bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combination of clozapine, cariprazine and fluoxetine in treatment-resistant schizophrenia patient with prominent negative symptoms: A Case report
Authors: Everte I. , Pamše-Romāne A. , Taube M. 
Published: September 2022

IntroductionDespite pharmacological advances in the treatment of schizophrenia, significant number of patients are still treatment-resistant. Clozapine is recommended as first-line treatment for treatment-resistant schizophrenia (TRS) in guidelines. Despite the greater efficacy of clozapine over other antipsychotics in the management of TRS, a significant number of patients fail to attain adequate response or develop adverse effects, and more interventions are needed.ObjectivesTo describe a clinical case of treatment-resistant schizophrenia patient with prominent negative symptoms treated with combination of clozapine, cariprazine and fluoxetine, and to review the literature.MethodsClinical case presentation through review of the clinical file and non-systematic review on PubMed and ResearchGate.ResultsA 41 year old female patient presented to inpatient clinic with low mood, occasional commanding and commenting verbal hallucinations, occasional suicidal thoughts, blunted affect, anhedonia, asociality, she was apathetic, lacked motivation to get up from bed, had night’s sleep disturbance. Patient was diagnosed with Schizophrenia in 2009, she has been hospitalized in Psychiatric wards for 16 times. She has received treatment with combinations of several antipsychotic drugs and antidepressants, had side-effects and have not reached full remission. During treatment with clozapine (up to 175mg per day) in combination with cariprazine (up to 4.5mg per day) and fluoxetine (up to 20mg per day), gradually negative symptoms decreased, patient became more active, showed interest in daily and rehabilitation activities, night’s sleep improved.Conclusions
Patient with treatment-resistant schizophrenia benefited from combination of clozapine, cariprazine and fluoxetine. Further research is necessary on treatment combination strategies for TRS.DisclosureNo significant relationships.
Ultra-treatment-resistant Schizophrenia. A case report
Authors: Osca Oliver A. , Palomo Monge M. , Pérez Fominaya M. , López Rodrigo M.V. , Tascón Guerra M.F. 
Published: September 2022

IntroductionDespite the efficacy of antipsychotics, up to about 30% of schizophrenia patients do not respond adequately to treatment and are called treatment-resistant schizophrenia (TRS) patients. The treatment of choice in these patients is clozapine, which is used last due to the adverse effects it can cause. However, it has been shown that half of TRSs are also resistant to clozapine, leading to ultra-resistant schizophrenia.ObjectivesWe present a clinical case corresponding to a 33-year-old man, single, residing in a community residence, undergoing psychiatric follow-up from the age of 7, receiving during this period the diagnoses of schizotypal personality disorder and paranoid schizophrenia.MethodsAs of 2015, he began to make autolytic attempts, the last being this year, 2021. Moment in which he manifests for the first time presenting imperative, sporadic auditory pseudo-hallucinations, which incite self-harm. These sensory-perceptual alterations appeared from 2015, together with the worsening of the negative symptoms.ResultsThe patient has been treated with numerous antipsychotics, without complete remission, so since 2019 treatment with Clozapine 200mg was started. As the symptoms did not subside, the dose was increased to 400mg, at which point some of its side effects began to appear; urinary incontinence, sedation, sexual impotence … so the patient abandoned the treatment, suffering a relapse of his mental pathology.ConclusionsDespite the arrival of atypical antipsychotics, it remains a challenge that there is a complete remission of symptoms in some patients with schizophrenia, for which we consider that psychopharmacological research in this group of patients is of the utmost importance.DisclosureNo significant relationships.
Variation in cognitive insight processes between schizophrenia and bipolar disorder in a Tunisian population
Authors: Ben Hmida M. 
Published: September 2022

IntroductionCognitive insight is a relatively recent concept referring to the ability, not only to reassess unusual experiences objectively after corrective feedback but also to distance oneself from them and it seems to be specifically altered in schizophrenia. Yet, despite its importance in the understanding of psychotic symptoms, this process has never been studied in the North African population.ObjectivesTherefore, this paper aims to compare cognitive insight performances between two Tunisian psychiatric populations and to explore its relationship with other cognitive processes.MethodsThe study population comprised 17 participants with schizophrenia, 9 with bipolar disorder, and 30 healthy controls. The groups were paired for age, education level, and socioeconomic status. We assessed depression, global executive functioning, verbal episodic memory, metamemory (online and offline), and cognitive insight. The latter was evaluated by the Beck Cognitive Insight Scale.ResultsThe results showed that, compared to the other groups, participants with schizophrenia obtained a lower self-reflectiveness score and a higher self-certainty score, resulting in a significantly lower composite index. These findings seem to indicate the alteration of cognitive insight in schizophrenia. However, no significant differences were found between the other two groups. Moreover, correlational analyses showed that cognitive insight components were only associated with metamemory indices which proved to be the best predictors of this ability, along with the global executive score.ConclusionsIn conclusion, our data seems to corroborate the international literature reporting a cognitive insight deficit in schizophrenia. However, further research is needed in order to better understand the specific processes underlying this metacognitive function.DisclosureNo significant relationships.
The First Research in Your Career: How to Use your Resources as Productively as Possible
Authors: Sartorius N. 
Published: September 2022

The first engagement in research in your career This presentation will argue that in addition to considering the scientific interest of a topic presented for research it is important to consider other criteria before engaging in a study. These include the place of the study, the team which will be engaged in the work, the ownership of the data which will be produced, the duration of the study and other matters. The presentation will also discuss the amount of time that should be given to scientific research early in one’s career and the nature of the gain that engagement in research can offer for one’s development and career.DisclosureNo significant relationships.
Psychotherapeutic intervention for treatment of psychotic symptoms in patients with paranoid development. About a case
Authors: Martín Villarroel C. , Carpio García L. , Sánchez Revuelta M. , Matsuura J. , Belmonte García G. , Santolaya López L. , Benavides Rivero E.F. 
Published: September 2022

IntroductionPsychotic symptoms are not exclusive to schizophrenia, they can be due to paranoid development and can be treated differently.ObjectivesThe objective of this paper is to study, from the following case, the effect of psychotherapeutic treatment in patients with paranoid development.MethodsA bibliographic search was performed from different database (Pubmed, TripDatabase) about psychological intervention for the improvement of paranoid symptoms. 20-year-old man, born into a family with marital problems, without difficulties in psychomotor development, socialization or academic performance, who began with behavioral alterations from the age of 5 that he had begun to suffer abuse from his father, showing aggressiveness towards other children and progressively worsening over the years: consuming cannabis, isolating himself, listening to protective voices and distrusting of people, to whom he responded aggressively believing that they wanted to harm him.ResultsInitially, he was treated with antipsychotics that were later suspended when acute psychotic symptoms were ruled out, diagnosing a paranoid development secondary to trauma, for which he had felt fear and defenselessness, and had learned to be alert and respond aggressively to everything he considered threatening, showing anger that he did not know how to express. During therapy, abstinence to drugs was worked on, therapeutic link, mentalization-based therapy, emotions, narrative techniques, trauma and systemic family therapy.ConclusionsTo conclude, we need to pay attention to development of pathologies like this so as not to rush with antipsychotics, when it may be due to a development secondary to trauma that needs to be treated psychotherapeutically.DisclosureNo significant relationships.
Negative symptoms - a real unmet need
Authors: Soares Da Costa I. , Moreira R. 
Published: September 2022

IntroductionSchizophrenia is frequently a chronic and disabling disorder, characterized by heterogeneous positive and negative symptoms. Negative symptoms are a major health concern and a core component of schizophrenia that account for a large part of the long-term disability and poor functional outcomes in patients with the disorder. Adequate treatment would mean important progress and Distinguishing primary from secondary negative symptoms may inform about treatment options.Objectives
Objective: to provide information that may be useful for clinicians treating patients with negative symptoms of schizophrenia.MethodsWe searched Pubmed and Cochrane Library database for english language articles.ResultsNegative symptoms are a core component of schizophrenia that account for a large part of the long-term disability and poor functional outcomes. Negative symptoms are common in schizophrenia; up to 60% of patients may have prominent clinically relevant negative symptoms that require treatment. Negative symptoms can occur at any point in the course of illness, although they are reported as the most common first symptom of schizophrenia. Negative symptoms can be primary symptoms, which are intrinsic to the underlying pathophysiology of schizophrenia, or secondary symptoms that are related to psychiatric or medical comorbidities, adverse effects of treatment, or environmental factors. Negative symptoms clearly constitute an unmet medical need in schizophrenia, and new and effective treatments are urgently needed.ConclusionsClinically relevant negative symptoms of schizophrenia need to be recognized, assessed, and as well managed as possible in order to achieve improved outcomes for patients. More studies are needed to establish the better approach to negative symptoms.DisclosureNo significant relationships.
Cariprazine as a useful treatment for patients with schizophrenia and antipsychotic-induced extrapyramidal symptoms: a case report and literature review
Authors: Llach C. , Ilzarbe L. , Sagué-Vilavella M. , Arbelo N. , Catalan R. , Gutierrez F. 
Published: September 2022

IntroductionThe discovery of second-generation antipsychotics represented an authentic breakthrough for the management of psychotic disorders. Nevertheless, they still don’t adequately manage some aspects of these disorders, such as negative symptoms (NS), cognitive impairment, or extra-pyramidal symptoms (EPS). New-generation antipsychotics present different pharmacological mechanisms and have been reported to ameliorate these aspects. Among them, cariprazine acts as a D2/D3 partial agonist with variable affinity with serotoninergic receptors, and many studies show its efficacy for preventing and treating positive symptoms as well as for the management of NS and EPS.ObjectivesTo report a case of a patient diagnosed with schizophrenia with highly invalidating antipsychotic-induced EPS that remitted after switching to cariprazine, while maintaining clinical stability. To review literature about cariprazine and its relationship with NS and EPS.MethodsWe describe the case of a 66-year-old woman diagnosed with schizophrenia and under treatment with three-month injectable paliperidone 175mg. During her follow-up at outpatient clinic, she presented a progressively highly invalidating non-trembling parkinsonian syndrome attributable to medication. Paliperidone plasmatic levels were within therapeutic range. An antipsychotic switch was agreed, and cariprazine was started.ResultsThe switch from a second-generation antipsychotic to cariprazine entailed the remission of a highly invalidating EPS while improving some of the NS and maintaining psychopathological stability.ConclusionsAssessing and differentiating NS and EPS is of an utmost importance during the follow-up of patients under antipsychotic treatment. Cariprazine is an interesting alternative when treating patients diagnosed with psychotic disorders that present mostly NS and antipsychotic-induced
EPS.DisclosureNo significant relationships.
Schizophrenic or blind but not both
Authors: Chamsi F.Z. , Katir I. , Korchi A. , Belbachir S. , Ouanass A. 
Published: September 2022

IntroductionAlthough visual impairment appears to be a risk factor for schizophrenia, early blindness may be protective. It’s a phenomenon that has puzzled even the smartest scientific brains for decades. It might surprise you: no person born blind has ever been diagnosed with schizophrenia.ObjectivesThe aim of this research is to discover the relationship between schizophrenia and congenital blindness and whether there is a protective gene and whether visual perception is an essential stage in the onset of diseases itself.MethodsIt’s a case study of a family consisting of 13 brothers and sisters, three of whom were blind at birth, three with schizophrenia. We proceeded with a study of the medical files of all the schizophrenic patients and also ophthalmological exams for all the family members.ResultsPreliminary observational analysis of this clinical case suggests the following hypothesis: the presumed protective role of congenital blindness against schizophrenia. Moreover, the ophthalmological exams showed no visual impairment in schizophrenic patients. The bibliographic research has objectified more than three recent studies in this direction.ConclusionsThe relationship between schizophrenia and congenital blindness is still unrecognized and controversial. Several studies are done in this neurodevelopmental field but so far there has been no assertion nor confirmation of the suggested hypothesis. More research is needed.DisclosureNo significant relationships.
Gender differences in clinical and psychosocial features in a large sample of Italian patients with schizophrenia
Authors: Bucci P. , Galderisi S. , Rossi A. , Rocca P. , Bertolino A. , Giordano G.M. , Mucci A. , Maj M. 
Published: September 2022

IntroductionAn extensive literature regarding gender differences relevant to several aspects of schizophrenia is nowadays available. It includes some robust findings as well as some inconsistencies. The identification of gender differences and the understanding of their explanations may help to clarify the underlying etiopathogenetic mechanisms of specific aspects of the disorder.ObjectivesThe present study aimed at investigating gender differences on premorbid, clinical, cognitive and outcome indices, as well as their impact on recovery, in a large sample of patients with schizophrenia recruited within the multicenter study of the Italian Network for Research on Psychoses.MethodsState-of-the-art instruments were used to assess the investigated domains. Group comparisons between male and female patients were performed on all considered indices. The associations of premorbid, clinical and cognitive indices with recovery in the two patient groups were investigated by means of multiple regressions.ResultsMales with respect to females had a worse premorbid adjustment – limited to the academic dimension – an earlier age of onset, a higher frequency of history of substance and alcohol abuse, more severe negative symptoms (both avolition and expressive deficit), positive symptoms and impairment of social cognition. No gender difference was observed in neurocognition nor in the rates of recovery.ConclusionsAlthough males showed some disadvantages in the clinical picture, this was not translated into a worse outcome. This finding may be related to the complex interplay of several factors acting as predictors or mediators of outcome.DisclosureNo significant relationships.
Microbiota, Immune System and Autism Spectrum Disorders: An Integrative Model Towards Novel Treatment Options
Authors: Marazziti D. , Carpita B. , Palermo S. , Parra E. , Dell’Osso L. 
Published: September 2022

The functioning of the central nervous system (CNS) is the result of the integration of bidirectional messages between the brain and peripheral organs. Despite the anatomical separation, gut microbiota, i.e., the microorganisms colonising the gastrointestinal tract, is related to the CNS through the so-called “gut–brain axis” that is also involved in immune processes. The recent literature indicates that the gut microbiota may affect brain functions through endocrine and metabolic pathways, antibody production and the enteric network, while supporting its possible role in the onset and maintenance of several neuropsychiatric and neurodevelopmental disorders, such as autism spectrum disorders (ASDs). The term ASDs includes autistic disorder, Asperger’s syndrome, childhood disintegrative and pervasive developmental disorders not otherwise specified different. All these conditions are characterised by persistent deficits in social communication and social interaction, as well as limited and repetitive behaviours, interests or activities. In the last two decades, an impressive number of cross-sectional studies reported significant differences in microbiota composition between children with an ASD and controls, thus strengthening the hypothesis of a possible link between GI dysbiosis and ASD. The amount of studies documenting the possible involvement of microbiota in ASD pathogenesis led to considering whether treatments acting on gut flora could ameliorate ASD symptoms. The available findings, although preliminary, would indicate data gut microbiota might represent an interesting field of research for a better understanding of the pathophysiology of ASD (of also of other neuropsychiatric disorders), and possibly a target for the development of innovative treatments just labelled as “psychobiotics”.DisclosureNo significant relationships.
Successful Treatment with Lurasidone of First-Episode Psychosis in Down Syndrome: Case Report and Literature Review
Authors: Delgado Montfort L. 
Published: September 2022

IntroductionCo-morbid psychiatric disorders are common in Down syndrome (DS). Evidence is limited for pharmacotherapy, specifically antipsychotics, for psychiatric co-morbidity in DS.ObjectivesTo describe a case of a patient with DS who developed a first-episode psychosis (FEP) and who responded to lurasidone in monotherapy and to review recent literature on the treatment of psychosis in patients with DS.Methods(1) Case report: FEP in DS patient treated with lurasidone 37 mg/day. (2) Narrative review on the treatment of psychosis in DS patients through PubMed database (1990-2020). Key terms: “psychosis”, “Down Syndrome”, “pharmacological treatment”, “antipsychotic drugs”.ResultsA 21-year-old woman with DS, without psychiatric history, presenting with behavioural anomalies, aggressiveness, soliloquies, and unmotivated laughs was referred to our outpatient clinic by her general practitioner. Symptoms began one year prior and progressively worsened, impairing her daily functionality. Previous blood workup was normal. She was diagnosed with FEP and began treatment with lurasidone 37 mg. At 4-week follow-up, she showed total remission of the psychotic symptoms, had no tolerability complaints, and returned to baseline functionality levels. Discussion: No reports of lurasidone use in psychosis in DS have been published. To treat psychotic symptoms in DS, most literature reports describe the use of typical antipsychotics, which are usually effective, but often poorly tolerated; atypical antipsychotics such as risperidone and aripiprazole have also been used.ConclusionsLurasidone may be a useful option in patients with FEP in DS. Further research is warranted on treatment of psychosis in this population.DisclosureNo significant relationships.
Sensory and Motor Difficulties in Autism
Authors: Gargot T. 
Published: September 2022

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social interaction and communication, and by restricted and repetitive behaviors. A meta-analysis describes motor difficulties in ASD (Downey and Rapport, 2012) in 85% to 90% of cases (Liu et al. 2010). Electronic devices will help to better characterize these movement impairments (Gargot et al., in press). Another meta-analysis shows difficulties in sensorial integration in ASD, with a prevalence ranging from 45 to 95% (Ben Sasson, 2009). Sensorimotor contigencies are learned interactively (Jacquey et al., 2020), in a perception-action loop, an early milestone in development (Piaget, 1937). A cascade model (Bonnet-Brilhault, 2017) hypothesizes that social difficulties stem in sensorimotor difficulties (Cook, 2016; Neal, 2011; Dziuk et al. 2007; Kojovic, 2019), themselves atypically developed due to a peculiar neurobiological background. This model predicts that early sensorimotor reeducation could prevent the development of social difficulties, whereas the rehabilitation of social skills would improve only part of the impairment, that is driven by sensorimotor processes. How to target these issues? Grandin, 1992 and Edelson et al., 1999 validated the efficacy of deep pressure therapy in ASD. It is important to improve attractivity and decrease the stigmatization of this method. Oto is a compressive armchair with inflatable cushions controlled electronically. It records level of pressure and its duration, chosen by the user. A systematic review showed the efficacy of virtual reality in ASD (Mesa-Gresa et al, 2018). A CAVE device could habituate children to ecological audio-visual stimulations.DisclosureThomas Gargot was paid by the French ministry of research (Doctoral school), French ministry of health (médaille d’argent, CCA-AHU) for a PhD and CCA position. During his PhD, he prepared several scientific presentations with Dr Asselborn. This work led