bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of the 2020 lockdown on the psychological functioning of outpatient psychiatric patients
Authors: Grah M. , Restek-Petrović B. , Lukačić T. , Grošić V. , Milovac Ž. , Prga Bajić T. , Mayer N.
Published: August 2024

Introduction

The coronavirus pandemic has led to sudden changes in the lives of people around the world. The health threat, earthquakes and epidemiological measures caused certain psychological reactions in everyone. Psychiatric patients are particularly vulnerable to stress, so we were interested in how the changes at the beginning of the pandemic affected their psychological functioning.

Objectives

To check changes in some areas of psychological functioning of outpatient psychiatric patients after the “lockdown” in 2020 and to examine their connection with some sociodemographic and treatment variables.

Methods

Patients of the University Psychiatric Hospital Sveti Ivan filled out a survey questionnaire designed for the purpose of research, which consisted of sociodemographic data and items examining different areas of psychological functioning, when they arrived for an outpatient check-up.

Results

Variables were formed that examine: changes in unpleasant emotions, lack of support, lack of social interaction, changes in performing daily duties, changes in self-help behaviors and health concerns. Statistical analysis showed a significant increase in all variables, with the largest occurring in lack of social interaction, health concerns, and unpleasant emotions. The predictors of changes in psychological functioning were female gender, younger age in combination with cohabitation with parents, and the number of hospitalizations.

Conclusions

After the “lockdown” in 2020, psychiatric patients report a deterioration in psychological functioning.

Disclosure of Interest

None Declared
Coping self-efficacy and personal growth in the situation of the COVID-19 threat
Authors: Kvasova O. G. , Karacheva E. A. , Prichkodko P. I. , Magomed-Eminov M. S. , Savina O. O.
Published: August 2024

Introduction

In studies of the socio-psychological consequences of the COVID-19 pandemic, models focused on the negative aspects of stressors, dysfunctions,  anxiety We present the attempt to expand the context and include in the field positive personal resources for psychological well-being and even post traumatic personality growth after disasters. Sometimes separation from family and friends, lack of medicines and medical resources, loss of income, social isolation to humanity, do not automatically assume that a person is capable and responsible for effectively coping with life difficulties.

Objectives

397 (students and patients of clinic average age 26, 2/3 are female

Methods

Peritraumatic Distress Index (CPDI) (Feng, 2020); Impact of Event Scale (Horowitz, 1979), Coping Self-efficacy Scale (Chespeu et al, 2006); Posttraumatic Growth Inventory (Tedeschi& Calhoun, 1996), MMI (Nuttin, 1986) – adapted by M. Magomed-Eminov.

Results

Significant negative correlation between coping self-efficacy and intensity of the impact of stressful events (IES) (rS = - 0,140, p < 0,05) was predictable.

CPDI and PTG showed significant correlation (Pearson’s r= 0.23, p<0.01) between Peritraumatic Distress Index and Post-Traumatic Growth indicators only in the group of respondents who have had  COVID-19. The data is confirmed by the content analysis of incomplete sentences of the subjects of COVID group. The correlation between these indicators in the Non-Covid group was insignificant.

Moreover additional information we got from narratives of infected patients: the data has been split into 3 groups of narratives in the context of cultural-historical activity theory which shows the triadic outcome of survivor after trauma : a) suffering, b) adaptation, coping, resilience, c) personal growth.

Conclusions

To interpret the data the authors propose the meaning-activity approach and personality work with negative life experience (Magomed-Eminov, 1998, 2007, 2009, 2021). Authors suggest that further research on the positive consequences of stressful events beside coping styles and mechanisms that would expand the repertoire of tools predicted the ability of a modern person to cope with adversity and use experience for deeper involvement of human resources with the help of personality work with personal experience.

Disclosure of Interest

None Declared
Developing scale for affective response: anxiety, anger, depression
Authors: Shin H. Y. , Kim D. Y. , Choi S. W.
Published: August 2024

Introduction

People experience various negative emotions when they encounter stressful events, and these negative emotions contribute to the onset of illnesses. These emotional responses are not limited to just one; a person can experience multiple emotions at once, and the primary emotional reactions can vary depending on the severity and duration of the illness or life events. This is reason why we created a self-report scale to assess short-term emotional responses, focusing on the current emotional state experienced subjectively by patients.

Objectives

The purpose of this study was to develop an affective response scale (ARS) and examine its validity and reliability.

Methods

We established clusters of affective via a literature review and developed preliminary items based on the structure. We conducted expert content validation to converge on the final items, followed by construct validity and reliability analyses.

Results

The research findings indicate that the Affective Response Scale was composed of three main dimensions: anxiety, anger, and depression. Content validity results confirmed the validity of most items. The scale developed in this study was found to be valid in both exploratory and confirmatory factor analyses, and it was identified to be stable and consistent through the analysis of the internal reliability.

Conclusions

These results indicate that the ARS is highly reliable and valid, and that it can be utilized as an effective measure of the patient’s emotion and its severity.

Disclosure of Interest

None Declared
Adaptation and analysis of the Hungarian version of the Snaith-Hamilton Pleasure Scale
Authors: Koumou V. , Nagy B. K. , Kabella B. , Feher A. , Pogany L. , Lazary J.
Published: August 2024

Introduction

Anhedonia (loss of ability of experience pleasure) is a transdiagnostic symptom which is presented as a prominent complain in several psychiatric disorders, such as depressive disorders, schizophrenia, bipolar disorder, addictive disorders, certain personality disorders etc. Specific instruments for assessment of anhedonia have been published in the international literature but their Hungarian versions are not available so far, however, the prevalence of affective disorders and suicide are also high in Hungary. The Snaith-Hamilton Pleasure Scale (SHAPS) is an instrument developed in 1995 (Snaith et al. Br J Psychiatry1995;167:99-103) which purposley has been constructed with items that can be easily translated into other languages.

Objectives

The aim of our study was to translate the 14 items into Hungarian and analyse its reability and sensitivity in a Hungarian sample consists of patinets and control persons. Further aim was to explore the differences of anhedonia profiles among diagnostic categories and subgroup of major disorders.

Methods

We recruited 170 subjects (101 controls and 59 patients; 78 men and 82 women; mean age=37,9±6,1y) into our study. Among the patients there were 27 subjects with major depressive disorer (MDD), 10 subjects with bipolar disorder (BD), 9 patients with schizophrenia (SCZ), 6 patients with addictive disorder (AD) and 7 patients with anxiety disorder (ANX)±. We created two major subgorups from the dfferent diagnostic categories: affective and psychotic subgroups to compare the anhedonic profiles. Differences of mean values between case and control, men and women and subgroups were analysed by t-tests and diganostic categories by ANOVA tests performing in SPSS 20.0 software.

Results

Among the MDD, the BD, the SCZ, the AD and the ANX groups, patients with MDD produced the highest score (6.9±3.5; 3.9±2.4; 5.9±3.9; 2.8±2.7;2.3±1.8, respectively), while controls prohibited 1.6±1.3. The case group scored significantly higher on the SHAPS than the control group (5.3± 3.6 vs. 1.6±1.3; p=0.0001). The means of SHAPS did not differ significantly between the affective subgroup and the psychotic subgroup (6.0±3.7 vs. 4.8±3.2; p=0.24). Among the subgroup of women, the age was significantly associated with the SHAPS score (p=0,04), however, this association has been not detected in men.

Conclusions

The Hungarian version of the SHAPS detected marked difference between cases and controls with good reliability and sensitivity. The instrument can be useful in daily clinical routin becuase subjects could fill it easily and quickly. In case of patients with pronounced anhedonia, treatments with spcifically targeting anhedonia can be preferred (e.g. rTMS as it was demonstrated in our earlier publications, see Lazary et al. Sci Rep 2021,11:8867; Elemery et al. Front Psychiatry 2022, 13:806731). This study was supported by the grant EFOP 5.6.2.

Disclosure of Interest

None Declared
Breath Gas Markers in Depression and Their Relationship with Brain Metabolism
Authors: Keskin Gokcelli D. , Itzhacki Sitton J. , Kesik J. , Henning D. H. , Farrher E. , Shah N. J. , Frodl T.
Published: August 2024

Introduction

Dysfunctional changes in the glutamatergic system play an important role in the pathophysiology of depression. Glutamate regulates various neuronal function, such as nerve migration, excitability, plasticity, as well as long-term potentiation and long-term synaptic depression. Failures in this process might cause emotional/cognitive changes associated with stress-induced depressive symptoms, a part of our current understanding of the pathophysiology of depression. These changes might be related to deviations in biochemical blood parameters, but also to volatile organic compounds (VOCs) measured in breath.

Objectives

1) To replicate our previous finding that concentration of volatile organic compounds in expiratory breath gas and metabolites derived from MR spectroscopy distinguish unmedicated depressed patients from healthy participants, (2) to determine whether the amount of these VOCs is associated with severity of depression and anxiety, and (3) to correlate breath-VOC-content with glutamatergic neurotransmission and energy metabolism derived from MR spectroscopy.

Methods

25 antidepressant-free patients with major depression according to DSM V (18-65 years of age) are recruited from our out- and inpatient clinics. The controls will consist of 25 healthy age-and-sex-matched participants. Breath gas analyses will be carried out at awakening, and 30 and 60 minutes thereafter, and at 5pm using PTR-TOF-MS with direct on time measurement through a special sampler. A 7 Tesla Siemens Terra MRI scanner will be used to undertake spectroscopic measurements. Concentrations of glutamate and β-hydroxybutyrate levels in the pregenual and dorsal anterior cingulate gyrus will subsequently be assessed.

Results

Statistical analysis for differences between groups corrected for multiple measurements will be carried out. Concentration of VOCs will be correlated with brain metabolism and severity of symptoms.

Conclusions

VOCs in breath are proposed to be an efficient and non-invasive marker for depression-related biochemical changes related to disease severity, and eventually useful for personalized treatment planning.

Disclosure of Interest

None Declared
Effects of a Cognitive Bias Modification Training on Resting State EEG Microstates in Patients with MDD and Healthy Controls
Authors: Kesik J. , Kratochwil Z. , Keskin-Gökcelli D. , Müller B. , Frodl T.
Published: August 2024

Introduction

Major Depressive Disorder (MDD) is associated with a high burden of disease and notable economic costs. Standard treatments (e.g. medication or cognitive therapy) have been shown to be effective, but some patients remain unresponsive. With the knowledge that MDD patients have been shown to display an attentional cognitive bias towards negative stimuli, Cognitive Bias Modification (CBM)-training to focus attention on positive information is thought to improve emotional processing and depressive symptoms. Some studies imply reduced duration and occurrence of microstate D in MDD compared to healthy controls. However, the effect of CBM on microstates is still unclear.

Objectives

(1) To replicate previous findings that duration and occurrence of microstate D is reduced in patients with MDD compared to healthy controls in an independent sample and (2) to investigate the effect of an active CBM-training versus a control-training on microstates and its association with symptom improvements.

Methods

Thirty patients receiving outpatient treatment with MDD according to DSM V (aged 18-60) will be recruited in Essen and Aachen. The control group will consist of 30 healthy age-and-sex-matched participants. Psychological testing will be administered and all participants will be randomized to either an active or a control training. During the next visit, resting state EEG and a GoNoGo Task with positive, neutral and negative pictures will be measured. The participants will take a tablet home to undergo 10 sessions of CBM within 14 days. The training will be consisted of a dot-probe-task. In the active condition the probe will be more likely to appear behind a positive versus a neutral picture, while appearing randomly in the control condition. After 14 days, a second EEG will be recorded.

Results

Differences in duration and occurrence of microstate D between patients and healthy controls will be analyzed by conducting ANCOVAs with age and sex as covariates. ANCOVAs for repeated measurements will be calculated to study effects of time (pre- vs. post-training) and group (patients vs. healthy controls in active training; patients in active vs. patients in control-training), on duration and occurrence of microstate D.

Conclusions

CBM-training is proposed to be an effective treatment option for MDD patients, reflected in a reduced topographical bias of microstate D in EEG.

Disclosure of Interest

None Declared
Depression: Biological Non-Pharmacological Interventions. A Review.
Authors: Rodríguez Batista F. A. , Trufero Miguel S. , Bordón Guerra R. , Neyra del Rosario A. R.
Published: August 2024

Introduction

Major depressive disorder stands as one of the most significant mental health issues in the general population. It impacts the patients’ quality of life and increases both morbidity and mortality. Response and tolerability to available pharmacological treatments are often inefficient, sometimes requiring extended periods to achieve acceptable remission through combinations or augmentations. Non-pharmacological approaches constitute an element in the therapeutic options for this mental disorder. In recent years, there has been a growing interest in non-pharmacological biological treatment interventions. Among the principal ones are Electroconvulsive Therapy (ECT), Transcranial Magnetic Stimulation (TMS), Deep Brain Stimulation (DBS), and Vagus Nerve Stimulation (VNS).

Objectives

The aim of this paper is to review the current available literature to expand our knowledge about biological non-pharmacological treatment in depression, particularly ECT, TMS, DBS, and VNS.

Methods

A qualitative review was conducted over the last 5 years, using the Medline database through PubMed. We selected studies in English or Spanish that met the objectives of the review, excluding references in other languages. The scientific evidence obtained was analyzed and synthesized.

Results

There is growing evidence in this area. TMS, whose place in clinical guidelines remains unclear, is a less available treatment but might be considered in patients with moderate to severe depression who cannot receive pharmacological treatment. DBS, which shows good results in treatment-resistant major depressive disorder, achieves response rates greater than 50%. VNS has accumulated studies since its approval for treatment-resistant depression, showing some latency of response but demonstrating improvement persistence for at least two years, although some studies have not clearly shown a benefit. We also found studies demonstrating the effectiveness and favorable cost-benefit balance of ECT.

Conclusions

This review highlights the importance of increasing knowledge in these types of treatments. They have shown significant progress in recent years. We have a better understanding and use of the technique of ECT, while newer options have gained evidence in effectiveness over these years, with improvements facilitating their use in patients with treatment-resistant depression.

Disclosure of Interest

None Declared
Exploring the Digital Mental Health Literacy of the Tunisian population: A Cross-sectional Online Survey
Authors: Chehaider O. , Lagha M. , Adouni A. , Ben Romdhane I. , Homri W. , Labbane R.
Published: August 2024

Introduction

In the digital age, the landscape of mental health information dissemination and consumption in Tunisia has experienced a profound transformation. As the digital revolution continues to reshape our lives, understanding how individuals seek and interact with mental health information online has become increasingly critical.

Objectives

The primary objectives of this study are as follows:

-

To comprehensively investigate the digital mental health literacy of individuals in Tunisia by administering an insightful online questionnaire.

-

To delve into the multifaceted aspects of how Tunisians engage with mental health content on digital platforms, unveiling their comfort levels, preferences, and decision-making factors.

Methods

This study conducted an online survey comprising three sections. The first gathered demographic information to profile our diverse participants. The second explored internet usage patterns, unveiling their digital activities. The third delved into perceptions of mental health information on social media, revealing preferences. Our survey reached participants of various ages and locations in Tunisia.

Results

The findings of this study cast a revealing spotlight on the digital mental health landscape in Tunisia. A significant proportion of our respondents frequently engaged with various social media platforms. Notably, Instagram emerged as the favored platform for 80% of our participants, while 72% chose Facebook as their preferred digital sanctuary. Intriguingly, 57% of our respondents actively embarked on quests for mental health information on YouTube, with a distinct preference for video-based content.

In the labyrinth of online mental health information, our participants exhibited a discerning eye. They assigned paramount importance to source credentials, references to reputable sources, and unwavering adherence to established medical guidelines. However, beneath this discernment, a noteworthy 65% harbored doubts regarding the accuracy of online information, reflecting the inherent challenges and complexities of navigating the digital information ecosystem.

Furthermore, our study unearthed areas where social media platforms may still grapple with shortcomings in addressing the multifaceted needs of mental health consumers. Participants eloquently expressed concerns about the accuracy of information, the availability of reliable platforms, and the crucial need for a diverse array of perspectives in mental health content on social media.

Conclusions

This study offers key insights into Tunisia’s digital mental health landscape. It highlights prevalent digital information consumption and preferences. Emphasizing the need for credible and diverse mental health information on social media is vital. This sample lays the foundation for enhancing available content, better supporting mental well-being in Tunisia.

Disclosure of Interest

None Declared
Schizophrenia and eating disorders: Epidemiological and clinical characteristics
Authors: Herelli E. , Lagha M. , Askri F. , Ben Romdhane I. , Wided H. , Labbane R.
Published: August 2024

Introduction

Schizophrenia is a common mental illness with a wide range of symptoms.

Given the high metabolic comorbidity observed in schizophrenia and the metabolic side-effects induced by the antipsychotics used in practice, the detection of eating disorders is crucial.

These disorders may occur at the same time as psychotic symptoms or independently of them.

Objectives

we aim to provide an overview of eating disorders in schizophrenia.

Methods

We conducted a systematic search using the 2 bibliographic databases PubMed and Google scholar including the following keywords: “Schizophrenia”, “Eating disorders”, “Reward mechanisms”.

Results

Eating disorders are a frequent comorbidity in schizophrenia.

Authors have reported that some patients with schizophrenia have an increased appetite and craving for fatty foods, increased caloric intake and frequency of consumption, which may be associated with increased disinhibition.

According to the literature, binge eating and night eating are frequently observed in patients with schizophrenia, with a prevalence of around 10%.

Studies have shown that people suffering from psychosis and treated with antipsychotics have high rates of binge eating, ranging from 4.4% to 16% for binge eating and from 8.9% to 45% for binge eating symptoms (without reaching the diagnostic threshold for binge eating).

Rates ranging from 16.1% to 64% for cravings were reported.

Anorexia nervosa appears to affect between 1% and 4% of schizophrenic patients.

Conclusions

Despite their frequent association with schizophrenia, eating disorders remain little studied. However, it is important to detect these disorders and elucidate the underlying psychopathological and neurobiological mechanisms in order to better manage metabolic comorbidity and improve patients’ quality of life.

Disclosure of Interest

None Declared
Perceptions of Obesity in Old Age: A Qualitative Study
Authors: von Humboldt S. , Ilyas N. , Leal I.
Published: August 2024

Introduction

The relationship between obesity and mental health in old age is complex and widely impacted by different biological, psychological, and social factors.

Objectives

The primary objectives of this qualitative research study are: a) To understand the influence of obesity on older adults’ well-being; b) to assess emotional experiences related to obesity in old age and; c) to explore how obesity influences the mental health of older adults.

Methods

This study included 346 participants aged 65 to 84 years (M=73.9; SD=5.61) from three different nationalities (English, Spanish, and Portuguese). All interviews went through content analysis.

Results

This study identified four main themes regarding the influence of obesity on older adults’ well-being: (1) Insatisfaction with Body Image (66%); (2) Feeling embarrassed (65%); (3) Feeling Social Isolated (57%); and (4) Lost Opportunities (46%)Three main themes for emotional experiences were frequently verbalized by the participants: (1) Shame (81%); (2) Guilt (78%); and (2) Incompetence (76%). Finally, three main influences in mental health due to obesity were reported: (1) Self-concept (88%); (2) Stress (78%); and (3) Melancholia (63%).

Conclusions

These results highlighted that obesity negatively influences older adults’ well-being and emotional experiences and has serious mental health-related negative outcomes for older adults. Interventions like community-based weight loss programs can be effective in controlling weight and improving the social interaction of obese older adults.

Keywords: Emotional experiences; mental health; obesity; older adults; well-being.

Disclosure of Interest

None Declared
Orthorexia and perfectionism in medical students in Tunisia
Authors: Mellouli A. , Ellouze S. , Boussaid N. , Turki M. , Zribi A. , Halouani N. , Aloulou J.
Published: August 2024

Introduction

Orthorexia is defined as a dependence on healthy food or an obsession to consume healthy food. One area deemed influential upon disordered eating and dietary intake is perfectionism.

Objectives

To investigate the relationship between orthorexia and perfectionism in medical students.

Methods

We conducted a cross-sectional, descriptive, and analytical study in the faculty of medicine of Sfax (Tunisia), between February and April 2023. A self-reported questionnaire was distributed to students via social media. We used ORTO-15 for the assessment of orthorexia, and the Big Three Perfectionism Scale (BTPS) to assess perfectionism.

Results

The research has enrolled 220 students. Their mean age was 21.40±1.68 years, with female predominance (70%). The ORTO-15 mean total score was 36.88±6.76. A total of 60% of participants had an orthorexic behavior. The BTPS mean total score was 45.52±12.45 with a mean score of 13.25±4.35 for rigid perfectionism, 18.31±6.37 for self-critical perfectionism, and 13.99±5.47 for narcissistic perfectionism.

Students with orthorexic behavior had significantly higher scores of perfectionism (p= 0.048).

Conclusions

Our study has drawn a significant association between orthorexia and perfectionism among medical students. This result suggests that students experiencing highly critical and judgemental beliefs associated with perfectionism are more susceptible to orthorexic eating behaviors.

Disclosure of Interest

None Declared
physician assisted dying : A French Perspective - a new revolution?
Authors: Courtet P.
Published: August 2024

The debates on euthanasia and assisted suicide (EAS) are topical in Europe. The extension of EAS for psychiatric reasons, already legalized in some countries, raises ethical and clinical issues, given the proximity between suicidal patients and patients who request or have accessed EAS. How can ESA be reconciled with the promotion of suicide prevention, which kills nearly 10,000 people per year in France? We will raise here several key questions that deserve a clear answer before considering going further in the social debates: how to ensure the irreversibility of psychological suffering? how to ensure that patients requesting EAS have full decision-making capacity? how to judge therapeutic futility? It seems crucial to protect the most vulnerable patients by ensuring that psychiatry benefits from scientific progress and can offer new solutions to suffering patients.

Thes issues will be discussed viewing the proposed law on EAS in France, which is supposed to come in February 2024…

Disclosure of Interest

None Declared
The Romanian forensic pscychiatry system related to the admission of patients- aspects of the criminal law
Authors: Anghel C. E. , Băcilă C. , Tănase M.
Published: August 2024

Introduction

In the Romanian forensic psychiatric and legal system, the legislation allows people diagnosed with mental disorders and who have committed a crime, without discrimination, to come under the Criminal Code, thus applying the safety measure of medical hospitalization. Although it is a complex measure, which requires increased attention in its application, any omission on the part of the authorities could lead to the violation of various human rights. The role of this measure is to improve the mental state of perpetrators, who represent, both for them and for society, an important danger. Approaching from this perspective we can say that this legal framework defines and limits the circumstances in which this measure can be produced to prevent the violation of human rights..

Objectives

The objective of this presentation was to carry out an analysis of the applying criteria for the safety measure of medical hospitalization, as well as the procedural aspects, in the national institutions where the perpetrators serve their sentences, called “psychiatric and security hospitals”

Methods

In this way, in our research we wanted to discover the most frequent pathologies blamed to be the cause of crimes and determined the application of these measures.

Results

All the results were evaluated and integrated according to the objective of this study.

Conclusions

In parallel with this analysis, we wanted to identify the main aspects that make the activity difficult and also to be able to offer the possibility of creating some solutions to improve the forensic psychiatric and legal system.

Disclosure of Interest

None Declared
Development and establishment of a patient advisory board for forensic psychiatric patients - Insights and experiences from the PART project
Authors: Drewelow E. , Daum M. , Ferra F. , Gerullis K. , Kilimann I. , Klein O. , Walde P. , Teipel S. , Völlm B.
Published: August 2024

Introduction

Participatory research (PF) actively involves people with lived experience (pwle), e.g. for a disease, in research. This improves the relevance, quality and impact of research and can help to raise third-party funds, increase recruitment numbers, select research methods. Pwle can support all stages of the research process, including dissemination. While PF is already standard in other countries, Germany is still lagging behind. Our participatory advisory board aims to create a sustainable structure to involve underrepresented patients.

Objectives

In the PART advisory board, pwle and researchers should actively cooperate in projects in the field of forensic psychiatry. In preparation to establish the advisory board procedures, key documents and training material were developed. In addition experiences, opinions, ideas and concerns of stakeholders and pwle in relation to PF were collected.

Methods

Guided interviews were conducted with stakeholders (clinical, research) and focus groups with in-patient pwle from forensic psychiatry. They were asked how they imagine the structure, tasks and goals of a participatory advisory board, what opportunities and obstacles they see. Anticipated framework conditions and support needs for the successful implementation were also asked. The interviews and focus groups were audio-recorded and transcribed. Data was analysed with MAXQDA using thematic analysis.

Results

In total, 8 expert interviews and 2 focus groups with 15 pwle were conducted in the first half of the year 2023. The analysis so far shows great interest in PF, although the term is mostly unknown and experience seems to be limited. The respondents identified opportunities for participatory research, but also challenges that need to be overcome in terms of its implementation. Both groups emphasise the importance of PF, especially in the field of mental illness, and express ideas for its implementation.

Conclusions

The results will be incorporated into the structure of the advisory board, so that PF in the field of forensic psychiatry will be more successful and the exchange between researchers and pwle will be facilitated. Detailed results as well as impressions from the first meeting(s) of the advisory board will be presented at the EPA conference.

Disclosure of Interest

None Declared
Fatal pulmonary embolism related to anti-psychotics: forensic implications. About four autopsy cases with review of the literature
Authors: Kacem M. , Bouali W. , Mahjoub Y. , Brahim S. , Zarrouk L.
Published: August 2024

Introduction

The association between the intake of antipsychotic drugs and the occurrence of thromboembolic complications is widely described in the literature. The occurrence of this complication may call into question the medical responsibility of the attending physician.

Objectives

The objective of this work is to describe the physiopathological mechanisms involved in the occurrence of thromboembolic complications in a patient under antipsychotic treatment, whether or not associated with physical restraint and to discuss the forensic implications.

Methods

Our study is retrospective on cases of fatal pulmonary embolism, discovered at autopsy, in connection with the taking of antipsychotics. The autopsies were carried out in the Department of Forensic Medicine of the Tahar Sfar University Hospital in Mahdia. The cases were collected over a period of 04 years. A review of the literature was carried out. We only selected articles published until February 2021 and dealing with cases of patients on antipsychotics, diagnosed with pulmonary embolism by performing a chest CT scan or during an autopsy.

Results

915 autopsy cases were performed during the study period. Twenty cases of pulmonary embolism, discovered at autopsy, were collected. Four cases were related to the taking of antipsychotics (incidence 0.004%), including two men and two women, aged between 25 and 52 years. They were all on antipsychotic treatment for at least 5 years, with the exception of one case who was put on 3 antipsychotics, 7 days before his death, with indication of physical restraint. After analysis of the memorial data, the external examination and the autopsy, the results of additional examinations, the death was attributed, in the 4 cases, to a massive fibrino-cruoric pulmonary embolism. A selection of 45 studies regarding thromboembolic complications associated with taking antipsychotics, was included in the final review.

Conclusions

The reported cases provided additional evidence on the involvement of antipsychotics in the occurrence of thromboembolic complications. Psychiatrists should be careful when prescribing these treatments. The establishment of therapeutic guidelines, taking into account the thromboembolic risk factors, becomes essential, in order to avoid the occurrence of a complication which could engage both the vital prognosis of patients and the responsibility of the physician.

Disclosure of Interest

None Declared
Behavioral and neurocognitive phenotypes in Crigler-Najjar syndrome in Tunisia
Authors: Bouayed Abdelmoula N. , Zekri R. , Bouaziz F. , Bensalem K. , Feki M. , Etteyeb A. , Abdelmoula B.
Published: August 2024

Introduction

Crigler-Najjar 1 (CN1) due to exon 3 mutations of the UGT1A1 gene is a not rare genetic disease in Tunisia with a founder effect. CN1 syndrome is very severe, and most of CN1 Tunisian patients die soon after birth, within a maximum of one year, due to kernicterus. Liver transplantation, which is the only available therapeutic method for CN1, remains unreachable.

Objectives

The aim of this study was to report behavioral and neurocognitive phenotypes in CN1 patients who survived to school enrollment.

Methods

We have selected all patients evaluated from 2004 to 2010, both clinically and molecularly, for a deficiency of bilirubin-UGT enzyme activity leading to a pathological elevation of unconjugated bilirubin with a suspicion of CN1 syndrome. Direct sequencing of targeted PCR amplification products was performed for molecular analysis of UGT1A1. Behavioral and mental features of patients were studied through our genetic counselling.

Results

We identified 15 patients with the homozygous c.1070 A>G Tunisian mutation. Their age at diagnosis ranged from one week to 9 months for 13 patients. Six of them died within a month of molecular investigation. Only two boys were of school age, i.e. 6 and 9 years. The first had been hospitalized at 3 months year-old for a prolonged jaundice treated with phenobarbital and phototherapy. His psychomotor and neurological development was normal, with school attendance at the age of six. The second patient presented with an unexplored jaundice at the age of 3 days, which was later complicated by seizures and treated with phenobarbital. Despite neurological and motor sequelae associated to language impairments with slurred speech, he attended school at the age of six.

Conclusions

The neurological and behavioral profile of CN1 patients depends on familial and medical management. Quick diagnosis, close follow up and early liver transplantation can improve prognosis.

Disclosure of Interest

None Declared
Multidisciplinary users oriented approach in the community mental health care
Authors: Racetovic G. , Grujic Timarac S. , Latinovic M.
Published: August 2024

Introduction

For more than 25 years, Bosnia and Herzegovina (BH) has maintained and improved reform processes in the field of mental health (MH) care. In the last 13 years, the results of the reform are visible, and they focused on the quality of services oriented to people with mental disorders (PMD), as well as raising the quality of specific services to the general population. The developed network of community mental health centers (CMHC) as the leading concept of the reform (community psychiatry) enabled affordable, timely and adequate protection of mental health in whole country, while relying on other resources, primarily clinical and hospital capacities and centers for social work.

Objectives

Reform orientation had several directions: broad promotion and prevention, protection of the rights of the people with mental health disorders, quality education and more specific qualifications and competencies of mental health professionals and public promotion as a part of destigmatization.

Methods

Overview of the mental health reform in last two decades.

Results

In last more than 25 years reforming processes were focused mainly to users of mental health services. Specific legislative was created and recently upgraded trough Mental Health Protection Law, as unique document focused to users, mental health professionals and services, and general population as well. Users organization were formed and have important role in creation of further directions in the reform. Main principles in daily care for users are community based with case management and intersectoral collaboration trough joint discharge planning. Also, special focus is given to media reporting about mental health as well as to children and adolescents, prenatal psychiatry and elderly.

Conclusions

Republic of Srpska and Bosnia and Herzegovina made significant steps and visible changes in the quaity of mental health services focused to users needs. Further activities will be oriented to continuous destigmatization of the people with mental health disorders, psychiatry and mental health professionals and further implementation of results achieved in reforming processes in our county.

Disclosure of Interest

None Declared
Implementation of a peer support intervention for family members of involuntarily hospitalised patients
Authors: Wells I. , Wintsch K. , Giacco D.
Published: August 2024

Introduction

Peer support has been identified as successful in improving patient wellbeing and empowerment and there is evidence that peer support can also help their family members (FMs). A peer support programme for FMs, developed in Germany, significantly improved FMs’ quality of life. We have worked to adapt this support programme for delivery in England. We will report the results of this adaptation process and of the implementation of peer support for FMs.

Objectives

To examine the feasibility of the peer support programme developed and assess whether it can be delivered using a “train-the-trainer” approach.

Methods

The peer support programme is being implemented in two stages. In stage one, FMs with experience of supporting an involuntarily hospitalised patient (family peer supporters (FPSs)) receive an online training programme consisting of four sessions. These sessions, provided by the research team and FMs with lived experience of caring for an involuntarily hospitalised patient, teach FPSs skills in communication, reflection, coping and trialogue (promotion of equal communication between FMs, professionals and patients). FPSs then use these skills to deliver support to FMs of patients who are currently involuntarily hospitalised. This support is delivered for up to three months. The impact of this programme is assessed through one-to-one interviews with FPSs and FMs. Questionnaires are also provided to FMs measuring their quality of life, caregiving burden and psychological wellbeing before and after receiving support from FPSs.

In stage two, a modified version of the training programme (based on FPS feedback) is provided to a new group of FPSs. This training will be delivered by FPSs from stage one. After receiving the training programme, stage two FPSs will deliver support to other FMs as described for stage one. Assessment of the modified programme will mirror stage one.

Results

Provision of the stage one training programme is complete, and delivery of support is in progress with modifications being made for stage two. Eight FPSs and six out of a target of 12 FMs have been recruited for stage one. FPSs reported the training programme to be a positive experience, highlighting that it was engaging, easy to understand and gave them the confidence to support other FMs. Technical difficulties and an overload of information were cited as areas to improve for the next stage.

Conclusions

FPSs described the peer support training programme as a positive experience overall. However, improvements need to be made for stage two which is in progress. A more comprehensive report of our findings, including the impact of this peer support programme and the feasibility of implementing it in England, will be provided as the programme progresses.

Disclosure of Interest

None Declared
Understanding females with attention deficit and hyperactivity disorder
Authors: Kilic O.
Published: August 2024

The predominant association of attention deficit and hyperactivity disorder (ADHD) with males, often leads to underdiagnosis or misdiagnosis in females. Recent studies have highlighted marked differences between genders in the manifestation, symptoms, and outcomes of ADHD. Understanding these differences is essential for accurate identification, diagnosis, and tailored interventions for affected individuals, particularly females. TThe multifaceted nature of ADHD demands a nuanced examination of its impact on females, considering how societal expectations, hormonal influences, and a range of symptom presentations may contribute to the variation in the manifestation of this disorder across genders. This presentation aims to contribute to a more comprehensive understanding of ADHD, fostering improved recognition and tailored strategies to support both males and females who suffer from this condition.

Disclosure of Interest

None Declared
Evaluation of a scalable psychosocial intervention for refugees in Greece
Authors: Papathanasiou C. , Kougioumtzi A.
Published: August 2024

Introduction

The world of the third millennium is witnessing the highest levels of displacement on record. To meet the specific needs of this vulnerable population, a task-shifting approach is developed, where individuals with refugee background and lived experience are trained and supervised my mental health professionals to provide emotional and practical support to members of their communities.

Objectives

The evaluation of a scalable psychosocial intervention for refugees based on the task-shifting approach.

Methods

The intervention consisted of sessions of Problem Management Plus (PM+) and peer case management delivered by a team of community psychosocial workers (trained refugees). The sample consisted of 173 participants, Arabic- and Farsi-speakers male and female, recognized refugees, and asylum seekers. Anxiety, depression, and psychological distress were measured before and after the intervention using the Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire - 9 (PHQ-9), and Psychological Outcome Profiles (Psychlops) scales respectively. Repeated measures analysis of variance (ANOVA) was adopted to evaluate the difference in the degree of change across patients’ characteristics over the follow up period. Statistical significance was set at p<0.05 and analyses were conducted using SPSS statistical software (version 26.0).

Results

Significant decreases were found in all post-test scales, indicating diminution of anxiety, depression symptoms, and psychological distress. Large effects sizes were found in all scales.

Conclusions

The findings support that task-shifting approach incorporating PM+ and case management is effective for the mental health of refugees. Peer support could be included in a stepped care model for refugee mental health and well-being in high-income countries. For future research a randomized controlled trial is proposed as a study protocol.

Disclosure of Interest

None Declared
War and Migration – when Mental Health is left behind
Authors: Ramos A. L. , Salgado H.
Published: August 2024

Introduction

Wars and armed conflicts are known to have devastating consequences for both physical and mental health of all the people involved. Studies have shown that conflict situations cause more mortality and disability than any major disease and, among the consequences of war, the impact on mental health of the civilian population is one of the most significant.

Forced migration, compelling people to become internally displaced or refugees who have fled to other countries, is responsible for additional physical and mental health problems. Regardless of the reasons for migration, the process itself can be a highly stressful life event, leading to a higher risk of psychiatric disorders. Refugees are particularly susceptible to mood and anxiety disorders, whose prevalence rates is almost twice as high as those found among non-refugee migrants.

Objectives

Since 2022, with the progression of the conflict between Russia and Ukraine, and the establishment of a real war scenario, many Ukrainians were forced to leave their homeland, to ensure their survival and security. In Europe, many countries took in Ukrainian refugees and Portugal was no exception.

In the Psychiatry Inpatient Service of University Hospital Center of São João, there were admissions of Ukrainian refugees who already had a known mental disease - at that time decompensated - and also new cases, to date without follow-up by the specialty.

Methods

In this work, we will carry out a bibliographical review on the impact of war and migration on mental health and the potential of proper medical approach, based on articles indexed in Pubmed, in the last 10 years.

Furthermore, we will present the cases of war refugees interned in our service between January 2022 and December 2023.

Results

We will describe the psychopathological features and also the sociofamilial circumstances of these patients, as well as explain the intervention and longitudinal support developed in these cases.

Conclusions

As a conclusion, we point out the importance of approaching mental illness in light of the individual’s context, knowing that this context may contain the problem and also the solution. War and forced migration bring increased challenges to psychiatry and, in an increasingly globalized society, geographical, linguistic or cultural barriers cannot impose limits on our best and most appropriate medical treatment.

Disclosure of Interest

None Declared