bluuebunny/crossref_metadata_2025 huggingface dataset:
In-treatment behaviors in a multicomponent intervention to promote smoking cessation and prevent weight gain among smokers with obesity: A pilot study
Authors: Aonso-Diego G. , Krotter A. , García-Pérez Á. , De Robles L. , Weidberg S. , Secades-Villa R. , García-Fernández G.
Published: February 2022

Introduction

Smoking rates are quite high among overweight and obese individuals. Many smokers with excess weight are at increased risk for health complications and report that concern about post-cessation weight gain is a barrier to quitting. It is necessary to perform studies to assess the efficacy of interventions for smoking cessation among individuals with excess weight.

Objectives

To describe in-treatment behaviors, in terms of smoking and weight, in an integrated intervention for smoking cessation and weight gain management.

Methods

A total of 16 smokers (37.5% females, Mage=52.31, SD=9.58) were randomly assigned to one of the two following 8-week smoking cessation conditions: 1) Cognitive-Behavioral Treatment (CBT) for gradual smoking cessation + a Weight Gain Prevention (WGP) module for weight stability (n=7); 2) the same treatment alongside Contingency Management (CM) for smoking abstinence (n=9). Smoking behavior (cigarettes per day, carbon monoxide (CO) in expired air and urine cotinine) and weight were tracked at every visit from baseline through the end of treatment.

Results

Cigarettes per day significantly decreased in both conditions (p≤.028), as well as CO (p≤.018) and cotinine (p≤.043). Regarding body weight gain, participants maintained their body weight (Kg) from baseline to the end of treatment (CBT+WGP: Δkg= .671, CBT+WGP+CM: Δkg= .667, p≥.058) and their BMI (CBT+WGP: 30.56 vs. 30.85, CBT+WGP+CM: 29.74 vs. 29.85, p≥.139).

Conclusions

Preliminary data indicated that a multicomponent intervention to promote gradual smoking cessation and prevent weight gain facilitates in-treatment tobacco reduction and weight stability. CM procedures improved in-treatment smoking behaviors.

Disclosure

No significant relationships.
Gaming addiction among Tunisian adolescent
Authors: Omri S. , Daoud M. , Smaoui N. , Feki R. , Charfi N. , Thabet J. Ben , Zouari L. , Bouali M. Maalej , Maalej M.
Published: February 2022

Introduction

Gaming is a source of addiction for adolescents. It is recognized as a behavioral and mental health condition, both by the American Psychiatric Association and by the World Health Organization.

Objectives

To determine the prevalence of gaming addiction among secondary school students.

Methods

This cross-sectional study was conducted between September and October of 2020 among students enrolled in secondary school. The participants had filled the Game addiction scale and a data file regarding the socio-demographic information, physical and information about the internet access and use.

Results

The initial sample was composed of 180 secondary school students. Among them 28 were excluded because they did not play video games. Final sample consisted of 152 students (90 males, 62 females) with a mean age of 13.14 ± 1.2 years. The average duration of connection among participants was 5.3 hours per day. Nearly one quarter of the participants (24,3%) played videogames more than 20 h per week. The prevalence of gaming addiction was 21,7%. The participants with gaming addiction were, on average, younger than those who were not addicted to gaming Game-addicted individuals were more likely to be male than female (13,8% vs 7,9%; p=0,036). There was, also, a significant relation between IA and having academic difficulties (p=0.042).

Conclusions

Based on our study findings, that gaming addiction is a challenging problem among Tunisian adolescents. We recommend authorities consider gaming addiction a serious problem for the young population and make this growing phenomenon an adolescent health priority.

Disclosure

No significant relationships.
Food addiction in a large non-clinical sample of Canadians
Authors: Samokhvalov A. , Murphy C. , Balodis I. , Mackillop J.
Published: February 2022

Introduction

The concept of food addiction emerged recently due to the similarities between food overconsumption patterns and addictive drugs. This concept is not yet included into ICD or DSM as it still needs to be further investigated. Relationship between obesity and food consumption as well as the psychological indicators of food addiction are of particular interest.

Objectives

To examine the prevalence of food addiction and its relationship to obesity, quality of life and multiple indicators of impulsivity.

Methods

Cross-sectional in-person assessment of 1432 community adults (age 38.93+/-13.7; 58% female). Measurements: Yale Food Addiction Scale 2.0, anthropometrics, body composition, World Health Organization Quality of Life scale, and impulsivity measures including impulsive personality traits, delay discounting, and behavioral inhibition.

Results

The prevalence of food addiction was 9.3% and substantially below that of obesity (32.7%). Food addiction was more prevalent among obese individuals and also was associated with higher BMI among non-obese participants. It was associated with significantly lower quality of life in all domains, and significantly higher impulsive personality traits, particularly negative and positive urgency.

Conclusions

In this general community sample, food addiction was present in slightly fewer than 1 in 10 individuals, approximately one-third the prevalence of obesity, but notably the food addiction has been mostly represented within the subsample of obese individuals. Food addiction was robustly associated with substantively lower quality of life and elevations in impulsivity, particularly in deficits in emotional regulation. These data suggest food addiction may be thought of as a subtype of obesity and, in non-obese individuals, possibly a prodrome.

Disclosure

No significant relationships.
Substance use disorders in adolescence - a review
Authors: Coelho J. Mendes , Peixoto C. , Bicho M. , Fontes H.
Published: February 2022

Introduction

Substance use disorders in adolescents are a growing problem worldwide. These disorders are often unrecognised, unvalued by families, society and clinicians and as a result underdiagnosed, with serious future consequences if improperly addressed.

Objectives

Updated review of the recent literature on this topic.

Methods

Unsystematic review of the most recent and relevant literature.

Results

Review of neurobiology, risk factors, co-morbidity, differential diagnosis, diagnostic criteria, evaluation and treatment of substance use disorders in adolescence.

Conclusions

Substance use disorder in adolescence includes a variety of behaviours related to the use of alcohol and/or drugs, for instance, inability to control substance use, impairment of function at school, home or work, interpersonal problems and hazardous use of substance. Further knowledge in identifying, early diagnosing and adequate intervention in adolescents’ substance use disorder may have paramount prognostic features.

Disclosure

No significant relationships.
Eeg coherence in depressive female adolescents with different types of auto-aggressive behavior
Authors: Iznak A. , Iznak E. , Damyanovich E. , Oleichik I.
Published: February 2022

Introduction

Intracortical interactions reflected in EEG coherence (Coh) play an important role in the control of behavior in both norm and mental disorders. EEG Coh in depression is less than in the norm. Non-suicidal self-injuries (NSSI) are widespread in adolescents and represent a significant risk factor for consequent suicidal attempts (SA).

Objectives

The aim of the study was to identify the differences in EEG coherence between depressive female adolescents who have NSSI or NSSI and SA in their history compared with healthy controls.

Methods

75 depressive female adolescents (16–25 years old) were enrolled in the study and divided into two subgroups: NSSI (n=38) and NSSI+SA (n=37). The control group included 20 healthy subjects (HC) matched by age and gender. Baseline EEG was recorded, and EEG coherence was analyzed in 8 narrow frequency sub-bands.

Results

In the NSSI subgroup, the number of “high coherent connections” (pairs of EEG leads with Coh>0.80) was the lowest in comparison with the NSSI+SA subgroup (intermediate values) and HC (the highest values) in theta-1 (4-6 Hz), theta-2 (6-8 Hz), alpha-1 (8-9 Hz) and alpha-2 (9-11 Hz) EEG frequency sub-bands, especially in frontal-central-parietal regions.

Conclusions

The lowest EEG coherence in the NSSI subgroup suggests that this subgroup is “more depressive” than the NSSI+SA subgroup, while the NSSI+SA subgroup is “more normal” but has increased suicidal risk. The results obtained suggested the use of EEG Coh data to clarify the degree of suicidal risk in depressive adolescents with different types of auto-aggressive behavior. The study supported by RBRF grant No.20-013-00129а.

Disclosure

No significant relationships.
Neurophysiological features associated with suicidal risk in dementias
Authors: Mudrenko I. , Yurchenko A.
Published: February 2022

Introduction

The bioelectrical activity of the brain of suicidals has specific features.

Objectives

Investigate neurophysiological features associated with high suicidal risk (SR) in dementias.

Methods

An electroencephalographic study of brain was performed in 66 patients with dementia, of which 33 (with high SR) were included in the main group, the other 33 (with low SR) – in the control group.

Results

SR correlates include an increase in the spectral density and amplitude (in μV) of the α-rhythm in the right central (C4) (109.4) – in the main group, compared with (64.5) – in the control; in the temporal areas (T4) (132.2) - in the main group, (70.0) – in the control group (p<0.001). The predominance of the spectral density of the slow θ-rhythm over the entire surface of the brain (p<0.001) and δ-rhythm in the projection of Fp2 (82.3) – in the main and (116.1) – in the control groups (p<0.001), F3 (54.80) and (68.1), respectively, (p<0.05), F4 (52.4) and (67.3), respectively, (p<0.01), C4 (52.0) and (62.0), respectively (p<0.05), P3 (44.4) and (58.9), respectively, (p<0.01), O1 (67.6) and (89.41), (p<0.001), O2 (68.5) and (85.8), respectively (p<0.001) are a predictor of low SR in dementias.

Conclusions

With the progression of changes in the brain in dementias SR decreases. In the initial phases of the dementing process with a relatively preserved functional capacity of the brain SR is high.

Disclosure

No significant relationships.
Epidemiological profile of the suicidal in the third poorest state of Brazil
Authors: De Souza Maia G. Lessa , Gomes Do Nascimento M. Melo
Published: February 2022

Introduction

Alagoas is one of the poorest states of Brazil and its HDI is the country’s worst.

Objectives

Present the epidemiological profile of suicides that occurred in the State of Alagoas from 2008 to 2018.

Methods

This research is epidemiological, descriptive and transversal. In this sense, data from the Universal Health System Informatics Department (DATASUS) were used to analyze the age range, marital status, race, sex, education and cause of death of the suicide victims.

Results

1245 people committed suicide in Alagoas in the period of 10 years, they were 951 men (76%) and 294 women (24%). The main cause of death was self-harm caused by hanging, strangulation and suffocation (ICD X-70), occurring in approximately 67% of cases (836 people), followed by self-poisoning by drugs and medication (ICD X-64) 140 people, and pesticides (CID X-68) 92 people. The auto injuries caused by firearms (ICD X-72 to X-74) totalled 45 victims, while the self-inflicted injuries intentionally caused by precipitation from a high place (ICD X-80) totalled 38 victims. Most of those who took their lives were single (57%), brown (88%), had between 15 and 39 years old (55%) and did not have their education level informed (75%).

Conclusions

Thus, the present study demonstrated that there is a compromise of important statistical data on education level and there is the inexistence of data on family income and sexual orientation, which may help to understand the phenomenon of suicide in Alagoas. Despite all this, it was possible to identify a group of risk for suicide in the State: brown, single and young men.

Disclosure

No significant relationships.
The suicidal survivor: Considerations for treatment in psychodynamic psychotherapy
Authors: De Souza A. Maia Andrade , De Souza Maia G. Lessa , Machado L. Helena Freitas
Published: February 2022

Introduction

Suicide is a phenomenon that is increasing in prevalence. Exposure to suicide by a loved one can be experienced as a traumatic event, capable of precipitating or aggravating preexisting psychiatric conditions. As much as we are clinically aware of gravity situation experienced by suicide survivors, there is a marked lack of studies on psychotherapeutic interventions in this population group.

Objectives

The present work aims to review the literature on the psychodynamic treatment of suicide survivors, considering their theoretical and technical aspects.

Methods

Narrative review of psychiatric and psychoanalytic literature.

Results

The initial reaction described on becoming aware of the suicide of someone close to you is of disbelief, shock and helplessness. This is followed by ambivalent feelings of hate and guilt, shame and hopelessness. Sometimes, a chronic depressive state expressed by the survivor’s guilt can emerge. The mourning work will initially encounter resistance to face the loss of the object, through mechanisms such as denial, repression and psychotic fantasies. The lost suicide has a traumatic impact, modifying relational patterns and it is commonly associated with important isolation. The survivor will be able to transfer via fear the death of the therapist and even fantasize that he will also kill himself.

Conclusions

Psychodynamic psychotherapy with suicide survivors finds theoretical and practical foundations in the literature, mainly through discussions of reports clinical and theoretical reviews on the topic. Through transfer and therapeutic alliance, new patterns of object relation can be sketched, in a context of mourning so often complicated by shutdown pressures and loneliness.

Disclosure

No significant relationships.
The psychopathology of the elderly with multimorbidity. Is an integrated training model feasible?
Authors: Riolo A. , Albert U.
Published: February 2022

Introduction

The aging of the population implies a greater risk of psychopathological events; at the same time multimorbidity constitutes the rule rather than the exception in the manifestations of the health problems of the elderly. Multimorbidity involves many diagnostic-therapeutic interventions, from general practitioners to neurology, geriatrics, psychiatry but these interventions do not appear integrated with each other.

Objectives

Evaluate the availability of psychogeriatrics training programs to increase the interest and skills of the medical profession on the multimorbidity of the elderly.

Methods

We have conducted a review of the scientific literature on integrated training programs in the field of psychogeriatrics over the past decade on pubmed, comparing the different training models proposed.

Results

A still limited amount of articles on integrated psychogeriatric training have been published although the demand for psychogeriatric care continues to increse. The frail elderly seems to have a connotation in terms of costs rather in terms of care; moreover, everything concerning the elderly is reduced to the organic dimension alone, neglecting psychopathology.

Conclusions

The feasibility of integrated training programs between primary care and specialists such as neurologists, geriatricians, psychiatrists is a priority in the field of psychogeriatrics in consideration of the relevant multimorbidity. It is appropriate both to update knowledge and to review the organizational models of care so that the frailty of the elderly with multimorbidity does not quickly translate into disabilities with high social welfare needs. It is also necessary for generalist psychiatry to return to the value of psychopathology of the elderly.

Disclosure

No significant relationships.
Risk profiles for mental disorders
Authors: Gülöksüz S.
Published: February 2022

Abstract Body

Prognostication is at the bedrock of clinical practice. In essence, diagnosis aims to inform clinicians for decision-making processes by providing a picture of future events such as course, outcome, and treatment response. To make a better clinical prediction on a case-by-case basis, diagnosis is enriched by individual characteristics and (bio)markers, with the aims of stratifying patients first and ultimately reaching the mountaintop: personalized medicine. However, there are two major obstacles on the road to personalized psychiatry. First, the current psychiatric diagnostic classification system is inadequate for tailoring individualized management plan, let alone for guiding the clinician for diagnosis-specific treatment selection—such that response to the same treatment plan largely varies among patients with the same psychiatric diagnosis, whereas patients with different psychiatric diagnoses benefit similarly from the same treatment protocol. Second, except for a few tests for ruling out other medical conditions, there exists no diagnostic, prognostic, or predictive (bio)marker in psychiatry. Risk profiling is even a more challenging and ambitious goal as early psychopathology is multidimensional, fluid, and pluripotent with heterotypic outcomes that cut across traditional diagnostic boundaries. By acknowledging this complexity and the shortcomings of current taxonomy, the field has recently shifted from risk profiling frameworks that rely on discrete diagnostic categories in isolation for prognostication (i.e. clinical high-risk for psychosis) to transdiagnostic clinical staging models. In this session, I will attempt to discuss where we are at with risk profiling in psychiatry and what steps need to be taken to achieve this ambitious goal.

Disclosure

No significant relationships.
“It is natural so it must be safe!”: Cannabis use during pregnancy, an update
Authors: Ramos S. Freitas , E Sousa D. Cruz , Jesus B. , Correia J. Martins , Vaz Soares M.I. Fonseca Marinho , Mendes J.
Published: February 2022

Introduction

Rates of cannabis use among pregnant women have been increasing. Psychiatrists may be required to provide counselling regarding marijuana use in pregnancy for their patients.

Objectives

To produce an up-to-date review of cannabis effects on pregnancy and the offspring.

Methods

We performed a non-systematic review of the literature apropos a clinical case.

Results

A 31-years-old, 22-weeks pregnant woman presented with severe anxiety, panic attacks and insomnia which she managed solely with cannabis. She had been previously treated with antidepressants and benzodiazepines with symptom remission but had suspended before her pregnancy without medical advice. She believed medication was more harmful to the baby than her cannabis use. There is little perception of risk concerning cannabis use in pregnant woman. Information on cannabis use is less likely to be obtained from healthcare providers than from anecdotal experiences, Internet searching and advice from friends and family. Prenatal use of cannabis has been associated with anaemia in the mother, whereas in the offspring it is associated with reduction in birth weight and greater likelihood of placement in intensive care units. There is insufficient evidence to support an association between marijuana use and any specific congenital abnormality, but also to demonstrate its safety.

Conclusions

It is essential for psychiatrists to have up-to-date knowledge of the effects of cannabis on the pregnancy and the offspring to properly counsel their patients. However, the effects of cannabis on maternal and foetal outcomes remain generally unknown. With rising numbers of female users, there is urgent need for further research.

Disclosure

No significant relationships.
Disenfranchised grief and early pregnancy loss – apropos a clinical case
Authors: Ramos S. Freitas , Jesus B. , Vaz Soares M.I. Fonseca Marinho , Correia J. Martins , Mendes J.
Published: February 2022

Introduction

Perinatal death includes losses such as ectopic pregnancies, miscarriages, stillbirths and neonatal deaths. Perinatal loss has well documented negative effects on the health of the bereaved parents. Early pregnancy loss (EPL) is the spontaneous death of a fetus within the first 20 weeks of gestation.

Objectives

To describe a clinical case of disenfranchised grief following EPL and to review the literature.

Methods

We reviewed the clinical file of a patient presenting to the psychiatry outpatient clinic with disenfranchised grief. We conducted a non-systematic review on PubMed and Google Scholar.

Results

A 29-years-old female patient presents to the outpatient clinic with depressive symptoms and thoughts of death. The symptoms had begun 4 months earlier, following the loss of pregnancy at 14 weeks. She felt her grief was not accepted by her family and social network. Progressively, her relationships deteriorated, and she felt more and more isolated. She experienced marked difficulty in caring for her older child. Compared to other types of mourning, the loss of a child is associated with grief experience that is particularly severe and complicated. Despite the high prevalence of EPL, many women suffer in silence due to the common belief these losses are insignificant and may develop complicated grief.

Conclusions

Perinatal loss of an infant has the potential to have a large impact on the mental health of the bereaved parents. Literature on the efficacy of different interventions is still scarce. Further studies are necessary on prevention strategies and interventions for parents already suffering from complicated grief or depressive disorders.

Disclosure

No significant relationships.
Mental health of Tunisian women during the first wave of COVID-19 pandemic
Authors: Sediri S. , Zgueb Y. , Aissa A. , Ouali U. , Nacef F.
Published: February 2022

Introduction

The coronavirus disease 2019 (COVID-19) pandemic created a situation of general distress. Although the focus has been initially more on the physical health during the pandemic, mental health concerns linked to the lockdown have quickly risen.

Objectives

The aim of this study was to evaluate the impact of the first wave of COVID-19 pandemic on Tunisian women’s mental health.

Methods

An online survey was conducted during the first wave of COVID-19 pandemic using the Depression Anxiety and Stress Scales (DASS-21). We also collected sociodemographic information and mental health status.

Results

A total of 751 women completed the questionnaire. More than half of the participants (57.3%) reported extremely severe distress symptoms, and 53.1% had extremely severe stress symptoms as per the DASS-21. Those who had a history of mental illness were found to have more severe symptoms of depression, anxiety and stress.

Conclusions

As this study was the first one to evaluate the acute impact of COVID-19 on mental health in Tunisia, Arab world and in Africa, it may be a sound basis for developing an effective psychological intervention aimed at women in these regions.

Disclosure

No significant relationships.
Problematic facebook use during COVID-19 pandemic among Tunisian women
Authors: Sediri S. , Zgueb Y. , Aissa A. , Ouali U. , Nacef F.
Published: February 2022

Introduction

Due to COVID-19 pandemic, the Tunisian government officially announced a lockdown on March 2020. This decision caused a significant change in the everyday life of Tunisians such as movement restriction revealing the psychosocial aspect of this crisis.

Objectives

This study aims to assess the impact of the COVID-19 pandemic on the mental health of Tunisian women and its association with social media addiction.

Methods

This study was conducted using an online survey, between April 25 and May 6, 2020. Women were asked about sociodemographic information, lockdown conditions. The Facebook Bergen Addiction Scale (FBAS) was used to evaluate addiction to Facebook and social media. The Depression Anxiety and Stress Scales (DASS-21) was used to evaluate depression, anxiety and stress.

Results

We included 751 participants. Scores of the FBAS ranged from 6 to 30 and the mean score was 16.49 (± 5.4). Forty percent (n = 300) of respondents might have facebook addiction, as per the scale. A significant positive correlation was found between Facebook addiction score and DASS scores of depression (p = 0.001, r = 0.43), anxiety (p = 0.001, r = 0.39) and stress (p = 0.001, r = 0.41).

Conclusions

Women who have higher rates of distress are more likely to have a problematic Facebook use during the COVID-19 pandemic which suggests that smartphone and internet use may be part of coping strategies implemented for the emotional distress secondary to this pandemic.

Disclosure

No significant relationships.
A review of pregnancy counseling with abnormal fetuses
Authors: Haqshenas S.
Published: February 2022

Introduction

This review study examines the cases of improving the therapeutic skills of therapists and areas of counseling and the important cases that midwives have to provide services and manage conditions if Diagnosis of an abnormal fetus requires attention.

Objectives

We aim to find the best ways of counseling for helping parents with diagnosed abnormal fetuses

Methods

A search conducted by using the keywords congenital anomalies, psychological counseling, prenatal counseling in PubMed, science direct, clinical key and Google scholar search engine. after screening, the complete data of 20 articles were included in this review article.

Results

The results showed that pregnancy counseling with abnormal fetuses includes medical and psychological counseling. In medical counseling, knowledge of the types of tests and their interpretation is important, and prenatal screening training programs for health care providers should be revised based on their educational needs. In psychological counseling, to meet the needs of a changing population of clients Midwives in the context of the wider healthcare system need accurate knowledge of religious beliefs and cultural contexts of their clients in order to take the best approach to relevant care. The occurrence of a diagnosis of congenital anomaly during transmission to parents adds to the accumulation of stress-related events that may increase the risk of developing psychological symptoms in the early stages after diagnosis.

Conclusions

Considering the different cultures of different countries of the world, midwifery counseling skills play an important part in the diagnostic and therapeutic process. Therefore, creating extraordinary educational programs on university education is needed for midwives.

Disclosure

No significant relationships.
An overview of the psychological effects of common contraceptive methods on women
Authors: Haqshenas S.
Published: February 2022

Introduction

The psychological effects of using any method of contraception are not hidden from anyone but in different methods, they have different effects.

Objectives

We aim to investigate the different psychological effects of common contraceptive methods in women.

Methods

A search conducted by keywords “contraception”, “psychological effects” and “women” in PubMed, Science Direct, Scopus and Clinical Key and Google Scholar search engine. Finally, data from 12 articles were used for this review study.

Results

The positive and negative psychological effects were slightly different in consumers. The effect of OC and IUD and sterilization on sex life compared to condoms was reported to be positive and in menstrual experiences, OC consumers reported higher satisfaction than other methods, in particular, IUD. The regret in using sterilization was higher than in other methods. Psychopathological disorders and psychological disorders developed while using these methods should be differentiated. Negative psychological effects of women using contraceptive methods are often due to their mental background to a mother’s role and fertility and the conflict that exists in these methods with their mental image. Also, cooperation and understanding of spouses on the acceptance of these methods and their positive or negative impact has been reported to be very effective.

Conclusions

Before providing any method of contraception, it is recommended to provide comprehensive counseling on each method and follow up with women while consuming to reduce these symptoms and improving their effectiveness.

Disclosure

No significant relationships.
Galactorrhoea as a side effect due to Bupropion- a case report
Authors: Bhandutia D. , Nayok S.
Published: February 2022

Introduction

Bupropion is a NDRI antidepressant with action on both serotonin and nicotinic receptors. Endocrine and sexual adverse effects are very rare and hence very unlikely to cause hyperprolactinemia. We report a case of a patient who developed galactorrhoea following Bupropion augmentation of Escitalopram. A 24 yr old unmarried nulliparous female was brought with complaints of low mood, loss of interest, decreased concentration in studies from 20 days. She was also reported to be smoking cigarettes since 2 years with occasional alcohol use. There was no menstrual abnormalities nor any use of regular medication. On MSE there was depressed affect with negative cognition and occasional death wishes with normal perception. HAM-D Score was 17-19. She was started on Escitalopram 10 mg/day and Clonazepam 0.5 mg/day. Depressive symptoms improved and 2 weeks later Bupropion 150 mg/day was added as anti-craving and for augmentation owing to residual depressive symptoms.

Objectives

Bupropion induced Galactorrhoea

Methods

Cross-sectional

Results

Within 2 weeks of starting Bupropion, she reported with complaint of galactorrhoea. Prolactin level came out to be 28.67 ug/L. Brain imaging was also reported to be normal. Escitalopram was stopped and substituted with Mirtazapine 7.5 mg/day, continued for a week. There was no improvement, hence Mirtazapine and Bupropion were discontinued and started on Sertraline 25 mg/day. Galactorrhoea started reducing within next 4-5 days and completely subsided within a week of stopping Bupropion.

Conclusions

Bupropion has action on serotonin receptors which might be hypothesized as cause. Also, it is a potent CYP2D6 inhibitor, causing increase levels of Escitalopram.

Disclosure

No significant relationships.
Depressive disorders after mild craniocerebral injuries in young females
Authors: Syrmos N.
Published: February 2022

Introduction:

Craniocerebral injuries are serious traumatic situations

Objectives:

Aim of this study is to present cases of deppresive disorders after mild craniocerebral injuries in young females

Methods:

8 cases are presented. Range of age between 15 and 30 years old. All of them reported depressive disorders during the post traumatic period after mild craniocerebral injuries mainly due to road traffic accidents.

Results:

All of them they receive appropriate neurological, psychiatric, psycological and rehabilitation support and treatment. They managed to have a good outcome after 12 months follow up.

Conclusions:

The development of depressive disorders after such traumatic events remains a strong predictor of a variety of difunctions (social, personal, work etc). The emergence of depressive disorders in many cases remains unexplored and poorly understood. The effect into the the overall health remains a very important factor to investigate. The combination and collaboration of the various medical disciplines is essential in order to help young people.

Disclosure:

No significant relationships.
Early career psychiatrists in europe during the COVID-19 outbreak: Results of the EPA ECPC-EFPT cross-sectional survey
Authors: Gondek T.
Published: February 2022

Abstract Body

The COVID-19 outbreak has left its mark on the work of mental health care staff. Many professionals had to radically change their working conditions or were delegated to work in different facilities, in many cases taking on different responsibilities with little time for training. Many psychiatrists overnight had to partially or fully start working within telemedicine. Due to the lockdown, psychiatric trainees in many countries were not able to complete their training as planned. The measures taken by the governments to limit the impact of the pandemic also affected the capacity to conduct research studies and directions of new research initiatives. Dr. Gondek will present the results of the EPA ECPC-EFPT Cross-sectional survey on the effects of the outbreak on work and wellbeing of Early Career Psychiatrists in Europe.

Disclosure

No significant relationships.
Presentation and outcomes of attention deficit and hyperactivity disorder in females and males
Authors: Kilic O. , Young S.
Published: February 2022

Abstract Body

Attention deficit and hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. Its primary clinical features include symptoms of inattention and hyperactivity/impulsivity, although young people often present with emotional dysregulation, excessive mind-wandering and executive dysfunction. Symptoms of ADHD often persist into adulthood together with high rates of comorbidity and significant psychosocial impairment across the lifespan. Berry, Shaywitz and Shaywitz proposed over 30 years ago that girls with ADHD form a ‘silent minority’ with greater internalized behavior which leads them to be under-identified. Even when referred for clinical assessment, their ADHD symptoms are missed or misdiagnosed for other conditions such as anxiety, depression and personality disorder. This means they will not receive the treatment they need. Compared with controls, they may be especially vulnerable to childhood adversities and health problems and they may cope with these difficulties with dysfunctional strategies (eg. with substance misuse and/or deliberate self-harming behaviours). If we are to enhance long-term outcomes in girls and women with ADHD, healthcare practitioners need to better understand the presentation of ADHD in females, improve detection and assessment of ADHD in order that they may access appropriate treatment. This workshop will focus on the differences in presentation and outcomes between males and females with ADHD.

Disclosure

No significant relationships.
Neuroimaging in ADHD: How far are scanners from clinical psychiatry?
Authors: Pereira-Sanchez V.
Published: February 2022

Abstract Body

Decades of neuroimaging research in attention/deficit-hyperactivity disorder (ADHD) have yielded a few apparently firm findings and many open questions. The long-term objective of these efforts is to uncover the underlying brain pathophysiology of the disorder, to reveal reliable biomarkers of prognosis and treatment response, striving for personalized medicine. Unfortunately, neuroimaging research in ADHD and other psychiatric disorders is still unable to inform clinical practice. This presentation will provide an up-to-date overview of neuroimaging in ADHD, highlighting the most promising results and current challenges of structural and functional research with magnetic resonance imaging (MRI). Evidence from large, multicentric studies and from highly-sophisticated resting-state functional MRI techniques will be presented; methodological and reproducibility limitations in current literature will be introduced, and the way forward to bring this area of research closer to clinical practice with patients with ADHD will be discused. Dr. Pereira-Sanchez is conducting original research using resting-state functional MRI to study potential correlates of treatment response to stimulants in children and adolescents with ADHD; he has also recently published two literature reviews of MRI studies in ADHD.

Disclosure

No significant relationships.
Pharmacological approaches of ADHD
Authors: Cooper R. , Williams E. , Seegobin S. , Tye C. , Kuntsi J. , Asherson P.
Published: February 2022

Abstract Body

Adults with ADHD describe self-medicating with cannabis. A small number of psychiatrists in the US prescribe cannabis medication for ADHD, despite there being no evidence from trials. The EMA-C trial (Experimental Medicine in ADHD-Cannabinoids) was a pilot randomised placebo-controlled experimental study of a cannabinoid medication, Sativex Oromucosal Spray, in 30 adults with ADHD. The primary outcome was cognitive performance and activity level using the QbTest. Secondary outcomes included ADHD and emotional lability (EL) symptoms. From 17.07.14-18.06.15, 30 participants were randomly assigned to the active (n=15) or placebo (n=15) group. For the primary outcome, no significant difference was found in the intent-to-treat analysis although the overall pattern of scores was such that the active group usually had scores that were better than the placebo group (Est=-0.17,95%CI-0.40-0.07, p=0.16, n=15/11 active/placebo). For secondary outcomes Sativex was associated with a nominally significant improvement in hyperactivity/impulsivity (p=0.03) and a cognitive measure of inhibition (p=0.05), and a trend towards improvement for inattention (p=0.10) and EL (p=0.11). Per-protocol effects were higher. Results did not meet significance following adjustment for multiple testing. One serious (muscular seizures/spasms) and three mild adverse events occurred in the active group and one serious (cardiovascular problems) adverse event in the placebo group. Adults with ADHD may represent a subgroup of individuals who experience a reduction of symptoms and no cognitive impairments following cannabinoid use. While not definitive, this study provides preliminary evidence supporting the self-medication theory of cannabis use in ADHD and the need for further studies of the endocannabinoid system in ADHD.

Disclosure

During this work-RC was a Ph.D. student funded by a grant to PA from Vifor Pharma. PA received funds (consultancy/sponsored talks/research/education) from Shire, Lilly, Novartis, Janssen, PCMScientific, Vifor Pharma, QBTech. Sativex was free from GW Pharm
The WHO-5 well-being scale and its correlation to depressive and manic symptoms among outpatients with bipolar disorder or unipolar depression
Authors: Straszek S. , Christensen A.-E. , Licht R. , Østergaard S. , Nielsen R. Ernst
Published: February 2022

Introduction

There is a lack of longitudinal studies of patients with bipolar disorder (BD) or unipolar depression (UD) in terms of psychological well-being as measured by the WHO-5 and the correlation to symptom scores. It is of interest to investigate whether the WHO-5 is useful in monitoring patients with mood disorders over time, as a tool in measurement-based care, and as a supplement to other psychometric measures.

Objectives

In this study we investigate the correlation at baseline between the depressive symptom scores according to the 6-item Hamilton Depression Score (HDS-6) and the WHO-5 scores in outpatients treated for BD or UD. Furthermore, in patients with BD we investigate correlations between manic symptom scores according to the modified Bech-Rafaelsen Mania Scale (MAS-M) and the WHO-5 scores. Lastly, in patients with BD or UD, we investigate the correlations between endpoint-baseline change in WHO-5 and change in MAS-M and HDS-6.

Methods

A longitudinal study of 200 outpatients diagnosed and treated for either BD or UD. Patients will be measured at baseline and at least four weeks later. Baseline data are presented as frequencies, means and standard deviations or medians with interquartile ranges as appropriate. All correlations are presented as scatter plots and a Spearman correlation analysis

Results

The study is ongoing, but the results will be available for presentation at the EPA in 2021.

Conclusions

The WHO-5 may represent a relevant outcome measure in the treatment of BD and UD.

Disclosure

No significant relationships.
Self-injurious behaviour in patients with bipolar disorder and attention deficit hyperactivity disorder after central stimulant start– a retrospective study based on the lisie cohort
Authors: Öhlund L. , Ott M. , Lundqvist R. , Sandlund M. , Renberg E. Salander , Werneke U.
Published: February 2022

Introduction

Currently, our understanding remains limited of how co-occurring bipolar disorder and attention deficit hyperactivity disorder (ADHD) should be treated.

Objectives

To evaluate the impact of central stimulant treatment on self-injurious behaviour in patients with a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD.

Methods

Retrospective cohort study (LiSIE) into effects and side-effects of lithium as compared to other mood stabilisers. Here, using a mirror-image design, we compared suicide attempts and non-suicidal self-injury events within 6 months and 2 years before and after central stimulant treatment start.

Results

Of 1564 eligible patients, 206 patients met inclusion criteria; having a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD at first central stimulant initiation. In these, suicide attempts and non-suicidal self-injury events decreased significantly within both 6 months (p = 0.004) and 2 years (p = 0.028) after central stimulant start. After multiple adjustments, this effect was preserved 2 years after central stimulant start (OR 0.63, 95% CI; 0.40 – 0.98, p = 0.041).

Conclusions

Central stimulant treatment may reduce the risk of self-injurious behavior in patients with a dual diagnosis of bipolar disorder or schizoaffective disorder and ADHD. However, to reduce the risk of manic switches, concomitant mood stabilising treatment remains warranted.

Disclosure

Michael Ott has been a scientific advisory board member of Astra Zeneca Sweden, Ursula Werneke has received funding for educational activities on behalf of Norrbotten Region (Masterclass Psychiatry Programme 2014–2018 and EAPM 2016, Luleå, Sweden): Astra
The role of affective temperaments in predicting symptom severity in bipolar disorder
Authors: Raia M. , Ciampi C. , Zinno F. , Caivano V. , Barone E. , Sampogna G. , Vecchio V. Del , Giallonardo V. , Steardo L. , Luciano M. , Fiorillo A.
Published: February 2022

Introduction

Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and high suicide rate. Although affective temperaments are considered possible mediators of outcome, their role on the course and outcome of BD remains poorly studied.

Objectives

The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to verify which affective temperaments are associated with a more severe clinical picture in a sample of patients with BD.

Methods

All patients with BD referring to the outpatient units of two Italian university sites have been recruited. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments.

Results

199 patients were recruited. 54.8% of patients had a diagnosis of bipolar I disorder. 56.8% of the sample reported at least one episode of aggressive behaviours and 30.2% of suicidal attempt. Predominant cyclothymic and irritable temperaments predicted more frequent relapses, a poorer quality of life (p<;0.05), more aggressive behaviours and suicide attempts (p<;0.01). The predominant hyperthymic disposition was a protective factor for several outcome measures, including relapses and suicidality (p<;0.01), and was correlated with a less severity of psychiatric symptoms and later age at onset (p<;0.05).

Conclusions

Early identification of affective temperaments in BD patients can help clinicians to identify those who could show a worse prognosis. A screening of affective temperaments can be useful to develop early targeted integrated pharmacological and psychosocial interventions.

Disclosure

No significant relationships.
The role of Vit D and parathyroid hormone in clinical severity of patients with bipolar disorder
Authors: Palummo C. , Marone L. , Caivano V. , Vece A. , Steardo L. , Luciano M. , Cerbo A. Di , Vecchio V. Del , Fiorillo A.
Published: February 2022

Introduction

Vitamin D modulates the biosynthesis of neurotransmitters and neurotrophic factors, thus influencing mood and its alterations. Decreased blood levels of Vitamin D are involved in many psychiatric disorders, in particular, affective disorders. As regards bipolar disorder (BD), an association between vitamin D deficiency and severity of illness has been found.

Objectives

In this observational study, we assessed calcium homeostasis imbalance in a sample of patients with BD; in particular, we explored whether serum levels of PTH, Vitamin D and calcium influence the clinical presentation of BD and its symptom severity.

Methods

All patients were administered with validated assessment instruments to assess psychopathology, affective temperaments and global functioning. Vitamin D and PTH levels were assessed in all patients. An-ad hoc schedule was administered for socio-demographic and clinical characteristics.

Results

The total sample consisted of 199 patients (females: 51%; mean age: 47.1 ± 13.2 years). Levels of serum PTH were directly correlated with the total number of hospitalizations (p< 0.01), and of depressive (p< 0.0001), manic (p< 0.001) and hypomanic episodes (p< 0.01). Serum levels of Vitamin D were positively associated with age at first psychiatric contact and were inversely correlated with the total number of depressive episodes (p< 0.05) and cyclothymic temperament (p< 0.05).

Conclusions

Increased levels of PTH and Vit D correlate with a worse clinical outcome of patients with BD. Our results highlight the importance to routinely assess PTH, Vit D and calcium levels in BD patients. Moreover, vitamin D may represent a valid add-on treatment for these patients.

Disclosure

No significant relationships.
Bipolar mania with psychosis vs without psychosis: A clinical characterization with indirect measures of severity
Authors: Andrade F. , Machado A.S. , Vieira A. , Silva A.
Published: February 2022

Introduction

The presence of psychotic symptoms is highest during acute episodes of bipolar mania. There is no evidence base regarding the implications of psychosis in the prognosis of bipolar disorder, despite common assumption that their occurrence reflects greater disease severity.

Objectives

We aim to compare sociodemographic and clinical characteristics of inpatients admitted for bipolar mania with and without psychotic features.

Methods

Retrospective observational study of inpatients admitted between January 1st 2017 and 31 October 2020 in a psychiatry inpatient unit of a tertiary hospital. Descriptive analysis of the results was performed using the SPSS software, version 26.0.

Results

Between 2017 and October 2020 there were 103 admissions due to mania bipolar I disorder, 53.4% (n=55) with psychotic symptoms. When compared with mania without psychosis, psychotic mania was associated to male gender (71.1% to 39.7%; c2(1, N = 103) = 10,06; p = 0.02) and younger age (t(103) = -2.43; p = 0.017). The proportion of compulsory admissions and average length of stay were similar between mania with psychosis and mania without psychosis. Also, having a manic bipolar episode with psychotic symptoms was not associated to being prescribed a long-acting injectable antipsychotic.

Conclusions

The presence of psychotic symptoms in bipolar manic episodes were associated to male gender and younger age but not to indirect measures of illness severity.

Disclosure

No significant relationships.