bluuebunny/crossref_metadata_2025_split huggingface dataset:
BAD NEWS FOR HYPOCHONDRIACS: Covid-19 Associated Aggravation of Somatic Symptom Disorder with Psychotic Depression
Authors: Jesus S. , Costa A. , Simões G. , Garrido P. 
Published: September 2022

IntroductionThe Covid-19 pandemic has brought with it far-reaching consequences that affect the mental health of a significant population. Those suffering from somatic symptom disorder (SSD) present a significant focus on physical symptoms, with excessive thoughts and behaviours, to an extent that results in major distress and dysfunction. Aggravation of SSD could be associated with various stressors, including the current pandemic, and culminate in an increased severity of the base presentation.ObjectivesThe authors present the case of an elderly man with previous diagnosis of SSD which began to aggravate and evolve into a depressive psychotic state, precipitated by the beginning of the Covid-19 pandemic.MethodsThe authors conducted a non-systematized literature review with focus on those articles most pertinent to the topic in question as well as presenting a clinical case as compliment.ResultsWith the pandemic overwhelming the globe, the literature has demonstrated a significant correlation with aggravation of mental health and psychiatric cases. The patient in question was previously followed in consultation for SSD. With the pandemic acting as precipitating stressor, the patient demonstrated a significant aggravation in his base presentation with the development of psychotic depression. He was subsequently hospitalized with implementation of psychotherapeutic and psychopharmacological methods, with remission of the psychotic state, with poor response of the SSD.ConclusionsExternal stressors are an important influence on psychiatric disorders. Whenever potential life stressors, especially those that exert influence on a global scale, the psychiatrist should be attentive to the possibility of significant aggravation of a stabilized clinical picture and offer support.DisclosureNo significant relationships.
Features of the Psychoemotional status of Patients with Type 2 Diabetes Mellitus
Authors: Chernus N. , Kamynina L. , Gorenkov R. , Sivkov A. , Savina T. , Serdakova A. , Sivkov S. , Zolotovickaja A. 
Published: September 2022

IntroductionThe study of the personal characteristics of patients with SD2 continues to be an urgent problem.ObjectivesStudy the features of the psychoemotional status of patients with type 2 diabetes mellitusMethodsThe study included 62 patients with T2DM (HbA1c 7,3±1,3%) and visceral obesity (Grade 2) were included mean age 56.1 ± 2.4; BMI: 34.8 ± 2.3.. Research methods: the Beck test, the Hamilton scale, the Spielberger-Hanin questionnaireResultsClinical signs of anxiety-depressive disorders were detected in (47) 75.8% of patients. - 1 group, 15 patients - 2 comparison group (without affective disorders). Beck’s test: 23.5 + 0.5 against 10.6 ± 0.3 and Hamilton’s shock 22.4 ± 0.4 against 7.9 + 0.2 revealed a reliable difference between groups (p < 0,001). In both groups of patients on the Spielberger-Hanin scale, moderate reactive anxiety was identified: 44.9 ± 0.7 versus 36.7 ± 0.5 point, which is significantly higher (p < 0,001) in patients of the 1 group. The level of personal anxiety 56.0 ± 0.5 versus 37.5 ± 0.4 points, which also revealed a reliable difference between groups (p < 0,001).ConclusionsThe findings suggest a high incidence of anxiety-depressive disorders in patients of patients with T2DM and visceral obesity, which should be considered in pathogenetic therapy for these patients.DisclosureNo significant relationships.
Conversion disorder in an 18-year-old boy: a case report
Authors: Vilella Martín C. , García Vázquez P. , Fernández Perea P. , Barrera García Y. , Serrano García A. , De Santiago Sastre J. , Gómez Martínez R. , Franch Pato C. 
Published: September 2022

IntroductionConversion is the transformation of a conflict (unconscious) into a somatic symptom or a “non-verbal way of expressing psychological discomfort”, through somatizations. The disorder suggests a neurological or medical disease, associated psychological factors appear and is not produced intentionally.ObjectivesTo describe a case of conversion disorder.MethodsRetrospective review of clinical records and complementary test, including psychiatry, electrophysiology and neurology.ResultsAn 18-year-old boy came to the emergency room for paralysis. He has anesthesia of lower limbs. He shows indifference towards this symthoms.He denies any stressful situation. On examination, no psychotic or affective symptoms were observed. Belle indifference. Blood tests and a cranial CT scan were performed without alterations, so the patient was admitted for study. The electromyogram, lumbar puncture and cranial magnetic resonance show negative results. Suggestion is carried out, proving effective and recovering gait and sensitivity. These episodes are repeated up to 4 times until finally, during an interview with the family, episodes of bullying come to light. We work in therapy with a diagnosis of conversion disorder.ConclusionsThe most frequent symptoms in conversion disorder are mutism, paralysis, anesthesia, blindness and seizures. It is usually monosymptomatic for each patient. Diferencial diagnosis with neurological pathology should be made.DisclosureNo significant relationships.
Pregabalin for the treatment of generalized anxiety disorder
Authors: Khallouk A. , Rhaouti A. , Boukdir A. , Stati S. , Nafiaa H. , Ouanass A. 
Published: September 2022

Introduction

Pregabalin is a treatement with a complexe mechanism of action. It’s an antiepileptic drug used as adjunctive treatment of partial epilepsy, it is also taken in the treatment of neuropathic pain, and generalized anxiety disorder, in addition to epilepsy. Some of the advantages of pregabalin include. pharmacokinetics, safety, and tolerability. Clinical trials have demonstrated the efficacy of pregabalin comparable to benzodiazepines, without risk of abuse.Objectivesto assess the efficacy of pregabalin in patients with generalized anxiety disorder in the Ar-Razi university psychiatric hospital in Salé in MoroccoMethodsTo assess the place of pregabalin in the treatement of anxiety disorders through patients hospitalized in the Ar-Razi university psychiatric hospital in Salé in Morocco The evaluation instruments are: For anxiety the Hamilton Anxiety Scale and For therapeutic efficacy CGI-therapeutic indexResultsbased on the results of our study on the patients who have improved after an optimal duration of treatment, in conjunction with psychological monitoring, we retain that pregabalin can significantly improve the quality of life of anxious patients and also guarantee them a better prognosisConclusionsPregabalin was significantly more efficacious for the treatment of psychic and somatic symptoms of generalized anxiety disorder and was well tolerated by most study patients.DisclosureNo significant relationships.
Clinical Correlates of Cardiac Conduction in Bipolar Disorder
Authors: Prieto M. , Carocca A. , Fullerton C. , Hidalgo A. , Diaz J. , San Martin P. , Godoy M. , Nuño M. , De Leon A. , Rodriguez J. , Sanchez R. , Batiz F. , Castillo A. , Cuellar-Barboza A. , Biernacka J. , Frye M. 
Published: September 2022

Introduction
Patients with bipolar disorder (BD) have an increased risk for cardiovascular morbimortality. Clinical risk factors, specifically for arrhythmias and sudden cardiac death remain understudied.ObjectivesThis study was conducted to assess differences in cardiac conduction among BD patients.MethodsWe included patients with BD in a cross-sectional design, confirmed by structured interview, age 18 through 80. Clinical characteristics were obtained using a structured questionnaire or medical records review. ECG intervals duration and morphology were manually assessed by cardiologists and compared among clinical subgroups using Chi-square, Mann-Whitney, and Kruskall-Wallis tests. Exploratory multivariable linear and logistic regression models were fitted to adjust for potential confounders.ResultsWe included 117 patients (60.7% women, 76.9% bipolar I, 50% history of psychosis, 22.6% suicide attempts). We found a significantly longer QTc interval in BD patients with hypertension (difference: 9.5 ms, p=0.006), obesity (difference: 25 ms, p=0.001), and metabolic syndrome (difference: 13 ms, p=0.007). Hypertension remained a significant predictor of longer QTc after adjusting for age, gender, and antipsychotic use (estimate 17.718, p=0.018). We observed a significantly shorter PR interval in women (difference: 6 ms, p=0.029), early age of onset (difference 6 ms, p=0.025), non-users of lithium (difference 4 ms, p=0.002), and early trauma (difference 4 ms, p=0.038). Finally, we identified significant correlations between symptom severity, blood glucose and PR interval (r=0.298, p=0.001; r=0.278, p=0.003; respectively).ConclusionsPatients with BD and hypertension may have an increased risk for QTc prolongation. Careful cardiovascular monitoring may be warranted.DisclosureNo significant relationships.
Social Isolation and its Brain Correlations: From Symptomatology to Neuroimaging Findings
Authors: Bellani M. 
Published: September 2022

According to the social brain hypothesis, the human brain includes a network designed for the processing of social information. This network includes several brain regions that elaborate social cues, interactions and contexts, i.e. prefrontal paracingulate and parietal cortices, amygdala, temporal lobes and the posterior superior temporal sulcus. We will explore neuroimaging studies that investigated social isolation in healthy subjects.DisclosureNo significant relationships.
Evaluation of the relationship between lithium treatment response and suicide attempt in bipolar disorder
Authors: Altınbaş K. 
Published: September 2022

IntroductionSuicide risk is 20-30 fold higher in bipolar disorder(BD) than general population. A positive family history of suicide, early-onset bipolar disorder, rapid cycling, and drug/alcohol addiction have been identified as risk factors for non-fatal suicidal behavior. Lithium is the only mood stabilizer known to have a suicide-reducing effect in patients with BD. Less than half of the bipolar patients respond lithium well. Even though mechanism of action on suicide behavior is not clearly known, it is thought that lithium significantly reduces “impulsive-aggressive” behavior via serotonergic system which might also be related with treatment response in BD.ObjectivesThe aim of this study is to evaluate the relationship between lithium response and history of suicide.MethodsThose who scored 7 points or more from the Alda total score were considered good responders. Patients were divided into those who responded well to lithium treatment and those who did not. History of suicide attemptbetween these two groups was compared.Results65.3% of the patients were female (n:49). The mean age of the patients was 36.82±13.35 years. 25 patients responded well to lithium treatment. Among the good responders, 32% of the patients and 25% of the non-responders had a history of suicide attempts. This difference was not statistically significant. (p=0.46 x²=0.13)ConclusionsThe insufficient number of data in the study was considered as a limitation of this study. In addition, there is a need for more studies as there are many factors that cause suicide attempts.DisclosureNo significant relationships.
Role of MAOI drugs as triggers of manic episodes in bipolar disorders: A case report and a narrative review
Authors: Olivier Mayorga L. , Ilzarbe L. , Andreu Gracia H. , Bueno Sanya L. , De Juan Viladegut O. , Barrio P. 
Published: September 2022

IntroductionUse of Monoamine Oxidase Inhibitors (MAOIs) has experimented an important reduction in recent years, being replaced by other antidepressant drugs (ADs) associated with a better safety profile. Its use has been restricted to instructed professionals treating resistant and atypical depression. Thus, treatment-emergent affective switch (TEAS) induced by MAOIs is a rare event nowadays.ObjectivesTo describe a manic episode associated to a one-year-long treatment with phenelzine, a MAOI agent.MethodsWe present the case of a 47-year-old man hospitalized in our acute psychiatric unit after presenting compatible clinical symptoms with a manic episode. He showed severe irritability, decreased need for sleep, pressured speech, increased energy and goal-directed activities. The patient had started phenelzine a year ago for the treatment of major depressive episode resistant to previous pharmacological essayed treatments. No previous history of TEAS was reported, although he had already taken other ADs and mood-stabilizer treatments in the past.ResultsSeveral studies reported the effectiveness of MAOIs for the treatment of monopolar depressive episodes resistant to other ADs, especially when atypical symptoms were observed. Data on the use of MAOIs for the treatment of drug-resistant bipolar depressive episodes is scarce. Few studies have described a good response without showing and increased risk of TEAS.ConclusionsAs MAOIs have fallen out of favour with modern psychiatry, there is scarce evidence on the prevalence of TEAS in patients undergoing treatment with these drugs. Further research is needed in order to accurately define these complex relationships.DisclosureNo significant relationships.
A review: Circadian Rhythm Dysfunction and Bipolar Disorder
Authors: Ribeiro M. , Lourenço A. , Lemos M. , Bastos J. , Pereira J.M. 
Published: September 2022

IntroductionCircadian rhythm (CR) dysfunction is a prominent feature in bipolar disorder (BD) and sleep disturbances are characteristic, although not essential to the diagnosis.ObjectivesTo review the literature regarding the CR dysfunction and its impact on the onset and clinical course of BD.MethodsWe conducted a MEDLINE search using bipolar disorder, circadian rhythm and sleep as keywords, selecting studies written in English.ResultsCR dysfunction is a trait marker of BD. It’s known that during depressive episodes insomnia is present, with difficulty falling asleep/ maintaining sleep and early awakening. Regarding mania, decreased need for sleep is a critical marker. During the euthymic period significant alterations in sleep pattern have been described. It’s also known that changes in the sleep pattern occur prior to those in mood patterns, indicating that sleep dysregulation may trigger the onset of mood episodes or relapses. Therefore, CR disruption may be associated with the pathophysiology of BD and some factors have already been identified: irregularity of the sleep-wake rhythm, eveningness chronotype, abnormality of melatonin secretion, vulnerability of clock genes and the irregularity of social zeitgeber.ConclusionsDisturbances of sleep are pervasive, and an essential feature of BD, worse during mood episodes, but still present during euthymic periods. It remains to determine whether circadian rhythm dysfunction is a trait marker or mood state dependent. Further studies are warranted to clarify this association.DisclosureNo significant relationships.
Bipolar Disorder - New era of Treatments: High dose Levothyroxine, rTMS and genetics
Authors: Zamar A. , Koutsomitros T. , Lulsegged A. 
Published: September 2022

IntroductionRapid cycling Bipolar disorder and mixed affective states are treatment resistant conditions. Standard treatments are ineffective. Homozygous polymorphism of DIO2 gene is associated 3.75-fold risk of bipolar disorder.ObjectivesHigh Dose Levothyroxine combined with repetitive transcranial magnetic stimulation (rTMS) in Rapid cycling Bipolar disorder: Is it thyroid disease?Methods20 RCBPD with ICD-10criteria for bipolar disorder. All were severely symptomatic. TFTs and ECGs were monitored weekly with cardiology and endocrinology backup. Genetic testing was undertaken for DiO1/DiO2 status.Results17 were female, average age 32.4 yrs. 19/20 had Single nucleotide polymorphisms (SNP) of either DIO1, DIO2 or both. All but two patients were treated with rTMS to induce cerebral neuroplasticity. Average pre-treatment fT4 was 17.0 pmol/L , and fT3 4.5 pmol/L Average post-treatment, fT4 was 59.7 pmol/L and fT3 5.3 pmol/L. Average fT4:fT3 ratio pre-treatment was 4:1, and post-treatment was 5:1. HDL range was 200-800 mcg daily for remission. Average dose 472 mcg daily. Discontinuation rate was 0%. All patients had ECG and cardiac review One patient required a dose reduction because of minimal side effects 12 patients needed one mood stabiliser All were in remission for a minimum of 6 months.ConclusionsWe speculate that BPD may be a form of cerebral hypothyroidism and that HDL helps to overcome the deficit while robust inactivating deiodinases in the periphery protect from systemic thyrotoxicosis. This is evidenced by findings of normal clinical examination and elevated rT3. rTMS exercises its well established neuroplastic effect, helping to achieve and maintain remission as an adjunct to HDL.DisclosureThe London Psychiatry Centre (TLPC) has pending patents for the combined protocol of rTMS and/or Thyroid hormones depending on the territory: - Pending US Patent application: (and/or) US20200384279 - Pending European patent appl
Use of intravenous valproate in acute manic: about a clinical case
Authors: Suárez Gómez M. , Suárez Gómez A. , Rodrigues P. , Sánchez Rus S.S. , Matos-Pires A. 
Published: September 2022

IntroductionAcute mania can have behavioral effects such as agitation, being a frequent cause of presentation in the emergency department. Pharmacological treatments include mood stabilizers and atypical antipsychotics. Valproate is an effective drug. However, the intravenous formulation is relegated to other pathologies, such as epilepsy.ObjectivesThe objective was to review the use of intravenous valproate in acute mania in the literature and present its use through a clinical case.MethodsA clinical case using intravenous valproate to treat an episode of acute mania is described and the scientific literature of the last 5 years is reviewed.Results
A 43-year-old patient attended the emergency department with a diagnosis of bipolar disorder type I in manic episode with agitation, rejection of oral medication, brought in by the police due to risk of aggression against family members, who reported that the patient had stopped taking her usual medication with valproate 500 mg / 24h and quetiapine 200 mg / 24h threemonths ago. Due to the possibility of having intravenous valproate, it was decided to administer 300 mg intravenously, as well as haloperidol 5 mg intravenously, and hospitalization was decided. The patient had a favorable evolution, with no side effects to the medication, and oral treatment was started after 8 hours, with a good response. In the literature there are few studies in this regard, although the most of them approved the use of valproate as a loading dose in acute mania.ConclusionsIntravenous valproate is an effective, safe, and tolerated treatment in acute mania. More studies are needed to collect precise information.DisclosureNo significant relationships.
The use of pramipexole in drug-induced parkinsonism: A case study on a patient with bipolar depression
Authors: Bueno Sanya L. , Bermejo Pastor A. , Andreu Gracia H. , De Juan Viladegut O. , Olivier Mayorga L. , Pacchiarotti I. 
Published: September 2022

IntroductionPramipexole is a dopaminergic agonist used in the treatment of Parkinson’s disease and restless leg syndrome. Although there is a lack of pharmacological options to treat drug-induced parkinsonism, not many studies have been made on the use of pramipexole in its management. There is also evidence on pramipexole effectiveness on major depressive episodes, particularly for bipolar and treatment-resistant depression.ObjectivesTo describe a case of drug-induced parkinsonism treated with pramipexole in a complex patient with bipolar disorder type I and obsessive-compulsive disorder, long-term treated with antipsychotics and valproate.MethodsWe present the case of a 51-year-old woman admitted in our psychiatric inpatient unit mainly to treat a bipolar depression. She also presented a parkinsonian syndrome, and a neurological study was conducted. As a negative DaTSCAN concluded its cause to be pharmacological, we decided to stop lurasidone and initiated pramipexole.ResultsGuidelines suggest that drug-induced parkinsonism should be managed by discontinuing causative drugs or switching to another agent. However, we decided to use pramipexole with the aim of not only treating the parkinsonian syndrome but helping manage the depressive episode. We observed a remission of the depressive symptoms and an improvement in the parkinsonian symptoms.ConclusionsAlthough the best way to treat drug-induced parkinsonism is to avoid its causative agents, in clinical practice it is not always possible as some patients have resistant and complex psychiatric syndromes. We suggest considering pramipexole in its management, especially when dealing with a patient with a comorbid unipolar or bipolar depression. Further research is necessary to clarify its utility.DisclosureNo significant relationships.
Uric acid levels among Tunisian patients with bipolar disorder during different phases of illness
Authors: Falfel D. , Hamdi G. , Ben Ammar H. , Ridha R. 
Published: September 2022

IntroductionBipolar disorder is a recurrent chronic disorder characterised by fluctuation of mood state. Recent studies focused on the involvement of adenosine and the purinergic system in the pathophysiology of bipolar disorder.ObjectivesWe aimed to investigate the difference in (SUA) levels between different phases of relapse and remission period.MethodsFor this aim a prospective study was conducted during six months at Razi psychiatric Hospital in Tunisia with patients diagnosed with BD The socio-demographic, clinical data were gathered from patient and a psychometric assessment using YMRS and Beck scale was employed. Uric acid level was studied during relapse and remission period.ResultsAmong 30 consentent patients included in the study : 65.7% were women, The age of the participants varied between 22 and 65 years old. Uric acid level at the relapse varied between 328 and 499 mmol/L and level of controlled value at the remission period which is eight weeks under treatment varied between 137 and 307 mmol/L. Patients under antipsychotic treatment were 55.9% the other were under lithium or mood stabilizer. There is no significant difference between patients with bipolar disorder type I or II neither for the molecule chosen for treatment (p<0.05).ConclusionsBipolar disorder is a chronic psychiatric disease which needs to be regulary controlled. Uric acid levels were higher in manic or depressive phases as compared with euthymia phase. Uric acid could be used as a trait marker in bipolar disorder and help psychiatrist to monitor patients and to adjust treatment in order to avoid relapsing.DisclosureNo significant relationships.