bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical features of bipolar disorder in adolescents with intellectual disability
Authors: Hafnaoui M. , Gadhoum R. , Abbes Z. , Hajri M. , Jelili S. , Halayem S. , Bouden A. 
Published: February 2022

IntroductionBipolar disorder in children and adolescents is distinguished by a variable and complex clinical expression. Mood is difficult to assess, mood symptoms are often masked and signs of disorganization may be in the limelight. This can be more difficult when adolescents have intellectual disability (ID).ObjectivesThis work aims to describe diagnostical and therapeutical features of bipolar disorder in adolescents with ID.MethodsCase reports about five patients who have been diagnosed with bipolar disorder associated to ID, all seen and treated in child and adolescent psychiatry department of Razi Hospital, in Tunis.ResultsThe study focused on three girls and two boys, all with mild to moderate ID. Four patients had psychiatric family history of bipolar disorder and ID. Only one patient was followed since childhood for mixed ADHD. The average age of onset of bipolar disorder was 14 years. Four cases were inaugurated by manic access; the fifth was a depressive disorder followed by a manic shift under sertraline. Only one case was rapidly favorable, under 10mg of Olanzapine, without any recurrence or relapse during 18 months of follow-up. Another case was slower but also favorable, under 10mg of Olanzapine. We found resistance to usual treatments for 2 patients; these did not evolve well under conventional thymoregulators, or different antipsychotic molecules, nor with combinations of two thymoregulators + an antipsychotic. One of them benefited from a combination of clozapine and lithium with excellent response.ConclusionsBipolar disorder comorbid with ID in adolescents is a difficult diagnostic entity and particularly hard to manage.DisclosureNo significant relationships.
The relationship between comorbid overweight-obesity and cold executive functions, verbal short-term memory, and learning in attention deficit hyperactivity disorder
Authors: Guler H.A. , Turkoglu S. 
Published: February 2022

IntroductionAttention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. ADHD is a risk factor for the development of overweight and obesity. One neuropsychological factor that may play a prominent role in the relationship between ADHD and obesity is executive functioning.ObjectivesThe aim of this study is to investigate the relationship between comorbid obesity/overweight and cold executive functions, verbal short-term memory, and learning in children with ADHD. This is the first study to examine relationship between verbal short-term memory-learning and obesity in patients with ADHD.MethodsThis study was conducted with 70 patients with ADHD and 30 healthy controls. In this study, patients diagnosed with ADHD were divided into two groups according to body mass index (BMI) as <85 percentile and ≥85 percentile. Cold executive functions were evaluated by Stroop Test (ST) and Cancellation Test (CT). Serial Digit Learning Test (SDLT) was administered to measure verbal short-term memory and learning capasity. In order to evaluate the severity of ADHD objectively, parents completed the Conners’ Parents Rating Scale-Revised Short Version (CPRS-RS).ResultsThe ST, SDLT and CT scores were significantly lower in both groups with ADHD than the control group. The CPRS-RS subscale scores were significantly higher in both groups with ADHD than the control group. There was no statistically significant difference in ST, SDLT, CT scores and CPRS-RS subscale scores between the two groups with ADHD.ConclusionsThis study show that overweight/obesity comorbid with ADHD was not associated with cold executive functions, verbal short-term memory, learning, or ADHD symptom severity.DisclosureNo significant relationships.
Behavior problems associated with brain heterotopia
Authors: Budisteanu M. , Papuc S. , Erbescu A. , Iliescu C. , Dobre M. , Barca D. , Tarta-Arsene O. , Motoescu C. , Dica A. , Sandu C. , Anghelescu C. , Craiu D. , Arghir A. 
Published: February 2022

IntroductionBrain heterotopia represent a group of rare malformations with a heterogeneous phenotype, ranging from asymptomatic to severe clinical picture (resistant epilepsy, severe developmental delay). The etiology is multifactorial, including both genetic and environmental factors.ObjectivesIn this paper we present our experience regarding behavior problems in patients with heterotopia.MethodsA cohort of 16 pediatric patients with brain heterotopia, six females and ten males, with age at last follow-up ranging from 2 months to 24 years were investigated by clinical examination, electroencephalographic studies, brain imaging, and genomic tests. Specific psychological tests and psychiatric evaluation were performed in all children for behavior problems assessment.ResultsSix individuals presented behavioral problems: autism (three patients) and hyperkinesia with attention deficit (three patients). All of them had intellectual disability or learning problems; five patients had epilepsy, with drug-resistant seizures in four cases. In two cases the behavioral problems occurred before the onset of epileptic seizures.ConclusionsBehavior problems are important features in patients with brain heterotopia, making the management of these patients more difficult, especially when they occur in association with drug-resistant epilepsy. Acknowledgements: This work was supported partially by grants of the Romanian National Authority for Scientific Research and Innovation CCCDI – UEFISCDI, Projects COFUND-ERANET E-RARE 3-HETER-OMICS-2 Number 87/2019 and 88/2019 within PNCDI III.DisclosureNo significant relationships.
Cycloid psychosis
Authors: Anton R. Hernandez , Conde L. Aranguren , Gardeazábal M. Basteguieta , Ozcariz P. Antía , Zariquiey N. Cancelo , De Sousa Figueiredo N. , Salinas V. Fronda 
Published: February 2022

IntroductionWhen we talk about cycloid psychosis we have doubts about their nosological enclave; whether they should be considered as a subform of schizophrenia or as independent psychoses.Some solutions were proposed, such as the thesis of mixed psychoses (Kretschmer) or that of intermediate forms (Bleuler, Schneider). Cycloid psychoses and bouffée delirante are recognized in ICD-10 under the name of acute polymorphic disorder without symptoms of schizophrenia (F23.0) and with symptoms of schizophrenia (F23.1).ObjectivesClinical caseMethodsWe present the case of a 16-year-old patient with no psychiatric history, with medical background of epilepsy; she was in fllow-up by Neurology and in treatment with valproate.Neurology indicates to stop treatment; it is then whwn the patient begins to appear disoriented, confused, with significant anguish and lability and regressive behaviors.She has sudden mood swings (from laughing to crying); sudden changes in emotional reaction (from distress to anger) and sudden changes in behavior (from agitation to prostration); verbiage with pressure of speech and dysprosodia; delusional ideation and incongruous affect; visual, auditive and kinesthetic hallucinations with important repercussion. We request blood and urine tests, drug test, EEG, cranial MRI.ResultsShe presents fluctuating, polymorphic and unstable affective and psychotic symptoms. What is the most appropriate diagnosis? We treat the patient with antipsychotic, mood stabilizer and anxiolytic treatment.ConclusionsPsychopathology in early ages is not so clearly defined and it can take very different forms. The diagnosis of cycloid psychosis can be useful as well as necessary to describe certain patients with similar characteristics and different from other groups.DisclosureNo significant relationships.
Acute pancreatitis induced by valproic acid
Authors: Khouadja S. , Melki R. , Taleb C. Ben , Zarrouk L. 
Published: February 2022

IntroductionValproic acid (VPA) is a commonly prescribed medication for epilepsy, migraine and especially bipolar disorder therapy. Although the common adverse effect associated with VPA are typically benign, less common adverse effects can occur; these include acute pancreatitis.ObjectivesDescribe the clinical and therapeutic characteristics of a case of acute pancreatitis induced by VPA with a review of the literature.MethodsWe report the case of a patient who presented an acute pancreatitis induced by VPA. The data was collected from the patient’s medical file. A review of the literature was performed by selecting articles from the PubMed search engine using ‘acute pancreatitis and valproic acid’ and ‘drug induced acute pancreatitis’ as key words.ResultsThis is a 51-year-old male patient with a history of type 2 diabetes, dyslipidaemia and psychiatric follow-up for bipolar disorder type I on lithium. He was admitted for a resistant depressive episode. We opted for the combination of two mood stabilizers (VPA and lithium). On the third day of treatment, the patient reported epigastric pain with incoercible vomiting. Laboratory tests showed increased levels of pancreatic enzymes and a biological inflammatory syndrome. The diagnosis of acute stage A pancreatitis was made.VPA was discontinued and the patient was put on symptomatic treatment with favourable outcome after one week. The etiological investigation ruled out other causes of acute pancreatitis. As a result, iatrogenic origin was retained.ConclusionsThis case supports the idea that acute pancreatitis may be induced by VPA, it has no predictable factors.DisclosureNo significant relationships.
Emotional, personal, cognitive and other mental disorders after removal of the tumor of the diencephalic region (in the long-term period)
Authors: Sidneva Y. , Astaf’Eva L. , Zaitsev O. , Kalinin P. , Kadashev B. , Kutin M. , Urakov S. , Voronina I. , Shkarubo A. , Fomichev D. , Andreev D. , Sharipov O. 
Published: February 2022

IntroductionIn the literature, there are conflicting data regarding the recovery of mental disorders, in particular, pathologies of the emotional, personality, behavioral and cognitive spheres, in patients after surgical treatment of tumors of the diencephalic region.ObjectivesTo evaluate the dynamics of psychopathological disorders after removal of a craniopharyngioma.Methods45 patients (18–68 y.o.), operated through transcranial access. The follow-up period ranged from 3 months to 9 years (on average 2.8 + 0.4). The main method is psychopathological, supplemented by rating scales and questionnaires.ResultsIn the late postoperative period, mental disorders were detected in 75% of patients (Table 1). Table 1. Dynamics of the main psychopathological symptom complexes (n = 45).Disorders (may be a combination)Before surgery (n,%)2 weeks after (n,%)18 months after (n,%)Emotional and volitional27 (60%)27 (60%)15 (33%)Cognitive - Korsakov syndrome18 (40%) 4 (9%)27 (59%) 8 (18%)18 (40%) 7 (15%)Personality21 (46%)25 (55%)23 (51%)The table shows that emotional-volitional disorders have a clear positive dynamics by 18 months after surgery compared with the preoperative level. Korsakov’s syndrome and personality disorders are less favorable. 23 patients (52%) returned to their previous profession; 22 (48%) stopped working due to a severe degree of disability, of which 7 (15%) need constant supervision.ConclusionsThe positive dynamics of psychopathological symptoms is observed only within 1.5 years after the removal of the craniopharyngioma, in the future they remain without a tendency to improve. 22 patients (48%) stopped working. The most severe degree of disability is 15% patients.DisclosureNo significant relationships.
Delusional disorder and tuberculosis: A clinical case
Authors: Falcão V. Podence , Avelar R. , Abreu C. , Heitor M. 
Published: February 2022

IntroductionTuberculosis is still a challenging disease, infecting around a third of the world’s population. As comorbidity with mental disorder is common, it is relevant to associate them at a diagnostic, therapeutic and prognostic level.ObjectivesWe present a clinical case describing a patient with psychosis, further diagnosed with tuberculosis during psychiatric treatment. Moreover, we present a summarized revision of the state of the art.MethodsRevision of the state of the art, drawing from PubMed and using the keywords “mental health”, “psychosis” and “tuberculosis”, in the last 10 years.ResultsMale, 61 years old, heavy smoker and alcohol drinker. Admitted for allegedly feeling “worms” in his body. After medical examination, a weight loss of 13 kg in five months and symptoms compatible with tenesmus stood out. Following diagnostic tests, the patient was diagnosed with Ekbom Syndrome and Ganglionar Tuberculosis; he was then medicated with the adequate antipsychotic and tuberculostatic agents, which resulted in overall clinical improvement.ConclusionsThis case illustrates the relationship between tuberculosis and mental disorders, in a patient with a low literacy level and a precarious socioeconomic background, known risk factors for mental disorder in patients with tuberculosis and are often associated with poor therapeutic adherence. Although proper treatment of the mental disorder is key to reducing the risk of tuberculostatic dropout, the stigma of mental disorder and tuberculosis decreases the probability of these patients seeking proper treatment. Thus, we alert the medical community for the possibility of psychiatric comorbidity in patients with diagnosed tuberculosis – and vice-versa –, allowing for an early intervention,DisclosureNo significant relationships.
Compartment syndrome and suicide attempt
Authors: Vázquez E. Rodríguez , Meseguer C. Capella , Cerejeira J. Gonçalves , Carrasco I. Santos , De Llano De La Viuda M. Queipo , Ramírez A. Gonzaga , Valera G. Guerra 
Published: February 2022

IntroductionThe compartment syndrome is a pathological condition characterized by a decrease, or even interruption, of the microcirculation within a soft tissue compartment. There have been a few cases reported about compartment syndrome due to a suicide attempt.ObjectivesTo present an unusual complication of an autolytic attemptMethodsA descriptive study of a clinical case and literature reviewResultsA 49-year-old woman, divorced. With no psychiatric history and no somatic antecedents. Comes to the hospital after been found lying face down on the bathroom’s floor for 48 hours, next to her two empty blister packs of lorazepam and naproxen. Her partner says they argued two days ago. Brain CT: with no abnormalities. Blood analysis: metabolic acidosis with rhabdomyolysis and kidney failure. She presents ischemic injuries in both inferior extremities with right food ischemia and with no pedal pulses. Compartment syndrome is diagnosed, being necessary a bilateral fasciotomy and later a right lower extremity amputation. Initiates referral from Vascular Surgery for self-poisoning. She refers to low mood and mild anxiety due to work and relationship issues/problems. She accepts that she self-poisoning only to attract her partner’s attention after the argument. The examination shows logical thought, emotional lability, good judgement, future-oriented without suicidal ideation. Clinical judgement: acute stress reaction.ConclusionsThe compartment syndrome is a rare complication of the suicide attempt. Our patient suffered a compartment syndrome lying on the bathroom’s floor for 48 consecutive hours without apparent trauma and no somatic antecedents. This syndrome could be developed by high naproxen and lorazepam intake.DisclosureNo significant relationships.
To diagnose or not to diagnose your BPD patient
Authors: De Picker L. 
Published: February 2022

Clinicians working in every field of psychiatry will likely encounter patients with borderline personality disorder (BPD) on a regular basis. Nevertheless, diagnostic assessment and disclosure in patients suspected to suffer from BPD can be difficult and even uncomfortable to many clinicians. In a survey among psychiatrists, 57% indicated they had failed to disclose a diagnosis of BPD at some point in their careers, citing diagnostic uncertainty and concerns about stigma as key issues.1This workshop will engage the audience in an intensive discussion of when and how to disclose a suspected diagnosis of BPD to a patient, and how to involve the patient in the diagnostic process. Dr. De Picker will demonstrate how BPD diagnostic disclosure can become a key intervention in every psychiatric setting by using a two-step process. The first step involves a review of the DSM-5 diagnostic criteria together with the patient. This is always followed by a narrative explanation using either the interpersonal hypersensitivity model or emotional vulnerability model as trait factor. With these two steps, diagnostic disclosure creates both an important validating experience for the patient and a not to be missed opportunity for psycho-education about the heritability, prognosis and treatability of borderline personality disorder which installs hope, trust and confidence. References: 1. Sisti D, Segal AG, Siegel AM, Johnson R, Gunderson J. Diagnosing, disclosing, and documenting borderline personality disorder: a survey of psychiatrists’ practices. J Pers Disord 2016; 30: 848–56.DisclosureDr. De Picker reports grants from University Psychiatric Centre Duffel, Johnson & Johnson Belgium and Boehringer-Ingelheim, outside the submitted work.
Assessment of quality of life in patients with primary hypothyroidism - the main criterion of treatment effectiveness
Authors: Pityk O. 
Published: February 2022

IntroductionСurrent research suggests that the assessment of the quality of life of patients with somatic and mental pathology should be one of the main criteria for assessing the quality of treatmen. Given this view, one of the valid assessment of the performance of integrated mental health and the effectiveness of treatment should be considered as quality of life, defined by WHO. Leading mental health criteria based on such factors as adaptation, socialization and individualization.ObjectivesThe aim was to investigate the quality of life of patients with hypothyroidism with non-psychotic mental disorders. We examined 132 patients with hypothyroidism. The age of patients ranged from 25 to 55 years. The main group included 108 patients with non-psychotic mental disorders, which are dominated asthenia (27.78 %), asthenic- depressive (32.41%) and asthenic-anxiety disorders (18.52%). The control group consisted of 24 patients with hypothyroidism without mental disorders.MethodsQuality of life was assessed using a questionnaire developed by Mezzich, Cohen, Ruiperez, Liu & Yoon (1999), covering the three main components of quality of life: subjective wellbeing/satisfaction, fulfillment of social roles, external living conditions.ResultsFound a significant difference in quality of life in patients with main and control group. The average in the overall perception of life (sense of satisfaction and happiness in general) in the main group was 5.19±1.15, in the control group 7.50±2.25.ConclusionsThe main conclusion is that patients with hypothyroidism really need psychiatric consultation and treatment should include not only endocrinological influence but neuropsychopharmacological and psychological too.DisclosureNo significant relationships.
A blank slate – apropos a clinical case
Authors: Ramos S. Freitas , Seabra M. , Horta P.Â. , Guimarães J. , Grangeia R. 
Published: February 2022

IntroductionDissociative Amnesia remains an enigmatic and controversial entity. It is classically described as responsible for autobiographic amnesia associated with a traumatic event.ObjectivesTo report a clinical case and review the literature.MethodsWe collected data from the patient’s clinical file with his informed consent. We conducted a non-systematic review of the literature.ResultsA 46-years-old patient presents to the emergency department for sudden global retrograde amnesia, with multiple domain amnestic syndrome (impairing verbal and visual memory, processing speed, mental flexibility, calculus, executive functions and language). He was initially admitted for a suspected infectious meningoencephalitis, which was not confirmed. Later an autoimmune encephalitis was pursued. Brain MRI showed a nonspecific left temporal and hipocampal hyperintensity and the EEG a mild left temporal dysfunction. The autoimmune encephalitis panel was negative and the formal diagnostic criteria were not met. The neurologic examination at discharge presented only with autobiographical and semantic amnesia. On the mental state examination, he presented with depressive symptoms reactive to the situation. There was no evident traumatic event apart from a promotion received the day before the amnesia started. He was prescribed escitalopram 10 mg/day. The amnesia was maintained at 9 months follow-up.ConclusionsOur case report illustrates a case of amnesia without evident organic or psychogenic cause, assumed as a dissociative amnesia. Further studies are necessary to clarify the pathophysiology of this condition and develop specific treatments.DisclosureNo significant relationships.
Alprazolam addiction: The case study
Authors: Pityk O. , Karbovskyi N. , Galyga N. , Rubanets O. 
Published: February 2022

IntroductionAlprazolam is an anxiolytic, a benzodiazepine derivative of the middle duration of action. It is one of the most frequently prescribed medication for the treatment of anxiety and panic disorder. Under the action of a drug, a person feels incredible ease, a sense of euphoria, absence of problems, a sense of safety.ObjectivesA 55-year woman was admitted to psychiatric clinic in Ivano - Frankivsk.MethodsShe was assesed by the clinicopsychopatological method (clinical interview) and additional methods (MRI, EEG, pathopsycological assessment).ResultsThe main findings were: atactic procession, tremor of the limbs and the whole body, poor attention, speech impairment, retarded thinking, fixation and reproductive amnesia with the components of progressive amnesia, change handwriting. The mood is lowered with unstable affect, lack of insight. She reported burning and tingling of the head as a main problem. She developed amotivation, bad activity and drowsiness, bradycardia, decreased blood pressure. She took Alprazolam during a period of 1,5 year in gradually increasing doses. The last dose was 12 tablets of Alprazolam per day. The patient was consulted again in a year. She does not take Alprazolam. She takes valproate and escitalopram. She did not demonstrate severe neurological symptoms which were seen a year ago.ConclusionsThus, though alprazolam is one of the best anxiolytic substance it should be prescribed only by the doctor for a short course (no more than 4-5 weeks). The treatment must include psychoeducation in order to make patients be aware about possible addiction and unsafety of prolonged and uncontrolled usage of alprazolam.DisclosureNo significant relationships.