bluuebunny/crossref_metadata_2025_split huggingface dataset:
Catatonia induced by abrupt discontinuation of clozapine - case report
Authors: Oliveira C. , Caldas F. , Gonçalves M. 
Published: February 2022

IntroductionCatatonia is characterized by a bizarre and severe psychomotor change. According to DSM-5, the presence of three or more symptoms is necessary to affirm the diagnosis: stupor, catalepsy, brain flexibility, mutism, negativism, posturing, mannerisms, stereotypes, agitation not influenced by external stimuli, grimaces, echolalia or echopraxia. The association between first- and second-generation antipsychotics (AP) and the onset of catatonia is well established in the literature. In contrast, clozapine is one of the second-generation APs that is recognized for its effectiveness in treating catatonia, rather than inducing it. However, it has been documented that abrupt discontinuation of clozapine can induce rapid clinical deterioration with multiple presentations including: psychoses, cholinergic rebound states, serotonergic syndromes and catatonia.ObjectivesReview the literature on catatonia associated with abrupt interruption of clozapine. Describe a clinical case.MethodsObservation of the patient and consultation the clinical file. Non-systematic literature review on catatonia, clozapine, side effects associated with rapid discontinuation and respective treatment.Results34-year-old man, with the diagnosis of Schizoaffective Disorder. Admitted due to an acute decompensation with psychotic symptoms resistant to treatment requiring the introduction of clozapine. In the absence of a clinical response, clozapine was suspended, with the consequent appearance of catatonia resistant to benzodiazepines in high doses.ConclusionsIts already well established that the abrupt discontinuation of clozapine can trigger catatonia. This clinical case and literature review suits to emphasize the importance of educating psychiatrists on the adverse effects of psychiatric drugs and, in this case, the cautious discontinuation of clozapine in order to avoid its rebound effects.
Quality of life in patients with schizophrenia
Authors: Hentati S. , Abdallah M. Ben , Daoud M. , Bouhamed M. , Baati I. , Sallemi R. , Feki I. , Masmoudi J. 
Published: February 2022

IntroductionSchizophrenia, with its high prevalence, chronic progression and social impact, is a major challenge for health professionals. For this reason it is important to assess the impact of this disease on these patients, mainly on their quality of life.ObjectivesTo study the quality of life in patients with schizophrenia and determine the factors correlated with it.MethodsA cross-sectional, descriptive and analytical study of 28 patients with schizophrenia followed up at the psychiatric consultation in Hédi Chaker University Hospital of Sfax. Data collection was performed using a sheet exploring socio-demographic and clinical data. We used the Quality of Life Scale (Q-LES-Q-SF).ResultsThe average age of our patients was 40.61±6.27 years. The sex ratio (M/F) was1.15. The socioeconomic level was low in 71.4%. The average number of relapses was 3.04±1.4. Follow-up and compliance were good in 28.6% of cases. The average number of hospitalizations was 3.04±1.4. The average of quality of life in patients with schizophrenia was 21±5.74. The quality of life was affected with age (p=0.023), with the high number of relapses and with a higher number of hospitalizations in psychiatric hospital (p=0.008). Quality of life was improved with regular follow-up and good adherence to the treatment (p=0.000).ConclusionsThe quality of life in mental disorders was impaired mainly in schizophrenics, hence the need to evaluate in a codified way the quality of life of our patients in order to raise awareness among general practitioners as well as psychiatrists to improve the therapeutic and social care of patients.
First-rank symptoms: Past, present and future
Authors: Jorge B. , Fernandes C. Pedro , Mangas M. Duarte , Carvalho J. 
Published: February 2022

IntroductionConceptualising Schneider’s first-rank symptoms (FRS) as a diagnostic test whose performance can be measured in terms of sensitivity and specificity involves some issues that require reflection. The first formal proposal was contained in a 1939 monograph Schneider wrote, but little is known of their prehistory. In recent years there has been renewed interest in their clinical value.ObjectivesThis work aims to review the the diagnostic the evolution and diagnostic accuracy of FRS.MethodsA non-systematic review was performed, searching Pubmed/MEDLINE for articles using the keywords “schizophrenia” and “first rank symptoms”.ResultsFrom the beginning of Western descriptive psychopathology in the early 19th century, symptoms have been observed later described as first-rank by Schneider. When FRS are conceived as simple clinical indicators at a low level of inference, the results of the meta-analytic estimate of their diagnostic accuracy can be considered as a valid appraisal of their performance and usefulness. However, when FRS are conceptualised from a psychopathological perspective as strange and incomprehensible experiences that cannot be reduced merely to their propositional content and require substantial expertise and skill to be properly evaluated, the meta-analytic estimates can hardly be seen as a valid evaluation of their diagnostic significance, considering that some FRS are extremely difficult to assess properly.ConclusionsThe descriptions of these symptoms present substantial temporal and geographical continuity, over two centuries and in many countries. There is contradictory information concerning the validity of FRS as a clinical indicator. Phenomenologically informed studies are needed to address this research gap.
The effects of the age of male early life circumcision on sexual functions later in life
Authors: Esen E.C. , Özer S. , Yıldırım Ö. , Hasırcı E. , Şah C. , Şahin B. , Duran B. , Çınar Ö. , Cihan A. , Kazaz İ. , Gül Ü. , Deliktaş H. , Kızılkan Y. , Altınkol A. , Kurt H. , Tosun Ç. , Güdeloğlu A. , Üre İ. , Tutuş A. , Alkış O. , Bozkurt O. , Turunç T. , Akkuş K. 
Published: February 2022

IntroductionAccording to psychoanalytic theory performing circumcision on a boy in phallic phase may aggravate this fear and cause sexual dysfunctions later in life. However this hypothesis is an unverified common-view rather than a scientifically proven conclusion.ObjectivesWe hypothesized that being circumcised during phallic phase is not a risk factor for sexual dysfunction. We also took a peak at how the experience of circumcision is being perceived and its psychological effects. Our secondary hypothesis was, sexual dysfunctions are more frequent among men who had a traumatic circumcision experience.MethodsFor this cross-sectional study, a total of 2768 sexually active, circumcised and voluntary men were recruited from 20 different urology outpatient clinics around Turkey.ResultsThere was no significant difference for PEDT and IIEF scores between participants who were circumcised at different ages (Graph-1,2). When participants were divided into 3 groups according to their circumcision age in accordance with psychoanalytic theory (before, after and during phallic phase) mean IIEF and PEDT scores did not differ. PEDT scores did not differ either by which emotion the participant describe their experience of circumcision or how vividly he remembered it. However participants who remembered their circumcision experience more vividly and had who describe their circumcision experience with fear/anxiety had a higher IIEF score (Graph-3).ConclusionsThe age of circumcision does not affect the risk of PE. This is one of the very few studies that challenges psychoanalytic theory with a scientific method. Remembering the circumcision experience with fear or anxiety did not increase the risk of sexual dysfunctions.
Sexual assault in the mahdia region : Epidemiological peculiarities of victims
Authors: Brahim S. , Mosrati M.A. , Bouali W. , Kacem M. , Sellami S. , Abid A. , Frej S. Ben , Henia M. , Chabbouh M. , Zarrouk L. 
Published: February 2022

IntroductionWomen around the world are still victims of violence and discrimination in many areas. In Tunisia, discrimination against women remains a reality, and they are often more vulnerable to violence, especially sexual violence, compared to men.ObjectivesTo describe the epidemiological characteristics of victims of sexual assault in the Mahdia region in TunisiaMethodsThis is a descriptive and retrospective study of 110 sexual assault cases examined at the legal medecin department of Mahdia University Hospital between January 2016 and August 2018.ResultsThe majority of victims were female (80 %). All genders, 77% were under the age of 25 years old. The median age of the men was 11.5 years. The median age of women was 18. The urban origin was more common (55.5%). Only 8.1% were married compared to 87.4% single. Only 2.7% said they were divorced and only one woman was a widow. 41.8% of the sample said they were still in school and almost 29,1% of the cases were out of work. 3.6% reported a history of sexual assault. The sexual act was the same in all situations. The perpetrator was unique in 73.6% of cases, male (100%), known to his victim (57%) or even a member of the family circle (14%). Sexual assault by penetration was mostly reported (51%), and it was almost exclusively penile(98.2%).ConclusionsSexual violence remains under-reported. The statistical data do not allow to know the phenomenon of its whole, because the majority of acts remain unknown, due to the absence of complaints or medical consultations.
Effect of childhood trauma on patients with schizophrenia
Authors: Ouali R. , Sellami R. , Cheffi N. , Elleuch S. , Cherif F. , Masmoudi R. , Masmoudi J. 
Published: February 2022

IntroductionRecent research shows that exposure to trauma, such as child abuse, may result in a heightened risk of developing schizophrenia and worsening of positive symptoms in schizophrenic patient.ObjectivesThe objective of this study was to examine the relation between childhood abuse and psychotic symptoms in patients with schizophrenia.MethodsParticipants were outpatients of Hedi chaker University Hospital Center in sfax, Tunisia, recruited between January and July of 2019, diagnosed with schizophrenia or schizoaffective disorder. The Childhood Trauma Questionnaire (CTQ-SF), the Positive and Negative Syndrome Scale (PANSS) were administered in this study to evaluate respectively childhood trauma and psychotic symptomsResults44 patients were included in this study with an average age 39,81 ±9,7. The rate of emotional abuse was 15.9%, physical abuse 31.8%, sexual abuse 15.8%, emotional neglect 6.8% and physical neglect 18.2%. PANS positive score (r=0,59 ; p< 10-3 ), PANS negative score (r=0,55 ; p< 10-3 ) and PANS psychopathology score(r =0,45, p<0,002) were higher in patients who had a history of childhood trauma in comparison with those who did not report experiencing this.ConclusionsThis study confirms that a history of Childhood trauma may have a serious impact in patients with schizophrenia.
Persistant genital arousal disorder and venlafaxine: A case report
Authors: Marguilho M. , Gonçalves M. , Pereira I. , Marinho G. , Nobre A. 
Published: February 2022

IntroductionIn this presentation we describe the case of a woman referred to the Sexology Department after having developed symptoms of Persistent Genital Arousal (PGAD) for the last 5 years, during treatment for Depression with Venlafaxine. PGAD is a clinical entity first described in 2001 by Leiblum and Nathan. Despite having received more attention in the last few years, its etiology remains unclear, with numerous causal factors of different natures being suggested.ObjectivesWe aim to describe this clinical case of PGAD and to discuss the possible etiological factors involved as well as to make a brief revision of the literature on this topic.MethodsWe conducted a detailed interview, focused on the nature of the complaints, psychological history, medications, diet and neurologic disorders and performed a thorough clinical examination. We also searched for relevant articles in medical databases such as PubMed and Google Scholar.ResultsA 52 year-old woman previously treated for Depression with Venlafaxine complains of involuntary sensations of genital arousal, with perceived vasocongestion, tingling and pulsatlity during her journey to work in public transportations. The symptoms subsided only after getting home 8-10 hours later and reaching orgasm by masturbating. She stopped Venlafaxine in 2015, but these symptoms persisted. Some authors suggest a link between SSRIs/SNRIs and PGAD.ConclusionsPGAD is a relatively recent addition to our diagnostic catalog with increasingly more cases being reported in the last few years. It is likely that the condition, however, has no discrete etiology and that a customized approach will be necessary to successfully treat most patients.
Sexual function assessment in men with PTSD
Authors: Maalej R. , Hamdi G. , Felfel D. , Ammar H. Ben , Maamri A. , Kissi Y. El , Zalila H. 
Published: February 2022

IntroductionExposure to extreme traumatic events can lead to post-traumatic stress disorder (PTSD). This disorder affects emotional, social and professional functioning. Recent studies suggest that it can lead to sexual dysfunction.ObjectivesThe aim of this study is to compare the level of sexual dysfunction between men with PTSD and control subjects.MethodsA total of 30 male PTSD patients and 30 controls were included in this study. We used the Post-Traumatic Stress Disorder Check Scale (PCLS) to assess the intensity of PTSD symptoms and the International Erectile Function Index (IIEF15) to assess sexual dysfunction of both patients and controls.ResultsThe mean IIEF-15 score was 51.16 ± 6.82 in patients followed for PTSD versus 77.33 ± 2.02 in healthy controls with a non-significant difference (p = 0.26). Three patients (10%) had an alteration of desire while the control reported only dysfunction but there was no significant difference between the mean scores of IIEF-SD (p = 0.22). No patient or control had erectile dysfunction and there was no significant difference between the IIEF-EF sub-scores in the 2 groups (p = 0.20). The mean sexual intercourse satisfaction (SD) score in the patients was 5.13 ± 1.10 versus 8.86 ± 0.40 with a non-significant difference (p = 0.09). Altered satisfaction with intercourse was noted in 15% (n = 5) of subjects with PTSD versus a single control.ConclusionsIt is important that practitioners address the subject of sexuality in patients followed for PTSD and refer their patients, if necessary, to a sexology consultation.
Perinatal depression as a risk-factor for infant sleep disturbances: Subjective data from a case-control study
Authors: O. P. M. Caccialupi , Pucci C. , Colaiori M. , Giacchetti N. , Aceti F. , Sogos C. 
Published: February 2022

IntroductionPerinatal period is characterized by a broad range of physical, psychological and relational changes. Maternal perinatal depression (PD) is defined as an episode of major depression with the onset from pregnancy to the first year after delivery. Depressive symptoms influence the earlier mother-child interaction and impact on child cognitive, affective and behavioral development.ObjectivesPurpose of our study was to evaluate the consequences of PD on sleep-wake patterns in the early stages of infant development. We aim to investigate the presence of poor sleep in infants/ toddlers and also to identify differences in sleep ecology variables.MethodsWe enrolled, from December 2019 to September 2020, a clinical sample of children born from women with PD (N=19, m.a.=13,7, SD= 7,6) and a healthy control group (N=21, m.a.=15,5, SD=5,43). Infant sleep data were obtained from the Brief Infant Sleep Questionnaire (BISQ). Poor sleepers were defined by the following criteria: >3 night wakings, nocturnal wakefulness >1 hr or total sleep duration <9 hr. Maternal depression was assessed with clinical and psychometric evaluation. T-test was used for comparison between the two samples.ResultsStatistical analysis indicates that there were not significant differences between the two groups concerning night wakings (p= .678), nocturnal wakefulness (p= .815), total sleep duration (p= .209) and nocturnal sleep onset time (p= .475).ConclusionsOur findings suggest that PD is not a risk-factor in the onset of infant sleep problems. Probably negative parentig, affective disengagement, delegation in maternal care and sedative effects of pharmacotherapy may affect mother’s perception of her infant’s sleep.
Association between brain-derived neurotrophic factor and symptoms of insomnia and depression in inflammatory bowel disease (IBD) patients
Authors: Sochal M. , Bialasiewicz P. , Gabryelska A. , Fichna J. , Talar-Wojnarowska R. , Małecka-Panas E. 
Published: February 2022

IntroductionBrain-derived neurotrophic factor (BDNF) plays an important role in depression and sleep disorders. It influences the inflammatory process and may affect the interactions between psychological state and gastrointestinal symptoms.ObjectivesThe study aimed to compare BDNF concentrations in the group of Crohn’s disease (CD), ulcerative colitis (UC) patients, and healthy control (HC), as well as to correlate it with the severity of depression and insomnia.MethodsThe study included 94 inflammatory bowel disease patients (IBD, 57 CD, and 37 UC) and 26 HC. Each participant completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Athens insomnia scale (AIS), and Beck Depression Inventory (BDI). BDNF protein concertation measurements were performed using ELISA. Funding: National Science Centre, Poland-2018/31/N/NZ5/03715.ResultsCD patients had a higher serum level of BDNF (22.5 ng/mL, IQR:17.5-28.5) than UC patients (19.1 ng/mL, IQR:12.3-24.6; p=0.045). CD group had higher BDNF concentrations than HC (17.5 ng/mL, IQR:13.2-23.8; p=0.010), but no such differences were found between UC and HC groups (p=0.544). A positive correlation was found between AIS and BDNF among IBD (r=0.22, p=0.035). Additionally, patients, who obtained high BDI scores (>7 points) had lower BDNF concentrations than others (p=0.004). The patients with long sleep latency (>10 min) achieved a higher BDNF level than others (p=0.038). However. BDNF level did not correlate with PSQI results.ConclusionsBDNF serum level is increased in CD, but not in UC patients. Overall, the severity of insomnia symptoms correlates positively with BDNF levels. Future research should focus on the further explanation of those observations.
Alcohol addiction complicated with comorbid amnestic disorders: The search for innovative approaches to treatment
Authors: Sosin I. , Babenko Y. , Sergienko O. , Mysko G. , Honcharova O. , Lisova I. 
Published: February 2022

IntroductionAlcohol amnesia and palimpsests belong to understudied areas in addictology concerning the pathogenesis, risk factors, and development of effective integrated, targeted modalities of therapy, prevention, and after-treatment care.ObjectivesDevelopment of a new integrated, pathogenetically grounded approach to the emergency and routine therapy for immediate and long-term consequences of amnestic alcohol intoxication.MethodsModern complex clinical-psychopathological, pathopsychological, laboratory, electrophysiological, biochemical examination; method of analogues and prototype analytical examination.ResultsIntegrated anti-amnestic pharmacotherapeutic triad: Noobut IC (Phenibut) orally, before meals, for 6 days, twice a day: 250 mg in the morning, 500 mg at night, within days 7-14 250 mg twice: in the morning and at night; Vitaxon 2.0 ml daily, intramuscularly, No10 totally; ozone therapy for 10 days (ozone dissolved in olive oil, 6 mg/100 ml concentration), 5 ml orally 3 times a day. Complex therapy is concurrent with synergistic psychotherapeutic potentiation. Supportive anti-relapse prevention of alcohol-induced amnesia, palimpsests with Noobut IC: 1 tablet (250 mg) orally in the morning for 2 months. The pathogenetic support of the pharmacotherapeutic triad in treatment for alcohol addiction, comorbid with amnestic disorders, is pathogenetically focused on pharmacological properties of each component of the triad and their potentiating effects, involving most pathogenetic mechanisms of this disease.ConclusionsRelieving and prophylactic efficacy of the proposed pharmacological triad (Noobut, Vitaxon, ozone and concurrent psychotherapeutic potentiation) is proven by the statistical reliability method and illustrated by clinical examples of patient-specific research.
Psychopathology in adult transgender people
Authors: Castellini G. , Ristori J. , Steensma T. 
Published: February 2022

Transgender people represent a broad spectrum of individuals that transiently or persistently identify with a gender different from the one assigned at birth (APA, 2013). Transgender healthcare issues have become an increased matter of interest over the last years, as shown by the growth of publications on the subject and by the increase of referrals reported worldwide in all age groups. However, transgender people report encountering numerous obstacles in accessing and receiving appropriate health care with professionals being described as not properly trained on specific gender issues. Considering the diversity and complexity of the gender spectrum in the different age groups and in light of the recent changes in the formal psychiatric classification, mental health providers play a critical role in meeting the needs of gender non-conforming children, adolescents and adults, according to individualized paths. This course has the following aims: (1) learn the principles of assessment of gender incongruence in childhood, adolescence and adulthood; (2) address co-occurring psychopathology (if present); (3) identify different treatment paths according to age and individualized psychological and/or medical needs; (4) work in a multidisciplinary team in line with an integrated model.DisclosureNo significant relationships.
Substance use amongst adult patients admitted to an irish acute mental health unit
Authors: Duggan A. , Murray N. , Buckley S. , Lalevic G. 
Published: February 2022

IntroductionComorbid substance misuse in mental illness presents a significant challenge to mental health services. It may lead to higher rates of relapse, hospital admissions and poorer treatment outcomes. Up to 47% of inpatients in Irish mental health units may experience substance misuse. Despite the Irish government’s ‘Vision for Change’ policy (2006), access to specialised services remains variable.ObjectivesEvaluate: -prevalence of substance misuse at an Irish mental health unit. -quality and detail of the recorded substance misuse history. -access to specialised services for patients experiencing substance misuse.MethodsA retrospective chart review of inpatients in a mental health unit over 12 months, was completed. Information recorded included: demographic details, diagnosis, substance use history; access to substance misuse services. Microsoft Excel was utilised for data input and analysis.Results267 patients were admitted over twelve months. Substance misuse was the primary diagnosis of 6% and the secondary diagnosis of 67%. 46% of patients reported current substance misuse, 52% reported historical substance misuse. Frequency and quantity of use was documented in 65% and 48% of cases respectively. 4% of patients with a substance misuse history were in current contact with addiction services.ConclusionsAlthough 46% of patients reported substance misuse, only 4% were in contact with specialised addiction services. This highlights a significant unmet need. There was variability in the quality of the recorded substance misuse history. In order to fully understand comorbid substance misuse, this be addressed. The addition of a more formatted substance misuse section, to admission proformas, may help to alleviate this issue.