bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drug utilization of paliperidone in adolescent schizophrenia patients: A retrospective cohort study in China
Authors: Dong S. , Zhang T. , Wu T. , Zhang L. , Sun H. , Dong W. , Wang H. 
Published: February 2022

IntroductionIn China, the indications of paliperidone extended in schizophrenia adolescents (12-17 years) was approved by National Medical Products Administration (NMPA) in 2017. But, the utilization of paliperidone in this group needs to be further investigated.ObjectivesTo assess paliperidone utilization in schizophrenia adolescents.MethodsThe study employed the electronic medical records (EMRs) database from a psychiatry specialized hospital (PH) and a general hospital (GH), respectively. General information, including birth date, gender, visit date, diagnosis (inpatient and outpatient) with ICD-10 coding, drug characterize, prescription date and dosage, was de-identified and standardized for analysis. Schizophrenia adolescents (ICD-10: F20.x) received at least one prescription of paliperidone between 2018 and 2019 were included in this study. Index date was defined as the date of first identified paliperidone prescription. The patients were followed up until the end of 2019 with the last record, or upon reaching 18 years. The database was analyzed based on days of supply, administration frequency, and daily dose.ResultsOverall, 112 and 117 eligible patients were included in the present study from PH and GH, respectively. The median drug supply was 179.0 days and 44.0 days, respectively, during which median number of prescriptions patients received was 6.0 and 3.0. Paliperidone was mostly initiated alone (57.1% and 88.9%) with frequency of once daily (97.3% and 88.9%), and the median of average daily dose during follow-up was 5.7 mg/day and 6.0 mg/day, respectively.ConclusionsThe duration of paliperidone usage was very different in two hospitals, but the dosages in both hospitals were generally agreed with prescribing information.
Thirteen year follow up of long term treated psychotic disorder: Personality aspects
Authors: Fagerberg T. , Gustavsson J.P. , Agartz I. , Jönsson E. 
Published: February 2022

IntroductionPsychotic disorders often cause a drastic change in the life situation of the affected individual. Personality is an aspect that can affect the symptoms and social function in psychotic disorders.ObjectivesNo study has examined stability of personality traits exceeding five years in patients with schizophrenia. The aim of this study was to investigate the stability of personality traits over a 13-year period among patients with psychotic disorder and healthy individuals and to evaluate case-control differences.MethodsAt three occasions during a 13-year period patients with psychotic disorders (n=28) and non-psychotic individuals (n=57) completed Swedish universities Scales of Personality (SSP). For all the individuals within- and between-subject analyses were performed at three occasions for all 13 subscales and the three overall factors of SSP. Correlations, means and SDs were calculated.ResultsTests of within-subject correlations showed differences in two subscales: Lack of Assertiveness, which were influenced by age and Physical Trait Aggression, where patients ratings were stable, whereas controls rated themselves less aggressive at higher age. Between-subjects correlations showed differences regarding any of the parameters diagnosis, time, age, gender or age x gender in nine of the 13 subscales as well as in factor Neuroticism.ConclusionsLong term follow-up showed a generally high stability of personality traits measured with SSP, especially among patients. Between-subject analyses over the 13 years showed that patients differed compared to controls for the SSP factor Neuroticism as well as the subscale Detachment, which is in accordance with previous studies.
Is treatment resistant depression a different subtype of depression?
Authors: Fiorillo A. 
Published: February 2022

Major depression is a serious, disabling, often chronic or recurrent mental disorder affecting over 350 million people worldwide. Treatment of major depression is now conceptualized as proceeding through three phases: the acute phase, the continuation phase, and the remission phase. Patients not achieving remission after several treatment trials are defined treatment-resistant, but a debate is ongoing regarding how many trials must fail before a patient can be defined as “treatment-resistant”. It must be acknowledged that depression is a heterogeneous disease, and several personal, socio-cultural and clinical factors should be taken into account in order to develop a personalized management plan for patients with major depression. A new concept of “difficult to treat depression” has been recently proposed. According to this concept, when a complete control of the disorder is not feasible, the treatment should aim at minimizing the impact of symptoms and the side effects of treatments on patients’ daily lives. Moreover, the concept of difficult to treat depression includes the presence of co-occurring problems/ behaviours/ disorders/ situations, which can worsen the course or management of depression. The management of patients with treatment resistant depression includes the optimization of disease management, in terms of symptom control, improvement of daily functioning and of quality of life. However, an approach aiming to personalize treatment of patients with major depressive disorder and focused on the specific clinical features of each patient can be valuable for optimizing the treatment of patients with resistant depression.DisclosureNo significant relationships.
Depression and quality of life in schizophrenia-spectrum
Authors: Smaoui N. , Elleuch S. , Bouali M. Maalej , Omri S. , Feki R. , Charfi N. , Zouari L. , Thabet J. Ben , Maalej M. 
Published: February 2022

IntroductionThe coming out of depressive disorders seems to be associated with severity of schizophrenia’s disease and with poor quality of life (QoL).ObjectivesThe aim of our study was to assess the relationship between depression and QoL in patients with schizophrenia.MethodsThis is a cross-sectional and analytical study including stabilized patients with schizophrenia or schizoaffective disorder followed up in the outpatient psychiatry department at Hedi Chaker hospital university of Sfax (Tunisia), between August and October 2019. We used the Calgary Depression Scale (CDS) to evaluate depression and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF) to assess QoL.ResultsWe recruited 37 patients with a mean age of 49.14 years and a sex ratio of 4.66. Seventy-three (73%) of patients were followed for schizophrenia and 27% for schizoaffective disorder. They were married in 43.2% and 35.1% of patients had a regular work. According to CDS, 18.9% of patients had depression with a mean score of 2.27 (SD 2). QLESQSF mean score was 65.51. Depression was negatively correlated with Quality of Life Enjoyment and Satisfaction (r=-0.59, p<0.001). We did not find a significant difference in depression according to the socio-demographic characteristics of the respondents or the clinical features of the disease.ConclusionsIt is clear that depression in patients with schizophrenia is associated with significant functional disability. Strategies to overcome the burden of depression may instil hope for functional recovery.
The universe of brief psychosis
Authors: Rocha T. Coelho , Cunha J. , Torres S. , Lopes A. 
Published: February 2022

IntroductionNowadays, ‘Acute and transient psychotic disorders’ in ICD-10 and ‘Brief psychotic disorders’ in DSM-5 are both classifications of the same clinical entity. Over the years, several concepts have been formulated to define the same syndrome.ObjectivesTo explore the historical evolution of brief psychotic disorders and relate them to current nosologies.MethodsLiterature review, using the most relevant papers, with the keywords “brief psychosis”, “bouffée délirante”, “cycloid psychosis”, “psychogenic psychosis”, “atypical psychosis” and “holodysphrenia”.ResultsInitially, in 1896, Kahlbaum coined the term ‘dysphrenia’, a group of severe form of psychosis that remitted without showing the typical sequence of disease states and without leaving a lasting alteration. Later, Kraepelin included this kind of disorder in manic depressive illness, which he first named as ‘periodic delirium’ and then as ‘delirious mania’. Magnan, in the pre-Kraepelinian era, created the term ‘bouffée délirante’, a sudden onset of delusional ideas with rapid evolution and intense symptomatology with complete remission usually followed after a short time. Later on, Henry Ey grabbed this entity and renewed it, contrasting it to the defined concept of schizophrenia. Other psychiatric schools have proposed numerous designations: ‘cycloid psychosis’ by Kleist from the German school, ‘psychogenic psychosis’ by Wimmer of the Scandinavian school and ‘holodysphrenias’ by Barahona-Fernandes from the Portuguese school. Cultural variants are also observed, as ‘amok’ seen in Malaysia or ‘shinbyung’ in Korea.ConclusionsThe intensity and polymorphism of brief psychosis present a clinical challenge. The historical evolution may be helpful on recognizing this entity in current clinical practice.
COVID-19 and psychiatric training: Results from the efpt country surveys
Authors: Nobels A. , Migchels C. , Seker A. , So C. , Trančik P. , Zaja N. , Stercu G. 
Published: February 2022

IntroductionSeveral studies link COVID-19 and the associated lockdown and social-distancing measures to adverse mental health outcomes. In order to address this increase in mental health problems, adequate training of mental health care professionals is of the utmost importance. Objectives: To measure the impact of the COVID-19 pandemic on psychiatric training in Europe and beyond. Methods: The European Federation of Psychiatric Trainees (EFPT) represents more than 20 000 trainees from over 30 European countries. Every year, country representatives, complete the ‘Country Report’, which contains detailed information on psychiatric training in every (member) country. Results: In July 2020, representatives of 34 European and 9 non-European countries completed the survey. In 73% of countries, psychiatric trainees were assigned to COVID-19 wards, in 43% to emergency wards. In 25% of countries, trainees did not receive any training on COVID-19 prior to their assignment. Compared to before the COVID-19 pandemic, trainees reported a decrease in clinical supervision in 65% of countries. In 51% of countries, (parts of) formal psychiatric training was cancelled. Psychotherapy training was cancelled in 25% of countries. In the majority of countries both formal and psychotherapy training were given online, however in 56% trainees experienced difficulties to attend. Conclusions: The COVID-19 pandemic has had an extensive impact on psychiatric training in Europe and beyond. The EFPT calls upon policy makers and supervisors to minimize the impact of COVID-19 on psychiatric training in order to provide psychiatric trainees with adequate skills to deal with the mental health consequences of the COVID-19 pandemic.DisclosureNo significant relationships.
Attitudes of relatives of patients with schizophrenia
Authors: Lajmi I. , Omri S. , Bouali M. Maalej , Smaoui N. , Feki R. , Thabet J. Ben , Zouari L. , Charfi N. , Maalej M. 
Published: February 2022

IntroductionInvestigating family member’s attitudesabout schizophrenia is an important step in its management. They likely influence the family’s help-seeking decisions and affect both adherence with biomedical interventionsand social integration of the patients.ObjectivesDescribe families’ beliefs about the symptoms and the treatments of schizophrenia.MethodsWe led a transversal study including 32 relatives of patients with schizophrenia (DSM 5). We collected data for both patients andrelatives. We asked relatives to respond by “yes/no/I am not certain” to the questionnaireincluding items dealing with symptoms and optimal cures forschizophrenia.ResultsThe mean age of the relatives was 60.8 years; 71.9% were parents; 37.5% were illiterate; 46.9% reported having another family member with a mental disorder (MD) and 15.5% of relatives were able to label the term “schizophrenia”. Nine participants (28%) believed that the patient makes shame to the family’s member and 72% of them was convinced that patient is dangerous.The majority of participants (90.6%) provedthe need for drugs and 65.6% attested the utility of psychotherapies.However, they believed innon-medical practices such as reading Holy Koran verses (87.5%), charity and exorcism (62.5%). Family history of MD was correlated to traditional practices (p=0.038). The belief that patient is dangerous and that he makes shame were associated with advanced age of relatives (p=0.000 and 0.037 respectively). Significant correlationwas found betweennon medical practices and erratic follow-up (p=0.043).ConclusionsThis study points outthe need to improve the psychoeducation of family members of persons with schizophrenia.
Therapeutic implications of structural and functional neuroimaging findings in delusional disorder: A case report and review of literature
Authors: Fucho G.F. , González-Rodríguez A. , Pedrero A. Alvarez , Guàrdia A. , Delgado L. , Cobo J. , Acebillo S. , Monreal J.A. , Vidal D. Palao , Labad J. 
Published: February 2022

IntroductionSeveral neuroimaging studies on psychosis spectrum have been published in the last decades, most of them based on schizophrenia. In the context of neuroanatomical dysfunctions, clinical and prognosis implications have been reported. Nevertheless, only a few studies have been focused on delusional disorder (DD).ObjectivesTo present the case of a patient diagnosed with DD who suffered from two cerebrovascular events after the onset of the psychiatric disease. Our aim is to elucidate potential implications of those lesions on the course of DD. We also reviewed the literature to assess evidence for specific changes in DD on brain structures and functions.MethodsCase report and non-systematic narrative review in PubMed (2000-2020).ResultsCase report: A 66-year-old female with DD presenting, during the course of the disease, general atrophy and consecutive ischemic lesions on parietal, occipital and cerebellar areas. Clinical stabilization was achieved 12-16 months after risperidone 1.5mg/day treatment. Review: 19 studies were included: Structural brain data (n=15), Functional data (n=13). Most of the structural neuroimaging studies reported white and gray matter abnormalities, particularly in temporal, parietal and frontal lobes, and in limbic structures. Functional neuroimaging studies pointed to temporal and parietal lobes, as well as basal ganglia and limbic related structures.ConclusionsTemporal, parietal, frontal, basal ganglia and limbic-related structures, as well as dysfunctions in other specific brain regions, may be implicated in the core symptoms of DD. These findings might be further investigated as potential neuroimaging markers of prognosis, such as partial or delayed response to antipsychotic treatment, as presented in our case.
Case series of delusional parasitosis in an emergency department: Sociodemographic features and clinical outcomes
Authors: Guàrdia A. , González-Rodríguez A. , Betriu M. , Estrada F. , Seeman M.V. , Uribe I. Parra , Labad J. , Vidal D. Palao 
Published: February 2022

IntroductionA delusion of parasitosis is defined as the fixed, false belief of infestation by invisible organisms or fibrous material of unknown origin. The differential diagnosis is true infection, substance use disorder, dementia or other neuropsychiatric disease.ObjectivesOur goal was to characterize delusions of parasitosis, classically named Ekbom syndrome, among individuals attending our emergency department (ED).MethodsOver a four-year period (2017-2020), we carried out a retrospective case-register study of patients with DSM-5 Ekbom syndrome attending an ED that provides mental health services to an area of nearly 450.000 inhabitants in Sabadell (Barcelona, Spain).ResultsThere were 13 eligible patients: 7 were diagnosed for the first time and 6 had multiple episodes. Female-to-male ratio was 1.6:1; average age was 56.9. The most common diagnosis was delusional disorder (n=5;8.5%), followed by schizophrenia (n=3;23.1%) and organic disorders (n=2;15.4%). Origin: Africa (n=5;38.5%), South-America (n=4;30.8%) and Spain (n=4;30.8%). Fifty percent showed poor treatment compliance. Antipsychotics used: risperidone (n=8;61.54%), olanzapine (n=4;30.8%). Five patients received antidepressants. Most patients had previously been seen by other medical specialties (internal medicine, dermatology and hematology). ‘’Match box sign’’: 7 patients (53.8%). Cerebral atrophy was present on brain scan in 4 patients. After discharge: acute psychiatric unit (n=7), outpatient appointments (n=4), day hospital (n=1) and 1 to a psychogeriatric unit.ConclusionsDelusions of parasitosis are rare in our emergency department. The typical patient is a postmenopausal woman, a visitor or immigrant to Spain. Effective treatment requires a focus on cultural, gender, and age aspects, with close cooperation between psychiatry and other relevant specialties.
Historical path of paraphrenia
Authors: Mata A. Hernández , Gómez A. Sotillos , Coscujuela P. Marco , Méndez B. Ordóñez 
Published: February 2022

IntroductionParaphrenia is a psychotic disorder characterized by an insidious development of a vivid and exuberant delusional system, accompanied by hallucinations and confabulations, without a personality deterioration. It is considered to be an intermediate entity between the disorganization of schizophrenia and the systematization of a delusional disorder.ObjectivesDevelop knowledge about paraphrenia as an individualized diagnostic entity and its historical path through the classical authors’ texts.MethodsExtensive research on the historical path of the paraphrenia diagnostic entity was carried out, as well as the current situation of the term.ResultsIn the German psychiatry it was Karl Kahlbaum who first introduced the term of paraphrenia. Later many authors of the German psychiatry delved into this diagnostic entity. Emil Kraepelin described four different subtypes of paraphrenia: paraphrenia systematica, expansiva, confabulans and phantastica. However, other authors such as Kleist or Bleuler, considered paraphrenia should not be judge as an individualized diagnostic entity as it should be considered inside schizophrenia, so the term disappeared in the German psychiatry. In the French psychiatry, unlike the German, the independence of chronic psychosis from schizophrenias was recognized, so the term had a longer path. Henry Ey recognized four important clinical features in this disorder: paralogical thought dominance, megalomania, confabulation and integrity of relation with reality.ConclusionsCurrently the term paraphrenia is no longer considered an individualized diagnostic entity. In fact, in today’s textbooks of psychiatry paraphrenia is considered a psychotic disorder that has nothing in common with the one described by the classical authors, and it is part of the late-onset psychosis.
Diagnostic confusion, clinical chaos - an acute and transient psychotic disorder case report and brief historical review
Authors: Carneiro M. , Piçarra M. , Reis M. , Neves S. 
Published: February 2022

IntroductionAcute and Transient Psychotic Disorder (ATPD) is a group of rare psychotic disorders characterized by acute onset, symptom fluctuation and short duration typically followed by complete recovery. Throughout the time, there have been different attempts to classify these disorders (Bouffée Délirante, Cycloid Psychosis, etc.); nevertheless, in the current date, ATPD encompasses a broad spectrum of heterogenous clinical presentations with low diagnostic stability over time.ObjectivesTo describe a case of ATPD, highlighting the variability of its’ psychopathological phenomena and establishing a comparison with historical descriptions of this nosological entity.MethodsClinical case report and brief review of literature.ResultsV, 20-year old male without psychiatric history, presents in the emergency room exhibiting fluctuant psychopathology over the preceding two weeks – initially with depressive mood, anhedonia, apathy, bizarre behaviors and soliloquies; afterwards, showing paranoid delusional ideation; total insomnia in the previous 2-3 days; finally, showing grandiose delusional ideation; and throughout the episode, revealing pseudohallucinatory verbal activity assuming multiple identities. Several stress factors were identified in close time-relation with the onset of these symptoms. V. started risperidone 2mg 2id and quetiapine 100mg id and was discharged 2 weeks later, fully recovering from these psychopathological phenomena. V. remains asymptomatic at 6 months of follow-up.ConclusionsHistorically, some classifications of this disorder focus on etiological factors, others on clinical evolution and course, and yet another group on separation from the Kraepelinian duality (schizophrenia and bipolar disorder). ATPD is a diagnosis with high clinical heterogeneity and low stability over time, which can have implications in follow-up and long-term outcome.
Storytelling in schizophrenia: Neuropsychological basis of pragmatic language dysfunction (preliminary study)
Authors: Gornushenkov I. , Pluzhnikov I. 
Published: February 2022

IntroductionStorytelling could be considered as one of the ecological way to study the pragmatic function of speech in schizophrenia. It demands the ability to create narrative (text) that would be appropriate to particular context. Neuropsychological basis of text-context relation impairment in schizophrenia needs clarification.ObjectivesTo study neuropsychological correlates of pragmatic text-context impairment revealed during storytelling in patients with schizophrenia.MethodsParticipants were 14 inpatients with schizophrenia and 18 students without mental disorders. Neuropsychological functioning was measured in both groups according to Luria’s method. Pragmatics assessed by storytelling on images which simultaneously depicts some narrative that should be correctly decoded and after expressed to investigator. The images were taken from Luria’s neuropsychological album and Bidstrup’s drawings.ResultsStories of patients with schizophrenia were different from control stories in two ways. Some patients produced stories which predominantly characterized by incompleteness that don’t give an opportunity to understand their narratives as connected whole because of its lacunarity. In other cases, stories predominantly characterized by distortion of the storyline which became not realistic and don’t match with the original picture. Incompleteness errors primarily correlates with neuropsychological dysfunction of left frontal lobe (p<0,001). Distortion errors also mainly correlates with dysfunction of frontal lobes (p<0,01), but qualitative analysis reveals right hemisphere involvement.ConclusionsImpairment of the pragmatic function of speech during storytelling in schizophrenia could manifest itself in at least two different ways. Preliminary results show that it could be connected with different neuropsychological mechanisms and worth considered with left-right frontal lobes opposition.Conflict of interestThe reported study was funded by RFBR, project number 20-013-00772