bluuebunny/crossref_metadata_2025_split huggingface dataset:
Framing the implementation process of a social innovation project for people with severe mental disorders in chile
Authors: Solis-Soto M. , Reginatto G. , Alvarado R. , Arratia T. , Burrone M. 
Published: February 2022

IntroductionThere are important challenges for the effective inclusion in society of people with severe mental disorders (SMD). The POTENCIAT intervention supports the formation of work cooperatives for the socio-labour inclusion of people with SMD working together with women in vulnerable situations and older adults.ObjectivesTo analyse the implementation process of the first phase of POTENCIATMethodsAccording to Nilsen, six components were analysed: implementation object, implementation activities, implementation actors, users, inner context and outer context. A qualitative study was performed during the first phase of the project (12-months). Participant observation and in-depth interviews with key actors, users and fieldwork team were conducted, as well as bibliographic analysis of field notes, meeting minutes and audios/videos of socialization activities. Ethical issues were considered.ResultsThe implementation object was positively valued as a response to perceived needs such as users involvement in a participatory approach. Shared decision-making process was emphasized. Implementation activities were accompanied by local teams and were adapted to participants needs and context characteristics (e.g. social distancing). Most users showed high expectations related to the solidarity economic model as well as physical and economic autonomy, which work as a key factor for commitment and retention in the project. A good working environment was recognized and a space for personal fulfillment. Some barriers were recognized, including cultural stigma, auto-stigma, and recruitment in pandemic context.ConclusionsEarly and proper addressing of factors that may positively and negatively affect the implementation process is mandatory to achieve the effective inclusion of people with SMD.
Contributions to the study of the relationship between blood pressure and mental health
Authors: Esgalhado G. , Louro A. 
Published: February 2022

IntroductionBlood pressure (BP) refers to the pressure that the blood exerts on the walls of blood vessels. There is a number of evidences that show that depression, anxiety, and also stress have a high incidence in people suffering from hypertension.ObjectivesTo correlate blood pressure levels with psychopathological symptomatology levels and to compare differences between genders, age and education levels.MethodsThis was a descriptive, inferential and correlational study encompassing 1407 participants, aged from 18 – 89 years of age (average age = 36 years). Measures included biomedical data - systolic blood pressure and diastolic blood pressure, arrhythmias and heartbeat, as well as the demographic variables - sex, age and education of the participants; mental health (psychopathological symptomatology) was measured using the Portuguese version of the BSI.ResultsIn the present study there were no statistically significant relationships between Systolic Blood Pressure, Diastolic Blood Pressure and General Symptom Index, as well as for each BSI dimension. Nevertheless, statistically significant differences were found between Diastolic Blood Pressure and obsessions-compulsions, interpersonal sensibility and hostility. Also, there are statistically significant differences for BP according to gender and education.ConclusionsThis study brings important contributions to the study of the associations between blood pressure and mental health, with import implications for intervention and prevention.
Mental health essentials for future healthcare professionals. A public health capacity building initiative
Authors: Arrasa M. Borrell , Eissa M. , Omrani O. El 
Published: February 2022

IntroductionMental disorders in Europe represent the leading cause of disability and the third leading cause of overall disease burden, following cardiovascular disease and cancers. As future healthcare professionals, with an imminent role in tackling this global health issue, we acknowledge that Mental Health is not adequately included in the medical curriculum. To address this gap, this workshop was created to equip medical students with the knowledge and skills that will empower them to lead a pioneering role in advocating for mental health for their patients, peers, and communities.ObjectivesBy the end of the workshop, all participants should have: - Increased their knowledge in the field of Mental Health disorders - Increased their skills in the field of Mental Health (preventive practices, intervention strategies towards others, etc.) - Explored the relations between stigma, vulnerability, and Mental Health - Strengthened the international perspective and global understanding concerning mental health issuesMethodsThis workshop utilized principles of non-formal education and was planned according to the 4MAT system to meet all four learning styles through theory blocks, space for reflection, practical application of knowledge, and future opportunities for application of content. This was achieved through various methodologies including presentations, self-discovery activities and exercises, roundtable debates, simulations, and role-playing.ResultsobtainedConclusionsThis workshop highlighted the importance of building the capacity of medical students to tackle the burden of Mental Health globally and within the region, and how similar student-led initiatives can further empower them to be change agents and impactful advocates for better Mental Health in their own communities.
An online forum to support consultant psychiatrists in their first five years of practice, introduced during the COVID-19 pandemic
Authors: Maclaren T. , Ahmed N. , Edwards S. 
Published: February 2022

IntroductionIn the United Kingdom, the move from trainee to consultant psychiatrist can be both exciting and daunting. Trainee psychiatrists have access to support and weekly supervision that is not available to consultants. Having an organised meeting for new consultants could help bridge this gap with peer-led support.ObjectivesImproving support and guidance to new consultants Networking with peers Promoting wellbeing, good clinical practice and career developmentMethodsWe identified a group of 85 consultants in their first five years of practice. Meetings were held online using videoconference. Senior leaders presented at each meeting, with a group discussion at the end. We surveyed attendees using an online platform.ResultsWe had excellent attendance rates from the group, with 30 to 45 consultants attending each webinar. Over 60% of attendees had been a consultant for less than a year. For 90%, this was their first experience of a new consultant forum. Attendees gave excellent feedback (Table). Being able to meet consultants from different specialties, hearing career stories from senior leaders and how they have managed the COVID-19 pandemic were cited as benefits.Table: Feedback scores (0 = not useful to 100 = very useful)StatementScoreThe forum helped me feel supported75Topics covered are relevant to me79I feel more connected with colleagues71ConclusionsThe forum was popular and the feedback was excellent. Using an online format worked well and made it easier to organise and plan sessions. There is potential to implement similar fora for other senior psychiatrists across Europe.
Systemic endotoxinemia as a probable factor in reducing the treatment effectiveness of endogenous psychosis
Authors: Zozulya S. , Otman I. , Oleichik I. , Anikhovskaya I. , Yakovlev M. , Klyushnik T. 
Published: February 2022

IntroductionInflammation is an important factor in the pathogenesis of endogenous psychosis. An inducer of inflammatory reactions can be endotoxin aggression of intestinal origin.ObjectivesTo determine the level of inflammation markers and indicators of systemic endotoxinemia in blood of patients with endogenous psychosis in relation to assessment of the treatment effectiveness.Methods25 patients with endogenous psychosis (F20, F25) were examined before and after treatment. The control group consisted of 25 healthy people. The activity of inflammatory markers - leukocyte elastase, α1-antitrypsin, antibodies to S-100B, and indicators of systemic endotoxinemia – endotoxin concentration and antiendotoxin immunity activity were measured in blood serum. The treatment effectiveness was assessed by the dynamics of inflammatory markers.ResultsBased on the results of determining the studied parameters before treatment, all patients were divided into two groups. In the 1st group (6 patients, 24%), an increase of inflammatory markers activity and high concentration of endotoxin in the blood serum were revealed (p<0,001, p<0,05, respectively). In the 2nd group (19 patients, 76%), only activation of inflammatory reactions (p<0,001) was detected. After therapy in the 1st group of patients, there was no positive dynamics of all studied markers, which indicated an active course of the pathological process. In the 2nd group, the normalization of inflammatory markers was shown (p<0,05), which corresponded to the formation of remission.ConclusionsThe results indicate that endotoxic aggression contributes to reduction of the effectiveness of endogenous psychosis therapy and can be considered as an additional therapeutic target.
A closer look to apathy
Authors: Silva D. , Martins R. , Polido F. , Cruz M.D.C. 
Published: February 2022

IntroductionApathy is a neuropsychiatry syndrome, conceptualised as a loss of motivation free of altered consciousness, cognitive impairment or emotional distress, associated with a wide range of brain disorders such as Dementia, Major depression and schizophrenia. Even though under-recognized and under-diagnosed, apathy hardly appears uncommon. Its reported frequency in various neurologic and psychiatric conditions varies widely, from less than 10 to over 80%, reflecting differences in population characteristics and assessment procedures.ObjectivesThe aim of this article is to review the concept of Apathy and clarify its nosology, pathopshysiology and treatment.MethodsAn online bibliographic search was carried out on PubMed and Medline using “Apathy” as a term.ResultsThe literature reviewed shows that apathy is a multi-dimensional clinical construct with a current definition and validated diagnostic criteria. Analysis reveals that apathy is strongly associated with disruption particularly of anterior cingulate cortex (ACC), ventral striatum (VS) and nucleus accumbens (N acc). Remarkably, these changes are consistent across clinical disorders and imaging modalities, playing a crucial role in normal motivated behaviour.ConclusionsThe neuromodulator dopamine is heavily implicated in ACC and VS. Therapeutically, numerous small studies suggest that psychostimulants, dopaminergics, and cholinesterase inhibitors may benefit those manifesting this syndrome. However, no adequately powered, randomized controlled trials have reported success and no medication have ever been approved for this disorder Further research is needed to help understand the functional neuroanatomy, neuromodulators involved and possible treatment options of this clinical construct.
Impact of day hospital care on adherence to psychiatric follow-up appointments and medications in patients with delusional disorder
Authors: González-Rodríguez A. , Sanz N. , Guàrdia A. , Pedrero A. Alvarez , Pérez D. Garcia , Fucho G.F. , Delgado L. , Uribe I. Parra , Monreal J.A. , Vidal D. Palao , Labad J. 
Published: February 2022

IntroductionDay care programs have been extensively used to treat people with acute psychiatric disorders. Day hospitals (DH) can act as an alternative to admission in patients with acute symptoms, shorten the duration of admission, be useful for rehabilitation and maintenance care or enhance treatment in patients with poor adherence to outpatient care. Few research has been conducted in delusional disorder (DD).ObjectivesTo investigate whether DH care increases adherence with psychiatric appointments in patients with DD. To describe functions of partial hospitalization in DD.MethodsComparative study including DD patients who attended a DH (Group 1:n=12) versus patients who did not receive DH care (Group 2;n=7). Patients attending DH were classified into 3 groups according to the program function at referral. Adherence with outpatient follow-up appointments (primary outcome) and pharmacy refill data (secondary outcome) were assessed after discharge over a 6-month period (DH) and compared with group 2. For statistical analyses, non-parametric tests were performed.ResultsProgram function (DH): alternative to admission (n=4); shortening of admission (n=5) and enhancing outpatient treatment (n=3). Patients receiving DH care were more frequently referred from the inpatient unit or emergency department compared to those who did not attend DH (commonly referred from primary care services). No statistically significant differences were found between both groups in adherence to psychiatric appointments. Patients who attended DH showed higher compliance with antipsychotics (89.29% vs.72.62, p<0.05).ConclusionsDH care may be a useful alternative to increase adherence with antipsychotics in DD patients with poor awareness of illness.Conflict of interestAGR has received honoraria, registration for congresses and/or travel costs from Janssen, Lundbeck-Otsuka and Angelini.
An insight on psychiatric insight
Authors: Rocha T. Coelho , Cunha J. , Torres S. , Lopes A. 
Published: February 2022

IntroductionInsight is a complex and multidimensional phenomenon. Metacognition, awareness of illness or anosognosia are some of the terms used to designate this feature of the mental state exam.ObjectivesTo attempt to explore the evolution of the concept of insight as a psychiatric symptom over the years and to bring up some up-to-date features on this theme.MethodsLiterature review, using the most relevant papers, with the keywords “psychiatric insight”, “awareness of illness”, “metacognition” and “phenomenology”.ResultsThe term ‘insight’ has been described since 1896 when Kraepelin had noticed that patients with dementia praecox were unaware of their condition. Nowadays, it is recognized in several psychiatric disorders, with different meanings in each one. Overall, insight in psychiatry involves an attempt to see one’s thinking and behaviour ‘objectively’ and comparing it to some representation of mental health. Impaired insight has been linked to poor treatment compliance and outcomes, overall symptom severity, higher relapse, lower self-esteem, and impaired psychosocial functioning. White matter and connectivity problems may be related to poorer insight, as well as impaired frontal lobe functioning. In psychotic disorders, lack of insight is a primary symptom with poorer outcomes. Regarding affective disorders, the lower the mood the better the insight. Neuroimaging has been correlating insight with the inferior frontal gyrus, anterior insula, inferior parietal lobule, and ventromedial prefrontal cortex. In everyday practice, there are scales used to assess insight.ConclusionsInferences about patients’ insight are important to evaluate severity of illness, suicidal risk, compliance, and response to treatment.
Impaired age self-consciousness in latent schizophrenia
Authors: Suleimanov R. , Artemieva M. , Danilin I. , Lazukova A. , Sokolov V. 
Published: February 2022

IntroductionThe topic of research was phenomenon of impaired age self-consciousness in non-psychotic latent schizophrenia patients defined.ObjectivesTo explore features of impaired age self-identity and to determine syndromic affiliation of the syndrome in comparison with premorbid personality disorders traits.MethodsThe study sample comprised 141 patients with latent schizophrenia (pseudo neurotic (F21.3 - 64.5%, 91 patients), coenesthopathic (F20.8 - 25.5%, 36 patients) and pseudo psychopathic (F21.4, - 9.9%, 14 patients)) aged 16-31 (average 22.1 years old) in 2007-2019. A follow-up, experimental psychological and clinical study was conducted.ResultsThe onset of impaired age self-identity was dominated by a radical drop of the subjective age in self-conscious mind of the patients accompanied by a tormented feeling of loss of self-dependence, role autonomy, helplessness, inability of decision making and to be answerable. Patients described this sudden condition as a loss of ‘maturity feeling’ and return to the juvenile perception of self. In a delusive and unclear manner, phrases such as ‘I feel inferior to others as if a helpless child among adults’, ‘I feel as if my childhood is back’ were uttered. Excessive worrying and enlivening of childhood memories were also included. This correlates to occurrence of humble and sometimes dependent/avoidant behavior, feeling of helplessness and fear with respect to caring for one self, rising subordination and suggestibility.ConclusionsThis phenomenon of regress to earlier ontogenetic level of personal development reported as impaired age self-consciousness can thus be regarded as an obligate form of depersonalization in patients with latent schizophrenia.
Angioedema with haloperidol - case report
Authors: Costa A. , Jesus S. , Alcafache J. 
Published: February 2022

IntroductionHaloperidol is a high-potency first generation antipsychotic and one of the most frequently used antipsychotic medications. It is a potent central antagonist of type 2 dopamine receptors, with low alpha 1 adrenergic activity and has no antihistamine or anti-cholinergic activity. It is a widely used drug with proven efficacy. Angioedema is a very rare side effect, occurring in <1% of cases.ObjectivesCase report and reflection on its etiologyMethodsA Pubmed search was performed with the MeSH terms “haloperidol” and “Anaphylactic reactions”. Relevant articles obtained from the respective bibliographic references were also consulted.ResultsThe following case describes the development of angioedema in a patient with an acute confusional syndrome on the second haloperidol IM administration for symptomatic control of agitation. Angioedema has been reported as an adverse effect of various antipsychotics such as clozapine, risperidone, ziprazidone and chlorpromazine, however, resulting from haloperidol administration is rare.ConclusionsIn long-term formulations sensitization testing is especially important but a single prior administration is not sufficient, a second controlled administration is essential to avoid this kind of fatal reactions.
Oxcarbazepine-induced hyponatremia: A case report
Authors: Pinto M. Barbosa , De Carvalho M. Viseu , Tavares F. Gomes , Reis J. 
Published: February 2022

IntroductionOxcarbazepine (OXC) is an antiepileptic drug widely used in the treatment of bipolar disorder (BD), specially when there are side effects with other mood stabilizers. Nevertheless, it isn’t innocuous of adverse effects and its consequences can even endanger the patient’s life.ObjectivesBrief review of the literature on OXC-induced hyponatremia and exposure of a case report.MethodsReview of the literature through research in the PubMed database, using the following keywords: “oxcarbazepine”, “hyponatremia” and “adverse effects”.ResultsAlthough most of the patients are asymptomatic, hyponatremia is one of the most important side effects of OXC. About 29.9% of the patients develop hyponatremia, but only 2.5-3% of psychiatric patients develop severe hyponatremia. The risk of hyponatremia is higher during the first three months of treatment. Severe and/or symptomatic hyponatremia has important clinical implications and may be associated with neurological damage, including seizures, brain stem herniation and death. A 44-year-old woman diagnosed with BD started OXC due to drug intoxications with other mood stabilizers. Six days after initiating treatment, she presented persistent vomiting and severe hyponatremia was detected in blood tests. OXC was suspended with symptomatic resolution.ConclusionsHealthcare professionals should be alert to symptoms that may arise in patients under OXC. Periodic evaluations of serum sodium levels should be carried out. Cases of severe and/or symptomatic hyponatremia should be rapidly identified and treated in order to reduce the risk of developing brain injury and death.
From mentee to mentor: Becoming an early career professor in psychiatry
Authors: Fiorillo A. 
Published: February 2022

In the last years several social, economic and scientific changes have occurred, which have had a significant impact on psychiatric clinical practice, research and training. Some traditional syndromes seem to be disappeared, while new forms of mental health problems are coming to psychiatric consultation. The psychosocial distress caused by the current ongoing crisis due to the COVID-19 or the maladaptive use of the new technologies among the younger generation, are some good examples of psychosocial factors causing new mental health disturbances. Psychiatrists and mental health professionals are not yet well-equipped for managing these, which represent major unmet needs in modern clinical practice. Furthermore, in this evolving social context, the societal role of psychiatrists is completely changed, moving from being “alienist” working in asylums to “mental health care providers” working in the communities. The role of psychiatrists is to improve global mental health and to promote well-being in the general population according to a life-span perspective. Nowadays, early career psychiatrists report several unmet needs that we are not able to manage. In this symposium, I will describe my personal experience of moving from my role of mentee to mentor.DisclosureNo significant relationships.
Bleeding risk between newer direct-acting oral anticoagulants and selective serotonin reuptake inhibitors. Case report and literature review
Authors: Higueras T. Gutiérrez , Cortés F. Calera , De La Cuesta Alonso S. Sainz , Forés S. Vicent 
Published: February 2022

IntroductionThe use of selectiveserotonin reuptake inhibitors (SSRIs) is an independent risk factor for bleeding events. Antidepressants and oral anticoagulants (OACs) are often prescribed together as depression and anxiety often coexist with cardiovascular diseases, atrial fibrillation and thromboembolic disorders. Serotonin is released from platelets in response to vascular injury, promoting aggregation. Inhibition of serotonin transporter (responsible for the uptake of serotonin into platelets) can lead into a reduced ability to form clots and a subsequent increase in the risk of bleeding. Direct oral aticoagulants (DOACs), rivaroxaban, apixaban and edoxaban are primarily metabolized via CYP3A4. The co-administration of antidepressants with inhibitory effects on CYP3A4 may theoretically interact with them.ObjectivesPresentation of a case of upper gastrointestinal bleeding after initiation of Apixaban in a patient taking Sertraline and literature review.MethodsWe carried out a literature review in Pubmed electing those articles focused on bleeding risk between newer direct oral antigulants and selective serotinin reuptake inhibitors.ResultsA 66-year-old woman sought medical assistance for generalized ecchymosis and melena. She was diagnosed with atrial fibrillation treated with apixaban 7 days ago. Concomitant treatment between apixaban and sertraline was the possible cause of upper gastrointestinal bleeding and ecchymosis. We had to switch sertraline into vortioxetine (with less dregree of serotonin reuptake inhibition) and add proton-pump inhibitor (Omeprazole) in order to decrease the risk of bleeding.ConclusionsSSRIs increase the risk of gastrointestinal bleeding, much more in case of concomitant use of oral anticoagulants. If SSRI use cannot be avoided, monitor closely and prescribe proton pump inhibitors.