bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards patient engagement in violence risk assessment and management: a patient perspective
Authors: Lantta T. , Anttila J. 
Published: September 2022

IntroductionIn current clinical practices, there exist very few methods that allow patients to be truly engaged in violence risk assessment and management. This may hinder an individual’s experience of basic psychological needs; autonomy, competence, and relatedness.ObjectivesTo describe patients’ ideas on how they would develop current violence risk assessment and management practices.MethodsThe data collection took place as part of a larger project in one PICU unit specialized in the treatment of patients with psychosis and violent behavior in Finland. Individual interviews were conducted with patients (n=13) and were guided to focus on the development of violence risk assessment and management. The data were analyzed using inductive content analysis.ResultsPatients’ ideas focused on themes related to developing patient engagement and violence risk management methods. Developing patient engagement involved noticing patient’s individuality and collaboration between a patient and staff: for instance, by shared risk assessment and individualized risk management. Developing violence risk management methods included themes about providing alternative risk management methods and developing nursing staff’s work. Suggestions were, for example, related to providing ways how to calm down, having meaningful activities during treatment days, and ensuring the realization of patient’s rights.ConclusionsPatients having treatment in the PICU unit have clear and concrete ideas on how violence risk assessment and management methods could be developed further. These findings indicate, that patients need to be given a more active role in their care and thus ensure that basic psychological needs are promoted. Funding by Academy of Finland (316206 ) and TYKS foundation.DisclosureNo significant relationships.
Effect of increased prolactin and psychosocial stress on erectile function
Authors: Sajdlova R. , Fiala L. 
Published: September 2022

IntroductionSexual dysfunctions in men are complex disorders that consist of organic and psychogenic components. The most common sexual dysfunction is erectile dysfunction. It is the inability to achieve or maintain an erection for satisfactory sexual performance. This disorder can be caused by high blood pressure, heart disease, vascular problems, psychological and hormonal factors such as problems with testosterone and prolactin levels.ObjectivesThe most common sexual dysfunction is erectile dysfunction. It usually affects men over the age of 40. The causes of erectile dysfunction can be organic, psychogenic or a combination of both. The most common organic causes of erectile dysfunction may be high blood pressure, diabetes mellitus, obesity or hormonal disorders. Psychogenic reasons are usually related to psychosocial stress. In this study, we tested the relationship between erectile dysfunction, hyperprolactinemia, and psychosocial stress.MethodsClinical examinations of 60 patients with erectile dysfunction, which also included psychosocial stress, focused on patient history, comprehensive sexological examination, biochemical analyzes of serum prolactin, total testosterone, thyroid stimulating hormone with psychometric evaluation of erectile function and a checklist of trauma symptoms (TSC-40)ResultsThe results show significant Spearman correlations of psychometric evaluation of erectile function with prolactin (R = 0.50) and results of the trauma checklist score (R = 0.55) as well as significant Spearman correlations between TSC-40 and prolactin (R = 0.52). This result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.ConclusionsOur result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.DisclosureNo significant relationships.
Interpersonal autonomic synchrony and sexual satisfaction: A preliminary examination
Authors: Freihart B. , Sears M. , Meston C. 
Published: September 2022

IntroductionA growing body of literature has increased our understanding of interpersonal autonomic synchrony (IAS), or exchanges across biological systems resulting in physiological covariation. While research suggests that IAS is more likely in relationships characterized by emotional intimacy, no research to date has examined the connection between IAS and the quality of sexual relationships.ObjectivesThe current study seeks to elucidate the relationship between IAS and sexual satisfaction (SS) using tasks that have previously been used to assess synchrony (i.e.,gazing, mirroring), as well as several conversation-based tasks (i.e., neutral and sex-related conversation tasks).MethodsCouples (n=28) completed procedures in a laboratory-based setting where they completed survey measures of SS before connecting to an electrocardiogram. Subsequently, heart rate (HR) data for each dyad were analyzed using a moderated multi-level modeling approach.ResultsIAS was detected, with men reliably predicting the HR of female partners, and women reliably predicting the HR of male partners (respectively, β=0.383, p<0.001; β=0.222, p<0.001). AIC values indicate a better fitting model for men predicting female HR. As such, moderation analyses were conducted for that model by study task, finding a significant interaction between SS and observed IAS during the mirroring task (β=0.004, p=0.009) and neutral-conversation task (β=0.016, p=0.009).ConclusionsThese findings reflect evidence that IAS may be relevant to SS at the couple-level. The ability of couples to coregulate while attempting to synchronize (as in the mirroring task) or exchange information (as in the neutral-conversation task) may meaningfully change how they experience their sexual relationship.DisclosureNo significant relationships.
Sexual Assault in the Mahdia Region: Medico Legal Aspects
Authors: Brahim S. , Mesrati M.A. , Henia M. , Kacem M. , Zarrouk L. 
Published: September 2022

IntroductionDespite recent legislative changes through the enactment of 2017-58 law on the elimination of violence against women and children, sexual violence remains fairly frequent and is often underestimated.Objectivesto describe the epidemiological peculiarities of victims of sexual assault in the Mahdia region and to discuss their medico legal implications.Methodsthis is retrospective study of 110 cases of victims of sexual assault examined at the legal medicine department of the TAHER SFAR University Hospital in Mahdia. This work was carried out over the period from January 2016 to August 2018.Resultsthe majority of victims were female (80%) and the main vulnerability factor was an age under 15 (26%). The perpetrator was generally unique (74%). Sexual assault by penetration was mostly reported (51% of cases), and was almost exclusively penile (98,2 of cases). The gynecological examination revealed a torn hymn in 43 victims, a compliant hymen without traumatic lesions in 7 victims (8%) and recent vulvar traumatic lesions without hymenal crossing in 5 victims (5,6%). Recent anal penetration was diagnosed in 6 male victims (6,8%). Among female victims, recent anal penetration was diagnosed in 5 victims (22,7%). One in four victims reported a market psychological impact with female predominance in 85% of cases. Complications of the most reported sexual assaults were pregnancy in 7% of cases. In total, only 57,3% of the certificates issued made it possible to conclude that the injuries.ConclusionsThe care of victims of sexual assault requires a multi- disciplinary approach; medical, psychiatric, social and legal.DisclosureNo significant relationships.
Alternative initiation regimen of paliperidone palmitate long-acting injectable
Authors: Menendez Gil I.E. , Romero Guillena S.L. , Plasencia Garcia De Diego B.O. 
Published: September 2022

IntroductionLong-acting injectable antipsychotics (LAIs) hold an important place in the treatment of psychosis. Knowledge of the best way to administer LAIs is important to maximize the efficacy and minimize the side-effectsObjectivesTo assess the effectiveness of flexible doses of palmitate paliperidone long-acting injectable (PPLAI) against standard doses in initiation regimen in the subset of acutely hospitalized patients with schizophrenia and other psychosisMethodsRetrospective, noninterventional study. Group of initiation regimen: A)“Standard-doses” (recommended PPLAI initiation regimen: 150mg-Day-1 and 100mg-Day-8±4days), B)“Low-doses” (any dosage lower than the Standard-dose) C)“High-doses” (150mg-Day-1 and 150mg-Day-8±4days) Effectiveness was measured with the number of psychiatric hospital admission and psychiatric emergency visit 6-months post-discharge. Length of stay of the index hospitalization, adherence to treatment and adverse events was confirmed in the medical record. Concomitant use of biperiden was recorded.Results51 patients were included. We found no statistically differences in study variables between groups (Table-1). Table-1.Standard doses(n=31)Low-doses(n=13)High-doses(n=7)Length of stay mean±sd17.23±13.0913.77±9.0217±10.55No psychiatric hospitalizations 6-month post-discharge,
%patients( n)71%(n=22)84.6%(n=11)85.7%(n=6)No psychiatric emergency visits 6-month post-discharge, %patients(n)61.3%(n=19)69.2%(n=9)85.7%(n=6)Prescription of biperiden 6-month post-discharge, %patients(n)13.3%(n=4)0%(n=0)14.3%(n=1)Adherence to treatment 6-month post-discharge, %patients(n)80.6%(n=25)84.61%(n=11)57.1%(n=4)ConclusionsNo differences were found in the effectiveness of flexible-doses in PPLAI initiation regimen. The use of low doses of PPLAI could keep the efficacy of the standard dose with a better side effect profile and treatment adherence. The strength of the conclusion is limited by the design and the number of patients.DisclosureNo significant relationships.
Immune-related genes are differentially associated with negative symptoms subdomains in patients with schizophrenia
Authors: Golimbet V. , Lezheiko T. , Korovaitseva G. , Kolesina N. , Plakunova V. , Mikhailova V. 
Published: September 2022

IntroductionNegative symptoms (NS) are a core feature of schizophrenia. NS show heterogeneity proven by factor analysis, which revealed two distinct negative symptoms subdomains: diminished expression (DE) and avolition/apathy (AA) (Marder et al. 2017, Fleischhacker et al. 2019). Some studies showed the different effects of these subdomains on clinical features of schizophrenia that suggest different pathophysiological mechanisms for their development (Stanculete 2021). It has been also shown that the levels of peripheral interleukins (IL) specifically correlate with NS (Enache et al. 2021), in particular, increased IL levels were determined in patients with deficit syndrome compared to non-deficit schizophrenia (Goldsmith et al. 2018).ObjectivesTo search for the association of genes for IL-4, IL-6, IL-10 and C-reactive protein (CRP) with NS subdomains.MethodsThe total sample included 551 patients (women 51,4%, aged 18-72 years) with ICD-10 diagnosis of schizophrenia. NS were assessed by PANSS. PANSS-derived factors include AA (items N2, N4, G16) and DE (N1, N3, N6, G5, G7, G13). Genotyping was performed for the following polymorphisms: C-589T IL-4, C-174G IL-6, C-592A IL-10, G-1082A IL-10, CRP (rs2794521).ResultsThere are effects of C-592A IL-10 (p=0.017) and G-1082A IL-10 (p=0.012) on AA subdomain. Post-hoc Bonferroni corrected comparisons show that carriers of the haplotype AA (C-592A)- AA (G-1082A) have the highest AA score. A significant effect of CRP (rs2794521) on AA is identified (p=0.007). There is a trend towards the association of C-589T IL-4 and C-174G IL-6 with AA. No association of these polymorphisms with DE was found.ConclusionsAA and DE may have different genetic background.DisclosureNo significant relationships.
Evaluation of the role of lisdexamfetamine on attention-deficit/hyperactivity disorder common psychiatric comorbidities: mechanistic insights on binge eating disorder and depression
Authors: Gutiérrez Casares J.R. , Quintero J. , Rodríguez P. , Montoto C. , Pozo-Rubio T. , Segú-Vergés C. , Coma M. 
Published: September 2022

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is a psychiatric condition in which children suffer from inattentiveness, hyperactivity, and or impulsivity. ADHD patients frequently present comorbid psychiatric disorders: in adults, the most common are depression, substance-related disorders, anxiety, and eating disorders. Children and adolescents present conduct disorders, learning disorders, anxiety and depression. Since ADHD and its psychiatric comorbidities share similarities, a partial overlap of their pathophysiological mechanisms has been suggested. ADHD, can be treated with lisdexamfetamine (LDX), a prodrug indicated by the FDA as treatment for binge eating disorder (BED) and ADHD.ObjectivesTo evaluate, through a systems biology-based in silico method, the efficacy of LDX as first-line ADHD treatment to improve ADHD psychiatric comorbidities. Furthermore, we explored the molecular mechanisms behind LDX’s action.MethodsWe used the systems biology- and artificial intelligence-based Therapeutic Performance Mapping System (TPMS) technology to characterise and model ADHD comorbidities. Artificial neural networks (ANNs) algorithms were used to identify specific relationships between protein sets. Finally, we modelled the mechanisms of LDX for the most relevant comorbidities by using sampling methods and comorbidity-specific virtual patients in each case.ResultsThis study predicts a strong relationship between LDX’s targets and proteins involved in BED and depression (Fig 1). Our results could be explained not only by LDX role in neurotransmitter regulation, but also by modulation of neuroplasticity (BDNF/NTRK2, GSK3), neuroinflammation (interleukins, inflammasome), oxidative stress (NOS2, SOD), and the hypothalamic-pituitary-adrenal (HPA) axis (CRH, CRHR1).ConclusionsThese findings could be used in pre-clinical and clinical future investigations to assess optimal treatment for ADHD patients with psychiatric comorbidities.DisclosureJRGC: speaker for Takeda and Shire, research funding from Shire and Lumbeck, collaborations with Laboratoires Servier JQ: speaker or scientific advisor for Takeda, Janssen, Rubio. Investigation funding: Instituto de Salud Carlos III. PR, CM, TPR: full-ti
Impact of ADHD as a Risk and a Treatment Factor in Intimate Partner Violence
Authors: Buitelaar N. 
Published: September 2022

Intimate partner violence (IPV) has a very high prevalence (25%) in society and has serious consequences for its victims. As former studies showed minimal effectiveness of therapeutic interventions addressing IPV, the Dutch guideline for Familial/Domestic Violence (NVVP, 2008) recommends to focus more on systemic factors and on individual risk factors of IPV. ADHD is one of these individual risk factors. This presentation focuses on the association between ADHD and IPV, presenting data and clinical examples. ADHD was missed in 56% of a sample of forensic outpatients. Reasons for this issue of underdiagnosis of ADHD in case of aggression and IPV are discussed. Also, data of the ITAP (impact of treatment of ADHD on IPV) study are presented, showing that ADHD in offenders of IPV with ADHD scored higher on minor physical aggression, minor and severe psychological aggression and clinician-rated IPV than offenders without ADHD. Further, after a one year treatment of ADHD and IPV, decrease in IPV was mainly associated with decrease in ADHD symptoms. The importance of screening and treatment of ADHD symptoms in all IPV offenders is discussed to make treatment of IPV more effective.DisclosureNo significant relationships.
Stroke care in people with and without schizophrenia: a retrospective, observational study
Authors: Quarenta J. , Gonçalves-Pinho M. , Freitas A. , Nascimento Ferreira S. 
Published: September 2022

IntroductionSerious mental illness tends to course with a higher prevalence of comorbidities and schizophrenia is a disabling disease that affects approximately 1% of the world population. Worldwide, cerebrovascular accidents are an important cause of mortality and disability and in Portugal they are one of the leading causes of death in the general population. There is growing evidence that the prevalence of strokes is higher in people with schizophrenia, with pronounced age and gender variations.ObjectivesTo describe the sociodemographic and clinical differences among patients hospitalized with a primary diagnosis of cerebrovascular disease with and without a secondary diagnosis of schizophrenia in Portugal.MethodsWe performed a retrospective observational study using a natiowide hopitalization database containing all hosptalizations registered in Portuguese hosptals from 2008 to 2015. Based on the International Classification of diseases version 9, clinical modification, hospitalizations with a primary diagnosis of stroke were selected (431;433;434), and from those, the ones with a secundary diagnosis of schizophrenia (295.xx) were isolated for a sociodemographic and clinical comparative study. Comorbidities were analysed using the Chalson index score.ResultsEpisodes associated with a secondary diagnosis of schizophrenia were younger (mean: 66 vs 73.7 years; p<0.001) and had longer median LoS (10.0 vs 8.0 days; p<0.001). In-hospital mortality was lower in patients with schizophrenia (11.7% vs 13.2%).ConclusionsThe understanding of the association of cerebrovascular accidents with schizophrenia is complex. Although some studies show conflicting evidence, more attention should be given to the investigation of the incidence, prevalence and impact of cerebrovascular diseases within this particular population.DisclosureNo significant relationships.
Effect of medical education on European primary care physicians’ knowledge in management of major depressive disorder and psychiatric emergencies
Authors: Thevathasan L. , Fairley L. , Phillips C. 
Published: September 2022

IntroductionThe challenge for primary care physicians (PCPs) is keeping up to date in managing major depressive disorder (MDD) and psychiatric emergencies.ObjectivesWe evaluated whether an online educational video lecture directed at PCPs, could improve knowledge and confidence regarding management of psychiatric emergencies associated with MDD.MethodsEducational effect was assessed using a 3-question repeated pairs, pre/post assessment survey. A paired-samples t-test was conducted to assess overall number correct and confidence change. A McNemar’s test was conducted to assess question-level significance. P values < 0.05 are statistically significant. Cohen’s d test was used to estimate the magnitude of effect of education. The activity launched on 8 April 2021, and preliminary data analysed as of 24 June 2021.Results511 PCPs participated in the programme, of which 86 PCPs completed the pre- and post-assessment test. An average overall correct response rate of 28% pre- increased to 64% post- (129% relative increase, P<0.001; Cohen’s d = 1.13). Knowledge on the burden of suicide and MDD improved from 23% pre- to 87% post- (278% relative increase,P<0.001). Knowledge regarding clinical data for novel therapies for use in psychiatric emergencies improved from 29% pre- to 50% post- (72% relative increase, P<0.01). Knowledge regarding signs of suicidal intent in patients with MDD improved from 31% pre- to 53% (71% relative increase, P<0.001) following education.ConclusionsThis study demonstrates the positive effect of online medical education on PCPs’ knowledge and confidence in contemporary management of psychiatric emergencies associated with MDD in Europe.DisclosureThe results of this study were derived from an educational programme which was developed through independent educational funding from Janssen Neuroscience
A collaborative, computer-assisted, psychoeducational intervention for depressed patients with chronic disease at primary care: protocol for a cluster-randomized controlled trial
Authors: Rojas G. , Martinez Diaz P.A. , Guajardo V. , Campos S. , Herrera P. , Vöhringer P. , Gomez V. , Szabo W. , Araya R. 
Published: September 2022

IntroductionDepression treatment recommendations seldom include chronic illness comorbidity.ObjectivesTo describe the rationale and methods for a cluster-randomized trial (CRT) in primary care clinics (PCC) comparing a computer-assisted psychoeducational (CAPE) intervention to usual care (UC) for depressed patients with hypertension or diabetes.MethodsTwo-arm, single-blind CRT in Santiago, Chile. Eight PCC will be randomly assigned to the intervention or UC. A total of 360 depressed individuals aged 18 or older PHQ-9 scores ≥ 15 and hypertension or diabetes will be recruited. Patients with alcohol/substance abuse; current treatment for depression, bipolar disorder, or psychosis; illiteracy; severe impairment; and residents in long-term care facilities will be excluded. Patients in the intervention will receive eight CAPE sessions by trained therapists, structured telephone calls to track progress, and usual medical care for chronic diseases. Psychologists and psychiatrists will regularly supervise therapists. To ensure continuity of care, the PCC team will meet monthly with a research team member. Patients in UC will receive standard medical and depression treatment. Three, six, and twelve months after enrollment, outcomes will be assessed. The primary outcome will be a 50% reduction in baseline PHQ-9 scores at six months. Intention-to-treat analyses will be used.ResultsA previous, small-scale pilot study provided valuable insights for study design.ConclusionsThis study will provide first-hand evidence on the effectiveness of a CAPE for depressed patients with chronic diseases at PCC in a Latin American country.DisclosureNo significant relationships.
Use of Lamotrigine in the pharmacological management of a lady with longstanding history of Trichotillomania
Authors: Tan J.H. , Gangaram P. 
Published: September 2022

IntroductionTrichotillomania is characterized by recurrent pulling of one’s hair despite attempts of stopping, resulting in hair loss. Previously classified as impulse control disorder, it is now considered an obsessive-compulsive related disorder in DSM-5. First-line therapy is cognitive behavioural therapy (CBT), with strong support for habit reversal training. For pharmacological therapy, selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed. Clomipramine has been used but is limited by its side effect profile. Many patients continue to experience distressing symptoms despite current treatment methods.ObjectivesLamotrigine, an anticonvulsant medication, is frequently utilized by psychiatrists to treat conditions like Bipolar Disorder. However, its utility in treating Trichotillomania has not been explored. We are interested to find out if it could benefit patients who have not responded adequately to current available treatment.MethodsWe report a case of a lady suffering from Trichotillomania for many years with limited improvement despite active treatment. We follow her progress after being started on Lamotrigine for six months.ResultsIn our case, a lady with longstanding Trichotillomania has previously been treated with SSRIs and Chlomipramine with limited response. An incidental trial of Lamotrigine after stopping her other medications has led to sustained improvement and stabilization of her condition. A possible hypothesis on how Lamotrigine’s mode of action could have led to this improvement will explored in this paper.ConclusionsThis case illustrates the potential of Lamotrigine to treat Trichotillomania in someone who has not responded adequately to usual treatment and could be an area worth looking into for future research.DisclosureNo significant relationships.