bluuebunny/crossref_metadata_2025_split huggingface dataset:
This girl is on fire
Authors: Vázquez P. García 
Published: February 2022

IntroductionBurning mouth syndrome (BMS) is a chronic condition characterized by a burning sensation of the oral cavity and is often associated with taste disturbances and xerostomia.ObjectivesTo study the psychotropics as part of the possible etiologies of this síndrome.Methods
A 67-year-old woman complained of burning pain in the tongue and oral mucosa, taste disorder, and sensory impairment. Slight improvement after treatment with Gabapentine 300mg (1-0-0). The pain is constant, with sharp characteristics. Improves when eating, the ability to taste is preserved. Subsequently, treatment with 2% lidocaine rinse (3-4 times / day) is tested, with temporary pain relief. Lorazepam 1mg (1-0-0), without improvement. Patient in follow-up by the Neuropsychiatry consultation for 3 years, due to major depressive disorder in treatment with Quetiapine 100mg (0-0-1).Results
In the first consultation the treatment is modified, adding Duloxetine 60 mg (1-0-0) and Alprazolam 0.5mg (1 / 2-1 / 2.0), and reducing the dose of Quetiapine to 75 mg and then 50mg. In the subsequent consultation, one month later, she only manages to reduce the neuroleptic dose by half, without noticing clinical improvement. After two months, she has completely removed the quetiapine, and completely disappearing the burning mouth sensation, improving his affective clinic in the same way.ConclusionsThere are a large number of drugs that produce xerostomia, in intimate relationship with the burning mouth. Among those we can find antihistamines, neuroleptics, antihypertensives, and benzodiazepines. In many cases, correcting or eliminating these etiologic agents does not improve or stop the initial symptoms, but sometimes, it does.
Peculiarities of the psychological state of patients with chronic non-infectious liver diseases
Authors: Koval I. , Khaustova O. , Skurat K. 
Published: February 2022

Introduction
The prevalence of chronic liver diseases (CLD) is over 30 million people worldwide, they are associated with significant health care costs, loss of productivity of patients, and has a significant impact on the quality of life associated with health.ObjectivesThe research objective was to determine current views on the psychological state of patients with CLD.MethodsA qualitative and quantitative analysis of the content of scientific Ukrainian and English literature published from 2014 to 2020, which sets out different views on the psychological state of patients with chronic liver diseases using the PubMed and Google Scholar databases. Only concept analysis, meta-analysis, and systematic reviews published in English, presented in the scientific literature were included.ResultsThe information on the peculiarities of the psychological state of patients with CLD was generalized. Based on the research, we can conclude that this group of patients is characterized by low mood, chronic fatigue, low level of social adaptation, increased anxiety, and reduced efficiency.ConclusionsStudies by different scientists from different countries agree that patients with chronic liver disease are characterized by the above symptoms. Some emphasize psychoneurophysiology and associate these symptoms with chronic inflammation, which occurs as liver damage progresses. Other researchers suggest that it is due to the quality of life of these patients and the severity of the disease. However, the scientific community has yet to find out what exactly caused this.
Epistemic injustice in a case of cyclic vomiting syndrome. A case report
Authors: Del Campo A. Cerame , Limeres P. Coucheiro , Soler A. Franco 
Published: February 2022

IntroductionWe present the case of a 19-year-old female patient treated in our hospital due to an outburst of persistent vomiting. The patient had a diagnosis of Cyclic Vomiting Syndrome (CVS), a year before the diagnosis the patient had been labeled as a somatizer and admitted into the department of psychiatry. Given her psychiatric record and the fact that CVS is a rare diagnosis we were consulted on arrival.ObjectivesCVS is an infrequent disorder of unknown etiology which shares similarities with migraine headaches. It is characterized by episodes of vomiting followed by periods of remission without active symptomatology with no organic pathology to account for the symptoms. Epistemic injustice (EI) is defined by Miranda Fricker as “a damage done to someone in their capacity as a knower”. She defined two forms of EI: testimonial and hermeneutical injustice.MethodsA case report is presented alongside a review of the relevant literature regarding CVS and epistemic injustice.ResultsOn arrival at the emergency department she tried explaining her condition, but her testimony was disregarded on the basis of her psychiatric record. It was only after the on-call psychiatrist explained the condition when she received the appropriate abortive treatment, after which she was admitted to the internal medicine department where she was followed by the liaison psychiatrist.ConclusionsCVS is a disabling disease still unknown to most clinicians in spite of the increasing quality evidence about its identification and treatment. The case highlight how cases of newly identified disease can suffer from testimonial and hermeneutical injustice.
Cross-sectional study of clinical and linguistic characteristics mental disorders in HIV infection
Authors: Neznanov N. , Khalezova N. , Burmistrova N. , Tabulina A. 
Published: February 2022

IntroductionCurrent epidemiological data on the pandemic prevalence of HIV in the world expand the boundaries of the problems associated with the threat of unpredictable spread of infection and the frequency of mental disorders that accompany HIV infection.ObjectivesSomatogenic mental disorders are determined by the fact that the central nervous system (CNS) is one of the reservoirs for HIV. HIV is indirectly a neurotropic virus and can cause associated neurocognitive impairment (HAND)MethodsIn study were used clinical-linguistic examination method for determining linguistic markers for mental disorders in HIV patients who did not receive specific antiviral therapy.ResultsAs a result, it was found that 50% of HIV-infected patients not suffering from addiction syndromes or surfactant abuse have mental disorders, which are characterized mainly by disorders of adaptive reactions and mild cognitive impairment. 57.7% of HIV-infected people who do not use surfactants showed a high level of social adaptation. For patients who do not use surfactants, and who have undergone a commission examination before starting ART, the leading psychopathological syndromes are anxiety, anxiety-hypochondria. 44.2% of patients did not have obvious psychopathological symptoms.ConclusionsStructure of emotional experiences was revealed in patients who recently learned about the burden of a serious chronic disease with the corresponding fear of death and self-stigmatization. Identified linguistic markers are additional signs that can be used by physicians and psychiatrists to diagnose both cognitive impairment and emotional impairment in patients with HIV infection.Conflict of interestNo significant relationships.
Link between cognitive impairment and metabolic syndrome in middle-aged patients
Authors: Neznanov N. , Piotrovskaya V. , Burmistrova N. , Tabulina A. 
Published: February 2022

IntroductionMetabolic syndrome (MS) is associated with an increased risk of developing a cognitive vascular disorders and dementia.ObjectivesThe associations of cognitive disorders (CD) with components of methabolic syndrome (MS) such as : body mass index, lipid spectrum, arterial hypertension and glucose level (GL) in middle age subjects were study.MethodsThe 271 patients with MS according IDF criteria, (aged 30 – 60 years) were examend. Current mild cognitive impairment (MCI) was confirmed by psychodiagnostic interview according to the criteria of ICD-10. All patients passed through: MMSE test, Cognitive Failures Questionnaire, Wechsler memory scale, Symbol Coding and Category Fluency test. Level of blood glucose and plasma indicators of lipid spectrum were assessed in the blood samples with «Abbott» kits. To assess the results the NCEP criteria were used.ResultsAll 271 subject were divided into 2 groups, group A – with CD and/or MCI (212 subjects) and the group B -without affective disorders (49 subjects). Using the Mann-Whitney test significantly strong connection between high levels of total cholesterol (TC), cholesterol low density lipoprotein (LDL-C), lipoproteins of very low density (VLDL), the GL and MCI in group A were obtained. Optional subjects with sings of PH, MS and MCI had a fairly high level of VLDL and LDL-C in comparison with subjects without MCI.ConclusionsThe meaning of the relationship between metabolic syndrome and mild cognitive impairments in middle-aged people is in increasing in the level of LDL and VLDL that can provoke MCI in middleage subjects with MS.
Kleine-levin syndrome
Authors: Freitas R. Mota , Valadas M.T. 
Published: February 2022

IntroductionKleine-Levin Syndrome (KLS) is an extremely rare disorder of unknown etiology. It affects mainly male adolescents and is thought to follow a relapse-remitting course. During episodes of illness, a wide array of neuropsychiatric symptoms may present and a psychiatric diagnosis might be incorrectly made.ObjectivesWe aim to review the literature on the clinical manifestations of KLS, as well as the current evidence regarding this disorder’s management.MethodsWe performed an updated review in the PubMed database using the terms “Kleine-Levin Syndrome”. The included articles were selected by title and abstract.ResultsKLS usually presents with recurrent episodes, lasting days to weeks, of severe hypersomnia, cognitive impairment, major apathy and derealization, among other neuropsychiatric symptoms. Although it was previously thought that complete normalization occurred between episodes, recent evidence suggests that around one third of patients have mild cognitive impairment and there are alterations in brain blood flow during the asymptomatic periods. During episodes of illness, management comprises environmental measures as well as drug therapy. Corticosteroids and amantadine have been successful in stopping episodes and lithium may be useful in a preventative role, however, there are no randomized controlled trials focusing on KLS treatment.ConclusionsKLS remains an elusive entity since it is an extremely rare disorder with unclear etiology, course, and no consensual treatment. Further research is warranted in this area, namely randomized controlled trials. It is important for the practicing psychiatrist to be aware of this illness in order to recognize it and adequately manage it.
Early intervention in psychosis: An innovation trigger in a challenging environment
Authors: Sile L. , Rancans E. 
Published: February 2022

In theory and practice early intervention has an indisputable role in the treatment of patients with psychotic disorders, however modern psychiatrists face challenges in their clinical work to find the balance between the best practice and available treatment options in their environment. One of the biggest challenges remains the implementation of high-cost treatment approaches in healthcare systems of middle-income countries. Moreover, one very important aspect to consider when implementing early intervention is to prepare your team for resistance against the innovation. In countries where psychiatric treatment is more hospital-oriented and out-patient care is limited to short face-to-face visits with psychiatrists, the system is rigid and unwilling to step up to more expanded treatment option, such as a team approach of more than 6 members to treat one patient. In Latvia we started our early intervention programme in 2019 (LAT-EIP), 34 patients enrolled, and 27 finished the programme. When we compared results between standard treatment and LAT-EIP, psychiatrist out-patient visits were comparable to LAT-EIP, but the rate of rehospitalization and assigned disabilities at 12 months follow-up differ dramatically: in LAT-EIP 7.4% had been readmitted and 7.4% were assigned with disability vs 36.1% and 34.4% of patients in standard treatment group, respectively, p<0.05. Nevertheless, the only hospital which continues to provide early intervention is the one which first established it. This presentation will try to explain step-by-step what enhances and what holds back innovation in psychiatry in one middle-income countries.DisclosureNo significant relationships.
“This is not a doctors thing, it is witchcraft” - A case report of acute psychosis concomitant to primary hyperparathyroidism
Authors: Lopes L. , Moura B. , Pereira S. 
Published: February 2022

IntroductionPrimary hyperparathyroidism (PHPT), usually caused by a parathyroid adenoma, is characterized by a pathologically high secretion of parathyroid hormone and consequent hypercalcemia. PHPT has a high prevalence among elderly patients and might be responsible for neuropsychiatric symptoms.ObjectivesWe aim to report the rare manifestation of acute psychosis accompanying a PHPT diagnosis, and to discuss the neurobiological relationship between hyperparathyroidism, hypercalcaemia and neuropsychiatric symptoms.MethodsWe present a clinical case based on patient’s history and clinical data, along with a literature review on PHPT neuropsychiatric symptons.ResultsWe present the case of a 68-year-old man diagnosed with PHPT in November 2019. He was brought up to psychiatric evaluation for the first time in May 2020 upon behavioral changes (aggressiveness and bizarre rituals). The patient described the sensation of burns scattered throughout the body since January 2020, felling anxious and frightened, sleeping poorly and progressive social isolation. He presented delusional ideas of mystical and paranoid content. No significant cognitive impairments were found. The patient’s psychosis was partially responsive to atypical antipsychotics. He’s waiting for surgery. Hypercalcaemia might manifest as mood disorders, cognitive changes and rarely as acute psychosis. Although there is not yet a clear mechanism to explain it, high calcium levels seem to cause neurotoxicity and neurotransmission dysfunction. Restoration of normal calcium levels tend to resolve neuropsychiatric symptoms, but in PHPT parathyroidectomy is usually recommended.ConclusionsNeuropsychiatric symptoms are responsible for great disability, and demand an organic in-depth investigation. A multidisciplinary team approach must always be considered in the management of such conditions.
Raised preoperative monocyte chemoattractant protein-1 as the independent predictor of delirium after cardiac surgery. A prospective cohort study
Authors: Kaźmierski J. , Miler P. , Pawlak A. , Jerczyńska H. , Frankowska E. , Woźniak J. , Woźniak K. , Brzezińska A. , Wilczyński M. 
Published: February 2022

IntroductionDelirium is a frequent and serious complication of cardiac surgery. However, the knowledge regarding pathogenesis of postoperative delirium is limited.ObjectivesTo investigate whether increased levels of monocyte chemoattractant protein-1 (MCP-1) and hyper-sensitive C-Reactive Protein (hsCRP) are associated with postoperative delirium in cardiac surgery patients.MethodsPatients were examined and screened for major depressive disorder (MDD) and cognitive impairment one day preoperatively, using the Mini International Neuropsychiatric Interview and The Mini-Mental State Examination Test. Blood samples were collected pre- and postoperatively for hsCRP and chemokine levels. Following surgical interventions, the Confusion Assessment Method for the Intensive Care Unit and the Memorial Delirium Assessment Scale with the cut-off score 10 were used to diagnose delirium.ResultsPostoperative delirium screening was found positive in 34% (61 of 177) of patients. Both, pre- and postoperative hsCRP, and preoperative MCP-1 levels were associated with postoperative delirium in univariate comparisons; p=0.001; p=0.0004; p < 0.001, respectively. However, according to a multivariate stepwise logistic regression analysis only MCP-1 concentration raised before surgery was independently associated with postoperative delirium, and related to advancing age of participants (Spearman’s Rank Correlation 0.192; p=0.0103). According to ROC analysis, the most optimal cut-off for MCP-1 concentration in predicting the development of delirium was 371.81 ng/ml with sensitivity of 77.0% and specificity of 58.6%.Conclusions
The present study suggests that raised preoperative MCP-1 concentration is independently associated with delirium after cardiac surgery. Preoperative monitoring of pro-inflammatory markers combined with regular surveillance may be helpful in the prediction and early detection of postoperative delirium in this patient group.
The trough of disillusionment: A critique of the “transition” paradigm
Authors: Gülöksüz S. 
Published: February 2022

I will attempt to address the issues surrounding the CHR concept in light of novel data and briefly discuss emerging alternatives. The root problem of the CHR early invention strategy is the exertion of reducing early nonspecific (pluripotent) psychopathology to a unidimensional model restricted only to positive psychotic symptoms, which define the binary categories of CHR and “transition” in help-seeking populations. This major conceptual handicap undermines the validity and clinical utility. The core predictor of the “transition” rate is the degree of the risk-enrichment and not the CHR status. Even with a significant pretest risk enrichment, the prognostic accuracy is mediocre. The incidence and “transition” rates of CHR in the community are very low; therefore, CHR does not represent a cost-effective clinical target—prevention paradox. CHR succeeding early pluripotent psychopathology is already late for intervention. “Transition” is not a categorical progression but a unidimensional shift in psychotic symptoms, and therefore, influenced by the fluctuation of psychotic symptoms, leading to both false positives and underestimation of nonpsychotic psychopathology. There exists no evidence for a specific effect of any intervention in preventing “transition”; therefore, CHR is not an ideal treatment target. Binary “transition” outcome does not represent a valid phenotype for research as “transition” rates are primarily driven by the sampling heterogeneity. The multidimensional psychopathology and functioning are more clinically relevant, overarching, and service-user-centered measures to define individual risk and outcome. Guided by the public health perspective, a universal early intervention framework, underscoring improved access to care, may represent a better strategy.DisclosureNo significant relationships.
Early changes in brain structure, functional connectivity and neuropsychiatric symptoms after HCV infection cure with direct-acting antivirals
Authors: Cavero M. , Mariño Z. , Navines R. , Pariente J. , Moreno E. Muñoz , Bartres C. , Nacar L. , Lens S. , Rodriguez-Tajes S. , Cañizares S. , Bargallo N. , Forns X. , Martin-Santos R. 
Published: February 2022

IntroductionHepatitis C virus (HCV) infection is known to be associated with neuropsychiatric manifestations as part of the disease. Previous neuroimaging studies showed brain connectivity dysfunction among HCV-infected patientsObjectivesTo assess, by MR in resting state, the potential structural and connectivity changes before (BL) and after HCV eradication (FU12) with direct-acting antivirals (DAA), along with clinical parameters.Methods
Twenty-one HCV-patients, aged≤55 years, without psychiatric history, nor advanced liver disease, and eligible for DAA, and 25 healthy controls were included. Evaluations were performed at BL and FU12. Brain volume and local gyrification index (LGI) were assessed in MR-T1, and functional connectivity by seed-based analysis (left insula). Depression (MADRS/PHQ9) and neurotoxicity symptomatology (NRS) were assessed. We compared patients between BL/FU12, and controls by means of paired/independent T-test analysis.ResultsSubstained virologycal response was obtained in all patients (100%). Depressive and neurotoxicity symptomatology improved after cure (p<0.01). HCV-patients showed a reduced volume in a right latero-occipital area compared to controls (CWP<0.005) in both BL and FU12. This difference was smaller between FU12 and controls. LGI was higher in FU12-HCV compared to BL-HCV. fMRI connectivity showed a high association between insula and occipital/parietal territories in patients than controls, being higher among BL-HCV and controls. Differences were limited to occipital areas among FU12-HCV and controls.ConclusionsNeuropsychiatric symptomatology improved after cure. Left insula is altered among HCV-patients in structured and connectivity (mainly occipital areas). After cure differences with controls were reduced, suggesting a partial restoration of brain connectivity.
Digital solutions for mental health care during the COVID-19 pandemic: A systematic qualitative review and swot analysis
Authors: Vukovic I. Sarajlic , Valeriani G. , Mijaljica G. , Thunström A. Osmanovic , Gonzales A. 
Published: February 2022

IntroductionSince its early stages, the Covid-19 outbreak has posed immense challenges for effective, scalable and rapid interventions. Telehealth approaches have been considered as key part of an effective pandemic response.ObjectivesThe aim of this systematic review was to evaluate the role of digital solutions in fighting the mental health needs during COVID-19 outbreak.Methods
This review was conducted through searching four databases including PubMed, Scopus, Web of Science, and Science Direct. Inclusion criteria included studies clearly defining any use of telehealth services in all aspects of mental health care during COVID-19 outbreak, published from December 31, 2019 to October 31, 2020, written in English language and published in peer-reviewed journals. Narrative synthesis was undertaken to summarize the findings according a SWOT (strengths, weaknesses, opportunities, threats) analysis.Results
62 studies met the inclusion out of the 278 search results. Data converged on: strengths in minimizing the risk of Covid-19 transmission, reduction of travel time and costs, comparable effectiveness to in-person care; weaknesses i.e. decreased ability to detect non-verbal cues, lower therapeutic alliance, possible technical connection problems; opportunities in improving the healthcare system and expanding its accessibility for patients also for the future; threats such as privacy and legal issues, and risk to overlook vulnerable populations (e.g. elderly, marginalized ethnic minorities).ConclusionsIn the midst of a global mental health emergency, telehealth may represent a “virtually perfect” solution. However, further implementations facing issues of quality, justice and healthcare equity are required to ensure that all patients receive the care they need.