Previous History Of Psychiatric Disorders Research Articles

7173 Cabergoline Induced Psychosis in a Patient with no Previous History of Psychiatric Disorder

Abstract Disclosure: B. Aryal: None. K. Kim: None. A. Shafi: None. M. Ganesh: None. Introduction: Cabergoline is a dopamine agonist (DA) used to treat prolactinomas. It is well established that DAs may cause psychotic symptoms. However, very few cases report cabergoline-associated psychosis in patients without personal or family history of psychiatric disorders. We report a rare case of cabergoline-induced psychosis in a patient with a prolactinoma without any underlying psychiatric disorder, which was managed with the addition of olanzapine. Case: A 41 year old male with no history of psychiatric disorder was started on cabergoline 0.5mg twice a week for a newly diagnosed prolactinoma. 4 weeks later, he presented to the emergency room for aggressive behavior and confusion for the past 2 weeks. He endorsed visual and auditory hallucinations. Cabergoline was discontinued. During hospitalization, he attempted suicide and required 1:1 observation. He was started on olanzapine per the inpatient psychiatry team. Surgical resection of the prolactinoma was considered given his acute psychosis associated with cabergoline. However, complete resection of the tumor was deemed impossible given encasement of the internal carotid arteries. After discussion with the patient, he underwent re-challenge with cabergoline 0.25mg weekly while on olanzapine under 1:1 observation in the ICU. He was monitored for 2 weeks and eventually discharged home on cabergoline 0.25mg twice a week and olanzapine with improvement in prolactin levels to 4973.7 ng/mL after 4 weeks. He continued to remain free of psychotic symptoms upon follow up as an outpatient. Discussion: Psychosis is a rare side effect of DA mediated via D2/D3 receptors in the mesocortical and mesolimbic pathways. Several cases report psychosis associated with cabergoline in patients with a history of psychiatric disorders. However only one case reports de novo psychosis. Our patient developed severe psychosis while on low-dose cabergoline for 4 weeks. This rare case of de novo cabergoline-associated psychosis re-emphasizes that psychosis may occur regardless of previous history of psychiatric disorder and independent of the dose or duration of cabergoline. Treatment of a prolactinoma in the setting of cabergoline-associated psychosis requires a multidisciplinary approach. Alternative treatment of surgical resection was considered for our patient. However surgical resection was not plausible given difficult surgical anatomy. Therefore he was monitored closely to re-initiate cabergoline while on olanzapine. Several cases report successful use of clozapine, aripiprazole, and quetiapine for patients with psychiatric symptoms while on cabergoline. Patients who are on cabergoline should be closely monitored for any psychotic symptoms. Further studies are warranted to identify patients at risk of developing psychosis while on cabergoline to tailor an individualized approach to therapy and monitoring. Presentation: 6/2/2024

Insomnia and Self-medication Among Pharmacists in Saudi Arabia

Background: Insomnia is considered one of the most common sleep disorders. One-third of the world’s population has one or more symptoms of insomnia, with 10% satisfying the criteria for clinical diagnosis. Objective: This study aimed to determine the prevalence of insomnia among pharmacists working in Saudi Arabia and its association with self-medication. Methods: This is a descriptive cross-sectional study. A self-administered questionnaire was distributed online by the Saudi Commission for Health Specialties, targeting pharmacists from different working areas in Saudi Arabia. The survey included socio-demographic data, level of education, working area, and work experience; use of pharmacologic and non-pharmacologic sleeping aid; reasons for self-medication; and the Insomnia Severity Index questionnaire. Results: A total of 515 pharmacists participated in the study (male 53.4% vs. female 46.6%). The prevalence of clinically significant insomnia was 48.2%. Of these, 66.5% were mild, 29.8% were moderate, and 3.6% were severe. The prevalence of pharmacists currently using sleep aid medications was 22.7%. Factors associated with clinically significant insomnia were younger age (21 – 30 years), female sex, unmarried status, living in the central region, chronic diseases, history of psychiatric disorder, consultation with a health care professional, current use of sleep aid medications, and use of psychological and behavioral intervention as a sleeping aid. Conclusion: Insomnia is common among pharmacists in Saudi Arabia, but self-medication is uncommon. Of all pharmacists, female young adults who were not married and had a previous history of psychiatric disorders were greatly affected by insomnia and self-medicated the most.

Acute psychosis with compulsive behaviour caused by hypothyroidism: a case report

IntroductionHypothyroidism is a common problem in clinical practice which can be seen with diverse psychiatric manifestations.ObjectivesHere we report a case of psychosis with compulsive behavior in a 46-year-old man who had no previous history of psychiatric disorder was brought to the emergency department by his family.MethodsDuring his evaluation, he described visual and auditory hallucinations. In addition, it was observed that dermatitis developed on her hands and around his mouth due to compulsive washing behavior. It was learned that he was diagnosed with hypothyroidism 2 months ago but he was not taking his medication. He was admitted inpatient clinic for 39 days and consulted to an endocrinologist. Inpatient treatment was initiated with haloperidol 10mg PO and levothyroxine. Given the persistence of irregular intake, it was decided to switch to haloperidol long-acting treatment.ResultsAfter only requiring both antipsychotic drugs and thyroxine replacement our patient showed progressive clinical recovery attaining full remission within 5 weeks.ConclusionsIt was clear that physicians should be aware of the possible different manifestations of endocrinologic disorders. All patients presenting with a first episode psychosis and compulsive behavior should be screened for thyroid dysfunctionDisclosure of InterestNone Declared

Behavioral self-regulation in pediatric bipolar disorder and healthy offspring of bipolar patients.

This study investigated behavioral self-regulation problems using the Children's Hostility Inventory (CHI) in pediatric bipolar disorder (PBD), healthy offspring of bipolar disorder patients (HOBD), and healthy controls (HC) without previous history of psychiatric disorders. The CHI was administered to 41 consecutive children and adolescents diagnosed with PBD, to 16 HOBD, and to 22 HC. The inventory assessed irritability, expression, hostility, and aggression and was completed by the children with the help of their mothers. Adolescents and their respective parents were interviewed separately using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). All subscales of the CHI presented statistically significant differences, except for the subscale assessing feelings of suspicion. Pairwise comparisons revealed consistently significant differences between the PBD group and controls, indicating more self-regulation difficulties in the PBD group, represented by high levels of hostility and aggressive behavior. There were no significant differences between the PBD and HOBD groups. Future studies should further investigate if such behavior is state-dependent or a trait of bipolar juvenile expression. Expression of hostility and irritability should be considered relevant targets in psychosocial approaches addressing this population.

Hypothyroidism Induced Mania: A Case Report

Hypothyroidism is associated with myriad of medical, neurological as well as psychiatric symptoms. There is classic association of depression with hypothyroidism and of mania occurring with hypothyroidism. Only few cases of mania associated with hypothyroidism are reported. This is the first case of mania associated with hypothyroidism in Nepalese patient. We report a case of 30-year-old female with symptoms of mania induced by primary hypothyroidism. She had no previous history of psychiatric disorder but her father was diagnosed depression. Psychosocial factors contributed to noncompliance of Tablet. Levo thyroxine. She was successfully managed with Tablet. Aripiprazole, thyroxine replacement, family therapy and psycho education sessions. Therefore, clinicians should be aware to assess thyroid function in patients presenting with mania, especially females with first episode. We should also evaluate for mania symptoms in cases of hypothyroidism. Psycho education of patient and family play vital role in the treatment process.

The use of methylphenidate in vascular dementia: A case report

IntroductionPatients diagnosed with vascular dementia often present with apathy, executive dysfunction or/and memory impairment. Some of these psychiatric domains are not responsive to antidepressants or acetylcholinesterase inhibitors. Since methylphenidate enhances frontal lobe function, it may be a valid therapeutic option.ObjectivesTo report a case where methylphenidate was used as a therapeutic approach in vascular dementia.MethodsWe present a case of a patient diagnosed with vascular dementia with substantial clinical improvement after treatment with methylphenidate.ResultsA 67 year-old male was observed in a psychiatric consultation reporting memory loss, inability to retain information and inattention. According to her spouse, the patient has been mostly isolated at home and recently he has become unable to accomplish some daily living activities. There was no history of previous psychiatric disorder. Cognitive assessment was performed using MoCA test: 19/30 points (predominantly in executive, attention and delayed recall domains). After this evaluation, it was introduced bupropion 150mg od and donepezil 5mg od with insignificant clinical improvement. The patient underwent a routine workup which was unremarkable and a brain computed tomography scan that revealed ischemic leukoencephalopathy. Three months later no clinical benefit was reported. Attention and functional improvement were observed after introduction of methylphenidate with progressive dose adjusting till 30 mg/day.ConclusionsBesides not being a consensual therapeutic approach, considering that there is a lack of efficient pharmacological strategies in vascular dementia, methylphenidate may play a significant role in this field contributing to clinical improving and ultimately to an enhanced quality of life.

Les accès psychotiques aigus liés à la pandémie COVID-19

The world is currently going through an extremely stressful time due to the COVID-19 pandemic. This exceptional and alarming situation could increase the incidence of mental health problems, including acute psychotic disorders. Our observation reports two cases of patients with an acute psychotic episode, with a delusional theme related to the coronavirus pandemic. The two patients, who did not have a previous history of psychiatric disorders, were hospitalized in our psychiatry department, after the start of mandatory sanitary confinement in our country. The clinical symptoms found were mainly a hallucinatory syndrome and a delusional syndrome with a religious theme, and delusional ideas centered on COVID-19. This case report suggests that intense psychosocial stress, caused by the current global crisis and confinement measures, may be a trigger for new-onset psychotic episodes, and impact the clinical and delusional expression of acute psychosis.

P038 ASSESSING THE ASSOCIATION BETWEEN ACTIVE IBD AND DEPRESSION/ANXIETY USING ADAPTIVE TESTING TECHNOLOGY

Abstract Introduction Both depression and anxiety are comorbidities of inflammatory bowel disease (IBD). Though previous studies have proposed a relationship between depression, anxiety and IBD, causality and directionality are unknown. We used a novel computerized adaptive testing technology to screen IBD patients for depression and anxiety and compared the screening results to disease activity. Methods Consecutive patients at our tertiary IBD clinic were asked to complete the validated CAT-MH™ survey (Adaptive Testing Technologies, Chicago, IL); we then reviewed disease and patient characteristics. Clinical remission status was determined by the senior author, blinded to the CAT-MH results. Simple statistics were performed. Results 100 patients (57 women, 81 Caucasian, 63 Crohn’s disease) participated in the study, 58 of whom had no previous history of psychiatric disorders. We identified 42 patients with depression (40 mild, 2 moderate). Of those with mild depression, 25/40 (62.5%) were previously undiagnosed; of those with moderate depression, 1/2 (50%) were previously undiagnosed. 27 subjects tested positive for anxiety (21 mild, 6 moderate). 11/21 (52.38%) of mild anxiety cases and 3/6 (50%) of moderate anxiety cases were previously undiagnosed. 1 of the 100 patients was positive for suicidal ideation in the past month. Sex, race, type of IBD, smoking status, IBD-related surgical history, and number of discontinued medications were not statistically significant factors in depression or anxiety by proportion of patients or severity score. Clinically active disease status was found to be positively associated with depression severity score (p=0.002, 95% CI 4.3–19.5) and anxiety severity score (p=0.019, 95% CI 1.4–16.0) (Table 1). Of the 30 patients who had clinically active disease, 18 (60%) were positive for depression and 12 (40%) were positive for anxiety. Of the 70 patients in clinical remission, 24 (34%) were positive for depression and 15 (21%) were positive for anxiety (Figure 1). Patients with active disease have a significantly greater relative risk for having depression (RR 1.8, 95% CI 1.1–2.7) and an almost significantly greater relative risk of having anxiety (RR 1.9, 95% CI 0.99–3.5). Conclusions Using a novel screening tool for depression and anxiety in IBD patients, we identified a positive correlation between clinically active disease status and the presence of depression and anxiety. Our results show that regardless of past surgical and therapeutic IBD history, patients in clinical remission are less likely to have these mental health conditions than those with active disease. Gastroenterologists should consider patients with clinically active disease at higher risk for psychological co-morbidities, and include such screening in their routine care. Further research will explore directionality between disease activity and psychological outcomes.

External Genitalia Trauma Following the First Manic Episode in an Elderly Woman With Sexual Disinhibition

Introduction: Late onset bipolar disorder is not common. In addition, bipolar disorder with a dominancy over sexual behaviors is very rare. Hence, traumatic and vigorous sexual behavior, such as masturbation and self-mutilation, are odd and rare occurrences. Case Presentation: An elderly woman in a manic phase of bipolar disorder without a previous history of psychiatric disorders was concomitant with problematic sexual over stimulation in the context of hyper sexuality. She had traumatized her genitals and underwent surgery for their repair. Following her admission and psychopharmacologic therapy, she recovered. Conclusions: The presentation of bipolar disorder in the elderly can be seen in sexual behaviors and self-mutilation that can lead to the need for reparative surgery. In each case, with trauma to the external genitalia, psychiatric problems should be considered.

Persistent orthostatic headache without intracranial hypotension: which treatment?

Orthostatic headache can be the leading symptom of intracranial hypotension, however, not all orthostatic headaches are due to cerebrospinal fluid leaks and these forms can be a clinical problem, especially for treatment. Aim of this study was to review patients with persistent orthostatic headache in whom a detailed head and spinal MRI follow-up did not reveal any sign of intracranial hypotension and to evaluate which treatment can be considered the first choice. Patients admitted to our headache center for evaluation of persistent orthostatic headache and followed after first admission with clinical and neuroradiological controls were systematically reviewed. 11 patients (7 M, 4 F) followed in a period lasted from 10 months up to 2 years were studied. Six patients (54, 5 %) reported a MRI performed previously elsewhere with a suspect diagnosis of intracranial hypotension which was not confirmed at MRI at our hospital such as during the radiological follow-up. Three patients (27.2 %) had developed orthostatic headache short after a neck or head trauma with no evidence of neuroradiological pathological signs and two patients (18 %) had a previous history of psychiatric disorder. We administrated antidepressants in five patients, atypical neuroleptic in three patients, association of antidepressant and antipsychotic in one patient and muscle relaxants in two cases. All patients showed a certain improvement of headache in the weeks after introduction of the pharmacological treatment; six (54, 5 %) had pain relief during the follow-up and five (45, 5 %) were pain free at the last clinical control. We found out that patients with the best outcome were the ones treated with antidepressants. Persistent orthostatic headache without any neuroradiological sign of intracranial hypotension is a challenging problem for clinicians. Although the International Classification of Headache Disorders (ICHD-3 beta version) criteria suggests the possibility of epidural blood patch in orthostatic headache without causes, we believe that a pharmacological treatment tailored on each patient should be always considered and antidepressants can be the first choice.

Relationship Between Hypothyroidism and Bipolar Disorders: a Case Report

Relationship between hypothyroidism and bipolar disoders: a case report Neuropsychiatric manifestations are common among patients with thyroid dysfunctions. Depression and cognitive impairments are the most frequent symptoms of hypothyroidism. Few cases of mania associated with primary hypothyroidism were observed in the literature. We report a case illustrating the association between the two diseases. A literature review was conducted through searches of PubMed and Medline. Miss R, 35 years old, who had no previous history of psychiatric disorders, was admitted in 2014 with symptoms associated to acute manic episode (diagnosed using DSMIV). Signs of florid hypothyroidism were noted at the exam and confirmed by biological tests. Family revealed multinodular goiter surgical operation (in 2013) with poor adherence to thyroxin replacement. Both antipsychotic drugs, mood stabilizers and thyroxin replacement were required for his remission . This case leads us to ask the following question: is it a fortuit comorbidity or does the mania is due to hypothyroidism? According to the results of literature, hypothyroidism with manic presentation is not common (10 reports of mania consistent with primary hypothyroidism). While occurrence of mania in hyperthyroidism involves the beta adrenergic system, mechanisms underlying the occurrence of mania in hypothyroidism remains unclear. However, recent studies begin to provide a better understanding of the links between thyroid dysfunctions and mood disorders. Psychiatric manifestations of hypothyroidism are various and lead to a better screening of thyroid dysfunctions, especially in patients with mood disorders

A Long Term Effects of a New Onset Psychosis after DBS Treated with Quetiapine in a Patient with Parkinson's Disease.

Deep Brain Stimulation represents a therapeutic option for PD patients. In this paper, we present and discuss a case of acute delirium and psychosis manifesting after DBS in a 58-years-old man affected by Parkinson's Disease. We highlight the importance of an exhaustive psychiatric evaluation in candidates for DBS and we underline the severity and non-reversibility of some adverse events associated with the implantation, suggesting the use of Quetiapine in the management of these effects. Acute psychosis may be listed as a potential severe adverse event associated with DBS, even in patients without a clear cut previous history of psychiatric disorders.

The outcome of agitation in poisoned patients in an Iranian tertiary care university hospital.

Introduction. This study was conducted to evaluate and document the frequency and causes of agitation, the symptoms accompanying this condition in intoxications, relationship between agitation score on admission and different variables, and the outcome of therapy in a tertiary care referral poisoning center in Iran. Methods. In this prospective observational study which was done in 2012, 3010 patients were screened for agitation at the time of admission using the Richmond Agitation Sedation Scale. Demographic data including age, gender, and the drug ingested were also recorded. The patients' outcome was categorized as recovery without complications, recovery with complications (hyperthermia, renal failure, and other causes), and death. Results. Agitation was observed in 56 patients (males, n = 41), mostly aged 19–40 years (n = 38) and more frequently in illegal substance (stimulants, opioids and also alcohol) abusers. Agitation score was not significantly related to the age, gender, and previous history of psychiatric disorders. Forty nine patients had recovery without any complication. The need for mechanical ventilation was the most frequent complication. None of the patients died. Conclusion. Drug abuse seems to be a must-to-consider etiology for patients presenting with acute agitation and its morbidity and mortality could be low in agitated poisoning cases if prompt supportive care is performed.

Evaluación de una intervención para dejar de fumar en personas con enfermedad mental

A high proportion of those seeking help to quit smoking have psychiatric disorders. The aim of this work is to analyze the effectiveness of those group smoking cessation programs who are usually employed in Primary Care and to compare their results to those obtained with non psychiatric patients. A descriptive longitudinal study with a one-year follow-up that evaluated smoking cessation groups conducted in a Primary Care setting between 2006 and 2011. Nineteen groups were carried out and 267 smokers were included; 36.3% had been diagnosed with a psychiatric disorder. The program consisted of five 90 minutes sessions (up to six weeks after abstinence) with telephonic follow-up for a year. Abstinence was verified by cooximetry at the end of the program and by self-declaration afterwards. Quantitative and qualitative variables were described, and the association between variables analyzed through binary logistic regression. Self-declared continuous abstinence rate at 12 months of was 39.7%, being slightly higher, not in a non significant way, in women (43.1% vs. 35.1%; p: 0.18). Smokers with no history of psychiatric illness showed better abstinence rates, although without significant differences (42.9% vs. 34.0%; p: 0.16). There was no significant interaction between sex and psychiatric pathology. Those with a psychiatric disorder relapsed in a significantly higher rate during the first six weeks after abstinence [23.7% vs. 10.6%, p: 0.019; OR:1.90(1.08-3.36)]; relapse rates were similar afterwards (44,1% vs. 42,5%; p> 0,8). This group intervention program for smoking cessation is effective. Although smokers with a present or previous history of psychiatric disorder may find abstinence harder to attain, they benefit from the intervention.

Effect of Medication for Residual Symptoms in BPPV: Randomized Controlled Trials

Objectives: Even after successful canalith repositioning procedures (CRPs) in benign paroxysmal positional vertigo (BPPV), residual symptoms could be continued without positional nystagmus. The aim of this study was to evaluate the effect of adjuvant medication on residual symptoms after successful CRPs Methods: Between January 2011 and August 2012, 150patients with idiopathic BPPV participated. Patients who had previous history of psychiatric disorder or migraine were excluded. All participants were diagnosed by video-nystagmography (VNG), and Dizziness Handicap Inventory (DHI) questionnaires were completed before CRPs. All subjects were divided into three groups after successful CRPs. Medication (M) group was treated with vestibular suppressant (dimenhydrinate 25mg), placebo (P) group and no medication (N) group. One week after, all patients completed follow up VNG for recurrence and repeated DHI questionnaires for comparing residual symptoms. Results: All participants regardless of groups showed significant symptom improvement after successful CRPs, but 76 patients complained of residual symptoms. Presence of residual symptoms was more prevalent in P or N group compared with M group ( P = 0.048, P = 0.03, respectively). Most frequent characteristics of residual symptoms were lightheadedness or mild headache (n = 36). However, in the analysis of DHI, total and subscale scores of DHI were not different between three groups before and after successful CRPs. Conclusions: Vestibular suppressant significantly reduced residual symptoms after CRPs. However, there is no significant reduction on DHI scores compared to a control group. It seems that residual symptoms may not be true vertigo but lightheadedness or headache.

A Suicide Attempt in a Context of Bipolar Symptoms Leading to a Diagnosis of Sneddon Syndrome

A Suicide Attempt in a Context of Bipolar Symptoms Leading to a Diagnosis of Sneddon Syndrome

The impact of psychological illness on outcome of corrosive esophageal injury

Esophageal stricture is a debilitating condition with significant morbidity and mortality, occurring often as a complication of the ingestion of corrosives. In the adult, majority of cases are intentional whilst being accidental in the pediatric population. We therefore sought to describe the circumstances of intentional corrosive ingestion and determine the presence and impact of psychiatric illness on the outcome of management. A retrospective analysis of case folders of patients managed with this condition over a ten-year period (2000-2009) was done by comparing sociodemographics and outcome of management in patients with and without psychiatric disorders. Twenty seven cases were reviewed. Mean age was 30.7 (SD =16.01), with a M:F ratio of 1.25:1.86.2% had a diagnosable psychiatric condition, the most common being depression in 55.6% of the patients. Caustic soda (55.6%) was the most common corrosive ingested. There was a significant difference in mean duration before presentation in patients with (1.7 days) and without (6.6 days) previous psychiatric illness (P = 0.01). A significant positive association was also found between surgical outcome and previous history of psychiatric disorder (P = 0.02). Early recognition of psychosocial distress is important to prevent deliberate self-harm. Counter-intuitively, a previous history of psychopathology limits esophageal injury by early presentation and therefore improve chances of a good surgical outcome.

SUICIDALITY in the perinatal period: comparison of two self-report instruments. Results from PND-ReScU

The aim of this study was to assess suicidality in a non-clinical sample during the perinatal period and to report suicidality rates in women with major or minor depressive episode (MmD), assessed with the SCID, during the perinatal period. Women (1,066) were recruited at the third month of pregnancy and followed until the 12th month postpartum (N = 500). Suicidality was assessed with the MOODS-SR and with item 10 of the EPDS at different time-points during the perinatal period. The period prevalence of suicidality was 6.9% (95% CI: 6.0-7.8) during pregnancy and 4.3% (95% CI: 3.4-5.2) during postpartum, assessed with the MOODS-SR, and was 12.0% (95% CI: 10.8-13.2) during pregnancy and 8.6% (95% CI: 7.4-9.8) during the postpartum period, assessed with the EPDS. The prevalence of suicidality in women who had MmD during pregnancy was 26.4% and 34.1%, assessed with the MOODS-SR and the EPDS, respectively, while it was 18.4% (MOODS-SR) and 30.6% (EPDS) during the postpartum period. Clinicians should assess suicidality in women presenting with MmD during the whole perinatal period. Furthermore, suicidality should be assessed in women with a previous history of psychiatric disorder that reported a lifetime suicidal ideation.

Anti-NMDA receptor encephalitis: an important differential diagnosis in psychosis

We present four cases of confirmed anti-NMDA receptor encephalitis; three presented initially with serious psychiatric symptoms and the other developed significant psychiatric symptoms during the initial phase of illness. Brain biopsy findings of one patient are also described. Psychiatrists should consider anti-NMDA receptor encephalitis in patients presenting with psychosis and additional features of dyskinesias, seizures and catatonia, particularly where there is no previous history of psychiatric disorder.

P03-240 - Preliminary study of emotion recognition using facial affect cards of the training of affect recognition program (TAR) in Spanish population

IntroductionSocial cognition is presently an important focus in rehabilitation of patients wish schizophrenic psychoses. Emotion recognition in one of its different components, the Training of Affect Recognition (TAR) is a therapy program specifically developed aiming at improving affect recognition.ObjectivesTo test if the material of the TAR program in terms a series of facial affect cards is reliable for emotion recognition in a Spanish control population.MethodsA sample of Spanish control subjects were shown the TAR's series of facial affect cards. It includes the following emotions: happiness, sadness, surprise, fear, angry and disgust, and the neutral facial affect. Reliability was assessed by means of the kappa coefficient. Kappa values higher than 0.4 were considered reliable, the following criterion was accepted: kappa values < 0.4, low reliability; 0.4 to 0.75, moderate reliability; > 0.76, strong reliability.ResultsThe sample was formed by subjects from the general population with no previous history of psychiatric disorders (n = 20). The following kappa values were obtained: happiness, 0.8406 (CI 0.7744–0.9068), sadness, 0.6171 (CI 0.5377–0.6964), surprise, 0.6582 (CI 0.5859–0.7304), fear, 0.4509 (CI 0.3569–0.5448), angry, 0.6252 (CI 0.5464–0.7040), disgust, 0.7700 (CI 0.6943–0.8456), neutral, 0.5534 (CI 0.4663–0.6404).ConclusionsIn a preliminary study in a sample of 20 Spanish control subjects using the TAR's series of facial affect cards, the six basic emotions and the neutral facial affect were recognized with at least a moderate reliability. A strong reliability was obtained in happiness and disgust, and a moderate reliability in surprise, angry, sadness, neutral, fear.