bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multifamily therapy in first episodes of psychosis: a pilot study
Authors: García Del Castillo I. , López García S. , Pérez Balaguer A. 
Published: September 2022

IntroductionMultifamily interventions have shown to reduce the risk of relapse of psychotic symptoms in first episodes of psychosis (FEPs) but are not frequently implemented in specific treatment programs. We have develop a pilot study for the implementation of the interfamily therapy in FEPs within a Mental Health Centre in the Community of Madrid.ObjectivesThe aims were to examine: relapses (measured as re-hospitalization), duration of re-hospitalizations and voluntary versus involuntary re-hospitalizations during participation in MFG compared with the previous year.Methods21 subjects participated in a MFG during 12 months, 11 participants with a diagnosis of psychosis and 10 family members. Interfamily therapy works as a new model of interactive psychoeducation among families where they share their own experiences and look for comprehension and solutions all together.ResultsOur clinical experience in an interfamily therapy intervention over 12 months has led us to identify a high degree of participation and acceptance by users and their families, and we have observed a lower relapse rate, with fewer of psychiatric admissions and of shorter duration among patients during the year of participation in the MFG compared to the year before treatment.ConclusionsMFG has been well accepted by both patients and their families, with a high degree of participation.The results observed in our experience of MFG treatment are consistent with the findings of previous studies that support the reduction of the relapse rate, the number of hospitalizations and their duration when family interventions are incorporated into treatment in recent-onset psychosis, especially in a multi-family group format.DisclosureNo significant relationships.
Assessment of depressive symptoms in hospitalized patients with schizophrenia
Authors: Abdelkefi M. , Ellouze S. , Ajmi S. , Turki M. , Halouani N. , Aloulou J. 
Published: September 2022

IntroductionThe prevalence of depressive disorders in patients with schizophrenia is estimated at 25%. Nevertheless, depressive symptoms occurring during the acute decompensation of schizophrenia have rarely been studied.ObjectivesThe aim of our study was to assess depressive symptoms in hospitalized patients suffering from schizophrenia.MethodsWe conducted a cross-sectional, descriptive and analytical study, including 30 schizophrenic patients, hospitalized in the psychiatry B “department of the Hedi Chaker university hospital in Sfax. The assessment of clinical severity of schizophrenia was performed by the Positive and Negative Syndrome Scale (PANSS), that of depressive symptoms by the “Calgary Depression Scale for Schizophrenia” (CDSS).ResultsThe mean age of patients was 41.2. Most of patients were male (86.7%) and unemployed (83.3%). Only 13.3% of them were married. Patients were hospitalized 8.83 times in average. A personal history of suicide attempts was found in 16.70% of cases. The mean score in the CDSS scale was 5.12. According to the CDSS score, a depressive state was diagnosed in 36.7% % of patients. Depression was associated with significantly more frequent history of suicide attempts (p=0.028), as well as significantly higher scores in the positive dimension of the PANSS (p=0.03).ConclusionsOur results show that depressive symptoms are common during the acute decompensation phase of schizophrenia. They are associated with impaired functioning of patients, as well as a higher risk of suicide. Screening for depressive symptoms in patients hospitalized for schizophrenia is therefore essential in order to ensure better management.DisclosureNo significant relationships.
Paraphrenia: a lost concept
Authors: Vicent Forés S. , Sainz De La Cuesta Alonso S. , Calera Cortés F. , Gutierrez Higueras T. 
Published: September 2022

IntroductionParaphrenia consists on a syndrome of insidious development with a chronic delirium of great phenomenological richness, predominating productive or delusional-hallucinatory forms and with time it evolves to pure fabulation. Delusions appear in 100% of cases predominating persecution, reference and false identifications. It is a classic term that disappeared with DSM-III, but is still useful for the description of certain clinical cases.ObjectivesPresentation of a case that clearly defines the classic term paraphrenia, which is now a days lost in new classifications.MethodsWe carried out a literature review of the term paraphrenia and presented a real case of a patient interned in our psychiatric ward.ResultsA 55-year-old woman, was without treatment or attendance to her psychiatrist for years, admitted to the hospital due to public disturbance. Even the lack of treatment did not repercuss greatly emotionally or behaviorally. During our interviews, she showed an expansive discourse rich in delirious content, as well as thought transmission and reading, auditive hallucinations and corporal influence. As we can see, this case exposes what would have classical been classified as a case of paraphrenia, nowadays we cannot find a better term to name this group of symptoms with the current classifications.ConclusionsWe can conclude that paraphrenia is halfway between schizophrenic disorganization and paranoic structuring. The personal deterioration is significantly lower than in schizophrenia and the expression of delirium differs from paranoia. Even though actual classifications provide simplicity and pragmatism, we risk losing the semiological and phenomenological richness of classic terminology.DisclosureNo significant relationships.
Thyroid psychosis: a case report
Authors: Izquierdo De La Puente A. , Del Sol Calderón P. , Garcia Moreno M. 
Published: September 2022

IntroductionWe present the case of a patient who after a year of psychotic symptoms is diagnosed with thyroid cancer with hyperthyroidism.ObjectivesA brief review is made of the psychotic symptoms in a patient with hyperthyroidism secondary to cancer of the gland.MethodsWe present the case of a 52-year-old patient, a former injecting drug addict, who after a year with psychotic symptoms, is diagnosed with thyroid cancer with hyperthyroidism. The patient reported that a year ago, he suddenly had a painless and indurated lump in his neck, associated with weight loss and confusional symptoms. One month after the appearance of the tumor, the patient began to present visual, kinesthetic and haptic hallucinations, with the sensation that supernatural beings were passing through and possessing him. Likewise, he referred to being able to see and feel the atoms of matter, being able to communicate with a superior being whom he called “creator”.ResultsThe patient is admitted for psychotic symptoms. During it, the necessary complementary tests are carried out, objectifying a clinical situation of hyperthyroidism. The study is extended, observing a hyperfunctioning nodule, which corresponded to thyroid cancer.ConclusionsNeuropsychiatric symptoms in hyperthyroidism are relatively common. In most cases, the most frequent are cognitive alterations, attention problems and working memory problems. It can also lead to depressive episodes, and more rarely, psychotic symptoms.DisclosureNo significant relationships.
Efficacy and tolerability Aripiprazole once-monthly long-acting injectable in schizophrenia. Two-injection start regimen
Authors: Romero Guillena S.L. , Plasencia Garcia De Diego B.O. , Gotor Sanchez-Luengo F. , Gómez González J. 
Published: September 2022

IntroductionAripiprazole once-monthly is a long-acting intramuscular injectable formulation of aripiprazole. The starting dose can be administered by following one of two regimens: • One injection start: On the day of initiation, administer one injection of 400 mg Aripiprazole once monthly and continue treatment with 10 mg to 20 mg oral aripiprazole per day for 14 consecutive days • Two injection start (New regimen): On the day of initiation, administer two separate injections of 400 mg Aripiprazole once monthly at separate injection sites, along with one 20 mg dose of oral aripiprazole.ObjectivesTo assess the effectiveness and tolerability of Aripiprazole long-acting injectable (ALAI) in patients with schizophrenia. The starting dose was administered following the two injection start regimenMethodsSample:10 patients with schizophrenia (DSM 5 criteria) who started treatment with ALAI. The starting dose was administered following the two injection start regimen. On a tri-monthly basis, the following evaluations were performed during a follow-up period of 6 months: The Clinical Global Impression-Schizophrenia scale (CGI-SCH), treatment adherence, the number of hospitalizations and Side effects reportedResultsMean variations from baseline scores at 6 months was (-1.1 ±0.89) on the GCI-SCH. The percentage of patients who remained free of admissions at the end of the 6 months was 90%. The rate of adherence to treatment after 6 months was 80%. The most frequent side effect was transient mild insomnia (20%) .ConclusionsAripiprazole long-acting injectable (The starting dose was administered following the two injection start regimen) is effective, safe and well tolerated in clinical practice conditionsDisclosureNo significant relationships.
Chronic delusional disorder and Chales Bonnet syndrome: differential diagnosis or comorbidity
Authors: Molina Liétor M.D.C. , Cuevas Iñiguez I. 
Published: September 2022

Introduction
Delusional idea disorders are a group of syndromes whose main or unique characteristic is the presence of consolidated delusional ideas that usually have a chronic character and do not fit into other diagnoses such as schizophrenia, affective disorder or other organic diseases. On the other hand, Charles Bonnet syndrome is an organ hallucinosis in whose context visual hallucinations may appear in patients with a visual deficit. Historically, it has been considered that the presence of another psychiatric condition is an exclusion criterion for the diagnosis of Charles Bonnet syndrome, although the presence of similar etiological and maintenance factors means that this situation of dignous exclusion must be reconsidered.ObjectivesThe objective of the present communication is to study the current state of the topics “delusional disorder” and “Charles Bonnet syndrome”. Another objective is to reconsider that the presence of previous or concurrent psychiatric pathology is an exclusion criterion for the diagnosis of Charles Bonnet syndrome..MethodsA bibliographic review on “delusional ideas disorder” and “Charles Bonnet syndrome” has been carried out, as well as a discussion on the diagnostic and exclusion criteria, based on the etiopathogenic and maintenance factors.ResultsBoth in “delusional ideas disorder” and in “charles bonnet syndrome” advanced age, social isolation and deficiencies in sense organs constitute etiological factors that facilitate the appearance of these syndromes and make their treatment difficult.ConclusionsDue to this, we consider that the appearance of another previous or present psychiatric illness should not be an exclusion criterion, both can appear in the same patient.DisclosureNo significant relationships.
Treatment-resistant schizophrenia : the relationship between clozapine plasma concentration and clinical outcome
Authors: Kammoun I. , Jouini R. , Aissa A. , Boukhchina R. , Zgueb Y. , Khelifa E. , Ouali U. , Jomli R. , Nacef F. , El Hechmi Z. 
Published: September 2022

IntroductionClozapine is highly effective in patients with treatment-resistant schizophrenia but, to ensure optimal clinical response it is important to optimize its use and this depends on adequate pharmacological monitoring.ObjectivesEvaluate the therapeutic response rate according to clozapine plasma concentration.MethodsIt was a cross-sectional, retrospective and analytical study, carried out over a period of six months, in the F and A psychiatry departments of the Razi hospital in Tunis, including patients followed for treatment-resistant schizophrenia and receiving clozapine. We evaluated the response to clozapine using the Brief Psychiatric Rating Scale (BPRS).Results
The average age was 37.7 ± 9.4. The mean age of introduction of clozapine was 31 years and the mean time to its introduction was 9.3 years. Clozapine was administered as a single drug in 85% of cases. The mean dose of clozapine was 373 mg/day. The mean of clozapine plasma concentration was 386.5 ng/ml with a minimum of 89 ng/ml and a maximum of 913 ng/ml. The clinical response rate to clozapine was 25% with a BPRS good response threshold value of less than 35. Patients with clozapine levels above the conventional cut-off of 350 ng/ml (n=34) had a response rate of 34.6%. A response rate of 37% was observed in the group of patients with a clozapine plasma concentration interval of 200-350 ng/ml. There was no statistically significant difference in therapeutic response (p=0186)ConclusionsOur study revealed a therapeutic response variation according to plasma clozapine concentration and showed the existence of a non-negligible and effective response rate.DisclosureNo significant relationships.
Identification of trema in first episode psychosis: a case report
Authors: Alvarez Garcia C. , García Martínez D. , Nocete Navarro L. 
Published: September 2022

IntroductionThe concept of trema refers to an initial phase in the psychotic process that is characterized by intense anguish, an experience of hostility and a feeling of imminent catastrophe. This situation engenders in the patient a sensation of being in a tunnel than can only lead to something terrible but ineffable.ObjectivesTo illustrate the incipient phase of psychotic disorder though the presentation of a case.MethodsA presentation of a clinical case.ResultsA 29-year-old man attends the emergency department due to anxiety of one moth of evolution, that had debuted after a stressful event in the patient’s life such as loss of employment. He suffered from intense morning-predominance anguish, depersonalization episodes, insomnia, hallucinosis, cognitive blocks that occasioned him great anxiety and apragmatic behaviors. Besides, he had language alteration and autolytic ideation with previous autolytic gestures. After evaluation, he was diagnosed with psychotic episode. He was hospitalized, and treatment with olanzapine and lorazepam was started.ConclusionsWith the exhibition of this case, we intended to point up the importance of a differential diagnosis with different disorders marked by anxiety as the main symptom. In our case, panic disorder should be taken in account as a differential diagnosis. Furthermore, as the evidence shows, the identification of prodromic phases in schizophrenia allows an early diagnosis and early intervention, improving the prognosis.DisclosureNo significant relationships.
Anticholinergic syndrome in a patient with schizophrenia
Authors: Marco Estrada O. , Tardon L. , Fernández T. , Navarro L. , Bioque M. , Arbelo N. 
Published: September 2022

IntroductionAnticholinergic syndrome (AS) is a complication that can appear due to different drugs with antimuscarinic effects, such as antihistamines, alkaloids, antipsychotics, tricyclic antidepressives or anesthetics, and it is characterized by urinary retention, dry mouth and skin, mydriasis, low-grade fever, and confusion or coma.ObjectivesTo describe a clinical case of AS admitted to our hospital.MethodsWe present a case report of a patient with schizophrenia who presented an anticholinergic syndrome. We also searched for previous studies of AS using a pubmed query.ResultsA 53-year-old male was admitted for a psychotic decompensation to another hospital in Barcelona. The usual treatment at home was amisulpride 1200mg/d, olanzapine 30mg/d and lormetazepam, and haloperidol 6mg/d and clotiapine 40mg/d were added to treat the decompensation. Then, the patient started to present mydriasis, mucocutaneous dryness, low-grade fever, slight hypertension and tachycardia, repeated retentions of urine, confusion, unintelligible speech and agitation, so he was referred to our hospital. Once he was admitted, haloperidol was withdrawn and support measures (bladder catheterization, fluid therapy, etc.) were applied. After a few days, most of the mentioned alterations were stabilized, but the psychotic symptoms, such as thought and behavioural disorganization, persisted and required electroconvulsive therapy, with subsequent improvement.ConclusionsAS is a relatively frequent side effect of psychiatric medication, which diagnosis is clinical, so, we must be capable to identify it and initiate early treatment to prevent possible complications. The first step, as reflected in the case described, is to stop the causative drugs, and apply support measures. Additionally, physostigmine can be used, as it is an effective antidote.DisclosureNo significant relationships.
blind or schizophrenic but not both
Authors: Fatima Zahra C. , 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 objective of this research is to discover the relationship between schizophrenia and congenital blindness is there a protective gene ! is that visual perception constitutes an essential stage in the onset of the disease itself !MethodsCase study of a family consisting of thirteen brothers and sisters, three of whom were blind at birth, three with schizophrenia. the study of the files of schizophrenic patients hospitalized in our structure since it opened in the 1970sResultsCase study of a family consisting of thirteen brothers and sisters, three of whom were blind at birth, three with schizophrenia, but there is none with blindness at birth and schizophrenia. PLus on the basis of medicals files there is no case of schizophrenia with blindness at birth. Preliminary observational analysis of this clinical case suggests the following hypothesis: the presumed protective role of congenital blindness against schizophrenia. The bibliographic research has objectified three recent studies in this direction in Australia, Denmark, and the USA.ConclusionsThe relationship between schizophrenia and congenital blindness is still unrecognized and controversialSeveral studies are done in this direction, but so far there is no assertion or confirmation of the hypothesisDisclosureNo significant relationships.
Ekbom syndrome: a case report
Authors: Bosnjak Kuharic D. , Cvitanic Mazuran M. , Polšek D. , Herceg M. , Jambrosic Sakoman A. 
Published: September 2022

IntroductionEkbom syndrome is a clinical term for delusional parasitosis, a condition characterized by the belief that one’s skin is infested by invisible parasites. Despite having no medical evidence, patients strive to prove their illness and interpret different sensations and symptoms as infestation with parasites.ObjectivesOur objective was to present a case report of a patient with Ekbom syndrome with detailed clinical information and treatment complications.MethodsWe included patient’s history, psychiatric evaluation, complete diagnostic work-up, therapy and follow-up.ResultsA 60-years old female patient was admitted to her first hospital treatment in our psychiatric clinic. Upon admittance, she was extremely tense, preoccupied with the idea that bed bugs have infested her body. She showed extensive medical documentation, including numerous dermatologic reports regarding her condition, interpreting them in accordance with her delusions. In attempt to help herself and “release” the bugs, she harmed herself causing multiple skin lesions across her body and face. The treatment was complicated with secondary skin infections, ulcers, cellulitis and oedemas. Initial treatment with olanzapine was switched to risperidone due to side-effects (sedation, increase of appetite, weight gain). Gradually, with pharmacological treatment, psychoeducation and support, remission was achieved, but poor insight to her previous condition and psychiatric symptoms remained.ConclusionsEkbom syndrome presents a serious disorder that can be complicated with secondary somatic complications, often requiring involvement of different medical specialists. Moreover, lack of insight into the need for psychiatric treatment can lead to therapy discontinuation and relapse of symptoms.DisclosureNo significant relationships.
A late-onset Ornitin Transcabamylase deficiency case as an organic psychosis
Authors: Mateos Sexmero M.J. , Blanco J.A. 
Published: September 2022

IntroductionOrnithine transcarbamylase (OTC) deficiency is the most frequent congenital defect among the urea cycle enzymatic disorders, due to mutations a!ecting the OTC gen (Xp21.1) that are inherited with an X-linked pattern. As it happens with sex-linked genetic disorders, late-onset OTC deficiency is more prevalent among women, so that females may be asymptomatic over the years and manifest symptoms only when they are submitted under severe metabolic stress, such as pregnancy, infections or new medications. The enzymatic defect involves a blockage a!ecting the main biochemical route that converts ammonia into urea. This leads to analytic hyperammonemia and the outburst of gastrointestinal, neurological and psychiatric symptoms with variable severity.ObjectivesExpounding the importance of inborn errors of metabolism as possible causes of a psychotic episode.MethodsDescribing the case, supporting our data with a bibliographic research made on PubMed.ResultsWe describe a psychiatric adult-onset OTC deficiency in a 37-year-old woman with borderline intellectual functioning and a psychotic episode in the context of an infection that was wrongly diagnosed at first as schizophrenia, until the genetic study was carried out. The woman’s familiar history shown an OTC deficiency among some family members, a mutation- carrier sister and at least two male children death by the first month of life.ConclusionsOrganic psychosis can be caused by a large number of medical diseases. A di!erential diagnosis of possible cerebral, toxic or metabolic causes of psychosis is necessary to avoid mistakes in diagnosis.DisclosureNo significant relationships.