bluuebunny/crossref_metadata_2025_split huggingface dataset:
The level of consciousness and mental reactions of children after acute brain injury (interdisciplinary rehabilitation)
Authors: Kamelkova A. , Martyshevskaya D. , Zakrepina A. , Sidneva Y. 
Published: February 2022

IntroductionThe process of recovery of mental reactions in children after acute traumatic brain injury is determined by complex methods with an interdisciplinary approach. Studies of emotional, communicative and behavioral reactions are based on an assessment by a psychiatrist and a teacher-defectologist.ObjectivesTo study mental reactions and identify predictors of positive recovery of consciousness after acute brain injury in children in early rehabilitation.Methods48 children (14–36 months) with acute severe traumatic brain injury who were admitted for treatment and rehabilitation (in CRIEPST). Methods: psychiatric and pedagogical examinations; also - neuroimaging data and others.ResultsThree groups of children were identified, depending on the different severity of emotional, communicative and behavioral indicators: Group 1 (11%): The level of consciousness is minimal positive. Reactions: stable gaze fixation; emotional reaction to sound (smile) and the face of an adult; short-term tracking of the gaze of the object; the ability to touch an object and hold it; sits himself. Group 2 (33%): The level of consciousness is minimal positive / negative, with an advantage of positive. Reactions: unstable gaze fixation; emotional reaction and involuntary movements to sound; reflex seizure of an object; sits with support. Group 3 (56%): The level of consciousness is minimal negative. Reactions: no emotional reactions, low motor and sensorimotor activity.ConclusionsPredictors of emotional-communicative and behavioral indicators of recovery of the level of consciousness were identified: sensory and motor, cognitive and socially-oriented. These predictors are the basis for choosing a rehabilitation program with interdisciplinary support and a treatment strategy.
Successful discharge from a mental health halfway house: A personalized process with integrated approaches
Authors: Chen F.-P. 
Published: February 2022

IntroductionIn Taiwan, residents of mental health halfway houses (MHHH) receive psychiatric rehabilitation services, aiming for independent living and community integration. Research is yet to investigate how MHHH may effectively assist residents’ discharge in this cultural context.ObjectivesTo examine the processes of assessment, preparation, assistance, and appraisal of discharge from MHHH staff’s perspectives.MethodsSemi-structured in-depth interviews were conducted with 11 halfway house staff members. Verbatim transcripts were analyzed with dimensional analysis procedures of the grounded theory methodology.ResultsSuccessful discharge is a personalized process with integrated approaches addressing three essential factors: (a) regular community involvement, (b) the residents’ capacity to work, and (c) the family’s acceptance and support. Staff supported individual residents’ community involvement by attending to residents’ personal interests, resource availability, financial concerns, and transportation. Moreover, staff provided rehabilitation trainings to develop work capacity. However, residents’ motivation and functioning as well as job opportunities might affect their employment. Finally, in Taiwan, residents were rarely discharged without their family members’ consent because residents tended to co-reside with their family after discharge or rely on family support while living separately. Staff worked to engage families, which was influenced by family relationship quality, past traumatic events, financial concerns, capacity to assist the resident, and/or the resident’s ability to assist with family affairs.ConclusionsTo achieve successful discharges, MHHH staff need to assist each resident by developing an integrated plan to enhance conditions of the aforementioned factors, including strategies for different familial situations to garner family support in this cultural context.
Conceiving and evaluating novel therapeutic strategies with patients and peer practitioners: The case of urban remediation program
Authors: Empson L. Abrahamyan 
Published: February 2022

IntroductionWhile extensive recent data details risk factors for psychoses in urban milieu, insights regarding recovery processes in cities are scarce. This hampers the translation of promising epidemiological and neuroimagery findings into effective therapeutic strategies. Given the twofold higher incidence of psychoses in cities and the fact that 68% of world population will be urban by 2050, it becomes an urgent matter of psychiatric care.ObjectivesThis presentation details specific targets for therapeutic interventions in city context to further discuss a pioneering participatory project with the aim to conceive a novel city specific recovery-oriented program.MethodsBased on most recent research data, some of which our own, a comprehensive survey of urbanicity studies and an overview of main avenues for developments will be presented.ResultsUrban milieu is a complex dwelling space made of protective and disruptive features. During each life course they may form unique combinations hampering or enhancing psychological well-being. Urban living is not only correlated with higher prevalence of psychoses, but also with better access to health care and lower rates of treatment resistant schizophrenia, pointing to some beneficial aspects of city living on recovery processes. The interplay between personal characteristics, urban resources and supportive social environments seems pivotal to recovery calling for multilevel interventions (CBT interventions, peer-support, go-alongs, resocialization) and integration of different stakeholders (patients, peer-practitioners, community actors).ConclusionsParticipatory approach (design thinking, urban lab etc.) represents an important means of innovation and ensures the best match between patients needs and therapeutic propositions.
Follow-up of patients with delusional disorder in a specialized outpatient clinic over a 2-year period
Authors: González-Rodríguez A. , Guàrdia A. , Pedrero A. Alvarez , Seeman M.V. , Delgado L. , Fucho G.F. , Acebillo S. , Monreal J.A. , Vidal D. Palao , Labad J. 
Published: February 2022

IntroductionIn order to prevent relapse and increase medication adherence, primary care physicians and psychiatric inpatient units should consider referring patients with delusional disorder (DD) to specialized outpatient clinics for treatment and follow-up.ObjectivesThis poster describes a sample of DD patients referred to a specialized unit for DD and documents rates of follow-up care.MethodsOver a 2-year period, 29 individuals were consecutively referred to the Parc Tauli -Delusional Syndrome Working Group, which provides treatment and clinical care for patients with delusional disorders for a catchment area of nearly 450.000 inhabitants in Sabadell (Barcelona, Spain). Criteria for inclusion in the program are relatively flexible. Referred patients are evaluated at baseline and at 6 months following their first appointment. Treatment and case management are offered by a multidisciplinary team consisting of psychiatric, nursing, and social work personnel. Psychological interventions are also offered.ResultsOf the 29 persons initially referred, 27 attended at least one scheduled appointment. Twenty-one out of the 27 patients received a confirmed diagnosis of DD (14 women,7 men), 2 suffered from schizophrenia and 4 were diagnosed with other psychiatric disorders and referred to other programs: primary care (n=2), affective program (n=1) and addictions unit (n=1). A breakdown of DD subtypes follows: persecutory (n=10,47.6%), jealous (n=4,19%), somatic (n=5,23.81%), mixed (n=2,9.5%). Three patients with DD (14.3%) were lost to follow-up. Attendance rates of the 21 DD patients: 80.4% (Women:77.67%, Men:100%).ConclusionsFor a traditionally difficult-to-engage population, adherence to multidisciplinary clinic appointments was relatively high. Loss to follow-up was lower than would have been expected.Conflict of interestAGR has received honoraria, registration for congresses and/or travel costs from Janssen, Lundbeck-Otsuka and Angelini.
Mothers with schizophrenia: Treatment, quality of life and motherhood experience
Authors: Sánchez S. Pérez , Herrero I. Martín , Fernández M.A. Cutillas , Portero A. Crespo , Güimil D. Raya 
Published: February 2022

IntroductionSchizophrenia is a chronic disease that deteriorates the functionality of patients, especially when forming a family and taking care of children. We are interested in analyzing the characteristics of mothers with schizophrenia and their degree of global activity when going from oral treatments to injectable treatments.Objectives1 To assess the quality of life and functional level of mothers with schizophrenia receiving paliperidone treatment. 2. Compare quality of life and functional level when going from oral treatment to long-term injectables.MethodsSample: Mothers, 37-45 years old, diagnosed with schizophrenia in monotherapy with oral paliperidone who started treatment with Paliperidone Palmitate LD IM (200 - 300 mg / month). Retrospective data collection. QLS quality of life scale.Results5 patients were included, caregivers of 1 child (80%), 2 children (20%) who met the inclusion criteria and completed the questionnaires. After its application and correction through non-parametric tests (N <30). During oral treatment, scores were observed in the QLS questionnaire of: mean intrapsychic functions 34.2, mean interpersonal relationships 19, mean instrumental role 8, mean daily activities 8. After 12 weeks of treatment with Paliperidone Palmitate IM, scores were obtained: functions Medium intrapsychic 36, medium interpersonal relationships 23, medium instrumental role 15, medium daily activities 11. A better functioning of the patients was observed in the instrumental and daily activities categories.ConclusionsIn our experience, injectable long-acting Paliperidone Palmitate is associated with the perception of better quality of life in mothers with schizophrenia and increases the ease of administration as well as planning in their daily life.
The relationship between combined antipsychotic use and clinical features in schizophrenia spectrum patients treated in inpatient ward: A retrospective study
Authors: Baklaci U. 
Published: February 2022

IntroductionThe combination of antipsychotics can be seen in up to 70% due to the presence of resistance to treatment, aggression, sleep disorders, and self destructive behavior in psychosis spectrum disorders in clinical practice. More side effects were observed in patients using antipsychotic combinations.ObjectivesThe aim of this study is retrospectively investigate the sociodemographic and clinical characteristics differences between antipsychotic combination and monotherapy groupsMethodsThe files of 754 cases admitted to the hospital from the first day of January 2013 to the last day of December 2016 were reached. Patients diagnosed as according to DSM-5 “Schizophrenia Spectrum and Other Psychotic Disorders” were included. From the files of these cases, sociodemographic characteristics, disease characteristics and antipsychotic properties (clozapine use, combined antipsychotic and depot antipsychotic use) were used. Pearson chi-square test and student t test were used in data analysisResultsAge was significantly lower in patients treated with combined antipsychotics than patients receiving monotherapy (t = 2,264, p = 0.026). Age of onset of psychosis was significantly lower in patients treated with combined antipsychotics (t = 2,771, p = 0.007). Education level was also found to be lower in this group (t = 2,333, p = 0.02) The duration of hospitalization was longer in patients treated with combined antipsychotics (t = 3,069, p = 0.002).ConclusionsThere were statistically significant differences between the patients treated with combined antipsychotics compared to the group treated with monotherapy. These are the differences in the age of onset of psychosis, education level and duration of hospitalization.
Working memory and abstract thinking in patients with schizophrenic spectrum disorders
Authors: Popov M. , Pluzhnikov I. 
Published: February 2022

IntroductionAccording to a selective meta-analytical review, weakness of working memory is considered as one of the fundamental disorders in schizophrenia. Some researchers propose identifying this disorder as an endophenotypic marker of schizophrenia diathesis. Many researchers also emphasize violations of “abstract thinking”, that is, the ability of patients to operate with abstract concepts. Many scientists understand the violation of “abstract thinking” as the difficulty of patient in operating with the dominant signs of the concept. Based on these approaches, we assume a dark relationship between working memory and abstract thinking.ObjectivesThe aim of this study is to investigate the relationship between working memory and abstract thinking defect in patients with schizophrenic spectrum disorders.Methods16 patients with schizophrenic spectrum disorders were studied. To study abstract thinking, the following neuropsychological and psychometric techniques were used: exclusion of objects, D-KEFS understanding of proverbs (latent concepts were recorded). The following techniques were used to study working memory: n-back; Wechsler Test, subtest Digit Repetition.ResultsAs a result of preliminary research, the following data was obtained. We found significant differences between the number of irrelevant features (which corresponds to impaired abstract thinking) and the severity of impaired working memory (p = 0.035). The more the memory was impaired, the more the subjects demonstrated the impairment of abstract thinking.ConclusionsThus, our results justify our assumption. A relationship between working memory and abstract thinking is founded to be possible. Further studies of this issue requires a wider techniques battery as well as a larger sample.Conflict of interestThe reported study was funded by RFBR, project number 20-013-00772
Planning impairment in schizophrenia: The possible role of abstract thinking and short-term memory
Authors: Alekseev A. , Morozova M. , Rupchev G. 
Published: February 2022

IntroductionThe planning impairment is one of the basic aspect of cognitive dysfunction, but its mechanisms in schizophrenia remain unclear.ObjectivesTo assess the links between planning and cognitive functioning in schizophrenic patients and in norm.Methods50 patients with schizophrenia (age 34.92±8.54; illness duration 8.34±5.87) and 50 healthy volunteers (age 32.42±7.26) were examined. Brief Assessment of Cognition in Schizophrenia, Benton’s test for short-term memory assessment; sub-test Similarity (from WAIS) to assess abstract thinking were used.ResultsPatients showed significantly worse results in all parameters (Tab.1). Table 1: Differences of planning between groups.SchizophreniaNormp-levelTOL-DX92,64±14,48102,52±11,970,00033Similarity16,92±3,9719,76±2,850,00009BVTR Score6,73±1,787,60±1,320,00709In healthy subjects, significant relationship was found between planning and abstract thinking, and there was no relationship between planning and short-term memory (Tab.2). Table 2: Correlations in the Norm groupSpearman Rp-levelTOL-DX & Similarity0,3925300,004809TOL-DX & BVTR0,1864940,194710In patients with schizophrenia, the opposite picture was observed (Tab.3). Table 3: Correlations in the Schizophrenia group.Spearman Rp-levelTOL-DX & Similarity0,2623890,071596TOL-DX & BVTR0,3445660,015331The effectiveness of planning in patients was significantly associated with short-term memory, but not with abstract thinking.ConclusionsStudy results indicate a possible role of basic aspects of mental activity such as short-term memory in planning impairment in patients with schizophrenia. Problem solving and reasoning disorders represent two relatively independent forms of thought disorders in schizophrenia.
Diagnostic change 2 years after a first episode of psychosis
Authors: Aranguren L. , Martinez M. , De Jalón E. García , Fernández A. , Ariz M.C. , Otero M. , Pereda N. 
Published: February 2022

IntroductionPsychiatric diagnoses are derived from expert opinion (1). Since no objective tests or markers are on the horizon, clinical psychiatry is anchored to “the patient’s altered experience, expression and existence, associated with suffering in self and/or others”(2). Many studies have examined diagnostic stability over time. In the last years investigators have been reporting prospective and retrospective consistencies of diagnoses between two time points, specially in first episodes of psychosis (3).ObjectivesTo examine the prospective and retrospective stability of diagnostic categories 2 years after the first episode of psychosisMethodsData were examined from the First Episode Psychosis Program of Navarra (PEPsNA), a prospective observational study of a cohort of patients with first-episode psychosis in Navarra (Spain). Diagnosis was assigned using DSM-IV-TR at baseline and 24 months later. Diagnoses were divided into 5 categories: Affective psychosis, Schizophrenia spectrum psychosis, Schizoaffective disorder, acute psychosis and other diagnoses. Diagnostic change was examined using prospective and retrospective consistencyResultsA total of 78 first-episode psychosis cases with baseline and 24 months follow-up were identified. Table 1 shows the diagnosis movement matrix, and Figure 1 its graphical representation. Of cases, 71.8% (56/78) had the same baseline and 24 months follow-up diagnosis. Prospective and retrospective consistencies are shown in Table 2ConclusionsThe prospective and retrospective consistencies of Schizophrenia spectrum psychosis and acute psychosis were higher than others. Affective psychosis and Schizoaffective disorder show very variable consistencies
Impact of a first psychosis program in functional variables after two years of follow-up
Authors: Martinez M. , Pereda N. , De Jalón E. García , Lizarbe T. , Aquerreta A. , Monclus F. , Otero M. 
Published: February 2022

IntroductionEarly Intervention Services for Early-Phase Psychosis have shown efficacy and effectiveness (Correl C, JAMA). In Pamplona, Spain, there is an Early Intervention Program that has been providing multiprofesional assistance for First Psychotic Patients for the last two years.ObjectivesThe aim of this study is to analize the longitudinal effects of the different interventions in several functional variables: GAF, Occupational State, CGI-CogS, QLS, Sofas and WHODAS II applied to 240 patients during two years of follow-up.MethodsWe apply an standard evaluation protocol to every patient at different times: premorbid, initial time and at months 6, 12, 18 and 24. We analyse the data with the SPSS statistical program to see the results in these variables.ResultsThe GAF scale shows a decline during the first 6 months, but tends to reach and maintain the premorbid levels after a year of treatment. Regarding baseline, patients with normalized jobs or studies are 60.7%. This percentage persists during the next months of follow-up but decline at the 24th month Both the Whodas and Sofas scale show improvement tends. The QLS results show a progresional improvement in every subcale during the whole time of follow-up.ConclusionsThe Early Intervention Services in Psychosis improve, not only psychopatological dimension but also functional areas, what is important for the whole recovery of First Psychotic Patients.
Risk factors for psychotic relapse in chronic schizophrenia after dose-reduction or discontinuation of antipsychotics. A systematic review and meta-analysis
Authors: Bogers J. , Hambarian G. , Vermeulen J. , Dehaan L. 
Published: February 2022

IntroductionPatients are often treated with high doses or combinations of antipsychotics, which may hamper recovery. Dose-reduction (DR) or discontinuation of antipsychotic medication in chronic patients carries the risk of psychotic relapse.ObjectivesTo identify risk factors of psychotic relapse after DR or discontinuation, we (i) determined the rate of relapse after DR or discontinuation in patients with chronic schizophrenia, and (ii) assessed risk factors for psychotic relapse.MethodsFrom studies on dose-reduction from January 1950 through June 2019 we calculated event rates per person-years including 95% confidence intervals. We extracted: (1) patient characteristics (age, percentage of male subjects, setting, duration of illness), (2) dose-reduction/discontinuation characteristics (start-dose, end-dose, dose-reduction in milligrams and percentage of start-dose, time-period of dose-reduction), (3) follow-up characteristics (time after dose-reduction), and (4) study characteristics (blinding, publication-year and relapse definition).Results46 unique cohorts, presenting 1677 patients in which doses were reduced/discontinued were included in meta-analysis. We found an overall event rate per person-years on psychotic relapse of 0.55 (CI95% 0.46-0.65;p<0.0001;I2 =79). Most robust event rates for psychotic relapse were seen for discontinuing antipsychotics, and if not discontinuing, dose-reduction till under 5mg haloperidol equivalents daily (HE). Abrupt reduction yielded higher rates than gradual reduction. During short follow-up time more relapses occurred than in studies with long follow-up time.ConclusionsIn patients with chronic schizophrenia discontinuing, and to a lesser extent DR till end-dose<5mgHE, patients who reduce doses abrupt, inpatients, and patients with a short duration of illness carry highest relapse risk. Most relapses occur during the first half year after DR.
Suicide attempts in women with severe mental illness in the perinatal period
Authors: Gressier F. , Sutter-Dallay A.-L. 
Published: February 2022

Suicide is one of the leading causes of perinatal maternal mortality (1). Maternal suicidality has a negative impact on the mother-baby relationship and child development. However, little is known about specific risk factors for perinatal suicide attempts in women with severe mental illness. In a sample of 1439 women with severe mental illness in the perinatal period and jointly admitted with their baby in a mother and baby unit, 154 (11.7%) attempted suicide, 49 in pregnancy (3.7%) and 105 (8.0%) in the post-partum period (2). Suicide attempt in pregnancy was related to alcohol use, smoking during pregnancy and a history of miscarriage, and in the post-partum period to major depressive episode or recurrent depression and younger age. Women who attempt suicide either in pregnancy or in the postnatal period could have different psychopathological and environmental profiles. Past obstetric history and addictive behaviours during pregnancy are essential elements to explore. In addition, depressive symptoms should be assessed in all women to treat major depression, as a means of preventing suicide attempt. Special attention to risk of suicide is needed during the perinatal period for women with severe mental illness. For women suffering from an acute psychiatric disorder, or a history of mental illness, multi-disciplinary management should be implemented. 1. Oates M. Suicide: the leading cause of maternal death. Br J Psychiatry. 2003;183:279-81. 2. Gressier F et al. Risk factors for suicide attempt in pregnancy and the post-partum period in women with serious mental illnesses. J Psychiatr Res. 2017;84:284-291.DisclosureNo significant relationships.