bluuebunny/crossref_metadata_2025 huggingface dataset:
Melancholia. Historical evolution through a case report
Authors: Limeres P. Coucheiro , Lega L. Amaya , Soler A. Franco , Del Campo A. Cerame
Published: February 2022

Introduction

The diagnosis of psychotic depression has its origin in the millennial term of Melancholia.

Objectives

A case of psychotic depression is presented to highlight its psychopathological characteristics and to make a historical overview of its origins.

Methods

We present the case of a 40-year-old male patient with a history of dysthymic mood who developed a major depressive mood, loss of self-care, decreased apetite, insomnia and repetitive speech with ideas of guilt and ruin of psychotic characteristics.

Results

Melancholy is a term used since the time of Hippocrates, who spoke of it as the state that appears after the prolongation of an intense period of sadness. It was extolled and self-attributed by authors such as Montaigne and branded as selfish by authors such as Cicero in the days when reason and madness formed a whole and distinguishing their limits was a complex task. Esquirol changed his name to Lypemania to get rid of its poetic nuances and framed it within partial insanity. Both he and the rest of the psychopathologists of the XIX century and early XX considered the melancholic as the great tormented, the one who despises himself and blames all ills, who suffers from apathy and above all presents a strong pain of the soul.

Conclusions

Later it was Falret and Baillarger who unified melancholy with mania in what they nominate as circular and dual-form insanity. This gave way to the Krapelinian entity of manic-depressive insanity, the direct predecessor of the current Bipolar Disorder, which includes the diagnosis of our clinical case.

Disclosure

No significant relationships.
A delusion of pregnancy in man with hyperprolactinemia
Authors: Aissa A. , Ghabi H. , Khattech D. , Meddouri S. , Ouali U. , Nacef F.
Published: February 2022

Introduction

A delusion of pregnancy in men has been rarely reported in psychiatric disorders. The literature on this delusion in male schizophrenia is limited. It was reported especially in medical conditions. In psychiatric disorders, it has been explained for a long time by psychodynamic theories.

Objectives

To present a case of a pregnancy delusion in man associated temporally to neuroleptic-induced hyperprolactinemia and a review of literature of medical and psychological etiologies of this symptom

Methods

We presented a case of a pregnancy delusion in man associated temporally to neuroleptic-induced hyperprolactinemia and we elucidated through a review of literature of medical and psychological etiologies of this symptom.

Results

Case report A 46-year-old man, unmarried, who had a mild intellectual disability and a 22-year history of schizophrenia. He was admitted to our hospital for psychotic relapse due to the interruption of his medication. This patient had been treated for years with long action injection medication. On admission he was disorganized, verbalizing a poorly-systematized fuzzy delirium. And he believed he was pregnant. Serum prolactin levels was 38 ng/ml (3-25ng/ml). He was put on Haldol decanoate 150mg/month, chlorpromazine 150mg/day, and diazepam 15mg/day.

Conclusions

The presentation of a delusion of pregnancy in man is rather infrequent. The delusion may have many social, psychological, and biological determinants to its genesis. This case highlights the importance of medical investigations notably the assay of prolactin in the assessment of patients who present with delusions of pregnancy.

Disclosure

No significant relationships.
Reduced sensitivity to situational change in individuals with autism spectrum condition
Authors: Tei S. , Fujino J.
Published: February 2022

Introduction

Individuals with autism spectrum condition (ASC) frequently report difficulties in detecting changes in social situations, which considerably hinder interpersonal communications.

Objectives

To better understand the features of detecting changes in social situations among individuals with ASC.

Methods

Individuals with ASC (N=24) and typical development (TD) (N=24) were included. To examine participants’ sensitivity to situational contexts, we conducted an economic-game task: a modified computer version of the ultimatum game (mod-UG). In UG, two players were offered a chance to win 10 coins after dividing it amongst themselves. The proposer suggests how to split the sum and the responder can accept or reject the deal. After practice, all participants played the role of responders with an imaginary proposer. Participants had to decide whether to accept or reject proposers’ fair/unfair offers. In our mod-UG, additional condition was included that involved intentionality considerations: Unfair offers were displayed with another identical unfair offer. This emphasized the proposers’ inevitable situation of unfair offers. Subsequently, we conducted a 2×2 repeated-measures ANOVA (unfair offers with/without additional cues)×(ASC/TD).

Results

Participants indeed accepted unfair offers significantly more frequently when the other player’s unfair proposal was unavoidable in cue-added conditions, when compared to unfair offers in no-cue conditions. This suggested that participants considered their opponent’s perspective more attentively in cue-added conditions. However, this effect was significantly decreased in the ASC-group (p<0.05; group-condition interaction).

Conclusions

Decreased sensitivity to situational changes among ASC-individuals may be partly due to diminished or inflexible shifting of perspective. Whether this systematized decision-making associates with attentional-bias and stereotyped-behaviors requires further investigation.

Disclosure

No significant relationships.
Delusional infestation: Two case reports
Authors: Peixoto C. , Rego D. , Bicho M. , Coelho J. Mendes , Medeiros H.
Published: February 2022

Introduction

Delusional infestation (DI), also known as delusional parasitosis or Ekbom syndrome, is a rare disorder, characterised by fixed belief that the skin, body or immediate environment is infested by small pathogens, despite the lack of any medical evidence for it.

Objectives

To describe and discuss two clinical cases of DI, in order to show two different ways of presenting in this entity.

Methods

Two case report and non-systematic review.

Results

We present the case of a 76-year-old woman, without psychiatric history, with an DI with 5 years of evolution, referred to a psychiatric consultation by a dermatologist. The second case, is a 41-year-old woman with a history of multiple substance use disorder, with an DI with a month of evolution, who resorted to the emergency department. DI is not a single diagnostic entity. The classic form, as represented in the first case,is a primary form, which develops without any known cause or underlying disease, corresponding to a persistent delusional disorder. However, about 60% of patients have secondary forms of DI, in the context of substance misuse, some medications or in the course of physical or psychiatric diseases (e.g. stroke, delirium, dementia, depression, schizophrenia).

Conclusions

DI can occur as a primary delusional disorder or secondary to several other medical conditions. An in-depth clinical history is essential in order to make the correct diagnosis. A multidisciplinary approach is also important, to exclude any possible organic etiology, not forgetting that many patients may turn to other medical specialities first.

Disclosure

No significant relationships.
Temporality, lived time and psychopathology of everyday life
Authors: Carneiro M. , Nascimento S. , Rocha T. Coelho , Cunha J.
Published: February 2022

Introduction

Since Ancient Times, Man has tried to analyze the passage of time, looking for repetitions, relating them to space to build a notion of a mechanical and chronological time. The idea and problem of time play a central role in both modern philosophy and psychiatry. Many authors contributed to the notion of “lived time” and placed the focus on how time is lived and perceived by the individual. Even though the notion of “time assimilated in space” has an important role in psychiatric nosology, the “lived time” has a psychopathological impact and is a field of study and debate.

Objectives

This work aims to acknowledge the relevance of the experience of temporal structures (past, present and future) and how they relate to psychopathology.

Methods

We did a non-systematic literature revision in the main databases.

Results

Phenomenological psychopathology has been profoundly interested in the philosophical discussions on the nature of time and its relation with the subject’s experience and condition. For instance, the melancholic experience, the maniac experience and the schizophrenic experience constitute changes in how time structures are perceived and lived by the individual.

Conclusions

Temporality has drawn attention to researchers from many different areas of study, having as of this day many approaches possible. It is important to know those contributions and conceptualizations in order to improve as a clinician.

Disclosure

No significant relationships.
Delusional disorders with religious content
Authors: Borisova O. , Kopeyko G. , Gedevani E. , Kaleda V.
Published: February 2022

Introduction

Delusional Disorders with Religious Content (DDRC) require careful study concerning their prevalence, psychopathological heterogeneity and the risk of destructive behavior.

Objectives

To classify the clinical forms of DDRC

Methods

By clinical-psychopathological, follow-up and statistical approaches 2523 cases of patients with mental disorders who received inpatient care in a state clinic for year were analyzed; in 225 cases of total 2523 delusional disorders in schizophrenia (ICD-10: F20.0, F20.01, F20.02) were diagnosed.

Results

The comparative analysis of delusional disorders (225 cases, 100%) with religious (70 cases -31.1%) and non-religious content (155 cases - 69.9%) revealed prevalence of DDRC in non-believers (p <0.01). Delusional destructive behavior occurred in 47.1% of 70 cases in patients with DDRC (15% of total 225).Delusional disorders 225 cases (100%)DDRC (70 cases, 31,1%)Delusional disorders with non-religious content (155 cases - 69.9%)BelieversNon-believers
BelieversNon-believers
Total Cases18 (8%)52 (23,1%)4 (1,8%)151 (67,1%)With Destructive behavior10 (4,4%)23 (10,2%)061 (27,1%)33 (14,6 %)61 (27,1%)

The predominant content of DDRC (among the Delusions of Possession, Sinfulness/guilt, Messianism, Manichaean and the End-world Delusions) was the Delusions of Possession - 36.8%. Psychopathological heterogeneity of DDRC was identified and specific types of DDRC were described.

Conclusions

DDRC is associated with the development of massive psychopathological symptoms and significant severity, and often accompanied by various forms of destractive behavior. This circumstance requires constant and careful management of these patients, collection of their religious history and asks for specific therapeutic approaches.

Disclosure

No significant relationships.
Iatrogenesis in mental health care
Authors: Revuelta M. Sánchez , Matsuura J. , Villarroel C. Martín , Garcia L. Carpio , Cutanda J. Dominguez
Published: February 2022

Introduction

The need for preventive mechanisms in psychiatric pathology has been raised, therefore authors talk about primary, secondary and tertiary prevention. However, this emphasis on those preventive aspects has tended to ignore an essential part: quaternary prevention.

Objectives

Reflecting the importance of avoiding ignoring iatrogenic forms of psychopathology by studying a clinical case and reviewing available literature.

Methods

We will present a clinical case of a patient with residual schizophrenia who undergoes an escalation of pharmacological interventions that lead to functional deterioration after initiating behavioral alterations. We will also review available literature about quaternary prevention.

Results

M. is an institutionalized patient who was taking a combination of three neuroleptics, anxiolytics and stabilizers for the treatment of behavior problems such as heteroaggressiveness. When the patient was referred to psychiatry consultations after being hospitalized, he could not move, had lost sphincter control and had serious communication problems. However, treatment was suspended and only one neuroleptic was maintained. The patient regained sphincter control and kept a residual but communicative delusional speech.

Conclusions

It is important to see how sometimes we can get into therapeutic escalation without correcting the underlying problem by focusing on a symptom, because behavioral alterations will persist regardless of pharmacological treatment changes. Sometimes clinical fluctuations make us confuse basal state and decompensation, ignoring the fact that we lack the way to modify the course. Authors believe that a rational approach to treatment should take into account the balance between potential benefits and side effects applied to an individual patient.

Disclosure

No significant relationships.
Lorazepam causing drug-induced liver injury : Rare entity
Authors: Sellami S. , Mami H. , Moalla M. , Oumaya M. , Bouzid R.
Published: February 2022

Introduction

Lorazepam is a benzodiazepine derivative that is globally used for the therapy of anxiety and insomnia.

Objectives

The objective of our work was to show that Lorazepam can be a cause of unexpected liver injury even though it is a rare entity.

Methods

We reported the case of a patient who had a Drug-Induced Liver Injury (DILI) under Lorazepam. We performed a literature review based on a PubMed search with the following keywords: “Lorazepam,DILI”.

Results

A 20 year-old-Tunisian woman was hospitalized in the psychiatry department of the hospital of Nabeul in Tunisia for a brief psychotic episode.She had a DILI under Olanzapine, Chlorpromazine and Lorazepam, which conducted us to interrupt her treatments except for the Lorazepam(5mg/day). The hepatic tests went back to normal even under Lorazepam. Few days later, the liver enzymes increased again to reach very high levels. Extensive workup was negative for other causes of liver injury, including viral hepatitis A, B, C and E.; capillary electrophoresis of serum proteins was normal; Exhaustive immunological tests were performed searching for auto immune hepatitis(anti-smooth muscle antibodies, anti-LKM1, anti-LC1, anti-SLA/LP) primary biliary cholangitis(anti-mitochondrial antibodies, anti-GP210, anti-sp100) and other antibodies like antinuclear antibodies were negative. Liver biopsy showed polymorphic inflammatory infiltrate including some eosinophilic polynuclear cells and rare vaguely epitheloid macrophages, with necrotico-inflammatory foci in the lobules, all of which were consistent with DILI. Lorazepam was discontinued and within 10 days her liver enzymes decreased and completely normalized.

Conclusions

Lorazepam, with an unknown action mechanism, can be a cause of DILI.

Disclosure

No significant relationships.
Therapeutic effect of qinghuanling on negative symptoms and cognitive function of schizophrenia
Authors: Zhang Y. , Cui X.
Published: February 2022

Introduction

Therapeutic effect of Qinghuanling on negative symptoms and cognitive function of schizophrenia

Objectives

To evaluate the therapeutic effect of Qinghuanling on cognitive impairment in schizophrenia, and to provide basis for clinical medication.

Methods

24 male patients with schizophrenia were randomly divided into study group and control group. The study group was given quetiapine fumarate combined with Qinghuanling, and the control group was given quetiapine fumarate. The positive and negative symptom scale (PANSS) and adverse event response scale (TESS) were evaluated regularly.

Results

The PANSS score of the study group was significantly lower than the control group from 6th week (64.10 ± 7.64 vs 72.31 ± 11.16; 51.60 ± 7.40 vs 63.23 ± 7.08, P < 0.05). Among them, the score of negative factor in the study group was significantly lower than that in the control group at the end of 6 and 8 weeks (2.16 ± 0.40 vs 2.75 ± 0.38; 1.65 ± 0.42 vs 2.38 ± 0.43, P < 0.01); the score of cognitive factor in the study group was significantly lower than that in the control group at the end of the 8th week (1.87 ± 0.20 vs 2.12 ± 0.27, P < 0.05). Compared with before treatment, PANSS score and symptom cluster factor score of the two groups were significantly decreased from the 2nd weekend to the 8th weekend (P < 0.05).

Conclusions

The combined use of Qinghuanling can significantly improve the therapeutic effect of schizophrenia, especially for the symptom cluster score of negative factors and cognitive factors, with high safety.

Disclosure

No significant relationships.
Efficacy and tolerability of eslicarbazepine acetate as monotherapy in patients of newly diagnosed focal epilepsy
Authors: Saxena S. , Singh S.
Published: February 2022

Introduction

Eslicarbazepine Acetate, a novel anti-epileptic drug has been approved as monotherapy in focal onset seizures, with/without secondary generalization in adults. Eslicarbazepine has many advantages over older anti-epileptic drugs and is useful in patients of new onset focal epilepsy.

Objectives

Aim of our study was to determine the efficacy and safety of Eslicarbazepine Acetate, observe its well-tolerated use and monitor adverse effects in newly diagnosed patients of focal epilepsy.

Methods

Study was done at Department of Psychiatry, Teerthanker Mahaveer University, Moradabad. A total of 30 newly diagnosed cases of focal epilepsy between 18-60 years of age were studied for 6 months, using a Semi-structured Interview and Liverpool Adverse Events Profile.

Results

Majority of patients were males (58%), between 21-30 years. Patients with partial/focal seizures (63%) were more common than those of generalized seizures (37%). Majority of the participants had 1-2 episodes of focal seizures weekly(48%), while some had almost daily(32%). Majority were on Eslicarbazepine Acetate 800 mg in two divided doses daily (64%), while the others received 1200 mg in three divided doses(32%). The mean Liverpool Adverse Events Profile score initially was 28.34 ± 6.28 which significantly improved after 4 weeks treatment to 22.80 ± 4.35 (p < 0.05). The improvement in newly diagnosed focal seizures patients was significantly more than other patients (p < 0.05). No major side effects were observed.

Conclusions

Eslicarbazepine Acetate as a monotherapy is effective in treating focal epilepsy. Better results of this drug are found in newly diagnosed focal epilepsy patients.

Disclosure

No significant relationships.
Glucagon-like peptide-1 receptor agonists in patients treated with antipsychotics
Authors: Delgado A. , Velosa J. , Avelar R. , Franco J. , Heitor M.
Published: February 2022

Introduction

Glucagon-like peptide-1 (GLP-1) is an endogenous peptide that stimulates insulin secretion and decreases glucagon secretion. The use of GLP-1 receptor agonists (GLP-1RA) showed efficacy reducing the weight and glucose levels in patients with and without type 2 diabetes. This effect was also associated with a decreased risk of major cardiovascular events.

Objectives

Our aim is to review the role of GLP-1RA in psychiatric patients at cardio-metabolic risk due to antipsychotics treatment.

Methods

We reviewed articles published in PubMed using the keywords: “GLP-1” “glucagon like peptide” “antipsychotics” and “psychiatry”.

Results

The number need to treat (NNT) to achieve clinical meaningful weight loss was 3.8. GLP-1RA treatment was also associated with greater reductions in body mass index, fasting glucose, HbA1c and visceral fat. This effect is true for antipsychotic treatment in general and for those on clozapine and olanzapine in particular. Overall, the GLP-1RA are well tolerated with nausea being the most common related adverse effect. Other variables such as age, sex, psychosis severity, nausea or any adverse drug reaction did not affect the weight loss.

Conclusions

Studies showed a promising role in the management of antipsychotics induced weight gain, particularly in clozapine and olanzapine treated patients. Although these promising results, the route of administration, with a daily or weekly subcutaneous injection, and the GLP-1RA associated financial costs, can be viewed as important factors which can limit the wide use of this type of treatment in psychiatric patients.

Disclosure

No significant relationships.
Levetirazetam psychosis
Authors: Martín C. Vilella , De La Torre López M.Á. Alonso , Vázquez P. García , Rodríguez I. Gonzalez , Sevillano S. Nuñez , García A. Serrano
Published: February 2022

Introduction

Levetirazetam is an antiepileptic drug with psychiatric adverse reactions. It includes psychosis, paranoia or hallucinations. The frequency is less than 1%.

Objectives

To describe and study a case of Psychosis produced by Levetirazetam

Methods

Retrospective review of clinical records and complementary test, including psychiatry, electrophysiology and neurology. Diagnosis schales such as Salamanca Questionnaire were used as suport.

Results

A 42-year-old woman diagnosed with tuberous sclerosis and undergoing treatment with levetirazetam acudes to the emergency department for behavioral disorders. She has presented an episode of aggression against a relative threatening him with a kitchen knife. The family reports that since the change in antiepilepticus 1 month ago, the patient has presented strange behaviors. Te Patient is conscious, uncooperative. Barely Approachable. Suspicious of her surroundings, with psychomotor restlessness, self-reference ideas and sparse speech. Auditory hallucinations seem to be present, as well as depressed and irritable mood. Psychic and somatic anxiety is found. Levetirazetam is discontinued, being replaced by valproic acid. Risperidone is started at a 3 mg dose. Treatment is well tolerated, and clinical stability is achived. Cluster A personality traits are found. Complementary test Blood and Urine simples, Imaging tests (CT and MRI), electroencephalogram and Electrocardiogram show no alterations

Conclusions

Levetirazetam can cause psychiatric adverse effects. it is important to make a proper diagnosis before a first psychotic outbreak in later life. Drugs that can produce psychiatric side effects should be identified and patients should be inform.

Disclosure

No significant relationships.
Clozapine in severe psychotic disorders: Balancing safety with efficacy
Authors: Leite R. Almeida , Costa A. , Borges J. , Mesquita A.
Published: February 2022

Introduction

Clozapine is a member of the dibenazepine class of antipsychotic drugs and has been designated an atypical antipsychotic drug. Clinical studies have shown that clozapine is effective in ameliorating the core symptoms, as well as the negative symptoms, in severe psychotic disorders and is therapeutically effective in treating about 30% of schizophrenic patients who are resistant to standard antipsychotic drugs.

Objectives

The goal is to review pharmacology, efficacy, and clinical use of clozapine, such as its side effects, and the benefit-to-risk ratio of this antipsychotic drug.

Methods

Non-systematic literature review based on scientific databases such as PubMed, using key words such as “clozapine”, “efficacy”, “side effects” and “resistant schizophrenia”.

Results

Clozapine was developed as the first atypical antipsychotic with activity for both the negative and positive symptoms of schizophrenia. The primary indications for clozapine are treatment-resistant psychotic disorder, defined as persistent moderate to severe delusions or hallucinations despite two or more clinical trials with other antipsychotic drugs, and patients who are at high risk for suicide. Concerns over a number of safety considerations are responsible for much of the underutilization of clozapine, such as agranulocytosis, metabolic side effects and myocarditis. These side effects can be detected, prevented, minimized and treated, but there will be a very small number of fatalities.

Conclusions

Awareness of the benefits and risks of clozapine is essential for increasing the use of this lifesaving agent.

Disclosure

No significant relationships.
An innovative anticonvulsant - a GABAA receptor modulator with an alternative mechanism of action and enzyme-inducing detoxifying properties
Authors: Shushpanova T. , Bokhan N. , Stankevich K. , Novozheeva T. , Shushpanova O. , Udut V. , Garganeeva N. , Markova E. , Knyazeva E. , Safronov S. , Boev R. , Solonskii A.
Published: February 2022

Introduction

The development of original drugs - new generation GABAA receptor modulators (GABAAR), with an anti-alcohol orientation, non-addictive and stimulating detoxification processes, makes it possible to increase the effectiveness of therapy and reduce the cost of treatment.

Objectives

Study the mechanism of interaction between m-Cl-BHU and GABAA - receptor

Methods

Molecular docking was performed to study the molecular docking of m-Cl-BHU with at the binding site of the target protein GABAAR.Radioreceptor studies were carried out using [3H] flunitrazepam binding with synaptosomal receptors in the cerebral cortex of Wistar rats in experimental alcoholism under the influence of therapy with m-CL-BHU. Kinetic parameters (T1/2, Clt, MRT, MET, AUC) of a model substrate - antipyrine were determined in the saliva of healthy volunteers and alcoholic patients.

Results

IResults of molecular docking (Schrödinger program (Glide) showed: m-CL-BHU (meta-chlorobenzhydryl urea) is complementary to the benzodiazepine GABAAR. Binding energy is low) (scoring (GScore) -11.14 kKal/mol); m-CL-BHU interacts with key amino acids at the α1γ2 interface: Tyr159, Tyr209, H101 Phe77 and is characterized by a high degree of model fit - dG insert: 0.741 Binding of [3H] flunitrazepam to the benzodiazepine site of GABAAR in rat brain in experimental alcoholism, who received 14 days of m-CL-BHU at 100 mg/kg /day, increased in receptor affinity. Changes in the kinetic parameters (T1/2, Clt, MRT, MET, AUC) of a model substrate - antipyrine in the saliva of healthy volunteers and alcoholic patients using Galodif (m-CL-BHU) at 300 mg/day 21 days

Conclusions

m-CL-BHU - GABAA receptor modulator with an alternative mechanism of action

Disclosure

No significant relationships.
Cognitive performance under stress: An experimental study in fire cadets
Authors: Lebedeva N. , Balakaeva A.
Published: February 2022

Introduction

Future firefighters are trained and selected for a job requiring the ability to perform well under high stress and time pressure.

Objectives

The research is focused on the experimental study of fire cadets’ cognitive performance indicators (speed/accuracy) under stress.

Methods

The study follows Solomon Four Group Design with two variables: stress stimuli (exposure/non-exposure) and participants’ background (50 male fire cadets; 50 male civilian students). Stress stimuli consisted of emergencies’ photos, audio, videos. ECG, EMG, systolic wave amplitude, pulse transit time were measured during the experiment to determine the respondents’ stress levels. The cognitive reflection test (CRT) was performed. Mann-Whitney U-test, Spearman’s rank correlation coefficient were used.

Results

There were no differences between students and fire cadets in CRT time (p=0.515, students: 118.1±38.6 sec, cadets: 143.5±78.1 sec) and accuracy (p=0.246, students: 1.2±0.9, cadets: 1.4±0.9). Fire cadets in the stress exposure group (mean time=122, mean accuracy=1.22) performed CRT significantly faster (p=0.039) than non-exposed cadets (mean time=166, mean accuracy=1.56). The accuracy difference was insignificant (p=0.206). Fire cadets with prior emergency work experience (n=30, mean time=159.7, mean accuracy=1.6) were no different from other cadets (n=20, mean time=159.7, mean accuracy=1.1) both in time (p=0.289) and accuracy(p=0.07). The performance difference between civilian student groups was insignificant (exposure: mean time=123, mean accuracy=1.32; non-exposure: mean time=113, mean accuracy=1.06).

Conclusions

Stress exposure enhances fire cadets’ CRT performance (in speed, but not in accuracy). Emergency work experience did not contribute to this effect, which could be explained by the self-selection effect (since only people inclined to emergency work choose to become a firefighter).

Disclosure

No significant relationships.
Electroconvulsive therapy after conservative treatment of vertebral fractures
Authors: Martins S. , Quarenta J. , Teixeira T. , Pinheiro J.
Published: February 2022

Introduction

Electroconvulsive therapy (ECT) remains a valuable treatment for major depression with psychotic symptoms. However, it is necessary to pay special attention when there is a history of fractures.

Objectives

Through the description of the following clinical case, we will emphasize the importance of screening for vertebral fractures within ECT and the different procedures that must be taken if that occurs.

Methods

We undertook a narrative literature review by performing a search on PubMed for English-written articles. The query used was “Electroconvulsive Therapy” AND “Vertebral Fractures”.

Results

A 71-year-old woman was admitted with an episode of psychotic depression. Basic tests were performed and were all normal. After not responding to pharmacologic treatment, she was referred for ECT. The patient had a full recovery after 4 weeks of biweekly sessions. She was discharged and proposed for maintenance ECT. However, she started complaining of back pain after falling and did an X-ray and CT scan which revealed fractured L1 and L2. It was suggested conservative treatment with a Jewett orthosis. Within this period, the ECT was suspended and after a 4-week treatment, the fracture was consolidated. As there was no risk of neurological compression, the treatment was restarted with the same dosage of succinylcholine, and it was achieved complete muscular relaxation. The patient fully recovered without any orthopedic sequel.

Conclusions

Electroconvulsive therapy can be safely performed after conservative treatment of vertebral fractures, if special attention is provided to complete muscular relaxation. For this effect, the dosage of succinylcholine can be adjusted.

Disclosure

No significant relationships.
Non-stop management of an electroconvulsive therapy unit (ECT-U) during the first two months of COVID-19 lockdown in Spain
Authors: Llorca-Bofí V. , Batalla I. , Adrados-Pérez M. , Buil-Reiné E. , Pifarré J. , Torrent A.
Published: February 2022

Introduction

Since the declaration of the national lockdown in Spain on March 14th until the publication of the SEPB recommendations on May 11th, most of the ECT-U closed or drastically reduced their activity.

Objectives

To present our non-stop management of an ECT-U during the first two months of COVID-19 lockdown in Spain.

Methods

We retrospectively analysed the time between sessions, the clinical, pharmacological and electrical data records of maintenance patients (m-ECT) and compared them with their own records in the two-month period prior to COVID-19. We analysed the length of admission, clinical, pharmacological and electrical records in hospitalized patients (i-ETC) and compared them with patients from the entire year prior to COVID-19 paired by age, sex and diagnosis.

Results

The ECT-m programme included 17 patients: we postponed the ECT in 8 patients; 1 patient was hospitalized and 8 patients continued normally. The time between m-ECT increased by 8.37±4.89 days (p=0.018) without relapse. During the COVID-19 period, we performed ECT-i in 14 patients without new infections. In i-ECT the duration of admissions increased by 22.1 ±1.2 days (p=0.006), the load increased by 81.53 ±87.8 mC (p=0.027) and the time of the electrical seizure decreased by 7.9 ±9.2 seconds (p=0.037).

Conclusions

The modifications that reach a statistical significance are explained by the readjustment of the ECT-U, with no clinical significance. With the appropriate measures, neither m-ECT nor i-ECT were discontinued. Thus we maintained adequate patient management.

Disclosure

No significant relationships.
Efficacy of dialectical behavioral therapy DBT for couples with emotional dysregulation
Authors: Rady A. , Abdelkareem A. , Mouloukheya T. , Elkholy N.
Published: February 2022

Introduction

Couple therapy continues to gain in stature as a vital component of mental health services. The linkage of relationship distress to disruption of individual emotional and physical well-being emphasizes the importance of improving and extending empirically based strategies for treating couple distress

Objectives

To evaluate the efficacy of dialectical behavior therapy “DBT” in outpatients couples with emotional dysregulation

Methods

Twenty couples presented with marital distress and at least one of them suffers from emotional dysregulation assigned at their convenience or according to immediate availability of treatment slot to a couple DBT group. Arabic version of DERS was used for assessment of emotional dysregulation before and after intervention. Dyadic Adjustment Scale was used for assessment of marital adjustment

Results

Both male and female partners showed significant improvement in marital adjustment and emotional regulation. Female partner showed significant higher change amplitude in both scales. Female partners showed significant improvement in all DERS subscales except for (GOALS) subscale (significant decrease), while male partners showed significant improvement in (IMPULSE), (AWARNESS), (STRATEGIES) and (CLARITY) subscales

Conclusions

Dialectical behavioral therapy for couples is an effective approach to couples with emotional dysregulation in one or both partners

Disclosure

No significant relationships.
A literature therapeutic group at a psychiatric closed-unit
Authors: Yaniv H. , Nimni D. Shalom , Raskin S.
Published: February 2022

Introduction

This lecture will present a therapeutic group that took place at a closed-unit in a psychiatric hospital. The members of this group were patients suffering from psychotic disorders

Objectives

Patients suffering from psychotic disorders.

Methods

The patients had difficulty in organizing their thoughts as well as with the expression of their internal-world and emotions. Moreover, they were suspected of the units’ staff members. These circumstances led us to create a theme group that combines a verbal-affective metaphoric instrument - literature. Art, such as literature, represents the mind of its creator and when incorporated into the therapeutic process, can serve as a third-voice - a symbolic language that conveys an idea indirectly and arouses the patient’s personal associations and emotions. The use of literature, while relating to content that aroused from a poem or a short story, led to a connection or an identification with the emotion expressed in the writing stimuli or in opposition to it, and from there to a projection of the internal world of the patient.

Results

Through the possibility of alternating between proximity and distance, regard the metaphoric instrument, patients could organize their associations and emotions and express them in a more beneficent way – “normalization” of the cognitive and expressive process.

Conclusions

The analysis of the different group’s sessions, points to the potential of using literature in a therapeutic group with patients in their acute state, at the closed-unit. Examples of verbal reports from different group settings, in which literature was used, will be presented.

Disclosure

No significant relationships.
On gender and stroop effect. The REM-ACT study: Acceptance and commitment therapy versus a mindfulness-based emotional regulation intervention in anxiety disorders. A randomized controlled trial
Authors: Castellanos-Villaverde T. , Fernández-Jiménez E. , Vidal-Bermejo E. , Torrea-Araiz I. , Navarro-Oliver G. , Hospital-Moreno A.
Published: February 2022

Introduction

Results about the effects of mindfulness training on the executive function of inhibition are mixed. Research about interventions in anxiety disorders is needed to exam the differential efficacy among men and women, and the factors involved in those potential gender differences.

Objectives

To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on inhibitory control according to gender.

Methods

This study was carried out in a Mental Health Unit in Spain (Colmenar Viejo, Madrid). Firstly, 80 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 64 patients decided to participate (mean age = 40.66, S.D. = 11.43; 40 females). Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2x2 mixed ANOVA (pre-post change x intervention type x gender) was conducted, with Sidak-correction post-hoc tests. The dependent variable was the Interference score of the Stroop test.

Results

Normality and homoscedasticity assumptions were met. No statistically significant differences were observed on age or gender between interventions. A statistically significant interaction effect was observed between pre-post change x intervention x gender on Interference [F(1, 52) = 5.004, p = .030; statistical power observed = 59.3%]. Improvement in interference was larger for women after ACT (p = .000) and for men after MER (p = .002).

Conclusions

These preliminary results show improvements in inhibition after the two interventions examined. However, each treatment maximizes improvement in different ways according to gender. Further research is required.

Disclosure

No significant relationships.
On gender and TMT-A. The REM-ACT study: Acceptance and commitment therapy versus a mindfulness-based emotional regulation intervention in anxiety disorders. A randomized controlled trial
Authors: Vidal-Bermejo E. , Fernández-Jiménez E. , Castellanos-Villaverde T. , Torrea-Araiz I. , Navarro-Oliver G. , Hospital-Moreno A.
Published: February 2022

Introduction

There is paucity of empirical studies which compare various mindfulness-based interventions on speed of visuomotor tracking and also analyse the differential effect of gender.

Objectives

To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on speed of visuomotor tracking according to gender.

Methods

This study was carried out in a Mental Health Unit in Spain (Colmenar Viejo, Madrid). Firstly, 80 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 64 patients decided to participate (mean age = 40.66, S.D. = 11.43; 40 females). Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2x2 mixed ANOVA (pre-post change x intervention type x gender) was conducted, with Sidak-correction post-hoc tests. The dependent variable was the score on TMT-A.

Results

Normality and homoscedasticity assumptions were met. No statistically significant differences were observed on age or gender between interventions. No statistically significant interaction effect was observed between pre-post change x intervention x gender on TMT-A [F(1, 52) = 2.867, p = .096, statistical power observed = 38.3%]. However, simple effects were statistically significant: while males improved on TMT-A after MER (p = .000; Cohen’s d = 1.092), females did so after ACT (p = .000; Cohen’s d = 1.506).

Conclusions

These results show that gender moderates the improvement of the two mindfulness-based interventions examined on the speed of visuomotor tracking. More research is needed to confirm these findings.

Disclosure

No significant relationships.
Online group psychotherapy during the “lock down”
Authors: Romac D.
Published: February 2022

Introduction

The Covid-19 pandemic has limited the classic psychotherapy treatment. EAP provided temporary recommendations for online psychotherapy in March of 2020 which brought new possibilities and limitations and contains rules, ethics and techniques. From the perspective of a psychodynamic therapist, the specificity of online group psychotherapy in the context of strong stressors is described.

Objectives

During the “lockdown” period and the earthquakes that occurred simultaneously in Zagreb in March of 2020, the secure Internet platform enabled the continuity of the group’s work in a video link modality.

Methods

Online group had regular weekly meetings which lasted 1.5 hours. The classic rules of group analytical therapy were adapted to the new setting in virtual space. A risk assessment was also performed.

Results

The six group members and therapist have connected online through more freedom, developed new levels of sensitivity, flexibility and creativity. They have also accepted limitations. The online group is able to provide holding, but deeper connections require a physical presence to exchange emotions that technology interferes with as well as the process of empathizing. Previous live sessions crucial to maintaining emotional connections have served as reservoirs for a period in which communication over the Internet was insufficient.

Conclusions

Internet technology can temporarily enable the continuity of a group psychotherapy. Technical and institutional support is recommended. The advantages of technology can be used if the technique is adapted, realistic goals set, and clinical limitations accepted. Many questions about the possibilities of “online psychotherapy” are open and unexplored.

Disclosure

No significant relationships.
Medication preparation program in Liencres Hospital
Authors: Isidro G. , Bezanilla A. , Galván M. , Saiz Y. , Voces B. , Guitián M.
Published: February 2022

Introduction

The need to implement a program of autonomy in the handling of oral medication has been observed at the time of discharge from the hospital.

Objectives

- That the patient is able to know his medication, differentiating between active ingredient and commercial brand. - That the patient is able to interpret the guideline in the electronic prescription. - That the patient is able to prepare his weekly medication autonomously.

Methods

- The doctor in charge indicates the Program in those patients susceptible to benefit of the same and after consensus with the multidisciplinary team. He validates and prints the electronic prescription well in advance. Preferably the patient himself (alone or accompanied by family members or Educators) get their medication and a weekly “polydosis” at a pharmacy office bringing him with him to the Unit. - Occupational Therapy helps the patient interpret the electronic prescription guideline and place the weekly medication in the “polydosis” and works with the patient in forecasting execution tasks of medication needs for outpatient follow-up.

Results

The program is well accepted by patients. None of the patients included so far have had an early relapse.

Conclusions

The program has helped patients interpret the medical indications given mnesical and executive difficulties of patients with severe mental disorder.

Disclosure

No significant relationships.
Trauma and the role of the wounded healer
Authors: Hankir A. , Zaman R. , Carrick F.
Published: February 2022

Abstract Body

Carl Jung used the term, ‘The Wounded Healer’ as an archetypal dynamic to describe a phenomenon which may take place in the relationship between analyst and analysand. Jung discovered the Wounded Healer archetype in relation to himself. For Jung, ‘It is our own hurt that gives the measure of our power to heal‘. Indeed, recurrent themes in the autobiographical narratives of Wounded Healers is that their experiences living with trauma inspired them to become more empathetic, driven and insightful. Many report that debilitating though the symptoms of mental illness are, the stigma is far worse. In this paper we describe the inception of an innovative anti-stigma programme, ‘The Wounded Healer’ that blends the power of storytelling and the performing arts with psychiatry and how The Wounded Healer helps to heal the wounds that were afflicted by the trauma of stigma.

Disclosure

No significant relationships.
Physical training for inpatients
Authors: Bjerke T. , Wynn R.
Published: February 2022

Introduction

There is a high degree of comorbidity between serious mental illness (SMI) and substance use disorders (SUD) and cardiovascular disorders. Other life-style related disorders are also common in patients with SMI and SUD. Consequently, comorbidity with somatic diseases contributes to a dramatic reduction in life-expectancy for these patient groups. Physical training has been shown to have positive effects also for mental health, but there has been little systematic use of physical training as part of the treatment for patients suffering from SMI and SUD in Norwegian health care.

Objectives

To present a new project on physical training for patients suffering from SMI and SUD.

Methods

We briefly describe a project in a major Norwegian hospital, where physical exercise will be offered as part of the treatment for patients suffering from SMI and SUD.

Results

The Division for Substance Use and Mental Health now offers an exercise room for inpatients at the main clinic in Tromsø, Norway. The exercise room contains various equipment including treadmills and equipment for strength training. This facility has recently been made available and is currently being used by a selection of patients. A study of user experiences is forthcoming and a systematic study of effects of physical exercise for patients suffering from SMI and SUD is being planned.

Conclusions

Physical exercise has been shown to have positive effects also on mental health. In one major Norwegian hospital, facilities are now offered for inpatients suffering from SMI or SUD. The effects of physical exercise on patients with SMI and SUD will be examined.

Disclosure

No significant relationships.
Improve health care access is possible. A case report
Authors: Gori O. , Raggini R. , Sant’Angelo R. , Tricomi G. , De Paoli G. , Grittani S. , Piraccini G.
Published: February 2022

Introduction

Within the hub and spoke organizational model provided by the Emilia Romagna Region for assistance to people with autism spectrum disorder (ASD), Cesena ward of psychiatry represents the hospital Hub. Here, a dedicated team (doctors, psychologist, case manager) creates individualized pathways to ensure second-level specialist diagnostics and the management of comorbidities affecting subjects diagnosed with Autism Spectrum Disorder and Intellectual Disability (ID).

Objectives

We report the case of a 23-year-old man, who from the age of 6 was opposed to any instrumental diagnostic investigation.

Methods

In order to guarantee the patient’s full collaboration in carrying out essential diagnostic activities, short behavioural paths were created including video modelling. The Vi.Co app was used and a new app was created to target behaviors that could not be included in Vi.Co

Results

It was thus possible to make the patient compliant with the execution of blood samples, ECG, MRI of the brain in sedation and CT dental scan.

Conclusions

In our case, communication support systems and behavioral strategies have proved to be excellent allies in significantly improving the quality of care for our young patient. Considering the worst prognosis of pathologies and the reduced life expectancy of subjects suffering from ASD and ID, known in the literature, in our opinion, the first essential step becomes facilitating access to care for these patients.

Disclosure

No significant relationships.