Issue 4 (2017)
This is the fourth 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: 2017-04-22
Biomarkers and schizophrenia: a qualitative review
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By: Joana Ribeiro da Silva and Sara Azevedo Pinto
Schizophrenia (SCZ) is a psychiatric disorder with a broad spectrum of biological and clinical manifestations of yet not completely clear pathophysiological mechanisms. Several lines of evidence have been supporting the idea that immunoinflammatory, oxidative, hormonal and cellular dysfunctions are implicated on the biomolecular basis of SCZ. However, accurate diagnosis and selection of appropriate treatments remains challenging as a result of the scarcity of objective tests. Furthermore, there is a compelling need to find biomarkers that could predict drug response and tailor pharmacological treatment, particularly in drug-naïve first episode psychosis (FEP). Hence, numerous technologies have been employed in order to search for SCZ biological markers, but evidence relating them to treatment efficacy is lacking. In this regard, some preliminary data suggest promising results. The current review provides information on: (1) potential biomarkers associated with biological disturbances and (2) biological markers associated with treatment response.
Keywords: Schizophrenia, Biomarkers, Treatment.
International Journal of Clinical Neurosciences and Mental Health 2017; 4:2
Information needs of family caregivers of dependent individuals
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By: Pedro Nuno Neves, Carlos Sequeira, Lleixà-Fortuño Mar, Lia Sousa, and Carme Ferre-Grau
The increase in the number of dependent individuals means that more and more families find themselves in the situation of caregivers, with all the consequences that performing this role entails. Based on this reality, we considered it to be completely relevant to systematize knowledge in this area. This study aimed to identify the information needs of the family caregiver-dependent individuals in the available scientific literature, having performed an integrative review of the literature. The main results and conclusions indicate that the information needs of family caregivers can be grouped into three main themes: 1) caregiver knowledge and skills, 2) potential resources for the caregiver and 3) caregiver coping strategies and well-being. The comprehensive nature of the integrative review as the chosen method allowed us to get a good understanding of the information needs of family caregivers of dependent individuals. The relevance of this study to clinical practice is that, although it is still necessary to expand and enhance the scope of research in this area, we consider this information essential for all health professionals seeking to provide effective support to family caregivers, as well as to serve as support for the development of intervention projects and health services.
Keywords: Information needs, Health literacy, Family caregivers, Dependent individuals.
International Journal of Clinical Neurosciences and Mental Health 2017; 4:5
Letter to the Editor
Psychiatry and HIV infection: what changed?
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By: Inês Souto Braz, André Bonito Ferreira, André Ribeirinho Marques, Sérgio Dinis, Isabel Nabais, Graça Gonçalves, and Sílvia Ouakinin
Background: The human immunodeficiency virus (HIV) infection is a chronic disease with significant comorbidity with mental disorders. Patients with mental health problems are at an increased risk of contracting HIV and infected patients are also at an increased risk of developing mental health problems, both cases contributing to a worse global prognosis. This cross-sectional study intends to characterize a sample of patients followed in a psychiatric department in order to understand the crucial role of Liaison Psychiatry in this area.
Methods: Retrospective review of clinical records of patients followed between June and December of 2016 and assessment of multiple clinical and sociodemographic variables.
Results: There were 117 psychiatric appointments for 69 HIV-infected patients. The average age was 51.6 (±9.86) years and the gender distribution was balanced. We found that 69.5% of HIV-infected patients presented affective or neurotic disorders (ICD-10), 73.9% were under antidepressant treatment and 72.1% under psychotherapy. Comparing HIV-infected patients with and without antidepressant therapy, we found that patients under antidepressant treatment had a longer duration of HIV infection (p=0.038). All patients presented stable immunological status.
Conclusions: The paradigm shift of HIV infection—the transition to a chronic disease model—required an adaptation by healthcare providers. As depression is the most prevalent psychiatric condition in this population, its early detection is crucial in order to improve disease outcome and quality of life.
Primary Progressive Freezing: does it stand on its own?
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By: Mafalda Seabra, Joana Guimarães, Carolina Garrett
Background: Freezing of gait is a gait disorder frequently attributed to Parkinsonism. When it occurs in isolation the term Primary Progressive Freezing can be applied. It is a rare finding and recently its validity was questioned.
Case report: An 85-year-old man, without known vascular risk factors, came to our attention after falling several times. He complained of difficulty initiating gait and turning. Neurological examination in the initial consult unveiled freezing, particularly when initiating gait, without other overt signs of Parkinsonism. Levodopa+carbidopa+entacapone had already been introduced by another physician, and later rasagiline was added, but the latter was suspended due to absence of response. Imaging studies showed ischemic lesions in the posterior aspect of the left corona radiata and diffuse supratentorial and infratentorial atrophic lesions.
Primary progressive freezing is a movement disorder that can be considered in the differential diagnosis of the Parkinson-Plus syndromes currently in need of better characterization. In this patient, after excluding other causes, it appears to be an adequate explanation for this unusual presentation.
Freezing, Gait disorder, Parkinson-plus syndromes.
International Journal of Clinical Neurosciences and Mental Health 2017; 4:7