bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence-based Pharmacological Treatment in the Maintenance Phase of the Type I Bipolar Disorder: Anticonvulsants or Antipsychotics?
Authors: Vasiliu O. 
Published: September 2022

IntroductionType I bipolar disorder (BDI) is characterized by a chronic evolution, with recurrent mood episodes that severely disrupt the overall functionality and quality of patients’ life. An adequate maintenance treatment is necessary to prevent relapses and to improve the functional prognosis of these patients.ObjectivesTo find data regarding the most evidence-based therapeutic strategies in the maintenance phase of BDI.MethodsA literature review was performed through the main electronic databases (PubMed, CINAHL, SCOPUS, EMBASE) using the search paradigm “type I bipolar disorder” AND “mood stabilizers” AND “antipsychotics” AND “anticonvulsants”. All papers published between January 2000 and August 2021 were included.ResultsThe main recommendation is to continue in the maintenance phase the same medication that has proven its efficacy and tolerability in the acute phase. In BDI the most evidence-supported pharmacological approaches for the maintenance phase were lithium, valproate, lamotrigine, and carbamazepine as anticonvulsants/mood stabilizers, as well as olanzapine, quetiapine, and aripiprazole as antipsychotics. Lithium and valproate have been associated with positive influence over neuroplasticity, while antipsychotics have considerably higher metabolic adverse events. Monotherapy is recommended, but drugs associations are frequently met in clinical practice. There are no consistent data about the superiority of one class over the other, but lithium has a proven effect of decreasing the suicide rate in this population.ConclusionsBoth anticonvulsants and antipsychotics are used in the maintenance phase of the BDI, without significant differences in the efficacy rates. However, benefits and risks should be weighted for each class and each individual agent recommended.DisclosureNo significant relationships.
Is there a relationship between clinical stage and cardiovascular disease risk in bipolar disorder?
Authors: Altınbaş K. , Kavak Sinanoğlu G. 
Published: September 2022

Introduction
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in bipolar disorders(BD). The heart age of patients with BD was found to be 8.5 years higher than gender-age matched health controls. Metabolic side effects of antipsychotics, poor diet, insufficient physical activity, smoking and sedentary life style increase the risk of cardiovascular disease in bipolar patients. QRISK-3 is an approved risk classification that calculates the 10-year risk of developing a heart attack or stroke.ObjectivesThis study aims to determine whether there is a difference between cardiovascular disease risk scores and clinical stages of bipolar disorderMethods35 outpatients that were followed up in Selcuk University Medical Faculty were evaluated. The clinical stages and qrisk3 scores were calculated.Results68.6% (n:24) of the patients were female. 42.9% of patients were in stage 3b (recurrent relapses, complete remission between episodes). The mean age was 36.94 ±10.46 years. The mean heart age was 50.54±17.35. The mean Q risk3 score was 5.59±8.18. There was no difference between bipolar patients at stage 2 and stage 3 in terms of age(p=0.36 and gender(p=0.73). When we compared the qrisk3 total socres and heart age of the patients in stage 2 and 3, we could not find any difference between groups (p=0.74, p=0.57 respectively).ConclusionsEven though we could not find any difference of qrisk scores at different clinical stages of patients with BD, the CVD risk increases with the age. Prospective longitudinal follow-up studies are required to evaluate dual interaction of clinical stages and CVD risk in BD.DisclosureNo significant relationships.
Neonatal onset of bipolar spectrum disorder through a three-generation familial study
Authors: Abdelmoula B. , Sellami S. , Keskes M. , Bouayed Abdelmoula N. 
Published: September 2022

IntroductionAge at onset of pediatric bipolar spectrum disorder (BSD) is an important marker of a more severe form and a highly heritable mood/mental disorder.ObjectivesHere, we report a familial Tunisian BSD follow-up study showing a very early onset of the BSD at the neonatal period.MethodsA 28-year-old female and her 30-year old sister were referred for genetic and psychological assessments due to recurrent depressive episodes.ResultsPsychological assessment revealed a BSD type II with episodes of hypomania for both patients. The 30-year old sister presented a mixed form of BSD coupled with autistic traits, hyposomnia and obsessive-compulsive behaviors. Intellectual and cognitive abilities were without concerns. Familial history revealed BDS among paternal relatives including the brothers’ and sisters’ father as well as all their uncles offspring’s, and their grandparents, who were consanguineous. The depressive mood was a common sign in the three generations. Personal history revealed significant signs of a very early onset of the disorder since the neonatal period for the two sisters as well as for their four paternal cousins who also presented BSD features. Familial risk of BSD in this family correlates with a variably higher personal risk of other psychiatric disorders such as anxiety, drug abuse, personality disorders, and autism spectrum disorder.ConclusionsEnvironmental conditions, familial care and educational level have a strong correlation with the severity and the efficiency of cognitive management of BSD and its psychiatric comorbidities. BSD is highly heterogeneous and polygenic and personalized management has considerable clinical repercussions benefits.DisclosureNo significant relationships.
Results of a Randomized, Double-Blinded Trial of Micronutrients and Fish Oil among Patients Diagnosed with Bipolar Disorder
Authors: Mehl-Madrona L. 
Published: September 2022

IntroductionIn a previous open-label study, we found that patients with bipolar disorder improved in symptom level when taking micronutrients and fish oil. We planned a randomized, double-blind, controlled trial to explore the feasibility and parameters needed for a larger clinical trial.ObjectivesWe aimed to determine the parameters necessary to conduct a large-scale clinical trial through completing a feasibility study.MethodsPatients were screened for having the diagnosis of bipolar disorder and being willing to take up to 16 micronutrient capsules and 3 fish oil capsules per day. Patients were randomized in a 3:2 ratio to micronutrients or placebo. Patients were seen monthly with assessment of the Clinical Global Impression Scale, the UKU Side Effects Scale, and a review of their medication doses. On a quarterly basis, patients completed the BASIS-24, the MYMOP-2, the Young Mania Scale, and the MADRS questionnaireResultsThe setting was a primary care clinic in Maine in the United States. The patient population was low-income and primarily rural. Disease severity was mild to moderate as only 2 patients were hospitalized during the study. All were symptomatic. One hundred twenty-five patients were screened and accepted randomization. The attrition rate was high and only 52 subjects completed 6 months of treatment. No differences were found between the two groups. We calculated that a minimum of 250 subjects would be needed to have 80% power to detect a difference. All patients improved dramatically in all measures.ConclusionsBipolar patients in primary care remain moderately symptomatic and will improve dramatically with monthly visits.DisclosureNo significant relationships.
A blemish on bipolar disorder: aggressive behaviour
Authors: Zanardi R. , Manfredi E. , Attanasio F. , Carminati M. , Colombo C. 
Published: September 2022

IntroductionMany studies have searched for an association between violence and psychiatric diagnoses, without providing a confirmative result.ObjectivesWe have sought to deepen this topic, analysing different aspects of aggressivity, focusing on a specific diagnosis and its particular phases of illness, and looking for a correlation between psychiatric co-diagnoses and outpatients’ visits adherence.MethodsWe studied 151 bipolar type I inpatients presenting complaint, past medical and family history; we collected information about lifetime hetero/self-aggressive behaviours, irritability, agitation, suicide attempts, alcohol, or substance abuse.ResultsThe overall aggressivity in our sample resulted in 11.92% of cases, while the number of aggressive episodes during euthymia decreased to 2.64%, close to the population without psychiatric disorders. Personality disorders and alcohol abuse appeared to be the main risk factors for irritability [Fig. 1]; substance abuse for both irritability and hetero-aggressive behaviour [Fig. 2]. We observed that subjects who displayed better compliance to follow-up visits exhibited a significant lower aggressive behaviour than less adherent subjects. Moreover, our data disconfirm the common conception that correlates the presence of psychotic features to violence.ConclusionsStudying aggressive in a bipolar population, we observed that the rare episodes of aggressiveness were condensed in active phases of illness and mainly related to alcohol or substance abuse, while violent acts during long periods of wellbeing appear in line with those of the general population. We are confident our data might be helpful in deconstructing the stigma that a psychiatric diagnosis equals to violent behaviour.DisclosureNo significant relationships.
Clinical validation of EDIT-B test for the diagnosis of bipolar disorder
Authors: Abraham J.-D. , Salvetat N. , Guerra P. , Ferrari M. , Le Guen P. , Biglia O. , Henry C. , Kessing L. , Haro J.M. , Vieta E. , Weissmann D. 
Published: September 2022

IntroductionBipolar disorder (BD) is a psychiatric disorder characterized by alternating episodes of high mood and low mood similar to depression. To differentiate BD patients from unipolar (UN) depressed patients remains a challenge and the clinical scales available failed to distinguish these 2 populations. ALCEDIAG developed EDIT-B, the first blood test able to make a differential diagnosis of BD. Based on RNA editing modifications measurement and AI, the test requires a simple blood draw and equipment available in most central laboratories. A first study on 160 UN and 95 BD patients allowed a differential diagnosis with an AUC of 0.935 and high specificity (Sp=84.6%) and sensitivity (Se=90.9%). A multicentric clinical study has been set up to validate these performances.ObjectivesThe objective of this project is to run a multicentric clinical study in Europe and assess the performances of the test.MethodsThe EDIT-B project, led by Alcediag, is supported by EIT-Health grant (European institute of Innovation and Technology) and gathers 4 clinical centers in 3 countries (France, Spain, Danemark), a CRO for the clinical study management (Aixial), a CRO for the development of a diagnostic kit (Veracyte), a diagnostic lab for molecular biology analyses (Synlab), and a regulatory company (PLG).ResultsAt the end of the study, the EDIT-B performance will be confirmed and the test will be CE-marked.ConclusionsThis test will address the needs of millions of patients suffering from misdiagnosis and therefore allow them to receive the correct treatment.DisclosureJDA, NS and DW are employees of Alcediag.
Therapeutic characteristics of patients followed for bipolar disorder with rapid cycles: Study on a Tunisian population
Authors: Karoui M. , Amri G. , Kammoun R. , Nefzi H. , Ellouz F. 
Published: September 2022

IntroductionBipolar disorder is a frequent and particularly severe psychiatric pathology that causes significant morbidity and mortality. The rapid cycling forms are more severe in terms of their expression, evolutionary course, therapeutic responses and associated comorbidities.ObjectivesThe aim of this study is to conduct a descriptive assessment of therapeutic characteristics in patients with rapid cycling bipolar disorder.MethodsOur work involved a population of 97 patients followed for bipolar disorder diagnosed according to DSM5 criteria, including 37 patients meeting the specification “with rapid cycles”. The patients were divided into two groups: - Group of patients with bipolar disorder with rapid cycles (TBCR) - Group of patients with bipolar disorder without rapid cycling (TBNCR). We compared the therapeutic features among these two groups.ResultsThe dominant polarity was depressive in patients with rapid cycles. They required more mood stabilizers. A greater proportion of them had received treatment with serotonin reuptake inhibitor antidepressants. They were more likely to use hypnotics such as antihistamines and zolpidem.Conclusions
Rapid cycling TB is a relatively common clinical modality that should be investigated and identified.The use of antidepressants is associated with this course of the disease. Their utilization in the treatment of bipolar depression must be thoughtful and well studiedDisclosureNo significant relationships.
The IT4 anxiety project : Improving Anxiety Prevention and Management with Innovative Digital Solutions
Authors: De Moffarts V. 
Published: September 2022

Technological innovations give new perspectives in many fields, including health. It was in this context that the IT4Anxiety project was born in 2019 bringing together mental health professionals and start-ups, but also universities, research centres, higher education establishments and public authorities from the North-West Region of Europe. The project is challenging our ability, as partners, to gather stakeholders from different background, medical and non-medical field, in order to support the implementation and co-conception of innovative solutions with the objective of reducing the anxiety of mental health service users. During the four years of project implementation (2019-2023), the stakeholders will have opportunities to work with the end-users, expecting to address the needs of around 3,000 mental health service users suffering from anxiety. The fifteen start-up involved in the project activities will be recruited through hackathons and calls based on identified needs. They will join the project in order to test and improve their solutions. This will create opportunities to connect the start-ups with the medical world, research codes and procedures and to give them a new perspective in the understanding of their targeted market segment. Furthermore, almost a thousand mental health professionals will be trained in e-mental health, benefiting from our training modules and an e-mental health job profile will be designed and implemented in our partner hospitals in Belgium and in Germany.DisclosureNo significant relationships.
Attention-Deficit/Hyperactivity Disorder and Parenting: Toward a Cognitive/Schema Model
Authors: Miklósi M. , Nagy V. , Oláh S. 
Published: September 2022

IntroductionAttention-Deficit/Hyperactivity Disorder (ADHD) runs in families; however, there are mixed results on the interaction effects of parent’s and child’s psychopathology on parenting qualities. Cognitive/schema therapy is a promising treatment approach for adult ADHD; we know little about the effect of cognitive factors on parenting, however.ObjectivesWe aimed to fill this gap by exploring the role of dysfunctional schema modes in the associations between adult ADHD symptoms, child’s externalizing symptoms, and perceived parental competence in a dimensional approach.MethodsA community sample of parents (N=100, mean age=38.25 years, SD=5.73) filled out online questionnaires assessing ADHD symptoms (Adult ADHD Self-Report Scale), dysfunctional schema modes (Schema Mode Inventory), perceived parental competence (Parental Sense of Competence Scale), and child’s psychopathology (Strength and Difficulties Questionnaire).ResultsIn a multivariate model, higher levels of parental ADHD symptoms were related to higher levels of dysfunctional schema modes. However, neither the child’s externalizing symptoms nor the interaction term of parent’s symptoms by the child’s symptoms had any effect on dysfunctional schema modes. Furthermore, the child’s externalizing symptoms had a direct negative association with parental self-efficacy beliefs, whereas the relationship between adult ADHD symptoms and parental self-efficacy was mediated by the detached and overcompensating dysfunctional schema modes.ConclusionsOur results suggest that the activation of dysfunctional schema modes is related to the parent’s but not the child’s psychopathology. The activation of dysfunctional schema modes may play an important role in the self-efficacy beliefs of parents with ADHD. Targeting that cognitive factors may enhance the effect of behavioral parent training programs.DisclosureThis research was supported by National Research, Development, and Innovation Office (NKFIH) OTKA-PD-134849 grant.
Training Issue about Digital Tools : from Users & Carers to Professionals
Authors: Dulière M. 
Published: September 2022

The Interreg IT4Anxiety Project gives birth to training modules in digital health. The European Interreg IT4Anxiety project, led by the CNP St-Martin, is launching a new range of training modules in digital health awareness at the Haute Ecole de la Province de Namur, the University of Applied Sciences (HEPN). Electronic medical records, teleconsultation, mobile applications, virtual reality… Digital tools are already part of the daily life of workers in the health sector. However, until now, no curriculum has included appropriate training to enable caregivers to acquire the fundamental knowledge needed to use digital tools effectively in their professional practice. Thanks to the expertise and support of its various partners in the IT4Anxiety project, the Haute Ecole de la Province de Namur will provide digital health awareness training starting in 2022. These training modules will be provided as part of the in-situ training of caregivers and are already being tested in the academic training of future nurses. In addition to discovering the potential of new technologies in the health field, health professionals and future professionals will learn to identify the appropriate use of these tools, to deploy them and to use them in their profession, in a respectful and caring relationship with a critical eye. The structure of the courses, the assessment and the feedback from the HEPN will form the basis for an international deployment of this training by the German, French, Dutch and English partners of the IT4Anxiety project.DisclosureNo significant relationships.
“She gets out of control when she’s on her period”. Cyclic menstrual psychosis. A case report
Authors: López Rodrigo M.V. , Osca Oliver A. , Palomo Monge M. , Tascón Guerra M.F. , Pérez Fominaya M. 
Published: September 2022

IntroductionCyclical psychosis related to the menstrual cycle is an entity not included in the DSM-V and ICD-10 classifications, however there are data collected in the literature on cases that agree with this diagnosis. When reviewing cases, psychotic symptoms of sudden onset are described a few days before menstruation, with the symptoms resolving in a self-limited way when the bleeding ends. The end of psychotic symptoms is not directly related to the use of antipsychotics. The complete clinical picture is nonspecific and fluctuating. With acute onset, short duration, cyclical repetition, with psychotic symptoms (mutism, confusion, delusions, hallucinations) or a manic episode. We present the case of a 14-year-old adolescent with a history of epileptic seizures in childhood, without current treatment. She goes to the emergency department brought by her father and brother presenting psychomotor agitation, verbiage, flight of ideas, loss of the common thread in the speech, referring delusional ideas with experience of harm. His relatives report that he has not slept for a few days, with soliloquies, unmotivated laughter. They refer that the picture has been repeated in recent months during the days of menstruation.ObjectivesKnowing a diagnosis not included in the current classifications.MethodsImaging tests and neurological evaluations rule out organic picture.ResultsGiven the periodicity of the condition, the symptoms are self-limiting at the end of menstruation, without a clear relationship with psychopharmacological treatment (although agitation improves).ConclusionsCyclical menstrual psychosis approximates affective disorders, especially bipolar disorder in adolescence. The role of psychotropic and hormonal treatment is debatable.DisclosureNo significant relationships.
Cultural Factors of Suicidality
Authors: Küey L. 
Published: September 2022

Suicidal behavior is a complex human behavior expressed in a spectrum of various acts. From a suicidal gesture to a completed suicide, all reflect a cry for help and need clinical and scientific attention. The process ending up with suicidal act is shaped by multi-factors, including the socio-cultural ones. Suicide is indeed related to a deep feeling of hopelessness; not to have any control over their lives and circumstances except than deciding to stay alive or dead, and so related to serious psychopathologies, as depressive and substance use disorders. Hence, it is frequently seen as a personal act or as a question of individual decision. But since Durkheim‘s ground breaking work, which still inspires suicide researchers, the cultural factors behind this socially determined phenomenon have been widely discussed. Suicide is totally a personal act and a fully socio-cultural phenomenon. The cultural factors of suicidality are among the social determinants of health/ill health. Epidemiological evidence and cross-cultural comparisons show huge differences in suicide rates across countries and even between regions of same countries, and these are constant differences. Furthermore, even the definition of suicide is effected by the social circumstances. Certain socio-cultural patterns shape how and when people commit suicide; i.e., these patterns have decreasing or increasing effect on suicide rates, which provides basis for suicide prevention. Likewise, social solidarity, high group integration and collective sensitivity may have preventive effects. This brings us to the discussion of the effects of big social turmoil or wars or pandemics on suicidal behavior.DisclosureNo significant relationships.