bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the crisis intervention team (CIT) training improve police officers’ knowledge, attitude, and mental health stigma?
Authors: Veluri N. , Mansuri Z. 
Published: February 2022

IntroductionThe Crisis Intervention Team (CIT) training was developed to educate police officers regarding the complexity of mental health (MHI) issues, and better prepare them for crisis encounters with persons with mental illness (PwMI).ObjectivesTo determine if CIT training improves police officers’ knowledge, attitude, and stigma about mental health issues.MethodsA systematic review followed the PRISMA protocol and was conducted on the PubMed database (Figure 1). Search strings were “crisis intervention team training,” “crisis intervention team,” “CIT,” “effectiveness,” and “police.” Inclusion eligibility required primary studies using surveys that measured the CIT training outcomes (i.e., knowledge, attitude, and stigma). Literature/narrative reviews or opinions were excluded.ResultsThe comprehensive meta-analysis software version 3.0 was utilized during analysis. Randomized odds ratios using a 95% confidence interval (CI) were obtained. Officers’ scores for knowledge, attitude, and stigma about MHI were taken before and after the survey. The Control group consisted of officers without CIT training. The CIT trained officers displayed an improvement in knowledge (OR 2.35, CI: 1.51– 3.67), attitude (OR 2.55, CI: 1.36–4.78), and stigma (OR 3.11, CI: 1.88–5.17). The results were statistically significant, with a p-value of less than 0.001 (Figure 2).ConclusionsCIT trained police officers displayed a significant improvement in their knowledge, attitude, and reduced stigma towards PwMI. Although our study displays CIT training’s positive effects, previous studies reported a nullified effect of CIT in reducing arrests and the use of force during police officers encounters with PwMI. Future researchers must explore this gap, mainly focusing on gender and race bias.
The challenges in schizophrenia treatment in real-life: The uncomfortable truth
Authors: Rancans E. 
Published: February 2022

Certain percentage of the first-episode schizophrenia patients presents with negative symptoms, which persists over the year and influence treatment outcomes (Galderisi et al. 2013). Treatment of negative symptoms has been a significant continuous clinical challenge. Majority of recently published guidelines recommend antipsychotic monotherapy as the standard of care, recommending antipsychotic combination therapy only after a failed trial with clozapine (George A. Keepers et al. 2020; Faden et al. 2020). However, real-life forces clinicians to look for possible combinations of medications early on, especially to tackle negative symptoms. The systematic review of global prescribing practices covering four decades found the pooled median rate of antipsychotic combination therapy approximately 20% (Gallego et al. 2012). One of the largest retrospective studies every conducted (n = 62,250) assessed rehospitalisation rates and the long-term use of antipsychotic polypharmacy in schizophrenia. Antipsychotic combination treatment was associated with an approximate 10% lower relative risk of psychiatric rehospitalisation compared with antipsychotic monotherapy (Tiihonen et al. 2019). Real-world effectiveness study of antipsychotic monotherapy vs. polypharmacy in schizophrenia from Eastern Europe is also supporting this approach (Katona, Czobor, and Bitter 2014). At the same time antipsychotic combination therapy can increase the total antipsychotic dose burden, frequency of adverse effects, potential drug-drug interactions and incur additional costs. In our recent naturalistic study in schizophrenia outpatients (n=120) with insufficient effectiveness of previous antipsychotics therapy on negative symptoms, we were able successfully switch therapy form several different antipsychotic combinations to monotherapy and gain clinical benefits (Rancans et al, 2020).DisclosureNo significant relationships.
Gut microbiota and its implications for psychiatry
Authors: Ochoa A. Matas , Quiroga A. Rodriguez , De Velasco R. Martinez , Garcia P. Nava , Arguis C. Banzo , Alonso I. Moreno 
Published: February 2022

IntroductionIn recent years there has been increasing interest in knowing the function of the microbiota, especially its role in the gut-brain axis. The microbiota is the set of millions of microorganisms that coexist in a symbiotic way in our body and are located in the digestive tract mainly. Numerous evidences show that the microbiota could modulate the information directed to the brain and therefore the pathogenic basis of numerous psychiatric and neurological disorders.ObjectivesA better understanding of the microbiota and its interaction with the brain and mental health.MethodsReview of recent literature about the implications of the gut microbiota in psychiatry.ResultsThe connection between the microbiota and the central nervous system (gut-brain axis) occurs through the vagus nerve, the systemic pathway (through the release of hormones, metabolites and neurotransmitters) and the immune system (through the action of cytokines). Changes in the microbiota are associated not only with gastrointestinal diseases, but also with disorders such as depression, anxiety, autism, anorexia, attention deficit and hyperactivity, Alzheimer’s disease and Parkinson’s disease. As some research indicates, changes in diet and composition of the microbiota can reduce the risk of suffering these diseases or reduce their symptoms. Other therapeutic alternatives postulated are the use of probiotics or fecal microbiota transplantation.ConclusionsDespite growing interest in the microbiota in the last few years, little is known about the mechanisms underlying this communication. More research is expected to contribute to the design of strategies that modulate the gut microbiota and its functions in order to improve mental health.
Immune heterogeneity of non-psychotic mental disorders
Authors: Zozulya S. , Androsova L. , Otman I. , Vetlugina T. , Nikitina V. , Klyushnik T. 
Published: February 2022

IntroductionCurrent studies indicate the involvement of inflammation in the pathogenesis of chronic non-infectious diseases, and therefore it is of interest to study the role of inflammation markers in non-psychotic mental disorders (NPMD).ObjectivesTo identify a number of inflammatory markers in serum of patients with NPMD.Methods73 patients with NPMD were examined (F43.2; F06.6). The comparison group consisted of 76 patients with endogenous psychosis (EGP) (F20.0; F25.0). The control group included 80 healthy people. The serum activity of leukocyte elastase (LE), α1-proteinase inhibitor (α1-PI) and the level of autoantibodies (aAb) to neuroantigens were determined.ResultsThree groups of patients with different variants of inflammatory response to the pathological process were identified. In group 1 (23.3%), all indices corresponded to the control values, which indicated the absence of the pathological process in brain. In group 2, there was a significant increase in activity both LE and α1-PI compared to control (p<0.05). This type of immune reaction characterized a balanced inflammatory response. It was found in 52% of patients with NPMD and in all patients with EGP. The aAb level also exceeded the control values (p<0.05). Group 3 (24.7%) showed an increase in α1-PI activity (p<0.05), but not in LE activity compared to control. Insufficient LE activity reflects a decrease in the functional activity of neutrophils.ConclusionsThe immune heterogeneity of NPMD according to the level of inflammatory markers was identified. 52% of patients with NPMD have a pronounced activation of inflammatory reactions accompanied by increased levels of aAb to neuroantigens.
Lying in psychiatry: A review
Authors: Valadas M.T. , Freitas R. Mota 
Published: February 2022

IntroductionLying can be defined as stating a deliberate falsehood with the intent to deceive. It is part of our everyday life but it can be pathological, without motivation and a symptom of psychiatric illness. Although pathological lying has been debated for a century, it remains a controversial issue in Psychiatry.ObjectivesWe aim to perform a review regarding pathological lying and related issues.MethodsWe performed an updated review in the PubMed database and GoogleScholar using the terms “pathological lying”, “compulsive lying”, “mythomania” and “pseudologia fantastica”. The included articles were selected by title and abstract. We also consulted reference textbooks.ResultsWe described the difference between normal and pathological lying and debated the different types of pathological lying, such as compulsive lying, mythomania and pseudologia fantastica.ConclusionsRecognizing lying is crucial for a skilled patient interview and distinguishing between pathological and non pathological lying may be decisive for an accurate differential diagnosis.
Visual hallucinations in parkinson’s disease: Experience from a portuguese level 3 hospital
Authors: Quarenta J. , Teixeira T. , Martins S. 
Published: February 2022

IntroductionParkinson’s disease is a neurodegenerative pathology characterized by motor and non-motor symptoms. Hallucinations, especially visual ones, are frequent in this context, with an estimated prevalence of 16 to 40% and associated with a less favorable prognosis. These hallucinations can range from coarse formations to well-defined structures.ObjectivesTo assess the prevalence of visual hallucionations in a sample of patients diagnosed with Parkinson’s Disease.MethodsA cross-sectional descriptive study conducted in a Neurology Department of a Level III portuguese hospital. The sample included patients with Parkinson’s Disease observed in an outpatient Neurology appointment between October 1 and December 9, 2019.ResultsIn the period considered, 100 patients with Parkinson’s disease were observed, 65% male, with an average age of 69 years. In 11% of the patients visual hallucinations were reported, of which about half were well defined. All of them had no previous history of visual hallucinations and were under dopaminergic medication.ConclusionsThe results show an inferior prevalence when comparing to the literature, albeit still frequent. Therapeutic adequacy has a well recognised impact at a functional level and prognosis. Therefore we stress the importance of a regular follow-up of these patients, recommending a rigorous and comprehensive clinical review.
From mid-career professor to chairperson: What remains similar what is different?
Authors: Falkai P. 
Published: February 2022

For a Mid-career Professor in Germany, there are defined clinical and teaching responsibilities. One can focus either on one’s research or on clinical work and teaching. When tasks are becoming more demanding or significant overarching decisions need to be taken, there is always a chairperson to be asked or to help delegate tasks. As chairperson, one is mostly independent from other persons except for the dean of the medical faculty. One is however, at least in Germany, the chairpersons fully responsible for keeping up teaching, patient care, research as well as running the department. The Chairperson is measured by the achievements of these four tasks. It need special attention to keep up a balanced time schedule to cover clinical care, research, teaching and departmental management. A good chairs means working together with your staff on long-term goals, developing the department fruitfully and trying to fulfil these goals.DisclosureNo significant relationships.
Clozapine-associated eosinophilia with multiple systemic involvement - case report and review of literature
Authors: Orlović I. , Sugnet T. , Peco M. , Zatezalo V. Golubić , Karlica H. , Karlović D. 
Published: February 2022

IntroductionDue to its mood-stabilizing properties, clozapine is known for reducing symptom severity in manic episodes of treatment-resistant bipolar disorder as well as in treatment-resistant schizophrenia. However, its use may be hindered by potential adverse effects, including hematologic ones, such as non-dose-dependent eosinophilia. The mechanism of the underlying process probably involves a type-I hypersensitivity reaction, which can manifest as either transient asymptomatic eosinophilia or as eosinophilia with multiorgan dysfunction.ObjectivesWe present the case of a patient diagnosed with manic episode of schizoaffective disorder who developed eosinophilia, with severe systemic manifestations, in response to clozapine therapy. A review of literature will be conducted in order to provide further insight into the phenomenon.MethodsCase report and literature review.ResultsThe incidence of eosinophilia reported in literature ranges between 0.2% and 62%, with its appearance about three weeks after clozapine initiation. Although clozapine is an antipsychotic that normally requires frequent monitoring due to the potential side effect of agranulocytosis, we would like to place emphasis on the possible risk of eosinophilia, in connection with potential fatal complications. As described in this report, eosinophilia could long remain unrecognized due to subsequent multiorgan involvement, including lymphadenopathy, leukocytosis, lymphopenia, anemia, liver enzyme elevations, as well as pleural effusion, all of which were described in our patient.ConclusionsClozapine-associated eosinophilia may be used as an early marker of possible clozapine-induced systemic complications and it may warrant prompt discontinuation of the causing drug, as suggested by the literature.
Benzodiazepines prescribing in anxiety : Between practice and guidelines
Authors: Lagha M. , Ouali U. , Nacef F. 
Published: February 2022

IntroductionBenzodiazepines (BZD) are psychotropic drugs prescribed in psychiatry for their anxiolytic, hypnotic and sedative properties. Several guidelines aimed to limit the chronic use of BZDs. However, BZDs prescribing that does not comply with international recommendations remains widespread, estimated in France at 30% for anxiolytic BZDs.ObjectivesThe aims of our study were to evaluate BZDs prescribing practices in the treatment of anxiety and to assess their compliance with international recommendations.MethodsThis is a cross-sectional study conducted through a Google-forms self-administered questionnaire,intended for psychiatrists and psychiatric residents, over a period of two months, from April 1 to May 31, 2019.ResultsOne hundred physicians practicing in psychiatry answered our questionnaire. The response rate was 28%. The most prescribed BZD for anxiolytic purposes was Prazepam (76.2%). Clonazepam was prescribed for anxiolytic purposes in 10.5% of cases. Of the 105 participants, 48 indicated that they prescribed BZDs for anxiolytic purposes in states of acute stress (45.7%), 28.6% prescribed them for the treatment of mild to moderate anxiety manifestations in anxiety disorders. For the treatment of anxiety without panic attacks, 20% indicated that they prefer a short half-life BZD, 80% a long half-life BZD. The maximum duration of BZDs prescription for anxiolytic purposes was 12 weeks (62%), and 6 months in 10% of cases.ConclusionsBZDs are often prescribed in psychiatry for their anxiolytic property, sometimes in a way that does not comply with the recommendations of good practice, with regard to the prescribed molecules, their indications and the duration and modalities of prescription.
The way forward: Insights and suggestions from an early career psychiatrist
Authors: Pinto Da Costa M. 
Published: February 2022

People with psychosis are commonly socially isolated, both due to their condition, and the stigma towards them. Remote volunteering over smart-phone can be a way to overcome social isolation and physical distance, promoting social inclusion. This talk will present the qualitative findings from a feasibility study – the Phone Pal – which connected in the United Kingdom patients with psychosis with community volunteers, to communicate with each other for up to 12 weeks via smart-phone (through texts, WhatsApp messages, e-mails, audio or video calls). Participants described at the end of the study their experiences of communicating with their match over the smart-phone in terms of frequency, duration and timing of communication, their communication method, content and style, and the changes of communication over time. Several participants reported a positive impact of being connected with someone, meeting a new person, feeling supported and feeling better, and a few described challenges, such as disappointment, guilt and burden. These interview findings show that some matches were able to develop a positive and friendly relationship, and were willing to continue to be in contact with each other beyond the study duration. It is hoped that this talk will generate a lively discussion, gathering further understanding about the potential benefits and challenges of remote volunteering over smart-phone for patients and volunteers, and its potential usefulness in the current pandemic times.DisclosureNo significant relationships.
Vns as alternative treatment for maintenance ect in a patient with treatment resistant depression - a case study
Authors: Migchels C. , Sienaert P. 
Published: February 2022

IntroductionVagus Nerve Stimulation (VNS) is a neuromodulatory intervention which involves attaching an electrode to the vagus nerve. Studies investigating VNS as an acute treatment method for treatment resistent depression have shown very limited results, however there are data suggesting that VNS might have a beneficial effect on a longer term. There are also studies that suggest that a history of response to ECT might indicate a higher response rate to VNS. VNS was suggested as treatment for a patient who received maintenance ECT for treatment resistant unipolar depression during 9 years. 3 months after VNS was implanted, ECT was stopped due to the Covid-19 pandemic. In this case study we will review the patient’s response to treatment with VNS and the sudden stop of long-term ECT treatment.ObjectivesTo review the response to acute and maintenance ECT and VNS in this patient diagnosed with treatment resistant unipolar depression, and to compare this to the data suggesting VNS as an alternative treatment method for maintenance ECT in patients with treatment resistant depression.MethodsUsing the extensive data collected during the patient’s treatment, we will review the clinical response and side-effect burden of this patient to acute and maintenance ECT and to VNS.ResultsThe patient showed a vast improvement in depressive symptoms a few months after start of VNS treatment, while long-term maintenance ECT was stopped.ConclusionsThis patient’s response to VNS supports the data suggesting VNS as an alternative treatment method for maintenance ECT in patients with treatment resistant depression.Conflict of interestThis patient received VNS treatment as part of a study conducted in our centre (UPC KULeuven) with support of Livanova. Me nor my supervisor (prof. Sienaert Pascal) are directly involved in this study. I have received no financial or other compensation fr
Predictors of response to electroconvulsive therapy and its importance in the treatment of patients with obsessive-compulsive disorder
Authors: Correia J. Martins , Vaz Soares M.I. Fonseca Marinho , Ramos S. Freitas , Jesus B. , E Sousa D. Cruz , Caetano S. 
Published: February 2022

IntroductionElectroconvulsive therapy (ECT) presents itself as a highly effective therapeutic approach in various psychiatric conditions, especially affective disorders and catatonia. Although obsessive-compulsive disorder (OCD) is not an established indication for ECT, there are several positive results that have been replicated, giving us an account of its potential applicability.ObjectivesTo emphasize the importance of defining predictors of response to ECT in OCD.MethodsThe authors’ clinical experience is combined with the review of clinical cases, available in the literature, related to the application of ECT in OCD.ResultsPersonal or family history of affective pathology and obsessions of sexual content were identified as potential predictors of response to ECT in patients with obsessive and compulsive symptoms.ConclusionsAlthough preliminary and based solely on case reports, the replicability of results should promote special attention to situations in which OCD is marked by particular characteristics that favor the response to ECT. In this way, it would be possible to prevent the dragged consumption of health resources and minimize the expected chronicity associated with this clinical condition.
Electroconvulsive therapy in the psychiatric depatement of the Mahdia EPS over two years
Authors: Brahim S. , Bouali W. , Henia M. , Abid A. , Chabbouh M. , Zarrouk L. 
Published: February 2022

IntroductionThe electroconvulsive therapy is an ancient therapeutic technique used in the traitment of certain psychiatric diseases.Objectivesdiscuss the technical aspects, indications, therapeutic response and tolerance of ECTMethodsThis was a descriptive retrospective study that interested all patients who were hospitalized in the psychiatric department of the Mahdia University Hospital in 2017 and 2018 and were benefited from ECT sessionsResultsThe number of patients who received ECT was 34, representing 4.33% of patients, 25 men and 9 women with an average age of 39, the number of ECT sessions was 785. The major diagnosis was bipolar disorder in 47,1% of patients, followed by schizophrenia in 35,3% and major depressive disorder in 14,7 %. Resistance to treatment and major suicidal risk were the main indications. All sessions were performed in a bilateral temporal mode. the initial energy delivered varied between 50 and 101 millicoulombs. The duration of the crise obtained was predominantly between 21 and 30 seconds. The average number of sessions during the attack phase was 13.88, whereas it was 2.5 sessions during the consolidation phase. The mean scores of the psychometric evaluations showed a marked improvement, especially in the mania scores (65.89%) and the beck depression inventory (63.55%). Only four incidents were reported in all patients. Only five patients (14,7%) had side effects and the most marked effect was anterograde amnesia.ConclusionsMental health programs in Tunisia should promote the generalization of this method throughout the Tunisian territory, given the efficacy demonstrated in mood disorder, several psychoses and other psychiatric pathologie.
Emotional experiences reported by psychologists attending patients with suicidal crises in a service in northeastern Brazil: A qualitative study
Authors: Turato E. , Guerra L. , Oliveira C.A. , Gondinho B. , Leme P.A. 
Published: February 2022

IntroductionContextualization: Emotional experiences of psychologists related to the care of suicide crises are important since the health professional has been trained to save lives. It makes him apprehend the aggressive side of suicide and symbolize it as an attack. When the patient’s desire to liveceases, the professional may feel confused, since his/her profession/vocation was confronted.ObjectivesAIM: To explore and interpret the meanings of emotional experiences reported by psychologists who care for patients in suicide crises.MethodsStrategies: clinical-qualitative design, semi-directed interviews with open-ended questions in-depth. Six clinical psychologists from a Brazilian city participated, with a sample closed by information saturation. Interviews audio recorded, full transcribed and categorized by Qualitative Content Analysis. Results were peer-reviewed in meetings in a Qualitative Research Study Group.ResultsFindings: Three emerging categories - (1) Ambivalent emotions as challenges for clinical management, (2) The non-paralyzing experience of emotions, (3) The management that is learned in practice.ConclusionsConsiderations: assistance to patients with a suicidal crisis can generate ambivalent emotions, not always paralyzing. When recognized and elaborated can assist in clinical practice. It can be tools that will support qualified approaches, especially in relation to suicide. As a public health problem, it demands a combination collective actions with effective individual clinical approaches.