bluuebunny/crossref_metadata_2025 huggingface dataset:
1H-MRS of the anterior cingulate cortex in obsessive-compulsive disorder: metabolic abnormalities in pgACC - controlled study
Authors: Nosková E. , Fajnerová I. , Pajuelo D. , Stopková P. , Horáček J.
Published: August 2023

Introduction

Obsessive-compulsive disorder (OCD) is connected with increased activity in cortico-striatal-thalamic-cortical (CSTC) loop. The anterior cingulate cortex (ACC) is a part of this loop and plays a role in error detection and monitoring and processing of conflicting information, core OCD clinical signs. This area also contains a high density of Von Economo neurons. Biochemistry in this area is closely connected with the pathophysiology of OCD.

Objectives

Decreased concentrations of total N-acetylaspartate (tNAA) have been reported in ACC in patients with OCD compared to healthy controls (HC), with increase after successful treatment. Findings by other metabolites: choline-containing compounds (tCho), total creatine (tCr) and myo-inositol are not consistent. Differences in levels of tNAA, tCho, tCr would correlate with the severity of symptoms measured by Y-BOCS. In the comparison in the subgroup of patients with/ without medication, there will be differences in levels of metabolites.

Methods

54 patients diagnosed with OCD according to ICD-10 and DSM-IV criteria, and 54 HC matched for age and sex were included in the study. They underwent MRI and MR Spectroscopy on a 3T Magnetom Prisma scanner (Siemens, Germany) equipped with a 64-channel volume head coil (Fig. 2). After spectral quality control, 28 OCD and 28 HC subjects were included in the statistical analysis. OCD subjects were interviewed using the Y-BOCS to evaluate the severity of the symptoms. Patients enrolled in the study were without medication at least 5 days before MRI or on a stable dosage of SSRI antidepressants. To assess the intergroup differences Wilcoxon Rank Sum test or Kruskal-Wallis test was used as appropriate. The correlation between metabolite levels and clinical characteristics was assessed by Spearman’s rank correlation coefficient. The statistics were calculated using R, version 4.1.1.

Results

We found no differences in levels of tNAA in ACC in OCD vs. HC (p=0,21; see Tab.1, Fig.1). We found significantly increased level of tCho, tCr and Ins in OCD vs. HC (p=0,03; p=0,004 resp.; p=0,017 resp.). tCr levels corelated negatively with YBOCS compulsions subscale (p=0,046; cor=-0,38). tCho levels showed a trend to negative correlation with Y-BOCS compulsions subscale (p=0,067; cor=-0,35). Analysis on the subgroup with (13 subjects, 46,43 %) and without (13 subjects, 46,43 %) stable SSRI medication did not reveal significant differences.

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Conclusions

Our study found difference in ACC by OCD patients compared to HC, mainly increased tCho, tCr and Ins. Also, the study shows a significant correlation between the severity of compulsions and tCr levels. We can see this trend also in the correlation of the tCho and Y-BOCS compulsions subscale. Similar tNAA level by OCD and HC groups could indicates correctly adjusted medication or stable state by enrolled patients.

Disclosure of Interest

None Declared
PROPSY: a new strategy to implement precision psychiatry in France
Authors: Llorca P. M.
Published: August 2023

Over a 5-year program-project, focusing on 4 of the most disabling disorders (i.e. Bipolar Disorder, Major Depressive Disorders, Schizophrenia, and Autism Spectrum Disorders), PROPSY’s ambition is to bring solutions for precision medicine in psychiatry. This ambition requires overcoming multiple challenges: (i) to discover prognostic and stratification biomarkers, (ii) to better understand underlying causes and mechanisms, (iii) to develop targeted therapeutic strategies (iii) to reduce stigma and false representation, (iv) to reduce the direct and indirect economic costs. To tackle these challenges, PROPSY is an inclusive program project composed of 5 operational work packages. PROPSY will also implement this knowledge into clinical practice, in a truly learning healthcare system, and increase awareness with Patients’ Associations to reach out to civil society. This research effort in precision psychiatry aims to strengthen the coordination of the French workforce along with international collaborations in connection with users and policymakers

Disclosure of Interest

None Declared
Effects of cognitive rehabilitation interventions on non-central nervous system cancer survivors: A meta-analysis
Authors: Oliveira A. F. , Reis J. D. , Santos I. M. , Torres A.
Published: August 2023

Introduction

Cancer treatments can have a detrimental impact on cancer survivors’ cognitive function. Cognitive rehabilitation is considered the first-line intervention to address cognitive difficulties of cancer survivors. Nevertheless, its efficacy remains unclear.

Objectives

This meta-analysis aimed to understand the effects of cognitive rehabilitation in non-central system (non-CNS) cancer survivors, through the assessment of the overall efficacy on subjective cognitive outcomes.

Methods

This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. An electronic search on the databases PubMed, Scopus, and Web of Science was conducted in May 2021, considering the past 15 years, by two independent authors. Studies were eligible if they included cancer survivors (excluding CNS cancers) who were exposed to cognitive rehabilitation interventions, in which the subjective cognitive effects were measured through self-report questionnaires. The quality of studies was assessed using the Cochrane Risk of Bias Tool for Randomized Trials. The effect size was the standardized mean difference in the cognitive assessment, between baseline and post-intervention. Statistical heterogeneity was assessed using I2 Statistic. Publication bias was evaluated with Egger’s test. P<0.05 was considered statistically significant. The meta-analysis was performed using R software.

Results

Among 14 studies, with 1115 cancer survivors, one study included a pediatric population, other young adult survivors, and the remaining adult population. The most used scale for measuring cognitive changes was the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) and, as recommended, the Perceived Cognitive Impairments (PCI) subscale was used as the primary measure of subjective cognitive function. Results indicated beneficial effects following cognitive rehabilitation, with an overall standard mean difference between pre- and post-treatment of 3.4447, with CI95% [1.5543; 5.3350], p-value<0.0004. The subgroup analysis between the measures of cognitive outcomes showed that the heterogeneity is Group=Other 0.00% (I2) and for the Group=FACT-Cog PCI is 86% (I2). Analyzing the FACT-Cog PCI, the CI95% [-2.93; 6.43] includes 0, meaning that the overall effect in this subgroup is non-significant. The meta-analysis does not demonstrate publication bias (p-value of the Egger test=0.3220).

Conclusions

Improvement of cognitive function in non-CNS survivors throughout cognitive rehabilitation appears to be effective. The findings of this meta-analysis can help inform clinical practice and assist practitioners in recommending and developing interventions of cognitive rehabilitation and deciding how to evaluate them. Further research is required to strengthen this evidence.

Disclosure of Interest

None Declared
Profile of patients undergoing treatment with long-acting injectable antipsychotic drugs in a psychiatry hospital in Portugal
Authors: Correia J. R. P. , Moreira R. A. , Maldonado E. , Gomes H. J. , Gomes J. R.
Published: August 2023

Introduction

The treatment with long-acting injectable antipsychotics (LAIAs) is more and more frequent and it shows advantages regarding adherence, effectiveness and tolerance.

Objectives

To describe and compare the profile of patients under treatment with LAIAs in a psychiatric hospital in Portugal.

Methods

An observational and retrospective study was carried out with the collection of data referring to patients hospitalized with a first psychotic episode between 01/01/2019 and 30/06/2022 in a psychiatric hospital in Portugal and the respective evaluation of sociodemographic and clinical data through the information recorded in the clinical files.

Results

During the 42 months of the study, we selected 78 patients who presented psychotic symptoms on admission. Patients with a history of previous psychotic episodes and prescription of antipsychotic therapy prior to hospitalization were excluded.

Of 78 patients hospitalized with a first psychotic episode, 34 - which corresponds to approximately 44% - were discharged with LAIAs.

Patients receiving LAIAs had an average age of 39 years. The average number of days of hospitalization was 28 days; 41% were female (n=14) and 59 were male (n=20); 35% (n=12) consumed psychoactive substances previously on admission to hospital; 62% (n=21) were discharged under the compulsive treatment regimen. Regarding the diagnosis at discharge, based on the international classification of disease-11 (ICD-11), the most common were schizophrenia, psychotic disorder induced by psychoactive substances and acute and transient psychotic disorder.

From the statistical analysis carried out, no correlation was observed between the rate of readmissions and the administration of LAIAs, nor was there any correlation between the rate of readmissions and compulsive outpatient treatment.

Conclusions

Despite what is described in the literature, in the sample under study, the LAIAs were not superior in the variables studied, namely in reducing the readmission rate. Possible explanations for the results obtained may be justified by the size of the sample under study and the follow-up time of the cases.

Disclosure of Interest

None Declared
Is there a dose-response relationship between cannabis use and violence? A longitudinal study in individuals with severe mental disorders
Authors: Beaudoin M. , Dellazizzo L. , Giguere S. , Guay J.-P. , Giguere C.-E. , Potvin S. , Dumais A.
Published: August 2023

Introduction

Recent longitudinal studies point towards the existence of a positive relationship between cannabis use and violence in people with severe mental disorders. However, the existence of a dose-response relationship between the frequency and/or the severity of cannabis use and violence has seldom been investigated.

Objectives

This study aimed to determine if a dose-response relationship between cannabis use and violence exists in a psychiatric population.

Methods

This observational study was conducted at the Institut universitaire de santé mentale de Montréal (Montréal, Canada). A total of 98 outpatients (81 males and 17 females, all over 18 years of age) with severe mental disorders were included in the analyses. Clinical evaluations were conducted every 3 months for a year. Substance use, violent behaviors, and potential covariables were assessed through self-reported assessments, urinary testing, as well as clinical, criminal, and police records. Using generalized estimating equations, the association between cannabis use frequency (non-users, occasional, regular, and frequent users, assessed using the Time-Line Follow-Back and confirmed with urinary testing) and violence was investigated, as well as the association between the severity of cannabis use (measured using the Cannabis Use Problems Identification Test – CUPIT) and violent behaviors.

Results

Cannabis use frequency and severity were significant predictors of violent behaviors. After adjustment for time, age, sex, ethnicity, psychiatric diagnoses, impulsivity and use of alcohol and stimulants, odds ratios were of 1.91 (p <0.001) between each frequency profile, and 1.040 (p <0.001) for each increase of one point of the severity of cannabis use score (0 to 79).

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Conclusions

These findings have important implications for clinicians, demonstrating that cannabis use may have serious adverse consequences in a psychiatric population. Nevertheless, the mechanisms underlying this association remain unclear.

Disclosure of Interest

None Declared
Use of tianeptine sulfate over-the-counter, literature review, and case report
Authors: Palma Conesa A. J. , Rico Rangel M. I. , González Milla I. , Aranzadi A.
Published: August 2023

Introduction

Tianeptine is prescribed as an antidepresant in Europe. The prescription drug is produced as tianeptine sodium. However, it can also be found on the Internet as tianeptine sulfate sold as a nootropric. Misuse of tianeptine sodium has been documented, but there’s little scientific evidence of tianeptine sulfate use.

Objectives

Review the use of tianeptine sulfate without prescription.

Present a clinical report of tianeptine sulfate use.

Methods

PubMed review of tienptine use without prescription.

Clinical report of a patient using tianeptine sulfate adquiered on the Internet.

Results

Systematic review on PubMed using the search term “tianeptine abuse” conducted on 01/10/2022. A total of 71 articles were found from wich 33 mentioned the use of tianeptine use without prescription. A total of 23 case reports of tianeptine use without prescription were found. None of them made the difference between tiaenptine sodium or tianeptine sulfate. Only one article mentioned the use of tianeptine sulfate from an Internet search on Internet fora (Smith et al. Am J Drug Alcohol Abuse 2021 47(4), 455–466).

The case report of a 23 years old patient is presented. Diagnoses: ADHD (F98.8); Psychotic episodes four (F23) and two (F16.150) years ago; Major depressive disorder (F32.2). Use of psychedelics, cannabis, psychoestimulants and opioids meeting substance use disorder (SUD) criteria. The patient brought proof of the tianeptine sulfate bought on the Internet (image 1) for self-treatment of his depressive symptoms. Tianeptine sodium is prescribed. The patient then restarts opioid use with fear of a new opioid use disorder episode and an oxicodone prescription is maintained. The patient then interrupts the antipsychotic medication and suffers a psychotic relapse. After this psychotic episode a LAI treatment with paliperidone is started. Currently, the patient is recovered and maintains psychopathological stability and abstinence from other substances. Blod test result unaltered. Current treatment: lisdexamphetamine 70mg /day, tianeptina sodium 12.5mg/day; oxicodone 40mg/12h and paliperidone 150mg /28d.

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Conclusions

Tianeptine sulfate is believed to present some diferences versus tianeptine sodium: it is sold only through the Internet without prescrption, the daily dose is 25mg per day versus 12.5mg every 8 hours and it might be more potent and long lasting. Those differences were confirmed by the patient after the prescription of tianeptine sodium.

Self-medication with psychoactive substances is one of the theories for substance use and might lead to a substance use disorder. This case shows how the prescription of a drug similar to the one used without presription might favour the therapeutical alliance and reduce the risk associated to the use of non-regulated substances.

Further research is needed to better understand the use of tianeptine sulfate.

Disclosure of Interest

None Declared
The relationship between women’s personality traits and addiction to social networking sites on the example of Facebook
Authors: Cybulska A. M. , Rachubińska K. , Schneider-Matyka D. , Grochans S. , Grochans E.
Published: August 2023

Introduction

Social network addicts may differ significantly from non-addicts in terms of personality traits, such as agreeableness, neuroticism, and conscientiousness. Addicts may be prone to negative emotions and unpleasant experiences, which may be associated with a higher level of neuroticism. Addicts often fail to cope in the real world, often experience negative emotions, quickly give up their goals, see themselves and others in a negative light, and escape into virtual reality. The virtual world is devoid of the anxiety that an individual faces in real life interactions, hence the tendency for addiction among people with higher levels of neuroticism. The primary cause of Internet Addiction may be innate temperamental traits (i.e., impulsiveness of behavior and impulsiveness of decisions) that influence the susceptibility to functional and chemical addictions. According to the concept of addictive personality, people who have this problem are prone to addiction as such, regardless of what they are addicted to.

Objectives

The purpose of this study was to generally assess the degree of women’s dependence on social networking sites on the example of Facebook, taking into account personality traits according to the five-factor model of personality, the so-called Big Five by Costa and McCrae

Methods

The study included 556 women. This survey-based study was carried out using the questionnaire technique. The following research tools were used to analyze behavioral addictions in adult women: the Bergen Face- book Addiction Scale (BFAS), the NEO Five-Factor Inventory (NEO FFI) and the author’s questionnaire.

Results

Among the surveyed women, 69.6% were average Facebook users, of whom 16.4% had scores indicating possible Facebook addiction, and 14.0% had scores indicating addiction. The higher the neuroticism, the more serious the Facebook addiction (r = 0.26; p < 0.001; R2 = 6.7%). A weak negative correlation was obtained for the agreeableness subscale e (r = -0.08; p < 0.05; R2 = 7.2%). A weak negative correlation was also obtained for the subscale of conscientiousness (r = -0.16; p < 0.001; R2 = 2.6%). There was no statistically significant correlation between the log10 score obtained on the BFAS and the score on the NEO-FFI subscales of extraversion (r = 0.04; p = 0.40) and openness to experience (r = 0.04; p = 0.30).

Conclusions

The personality types of the studied women indicated relationships in terms of behavioral addictions. Women characterized by neuroticism showed stronger addiction to Facebook. Women characterized by high conscientiousness were at lower risk of behavioral addictions, while agreeableness as a personality trait significantly protected the surveyed women against Facebook addiction.

Disclosure of Interest

None Declared
System of combined psychotherapeutic and physical rehabilitation of children with cyber addiction
Authors: Mykhaylov B. , Kudinova O. , Shestak I.
Published: August 2023

Introduction

Contemporary children practically live in cyberspace, constantly using various devices,and many of them have an addiction that leads to violations of their mental and physical formation.

Objectives

Based on the mental and the physical examination of children suffering on cyber addiction with the sings of clinical manifestations determine the targets and form of ccmbined correctional rehabilitation system.

Methods

The clinical investigation based on psychiatric examination with the narrative motivation interview,psychological examination by Eysenck “extra/introversion”test and physical examination with special attention to the musculoskeletal system.

Results

The randomized investigation of childhood population was performed.198 children of different age (7 – 14 years old) were examined.72 (36.4%) of them showed significant signs of cyber addiction with a narrowing of interests, a reduction in social ties, and a decrease in school performance. They spent from 3 to 10 hours on gadgets per day.140 (71%) of them, also showed signs of fubbing, that is, the priority of telephone communication over direct communication with the interlocutor.The significant results of Eysenck test examination were following: 126(64%) of them were introverts and 72(36%) of them were extraverts. During the physical examination,91 (46%) of these children had different spine and musculoskeletal disturbances.In the group of addictional children the vast majority of subjects, 87%, have characteristic defects of the musculoskeletal system. The most symptomatic in the diagnosis of cyberaddiction and phubbing of school-age children are: round back, stooping, scoliotic posture and types of lateroflexion.The severity of cyber addiction and the degree of musculoskeletal disorders were inversely proportional. The results served as the basis for the development of a combined system of psycho-physical rehabilitation. The psychotherapy based on CBT according to A. Beck, modified for children’s in concordance with specialized program “Vertebra-Dinamik” to correct defects of the musculoskeletal system. The basis of the corrective “Vertebra-Dinamik” technique includes a comprehensive approach to the use of isometric and statodynamic exercises of moderate intensity with elements of relaxation. Approbation of the developed system showed its high( 80%) and moderate(20%) efficiency.

Conclusions

To successfully overcome cyber addiction and its negative consequences, the most optimal system is the complex application of psychotherapeutic and physical rehabilitation methods.

Disclosure of Interest

None Declared
Exploratory study of handwriting disorders in school-aged children for a better nosography
Authors: Lopez C. , Vaivre-Douret L.
Published: August 2023

Introduction

Handwriting disorders (HDs) are prevalent in elementary school children, but their nature is poorly understood. Moreover, the diagnosis of dysgraphia is often too quickly concluded on a single assessment.

Objectives

In the present study, we aimed to use a transdisciplinary assessment approach. We looked for to provide objective data to better understand the nature and aetiology of HDs.

Methods

27 school aged children with HDs aged 6-11 years were included in the study and were compared to typically developing children. They performed a normed prescriptural task of copying cycloid loops. Postural and gestural inter-segmental coordination of arm movements were recorded with two video cameras allowing 2D reconstruction of the gesture. Spatial/temporal kinetic and kinematic measures were recorded with a digital pen. All children underwent normed and standardized clinical assessments of neuropsychomotor, neuropsychological and oculomotor functions. The handwriting test (BKK) were used.

Results

Handwriting disorders seem very heterogeneous. However, there is a significantly poorer gestural of inter-segmental coordination and of kinetic/kinematic performances of the tracings in HDs. Furthermore, it was possible to highlight three levels of HDs: mild HD not detected by the BHK test (26% of children), moderate HD with the BHK (33%), dysgraphia identified by the BHK (41% of children). The mild nature of HDs not dectected by the BHK seems to occur to a relatively low frequency with associated disorders identified during clinical assessments. On the contrary, dysgraphia appears linked to a high frequency of the associated disorders with a majority of oculomotor disorders (55% of children) leading to visual-perceptual difficulties (44%).

Conclusions

HDs appear to be multifactorial but have a common characteristics of immaturity of gestural synergy of the arm, associated with poorer spatio-temporal kinetic and kinematic parameters. Dysgraphia occurs with more severe disorders as oculomotor and visual perception impairments. Our findings highlight the importance to identified a nosography of HDs with a transdisciplinary evaluation to better understand the nature and aetiology of the disorders in order to better clinical decision-making processes for handwriting remediations.

Disclosure of Interest

None Declared
Digital mental health: Perceptions and opinions of Tunisian patients
Authors: Jemli H. , Ouali U. , Hajri M. , Jenhani R. , Djelassi M. , Jomli R.
Published: August 2023

Introduction

With the rapid advancement of modern technology, many countries have adopted mental health care systems supplemented by digital means of communication. Are Tunisian patients “ready” for the “digital revolution”?

Objectives

The aim of our study was to assess perceptions of people living with mental illness on digital mental health.

Methods

We developed a cross-sectional study where we randomly included patients who were treated for a psychiatric disorder in a public or a private practice. Inclusion criteria were: subject 18 years old or older, clinical remission for at least three months. We developed a questionnaire on sociodemographic and clinical variables. We also included questions on patients’ level of interest in using digital mental health services such as teleconsultation and mental health smartphone apps. Perceived obstacles in using digital mental health by patients were also evaluated.

Results

Our sample size was 260 patients. The mean age of our population was 36,4 years old with. The mean distance from the household to the mental health care provider was 17,3 km.

Two thirds of the sample had access to a wifi connection at home (172 patients). When asked about the content of internet searches, 66% have already looked for information on their mental health or mental disorders on web pages. Patients were very interested in video teleconsultation with their therapists (72%), psychoeducation apps (68%) and online mood journals (61%). They expressed little to no interest in online exchanges with other patients and medication reminder apps. The most reported obstacles in implementing digital mental health as noted by patients were : lack of perceived effectiveness, virtual communication with their therapist and confidentiality issues.

Conclusions

Mental health patients in Tunisia expressed a great interest in teleconsultations and online psychoeducation programs. Further research on the willingness of mental health professionals to adopt digital mental health services are needed.

Disclosure of Interest

None Declared
Ethical issues in assertive outreach and crisis intervention teams
Authors: Martínez Jambrina J. J.
Published: August 2023

Introduction

Assistance to people suffering serious mental illnesses has undergone large variations in the last twocenturies. After World War II, The community became a new destination for them.But hardly anyone knew how to cope with mental illness in thecommunity. Thus, several initiatives arose in the US. Both social work and psychiatry,moved towards a pragmatic point of view by the rising tide of patients seeking help: initiatives trying to providesolutions to themost basic needs of patients: accommodation, food,medical care, takingof medication, etc. By the 1970s, Mary Ann Test and LeonardStein had proven the effectiveness of theirLife Coaching in Madison, Wisconsin. In 1981 his program is disseminated by several states under the name of Assertive TreatmentCommunity and thus spread throughout the United Statesand Canada, Australia and Europe. Psychiatry has recognized it as the program that got the most for supporting the community model. 50 years later the basics of the TAC model remain more or less thesame. But home interventions caused a continuous conflict in the ethical field notwell addressed…

Objectives

WHY IS AN ACT team a fertile ground for ethicalconflicts?This approach is coercive or assertive?There are several reasons. There is a specific ETHICAL ENVIRONMENT in THE ACT team

1.“Diffusion of Responsibility”-

2. Mutual confirmation bias:

3. There is a tendency to think that professionals areethical by nature.

4. Biased search for information when problems arise.

Sources are sought to confirm us before clarifying whathappened

5. A special tendency to conformism.

6.Repetitive responses.

Methods

We will analyze the main ethical conflicts arising in ACT teams:

1. CONFLICTS OF AUTONOMY

2. PRIVACY AND CONFIDENTIALITY ISSUES

3. CONFLICTS OF DUTIES

4. ASSERTIVENESS VERSUS COERCION

Results

The great challenge is knowing how and when to intervenewith patients with variable decision-making capacity orwithout any insight, as well as the impact on theirautonomy. It is an exercise both in art and inphenomenological training: Because there are subtledeficits, difficult to appreciate, but there are otherdeficits that are obvious.

Conclusions

The challenge: balancing the needs and safety of thecommunity with the needs and safety of the individual.ACT teams staff must juggle both perspectives, whilemaintaining a therapeutic alliance.

The continuous contact with the patient in an ACT teamgives, especially to clinicians, a privileged place ofobservation to act correctly in those situations and to be asupport so that whoever arrives lacking in affectivity orwith relational problems could grow until reaching a moreprudent and competent judgment.

WHAT COULD HAPPEN IF WE TRAIN PROFESSIONAL IN BIOETHICS MORE IN PATIENT´S RIGHTS, A FIELD FOR LAWYERS??

Disclosure of Interest

None Declared
Emotional stabilization interventions for people exposed to chronic traumatic events, in
humanitarian settings
Authors: Dozio E.
Published: August 2023

Introduction

In contexts of chronic crisis, such as wars, the population is affected by prolonged
traumatic exposure. In this type of context, it is sometimes difficult to provide
psychological support to work through the trauma because the environment is neither stable
nor reassuring. It is about finding care devices that despite the complexity of the
situation, manage to bring relief and improve the ability to manage negative emotions and
stress.

Objectives

The objective of the intervention was to relieve people in distress, to help them
contain their reactions to moments of anxiety so that they are more available and calm in
their daily lives. Since the intervention could not provide long-term treatment for the
potential traumatic stress, due to the abuses still in progress, it aimed to prevent the
appearance and installation of the symptoms.

Methods

A group protocol based on emotional stabilization exercises was offered to children
and adults from communities affected by the fighting in the civil war in the Central African
Republic in 2021. In addition to giving elements of psychoeducation, participants could
practice exercises aimed at stabilizing emotions and managing stress.

People could benefit from this psychosocial support with daily frequency for four
consecutive days. At the beginning and at the end of the care device, psychometric scales
were administered in order to be able to measure the improvement in well-being (WHO5) the
reduction in symptoms of anxiety and depression (HAD) as well as traumatic symptoms in adults
(PCL -5) and children (CPTS-RI).

Results

Between February and April 2021, 1,200 adults and 400 children were able to
participate in the emotional stabilization device. 90% of the participants showed an
improvement in well-being and a reduction in stress and axiety reactions. The participants
particularly appreciated the exercises for the ease with which they could be reproduced in
daily life and transmitted to other members of the family and the community. Despite the fact
that exposure to stress remained significant and daily, they expressed the feeling of having
regained some control, at least over their own emotions and reactions.

Conclusions

In situations of chronic stress, where psychic traumatic symptoms cannot be treated
sustainably, this emotional stabilization protocol can be an effective option to regulate the
emotional states of exposed people and give them tools to cope with anxiety.

Two important points to emphasize are also the fact that this device can reach a large
part of the population without a lot of means and that it can be provided by
non-professionals in mental health, if properly trained and constantly supervised by
experts.

Disclosure of Interest

None Declared
Trazodone induced euprolactinemic galactorrhea – a case report
Authors: Mortágua D. , Rafaela D.
Published: August 2023

Introduction

Trazodone is an antidepressant that exerts its effect through serotonin reuptake inhibition and 5-HT2A and 5-HT2C receptor antagonism. Galactorrhea, as well as the increase in prolactin levels, have been seldom related to antidepressants. These adverse effects are more frequently observed with antipsychotic medication.

Objectives

To present and discuss a case of Trazodone induced galactorrhea in a 24-year-old female patient diagnosed with a moderate depressive episode, without psychotic symptoms.

Methods

Clinical case description and literature review.

Results

We present the case of a healthy 24-year-old woman, medicated with oral contraceptives, presented to a Psychiatry Consultation due to worsening depressive and anxious symptoms. Prolonged-release Trazodone was initiated with the indication to gradually titrate up to 300 mg/day. On the third day of treatment (at the time, at a dose of 75 mg/day), the patient began to experience breast pain and galactorrhea. On the seventh day, due to continuation of the complaints, she went to a Gynecology Consultation, having carried out an analytical study, in which a prolactinemia value was registered within the normal range (18 ng/mL). The possibility of pregnancy or continued intake of anabolizing steroids was excluded. The condition reversed upon discontinuation of the drug.

Conclusions

The endocrine and reproductive effects of antidepressants are uncommon and galactorrhea is only rarely mentioned as a possible adverse effect of this type of medication. The neurobiological mechanisms underlying this association are unclear. The existing literature points to the possibility that serotonergic antidepressants act by suppressing dopamine neurotransmission (by indirect inhibition of the tuberoinfundibular pathway), facilitating the release of prolactin and thus contributing to the increase in its levels. However, there are also case reports of antidepressant-induced galactorrhea in the presence of normal prolactin levels. In the present case, a state of euprolactinaemia was, in fact, verified. The findings reinforce the importance of carrying out more studies and on a larger scale, to better clarify the mechanisms underlying this association.

Disclosure of Interest

None Declared
Setting the research agenda for medically not yet explained symptoms (MNYES): a priority-setting partnership of patients, caregivers and clinicians
Authors: Van Der Feltz-Cornelis C. M. , Sweetman J. , Moriarty A. , Perros P. , Kaul A. , Gall N.
Published: August 2023

Introduction

This study establishes research priorities for Medically Not Yet Explained Symptoms (MNYES). A significant number of patients suffer from these symptoms, also known as MUS, that are likely to cause work disability and impact on quality of life. Research into MNYES in general has been poorly funded over the years, has been primarily researcher-led, and was sometimes controversial.

Objectives

To identify research priorities from the perspective of patients, caregivers and clinicians, following the James Lind Alliance (JLA) priority setting partnership (PSP) method.

Methods

The PSP Steering Group termed these symptoms Medically Not Yet Explained Symptoms (MNYES). This was an operational definition not intended to add to or replace other definitions already in use, that was constructed to embrace the views of all stakeholders. The nomenclature MNYES was chosen to indicate our incomplete understanding of these conditions. This could pertain to biological, psychological and social factors, as well as factors involving the trajectory of patients through various healthcare settings.

The study involved five key stages: defining the appropriate term for the conditions under study by the PSP Steering Group; gathering questions on MNYES from patients, caregivers and clinicians in a publicly accessible survey; checking these research questions against existing evidence; interim prioritisation in a second survey; and a final multi-stakeholder consensus meeting to determine the top 10 unanswered research questions using the modified nominal group methodology.

Results

Over 700 responses from UK patients, caregivers and clinicians were identified in two surveys from a broad range of medical specialities and primary care. Patients prioritised research questions regarding diagnosis and aetiology; clinicians and caregivers prioritised outcomes and treatment, relatively.

The top 10 unanswered research questions cover the domains of: treatment; the role of clinicians; symptoms and outcomes; and recovery.

Conclusions

This JLA PSP may well be the first attempt at capturing the thoughts of a wide group of medical professionals, patients and caregivers in one place with the aim eventually of standardising care and reducing unhelpful variability in the management of MNYES. Following the JLA approach is a strength of the study. The choice of the term MNYES conveys a message of hope, which responds to a need identified by patients, carers and clinicians alike for vigorous research in this domain. The research priorities are expected to generate much-needed, relevant and impactful research into MNYES. Better funding possibilities for MNYES are urgently needed.

Disclosure of Interest

None Declared
Anxiety disorder following dental care: About 150 cases
Authors: Tbatou L. , Sofiya B. , Fouad L.
Published: August 2023

Introduction

The dental surgeon may be the cause of a psychological trauma - without necessarily knowing it - as well as being confronted with patients who have undergone a trauma as a result of dental care or with patients who have undergone some kind of trauma and that the dental practice exacerbates their anxieties. In this case, the treatment becomes difficult or even inaccessible or a cause of treatment failure.

Objectives

Study the events that can cause trauma and the different approaches to psychological trauma in dental care.

How to explore the traumatic event in a patient and propose its erasure?

Study the events that can cause trauma and the different approaches to psychological trauma in dental care. How to explore the traumatic event in a patient and propose its erasure?

Methods

This is a descriptive and analytical cross-sectional study based on a hetero questionnaire filled in by patients who consulted a dental surgeon.

Results

41% are men, 76% are aged between 30 and 50 years, for the marital status: 43% are single, 38% are married, 72% have an average socioeconomic level, 36% of patients have a personal history of a psychiatric disorder, 21% personal history of a medical disease, 32% have a disorder related to the use of psychoactive substances,

For the reason of consultation: 28%: dental square, 42%: oral malformations, 17%: gingival problem, 8% dental extraction. Medication used: 65% of patients used anti-inflammatory drugs, 77% used antibiotics, 13% used paracetamol. Duration of treatment: 86% one year

41% are men, 76% are aged between 30 and 50 years, for the marital status: 43% are single, 38% are married, 72% have an average socioeconomic level, 36% of patients have a personal history of a psychiatric disorder, 21% personal history of a medical disease, 32% have a disorder related to the use of psychoactive substances, For the reason of consultation: 28%: dental square, 42%: oral malformations, 17%: gingival problem, 8% dental extraction. Medication used: 65% of patients used anti-inflammatory drugs, 77% used antibiotics, 13% used paracetamol. Duration of treatment: 86% one year .

Conclusions

He should be careful, attentive and open to the principles of the psychology of communication in his psychological approach, in order to adapt the level of difficulties of care to the capacity of comprehension, so as to take care of the patient in his globality and avoid any traumatic act. He should not hesitate to send his patient to a psychiatrist if necessary.

Disclosure of Interest

None Declared
Use of Methylphenidate to Improve Cognition in Autism Spectrum Disorder (ASD)
Authors: Ashraf S. , Bachu A. , Srinivas S. , Tankersley W. , Shah K.
Published: August 2023

Introduction

Methylphenidate (MPH) is used to treat attention deficit hyperactivity disorder (ADHD) and has shown unique benefits in children and adolescents with autism spectrum disorder (ASD). In addition to improving attention, hyperactivity, and repetitive movement, it also improves cognition in ASD. Our focus is to explore the understudied benefits and safety of methylphenidate use for cognition in ASD children.

Objectives

1) To study the response and benefit of methylphenidate in autistic kids to improve cognition and life function.

2) To assess the safety profile and risks of using methylphenidate at different doses in children with autism as a guiding tool for prescribing physicians.

Methods

A literature search was conducted using relevant medical subject headings (MeSH) terms in PubMed, Medline, and PubMed Central. We identified all published articles from inception until September 30, 2022. Initial search results found 41 studies, of which 15 were excluded as they did not meet inclusion and exclusion criteria. After a thorough full-text review, we included 5 studies in our final qualitative synthesis review.

Results

Methylphenidate was found to have the unique benefit of increasing cognitive processing speed, thus improving everyday life function in ASD and ADHD children compared with only ADHD, with a clinical significance of p<0.001. Stimulants may improve the processing of social situations and interactions or social functions due to this unique response (Peled, J et al. Nordic journal of psychiatry 2020; 74(3), 163–167) A clinically significant performance gain on cognitive tasks was identified with a linear dose-response at three different doses (10 mg, 15 mg, 20 mg) of methylphenidate. ASD children with ADHD made significantly fewer omission errors, [F(3,69) = 7.21, p < 0.001], and commission errors [F(3,69) = 4.64, p = 0.005] on MPH, compared to placebo. They also showed more response at higher MPH doses, [F(3,69) = 10.45, p < 0.001]. Thus, the children were faster, more accurate, and had fewer errors at higher MPH doses (Pearson, D. A. et al. Journal of child and adolescent psychopharmacology 2020; 30(7), 414–426). There were no serious side effects or suicidality reported for low dose and a medium dose of MPH in ASD children assessed with Response Impressions and Side Effects Checklist-Kids (RISC-K), A 38-item parent rating scale (Kim, S. J. et al. Journal of autism and developmental disorders 2017; 47(8), 2307–2313).

Conclusions

The findings support the positive response of methylphenidate on cognitive function in ASD children. No serious adverse effects or suicidality were noted. Multi-center well-designed studies are recommended to determine further efficacy and safety of MPH in ASD children for cognition.

Disclosure of Interest

None Declared
Exploring the Restoration of Brain Connectivity during Weight Normalization in Severe
Anorexia Nervosa
Authors: Kaufmann L.-K.
Published: August 2023

Anorexia nervosa is a persistent and often difficult to treat eating disorder with
significant physical and mental health consequences. While it is known that the disorder is
associated with alterations in brain functional connectivity during the phase of acute
underweight, the effect of weight normalization on brain connectivity remains
unclear.

This talk focuses on the recovery of intrinsic brain connectivity during weight
normalization in severe anorexia nervosa, presenting data from a longitudinal study. Using
resting-state functional magnetic resonance imaging, we assessed brain connectivity at three
different stages of inpatient treatment. Our findings indicate that patients with severe
anorexia nervosa have weaker intrinsic connectivity and altered network topology, which do
not improve during treatment. These persistent disruptions in brain networks suggest that
severe anorexia nervosa may have long-term effects on the way the brain processes
information, even after weight is restored.

Disclosure of Interest

None Declared
Neurobiological effects of early trauma exposure in people with eating disorders: implications for treatment
Authors: Cascino G.
Published: August 2023

People with eating disorders (EDs) exhibit a prevalence of childhood maltreatment higher than general population and, as for other psychiatric conditions, a history of childhood maltreatment in the context of EDs has been found associated with an earlier age at onset, a greater clinical severity, a more frequent comorbidity with other psychiatric conditions and a poorer treatment response . Neuroendocrine modifications as well as a heightened biological and emotional vulnerability to acute social stressor exposure and cortical measures alterations have been reported in people with EDs and history of childhood maltreatment. This evidence suggests the possibility to identify a “maltreated ecophenotype” also in people affected by EDs which recommends grouping individuals affected by the same psychiatric condition into subgroups characterized by different clinical and biological correlates in order to tailor treatements.

Disclosure of Interest

None Declared
Intranasal Oxytocin as an adjunct treatment in patients with major depression with and
without comorbid borderline personality disorder
Authors: Maoz H.
Published: August 2023

Introduction

The mechanisms leading to Oxytocin’s differential effects among patients with
borderline personality disorder have thus far been elusive.

Objectives

This study was aimed to explore the differential effect of OT administration among
depressive patients with or without comorbid borderline personality disorder, and to explore
the mediating role of attachment in these differential patterns.

Methods

Patients treated with psychotherapy in an inpatient settings (N=58) were randomized
and double-blindly allocated to receive oxytocin or placebo for a period of four weeks. The
effect of OT on therapy process and outcome was examined among patients with (n=35) and
without (n=23) borderline personality disorder. Moderated mediational models were estimated
to explore whether attachment differentially affected the association between oxytocin and
treatment outcomes.

Results

patients without BPD showed significantly larger improvements following OT
administration (B=-8.32, p=.001) as compared to placebo in OQ-45. On the other hand, patients
with BPD showed no significant improvement following OT (B=0.61, p=.76). The same pattern was
observed in the HSCL, where patients without BPD demonstrated significantly larger
improvements following OT administration (B=-0.29 ,p=.0009) as compared to placebo, while
patients with BPD demonstrated no significant improvement (B=-0.04 ,p=.55). Moderated
mediational models indicated no significant moderated indirect effect, however, a significant
trend of indirect effect only in the BPD group was observed, whereby the no-BPD group showed
a stronger direct effect (β=-0.19, t=-1.30, p=.20), whereas the BPD group showed a stronger
indirect effect (β=-0.72, SE=0.45, CI= -1,71, -0.00).

Conclusions

Patients with depression and comorbid BPD benefit less from OT administration as
compared depressive patients without such comorbidity. It is possible that the involvement of
the attachment system may be associated with the attenuation of OT’s effect.

Disclosure of Interest

None Declared