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Preservation of health, increase in life expectancy determine the need to improve the effectiveness of medical recommendations, which, despite the success of pharmacology, are insufficient for reasons related to the low level of compliance with these recommendations by patients.
Objectives
Participants of the study-148 employees of medical institutions: 12 men, 136 women, their age ranged from 27 to 74 years.
Methods
Despite the absence of signs of decompensation of concomitant pathology, representatives of the subgroups took a different amount of concomitant therapy. Using the scale of assessment of drug compliance, it was found that compliance is most reduced in the subgroup of 41-50 years. In this subgroup, a comprehensive decrease in compliance across the “behavioral”, “emotional”, and “cognitive” domains was detected in 87.8% of cases, while in the younger subgroup partial non-compliance was 32.4%, in the older subgroup - 74.5%
Results
An analysis of the states of cognitive functions in 52 representatives of the middle age subgroup with low compliance rates showed that, unlike other representatives of the same subgroup, their indices for a number of neuropsychological tests are close to the results of more adult participants in the study.Individuals demonstrating low compliance with quite favorable CNS resources are at risk for the formation of pathological aging.
Conclusions
Compliance is considered as Compliance is considered as a control mechanism for preventing normal aging into pathological by regulating risk factors that are dangerous for the brain and associated with the formation of dementia
Traditional categorical classifications of personality disorders (PD) have been criticized for insufficient structural and cross-cultural validity. In the DSM-5 Section III, alternative model of the PDs (AMPD), the maladaptive personality traits are divided into five domains: negative affect, detachment, antagonism, disinhibition and psychoticism. The Personality Inventory for DSM-5 Brief Form (PID-5-BF) is a 25-item self-report questionnaire that measures the severity of each of these five domains. To date, no questionnaires assessing pathological personality traits following the AMPD have been validated in Russia.
Objectives
This study aimed to investigate the factor structure of the Russian version of PID-5-BF.
Methods
Five hundred and 86 (female - 505 (86,2%), age - 18–77 years (M - 28.2, SD - 11.5)) consecutive inpatients with non-psychotic mental disorders were assessed with the Russian language version of the PID-5-BF. Exploratory structural equation modelling (ESEM) with Robust Diagonally Weighted Least Squares method of extraction and Robust Equamax rotation was performed in Factor v 11.04.02.
Results
The results of the ESEM analysis showed good fit of the five-factor model (CFI - 0.982; TLI - 0.971; RMSEA (95% CI) - 0.036 (0.01-0.05). Most of the items had the highest factor loadings on their mother domains. However, two items showed weak loadings on their designated factors (<0.4), and attention seeking item had a primary load to (low) detachment instead of antagonism.
Conclusions
The PID-5-BF was found to be a valid and reliable tool for the evaluation of the AMPD trait domain
Patients treated for chronic mental disorders and who receive atypical antipsychotics are in most cases at risk of gaining weight, the excess of which is complicated in the long term by metabolic syndrome (MS). The management of these patients is effective if it includes Therapeutic Education.
Objectives
Describe the therapeutic education program developed for patients on antipsychotics who have metabolic syndrome
Methods
In this work, we present the educational program that we have developed for patients undergoing psychiatric treatment with atypical antipsychotics, who have been stabilized for at least 3 months and who suffer from SM.
Results
It is a program that starts with the inclusion consultation and educational diagnosis with the first step of clinical (weight, abdominal perimeter and BMI), biological (blood sugar, HbA1C, cholesterol, HDL, triglycerides) and psychometric (SF12, MAQR, food and physical activity diary) assessments. Our initial program includes 6 sessions and 2 maintenance sessions at 1 month and 3 months after the 6th session. The objectives were divided between information about DM, motivation to eat a balanced diet, physical activity and improvement of quality of life. We also included stress management and positive psychology activities. Assessments are repeated at the end of the initial program and at the last maintenance session.
Conclusions
Our program was developed according to the Geneva therapeutic education recommendations. We plan to apply it to groups of patients in our department
The past years BDSM (an acronym for bondage and discipline, dominance and submission, and sadism and masochism) has gained a significant amount of attention and popularity in the general population, portraying an inaccurate image of BDSM and the people who share these interests. Yet despite this increasing popularity, only little empirical research has focused on this subject and it’s possible driving mechanisms so far, sustaining the existing misconceptions and stigma towards BDSM in general and BDSM practitioners in specific.
Objectives
We aimed to gain more insights on understanding the underlying psychological mechanisms, such as sensation seeking and coping, in people who participate in BDSM-related activities, as well as into the factors which contribute to the existing stigma and discrimination
Methods
In a national survey study 256 Dutch-speaking BDSM-practitioners were compared to a matched sample of people from the general Belgian population (N = 300) who lack any interest in BDSM in two separate studies.
Results
About 86% of the general population maintained stigmatizing beliefs about these sexual interests and practices. In regard to sensation seeking and coping, compared to controls, BDSM practitioners reported signifcantly higher levels of sensation seeking for all dimensions, as well as the use of more active coping skills.
Conclusions
People who do not conform to the current social standards of our society often seem to remain the subject of stigmatization and discrimination. Further research is needed to explore the psychological processes that drive BDSM interests in order to destigmatize and normalize consensual BDSM-related activities.
Childhood trauma has been demonstrated to be associated with several indicators of worse course in bipolar disorder (BD). Links between early adversity and the complexity of the disorder might be mediated by various dimensions of psychopathology, such as impulsivity.
Objectives
The aim of this study was to investigate the impact of traumatic childhood experiences on impulsivity in individuals with bipolar disorder.
Methods
We conducted a cross-sectional, descriptive, and analytical study. Sixty-one euthymic patients with bipolar disorder were recruited in the department of psychiatry B of Razi Hospital, during their follow-up. The Childhood Trauma Questionnaire (CTQ) and the Barratt Impulsiveness Scale-11 (BIS-11) were used to assess childhood traumatic experiences and impulsivity.
Results
The mean age of patients was 43.4. The sex ratio was 2.4. The mean score obtained on the Bis-11 scale was 74.8. More than half of patients (53%) had high levels of impulsivity. Almost two-thirds of patients (64%) had experienced at least one type of childhood trauma. Higher scores on the various dimensions of childhood trauma apart from physical neglect, were significantly associated with higher total BIS-11 score as well as with all its subscales. Linear regression with the CTQ total score as the independent variable showed a statistically significant effect of childhood trauma score on attentional impulsivity.
Conclusions
Our findings suggest that interventions that target impulsive behavior in individuals with bipolar disorder should pay particular attention to traumatic childhood experiences. Furthermore, early identification and management of childhood trauma may reduce levels of impulsivity and thus improve the outcome and prognosis of bipolar disorder.
Qatar established its Forensic Community Mental Health Team (FCMHT) in 2019 as part of the region’s first comprehensive forensic psychiatry service. We present here the data on clinical and offending outcomes since its establishment and compare this with data from before the service was established
Objectives
To compare clinical and offending outcomes in mental health patients with criminal offending histories in Qatar before and after the establishment of Forensic Community Mental Health Team (FCMHT).
Methods
This is a retrospective study comparing the socio-demographical characteristics, clinical outcome and recidivism measures of forensic patients, under the FCMHT for the last two years with data from a similar period before the services were in place.
Results
Data for 170 patients in total was analyzed. 85 patients currently under the active care of forensic community team were matched with a comparable group before the establishment of the services. The re-admission and reoffending rates after the establishment of the service over 1 year of follow up was 15% and 20% respectively compared with 60% and 85% of the group before the service.
Conclusions
Since its inception, the FCMHT has made significant positive impact on quality of life, mental well-being and safety of patients under its care. Close working relationships with criminal justice system, families and carers has helped fight stigma and promote safer community.
Ayahuasca (AYA) is a psychotropic plant from South America used for religious purposes by indigenous people of the Amazon. Increasing evidence indicates that AYA may have therapeutic potential in the treatment of mental health disorders like depression – a common life-disrupting, highly recurrent disorder – that is among the leading causes of disability worldwide.
Objectives
The aim of this exploratory study is to gather and assess scientific evidence about clinical effects of AYA in the treatment and symptomatological expression of patients with depression.
Methods
A literature research was conducted on PubMed, starting from the MeSH terms: “Banisteriopsis” and “Depression”. Results corresponding to investigations using AYA, and based on an adult population with depressive disorders, were selected for our analysis.
Results
The research provided 8 results, of which 6 met the defined criteria. Different types of studies with variable samples were considered, including retrospective and prospective observational studies, meta-analysis and a narrative review. Overall, evidence about the use of AYA in depressive disorders is associated to reductions in depression scales, to significant antidepressant effects and in mediating improvement of grief symptoms. AYA administration increased introspection and positive mood, self-acceptance, empathy, openness and potentiated improvements in emotional processing. The underlying potential mechanisms, adverse effects and the current limitations related to its study and use are analysed and discussed.
Conclusions
The use of AYA in depression shows promising results that should be further explored in controlled trials with larger sample sizes, in order to better evaluate its clinical effects, safety profile and related short and long-term effects.
Studies assessing the psychological impact of COVID-19 have shown that patients with COVID-19 had significantly higher levels of depression, anxiety, and post-traumatic stress symptoms than healthy controls.
Objectives
The objectives of our study were to assess dysfunctional anxiety in women recovered from COVID-19 and to compare it to healthy controls.
Methods
This is a cross-sectional case-control study.
We randomly recruited women, from April 1st to 30th, 2021.The women in the case group have been infected with Sars-Cov 2, with a benign or pauci-symptomatic clinical form, and cured for one to two months at the time of the study without any post-COVID complications. Women included in the control group have not been infected with Sars-Cov 2 .Anxiety was assessed by the Coronavirus Anxiety Scale (CAS).
Results
In total, we recruited 30 women in the case group and 30 women in the control group.The average age of the case group was 35.8 ±6.8 years versus an average age of 35.3 ± 6.33 years in the control group. The majority of coronavirus infections were symptomatic (83.3% (n=25)). Nearly one-third of the patients in the case group had a CAS score greater than 9, indicating dysfunctional anxiety probably related to coronavirus (33.3%), with a significant difference with the control group (p=0.026).
Conclusions
COVID-19 is significantly associated with dysfunctional anxiety, even in mild or pauci-symptomatic clinical forms.
The Covid-19 pandemic has brought with it far-reaching consequences that affect the mental health of a significant population. Those suffering from somatic symptom disorder (SSD) present a significant focus on physical symptoms, with excessive thoughts and behaviours, to an extent that results in major distress and dysfunction. Aggravation of SSD could be associated with various stressors, including the current pandemic, and culminate in an increased severity of the base presentation.
Objectives
The authors present the case of an elderly man with previous diagnosis of SSD which began to aggravate and evolve into a depressive psychotic state, precipitated by the beginning of the Covid-19 pandemic.
Methods
The authors conducted a non-systematized literature review with focus on those articles most pertinent to the topic in question as well as presenting a clinical case as compliment.
Results
With the pandemic overwhelming the globe, the literature has demonstrated a significant correlation with aggravation of mental health and psychiatric cases. The patient in question was previously followed in consultation for SSD. With the pandemic acting as precipitating stressor, the patient demonstrated a significant aggravation in his base presentation with the development of psychotic depression. He was subsequently hospitalized with implementation of psychotherapeutic and psychopharmacological methods, with remission of the psychotic state, with poor response of the SSD.
Conclusions
External stressors are an important influence on psychiatric disorders. Whenever potential life stressors, especially those that exert influence on a global scale, the psychiatrist should be attentive to the possibility of significant aggravation of a stabilized clinical picture and offer support.
Dysfunctional breathing is experienced as a feeling of “difficulty in inhaling” and shortness of breat , which may be similar to the symptoms of coronavirus infection (Gavriatopoulou et al., 2020). The conditions of the COVID-19 pandemic create an increased level of anxiety and attention to respiratory sensations, which becomes a favorable ground for the occurrence of dysfunctional breathing.
Objectives
To examine the relationship of ideas about the pandemic with the occurrence of dysfunctional breathing in the Russian population during the COVID-19 pandemic.
Methods
The Naimigen Questionnaire (Van Dixhoorn, Duivenvoordent, 1985) and the author’s socio-demographic questionnaire were used, which included questions about personal experience of the pandemic. The study was conducted online from April 27 to December 28, 2020. It was attended by 1,362 people from all regions of Russia, including 1,153 women and 209 men aged 15 to 88 years (38.3±11.4).
Results
It was found that respondents who are more confident in the danger of coronavirus have more respiratory difficulties (N=517;NQ=19±10.6) compared to those who consider its danger exaggerated (N=454,NQ=15.9±9.2,p=0.000). Respondents who are completely convinced of the absence of a condemnation for COVID-19 disease have less pronounced dysfunctional breathing (N=331,NQ=15.26±9.5), compared to those who sure about it (N=88,NQ=19.16±10.05, p=0.007). Respondents who have relatives ill COVID-19 (N=430) have a higher score on NQ (18.6±10.5), compared with those dont have (N=932, NQ=17.1±9.7, p =0.011).
Conclusions
The dysfunctional breathing is associated with the respondents’ beliefs about the danger of coronavirus and the expectation of stigmatization in COVID-19 disease, as well as with the experience of COVID-19 disease among relatives.
Disclosure
Research is supported by the Russian Science Foundation, project No. 21-18-00624.
Depression during pregnancy leads to deterioration of the mothers’ and the fetus’ health.
Objectives
To explore women’s perception and attitude towards using antidepressants during pregnancy and identify the factors that influence decision making regarding antidepressants use.
Methods
A cross-sectional survey of 991 subjects using convenient sampling. All study subjects (PNU affiliates; staff and students) were invited to fill out an electronic questionnaire, KAAUH staff and PNU female associates who were less than 18 years old were excluded. Answers were reported using 5- point Likert scale. The responses were summed up to give a total score for each respondent. The cutoff point is 75%. Respondents who scored above or equal 75% of the total score was considered as positive perception or favorable attitude.
Results
The majority of women had negative perception and favorable attitude towards using antidepressants during pregnancy reaching 64%. While, women with positive perception and favorable attitude represented about 20% of the study subjects. The main factors influencing decision making were, education specialty (health, none-health) and subject history of diagnosis with any psychological disorder. Social stigma, religious believes and fear of addiction were reported by surveyors to be the reason influencing their perception and attitude about antidepressants use (P value <0.005).
Conclusions
This study reveals that although Saudi women reflect a negative perception towards using antidepressants during pregnancy, yet they have a favorable attitude once depression during pregnancy becomes an issue.
Clozapine is widely known as the drug of choice in treating refractory schizophrenia. However, clozapine prescription requires close clinical and biological monitoring to prevent harmful side effects like agranulocytosis, neutropenia and myocarditis.
Objectives
To show the benefits of lithium carbonate in the clozapine rechallenge of a patient with neutropenia under clozapine.
Methods
We present the clinical case of a patient who developed neutropenia under clozapine, we rechallenged with clozapine after lithium treatment to stimulate hematopoietic functions.
Results
A 42-year-old man diagnosed with refractory schizophrenia, under clozapine for 11 years with a good clinical response at a dosage of 500mg per day (clozapine serum level 328ng/ml), developed a neutropenia (BCC at 840/mm3) within an interval of 2 months. Clozapine treatment was suspended and the patient presented a severe psychotic relapse requiring hospitalization. During hospitalization the patient remained symptomatic under haloperidol 15mg daily. At week 3 of clozapine cessation, neutrophil count reached 1510/mm3. After week 4 we introduced lithium carbonate and while reaching 500mg per day we observed an increase in the neutrophil count to 4850/mm3. We rechallenged with clozapine at week 12 after a poor clinical response, with incremental dosage to 150mg per day in 17 weeks. The blood cell count did not show any abnormalities and the patient had a good clinical response up to 11 months after the clozapine rechallenge.
Conclusions
Despite the lack of guidelines assessing clozapine rechallenge after neutropenia, the use of lithium carbonate may be considered to stimulate hematopoietic functions.
Emotional regulation appears to be a key factor in self-injury. But body image also may play an important role in self-harming.
Objectives
Analysis of the relationship between non-suicidal self-injurious behavior and various aspects of body representation and body perception in adolescents and young women suffering from depression.
Methods
The study involved 85 women with endogenous depression. The answer to the question “Sometimes I purposely injure myself” was used as an indicator of self-harm. The methods include: SCL-90-R, Body Investment Scale (BIS), Physical Appearance Comparison Scale-Revised (PACS-R), Body Satisfaction Scale (BSS), Cambridge Depersonalization Scale (CDS).
Results
The relationship between self-injurious behavior and emotional, cognitive and behavioral characteristics of the self-body perception was revealed: more negative body image - dissatisfaction with its parts and the whole body (correlation with BSS_head ,238*, BSS_body ,472**, BSS_total_score ,453**), which is accompanied by behavioral manifestations - reduced “Protection” (correlation with BIS -,281**), higher rates of self-surveillance and comparisons of the self-body with others (PACS-R ,323**), depersonalization (CDS ,301**), body dissociation (CDS ABE ,346**), somatization (SCL-90-R ,226*).
Conclusions
For young women with depression, it has been shown that when self-harming, the self-body is “devalued”, perceived as “bad,” and the need to protect it is ignored. The severity of self-harm directly correlates with the phenomena of somatopsychic depersonalization. The results obtained may indicate that rejection of the self-body, “alienated” attitude and deprivation of the body of “subjectivity” can contribute to its use as a tool for solving psychological problems, which is a risk factor for the development, consolidation and aggravation of self-injurious behavior.
COVID-19 caused an ongoing health emergency that rapidly spread worldwide, so all countries adopted exceptional health measures to reduce disease’s transmission. The stress caused by pandemic presents increasing risks for family violence and for child abuses. Interinstitutional Equips of Abusive and Maltreatment (IEAM) deals with the management of abusive families in Palermo’s territory. IEAM starts evaluations after the interventions of the court solicited by a complaint filed by teachers, law enforcements or members of the family. IEAM is formed by consultations in maternity ward, child welfare service and school educational psychologists.
Objectives
The purpose of this research was to evaluate the variations of child abuse and maltreatment reported during local and National lockdown due to pandemic. Reported cases were compared with the previous year.
Methods
The authors collected data of IEAM’s advisory from January 2019 until August 2021. The number of cases was evaluated monthly.
Results
We observed 124 cases in 2019, 145 in 2020 and 94 until August 2021. Advisory reductions coincided with the service activity reduction in August of every year and in March 2020 when Italy declared national lockdown. Social isolation represents a risk factor for child abuse. Although the increase of cases was quite stable, there are reasons to speculate that the reporting of child abuse and maltreatment decreased since home isolation hampered the access to responsible services.
Conclusions
School closure together with the strong reduction of social care and monitoring during and after lockdown might have increased the domestic violence. Lastly, the child abuse may be underreported despite the effective increase.
Eating disorders (ED) and gender dysphoria (GD) are associated with a change in body perception. Therefore, body dissatisfaction plays a common and central role in these disorders. In GD, body image concerns are related to the features of the biological sex. In ED, body dissatisfaction comes from a distorted perception of weight and body shape and plays an important role in the development and maintenance of the psychopathology.
Objectives
To present and discuss the clinical case of a patient with a previous diagnosis of GD who presented with a clinical condition suggesting a restrictive anorexia nervosa (AN).
Methods
Patient´s clinical files consultation and literature review using Pubmed and the keywords: eating disorders and gender dysphoria.
Results
We present the case of a 25-year-old patient who was living in a shelter for victims of domestic violence and was admitted for severe restrictive AN. The patient was discharged after 40 days and medicated with sertraline, diazepam and olanzapine, as well as her previous medication (hormonal therapy): cyproterone, finasteride, estradiol, oxybutynin.
Conclusions
Although studies on this subject are still scarce, there has been some progress and the literature recognizes the coexistence of these conditions. However ED symptoms in patients with GD could have a different meaning: they may represent a dysfunctional coping strategy adopted to block features of the biological sex. Therefore health professionals may take a more holistic approach to body image. Additional studies will be necessary, allowing the establishment of cause-consequence interactions between weight loss and psychopathology related to GD.
Despite pharmacological advances in the treatment of schizophrenia, significant number of patients are still treatment-resistant. Clozapine is recommended as first-line treatment for treatment-resistant schizophrenia (TRS) in guidelines. Despite the greater efficacy of clozapine over other antipsychotics in the management of TRS, a significant number of patients fail to attain adequate response or develop adverse effects, and more interventions are needed.
Objectives
To describe a clinical case of treatment-resistant schizophrenia patient with prominent negative symptoms treated with combination of clozapine, cariprazine and fluoxetine, and to review the literature.
Methods
Clinical case presentation through review of the clinical file and non-systematic review on PubMed and ResearchGate.
Results
A 41 year old female patient presented to inpatient clinic with low mood, occasional commanding and commenting verbal hallucinations, occasional suicidal thoughts, blunted affect, anhedonia, asociality, she was apathetic, lacked motivation to get up from bed, had night’s sleep disturbance. Patient was diagnosed with Schizophrenia in 2009, she has been hospitalized in Psychiatric wards for 16 times. She has received treatment with combinations of several antipsychotic drugs and antidepressants, had side-effects and have not reached full remission. During treatment with clozapine (up to 175mg per day) in combination with cariprazine (up to 4.5mg per day) and fluoxetine (up to 20mg per day), gradually negative symptoms decreased, patient became more active, showed interest in daily and rehabilitation activities, night’s sleep improved.
Conclusions
Patient with treatment-resistant schizophrenia benefited from combination of clozapine, cariprazine and fluoxetine. Further research is necessary on treatment combination strategies for TRS.
Refugees are forced migrants but there is a large variation in the distance that refugees cover and there is a knowledge gap on how this may affect refugees’ health and health care needs.
Objectives
Herein, we investigate the association between long-distance migration and post-traumatic stress disorder (PTSD), a serious psychiatric disorder associated with deteriorating mental and somatic health and highly prevalent in refugees.
Methods
Included were 712 adult Syrian refugees and asylum seekers in Lebanon and Denmark arriving no more than 12 months prior to inclusion. The Harvard Trauma Questionnaire was used to assess PTSD and the estimate of association was obtained by multiply imputing missing data and adjusting for confounding by propensity score-weighting with covariates age, sex, socioeconomic status, trauma experience, and WHO-5-score, reporting the bootstrap 95-percentile confidence interval (95% CI). Additionally, a number of sensitivity analysis were carried out.
Results
The prevalence of PTSD was high in both Lebanon (55%) and Denmark (60%) and long-distance migration was associated with a 9 percentage point (95% CI [-1; 19]) increase in the prevalence of PTSD among newly arrived Syrian refugees and asylum-seekers.
Conclusions
In the present study the prevalence of PTSD increased after long-distance migration which may support considering “long-distance migration” in refugee health screenings and in particular when assessing the risk of post-traumatic stress disorder. This is a first step in examining the health effects of migration on refugee health.
In Ecuador, the first case of covid19 was reported on February 29th of 2020, forcing people to remain in lockdown, which increased gender violence; post-traumatic stress disorder (PTSD) and depression.
Objectives
Determine the cases during the lockdown caused by the covid-19 pandemic we found victims of some type of gender-based violence, depression, and PTSD.
Methods
An observational, cross-sectional descriptive study was carried out based on surveys conducted online, the study was conducted on January 29th of 2021, in the province of Guayas-Ecuador. Performed with “google forms” platform, data on affiliation, the situation of intimate partner violence and the Davidson trauma test (PTSD) and the Beck test (depression) were collected.
Results
A total of 411 samples were obtained, classified according to age, sex, number of children, education, occupation, intimate partner relationship, whether they had suffered gender violence and types of violence. 88 (21.41%) people reported having suffered some type of violence, of which 25 (28.42%) were men and 62 (70.45%) were women. The most common was psychological with 53 (60.23%) people. 82 respondents tested positive to Davidson test for PTSD, equivalent to 20% of the total sample. 51 people (12%) reported suffering from mild depression, 53 (13%) reported suffering from moderate depression and 38 people (9%) reported major depression with Beck test.
Conclusions
In this study we evidenced that although the interviewers claimed they had never suffered gender violence , it was observed that the results were incongruent, so it is important to highlight that talking about gender violence is still considered a stigma in our society.
Nonadherence to antipsychotic medications and disengagement from psychiatric services are frequent among people with psychosis. Research indicates how the beliefs of people with psychosis about the etiology of their symptoms, or their causal beliefs, affect treatment choice and outcomes. Yet, there is less research on causal beliefs of clinicians or on the impact of patient–clinician disagreements on treatment and adherence.
Objectives
This review aimed to explore the scope of the literature focusing on clinicians’ causal beliefs and to map the degree of patient–clinician concordance in causal beliefs.
Methods
A systematic literature search of PubMed, Embase, Scopus, PsycInfo, and ASSIA and a grey literature search of PsyArXiv and MedNar yielded 11,821 eligible references.
Results
Forty-two articles indicated that whereas clinicians endorse mainly biogenetic beliefs (9/15 articles, 60%), patients endorse mainly psychosocial causal beliefs (16/31, 52%) and other non-biogenetic causal beliefs (8/31, 26%). Most studies did not compare causal beliefs of people with psychosis and their treating clinicians.
Conclusions
While clinicians and people with psychosis often hold complex causal models, a gap in causal beliefs between these groups appears to exist, which may affect the therapeutic relationship and pose barriers to treatment adherence. Future studies should address this gap by developing interventions that facilitate open communication about causal beliefs to promote treatment alliance and an agreed-on treatment plan.
Klinefelter’s syndrome (KS) is considered as a genetic risk factor for intellectual disability and specifically for impairment on verbal skills. Prenatal and perinatal morbidity concurrent with this diagnosis determine the entity and typology of neurodevelopmental deficits.
Objectives
To describe the intellectual and adaptive functioning of a patient with KS and prenatal and perinatal difficulties, assessed in the Service of Psychiatry, Clinical Psychology and Mental Health at La Paz University Hospital (Madrid).
Methods
A descriptive study was conducted of a 6 year and 7-month-old boy with diagnosis of KS (karyotype XXY), extremely low weight at birth (752 gr.), Arnold Chiari type I malformation with post-hemorrhagic hydrocephalus and periventricular leukomalacia, bronchopulmonary dysplasia, intra-atrial septal defect, left kidney agenesis with iatrogenic adrenal insufficiency, and acute ventriculitis due to E. Coli. Neuropsychological evaluation was carried out in October 2021. Leiter-3 scale was selected due to the absence of expressive language; and his parents completed the questionnaire Adaptive Behavior Assessment System-II.
Results
The nonverbal intelligence quotient was observed in the very low range (full-scale IQ = 69). The result of general adaptive behavior (z = -2.83), showed very high functional disability both in the conceptual, social, and practical domains.
Conclusions
The high number of causes of disability in this patient is consistent with a high degree of functional disability. Efficient evaluation sessions of intellectual performance, adaptive functioning, and necessary supports, due to the absence of expressive language and limited receptive language, are required. A specific neuropsychological evaluation profile should be established for KS.