Foreign body in the scalp: A thorn in the flesh – case report

Open scalp wounds are often associated with retained foreign bodies and are poorly reported. Despite meticulous radiological evaluations, foreign bodies can still be missed. Complication such as chronic headache, scalp abscess, chronic osteomyelitis, organic personality disorder had been reported. Coupled with the potential for medicolegal concerns, retained foreign bodied in the scalp thus require critical evaluation and management. Herein we reported a case of a retained stalk of grass (foreign body) in the scalp that is complicated with scalp abscess and chronic headache and call for a high index of suspicious in the management of foreign bodies in the scalp.

Clinical Case of Organic Pseudopsychopathic Disorder in a Teenager in Terms of Differential Diagnostics with Childhood Schizophrenia

Background: Organic personality disorder is one of the most pressing problems of modern practical psychiatry, due to the multifactorial etiology of this pathology, the variety of clinical symptoms, and the complexity of differential diagnosis. Results: The clinical analysis of a difficult to diagnose case, of a 13-year-old girl who committed an act of criminal aggression is presented. Based on anamnesis data, examination data, analysis of the features of psychopathological symptoms and dynamic clinical observation, the final diagnosis of "Organic pseudopsychopathic personality disorder due to mixed causes (perinatal factors and traumatic brain injury), with significant behavioral disorders requiring treatment, with schizophrenic symptoms" was made. Initially mistaken for the childhood form of schizophrenia based on the clinical pattern and complaints. Methods: The results of the patient's clinical examination using a complex of psychodiagnostic techniques, instrumental research methods, observation data in the department, and an analysis of the patient’s anamnesis are presented. Conclusion: The main stages of diagnosis, the course of the study, the difficulties in the differential diagnosis, and the key insights that played a role in substantiating the diagnosis are highlighted.

Psychodiagnostics of sexual awareness and of interpersonal interaction attitudes in the practice of compulsory treatment of patients with pedophilia and comorbid mental disorders

This article presents the results of a study that assesses the dynamics of the parameters of sexual awareness in mentally sick patients (sexual criminals with pedophilia and comobrid mental disorders in the process of compulsory treatment). 52 patients were examined before and after the course of treatment (psychopharmacological effect combined with antiandrogens and cognitive-behavioral psychotherapy); among which there are 32 subjects with heterosexual pedophilia, 11 subjects - with homosexual pedophilia, 9 subjects - with bisexual pedophilia; 22 subjects (43,3 %) diagnosed with schizophrenia, 18 subjects (34,6%) - with organic personality disorder, 12 subjects (23%) - with mild mental retardation. Methods used: “MiF” - a modified gender identity test; “TsTO” - “Color Test”; "Coding"; Vagner Test (a computer version of the HAND test) and the Drawing Test “Man. Woman. Child». The identified changes make it possible to detect actual targets for psychotherapeutic intervention and can be taken into account when determining the risk of recidivism and of patients’ danger degree.

Pathocharacterological Profiles in Individuals With Personality Disorders With a Criminal History

In the article presents the results of the pathocharacterological profiles in individuals with personality disorders and organic personality disorder with a criminal history. It was revealed that the aggressiveness and preference of simple tasks in the structure of self-control corresponded to a high level of manifestation of pathocharacterological features in people with personality disorders. A group of individuals with an organic personality disorder with pronounced pathocharacteristic features characterized: inability to build a model of significant conditions for achieving the goal, severity of anger and hostility, low inhibition of behavior, low level of self-control, the predominance of defense mechanisms such as isolation, denial, displacement and such unproductive coping strategies like confrontation and avoidance. Identified psychological predictors that make a significant contribution to the assignment to groups of individuals with personality disorder and organic personality disorder, taking into account type of the offence. The resulting discriminant models for psychological indicators had a satisfactory and high predictive value.

Use of Memantine in Organic Personality Disorder: A Case Study

This is a case study of a 27-year-old man with co-morbid congenital communicating hydrocephalus and epilepsy. The patient had multiple hospitalizations in psychiatric clinics due to serious domestic violence caused by compulsive buying demands. Impaired social interaction skills, diminished judgment, planning, insight and temporal organization difficulties were also present and the diagnosis of organic personality disorder was given.The patient was treated with 1.5 g valproc acid for epilepsy and for the behavioural difficulties multiple antipsychotics, benzodiazepines, SSRI's and beta-blockers were administrated, without major benefits. Due to serious aggression and impulsive behaviour, it was administrated memantine 20 mg/day according to NMDA receptor antagonist hypothesis and gradually reduced the benzodiazepines and SSRI's.A significant decrease in the average score of the Barratt Impulsiveness Scale (BIS-11) and to violence incidences was observed. Also, social interaction skills were improved and a slight improvement at patient's judgment was observed.The patient had good tolerance during the treatment and no side effect was reported. It is the first scientific report on memantine effectiveness in this patient group. Further research is needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Lymphocytes with Fas-receptors of readiness to apoptosis in non-psychotic mental disorders

IntroductionApoptosis is a complex physiological process of the organism which supports cellular homeostasis, provides important aspects of development and functioning of the immune system. In various pathological conditions the process of apoptosis can be impaired that leads to decrease or increase in pro-apoptotic activity.Materials and methodsWe conducted investigation of relative and absolute number of CD3+CD95+–lymphocytes in groups of patients with adjustment disorders (n = 90), PTSD (n = 100), organic emotionally labile (asthenic) disorder (n = 232), organic personality disorder (n = 93). Clinical verification was conducted according to ICD–10. Control group included 190 practically healthy persons. Fas protein (CD95) expression on CD3 lymphocytes surfaces was detected using flow cytometry. Cytometric measurements were conducted on flow cytofluorimeter FacsCalibur (Becton Dickinson, US).ResultsIn the control group relative number of CD95+–lymphocytes was 11.6%, absolute–0.21 × 109/L. In all examined patients as compared with control the reliable increase both in relative and absolute number of lymphocytes of CD3+CD95+–phenotype was identified. So, in persons with adjustment disorder content of this indicator made 17.0% and 0.28 × 109/L (Р = 0.0015), in PTSD–18.0% and 0.33 × 109/L (Р = 0.0007) and in patients with organic asthenic disorder–19.0% and 0.32 × 109/L (Р = 0.0048), respectively. The highest content in blood of CD3+–lymphocytes, expressing on the surface of membrane the basic marker of apoptosis CD95 is observed in patients with organic personality disorder: 26.0% and 0.44 × 109/L (Р = 0.0003).ConclusionIn case of intensification of psychopathological symptoms especially in persons with non-psychotic organic mental disorders a receptor-mediated signaling pathway of apoptosis is activated – process of programmed cell death.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A Systematic Review of the Prevalence and Incidence of Neuropsychiatric Conditions in Populations With Traumatic Brain Injury

IntroductionThe relationship between traumatic brain injury and neuropsychiatric conditions has a strong clinical link. Despite significant clinical presentations, there has been a limited focus on quantifying the association between traumatic brain injury and psychiatric disorders.ObjectivesTo conduct a systematic review to determine the prevalence and incidence of neuropsychiatric conditions in patients with traumatic brain injury.AimsTo determine the association between traumatic brain injury and psychiatric illness.MethodsA systematic search was made of Medline, PsycINFO, EMBASE and article bibliographies. Search terms for rates of psychosis, mood disorders, anxiety conditions, organic personality disorder, neuropsychiatric disorders, neuro-behavioural disorders, aggression, dementia and frontal lobe disorder were utilised. We followed MOOSE criteria and did not apply temporal limits.ResultsThere were 845 relevant searches in total. After exclusion of duplicates, case reports, case series reports, letters, reviews, commentaries, systematic reviews, and editorials there were 143 relevant abstracts identified. This was further reduced to a review of 48 full text papers. We identified prevalence rates of depression between 6.9–62.5%, mania of 9–12.5%, PTSD 1.9–50%, aggression 28.4–57%, anxiety disorders 6–63% (including GAD 8–9%, agoraphobia 2–6%, panic disorder 9%, social phobia 1%) insomnia 11–29%, personality change of 33.3%, dementia 8.16% and substance use 3–8%.ConclusionsWe have identified significant rates of neuropsychiatric morbidity in patients with traumatic brain injury. We have particularly identified limited research studies into psychosis, mania, dementia and personality disorders in this patient group. The review further emphasises the importance of identifying neuropsychiatric comorbidities in post-traumatic brain injury and the importance of addressing these comorbidities.Disclosure of interestThe authors have not supplied their declaration of competing interest.