European Psychiatry

Article	Citations
COVID-19 pandemic effects on health worker’s mental health: Systematic review and meta-analysis	144
EPA guidance on assessment of negative symptoms in schizophrenia	107
Social isolation, mental health, and use of digital interventions in youth during the COVID-19 pandemic: A nationally representative survey	90
EPA guidance on treatment of negative symptoms in schizophrenia	84
Prevalence and correlates of suicidal ideation among the general population in China during the COVID-19 pandemic	67
Is Europe facing an opioid crisis like the United States? An analysis of opioid use and related adverse effects in 19 European countries between 2010 and 2018	60
Catatonia in autism spectrum disorders: A systematic review and meta-analysis	52
Viewpoint: Investing in strategies to support mental health recovery from the COVID-19 pandemic	51
European Psychiatric Association guidance on treatment of cognitive impairment in schizophrenia	49
Surveilling COVID-19 Emotional Contagion on Twitter by Sentiment Analysis	47
A systematic review on the role of microbiota in the pathogenesis and treatment of eating disorders	45
Social isolation and suicide risk: Literature review and perspectives	44
Socioeconomic status, individual behaviors and risk for mental disorders: A Mendelian randomization study	42
Mental health services during the first wave of the COVID-19 pandemic in Europe: Results from the EPA Ambassadors Survey and implications for clinical practice	33
European Psychiatric Association guidance on assessment of cognitive impairment in schizophrenia	32
Prevalence of post-traumatic stress symptoms among people influenced by coronavirus disease 2019 outbreak: A meta-analysis	32
Artificial intelligence and suicide prevention: A systematic review	30
Racism and mental health and the role of mental health professionals	30
How is COVID-19 affecting patients with obsessive–compulsive disorder? A longitudinal study on the initial phase of the pandemic in a Spanish cohort	29
One year after the COVID-19: What have we learnt, what shall we do next?	27
Early evidence on the mental health of Ukrainian civilian and professional combatants during the Russian invasion	27
Excess mortality in depressive and anxiety disorders: The Lifelines Cohort Study	26
A systematic review on shared biological mechanisms of depression and anxiety in comorbidity with psoriasis, atopic dermatitis, and hidradenitis suppurativa	26
Changes in mental illness stigma over 30 years – Improvement, persistence, or deterioration?	26
Sex and age differences in ICD-11 PTSD and complex PTSD: An analysis of four general population samples	25

The association between C-reactive protein, mood disorder, and cognitive function in UK Biobank	24
Did we learn something positive out of the COVID-19 pandemic? Post-traumatic growth and mental health in the general population	24
Depressive symptoms and cognitive impairment: A 10-year follow-up study from the Survey of Health, Ageing and Retirement in Europe	23
Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis	22
High depression symptomatology and mental pain characterize suicidal psychiatric patients	22
Feelings of worthlessness links depressive symptoms and parental stress: A network analysis during the COVID-19 pandemic	21
Early Intervention in Psychosis services: A systematic review and narrative synthesis of the barriers and facilitators to implementation	21
Identification and management of cardiometabolic risk in subjects with schizophrenia spectrum disorders: A Delphi expert consensus study	20
Relationships of affective temperament ratings to diagnosis and morbidity measures in major affective disorders	20
The youngest are hit hardest: The influence of the COVID-19 pandemic on the hospitalization rate for children, adolescents, and young adults with anorexia nervosa in a large German representative samp	20
Measuring neuropsychiatric symptoms in patients with early cognitive decline using speech analysis	18
Care pathways for people with major depressive disorder: A European Brain Council Value of Treatment study	17
Examining the association between exposome score for schizophrenia and functioning in schizophrenia, siblings, and healthy controls: Results from the EUGEI study	17
Long-term development of post-traumatic stress symptoms and associated risk factors in military service members deployed to Afghanistan: Results from the PRISMO 10-year follow-up	16
Pathways to eating disorder care: A European multicenter study	16
Language proficiency and mental disorders among migrants: A systematic review	16
Mental health of helpline staff in Ukraine during the 2022 Russian invasion	15
Suicide trends in Norway during the first year of the COVID-19 pandemic: A register-based cohort study	14
Exosomes in schizophrenia: Pathophysiological mechanisms, biomarkers, and therapeutic targets	14
Inpatients with severe-enduring anorexia nervosa: Understanding the “enduringness” specifier	14
Depression and executive functioning bidirectionally impair one another across 9 years: Evidence from within-person latent change and cross-lagged models	13
Disentangling the symptoms of schizophrenia: Network analysis in acute phase patients and in patients with predominant negative symptoms	13
An fMRI study of cognitive reappraisal in major depressive disorder and borderline personality disorder	13
The association of kynurenine pathway metabolites with symptom severity and clinical features of bipolar disorder: An overview	13
A randomized controlled trial of a 14-day mindfulness ecological momentary intervention (MEMI) for generalized anxiety disorder	13
Postmarket safety profile of suicide/self-injury for GLP-1 receptor agonist: a real-world pharmacovigilance analysis	12
Assessment of beliefs and attitudes about electroconvulsive therapy posted on Twitter: An observational study	12
Cost-utility and cost-effectiveness of individual placement support and cognitive remediation in people with severe mental illness: Results from a randomized clinical trial	12
On the relation between a green and bright window view and length of hospital stay in affective disorders	12
Economic analyses of supported employment programmes for people with mental health conditions: A systematic review	12
The role of pre-pandemic depression for changes in depression, anxiety, and loneliness during the COVID-19 pandemic: Results from a longitudinal probability sample of adults from Germany	12
Continuous theta burst stimulation over the bilateral supplementary motor area in obsessive-compulsive disorder treatment: A clinical randomized single-blind sham-controlled trial	12
Joint European policy on the COVID-19 risks for people with mental disorders: An umbrella review and evidence- and consensus-based recommendations for mental and public health	12
Investigating the relationship between autistic traits and symptoms and Catatonia Spectrum	12
The role of loneliness in the development of depressive symptoms among partnered dementia caregivers: Evidence from the English Longitudinal Study of Aging	11
Influence of childhood maltreatment on prevalence, onset, and persistence of psychiatric comorbidities and suicide attempts in bipolar disorders	11
How to improve the physical health of people with severe mental illness? A multicentric randomized controlled trial on the efficacy of a lifestyle group intervention	11
Causal associations of intelligence with schizophrenia and bipolar disorder: A Mendelian randomization analysis	11
Individual and joint associations of anxiety disorder and depression with cardiovascular disease: A UK Biobank prospective cohort study	11
High intelligence is not associated with a greater propensity for mental health disorders	11
Transition to psychosis in randomized clinical trials of individuals at clinical high risk of psychosis compared to observational cohorts: a systematic review and meta-analysis	11
Aggressive challenging behavior in adults with intellectual disability: An electronic register-based cohort study of clinical outcome and service use	11
Chronic obstructive pulmonary disease in severe mental illness: A timely diagnosis to advance the process of quitting smoking	10
Outcome measures in forensic mental health services: A systematic review of instruments and qualitative evidence synthesis	10
Identification of common neural substrates with connectomic abnormalities in four major psychiatric disorders: A connectome-wide association study	10
Efficacy and safety of mij821 in patients with treatment-resistant depression: Results from a randomized, placebo-controlled, proof-of-concept study	10
Association of domain-specific physical activity with depressive symptoms: A population-based study	10
The use of big data in psychiatry – the role of pharmacy registries	9
Development of public stigma toward people with mental health problems in Czechia 2013–2019	9
Predicting involuntary hospitalization in psychiatry: A machine learning investigation	9

Paternal childcare at 6 months and risk of maternal psychological distress at 1 year after delivery: The Japan Environment and Children’s Study (JECS)	9
Reading skills deficits in people with mental illness: A systematic review and meta-analysis	9
The Association Between the Suicide Crisis Syndrome and Suicidal Behaviors: The Moderating Role of Personality Traits	9
A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London	9
An evaluation of symptom domains in the 2 years before pregnancy as predictors of relapse in the perinatal period in women with severe mental illness	9
Insideout project: Using big data and machine learning for prevention in psychiatry	9
Impact of COVID19 Lockdown in Eating Disorders: A Multicenter Collaborative International Study	9
Changes in striatal dopamine transporters in bipolar disorder and valproate treatment	9
Schizophrenia hospitalizations - a big data approach	9
Suicide reattempt in a population-wide brief contact intervention to prevent suicide attempts: The VigilanS program, France	8
Association of loneliness and social network size in adulthood with childhood maltreatment: Analyses of a population-based and a clinical sample	8
Attention-deficit/hyperactivity disorder as a risk factor for dementia and mild cognitive impairment: A population-based register study	8
Relapse and frequency of injection of monthly paliperidone palmitate—A retrospective case–control study	8
Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in depressed patients with suicidal behavior: A systematic review	8
Association of sociodemographic, proximal, and distal clinical factors with current suicidal ideation: Findings from a nonclinical sample of young adults	8
The Goldwater Rule at 50 and its relevance in Europe: Examining the positions of National Psychiatric Association Members of the European Psychiatric Association	8
Dimensions of psychopathology associated with psychotic-like experiences: Findings from the network analysis in a nonclinical sample	8
Prevalence and related factors of child posttraumatic stress disorder during COVID-19 pandemic: A systematic review and meta-analysis	8
The future of diagnosis in clinical neurosciences: Comparing multiple sclerosis and schizophrenia	8
Using retinal electrophysiology toward precision psychiatry	8
Is TikTok increasing the number of self-diagnoses of ADHD in young people?	8
Pattern of long-term weight and metabolic changes after a first episode of psychosis: Results from a 10-year prospective follow-up of the PAFIP program for early intervention in psychosis cohort	8
The biopsychosocial model of schizophrenia and cancer: Unraveling the etiopathogenesis of complex diseases	7
Prolonged impact of the COVID-19 pandemic on self-harm hospitalizations in France: A nationwide retrospective observational study	7
Polygenic risk scores enhance prediction of body mass index increase in individuals with a first episode of psychosis	7
Evaluating the performance of machine learning models for automatic diagnosis of patients with schizophrenia based on a single site dataset of 440 participants	7
The use of personal protective equipment as an independent factor for developing depressive and post-traumatic stress symptoms in the postpartum period	7
Characterization of suicidal depression: A 1 year prospective study	7
The early impact of the COVID-19 pandemic on patients with severe mental illness: An interrupted time-series study in South-East England	7
The network structure of ICD-11 adjustment disorder: A comparison of clinical and nonclinical samples	7
Real-world effectiveness of aripiprazole once-monthly REACT study: Pooled analysis of two noninterventional studies	7
Efficacy and safety of lurasidone in adolescents and young adults with schizophrenia: A pooled post hoc analysis of double-blind, placebo-controlled 6-week studies	7
The role of affective temperaments in bipolar disorder: The solid role of the cyclothymic, the contentious role of the hyperthymic, and the neglected role of the irritable temperaments	7
COVID-19 and cognitive function: Evidence for increased processing speed variability in COVID-19 survivors and multifaceted impairment with long-COVID symptoms	6
Neural signatures of data-driven psychopathology dimensions at the transition to adolescence	6
Impact of borderline personality disorder traits on the association between age and health-related quality of life: A cohort study in the general population	6
Hazardous alcohol consumption among older adults: A comprehensive and multi-national analysis of predictive factors in 13,351 individuals	6
Associations between childhood maltreatment and oxidative nucleoside damage in affective disorders	6
Cost-effectiveness of psychosocial assessment for individuals who present to hospital following self-harm in England: A model-based retrospective analysis	6
Neuroanatomical correlates of reality monitoring in patients with schizophrenia and auditory hallucinations	6
Delta and theta eeg activity during resting state is altered in patients affected by major depression	6
Impact of compulsory admission on treatment and outcome: A propensity score matched analysis	6
Have the psychiatric needs of people seeking gender reassignment changed as their numbers increase? A register study in Finland	6
Childhood trauma and cardiometabolic risk in severe mental disorders: The mediating role of cognitive control	6
Is decision-making impairment an endophenotype of anorexia nervosa?	6
Genetic influences on externalizing psychopathology overlap with cognitive functioning and show developmental variation	6
Telework during COVID-19 outbreak: Impact on mental health among Italian workers	6
Hospitalization for COVID-19 is associated with a higher risk of subsequent hospitalization for psychiatric disorders: A French nationwide longitudinal study comparing hospitalizations for COVID-19 an	6
A longitudinal study of post-traumatic stress, depressive, and anxiety symptoms trajectories in subjects with bipolar disorder during the COVID-19 pandemic	6
A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder	6
Investigating the association between physical health comorbidities and disability in individuals with severe mental illness	6
Predictors of real-life functioning in subjects with schizophrenia: A 4-year follow-up study	6
Does social cognition change? Evidence after 4 years from the Italian Network for Research on Psychoses	6
Epidemiology of posttraumatic stress disorder: A prospective cohort study based on multiple nationwide Swedish registers of 4.6 million people	6
Factors predicting relapse and treatment discontinuation with paliperidone 3-monthly long-acting injection: A 2-year naturalistic follow-up study	5
ITAlian Partnership for Psychosis Prevention (ITAPP): improving the mental health of young people	5
Exploring the association between brain-derived neurotrophic factor levels and longitudinal psychopathological and cognitive changes in Sardinian psychotic patients	5
Denial attitude towards COVID-19 among general population in Saudi Arabia	5
Evidence of an interaction between FXR1 and GSK3β polymorphisms on levels of Negative Symptoms of Schizophrenia and their response to antipsychotics	5
COVID-19 vaccination rates in hospitalized mentally ill patients compared to the general population in Germany: Results from the COVID Ψ Vac study	5
Remote Assessment of Disease and Relapse in Major Depressive Disorder (RADAR-MDD): Recruitment, retention, and data availability in a longitudinal remote measurement study	5
Bullying victimization/perpetration and non-suicidal self-injury: A systematic review	5
Face mask exemptions, psychiatric patients, and COVID-19	5
Mental disorders into adulthood among adolescents placed in residential care: A prospective 10-year follow-up study	5
Prevalence and clinical correlates of self-harm and suicidality during admission of children in a mental health inpatient unit	5
Association of anandamide and 2-arachidonoylglycerol concentrations with clinical features and body mass index in eating disorders and obesity	5
Life satisfaction prevents decline in working memory, spatial cognition, and processing speed: Latent change score analyses across 23 years	5
Searching for bridges between psychopathology and real-world functioning in first-episode psychosis: A network analysis from the OPTiMiSE trial	5
Dynamic networks of psychological symptoms, impairment, substance use, and social support: The evolution of psychopathology among emerging adults	5
Cognitive decline and alcohol consumption in the aging population—A longitudinal analysis of the Survey of Health, Ageing and Retirement in Europe	5
Prescriptions of psychopharmacologic drugs in Austria in 2019 and 2020 – Implications of the COVID-19 pandemic	5
Structural brain correlates of childhood trauma with replication across two large, independent community-based samples	5
Effect of standardized post-coercion review on subjective coercion: Results of a randomized-controlled trial	5
Mindfulness-based cognitive therapy added to usual care improves eating behaviors in patients with bulimia nervosa and binge eating disorder by decreasing the cognitive load of words related to body s	5
Time experience in patients with schizophrenia and affective disorders	5
Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patie	5
The role of achievement attribution in the associations between parent–child communication and psychological well-being among adolescents: A mediation analysis	4
Euthanasia of a person with a psychiatric disorder does not violate the European Convention on Human Rights (Mortier v. Belgium [no. 78017/17])	4
Predicting antipsychotic-induced weight gain in first episode psychosis – A field-wide systematic review and meta-analysis of non-genetic prognostic factors	4
Metacognitive knowledge and experience across multiple cognitive domains in euthymic bipolar disorder	4

Assessing the relationship between maternal risk for attention deficit hyperactivity disorder and functional connectivity in their biological toddlers	4
AI-driven adaptive treatment strategies in internet-delivered CBT	4
A Review of Aeruginascin and Potential Entourage Effect in Hallucinogenic Mushrooms	4
Short-term efficacy and safety of lurasidone versus placebo in antipsychotic-naïve versus previously treated adolescents with an acute exacerbation of schizophrenia	4
The impact of gender in the COVID-19 pandemic	4
Prevalence of different types of online behavior and internet addiction among adolescents in central siberia: Gender and age aspects	4
Dynamics between insight and medication adherence in first-episode psychosis: Study of 3-year trajectories	4
How subjective well-being, patient-reported clinical improvement (PROMs) and experience of care (PREMs) relate in an acute psychiatric care setting?	4
Mandatory certification for clozapine prescribing	4
Major depressive episode and postpartum depression: A network analysis comparison on the IGEDEPP cohort	4
Depression and post-traumatic stress disorder after perinatal loss in fathers: A systematic review	4
Who needs to be “burned-out”? Time for a new approach to job-related distress	4
Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysis	4
On the complex and dimensional relationship of maternal posttraumatic stress disorder during early childhood and child outcomes at school-age	4
Supporting return to work after psychiatric hospitalization—A cluster randomized study (RETURN-study)	4
Psychosocial function, legal involvement and violence in mental disorder	4
In vivo serotonin 1A receptor hippocampal binding potential in depression and reported childhood adversity	4
Comparative analysis of impulsivity profiles in adult Attention Deficit Hyperactivity Disorder and Borderline Personality Disorder	3
Green space and schizophrenia: A review	3
Schizophrenia stigma in mental health professionals and associated factors: A systematic review	3
The portuguese version of the big three perfectionism scale – further validation with adults from the general population	3
Comparison of neuropsychological profiles in children and adolescent with anorexia nervosa and avoidant/restrictive food intake disorder (ARFID)	3
Electroencephalography microstates imbalance across the spectrum of early psychosis, autism, and mood disorders	3
Comorbidity of autism with hyperkinetic disorder	3
If you feel you can’t, you won’t: the role of subjective and objective cognitive competence on psychosocial functioning in depression	3
Exercise addiction, body dysmorphic disorder, and use of enhancement drugs during the COVID-19 pandemic confinement period: A transcultural study	3
Antepartum depressive and anxious symptoms: Association with physiological parameters of the newborn	3
Development and first validation of the Portuguese version of the Big Three Perfectionism Scale–Short Form (BTPS-SF)	3
Psychosocial interventions for carers of people with severe mental and substance use disorders: a systematic review and meta-analysis	3
Suicidality in post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD)	3
Pregabalin addiction caracteristics at oran: A cohort study	3
Psychiatric manifestations of paraneoplastic syndromes	3
Trace of depression: Network structure of depressive symptoms in different clinical conditions	3
Cesarean section and parenting stress: Results from the Japan Environment and Children’s Study	3
Predictors of persistence in patients with schizophrenia treated with aripiprazole once-monthly long-acting injection in the Spanish clinical practice: a retrospective, observational study	3
Quality of care in psychiatry is related to research activity	3
Depression and anxiety in hospitalized children with epilepsy during COVID-19 pandemic: Preliminary findings of a cross-sectional study	3
What are the physical and mental health implications of duration of untreated psychosis?	3
The role of cognitive reserve and clinical symptoms in the association between genetic liability for educational attainment and functioning in first-episode psychosis: a mediation analysis	3
European Psychiatric Association–European Academy of Neurology statement on post-COVID syndrome	3
Dissociation between neuroanatomical and symptomatic subtypes in schizophrenia	3
Autism care pathway in Europe	3
Effects of the COVID-19 pandemic on mental health - what do we know so far?	3
Prevalence of depression in Europe using two different PHQ-8 scoring methods	3
Effects of prenatal subjective well-being on birth outcomes and child development: A longitudinal study	3
The heterogeneity of depressions: A phenomenological viewpoint	3
The effectiveness of trauma-focused psychotherapy for complex post-traumatic stress disorder: A retrospective study	3
Premature termination, satisfaction with care, and shared decision-making during home treatment compared to inpatient treatment: A quasi-experimental trial	3
The impact of Gender Identity Clinic waiting times on the mental health of transitioning individuals	3
Adults with adhd symptoms express a better inhibitory capacity when the perceptual load is higher	3
Early identification of treatment non-response in first-episode psychosis	3
WPA Global Guidelines for Telepsychiatry	3
The impact of body mass index on the pregnancy outcomes and risk of perinatal depression: Findings from a multicenter Italian study	3
A Case Report of Kratom-Induced Psychiatric Decompensation	3
Cost-effectiveness of implementing a suicide prediction tool (OxMIS) in severe mental illness: Economic modeling study	3
University entrance exam anxiety of adolescents during COVID-19 pandemic: Cognitive flexibility and self-regulation	3
Effects of strict COVID-19 lockdown on patients with obsessive-compulsive disorder compared to a clinical and a nonclinical sample	3
Psychometric Properties of the Arabic Big Five Inventory-2 Short Form among Undergraduates in Kuwait	3
Improving mental health care in depression: A call for action	3
Art therapy in eating disorders. A systematic review of literature	3
Coping strategies towards mobbing used by medical and nursing staff in the hospitals of the prefecture of Etoloakarnania, Greece	3
Early intervention in psychosis services: A systematic review and narrative synthesis of barriers and facilitators to seeking access	3
Attention deficit hyperactivity disorder symptoms and cannabis use after 1 year among students of the i-Share cohort	3
Associations of subclinical autistic-like traits with brain structural variation using diffusion tensor imaging and voxel-based morphometry	3
Features of the structure of psychopathological consequences in COVID-19	3
A study on patterns of use of mobile phone and nomophobia in medical undergraduate students during a COVID-19 pandemic lockdown	3
Trends in the incidence of hospital-treated suicide attempts during the COVID-19 pandemic in Oviedo, Spain	3
Mentation processes such as excessive mind wandering, rumination, and mindfulness mediate the relationship between ADHD symptoms and anxiety and depression in adults with ADHD	3
Study design of VGOAL-J: an observational, prospective cohort study to assess effectiveness of vortioxetine on goal achievement and work productivity in patients with MDD in Japan	3
The magnitude of depression in heart failure patients and its association with NYHA class	3
I-mindfulness-based cognitive therapy (i-MBCT) in the treatment of COVID-19 related adjustment disorder. a RCT study with active control group	3
Psychiatric and psychosocial characteristics of suicide completers: A 13-year comprehensive evaluation of psychiatric case records and postmortem findings	3
Risks of all-cause death and completed suicide in patients with schizophrenia/schizoaffective disorder treated with long-acting injectable or oral antipsychotics: A population-based retrospective coho	3
Music and emotion	3
COVID-19 pandemic and first episode of psychosis: Clinical characteristics	2
Improving treatment of patients with psychosis in low-and-middle-income countries in Southeast Europe: Results from a hybrid effectiveness-implementation, pragmatic, cluster-randomized clinical trial	2
Internally displaced persons and their mental health status	2
Mental health and climate change – a developmental life course perspective	2
Insomnia at the onset of addiction treatment may be related to earlier relapses: A one-year follow-up study	2
From the lecture theatre to your digital device: Reflections on the production of educational podcasts within undergraduate psychiatry training	2
Sexual counselling and sexual therapy in chemsex users in an NGO in spain	2
The regulation of emotions: Gender differences	2
Suicidality in University Students Throughout the COVID-19 Pandemic	2
Effects of media stories featuring coping with suicidal crises on psychiatric patients: Randomized controlled trial	2
Early career psychiatrists in europe during COVID-19 outbreak: Results of the EPA ECPC-EFPT cross-sectional survey	2
Cortical morphological heterogeneity of schizophrenia and its relationship with glutamatergic receptor variations	2
Transdiagnostic Role of Glutamate and White Matter Damage in Neuropsychiatric Disorders: A Systematic Review	2
Professional burnout and increased workload during covid-19 in higher education teachers in monteria - colombia	2
The Screen for Cognitive Impairment in Psychiatry (German version, SCIP-G): Validation, dimensionality analysis and practical application in inpatient psychiatric treatment	2
Bilateral pretibial edema associated with risperidone: A case report	2
Lower functional hippocampal connectivity in healthy adults is jointly associated with higher levels of leptin and insulin resistance	2
Pain and gain of auditory intrusions with video game content: Game transfer phenomena in clinical cases	2
Cannabis use in Tunisian high school adolescents: MedSPAD 2021	2
Prospects for the use of artificial intelligence methods in autism spectrum disorders	2
Donepezil-induced psychosis: a cautionary report of a rare adverse reaction	2