bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vexatious litigant vs paranoia querulans: A systematic review
Authors: Pinzón-Espinosa J. , González-Rodríguez A. , Guàrdia A. , Sabaté M. Betriu , Manozzo-Hernandez P. , Pedrero A. Alvarez , Acebillo S. , Labad J. , Vidal D. Palao 
Published: February 2022

IntroductionParanoia querulans is a type of persistent delusional disorder of the persecutory subtype, recognized under ICD-10 and DSM-IV. Being a classically described entity, evidence is lacking from its conceptualization as a nosological entity to diagnosis and treatment. Furthermore, controversy still exists regarding its interplay between the judicial and mental health systems.ObjectivesTo summarize current evidence and knowledge regarding Paranoia querulans on its conceptualization, ethiopathological explanations, therapeutical management and interface between psychiatry and the law.MethodsA systematic review was undertaken between June and October 2020 in the PubMed, Web of Science and Scopus databases according to PRISMA directive. Key-terms: ((querul* OR vexatious) AND (paranoia OR delusio* OR neuros* OR behavi* OR complai*) OR litig*) AND psychiatry. No language or time restrictions were established.ResultsA total of 1648 studies were initially identified (PubMed: 679; WOS: 945; Scopus: 24; other: 0); after duplicates were removed, n=1381 studies remained. After screening title and abstract, 56 studies were included. Their main content was categorized into: 1. Conceptualization (n=26): Neurosis (n=5), psychosis (n=9), behavioral disorder (n=5); no psychiatric diagnosis (n=7). 2. Descriptive psychopathology (n=8) 3. Etiopathogenesis (n=9): Social or personality basis (n=3), culture (n=4), trauma (n=1), cognitive decline (n=1) 4. Management (n=1) 5. Psychiatry and Law: same object, different objectives (n=12)ConclusionsThere is controversy regarding the nosological entity of querulousness, from psychosis to neurosis or behavioral disorders. Some authors consider this behavior to not be a psychiatric diagnosis. Furthermore, most papers dealt with a social or nurture-based origin. There is a dearth of information regarding treatment.Conflict of interestJPE has received CME-related fees from Lundbeck.
The role of GSK-3 in mood disorders: Preliminary data from an experimental study
Authors: Salvo G. Di , Rosso G. , Hoxha E. , Teobaldi E. , Balbo I. , Tempia F. , Maina G. 
Published: February 2022

IntroductionThe identification of potential biomarkers is crucial to improve the management and treatment of mood disorders. Glycogen synthase kinase-3 (GSK-3) is a multifunctional enzyme with an important role in the etiology of mood disorders. Recent findings suggested GSK-3 as a putative biomarker in mood disorders.ObjectivesThe aims of the study are: - to evaluate GSK3 as potential biomarker for differential diagnosis (MDD and BD); - to analyze the regulation of GSK3 by psychopharmacological treatments.MethodsPatients included fulfill the following criteria: (a) principal diagnosis of MDD or BD (DSM-5); (b) age ≥ 18 years; (c) drug-free for at least 4 weeks before the inclusion. For each patient included a healthy control is enrolled, matched by gender and age. All included subjects at the study entry point (t0) are assessed through: - semistructured clinical interview and clinical rating scales (Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale; Young Mania Rating Scale, Clinical Global Impression) - blood draw, to measure GSK-3 levels Patients with MDD or BD are assessed again after 1 week (T1) and after 2 month (T2) of specific pharmacological treatment.ResultsSo far, we enrolled 16 patients and 16 healthy controls. The enrollment is still ongoing.ConclusionsWe expect to find GSK-3 levels differently expressed between healthy controls, patients with DDM and patients with BD. This finding would be crucial as it could contribute to the improvement of differential diagnosis. Moreover, we expect to observe a change in GSK-3 levels after psychopharmacological treatments.
Achieving holistic care for the mentally ill: The need for more caregiver support groups in Africa
Authors: Ogunmodede A.J. , Ogunmodede J. , Buhari O. , Adegunloye O. 
Published: February 2022

IntroductionCaregiver support groups provide an avenue for interactions among the caregivers of the mentally ill, where they share their fears, hopes and uncertainties about their ill relatives. They are a means to be “heard” by care providers, a platform for psychoeducation as well as an avenue for participation in clinical decision making and formulation of patients’ care plans. In most parts of Africa, such support groups do not exist and where they do, they are poorly structured and poorly funded.ObjectivesThis review was aimed at examining the concept of caregiver support groups for the mentally ill globally as revealed in the currently avaliable body of knowledge, as well as raise awareness for the need for such groups in AfricaMethodsA review of related literature was done using appropriate key words and search engines.ResultsThis review revealed the presence of well- structured support groups for the caregivers of the mentally ill in many parts of the world. The advantages of such groups and their contributions to the holistic care of these patients in those regions were also discussed, while suggesting a possible structure for their creation, sustainability and focus in Africa.ConclusionsThe support of caregivers for the mentally ill must be given keen attention by both care providers and policy makers, with prime importance given to the creation and funding of more caregiver support groups in the continent in order to achieve quality and holisitic care for the mentally ill.
The relationship between stigma and help-seeking intentions in college students
Authors: Abassi B. , Fekih-Romdhane F. , Maktouf H. , Moalla I. 
Published: February 2022

IntroductionFew people seek mental health care despite the high prevalence of mental illnesses and their serious consequences. Barriers explaining this lack or absence of help-seeking have been the subject of several studies with stigma being the most prominent barrier.ObjectivesWe aimed to assess the relationship between stigma and help-seeking intentions in a sample of Tunisian college students.MethodsThis was a cross-sectional survey. The “Mental Health Knowledge Schedule”, and the “Reported and Intended Behavior Scale” were administered to a total of 714 college students (62.2% female; mean age =20.9).ResultsMore than one-third of students (39.6%) felt that it would be “unlikely” or “very unlikely” to seek the help of a health professional for mental health problems. Pearson product moment correlations indicated that help-seeking intentions significantly and positively correlated with behavior (p<0.001, r=0,103) and knowledge (p<0.001, r=0,163). The multiple hierarchical linear regression analysis found that after controlling for demographic variables (gender, age) and other personal-related variables (marital status, family income, living environment, substance use, personal psychiatric history), help-seeking intentions were significant contributors to behaviors and knowledge.ConclusionsGiven that stigma and discrimination against people with mental illness is a real and perceived barrier to seeking help and treatment, psycho-educational campaigns should be put in place to address the negative perceptions and attitudes of the general population about mental health issues, and should be tailored to the needs of specific groups (including students in different disciplines), taking into account their attitudes, fear and concerns about mental illness.
Evaluation of the effect of mental health training of primary health care workers on attitudes towards mental illness
Authors: Buhari O. , Ogunmodede A.J. , Adegunloye O. 
Published: February 2022

IntroductionThe World Health Organization (WHO) set a target of task shifting as a means of achieving improved mental health services within the community as a means of tackling the unmet needs of mental health care. Primary health care workers (PHCWs) have been identified as essential to achieving this goal.ObjectivesThis study was to identify attitudes and beliefs of PHCWs on mental illness, and to assess the effect of a mental health training on these attitudes and beliefs.MethodsThe attitude towards mental illness (ASMI) scale was administered on 91 PHCWs pre- and post- a 4 day training on mental health to assess change in attitude across 6 domains.ResultsOur findings revealed significant positive change in four domains, namely separatism (p = < 0.001), restrictiveness (p = < 0.001), benevolence (p = p =< 0.001) and stigmatization (p = < 0.001). The changes in stereotyping (p = 0.475) and pessimistic prediction (p = 0.056) domains were not clinically significant.ConclusionsPrimary health care workers’ negative attitude and stigmatizing beliefs can be improved upon via regular enlightenment programmes and training. This can be done at regular intervals
Mental health service providers: Barriers in collaboration
Authors: Shchedrinskaya O. , Bebtschuk M. , Snarskaya E. 
Published: February 2022

IntroductionCollaboration between psychiatrists and psychologists (counsellors) is one of the key factors impacting efficiency of services in child and youth mental health. Despite the clear benefits, a teamwork approach is still limited and has some difficulties.ObjectivesThe objective of the study was to explore potential barriers in the collaboration between professionals with different backgrounds.MethodsAnonymous online survey for staff from various mental health clinics across Russia was completed by 142 psychologists and 70 psychiatrists (Σ =212).Results77.7% participants reported that collaboration is helpful in adult mental health services; 91.3% see partnership as an essential part of child and youth mental health. 61.6% specialists work together; 44.7% described it as a successful experience. At the same time 58.4% believe that pharmacological treatment should start first, and counselling may be postponed. 49.5% believe that doctors often diminish the importance of counselling. Fears and biases towards psychiatrists were reported by 28.9% of the sample. 25.4% participants reported lack of trust and limited understanding of counselling methods. Top barriers for collaboration that were reported: lack of opportunities on an organizational level (20% doctors and 45% psychologists), unclear professional boundaries and responsibilities (28.5% doctors and 15.4% psychologists), lack of motivation (20% doctors and 7% psychologists), lack of positive experience (11.2% psychologist and 0% doctors). The main reported benefit of collaboration by 39.6% was improved compliance and better treatment outcomes.ConclusionsIn order to make collaboration among mental health professional more efficient, there is a need to address the barriers listed above.
Levels of depressive and anxious symptoms of pregnant women before vs. during the COVID-19 pandemic
Authors: Barros M. , Aguiar M. , Macedo A. , Azevedo J. , Pereira A.T. 
Published: February 2022

IntroductionThe effects on the population’s mental health due to the rapid global spread of COVID-19 are even greater for specific groups such as pregnant women.ObjectivesTo compare levels of depressive and anxiety symptoms of pregnant women before vs. during the COVID-19 pandemic and to analyze the role of COVID-19 fear in perinatal psychological disorder.Methods200 Brazilian women evaluated during the pandemic in May-June 2020 (Sample-1) with the Brazilian Covid-19 Fear Scale for the Perinatal Period (Barros et al. 2020) and Screening for Perinatal Depression and the Perinatal Anxiety Crawl Scale, both with α> .90. Sample-1 was compared with a sample of 300 Portuguese women; these responded to the same questionnaires, before the pandemic, in 2017 and 2018 (Sample-2).ResultsSample-1 had significantly higher mean scores of depression (52.73 ± 20.26 vs. 35.87 ± 16.98, t = 10.77, p <.001) and anxiety (36.58 ± 18.23 vs. 18.50 ± 13.71, t = 11.94, p <.001) and correlated significantly (p <.05) and moderate (r.30) with the fear of COVID-19. Hierarchical regression analyzes showed that, even after controlling for the effect of risk factors for PPP (Pereira et al. 2020), fear of COVID-19 is a significant predictor of depressive symptomatology levels (increments of 2-5%) and anxious (10-15%) during the pandemic.ConclusionsThe Sample-1 being from a different country may be a confusing factor, however, the magnitude of differences in PPP levels and the relevant role of fear in COVID-19, alert us to be aware of perinatal mental health.
Development and testing the effectiveness and feasibility of a structured violence risk management intervention to support safety in psychiatric hospitals
Authors: Lantta T. 
Published: February 2022

IntroductionThis presentation focuses on two major problems in psychiatric hospital care: patient violence and lack of patient engagement. Interventions already exist for managing patient violence. However, the challenge in using these interventions is poor integration to clinical practice and these methods do not entail elements of patient engagement.ObjectivesThe aim of the presentation is to give on overview of a project aiming to develop and test new structured intervention for violence risk management. Intervention aims to increase safety in care environments and engagement of patients.MethodsIntervention Mapping protocol together with staff and patients will be used in the project. Quasi-experimental design is used to test the intervention in 4 month period in two psychiatric hospital units.ResultsBy the end of the year 2020, development of the the new violence risk management intervention is nearly finished. The presentation will give an outline of the developed intervention and how staff and patient engagement in the development phases were ensured.ConclusionsThe project described in this presentation is an example how a feasible violence risk management method can be developed together with staff and patients receiving psychiatric care. By ensuring engagement of the target groups, here staff and patients, it is possible to promote real integration of a new working method to psychiatric inpatient care. This project was funded by the Academy of Finland (316206).
Characterization of compulsory hospitalization in the psychiatry department of Faro
Authors: De Carvalho M. Viseu , Tavares F. Gomes , Pinto M. Barbosa , Oliveira M. Mota 
Published: February 2022

IntroductionThe mental health law is not universal. In Portugal the urgent compulsory regimen is based on the principles of the presence of severe mental anomaly and risk to themselves or others.ObjectivesCharacterization of patients admitted in compulsory hospitalization (CH) between 2018 and 2020, in the University Hospital Center of Algarve - Faro DepartmentMethodsRetrospective study from January/2018 to August/2020. Social, demographic, epidemiological and clinical data were evaluated.ResultsOf 1191 patients who were admitted 36% occurred in CH. There was a predominance in male sex (58%), the average age was 43 years old. For 62% it wasn´t the first hospitalization and 58% had a recent prescription. Admission occurred most frequently because of the presence of psychotic symptoms (figure1) and according to the international classification of disease (ICD10) the most frequent diagnosis was unspecified nonorganic psychosis (figure2). At discharge 59% of the patients remained on compulsory treatment (CT), where the most frequent diagnosis was schizophrenia. Although most of these patients were discharged with oral and long-term injectable antipsychotics, there were higher rates of readmissions when compared to non-CT group, were the most frequent diagnosis was mental and behavioural disorders due to psychoactive substance use and most of the patients were discharged only with oral therapy.ConclusionsPatients in compulsory regimen have a severe mental illness with higher rates of readmission. We highlight the use of long-term injectable antipsychotics in terms of compliance. These findings corroborate the need for specialized and multidisciplinary approach in terms of psychosocial rehabilitation in these patients.
Mental well-being in residents of different regions of Russia
Authors: Shilko R. , Shaigerova L. , Almazova O. , Dolgikh A. 
Published: February 2022

IntroductionSome attempts are being made to describe the mental health and well-being of the population in relation with the regional specifics in a particular area of the Russia, however, they are rare and local (limited to one region).ObjectivesThe current study aims to identify sociocultural mediation of mental well-being based on its measures in Russia’s regions with different ethno-cultural composition of population.MethodsThe study involved 210 men and 403 women aged 14 to 76 years (M = 26.9; SD = 13.7) from six regions of the Russian Federation: Moscow, St. Petersburg, Udmurtia, Sakha, Sverdlovsk and Kemerovo. The mental well-being of participants was assessed using the Warwick-Edinburgh Mental Wellbeing Scale (Tennant et al., 2006; Tennant et al., 2007).ResultsThe measures of mental well-being were different in the regions: Moscow (M=51.04; SD=8.03), St.-Petersburg (M=50.05; SD=5.78), Udmurtia (M=47.57; SD=9.50), Sakha (M=50.99; SD=8.47), Sverdlovsk (M=54.86; SD=8.43), Kemerovo (M=51.84; SD=7.51). Using one-way analysis of variance (ANOVA), it was found that there are significant differences in the assessment of psychological well-being between study participants from different regions (F = 6.692; p <0.001). Residents from the Sverdlovsk evaluate their mental well-being as significantly better than the ones from Moscow (MD=3.821; p=0.012), St.Petersburg (MD=4.812; p=0.023), the Udmurtia (MD=7.284; p <0.001) and the Sakha (MD=3.869; p=0.003).ConclusionsResidents from Russia’s regions with different ethno-cultural composition of population demonstrate some difference in mental well-being measures that may be caused by sociocultural factors. The reported study was funded by the Russian Foundation for Basic Research, project number 17-29-02506.
Adverse childhood experiences and suicidal ideation among immigrants in Santiago, Chile
Authors: Errazuriz A. , Avello D. , Morales S. , Pino R. 
Published: February 2022

IntroductionUnderstanding suicidal ideation and its association with childhood adversity is crucial for preventing suicide. Although the “healthy immigrant effect”, whereby immigrants are healthier than the native-born population, has been well documented across studies, little research has examined the presence of such effect on lifetime suicidal ideation (LSI) and its association to early adversity.ObjectivesThe aim of this study was to compare the prevalence of LSI between the immigrant and native-born population in Chile and explore the association between childhood adversity and suicidal ideation in immigrants.MethodsData from two cross-sectional health surveys: the Santiago Immigrant Wellbeing Study (STRING, n=1,091; 2019) and the Chilean National Health Survey (ENS2016, n=3,432) were used. Each study used multistage probability sampling and estimates were weighted to approximate the distribution of demographic variables in each population. Outcomes included LSI measured by WHO-CIDI and an adapted version of the Adverse Childhood Experience Questionnaire. Multivariate logistic regression was employed.Resultsindicated that immigrants were less likely to report LSI compared with the native-born population. Moreover, male and female immigrants had lower risk of having SI than native-born counterparts. After controlling for socioeconomic status, social support, and health conditions, childhood adversities predicted an increased risk of LSI in immigrants. No gender differences were found in the effects of childhood adversity on suicidal thoughts.ConclusionsFindings confirm the presence of a healthy immigrant effect in LSI and support a life course perspective, highlighting the importance of assessing early life disadvantages to understand suicidal ideation among immigrants.
Augmentation strategies for treatment-refractory clozapine patients
Authors: Freudenreich O. 
Published: February 2022

BackgroundClozapine can be a life-saving and course-altering treatment for patients with psychosis, particularly treatment-resistant schizophrenia. Unfortunately, clozapine monotherapy rarely leads to a full symptomatic remission.AimsThis talk outlines key decision points in the use of clozapine: how to select patients for clozapine treatment and how to optimize clozapine’s efficacy in patients with a poor response to an adequate clozapine monotherapy trial.ConclusionsClozapine’s main indication is for treatment-resistant schizophrenia. Therapeutic drug monitoring (TDM) should be used to optimize clozapine dosing during a clozapine trial and to rule-out pseudo-resistance. Up to 50% of patients do not respond to clozapine monotherapy and augmentation strategies can be utilized in such cases. Pharmacological add-on treatments are selected based on the most prominent symptom cluster (refractory psychosis, negative symptoms, depression and suicidality, aggression). Electroconvulsive therapy is the most effective augmentation strategy for refractory psychosis and suicidality. Non-pharmacological interventions and a focus on quality of life become important considerations in clozapine non-responders.CommentsClozapine is an important and underutilized tool in the management of treatment-resistant schizophrenia. It should be offered timely, as soon as treatment-resistance becomes apparent. Clinicians can use personalized augmentation strategies as part of a comprehensive treatment plan in order to achieve improvements even in patients with a poor response to clozapine alone. However, polypharmacy should be used judiciously, keeping in mind medical morbidity and quality of life.DisclosureI have the following financial relationship with a commercial interest to disclose (recipient SELF; content area SCHIZOPHRENIA): Alkermes – Research grant (to institution), consultant honoraria (Advisory Board); Avanir – Research grant (to institution);
A surface-based morphometry study of risk and resilience markers associated with supramarginal thickness in schizophrenia
Authors: Tomyshev A. , Omelchenko M. , Kaleda V. , Lebedeva I. 
Published: February 2022

IntroductionConventional structural neuroimaging methods can identify changes in cortical thickness but cannot relate these changes to specific cortical layers due to a lack of sensitivity. However, several indirect measures sensitive to changes specifically occurring in supragranular cortical layers were developed recently (github.com/kwagstyl/schizophrenia_gyral_sulcal).ObjectivesThe aim was to assess the ability of these novel measures to detect cortical layers thickness characteristics potentially associated with risk or resilience to developing schizophrenia.Methods43 first-episode schizophrenia (FES) male patients, 29 non-converted individuals at ultra-high risk of psychosis (ncUHR, mean follow-up period – 6.5 years), and 43 matched healthy controls (HC) underwent structural MRI at 3T Philips scanner. Images were processed via FreeSurfer and MATLAB to derive two markers specific to supragranular thickness change: gyral-sulcal thickness differences (GSTD) and gyral-sulcal intrinsic curvature differences on pial surface (GSCD).ResultsGSCD measures were increased in temporal, parietal and occipital cortices, whereas both GSTD and GSCD were increased in the right frontal cortex in FES compared to HC. No GSTD or GSCD were changed in ncUHR compared to HC, and GSCD was decreased in the frontal cortex compared to FES.ConclusionsOur findings from the indirect measures indicate a potential predominance of supragranular thinning in FES and suggest that a supragranular thinning in the right frontal lobe might be associated with precipitating risk and/or illness effects of schizophrenia. At the same time, no clear supragranular markers directly associated with resilience or risk mechanisms were identified. The work was supported by RFBR grant 20-013-00748.