bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improve health care access is possible. A case report
Authors: Gori O. , Raggini R. , Sant’Angelo R. , Tricomi G. , De Paoli G. , Grittani S. , Piraccini G. 
Published: February 2022

IntroductionWithin the hub and spoke organizational model provided by the Emilia Romagna Region for assistance to people with autism spectrum disorder (ASD), Cesena ward of psychiatry represents the hospital Hub. Here, a dedicated team (doctors, psychologist, case manager) creates individualized pathways to ensure second-level specialist diagnostics and the management of comorbidities affecting subjects diagnosed with Autism Spectrum Disorder and Intellectual Disability (ID).ObjectivesWe report the case of a 23-year-old man, who from the age of 6 was opposed to any instrumental diagnostic investigation.MethodsIn order to guarantee the patient’s full collaboration in carrying out essential diagnostic activities, short behavioural paths were created including video modelling. The Vi.Co app was used and a new app was created to target behaviors that could not be included in Vi.CoResultsIt was thus possible to make the patient compliant with the execution of blood samples, ECG, MRI of the brain in sedation and CT dental scan.ConclusionsIn our case, communication support systems and behavioral strategies have proved to be excellent allies in significantly improving the quality of care for our young patient. Considering the worst prognosis of pathologies and the reduced life expectancy of subjects suffering from ASD and ID, known in the literature, in our opinion, the first essential step becomes facilitating access to care for these patients.DisclosureNo significant relationships.
The impact of new psychosocial stressors on the mental health of young people: Results from a national multicentric study in italy
Authors: Sampogna G. 
Published: February 2022

Abstract BodyThe COVID-19 pandemic with the related containment measures is having a negative impact on the mental health of the general population worldwide. This event has been described as a new form of trauma, which is influencing not only physical and mental health, but also the society as a whole. Among Western countries, Italy has been one of the first severely hit by the pandemic in terms of number of cases and mortality rates. In March, 2020, strictly restrictive measures has been issued in order to contain the spread of the disease. This period has been known as “Phase one” of the national health emergency, where all not necessary activities were closed, almost 30,000 people died and almost 100,000 people were home-isolated. In this context, the COvid Mental hEalth Trial (COMET) network, including ten university Italian sites and the National Institute of Health, has been established in order to promote a national online survey for assessing the impact of lockdown measures on the mental health of the Italian general population. In the COMET survey, it has been included a specific focus on young people, which are expected to be the most vulnerable to the consequences of the pandemic and of the strict containment measures. Findings from this study can be useful to inform national and international associations on the importance to provide adequate support to the mental health of the young people.DisclosureNo significant relationships.
Lurasidone treatment in a delusional disorder patient with atrial fibrillation: A case report
Authors: Marini S. , Matarazzo I. , Gentile A. 
Published: February 2022

IntroductionPsychosis itself may be associated with an increased risk of atrial fibrillation. Moreover, antipscyhotic treatment increases this risk. Recently D’Urso et al. reported aripiprazole-induced atrial fibrillation in a patient with concomitant risk factors.ObjectivesTo the best of author’s knowledge no data has been published about the safety and the efficacy of lurasidone treatment in psychotic patient with comorbid atrial fibrillation.MethodsA 68 years old patient with persistent atrial fibrillation and hypertension in treatment with amiodarone 100 mg/day, lurasidone 25 mg/day, rivaroxaban 15 mg/day, clopidogrel 75 mg/day, bisoprolol 1,25 mg/day, tamsulosin 0,4 mg/day presented delusional ideas of jealousy for not real betrayal by his wife, social withdrawal, reduced sleep. Blood pressure 130/80 mmHg, heart rate 70 bpm, Qtc 420 msec. The patient was drug-naïve for any psychotropic treatment. The authors decided to start lurasidone treatment at the dosage of 18,5 mg/day.ResultsAfter the first administration of lurasidone treatment sleep was resolved. After two weeks delusional ideas and social withdrawal were markedly improved. After one month of treatment, blood pressure, heart rate and Qtc remained almost stable. The authors decided not to increase the dosage of lurasidone because of the age of the patient and the comorbid cardiovascular pathologies.ConclusionsLurasidone has showed safety and efficacy in the treatment of this patient with delusional disorder and comorbid atrial fibrillation. This is a preliminary data that requires follow up and further studies to confirm the usefulness of lurasidone in psychotic patients with atrial fibrillation and cardiovascular risks.DisclosureNo significant relationships.
From kraepelin to the present. Dementia praecox – a case study
Authors: Basto M.D.R. , Lopes L. , Miguel A. , Certo A. , Venâncio Â. , Horta A. 
Published: February 2022

IntroductionIn the late XIXth century Kraepelin described a new nosologic division for the psycothic disorders – Paranoia and Dementia Praecox. He emphasized that dementia praecox is a central nervous system disease, involving permanent lesions on cerebral cortex. Besides biological deterioration, it appears as the result of psychic degenerative process. From the mid-20th century onward, antipsychotic drugs had been robustly generalized, and in parallel to the current classifications, residual symptoms in schizophrenia tend to be rare but still prevail in our patients.ObjectivesThe aim of our work is to report a clinical case of residual schizophrenia in parallel with the classic classification of Dementia Praecox and also do an overview of this disorder and its historical perspective.MethodsWe conducted clinical interviews with the patient and family members, reviewed clinical records and conducted a query in the MEDLINE database using the terms &quot; Dementia Praecox &quot;, “Psychosis”, “Paranoia”, “Kraepelin”, “History”.ResultsWe present the clinical case of a 74-year-old man with onset of psychotic symptoms on his twenties and diagnosed with Schizophrenia. In the past years, after acute psychotic episodes it was increasingly difficult to return to prior levels of functioning. Currently, he was brought to psychiatric emergency ward presenting bizarre behavior, stereotyped movements and speech disturbances, which reveal disorganized thinking and inability to express his emotions.ConclusionsAlthough these syndromes are nowadays relatively rare, it is important to keep them in mind, in order to understand the natural progression of psychotic diseases, improve their rehabilitative treatment and prognosis.DisclosureNo significant relationships.
When psychosis follows obsession – a schizo-obsessive disorder case report
Authors: Pereira F. , Martins P. , Barros J. 
Published: February 2022

IntroductionThe relation between obsessive-compulsive symptoms and psychosis presents in different ways. While obsessive-compulsive symptoms can present as prodromes of schizophrenia, or in overlap with psychotic phenomenology, a new clinical entity as been proposed as a subgroup of schizophrenia: the schizo-obsessive disorder.ObjectivesThe present review aims to emphasize the comorbility between schizophrenia and obsessive-compulsive disorder, bringing to light the importance of early detection and adequate treatment approaches.MethodsThe authors describe the patient’s disease progression and discuss the longitudinal dynamics between obsessive-compulsive disorder and schizophrenia, providing a brief and updated literature overview.ResultsThe illustrated case addresses a 31-year-old male patient diagnosed with obsessive-compulsive disorder at the age of 16, who later developed delusional ideation compatible with a schizophrenia diagnosis. At the onset of disease, the patient developed obsessive-compulsive symptoms such counting and repetitive hand-washing rituals that later turned into sexual obsessions concerning homossexuality. Following his 25th birthday, the patient became increasingly disorganized with frequent agressive outbursts toward his family and the obsessive egodystonic ideation turned into delusional egosyntonic ideation. Over the years, the patient shows intermittent obsessive-compulsive behavior while sustaining schizophrenia symptoms, particularly the negative symptoms.ConclusionsDespite the controversy associated with the recently proposed new subgroup of schizophrenia, the schizo-obsessive disorder, we believe the patient described fits the diagnosis. Clinicians managing patients of schizophrenia should evaluate the patients thoroughly for presence of comorbid obsessive-compulsive symptoms/disorder and must take the same into account while managing the patients.DisclosureNo significant relationships.
Cotard syndrome in a patient with multiple sclerosis: A case report
Authors: Vieira S. , Marinho G. 
Published: February 2022

Introduction“Cotard syndrome” is a rare condition characterized by a constellation of clinical features, including hypochondriac and nihilistic delusions, the most characteristic of which are the ideas that one is dead or that their organs do not exist. It is more commonly associated with psychotic depression and schizophrenia but can also be found in several neurological disorders. In the clinical practice it generally appears as an “incomplete Cotard”, reduced to hypochondriac delusions attributed to the malfunction or occlusion of the organs, usually the digestive tract and abdominal viscera. Consequently it is common for these patients to reject food or medications. In literature it has been divided into three types, according to the clinical symptoms: psychotic depression, Cotard type I, and Cotard type II.ObjectivesLiterature review on Cotard Syndrome and its link with Multiple Sclerosis, based on a clinical case.MethodsPubmed and Google Scholar search using the keywords Cotard Syndrome, Multiple Sclerosis.ResultsHereby we present a clinical case of a 53-year-old female patient, with multiple sclerosis, who presented with hypochondriac and nihilistic delusions and refusal of food and medication. The patient was treated with olanzapine with rapid remission of delusional activity.ConclusionsMultiple sclerosis is an immunemediated chronic disease, affecting predominantly the sensory and motor function. In addition, psychiatric comorbidity is very frequent with up to 50 % lifetime risk of depression. While various neurological disorders have been described in association with Cotard syndrome, its link with multiple sclerosis has been scarcely reported.DisclosureNo significant relationships.
Improving health care response to domestic violence
Authors: Dowrick A. 
Published: February 2022

Abstract Body1 in 4 women in Europe will experience domestic violence and abuse (DVA) in their lifetime. Abuse can take many forms, including, psychological, physical, sexual, financial, and emotional abuse. There is growing recognition of the health consequences of DVA in public policy and academic research across Europe and the globe. These include but are not limited to: a negative impact on mental health; increased substance misuse; increased presentation in emergency departments; increased rates of abortion or miscarriage; and increased presence of any sexual health problem. International and national policy guidance indicates that healthcare professionals have important roles in responding to patients experiencing DVA, usually with regard to identifying abuse and referring for specialist support. Barriers to engaging in DVA relate to lack of confidence in recognising abuse or initiating conversations about it, stigma surrounding DVA, fears of exacerbating violence, limited awareness of the resources available to support patients, and limited training in providing trauma-informed medical care. This session will give insight into efforts to improve the healthcare response to DVA. It will draw together examples of healthcare DVA programmes from across the globe and bring together lessons learnt about what works and what does not work in addressing DVA in clinical settings, with specific insights for professionals working in mental health services.DisclosureNo significant relationships.
What does static electricity has to do with schizophrenia?
Authors: Paraschakis A. 
Published: February 2022

IntroductionThe suspiciousness of a paranoid patient could reach extremes.ObjectivesTo present the lessons learned after an interview with a similar patient.MethodsCase report.ResultsFifty-two year old woman suffering from paranoid schizophrenia (F20.0). Symptoms almost identical to her previous (two) hospitalizations: delusions of thought reading and of being surveilled by electronic equipment in her house/neighborhood. This time, though, she was additionally convinced of being the object of medical experiments and of being electronically surveilled even within the ward. Treatment: risperidone 12mg/day, lorazepam 3.75mg/day, biperiden 2mg/day. Three weeks after admission, the author noted a slight tremor in her hands (most certainly of extrapyramidal origin). I asked her to place both hands in front of her, fingers wide open, to assess it better. The patient followed with the fingers attached, though. Consequently, I approached my hands to hers -to show how it should be done correctly-, touching them lightly. Then, a spark was generated between our hands. Evidently, it was an electrostatic discharge (I was wearing a wool sweater that day; static electricity could easily accumulate on wool). She became outraged: “what kind of experiments are you doing to me?”, “what electronic devices are you using?”, “this is the proof of what I have been constantly saying”.ConclusionsThe symptoms of psychotic relapses could evolve over time. A clinician should refrain from any strictly unnecessary physical contact with an exceedingly paranoid patient, particularly when the latter claims that is the object of “medical experiments”. The elaborative “ability” of such patients could be, simply, astounding.DisclosureNo significant relationships.
Achievement of remission after first-episode psychosis in youth
Authors: Kaleda V. , Tikhonov D. 
Published: February 2022

IntroductionDynamic assessment of remission achievement after first-episode psychosis (FEP) is necessary for early detection of post-psychotic depression, negative symptoms and changes in personality traits. The latter allows to decrease suicide risk and optimize treatment and social rehabilitation.ObjectivesWe aimed to analyze achievement of remission after FEP in youth and to define prognostic criteria for psychosis outcome.MethodsFifty-six patients (16-25 y.o., mean age 19,8 ±2,5 y.o.) after FEP have been receiving follow-up outpatient visits for 3 years. PANSS was applied to assess psychotic symptoms. Depressive symptoms were assessed with HAMD-21.ResultsRemission achievement after FEP is a three-stage process. The stage of reduction and modification of psychotic symptoms is characterized by diminishing personality deterioration and decrease of leading positive symptoms. The second stage, stabilization, is defined through the presence of depressive symptoms with positive (HAMD-21 17,49 ± 7,49) and negative affectivity (HAMD-21 23,68 ± 9,24) with preponderance of emotional, volitional, and cognitive deficits as well as high suicide risk. The third stage, reintegration, is characterized by the combination of negative symptoms with preserved personality resources. There are three reintegration trajectories, with predominant affective or negative symptoms or personality deficits. Mean decrease of PANSS scores was 54,88 ± 6,17 during the overall remission. In the majority of cases (62,5%) the stage of reintegration was finished with the achievement of high-quality remission, coinciding with international remission criteria. The study was supported by RFBR grant 18-013-01214ConclusionsOur approach to remission assessment allowed us to decrease suicide risk and to provide optimal treatment.DisclosureNo significant relationships.
Religious delusions in adolescence and young adults: Features of psychopathology and clinic
Authors: Kaleda V. , Popovich U. , Romanenko N. 
Published: February 2022

IntroductionReligious delusions is a complex psychopathological phenomenon. The delusional disorders with religious content in young age, the need for an additional detailed study of the conditions of their formation, patterns of the course and outcome of the disease determine the relevance of this study.ObjectivesTo identify the psychopathological features, the conditions of formation, the characteristics of the course of psychosis with religious delusions in young age.Methods95 patients (62 male and 33 female) with religious delusions (delusion of sin - 33,7%, delusion of demonic possession (40,0%), messianic and antagonistic delusion - 18,9%, oneiroid with religious content – 7,4 %) in psychotic episode (F20, F25 according to the ICD-10) at a young age (16-25 years) were included in the study and examined with clinical-psychopathological, clinical-follow-up and psychometric (PSP, SANS) methods. The average duration of follow-up was 7.4 ± 2.3 years.ResultsIn a post-psychotic period it is possible to preserve or form religiosity, as well as a complete reduction of the religious worldview in patients who had been indifferent to religious issues before the first episode of the disease. Though, the formation of residual psychotic symptoms with religious content were noted with greater frequency. The delusions of demon obsession in a psychosis episode is unfavorable prognostic factor.ConclusionsGeneral psychopathological features of psychotic states with religious delusions, according to the specificity of young age, were identified. A role of the previous religiosity, including overvalued religious ideas, was clarified.DisclosureNo significant relationships.
Factors associated with real-world functioning in first stages of schizophrenia disorder
Authors: Martínez-Cao C. , García-Fernández A. , Valtueña-García M. , García-Portilla M.P. , Bobes J. 
Published: February 2022

IntroductionSchizophrenia is one of the most disabling diseases affecting the patient’s ability to live independently, to be socially active and to work or study1,2. Therefore, identifying predictors of functioning in the first stages of the disease is important to prevent a negative progression of functional outcome in these patients3.ObjectivesTo identify the factors associated with real-world functioning in patients with recent onset of the disease.MethodsSecondary analysis of a cross-sectional, naturalistic study. 84 patients with Schizophrenia (F20), aged 18-71 in their first five years of the disorder under maintenance treatment. Assessments: PANSS, CDS, CGI-S, CAINS; functioning: PSP, cognition: MATRICS. Statistical analysis: student-t test, ANOVA, Pearson correlation and lineal regression.ResultsMean age (SD): 31.30 (10.08); men: 62.8%. Statistical significant differences (p<0.05) were found in work status, benzodiazepines and antidepressants use. Furthermore, significant correlations (p<0.05) were found with depressive, positive and negative symptoms (avolition, anhedonia, alogia and affective flattening) and cognition. A significant predictive model was obtained that explains the 72.1% of the variance [F(5,74)= 20.952; p< 0.001]. This model included depressive symptoms (B= -0.940; p= 0.001), negative symptoms (B= -1.696; p< 0.001), avolition and anhedonia (B= -0.643; p= 0.001), affective flattening and alogia (B= 1.197; p= 0.003), and visual learning (B= 0.202 p= 0.039).ConclusionsNegative and depressive symptoms are the main determinants of real-world functioning in patients with recent onset of schizophrenia. Visual learning also contributes to this outcome. On the other hand, the positive relationship between expressive domain and functioning needs furthermore investigation.DisclosureNo significant relationships.
Training as a psychiatrist during a pandemic
Authors: Migchels C. 
Published: February 2022

Abstract BodyTraining is a crucial time in any psychiatrist’s career. It’s a time when you are faced with new responsibilities and challenges, both professionally and personally, and senior and peer support are indispensable. The Covid-19 pandemic has had an impact on all the essential needs of trainees: supervision, theoretical training, clinical care and contact with both patients and colleagues have been put under pressure and are no longer the self-evident part of training that they were before. Trainees are facing an unprecedented balancing act between their duties as physicians, their training needs and their dedication to the often vulnerable patients under their care, all whilst dealing with the personal consequences of the pandemic and the restrictions that have been put in place. Based on the experiences of the European Federation of Psychiatric Trainees (EFPT) we will have a look into what has changed in the lives of trainee psychiatrists globally since the start of the pandemic, the difficulties that have occured and the lessons that have been learned. Examples of ways of dealing with the above mentioned challenges and opportunities for the future will be discussed.DisclosureNo significant relationships.
CT abnormalities in late-onset schizophrenia and schizoaffective disorder correlate with number of psychotic episodes and cognitive dysfunction
Authors: Savina M. , Bozhko O. , Savvateeva N. , Sheshenin V. , Pochueva V. , Cherkasov N. 
Published: February 2022

IntroductionLate-onset psychosis is associated with development of dementia. Search for neuroimaging signs in these patients is important.ObjectivesThis study aimed to assess CT abnormalities and their clinical correlations in late-onset psychosis.MethodsPatients with DSM-V diagnosis of late-onset schizophrenia (LOS, n= 43, age 65.2±9.4, 90% females) and schizoaffective disorder (LOSAP, n=9, age 64.9±5.8, 30% females) underwent CT and cognitive examination before discharge. Atrophy and ventricles enlargement were ranged from 0 (abs.) to 3 (sev.); vascular pathology - from 0 (abs.) to 2 (mult.). Patients were compared with 16 controls (age 58.1±10.8, 50% females). Nonparametric statistic was used.ResultsPatients had more severe frontal (χ2 19.7, р=0.003), temporal (χ2 10.7, р=0.097), parietal (χ2 21.7, р=0.001), cerebellar (χ2 14.8, р=0.005) atrophy and ventricles enlargement (χ2 15.6 р=0.016). 29 % of LOS and 44% of LOSAP patients had leukoaraiosis. All findings correlated with age. In patients ventricular enlargement correlated with number of psychotic episodes (r=0.338, р=0.014), lower MMSE (r=-0.314, p=0.045), immediate (r=-0.508, р=0.002) and delayed (r=-0.404, р=0.016) verbal recall. Temporal atrophy correlated with number of episodes (r=0.439, р=0.001), lower MMSE (r=-0.327, p=0.037) and immediate verbal recall (r=-0.339, p=0.046); cerebellum atrophy - with lower MMSE (r=-0.338, р=0.036) and FAB (r=-0.407, р=0.01); leukoaraiosis - with number of episodes (r=0.503, р=0.001), prolonged hospital stay (r=0.345, p=0.024); vascular pathology – with number of episodes (r=0.336, р=0.015), lower visual recall (r=-0.399, р=0.019), performance time in TMT-B (r=0.404, р=0.024).ConclusionsCorrelations between CT pathology, cognitive dysfunction and number of psychotic episodes may reflect progression of brain pathology due to psychosis.DisclosureNo significant relationships.