bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of traumatic childhood events on functioning in patients with schizophrenia
Authors: Neily C. , Charfi N. , Smaoui G. , Feki R. , Omri S. , Zouari L. , Ben Thabet J. , Maâlejboauli M. , Maalej M.
Published: September 2022

Introduction

A history of adverse childhood experiences (ACEs) can increase the risk of schizophrenia spectrum disorders and might be related to unfavorable clinical and functional outcomes of psychosis

Objectives

To assess the relationship between the history of ACEs and functioning in stabilized patients with schizophrenia or schizoaffective disorder.

Methods

We conducted a cross-sectional, descriptive and analytical study. It was carried out on out patients with stabilized schizophrenia or schizoaffective disorder. The diagnosis of schizophrenia and schizoaffective disorder was established based on DSM-5 criteria. We used the ACEs scale to screen for traumatic events that occurred in the childhood and we used the Functional Assessment Staging Scale (FAST) to assess the patients’ ability to function and perform tasks of daily living

Results

Seventy five patients were included.The mean age was 39.81 ±9.96 years.The sex ratio was 4 .34. The mean score of ACE was 3.55 ± 2.41 and 88% of patients had experienced at least one traumatic event.The mean sore of the FAST scale was 33 ± 14.95.The total score of FAST was significantly higher in case of physical negligence in childhood (p=0.018). No correlation was found with the others ACEs.The FAST sub score of cognitive functioning correlated with the history of parents separation (p= 0.47) and physical negligence (p= 0.03). we also found that The FAST sub score of interpersonal relationships correlated with the history of emotional abuse (p=0.021)

Conclusions

Our data has shown that ACEs contribute to functioning impairment in schizophrenia and schizoaffective disorder.This impairment affects mainly the cognitive functioning and the interpersonal relationships

Disclosure

No significant relationships.
Risky Decision-Making in Schizophrenia: Examination of association between smoking, substance use and performance on the Iowa Gambling test: Pilot Study
Authors: Dannon P. , Kertzman S.
Published: September 2022

Introduction

There are two common hypotheses to explain such high comorbidity between nicotine dependence and schizophrenia (SZ): self-medication for decreasing psychiatric symptoms or common environmental risk factors can predispose to both nicotine dependence and other risky behaviors in SZ

Objectives

Little is known about the influence of cigarette smoking comorbidities such substance use disorder (SUD), criminal history, or risky decision among patients with SZ.

Methods

The Iowa Gambling test (IGT) was administered to thirty-nine patients with SZ of whom 69% reporting cigarette smoking. Both groups were evaluated using a socio-demographic questionnaire and clinical assessment using PANSS and self-report questionnaire the Barratt Impulsiveness Scale (BIS-11). To evaluate decision making was evaluated with the Iowa Gambling Task (IGT).

Results

The full SZ sample performed worse on the IGT then normal population. Smokers with SZ performed significantly worse than nonsmokers on the IGT primarily because they preferred “disadvantageous” decks to a greater degree. The PANSS and impulsivity tendencies (BIS-11) did not predict overall performance on the IGT. Smokers with SZ had impaired affective decision-making. Behavior suggested preferential attention to the frequency amount of gain and inattention to amount of loss suggesting impairments in risk/reward decision-making

Conclusions

This study is the first to compare IGT in smokers and nonsmokers with SZ with adjustment of SUD, criminal history, and existing tattoo to further examine IGT performance. These results support the hypothesis that comorbidities between nicotine dependence and SZ can be linked to other common factor that is associated with other externalizing behaviors in SZ.

Disclosure

No significant relationships.
Folie à deux, about a case
Authors: Palomo Monge M. , Tascón Guerra M.F. , Pérez Fominaya M. , López Rodrigo M.V. , Osca Oliver A. , García Montero C. , Ros Font V.
Published: September 2022

Introduction

First described in France by Lasègue and Falret as the presence of the same psychiatric symptom in 2 individuals. It involves the transference of delusional ideas from a “primary” affected individual to one or more “secondaries,” in close association.

Objectives

We present the case of a patient, diagnosed with schizophrenia, who, after several years of evolution, and after a relapse, comes accompanied by his mother, who recently began to present the same delusional symptoms that the patient reported previously.

Methods

After several pharmacological adjustments, control of the patient’s symptoms is achieved and it is he himself who is able to identify the symptoms that his mother presents, allowing her to also attend and be treated.

Results

Induced delusional disorder F.24

Conclusions

Among the variants that the folie a deux encompasses (folie imposée, folie communiquée, folie simultenée, folie induite) in this case we are probably talking about a folie communiquée, given the resistance over time of the patient’s mother until the symptoms develop. It is important to know these syndromes to be able to make a clear diagnosis, and depending on the way of onset and evolution, to be able to distinguish between the different subtypes, in order to avoid future complications and guide the corresponding treatment.

Disclosure

No significant relationships.
Gender differences in patients attending Early Psychosis Intervention Programme
Authors: Mulero Garcia A.B. , Sánchez Martínez E. , Gómez Sanchez-Lafuente C.
Published: September 2022

Introduction

Studing the scope of differences found in terms of gender in First Psychotic Episodes patients, should enhance our understanding of such disorders and improve the therapeutic approaches.

Objectives

Our main objective was to compare the sociodemographic variables between men and women included in the Early Intervention Program in Psychosis of the Regional University Hospital of Malaga between the years 2016-2020.

Methods

Retrospective study in which the characteristics of 135 patients who started the Early Intervention Program in Psychosis of the Regional University Hospital of Malaga between the years 2016-2020 were analyzed. Statistical analysis was performed using SPSS 25.0. For the comparison of variables, Student’s t was used for quantitative variables and Chi square for dichotomous variables.

Results

Patients included in the Program; 32% were women and 68% were men. The average of age at the beginning was 35.56 for women and 28,47 for men. Most of the women were married and most of the men were single. The majority of men lived with their original family and for women with their own family. In relation with the consumption of toxins, alcohol and to smoke, were more frequent in men. More results in poster.

Conclusions

Despite the limitations due to our study design, the results obtained are in agreement with some of the discussions that are currently in force. Given that, female gender is associated with lower risk of psychosis, better premorbid adjustment, lower drug consumption and a later onset of the disease in the first-episode psychosis.

Disclosure

No significant relationships.
On the problem of the catatonic disorders taxonomy
Authors: Lobanova V. , Smulevich A. , Voronova E.
Published: September 2022

Introduction

In accordance with the systematics of modern international clinical guidelines (DSM-V, ICD-11), catatonia is qualified as a transnosological formation, which boundaries expandes by including non-psychotic movement disorders (hysterical, affective, negative, etc.). This study presents the psychopathological systematics of movement disorders, based on a new dimensional model of catatonia.

Objectives

60 patients with an established diagnosis of schizophrenia or SSD (F20, F21, F25.01, F25.11, F25.21, F25.22), catatonic disorders in the structure of which persist throughout the course of the disease or determine the clinical picture of phases.

Methods

Clinical, psychometric (BFCRS, SANS, SAPS, HADS), statistic.

Results

Three catatonic syndromes (S.) have been identified. 1. S. of stereotypical catatonia - presented by the mechanism of affiliation with negative symptoms (R between BFCRS Total Score (TS) and Avolition-Apathy SANS – 0,875): tendency to stereotypical activity; general, increasing slowness (SANS avolition-apathy -2,9±0,5; BFCRS TS – 11,1±0,2). 2. S. of parakinetic catatonia - includes paroxysms formes by the mechanism of mental automatism (with the loss of motor acts voluntary effect ) (R BFCRS TS/Persecutory Delusions SAPS– 0,764): irregular polymorphic movement disorders of hyperkinetic and akinetic types, impulsive actions, akinesias (Persecutory Delusions - 2,3±0,4; BFCRS – 19,5±2,3). 3. Affective - catatonic S. - including both the lightest (at the level of recurrent depression) variants of affective-catatonic phases (R BFCRS TS/HADS – 0,732; BFCRS – 5,1±0,4; HADS -15,1±2,4), and more severe affective-catatonic states based on schizoaffective psychoses (R BFCRS TS/SAPS TS– 0,783; BFCRS – 15,3±2,1; SAPS – 3,1±0,2).

Conclusions

Catatonia is not a single dimension, represented by heterogeneous movement disorders, differing both in the mechanism of formation and in the psychopathological structure.

Disclosure

No significant relationships.
Modified Completion Test (MCT) in Psychological Diagnostics of Patients with Paranoid Schizophrenia — Stage of Retelling the Story
Authors: Burlakova N.
Published: September 2022

Introduction

The modified completion test (MCT) based on the stories by H. Ebbinghaus enables to assess cognitive functions in situation close to a real-life task with an affective load (Burlakova,2016,2020). MCT includes the following stages: 1) filling the gaps in the story; 2) reading and retelling; 3) making up a continuation and a title; 4) retelling the story and its continuation after 30–40 minutes.

Objectives

The objective was to research diagnostical potential of the second stage of MCT for patients suffering from paranoid schizophrenia with hallucinatory syndrome.

Methods

The study included 42 patients (28 female, 14 male) with schizophrenia (disease onset at least 5–7 years ago), aged from 19 to 51 (average age 35±8), receiving treatment. Control group consisted of 44 people (average age 37±6), never sought psychiatric help, never diagnosed with any mental disorders. Groups were organized to be equal in gender proportions, age, and educational level.

Results

In comparison to the control group, the psychiatric patients demonstrated: 1) lower connectedness in narration, lower ability to reproduce main elements of the plot; 2) unusual logic in introduction of new details, extensiveness of such details; 3) lower integrity of mnestic functions, lower ability to maintain concentration. The clinical group: 1) imposed on the text principally different logic, subjectively significant, yet far from the original context; 2) suddenly introduced of new ideas; 3) had confabulations; 4) were altiloquent.

Conclusions

The stage of retelling enables to assess semantic memory, regulatory functions, connectedness of the narration, cogitation and to examine cognitive functions in the context of patient’s personality.

Disclosure

No significant relationships.
High-frequency rTMS in the treatment of depressive symptoms in schizophrenia: a neurophysiological profile of respondents and nonresponders
Authors: Kaleda V. , Pomytkin A. , Lebedeva I.
Published: September 2022

Introduction

Depressive symptoms in schizophrenia have a high prevalence – up to 20-60 %, at the different illness stages. Non-pharmacological treatment, namely rTMS, seems like a promising approach that lacks side-effects typical for antidepressants. RTMS is widely applied in the treatment of depression, however the studies within schizophrenia domain are still rather few

Objectives

The aim was to examine a potential of neurophysiological data for prediction of the effects of rTMS in the treatment of patients with schizophrenia with depressive symptoms

Methods

20 male patients with schizophrenia (F20.004, F20.014, F20.414, ICD–10) were examined at the stage of incomplete remission with predominance of prolonged (more than 6 months) treatment resistant depressive symptoms. An examination (clinical and neurophysiological (oddball ERP and EEG) fragments)) was repeated twice - before and after a course of 10 Hz rTMS (left DLPC, 2000 pulses per session, 15 sessions).

Results

Poor outcome was associated with initially higher coherence in alpha and lower - in beta1 EEG bands. The amplitudes of non-target N100 and mismatch negativity didn’t differ the groups of responders and nonresponders

Conclusions

The disturbances within brain networks of beta1 and alpha generators merit attention as potential neurophysiological markers with predictive value in rTMS treatment of patients with schizophrenia with depressive symptoms.

Disclosure

No significant relationships.
DNA-hydrolyzing catalytic IgGs from schizophrenia patients do not affect cell viability of the SH-SY5Y human neuroblastoma cell line
Authors: Epimakhova E. , Ermakov E. , Kazantseva D. , Parshukova D. , Dmitrieva E. , Smirnova L. , Ivanova S. , Semke A.
Published: September 2022

Introduction

DNA-hydrolyzing catalytic IgGs have caspase-dependent cytotoxic effects in autoimmune diseases. Recently, DNA-hydrolyzing IgGs have been discovered in schizophrenia. However, their cytotoxic properties have not been studied.

Objectives

To assess the effect of serum IgGs with DNA-hydrolyzing activity of schizophrenia patients on the cell viability of the SH-SY5Y human neuroblastoma cell line.

Methods

Serum of 8 patients with paranoid schizophrenia in the acute phase and 7 mentally and somatically healthy persons were used. IgG was purified from serum by affinity chromatography on Protein-G-Sepharose columns. The DNA hydrolyzing activity of IgG was assessed by the degree of hydrolysis of the pBluescript plasmid. The cell viability of the SH-SY5Y human neuroblastoma cell line after exposure to purified IgG preparations was assessed by high-throughput screening on the CellInsight CX7 platform (Thermo Scientific, USA) using the fluorescent dyes propidium iodide and Hoechst.

Results

Of the 8 IgG preparation obtained, 4 drugs had high DNA-hydrolyzing activity. All tested IgG preparations from healthy donors were inactive. One-way ANOVA analysis of the proportion of dead cells of the SH-SY5Y line after exposure to antibodies (0.1 mg/ml) showed no significant differences in the proportion of dead cells (p=0.688 after 24 hours; p=0.831 after 48 hours). Similar results were obtained at a higher concentration of antibodies - 0.2 mg/ml.

Conclusions

Thus, it has been shown in vitro that IgGs isolated from the serum of schizophrenia patients with or without DNA-hydrolyzing activity does not exhibit cytotoxic properties against the SH-SY5Y human neuroblastoma cell line. Support by Grant of RSF № 18-15-00053P.

Disclosure

No significant relationships.
Adjunctive treatment with aripiprazole for olanzapine-induced hyperprolactinemia
Authors: Bise S. , Sulejmanpasic G. , Hrnjica A. , Šarkić-Bedak Š.
Published: September 2022

Introduction

Hyperprolactinemia is a common unwanted antipsychotic-induced adverse effect, particularly in female patients, and can induce poor adherence to treatment. Aripiprazole is an antipsychotic with partial agonist activity over the dopamine D2 receptors which can be effective in reducing hyperprolactinemia in patients treated with antipsychotics.

Objectives

We investigate the efficacy of adjunctive treatment with aripiprazole for olanzapine-induced hyperprolactinemia and related hormonal side effects (amenorrhea, oligomenorrhea) in female patients with schizophrenia.

Methods

Eight female patients (22 to 40 years old) participated in this study with a diagnosis of schizophrenia and hyperprolactinemia-related hormonal side effects (amenorrhea, oligomenorrhea). Patients were treated with aripiprazole 10 mg/day added to a fixed olanzapine dose of 20 mg/day. Serum prolactin levels were measured at baseline and after 2, 4, 6, and 8 weeks. Symptoms and side effects were assessed using the Brief Psychiatric Rating Scale, Clinical Global Impressions Severity scale, Barnes Akathisia Scale.

Results

Adjunctive treatment with aripiprazole resulted in significantly lower prolactin levels beginning at week 2. 87.5 % of patients at week 8 had prolactin levels normalize. Among 8 patients with menstrual disturbances, 75% of patients regained menstruation during the study. No significant changes were observed regarding psychopathology and adverse effect ratings.

Conclusions

Adjunctive aripiprazole treatment is effective for resolving olanzapine-induced hyperprolactinemia and reinstatement of menstruation in female patients, provides significant improvement and it appears to be safe with a lower risk of metabolic syndrome, without increased risk of adverse effects.

Disclosure

No significant relationships.
Negative and Cognitive Symptoms of Schizophrenia: Are there Adequate Pharmacological Treatments?
Authors: Vasiliu O.
Published: September 2022

Introduction

The ongoing debate regarding the treatment efficacy for negative and cognitive symptoms in schizophrenia is a subject of continuous frustration among psychiatrists. These symptoms are reputedly hard to tackle therapeutically and their impact on long-term functional prognosis made them an important target for the maintenance treatment.

Objectives

To review the literature in order to find the most adequate treatment options for negative and cognitive symptoms of schizophrenia.

Methods

A literature review was performed through the main electronic databases (PubMed, CINAHL, SCOPUS, EMBASE, www.clinicaltrials.gov) using the search paradigm “schizophrenia” AND “negative symptoms” AND “cognitive symptoms” AND “pharmacological treatment”. All papers published between January 2000 and August 2021 were included.

Results

The efficacy of atypical antipsychotics over cognitive dysfunctions in schizophrenia decreases with time, without significant differences between the agents. Clozapine, amisulpride, olanzapine, and risperidone have superior efficacy over positive and negative symptoms, with small to moderate effect sizes. Meta-analyses show decreased severity of negative symptoms during treatment with atypical antipsychotics, especially with clozapine, amisulpride, olanzapine, zotepine, and risperidone. Atypical antipsychotics had a superior effect over neurocognitive domains when compared to the typical antipsychotics. Newer atypical antipsychotics, with partial D2/D3 agonism, are preferred to other atypical agents, although based on a low level of evidence. Antidepressants, especially mirtazapine, may be a solution for negative symptoms, while modafinil/armodafinil is also useful as an add-on.

Conclusions

Although new therapeutic options are explored, there is a paucity of encouraging results from the pipeline regarding the treatment efficacy over negative/cognitive symptoms.

Disclosure

No significant relationships.
Does smoking affect the prevalence of caffeine use in schizophrenia?
Authors: Becerra Darriba H.
Published: September 2022

Introduction

Caffeine acts as a competing antagonist of adenosine receptors, increasing the release of norepinephrine and the activation of noradrenergic neurons. Long-standing schizophrenia patients frequently develop a comorbidly high daily caffeine intake. This could be explained by its relationship with smoking [1,2].

Objectives

To determine caffeine consumption in schizophrenia and predisposing factors.

Methods

Cross-sectional study designed on a sample of 68 outpatients with a follow-up of at least 5 years at the Mental Health Unit, aged between 18 and 65 years, diagnosed with schizophrenia (ICD-10). Average daily caffeine intake was quantified by reference values for each beverage: coffee (66.7mg/100ml), tea (30mg/100ml), soft or energy drinks (11.5mg/100ml). High intake was defined as a consumption of ≥200mg of caffeine per day. Retrospective review of medical records revealed tobacco use and negative symptoms observed on the PANSS scale. Statistical analysis were performed using SPSS v21.0 (significance p<0.05).

Results

88.2% of the subjects were daily caffeine consumers with a mean intake of 146.7mg/day (SD=5.8), and a mean consumption time of 6.2 years. Coffee was the predominant beverage in 66.7% of the cases, followed by soft or energy drinks (25%) and tea (0.1%). 45% of participants also had a high caffeine intake of ≥200 mg/day. Comorbid smoking was found in 93% of these patients. Negative symptomatology prevailed among caffeine consumers (PANSS-N= 41.3).

Conclusions

Xanthine abuse seems to be highly prevalent in people with schizophrenia, and there may be a relationship with smoking and negative psychotic symptoms.

Disclosure

No significant relationships.
Research in Mental Health During the Pandemic
Authors: Gaughran F.
Published: September 2022

Abstract Body

All healthcare had to rapidly adjust to covid-19; remote options were implemented at pace and unnecessary face to face contact minimised, with infection prevention and control taking primacy. Many research projects were suspended and some clinical researchers moved to frontline care. For psychiatric academic trainees, covid-19 affected recruitment, and risked delaying work on research degrees such as PhDs, potentially beyond the timeframe of a grant, leading to funding uncertainties. Those valuable casual conversations with senior colleagues in the café stopped and with many schools closed, parents had extra pressures on their time at home. In the UK the government prioritised “Urgent Public Health” (UPH) studies and took a co-ordinated approach to research approvals and recruitment strategies, contributing to the success of covid-19 platform trials such as RECOVERY. While initially only a minority of UPH studies were open to people with serious mental illnesses, now the effect of the pandemic on mental health has become a research priority. In parallel, service planners recognised the value of emergent research in informing decision-making creating de facto learning health systems. While covid-19 interrupted research as we knew it, it necessitated new ways of working, some of which will persist. These included an increase in remote data collection, allowing greater access to research opportunities for potential participants, along with more efficient research approval and evidence dissemination pathways.

Disclosure

No significant relationships.
Folie en Famille: A Case Report of Shared Delusory Parasitosis
Authors: Al Siaghy A. , Zoghbi Y. , Azeem M.
Published: September 2022

Introduction

Delusional parasitosis, first documented in 1946, is a rare psychiatric illness described as both a stand-alone diagnosis, as well as a secondary condition to an underlying psychiatric or medical pathology, or substance use. Interestingly, the fixed false belief of being infested has also been identified in partners of individuals with the disease, and in some cases the delusion permeated families and was thus given the name “folie en famille”.

Objectives

To describe the first reported case of delusional disorder, somatic type, with similar delusional symptoms in the patient’s husband, in the State of Qatar.

Methods

Patient and her husband were interviewed. Her file was reviewed for past history and medications.

Results

34-year-old female with no past psychiatric history, 5 months post-partum, reported fixed beliefs of insect infestation in her baby’s skin, hers, and her husband’s, of 2 months duration. She reports a pruritic rash, and perceives proliferating insects in different life stages. The family relocated 5 times in 2 months. They bathe in vinegar several times a day to exterminate the insects. Husband mirrors her account of infestation with milder symptoms. Repeated medical investigations were insignificant. OCD, mood disorder, and other psychotic illnesses were ruled out.

Conclusions

Delusional parasitosis presents a unique therapeutic challenge to psychiatrists. It is necessary to build rapport with patients, rule out comorbidities, and conduct randomized controlled trials to evaluate the effectiveness of psychotropic drugs in its treatment. In cases of shared delusions, identifying the primary patient is crucial for treatment of all the individuals that share the delusion.

Disclosure

No significant relationships.
Antipsychotics induced constipation in patients with mental disorders. treatment suggestion with prucalopride in refractory cases. case report and literature review
Authors: Mpouras P. , Argitis P. , Pikou O. , Karampas A. , Karavia S. , Kakavitsas F.-E. , Chaviaras Z.
Published: September 2022

Introduction

Successful stabilization of patients with mental disorders requires most of the times the use of more than one antipsychotic medications with increase prevalence of clozapine in refractory cases. Constipation consists one of the most debilitating side effect of the therapy, which gradually progresses to a chronic state of bowel movement dysfunction, with recurrent episode of paralytic ileus of various severity.

Objectives

We describe the case of a middle age male treated with clozapine for refractory mental disorder, who developed ileus and subsequent bowel dysfunction not amenable to laxatives.

Methods

The acute episode have been treated conservatively with nasogastric decompression, intravenous replacement of fluids and electrolytes, antibiotics chemoprophylaxis and low molecular weight heparin. His overall physical status was unremarkable for obesity, diabetes, hypertension, allergies, previous operations and a former endoscopic evaluation conducted in the recent past, which had ruled out malignant neoplastic disease.

Results

A course of per os prucalopride have been instituted, which showed preliminary promising results in restoring proper bowel movements, without any serious side effect and without the need to discontinue his course with antipsychotics. Prucalopride is a 5 HT4 agonist which selectively binds to the receptors of the intestine, resulting in muscular contractions as well as clorium secretion from the mucosa promoting an osmotic defecation.The substance has been extensively use in the treatment of irritable bowel disease of the chronic constipation type.

Conclusions

We suggest the more systematic use of this agent in this group of patients after proper endoscopic evaluation and restoration of all secondary causes of constipation.

Disclosure

No significant relationships.
Clinical factors affecting functioning in patients with schizophrenia or schizoaffective disorder
Authors: Neily C. , Charfi N. , Smaoui G. , Feki N. , Omri R. , Zouari L. , Ben Thabet J. , Maâlejboauli M. , Maalej M.
Published: September 2022

Introduction

Schizophrenia is often associated with impaired functioning abilities due to its disabling symptoms.

Objectives

to determine the clinical factors that impact the functioning in stabilized patients withschizophrenia and schizoaffective disorder.

Methods

We conducted a cross-sectional, descriptive and analytical study. It was carried out on an outpatient population with schizophrenia or schizoaffective disorder diagnosis. We used the Functional Assessment Staging Scale (FAST) to measure the functional capacity, the PANSS to assess psychosis symptom severity and the Calgary scale to screen for comorbid depression.

Results

Seventy-five patients were included with 61 males (81.3%).The mean age was 39.81 ± 9.96 years. The mean sore of the Fast scale was 33 ± 14.95. 90% of our patients scored higher than 11 on the FAST scale revealing a functioning deficiency. 18.7% scored higher than 6 on the Calgary scale revealing a comorbid depression .No significant correlations were found between the FAST score and the age of patient, the gender,the age of onset of psychosis, the duration of untreated psychosis and the number of life-time episodes. Scores of PANSS were significantly higher among patients with a functioning deficiency (p<0.00).No significant correlation was found between the FAST score and the Calgary score.

Conclusions

Our study suggests that the severity of residual positive and negative symptoms affects negatively the functioning of patients with schizophrenia or schizoaffective disorder. Thus, targeting those symptoms in the treatment may have significant functional benefits.

Disclosure

No significant relationships.
Early Career Psychiatrists in Europe During COVID-19 Outbreak: Results of The EPA ECPC-EFPT Cross-Sectional Survey
Authors: Gondek T.
Published: September 2022

Abstract Body

The COVID-19 pandemic has affected the lives and work of Early Career Psychiatrists (ECPs). Some had to revamp their professional life, start using telepsychiatry without prior training, change their workplace during the pandemic, or were quarantined. Others were not able to complete their training or take obligatory courses as planned. The aim of the study was to understand the impact of the pandemic on education and professional development, working conditions and wellbeing of ECPs, as well as their attitude to telepsychiatry. The anonymous, 24-question cross-sectional survey was conducted by the European Psychiatric Association Early Career Psychiatrists Committee (EPA ECPC) and the Task Force on Meetings and Associations with the collaboration and support of the European Federation of Psychiatric Trainees (EFPT). 517 participants from 39 different countries (member states of the Council of Europe) have been included in the analysis. Statistical analyses have been performed. Final results will be presented during the symposium. Identifying the impact of the COVID-19 pandemic on ECPs will help us better prepare for similar events in the future, equip them with the necessary skills and provide them with the right support.

Disclosure

No significant relationships.
A case report of de novo psychosis after epilepsy surgery
Authors: Adão C. , Rodrigues D.F. , Sequeira A.S. , Trindade P. , Velosa A.
Published: September 2022

Introduction

Epilepsy is a common and severe neurologic condition, with a high prevalence of psychiatric comorbidity. Epilepsy surgery has been used for its treatment, resulting in remission or significant reduction of crisis. An improvement of previously existing psychopathology has been more frequently described, however its exacerbation or de novo psychopathology post-surgery has also been reported. The prevalence rate for post-surgery psychosis is 1.1%. There are no clear risk factors associated to this condition, or a proposed pathological mechanism. However, most cases described in the literature are of patients submitted to temporal lobectomy.

Objectives

Description of a clinical case of a first-episode psychosis post-epilepsy surgery and review of the literature.

Methods

Description of a clinical case. Non systematic review of the literature, searching the terms “psychiatric”; “psychosis”; “epilepsy surgery” in the databases Pubmed, Medline and Cochrane.

Results

Male, 29-year-old patient, diagnosed with refractory temporal lobe epilepsy. Neuropsychiatric history of mixed adaptation disorder, treated with escitalopram 10 mg daily. Submitted to anterior temporal lobectomy with no complications. On the 6th day post-surgery, he developed persecutory and self-referent delusions. There’s no evidence of other causal factors. Treated with paliperidone 3 mg daily with symptom remission after one week. The diagnosis of brief psychotic disorder was made.

Conclusions

We present a case of a de novo psychotic disorder, a rare complication of epilepsy surgery. In the future, it might be interesting to study this association in detail, with the goal of deepening the knowledge of the neurobiology of psychosis, particularly the involvement of temporal circuits.

Disclosure

No significant relationships.
Multifamily therapy in first episodes of psychosis: a pilot study
Authors: García Del Castillo I. , López García S. , Pérez Balaguer A.
Published: September 2022

Introduction

Multifamily interventions have shown to reduce the risk of relapse of psychotic symptoms in first episodes of psychosis (FEPs) but are not frequently implemented in specific treatment programs. We have develop a pilot study for the implementation of the interfamily therapy in FEPs within a Mental Health Centre in the Community of Madrid.

Objectives

The aims were to examine: relapses (measured as re-hospitalization), duration of re-hospitalizations and voluntary versus involuntary re-hospitalizations during participation in MFG compared with the previous year.

Methods

21 subjects participated in a MFG during 12 months, 11 participants with a diagnosis of psychosis and 10 family members. Interfamily therapy works as a new model of interactive psychoeducation among families where they share their own experiences and look for comprehension and solutions all together.

Results

Our clinical experience in an interfamily therapy intervention over 12 months has led us to identify a high degree of participation and acceptance by users and their families, and we have observed a lower relapse rate, with fewer of psychiatric admissions and of shorter duration among patients during the year of participation in the MFG compared to the year before treatment.

Conclusions

MFG has been well accepted by both patients and their families, with a high degree of participation.The results observed in our experience of MFG treatment are consistent with the findings of previous studies that support the reduction of the relapse rate, the number of hospitalizations and their duration when family interventions are incorporated into treatment in recent-onset psychosis, especially in a multi-family group format.

Disclosure

No significant relationships.
Assessment of depressive symptoms in hospitalized patients with schizophrenia
Authors: Abdelkefi M. , Ellouze S. , Ajmi S. , Turki M. , Halouani N. , Aloulou J.
Published: September 2022

Introduction

The prevalence of depressive disorders in patients with schizophrenia is estimated at 25%. Nevertheless, depressive symptoms occurring during the acute decompensation of schizophrenia have rarely been studied.

Objectives

The aim of our study was to assess depressive symptoms in hospitalized patients suffering from schizophrenia.

Methods

We conducted a cross-sectional, descriptive and analytical study, including 30 schizophrenic patients, hospitalized in the psychiatry B “department of the Hedi Chaker university hospital in Sfax. The assessment of clinical severity of schizophrenia was performed by the Positive and Negative Syndrome Scale (PANSS), that of depressive symptoms by the “Calgary Depression Scale for Schizophrenia” (CDSS).

Results

The mean age of patients was 41.2. Most of patients were male (86.7%) and unemployed (83.3%). Only 13.3% of them were married. Patients were hospitalized 8.83 times in average. A personal history of suicide attempts was found in 16.70% of cases. The mean score in the CDSS scale was 5.12. According to the CDSS score, a depressive state was diagnosed in 36.7% % of patients. Depression was associated with significantly more frequent history of suicide attempts (p=0.028), as well as significantly higher scores in the positive dimension of the PANSS (p=0.03).

Conclusions

Our results show that depressive symptoms are common during the acute decompensation phase of schizophrenia. They are associated with impaired functioning of patients, as well as a higher risk of suicide. Screening for depressive symptoms in patients hospitalized for schizophrenia is therefore essential in order to ensure better management.

Disclosure

No significant relationships.
Paraphrenia: a lost concept
Authors: Vicent Forés S. , Sainz De La Cuesta Alonso S. , Calera Cortés F. , Gutierrez Higueras T.
Published: September 2022

Introduction

Paraphrenia consists on a syndrome of insidious development with a chronic delirium of great phenomenological richness, predominating productive or delusional-hallucinatory forms and with time it evolves to pure fabulation. Delusions appear in 100% of cases predominating persecution, reference and false identifications. It is a classic term that disappeared with DSM-III, but is still useful for the description of certain clinical cases.

Objectives

Presentation of a case that clearly defines the classic term paraphrenia, which is now a days lost in new classifications.

Methods

We carried out a literature review of the term paraphrenia and presented a real case of a patient interned in our psychiatric ward.

Results

A 55-year-old woman, was without treatment or attendance to her psychiatrist for years, admitted to the hospital due to public disturbance. Even the lack of treatment did not repercuss greatly emotionally or behaviorally. During our interviews, she showed an expansive discourse rich in delirious content, as well as thought transmission and reading, auditive hallucinations and corporal influence. As we can see, this case exposes what would have classical been classified as a case of paraphrenia, nowadays we cannot find a better term to name this group of symptoms with the current classifications.

Conclusions

We can conclude that paraphrenia is halfway between schizophrenic disorganization and paranoic structuring. The personal deterioration is significantly lower than in schizophrenia and the expression of delirium differs from paranoia. Even though actual classifications provide simplicity and pragmatism, we risk losing the semiological and phenomenological richness of classic terminology.

Disclosure

No significant relationships.
Thyroid psychosis: a case report
Authors: Izquierdo De La Puente A. , Del Sol Calderón P. , Garcia Moreno M.
Published: September 2022

Introduction

We present the case of a patient who after a year of psychotic symptoms is diagnosed with thyroid cancer with hyperthyroidism.

Objectives

A brief review is made of the psychotic symptoms in a patient with hyperthyroidism secondary to cancer of the gland.

Methods

We present the case of a 52-year-old patient, a former injecting drug addict, who after a year with psychotic symptoms, is diagnosed with thyroid cancer with hyperthyroidism. The patient reported that a year ago, he suddenly had a painless and indurated lump in his neck, associated with weight loss and confusional symptoms. One month after the appearance of the tumor, the patient began to present visual, kinesthetic and haptic hallucinations, with the sensation that supernatural beings were passing through and possessing him. Likewise, he referred to being able to see and feel the atoms of matter, being able to communicate with a superior being whom he called “creator”.

Results

The patient is admitted for psychotic symptoms. During it, the necessary complementary tests are carried out, objectifying a clinical situation of hyperthyroidism. The study is extended, observing a hyperfunctioning nodule, which corresponded to thyroid cancer.

Conclusions

Neuropsychiatric symptoms in hyperthyroidism are relatively common. In most cases, the most frequent are cognitive alterations, attention problems and working memory problems. It can also lead to depressive episodes, and more rarely, psychotic symptoms.

Disclosure

No significant relationships.
Efficacy and tolerability Aripiprazole once-monthly long-acting injectable in schizophrenia. Two-injection start regimen
Authors: Romero Guillena S.L. , Plasencia Garcia De Diego B.O. , Gotor Sanchez-Luengo F. , Gómez González J.
Published: September 2022

Introduction

Aripiprazole once-monthly is a long-acting intramuscular injectable formulation of aripiprazole. The starting dose can be administered by following one of two regimens: • One injection start: On the day of initiation, administer one injection of 400 mg Aripiprazole once monthly and continue treatment with 10 mg to 20 mg oral aripiprazole per day for 14 consecutive days • Two injection start (New regimen): On the day of initiation, administer two separate injections of 400 mg Aripiprazole once monthly at separate injection sites, along with one 20 mg dose of oral aripiprazole.

Objectives

To assess the effectiveness and tolerability of Aripiprazole long-acting injectable (ALAI) in patients with schizophrenia. The starting dose was administered following the two injection start regimen

Methods

Sample:10 patients with schizophrenia (DSM 5 criteria) who started treatment with ALAI. The starting dose was administered following the two injection start regimen. On a tri-monthly basis, the following evaluations were performed during a follow-up period of 6 months: The Clinical Global Impression-Schizophrenia scale (CGI-SCH), treatment adherence, the number of hospitalizations and Side effects reported

Results

Mean variations from baseline scores at 6 months was (-1.1 ±0.89) on the GCI-SCH. The percentage of patients who remained free of admissions at the end of the 6 months was 90%. The rate of adherence to treatment after 6 months was 80%. The most frequent side effect was transient mild insomnia (20%) .

Conclusions

Aripiprazole long-acting injectable (The starting dose was administered following the two injection start regimen) is effective, safe and well tolerated in clinical practice conditions

Disclosure

No significant relationships.
Chronic delusional disorder and Chales Bonnet syndrome: differential diagnosis or comorbidity
Authors: Molina Liétor M.D.C. , Cuevas Iñiguez I.
Published: September 2022

Introduction

Delusional idea disorders are a group of syndromes whose main or unique characteristic is the presence of consolidated delusional ideas that usually have a chronic character and do not fit into other diagnoses such as schizophrenia, affective disorder or other organic diseases. On the other hand, Charles Bonnet syndrome is an organ hallucinosis in whose context visual hallucinations may appear in patients with a visual deficit. Historically, it has been considered that the presence of another psychiatric condition is an exclusion criterion for the diagnosis of Charles Bonnet syndrome, although the presence of similar etiological and maintenance factors means that this situation of dignous exclusion must be reconsidered.

Objectives

The objective of the present communication is to study the current state of the topics “delusional disorder” and “Charles Bonnet syndrome”. Another objective is to reconsider that the presence of previous or concurrent psychiatric pathology is an exclusion criterion for the diagnosis of Charles Bonnet syndrome..

Methods

A bibliographic review on “delusional ideas disorder” and “Charles Bonnet syndrome” has been carried out, as well as a discussion on the diagnostic and exclusion criteria, based on the etiopathogenic and maintenance factors.

Results

Both in “delusional ideas disorder” and in “charles bonnet syndrome” advanced age, social isolation and deficiencies in sense organs constitute etiological factors that facilitate the appearance of these syndromes and make their treatment difficult.

Conclusions

Due to this, we consider that the appearance of another previous or present psychiatric illness should not be an exclusion criterion, both can appear in the same patient.

Disclosure

No significant relationships.
Treatment-resistant schizophrenia : the relationship between clozapine plasma concentration and clinical outcome
Authors: Kammoun I. , Jouini R. , Aissa A. , Boukhchina R. , Zgueb Y. , Khelifa E. , Ouali U. , Jomli R. , Nacef F. , El Hechmi Z.
Published: September 2022

Introduction

Clozapine is highly effective in patients with treatment-resistant schizophrenia but, to ensure optimal clinical response it is important to optimize its use and this depends on adequate pharmacological monitoring.

Objectives

Evaluate the therapeutic response rate according to clozapine plasma concentration.

Methods

It was a cross-sectional, retrospective and analytical study, carried out over a period of six months, in the F and A psychiatry departments of the Razi hospital in Tunis, including patients followed for treatment-resistant schizophrenia and receiving clozapine. We evaluated the response to clozapine using the Brief Psychiatric Rating Scale (BPRS).

Results

The average age was 37.7 ± 9.4. The mean age of introduction of clozapine was 31 years and the mean time to its introduction was 9.3 years. Clozapine was administered as a single drug in 85% of cases. The mean dose of clozapine was 373 mg/day. The mean of clozapine plasma concentration was 386.5 ng/ml with a minimum of 89 ng/ml and a maximum of 913 ng/ml. The clinical response rate to clozapine was 25% with a BPRS good response threshold value of less than 35. Patients with clozapine levels above the conventional cut-off of 350 ng/ml (n=34) had a response rate of 34.6%. A response rate of 37% was observed in the group of patients with a clozapine plasma concentration interval of 200-350 ng/ml. There was no statistically significant difference in therapeutic response (p=0186)

Conclusions

Our study revealed a therapeutic response variation according to plasma clozapine concentration and showed the existence of a non-negligible and effective response rate.

Disclosure

No significant relationships.
Identification of trema in first episode psychosis: a case report
Authors: Alvarez Garcia C. , García Martínez D. , Nocete Navarro L.
Published: September 2022

Introduction

The concept of trema refers to an initial phase in the psychotic process that is characterized by intense anguish, an experience of hostility and a feeling of imminent catastrophe. This situation engenders in the patient a sensation of being in a tunnel than can only lead to something terrible but ineffable.

Objectives

To illustrate the incipient phase of psychotic disorder though the presentation of a case.

Methods

A presentation of a clinical case.

Results

A 29-year-old man attends the emergency department due to anxiety of one moth of evolution, that had debuted after a stressful event in the patient’s life such as loss of employment. He suffered from intense morning-predominance anguish, depersonalization episodes, insomnia, hallucinosis, cognitive blocks that occasioned him great anxiety and apragmatic behaviors. Besides, he had language alteration and autolytic ideation with previous autolytic gestures. After evaluation, he was diagnosed with psychotic episode. He was hospitalized, and treatment with olanzapine and lorazepam was started.

Conclusions

With the exhibition of this case, we intended to point up the importance of a differential diagnosis with different disorders marked by anxiety as the main symptom. In our case, panic disorder should be taken in account as a differential diagnosis. Furthermore, as the evidence shows, the identification of prodromic phases in schizophrenia allows an early diagnosis and early intervention, improving the prognosis.

Disclosure

No significant relationships.