Issue 3 (2016)
This is the third 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 operates under an Open Access model, and therefore everyone is invited to join this initiative.
| Issue date: 2016-02-12
Social Cognition, Negative Symptoms and Psychosocial Functioning in Schizophrenia
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By: Nuno Madeira, Salomé Caldeira, Miguel Bajouco, Ana Telma Pereira, Maria João Martins, and António Macedo
Although functional recovery could be advocated as an achievable treatment goal, many effective interventions for the treatment of psychotic symptoms, such as antipsychotic drugs, may not improve functioning. The last two decades of cognitive and clinical research on schizophrenia were a turning point for the firm acknowledgment of how relevant social cognitive deficits and negative symptoms could be in predicting psychosocial functioning. The relevance of social cognition dysfunction in schizophrenia patients’ daily living is now unabated. In fact, social cognition deficits could be the most significant predictor of functionality in patients with schizophrenia, non-redundantly with neurocognition. Emerging evidence suggests that negative symptoms appear to play an indirect role, mediating the relationship between neurocognition and social cognition with functional outcomes. Further explorations of this mediating role of negative symptoms have revealed that motivational deficits appear to be particularly important in explaining the relationship between both neurocognitive and social cognitive dysfunction and functional outcomes in schizophrenia. In this paper we will address the relative contribution of two key constructs—social cognitive deficits and negative symptoms, namely how intertwined they could be in daily life functioning of patients with schizophrenia.
Keywords: Schizophrenia, Social Cognition, Negative Symptoms, Functioning.
International Journal of Clinical Neurosciences and Mental Health 2016; 3:1
Perinatal depression screening, prevention and early intervention: recent advances in Portugal
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By: Ana Telma Pereira, Mariana Marques, Cristiana Marques, Elisabete Bento, Julieta Azevedo, Sandra Xavier, Maria João Soares, and António Macedo
Perinatal depression (PD) is a significant public health concern, needing a more efficient detection, prevention and treatment. Experts in the area recently recommended universal psychosocial assessment programs that combine the evaluation of PD symptoms and psychosocial risk factors. Within a new research project, our team has been exploring this avenue to try to reduce the high negative impact of PD. Our aims are: (1) to analyze the predictive ability of a new instrument (Perinatal Depression Screening and Prevention Tool/PDSPTool) to assess both PD symptoms and risk factors previously validated/identified by our team; (2) to test the efficacy of prevention and/or early intervention program —Mother in Me (MIM), focused on psychoeducational and psychotherapy sessions focusing on Cognitive-Behavioral Therapy (CBT) and on exercises from the third generation CBT. The new instrument (PDSPT), includes the short version of the Postpartum Depression Screening Scale (adapted and validated for pregnancy) and other valid self-report questionnaires to assess the PD risk factors in Portuguese women: lifetime history of depression, prenatal insomnia and prenatal negative affect. The PDSPTool and the Diagnostic interview for Psychological Distress have been administered to pregnant women (third trimester), recruited in the primary health care centers and maternity hospitals, where the vast majority of Portuguese women have their pregnancy and puerperium followed. The effectiveness of the program will be tested at 5 weeks, 3 and 6 months postpartum, based on the PDSS cutoff points and on the administration of the interview.
Keywords: Perinatal depression, Risk Factors, Screening, Prevention, Intervention.
International Journal of Clinical Neurosciences and Mental Health 2016; 3:2
The other face of the seizure
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By: Filipa Martins Alves, Mercedes Alvarez, and Anibal Fonte
Background: Epilepsy coexists with a variety of psychopathological phenomena and the association between psychotic episodes and several epileptic syndromes is long recognized. Epileptic psychotic states can be classified according to their temporal relationship with seizure occurrence into interictal and peri-ictal, and within these pre-ictal, ictal and postictal.
Case Report: We aim to present the case of a 52-year-old male with a temporal lobe epilepsy due to mesial temporal lobe sclerosis. As this is a refractory epilepsy, he was submitted to left hippocampectomy, being seizure free for about three years. Recently, given the stabilization of epilepsy, the antiepileptic drugs were reduced. Contrary to the expectations, the patient recurred to the emergency room presenting postictal psychosis, described by a lucid period followed by confusion, irritability and heteroaggressiveness, as well as sexual disinhibition and delusions. We received the patient in the hospital with no mention that he had had a seizure and that this could be the source of his psychosis.
Discussion: The reported case highlights the significance of the differentiation of the psychosis cases associated with epilepsy, which often remain underdiagnosed or wrongly diagnosed as psychosis not related to this organic pathology.
Keywords: Postictal psychosis, Seizures, Temporal Lobe Epilepsy, Violence.
International Journal of Clinical Neurosciences and Mental Health 2016; 3:3
Mindfulness-based intervention in cancer recovery: a pilot feasibility study in a Portuguese sample
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By: José Carlos Lopes, Sandra Vilarinho, Vera Afreixo, Luís Almeida, Francisco Luís Pimentel, and David Shannon
Objectives: The aim of the present study was to assess, through a pilot randomised controlled trial, the feasibility and efficacy of a mindfulness-based intervention in oncology (MBIO) with Portuguese cancer patients, considering that such kind of interventions can be conditioned by cultural factors and that most studies have been carried out in countries with a different ethos.
Methods: A Portuguese version of an eight-week MBIO was delivered to 26 ambulatory cancer patients, aged between 46 and 64 years, attending two hospital centres in Portugal. Patients’ health-related quality of life (QoL) and mindfulness processes were assessed before (T1), just after (T2), and 12 weeks following the programme (T3), with self-reported measures, using validated Portuguese versions of two scales: the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 and the Mindful Attention Awareness Scale.
Results: At T2, the attrition rate was null for the intervention group and 36% for the control group. Compared to controls and in reference to base-line (T1), participants in the intervention group had significantly (p ? 0.05) improved (a) QoL function score at T2, and (b) QoL global health status, total score and symptom score at T3. Mindfulness approached a significant (p = 0.12) positive change at T2.
Conclusion: Overall, findings indicate that MBIOs may be feasible and effective in a Portuguese sample, opening up perspectives for larger scale studies, with more representative samples of the Portuguese population.
Cancer; Oncology; Mindfulness; Mindfulness-Based Intervention; Quality of Life.
International Journal of Clinical Neurosciences and Mental Health 2016; 3:4
Neuroimaging in Amyotrophic Lateral Sclerosis: Magnetic resonance techniques
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By: Débora Gonçalves, Andreia Costa, and Pedro Abreu
Objectives: Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative motor neuron disease whose clinical presentation and evolution varies greatly among patients. The limited role of conventional Magnetic Resonance Imaging in ALS encourages the study of new advanced Magnetic Resonance Imaging (MRI) techniques. Our aim was to review the advances of MRI techniques applied to ALS and to analyze their contribution to the knowledge and monitoring of this disease.
Methods: We performed a Pubmed® database search with the following MeSH terms: “Amyotrophic Lateral Sclerosis”, “Neuroimaging”, “Magnetic Resonance Imaging”. Articles from the last decade were preferentially included but previous important publications were added.
Results: Sixty-eight articles were considered in our revision article. Imaging methods were categorized as structural, functional and metabolic and their usefulness in detecting ALS related damage in brain and spinal cord was evaluated.
Advanced MRI techniques consistently prove that ALS is a multisystem disease, involving both motor and extra-motor neuronal areas. Primary motor cortex, corticospinal tract and corpus callosum are major regions involved, but several temporal, frontal and subcortical areas are also affected in ALS, as well as some neuronal networks related to sensoriomotor activity and cognition. Advanced neuroimaging techniques are providing a unique opportunity to study ALS and its underlying pathophysiology and disease course, which may enable the discovery of novel ALS drug targets.
Amyotrophic Lateral Sclerosis, Neuroimaging, Magnetic Resonance Imaging.
International Journal of Clinical Neurosciences and Mental Health 2016; 3:5
Life training for aging and migration
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By: Marta Gonçalves and Benjamin Cook
Immigrants tend to have better mental health than their host country-born counterparts, despite disadvantaged socioeconomic status—the so-called immigrant paradox. The acculturation hypothesis suggests a decline in their mental health over time in the host country. Increased perceived discrimination and family cultural conflict are pathways by which acculturation might relate to deterioration of mental health for immigrants. In this paper we will present an intervention approach, which proposes that a strategy for ensuring maintenance of mental health for immigrants is changing lifestyle. This approach called “Life Training: My 7 Core Areas of Health” is based on the theoretical model of Ralf Schwarzer—The Health Action Process Approach and works on psychological processes that are under behavioral change in seven areas of health: physical, psychological, social, spiritual, financial, family and leisure. This is a discussion paper in which two claims are made. First, that some migrants’ health can worsen as they age which is associated with their migrant status. Second, that there may be, as yet untested in this respect, models of health behavioral change, which can mitigate these risks.
Keywords: Immigrants, Mental health, Aging, Life training, Health behavior change, Health action process approach.
International Journal of Clinical Neurosciences and Mental Health 2016; 3:7