculogyric dystonia treated with electroconvulsive therapy(ECT)
Authors: Bhat Shah K. , Bhat T. S. , Pawar J. S. , Pande N. 
Published: August 2023

IntroductionAripiprazole is the third generation Antipsychotic, and Dopamine serotonin system stabiliser.It is partial agonist at D2 and 5 HT1 A and antagonist at 5 HT2.Most commonly seen adverse effects are Akathesia, fatugue,insomnia and headache the major advanatage is less propensity for extrapyramidal side effects and lmetabolic side eefects.ObjectivesTo report a case of Schizophrenia treated with Aripiprazole 15mg/day developiing occular gyric crisis which was tratment resistant.MethodsWe administered Electroconvulsvive therapy, bidirectional brief pulse constant current 8 ECTS, under General anesthesia with medical fitness .ResultsPatient Showed complete resolution of Dystonia after second ECTs and Showed improvment in Pyschosis Parameterd. Assessment using Naranjo Protocol made.ConclusionsElectroconvulsive therapy therapy is viable alternative to manage Dystonia when medical treatment failsDisclosure of InterestNone Declared
Psoriasiform rash after initiation of treatment with olanzapine and carbamazepine.
Authors: Abdelkefi M. , Guermazi F. , Trigui H. , Masmoudi R. , Baati I. , Masmoudi J. 
Published: August 2023

Introductionolanzapine and carbamazepine are effectively used in treatment of schizoaffective disorder but they can have numerous side effects including skin eruptions that can be severe sometimes.ObjectivesTo study the relationship between toxidermia and treatment with Olanzapine and Carbamazepine.MethodsWe report the case of a patient who developed a psoriasiform skin rash following the intake of Olanzapine and Carbamazepine.ResultsMrs SL, 46 years old, with no prior medical or surgical history, has been diagnosed with schizophrenia since the age of 26. She was initially treated with Haloperidol and Risperidone with an irregular follow-up. Then, due to the emergence of mood disorder symptoms, the patient was put on 20 mg/day of Olanzapine and 400 mg/day of carbamazepine. One month later, the patient presented a generalized rash requiring the discontinuation of the current medications. She was treated with corticosteroids, and then she was referred to our department to make the appropriate adjustment of her psychiatric treatment.In view of the persistence of a dry erythroderma with erosive lesions of scratching and palmoplantar keratoderma, a skin biopsy was performed showing a psoriasiform and eosinophilic dermatosis that could be consistent with a toxidermia. The pharmacovigilance investigation concluded the incrimination of Olanzapine and carbamazepine in this symptomatology and recommended to avoid their prescription for this patient.The need for a mood stabilizer presented us with a challenge, particularly in view of the potential risk of cross-toxicity. We opted for the reintroduction of Risperidone with strict monitoring of the skin condition.ConclusionsEach prescribed drug must be considered as potentially capable of causing cutaneous reactions as an adverse effect. Both the prescriber and the patient must be made aware of this phenomenon.Disclosure of InterestNone Declared
Clinician’s attitude towards clozapine prescription
Authors: Brugue O. , Gonzalez M. , Moreno L. , Ivorra C. , Hernandez R. , Cepedello S. , Labad J. 
Published: August 2023

IntroductionCurrent clinical guidelines recommend the use of clozapine for the treatment of refractory schizophrenia, present in up to a third of patients with this disease. Despite the evidence, the data point to low prescription, underdosing, and delayed initiation.ObjectivesThe objective of the study is to elucidate which factors may interfere in clozpine prescription.MethodsThis is a cross-sectional observational study, carried out using a survey designed specifically for it.It was answered online by seventy psychiatrists affiliated with the Catalan Society of Psychiatry.ResultsMore than half admitted having prescribed two or more antipsychotics without having previously ruled out pseudorefractoriness through depot treatment. 70% recognized the need for monitoring as the main prescription barrier, while the main reason for withdrawal was its adverse effects. The most alarming was considered agranulocytosis, with drooling, drowsiness and weight gain being the most reported.Statistically significant differences (p=0.031) were found in relation to the years of experience and the device where clozapine was preferred to be started: <10 years in hospital, 10-20 years in partial hospitalization and >20 years outpatient office.Statistically significant differences were observed in the preference of the device for its initiation depending on the usual work device: hospitalization (p<0.000) and partial hospitalization (p=0.046) preferred to schedule it from their respective devices, without any preference in consultations.The level of experience and the most reported side effect were statistically significant: for the newest psychiatrists it was weight gain (p=0.031), without presenting differences in the rest of the groups.ConclusionsClozapine is the psychoactive drug of choice in refractory schizophrenia, so efforts should be devoted to reducing prescription barriers, offering training on its management and innovating forms of monitoring to promote its use.Disclosure of InterestNone Declared
Myocarditis induced by clozapine and COVID-19 infection: a case report
Authors: Veloso P. , Gomes M. , Faria R. , Matos D. , Pereira F. 
Published: August 2023

IntroductionClozapine is the only available treatment for refractory schizophrenia and is rarely associated with the development of myocarditis. Usually, the onset of symptoms occurs within the first month of treatment. The symptoms of myocarditis include fever, flu-like symptoms, fatigue, and dyspnea, symptoms that overlap with the COVID-19 infection. Coronavirus has been associated with cardiovascular complications, including myocarditis. It is not known whether clozapine increases the risk of developing viral myocarditis in patients with COVID-19 infection.ObjectivesReport a case of myocarditis in a patient treated with clozapine, who also had a history of COVID-19 infection.MethodsCollection of clinical information and review of the literature.ResultsA 24-year-old man was admitted following severe psychotic symptoms that have been developing for the past several months. He presented with disorganized speech and behavior, paranoid delusions, thought alienation, auditory hallucinations, and blunted affect. He had no known medical co-morbidity, but he had tested positive for COVID-19 the month before admission. The lab and imaging tests and the electrocardiogram (EKG) were normal. He was diagnosed with schizophrenia and after treatment failure with three antipsychotics, the patient was started on clozapine, with symptom improvement. Two weeks after clozapine initiation, he started flu-like symptoms, fever, chest pain, and tachycardia. Lab tests showed leukocytosis (12 400 cells/uL), elevated inflammatory markers (C-reactive protein 143,30 mg/L) and cardiac biomarkers (troponin I 12.139 ng/mL, NT-proBNP 9321 pg/ml). The evaluation for viruses, including SARS-CoV-2, was negative. The EKG revealed ST-segment elevations and a transthoracic echocardiogram showed systolic dysfunction (left ventricular ejection fraction was 37%). Cardiac magnetic resonance confirmed severe left ventricular dysfunction and diffuse myocardial edema. The patient’s symptoms resolved following the discontinuation of clozapine and supportive therapies. Troponin and EKG normalized over the following 7 days. By this time, the patient tested positive for COVID-19.ConclusionsThe temporal relationship with the initiation of clozapine supports the diagnosis of clozapine-associated myocarditis. However, the COVID-19 infection may have played a part in the emergence of cardiac alterations. We hypothesize that the co-occurrence of COVID-19 and clozapine treatment may act synergically as both factors increase the risk of developing myocarditis. However, further studies are needed to evaluate the relationship between these factors. While clinicians should stay alert for the risk of clozapine-associated myocarditis, the overall risk is low, and given the effectiveness of clozapine, as well as the absence of other evidence-based treatments, people with refractory schizophrenia should be given a monitored trial of clozapine, regardless of their COVID-19 status.Disclosure of InterestNone Declared
Mirtazapine-induced psychosis on a young patient with severe malnutrition
Authors: Sollano R. T. E. , Enriquez A. K. L. 
Published: August 2023

IntroductionMirtazapine is an antidepressant commonly prescribed to patients with depression and problems with weight and sleep. Case reports on Mirtazapine-induced psychosis either on initiation or increase in dosage in elderly patients and those with renal and liver impairment are found in the literature.ObjectivesTo present a case of Mirtazapine-induced psychosis in a patient with severe malnutrition, and with no history of psychosis and despite on sedating antipsychotic.MethodsThis is a case report.ResultsMs. NC, a 40-year-old female with major depressive disorder, anorexia nervosa, stimulant use disorder, and sedative, anxiolytic, hypnotic use disorder with no history of psychosis even when intoxicated or during withdrawal, was admitted for involuntary inpatient psychiatric care for detoxification and management of severe malnutrition. Ms. NC has always been conscious with her weight growing up but it was only during the COVID-19 pandemic that excessive preoccupation with weight and symptoms of clinical depression were noted. Ms. NC restricted her diet and engaged in excessive exercise resulting to BMI of 16.1. She started use cocaine and diazepam daily to address the weight and mood, and sleep and anxiety, respectively. Due to a suicidal attempt, consult was done with a psychiatrist, and patient was eventually maintained on Mirtazapine 30mg and Gabapentin 100mg which addressed the mood and sleep. Despite improvement in mood and decrease in use of cocaine and diazepam, patient started to use methamphetamine around once a week. Despite with euthymic mood, preoccupation with weight resurfaced. After a few months, she restricted her food intake to only four times a week with no binge-eating or purging resulting to BMI to 13.8. Upon admission, Mirtazapine 30mg was continued and Gabapentin was increased to 300mg. Special care in her food intake was done to prevent refeeding syndrome. Benzodiazepine withdrawals symptoms were minimal. She has normal values for electrolytes, liver function tests and creatinine. On the first days of admission, she was noted to be irritable and was mostly asleep. On the fifth hospital day, she started to have difficulty sleeping and was placed on Olanzapine up to 10mg and Gabapentin 600mg but no improvement in sleep. On the tenth hospital day, Mirtazapine was increased to 45mg and later in the night, had visual and auditory hallucinations and paranoia. Upon discontinuation of Mirtazapine and initiation with Clozapine up to 75mg, the psychosis resolved after five days.ConclusionsMirtazapine-induced psychosis may be seen in patients with severe malnutrition. Despite its advantages in terms of weight gain and sleep, psychiatrists should be wary of this possible side effect when initiating or increasing Mirtazapine for patients with severe malnutrition.Disclosure of InterestNone Declared
Locus of control as a personal coping resource of a sportsman
Authors: Fedorchuk S. , Petrovska T. , Kohut I. , Hanaha O. , Arnautova L. 
Published: August 2023

IntroductionIn sports psychology, the issue of finding resources to overcome stress remains relevant at present. Currently, the priority is the search for personal resources that can help overcome difficult life situations. Currently, the priority is the search for personal resources that can help overcome difficult life situations. Research by many psychologists (Folkman S., Hobfoll S., Haan N.A., Heim E., Lazarus R., Moos R.N., Schaefer C., Grin O.R., Dementiy L.I., Kalnysh V.V., Tukaiev S.V., Khazova S.A. et al) is devoted to this topic. Among the coping resources, the authors single out motivation, locus of control, resilience, self-control, purposefulness, outlook, intelligence, etc.ObjectivesThe purpose of the study is the analysis of literary sources regarding the study of the locus of control as a personal coping resource of an athlete.MethodsTo realize the goal of the work, the following were used: theoretical analysis and generalization of literary sources and Internet data.ResultsAccording to the results of research by domestic scientists, the locus of control and responsibility can act as a coping resource. It was found that the internal locus of control is associated with a low level of anxiety, and the external one with a high one; in addition, an inverse relationship between the locus of control and the level of neuroticism was found (Dementiy, 2005). This indicates that respondents with an internal locus of control are more stable in their behavior in situations that provoke anxiety and actualize personal anxiety. Internality allows a person to maintain a sense of control over the situation and his condition. It has been proven that the relationship between the locus of control and the state of anxiety depends on volitional self-control. However, along with this, the phenomenon of “heaviness of responsibility” is known in the scientific literature, which manifests itself in a sharp increase in anxiety with an internal locus of control. This may indicate that internality “loses” its resourcefulness under certain conditions: relationships between internality and anxiety are evident only at a low level of self-control. In the case when a person has developed self-control, such a connection is broken.ConclusionsThe generally accepted structure of personal resources, which determine the effective behavior of an individual under conditions of stress, has not yet been formed. Locus of control can act as a coping resource in the structure of self-regulation of an individual.Disclosure of InterestNone Declared
ELECTROCONVULSIVE THERAPY FOR AGITATION IN LEWY BODIES DEMENTIA
Authors: Echeverria C. , Libuy J. , Alarcón J. , Rodriguez J. 
Published: August 2023

IntroductionDementia with Lewy Bodies (DLB) is a primary degenerative dementing syndrome characterized by visual hallucinations, fluctuation in cognition, depressive symptoms and parkinsonism. Literature has shown the utility of electroconvulsive therapy (ECT) in demented patients regarding depressive symptoms and agitation. Nevertheless, the majority of cases described include patients with vascular dementia and Alzheimer’s disease. There are no cases informed concerning ECT in DLB patients with agitation and aggressive behaviors.ObjectivesEvaluate the impact of electroconvulsive therapy (ECT) for agitation in a patient with diagnosis of Lewy Bodies Dementia (DLB).MethodsCase report. 68-year-old male, with no prior neuropsychiatric history, was present for psychiatric evaluation for 5 year history of progressive dementia with fluctuations in cognition, complex visual hallucinations, delusional beliefs, depressive mood, anhedonia, irritability, associated to parkinsonism and increasing autoaggressive behaviors and agitation.An extensive neurologic workup including neuroimaging, EEG and laboratory studies failed to reveal a specific etiology. Neuropsychological testing reveals frontal, attentional, and visuospatial dysfunction. A presumptive diagnosis of DLB was made.Medication trials including donepezil, memantine, lamotrigine, sertraline, quetiapine, risperidone and melatonin failed to manage his depressive, psychotic and behavioral disturbances.ResultsConsidering past medication failures and prominent behavioral disturbances family consented for an acute course of ECT.Initial acute phase consisted of 6 sessions of right unilateral, brief pulse width (0.3 ms) ECT tri-weekly utilizing Mecta Spectrum. Anesthesia was induced with propofol, and received succinylcholine for muscle relaxation. Initial charge was 115 mC (6x seizure threshold), then raised to 192 mC. Seizure duration averaged in 22 seconds. No adverse reactions reported.Clinical outcomes were measured with the CGI-Efficacy Index. Pre-ECT CGI-SI score was 6 (severely ill) and post-ECT CGI-I was 3 (minimally improved).ConclusionsMood and behavioral disturbances are a frequent primary motive consultations in DLB patients. The treatment is challenging due to the sensitivity to antidopaminergic medications evidenced in this type of patients. This case suggests that ECT has an impact in the treatment of agitation and aggression in DLB patients, although further investigation is needed.Disclosure of InterestNone Declared
Cognitive behavioral therapy for patients with schizophrenia
Authors: Binic I. , Petrovic J. , Antonijevic J. , Pancic D. , Zdravkovic M. , Petrovic F. 
Published: August 2023

IntroductionIn treating schizophrenia, there is growing interest in introducing and renewing psychosocial therapies, including psychotherapy. In recent years, this has specifically entailed the adaption of particular cognitive behavioral therapy (CBT) approaches, which were previously only utilized for treating anxiety and mood disorders. The negative symptomatology of schizophrenia, which has proven to be especially difficult to treat, can be a challenge for CBT, particularly in terms of enhancing relationships with family and friends and work engagement.ObjectivesThe objective was to summarize the advantages of CBT treatment in schizophrenia briefly.MethodsPatients with schizophrenia frequently have comorbid problems, such as anxiety disorders (and disorders) and traumatic experiences, which can be effectively treated with CBT. In addition to pharmacological therapy, CBT is acknowledged as the gold standard in several countries for the treatment of schizophrenia. According to studies, combining CBT with medication can minimize psychotic symptoms.ResultsRegarding treatment, Beck describes the use of typical CBT techniques: building trust and engagement; working collaboratively to understand the meaning of symptoms; understanding the patient’s interpretation of past and present events, particularly those that the patient believes are related to the development and persistence of his or her current problems; normalizing these experiences and educating the patient about the stress-vulnerability model, and socialization. Clarifying the emotional and behavioral repercussions of a delusion’s activation leads to an initial examination of the evidence-based on more peripheral interpretations. It is recommended to treat negative symptoms such as amotivation, anergia, anhedonia, and social disengagement with behavioral self-monitoring, activity scheduling, ratings of mastery and enjoyment, graded work assignments, and assertiveness training.ConclusionsIn treatment settings where physicians are already utilizing high-quality psychoeducational materials to enhance adherence, an excellent foundation exists for introducing individual CBT for schizophrenia patients.Disclosure of InterestNone Declared