bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of Gender Roles on Eating Attitudes: A Study Among Female College Students Abstract
Authors: Ozel B. , Hosgören Alıcı Y. , Kocak O. M. , Ceran S.
Published: August 2024

Introduction

Eating disorders (ED) are serious mental and physical illnesses that involve complex and damaging relationships with eating, exercise, and body image. They emerge due to a multifaceted interplay of factors, including familial predispositions, personality traits, and cultural influences. While societal beauty standards are recognized as significant risk factors, it is hypothesized that the roles and responsibilities associated with adult womanhood may also contribute to their development. In particular, the unique challenges faced by women, especially in developing countries like Turkey, may lead to discontent with traditional gender roles.

Objectives

This study aims to explore the connection between eating disorders, female identity perceptions, body attitudes, expectations regarding women’s roles within families, and their potential association with body dysphoria. We investigate whether eating disorders are linked to a form of sexual dysphoria and body dysmorphia related to femininity rather than solely driven by societal beauty ideals.

Methods

Data from 228 female college students, both undergraduate and graduate, were collected via online surveys. The survey instruments included a sociodemographic form, the Eating Attitude Test, the Gender Roles Attitude Scale, and the Multidimensional Body-Self Relations Questionnaire.

Results

The average age of the participants was 24.41 (18-33) years. Regression analysis revealed that age (β=-0.155, p=0.015), the belief that physical appearance would be less important if they were male (β=0.292, p<0.001), and maternal criticism about weight (β=0.239, p<0.001) were influential factors in shaping eating attitudes. Surprisingly, no significant relationship was found between eating attitudes and traditional gender roles (β=0.072, p=0.246). However, we did establish a connection between aspiring to meet ideal thinness standards and perceiving women as disadvantaged in the workplace due to their traditional gender roles (t(226)=2.32, p=0.021), as well as with maternal criticism (t(225)=3.55, p<0.001).

Conclusions

Our findings suggest that the absence of a direct link between eating attitudes and traditional gender roles may be attributed to an individual’s perception of their environment rather than their self-assessment of masculinity within an egalitarian context. Notably, maternal influences specifically their criticism regarding their daughters’ weight and the roles assigned to mothers significantly shape these perceptions and, consequently, eating behaviors, aligning with existing literature (Ferreira et al., 2021). This underscores the need to consider eating disorders within a broader biopsychosocial framework, encompassing attitudes toward the world and one’s role within it.

Disclosure of Interest

None Declared
Influence of neuromarketing on the increase in shopping anxiety in women in the city of santa marta
Authors: Perez Correa K. L. , Guardiola Esmeral A.
Published: August 2024

Introduction

New technological trends and access to more information have generated an anxious disorder and the need to obtain everything that the consumer society has to offer, this has increased with the influence of neuromarketing in internet ads.

Objectives

The objective that was raised in the present investigation was to analyze the influence of neuromarketing in the increase of anxiety reflected in compulsive purchases of women in the city of Santa Marta.

Methods

The field research design is non-experimental and cross-sectional, the sample taken was of 500 women with purchasing power of more than three Colombian minimum wages.

The IDARE Ch. Spielberger, R. Díaz Guerrero et al. (1966) checklist was applied; To review the relationship between advertising with neuromarketing, anxiety and compulsive purchases, a Likert-type scale instrument was designed and validated with the Alpha Cronbach Coefficient. Analysis of Covariance ANOVA, inferential statistics and SPSS were performed.

Results

57% of the women meet the criteria for the IDARE clinic. The analysis of the questionnaire showed a goodness of fit of R² = 0.697. The result indicates that the more hours women spend on the internet with access to ads focused on neuromarketing, the more they feel the need to buy, and this generates anxiety processes.

Conclusions

The mental triggers used by neuromarketing accelerate the need in women to buy the solutions that they sell and the same need to buy is evident in the signs of anxiety that is reflected in the women under study. Training that educates women to spend less time connected to the Internet is recommended, but it is also essential that they understand that advertising and marketing exert pressure that increases their anxiety and need to purchase, so it is recommended the implementation of training in personal management and control.

Disclosure of Interest

None Declared
Assessing coping strategies among intimate partner violence victims
Authors: Tabib F. , Guermazi F. , Hentati S. , Mnif D. , Feki I. , Baati I. , Masmoudi J.
Published: August 2024

Introduction

Intimate partner violence (IPV) is a major source of perceived stress for the women who suffer from it. To cope, they tend to implement multiple coping strategies depending on a number of contextual factors including, among others, the severity and frequency of abuse, the duration of the relationship, and available resources such as social support and financial resources.

Objectives

To study the coping strategies used by women who are victims of IPV.

To study the factors associated with coping strategies among these women.

Methods

We conducted a descriptive and analytical cross-sectional observational study, carried out over a 10-month period from March 2021 to December 2021, among female victims of IPV consulting psychiatric emergencies at UHC Hedi Chaker, Sfax, Tunisia for medical expertise at the request of the court.

The Brief-COPE is a 28-item self-assessment questionnaire designed to measure coping with a stressful life event. It can be divided into 3 subscales: problem-focused, avoidance-focused, and emotion-focused.

Results

The total number of participants was 120 with an average age of 37.27 years. The majority had secondary education or less (62.5%), were professionally active (53.3%), and were financially dependent on their partners (26.7%). As for the women’s clinical characteristics, 19.2% were under psychiatric care and 15% had attempted suicide (SA). Almost all the women surveyed (99.2%) had reported at least one previous incident of IPV. These incidents were daily in 60.5% of cases. Emotional violence was severe in 75.8% of women.

The emotion-focused strategy was the most widely used, with a mean score (29.68) on the Brief cope scale. It was correlated with the absence of a personal psychiatric history (p=0.02), the absence of SA (p=0.036), and the occasional frequency of IPV (p=0.037). The scores for problem-focused coping and avoidance-focused coping are 19.3 and 17.24 respectively. Avoidance-focused coping was negatively correlated with the presence of severe emotional abuse.

Conclusions

The most used strategy by our population was the emotion-focused strategy, with a relatively high average score compared to the other strategies. Indeed, it may be an extremely effective strategy for recovering from a traumatic event, through actions designed to help these women manage and relieve their psychological distress and reduce its negative impact.

Disclosure of Interest

None Declared
‘Guttas Campus’ - participants’ experiences of a group-based intervention to prevent school dropout
Authors: Ramdal G. , Wynn R.
Published: August 2024

Introduction

It is important to prevent school dropout and to help students who have dropped out re-enroll in school. Dropping out of school is associated with an increased risk of unemployment, low salaries, and receiving social security or disability benefits. In this study, we interviewed participants in ‘Guttas Campus’ (The Boys’ Camp), which is a group-based intervention that aims to support disengaged boys from the 9th grade and through their transition to high school. The intervention consists of a two-week learning camp. The students subsequently participate in mentoring groups, with teachers and other camp participants, for a period of 18 months.

Objectives

We present a study of a school dropout prevention program.

Methods

16 students were interviewed qualitatively. The interview data were analysed by drawing on the method of Grounded Theory.

Results

When the students who have completed the learning camp were asked what they believed were the most important and useful parts of the intervention, some common themes emerged: 1) The learning camp community provided a safe environment and helped give the participants learning and coping experiences that increased their self-confidence. 2) The students brought up the method of teaching, which they described as more persistent, adaptive and encouraging than they had been used to from regular school. 3) The students also mentioned the intervention’s focus on character strengths such as willpower, self-control and optimism as central to increasing their motivation to learn.

Conclusions

The students that were interviewed were generally positive to the intervention, as mentioned several factors that they believed were useful in increasing their motivation and ability to learn.

Disclosure of Interest

None Declared
The Imperative of Trauma-Informed Care: A Comprehensive Review and Strategies for Implementation in Health Services
Authors: Cunha C. , Gomes M.
Published: August 2024

Introduction

Psychological trauma is a significant public health concern with long-lasting effects on physical and mental well-being. Trauma-informed care is an approach to providing support and services that acknowledges and integrates an understanding of the pervasive impact of trauma on individuals. This review delves into the critical imperative of trauma-informed care within the realm of health services. Recognizing the pervasive impact of trauma on individuals’ physical and mental well-being, this REVIEW aims to explore existing literature, identify key objectives, and propose effective methods for implementing trauma-informed strategies in health services.

Objectives

To Review Existing Literature on Trauma: Conduct an review of the literature to comprehend the varied dimensions and consequences of trauma on individuals’ health; To Identify Key Principles of Trauma-Informed Care: Explore established principles of trauma-informed care, highlighting their relevance and applicability within health service settings; To Propose Implementation Strategies: Develop practical strategies for integrating trauma-informed care into health services, ensuring a comprehensive and sensitive approach to patient care.

Methods

A review of published articles, books, and reports related to trauma and trauma-informed care to establish a foundational understanding.

Results

Psychological trauma can have profound and multifaceted impacts on individuals, affecting their mental, emotional, and even physical well-being. The consequences of psychological trauma can vary widely based on the nature, severity, and duration of the traumatic experience, as well as individual factors such as resilience and support systems. Trauma-informed care aims to create an environment that is sensitive to the needs of those who have experienced trauma, and it is based on six key principles: safety, trustworthiness, peer support, collaboration, empowerment, and cultural competence. Healthcare providers need to understand trauma beyond the personal and acknowledge the cultural, historical, social, political, and structural trauma that impact individuals and communities across generations. This approach recognizes that there is a risk of retraumatization in social and health services, especially for minority communities.

Conclusions

This review underscores the pressing need for health services to adopt trauma-informed care strategies. By acknowledging the prevalence and impact of trauma on health outcomes, the healthcare sector can transition towards a more patient-centered and empathetic approach.

Disclosure of Interest

None Declared
Fahr’s Disease and its neuropsychiatrist manifestations: A case report
Authors: Fernández B. , Moreira R. A. , Gomes H. J. , Justo J. M.
Published: August 2024

Introduction

Fahr’s Disease, also known as Fahr’s Syndrome, is a rare genetically dominant disease, characterized by the abnormal accumulation of calcium deposits, or calcifications, in various areas of the brain, particularly the basal ganglia. These calcifications, which are typically bilateral and symmetrical, can lead to a wide range of neurological and psychiatric symptoms, making diagnosis and management challenging. It usually manifests between the ages of 40 and 60, primarily after the age of 30.

Objectives

To contribute to the medical literature by sharing this rare case, thereby increasing awareness and knowledge about Fahr’s Disease among healthcare professionals.

Methods

Non systematic review of the literature and access to the medical history of the patient.

Results

We present a case of a 42 year old woman, who came to our hospital with behavior changes, with increasing confusion and new mystical beliefs, insomnia and agitation.

According to the patient’s husband, the patient sounded confused and inappropriate in her speech. The patient was admitted for evaluation of altered mental status. The patient was alert and oriented to person, place, time, and situation in the emergency department, with shudder while neurologically intact. The patient was unpolite, agitated.

Psychiatry was consulted for evaluation. We decided to admit the patient and did a posterior study with a CT scan and MRI. The MRI, as well as CT scan revealed “dense calcification of the dentate nuclei and the basal ganglia”, highly suggestive of Fahr’s syndrome. The patient’s phosphorus level was 3.5 mg/dl (normal level: 2.5-4.5 mg/dl). Parathyroid hormone (PTH) intact was 53 pg/ml (normal level: 15-65 pg/ml), and calcium level was 10,3 mg/dl (normal level: 8.4-10.5 mg/dl). The vitamin D 25-hydroxy concentration was 43,5 ng/ml (normal level: 30-60 ng/ml).

Conclusions

In conclusion, Fahr’s Disease is a rare and complex neurological disorder characterized by idiopathic calcification of the bilateral basal ganglia, resulting in a diverse range of neurological and psychiatric symptoms. Diagnosis involves clinical evaluation and neuroimaging, while treatment is primarily symptomatic. Further research is needed to better understand the underlying genetic and biochemical mechanisms driving calcification in the brain and to develop more effective therapeutic strategies for this challenging condition.

Disclosure of Interest

None Declared
Issues around vulnerability among people attended by a Portuguese community-based association: a qualitative secondary analysis
Authors: Laranjeira C. , Querido A. I.
Published: August 2024

Introduction

Despite vulnerability being a poorly understood concept is a key concept in health and social care disparities. Typically, vulnerable groups include individuals with physical and/or mental disabilities, children, the elderly, members of the lower social classes, and refugees. In Portugal, the pandemic was responsible for worsening inequalities in access to health and social care for the most vulnerable. To the best of our knowledge, there is a dearth of qualitative research on vulnerability from the viewpoint of those who are vulnerable or work with the most vulnerable.

Objectives

As expressions of vulnerability are strongly influenced by cultural factors, this study aims to examine issues of vulnerability among people who attend and work in a Portuguese community-based association.

Methods

Secondary analysis of qualitative data from twelve vulnerable people and fifteen professionals who attended these people. The manifestations of the vulnerability reported by participants included being homeless, being a migrant, having an infectious disease, being drug dependent, living with socioeconomic difficulties (unemployment), and experiencing a process of loss and grief. They also reported having a mental or physical health problem, or both. Depression and anxiety were the most often reported mental health disorders. Regarding the academic background of professionals, most of them (n = 12) are from social sciences (e.g., social workers, social mediators, and psychologists).

Results

Three main themes emerged from the study: (1) meanings of human vulnerability; (2) barriers to vulnerability mitigation; and (3) approaches to addressing vulnerability. Our findings revealed that vulnerability is a very dynamic process of openness to conditions that impact individual outcomes. However, there is a conceptual gap: being vulnerable is perceived as something negative, but vulnerability also has the potential to change priorities in life for the better. Some participants emphasized the importance of self-care to avoid becoming vulnerable themselves, particularly in terms of mental health.

Conclusions

Understanding the social determinants of vulnerability is necessary to achieve satisfactory care for human groups. Practitioners need to be aware of these larger societal dynamics, understand them, and make sure their services are responsive to cultural differences. In order to develop interventions that promote social and health outcomes, practitioners should be encouraged to share knowledge on best practices.

Disclosure of Interest

None Declared
Musculoskeletal disorders and psychosocial risks among electricians
Authors: Sellami I. , Feki A. , Abbes A. , Jmal Hammami K. , Hajjaji M. , Baklouti S. , Masmoudi M. L.
Published: August 2024

Introduction

There is a growing concern about the link between musculoskeletal disorders (MSD) and psychosocial risk (PSR) among electricians. Both MSD and PSR represent a threat to the electrician’s health, quality of life and productivity.

Objectives

This study aimed to assess the link between PSR and MSD among electricians.

Methods

The study was conducted in a group from an electricity society. Data were gathered between January-June 2022 using a self-administered questionnaire evaluating socio-professional characteristics, the Nordic musculoskeletal questionnaire during the previous year and the validated French version of the questionnaire KARASEK.

Results

Our study included 68 male electricians. The mean age was 39.2 ± 10.3 years. The average job tenure was 16± 11.4 years. According to the Nordic musculoskeletal questionnaire, 50% of participants experienced pain during the last 12 months.

About half of the electricians had high psychological demand (48.5%), 63.2% had a low latitude, and 76.5% had low social support. According to the Karasek model, tense electricians accounted for 26.5% and assets 22.1%. MSDs were associated with high psychological demand at work (p = 0.02).

Conclusions

This study demonstrated that PSR and MSDs are associated among electricians and are highly prevalent. They represent an important concern of the occupational and safety health system. The prevention of MSD should take into account the specific working conditions of electricians to reduce their exposure to psychosocial risk factors in the workplace.

Disclosure of Interest

None Declared
The relationship between childhood trauma and adulthood anxiety and depression among Tunisian university students
Authors: Turki M. , Hammemi W. , Ellouze S. , Barkallah M. , Mannoubi I. , Halouani N. , Aloulou J.
Published: August 2024

Introduction

Traumatic childhood has increasingly high incidence rates and can be predictive of negative health outcomes. There is a large consensus indicating that childhood trauma is significantly involved in the development of mood disturbances in adulthood.

Objectives

The aim of this study was to examine the relationship between retrospectively recalled childhood trauma and adulthood anxiety and depression in a sample of undergraduate university students.

Methods

A cross-sectional study was conducted among a sample of 365 university students randomly selected from 8 universities in Sfax (Tunisia). Information about childhood maltreatment, depressive and anxiety symptoms were gathered through the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and the Hospital Anxiety and Depression Scale (HADS) respectively. To test the hypothesis, examining the relationship between anxiety, depression, and childhood trauma, we used Spearman’s correlation test. Multivariate logistic regression models were used as well.

Results

The mean age of our participants was 20.3 years. More females (68.2%) than males participated in the study. Our findings showed that the five childhood trauma subtypes (emotional abuse and neglect, physical abuse and neglect, sexual abuse) were significantly correlated with anxiety and depression symptoms severity (p<0.01). Emotional abuse was the strongest risk factor for adulthood anxiety symptoms (OR=6.002, 95% CI= [3.238; 11.125]) while emotional neglect was the strongest risk factor for depressive symptoms in adulthood (OR=6.214, 95% CI= [3.428; 11.267]). Multivariate analysis revealed that, in subjects with childhood trauma, scores of anxiety symptoms were positively and highly associated with the severity of emotional abuse (adjusted B=1.438, 95% CI= [1.951; 9.092], p=0.000). Depression symptoms severity were as well positively correlated with severity of emotional abuse (adjusted B=0.848, 95% CI= [1.043; 5.224], p=0.039), and severity of emotional neglect (adjusted B=1.044, 95% CI= [1.263; 6.389], p=0.012).

Conclusions

This study highlighted the relevance of childhood trauma as a factor contributing to anxiety and depression in adulthood. Thus, early psychological support of victims of childhood trauma can reduce the rate of anxiety and depression among these subjects.

Disclosure of Interest

None Declared
The Delicate Balance: Aptitude of Physicians with Psychiatric diseases
Authors: Khaterchi N. , Bahri G. , Youssef I. , Mersni M. , Ben Said H. , Brahim D. , Mechergui N. , Methni M. , Ben Said C. , Bram N. , Ladhari N.
Published: August 2024

Introduction

The delicate balance between the need to ensure quality patient care and the reality of physicians dealing with psychiatric diseases poses a major challenge within the medical field. This issue raises fundamental ethical, legal, and medical questions, highlighting the complexity of decision-making regarding professional aptitude for practitioners affected by mental disorders.

Objectives

To examine the impact of psychiatric diseases on the medical aptitude of physicians.

Methods

This was a retrospective descriptive study that focused on physicians with psychiatric diseases referred to the occupational pathology clinic at Charles Nicolle Hospital in Tunis for medical evaluations of their work aptitude between January 1, 2021, and September 15, 2023.

Results

During the study period, we collected data from 20 patients. The mean age was 38 ± 11 years, with a sex-ratio (F/M)of 4.5. Five examined physicians had family histories of psychiatric disorders. Medical specialties were the most represented (N=17), including three general practitioners, two family medicine practitioners, and two anesthesiologists. The study population included 10 residents, eight hospital assistants, and two medical interns. The most common psychiatric diagnosis was depression (N=7), followed by bipolar disorder (N=5). The medical treatment prescribed was combinations of antidepressants and anxiolytics in seven cases, antipsychotics in five cases, and antidepressants in two cases. Medication adherence was noted in 10 physicians. Fourteen physicians had taken long-term sick leave, with an average duration of 203 days. Five physicians were declared fit to continue their regular professional activities, seven physicians were declared fit with restrictions on night work, and one physician was declared fit with workplace accommodations.

Conclusions

This study highlights the challenges surrounding the medical aptitude of physicians with psychiatric diseases. However, it is imperative to promote mental health awareness and to implementsupport measures to ensure both compassion for physicians and patient safety.

Disclosure of Interest

None Declared
Somatic disorders in patients followed for a psychiatric disorder at the Ar Razi hospital in Morocco
Authors: BENSALAH Y. , BELBACHIR S. , OUANASS A.
Published: August 2024

Introduction

Somatic disorders in patients suffering from psychiatric disorders have become an important issue in the overall care of these patients

Comorbidity studies show that 30 to 60% of patients consulted or hospitalized in psychiatry present an associated organic pathology

However, the detection of somatic conditions in psychiatric patients remains too late and this exposes them to sometimes lethal somatic complications

Objectives

To evaluate the prevalence of somatic disorders in patients followed for a psychiatric disorder at Ar Razi hospital in Salé – Morocco, and to determine the associated factors

Methods

We carried out a cross-sectional study with 80 patients followed for a psychiatric disorder at Ar Razi hospital in Salé presenting clinical signs in favor of an organic pathology and transferred for specialized advice to the medical-surgical services, in the period from September 1st, 2022 until August 31st, 2023.

Results

Most of our patients were male (65%) with ages ranging from 18 to 65 years. Addictive behaviors were found in more than half of our patients.

The most frequent reasons for requests for advice from medical-surgical services was the suspicion of an organic cause of psychiatric symptoms in 25% of cases or the presence of an organic warning sign in 30% of cases.

The comorbidity of somatic illness and psychiatric disorder was noted in 35% of cases.

Somatic comorbidities were essentially: infections and cardiovascular diseases.

Side effects of psychotropic drugs were predominantly neurological in 40 % of cases

Conclusions

Somatic comorbidities in patients hospitalized or in consultation in psychiatric hospitals are very common, often unrecognized, hence the need for early screening in order to improve care.

Disclosure of Interest

None Declared
Subjective discomfort and lack of volitional drive with neuroleptic pharmacotherapy - a phenomenological case study
Authors: Korošec Hudnik L. , Kosmačin I.
Published: August 2024

Introduction

In comparison to extrapyramidal and metabolic side effects, the subjective aspects of neuroleptic treatment have been less extensively researched. Nevertheless, they are equally significant given their potential to influence adherence and functional outcome. Historically, terms such as “neuroleptic dysphoria,” “neuroleptic-induced psychic indifference,” and “neuroleptic-induced deficit syndrome” were used to characterize a range of unpleasant mood states on the one hand and a documented and observable motivational deficit on the other. The latter aligns with the findings from preclinical neuroscientific studies and animal models highlighting the significant involvement of mesolimbic dopamine in motivational processes. Despite an abundance of anecdotal data these adverse effects are often undetectable in large-scale clinical studies that utilize standardized assessment measures.

Objectives

To present adverse subjective changes in arousal, mood and volitional drive resulting from neuroleptic intake from a patient’s perspective.

Methods

The subject is a patient, with no reported negative symptoms or lasting functional impairment described, who underwent a gradual 6-month discontinuation of risperidone in an outpatient setting following a complete recovery after a single psychotic episode. A semi-structured interview modelled after The Clinical Assessment Interview for Negative Symptoms (CAINS) was conducted. We aimed to elicit descriptions of the subjective experience while ensuring our approach remained non-suggestive.

Results

In addition to describing potential akathisia and lethargy at higher doses, the subject reported a significant lack of motivation and a notably reduced willingness to exert effort towards achieving specific goals or engaging in activities that he still found rewarding or pleasurable. Furthermore, he consistently noted gradual improvements across various psycho-social aspects following the discontinuation of the medication. These adverse and unpleasant experiences were presented as the primary reason for wanting to discontinue pharmacological treatment.

Conclusions

Certain adverse effects of antipsychotic medications can only be elucidated by the clinician through the examination of the patient’s subjective experiences. Medication induced dysphoria and volitional deficits have the potential to profoundly impact treatment adherence, leading to unrecommended discontinuation of neuroleptics, and can cause important functional impairment.

Disclosure of Interest

None Declared
Neurodevelopmental lags and type of delivery in a Colombian infant population
Authors: Jimenez-Martinez M. , Bernal-Gómez B. M. , Avila-Jimenez S.
Published: August 2024

Introduction

The Choice giving birth by cesarean section when it is not biologically necessary implies a greater risk to the health of the mother and child Toral et al. Eletrônica Estácio Saúde 2018; 95(1) 27-30,refers the psychological relevance to identify perinatal effects of a good medical practice at birth. In this respect Poojari et al. Early Hum Dev 2019;115 93-98, state that a cesarean section as a surgical risk, causes decrease fetal oxygenation and an impairment release of stress-related hormones in the maternal-fetal binomial that does not favor neural connections at birth

Objectives

Identify the neurodevelopmental lags in infant on children under 24 months of age born by cesarean section and vaginal delivery,

Methods

A cross-sectional descriptive correlational; Sample consisted of 100 children of a term gestation, 70 with spontaneous vaginal birth and 30 whose birth was by cesarean section, aged between one and twenty-four months; using the Abbreviated Development Scale, an instrument created and validated for the Colombian population (Cronbach’s alpha, 0.94). All parents signed the informed consent.

Results

All test scales were applied (gross and fine motor, language and social personal), the results showed that children born by cesarean section had better development in areas of fine motor and language, while children born by vaginal delivery had better development of gross motor. See (graphic 1).

Graphic 1: Areas of development according to the type of delivery.

References

Conclusions

The influence of contextual variables such as age and educational level of the mother on language and social areas was also found

Disclosure of Interest

None Declared
Mental Health and Addictions in Pregnancy: Feasibility and Acceptability of a Computerized Clinical Pathway and Prevalence Rates
Authors: Carmona Camacho R. , Chamorro Delmo J. , Alvaro Navidad M. , Lopez Carpintero N. , Estrella Sierra N. , Guimaraes de Oliveira R. , Olhaberry Huber M. , Mata Iturralde L. , Álvarez García R. , Baca Garcia E.
Published: August 2024

Introduction

Mental Health problems and substance misuse during pregnancy constitute a serious social problem due to high maternal-fetal morbidity (Cook et al, 2017; JOCG, 39(10) ,906-915) and low detection and treatment rates (Carmona et al. Adicciones. 2022;34(4):299-308)

Objectives

Our study aimed to develop and test the feasibility and acceptability of a screening and treatment clinical pathway in pregnancy, based on the combination of e-Health tools with in-person interventions and, secondly, describe the prevalence of mental illness and substance use problems in this population.

Methods

1382 pregnant women undergoing her first pregnancy visit were included in a tailored clinical pathway and sent a telematic (App) autoapplied questionnaire with an extensive battery of measures (WHO (Five) Well-Being [WHO-5],Patient Health Questionnaire [PHQ-9], General Anxiety Disorder [GAD-7], Alcohol Use Disorders Identification Test [AUDIT], Drug Abuse Screening Test [DAST], Columbia Suicide Severity Rating Scale [C-SSRS] and specifically designed questions on self-harm and psychopharmacological drugs).

Patients who did not respond to the questionnaire on their own received a counseling call.

Based on the screening results, patients were classified into five groups according to severity (Figure 1) and assigned a specific action pathway (Figure 2) that included a range of intervention intensity that goes from an individual psychiatric appointment to no intervention.

Results

Of the 1382 women included in the clinical pathway, 565(41%) completed the evaluation questionnaires. Of these, 205 (36%) were screened as positive (Grades III,IV or V. Table 1) and 3(0.5%) were classified as needing urgent care. Of the patients offered on-line groups (100), 40% (40) were enrolled in them.
Table 1:

Grade distribution of those screened as positives

Grade III97 (17,2%)Grade IV105 (18,6%)Grade V3 (0,5%)

Concerning prevalence rates, 73 (12,9%) patients endorsed at least moderate anxiety according to GAD-7 (≥10), 65 (11,5%) endorsed at least moderate depression according to PHQ-9 (≥ 10), 17 were positive on DAST (3%) and 63 (11%) patients scored above the threshold in AUDIT-C(≥ 3) for alcohol use.

Image:

Image 2:

Conclusions

High prevalence rates suggest that effective detection and treatment mechanisms should be integrated into usual care. The use of standardized clinical pathways can help with this aim, allowing better clinical management and referral to treatment, but still face challengues to increase retention. The use of e-health tools offers the opportunity to improve accessibility and therapeutic outcomes through online interventions.

Disclosure of Interest

None Declared
Traits of narcissistic vulnerability in adults with Autism Spectrum Disorders without intellectual disabilities
Authors: Broglia G. , Nistico’ V. , Di Paolo B. , Faggioli R. , Bertani A. , Gambini O. , Demartini B.
Published: August 2024

Introduction

The relationship between Autism Spectrum Disorders (ASD) and Narcissistic Personality Disorder (NPD), considering the dimensions of narcissistic grandiosity and vulnerability, represents an important differential diagnosis and potential ground of comorbidity, since both conditions show high grades of pervasiveness, a life-long course, ego-syntonic traits, and difficulties in building up and sustaining interpersonal relationships Although the co-diagnosis rates, according to the categorical criteria in use, are limited (0%-6.4%), it is common to encounter diagnostic doubts in clinical practice.

Objectives

Here we aimed to explore both the dimensions of narcissistic vulnerability and grandiosity in a group of adults diagnosed with ASD without intellectual disabilities.

Methods

87 individuals with ASD completed the Pathological Narcissism Inventory-52 Items (PNI-52). The mean scores of our sample were compared with the normative distribution available in the literature. Participants also underwent a detailed sociodemographic and anamnestic interview, along with an assessment for autistic traits, comprising the “Ritvo Autism and Asperger Diagnostic Scale-Revised” (RAADS-R) and the Autism Quotient (AQ).

Results

Individuals with ASD scored significantly higher than neurotypical controls at the Total Score and at the Vulnerable Narcissism subscale, but not at the Grandiose Narcissism subscales. Demographic features did not influence these results. Vulnerable narcissism was significantly associated with the RAADS-R subscale Social Relatedness.

Conclusions

Our findings could potentially be indicative of a greater comorbidity rate between the two disorders with respect to the one reported to date, possibly because DSM-5 criteria are mainly focused on the grandiose dimension. Potential explanatory links between ASD phenomenology and vulnerable narcissism, such as the personality dimension of neuroticism, are discussed, together with the possible role of narcissistic vulnerability in mediating internalizing symptoms (e.g., anxiety, depression) in individuals with ASD.

Disclosure of Interest

None Declared
Internalized Stigma in Patients with Bipolar Disorder: A Cross-sectional Study on Its Associations with Sociodemographic, Marital and Clinical Characteristics
Authors: Tanyeri Kayahan S. , Vahip S.
Published: August 2024

Introduction

Bipolar disorder (BD) is a chronic and complex affective disorder among top diseases that cause disability worldwide. Internalized stigmatization is a process including the awareness of negative stereotypes adopted by the society, participation in and internalization of these judgements, associated with impaired social functionality. Studies examining internalized stigma and related factors in BD is limited.

Objectives

In this study, it is aimed to investigate the associations between internalized stigmatization and clinical characteristics, as well as sociodemographic and marital features of patients with BD.

Methods

This observational and cross-sectional study was conducted at a specialized affective disorders clinic in a university hospital between November 2020 and March 2021. During routine follow-up, each consecutive patient with BD was invited and a total of 118 were included in the study. Information about sociodemographic, marital and clinical characteristics of patients was collected through a prepared data form and follow-up documents. Internalized Stigma of Mental Illness Scale (ISMIS) was administered to assess internalized stigma. Statistical analysis of data was conducted by SPSS version 25 and a statistical significance level of p<0.05 was determined.

Results

Mean ISMIS total score of the sample was 56.50 ±13.65. Multiple linear regression was used to test the predictors of higher ISMIS scores. Being currently unemployed (p=0.012, Β=0.208), shorter BD duration (p<0.001, Β=0.302) and presence of inter-episode residual symptoms (p=0.004, Β=0.248) predicted higher ISMIS total. Younger age (p=0.002, Β=0.264), being female (p=0.007, Β=0.226) and absence of mania dominance (p=0.019, Β=0.190) predicted higher alienation scores. Presence of inter-episode residual symptoms predicted both stereotype endorsement (p<0.001, Β=0.320) and perceived discrimination (p<0.001, Β=0.358). Younger age (p=0.001, Β=0.281) and total number of depressive episodes (p=0.015, Β=0.212) also predicted perceived discrimination. Shorter BD duration and absence of seasonality predicted higher ISMIS social withdrawal, while history of hospitalization predicted higher ISMIS stigma resistance.

Conclusions

Our study demonstrated similar mean ISMIS total scores to the findings previously reported in Türkiye, while roughly lower than results in the international literature. Considering that internalized stigmatization was increased in earlier stages of BD and in younger patients, as well as in patients with inter-episode residual symptoms, it might be important to implement psychosocial interventions for internalized stigmatization and appropriate psychoeducation programs in the earlier periods of BD. Therefore a multidimensional and holistic approach towards internalized stigmatization may positively contribute to the functionality of patients with BD.

Disclosure of Interest

None Declared
Prevalence of Prolonged Grief Disorder and Related Clinical Factors During the COVID-19 Pandemic in Turkey
Authors: Tekdemir R. , Kandeger A. , Tan Ö. , Aydın M. , Altinbas K.
Published: August 2024

Introduction

Prolonged grief disorder has recently been added to the Diagnostic and Statistical Manual of Mental Disorders 5, Text Revision. To understand the health burden and then allocate economic and professional resources, it is necessary to provide epidemiological data for this new disorder. More information on the characteristics of people suffering from PGD is also beneficial to better identify individuals at risk.

Objectives

This study, therefore, aimed to estimate the prevalence of the PGD criteria in a special period such as the Covid-19 pandemic and in a representative population-based sample, evaluate the sociodemographic, and loss-related correlates of PGD caseness and explore possible predictors.

Methods

The study included 126 people (97 females/29 males) who lost a relative for any reason during the Covid-19 pandemic period (March 2019-January 2022) in Turkey.We used self-reported data from articipants who all completed questions on socio-demographic and loss-related characteristics plus Hospital Anxiety and Depression Scale (HADS), Prolonged Grief Disorder Scale (PG-13), Multidimensional Scale of Perceived Social Support (MSPSS), Adult Separation Anxiety Questionnaire (ASA-27).

Results

Median age was 34 years, range (18-63); 12 participants were diagnosed with PGD (9.5%). No difference was detected between deaths due to COVID-19 and its complications and deaths due to other causes in terms of PGD diagnosis and PGD symptom severity. When we divide the participants into two groups according to PGD diagnosis (PGD and nonPGD):The average age of the PGD group was higher (Z=-2.068; p=0,31) and they had more additional medical conditions (χ²=7.21; p=0,007). Thoughts of guilt were more common in the PGD group (χ²=7.92; p=0,005). Additionally, HADS-total, HADS -depression, HADS -anxiety and ASA-27 were higher in the PGD group (respectively: Z=-4.047; P=0,00, Z=-4.209; P=0,00, Z=-3.437; P=0,001, Z=-1.975; P=0,048). PGD occurred most frequently after first-degree losses (χ²=13.67; p=0,00) and was inversely proportional to the age of the loss (Z=-1.979; P=0,04). In the nonPGD group, the rate of believing in any religion (χ²=5.807; p=0,016). and the level of fulfilling the requirements of the religion were higher ( χ²=10.584; p=0,05). In the linear regression analysis examining the predictors associated with the severity of prolonged grief; the deceased person was a first-degree relative (t= 6.23; p<0,001) and younger in age (t=-3.71; p<0,001), the presence of guilt (t= 3.28; p=0,001), and increased separation anxiety (t= 4.13; p<0,001) and depression scores (t= 4.29; p<0,001) were significant boost of prolonged grief severity.

Conclusions

Although higher PGD rates were expected in deaths due to Covid-19 compared to deaths due to other causes, we did not detect any significant difference in this study. However, this study identified some possible predictors associated with PGD.

Disclosure of Interest

None Declared
Depressive Symptoms and Urbanization - A Cross-Sectional Network Analysis
Authors: Ochnik D. , Buława B. , Nagel P. , Budziński M. , Gachowski M.
Published: August 2024

Introduction

With increasing urbanization, more people are exposed to mental health risk factors stemming from the urban social or physical environment. However, research on urbanization and depression is not clear.

Objectives

This study aimed to explore environmental and social factors with depression symptoms in view of a network theory of mental health disorders.

Methods

The study was conducted among a representative sample of 3,296 habitants of Metropolis GZM (63% of women)– the most urbanized region in Poland. The measurements used were PHQ-9, UCLA, Neighbourhood Cohesion (Neighbourhood Belonging and Social Cohesion), REAT 2.0 (Quality of architecture in neighborhood area), distance and frequency use of green public areas, Self-Rated Health, Physical Activity, size of place of residence per person.

Results

The prevalence of depression risk in villages (N=713), towns under 20,000 (N=219), towns (under 99,000; N=823), and cities (under 300,000; N=1541) was 44.2%, 44.7%, 39.2%, and 34.9% respectively.

The depression nodes with the highest centrality degree and expected influence were PHQ9 (suicidal thoughts), PHQ2 (feeling depressed), and neighborhood belonging. Living in a more urbanized area (UA) had a smaller centrality degree in the network. Edges between PHQ9 and environmental factors were mediated by loneliness (UCLA). Poor architectural conditions (REAT) were linked positively with neighborhood belonging and adversely with social cohesion. Living in UA was negatively related to PHQ9, PHQ5 (eating control), and PHQ2, social cohesion, and green area distance, while positively to PHQ7 (problems with being focused), poor physical health, REAT, and neighborhood belonging (Figure 1).

Conclusions

Living in a city is negatively related to the most central depression symptoms. Even though social cohesion is negatively linked to UA, neighborhood belonging is higher in more urbanized areas.

The balance between detrimental environmental factors and those that protect mental health requires a better understanding of the interaction between urban living and depression.

Disclosure of Interest

None Declared
Rates of delirium referrals to the Neuropsychiatry Service in a tertiary referral centre hospital
Authors: Gunawardena S. M. , Riaz S. , Murphy K.
Published: August 2024

Introduction

Beaumont Hospital is the National Neurosurgical Centre in Ireland. Due to the high numbers of referrals from Neurology and Neurosurgery, The Department of Psychiatry established a specialist Neuropsychiatry inpatient Liaison service and a weekly Neuropsychiatry outpatient clinic. Many of the referrals that the service receive involve the management of delirium. Delirium is a common medical complication, particularly in neurosurgical settings. Delirium causes significant symptom burden which can lead to distress to all involved and impacts quality of life.

Objectives

The aim was to improve the rates of referrals for delirium presentations and referral rates overall from Neurology and Neurosurgery. The neuropsychiatry service have implemented a delirium protocol for all medical and surgical teams in Beaumont Hospital. This protocol can be accessed through the Beaumont hospital phone app, or on site on each ward. For this reason, delirium can be managed by medical teams in the first instance. If this is not successful, neuropsychiatry can be contacted for further advice or review of patients with more complicated presentations.

Methods

The neuropsychiatry service receives referrals through the Patient Information Profile Explorer system which is accessed through the Beaumont Hospital online portal. In the event of an urgent referral, neurology or neurosurgery teams can contact the neuropsychiatry service directly by phone. Referrals are logged on the team referral log book, and details of the referral are recorded along with diagnosis and management. Data was collected retrospectively from the PIPE and log book to measure the rates and reasons for referrals over a one year period. Rates and details of referrals were initially recorded between July-December 2022. An educational intervention was provided where psychoeducation was provided to junior hospital doctors during protected teaching times and further education was provided over the phone when referrals were discussed between team members. Rates and details of referrals were then recorded between January-July 2023.

Results

There was a reduction in referrals when comparing the two six month periods. There were 115 neuropsychiatry referrals from July to December 2022 and 78 referrals from January to July 2023. Rates of delirium referrals also reduced from 31% to 25% after psychoeducation was provided to junior doctors.

Conclusions

This audit highlights the importance of communication and education for medical and surgical trainees in the management of delirium. There is a high rate of turnover of junior doctors throughout the year in Beaumont Hospital. For this reason, it is imperative that continued education is provided to allow them to follow the delirium protocol independently before seeking tertiary service assistance. Ultimately, early and rapid intervention of delirium can have a positive impact on patient care and prognosis

Disclosure of Interest

None Declared