bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Clinical café meeting” - a clinician peer support and case discussion meeting: A tool for reflective practice and consolidation of resilience
Authors: Raji A. , Rogers J. , Foley B. , Roxburgh B. , Nawaz S. , Milligan S. , Ali J. , Shullaih Z. , Libbus Y. 
Published: August 2023

Introduction
Previous studies have shown that Peer Support Programs (PSPs) promote workforce wellness by supporting clinicians during times of heightened stress and vulnerability (Keyser, et al., 2021). Inclusion of case discussions in PSPs can provide opportunity for reflective practice, quality improvement, and professional development, in addition to strengthening clinicians’ resilience.ObjectivesTo describe the experience and perceived benefits reported by participants (psychiatrists) of a peer support and case discussion group meeting, of a clinical department of psychiatry (DOP) in Cape Breton, Canada, which the group calls “clinical café meeting”.MethodsQualitative data collected, were informal comments (with focus on the participants’ experience and perceived benefits) from the group participants during the once a month, one-hour clinical cafe meetings.ResultsFrom September 2015 to September 2021, attendance ranged from 2 to 10 participants. All participants voiced that, they see each meeting as an opportunity to “analyze their feelings and knowledge relevant to clinical practice situations, especially those associated with uncomfortable feelings (Atkins & Murphy reflective model, 1993), and challenges they face, in relation to the healthcare system. Many participants voiced how input from group participants help them with gaining a new perspective on practice situations that were discussed, and ideas on how they could deal with similar clinical situations or challenges, in a more robust way, in the future. Many participants also find the clinical café meetings to be helpful in consolidating their resilience.Conclusions
PSP (with case discussion) participants, in a Canadian DOP, described their experience of the group meetings, as beneficial, including contributing to strengthening of their resilience.Disclosure of InterestNone Declared
Taiwan National Health Insurance and Proportional Physician Fee of Psychiatrist in General Hospital during the COVID-19 pandemic : Case Report
Authors: Wang S.-C. , Lin Y.-H. 
Published: August 2023

IntroductionIn Taiwan, National Health Insurance has been implemented for 27 years and continues to receive international recognition. People pay part of the quota at the time of medical treatment, and the rest of the medical expenses will be paid by the national health insurance. In this study, the researcher, a psychiatrist in the general hospital, investigated the correlation between service and revenue. He has started to work in this hospital since November 1st, 2021, without any other psychiatrist peers.ObjectivesThis study used proportion of PPF as performance indicator and aimed to observe the changes of PPF unit from November 1st, 2021, to January 31st, 2022, examining the trend of PPF growth. The purpose is to figure out an appropriate model to optimize medical services and performance outcomes.MethodsDemographic data were collected through PPF projects, consisting of 17 inpatient ward items and 14 outpatient items from November 1st, 2021, to January 31st, 2022, and items with no performance or related to physiological examination has been excluded. In addition, items with a ratio of greater than 1.5% are presented in the bar graphs, as shown in
Figure 2 and 3. The performance proportion of inpatient ward and outpatient were calculated separately.Results
Demographic data found PPF rises significantly over time
(Figure 1). The 2nd month PPF unit (27.09%) was 2.5 times the 1st month PPF unit (10.70%), and the 3rd month PPF unit (62.21%) was 2.2 times the 2nd month PPF unit (27.085%). The highest proportion of PPF items were general hospital bed inpatient consultation fee for inpatient ward item
(Figure 2) and psychiatric outpatient consultation fee for outpatient item
(Figure 3). Furthermore, only the proportion of psychiatric outpatient consultation – more than two consecutive transfers increased continuously and the proportion of psychiatric outpatient consultation – adjusted by the hospital decreased, the other items has not changed significantly.Image:Image 2:Image 3:ConclusionsIn the first three months of the psychiatrist employment, the performance showed an increasing trend. These findings may suggest that the psychiatrist could be competent in a general hospital with patients’ confidence. In addition, under an optimal model of PPF and medical service, psychiatrists would more like to work in the general hospital, to serve acute psychiatric patients in need.Disclosure of InterestNone Declared
Clozapine use in drug induced psychosis in Parkinson´s disease: a case report and review of literature.
Authors: Sanz Giancola A. , Setién Preciados P. , Arroyo Sánchez E. , Romero Gerecther I. , Martín Velasco M. , Díaz Mayoral C. 
Published: August 2023

IntroductionThe occurrence of psychotic symptoms induced by dopaminergic drugs marks a new phase in the course of Parkinson’s disease (PD). The term drug induced psychosis may be used when other significant psychiatric diseases are excluded in patients with no history of psychosis. The prevalence of dopaminomimetic psychosis varies from 5% to 20%. Therefore, knowledge of the psychopharmacological management of this condition is essential.ObjectivesThe purpose of this case report and literature review is to to learn the psychopharmacological management of this not uncommon medical complication.MethodsDescriptive case study and review of literatureResultsWe present the case of a 71-year-old man with a medical history of Parkinson’s disease with partial response to treatment with high doses of levodopa and carbidopa.He was brought to the emergency department by his family due to the presence of behavioural alterations at home.The patient reported seeing men in foam trying to harm his family. In a disjointed way in his speech, he links this idea with the delusional belief that he is being watched by electronic devices placed throughout the house. In a variegated manner he links this with a coelotypical type of discourse, however the delusional ideation remains unstructured throughout.With no previous personal or family history of mental health and ruling out underlying organic conditions, a diagnosis of psychosis secondary to pharmacological treatment for Parkinson’s disease is presumed.Considering the risks and benefits, it was decided to maintain the anti-Parkinson’s dose in order to avoid worsening the patient’s motor function. Therefore, after reviewing the literature, the best option was to introduce clozapine at low doses, up to 50 mg at night, with the respective analytical control. After a week’s admission, the patient began to improve psychopathologically, achieving an ad integrum resolution of the psychotic symptoms.ConclusionsDespite the availability of other antipsychotic treatments such as quetiapine or the more recent pimavanserin, clozapine remains the treatment of choice for drug-induced psychosis in Parkinson’s disease.Disclosure of InterestNone Declared
Relation between stressful life events and psychosis
Authors: Osca Oliver A. , Pérez Iglesias R. , López Rodrigo M. V. , Ros Fons V. , D´Hiver Y. , Sánchez G. , Pérez Fominaya M. 
Published: August 2023

IntroductionNumerous studies establish clear connections between traumatic childhood experiences and the risk of developing psychosis. According to the study carried out by Filippo Varese, childhood traumas, understanding by; physical, psychological or sexual abuse, abandonment, death of the parent and “bullying”, increase up to three times the risk of suffering from psychosis.Objectives-Determine the prevalence of traumatic events in the sample studied.-Determine which traumatic event has a greater relationship with the risk of presenting a psychotic episode.-To determine whether traumatic events may be more strongly associated or not with gender differences, age at onset and family story.MethodsA descriptive study is carried out in which the traumatic events are evaluated (through the CAVE questionnaire) of 98 patients who have been treated for a psychotic episode in the last two years in the Early Intervention Unit for Psychosis (ITPCan).The stressful life history questionnaire (CAVE) consists of 52 questions divided into blocks: school stage, work, partner, family, health and other stressful events. All of them focused on those stressful events prior to the onset of psychotic symptoms. Stressful events have been considered to be those events in which the patients studied have scored 10 (maximum score) on the anxiety scale.Inclusion criteria:
-Older than 18 years-old-Having presented a first psychotic episode.Exclusion criteria:-Intellectual disabilitiesResultsFor now, the data studied in this sample are similar to those described in most of the studies reviewed: more than half of the patients present at least one traumatic event before the onset of psychotic symptoms and a third of these have had any traumatic experience before the age of 18.The percentage of the presence of at least one traumatic event within the categories of the CAVE questionnaire would be:14.2% in the school stage26.7% in the workplace26% in relationships24.3% in family relationships12.1% in events related to the patient’s own health problemsConclusionsWe continue to increase the sample to have a more significant result.Disclosure of InterestNone Declared
Late-onset schizophrenia: a differential diagnosis
Authors: López Rodrigo M. V. , Palomo Monge M. , Osca Oliver A. , Tascón Guerra F. , Ros Fons V. 
Published: August 2023

IntroductionRegarding the diagnosis of schizophrenia, a peak of onset of symptoms is considered at 25 years. The debut after 60 years is considered late onset and is rare, generating controversies in the diagnosisObjectivesWe present the case of a 58-year-old patient with no personal or family history of mental health, who came to the emergency room for the first time, reporting feeling in danger. He comments itching on his skin, verbalizing seeing bugs running through it, relating this phenomenon to “witchcraft by my brothers”, he also refers to feeling like “they watch my thoughts and block it through a mobile application, they enter through my eye right and this gives me less vision and a headache. He also refers to having the ability to listen to how his brothers talk about how they are going to “hurt me.” Psychopathologically, we highlight that she is oriented in the three spheres, presenting delusional ideation with an experience of harm, a phenomenon of thought theft and auditory and tactile hallucinations.MethodsAnalytical and imaging tests, as well as toxins in urine, were negative.ResultsDiagnosis of psychotic episode is made to see evolution. The clinic partially yields to treatment with atypical antipsychotics. At this time, the patient has no awareness of the disease.ConclusionsDespite being a diagnosis that is scarcely prevalent, once organic disease has been ruled out.Disclosure of InterestNone Declared
EEG power spectrum analysis for Tunisian schizophrenic patients
Authors: Mnif M. , Smaoui N. , Triki L. , Donia J. , Feki R. , Gassara I. , Omri S. , Maalej M. , Charfi N. , Zouari L. , Ben Thabeut J. , Masmoudi K. , Maalej M. 
Published: August 2023

IntroductionSchizophrenia (SCZ) is a common and disabling psychiatric condition. Its diagnosis is entirely clinical. Many researchers have looked into electroencephalogram (EEG) power spectrum analysis for SCZ to find specific abnormalities.Objectives
The objective of this study was to analyze the EEG of patients with SCZ using power spectral density and to compare them with those of healthy controls, in order to look for specificities.Methods
This was a cross-sectional, descriptive, and analytical case-control study conducted with patients followed for SCZ in the psychiatry "C" department at the Hedi Chaker hospital in Sfax. Healthy controls were included. Patients were assessed by the Positive and Negative schizophrenia scale (PANSS). All participants benefited from an EEG at rest condition at the service of the functional exploration at the Habib Bourguiba hospital in Sfax. We have measured the powers of each band using Welch power spectral density method called absolute power (AP). Statistical analyses were carried out.ResultsFifteen schizophrenics and 15 controls, all male, were included. The average age of schizophrenics and healthy controls was 40 years ±12.72 years and 47.93 ± 15.61 years respectively. There were no significant differences in age between patients and controls. Schizophrenics had a mean PANSS of 64.6±22.7.At the quantitative EEG, differences appeared to be insignificant. There was an overall decrease in AP for the alpha band particularly in the parietal and occipital lobes in schizophrenics (53,16 ± 48,83 μV2 and 75,17 ± 56,28 μV2 respectively) compared to controls (335,15 ± 994,73 μV2 and 400,24 ± 1109,95 μV2 respectively). There was also an overall decrease in AP for the different frequency bands in schizophrenics compared to controls. However, values persisted high in the temporal lobe for all frequency bands.ConclusionsIn conclusion, this decrease in AP for the alpha band in the parietal and occipital lobes in schizophrenics can be a sensitive biomarker for diagnosing SCZ.Disclosure of InterestNone Declared
Persistent delusional disorder: psychopathological remission associated with clozapine-induced epileptic seizures
Authors: Felizardo M. , Freitas C. 
Published: August 2023

IntroductionPersistent delusional disorder has some features similar to schizophrenia, although the functionality of patients with this diagnosis is usually higher and is diagnosed at an older age. Although the pharmacological treatment of schizophrenia has been studied extensively, there is not much data on the treatment of persistent delusional disorder. Regarding the use of clozapines specifically in persistent delusional disorders, there are some case reports with encouraging results. Electroconvulsive therapy is not generally used as a treatment for persistent delusional disorder.ObjectivesTo reflect on the relevance of using electronvulsive therapy in the treatment of persistent delusional disorder.MethodsThrough the description of a clinical case in which there was evidence of remission of resistant psychotic symptoms after clozapine-induced epileptic seizures, the authors hypothesize the existence of a direct relationship between the crisis and the resolution of a persistent delusional disorder.ResultsA.F., 78 years old, male. No personal history of psychiatric or medical-surgical illness. Admitted for psychotic decompensation framed in persistent delusional disorder. The patient underwent pharmacological treatment with resistance to three lines of antipsychotics. With the introduction of clozapine 100mg/day, the patient had two epileptic seizures, followed by complete remission of psychotic symptoms.ConclusionsThe clinical case described refers to a patient diagnosed with resistant persistent delusional disorder, with almost immediate resolution of the condition after epileptic seizures induced by clozapine. Taking into account the clinical response in our patient to two spontaneous epileptic seizures, we hypothesize that electroconvulsive therapy may be effective in the treatment of persistent delusional disorder.Disclosure of InterestNone Declared
Assessing the impact of Tadalafil on the sexuality and quality of life after acute urinary retention: a randomized controlled Trial
Authors: Bouassida K. , Loghmari A. , Ben Othmen M. , Tlili G. , Acacha E. , Ben Abdallah W. , Kahloul M. , Hmida W. , Jaballah R. , Zorgati A. , Boufek R. , Jaidane M. 
Published: August 2023

IntroductionAcute urinary retention (AUR) is known to have major impact on the quality of life and sexuality of patients with benign prostatic hyperplasia (BPH). However, little is known about specific approachs that could reduce this impact. Tadalafil, an efficient medication in uncomplicated BPH, may be also useful in serious complications, especially the AUR.ObjectivesThe aim of this study is to assess the impact of Tadalafil on sexuality and quality of life in patients AUR related to BPH.MethodsThis is a randomized, double-blind clinical trial conducted in the Urology and Emergency Departments of Sahloul Teaching Hospital, between June 2020 and January 2022. Consenting men over the age of 45 who had an AUR complicating a BPH were included. Fifty three patients were enrolled and randomized into two groups: intervention group (n=29) in which patients received 5 mg/day of Tadalafil, and control group (n=24) in which patients received a comparable tablet of placebo. The evaluation focused on sexuality and quality of life. For theses purposes we used SF-36 short form and IIEF 15.ResultsSocio-demographic characteristics were comparable between both groups. Sexuality assessed by IIEF 15 was significantly better in the intervention group (p=0.02). The four SF-36 domains were also significantly improved by Tadalafil: “Physical Function” (p=0.046), “Pain” (p=0.01), “General Health” (p=0.029) and “Health change” (p=0.02).ConclusionsSexuality and quality of life could be improved by Tadalafil in complicated BPH.Disclosure of InterestNone Declared
Sexual dysfunction and motor disability in Parkinson’s disease: any link?
Authors: Mousli A. A. , Zouari R. , Lahmer A. , zakaria S. , Rachdi A. , Nabli F. , Ben Sassi S. 
Published: August 2023

IntroductionParkinson’s disease (PD) is a chronic, neurodegenerative disorder leading to dopamine deficiency. Phenotypically, there is a wide spectrum of motor and non-motor symptoms (NMS). Among NMS, sexual dysfunction (SD) is one of the most disabling and crippling symptom. However, SD are usually neglected and underdiagnosed in PD patients.ObjectivesOur study aimed to estimate the effect of motor disability and the disease course on sexual dysfunction in PD patients.MethodsThis retrospective study included 42 patients (18 males and 24 females) from the department of neurology of the National Institute of Neurology Mongi Ben Hmida in Tunis, Tunisia, diagnosed with PD between 1999 and 2022. The diagnosis of PD was confirmed according to the Movement Disorder Society (MDS) diagnostic criteria of PD. The MDS Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) motor was used to estimate motor disability and Hoehn and Yahr (H&Y) stage was used to rate disease severity. The SD of PD patients was measured by applying the sexual items of Scales for Outcomes in Parkinson’s Disease - Autonomic Dysfunction (SCOPA-AUT).ResultsSD was observed in only 11 patients (26.2%) with a sex-ratio of M/F = 1.2 and a mean age of 52 (between 40 and 72). The mean age of PD onset was 47. According to the MDS-UPDRS part III, 1 patient had a severe motor disorder (MDS-UPDRS> 59), and according to the H&Y scale, no patient had a severe stage of the disease. Nine patients had motor complications such as motor fluctuations and L-Dopa induced dyskinesia.The SD described by our patients were: women reported Vaginal Dryness (4 patients), with difficulties reaching an orgasm (3 patients); men reported erectile dysfunction (6 patients), and difficulties in reaching an orgasm (6 patients). Among these patients, 3 were treated for SD with Tadalafil (all males).In our study, no significant gender-related differences were found in scores related to SD in patients with PD. Neither the disease severity nor the motor disability was significantly associated to sexual disorders (respectively p=0.26 and p=0.12). Also, Motor complications induced by L-Dopa medication, assessed by the part IV of MDS-UPDRS scale, had no significant effect in the occurrence of SD in PD (p=0.78).ConclusionsSexual behavior has neuronal and hormonal modulation. Lack of dopamine seems to have an important role in the development of SD. However, it occurs independently of the disease severity and the motor disability. Thus, clinicians should be aware of the importance of assessing and treating such symptoms since the beginning of the disease.Disclosure of InterestNone Declared
Antipsychotic-induced priapism: case report and review of the literature.
Authors: Machado D. R. , Borges A. C. , Maia J. , Domingues V. , Laureano C. 
Published: August 2023

IntroductionPriapism is a painful and prolonged penile erection in the absence of sexual stimulation. It is a urology emergency that, if not treated, may cause erectile dysfunction. Pharmacologically induced priapism is the most common form of priapism and almost half of all cases are caused by antipsychotic (AP) drugs. Considering priapism is a rare but important side effect, it is of major importance that psychiatrists be aware of it. Thus, we herein report the case of a 46-year-old man that developed priapism upon receiving intramuscular APs in a psychiatric emergency setting.ObjectivesTo alert for the importance of priapism as a potential side effect of AP drugs and to understand the physiological mechanisms involved in antipsychotic-induced priapism.MethodsA non-systematic review of the literature was carried out on PubMed. We looked for reviews and case reports published in the last 10 years containing the terms “priapism”, “antipsychotics” and “psychopharmacology priapism”. We also present a clinical case of antipsychotics-induced priapism.ResultsWe report the case of a 46-year-old man that was brought to the Psychiatric ER by police authorities due to disruptive and aggressive behaviour, a sense of increased energy and power and delusional speech of grandiose and persecutory content. No clinical records of psychosis or bipolar disorder were known, and the patient had never been medicated with AP drugs. The patient was involuntarily admitted to the psychiatric inward for treatment. Due to the aggravation of his aggressive behaviour, with potential danger for himself, other patients and the nursing staff, he was medicated with 5 mg of haloperidol and 25 mg of chlorpromazine. About an hour later the patient developed a painful erection that lasted at least for 4 hours. He was promptly sent to the Urology ER where an intracavernosal aspiration followed by injection of phenylephrine was needed to reverse priapism. APs are the most common cause of drug-induced priapism. Even though typical APs were pointed as more prone to cause this side effect, it is now known that atypical APs, including third-generation ones such as aripiprazole, may also cause priapism. It is thought that the α1- adrenergic antagonist action of most APs inhibits the contraction of smooth muscle in the corpus cavernosum of the penis, impeding venous outflow and thus causing ischemic priapism. To reduce the risk, the dosage of the AP may be reduced or changed to an AP with lower affinity for α1- adrenergic receptors.ConclusionsPriapism is a rare but important side effect of APs. Being aware of it and of its physiological mechanism is of major importance when treating patients with APs.Disclosure of InterestNone Declared