Psiquiatria Biologica最新文献

{"title":"The hidden footprint of the pandemic: A three-year analysis of the impact of COVID-19 confinements on substance addiction","authors":"Lucía Ibarra-Pertusa ,&nbsp;Vicent Llorca-Bofí ,&nbsp;Eugènia Nicolau-Subires ,&nbsp;Carla Albert-Porcar ,&nbsp;Marina Adrados-Pérez ,&nbsp;Laura Arenas-Pijoan ,&nbsp;Núria Domènech-Martínez ,&nbsp;María Mur-Laín ,&nbsp;Jorge López-Castroman ,&nbsp;María Irigoyen-Otiñano","doi":"10.1016/j.psiq.2025.100732","DOIUrl":"10.1016/j.psiq.2025.100732","url":null,"abstract":"<div><h3>Introduction</h3><div>It has been studied how the COVID-19 pandemic led to higher rates of substance abuse and relapse. However, few longitudinal studies have been conducted to examine the clinical course of incident patients with substance use disorders (SUDs) in the context of the pandemic.</div></div><div><h3>Aim</h3><div>To assess the subsequent evolution of incident cases of SUD diagnosed during the confinements in the psychiatric emergency department.</div></div><div><h3>Methods</h3><div>Retrospective clinical information was obtained on all patients diagnosed with SUD in the psychiatric emergency department during the two confinements in Spain (<em>N</em> = 156). Sociodemographic characteristics and clinical variables related to consumption were extracted from electronic health records in the period 2020–2023. Clinical severity was established with the number of hospital admissions, emergency department visits and suicidal behaviors.</div></div><div><h3>Results</h3><div>Incidence was higher in men without previous psychiatric comorbidity. Patients in methadone maintenance therapy showed greater adherence to follow-up, although the group that achieved the longest abstinence were male cocaine users. In terms of dose, the prescription of antidepressants and antipsychotics increased, especially long-acting formulations. Greater clinical severity was observed in cocaine and polydrug users, as these were the groups with the highest number of suicide attempts. Finally, only half of the patients were followed up to the end of the 18-month observation period.</div></div><div><h3>Conclusion</h3><div>Delay in the first outpatient psychiatric follow-up visit, return to the emergency department and increased prescription of psychotropic medication were associated with greater clinical severity. Cocaine and polydrug use are an additional risk factor for suicidal behavior in this population.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 3","pages":"Article 100732"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroid-induced neuropsychiatric effects: A rare case of persistent bipolar disorder","authors":"Catarina Pinto Desport ,&nbsp;Liliana Correia de Castro ,&nbsp;Mónica Figueiredo Santos","doi":"10.1016/j.psiq.2025.100731","DOIUrl":"10.1016/j.psiq.2025.100731","url":null,"abstract":"<div><div>Corticosteroids are commonly prescribed for various medical conditions, but their neuropsychiatric side effects are significant and often overlooked. These side effects can occur at any point during treatment and can range from mild to severe, and the prognosis is often excellent. We present the case of a 49-year-old woman who received a single course of corticosteroids for the treatment of plantar fasciitis. Shortly after, she became manic with psychotic symptoms and, soon after, experienced a severe depressive episode that required hospitalization. Despite discontinuation of the corticosteroids, she went on to have another manic episode. This case appears to represent a rare instance of persistent bipolar disorder following a manic episode triggered by exogenous steroid administration. There is no consensus on the risk factors for these severe complications or on guidelines for management. We aim to present this rare clinical case while reviewing the available literature on the topic.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 3","pages":"Article 100731"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factores protectores e intervenciones preventivas frente al suicidio en las minorías sexuales y de género. Una revisión sistemática","authors":"José María Madruga Rubio ,&nbsp;Antonio Hipólito Guzmán del Castillo","doi":"10.1016/j.psiq.2025.100730","DOIUrl":"10.1016/j.psiq.2025.100730","url":null,"abstract":"<div><div>This study is a systematic review aimed at identifying protective factors and preventive interventions against suicidal behaviors within the sexual and gender minorities. A total of 30 articles were included, sourced from PubMed, Embase, Cochrane, and IBECS databases. Of these, 11 focused on protective factors and 19 on preventive interventions. Critical analysis of the articles revealed that the most researched protective factors are self-acceptance and an inclusive school environment, while the primary interventions focused on mitigating minority stress through various therapies. Additionally, other interventions with different objectives were identified. The transdiagnostic approach is being applied in multiple therapies and is of particular interest, as certain mental health stressors appear to be common across the entire LGTBIQ+.<!--> <!-->community. A key limitation is that several of the studies are ongoing, preventing the extraction of conclusive results. We conclude that some challenges remain, such as the limited exploration of self-harming behaviors among bisexual individuals and the lack of studies outside school settings. A positive school environment emerges as a significant protective factor, while preventive interventions, though promising, require further investigation and exploration of options such as family therapy and mindful self-compassion. In the future, it is crucial to improve interventions during critical moments of suicidal behavior and assess their effectiveness in conjunction with other strategies.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 3","pages":"Article 100730"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Síntomas psicóticos en cáncer de pulmón. A propósito de un caso","authors":"Elena Ramos García ,&nbsp;Francisco Guillermo Puig Sánchez ,&nbsp;María Palomo Monge","doi":"10.1016/j.psiq.2025.100727","DOIUrl":"10.1016/j.psiq.2025.100727","url":null,"abstract":"<div><div>Psychotic symptoms can occur within a variety of disorders, including some of organic etiology. The differential diagnosis of these conditions is often complex, although its relevance is of utmost importance for the orientation and design of the therapeutic plan.</div><div>The case of a 70-year-old patient referred to the Psychiatric Emergency Department for psychotic symptoms in the context of a brain metastasis from lung cancer is presented below.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 3","pages":"Article 100727"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Síntomas psicóticos tras mordedura de una víbora de Seoane. A propósito de un caso","authors":"María del Pilar Paz-Otero,&nbsp;Carmen Elena Regueiro Martín-Albo,&nbsp;María Rosario Pérez Moreno,&nbsp;Idir Mesián Pérez","doi":"10.1016/j.psiq.2025.100729","DOIUrl":"10.1016/j.psiq.2025.100729","url":null,"abstract":"<div><div>Snake bites in Spain are rare phenomena that constitute a potentially serious medical emergency. Among the main venomous snakes in our country is the Seoane's viper, whose venom has a hemotoxic and neurotoxic profile, although its specific effects on the central nervous system have not yet been studied in depth. Moreover, the diagnosis and treatment of this type of cases involves an added difficulty due to the scarce literature available, and to date, there is no clinical case described of psychotic symptomatology after the bite of this type of viper.</div><div>We present the case of a 16-year-old patient, with no psychiatric history of interest, who two weeks after being bitten by a Seoane's viper suddenly developed florid and fluctuating psychotic symptoms, with the presence of hallucinations, delusional ideas, disorganized thinking, mood oscillations and motor symptoms. The snake bite and the torpid evolution, marked by an atypical clinical presentation and a limited response to treatment, pose important difficulties both in the differential diagnosis and in the therapeutic management.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 3","pages":"Article 100729"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abordaje de los síntomas psicológicos y comportamentales en demencia: serie de casos","authors":"Angela Izquierdo de la Puente ,&nbsp;Pablo del Sol Calderón ,&nbsp;Roberto Fernández Fernández ,&nbsp;María Garcia Moreno ,&nbsp;Miguel Vizcaíno Da Silva ,&nbsp;Ana Pérez Balaguer","doi":"10.1016/j.psiq.2025.100726","DOIUrl":"10.1016/j.psiq.2025.100726","url":null,"abstract":"<div><div>A brief review is made of the pharmacological approach to psychological and behavioural symptoms (SPCD) in dementia with the presentation of a series of cases in outpatient follow-up.</div><div>There are 6 cases, with a mean age of 87.3, five women and one man, with a diagnosis of dementia (multifactorial and Alzheimer's disease) who present to mental health for moderate apathy, ‘depressed mood’, restlessness and in four of them also poorly structured delusional ideation of harm. None of them had a history of psychotic disorder and only one of the patients had presented in her youth with an adaptive disorder that required antidepressant treatment.</div><div>The six cases had received treatment with antidepressants (SSRIs, either escitalopram or sertraline at low doses) as well as treatment with risperidone at a dose of 2.3mg as maintenance treatment of mood disorder symptoms, from Primary Care and Geriatrics in three of them. Those receiving antidepressant monotherapy maintained moderate apathy, as well as episodes of psychomotor restlessness. On the other hand, those receiving combined treatment with SSRIs and risperidone not only did not improve their affective symptoms, but also had extrapyramidal symptoms that affected them on a daily basis.</div><div>On examination, none of them showed first-rank depressive symptoms, but rather a flattening of the affective state in relation to moderate-severe cognitive impairment. In order to optimise treatment and to avoid inappropriate use of antipsychotics in these patients who are more susceptible to adverse effects, it was decided to start treatment with duloxetine, with a very progressive increase in dose and in two doses, until reaching doses of 90-120 mg as maintenance treatment of mood disorder symptoms.</div><div>After a month and a half of this treatment, the patients had significantly improved their apathy and restlessness, as well as reducing delusional ideation by improving their level of anxiety.</div><div>It is important to re-evaluate and adjust pharmacological treatment in elderly patients with dementia and SPCD. Duloxetine, a serotonin and noradrenaline reuptake inhibitor (SNRI), was shown to be effective in managing symptoms, especially apathy and restlessness, without the adverse effects associated with antipsychotics.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 3","pages":"Article 100726"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eficacia comparativa del aripiprazol de liberación prolongada: estudio de administración mensual versus bimestral en pacientes con trastorno mental grave","authors":"Angela Izquierdo de la Puente ,&nbsp;Pablo del Sol Calderón ,&nbsp;Roberto Fernández Fernández ,&nbsp;María García Moreno ,&nbsp;Miguel Vizcaíno Da Silva","doi":"10.1016/j.psiq.2025.100725","DOIUrl":"10.1016/j.psiq.2025.100725","url":null,"abstract":"<div><div>A comparison of the efficacy of monthly and bimonthly aripiprazole extended-release aripiprazole in patients with severe mental disorder on outpatient follow-up was conducted. Extended-release aripiprazole is an antipsychotic used in the maintenance treatment of schizophrenia in stabilised adults. The extended-release injectable (ERI) formulation has been shown to increase adherence and reduce relapse rates compared to oral antipsychotics. In the case described, patients with a mean age of 45 years and diagnoses of paranoid schizophrenia, bipolar disorder and delusional disorder were psychopathologically stable for more than a year on monthly aripiprazole treatment (400 mg or 300 mg). Three months ago, treatment was changed to bimonthly administration of 960 mg.</div><div>Comparing the efficacy: in psychopathological stability, patients have remained stable, without relapse or symptomatology, during the three months following the switch to bimonthly administration. This suggests that the efficacy of the bimonthly formulation is comparable to the monthly formulation in terms of maintaining clinical stability. Regarding the treatment adherence, the bimonthly formulation (Abilify Maintena 960 mg every two months) allows for better adherence to treatment. This is because it reduces the frequency of administration, which may be beneficial for patients on outpatient follow-up. In drug levels, the bimonthly formulation avoids sharp peaks and troughs in drug levels, which may result in better symptom control and a reduction in the frequency of relapses. With regard to patient follow-up, although bimonthly administration reduces the frequency of visits to receive treatment, it still allows healthcare professionals to maintain regular contact with patients, improving follow-up and assessment of their progress. In patient preference, the TSQM (Treatment Satisfaction Questionnaire for Medication) questionnaire mentioned in the study will allow assessment of patient satisfaction with treatment, which is crucial for comparing perceived efficacy between monthly and bimonthly formulations.</div><div>It is important to note that although initial results appear promising, the three-month observation period is relatively short. Long-term follow-up is recommended to confirm the sustained efficacy of the bimonthly formulation compared to the monthly formulation. In conclusion, based on the sustained stability of patients and the potential advantages in terms of adherence and medication levels, the bimonthly extended-release formulation of aripiprazole appears to be as effective as the monthly formulation in the maintenance treatment of patients with severe mental disorder on outpatient follow-up. However, long-term studies with larger samples are needed to confirm these preliminary findings.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 3","pages":"Article 100725"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abordaje clínico y terapéutico del trastorno bipolar en España: una encuesta nacional","authors":"Pilar Sierra","doi":"10.1016/j.psiq.2025.100728","DOIUrl":"10.1016/j.psiq.2025.100728","url":null,"abstract":"<div><h3>Introduction</h3><div>Bipolar disorder is characterized by heterogeneous clinical manifestations, which complicate its diagnosis and treatment. Despite the availability of evidence-based guidelines, their application is limited. This study analyzes the clinical and therapeutic approaches adopted by professionals involved in its management in Spain.</div></div><div><h3>Methods</h3><div>A 50-item, anonymous and voluntary self-administered survey of 83 psychiatrists was carried out. Diagnostic, clinical and therapeutic aspects were addressed.</div></div><div><h3>Results</h3><div>90% of the psychiatrists stated that they followed clinical guidelines, but gave priority to their personal experience when choosing the treatment. Forty-six percent never used psychometric scales. Mixed episodes were considered the most difficult to treat and depressive episodes were considered to have the greatest functional impact. Lithium was the most commonly used stabilizer in type I bipolar disorder, and antipsychotics in type II. Forty-two percent avoided prescribing lithium in patients over 65 years of age. Valproate was prescribed to women of childbearing age by 30%. Quetiapine was the most commonly used antipsychotic in maintenance and bipolar depression. Confidence in therapeutic adherence was low. Electroconvulsive therapy was considered an effective alternative by 48% and transcranial magnetic stimulation by 11%. Almost half did not perceive a significant impact of suicide prevention and stigma reduction campaigns.</div></div><div><h3>Conclusions</h3><div>The study highlights consensus and discrepancies in the approach to bipolar disorder, evidencing variability in prescription patterns. It highlights the relevance of continuous training and the need to promote greater adherence to clinical guidelines.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 3","pages":"Article 100728"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schizophrenia in 22q11.2 deletion syndrome: A case report","authors":"Sergio Cardona Bejarano MD ,&nbsp;Lorena García-Fernández PhD MD","doi":"10.1016/j.psiq.2025.100714","DOIUrl":"10.1016/j.psiq.2025.100714","url":null,"abstract":"<div><div>22q11.2 deletion syndrome (22q11.2DS), also known as velocardiofacial syndrome (VCFS) or DiGeorge syndrome, is a common autosomal dominant disorder caused by a microdeletion on chromosome 22, leading to a spectrum of congenital defects and neuropsychiatric manifestations, including a significantly increased risk of schizophrenia. This case report details a 23-year-old male with confirmed 22q11.2DS who presented with acute psychosis, following a history of developmental delays, attention deficit hyperactivity disorder, obsessive-compulsive disorder, and cognitive impairments. The neuropsychiatric symptoms are attributed to genetic disruptions in dopamine and glutamate pathways, notably involving the COMT and PRODH genes, which contribute to dopaminergic dysregulation and NMDA receptor dysfunction. Neuroimaging supports these findings, with structural anomalies in the prefrontal cortex and thalamus. The case exemplifies the complex interaction of genetic predisposition and environmental stressors in the onset of schizophrenia in 22q11.2DS. Early intervention targeting both genetic factors and environmental stressors is critical in managing the neuropsychiatric burden in this population, emphasizing the need for comprehensive, multidisciplinary care.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 2","pages":"Article 100714"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conversion disorder in adolescence: Detailed report of a clinical case","authors":"Mateo Andrade ,&nbsp;Dennis Olmedo","doi":"10.1016/j.psiq.2025.100713","DOIUrl":"10.1016/j.psiq.2025.100713","url":null,"abstract":"<div><h3>Introduction</h3><div>Conversion disorder, or functional neurological disorder, is a complex condition characterized by neurological symptoms without an underlying organic medical cause. This paper presents a clinical case analysis of a 15-year-old female adolescent diagnosed with conversion disorder.</div></div><div><h3>Objective</h3><div>To detail the psychobiological, social, and environmental factors that contribute to the appearance of symptoms, as well as to describe the diagnostic and therapeutic strategies applied.</div></div><div><h3>Method</h3><div>This is an observational study focused on the case report of a female teenager hospitalized in Quito, Ecuador. The inclusion criteria were a confirmed diagnosis of conversion disorder and informed consent and assent from the patient and her parents. Data were collected through medical history recording. No statistical analysis was required due to the descriptive nature of the study.</div></div><div><h3>Results</h3><div>The patient was evaluated for hyporexia, insomnia, anhedonia, suicidal ideation, and significant psychomotor regression. During her hospitalization, she exhibited sporadic and violent movements of her upper extremities, along with episodes of disconnection from her surroundings. The examinations performed, including electroencephalogram, computed tomography, and brain MRI, did not reveal structural abnormalities or epileptiform activity. The diagnosis of conversion disorder was confirmed according to DSM-5 criteria, ruling out other neurological and psychiatric conditions. Treatment included pharmacological therapy along with behavioral and family therapy. The inclusion of the mother in therapy sessions contributed to significant improvement, reflected in the decrease in suicidal risk and the reduction of behavioral alterations.</div></div><div><h3>Discussion and conclusion</h3><div>This case highlights the importance of thorough evaluation and comprehensive management in the treatment of conversion disorder in adolescents, the value of multidisciplinary intervention, and the crucial role of family involvement in recovery.</div></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":"32 2","pages":"Article 100713"},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}