bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personality disorder not otherwise specified heterogeneity and its implication in psychiatric residential treatment
Authors: Bailo L. , Vimercati P. , Caslini M. , Damiano S. , Pellegrini E. 
Published: February 2022

IntroductionVilla Ratti is a therapeutic community dedicated to the treatment of Personality Disorder with a particular focus on Borderline Personality Disorder (BPD), but this diagnosis may manifest in very different clinical conditions (Bayer & Parker, 2017; Scott, 2017).Objectives
Since the second most common diagnosis we encounter from referring psychiatrists is Personality Disorder Not Otherwise Specified (PDNOS) (26,4%) and this diagnosis serves sometimes as a skeleton key for complex or unclear diagnostic scenarios (Verheul & Widiger, 2004), our main goal is to investigate how the variability within this category is reflected in terms of diagnostic accuracy, different development of the therapeutic and rehabilitative course, and of different outcomes at the end of the treatment.MethodsTo reach this goal, we collected data on all patients referred with a PDNOS diagnosis and compared their treatment program. scenarios.ResultsOur data showed how a PDNOS diagnosis hid in most cases complex personality disorders and comorbidities that reflected different specific difficulties and interventions during their treatment and, consequently, resulted in different outcomes.ConclusionsOur experience led us to give additional attention to referred PDNOS diagnosis and to observe how much a clear diagnostic picture of a patient is crucial to correctly plan a treatment program and adapt local service interventions both for personality disorder and comorbidity
Therapeutic management of major depression and psoriazis dual diagnosis
Authors: Vasiliu O. 
Published: February 2022

IntroductionPsoriazis and major depressive disorder (MDD) have a high degree of overlap, and inflammatory citokines like tumor necrosis factor alpha, interleukins 1, 2, 6 and 10, and C-reactive protein have been involved in their common pathogenesis. The prevalence of MDD in patients with psoriazis has been reported to range between 28% to 67%.Objectives
To monitor the core symptoms evolution in patients diagnosed with psoriazis and MDD during antidepressant treatment.MethodsFour patients diagnosed with psoriazis and MDD (according to the DSM-5 criteria) were monitored during 6 months using Physician Static Global Assessment (PSGA), Hamilton Depression Rating Scale (HDRS)-17 items, and Global Assessment of Functioning (GAF). All patients underwent specific psoriazis and antidepressant treatment (with flexible dose of sertraline 100-200 mg daily, n=2, or escitalopram 10-20 mg/day, n=2).ResultsAll patients significantly improved their depressive symptoms during sertraline or escitalopram treatment (-8.7 points on HAMD at week 24, p<0.001), while their global functioning increased (+24.7 on GAF, p<0.001). The PSGA score decreased and reached a level of signifiance at week 24 (-1.2, P<0.01). The duration of active periods of psoriazis was less longer during the 6 months of monitoring than in the 6 months previous to the antidepressant initiation (by self-report, -10.5 days). No treatment discontinuation due to low tolerability was reported.Conclusions
Antidepressant treatment with selective serotonin reuptake inhibitors is efficient and well tolerated in patients with MDD and psoriazis. The duration of active symptoms of psoriazis tends to be less longer than previous to the antidepressant initiation.
A cup of coffee, what else?
Authors: Vázquez P. García , Martinez R. Gomez 
Published: February 2022

IntroductionCaffeine is the worldwide most frequently consumed psychostimulant. Its availability is nearly unlimited and in Europe it is not subject to state regulation. n the DSM-5 “caffeine use disorder” is categorized as a possible future disorder that currently needs further study.ObjectivesTo describe clinical evaluation, diagnosis, treatment and evolution of a 24 years old female patient.MethodsA 24-year-old woman admitted to the Dual Pathology Unit with a diagnosis of: unspecified psychotic disorder, mild intellectual disability and borderline disorder. In week 17 of admission, she decided to suspend the medication, with significant improvement. Therapeutic permits increase and Wais-III is repeated, resulting in having a limited intellectual capacity. Two months after being discharged, she was readmitted with manic symptoms. The nursing staff discover that she was drinkiing a large amount of caffeine (up to 4 liters / day). After gradually stopping caffeine intake, she was discharged without psychopharmacological treatment, being able to lead a normalized life, even studying a medium degree. No more incomes were need.ResultsCaffeine produces psychomotor-activating, reinforcing, and arousing effects.ConclusionsThe pattern of caffeine use of patients should be considered in the medical practice. The psychostimulant properties of caffeine are reviewed and compared with those of prototypical psychostimulants able to cause substance use disorders.
The interactions between COVID-19 drugs and psychotropic agents
Authors: Hiemke C. 
Published: February 2022

Coronavirus disease (COVID-19) is a systemic infection targeting multiple organs. Interstitial pneumonia is the landmark feature of this condition. Severe acute respiratory symptoms requiring intensive care support arises for about one out of twenty symptomatic cases. Aminochinolone, antiviral, antibiotic, corticoid, anticoagulant and immunobiological drugs are used, mostly to treat symptoms. Only remdesivir exhibiting weak antiviral activity is approved for COVID-19. Psychotropic medications may interact with medical treatments for COVID-19. The aim of this presentation is to highlight pharmacokinetic and pharmacodynamic drug-drug interactions to be expected for medical treatments of COVID-19. Remdesivir and favipiravir exhibit hepatotoxic properties which may be enhanced under combinations with tricyclic antidepressants or agomelatine. Favipiravir, hydroxychloroquine, chloroquine, azithromycin, lopinavir/ritonavir have QT interval prolongation potential and must be considered for combinations with antidepressant and antipsychotic drugs. For hydroxychloroquine, hypoglycemic activity may give rise to endocrine disturbances. Pharmacokinetic drug-drug interactions can be expected for lopinavir/ritonavir which inhibit cytochrome P-450 (CYP) 3A4 and induce CYP2C9 and CYP2C19. Combinations with psychotropic drugs that are substrates of these enzymes (victim drugs) will affect drug concentrations in blood and lead to supra- or subtherapeutic levels. Moreover, it must be assumed that the COVID-19 infection is associated with an enhanced production of cytokines which has a known impact on CYP enzyme activities. Though studies on interactions between psychotropic medications and medical treatments for COVID-19 are lacking, multiple drug interactions can be predicted and expected considering the side effect profiles and CYP inhibitory, inducing and substrate properties of combined drugs.DisclosureNo significant relationships.
Depressive symptoms and related factors in elderly diabetic patients
Authors: Omezzine R. Gniwa , Bouali W. , Sriha A. Belguith , Zarrouk L. 
Published: February 2022

IntroductionDiabetes is a major public health problem in Tunisia. Its prevalence increases with age. In addition, depression, at the top of mental disorders list, mainly remain undiagnosed, in particular in the elderly and consequently untreated.ObjectivesThe aim of this study was to estimate depressive symptoms and related factors in elderly diabetic patients.MethodsThis is a cross-sectional study, conducted among type 2 diabetic patients aged ≥ 60 years old, attending Mahdia’s primary health center, from January 2019 to March 2019. Depressive symptoms were assessed by using the Geriatric Depression Scale (GDS).Results95 diabetic patients were recruited. The average age was 75 ± 7.4 years and the sex ratio was 0.9. In our sample, 68.4% of patients were categorized according to having depressive symptoms. The proportion of participants with mild and severe depression symptoms were 25.3% and 43.1%, respectively. Analytical results demonstrate many factors which were significantly associated with depressive symptoms: female gender, living alone, history of hypertension, presence of complication, and using insulin (p < 0.05).Conclusions
Our study shows that depressive symptoms are common in elderly subjects with diabetes, and there have been many significant risk factors associated with it. So there is need for physicians to detect, confirm, and treat depression in elderly diabetic patients.
Depression after acute traumatic injuries in children
Authors: Sidneva Y. , Valiullina S. , Lvova E. 
Published: February 2022

Introduction
Acute traumatic injuries in children are diverse: skeletal trauma, traumatic brain injury (TBI), spinal injury (SCI), amputations, combined trauma and others. Severe injuries lead to severe disability and desadaptation of the child. It is known that children tolerate hard the awareness and acceptance of their new state.ObjectivesTo study emotional disorders after traumatic injuries in children at early stages of rehabilitation.Methods159 children up to 18 y.o.: 80 (TBI), 60 (SCI), 19 (amputation, skeletal injury, electro-trauma). Methods: psychopathological, psychological; scales, questionnaires.Results
In children after severe and moderately severe TBI, depression was detected in 43% as a consequence of injury and recovery of mental activity. In children with SCI, depression was detected in 48% as a reaction to stressful situation. In children with amputation, severe skeletal injury, electro-trauma depression was in 60%, both as a consequence of organic recovery of mental activity and as a reaction to psycho-traumatic situation. In the acute period, children had comprehensive interdisciplinary rehabilitation. Neuropsychiatrist recommended neuropharmacotherapy with antidepressants from the group of serotonin reuptake inhibitors (sertraline), GABA preparations. For psychological support, gestalt correction techniques were used.ConclusionsAfter acute trauma, depression in children occupies a significant place in clinical picture. Genesis of depressive disorders can be caused both by organic damage to brain structures and by reaction to psychotraumatic situation. In order to improve rehabilitation effectiveness, to make patient’s returning to usual living environment easier as well as to improve the quality of life, interdisciplinary approach is needed since early stages of rehabilitation and after.
Unusual drug-resistant psychotic state with epilepsy manifestations, cognitive deterioration and muscular atrophy - case report
Authors: Bazhmin M. 
Published: February 2022

Introduction
This article will focus on the case of patient whose disease manifested after episode of dehydration at 16 years of age and within 8 years led to his death. During the eight years of illness, the patient suffered from polymorfic psychotic states accompanied by various types of epileptic seizures, including absence and grand-mal seizures, resistant to drug therapy. In addition, he suffered from multiple motor disorders, skeletal and mimiс muscle atrophy, as well as progressive cognitive decline from very high level of cognitive functions to level of moderate deterioration. Despite repeated evaluations, there was no unequivocal diagnosis of his disorder.ObjectivesMale, born in 1994, without a known hereditary pathology in the field of neurology or psychiatry. Pregnancy and childbirth proceeded without features and the early stages of cognitive-motor development were marked as normative, with the exception of a single epileptic seizure at the age of 3 years (according to the description of the parents). Until the age of 16, the patient was not under the supervision of a neurologist or psychiatrist, developed on a par with his peers, successfully attended school with high marks in the exact sciences, and went in for sports.MethodsCase reportResultsCase reportConclusionsA patient is considered with a non-standard course of psychosis and epilepsy, which was accompanied by multiple neurological and psychiatric symptoms.In Israel there are only 13 patients with a resemble clinical picture and there is no diagnosis or group of diagnoses in ICD, DSM or any neulogical classificatin tha can describe his disease.
Emotional outcomes in tunisian stroke survivors
Authors: Charfi N. , Elleuch S. , Smaoui N. , Bouali M. Maalej , Zouari L. , Dammak M. , Mhiri C. , Thabet J. Ben , Maalej M. 
Published: February 2022

IntroductionDepression and anxiety are recognized as common psychiatric complications of stroke, yet little is known about their clinical correlates and their impact on functional outcome.ObjectivesTo assess the prevalence of anxiety and depression during the first year post-stroke; To determine their relationships with clinical and functional variables.MethodsWe conducted a cross-sectional study, which included 147 patients, followed for stroke that had occurred over the past year. We used the HAD scale in its Arabic version for screening for anxiety and depression and the modified Rankin scale to assess the degree of disability due to stroke.ResultsAnxiety was detected in 55.1% of patients and depression in 67.3% of them. These emotional disturbances were more common during the first six months post-stroke. Depression was more common among male gender (p=0.003). Older age and more than secondary educational attainment correlated with post-stroke anxiety (p respectively 0.013 and 0.002). Post-stroke anxiety and depression were significantly more common in case of infarcts involving the territory of the Sylvian and the anterior cerebral artery (p respectively 0.01 and 0.001). Depression was significantly associated with the presence of motor deficit on the initial neurological examination (p<0.001) and subsequent neurological sequelae (p<0.001). Anxiety and depression were significant predictors of functional disability during the 12 months post-stroke (p=0.007).Conclusions
Anxiety and depression impair functional ability after stroke. These data may help identify the patients at greatest risk of poor emotional outcomes and thus help in planning appropriate interventions.
Predicting one-year outcomes in first-episode psychosis
Authors: Lindgren M. , Keinänen J. , Kemppainen A. , Karpov B. , Kieseppä T. , Suvisaari J. 
Published: February 2022

The outcome of first-episode psychosis (FEP) varies and may be predicted by several baseline measures. In the Helsinki Early Psychosis Study, young adults with FEP (n=97) from the Helsinki area in Finland were broadly assessed as soon as possible after first psychiatric contact for psychosis. Age- and gender-matched population controls were also assessed (n=62). The participants were followed up via appointments and medical records. We present both published and unpublished results on predictors of 12-month clinical, functional, and metabolic outcomes. More severe cognitive deficits at the beginning of treatment predicted several outcomes such as occupational status and functional level – beyond baseline positive and affective symptom levels, but not when negative symptoms were accounted for. More severe baseline obsessive-compulsive symptoms were predictive of a lower rate of remission, whereas a higher level of anxiety symptoms predicted better functional outcome, when the severity of positive symptoms was adjusted for. Adverse childhood experiences measuring cumulating psychosocial stress did not predict occupational status or functional level when positive and negative symptoms and neurocognition were controlled for, whereas in controls having experienced school bullying was associated with lower functioning. Insulin resistance in early psychosis appeared as an early marker of increased vulnerability to weight gain and abdominal obesity in young adults with FEP. Further, increased waist circumference predicted worsening low-grade inflammation, increasing further the cardiovascular risk. In sum, we have found different types of prognostic markers in FEP. Identifying the individuals at risk of less favorable outcomes could affect treatment choices in FEP.DisclosureNo significant relationships.
Comorbid anorexia nervosa and schizophrenia
Authors: Lobo C. De Andrés , Adame C. Vallecillo , Aparicio T. Jiménez , De Llano De La Viuda M. Queipo , Ramírez A. Gonzaga , Valera G. Guerra , Carrasco I. Santos , Cerejeira J. Gonçalves , Meseguer C. Capella , Vázquez E. Rodríguez 
Published: February 2022

IntroductionAlthough schizophrenia and anorexia nervosa are very different disorders, when they occur in the same patient it can be difficult to distinguish whether the alterations in body image are due to psychotic symptoms or correspond to a comorbid eating disorder. It is also relevant to know how they can interact with each other.ObjectivesPresentation of a clinical case of anorexia nervosa in the context of a patient with a previous diagnosis of paranoid schizophrenia.MethodsBibliographic review of the relationship between schizophrenia and alterations in the perception of body image by searching for articles in Pubmed.ResultsWe present a 48-year-old woman who resides with her mother and a sister. Diagnosed with paranoid schizophrenia and eating disorder. She had previously been admitted to hospital twice. Since 2004, she has been followed up in mental health consultations. The patient reports constant weight changes. A year ago she began to feel overweight and began to restrict her intake and to exercise, having lost 20 kg. She reports psychotic symptoms in the past, that she now denies. Various scales show moderate impact of weight on personal perception of psychosocial adjustment, an impulse to thinness and a significant distortion of body image, perceiving herself as heavier than she is and wishing she was lighter.ConclusionsIn schizophrenia, confusion in bodily experiences and states is not uncommon. The possible interactions between the symptoms of schizophrenia and anorexia nervosa complicate the adequate care of these patients. Further research on comorbidity of these two disorders is necessary.
Depression, distress and their association with patterns of psychoactive substance use during the COVID-19 emergency state in latvia
Authors: Vrublevska J. , Šibalova A. , Aleskere I. , Rezgale B. , Smirnova D. , Fountoulakis K. , Rancans E. 
Published: February 2022

Introduction
The WHO warned that the COVID-19 pandemic could have psychiatric consequences such as elevated levels depression, increased alcohol and drug use, and other behaviours that exert a strong influence on health. In Latvia a state of emergency was announced on March 12th, was extended twice and lifted on June 10th.ObjectivesTo estimate the prevalence of depression and distress in the general population of Latvia and association with substance use during the state of emergency.MethodsThe nationwide representative online study in the general population of Latvia was conducted in July 2020 during three week period. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to determine the presence of distress/depression. The structured questionnaire to determine psychoactive substance use was applied. Proportions of independent variables across the study groups were compared using Chi-square
test.Results
The study sample included 2608 respondents. The prevalence of depression and distress was estimated at 5.7% (95%CI 4.92 – 6.71) and 13.5% (95%CI 6.85 – 8.91), respectively. Patients with depression (28% vs. 7.4%, p <0.001) and distress (30.9% vs. 7.4% p <0.05) smoked more tobacco compared to respondents without distress/depression. Those with depression or distress were significantly more likely to consume more alcohol during the emergency state than people without depression or distress (14.0% and 17.7% vs. 6.6%, p <0.001). The changes in the use of other psychoactive substances in those who had depression or distress were not statistically significant.ConclusionsPreparing support systems to mitigate mental health consequences is needed urgently.
Association between complete corpus callosum agenesis and recent-onset schizophrenia: A case report
Authors: Abassi B. , Fekih-Romdhane F. , Maktouf H. , Cheour M. 
Published: February 2022

IntroductionCorpus callosum agenesis (CCA) is a rare congenital disorder in which there is a partial or complete absence of the corpus callosum. Within the framework of an anatomoclinical approach to schizophrenia, a few studies have focused on its association with neurological disorders, including CCA.ObjectivesIn this perspective, we report a rare case of an adolescent with intellectual disability, with whose complete CCA was revealed by a recent-onset schizophrenia.MethodsA case report and literature review.ResultsThe teenager M.A. is from a first degree consanguineous marriage. He had no family history, no special habits and no history of seizures. Since early childhood, he had had a psychomotor acquisition delay and relationship difficulties that tended to worsen later. At school, he was teased by his peers and failed 4 times in different rows. At the age of 15, he dropped out of school. Verbal and physical aggressiveness, soliloquy, unmotivated laughter and vague ideas of persecution suddenly appeared, hence his psychiatric consultation one month later. Neuropsychological tests indicated current low Intelligence Quotient (60). Brain imaging revealed complete ACC (see Figure 1). He was diagnosed with schizophrenia and put on antipsychotic treatment at adequate doses and durations, with poor therapeutic response.ConclusionsOur observation provides additional support for neurodevelopmental models of schizophrenia, and confirms literature data indicating that severe structural brain abnormalities would lead to early onset psychotic symptoms which are often refractory to pharmacological treatments
Molecular lipids in prediction of psychosis and the associated cardiometabolic co-morbidities
Authors: Oresic M. 
Published: February 2022

Lipid metabolism has been an area of increased interest in psychosis research, not only due to its link to metabolic comorbidities, but also due to its putative role in the pathophysiology of psychosis. Lipid disturbances are observed already in the period preceding the onset of psychosis. For example, we performed mass spectrometry based lipidomics in a cohort of individuals at clinical high risk for psychosis (the EU-GEI study) and found that the individuals who transitioned to psychosis within a 2-year follow-up period displayed decreased levels of ether phospholipids. This finding may be of direct (patho)physiological relevance, as ether phospholipids (particularly plasmalogens, a major subgroup of ether phospholipids) are highly enriched in the brain, are supplied to the brain by the liver, have many structural and functional roles, and may act as endogenous antioxidants. Accumulating evidence also suggests that lipid disturbances play a crucial role in the development of metabolic comorbidities associated with psychotic disorders. Our lipidomic studies have shown that psychotic patients who rapidly gain weight during follow-up have elevated triglycerides (TGs) with low double bond count and carbon number at baseline. These TGs are known to be associated with non-alcoholic fatty liver disease (NAFLD) and with increased risk of type 2 diabetes. In conclusion, although the mechanisms linking dysregulation of lipid metabolism with the pathophysiology of psychosis are currently poorly understood, findings by us and others suggest that metabolic abnormalities are evident in people who are vulnerable to psychosis, and to the associated metabolic comorbidities.DisclosureNo significant relationships.