Presentation and management of anxiety in individuals with acute symptomatic or asymptomatic COVID-19 infection, and in the post-COVID-19 recovery phase
We present the mechanisms of anxiety in symptomatic or asymptomatic COVID-19. We discuss the presentation of anxiety in patients without or with prior psychiatric illness, and with co-morbidities. Timely diagnosis and management of anxiety in COVID-19 patients is important. Given the frequent complication of COVID-19 with Acute Respiratory Distress Syndrome and Intensive Care Unit stay, anxiety may be a long-term complication. We review the diagnostic tools for anxiety in COVID-19, and summarise pharmacologic and non-pharmacologic treatments. We provide recommendations for diagnosis, treatment, prevention and follow up of ...
Source: International Journal of Psychiatry in Clinical Practice - February 26, 2021 Category: Psychiatry Authors: Genoveva Uzunova Stefano Pallanti Eric Hollander Source Type: research

COVID-19 pandemic: demographic and clinical correlates of disturbed sleep among 6,041 Canadians.
CONCLUSION: As the pandemic continues, more Canadians are likely to develop sleep problems, an important consideration for planning mental health services. KEY POINTS This is the first study to examine the prevalence rates and demographic and clinical correlates of disturbed sleep in a large sample (n = 6041) of Canadians during the COVID-19 pandemic. Prevalence of disturbed sleep was high at 77.8%. Individuals aged 41-60 years were twice as likely to present with sleep disturbance compared to individuals ≤25 years (OR 1.89, 95% CI: 1.27-2.81). Individuals with moderate/high anxiety symptoms, moderate/high...
Source: International Journal of Psychiatry in Clinical Practice - February 21, 2021 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Evaluation of opening a type III/IV medical psychiatric unit.
Authors: Jansen LAW, Somanje-Bolweg RRJ, Wierdsma AI, Busschbach JJV, Lijmer JG Abstract OBJECTIVE: The aim of this study is to examine the impact of opening a medical psychiatric unit (MPU) on a variety of outcomes. METHODS: In this non-equivalent groups design, there were two groups: 'pre-MPU' and 'actual MPU'. Staff assessed whether patients in the pre-MPU group were eligible for admission to a planned MPU, resulting in virtual admissions and discharges. The actual MPU group consisted of patients admitted after opening of the MPU. RESULTS: The length of stay (LOS) in the hospital was one day longer for p...
Source: International Journal of Psychiatry in Clinical Practice - February 17, 2021 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

COVID-19 pandemic and mental health in Lebanon: a cross-sectional study.
CONCLUSION: This study found a strong interrelationship between psychological stress, depression, anxiety and obsessive-compulsive traits during the COVID-19 pandemic and identified the most vulnerable sub-groups in the Lebanese population. Additional measures should be deployed by health authorities in Lebanon and worldwide to face the impact of COVID-19 pandemic on mental health. Key points Following the evolution of the COVID-19 pandemic in Lebanon compared to not was significantly associated with higher stress, higher depression, lower obsessive-compulsive disorder, higher anxiety. Higher compulsion, having a universit...
Source: International Journal of Psychiatry in Clinical Practice - February 17, 2021 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

The effects of childhood emotional maltreatment and alexithymia on depressive and manic symptoms and suicidal ideation in females with bipolar disorder: emotion dysregulation as a mediator.
CONCLUSIONS: This study indicates that patients with BD who experienced emotional abuse during childhood and have difficulties identifying emotions report greater emotion dysregulation. These individuals, in turn, are more likely to experience more severe depressive and manic symptoms as well as suicidal ideation. Key points Childhood emotional maltreatment and emotional and clinical factors in bipolar disorder were assessed. Childhood emotional abuse indirectly affected clinical factors via emotion dysregulation. Difficulty in identifying feelings was linked to clinical factors via emotional dysregulation. Emotional dysre...
Source: International Journal of Psychiatry in Clinical Practice - February 11, 2021 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Mitochondrial DNA copy number may be associated with attention deficit/hyperactivity disorder severity in treatment: a one-year follow-up study.
CONCLUSIONS: There may be a relationship between decreased ADHD severity with treatment and positive effects of mitochondrial functions. Mitochondrial dysfunction may play a role in pathophysiology of ADHD. KEY POINTS This was the first study to follow up ADHD patients in order to investigate mitochondrial dysfunction by measuring mtDNA copy numbers 1 year after the initial measurements. mtDNA copy number, one of the best markers of mitochondrial dysfunction, did not change in ADHD patients over a period of 1 year regardless of treatment. Mitochondrial dysfunction may play a role in the pathophysiology of ADHD, where it ma...
Source: International Journal of Psychiatry in Clinical Practice - February 10, 2021 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Treatment strategies in managment of schizophrenia patients with persistent symptoms in daily practice: a retrospective study.
This study aimed to assess clinical preferences of clinicians in those showing treatment resistance to antipsychotics and to determine correlates of interventions. METHODS: Treatment strategies applied in the patients with schizophrenia in daily practice were inquired retrospectively. Those showing poor response to at least two antipsychotics and were administered a clinical intervention in a University Hospital between January and September 2018 were included. Clinical correlates of distinct interventions were evaluated. RESULTS: The most common intervention (47%) was transition to a long-acting injectable antipsy...
Source: International Journal of Psychiatry in Clinical Practice - February 10, 2021 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Functional interventions as augmentation strategies for obsessive-compulsive disorder (OCD): scoping review and expert survey from the international college of obsessive-compulsive spectrum disorders (ICOCS).
CONCLUSION: Patients with OCD may benefit from a detailed functional assessment, to identify areas of unmet need. A variety of interventions show theoretical promise for treating the complex functional difficulties in OCD as adjuncts to first-line treatments, but the published evidence is weak. Randomised controlled trials are needed to determine the clinical effectiveness of these interventions. Highlights Functional-cognitive problems are common in patients with OCD. First-line evidence-based treatments have limited effect on these functionalcognitive difficulties. In our scoping review we found 44 studies reporting of i...
Source: International Journal of Psychiatry in Clinical Practice - January 29, 2021 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

The effects of selective serotonin reuptake inhibitors on male and female fertility: a brief literature review.
Conclusions: SSRIs should be avoided male patients of reproductive age who wish to conceive, while the use of these antidepressants seems to be justified in women with depression or anxiety who have undergone IVF. Key points SSRIs could cause dose and duration-dependent reversible adverse effects on male fertility parameters. In depressed or anxious male patients of reproductive age who wish to conceive mirtazapine or bupropion should be used because of their lower potential to cause sexual side effects. The results of certain experimental studies indicate that paroxetine and escitalopram may have a negative effect on the ...
Source: International Journal of Psychiatry in Clinical Practice - January 24, 2021 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Affective temperaments and the risk of gestational diabetes mellitus.
Authors: Rezaei Ardani A, Tara F, Hatami SB, Naghizadeh Kashani S, Emadzadeh M, Nahidi M Abstract OBJECTIVE: Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. The current study aimed to investigate the possibility of a relationship between affective temperaments and GDM. METHODS: This ethically approved cross-sectional study was conducted on 120 pregnant women with impaired glucose tolerance and 120 healthy pregnant women, all of whom were admitted to hospitals affiliated with Mashhad University of Medical Sciences for delivery during 2019. Depression Anxiety Stress Scale...
Source: International Journal of Psychiatry in Clinical Practice - January 24, 2021 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

A new approach for seasonal pattern: is it related to bipolarity dimension? Findings from an Italian multicenter study.
CONCLUSIONS: A large number of patients with BD and seasonal pattern, but also a considerable number of patients with MDD and seasonal pattern, endorsed manic items during a current MDE. Seasonal pattern should be associated with a concept of bipolarity in mood disorders and not only related to bipolar disorder. A correct identification of seasonal patterns may lead to the implementation of personalised pharmacological treatment approaches. KEY POINTS High prevalence of mixed features in mood disorders with seasonal pattern, supporting the need for a dimensional approach to major depressive disorder and bipolar disorder. S...
Source: International Journal of Psychiatry in Clinical Practice - January 6, 2021 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Effects of lockdown on emergency room admissions for psychiatric evaluation: an observational study from the AUSL Romagna, Italy.
CONCLUSIONS: Lockdown changed dramatically health priorities in the local population, including people with mental health. We speculate that our observations do not only refer to the confinement due to the lockdown regime but also to fear of contagion and adoption of different coping strategies, especially in women. Key-points During lockdown 15% reduction of psychiatric visits and>17% reduction in the number of psychiatric patients referring to the ER was observed. in the first four weeks of the lockdown almost 25% reduction of both visits and patients was observed Female gender and being a local resident were factors ...
Source: International Journal of Psychiatry in Clinical Practice - December 23, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Grey matter volume abnormalities in the first depressive episode of medication-na ïve adult individuals: a systematic review of voxel based morphometric studies.
CONCLUSION: The present systematic review provided additional support for the involvement of grey matter structural abnormalities in limbic-cortical circuits as possibly specific structural abnormalities in the early stage of MDD. Key points Distinct brain regions in MDD patients might be associated with the early stages of illness, and thus it is critical to study the causal relationship between brain structures and the onset of the disease to improve the evaluation in clinic. Grey matter alterations in the fronto-limbic networks in the first episode, medication-naïve MDD might suggest that these abnormalities may pl...
Source: International Journal of Psychiatry in Clinical Practice - December 23, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Psychological pain and depression: it's hard to speak when it hurts.
CONCLUSION: Psychological pain is a specific clinical entity that should be considered to be more significant than just a symptom of depression. High level of psychological pain appears to be associated with a deficit of phonemic verbal fluency in depressed men. This finding could help to target psychotherapeutic treatments and improve screening. Key points Patients with high psychological pain do not differ on the Trail Making Test, the Stroop Test or the Sematic Verbal Fluency Measure to patients with low psychological pain High psychological pain is associated with a deficit in phonemic verbal fluency in depressed men F...
Source: International Journal of Psychiatry in Clinical Practice - December 6, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

A review of evaluation approaches for telemental health programs.
CONCLUSIONS: This review is the first to summarise approaches to evaluate telemental health programs. Strengths and weaknesses of the evaluation outcomes are discussed in this review, highlighting essential factors that should be taken into consideration when developing a standardised framework for the evaluation of future telemental health programs. KEY POINTS The methods used to evaluate telemental health programs are varied and no gold-standard for measurement of success exists. Clinical and non-clinical outcomes are being used to evaluate telemental health programs. More emphasis should be placed on feasibility measure...
Source: International Journal of Psychiatry in Clinical Practice - November 29, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Differences of apathy perfusion correlates between Alzheimer's disease and frontotemporal dementia. A 99mTc-HMPAO SPECT study with automated Brodmann areas analysis.
CONCLUSIONS: Significant overlapping of apathy perfusion correlates between AD and FTD is seen in frontal areas and anterior cingulate. Right occipital cortex is also involved in AD, while right temporal cortex and left posterior cingulate are involved in FTD. Nuclear imaging could be a useful biomarker for revealing apathy underlying mechanisms, resulting in directed treatments. KEYPOINTS Underlying neural networks and clinical manifestation of apathy may differ between AD and FTD. Apathy in AD is correlated with hypoperfusion in bilateral frontal areas, more prominent on the right, left anterior cingulate and right occip...
Source: International Journal of Psychiatry in Clinical Practice - November 20, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Lithium - past, present, future.
CONCLUSION: Given the clinical and biological properties of lithium, this drug is presently greatly underutilized in mood disorders. Therefore, the efforts should be undertaken for challenging a skepticism about the use of lithium and optimizing its long-term administration. In such a way, more patients with mood disorders can become the beneficiaries of lithium's therapeutic action. KEY POINTS Lithium is a drug of choice as a mood-stabiliser for the maintenance treatment of bipolar disorder. Augmentation of antidepressants by lithium is one of the best strategies in treatment-resistant depression. Lithium exerts anti-suic...
Source: International Journal of Psychiatry in Clinical Practice - November 12, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Adverse drug reactions associated with concurrent acute psychiatric treatment and Covid-19 drug therapy.
CONCLUSIONS: From our point of view, non-cardiac adverse effects should not be overlooked while treating comorbid psychiatric and COVID-19 patients. KEY POINTS Acute inpatient psychiatric treatment of patients who have comorbid COVID-19 is a complex situation requiring multidisciplinary action. Adverse drug reactions, which may or not result from the interaction of psychiatric and COVID-19 treatment, should be of concern for this patient group. While there is controversy over the benefits of some of the off-label COVID-19 medications, there should also be discussion over safety and concomitant medication use. In order to b...
Source: International Journal of Psychiatry in Clinical Practice - November 6, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Editorial.
Authors: Kasper S PMID: 33131353 [PubMed - as supplied by publisher] (Source: International Journal of Psychiatry in Clinical Practice)
Source: International Journal of Psychiatry in Clinical Practice - November 3, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Assessment of cognitive performances in major depressed patients: a 6-month follow-up study.
CONCLUSIONS: Results from the current study indicate that cognitive impairment is more severe for depressed patients, decreases for euthymic subjects, and lasts longer after depressive symptoms remit. PMID: 33118408 [PubMed - as supplied by publisher] (Source: International Journal of Psychiatry in Clinical Practice)
Source: International Journal of Psychiatry in Clinical Practice - October 31, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Psychiatry's pursuit of euthymia: another wild goose chase or an opportunity for principle-based facilitation?
Authors: Kelley TM, Pettit WF, Sedgeman JA, Pransky JB Abstract The authors are encouraged that the field of psychiatry is moving towards including euthymia and its components (e.g., well-being, flourishing and resilience) as well as dysfunction (i.e., psychopathology and its symptoms) in its assessment and treatment. We are concerned, however, that to guide its pursuit of euthymia, psychiatry appears to be adopting the same 'outside-in' paradigm as positive psychology; that the positive must be 'put into' people via assisting them to adopt new positive beliefs and persistently practice psychotherapeutic techniques...
Source: International Journal of Psychiatry in Clinical Practice - October 31, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

The assessment of affective temperament and life quality in myofascial pain syndrome patients.
CONCLUSION: This research assesses for the first time of the affective temperament characteristics of MPS patients. KEY POINTS Myofascial pain syndrome patients have distinct temperaments than the control group. Myofascial pain syndrome patients had remarkably higher TEMPS-A depressive, cyclothymic, and anxious scores than the healthy control group. Life quality, clinical severity, and courses can be affected by differences in temperament. Clinicians can readily apply the TEMPS-A temperament scale in patient application to demonstrate these differences. The anticipation of a psychiatric situation plays a more significant r...
Source: International Journal of Psychiatry in Clinical Practice - October 23, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Changing patterns of prenatal depression and anxiety status in different trimesters and modified form of Zung scales for pregnant women.
CONCLUSION: Pregnant women had higher severity of depression and anxiety status in 1st trimester than that in 2nd and 3rd trimester. The modified form of SDS/SAS may be more brief and suitable to assess the depression and anxiety status in pregnant women. KEY POINTS Pregnant women had a higher severity of depression and anxiety status in the 1st trimester than that in the 2nd and 3rd trimester. The present study suggests that prenatal depression and anxiety status are prevalent in Chinese pregnant women. Prevention or treatments focus on high-score items of SDS and SAS would be beneficial for rectifying prenatal depression...
Source: International Journal of Psychiatry in Clinical Practice - October 21, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Relationship between impulsivity, comorbid anxiety and neurocognitive functions in bipolar disorder.
CONCLUSION: Anxiety disorder comorbidity increases impulsivity in bipolar disorder. KEYPOINTS In the presence of anxiety disorder spectrum comorbidity, bipolar disorder patients will have increased impulsivity and the clinical course may be more severe. Trait anxiety levels and anxiety sensitivity may be predictive factors for impulsivity. In the presence of anxiety disorder spectrum comorbidity, it should be taken into consideration that these patients may be more impulsive and should be treated with more care in terms of evaluation of the disorder. PMID: 33063587 [PubMed - as supplied by publisher] (Source: Internati...
Source: International Journal of Psychiatry in Clinical Practice - October 20, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Pituitary-adrenal axis hormones in early-onset versus late-onset panic disorder.
CONCLUSIONS: These findings suggest that the two onset-groups demonstrate significant differences in the hypothalamic-pituitary-adrenal axis functioning, at least when acutely-ill. Key points Early-onset panic disorder (EOPD) may differ biologically from late-onset PD (LOPD). EOPD was correlated with greater adrenocorticotropic hormone (ACTH) plasma levels. EOPD was correlated with greater dehydroepiandrosterone sulphate plasma levels. In EOPD only, ACTH levels were positively correlated with panic and anxiety symptoms. PMID: 33043745 [PubMed - as supplied by publisher] (Source: International Journal of Psychiatry in Clinical Practice)
Source: International Journal of Psychiatry in Clinical Practice - October 14, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

How does adolescent motherhood affect mother-infant/toddler relationship and emotional availability.
Authors: Cikili Uytun M, Yurumez E, Oztop DB, Mentese Babayigit T, Efendi GY, Kilic BG Abstract BACKGROUND: The present study examined the different aspects of infant-mother relationships in adolescent mothers and compared them in adult mothers. METHODS: Children aged 18-40 months who were referred to our outpatient Infant Mental Health Department were analysed retrospectively. Sociodemographic data, Parent-Infant Relationship Global Assessment Scale (PIR-GAS) scores, and Emotional Availability (EA) Scales scores were analysed. Twenty-nine adolescent mothers being younger than 20 years at the begi...
Source: International Journal of Psychiatry in Clinical Practice - October 8, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Delirium associated with the use of macrolide antibiotics: a review.
CONCLUSIONS: Considering that these drugs may be a possible cause of delirium, clinicians should be aware that timely recognition of this possible side effect can lead to earlier discontinuation of the culprit drug, reduce time spent in a delirious state and improve patients' outcomes. KEY POINTS Cases of delirium which satisfied inclusion criteria were found for clarithromycin, azithromycin, erythromycin and telithromycin. Cases of delirium were described in patients of various age groups, including children. Drug-drug interactions may have contributed to the occurrence of delirium in some of the cases. Time to onset of d...
Source: International Journal of Psychiatry in Clinical Practice - October 8, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Hikikomori: psychopathology and differential diagnosis of a condition with epidemic diffusion.
CONCLUSIONS: Hikikomori could represent the clinical answer to a social evolution, similarly to other phenomena such as binge behaviours and use of psychoactive substances. Further studies are needed to clarify diffusion, diagnosticassessment and differential diagnosis. Key points Hikikomori is now considered a contemporary society-bound syndrome linked to modern society changes. Hikikomori might be a coping strategy to avoid relationships, social judgement and possible failures. Hikikomori might represent an extreme suffering that needs to be identified early: it is linked to severe form of modern type depression and it i...
Source: International Journal of Psychiatry in Clinical Practice - September 30, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Dimensions of Anger Reactions (DAR-5): a useful screening tool for anger in the general population.
CONCLUSIONS: The shortness of the DAR-5, along with its cost-effective applicability, qualifies this measuring tool as a useful instrument for inclusion in the routine assessment of anger reactions in the general population. Key points This is the first time the validity of DAR-5 has been demonstrated in a developing country. The Portuguese version of DAR-5 has appropriate sensitivity and high specificity. The DAR-5 demonstrated to be a reliable and stable instrument, irrespective of sex. PMID: 32975451 [PubMed - as supplied by publisher] (Source: International Journal of Psychiatry in Clinical Practice)
Source: International Journal of Psychiatry in Clinical Practice - September 27, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Wernicke Encephalopathy in schizophrenia: a systematic review.
CONCLUSIONS: The development of a full triad and additional symptomatology suggests a late recognition of signs and symptoms of WE in schizophrenia. Prophylactic thiamine checks and treatment in patients with schizophrenia are relevant, and if WE is suspected adequate parenteral thiamine supplementation is necessary. Key points Only few cases of schizophrenia-related WE have been published in the literature, though challenges in diagnosing and recognising WE suggest that the vast majority of cases go undetected. Acute thiamine deficiency leads to Wernicke's Encephalopathy. Patients diagnosed with schizophrenia are at risk ...
Source: International Journal of Psychiatry in Clinical Practice - September 24, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

The incidence and economic impact of aggression in closed long-stay psychiatric wards.
CONCLUSIONS: The current study found a high rate of aggression incidents in closed long-stay psychiatric wards. Reports of aggression on these types of wards are scarce. Nevertheless, aggression seems to have a severe impact on invested time and related costs, which suggests a need for aggression-prevention and de-escalating programs. Key points Aggression incidents are highly prevalent and are accompanied by high costs. The effect of aggression incidents on the workload for staff members is high, especially for nursing staff. Studies across countries on the incidence and the costs of aggression among psychiatric inpatient...
Source: International Journal of Psychiatry in Clinical Practice - September 22, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

A medical algorithm for Cotard delusion based on more than 300 literature cases.
CONCLUSIONS: Despite its challenging diagnosis, the delusion can be treated with readily available care. Hopefully, this work can be a useful tool to doctors when encountering this odd affliction. PMID: 32935595 [PubMed - as supplied by publisher] (Source: International Journal of Psychiatry in Clinical Practice)
Source: International Journal of Psychiatry in Clinical Practice - September 18, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

The relationship between nomophobia and psychiatric symptoms in adolescents.
CONCLUSIONS: Since anxiety and hyperactivity were predictors of nomophobia according to the study, adolescents with attention deficit hyperactivity disorder or anxiety disorder should be examined for nomophobia as well. Key points Nomophobia levels of internalising and externalising disordered groups did not differ. Internalising group had higher scores in two sub-dimensions of nomophobia. All anxiety and depression symptoms correlated with nomophobia. Hyperactivity and oppositional symptoms correlated with nomophobia. Total anxiety and hyperactivity were predictors of nomophobia. PMID: 32940094 [PubMed - as supplied b...
Source: International Journal of Psychiatry in Clinical Practice - September 18, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Culturally adapted family intervention for schizophrenia in Pakistan: a feasibility study.
CONCLUSIONS: Importantly, this study determines that pathways into a psychosocial intervention can be established in Pakistan. A combination of factors contribute to low levels of access to psychiatric care including different explanatory models of illness, small numbers of trained staff, limited resources and reliance on traditional healers. These results support the feasibility, acceptability and merit of conducting a full-scale trial of CulFI in comparison with standard care. ClinicalTrials.gov Identifier: NCT02167347 KEY POINTS The significant treatment gap in LMICs leaves families providing much of the care for people...
Source: International Journal of Psychiatry in Clinical Practice - September 17, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Editorial.
Authors: Kasper S PMID: 32909469 [PubMed - as supplied by publisher] (Source: International Journal of Psychiatry in Clinical Practice)
Source: International Journal of Psychiatry in Clinical Practice - September 12, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Negative symptoms in schizophrenia, assessed by the brief negative symptom scale, self-evaluation of negative symptom scale, and social cognition: a gender effect.
CONCLUSIONS: Gender differences were found in the assessment of negative symptoms by a clinical scale and the relationship between negative symptoms and social cognition. KEY POINTS Female patients scored better in the BNSS, PSP and both parts of the Faux-Pas test Gender differences were present in the assessment of negative symptoms by clinical (BNSS) but not the self-assessment (SNS) scale. Female patients obtained a significant correlation between the results of the SNS scale, BNSS, PSP, and the affective part of the Faux-Pas test what was not the case in male subjects. PMID: 32862741 [PubMed - as supplied by publis...
Source: International Journal of Psychiatry in Clinical Practice - September 1, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Precision psychiatry in clinical practice.
Authors: Zanardi R, Prestifilippo D, Fabbri C, Colombo C, Maron E, Serretti A Abstract The treatment of depression represents a major challenge for healthcare systems and choosing among the many available drugs without objective guidance criteria is an error-prone process. Recently, pharmacogenetic biomarkers entered in prescribing guidelines, giving clinicians the possibility to use this additional tool to guide prescription and improve therapeutic outcomes. This marked an important step towards precision psychiatry, which aim is to integrate biological and environmental information to personalise treatments. Only...
Source: International Journal of Psychiatry in Clinical Practice - August 29, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Sex differences in maturation and aging of human personality on the basis of a recently developed complex hierarchical model of temperament and character.
CONCLUSIONS: While there is stability with the two top factors of personality, there are age-related changes in lower-level modules probably indicating maturation, adaptation or changes in orientation through the adult life span. Gender differences in all levels including the two top superfactors, higher and lower modules reflect and explain differences in multiple aspects of internal experience, interaction and behaviour in the two genders. The results are clinically essential for incorporating age and gender-related differences of experience and behaviour in understanding temperamental implications in affective disorders...
Source: International Journal of Psychiatry in Clinical Practice - August 26, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Elevated neutrophil-to-lymphocyte ratio in children and adolescents with attention-deficit/hyperactivity disorder.
CONCLUSIONS: Our findings suggest that NLR and PLR may be inflammation biomarkers in children and adolescents with ADHD. Moreover, the significance of NLR is not influenced by medication use, age and sex. Prospective studies that address alterations in NLR and PLR and other pro-inflammatory cytokines following ADHD treatment may provide additional information about the inflammatory mechanisms in ADHD. Key points The mean NLR and PLR were significantly higher in patients than in controls. The significance of NLR is not influenced by medication use, age and sex. No associations were found between NLR and PLR and ADHD symptom...
Source: International Journal of Psychiatry in Clinical Practice - August 15, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Satisfaction with antipsychotics as a medication: the role of therapeutic alliance and patient-perceived participation in decision making in patients with schizophrenia spectrum disorder.
Authors: Torrecilla-Olavarrieta R, Pérez-Revuelta J, García-Spínola E, López Martín Á, Mongil-SanJuan JM, Rodríguez-Gómez C, Villagrán-Moreno JM, González-Saiz F Abstract OBJECTIVES: The aim of this study was to identify independent predictors of satisfaction with antipsychotics in patients with schizophrenia spectrum disorders treated in a mental health catchment area. METHODS: Observational analytical study of patients (n = 150) recruited through a convenience sampling method from five mental health units. Satisfaction with th...
Source: International Journal of Psychiatry in Clinical Practice - August 15, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

COVID-19 and acute inpatient psychiatry: the shape of things to come.
Authors: Boland X, Dratcu L Abstract Psychiatric services that provide acute inpatient care have to respond to the challenges brought about by the COVID-19 pandemic to consistently deliver high standards of treatment to patients and ensure the safety of staff. This can only be achieved by fostering a culture that rewards initiative and empowers inpatient teams to implement and comply with changes which everyone understands and benefits from. The experience of an inner London acute psychiatric unit has shown the value of combining proactive leadership, multidisciplinary decision making and good communication in adap...
Source: International Journal of Psychiatry in Clinical Practice - August 14, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Serum zonulin and claudin-5 levels in children with attention-deficit/hyperactivity disorder.
CONCLUSION: These findings provide additional evidence for dysregulation of the blood-brain barrier, especially abnormalities in claudin-5 function, which may be involved in the aetiology of ADHD. Key points ADHD is one of the most common neurodevelopmental disorders of childhood. Although ADHD is quite common, its aetiology has yet to be fully explained. In recent years, studies on the relationship between intestinal and blood-brain brain barrier permeability and psychiatric disorders have increased. In our study, serum claudin-5 levels were higher in the ADHD group compared to the control group, while serum zonulin level...
Source: International Journal of Psychiatry in Clinical Practice - August 14, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Intensive intervention for adolescents with autism spectrum disorder: comparison of three rehabilitation treatments.
CONCLUSIONS: A high intensity intervention ameliorates the core symptoms of ASD, enriching evidence of effectiveness regarding adolescents with ASD. KEY POINTS Individuals with ASD need lifespan support and they struggle to access employment, independent living and community inclusion. There are several rehabilitative interventions for individuals with ASD but the evidence of their effectiveness in adolescents is insufficient. The main purpose of this study was to evaluate the possible enhancement produced by three intensive interventions (ABA, TEACCH, BEI) of symptom severity and adaptive functions. Results show that inde...
Source: International Journal of Psychiatry in Clinical Practice - August 5, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Risk of suicide after discharge from inpatient psychiatric care: a systematic review.
CONCLUSIONS: The findings of this review suggest that significant suicide predictors both common and unique to those established for suicide in the general population exist and can be utilised in a clinically meaningful way, despite the difficulties inherent in studying this population. KEY POINTS The risk of suicide after psychiatric hospitalisation is high. Factors that predict suicide after psychiatric hospitalisation overlap only partially with risk factors for suicide in general. Important risk factors for suicide in the post-discharge period include male sex, a history of self-harm, a history of suicide attempts, the...
Source: International Journal of Psychiatry in Clinical Practice - August 5, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

The ongoing discussion on termination of life on request. A review from a German/European perspective.
CONCLUSIONS: Experience from the Netherlands shows that widening criteria for EAS has problematic consequences. KEY POINTS Termination of life on request, which a subgroup of people support, is a matter of ongoing debate. Because of several problematic aspects, including ethical considerations, only a few countries in the world allow active euthanasia or assisted suicide. Even if euthanasia is well regulated, legalising it can have problematic consequences that are difficult to control, such as an unwanted excessive increase in euthanasia cases. The well-documented experiences with the euthanasia law in the Netherlands ser...
Source: International Journal of Psychiatry in Clinical Practice - August 1, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research

Relapse prevention in recurrent major depressive disorder. A comparison of different treatment options based on clinical experience and a critical review of the literature.
CONCLUSIONS: The sequential model appears to be particularly indicated in recurrent depression. KEY POINTS Relapse is a major challenge of depressive disorders treatment Treatment options currently available include long-term antidepressants, intermittent antidepressants, addition of psychotherapy to pharmacotherapy in the sequential model Maintenance with antidepressants in recurrent depression has recently been questioned The sequential model appears to be particularly indicated in recurrent depression. PMID: 32716222 [PubMed - as supplied by publisher] (Source: International Journal of Psychiatry in Clinical Practice)
Source: International Journal of Psychiatry in Clinical Practice - July 29, 2020 Category: Psychiatry Tags: Int J Psychiatry Clin Pract Source Type: research