bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clozapine and urinary incontinence
Authors: Osca Oliver A. , Palomo Monge M. , Tascón Guerra M.F. , Pérez Fominaya M. , López Rodrigo M.V. 
Published: September 2022

IntroductionClozapine is an atypical antipsychotic, which has been shown to have superior efficacy in the remission of positive and negative symptoms in patients with treatment-resistant schizophrenia, compared to other antipsychotics. However, its benefits have been limited by the lethal adverse effects that this drug can cause, the most common, agranulocytosis. Other less serious and more common adverse effects are sedation, hypersalivation, hypo and hypertension, weight gain and urinary incontinence. It is estimated that approximately 1% of patients treated with Clozapine suffer from urinary incontinence. Data that varies from 0.3% to 42% in the articles reviewed, being undervalued in some of these for many reasons; it is stigmatizing and the patient is ashamed to express it.ObjectivesThe objective of this study is to assess the percentage of urinary incontinence in patients in treatment with clozapine, taking into account the presence or absence of this side effect as the main variable, and the diagnosis, gender and dose of clozapine as secondary variables.MethodsA retrospective observational study was carried out in which 40 patients belonging to the Adult Mental Health area of the Nuestra Señora del Prado Hospital, were collected, all of them diagnosed with some type of psychotic disorder and undergoing treatment with Clozapine.ResultsOf the total of patients studied, 25% presented urinary incontinence as an adverse effect, and of these, 60% were with doses equal to or greater than 400 mg of Clozapine.ConclusionsWe must be careful and bear this side effect in mind in all patients taking Clozapine.DisclosureNo significant relationships.
Molecular diagnosis of cytogenetic abnormalities in patients with schizophrenia
Authors: Bar Shai M. , Peleg A. , Zalozhin T. 
Published: September 2022

IntroductionSchizophrenia is a severe and chronic disorder causing significant disability and functional decline. Schizophrenia is a polygenic disease, with about 100 monogenic sites and 11 sites of chromosomal deletions / duplications involved in its pathogenesis identified. It is a pleiotropic disease, with causative genetic changes leading to multiple symptoms, including bipolar disorder, autism spectrum disorders, ADHD, mental retardation and epilepsy. The chromosomal microarray (CMA) technology detects submicroscopic chromosomal changes, which are involved in neurodevelopmental disorders, and are subject to prenatal diagnosis. Pathological findings in CMA are detected in 10-20% of patients with neurodevelopmental disorders and can contribute significantly to medical follow-up, prognosis assessment, influence treatment choice, and allow prenatal diagnosis. Preliminary studies in schizophrenia identified pathological CMA findings in 10–30% of patients.ObjectivesCMA testing of schizophrenia patients to detect genetic changes causing the disease.MethodsRecruitment of schizophrenia patients from the Haifa and Western Galilee districts of Clalit, genetic counseling in Carmel Hospital, CMA testing of the consenting patients.ResultsSchizophrenia patients with and without neurodevelopmental disorders underwent CMA analysis, with the findings of significant chromosomal submicroscopic disorders (such as 22q11 microdeletion, among others) in 30% of the patients, providing the explanation for the patients’ symptoms and enabling specific medical follow-up and adjusted pharmacological treatment.ConclusionsCMA can be used in diagnosing schizophrenia, assessing prognosis, adjusting pharmacological treatment and follow-up and providing genetic counseling including prenatal diagnosis, as in cases neurodevelopmental disorders. The findings support the application of CMA as part of a routine procedures in schizophrenia.DisclosureNo significant relationships.
Radiation-associated cerebroophtalmic effects
Authors: Loganovsky K. , Fedirko P. , Marazziti D. , Loganovskaja T. , Kuts K. , Perchuk I. , Babenko T. , Antypchuk K. , Kreinis G. 
Published: September 2022

IntroductionWe proposed to consider the brain and eye as a target of ionizing radiation exposure. Prevention of potential radiation-associated cerebroophtalmic effects are crucial for successful long-term space missions; interventional radiology; medical, occupational and accidental irradiationObjectivesDetermination of radiation-associated cerebroophtalmic effects in the long term after irradiation in adulthood and in utero.MethodsNeuropsychiatric, ophtalmological, neurophysiological and neuropsychological assessment of irradiated in adulthood (57 Chernobyl accident clean-up workers, liquidators), 52 persons exposed in utero as a result of the Chernobyl accident, comparison group (51 combatants of the Antiterrorist operation in Donbass), and 53 healthy people.ResultsRadiation-associated cerebroophthalmic pathology is characterized by high neuropsychiatric and ophthalmic comorbidity, which increases in proportion to the radiation dose, and is mainly represented by chronic vascular and degenerative diseases of the brain and retina, mild cognitive impairment (after irradiation in adulthood), as well as disorders of the autonomic nervous system; non-psychotic organic mental disorders; neurotic, stress-related and somatoform disorders; vascular and dystrophic processes in the retina (after in utero exposure). Characteristic of both radiological scenarios remains intellectual disharmony due to a decrease in the verbal IQ. The delay and attenuation of cerebral visual afferentation processing were observed in prenatally exposed.ConclusionsRadiation-associated cerebroophtalmic effects in the long term after irradiation in adulthood and in utero could be mainly classified as a “small vessel disease of the brain and eye” of vascular-degenerative nature and possible latent demyelination after irradiation in utero.DisclosureNo significant relationships.
Pathoplastic effects of metabolic disorders in severe mental illness
Authors: Fiorani M. , Orsolini L. , Volpe U. , Salvi V. 
Published: September 2022

IntroductionPatients with severe mental illness (SMI) have a higher risk of weight gain, dyslipidemia and insulin-resistance. It was observed that insulin resistance has a pathoplastic effect: in Schizophrenia it was associated with a greater severity of negative symptoms, whereas in Bipolar Disorder it was associated with more chronicity and rapid cycling. Moreover a correlation was observed between obesity and a worse outcome in Bipolar Disorder type I.ObjectivesWe aimed at assessing the influence of dysmetabolisms on clinical characteristics in patients with SMI.MethodsWe recruited 78 patients with SMI consecutively hospitalized in the Psychiatry Clinic of the Ospedali Riuniti of Ancona, Italy. We administered a checklist for socio-demographic and clinical features (diagnosis, age of onset, illness duration, number of episodes, number of episodes per year, suicidal attempts and comorbidities), and evaluated the following metabolic parameters: weight, height, BMI, abdominal circumference, blood pressure, total cholesterol, HDL, triglycerides, glycemia and insulinemia. We determined insulin-resistance according to the HOMA-IR model. We performed bivariate Pearson correlations to compare metabolic and socio-demographic/clinical parameters.ResultsThe analyses showed positive correlations between BMI and disease duration (P = 0.003), and BMI and the number of episodes (P = 0.022). Furthermore, a positive correlation was found between HOMA-IR and the number of episodes per year (P = 0.008). The associations remained statistically significant after controlling for age through partial correlations.ConclusionsWeight gain and insulin-resistance in severe mental illness are associated with a more severe SMI, as suggested by the greater number of acute episodes.DisclosureNo significant relationships.
Pseudobulbar affect as an early manifestation of HIV-related toxoplasmosis
Authors: Arbelo N. , Ilzarbe L. , Gascón González M. , Llach C. , Pintor L. 
Published: September 2022

IntroductionPseudobulbar affect (PBA) is an emotional disorder characterized by uncontrollable outbursts of laughing and/or crying. It is caused by lesions that damage pathways in the frontal lobe and descending to the brain stem, basis pontis and cerebellum. The main causes are neurodegenerative diseases.ObjectivesTo present a case of PBA secondary to cerebral toxoplasmosis.MethodsThe present study is a case report of a patient admitted for HIV-related toxoplasmosis to our hospital. We also researched previous case reports of PBA secondary to CNS infection using a pubmed query.ResultsMr. JA is a 38-year-old male, with no prior psychiatric or medical history. He reported having had same-sex sexual encounters previously. He was admitted for ataxia and dysarthria in a medical unit, and diagnosed of HIV infection, with a CD4 count of 19 cells/μL. The MRI showed a lesion of 22x19x18mm with ring enhancement predominantly in basis pontis, compatible with toxoplasmosis(Image1). Treatment with sulfadiazine, pyrimethamine and dexamethasone was initiated. After five days of hospitalization he was referred to Consultation-Liaison Psychiatry for involuntary and uncontrollable outbursts of laughing and crying, insomnia, but no other psychopathological symptoms. Therefore, citalopram 20mg per day was started, with reduction on the frequency of outbursts.ConclusionsThe clinical presentation suggested the diagnosis of PBA due to cerebral toxoplasmosis. Although we found no previous reports of PBA related to HIV infection or toxoplasmosis, the location of the toxoplasmosis lesion is congruent with the typical damaged pathways in PBA. To our knowledge, this is the first report about PBA secondary to HIV-related toxoplasmosis.DisclosureNo significant relationships.
Refractory obsessive-compulsive disorder: a challenging treatment
Authors: Ramos A.L. , Salgado H. 
Published: September 2022

IntroductionObsessive-compulsive disorder (OCD) is a chronic and impairing condition included in the DSM-5 Obsessive-Compulsive Spectrum Disorders. Despite psychopharmacological and psychotherapeutic measures, there are patients who remain refractory to different therapeutic strategies.ObjectivesThe authors aim to present different alternatives in approach, treatment and management of refractory OCD, based on a review of the existing literature.MethodsAnalysis of the data about this subject, considering the review articles and the case reports published at current time and highlighting the most essential topics, concerning the latest developments in the area.ResultsTherapeutic options are presented, including transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation (DBS) and ablative neurosurgery.ConclusionsThe treatment of OCD represents a great challenge in clinical practice. Despite the advances accomplished by a more extensive knowledge of the disease and a burden of new techniques in the last decades, more treatment strategies are needed, especially for patients with non-response to conventional treatment.DisclosureNo significant relationships.
Prediction of Treatment Response in Patients with Major Depressive Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Studies
Authors: Torres M. , Manghera P. , Miller C. 
Published: September 2022

IntroductionIdentifying the optimal treatment for individuals with major depressive disorder (MDD) is often a long and complicated process. Functional magnetic resonance imaging (fMRI) studies have been used to help predict and explain differences in treatment response among individuals with MDD.ObjectivesWe conducted a comprehensive meta-analysis of treatment prediction studies utilizing fMRI in patients with MDD to provide evidence that neural activity can be used to predict response to antidepressant treatment.MethodsA multi-level kernel density analysis was applied to these primary fMRI studies, in which we analyzed brain activation patterns of depressed patients (N= 364) before receiving antidepressant treatment.ResultsThe results of this analysis demonstrated that hyperactivity in six brain regions significantly predicted treatment response in patients with MDD: the right anterior cingulate, right cuneus, left fusiform gyrus, left middle frontal gyrus, right cingulate gyrus, and left superior frontal gyrus.ConclusionsThis study provides evidence that neural activity, as measured by standard fMRI paradigms, can be used to successfully predict response to antidepressant treatment. This may be used in the future clinically to improve decision-making processes and treatment outcomes for patients.DisclosureNo significant relationships.
Effects of a brief psychodynamic intervention on depressive patients. The “unfreezing” of psychic activity
Authors: Haliday H. , Reynaud M. , Lignier B. 
Published: September 2022

IntroductionWhile psychotherapy is an essential aspect of the treatment of depression, there are few studies focusing on the effectiveness of psychoanalytic and psychodynamic group therapies for depressed patients.ObjectivesIn this presentation, we will study the effects of a brief, 4-session psychodynamic intervention (BPI) led by a group of therapists, as inspired by the Lausanne model.MethodsThe patients were recruited in a therapeutic setting. A free consent form was completed and the ethics of research explained to each participant. Our sample consisted of 32 patients (average age = 43.81 years, sex ratio: 1M/ 4F). The therapists gathered data by completing several assessment scales after each therapy session: MADRS, ESM, EFP, HAQ-IT, EDICODE, Counter-Transfer Scale. The SPPS software (V21) was used to analyze the data.ResultsThe patients’ mean MADRS score dropped by more than 11 after the four sessions. This improvement matches a more positive and committed self-reported counter-transference of the therapists towards the patients. As their insight increases, patients show greater behavioral and psychic activity. We name this exit of the depressive inhibition the “unfreezing” process. It enables more satisfactory human interactions and a more focused and structured self-narrative.ConclusionsBPI led by a group of therapists seem to be an effective therapeutic adjuvant in the “unfreezing” of the psychic processes in depressive patients. Our results point out the importance of jointly aiming at symptomatic improvement and therapeutic alliance.DisclosureNo significant relationships.
The Importance of Cognitive Appraisal and Social Support in Pregnancy During COVID-19 from an Interdisciplinary View
Authors: Howard M. 
Published: September 2022

Aim: To describe how a US-based psychiatric Mother-Baby Unit adopted a virtual platform during the pandemic. Objectives: When the Covid-19 pandemic descended, mental health clinicians world-wide were faced with maintaining access and care delivery. Pregnant and newly postpartum women experienced the pandemic and lockdown through the lens of impending parenthood and new parenthood--amplifying distress, isolation, and lack of social and family support. The lockdown prevented those with most acute illness from accessing daily treatment in our structured, supportive intensive treatment setting. We acknowledged the urgency of developing a method to continue to treat our patients in a group environment that offered psychotherapy, psychopharmacology, dyadic and family intervention, and social support. Methods: The hospital purchased “Zoom for Health” platform to ensure compliance with regulatory guidelines. Cameras for individual computers were purchased with philanthropy funds, obtaining them quickly, compared to waiting for hospital funding. The clinical team designed a schedule of groups and individual sessions, each with their own zoom link. Each morning, a team member, sent the daily schedule through the patient portal of the EMR. Conclusion: Before the pandemic, the census was 12 pts per day. The full-day program paused for 7-10 days although individual sessions and medication management were conducted by phone as the virtual platform was constructed. Once established, census resumed normal levels. Challenges to running the Day Hospital virtually included: technology glitches, family demands and distractions, and privacy concerns. Overall, the program was a success wherein women requiring intensive treatment were able to receive treatment and social support.DisclosureNo significant relationships.
Antidepressants in epilepsy
Authors: Gutiérrez Rodríguez M.M. , Corral Y Alonso M.D.L.A. , Moreno Menguiano C. , Garcia Sánchez F. , Vazquez Vazquez J.J. , Bañón González S.M. 
Published: September 2022

IntroductionDepressive disorders are one of the most frequent psychiatric comorbidity in epilepsy and they have a negative impact on the quality of life. Depression often requires antidepressant treatment. However, it is often left untreated in people with epilepsy, in part due to fear that antidepressants could cause seizures.ObjectivesThe goal of this study was to do a review and describe the evidence of the efficacy and safety of pharmacological treatment for depression in epilepsy.MethodsReview of literature sources were obtained through electronic search in PubMed database with special focus in papers published in the last 5 years.ResultsThe existing evidence of the effectiveness of antidepressants in treating depressive symptoms associated with epilepsy is still limited and response rate was highly variable. It is essential first to optimize seizure control and minimize unwanted antiepileptic drug-related side effects. As the first line of treatment you should consider the use of SSRI or IRSN. The improvement in depressive symptoms ranged from 25% to 82% according to the different studies and depending on the antidepressant administered. A review of the literature indicates that the risk of antidepressant-associated seizures is low although some antidepressants such as amoxapine or bupropion are not recommended.ConclusionsThere are few comparative data to support the choice of antidepressant drug or drug class in terms of efficacy or safety for the treatment of people with epilepsy and depression. It would be important to design controlled trials of antidepressants in large cohorts of participants with epilepsy and clinically significant depression.DisclosureNo significant relationships.
Clinical stability after compassionate use of intranasal esketamine in treatment-resistant depression
Authors: Hernandez Huerta D. , De Santiago Diaz A. , Rodriguez Gomez-Carreño C. , Abril Garcia M.A. , Toledo Romero F. , Guerrero Morcillo A. , Martinez Pastor C.J. , Vega Piñero M. 
Published: September 2022

IntroductionThe compassionate use of intranasal esketamine is approved in Spain for treatment-resistant depression (TRD).ObjectivesThe objective of the study is to assess the clinical stability in the medium-term follow-up of patients with TRD after esketamine use.MethodsDescriptive, retrospective and multicenter study carried out in Spain. Patients with TRD who had received esketamine treatment, and for whom there were clinical data of subsequent evolution, were included. The scores on the MADRS and Hamilton scales were changed into scores on the CGI scale according to the studies by Leucht et al. The Student’s t test was performed to assess differences in the CGI.ResultsEleven patients were included: 72.7% were women and the mean age was 56 (SD: 12.9). The maximum dose of esketamine used was 84mg in 63.7%. The onset of antidepressant action was observed from the 1st dose in 72.6% of the patients. The mean time in treatment was 6.6 months (SD: 2.3) and 90.9% reached remission criteria. After 7.4 months (SD: 3.0) from the end of the treatment, 90.9% remained in remission and without visits to the emergency room or hospitalization for psychiatric reasons. The mean baseline score on the CGI-SI was 5.7 points, at the end of the treatment was 1.2 points and after longitudinal follow-up it was 1. Statistically significant differences were observed (p<0.001) both at the end of the treatment and in the post-esketamine follow-up compared with baseline score.ConclusionsIn our sample, the use of esketamine in TRD shows clinical stability in the medium-term follow-up.DisclosureDaniel Hernández has participated in medical meetings and/or received payment for presentations from Otsuka, Lundbeck, Janssen, Angelini, Casen Recordati, and Ferrer.
A review of brain stimulation and neuromodulation therapies as a treatment of depression as a behavioural and psychological symptom of vascular dementia
Authors: Tiwary T. , John D. , De Souza S. 
Published: September 2022

IntroductionVascular dementia (VaD) accounts for approximately 15% of all cases of dementia. While there are many different definitions of vascular dementia, it is generally understood to refer to “disease with a cognitive impairment resulting from cerebrovascular disease and ischaemic or haemorrhagic brain injury”. Research suggests that 30% of patients with VaD also suffer from depression. The treatment of depression in VaD with pharmacological therapy is relatively well-established, with the first line drug being a selective serotonin reuptake inhibitor (SSRI). However, a relatively under-researched area is the use of brain stimulation and neuromodulation therapies for the treatment of depression in VaD.ObjectivesThis review aims to provide a critical analysis on the efficacy and safety of brain stimulation therapies in treating depression in VaD to determine whether it is an appropriate treatment option.MethodsThe databases used were PubMed and WebofScience. The available literature was analysed which resulted in three papers which met the inclusion criteria and were critically appraised.ResultsIn all three studies, depressive symptoms improved after ECT was administered, regardless of the specific tool used to measure the severity of depression. The side effects experienced were also only temporary and resolved independently which speaks to the safety of ECT as a treatment option.ConclusionsThe results of the study prove that ECT is a safe and effective option in treating depression in VaD. However, more research is needed for the medical community to fully understand the different treatment options and say with certainty which is the safest and most effective.DisclosureNo significant relationships.
Eating Disorders in Pregnancy
Authors: Micali N. 
Published: September 2022

Eating Disorders are common psychiatric disorders, and their occurrence is not rare in pregnancy. The aim of this presentation will be to provide an overview of eating disorders in pregnancy. I will first cover prevalence and nature of eating disorders and their symptoms in pregnancy. I will present quantitative and qualitative data from my own research. I will then present research on the effects of eating disorders on pregnancy and obstetric outcomes. I will conclude discussing issues around identification of eating disorders in pregnancy; in particular research from my lab on gaps in identification, and how to improve identification of eating disorders in pregnancy.DisclosureNo significant relationships.