bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antipsychotics use in dementia: How safe are they?
Authors: Lopes C. 
Published: February 2022

IntroductionAntipsychotics are frequently used for managing psychiatric and behavioral symptoms of dementia. However, it’s an off-label resource which remains controversial due to significant safety concerns in the elderly population, namely increasing cardiovascular adverse effects.ObjectivesTo access antipsychotic safety and potential risks when used in dementia.MethodsA non-systematic review was carefully conducted on PubMed using the following keywords: “dementia”, “antipsychotics” and “safety.” We selected clinical trials, meta-analysis, randomized controlled trials published in the last 10 years.ResultsA total of 43 articles was obtained, of which 22 were excluded because they didn’t meet our inclusion criteria. Regarding atypical antipsychotics, one study found an incidence of severe events in 23,7% of patients and a OR=2.5 for cerebrovascular side effects. Quetiapine was suspended midway given it had a higher incidence of adverse effects compared to others. There weren’t any significant statistic differences concerning serious events between classes of antipsychotics(p<0,01). No study was found comparing typical and atypical antipsychotics safety in dementia.ConclusionsOverall, we can conclude that antipsychotics pose a risk of serious adverse effects when used in elderly patients, namely cerebrovascular events. Among atypical antipsychotics, quetiapine, used frequently for controlling neuropsychiatric symptoms in these patients appears a higher risk for severe adverse events compared with other drugs. Their use should be restricted after there aren’t any other options available. New protocols could be developed to control these symptoms, for example, environmental measures before resorting to antipsychotics.
Use of methylphenidate in alzheimer’s dementia: Effect on apathy
Authors: Borralho R. , Oliveira C. 
Published: February 2022

IntroductionAlzheimer’s Disease (AD) is associated with neuropsychiatric symptoms such as agitation depression and apathy. It has been proposed that the pathophysiology of apathy, that is defined as quantitative reduction in goal-directed activity compared with previous functioning, in AD is associated with degeneration of prefrontal cortex and dysfunction of dopamine and norepinephrine neurons in the brain. Methylphenidate (MPH) is a dopamine and norepinephrine reuptake inhibitor and its action increase the availability of these neurotransmitters in the extracellular space of striatum and prefrontal cortex. Over the past decade there has been an effort to study the benefit of the use of MPH for treatment of apathy in patients with Alzheimer’s dementia.ObjectivesStudy the benefit of methylphenidate in the treatment of apathy in AD.MethodsBasic literature review collecting data from PubMed (2010-2020) using the words “Methylphenidate”, “Apathy”, “Alzheimer”, “Dementia”.ResultsClinical trials using 10 to 20mg of MPH per day, for 6 weeks, demonstrated a mitigation in apathy symptoms in one third of patients, with good tolerability. Another clinical trial using the same dosage, for 12 weeks, led to improvement in cognition, functional status, depression and caregiver burden.ConclusionsNew clinical trials with larger groups of patients over a longer period are needed to consolidate the existing results. Although there are still many questions concerning the usefulness of methylphenidate in this population that need to be answered, methylphenidate might be an option to deal with one of the most prevalent neuropsychiatric symptoms, apathy, in some AD patients.
A preliminary study of stroke patients and attention: Exploring the role of spirituality and religiousness on cognition
Authors: Giannouli V. , Giannoulis K. 
Published: February 2022

IntroductionSpirituality and religiousness are not so far extensively investigated in patients after stroke.ObjectivesThe aim of this preliminary study is to explore whether self-reports in two questionnaires measuring the personal experience of spirituality and religiousness can influence cognition and more specifically performance on neuropsychological tests examining attention.MethodsFifteen male stroke patients participated voluntarily one year after their hospitalization. The mean age of the patients was 75.58 years (SD = 7.50, range 61-90), level of education 15.47 years (SD = 3.82). In addition to that, fifteen controls with similar demographics, free of physical and mental diseases, were also examined. Depressive symptoms of the participants were assessed with the 15-item Geriatric Depression Scale. The Daily Spiritual Experience Scale, the Systems of Belief Inventory (SBI-15R) and a number of standardized tests examining attention were administered: Trail Making Test-Part A (TMT-A) time to completion, the Digit Span (WAIS-III) greatest forward span, the Ruff 2 & 7 Selective Attention Test automatic detection speed (ADS) and controlled search speed (CSS).Resultsindicated that there was a statistically significant difference between the control group and the stroke group in attention. No statistically significant difference was found between the two groups regarding the levels of spirituality and religiousness.ConclusionsAlthough spirituality and religiousness may be related with quality of life, cognitive functioning such as attention does not seem to be influenced by these variables one year post-stroke. Future research should further investigate the possible influence of the abovementioned factors in post-stroke recovery and rehabilitation.
Pad, psychiatry and stigma
Authors: Kowalinski E. , Huber C. 
Published: February 2022

In 2018, the Swiss Academy of Medical Sciences (SAMW) published a new guideline on physician-assisted dying (PAD). In line with the SAMW guideline published in 2004, the patients’ ability to judge, their self-determination, careful consideration and permanence of their wish to die as well as the lack of therapeutic options were set as necessary conditions. However, while the previous wording considered assisted suicide to be ethically justifiable if the patient’s condition is terminal, the new guideline requires that it is unbearable. This difference has been the subject of intense discussion in Swiss healthcare professionals and the population alike. This controversy is particularly important for those affected by mental illness who have a persistent desire to die. This is because mental disorders cannot usually be classified as terminal illnesses, but they can certainly lead to suffering that is perceived as unbearable. Furthermore, it is known that persons with mental illness are subject to stigmatization. It is therefore likely that there is a connection between the stigmatization of mentally ill people and the position on PAD for this group. This talk provides theoretical background on this discusion and proposes a study protocol to investigate the acceptance of PAD in relation to the type of illness as well as the factors of unbearable suffering and terminality. It will furthermore look into the criteria of the 2004 and 2018 guidelines and will explore if there is a connection between stigmatization and the assessment of whether a person should be granted access to assisted suicide.DisclosureNo significant relationships.
The use of artificial intelligence and machine learning in the care of people with dementia: A literature review
Authors: Belam G. , Nilforooshan R. 
Published: February 2022

IntroductionArtificial intelligence and machine learning are increasingly being researched within the field of psychiatry to find out what use it might be. With this review, therefore, we would like to assess what literature, if any, exists that answers the question of whether this technology can be useful for providing dementia care. We also wanted to consider the ethical questions of autonomy, consent and privacy when working with this vulnerable group of patients.ObjectivesTo identify and appriase the literature to assess the existing research landscape of the area of machine learning and AI, relating to the care of people with dementia.MethodsA literature search was conducted, searching the PsychInfo, Medline, PubMed and Embase databases. We assessed the quality of the research and considered what overall findings there were in the existing literature.Results619 papers were identified, of which 28 related to the use of AI in the care of people with dementia. The papers were divided into categories to show the utility and effectiveness these technologies may have: 1: to alert caregivers to problems 2: to facilitate activities for people with dementia 3: to help plan care for people with dementia 4: to consider the ethical implications of the use of artificial intelligence and machine learningConclusionsDespite a paucity of literature in the area, existing studies show potential, if used well, for technologies to be a useful addition to care of people with dementia. The experience of patients and their carers must be integral to their development and use.
Pad in forensic psychiatry
Authors: Franke I. 
Published: February 2022

IntroductionA recent court decision in Germany defined assisted suicide as a basic human right. Consequently, the discussion regarding PAD needs to be extended to people who are in forensic/secure psychiatric hospitals or prisons, sometimes without any prospects of release. Several studies have shown that long-term hospitalization and detention are associated with feelings of hopelessness, depression and suicidal ideations. Moreover, the resources for adequate therapy are often rare. This results in complex moral challenges for mental health care.ObjectivesTo review current practices in countries that allow PAD and to discuss ethical conflicts.MethodsLiterature review; international comparison of current regulations.ResultsA majority of the literature on PAD in detention refers to prisoners with terminal medical conditions. Single case reports of PAD-requests of mentally disordered offenders aroused great public interest. The resulting ethical conflicts are similar to those issues regarding PAD and mental disorder in general. However, in secure treatment settings and detention additional aspects such as adverse living conditions and inadequate access to mental health care need to be taken into account.ConclusionsIf unbearable pain is not a precondition for assisted suicide, then mentally disordered and healthy offenders have a right to request PAD, provided they have medical decision-making capacity. Considering the common insufficient mental health care for people in detention, policy and law makers need to ensure that access to PAD will not replace therapy. Professionals involved in PAD evaluations need support by specific guidelines.DisclosureNo significant relationships.
Burnout and predisposing factors in medical oncology in tunisia
Authors: Daldoul A. , Khechin W. , Krir W. , Ezzairi F. , Kefi H. , Zaied S. , Ahmed S. Ben 
Published: February 2022

IntroductionHealth care professionals are particularly concerned with burnoutObjectivesThis study aimed to evaluate the the factors predisposing to occupational burnoutMethodsThis was a cross sectional study including health care professionals in medical oncology working in public hospitals in Tunisia. It was carried out from 15 January 2019 to 15 June 2019. Health profeessionals were asked to answer the Maslach –Burnout Inventory Test.ResultsThe mean age was 34 ± 6.7 years [23 - 57]. The sex ratio was 0.22. Our study population included 37 doctors (53%) and 33 nurses (47%). The inappropriate working conditions mentioned by the participants were as follows: The requirementss of patients and their families (91.5%), the lack of resources (87%), overwork found (83%), unsatisfactory effort- salary ratio (83%) and the reduced number of staff (77%). Several Burn-out factors mentioned by the participants were significantly associated with a high emotional exhaustion syndrome: overwork, poor service organization, lack of resources, lack of time, lack of recognition, conflicts with colleagues, lack of communication, unsatisfactory salary - effort ratio, assaults by patients. Several factors were positively and significantly associated with a high depersonalization score: overwork, poor service organization, small number of staff, lack of resources, lack of respect, lack of recognition. The global burnout associating the achievement of the three dimensions was significantly associated with overwork, lack of recognition, conflicts with colleagues and assault by patients.ConclusionsBurnout has become a major issue in Tunisian medicine. If left untreated, burnout epidemic may continue to worsen, to the detriment of patients and doctors
Maternal cancer and autism spectrum disorder: Analytical cross-sectional study
Authors: Daldoul A. , Moussa R. Ben , Krir W. , Bouslah S. , Kefi H. , Zaied S. , Gaddour N. 
Published: February 2022

IntroductionAutism spectrum disorder (ASD) and cancer are two pathologies that appear to be different, but whose multifactorial determinism involves shared genetic and environmental factors.ObjectivesThis study aimed to find an association between maternal cancer and ASD in children by comparing the frequencies of ASD between children of mothers followed for cancer and children of mothers free from cancerMethodsWe recruited, between March and August 2018, women divided into 2 groups: G1; women followed for cancer at the oncology consultation of Monastir and Sousse (N1 = 100) and G2; women free from cancer (N2 = 101). We screened their offspring aged 18 months to 11 years for ASD using the C-AQ and the M-CHAT. We confirmed the diagnosis of ASD using ADI-R in children who tested positive.ResultsNous avons examiné un total de 332 enfants. La fréquence des enfants atteints de TSA chez les mères G1 était de 5,4%, celle des enfants de mères G2 était de 1,2 avec une association significative entre cancer maternel et TSA (p = 0,035), qui est restée significative après analyse multivariée. (p = 0,001) D’autres facteurs que nous avons trouvés associés aux TSA dans notre population sont la présence d’une expérience stressante pendant la grossesse; exposition précoce avant l’âge de 2 ans à la télévision> 2 heures par jour; antécédents psychiatriques de la mère, du père et de la fratrie et dépression post-partum.ConclusionsLe cancer maternel et les TSA semblent partager des mécanismes étiopathogènes communs
Ethics of pad in mental disorders
Authors: Trachsel M. , Jox R. 
Published: February 2022

Involuntary psychiatric hospitalization for suicide prevention and physician assistance in dying (PAD) for patients with severe and persistent mental illness (SPMI) combine to create a moral tension. Switzerland has the longest history of non-medicalized assistance in dying, considered as a civil right even beyond pathological situations. The debate in Switzerland centers on the notion of suffering in the context of PAD. In 2018, the Swiss Academy of Medical Sciences revised their end-of-life policy stipulating intolerable suffering due to severe illness or functional limitations and acknowledged as such by the physician as a core criterion for PAD. However, we argue that suffering is a necessary but insufficient condition for PAD, the other criteria being decision-making capacity (DMC) and refractoriness of the suffering. Moreover, we hold that suffering is a subjective experience that can only be quantified by the patient and cannot be compared between two persons in an objective way. According to this concept, however, some patients with SPMI, refractory suffering, and preserved DMC will meet the criteria for PAD. Therefore, we call for palliative care approaches in psychiatry which includes relief of suffering as much as possible, but also accepting PAD after a conscientious assessment of the criteria.DisclosureNo significant relationships.
Current pharmacological treatment of fibromyalgia- a literature review
Authors: Vasiliu O. 
Published: February 2022

IntroductionFibromyalgia is a chronic condition, with a high degree of psychiatric comorbidity and an insufficiently explained pathogenesis. Therefore, its therapeutic management is challenging, with both pharmacological and non-pharmacological approaches being suggested as treatment options.ObjectivesTo analyze the current level of evidence in favour of pharmacological treatment for fibromyalgia.MethodsA literature review was performed through the main medical databases using the search paradigm “fibromyalgia” AND “pharmacological therapy” OR “antidepressants” OR “moodstabilizers” OR “anxiolytics”. All papers published between January 2000 and August 2020 were included in the primary analysis.ResultsA gradually increasing interest for the treatment of fibromyalgia has been observed in the last decade, and the number of clinical trials for this indications has almost doubled in this period, when compared to the previous decade. Pregabalin, duloxetine, and milnacipran are the most supported by evidence pharmacological treatments for fibromyalgia, especially for the pain component. Amitriptyline, gabapentin, cyclobenzaprine, and tramadol have also been studied in various clinical trials, but tehre are less evidence to support their use. Cognitive dysfunctions, sleep disorders, and mood disturbances benefit from far less investigation in clinical trials, therefore no clear recommendation can be made regarding the superiority of an agent over another.ConclusionsThe pain component of fibromyalgia benefits from treatment with pregabalin, duloxetine, and milnacipran, while the affective component and the cognitive dimension still need more research from the psychopharmacological perspective.
Therapeutic approaches in chronic fatigue syndrome
Authors: Vasiliu O. 
Published: February 2022

IntroductionChronic fatigue syndrome (CFS) is a complex condition, with an insufficiently known pathophysiology, that raises multiple challenges to the treating physicians. Due to its yet mostly unknown underlying mechanisms, there is no consensus treatment recommendation for CFS. The risk to associate major depression, anxiety disorders or substance use disorders is frequently reported, and this co-morbidity further complicates the evolution of CFS.ObjectivesTo search the existing literature for pharmacological and psychotherapeutic recommendations in CFS.MethodsA literature search was performed using the main electronic databases using the paradigm „chronic fatigue syndrome” AND „psychopharmacological treatment” OR „psychotherapy”. All papers published between January 2000 and August 2020 were included in the primary analysis.ResultsAnti-inflamatory drugs (corticosteroids and non-steroidal drugs), antidepressants, moodstabilizers, anxiolytics, immuno-modulatory drugs, and antivirals have been investigated for CFS, but the trials had low-quality designs, used various definition of CFS, and different criteria for monitoring the efficacy of treatment. Cognitive behavioral therapy (CBT) may be promising for decreasing the fatigue severity, but larger trials are needed. Graded exercise therapy (GET) also may be of some use for improving patients ability to engage in activities, but caution should be in order because of the risk of over-exercising that may exacerbate the core CFS symptoms.ConclusionsLarger trials are needed in order to validate pharmacological and psychotherapeutic recommendations for CFS. No drug may be considered first line treatment for this indication, while CBT and GET may be useful, although they do not address all the central symptoms of CFS.
Can interoceptive attentiveness modulate the brain correlates of observation of pain in others? A fnirs study
Authors: Angioletti L. , Balconi M. 
Published: February 2022

IntroductionEmpathizing with others’ pain appears to recruit the whole pain matrix, including a collection of frontal regions involved in the affective, motivational, cognitive, and attentional dimension of pain.ObjectivesThis research explored how the modulation of interoceptive attentiveness (IA) can influence the frontal (dorsolateral prefrontal cortex -DLPFC- and somatosensory cortices) activity related to the emotional regulation and sensory response of observing pain in others.Methods22 healthy participants were required to observe face versus hand, painful/non-painful stimuli in an individual versus social condition while brain hemodynamic response (oxygenated [O2Hb] and deoxygenated hemoglobin [HHb] components) was measured by functional Near-Infrared Spectroscopy (fNIRS). The sample was divided into experimental (EXP) and control (CNT) groups and the EXP group was explicitly required to focus on its interoceptive correlates while observing the stimuli.ResultsIn the individual condition, higher brain responsiveness was detected for painful confronted to non-painful stimuli, and a left/right hemispheric lateralization was found for the individual and social condition, respectively. Besides, both groups showed higher DLPFC activation for face stimuli displayed in the individual condition compared to hand stimuli in the social condition. However, face stimuli activation prevailed for the EXP group, suggesting the direct interoceptive phenomenon has certain features, namely it manifests itself in the individual condition and for pain stimuli.ConclusionsWe can conclude that IA modulation promoted the recruitment of internal adaptive regulatory strategies engaging both DLPFC and somatosensory regions towards emotionally relevant stimuli (painful faces displayed in the individual condition). Therefore IA could be trained for promoting emotion regulation and empathic response.
Pilot study testing the emotional response to physical exercise following a negative emotional induction in adults with borderline personality disorder
Authors: St-Amour S. , Cailhol L. , Bernard P. 
Published: February 2022

IntroductionPhysical exercise is a well-documented treatment for individuals with mental disorder. It helps improve symptoms and functioning of these individuals. Moreover, recent studies indicated that exercise improve emotional regulation which is one of the main target in borderline personality disorder (BPD) treatment. Therefore, exercise might have important benefits in this population. However, no previous study examined this effect.ObjectivesThis pilot study documents the facceptability of a protocol testing the effects of exercise on the response to a negative emotion in adults with BPD.Methods28 adults with a diagnosis of BPD have been recruited in a psychiatric hospital. Participants filled several questionnaires then viewed a scene from Silence of the Lambs to induce negative emotions. They were then assigned to 20 minutes of exercise or a neutral video of 20 minutes. Affects were assessed 7 times during the protocol.ResultsIn this sample, 9 participants reported at least equal levels of affect after the induction than before. Preliminary results show a tendency of higher response of physical exercise than control on positive affects and no participant had any adverse effect from exercise.ConclusionsThis pilot study was the first to test the effects of exercise on symptoms of BPD. It also informs on the best way to conduct the principal study. First, the mood induction was poor, thus it will be changed for a stronger induction strategy. Then, the control intervention will be a placebo exercise. These modifications will enable a better understanding of the effects of exercise on emotion regulation with BPD population.