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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 Nr:


|    Issue date: 2017-04-22


Adaptive leadership in the promotion of youth mental health - read full article

By: Marta Gonçalves

The aim of this paper is to discuss if adaptive leadership in the promotion of youth mental health can be one driver of cultural change not only among mental health workers and patients, but also in the society as a whole, including different sectors such as health, social service, justice, and education. I present a qualitative approach both to categorise leadership practice in Europe in traditional and adaptive styles and to understand if adaptive leadership is more effective than traditional leadership in the promotion of child and youth mental health. The attempt to increase social inclusion of people with mental health problems has posed a posed significant challenges in Europe, particularly in giving priority to services for children, adolescents, and older people. Stigma appears to continue to be a significant barrier to the effective promotion of mental health. In many European countries, there is lack of political will to implement evidence-based, sustainable policies and programs concerning mental health issues. The potential practical implications for the adaptive leadership approach are significant, considering the increasing mental health issues in Europe and worldwide.

Keywords: Mental health promotion, Stigma, Youth, Adaptive leadership.

International Journal of Clinical Neurosciences and Mental Health 2017; 4:1
DOI: http://dx.doi.org/10.21035/ijcnmh.2017.4.1

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Review Article

Biomarkers and schizophrenia: a qualitative review - read full article

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
DOI: https://doi.org/10.21035/ijcnmh.2017.4.2

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The need for a dis-ease model for medicine: illness, sickness, disease, disorder and predicament - read full article

By: Simon R. Wilkinson

This paper presents an alternative to the standard medical model with its focus on disease. Medicine has moved to a high technology informed practice to the detriment of a more personalised and family anchored humane practice. This is a major complaint of patients and their carers. Through presenting a developmental perspective to the manner in which we learn to present and manage our discomforts, our primordial dis-ease takes centre-stage. This necessitates an understanding of the interrelationship of illness experience, sickness attributions, medical practice with the predicaments with which are challenged daily.

Keywords: Disease, Disorder, Diagnoses, Medical model, Illness, Sickness, Predicament.

International Journal of Clinical Neurosciences and Mental Health 2017; 4:3
DOI: https://doi.org/10.21035/ijcnmh.2017.4.3

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Integrating neuroscience in clinical psychiatry: a paradigm shift - read full article

By: Dev Roychowdhury

The field of psychiatry is witnessing debates over the diagnostic nosology that is used to understand and treat psychopathological conditions. Recent findings from the field have highlighted the lack of objective specificity that is required to comprehensively understand, delineate, and treat psychopathological manifestations. Studies in human neuroscience, on the other hand, have expanded our understanding of the brain and how it regulates human cognition, emotion, and behaviour. Considering these advances, it is evident that there is an insistent need for the reappraisal of current diagnostic standards and criteria, and the inclusion of a dynamic and translational clinical neuroscientific approach to study psychopathology. The present viewpoint comments on the challenges facing psychiatric diagnostic nosology and calls for the integration of neuroscientific approaches in clinical psychiatry.

Keywords: Neuroscience, Psychiatry, Diagnosis, Nosology, Translational research.

International Journal of Clinical Neurosciences and Mental Health 2017; 4:4
DOI: https://doi.org/10.21035/ijcnmh.2017.4.4

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Review Article

Information needs of family caregivers of dependent individuals - read full article

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
DOI: https://doi.org/10.21035/ijcnmh.2017.4.5

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Letter to the Editor

Psychiatry and HIV infection: what changed? - read full article

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. 

Keywords: Psychiatry, HIV, Liaison Psychiatry, Depression.

International Journal of Clinical Neurosciences and Mental Health 2017; 4:6
DOI: https://doi.org/10.21035/ijcnmh.2017.4.6

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Case Report

Primary Progressive Freezing: does it stand on its own? - read full article

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. 
Conclusion: 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.

Keywords: Freezing, Gait disorder, Parkinson-plus syndromes.

International Journal of Clinical Neurosciences and Mental Health 2017; 4:7
DOI: https://doi.org/10.21035/ijcnmh.2017.4.7

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