bluuebunny/crossref_metadata_2025_split huggingface dataset:
When less is more: deprescription in a long-stay hospital. A case report
Authors: De Hita Santillana R. , Cerame A. , Costa M.L. 
Published: September 2022

IntroductionWe present the case of a 54-year-old man diagnosed with mixed histrionic / obssesive personality disorder admitted in a long-stay hospital. Symptoms began at 40 years of age, predominantly anxiety and agoraphobia alongside somatic complaints. During his admission, the symptoms markedly fluctuated. The patient alternated periods in which he presented confusion with others of irritability, disinhibition, and stereotyped movements. Moreover the patient spent long periods of time in bed with little or no communication with other patients or staff.The different pharmacological approaches which were carried out and their consequences are analyzed.ObjectivesIt is a common practice to increase the number of prescribed drugs or their doses when symptoms worsen. The result is polymedication and higher doses above maximum levels in the technical sheet. Reducing medication is rarely considered as a strategy.MethodsA case report is presented alongside a review of the relevant literature regarding different long-term pharmacological treatments and their side effects.ResultsThe suspension of the antipsychotic treatment which had been administered for years represented a significant improvement. Withdrawal of Olanzapine resulted in a significant improvement.ConclusionsIt is important to review the prescription of each medication in time, as well as to consider their possible side effects.DisclosureNo significant relationships.
Clozapine cessation
Authors: Ktari H. , Ouertani A. , Madouri S. , Aissa A. , Zgueb Y. , Ouali U. , Jomli R. 
Published: September 2022

IntroductionApproximately 30% of individuals diagnosed with schizophrenia suffer from treatment-resistant or refractory schizophrenia. The gold standard for treatment is clozapine. However, a significant number of patients discontinue clozapine treatment and this carries a poor prognosis.ObjectivesThis study explores patients’ motives for cessation of clozapine therapy and its prevalence.MethodsA longitudinal, retrospective and descriptive study on a period of 20 years, at the psychiatry department A of the Razi hospital in Tunisia. Data was collected from the medical files of patients trated by clozapine using a pre-established sheet.ResultsThe studied sample included 64 patient records. Treatment with clozapine was stopped spontaneously or following a medical decision in 37 patients (57.8%). The total number of clozapine stops in these 37 patients was 70. Indeed, each one of these patients had stopped treatment at least once. Clozapine was discontinued by some patients in the study sample for poor compliance(45.9%), for adverse side effects of treatment (16.2%) and by treating physicians for poor response treatment (8.1%). Clozapine was discontinued by 11 patients for hematological adverse reactions, representing 27.9% of the total number of clozapine discontinuations. Withdrawal of clozapine was indicated in 2 cases of agranulocytosis(18.2%), in 2 cases of moderate neutropenia(18.2%), in 3 cases of eosinophilia (27.2%), in 3 cases of thrombocytopenia (27.2%) and in 1 case of severe anemia (9.2%).ConclusionsClozapine discontinuation was essentially caused by poor patients’ observation and hematological adverse reactions appearance.Future research should seek to further investigate clozapine cessation factors in order to better benefit from the medical virtues of this molecule.DisclosureNo significant relationships.
Effects of psychotropic switches on weight change: a prospective cohort study
Authors: Piras M. , Ranjbar S. , Dubath C. , Laaboub N. , Grosu C. , Gamma F. , Von Plessen K. , Von Gunten A. , Conus P. , Eap C. 
Published: September 2022

IntroductionMany psychotropic drugs can induce weight gain with differences in their metabolic risk profiles (i.e. high, medium or low-risk).ObjectivesTo compare the weight evolution of patients switching versus patients keeping their psychotropic drugs with different risk-profiles.MethodsData for patients switching or keeping the same drug were obtained from the Psyclin (from 2007 to 2015) and Psymetab (2007- 2019) cohort studies, conducted at the Lausanne University Hospital, Switzerland. Patients either switched from a high to a low-risk, a high to a medium-risk, a medium to a low-risk drug, or for a drug with the same risk category. Patients not switching either kept a high, medium or low-risk drug. The evolution of weight is currently being analyzed using a linear mixed-effect model.ResultsPreliminary results showed that switching from a high to low-risk molecule had the strongest impact on weight changes. The analysis being ongoing, the quantitative results will be presented at the congress.ConclusionsSwitching from a high-risk to a low-risk molecule is likely to have the strongest impact on weight changes.DisclosureNo significant relationships.
Altered interpersonal distance regulation in autism spectrum disorder
Authors: Farkas K. , Pesthy O. , Guttengéber A. , Weigl S. , Komoróczy E. , Szuromi B. , Réthelyi J. , Németh D. 
Published: September 2022

IntroductionInterpersonal distance regulation is an essential element of social communication. Its impairment in autism spectrum disorder (ASD) is widely acknowledged among practitioners, but only a handful of studies reported empirical research. However, these studies did not measure the alterations of vegetative functions related to interpersonal distance.ObjectivesWe introduced a new experimental design to systematically measure interpersonal distance along with heart rate variability (HRV) in adults with ASD and tested the modulatory effect of intentionality, eye contact, moving activity, and attribution.MethodsTwenty-two adults diagnosed with ASD and 21 matched neurotypical controls participated in our study from 2019 October to 2020 February. Our new experimental design combined the modified version of the stop distance paradigm with HRV measurement controlling for eye contact between the experimenter and the participant to measure interpersonal distance in incidental and intentional conditions.ResultsOur results showed greater preferred distance in ASD in the intentional (W=103, p=0.002) but not in the incidental condition. These results were altered with eye contact and the participant’s role (active vs. passive) in the stop distance task (F(1,41)=6.150, p=0.017). Moreover, we found lower baseline HRV (t
=-2.060, p=0.023) and reduced HRV reactivity in ASD; however, these vegetative measurements could not predict preferred interpersonal distance.ConclusionsOur study highlights the importance of interpersonal distance regulation in ASD and the need for comprehensive experimental designs to grasp the complexity and underlying factors of distance regulation in typical and atypical populations.DisclosureNo significant relationships.
Sharing is caring: a review on Oxytocin role in human behaviour and clinical implications
Authors: Ramalheira F. , Conde Moreno M. 
Published: September 2022

IntroductionOxytocin, also known as the love molecule, was discovered in 1906 because of its effects on uterine contractions. It exists in all mammals and is partly responsible for delivery. Nonetheless, it seems that oxytoxin also takes part in something as important to nursing as the physical changes in childbirth – the behavioural predisposition to form human bonds and to care for others.ObjectivesPresent a review on Oxytocin and its functions in human behaviour and possible clinical implicationsMethodsPubmed and Google Scholar search using the keywords “oxytocin”, “behaviour”, “oxytocin in humans” and “psychiatry”.ResultsBesides acting as a peripheral hormone following posterior hypophisis secretion, oxytocin can be diffused through several brain areas, acting as a neuropeptide in neurochemical circuits that promote sexual behaviour, maternal and caring behaviour towards newborns, and other subtle social processes like vinculation, social memories formation, aggressiveness towards strangers and anxiety reduction. These evolutionary advantages constitute the roots for feelings of love and social phenomena like solidarity and affection. Oxytocin is increased in response to sex hormones, during pregnancy and social interactions, especially mother-child contact; additionally, is associated with endorphin release and feelings of well-being. Several studies associate the oxytocinergic system to multiple clinical implications, such as Anxiety Disorders, PTSD, Depression, Autism, Borderline and Anti-social Personality Disorder.ConclusionsOxytocin has an important role in shaping social behaviours and in the development of secure interpersonal bonds. In the future, it can be a possible target for some psychiatric conditions; however, more research is required to prove therapeutic outcomes.DisclosureNo significant relationships.
Outstanding Seizure Characteristics With Etomidate and Ketofol
Authors: Özden H.C. , Gurel S.C. 
Published: September 2022

IntroductionElectroconvulsive therapy (ECT) is administered following general anaesthetic induction with methohexital, thiopental, etomidate, alfentanil, remifentanil, propofol or ketamine. One approach for idealizing the induction anaesthesia for ECT is combining two agents (e.g. ketamine-propofol) with synergistic anaesthetic properties and non-additive anticonvulsive and hyperdynamic effects.ObjectivesTo establish any superiority between ketamine-propofol (ketofol) combination and etomidate in terms of seizure characteristics and hemodynamic measures.MethodsWe have combined our previous case series (etomidate vs thiopental) with new data regarding propofol and ketofol. ECT stimulus duration, stimulus frequency, the stimulus charge applied, duration of central seizure time, number of stimulation trials, plus anaesthetic used in the individual sessions were retrieved. A total number of 1092 sessions (239 sessions with etomidate, 233 with thiopental, 275 with propofol, and 345 with ketofol induction) were included in the linear mixed-effects model analysis.ResultsEtomidate was superior in terms of seizure duration compared with thiopental. There was no significant difference in seizure durations between ketofol, propofol and thiopental, however, number of failed stimulation trials within a session increased significantly with propofol use compared with etomidate and ketofol. The required amount of charge (stimulation dosage) was significantly lower when ketofol was used, compared with thiopental. Additionally, within the ketofol sessions only the propofol dose significantly increased the amount of required dose.ConclusionsEtomidate and ketofol displayed certain superiorities in terms of seizure characteristics when used as induction anaesthetics for ECT. Therefore, both etomidate and ketamine used in combination with propofol may be considered to be the gold standards of ECT anaesthesia.DisclosureNo significant relationships.
Group therapy in Schizophrenia. What’s the evidence?
Authors: Azevedo F. , Silva L. , Quintão A.A. , Moura N. , Duarte P. 
Published: September 2022

IntroductionThe American Psychiatric Association and NICE’s Guidelines for schizophrenia recommend psychosocial interventions as adjuvants to pharmacological treatment, highlighting the role of cognitive behavioral therapy for psychosis, psychoeducation, family intervention, cognitive remediation, autonomy training, social skills training, and supported employment. Although highly recommended in their individual forms current guidelines make no definitive statement about their group applicability.ObjectivesThe goal of this work was to critically review the evidence of group interventions in schizophreniaMethodsNon-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “schizophrenia”, “group therapy”.ResultsGroup therapy has shown important benefits in different conditions over the years, likely through mechanisms such as peer motivation, controlled confrontation, increased insight and even a tendency to homogenous results between group participants through peer influence. These results have been reproduced in schizophrenia though the benefits of applying group concepts to structured psychosocial interventions is still under study.ConclusionsRecent evidence suggests some evidence-based interventions can be applicable in group form, namely social skills training, cognitive remediation, psychoeducation, and multifamily groups, synergizing the already known benefits with newer therapy models and decreasing costs for patients and healthcare systems. Adequate controlled studies between individual and group therapy will shed further light on this matter.DisclosureNo significant relationships.
Impact of Dialectical Behavior Therapy Prolonged Exposure protocol on trauma-related symptoms in Egyptian women with Borderline Personality Disorder
Authors: Esmaiel M. , Abdelhamied M. 
Published: September 2022

IntroductionAlthough around 50% of individuals with borderline personality disorder (BPD) suffer from trauma-related disorders, literature lacks a specific treatment for these serious co-occurring problems. Dialectical Behavior Therapy Prolonged Exposure (DBT PE) is a recent protocol developed by Melanie Harned, integrating (PE) into standard (DBT). The protocol has showed promising results in treating comorbid PTSD in BPD patients. The current study, however, was the first trial to apply DBT PE protocol in Egypt.ObjectivesTo investigate the efficacy of (DBT PE) protocol in reducing trauma-related symptoms (psychological trauma symptoms and trauma-related cognitions) among Egyptian women with BPD.MethodsSixteen women diagnosed with BPD and trauma-related symptoms, were recruited from “DBT clinic”, a private outpatient clinic in Alexandria, Egypt and randomly divided into equivalent (Therapeutic & Control) groups. The therapeutic group received DBT PE protocol while the control group received Treatment as usual (TAU). Participants were assessed pre and post-intervention using: The short version of the Borderline Symptom list, The Trauma Symptom Checklist-40, and The Posttraumatic Cognitions Inventory. The therapeutic group started treatment with standard comprehensive DBT concurrently with DBT PE protocol (14 individual sessions, 120 minutes/ week), according to readiness criteria suggested by the treatment developer.ResultsPatients who received DBT PE protocol showed significantly lower degrees of psychological trauma symptoms and trauma-related cognitions compared to patients in control group.ConclusionsDespite being applied for the first time in Egypt, DBT PE protocol proved to be an effective intervention in reducing trauma-related symptoms in a sample of Egyptian BPD patients without any need to modify the original protocol.DisclosureNo significant relationships.
Socrates’ “maieutics” and the ethical foundations of psychotherapy
Authors: Doerr O. 
Published: September 2022

IntroductionThe noun “maieutics” derives from maia (mother, midwife) and the related verbs “maieusis” and “maieonuai” mean “giving birth” and “easing childbirth”. Socrates’ maieutics aspires to give birth to the truth in the youth. Since homeric times psychotherapy has been part of medical act. Initially, the physician’s word had a magical character. Plato rationalized this in many of his dialogues, specially in “Charmides”.ObjectivesThe search of the essential characteristics of this therapeutic method described by Plato, as well as its ethical implicationsMethodsHermeneutic methodResultsThe consequences for doctor-patient relationship in general and psychotherapy in particular are: 1. Remedy and “epodé” (charm) must be applied in every doctor-patient relationship. 2. The body can only be healed if the soul is cured first by a charm. 3. The openness of the patient’s soul to the physician and the physician’s beautiful speech to the patient will enable the latter to reach the state of “sophrosyne” (temperance), condition of possibility of true health.ConclusionsIn the discussion of the meaning of “sophrosyne”, Socrates questions disciples’ propositions and concludes that the only thing one can be sure of is that “sophrosyne” is a way of searching virtue (arete). Later, in Theaetetus, Plato adds another element: temperance is a “homoiosis theó”, that is, the assimilations of patient to God. With this Plato seals the ethical character of psychotherapy for ever.DisclosureNo significant relationships.
Last Steps as a Trainee, First Steps as a Consultant Specialist
Authors: O’Loughlin C. 
Published: September 2022

The transition from being a senior trainee to a qualified specialist presents a variety of challenges under normal circumstances, with the pandemic further disrupting the experience of trainees. This presents an environment where the acquisition of key competencies, both clinical skills and wider capabilities, becomes more demanding for trainees and where training organisers need to re-evaluate their programmes to consider the different opportunities available. This introduction to the interactive session will consider how the experience in the United Kingdom led to new ways of delivering training, the challenges faced and consider the key skills new specialists need to be effective clinical leaders as they move into a senior role.DisclosureNo significant relationships.
Interdisciplinary approach to pediatric rehabilitation - The MDT method
Authors: Vashdi E. 
Published: September 2022

IntroductionInterdisciplinarity involves the combining of two or more academic disciplines into one activity (e.g. a research project). It is about creating something new by crossing traditional boundaries between academic disciplines or schools of thought, as new needs and professions emerge, and thinking across them. The roots of interdisciplinarity can be found hundreds of years ago however, In the twentieth century it became a more academic movement.ObjectivesInterdisciplinarity also involves integrated thinking, borrowing ideas and metaphors, collaboration, flexibility in thinking, innovation and complex problem solving. The traditional professional model is usually disciplinary. Complex problems sometimes demand interdisciplinary solution. There is a constant dispute between the disciplinary and interdisciplinary approaches.MethodsThe MDT (Multidimessional therapy) method is part of the transdisciplinary approach. This is the next step after interdisciplinarity in which there are no boundaries between disciplines and the role of a primary therapist is established.ResultsThe MDT is a system that implements the integrative therapy perception, and strives for optimal integration of all developmental areas, disciplines, methods, goals, schools, activities etc. So the child is seen as a whole and all developmental areas are considered in unison. The integration takes place at different aspects of therapy: evaluation, analysis process, case management, team work, disciplines and methods, therapist, goals and exercises.The MDT uses variuos integrative tools evaluation such as analysis process, primary therapist or integrative goals and exercises.ConclusionsThis lecture will present the structure and uniqueness of the system and the approach in order to introduce the beneficiary aspects of the integrative model in treatment of complex cases.DisclosureNo significant relationships.
20 years of daily hospital for non-psychotic disorders, organisational structure and treatment modalities
Authors: Caratan S. , Kocijan Lovko S. , Ivrlač A. , Goršić L. , Matoš T. 
Published: September 2022

IntroductionAnxiety and depressive disorders are among the most prevalent psychiatric disorders, yet there aren’t many studies adressing treatment modalities in daily hospitals.ObjectivesThe aim of our study is to present organisational structure and treatment modalities in Daily hospital for non-psychotic disorders in University Psychiatric Clinic “Sveti Ivan“, Zagreb, Croatia.MethodsAll patients in Daily Hospital attend 6 months programme. The treatment programme consists of psychodynamic group psychotherapy, cognitive-behavioral therapy, occupational therapy, antistress and mindfulness workshops, psychoeducational workshops, cinema therapy and sociotherapy. Along with clinical follow-up, all the patients are given sociodemographic questionnaire designed for our programme, World Health Organisation Quality of Life Questionnaire (WHOQoL BREF) and The Depression, Anxiety and Stress Scale 21 (DASS-21).ResultsAt discharge moderate to significant improvement was observed in different aspects of functioning among most of the participants, verified by clinical follow-up as well as by results obtained through questionnaires.ConclusionsOur data show that patients with anxiety and depressive disorders can be efffectively treated by such comprehensive treatment approach.DisclosureNo significant relationships.
Facial emotion recognition deficits in first-degree relatives of patients with bipolar disorder: a systematic review protocol
Authors: Calçada C. , Ferreira A.R. , Fernandes L. 
Published: September 2022

IntroductionBipolar Disorder (BD) is one of the most challenging and severe psychiatric disorders. Considerable research in BD patients points to deficits in Facial Emotion Recognition (FER) as a potential BD endophenotype. Accordingly, such deficits have also been found in unaffected BD first-degree relatives, but no study has been conducted to synthetize this evidence.ObjectivesTo conduct a systematic review of studies exploring FER deficits in first-degree relatives of patients with BD.MethodsPRISMA 2020 recommendations will be followed. PubMed, Scopus, Web of Science and SciELO electronic bibliographic databases will be searched, as well as grey literature. Reference lists of the included studies will be hand-searched for additional eligible studies. Search strategy will include key-terms in accordance with the pre-established PICOS definition. No restrictions will apply regarding study design, setting, publication date nor language. Outcomes of interest will be FER deficits. Retrieved studies will be screened for eligibility by two independent reviewers using a two-phase approach. The methodological quality of primary studies will be assessed and data extracted independently using a standardized extraction form.Resultswill be described using narrative and tabular approaches. Studies heterogeneity will be verified and if adequate a meta-analysis will be conducted. Findings will be disseminated through a peer-reviewed publication.ConclusionsIt is expected that this systematic review will support the hypothesis that FER deficits may constitute a potential candidate for a BD endophenotype, which will not only improve the understanding of BD neurobiology, but also enable its identification in earlier stages, allowing timely treatments and better patients’ outcomes.DisclosureNo significant relationships.