bluuebunny/crossref_metadata_2025 huggingface dataset:
Intranasal Esketamine + CBT: a 6 months follow-up of a resistant depression complicated case
Authors: Martiadis V. , Raffone F. , Cerlino R. , Mistico F. , Russo M.
Published: September 2022

Introduction

TRD is a highly disabling condition, often responsible for chronic clinical course, high number of relapses and elevated suicide risk. Intranasal esketamine is currently the only available pharmacological therapy specifically indicated for TRD, as add-on therapy to antidepressant treatment with SSRI or SNRI.

Objectives

The purpose of the study was to evaluate the safety and efficacy of intranasal esketamine associated with CBT in a complex clinical case of TRD, over a six-month follow-up.

Methods

A 67-year-old patient with TRD was selected for treatment with intranasal esketamine+CBT as add-on to antidepressant therapy. Before each treatment session the HAM-D rating scale was administered. The patient underwent weekly CBT sessions throughout the 6 months follow-up. The effect on physical well-being and social functioning was evaluated by means of Short-Form-Health-Survey-36.

Results

After the first two administrations of intranasal esketamine the total score on HAM-D decreased by 10 units (from 26 to 16). After 6 weeks of treatment decreased from 26 to 12 with the disappearance of suicidal ideation present at T0. After 6 months the total HAM-D score decreased from 26 to 8. Treatment was well tolerated, with mild adverse effects, confined to the first two hours post-administration. In particular, mild sedation, dizziness, slight transient blood pressure rise were reported, never required medical intervention and resolved spontaneously during the observation period.

Conclusions

Intranasal esketamine add-on therapy + CBT was an effective and safe treatment allowing to achieve and maintain symptomatic remission in a complex case of TRD, improving quality of life, social functioning, and reducing suicidal ideation over a six-month follow-up.

Disclosure

No significant relationships.
Utilization of Psychiatric Team Driven Ketamine Infusions
Authors: Ithman M. , Sobule B. , Campbell A.
Published: September 2022

Introduction

In 2018 Missouri University Psychiatric Center, an inpatient psychiatric hospital established a ketamine infusion team to treat severely depressed and acutely suicidal clients. Over 80 infusions were delivered over three years, with positive outcomes and minimal side effects.

Objectives

To evaluate outcomes of an inpatient psychiatric intravenous ketamine team to deliver treatment without anesthisia colloabration, which could open the horizon for future intravenous medications in a psychiatric inpatient setting.

Methods

A team consisting of a psychiatrist supported by a psychiatric PA, psychiatric pharmacist, and a mental health nurse devloped a protocol including physical and mental health screening, inclusion/exclusion criteria, dosing, and client monitoring. For data collection, the team monitored vital signs and mental status changes for tolerability and depression screening tools for efficacy.

Results

Table 1:

Ketamine Infusion Data

Total Clients32Male15Female17Dosing0.5mg/kg adjusted bodyweight infused over 40 minutesAverage Baseline Depression Screening (PHQ or QIDS)*20.8Average Baseline Follow up Screening (PHQ or QIDS)*7.5Average Change in Screening Score (PHQ or QIDS)*-14.1% Change From Baseline in Screening Score (PHQ or QIDS)*65.5%Adverse Events DocumentedDissociation 5 (15.6%); Nausea/Vomiting 3 (.09%), Extreme Euphoria 2 (.06%); sedation 1 (.03%); BP Increase 1 (.03%)

Conclusions

Overall, ketamine infusions were tolerated well with limited adverse drugs reactions reported or observed and were easily addressed by the team without any serious adverse events. Given the rapid improvement of symptoms and overall tolerability, intravenous ketamine infusions conducted solely by a psychiatric-based team advances our field for further treament modalities.

Disclosure

No significant relationships.
Study of the efficacy and safety of various pharmacotherapy regimens for atypical depression in the framework of bipolar affective disorder, recurrent depressive disorder, psychogenic depression
Authors: Verbitskaya M. , Tyuvina N. , Tyulpin Y.
Published: September 2022

Introduction

To improve the effectiveness of treatment for atypical depression, it is necessary to revise the accumulated experience, taking into account new knowledge and drugs.

Objectives

Comparative study of the efficacy and safety of therapy for atypical depression (AtD) in the structure of bipolar affective disorder (BAD), recurrent depressive disorder (RDR) and psychogenic depression (PD).

Methods

Clinical and clinical follow-up methods examined 77 patients with AtD, of which 35 - with bipolar disorder, 18 - with RDR and 24 - with PD. Patients in all three groups received monotherapy with an antidepressant or a mood stabilizer, or a combination of antidepressant and antipsychotic, antidepressant and mood stabilizer, mood stabilizer and antipsychotic, as well as a combination of antidepressant, antipsychotic and mood stabilizer.

Results

Agomelatine was the most frequently used (27.3%) and effective in reducing MADRS in all groups both in monotherapy and in combination with other drugs. Also in the PD group, escitalopram and vortioxetine were highly effective. Of the antipsychotics, when combined with antidepressants, sulpiride was found to be the most effective. When comparing the tolerance of antidepressants in all groups showed the best results (by the CGI scale), agomelatine and venlafaxine, in the BAR group is also vortioxetine.

Conclusions

The best strategy for effective and safe treatment of atypical depression is the use of modern antidepressant, which does not increase the symptoms of the atypical spectrum and, if necessary, can be supplemented with some antipsychotics.

Disclosure

No significant relationships.
Experience of Using a Smartphone Mood Relapse Warning Application among Patients with Bipolar Disorders: A Qualitative Inquiry
Authors: Lin E.C.-L. , Chiou M.-S.
Published: September 2022

Introduction

Although several studies preliminary supported the effects of using smartphone mental health application (app) in patients with bipolar disorder (BD), patients’ subjective experience deserves more attention.

Objectives

The present study aimed to explore how the BD patient experienced while using the APP in detecting their mood relapse warning signs (MRW app) which has been developed by our team (Su et al., 2021).

Methods

The MRW app collects 2 passive (location and GPS removal distance) and 6 self-reported data (daily mood, wake and sleep time, the brief record of mood and life, voice pitch, speech tone and rhythm, facial expression, and weekly emotional scale). By using qualitative research design, 15 patients recruited from the psychiatric outpatient department in a medical center were in-depth interviewed.

Results

Four themes were identified as their subjective experience to use the app as: including positive and negative experience, facilitators, price, and barriers. Interconnected relationship was found in each theme; and counterbalancing associations between positive vs. negative experience, facilitators vs. price and barriers were also demonstrated.

Conclusions

Such first-person experience of using the app in illness detection could unveil technological myths and present its impacts upon patients’ lives in the real world. Implication for practice and future studies were be discussed.

Disclosure

No significant relationships.
Can the integration of Motivational Interviewing skills in a virtual self-conversation be effective in promoting lifestyle changes among healthy adults and patients with obesity? A usability study
Authors: Anastasiadou D. , Vázquez-De Sebastián J. , Spanlang B. , Slater M. , Quiroga J.A. , Parramón Puig G. , Ciudin A. , Comas M. , Lusilla-Palacios P.
Published: September 2022

Introduction

The integration of Motivational Interviewing (MI) with behavioural and psychological interventions for the treatment of obesity has the potential to improve health-related outcomes of patients in the long-term.

Objectives

Our objective is to examine the usability of a VR embodiment tool for treating obesity.

Methods

Fourteen participants (6 healthy and 8 with morbid obesity) with a desire to make lifestyle changes were randomly assigned to the experimental group (EG) and the control group (CG). Participants from the EG engaged in a virtual self-conversation aiming at understanding their own motivation to make lifestyle changes. Using the body swapping technique, participants were embodied alternately in their own virtual representation and in their counsellor’s body. To better guide this virtual self-conversation, participants were previously trained on MI skills. Participants from the CG were embodied in their own virtual bodies and participated in a “scripted dialogue” with a virtual counsellor who gave them practical recommendations about how to achieve lifestyle changes. A mixed-methods design was used, involving a semi-structured interview examining users´ satisfaction with the virtual experience, as well as self-report questionnaires, including readiness to change habits, body ownership, and system usability.

Results

Participants showed high usability of the platform with higher scores among participants from the EG compared to the CG. Levels of body ownership were satisfactory, with no differences between groups.

Conclusions

Through the integration of MI in the VR context with the patient being properly trained to carry out his/her own motivational self-conversation, we will provide an important advance in the psychological treatments of obesity.

Disclosure

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 951930
YOU’VE BEEN CATFISHED: An exploration of social deception on online platforms
Authors: Jesus S. , Costa A. , Simões G. , Dias Dos Santos G. , Almeida M. , Garrido P.
Published: September 2022

Introduction

Life is a stage in which we are all actors and online we can choose who we want to be. Catfishing is a modern phenomenon in which individuals present themselves online as someone they are not as a means of engaging with others through an idealized avatar. This term has gained prominence since its portrayal in documentary and television series. With the emergence of catfishing, an expectation of betrayal in online relationships is anticipated with increasing caution being exercised by those that engage in online forums.

Objectives

The authors aim to explore this phenomenon and explore what personality traits might be associated with those who engage in catfishing others and in those that fall for the dupe.

Methods

A review of the recent literature on the topic with focus on that which is most relevant to the theme was included.

Results

The literature demonstrates that catfishing is an increasing trend as our online social interaction also increases. Catfishing appears to exist on a scale, where approximately 80% of the online population engage in some form, by means of amplifying their social status. Those with low self-esteem, poor self-worth with and a need to connect and to be validated were most susceptible.

Conclusions

The internet permits anonymity where trading “real world” skins with digital ones creating avatars in order to seek what is desired. Catfishing raises questions about the nature of the human self and the role it plays in deception. Understanding how patients use the internet may provide insight into how personality acts on a stage of total anonymity.

Disclosure

No significant relationships.
Prediction and classification of anxiety-related psychological scale and VR sickness based on autonomic physiological responses during VR treatment in patients with social anxiety disorder
Authors: Chun J.Y. , Kim H.-J. , Lee S. , Kim M. , Cheong T. , Cho C.-H.
Published: September 2022

Introduction

Social anxiety disorder (SAD) can accompany emotional symptoms as well as physical reactions. The assessment and real-time measurement of SAD is difficult in real-world.

Objectives

This study aims to predict the severity of specific anxiety states and virtual reality (VR) sickness in SAD patients by a machine learning model based on only quantitative measuring of autonomic physiologic signals during VR therapy sessions.

Methods

In total, 32 individuals with SAD symptoms were enrolled in VR participatory sessions. We assessed patients’ specific anxiety symptoms through Internalized Shame Scale (ISS) and Post-Event Rumination Scale (PERS), and VR sickness through Simulator Sickness Questionnaire (SSQ). Specific anxiety symptoms and VR sickness were divided into severe and non-severe states based on the total score of each scale by K-means clustering. Logistic regression, Random Forest, Naïve Bayes classifier, and Support Vector Machine were used based on the physiological signal data to predict the severity group in subdomains of ISS, PERS, and SSQ.

Results

Prediction performance (F1 score) for the severity of the ISS mistake anxiety subdomain was higher than other scales with 0.8421. For VR sickness, prediction performance for the severity of the physical subdomain was higher than the non-physical subdomain with 0.7692.

Conclusions

The study findings present that mistake anxiety and physical sickness could be predicted more accurately by only autonomic physiological signals, suggesting these features are probably associated with autonomic responses. Based on the present study results, we could provide the evidence for predicting the severity of specific anxiety or VR adverse effects only based on in-situ physiological signals.

Disclosure

No significant relationships.
Levels of intervention and support for newly presenting clients with eating disorders
Authors: Grau A. , Evans C. , Medina J.C. , Paz C.
Published: September 2022

Introduction

Clients with Eating Disorders may be treated as inpatients (IP), day hospital (DH) or community patients (Ambu). The ITAMITED study is following to treatment termination (or end of October 2025) all new clients with EDs presenting between November 2017 and October 2020 to eight centres in Spain.

Objectives

To describe to what extent initial care levels (IP, DH, Ambu) are associated with gender, age, social relationships, ED diagnosis Body Mass Index (BMI) and baseline medication.

Methods

The study is exploratory/descriptive, practice-based evidence (PBE). Consecutive new clients were approached for participation. Inclusion criteria were a diagnosis of an ED and opting in to treatment.

Results

The only variables not showing a statistically significant relationship with level were gender (no relationship), diagnosis of bulimia and use of prescribed psychostimulant medication (which was rare). OP care was associated with older age which did not discriminate between DH and IP. Similarly, being in a relationship was associated with OP care but didn’t differentiate between DH and OP. Relationships with ED diagnosis other than AN type I were complex but significant. Relationships with AN type I, BMI and being on antipsychotics, antidepressants, anxiolytics, mood stabilisers and a catch-all category of all other medication all showed an ordered relationship IP > DH > Ambu. The most powerful relationships were with BMI and diagnosis of AN type I.

Conclusions

Initial level of care is associated with many factors and strongly with many of them. This will complicate the analyses of trajectories of change but reflects the heterogeneity of this client group.

Disclosure

I am Clinical Director of ITA but analyses are prespecified. Evans, Medina and Paz are not remunerated by ITA nor related to ITA or any of its employees they would counter any pressure on analyses or reporting that might arise from my position.
Body image dissatisfaction and body regulation practices
Authors: Nikolaev E.
Published: September 2022

Introduction

Body image dissatisfaction as negative evaluation of personal physical characteristics is often associated with low self-esteem, eating and affective disorders. What body regulation practices can people resort to when they are dissatisfied with their body image?

Objectives

The goal is to determine body image practices that help people to reduce tension caused by dissatisfaction with their body image.

Methods

We obtained the data by using a focus group technique. The group comprised 43 healthy undergraduate university students of both genders. Afterwards, the data were subject to analysis and systematization.

Results

The findings revealed 11 variants that represent the spectrum of body regulation practices, which semantically can form three groups. The first group combines adaptive regulation practices that help people successfully adapt to actual life situation, develop their capabilities concerning their physiology, personality, intellectual interests, and image making. The second group combines compensatory regulation practices that mainly focus on one of the sides of body regulation, which bear a certain threat to their health (weight control, building up muscle bulk, medical cosmetology procedures, body modification). The third group includes non-adaptive body regulation practices associated with high risk to their health and personal wellbeing (auto-aggressive, hetero-aggressive, and psychopathological).

Conclusions

Information about preferable body regulation practices used by people who are dissatisfied with their body image can help predict health hazards and disorders, as well as work out targeted prevention programs.

Disclosure

No significant relationships.
Anorexia Nervosa and Gender Dysphoria: A Clinical Case
Authors: Martins J. , Vaz R. , Costa A. , Brás J. , Sousa R. , Abreu J. , Almeida E. , Casanova T.
Published: September 2022

Introduction

Eating disorders (ED) and gender dysphoria (GD) are associated with a change in body perception. Therefore, body dissatisfaction plays a common and central role in these disorders. In GD, body image concerns are related to the features of the biological sex. In ED, body dissatisfaction comes from a distorted perception of weight and body shape and plays an important role in the development and maintenance of the psychopathology.

Objectives

To present and discuss the clinical case of a patient with a previous diagnosis of GD who presented with a clinical condition suggesting a restrictive anorexia nervosa (AN).

Methods

Patient´s clinical files consultation and literature review using Pubmed and the keywords: eating disorders and gender dysphoria.

Results

We present the case of a 25-year-old patient who was living in a shelter for victims of domestic violence and was admitted for severe restrictive AN. The patient was discharged after 40 days and medicated with sertraline, diazepam and olanzapine, as well as her previous medication (hormonal therapy): cyproterone, finasteride, estradiol, oxybutynin.

Conclusions

Although studies on this subject are still scarce, there has been some progress and the literature recognizes the coexistence of these conditions. However ED symptoms in patients with GD could have a different meaning: they may represent a dysfunctional coping strategy adopted to block features of the biological sex. Therefore health professionals may take a more holistic approach to body image. Additional studies will be necessary, allowing the establishment of cause-consequence interactions between weight loss and psychopathology related to GD.

Disclosure

No significant relationships.
Impact of social media on self-esteem and body image among young adults
Authors: Molina Ruiz R. , Alfonso-Fuertes I. , González Vives S.
Published: September 2022

Introduction

The extent to which social media contributes to body image dissatisfaction and lower self-esteem is currently under debate

Objectives

This research seeks to study the relationship between the use of Instagram (one of the main platforms used by young people nowadays) and the degree of dissatisfaction with body image and the level of self-esteem among their younger users

Methods

A sample of 585 Spanish adults between 18 and 40 years old was used, to whom the Body Shape Questionnaire (BSQ), the Rosenberg Self-esteem Scale and the Social Comparison of Appearance Scale (PACS) were applied.

Results

A positive correlation was observed between the frequency of use of the social network and dissatisfaction with body image and low self-esteem. In addition, it was found that content observation time significantly predicts body dissatisfaction and low self-esteem. On the other hand, the type of content both published and observed, showed no effect on any of these variables, although it has been found that the relationship between the use of the platform and the study variables seems to be mediated by the tendency of their users to compare their appearance with others.

Conclusions

These results invite us to reflect on the use of social networks and their impact on constructs as relevant to the person as self-esteem and body image and on how different policies should be taken into account to prevent a negative impact on the mental health of their users

Disclosure

No significant relationships.
Hazards of administration of benzodiazepines in patients with adaptive hyperventilation: a case rapport
Authors: Petrykiv S. , Arts M. , De Jonge L.
Published: September 2022

Introduction

Only three population-based observational human studies provided evidence that benzodiazepines (BZD) are associated with clinically adverse respiratory outcome. Striking was the finding that BZD drug exposure was associated with a 32% significantly increased adjusted risk of all-cause mortality, including, of note, the subgroup of individuals with no comorbidities. Causation, however, cannot be inferred in observational study design and, highly likely, recipients received BZD’s in these studies to help treating anxiety related to inter alia pre-existing respiratory symptoms.

Objectives

Based on one fatal particular case, authors of current rapport explain what can go wrong when BZD’s are given in patient with respiratory impairment.

Methods

Authors provide a model on how an increase in carbon dioxide can lead to impaired cerebral autoregulation in a person with pre-existing respiratory decompensation. Discussion of integrative metabolic and vascular physiology.

Results

Case rapport of a 18 y.o. otherwise healthy man, who was hospitalized with a novel episode of diabetic ketoacidosis accompanied by profound hypocapnia and anxiety, and who deteriorated and died shortly after airway management because of a clinically important acid-base balance disturbance caused by increased carbon dioxide. All the blood tests and results of respiratory monitoring were collected and carefully assessed.

Conclusions

Current case suggests that the P(CO(2))--HCO(3) hypothesis is consistent with known data on impaired cerebral autoregulation in diabetic ketoacidosis, driven mainly by increased levels of pCO2. In our opinion, it indicates the recommendation not to administrate BZD’s in patients with pre-existing compensatory hyperventilation as it may counter to the logic of adaptive physiology.

Disclosure

No significant relationships.
Mutism. What to expect?
Authors: Santos Carrasco I. , Gonçalves Cerejeira J. , Fernández Lozano M. , Gonzaga Ramírez A. , Queipo De Llano De La Viuda M. , Guerra Valera G. , Vallecillo Adame C. , De Andrés Lobo C. , Jiménez Aparicio T. , Rodríguez Rodríguez B. , Navarro Barriga N. , Mateos Sexmero M.J. , Pérez E. , Gallardo Borge L.
Published: September 2022

Introduction

Mutism is the inability or unwillingness to speak, resulting in an absence or marked paucity of verbal output. Mutism is a common manifestation of psychiatric, neurological, and drug-related illnesses. Psychiatric disorders associated with mutism include schizophrenia, affective disorders, conversion reactions, dissociative states, and dementias. Neurological disorders causing mutism affect the basal ganglia, frontal lobes, or the limbic system.

Objectives

Outline the importance of setting a differential diagnosis of mutism in the Emergency Room.

Methods

Review of scientific literature based on a relevant clinical case.

Results

Male, 58 years old. He has lived in a residence for 3 months due to voluntary refusal to ingest. Diagnosed with paranoid personality disorder. He is refered to the Emergency Service due to sudden mutism. During this day, he has been stable and suitable with a good functionality. For 3 hours he is mutist, oppositional attitude and stiff limbs, refusing to obey simple orders. Hyperalert and hyperproxia. Not staring. After ruling out organic pathology: normal blood tests, negative urine toxins and cranial CT without alterations, he was admitted to Psychiatry for observation and, finally, he was diagnosed with Psychotic Disorder NOS.

Conclusions

Mutism most often occurs in association with other disturbances in behavior, thought processes, affect, or level of consciousness. The most common disorder of behavior occurring with mutism is catatonia. The differential diagnosis of mutism is complex. In some cases the diagnosis will be clarified only by careful observation and after a neurological evaluation. Published studies show neurological disorders presenting with mutism can be misdiagnosed as psychiatric.

Disclosure

No significant relationships.
validation of a scale for assessing patient satisfaction with the quality of care received in psychiatric settings
Authors: Razki K. , Zgueb Y. , Aissa A. , Ouali U. , Jomli R.
Published: September 2022

Introduction

The complexity of the feeling of satisfaction makes its measurement complex, in this context our work aims to develop a simple and practical measurement tool to identify problems within the processes of psychiatric care in order to provide corrective interventions.

Objectives

to validate the psychometric properties of a scale designed for us to assess patients’ satisfaction with the quality of psychiatric care received.

Methods

This is a validation study conducted on a sample of 200 patients followed at RAZI Hospital in Tunisia, outside any period of hospitalization. The questionnaire consisted of 28 items and was structured around eight dimensions (the patient’s perception of his or her own mental disorder, the quality of the doctor-patient relationship, the quality of the nursing team-patient relationship, the organisational aspect and conditions of the hospital ward, the therapeutic discharge planning, the respect of human rights, and the quality of the patient’s health, The organisational aspect and conditions of the hospital ward, Therapeutic discharge planning, Respect for patients’ human rights, Satisfaction with overall care and Loyalty.

Results

Both face validity and content validity were satisfactory. Internal consistency was sufficient with a Cronbach’s alpha of 0.913. The inter-dimensional correlation reflected statistically significant and logical correlations within our scale. Temporal stability was satisfactory. An exploratory factor analysis revealed seven factors with a Kaiser-Meyer-Olkin score of 0.852.

Conclusions

Our scale has demonstrated good psychometric properties. It can be reliably used as a measure of the satisfaction of Tunisian patients with the psychiatric care received.

Disclosure

No significant relationships.
Aging and mental health of the Chornobyl catastrophe survivors
Authors: Gunko N. , Loganovsky K. , Buzunov V. , Korotkova N.
Published: September 2022

Introduction

The Chornobyl catastrophe (ChC) has impacted on depopulation and mental health of the survivors, however, the rate of demographic aging and mental health survey remain at issue.

Objectives

To determine the rate of demographic aging of ChC survivors and to analyze the state of their mental health survey.

Methods

Information from the Ministry of Health and the State Statistics Service of Ukraine, Clinical and Epidemiological Register, the State Register of ChC survivors, and clinical neuropsychiatric data were analyzed.

Results

In 2018, compared to 1995, the number of the ChC survivors decreased by 987 thousand with high level of aging: ChC clean-up workers – 59.0%; evacuees – 25.0%, and residents of radioactively contaminated territories (RCT) – 30.7%. There are negative tendencies in age parameters of survival of the RCT population. Long-term mental health disorders and neuropsychiatric effects in the ChC survivors have been identified, which may indicate an accelerated aging. Neurophysiological and molecular-biological atypia of aging processes under an exposure to low doses of and low dose rate of ionizing radiation have been found. Existing statistical and registry data underestimate the level of mental disorders in the population of Ukraine, including the ChC survivors by an order of magnitude.

Conclusions

The negative tendencies in age parameters of survival indicate the need to continue research to identify the factors “responsible” for such changes. Mental health disorders and neuropsychiatric effects in the ChC survivors are underestimated. It is necessary to create a national psychiatric registry of Ukraine and long-term (lifelong) monitoring of survivors.

Disclosure

No significant relationships.
I am not autonomous enough! The role of autonomy beliefs in the relation between social stigma and recovery
Authors: Lampropoulos D. , Klaas H. , Spini D.
Published: September 2022

Introduction

It has been suggested that liberal values such as lack of autonomy and burden discourses shape the public’s relation toward people with health problems. However, previous research on the role of such values on one’s recovery and well-being is scarce.

Objectives

We investigated whether perceived autonomy mediates the impact of stigma and negative social experiences on life satisfaction and recovery.

Methods

Our sample, drawn from a subsample of the Swiss Household Panel survey, consisted of 326 individuals reporting a mental health problem (50.3% women, Mage = 50.7, SD = 13) and 354 individuals reporting a physical health issue (49.7% women, Mage = 53.6, SD = 14.7). We tested a model where perceived autonomy, measured with four items drawn from the Acceptance of Illness Scale (AIS), mediates the impact of experienced stigma and negative social experiences on health satisfaction and self-reported recovery.

Results

Our analysis of direct and indirect paths confirmed our hypothesis. Our model showed a good fit to the data for persons with a mental health problem (CFI = .984; RMSEA = .038) and an adequate fit for persons with a physical health problem (CFI = .92; RMSEA = .080).

Conclusions

Our results provide empirical evidence for the potentially self-stigmatizing role of the autonomy ideal for people with health problems and invite for the development of further research and practice regarding this role.

Disclosure

No significant relationships.
National Study on Mental Health and Emotional Wellbeing among Young People in Malta: Phase 1
Authors: Sacco R. , Camilleri N. , Newbury Birch D.
Published: September 2022

Introduction

Half of all mental disorders (MD) begin by age 14, however, the majority of disorders remain untreated well into adulthood due to inadequate service provision. Prevalence studies of MD among young people (YP) are needed to elucidate the current epidemiology and better service development to prevent and help YP with MD in the Maltese islands. This abstract describes the first phase of a 3-phase national study.

Objectives

1. To screen for MD among a sample of 5–16-year-olds. 2. To determine the presence or absence of a range of protective and risk factors among YP with and without a MD.

Methods

A multi-stage random sample of 800 YP aged 5-16 years were recruited from 39 schools across the Maltese Islands. Participants were screened for MD using the SDQ, SCARED, AQ10, SCOFF and AUDIT, and asked questions on life experiences.

Results

25.2% of YP were identified as being at risk of suffering from a MD (T1). Only 10% of these were referred to MHS. A greater proportion of YP identified as having a possible MD (compared to those without), were found to have a physical impairment (19%), problematic family dynamics (12%), adverse life events (T2) and parents with a history of health/social problems (T3).

Conclusions

The K-SADS will be conducted on YP identified as having a possible MD to ascertain a categorical diagnosis and establish prevalence rates for MDs as defined by DSM-5 criteria. Recommendations to improve and develop new mental health services to meet the needs for these YP will be disseminated amongst commissioners.

Disclosure

No significant relationships.
Ethnic disparities in multi-morbidity in women of reproductive age in the UK: a data linkage study
Authors: Catalao R. , Ashworth M. , Hatch S. , Howard L.
Published: September 2022

Introduction

Few studies have explored ethnic inequalities in physical and mental health in women at preconception.

Objectives

Explore inequalities in multimorbidity in women of reproductive age.

Methods

Data from Lambeth DataNet, anonymized primary care records of this ethnically diverse London borough, linked to anonymized electronic mental health records (“CRIS secondary care database”) were extracted on preconception risk factors including BMI, smoking, alcohol, substance misuse, micronutrient deficiencies and physical health diagnoses for women aged 15-40 with an episode of secondary mental health care (January 2008-December 2018) and no pregnancy codes (n=3,633) and a 4:1 age-matched comparison cohort (n=14,532) .

Results

Women in contact with mental health services (whether with or without SMI diagnoses) had a higher prevalence of all risk factors and physical health diagnoses studied after adjustment for deprivation and ethnicity. Women from minority ethnic groups [79.5% of total sample] were less likely to be diagnosed with depression in primary care compared to White British women [adj OR 0.66 (0.55- 0.79) p<0.001] and Black women were more likely to have a severe mental illness [adj OR 3.41(2.63-4.43), p<0.001]. Black and Asian women were less likely to smoke or misuse substances and more likely to be vitaminD deficient. Black women were also significantly more likely to be overweight [adj OR 4.56(3.96-5.24 p <0.001] and have two or more physical health conditions [adj OR 2.98(2.19-4.07) p<0.001] than White British women after adjustment for deprivation and SMI diagnoses.

Conclusions

Our results highlight a need for culturally centered integrative models of care across primary and secondary mental health services.

Disclosure

Closing the Gap is funded by UK Research and Innovation and their support is gratefully acknowledged (Grant reference: ES/S004459/1). Any views expressed here are those of the project investigators and do not necessarily represent the views of the Closing
Pain Medication in the Elderly Patient
Authors: Riese F.
Published: September 2022

This presentation highlights core pharmacological aspects of opioid and non-opioid pain medications in the elderly patient. Specifically, it covers pharmakinetics, pharmacodynamics and drug-drug interactions of select pain medications. The presentation aims to promote safe use of pain medications in the elderly.

Disclosure

No significant relationships.
Containing Chaos: A Self-Reflection of a Final Year Medical Student’s Elective in a High Security Psychiatric Hospital
Authors: Nieuwoudt R.
Published: September 2022

Introduction

Throughout training, medical students are often only exposed to a limited selection of psychiatric specialities, predominantly general adult inpatient settings. This medical student had the opportunity to undergo a placement at a high security forensic hospital. With only three such hospitals in England, this is an environment that few students and even qualified doctors have been able to experience. In this presentation, the author will explore their prior expectations, key skills gained, and surprising realisations that made the elective highly valuable.

Objectives

To reflect on the skills learned and revelations made during the elective period and share these as a presentation.

Methods

The author completed a 6-week placement at Ashworth High Security Psychiatric Hospital. He then reflected on his experiences.

Results

This placement allowed the development of a range of skills and personal discoveries. The skills included enhanced personal safety awareness, improved use of varied communication styles, and de-escalation and management techniques with higher risk patients. The main finding was the fine line between Ashworth’s patients and mainstream society, and how easily these two entities can overlap. Carl Jung spoke of a ‘shadow’ that must be integrated, and the humanity within each patient made this philosophical concept a sobering reality.

Conclusions

High security placements are valuable educational opportunities and teach important skills, not often found in the current medical school curriculum. These placements offer the transferable communication and interpersonal skills essential in any budding psychiatrist, and also provide a vital environment for self-reflection and personal growth.

Disclosure

No significant relationships.
Bio-psycho-social model of aggressive behaviour
Authors: Mihai A.
Published: September 2022

Introduction

The state of knowledge from scientific literature will be presented from biologic perspective, psychopathology and social context in development of agression.

Objectives

The aim of this presentation is to create a bio-psycho-socio model of agression.

Methods

The literature research in risk factors of aggressive behaviour was done, and the results grouped in three domains biologic, psychologic and social. A didactic bio-psycho-socio model was constructed.

Results

The complex picture of aggressivity could be distorted if we reduce understanding to a narrow super-specialization perspective. This presentation enlarge approach with genetic, endocrine, neurologic, psychologic and sociologic perspective. All this data will be include in a schematic bio-psycho-socio model, and describe the application in mental health practice in understanding the patients with psychiatric disorder. The main result will be a Bio-psycho-social model of aggressive behavior, which could be helpful in understanding and predicting aggressive behavior.

Conclusions

Complex perspective of aggresive behaviour could help better understand and prevent aggresive behaviour

Disclosure

No significant relationships.
The influence of child and adolescent maltreatment on personality disorders and criminal activity in adult women
Authors: Kachaeva M. , Kharitonova N. , Semenova N. , Rusakovskaya O. , Vasyanina V. , Shishkina O. , Skibina N. , Nazarova L.
Published: September 2022

Introduction

Since the rates of female criminality are rising it would appear important to conduct the study of the relationship between criminal behaviour and psychiatric diagnoses in female offenders.

Objectives

The main purpose of this investigation is to find out origins of crimes in women and to reveal the influence of child and adolescent maltreatment on personality disorders in adult women.

Methods

Clinical psychopathological, psychological, statistical.

Results

A cohort of 13 females with diagnosis of personality disorders was examined. All of them had committed crimes of violence. In the majority of the sample women had a previous history of psychiatric admissions (child psychiatric hospitals, adolescent units). The retrospective review revealed that the majority of women in their childhood were exposed to emotional, physical and sexual abuse in their families. Our results point that maltreatment may distort personality formation and social adjustment and contribute to behaviour problems, negative relation to socialization and criminal behaviour in adulthood.

Conclusions

The study revealed that psychiatric disorders in childhood and adolescence are predictive of adult criminality in females and also revealed the risk of girls who are victims of maltreatment to become a perpetrator in adulthood. This findings may be used as prognostic indicators of development of aggression in female forensic patients.

Disclosure

No significant relationships.
Use of the results of the study of oral fluid and buccal epithellium in the diagnosis of Alzheimer`s disease
Authors: Sidenkova A.
Published: September 2022

Introduction

The aim of the study was a comparative analysis of the results of neuropsychological tests with the indicators of the study of oral fluid and buccal epithelium cytograms in patients with Alzheimer’s disease.

Objectives

In the main group of 12 patients with Alzheimer’s disease, m=76.25±4.89. There were 12 cognitively healthy people in the control group. The average MMSE score among the observations of the main group was 13.42±3.63.

Methods

The ADAS-COG scale was used to detail the impaired cognitive functions. The concomitant pathology is compensated. The content of BDNF, TNF-α, IL1RA, IL-6, and IL-8 was determined in the oral fluid and in the blood serum.

Results

When analyzing buccal cytograms, attention was drawn to a pronounced increase in the number of cells with micronuclei in patients with AD to 1.8%; in the control group, the median was 0.1% (p<0.05). A direct correlation was established between the number of binuclear cells and the level of BDNF in the blood serum (r=0.646; p=0.03) in patients with AD. It is also important to note that the level of serum BDNF had a significant direct correlation with immediate memory, and the concentration of salivary BDNF correlates with the parameter of naming objects.

Conclusions

Correlations between amnesia, speech disorders, praxis, gnosis and pathology of the oral fluid and buccal epithelium, especially with the severity of karyopycnosis and karyorexis, have been established, indicating a direct correlation between the neurodegenerative process pathogenetically associated with Alzheimer’s disease and the processes of systemic inflammation and degeneration of the buccal epithelium.

Disclosure

No significant relationships.
I am the best and I have everything in life
Authors: Vallecillo Adame C. , Jiménez Aparicio T. , De Andrés Lobo C. , Gonzaga Ramírez A. , Queipo De Llano De La Viuda M. , Guerra Valera G. , Santos Carrasco I. , Gonçalves Cerejeira J. , Fernández Lozano M. , Mateos Sexmero M.J. , Rodríguez Rodríguez B. , Navarro Barriga N. , De Uribe Viloria N.
Published: September 2022

Introduction

Megalomanic ideas in a patient with limited intellectual functioning may be due to the psychotic clinic or be the result of their disability.

Objectives

This case is intended to highlight the importance of a joint approach between psychiatrists and psychologists to assess functionality before and after the psychotic episode.

Methods

34-year-old woman with no mental health history. She came to the emergency department for an episode of aggression at home. Her parents report that they have observed strange behaviour, she is more aggressive, speaks alone, changing voices and global insomnia in the last few days. Her language is incoherent and disorganised, with a long response latency. Megalomaniacal and catastrophic delusions. Possible auditory hallucinations and thought control phenomena.

Results

During admission, antipsychotic treatment was introduced with good tolerance and response on the part of the patient. She has been distancing herself from the ideas and has become somewhat critical. A psychological evaluation was carried out with different scales that showed borderline IQ.

Conclusions

It is important to make a good assessment of the patient’s symptoms in order to make a differential diagnosis. In this case, it is advisable to carry out a control and follow-up, as well as a neuropsychological assessment before and after the acute episode. In addition, a multidisciplinary approach with psychologists, psychiatrists and social workers is important.

Disclosure

No significant relationships.
Influence of assisted outpatient living in people with intellectual disabilities on individual quality of life and resilience – design of a doctoral thesis
Authors: Raczkiewicz V. , Neumann A. , Buchberger B.
Published: September 2022

Introduction

The research field of disability and mental health is politically and socially relevant, because the psychological well-being of people with intellectual disabilities has often been trivialized in therapy and legislation. Since the pursuit of mental health is coming into focus due to removal of stigma and emerging awareness, people with disabilities must have equal opportunities to choose their place of residence and get suitable psychosocial support.

Objectives

Our aim is to investigate the influence of assisted outpatient treatment (AOT) on the quality of life and resilience of people with intellectual disabilities who are living self-determined.

Methods

A participatory mixed-methods design is chosen as it enables the greatest possible standardization and allows a high flexibility. The project will be divided into three parts: A systematic literature search to gain knowledge about the field and to estimate the sample size, a pre-post-comparison of the WHOQOL-BREF to evaluate AOT in terms of self-perceived quality of life and a focus-group of handicapped people to reflect the study results with attention on resilience.

Results

To foster the doctoral thesis, several questions can be discussed: 1) How is the relation of disability and mental health to be described? 2) What might be the pros and cons of self-determined living? 3) Which steps need to be taken to implement AOT more often?

Conclusions

The topic is relevant in the public health sector and the results could help to sensitize professionals and the general society regarding to participation in everyday life. The recommendations developed may serve to implement comparable forms of housing.

Disclosure

No significant relationships.
Carer involvement in the transition from inpatient to community mental healthcare: Experiences of stakeholders
Authors: Kouroupa A. , Petkari E. , Giacco D.
Published: September 2022

Introduction

The involvement of informal carers (family and friends) in the care of people with severe mental illness (SMI) contributes to positive clinical outcomes, such as relapse prevention and symptom reduction. To date, the care pathway between inpatient and community care is not clearly defined impeding the smooth transition for patients, whilst carers are still barely involved in shared decision-making processes.

Objectives

To investigate the views and experiences of patients with SMI, carers and clinicians regarding the transition from inpatient to community mental health services.

Methods

Four mixed focus groups were conducted with individuals with SMI (n=12), carers (n=10) and clinicians (n=9) across four different mental health catchment areas in England. Participants discussed their experiences and provided their views on facilitators, barriers and solutions for carer involvement during the transition between mental health services. Data were analysed using thematic analysis.

Results

All stakeholders highlighted that factors that impede carer involvement are related to: confidentiality issues, unmet (structural and organisational) needs, and carer expectations. Patients with SMI, carers and clinicians agreed that carer involvement can be improved by providing psychoeducation to carers and training to staff, having accessible and transparent clinical procedures, and allocating specialised staff to carers.

Conclusions

The study findings emphasise that carer involvement is still overlooked, particularly when adults with SMI transition between services. The results provide guidance for practice emphasising the need for systematic involvement of carers across inpatient care, and for future research proposing effective ways of maximising carer involvement in mental health care.

Disclosure

No significant relationships.