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Issue 2 (2015)


This is the second issue of the International Journal of Clinical Neurosciences and Mental Health. The journal aims to provide high-quality publications in the areas of Psychiatry and Mental Health, Neurology, Neurosurgery, and Medical Psychology. This publication is intended to provide a forum for experts from all around the world to share their knowledge, expertise, and research efforts. The journal will operate under an Open Access model, and therefore everyone is invited to join this initiative.

Issue Nr:

2

|    Issue date: 2015-02-10

Editorial


Completing the first year of publication - read full article

By: Rui Coelho, Rui Mota-Cardoso, Carolina Garrett, and Rui Vaz

The International Journal of Clinical Neurosciences and Mental Health is now completing its first year of publication. This year brought interesting developments to this open access publishing initiative. We noted interest in the journal from an array of different fields associated with clinical neurosciences and mental health. Experts from different regions of the globe also associated themselves with journal by submitting or peer-reviewing manuscripts. And, therefore, with its extended reach journal constituted an important forum for knowledge transfer and debate in the areas of clinical neurosciences and mental health.

International Journal of Clinical Neurosciences and Mental Health 2015; 2:1


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Original Article


Welcome (one) more child: perspectives from mothers of large and non-large families - read full article

By: Marta Gonçalves and Rosário Boavida

Background: In many countries around the world we are currently witnessing a large decrease in the fertility rate. This phenomenon brings several social sustaining problems. Large families (families with three or more children) seem therefore essential on contradicting this tendency. The aim of this study is to explore attitudes towards conception in large (LFM) and non-large families mothers (NLFM).

Methods: We used a quantitative approach (N=210 LFM; 170 NLFM) and we analyzed how the family type relates to variables such as satisfaction with life, religiosity, attitudes towards contraception, and attitudes towards abortion. These variables were accessed in each participant through an online survey.

Results: We found evidence supporting the hypothesis that LFM have higher levels of satisfaction with life and religiosity; they have more negative attitudes towards contraception and abortion. We have also tested the hypotheses of the relationship between family type and attitudes towards contraception and abortion being moderated by the strength of different types of religiosity, finding some supportive data, at least for the attitudes towards contraception.

Conclusion: Although we conclude that additional research on large families and reproductive behavior is needed, this study emphasizes some of the factors that differentiate the specific population that contributes to an increase the fertility rate.

Keywords: Large families, Satisfaction with life, Religiosity, Conception.

International Journal of Clinical Neurosciences and Mental Health 2015; 2:2


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Original Article


Vulnerability to stress and psychopathology among third year medical students - read full article

By: João Gama Marques, Daniel Machado, Sílvia Ouakinin, and Maria Luísa Figueira

Background: Some studies describe high prevalence of psychological disturbances among 3rd year medical students. The specific nature of factors like perceived stress, medical identity formation, and psychodynamic features are usually pointed as responsible for triggering factors of emotional disturbances but there is resistance among medical student to search for help. The objective of the study was to assess stress vulnerability and psychopathology risk among 3rd year medical students in Portugal.

Methods: The authors conducted a cross-sectional, survey of medical students at the biggest Portuguese medical school, through an anonymous self-report questionnaire, including sociodemographic data, psychiatric history illness, plus stress vulnerability, with 23 Questions on Vulnerability to Stress (23QVS), and psychopathology, with Symptom Checklist 90 Revised (SCL-90-R).

Results: A 56% response rate was obtained among 228 students (70.1% women), with mean age of 20.82+1.27 years (mean ± standard deviation). Main stress factor was academic issues (50%), with female being more vulnerable than male. Stress vulnerability’s mean value was 33.88 ± 9.28 (cut-off point 23QVS > 43) and SCL90R’s Global Severity Index mean value was 0.389 (cut-off point SCL-90-R > 1.5). In a subsample of 24 students, with levels of stress vulnerability above cut-off point (23QVS > 43), a positive correlation was found with interpersonal sensitivity (r=0.517; p=0.1), depression (r=0.497; p=0.13), phobic anxiety (r=0.443; p=0.03), psychoticism (r=0.427; p=0.038) and SCL-90-R’s Global Severity Index (r=0.47; 0.02).

Conclusion: Low mean values for stress vulnerability and psychopathology were found, and among vulnerable subjects, there was a strong correlation between both dimensions.

Keywords: Stress, Psychopathology, Medicine, Students.

International Journal of Clinical Neurosciences and Mental Health 2015; 2:3


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Review Article


Pharmacological treatment of neuropathic pain: review of oral and topical therapy recommendations - read full article

By: Daniela Amorim

Background: Neuropathic pain is defined as pain initiated or caused by injury or disease of the somatosensory system. It is a chronic pain with an extremely high impact on patients quality of life, which is progressively incapacitating. This paper reviews the evidence-based guidelines on the management of neuropathic pain, aiming at establishing specific and targeted recommendations based on oral and topical drugs available in Portugal.

Methods: We reviewed the literature on the treatment of neuropathic pain from Medline and Cochrane databases. Guidelines proposed by several global organizations and implemented clinically in patients with different neuropathic pain conditions were analyzed and compared. The present recommendations focus on oral and topical drugs available in Portugal.

Recommendations: Recommendations for the treatment of neuropathic pain are based on three therapeutic lines. For best use of therapeutic resources, the evaluation of neuropathic condition is essential, allowing a detailed breakdown of drugs. In general, first-line therapy comprises tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, calcium channels alpha 2 delta ligands and topical lidocaine. Second-line therapy includes strong opioids and tramadol. Third-line therapy includes other antidepressants and anticonvulsants, N-methyl-D-aspartate (NMDA) receptor antagonists, topical capsaicin and gamma-aminobutyric acid (GABA) B receptor agonists. Combination therapy is also recommended.

Conclusion: Confirmatory diagnosis of neurological injury is essential to proper orientation of therapeutic strategies. An assessment of comorbidities and complete characterization of the neuropathic condition is recommended to establish specific profiles and provide individualized treatment.

Keywords: Neuropathic pain, Pharmacological management, Neuropathic pain syndromes.

International Journal of Clinical Neurosciences and Mental Health 2015; 2:4


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Review Article


Repetitive behaviors in Tourette Syndrome and Obsessive-Compulsive Disorder - read full article

By: Maria Miguel Brenha, Carla Rio, Filipa Sá-Carneiro, and João Massano

Tourette Syndrome (TS) is a neuropsychiatric disorder caracterized by tics that are frequently associated with obsessive-compulsive symptoms (OCS), estimated to be present in 28-63% of patients, though not always sufficient for the diagnosis of an Obsessive-Compulsive Disorder (OCD). Epidemiological, phenomenological and family-genetic studies support an interrelationship between tic disorders and OCD. The repetitive behaviors present in either TS and OCD —tics and compulsions—have been associated with dysfunctional cortico-striato-thalamo-cortical circuits, which is consistent with the hypothesis that OCS and tics might be part of the same spectrum. According to that, OCD with tics assumes an intermediate position between OCD without tics and TS, sharing clinical features with both entities. On the other hand, many studies have reported that tic-related OCD presents specific clinical, neurobiological, genetic and treatment response patterns and TS can be differentiated from OCD subgroups according to obsessive-compulsive symptomatology, presence of sensory phenomena and treatment response. Thus, the phenomenological distinction of repetitive behaviors in patients with TS is important to consider, since the treatment of tics and OCS differs.

Keywords: Tourette Syndrome, Obsessive-Compulsive Disorder, Repetitive Behaviors, Tic, Compulsion, Treatment.

International Journal of Clinical Neurosciences and Mental Health 2015; 2:5


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Letter to the Editor


Preliminary results of an Acceptance and Commitment Therapy (ACT) brief group intervention for psychosis - read full article

By: Paula Castilho, Ana Margarida Pinto, Ricardo Viegas, Sérgio Carvalho, Nuno Madeira, and Maria João Martins

Acceptance and Commitment Therapy (ACT) is a contextual-behavioral therapy with promising results in various psychological disorders, including psychosis. This study aims to compare the potential benefits of a 4-session ACT group intervention with the interventions commonly offered in Portugal. ACT participants improved in a wider range of measures and 2 of the 3 patients improved significantly in both symptoms, cognitive processes and positive indicators of adjustment (without any deterioration). Future studies should explore the relationship between participants’ clinical profile and benefits from ACT interventions.

Keywords: Psychosis, Acceptance and Commitment Therapy, Brief group intervention, Reliable change index.

International Journal of Clinical Neurosciences and Mental Health 2015; 2:6


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Original Article


The “Clinical Interview for Psychotic Disorders” (CIPD): Development and expert evaluation - read full article

By: Maria João Martins, Célia Carvalho, Paula Castilho, Ana Telma Pereira, and António Macedo

Background: New treatment approaches for psychosis indicate that effective interventions require a therapeutic focus on emotional regulation, cognitive appraisals, and functioning. Efficacy of psychotherapeutic interventions’ evaluation has changed from exclusively assessing symptom frequency/severity to a comprehensive and functional assessment of interference, functioning, and the relationship people have with symptoms. This shift led to new needs in clinical assessment. This study aimed to develop and submit to expert evaluation a new clinical interview for psychotic disorders which considers the new needs of the field.

Methods: CIPD was developed by a multidisciplinary team considering the DSM-5 criteria for psychotic and affective disorders. Relevant information was retrieved from leading research in the area of assessment and evaluation of interventions in psychosis. An expert panel of recognized professionals in the main areas of mental health evaluated each question of the interview (5-point Likert scale) regarding pertinence and clarity.

Results: A detailed description of CIPD is presented. Results from the experts’ evaluation showed that, overall, the CIPD questions were evaluated as pertinent and clear for the target population.

Conclusion: CIPD assesses both diagnosis or presence of psychotic symptoms and symptoms’ psychosocial correlates. Psychotherapy and pharmacotherapy may benefit from CIPD since it may detect subtle changes caused by intervention and changes in areas other than symptom reduction.

Keywords: Assessment, CIPD, Clinical Interview, Psychosis.

International Journal of Clinical Neurosciences and Mental Health 2015; 2:7


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