bluuebunny/crossref_metadata_2025_split huggingface dataset:
Translating theory into practice – dealing with pre- and post- menopausal women patients with schizophrenia
Authors: Semenova N. , Karpenko O. , Kazakovtsev B. , Krasnov V. 
Published: February 2022

IntroductionMuch has been written about psychosocial treatments (psychoeducation) in schizophrenia. However, for the psychiatric hospital as an organization wishing to create a service guided by an international wave of research there is a need for solutions which are practical and effective in addressing the gender issues and women patients’ needs.ObjectivesThis paper looks at and describes the process employed to develop a guidance document to enable the psychoeducation to provide information and to offer support to its women patients (pre- and post- menopausal age) in dealing with schizophrenia. Essential to this project was the understanding that the guidance would be easy to understand and practical whilst maintaining its strong foundation of research and good practice.MethodsWomen patient profile in a schizophrenia group hospitalized at the Moscow-based Psychiatric Hospital was analyzed.ResultsFemales of pre- and post- menopausal age actually outnumber males. Such women patients are unique in their needs and demands for health services. This is important subgroup, and some psychosocial interventions should be developed for them. Mental health professionals should be familiar with the unique health problems of these women, and the potential that psychoeducation have to increase their health awareness (information on menopause and aging, oestrogens and depression, on other somatic and psychological influences around menopause, on effects of physical activity etc.).ConclusionsThe implications of this guidance document to enable the psychoeducation for mental health promotion are discussed, in particular the gendered nature of perception of psychosocial treatments in schizophrenia.
Is apathy a true trans-diagnostic construct? preliminary findings of the european study on apathy in schizophrenia
Authors: Fernandez-Egea E. 
Published: February 2022

Apathy is a quantitive reduction of goal-directed activity either in behavioural, cognitive, emotional or social dimension in comparison to the person’s previous level of functioning in these areas. Apathy is prevalent across many neurodegenerative, neurological, and psychiatric disorders. It represents the most common behavioural and psychological symptom in people with Alzheimer’s Disease and is often observed in Parkinson’s disease, vascular dementia, stroke, traumatic brain injury, amyotrophic lateral sclerosis/motor neuron disease, frontotemporal dementia, progressive supranuclear palsy, major depression, and schizophrenia. However, the definition and terminology employed to refer to apathy can vary in the context of different conditions and specialities and the diagnostic criteria have evolved. Additionally, the term apathy is employed to describe both a symptom and a syndrome. Indeed, little progress has been achieved in assessing the validity of the same construct across different disorders (eg. neurodegenerative disorders, schizophrenia or affective disorders). In 2018, a new version of the diagnostic criteria for apathy (DCA) in neuropsychiatric disorders was published. The validity of this new consensus has yet to be assessed among all relevant populations, including schizophrenia. Six European centres (Naples, Geneve, Nice, Rennes, Barcelona, Cambridge) aimed to test the prevalence of apathy, measured with the 2018 DCA, in patients diagnosed with schizophrenia. As a second aim, we focused on the relationship between DCA and other measures of apathy and negative symptoms in schizophrenia (BNSS and PANSS). In this talk, we will compare the preliminary findings of this pan-European study in schizophrenia patients with previous studies on neurodegenerative disorders.DisclosureNo significant relationships.
Gender differences among psychiatric patients attended in a emergency department
Authors: Recio-Barbero M. , Santorcuato A. , Bacigalupe A. , López-Atanes M. , Fuertes-Soriano S. , Cabezas-Garduño J. , González-Briceño J.P. , Sáenz-Herrero M. 
Published: February 2022

IntroductionMental health disorders are considered a priority in health policies around the world. It is estimated that more than 900 million people worldwide have a mental disorder, in which stress-related disorders account for a high number of emergency department visits. The scientific literature has pointed out the importance of considering how gender and sex differences influence the clinical outcomes of people with mental illness, playing an important role in the clinical management of these patients.ObjectivesThe aim of this report is to investigate the presence of gender differences in the care of psychiatric patients attending the emergency department (ED), taking into account the clinical characteristics, reasons for consultation and practices.MethodsThe study considered all episodes of patients who visited the ED during 2017 and who were assessed by the psychiatric department. Statistical analyses were performed using IBM SPSS Statistic software.ResultsDuring the 12 months period, a total of 3180 episodes were evaluated by the psychiatric department in the ED. Of them, 1723 were female (54,2%) and 1457 male. Regarding clinical data, there were found statistically significant differences with respect to the pharmacological prescription in the ED, specifically in the prescription of benzodiazepines, psychiatric diagnoses after discharge and the indication of hospital admission between women and men.ConclusionsThis study emphasizes the importance of considering the existence of gender differences in both the clinical presentation as well as in the care of psychiatric patients attending the ED. The analysis of these variables would help to improve the health care of psychiatric patients.
Monitowapplication – an investigation of the usability during the first 18 months of commissioning in practice
Authors: Tarp K. , Holmberg T. , Møller A.M. , Lichtenstein M. 
Published: February 2022

IntroductionIn cognitive behavioral treatment of anxiety disorders, registration of emotions and behavior is an important part of the intervention. Normally, paper and pencil is used but registrations on a mobile application such as MONARCA may be a useful alternative.ObjectivesThis study investigates the usability of MONARCA during the first 18 months of commissioning in practice.MethodsTo explore the usability, semi-structured interviews were conducted with seven patients and three therapists, combined with data from a survey questionnaire where 10 patients and 12 therapists rated the usability of the app on the System Usability Scale. Participants were recruited from an outpatient clinic for affective disorders in The Mental Health Services in the Region of Southern Denmark.ResultsTechnical performance, time allocation, therapist effort, commitment, enthusiasm, and increased knowledge are imperative factors. Therapists and patients found that the benefits of registering emotions and behaviors on a mobile application were that it was easy for patients to remember to register daily, it was easy to gain an overview over symptom progress, and access to the registrations improved therapist’s ability to prepare sessions.ConclusionsOverall, the results from the interviews and survey indicated that both patients and therapists found MONARCA useful, but several improvement opportunities regarding application features and use in the treatment course were found.DisclosureNo significant relationships.
Did the effect of placebo increase in rcts of panic disorder across the years?
Authors: Segni F. Di , Zoppi T. , Forcina F. , Anibaldi G. , Bargagna P. , Telesforo C.L. , Montebovi F. , Callovini G. , Giuseppin G. , Janiri D. , Molinaro M. , Sani G. , Kotzalidis G.D. 
Published: February 2022

IntroductionThe curious effect of an increase of the placebo effect across year of publication has been shown for depression, schizophrenia, obsessive-compulsive disorder, as well as for some medical conditions like hypertension and pain.ObjectivesWe aimed to observe how randomised clinical trials with a placebo control behave at this respect in panic disorder trials.MethodsWe searched the PubMed database using the strategy: (panic disorder OR panic attack disorder) AND placebo, which on 3 November 2020 produced 779 records. Inclusion criteria were the above stated, excluded were all studies focusing on the same patients as others and those not providing intelligible data. In our selection we used the PRISMA statement and reached agreement with Delphi rounds.ResultsWe identified through other sources further 3 studies. The finally eligible studies were 82, excluded were 700 studies, mainly consisting of reviews (176), challenge studies (173), not dealing with panic disorder (67), studies with unsuitable designs to detect placebo effect (53), studies using same populations as others (36), those with misfocused outcomes (57), those lumping diagnoses and not allowing to separate data for panic disorder (22), and those not using placebo at all (21). Mean response to placebo in included panic disorder studies was 36.01±19.812, ranging from 0 to 76.19%; the correlation with year of publication was positive and significant (Pearson’s r= 0.246; p=0.026).ConclusionsThe effect of placebo in randomised control trials has increased across the years, but this field of research appears to be idle in recent years.DisclosureNo significant relationships.
The relationship between cognitive test anxiety and mindfulness among university students
Authors: Ünal-Aydın P. , Sevinç M. , Arslan Y. , Güçlü M. , Aydın O. 
Published: February 2022

IntroductionCognitive test anxiety is acknowledged as intense anxiety that prevents the effective use of the previously learned knowledge during the exam and leads to a decrease in success. Mindfulness is indicated as the ability to bring one’s attention to experiences in the present moment in a non-judgmental way. Despite promising outcomes of mindfulness techniques in regulating stress levels, much uncertainty still exists about the specific associations between cognitive test anxiety and mindfulness subcategories.ObjectivesThe aim of this study was to investigate the relationship between cognitive test anxiety and subcategories of mindfulness among university students which may help improving current mindfulness interventions that show promising results to tackle cognitive test anxiety.MethodsOne hundred-eighty-two university students were recruited for the study via online forms. Mindfulness was measured with Five Facet Mindfulness (FFMQ-S) and the cognitive test anxiety was assessed with Cognitive Test Anxiety Scale-Revised (CTAR).ResultsTotal scores of CTAR-R has an association between subscales of FFMQ; act-aware and non-judge in a positive direction, whereas; observe and describe in a negative direction. In addition, according to our regression model, FFMQ subscales of describing to indicated lower levels of CTAR scores, whereas act aware and non-judge indicated higher levels of CTAR scores.ConclusionsThe findings of the study partially corroborated the previous results by offering inferences about the subcategories of mindfulness. Additionally, these findings suggest that current interventions may target specific subcategories of mindfulness to maximize the positive outcomes of the treatment.DisclosureNo significant relationships.
Valproate induced encephalopathy: Paradigm of normal ammonia levels
Authors: Barbosa P. , Nombora O. , Monteiro J. , Ribeiro L. 
Published: February 2022

IntroductionValproic Acid (VPA) is one of the most commonly used mood stabilizer drugs. Although uncommon, serious adverse effects have been reported. One particularly relevant side effect is the induced encephalopathy, usually secondary to Hyperammonemia. However, some descriptions have shown an altered mental state with normal serum levels of ammonia.ObjectivesWe aim to present a case of VPA induced-encephalopathy without hyperammonemia and emphasize its suspicion when patients taking VPA present altered mental states.MethodsWe present a clinical case of VPA induced-encephalopathy without Hyperammonemia and a qualitative review of this topic using the Pubmed database.ResultsA 66-year-old woman, with an history of Major Depressive Disorder, previously medicated with Venlafaxine 75mg/day and Mirtazapine 30mg/day, was admitted in our acute psychiatric inpatient unit due to a first manic episode. During the stay, her antidepressants were interrupted, and she was started on VPA, then optimized to 750mg/day. After that, she presented an altered mental state with confusion and prostration. Analytical results were normal including normal ammonia levels and no imagiological abnormalities. Despite these results, we decided to stop VPA empirically. The patient clinical status resolved the day after.ConclusionsStudies have shown that only a few patients have developed encephalopathy with normal serum levels of ammonia. Although the pathogenesis behind this remains unknown, a few mechanisms have been proposed. Therefore, it is important to remind that even without abnormal analytical status, VPA is a possible cause of encephalopathy. We also emphasize the need for further studies on the mechanisms behind this phenomenon.DisclosureNo significant relationships.
Pontine hemorrhage as beginning of bipolar disorder or organic mania. A case report
Authors: Limeres P. Coucheiro , Soler A. Franco , Del Campo A. Cerame , Lega L. Amaya 
Published: February 2022

IntroductionPublished evidence describes the appearance of manic episodes in patients who suffer localized brain lesions with no prior psychiatric history.ObjectivesA case report is presented alongside a review of the relevant literature regarding the relationship between Bipolar disorder and strokes.MethodsWe present the case of a 54-year-old man who, after suffering a pontine hemorrhage, developed a depressive mood for which he was treated with Sertraline 50 mg. The following month the patient developed hypomanic mood, disinhibition, insomnia and megalomaniac ideation. He was treated with Risperidone 2 mg and the antidepressant was withdrawn. The symptomology disappeared shortly after but a few months later he developed a major depressive disorder (inhibition, ideas of ruin and guilt, low mood, decreased intake and daily activities…). He was treated again with antidepressants (Citalopram 30mg) and lithium was introduced in the absence of a total response.ResultsMania secondary to brain lesions has been observed in multiple studies, where an association is made mainly with lesions at the frontal, temporal, subcortical limbic brain areas and in lesions causing hypofunctionality on the right side. Most of the cases described occurred in male patients with no prior psychiatric record and with associated vascular risk.ConclusionsIt is important to carry out an exhaustive medical history to be able to identify the cases of secondary mania so as not to ignore the underlying neurological condition in the approach.DisclosureNo significant relationships.
A first manic episode in an elderly patient
Authors: Vázquez E. Rodríguez , Meseguer C. Capella , Valera G. Guerra , Ramírez A. Gonzaga , De Llano De La Viuda M. Queipo , Carrasco I. Santos , Cerejeira J. Gonçalves 
Published: February 2022

IntroductionThe bipolar disorder is characterized by instability mood. It normally happens in the middle-aged. In elderly patients with a first manic episode, you have to dismiss organic pathology.ObjectivesTo present an elderly patient with a first manic episodeMethodsA descriptive study of a clinical case and literature reviewResultsA 67-year-old man, married. Consulted Mental Health 5 years ago, about low mood after his early retirement. With no psychiatric treatment. Somatic antecedents: Acute myocardial infarction, hypertension and dyslipidemia. Came to the hospital accompanied by his son-in-law presenting rapid speech and thinking, bright clothing, risky behaviour, irritability, grandiosity deliration ideas and less sleep; being necessary a hospital admission. Blood and urine analysis: with no abnormalities. No toxics in the urine. Asenapine 20mg and Lorazepam 3mg were prescribed with clinical improvement. Brain CT: with no abnormalities. After that, Lithium 400mg per day was prescribed to avoid the induction of depression. Clinical judgement: manic episode. Bipolar disorder Type IConclusionsAfter dismissing somatic causes, the symptomatic treatment of a manic episode in older patients is on the same lines as the treatment for mania in young adults. 8-10% of psychiatric inpatients over age 55-60 years are diagnosed with bipolar disorder. Since there is an increase in the number of individuals living longer, an expected increase in the number of older adults who will be diagnosed with bipolar disorder. Older adults with bipolar disorder will increase in absolute numbers as well as the proportion of the general populations.DisclosureNo significant relationships.
To what extent do sexual hormones influence bipolar disorder?
Authors: Viegas F. Gonçalves , Ferreira F. , Figueiredo I. , Lourenço A. 
Published: February 2022

IntroductionIt is known that female reproductive events and hormonal treatments can impact the course of bipolar disorder (BD) in women, some of whom are more vulnerable to the development of mood instability under periods of hormonal fluctuation. The mechanisms involved are, however, largely unknown. The aim of this work is to review the impact of sexual hormones on the course of BD, regarding a clinical case.ObjectivesTo explore the role of sexual hormones in BD.MethodsLiterature review using Medline database.ResultsThis is a case of a 36-year-old woman with type 1 BD who develops a manic episode after starting oral contraception (OC). This episode remitted with suspension of the pill. Estrogen and progesterone are involved in various aspects of brain function, such as brain development, synaptic plasticity, and modulation of neurotransmitter systems. Studies indicate that there is a relationship between ovarian hormones and intracellular signaling systems involved in the pathophysiology of BD. However, research on OC use in patients with mood disorders is limited. Recent studies state that OC aren’t associated with a worse clinical course and don’t negatively influence BD, while other studies show there is a subgroup of bipolar women that improve with hormonal stability, while others get worse.ConclusionsFurther studies are needed to determine possible relationships between sexual hormones and BD, and it is essential to identify patients vulnerable to these risks by measuring baseline hormone levels, assessing hormone sensitivity through a history of mood changes during menstrual cycle and a history of previous mental health problems.DisclosureNo significant relationships.
Completed suicide in bipolar i patients after their first hospitalisation
Authors: Nieto E. , Palau A. , Alvarez P. , Russo C. 
Published: February 2022

IntroductionBipolar disorder is a mental disorder that has one of the greatest risk of completed suicide (CS)ObjectivesDetermine the rate and the risk factors of CS in a cohort of Bipolar I patients followed after their first hospitalizationMethodsWe choose all Bipolar I patients (DSM-IV) who were first time hospitalized in our Psychiatric unit between 1996 and 2016. We reviewed the charts of first hospitalization and recorded multiple baseline variables. In the follow-up we updated the database recording all patients who CS. We compared the different baseline variables between Bipolar patients who CS and the rest.ResultsOf a total of 254 bipolar I patients 9 (3,5%) CS in the mean of 13 years of follow up (rate 40 times higher than General Population). The average age at CS was 41.1 years (range between 26 and 71 years old) so there was a 9 years gap on average between the first psychiatric hospitalization and suicide. CS was characterized by a violent act (8 out of 9 cases, 89 %). When we compared BP patients who CS with the rest, only history of suicide in first-degree relatives was detected as a risk factor significantly associated (P<0.01) with CS. Conversely baseline treatment with anticonvulsants (mainly valproate) was detected as a significantly (P<0.004) protective factor of CS.Conclusions1-Bipolar I patients after first hospitalization completed suicide 40 times higher than general population almost always by violent method 2-History of CS in first-degree relatives is predictor of completed suicideDisclosureNo significant relationships.
Completed suicide in bipolar ii patients after their first hospitalization
Authors: Nieto E. , Palau A. , Russo C. , Alvarez P. 
Published: February 2022

IntroductionBipolar disorder, especially Bipolar II subtype, is a mental disorder that has one of the greatest risk of completed suicide (CS).ObjectivesDetermine the rate and the risk factors of CS in a cohort of Bipolar II patients followed after their first hospitalizationMethodsWe choose all Bipolar II patients (DSM-IV) who were hospitalized for first time in our Psychiatric unit between 1996 and 2016. We reviewed the charts of first hospitalization and recorded multiple baseline variables. In the follow-up we updated the database recording all patients who CS. We compared the different baseline variables between Bipolar II patients who CS and the restResultsOf a total of 59 bipolar II patients 6 (10 %) CS in the mean of 13 years of follow up (rate 120 times higher than General Population). The average age at CS was 45.3 years (range between 33 and 57 years old) so there was a 2 years gap on average between the first psychiatric hospitalization and suicide. CS was characterized by a violent act (5 out of 6 cases, 83 %). When we compared BP II patients who CS with the rest, only history of previous violent suicide attempt was detected as a risk factor significantly associated (P<0.04) with CS.ConclusionsBipolar II patients CS early after their first hospitalization and at very high rate (120 times than GP) almost always by violent method. History of previous violent suicide attempt is predictor of completed suicideDisclosureNo significant relationships.
Lithium intoxication and its implications, pertaining to a clinical case
Authors: Quintão A. , Simião H. 
Published: February 2022

IntroductionLithium is the most effective maintenance drug in Bipolar Disorder (BD), although it has a narrow therapeutic index, between 0.6 and 1.5 mEq/L; recommended doses for maintenance are 0.6-1.2 mEq/L.ObjectivesTo describe a clinical case of lithium intoxication and discuss relevant literature.MethodsClinical examination of a patient and her medical records; non-systematic PubMed review on “lithium intoxication”.ResultsA 73-year-old woman, diagnosed with BD, stabilized on lithium monotherapy for twenty-five years, was admitted to the Emergency Room (ER) with nausea, lethargy, drowsiness, confusion, cough, and fever. A respiratory tract infection is diagnosed, based on clinical presentation, x-ray and blood analysis. Blood tests also revealed a serum lithium concentration of 2.4 mEq/L and impairment of renal function, indicating lithium intoxication; hemodialysis was initiated, with lithium discontinuation. Over weeks, renal function and general state improved, and BD treatment was reinitiated, this time with valproic acid 800mg/day. Two weeks after discharge, she was admitted again at the ER, for an episode starting in the week prior, compatible with a manic episode; olanzapine 10mg was added to the prescription. A week after, the patient is admitted again in the ER, still in a manic episode.ConclusionsThere are no clear indications in the literature about reinitiating lithium on someone who had an intoxication. Given that lithium brings an unparalelled quality of life to BD patients, careful consideration about reintroduction, with close monitoring, should be made, but there is a critical need of more studies and guidelines to orient clinical practice.DisclosureNo significant relationships.