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   Table of Contents - Current issue
Coverpage
July-September 2021
Volume 35 | Issue 3
Page Nos. 103-156

Online since Friday, September 24, 2021

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REVIEW ARTICLE  

The Literary Works of Miguel de Cervantes from the Perspective of Psychopharmacology: The Four Aspects of Phármakon p. 103
Francisco Lopez-Munoz
DOI:10.4103/TPSY.TPSY_23_21  
Background: Miguel de Cervantes (1547–1617) was a Spanish writer, who has often been considered as the greatest writer in the Spanish language and one of the world's outstanding novelists. His novel Don Quixote, is a work often cited as both the first modern novel and one of the best works of world literature. The life of Cervantes has been full of fascinations, imaginations, attracting the attention from all walks of people, including psychiatrists. Methods: With career interest in psychopharmacology, the author in this review intends to focus on Cervantes's notions in his works on the use of psychotropic agents. The author also categorized psychotropic agents into four different scenarios of use – therapeutic remedies, toxic and poisonous agents (love philters, poisonous potions), antidotes as well as drugs of abuse (witches' ointments). Results: Cervantes' works were found that Cervantes made references to those preparations in Don Quixote, The Galatea, Journey to Parnassus, The Spanish English Lady, The Lawyer of Glass, The Jealous Old Man from Extremadura, The Dialogue of the Dogs, Pedro de Urdemalas and The Diversion. The main agents cited by Cervantes in the context analyzed included henbane, tobacco, rhubarb, rosemary, vervain, and in a masked way, opium. Cervantes did not identify the ingredients of other preparations with psychotropic properties, although, in the sense of the symptoms described by the author, they could be plants of the Solanaceae family, such as the henbane, nightshade, jimson weed, belladonna, or mandrake. Conclusion: Cervantes' texts, although by no means scientific treatises, give us with a correct description of the uses (and effects) of psychotropic substances in late Renaissance Spain, and explain how a group of drugs could have four archetypal qualities – remedy, poison, antidote, and drug of abuse.
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ORIGINAL ARTICLES Top

Prevalence and factors associated with suicidal behaviors in a cross-sectional sample of Nigerian young adults p. 117
Opakunle Tolulope, Opakunle Olubukola, Aloba Olutayo
DOI:10.4103/TPSY.TPSY_24_21  
Objective: In this study, we intended to assess the prevalence of suicidal behaviors and their associated factors among Nigerian young adults. Methods: This is a cross-sectional descriptive study involving 1171 Nigerian young adults from the six geopolitical regions of Nigeria. They completed a study-specific sociodemographic questionnaire, Suicidal Behaviors Questionnaire-Revised Scale, Satisfaction with Life Scale, 10-item Drug Abuse Screening Test, Hospital Anxiety and Depression Scale, and Rosenberg Self-Esteem Scale. Results: The mean age ± standard deviation of the respondents was 24.92 ± 2.42 years. The lifetime suicidal ideation, plan, and attempt were 9.6%, 5.7%, and 2.6%, respectively. Of them, 7.1% had the 12-month suicidal ideation, and 4.8% were at risk of suicide attempt. Totally, 9.6% of the respondents had high suicide risk. The symptoms of depression and anxiety were present in 13.5% and 23.1% of the respondents, respectively. Suicidal behaviors among Nigerian young adults were significantly associated with dissatisfaction with life (p < 0.05), anxiety (p < 0.001), drug abuse (p < 0.001), and low self-esteem (p < 0.01). Conclusion: Suicidal behaviors were relatively high among Nigerian young adults, and were associated with dissatisfaction with life, anxiety, psychoactive substance use, and low self-esteem.
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Cognitive function and alcohol use disorder: Path analysis for a cross-sectional study in Taiwan p. 124
Chun- Hua Cheng, Li- Ling Huang, Wei- Tsung Kao, Chwen- Yng Su, Frank Huang-Chih Chou, Kuan- Ying Hsieh
DOI:10.4103/TPSY.TPSY_25_21  
Objective: Alcohol has cognitive impacts on patients with alcohol use disorder (AUD). In this study, we intended to study cognitive impairments in patients with AUD and their potential interrelationships. Methods: We enrolled 60 patients with AUD or alcohol intoxication in Taiwan. The severity of alcohol use was assessed using a copy for severity of alcohol dependence questionnaire (SADQ). Cognitive function was evaluated using Stroop color and word test, continuous performance test-identical pairs, trail making test, visual alternating and divided attention subscales of computerized everyday attention test, visual elevator subscale of test of everyday attention, Benton judgment of line orientation test, spatial perception subscale of visual object perception test, visual motor organization subscale of Loewenstein occupational therapy, thinking operations subscale of Loewenstein occupational therapy cognitive assessment, digit symbol coding subscale of Wechsler adult intelligence scale-third edition, as well as symbol digit modalities test. Moreover, we used a structural equation modeling (SEM) to link age, duration of alcohol use, SADQ, and cognitive impairments. Results: Patients with AUD had significantly impairments of “attention” (p < 0.01), “visual motor coordination” (p < 0.001), and “executive function” (p < 0.01). SEM analysis showed that the higher level of attention, visual motor coordination, and executive functional impairments were significantly linked with old age (p < 0.01), long duration of alcohol use (p < 0.01), and higher score of SADQ (p < 0.01). Furthermore, we found that the three cognitive impairments were positively associated with each other. Conclusion: Old age, long duration of alcohol use, and severe alcohol use were the predictors of cognitive impairments and early detection. The early screening of predictive factors and timely interventions should be considered to improve cognitive function in patients with AUD.
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Lurasidone switching in patients with schizophrenia who showed suboptimal effect and/or intolerability to current antipsychotics: A multi-center, open-label, single-arm, flexible dose study p. 132
Shih- Ku Lin, Chin- Bin Yeh, Katsuhiko Hagi
DOI:10.4103/TPSY.TPSY_26_21  
Objective: In this study, we intended to evaluate the effectiveness and safety of switching to lurasidone in patients with schizophrenia and to get clinical experiences of real-world practice in those who showed suboptimal therapeutic effect and/or intolerability to lurasidone in Taiwan. Methods: We enrolled adult patients (aged 20–75 years) with schizophrenia who had been receiving antipsychotic medications but still continued to show mild-to-moderate symptoms or intolerability, for switching switch to an open-label lurasidone 40–160 mg daily for six weeks. The primary end point of the study was to assess the time to treatment failure, defined as any occurrence of insufficient clinical response, worsen underlying symptoms, or discontinuation due to adverse events. Secondary efficacy measures of the study included decreased scores in the positive and negative syndrome scale (PANSS) total and the clinical global impression-severity scale.(CGI-S), as well as increased clinical global impression-improvement scale (CGI-I). Safety measures included occurrences of treatment-emergent adverse events (TEAEs), abnormal vital signs, Electrocardiogram (ECG), and laboratory parameters. Results: We enrolled 54 patients with 51 completing the study. One patient terminated early due to adverse events and two patients had insufficient therapeutic efficacy. Mean ± standard deviation (SD) time to treatment failure was 27.7 ± 13.1 days. Mean ± SD changes from baseline to six weeks on PANSS, CGI-S, and were −16.8 ± 14.4, −0.6 ± 0.59, and −1.1 ± 1.0, respectively . The most common TEAE was hyperprolactinemia. Furthermore, body weight was significantly decreased from baseline to the end of the study by 0.83 ± 1.96 kg (p < 0.01). Mean ± SD blood prolactin level also was significantly decreased from baseline to week 6 (48.7 ± 52.8 ng/dL vs. 23.9 ± 57.8 ng/dL, p < 0.001). Conclusion: After switching from another antipsychotic, patients with schizophrenia treated with lurasidone showed a low rate of treatment failure among patients in Taiwan. The safety profile is similar to that in previous published lurasidone studies.
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Isobaric tags for relative and absolute quantitation in identifying proteins for clozapine treatment response in patients with schizophrenia: A preliminary study p. 140
Chin- Chuen Lin, Hung Su, Jentaie Shiea, Tiao- Lai Huang
DOI:10.4103/TPSY.TPSY_27_21  
Objective: Schizophrenia is a mental disorder characterized by reduced social engagement, abnormal emotional expression, and a lack of motivation. Isobaric tags for relative and absolute quantitation (iTRAQ) are a novel proteomic technique. In this study, we intended to identify potential biomarkers for predicting clozapine treatment response using iTRAQ. Methods: We identified patients with schizophrenia that responded to a four-week treatment with clozapine. Patient's peripheral blood mononuclear cells (PBMC) were collected before and after treatment. iTRAQ-based proteomics analysis was done to identify differentially expressed proteins in PBMC before and after treatment. STRING analysis map was built, and a target protein was selected. Western blot validation was then done. Results: In 10 identified clozapine treatment-responsive patients, we screened 2,735 proteins. Nine downregulated proteins and 11 upregulated proteins were differentially expressed by 1.5-fold after clozapine treatment. STRING network analysis revealed a series of apolipoproteins, and only apolipoprotein A4 (APOA-IV) was selected for validation. Western blot validations showed that protein levels of APOA-IV were significantly most downregulated in the patient after clozapine treatment (p = 0.05). Conclusion: In this study, we integrated clinical observation data, bioinformational protein interaction analysis, and iTRAQ labeling to study proteomics in patients with schizophrenia successfully treated with clozapine. We suggest that APOA-IV protein can be a biomarker for predicting clozapine treatment response in patients with schizophrenia. But these results in this study need a larger sample size to be validated.
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BRIEF REPORT Top

Cognitive deficits correlated with increased latency of event-related potentials in drug-free patients with generalized anxiety disorder p. 145
Shuo- En Hsu, Lan- Ting Lee, Hsin- Chun Tsai, Mei Hung Chi, Kao Chin Chen, I Hui Lee, Po See Chen, Yen Kuang Yang
DOI:10.4103/TPSY.TPSY_28_21  
Objective: Few studies have identified a relationship between cognitive deficits and altered event-related potentials (ERPs), which measure the synchronous activity of neurons in response to a stimulus in patients with generalized anxiety disorder (GAD). In this study, we intended to explore the relation between cognitive function and ERP in patients with GAD. Methods: Fourteen drug-free participants with GAD and 14 healthy controls were recruited. ERPs were measured, and neuropsychological tests were administered. We compared the differences of the data between two groups of the study participants. Results: Poor performances of full IQ and the numbers of the categories completed on the Wisconsin Card Sorting Test were found significantly correlated with increased frontal lobe latency in the patients with GAD (Spearman's ρ = −0.70, p < 0.05; Spearman's ρ = −0.85, p < 0.01), respectively, but not in the controls. Conclusion: As ERPs represent an index of information speed, we propose that patients with GAD could exhibit deficits in tasks requiring mental speed.
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LETTERS-TO-THE EDITOR Top

Paliperidone-induced dose-dependent sialorrhea treated with biperiden: A case report p. 149
Ji- Yu Lin, Pei- Chuan Wu
DOI:10.4103/TPSY.TPSY_29_21  
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Claw machine-induced gaming disorder: A case report p. 151
Chern Choong Thum, Yee Chin Chai
DOI:10.4103/TPSY.TPSY_30_21  
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A comment on risk of teenage pregnancy among adolescents with borderline personality disorder: A nationwide longitudinal study p. 154
Pei- Hsin Kao, Fong- Lin Jang
DOI:10.4103/TPSY.TPSY_31_21  
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Chen's reply on “A comment on risk of teenage pregnancy among adolescents with borderline personality disorder” p. 156
Mu- Hong Chen
DOI:10.4103/TPSY.TPSY_32_21  
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