bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case report of a dissociative identity disorder
Authors: Pinilla R. , Rodriguez C. , Ordoñez B. , Hermosillo R. 
Published: February 2022

IntroductionPatients with dissociative identity disorder (DID) present two or more identities, where one of them is the main one. Although it is a widely questioned diagnosis, it is currently found in the main DSM-5 and ICD-10 diagnostic manuals.ObjectivesPresent a case of dissociative identity disorder.Methods46-year-old woman who attended the CSM referred for her MAP due to anxiety-depressive symptoms. Throughout the interviews the patient brings up to 4 identities with alterations in memory, consciousness, multiple dissociative symptoms, sound thinking, constant fluctuations in mood. She is separated, has two children, takes care of them, although she is not able to maintain work functionality. The patient is seen once a week for 45 minutes. Psychotherapeutic treatment is carried out, the objective of which is to establish a safe therapist-patient bond to favor the integration of their parts, and pharmacological treatment, which was carried out with haloperidol, lorazepam and desvenlafaxine.ResultsThroughout sessions, the anxious symptoms diminished, being able to carry out psychotherapeutic work. Dissociative symptoms were slightly reduced, partially integrating some of the identities. There was a slight stabilization in mood and decrease in psychotic symptoms.ConclusionsThere is no well-established treatment for DID. Combined therapy (psychotherapy and pharmacological) may be an option for these patients. The therapeutic framing of the sessions, working the link, and the low-dose antipsychotic treatment were favorable.Keyworddissociative identity framing link
The failure of adherence of the antiretroviral therapy is a field of work for the psychologist to HIV possitive patients in intensive care units
Authors: Vasilescu C. , Largu M. , Lacatusu G. , Dorobat C. , Manciuc C. 
Published: February 2022

IntroductionHIV infection is currently considered a worldwide pandemic.ObjectivesThe objective of this paper is to outline the profile of HIV – positive patients in intensive care units, regarding the psycho-emotional and viral parameters.MethodsWe realized a retrospective study for a period of 36 months, evaluating HIV positive patients in intensive care unit in the “Sf. Parascheva” Infectious Diseases Clincal Hospital Iasi, Romania.ResultsFrom 1st of Janury 2011 to 31st of December 2013, the HIV/AIDS Regional Centre of Iasi recorded 2649 hospitalizations, of which 18 cases required intensive medical care, 10 males and 8 females. The number of days of hospital admission varied between 4.5 and 32 days in the Intensive Care Unit. Initialy the psychological interview was conducted for 16 of the 18th patients, 2 cases were with severely deteriorated health status that didn’t allowed communication. From them, 7 survived and they were evaluated at discharge from IIntensive Care Unit and also monitored long term, that revealed an increase in adherence to Antiretroviral Therapy and a change in lifestyle.ConclusionsHIV positive patients that requires intensive care showed a marked immunological collapse due to abandonment of the therapy or late detection. In order to fully accomplish the needs of the HIV positive patient, the infectious diseases specialist must collaborate with the psychologist.
Athens multifamily therapy project
Authors: Selakovic M. 
Published: February 2022

IntroductionThe Athens multifamily therapy project (A- MFTP) provides systemic multifamily group therapy to youths who experienced a first psychotic episode (FEP) and their families.ObjectivesThe participants were recruited from the ongoing longitudinal Early Psychosis Intervention Study –ELPIS, Athens FEP Project, which aims to investigate the involvement of genetic and environmental determinants on psychosis risk.MethodsA group of five families with a child who had experience FEP, attended two multifamily group sessions per month, in the time period from September 2017 to Jun 2018. Parents and offspring participated to the sessions, which were conducted by two co-therapists. Assessment of patients’ psychopathology was based on PANSS at baseline, end of therapy and 6-month follow-up. All participants fulfilled an instrument assessing family factors (SCORE-15) and the Reflective Functioning Questionnaire (RFQ) at the same three time points. Furthermore, participants were asked to give written opinions regarding the therapeutic process at the middle phase, the end of therapy and six months follow - up.ResultsA qualitative analysis identified the emerging themes and patterns, focusing on the language and the meaning constitutes. Communication techniques, emotional processing and problem solving were the main learnings for the members of the group. They highlighted the impact of the group processes on family communication and individual understanding, while the development of a “new family” emerged from the group relationships.ConclusionsA- MFTP seems to be a promising service aiming to improve mental health and wellbeing of participants, to contrast chronicity and to contribute to early intervention services for psychoses in Greece.
Recovery from borderline personality
Authors: Duarte D. 
Published: February 2022

IntroductionRecovery is much broader than experiencing remission of symptoms. It is understood as the experience of a subjectively significant and satisfying life, even if some symptoms of mental illness persist. The recovery process from borderline personality disorder (BPD) is complex and includes recognizing the need for change and developing greater self-acceptance.ObjectivesProvide an overview of personal recovery from BPD.MethodsThe authors did a non-systematic review in pubmed with the words: “borderline personality disorder” and “Recovery”.ResultsBPD is a serious mental disorder characterized by a pattern of instability in interpersonal relationships, self-image and affections, marked by impulsiveness and (para) suicidal behaviors. Unemployment and difficulties in obtaining and maintaining employment are highly prevalent on BPD and add social exclusion and deterioration of physical and mental health. Recent long-term follow-up studies offer a optimistic scenario, indicating high rates of clinical remission (not equivalent to full recovery). Most psychotherapies, such as dialectical behavioral therapy (DBT) or mentalization-based therapy, have proven their effectiveness in treating emotional dysregulation, impulsivity and interpersonal difficulties. Teams working with people with BPD should develop comprehensive multidisciplinary care plans. The care plan should identify long-term goals that should be realistic, and linked to the short-term treatment aims and develop a crisis plan that identifies potential triggers that could lead to a crisis.ConclusionsCognitive rehabilitation and psychoeducational interventions can be effective in individuals with BPD. These interventions can be easily implemented in mental health settings and offer benefits for improving overall functioning, which often remains affected after clinical remission in long-term follow-up.
Stigmatisation of schizophrenia, psychosis and autism in flemish newspapers
Authors: Thys E. , Struyven C. 
Published: February 2022

IntroductionStigma is a major burden and impediment for treatment and recovery in serious mental disorders, especially psychotic disorders. Therefore, it has been proposed to replace the term schizophrenia by psychosis susceptibility or psychosis spectrum disorder.ObjectivesWe have assessed stigma in the media through a 10-year survey of Flemish daily newspapers (2008-2017) by comparing the way schizophrenia and autism are portrayed. We added the term psychosis for the years 2013-17 to assess its suitability as a less stigmatising alternative.MethodsVia the websites of the seven Flemish newspapers, we searched for all articles published between 01 Jan 2008 and 31 Dec 2017 containing the keywords autism, schizophrenia, and related terms. The collected articles (n = 5,337) were then graded to their stigmatising content. We added the term psychosis for the years 2013-17.ResultsIn the collected articles the coverage of autism was mostly positive, whereas the coverage of schizophrenia was predominantly negative. The contrast was very substantial (p < 0.0001) and stable over the years. The portrayal of psychosis turned out to be mostly positive in the broadsheet newspapers and mostly negative in the tabloid papers.ConclusionsThe social stigma attached to schizophrenia and psychosis is poignantly reflected in the Flemish newspapers. The fact that a comparable disorder such as autism is depicted in a much more favourable way than schizophrenia indicates that a more positive image of schizophrenia is not only desirable but also achievable. Psychosis gives mixed results, a finding up for discussion.
Psychiatric stigma in patients with comorbid hiv infection
Authors: Khobeysh M. , Lutova N. 
Published: February 2022

IntroductionHIV-positive patients with schizophrenia spectrum disorders experience burden of double stigma. Comorbid pathology may alter structure of stigma and shall be considered in development of individual destigmatization programs.ObjectivesStudy of psychiatric stigma features in HIV-positive and HIV-negative patients with schizophrenic disorders.MethodsISMI (Ritsher et al., 2003), PDD (Link et al., 1991) – to study stigma in 70 patients divided into three groups with respect to their diagnosis (I — F20.x, II — F21.x, III— F2x+HIV); BPRS (Overall & Gorham, 1962) – to assess psychiatric status, RSAS (Eckblad et al., 1982) – to assess anhedonia. Dispersion analysis (Kruskal and Mann–Whitney tests), Spearman and Pearson correlation were used.ResultsPatients with comorbid HIV-infection showed increased level of perceived stigma, although they resisted the stigma internalization better than others did (Table 1).Patients with schizotypal disorders and patients at early stages of HIV infection experienced the most alienation and frailty to internalization of stigma (Tables 1, 2).Correlation relationship between social anhedonia and perceived stigma (r=0.5, p<0.05) observed in patients with HIV infection.ConclusionsComorbid HIV infection in psychiatric patients contributes to the psychiatric stigma structure. Differentiated approaches in rehabilitation of HIV-positive mental patients should be used.
Preliminary data on the psychometric proprieties of the italian version of the reflective functioning questionnaire
Authors: Velotti P. , Rogier G. , Zobel S. Beomonte , Ciavolino E. , Beyer S. , Fonagy P. 
Published: February 2022

IntroductionAssessing mentalizing abilities is a complex issue. Only recently an instrument assessing mentalizing capacity as a whole, the Reflective Functioning Questionnaire (RFQ), has been developed.ObjectivesTo reach the purpose of our study, we investigated the psychometric proprieties of the Italian version of the RFQ.MethodsThe study was conducted on a sample including a group of violent offenders and a group of community participants. All subjects fulfilled the RFQ, the Personality Inventory for DSM-5 (PID-5) and the Aggression Questionnaire (AQ).ResultsThe theoretical model was defined and analysed by using Partial Least Squares–Path Modelling with high-order construct definition. Data showed good psychometric proprieties of the Italian version of the RFQ. Also, specific patterns of correlations were identified between the RFQ subscales and both PID-5 and AQ scores. Offenders significantly differed from controls only in relation to one subscale of the RFQ.ConclusionsData supported the factorial structure of the RFQ found in the original validation study. Results also support the existence of a second-order variable, mentalizing, resulting from the convergence of hypomentalizing and hypermentalizing.
Longitudinal association between daytime sleepiness and cognitive decline in dementia: A study protocol
Authors: Silva J. , Ferreira A.R. , Fernandes L. 
Published: February 2022

IntroductionDementia is a major cause of disability worldwide. About 25%-40% of patients with mild to moderate dementia are affected by sleep-awake cycle disturbances, including increased daytime sleepiness and insomnia. However, little is known about the specific impact of excessive daytime sleepiness on the cognitive decline of dementia patients.ObjectivesTo evaluate the impact of daytime sleepiness on the cognitive decline of dementia patients. Additionally, longitudinal associations with functional impairment and neuropsychiatric symptoms will be explored.MethodsA longitudinal study will be conducted in a psychogeriatric consultation. Patients will be consecutively invited according to predefined eligibility criteria. Those aged ≥65 years, with dementia diagnosis or Mini-Mental State Examination (MMSE) <24, and with a knowledgeable caregiver, will be included. The exclusion criteria are: a caregiver <18 years, terminally ill, incapable to communicate or with a known diagnosis of insomnia, sleep related respiratory disorders, central hyperinsomnia, restless legs syndrome or sleep paralysis. Participants will undergo an assessment with a comprehensive protocol including: Montreal Cognitive Assessment (MoCA), Barthel and Lawton Index, Epworth Sleepiness Scale (ESS), Neuropsychiatric Inventory (NPI) and Global Deterioration Scale (GDS). Participants will be re-assessed 6 months after the initial evaluation. The Health Ethics Committee of Hospital Universitário de São João granted the study authorization (nº 260/2020).ResultsFindings will be disseminated via publication in peer-reviewed journals and presentations at national and international scientific conferences.ConclusionsThis study will address key questions on the relation of daytime sleepiness and dementia outcomes, in order to undertake corrective and preventive non-pharmacological and pharmacological approaches.
Beliefs about schizophrenia’s causes among family members
Authors: Lajmi I. , Omri S. , Smaoui N. , Feki R. , Thabet J. Ben , Bouali M. Maalej , Zouari L. , Charfi N. , Maalej M. 
Published: February 2022

IntroductionInvestigating family members’ causal beliefs regarding schizophrenia is an important step in the management of the illness; it may affect adherence to treatment of patients with schizophrenia.ObjectivesTo investigate the beliefs about the causes of schizophrenia among families of patients with schizophrenia.MethodsWe led a cross sectional descriptive study involving 32family members of patients suffering from schizophrenia who were followed in the psychiatry department of Hedi Chaker University Hospital in Sfax (Tunisia), between May to September 2019. Data was collected from the medical records and the questionnaire designed to the study.ResultsThe mean age of the relatives was 60.8 years, with a sex-ratio of 1.6. The relatives included 20 fathers (62.5%), six wives (18.8%), three mothers (9.4%), and three sisters (9.4%). Among them, 37.5 % were illiterate; 37.5% lived in rural area. Fourteen participants (43.8%) had cited at least two possible causes of schizophrenia. The most frequently cited causes were emotional shock (81%) and god’s will or fate (72%) followed by witchcraft (37.7%). The belief of God’s will and fate was associated with poor compliance to treatment (p=0.06). The belief of supernatural cause was correlated to rural origin (p=0.000) and advanced age of participants (p=0.000).Significant correlation was also found between family history of mental disorders and beliefs on hereditary causes (p=0.000).ConclusionsThese results suggest that family members of patients suffering from schizophrenia need to be better informed about its main causes to improve both compliance to treatment and social integration of this patients.
Electroconvulsive therapy combined with clozapine in the management of ultra-resistant schizophrenia
Authors: Khouadja S. , Charaa O. , Soussia R. Ben , Zarrouk L. 
Published: February 2022

IntroductionAlthough clozapine is the gold standard for treating patients with resistant schizophrenia, clinical symptoms persist in approximately 40-70% of the cases even after a year of treatment with clozapine. Electroconvulsive therapy (ECT) has been tried as augmentation therapy in the management of ultra-resistant schizophrenia.ObjectivesTo review recent studies concerning the effectiveness of ECT associated with clozapine in the management of ultra-resistant schizophrenia.MethodsThis is a review of the literature via Medline and Sciences direct. The database was searched using the keyword combination “clozapine” with “ECT”, “resistant schizophrenia” with “ECT and clozapine” and “clozapine resistant schizophrenia” with “ECT” from 2010 to 2020.ResultsWe found 4 reviews and meta-analyzes and 6 studies. According to the majority of recent reviews and meta-analyses studied, patients who were resistant to clozapine responded to the combination of clozapine and ECT in 54% of the cases. ECT by increasing the permeability of the blood-brain barrier facilitates the brain transmission of large molecules such as clozapine, thus promoting better efficacy of clozapine. The combination of ECT with clozapine was generally well tolerated in the majority of patients. The most frequently reported adverse reactions in the literature were memory impairment and headache. These effects did not appear to be chronic or persistent, but rather transient and mild. Other rare cases such as prolonged seizures, tachycardia, and confusion have been reported.ConclusionsECT associated with clozapine is an effective, relatively safe and tolerable treatment in the majority of cases.
Early career psychiatrists in europe during COVID-19 outbreak: Results of the EPA ECPC-EFPT cross-sectional survey
Authors: Gondek T. 
Published: February 2022

The COVID-19 outbreak has left its mark on the work of mental health care staff. Many professionals had to radically change their working conditions or were delegated to work in different facilities, in many cases taking on different responsibilities with little time for training. Many psychiatrists overnight had to partially or fully start working within telemedicine. Due to the lockdown, psychiatric trainees in many countries were not able to complete their training as planned. The measures taken by the governments to limit the impact of the pandemic also affected the capacity to conduct research studies and directions of new research initiatives. Dr. Gondek will present the results of the EPA ECPC-EFPT Cross-sectional survey on the effects of the outbreak on work and wellbeing of Early Career Psychiatrists in Europe.DisclosureNo significant relationships.
Cognitive impairment associated with psychosis (CIAPS): Validity of clinical criteria to detect cognitive impairment
Authors: Sánchez-Torres A. , Gil-Berrozpe G. , Lorente-Omeñaca R. , Zandio M. , Moreno-Izco L. , Janda L. , Peralta D. , Peralta V. , Cuesta M. 
Published: February 2022

IntroductionEven though cognitive impairment is considered a hallmark of schizophrenia, it has not been included as a criterion into major diagnostic systems.ObjectivesTo test whether a set of clinical-defined cognitive impairment criteria can have utility in the assessment of psychosis patients in clinical practice.MethodsWe assessed 98 patients with a psychotic disorder, diagnosed using DSM 5 criteria. We developed a set of cognitive impairment associated with psychosis (CIAPs) criteria following the format of current DSM criteria and based on previous literature. The CIAPs criteria include: A) criterion for evidence of cognitive impairment after the beginning of illness; B) cognitive impairment clinically evidenced, affecting functioning in everyday activities in at least two out of six cognitive domains; C) and D) exclusion criterion for either delirium or other neurocognitive disorders, respectively, as causal agents of the cognitive impairment. The psychosis patients dichotomized by the CIAPs criteria were tested regarding the neuropsychological performance in attention, speed of processing, verbal memory, visual memory, working memory, executive function and social cognition tasks. Also a Global Cognitive Index was calculated.ResultsForty-three patients with psychosis fulfilled the CIAPs criteria (43.9%). MANOVA profile analyses revealed a pattern of statistically significant deficits in all the cognitive dimensions except for social cognition in CIAPs+ patients regarding CIAPS-, with prominent deficits in processing speed and memory functions.ConclusionsThe CIAPs criteria could be an auxiliary method for clinicians to assess cognitive impairment. It may also permit clinical estimation of the influence of cognitive deficits on the ecological functioning of patients.Conflict of interestThis work was supported by the Government of Navarra (grants 17/31, 18/41, 87/2014) and the Carlos III Health Institute (FEDER Funds) from the Spanish Ministry of Economy and Competitivity (14/01621 and 16/02148). Both had no further role in the study des
What is important for doctor’s drug decision-making for the patient with acute schizophrenia?
Authors: Morozova M. , Rupchev G. 
Published: February 2022

IntroductionIn spite of the long history of antipsychotic treatment there are still no clear criteria, which can be robust support for drug decision-making.ObjectivesTo determine the important hallmarks of patient’s current state, life span and history of illness defining the doctor’s decision about the type of antipsychotic to be chosen.MethodsThe data from the case charts of 275 patients with episodic schizophrenia and rather benign course of the disease were analyzed.ResultsThe group included: male 62%, mean age 33 (SD 11), education 10 years 23%, 13 years 27%, 16 years 29%, disability - 51%, number of hospitalizations due to psychotic episodes in the past 7 (SD 6). The symptoms of the current episode varied from patient to patient: delusions and hallucinations, symptoms of disorganization, negative symptoms of different severity were registered Atypical antipsychotics were more often than typical prescribed to the patients with developmental problems: traumatic obstetric complications (p=0,009), poor somatic health in the childhood (p= 0,02), cognitive dysfunction during school years (p=0,04), and quality of first remission – presence of residual symptoms in the first remission (p=0.005). Good compliance in the past was one more important factor for choosing a atypical antipsychotic for a patient (p=0.05). It appeared that the most important for the decision-making was the specific features of the patient’s development and early period of the disease, but not the specific signs of current psychotic state.ConclusionsDoctor’s decision upon the type of antipsychotics in this category of patients is most probably based on other than current clinical symptoms signs.