bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating empathic and mentalizing abilities with interpersonal sensitivity in people with eating disorders: A network analysis approach
Authors: Patriciello G. , Marone L. , Vece A. , Barone E. , Monteleone A.M. 
Published: February 2022

IntroductionLiterature highlights that interpersonal sensitivity represents an important development and maintaining factor for Eating Disorder (ED). Mentalizing and empathy are two psychological constructs that play a crucial role in social functioning. However, the role of mentalizing and empathy in the socio-emotional processing deficits of ED patients has been under investigated.ObjectivesWe aimed to assess the complex interactions between the sub-components of mentalizing and empathy and ED symptoms through a network analysis approach.MethodsSeventy-seven women with EDs were included in our study. Eating disorder and affective symptomatology were investigated with self-report questionnaires. All patients underwent two computerized tasks: Movie for the Assessment of Social Cognition (MASC), assessing emotional and non-emotional mental state inferences; Empathic Accuracy Task-Revised (EAT-R), measuring accuracy in identifying and sharing others’ emotions. A partial correlation network and bridge function analyses were computed.ResultsIn the partial correlation network inference of cognitive mental states and shape concern were the nodes with the highest strength centrality. Inference of emotional mental states was the node with the highest bridge strength in the cluster of social cognition functions. Empathic and mentalizing abilities were directly connected with each other and with ED symptoms.ConclusionsThis is the first network analysis study which integrates self-reported symptoms and objective socio-cognitive performance in people with Eds. Our results provide evidence of the complex interactions between mentalizing, empathy and psychopathological symptoms in people with EDs. Therefore, confirm that the ability to infer others’ mental state may represent a useful target for clinical intervention in EDs.
Dysmorphophobia as a factor that worsens the affective state and the life quality of patients with eating disorders. The final data of the study
Authors: Okonishnikova E. , Bryukhin A. , Lineva T. , Belokrylov I. 
Published: February 2022

IntroductionAnorexia nervosa (AN) and bulimia nervosa (BN) take one of the first places in the risk of fatal outcome among eating disorders, have a tendency to chronicity and high suicidal risk. Psychopathological basis for AN and BN is a dysmorfofobia or a pathological dissatisfaction with one’s body, characterized by intrusive, overvalued or delusional ideas of physical disability. Dysmorfofobia affects the formation of affective pathology and reduces the life quality.ObjectivesThe study of the correlation between the degree of dissatisfaction with one’s bodies, affective disorders and life quality of patients with AN and BN.Methods130 female patients with AN and BN at the age of 13-44 years (the average age is 18). The disease duration from 6 months to 24 years. Validated Questionnaire image of one’s own body (QIOB) and the Scale of satisfaction with one’s body (SSOB); Hospital anxiety and depression scale (Zigmond A.); Questionnaire for the assessment of life quality (SF-36); Microsoft Excel standard correlation calculation.ResultsDissatisfaction with one’s body based on QIOB and SSOB tests has a significant positive correlation with anxiety and depression, a significant correlation with the psychological component of health, a weak correlation with the physical component of health.ConclusionsDissatisfaction with one’s body or dysmorfofobia of patients with AN and BN significantly affects their affective state and psychological component of life quality which leads to a decrease in functioning up to social maladaptation and disability to social maladjustment. The publication was prepared with the support of the “RUDN University Program 5-100”.
Clinical manifestations of vomitomania in bulimia nervosa
Authors: Bryukhin A. , Okonishnikova E. , Lineva T. , Batyrev Y. 
Published: February 2022

IntroductionIn the dynamics of bulimia nervosa, a significant proportion of patients show a pathological attraction to purifying behavior in the form of artificially induced vomiting. This variant of the pathology of the drives significantly aggravates the symptoms, causes a severe degree of maladaptation of patients and great difficulties in the treatment of the disease.ObjectivesTo identify and describe the manifestations of vomitomania in patients with bulimia nervosa, the impact on the outcome of the disease.MethodsClinico-psychopathological, psychological, catamnestic.Results120 patients with bulimia nervosa were examined: 112 women and 8 men aged 22-43 years. 86 of them (80 - women, 6 - men) were found to have vomitomania (a pathological urge to induce vomiting). Patients with pleasure, without feeling shy, awkward, described their own vomiting behavior - noted the expectation of vomiting, prepared for its implementation, observing complex rituals, imagined the vomiting act and its consequences in their minds, imagination. Describing vomiting, patients used superlative degrees of comparison, noted a sense of bliss, pleasure, “high” in the implementation of this irresistible desire. If it was impossible to induce vomiting, there was a feeling of depression, depressed mood, irritability, anger, physical distress - in fact, manifestations of withdrawal syndrome. Critical attitude to the above-described pathological behavior was absent in a significant part of cases.ConclusionsSpecial pathological attraction to vomiting – vomitomania - is a widespread symptom of bulimia nervosa and drive disorders in this disease. It presents significant challenges for therapy especially in comorbid bulimia nervosa with personality disorders and schizotypal disorder.
Childhood traumatic experiences and functioning of both neurobiological components of the endogenous stress response system in adult people with eating disorders
Authors: Pellegrino F. , Cascino G. , Barone E. , Monteleone A.M. 
Published: February 2022

IntroductionA large body of literature suggests that childhood trauma exposure is a non-specific risk factor for development of eating disorders (EDs) later in life. One potential mechanism through which early traumatic experiences may increase the risk for EDs is represented by long-lasting changes in the body stress response system.ObjectivesWe investigated the activity of the hypothalamus-pituitary-adrenal axis and of the sympathetic nervous system in adult ED patients with or without a history of childhood trauma exposure.MethodsWe recruited 35 women with EDs, admitted to the Eating Disorders Center of the Department of Psychiatry of the University of Naples “Luigi Vanvitelli”. Participants filled in the Childhood Trauma Questionnaire (CTQ), to assess exposure to childhood trauma. They were instructed to collect saliva samples at awakening and after 15, 30 and 60 minutes, in order to measure cortisol levels and salivary alpha-amylase (sAA), a marker of the sympathetic nervous system activity.ResultsAccording to the CTQ cut-off scores, 21 ED women were classified as maltreated (Mal) participants and 14 women as no-maltreated (noMal) ED participants. Compared to noMal ED women, Mal ED participants showed significantly decreased cortisol awakening response (CAR) and sAA morning secretion.ConclusionsPresent findings confirm that childhood trauma exposure impairs the CAR of adult patients with EDs and show that also the morning secretion of sAA is decreased in childhood maltreated adult ED patients. Therefore, our study shows for the first time a dampening in the basal activity of both components of the endogenous stress response system in childhood maltreated adult ED women.
Eating disorders and diabetes: A meta-analysis
Authors: Mastellari T. , Speciani M. , Gelati F.F. , De Ronchi D. , Panariello F. , Atti A.R. 
Published: February 2022

IntroductionDiabetic patients are asked to focus on their eating habits and calories intake. Together with individual factors, this could increase the risk of developing Eating Disorders (ED) associated with diabetes. A score of 20 points at the Diabetes Eating Problem Survey-Revised (DEPS-R) scale is considered as a valid threshold to identify Disordered Eating Behaviours (DEB) in diabetic patients. DEB can be considered as altered eating behaviours not fully meeting criteria for ED. As DEB are not formally recognised as specific ED in DSM-5, there is a great risk of not detecting them, thus underestimate their consequences.ObjectivesTo meta-analyse literature on ED and DEB, when in comorbidity with Type 1 and Type 2 Diabetes Mellitus, focusing on pathological medical consequences.MethodsPRISMA guidelines were followed for this meta-analysis. Articles were identified in literature by searching into PubMed, PsycINFO and Embase.Results1141 records were identified through database search. Figure 1 shows six studies comparing HbA1c % values for 2857 diabetic patients versus 752 diabetic patients with DEB. HbA1c % levels appear to be higher in patients with DEPS-R ≥ 20, compared to those with DESP-R scores below 20.ConclusionsRoutine screening for DEB using DEPS-R scale could favour early identification of diabetic individuals, at risk for progression into a proper ED. Clinicians should be vigilant about potential DEB when patients show poor long-term glycaemic control; similarly, patients with a DEPS-R score over 20 points may require more frequent glycaemic checks. This could help prevent serious medical complications.
Eating disorder examination-questionnaire – 7: Construct validity in a sample of portuguese overweight women
Authors: Pereira A.T. , Peixoto C. , Martins H. , Marques C. , Carvalho F. , Macedo A. 
Published: February 2022

IntroductionAlthough the Eating Disorder Examination Questionnaire (EDEQ; Fairburn et al. 2008) is the most used instrument worldwide for the assessment of eating disorders symptoms, its factorial structure considerably varies, which limits its construct validity. Using exploratory factor analisys in data from a sample of overweight women, our group found a three-factors structure of the EDEQ Portuguese version (Peixoto et al. 2013), Although it was in accordance with other psychometric studies (eg. Peterson et al 2007), it was different from the original matrix. Further investigation regarding its factor structure has been conducted, with studies supporting a modified seven-item-three-factors structure (dietary restraint, shape/weight overvaluation, body dissatisfaction) with improved psychometric properties (Grilo et al. 2013, 2015), including with Portuguese samples (Machado et al. 2018; Santos et al. 2019).ObjectivesTo analyze if the EDEQ version composed of seven items and three factors is replicated in a Portuguese sample of overweight women.MethodsThe EDEQ was administered to an outpatient sample of 276 women (Mean age= 43.85±11.89 years; Mean BMI=32.82±5.43 Kg/height2) attending a weight loss treatment consultation in a public hospital.ResultsConfirmatory factor analysis (CFA) revealed an adequate fit of the EDEQ-7 second order model with three dimensions (χ2/df=1.5497; RMSEA=.0452, CFI=.9955, TLI=.9914, GFI=.xxx; p<.001). The EDEQ7 Cronbach’s alphas for the total and its dimensions were α<.70.ConclusionsGiven its good psychometric properties, the overlap of the measurement model with those found with different samples and the reduced number of items, the EDEQ7 will be very useful both in research and clinical settings with/for overweight women.
Factors of psychiatric emergencies affecting boarding time in the emergency department
Authors: Avanoğlu K.B. , Gürel Ş. 
Published: February 2022

IntroductionPsychiatric emergencies are acute disturbances in thought, behavior or mood which require immediate medical intervention. As a substantial number of patients with mental illness present as psychiatric emergencies, the sustainability and management of psychiatric emergency services becomes significant.ObjectivesIn this study we aimed to examine the factors associated with psychiatric emergency care, taking the boarding time in the emergency department as primary outcome measure.MethodsCharts of 466 psychiatric emergency cases admitted to the Hacettepe University Emergency Department (ED) between December 2018 – September 2019 were evaluated. Boarding time (BT) in the ED, presence of self-harm, psychotic symptoms and agitation were noted.ResultsIn the examined period, number of patients admitted increased with time significantly (r= 0.562, p <0.01). However, increase in the number of patients was not correlated with an increase in BT. Patients with psychotic symptoms had greater BT compared to non-psychotic patients (7.01 hours vs. 11.24 hours, T= -2.796 df = 182.717 p <0.01). Patients with self-harm also had greater BT (7.47 hours vs. 9.85 hours, T = -2.013 df = 433 p <0.05). Patients with self-harm in relation with previous suicidal ideation displayed significantly a longer BT when compared with patients admitted due to self-harm without any suicidal plan (U=2572,5 p<0.01).ConclusionsA significant increase in BT with psychosis and self-harm due to a suicidal plan supports the need of intermediate facilities between the ED and inpatient units, as such facilities would create a positive impact in the care of psychotic and suicidal patients.
Self-amputation: Case report
Authors: Iñiguez I. Cuevas , Lietor M.D.C. Molina 
Published: February 2022

IntroductionSelf-amputation, the most severe form of self-mutilation, is unusual. In most cases, self-mutilation is related to psychiatric disorders, mainly psychotic spectrum disorders and substance abuse.ObjectivesThis case report aims to describe a case of unusual self-amputation in a man with a psychiatric history.MethodsCase report and literature review.ResultsA 35 years old man patient, divorced, unemployed, with 15 years of treatment history for anxiety and low mood. The patient reported history of childhood trauma. He was inpatient (2019) after a suicide attempt. The psychiatrist who was treating him did not give a diagnosis (referral diagnosis). The patient mentioned several times that he desired feet amputation, without planification, in context of high anxiety. He was distressed by the shape and noise of his ankles. The patient was not diagnosed with genuine hallucinations or delusions. Four months after his divorce he amputated his feet with an electric saw. He denied any intention to commit suicide by committing this act. He admitted that he wanted to get rid of discomfort. Despite this drastic action, his mood did not improve.ConclusionsSelf-amputation is not a common condition. Although some cases of self-amputation have been reported, this case illustrates not only the difficulty of making a differential diagnosis (psychosis, dissociation, trauma, dysmorphophobia, body identity integrity disorder…) but also the challenge of a multidisciplinary approach in the treatment of patients with self-amputations.
Trends in involuntary admissions for observation in malta
Authors: Zammit M.A. , Agius M. , Cutajar J. , Trigona B. Micallef 
Published: February 2022

IntroductionSchedule II of the 2013 Mental Health Act is part of the legal framework for involuntary admission to a licensed mental healthcare facility in Malta (Mount Carmel Hospital) for observation.ObjectivesTo identify trends in presenting features cited by registered specialists in psychiatry in Schedule II applications as well as impact of time of day on involuntary admission.MethodsSchedule II forms relating to all involuntary admissions to Mount Carmel Hospital between 01 June 2018 and 01 June 2019 were retrieved from paper files (n=364). Details relating to reason for using this legal framework were recorded and processed through custom linguistic analysis. Timings of application were also assessed. Data Protection permissions to retrospectively access patient files were obtained. All data collected was de-identified at source.ResultsThe commonest reason for use of Schedule II was psychosis (n=139). Substance abuse was recorded in 68 cases, with alcohol and cannabinoids the commonest substances cited. 155 instances relate to situations of increased risk, the commonest being aggressive behaviour (n=74). 61 cases recorded suicidal intent. Peak use of this schedule occurs between 17:00 and 18:00, which is outside normal working hours.ConclusionsPredominance of psychosis as a reason for involuntary admission concurs with trends reported internationally, including recent German, Irish and Dutch reports, as does increased use of involuntary admission with out-of-hours presentations. Practices relating to involuntary admission to a mental healthcare facility in Malta appear to reflect general trends in other European cohorts, despite differing legal frameworks.
Psychiatric admissions from the emergency department: An observational, retrospective study and recommendations for improved patient care and use of resources
Authors: Pirotta J. Ellul , Saliba E. , Cassar M.R. 
Published: February 2022

IntroductionPsychiatric patients visiting the Emergency Department (ED) often require ‘medical clearance’. We aim to review patient work-up in the ED to facilitate the management of these patients.Objectives- To identify common demographic variables, diagnoses and mental health legislative status of patients presenting to the ED requiring psychiatric admission - To assess whether patients underwent a medical work-up in the ED, and what investigations were carried out - To produce a hospital proforma for the management of psychiatric patients presenting at the EDMethodsData on adult psychiatric patients visiting the ED over a six month period was collected retrospectively, which was then analysed accordingly.Results473 patient admissions were reviewed. 32.8% were admitted to a non-psychiatric specialty before being accepted to psychiatry, with the most common reasons being due to overdose (30.3%), alcohol-related problems (19.4%), and medical complaints (18.7%). 63.2% of all patients were investigated in the ED, including 23.5% undergoing CT Brain imaging. The majority had a final diagnosis falling under F10-19 (30.2%) and F30-39 (30.9%) chapter categories of the ICD-10, with the former having the highest absolute number of patients undergoing testing in the ED. The F20-29 group (13.7%) was highest in total patients investigated (75.4%), CT brain imaging (56.9%), and rate of involuntary admissions (33.8%), suggesting they are the most resource intensive group.ConclusionsPatients with acute mental disorders present significant challenges to emergency physicians. Staff education and an inter-departmentally agreed upon proforma, taking into account the results of this study, may facilitate management of these patients within the ED.
Crowding analysis for patients with intossication and substance abuse during the first pandemic wave of 2019 coronavirus epidemic (COVID-19) at a lombardy ED
Authors: Savioli G. , Pesenti S. , Ceresa I. , Oddone E. , Bressan M.A. 
Published: February 2022

IntroductionThe 2019 coronavirus epidemic (CoViD-19) in Italy originated in Lombardy, on February 21, 2020. Crowding has been defined as a worldwide problem as cause of reduced quality of care and patient satisfaction. It is due and identified by three orders of factors: those at the access (input); those related to the patient’s process (throughput); and those at the exit from the ED (output).ObjectivesWe evaluated all the population who went to ED for intossication and substance abuse. Due to the high level of care needed by these, an excessive duration of LOS (length of Stay) can be counterproductive.MethodsWe evaluated all patients accessing our ED for intossication and substance abuse from February 22 to May 1, 2020 and during the same period of the previous year.ResultsWe enrolled 142 patients. The Crowding input factors are lower in the pandemic period: reduced attenders (41 vs 101) and reduced average waiting times (59 min vs 86 min). The Crowding throughput factors have instead worsened: LOS for both the visit rooms (810 vs 544 min) and the holding area (1205 min vs 947 min). The Crowding output factors also worsened: the percentage of access block is higher during the pandemic (10% vs 5%). The Total Access Block Time is significantly higher in the CoViD period for the holding area (1053 vs 930 min).ConclusionsThe pandemic period presented a worsened crowding for these patients due to the Access Block.
Between the first and second wave of the 2019 coronavirus pandemic (COVID-19): Presentation and crowding of attenders for mentale disorder and intossication/substance abuse
Authors: Savioli G. , Pesenti S. , Ceresa I. , Oddone E. , Bressan M.A. 
Published: February 2022

IntroductionDuring the 1st wave of CoViD-19 pandemic there was a drastic reduction in total number of accesses, with more serious cases and a exorbitant increase in crowding, due to access block.Objectivesevaluate population who went to ED for (1) mental disorders requesting a psychiatric visit and for (2) intossication and substance abuse, between the first and second wave of the coronavirus pandemicMethodsWe enrolled all patients who went at our ED from May 1 to October 20, 2020 and during the same period of 2019. We analized: vital parameters, age, sex, exit severity codes, hospitalization rate, Crowding input factors (number of access, waiting time, priority time to doc), Crowding throughput factors (LOS: Length Of ED Stay), Crowding output factors (percentage of access block; Total Access Block Time).ResultsThe results are shown in table 1Table 1Mental-disorderintossication/substance-abuseMay1-October 20,2020May1- October 20,2019May1-October 20,2020May1- October 20, 2019number of ED access543564182254higher (yellow and red) priority time to doc (%)28%29%50%39%worse exit severity codes (%)10%6%16%11%rate of hospitalization (%)26%20%16%9%average waiting times (min)60647679LOS lenght of stay (min)369326629506access block (%)3%2%5%4%Total Access Block Time: examination rooms (min)11.5388.3848.0598.889Total Access Block Time: holding area (min)8.3823.963182254ConclusionsWe would like to thank all employees of the IRCCS Policlinico San Matteo Foundation for their extraordinary efforts during the pandemic.