bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impressive Response with Brexpiprazole in Ekbom’s syndrome
Authors: Hsiao J. , Shen Y.-C. 
Published: September 2022

IntroductionAntipsychotics are the mainstream treatment of delusional disorder. However, limited therapeutic effect was recognized due to side effect and lack of insight.ObjectivesThis article presents a case with Ekbom’s syndrome, also known as delusional parasitosis, who has significant response with Brexpiprazole.MethodsA 58-year-old female developed her very first episode of psychosis 3 weeks before she visited our emergency department. Delusion of spiders laying eggs and bitsy spiders crawling over her body was claimed, followed by depressed mood and insomnia. The patient denied any substance use in recent months. Examination including biochemical studies, complete blood count, vitamin, and endocrine during admission were all normal. Brain image revealed senile cortical atrophy without apparent acute infarction. Cognitive abilities screening instrument (CASI) revealed total score 75, indicating borderline cognitive function. Ophthalmologist and dermatologist were consulted, and no specific abnormality was found.ResultsBrexpiprazole 2mg was prescribed. After 3 weeks of treatment, the delusion improved with less parasitosis content. We discharged the patient, and kept following her at outpatient department with Brexpiprazole 2mg for 2 months. We tried to taper Brexpiprazole to 1mg at clinic, but her delusional parasitosis relapsed within 1 month. Therefore, we titrated the medication back to 2mg, and kept some dosage for 4 months. No more relapse of psychosis or significant movement dysfunction was observed. The total treatment course was 7 months.Conclusions
Brexpiprazole, with its D2 partial agonism, shows impressive antipsychotic effect to Ekbom’s syndrome. Little side effect was observed in clinical practice, making Brexpiprazole a worth-trying psychopharmacological management of delusional parasitosis.DisclosureNo significant relationships.
The Navigate First Psychosis Program: A balance between the medical and recovery models in the debate about long term prophylactic antipsychotics. Mission Impossible?
Authors: Sharony L. , Josman R. 
Published: September 2022

IntroductionFirst psychosis programs have been developed during the past 30 years to influence the prognosis of a first psychotic episode by early integrative biopsychosocial interventions, with a focus on the processes that contribute to relapse. In the process of recovery, Navigate program emphasis on enabling a connection to what is important to the person (work, studies, relationships, intimacy), thus strengthening resiliency and quality of life and reducing self-stigma. Medication is part of any intervention program, however, there is a lot of ambivalence amongst the young person and family about its continuation and many will stop the medication altogether. Moreover, although evidence for the benefits of antipsychotic medication in short-term treatment is well established, there is an ongoing debate in the professional medical literature about the need and benefit of routine prophylactic long-term antipsychotics after first psychotic episode. There is also a significant uncertainty concerning the proportion of patients that will maintain remission without antipsychotics.ObjectivesIn this lecture, we will present some of the lessons that we have learned and are still learning from our clients, together with case examples.MethodsIn our Navigate Program, we have developed strategies based on literature and experience that enables the person/family to be part of the decision-making process, which at times presents dilemmas and risks but also promotes the potential for growth and transformation.ResultsHow do we talk about the medication issue? Who can continue without medication or with very low dosage? How can we taper antipsychotic treatment?ConclusionsAre we willing to take the risk?DisclosureNo significant relationships.
Are conspiracy theorists psychotic? A comparison between conspiracy theories and paranoid delusions
Authors: Veling W. , Sizoo B. , Van Buuren J. , Van Den Berg C. , Sewbalak W. , Pijnenborg G. , Boonstra N. , Castelein S. , Van Der Meer L. 
Published: September 2022

IntroductionConspiracy theories are popular during the COVID-19 pandemic. Conspiratorial thinking is characterised by the strong conviction that a certain situation that one sees as unjust is the result of a deliberate conspiracy of a group of people with bad intentions. Conspiratorial thinking appears to have many similarities with paranoid delusions.ObjectivesTo explore the nature, consequences, and social-psychological dimensions of conspiratorial thinking, and describe similarities and differences with paranoid delusions.MethodsCritically assessing relevant literature about conspiratorial thinking and paranoid delusions.ResultsConspiratorial thinking meets epistemic, existential, and social needs. It provides clarity in uncertain times and connection with an in-group of like-minded people. Both conspiratorial thinking and paranoid delusions involve an unjust, persistent, and sometimes bizarre conviction. Unlike conspiracy theorists, people with a paranoid delusion are almost always the only target of the presumed conspiracy, and they usually stand alone in their conviction. Furthermore, conspiracy theories are not based as much on unusual experiences of their inner self, reality, or interpersonal contacts.ConclusionsConspirational thinking is common in uncertain circumstances. It gives grip, certainty, moral superiority and social support. Extreme conspirational thinking seems to fit current psychiatric definitions of paranoid delusions, but there are also important differences. To make a distinction with regard to conspiratorial thinking, deepening of conventional definitions of delusions is required. Instead of the strong focus on the erroneous content of delusions, more attention should be given to the underlying idiosyncratic, changed way of experiencing reality.DisclosureNo significant relationships.
Quality of life of patients with schizophrenia
Authors: Guermazi A. , Smaoui N. , Jardak D. , Omri S. , Feki R. , Gassara I. , Maalej M. , Charfi N. , Zouari L. , Ben Thabet J. , Maalej M. 
Published: September 2022

IntroductionSchizophrenia (SCZ) is considered one of the most disabling mental illnesses with significant family, social and occupational repercussions resulting in impaired quality of life (QOL).ObjectivesTo assess the QOL of patients with SCZ or schizoaffective disorder (SAD) and to analyze the sociodemographic and clinical factors associated with its alteration.MethodsThis was a cross-sectional, descriptive and analytical study, which began in December 2019, conducted with 60 subjects followed for SCZ or SAD, at the psychiatry outpatient unit of the Hedi Chaker University Hospital in Sfax (Tunisia). General, clinical and therapeutic data were collected using a pre-established questionnaire. QOL was assessed with the «36 item Short-Form Health Survey» (SF-36).ResultsPatients enrolled had SCZ in 78.2% and SAD in 21.8% of cases. The mean age was 47.2 years and the sex ratio M/F was 4.5. They were single in 63.7% of cases and unemployed in 61.8%. Psychiatric family history, the presence of personal somatic illnesses and tobacco use were found in 43.6%, 61.8% and 67.3% of cases, respectively. The average QOL score was 57.7, the average physical health score was 61.1, and the average mental health score was 54.3. Female sex (p=0.02), being single (p=0.039), lack of work activity (p=0.00), tobacco use (p=0.05), and presence of medical history (p=0.034) were statistically correlated with impaired QOL.ConclusionsQOL in SCZ and SAD is impaired. This result encourages us to conceive of the patient in his whole life and not only from the point of view of the disease.DisclosureNo significant relationships.
Schizophrenia with obsessive-compulsive suicidal images
Authors: Vasadi V.-M. , Capatina O. , Fadgyas Stanculete M. 
Published: September 2022

IntroductionBackground A 19-year old patient with a history of traumatic childhood events presents herself for suicidal behavior driven by complex auditory hallucinations, self-mutilating behavior, and obsessive-compulsive suicidal images that depicted the patient lying dead on the floor with both wrists cut open. Prior to hospitalization, over the past 10 months, the patient exhibited symptoms of low mood, anhedonia, and an overall decline in school performance which led to a diagnosis of MDD with psychotic symptoms, but treatment with Duloxetine 60mg and Olanzapine 10mg proved to be inefficient.ObjectivesCase Presentation Upon admission the patient’s mimic and behavior did not support the described sadness, she presented a circumstantial discourse with frequent thought blockages and delusions. Associated the patient also described hypervigilance and avoidance behavior towards men, flashbacks, vivid nightmares, and obsessive-compulsive self-mutilating impulses and images.MethodsInitially, treatment was started with Olanzapine 20mg, which was augmented two months later with Sertraline 50mg and Bromazepam 3mg. This treatment led to an incomplete resolution of the obsessive symptoms, which led to the increase of Sertraline at 100mg, but at her 1-month check-up evaluation, she presented increased suicidal ideation and daily obsessive-compulsive images.ResultsThe patient was lastly diagnosed with schizophrenia, and due to the persistence of the suicidal ideations and delusions and the obsessive-compulsive symptoms, the treatment plan was revised.Conclusions
Improvement of symptoms appeared under treatment with 300mg Clozapine and 50mg Fluvoxamine. In total the patient needed 98 days of hospitalization and lasting remission of symptoms appeared only under treatment with Clozapine and Fluvoxamine.DisclosureNo significant relationships.
Family support in treatment of patients diagnosed with schizophrenia: a case report
Authors: Jambrosic Sakoman A. , Bosnjak Kuharic D. , Zegura I. 
Published: September 2022

IntroductionSchizophrenia is often accompanied by functional deterioration which can impede a person‛s everyday activities. Families are an important part in providing care for their ailed member‚ but often lack resources to deal with different challenges included in such care. Mental health professionals treating such patients sometimes neglect the importance of including their families‚ or primary caretaker in the treatment plan.ObjectivesWe will present two cases of patients diagnosed with schizophrenia with prominently negative symptoms and the challenges met by their caretakers and mental health professionals in the treatment.MethodsPatient history‚ psychiatric evaluation, psychiatric treatment‚ and the role of the family will be presented.Results21 years old patient came with his mother after years of not meeting the expected level of functioning. He was misdiagnosed for a couple of years. His treatment was impeded by loss in the family‚ which also affected both him and his mother. Inability to include her earlier in his treatment became a challenge. Second patient has been treated for schizophrenia with dominant negative symptoms‚ inconsistently‚ for ten years. Her family became more involved in her treatment only after she presented with positive symptoms. Their involvement was important as it resulted in patient‛s better compliance.ConclusionsSupporting a family member diagnosed with schizophrenia can be overwhelming for the families. Including family members in the treatment early on, can be beneficial both for the patient and the family.DisclosureNo significant relationships.
Increased risk of psychosis to ivermectin treatment
Authors: Romero Calderon A. , Marín Valdovino M. , González Meléndez A.M. , Leiva Soto J. , Garcia Baltazar A. 
Published: September 2022

IntroductionAdolescence: a state of mental fragility, where psychiatric disorders may debut, where have been reported several cases of toxidermy, encephalopathy and neuropsychiatric disorder related to ivermectin treatment (excluding organicity, substance abuse or medication) (1). It has effect on the dopaminergic system with an alteration on glycoprotein P leading to high levels of ivermectin causing neurotoxicity (2). In this poster, we discuss the case of a 14 y/o´s psychosis to ivermectinObjectivesPresentation of a clinical reportMethods14 years old woman. Background: father with schizophrenia. Comorbility: None. Initially, presented to ER with 2 week of treatment to ivermectin 6mg for pediculosis; presenting first psychotic episode. She presented first clinical outbreak of psychosis characterized by mystical-religious, erotomaniac, harm and reference delusions, auditory and visual hallucinations adding isolation, abulia, apathy, dialogued soliloquies, and spontaneous crying. No prior psychiatric treatment.ResultsIn hospitalization: elevated indirect and direct bilirubins and hiponatremia; neuroimaging studies are reported normal. Haloperidol 7.5 mg/day is indicated and parkinsonism is presented. Treatment is changed to olanzapine 15mg/day with notorious improvement. Diagnostic impression: Acute polymorphic psychotic disorder with symptoms of schizophreniaConclusionsPossible causes were analyzed, finding a relationship with ivermectin treatment. This case makes evident the importance of conducting in-depht evaluations and finding risks factors for psychosis.DisclosureNo significant relationships.
Painful ejaculation induced by venlafaxine: a case report
Authors: Kulacaoglu F. 
Published: September 2022

IntroductionSexual dysfunction is a quite common side effect of antidepressant treatment. Sexual side effects may affect the person’s adherence to treatment, quality of life, and relations. Premature ejaculation is rarely seen as an adverse effect of antidepressant drugs.ObjectivesWe aimed to present a clinical case of a 53-year-old man who developed painful ejaculation with the use of venlafaxine.MethodsWe made a narrative literature search in Pubmed and Google scholar with the terms of painful ejaculation induced by venlafaxine and antidepressant treatment.Results
A 53-year-old man was admitted to the psychiatric outpatient unit with symptoms of anhedonia, decreased sleep, decreased self-esteem for the last month. The patient was diagnosed with depression and he started to take 37,5 mg venlafaxine per day. After one month, when venlafaxine dose was increased to 75mg and the patient started to complain of painful ejaculation. The pain continued from the beginning to the end of the ejaculation. The pain increased more when the venlafaxine dose increased to 150mg per day. The patient was consulted at the urology clinic. The urological examination, laboratory tests (direct microscopic examination of the urethral discharge and urethral culture), and serum prostate-specific antigen levels were normal. No pathology was found in uroflowmetry and ultrasonography of the urinary system. The dose of venlafaxine decreased and the patient started to take 20 mg of fluoxetine per day. His symptoms disappeared after venlafaxine was discontinued.ConclusionsTo literature, this is the second presentation of painful ejaculation observed during the use of venlafaxine.DisclosureNo significant relationships.
Psychological Characteristics of Sex Offenders
Authors: Oronowicz-Jaśkowiak W. , Lew-Starowicz M. 
Published: September 2022

IntroductionA significant problem for clinical judicial experts when issuing court opinions is the possibility that the assessed person may be simulating, as well as lack of examination tools that would increase the objectivity and reliability of the assessment. This presentation covers studies on psychological characteristics of perpetrators of crimes against sexual freedom.ObjectivesThe participants were asked to complete psychological tools - Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, Emotion Understanding Test, Revised NEO Personality Inventory, Attachment Style Questionnaire.MethodsThe participants of the study consisted of 225 men serving sentences of imprisonment in a dozen of Polish prisons. Two clinical populations were compared: of perpetrators diagnosed and not diagnosed with sexual preference disorders. The control group consisted of offenders of crimes other than against sexual freedom.Resultsno personality and psychosocial variables were identified that would significantly differentiate offenders diagnosed and not diagnosed with parapaphilic disorder.ConclusionsThe results of this study justify the use of selected tools to complement the clinical diagnosis, allowing for obtaining additional data, independent from case files and interview, that would increase the probability of sexual preference disorders.DisclosureThe study was approved by the ethical committee at the Institute of Psychiatry and Neurology in Warsaw and the Director General of the Prison Service. Scientific work was financed from the budget for science in the years 2017-2021, as a research project D
Mental Health Professionals’ attitudes towards trans people
Authors: Cutillas Fernández M.A. , Jiménez Barbero J.A. 
Published: September 2022

IntroductionSince the emergence of the term “transsexualism” in the Ninth International Classification of Diseases (ICD-9), disciplines related to mental health have contributed to the perpetuation of stereotypical attitudes towards trans people. Recent years have shown the significant prevalence of mental pathology suffered by this group, and the need for specialized training to improve access to the health system.ObjectivesThe main objectives of this research are: (a) to find and analyse the scientific evidence published which assesses the attitudes of mental health professionals towards the trans community; b) to establish the main variables that modify these attitudes, paying special attention to gender, ideology, sexual orientation and previous training or experienceMethodsA systematic review of the literature was conducted following the PRISMA recommendations.ResultsTendency towards more positive and liberal attitudes among professionals than in the general population.Higher values for extreme prejudice among those professionals who attributed gender diversity to a psychological, ethico-moral or religious cause.Association of depathologising practices with belief in the psychosocial nature of diversity, clinical training and interpersonal contact with LGBT people. The following socio-demographic variables were related: being a woman, clinical psychologists, progressive political ideology, professionals who strive to know their own limitations and biases.ConclusionsMore positive attitudes than the general population but still insufficient Specific training in gender diversity and minority issues would be a key element in improving care for transgender people. The attitudes of professionals depend, in part, on the personal characteristics of the therapists.DisclosureNo significant relationships.
BDSM: pathological or healthy expression of intimacy?
Authors: Wuyts E. 
Published: September 2022

IntroductionThough BDSM interest (bondage & discipline, dominance & submission and sadism & masochism) has proven to be quite prevalent (46.8% in recent research), there is still significant stigma surrounding it, both in general society and among mental health practitioners.ObjectivesThis research explores the biological mechanisms associated with a BDSM interaction in the hope to strengthen the argument that it does not belong in the psychiatric field.MethodsThe present study collected data on peripheral hormone levels, pain thresholds and pain cognitions before and after a BDSM interaction and compared these results to a control group.Resultsshow that submissives have increased cortisol and endocannabinoid levels due to the BDSM interaction and that these increases are linked. Dominants showed a significant increase in endocannabinoids associated with power play but not with pain play. BDSM practitioners have a higher pain threshold overall and a BSDM interaction will result in a temporary elevation of pain thresholds for submissives. Additionally, pain thresholds in dominants will be dependent upon their fear of pain and tendency to catastrophize pain and submissives will experience less fear of pain than the control groupConclusionsEven though this is one of the first studies of its kind, several biological processes can be associated with BDSM interactions, strengthening the hypothesis of BDSM as a healthy form of intimacy and promoting its distinction from paraphilias as they are described in the DSM or ICD classifications.DisclosureNo significant relationships.
sexual offenders : Epidemiological and Criminological Profile
Authors: Charaa O. , Bouali W. , Brahmi L. , Haj Mohamed A. , Ben Soussia R. , Zarrouk L. 
Published: September 2022

IntroductionSexual assault is a major problem in Tunisian society. There is no definitive typology of the characteristics of those who sexually assault. A great diversity of sexual aggression behaviors and different motivations can be described.ObjectivesIt is about a retrospective survey, achieved from data of Medical Expertise of the sexual offenders achieved in psychiatric departement of hospital of mahdia. This study revealed 18 cases during the period from January 2010 to December 2020.MethodsThe objective of the work was to describe the epidemiological and criminological profile of the sexual assaults.ResultsMean age of the sample was 40 years [30-61]. Aggressors were almost exclusively males, have medium socioeconomic status and without a regular job. Fifty percent of the perpetrators had a psychiatric diagnosis: bipolar disorder (27.7%), schizophrenia (11.1%), antisocial personality disorder (5.5%) and intellectual disability (5.5%). Indecent assault (27.7%) was the most frequent aggression then the rape (22,2%). Thirty three per cent of the victims were minor.Among these expertised patients, 72% were considered responsible for their actions and only one was considered irresponsible.ConclusionsStudies on the characteristics of sexual offenders have concluded to the profile of the young, single and unemployed male, but it can’t be a commun profile.DisclosureNo significant relationships.
Sexual and Reproductive Health Needs Assessment & Interventions in a Female Psychiatric Intensive Care Unit
Authors: Covshoff E. , Blake L. , Rose E. , Bolade A. , Rathouse R. , Wilson A. , Cotterell A. , Pittrof R. , Sethi F. 
Published: September 2022

IntroductionThis quality improvement project was a collaboration between an adult, inpatient female psychiatric intensive care unit (PICU) in South London and the Sexual and Reproductive Health Rights, Inclusion and Empowerment (SHRINE) programme. SHRINE is a London-based programme delivering SRH care to any individual with serious mental illness, substance misuse and/or learning disability.ObjectivesThe primary aim of this quality improvement project was to assess patients’ sexual and reproductive (SRH) needs, and the acceptability of providing SRH assessments in a female PICU setting. Secondary aims were to explore the barriers to access and the feasibility of providing SRH assessments and SHRINE interventions in the PICU.MethodsA bi-monthly SRH in-reach clinic and a nurse led SRH referral pathway were implemented on the PICU over a seven-month period. Within a quality improvement framework, a staff training needs assessment was performed, training delivered, a protocol developed, staff attitudes explored, and patient and carer engagement sought.Results30% of women were identified as having unmet SRH needs and proceeded to a specialist appointment, representing a 2.5-fold increase in unmet need detection. 42% of women were assessed, representing a 3.5-fold increase in uptake. 21% of women initiated SRH interventions of which 14% had all their SRH needs met.ConclusionsResults identified SRH needs for PICU admissions are greater than realised. Staff highlighted the acceptability and importance of SRH care, if interventions are appropriately timed and the patient’s individual risk profile considered. Providing a nurse-led referral pathway for an SRH in-reach clinic is acceptable, feasible and beneficial for PICU patients.DisclosureNo significant relationships.