bluuebunny/crossref_metadata_2025_split huggingface dataset:
Priapism secondary to antipsychotic treatments with favorable response to amisulpride
Authors: Pérez Balaguer A. , Sanz-Aranguez-Ávila B. , Estévez-Peña B. , Fernández-Guisasola P. , Moyano-Ramírez E. 
Published: September 2022

IntroductionPriapism is an abnormally prolonged erection, painful and irreducible, unrelated to sexual stimulation. Around 25-40% of cases are iatrogenic, especially associated with pharmacological treatments, of which antipsychotics (first and second generation) account for 50%.ObjectivesThe aim is to discuss a clinical case to provide further evidence.MethodsThe patient was a 37-year-old man with a diagnosis of schizophrenia who was admitted for clinical decompensation. He had stopped antipsychotic treatment three months earlier due to side effects. He reported previous episodes of priapism associated with Risperidone, Aripiprazole, Olanzapine, and Paliperidone. At admission, he was administered Asenapine 20mg with development of priapism. Treatment was stopped. The urologists performed a lavage of the corpora cavernosa and administered adrenaline. In the absence of effectiveness, surgical intervention was successfully performed. Given the psychopathological improvement, he was discharged without antipsychotic treatment and close follow-up.ResultsHe presented a new admission one month later. Amisulpride was prescribed up to 800mg/day with good evolution and no adverse effects.ConclusionsAntipsychotic-induced priapism appears to be related to the blockade of alpha-1 adrenergic receptors in the corpora cavernosa. There is a positive correlation between the affinity for the receptor and the propensity to cause priapism. The dose and duration of the medication do not appear to be correlated. Other risk factors are a history of previous episodes, restarting medication after noncompliance, use of concomitant substances or medications that cause priapism. Our choice of amisulpride was based on the fact that it has no affinity for alpha-1 adrenergic receptors.DisclosureNo significant relationships.
Quetiapine induced ischemic colitis: about two cases
Authors: Martín M. , Molina Liétor M.D.C. 
Published: September 2022

IntroductionDue to its anticholinergic action, antipsychotic drugs, especially phenothiazines and atypical antipsychotics, have been described as a rare cause of drug-induced ischemic colitis. We present two cases of patients that were admitted to the gastroenterology unit of a general hospital and were diagnosed of quetiapine-induced ischemic colitis.ObjectivesTo describe an uncommon side effect of neuroleptic treatment.MethodsCase report and literature review.ResultsFirst patient, aged 73, with history of dysthymia, in treatment with desvenlafaxine, quetiapine, ketazolam, lorazepam, enalapril/hidroclorothiazide, omeprazole, simvastatin, tramadol/paracetamol, alendronate/colecalciferol and hidroferol, consulted in the emergency room for malaise, disorientation, haematuria, abdominal pain and changes in deposition rhythm; family members admitted frequent use of higher than prescribed doses of quetiapine and benzodiazepines. Second patient, aged 63, with history of histrionic personality disorder, in psychopharmacologic treatment with venlafaxine, quetiapine, diazepam, fentanyl, rupatadine, cinitapride, omeprazole, levosulpiride, simvastatin, fluticasone/salmeterol and celecoxib, consulted for abdominal pain and bloody diarrhoea. Colonoscopy findings in both of them were compatible with ischemic colitis. Quetiapine was withdrawn in both cases, as the main diagnostic hypothesis was quetiapine-induced ischemic colitis. The patients achieved full recovery.ConclusionsIschemic colitis is a rare but potentially fatal adverse effect of antipsychotic drugs, with clozapine being the most reported atypical antipsychotic thought to cause it. The risk associated with quetiapine is thought to be lower given its milder anticholinergic effect. Co-prescription with other drugs with anticholinergic actions increases the risk. Clinicians should be aware of this association and the onset of constipation should alert medical staff.DisclosureNo significant relationships.
The cognitive effects of esketamine: what do we know so far?
Authors: Barbosa M. , Guedes R. 
Published: September 2022

IntroductionEsketamine is an S-enantiomer of ketamine approved by the EMA for treatment-resistant depression (TRD). As an NMDA receptor antagonist, its administration results in increase of glutamate release and AMPA receptor activation, supporting both rapid-onset and long-term antidepressant effects. Short-term tolerability seems acceptable but major concerns remain regarding long-term safety, specifically regarding potential neurocognitive toxicity.ObjectivesTo clarify the potential short and long-term cognitive beneficial-effects and side-effects of esketamine.MethodsResearch was made using the Medline database, through the Pubmed search engine, using the keywords: “esketamine”, “cognition”. Only randomized-controlled trials were considered.ResultsOne study focused on the effects of intranasal esketamine (INE) on cognitive functioning in 24 healthy individuals, who were evaluated pre- and postdose (40 min, 2h, 4h and 6h). The results showed a decline in cognitive performance at 40 min postdose, returning to comparable levels as placebo by 2h postdose. Another study, with a follow-up of 1 year, involving 802 TRD patients, accessed the long-term safety of INE. In patients aged <65 years-old, performance on all cognitive tests remained stable or slightly improved from baseline during long-term treatment. In patients ≥ 65 years-old, the mean performance on all tests improved or remained stable, while the simple and choice reaction time began slowing at week 20.ConclusionsEsketamine has proven to be a promising new option for the treatment of TRD and available studies have shown promising results regarding patients’ cognitive function. Larger clinical trials are needed to further evaluate its short-term and long-term cognitive effects.DisclosureNo significant relationships.
Differences of use between paliperidone palmitate 3 month and paliperidone palmitate 1 month in real practice, with psychotic patients
Authors: Escobedo-Aedo P. , Merayo-Cano J. , Mata Iturralde L. , Muñoz Lorenzo L. , Ovejero S. , Sánchez Alonso S. 
Published: September 2022

IntroductionPaliperidone palmitate 1-month (PP1M) is a Long-acting injectable antipsychotic formulation, approved for the treatment of schizophrenia and schizoaffective disorder. Recently, paliperidone palmitate 3-months (PP3M) formulation was introduced, which maintains stability while offering a longer dosing interval for the maintenance treatment in patients previously treated with PP1M. Despite of this, many patients are treated with PP1M without transition to PP3M.ObjectivesTo identify variables explaining maintenance of PP1M treatment instead of going to PP3M. We hypothesize that more severe patients are delayed in transition to PP3M because of expectation to complete stabilization.MethodsA descriptive analysis of 123 patients, diagnosed with psychotic disorders, on treatment with paliperidone palmitate 1 month or 3 months, was performed. Age, sex, type of paliperidone treatment, hospitalizations after the initiaton of treatment, years since diagnosis, polytherapy and toxic habits were some of the variables measured and compared between both groups (PP1M and PP3M).ResultsMost of patients (63,41%) were on PP3M. Both groups shared characteristics like male sex predominance, schizophrenia as the most common diagnosis, having a recent onset diagnosis, same frequency of polypharmacy and same pattern of drug consumption. There was a slight difference between both groups regarding severity. PP1M and PP3M showed respectively 33% and 16,7% of admissions after initiation.ConclusionsNo clear pattern determines less transition to PP3M from PP1M. No statistical difference was found except form the difference found in admission after change of treatment (to PP1M or PP3M), which could reflect influence of severity in treatment. Future research is needed in order to better elucidate this association.DisclosureNo significant relationships.
Clozapine-induced myocarditis: a case report and literature review
Authors: Angélico Ferreira I. , González Fé M.A. , Marqués Pastor M.D.M. , Roset C. , Torres L. 
Published: September 2022

IntroductionWe present the case of a male patient, 47 years old, diagnosed with schizophrenia, that was admitted at our hospital presenting a confusional state, with agitation, motor discoordination and difficulty breathing. At the blood analyses there was evidence of an increase in cardiac enzymes. The clinical manifestations had begun 5 days before, with slight leucocytosis showing in a routine blood test made after initiating clozapine, followed by fever, vomiting and progressive impairment of general clinical state.ObjectivesTo describe a case of clozapine-induced myocarditis, which is a known, but rare, side effect of clozapine and to do a brief review of the existing knowledge on this matter.MethodsThe authors undertook an article review using PubMed database and a thorough analysis of the clinical case.ResultsThe hypothesis of clozapine-induced myocarditis was the main diagnosis considered since the beginning, nevertheless, a thorough clinical examination and complementary tests were made and all the previous psychopharmacological treatment was suspended. The final diagnosis was based on the clinical presentation (fever, vomiting, shortness of breath, confusion and impairment of general state), the elevation of CRP, PCT and TnI and findings on echocardiogram that suggested myocarditis (moderate systolic dysfunction of the left ventricle due to global hypokinesia and a non dilated left ventricle).ConclusionsThe clinical manifestations observed, the results of the complementary diagnostic tests and the review of the existing literature, allowed to make the diagnosis of clozapine-induced myocarditis. We find of considerable importance to continue to publish and study this matter as it is still insufficiently known.DisclosureNo significant relationships.
TOO MUCH OF NOT ENOUGH: Exploring Lack of Fear and Its Consequences
Authors: Jesus S. , Costa A. , Simões G. , Dias Dos Santos G. , Almeida M. , Alcafache J. , Garrido P. 
Published: September 2022

IntroductionFear is an unpleasant emotional response to perceiving a threat causing physiological changes. Humans feel fear for positive motives, as it plays a crucial role in our survival. Just as the right balance in life is ideal, pathological fear is often described in one of its exaggerations, of having too much. However, lack of fear or “hypophobia” can be just as devastating and debilitating. This can be demonstrated in the analogy between those who feel no pain who also demonstrate increased risk and decreased life expectancy.ObjectivesThe authors aim to explore the concept of fear, discussing currently known physiological mechanisms in order to explain the effects that alterations of these mechanisms can have on fear responses, namely lack of fear, and subsequently the consequence of this on mental health.MethodsA brief non-systematized literature review was performed based on works most pertinent to the topic discussed.ResultsMuted fear responses have been mentioned in the literature, principally associated with medical conditions affecting the physiological fear pathways, including Urbach-Wiethe disease. Amygdala damage provokes abnormal fear reactions and reduced fear experience. This appears to be similar to what is seen in psychopathy, where abnormalities in the limbic system produce abnormal fear responses.ConclusionsAny extreme can cause havoc on a well-balanced machine. Just as the excess of fear results in mental issues such as anxiety, a lack of fear can also be debilitating. Those demonstrating less fear could help investigators better understand mental health disorders that have been demonstrated to be mediated by similar processes.DisclosureNo significant relationships.
Electroconvulsive therapy for Depression in Anorexia Nervosa. A review
Authors: Azevedo F. , André R. , Donas-Boto I. , Jeremias D. , Almeida C. 
Published: September 2022

IntroductionAnorexia nervosa has an important burden on both patients and families, with important comorbidities such as depression and obsessive symptoms. These are more resistant to pharmacological treatment than in non-anorexia patients, due to both biological and psychological mechanisms. Electroconvulsive therapy is the best available therapy for treatment resistant depression making it a treatment to consider in treatment resistant depression in anorexia though only case reports exist.ObjectivesTo review the current evidence for electroconvulsive therapy of depression in patients with anorexia nervosa as well as it’s ethical challengesMethodsNon-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “electroconvulsive therapy”, “anorexia nervosa”.ResultsElectroconvulsive therapy in anorexia has no controlled trials with mostly case reports available on scientific databases. It presents important challenges due to patient age, medical status and ethical challenges. Even less evidence exist for electroconvulsive therapy in children and adolescents than for adults, anorexia can complicate medical status presenting an anesthetic and life-support challenge and it’s egosyntonicity can place a legal and ethical challenge when patient refuses treatment.ConclusionsAnorexia has a dramatic burden on patients and families affected, with integrated evidence-based treatment being necessary both for treating the current episode and for remission prevention. Case-reports show that electroconvulsive therapy can play a role on treatment resistant depression in anorexia.DisclosureNo significant relationships.
Repetitive transcranial magnetic stimulation (rTMS) for catatonia– a case report
Authors: Licht C. , Fuchs S. , Ruttmann A. , Richter K. , Hillemacher T. 
Published: September 2022

IntroductionCatatonia is one of the most common severe motor syndromes, with an estimated prevalence among psychiatric inpatients of about 15 %. Benzodiazepines and electroconvulsive therapy (ECT) are the most widely studied treatment methods recommended as first-line therapy. We present the case of a 55-year-old female patient with paranoid schizophrenia and severe life-threatening catatonia who remitted under a short series of rTMS.Objectivess. IntroductionMethodsThe point of resting motor threshold (RMT) for the musculus rectus femoris was determined for the left hemisphere. A straight line 3 cm anterior and parasagittal from that point defined the SMA. A total of three sessions, each with 1000 pulses at intensity 66 % of the RMT, were performed within 24 and 120 hours apart. Stimulation protocol was set to 1Hz in the area of the left SMA with 25 series of 40 pulses, pulse width 25 ms, angle of attack 45°. Hardware: MagVenture, 8-coil “cool-B65 butterfly-shaped coil from Medtronic.ResultsWithin 24 hours after the first session, a marked improvement of catatonic symptoms like independent locomotion and verbal communication was recognized. One week after the whole rTMS treatment, a food intake without a gastric tube was possible.ConclusionsThe present case demonstrates that pronounced catatonia may be successfully treated with inhibitory rTMS. Our results underline the importance of non-invasive brain stimulation as a valuable addition to the existing treatment spectrum for catatonia. Future research is empowered to path the way for a significant expansion of treatment.DisclosureNo significant relationships.
Spiritually oriented therapy approach applying in complex rehabilitation of patients with mental disorders
Authors: Mitikhin V. , Magay A. , Alieva L. , Nochevkina A. 
Published: September 2022

IntroductionNumerous studies point to a high effectiveness of psychosocial rehabilitation using psychopharmacological treatment, psychosocial methods and spiritually oriented care technologies.ObjectivesDescription of the experience of using a spiritually oriented approach in complex rehabilitation of patients with mental disorders.MethodsClinical, pathopsychological, statistic. The study involved two groups of patients with illness (ICD-10 F 20.04 – F 20.05, F25.х, F21.3-21.4, F 33.4, F31.7, F32.2 – 18 patients) and comorbid addictive disorders (ICD-10 F10.2х1- F10.2х2 - 17 patients). “The Social Adjustment Scale–Self-Report SAS-SR” (М. Weissman, S. Bothwell, 1976); “Medical Outcomes Study 36-item short form health survey” (SF-36, John E.Ware, 1992); “Methodology of the severity of anti-drug potential” (Kopeyko G.I. et al, 2018); “The Scale of Religiosity” (Kaz’mina O.Y., 2000) were used to assess the effectiveness.ResultsAll patients received psychopharmacological treatment and participated in rehabilitation work in patient community organizations using psychosocial and spiritually oriented therapy. The rehabilitation program included psychoeducation, skills training, group and individual psychotherapy, social activity. Spiritually oriented assistance was realized in the tradition of dialogical approach (Florenskaya T.A., 1992) and included conversations on Evangelical topics, work in therapeutic groups on the principles of a religious community. Longer remission times, a social functioning improvement, a tendency to change lifestyle based on the values of religious worldview, anti-drug potential increase and a higher understanding of religious life with an orientation towards internal religiosity were revealed among the participants of complex rehabilitation program.ConclusionsPerspective of using biopsychosociospiritual approach in psychiatry in work with patients with schizophrenia and patients with comorbid addictive disorders was shown.DisclosureNo significant relationships.
Transdiagnostic cognitive-behavioral group therapy for anxiety disorders: Therapists’ perception of group management in community-based care
Authors: Durand C. , Provencher M. , Norton P. , Roberge P. 
Published: September 2022

IntroductionCognitive-behavioral therapy (CBT) is recognized as an effective treatment for anxiety disorders. Transdiagnostic group CBT (tCBT) targets cognitive and behavioural intervention strategies common to anxiety disorders. tCBT allows the treatment of a larger number of patients simultaneously and therapists only need to master a single intervention protocol. However, tCBT may present several challenges for therapists, particularly regarding group management.ObjectivesTo explore therapists’ perceptions and experience of group management during tCBT for mixed anxiety disorders.MethodsA qualitative study embedded in a randomized controlled trial of group tCBT (Roberge & Provencher; CIHR, 2015-2021). Semi-structured interviews were conducted with 18 of the 21 therapists to document their perceptions and to identify improvements for tCBT delivery. The data were analyzed using a deductive approach and based on the interactive cyclical process of data reduction, display and conclusion drawing.ResultsTherapists raised the challenge of the heterogeneous characteristics of participants’ anxious profile, since they had to be creative to provide exercises that were suitable for a whole group. Exposure exercises, a key component of tCBT, were particularly affected by the composition of the groups. Previous group animation experience and the ability to establish a therapeutic alliance from a group perspective were important facilitators. Co-therapy also facilitated the intervention, since it allowed the therapists to be more vigilant to group dynamics and favored the organization of tCBT.ConclusionsThis study highlights the importance of exploring therapists’ perceptions and experience about group management in order to identify facilitators and barriers of group tCBT in community-based
care.DisclosureNo significant relationships.
Sexual harassment-abuse and psychotherapy: the strenght of therapeutic relathionship
Authors: Moutafi C. , Kalafataki I. 
Published: September 2022

IntroductionThe term trauma comes from the ancient Greek word “titrosko” than means perforate. Sexual harassment and abuse of a person during childhood is an important risk factor for mental trauma.ObjectivesPresent the impact of sexual harassment and abuse in the mental health of adolescents and the imprortance of therapeutic relationship.MethodsFrom the literature review the child needs love which is demostrated with tenderness. The adult (perpetrator) with a disorder responds to the child’s tenderness with the language of passion. The immature Ego of the child is not strong enough to deal with the adult behavior and this causes anxiety, helplessness, confusion and guilt about the relationship with the adult. During the psychotherapeutic process, 4 main protagonists emerge : the victim, the perpetrator, an absent mother and an omnipotent savior.ResultsMental trauma can adversely affect the development of the neurobiological system resulting in difficulty coping with stressful events. Untreated trauma can lead to serious psychopathology such as anxiety disorders , depressive disorder, personality disorders, addictions. The creation of a therapeutic relationship, understanding the adolescent and his family potential, the recognition and treatment of transference-countertransference phenomena and the existence of a clinical setting that acts as a restraint mechanism could contribute to the therapy of mental trauma.ConclusionsThe Therapeutic Department for Adolescents could be an environment to contain, process and transform the painful into pleasant emotions, as well as aiming the authenticity of the person with a history of sexual harassment and abuse.DisclosureNo significant relationships.
Evaluation of the knowledge in seismotherapy of the nurses of the neuropsychiatry pole
Authors: El Kefi H. , Kabtni W. , Borgi S. , Gafsi I. , Bencheikh C. , Oumaya A. 
Published: September 2022

IntroductionElectroconvulsive therapy, also known as seismotherapy or electroshock therapy, consists of passing an alternating current of variable intensity between two electrodes placed on either side of the patient’s skull to create a generalized convulsive seizure with therapeutic effects.ObjectivesTo evaluate the knowledge of the nurses of the neuropsychiatry pole of the Military Hospital of Tunis in seismotherapy.MethodsDescriptive study, carried out in February 2021 in the pole of neuropsychiatry of the Military Hospital of Tunis (Services of psychiatry, neurology and neurosurgery). We developed for this study a form gathering sociodemographic questions and technical questions on seismotherapy (indications, contraindication, monitoring parameters …).ResultsThirty-nine (39) nurses agreed to answer the questionnaire. The average age was 37 years, 12 men and 27 women, with a sex ratio of 0.44. The majority (62%) of the participants had no idea about seismotherapy, 92% had never attended a session, 90% had no specific training, 87% thought that seismotherapy was indicated for all psychiatric illnesses. Seismotherapy was feasible on an empty stomach for 13% and after free and informed consent of the patient for only 33%.ConclusionsAlthough included in the nursing curriculum, the knowledge in seismotherapy of the nurses of the neuropsychiatry pole seems limited. A specific training program is indicated in anticipation of the establishment of a seismotherapy unit at the Military Hospital of Tunis.DisclosureNo significant relationships.