bluuebunny/crossref_metadata_2025 huggingface dataset:
Paliperidone palmitate 6-month formulation for the treatment of schizophrenia: a 14-month follow-up study
Authors: Romero Guillena S. L. , Marín Mateos H. , Rodriguez Menendez G.
Published: August 2024

Introduction

Relapse prevention is critical because psychopathology and functionality can worsen in patients with schizophrenia because the repeated episodes and we have strong evidence of antipsychotics efficacy for relapse prevention, but nonadherence rates in patients with schizophrenia are very high, even in comparison with other illness.

There is extensive clinical trial evidence for the use of paliperidone palmitate 1-month (PP1M) and paliperidone palmitate 3-month (PP3M) formulations for maintaining treatment continuity and preventing relapses and risk of hospitalizations in patients with schizophrenia. (Najarian et al. Int J Neuropsychopharmacol 2022; 25(3) 238-251). Paliperidone palmitate 6-month (PP6M) formulation is a presentation that provides a dosing interval of once every six months.

Objectives

The principal aim of this study was to evaluate the effectiveness, safety, and tolerability of the PP6M in patients with non-acute schizophrenia on an outpatient basis

Methods

Methods: Sample: 22 patients diagnosed with schizophrenia (DSM 5 criteria) that started treatment with PP6M after being stabilized with PP1M (N:10) or PP3M (N:12) (the treatment dose was not changed in the four months before study inclusion)

Bimonthly, the following evaluations were performed during a follow-up period of 14 months:

The Clinical Global Impression-Schizophrenia scale (CGI-SCH)

Treatment adherence, concomitant medication, adverse events and the number of hospitalizations and emergency visits

Efficacy values: Percentage of patients who remained free of admissions at the end of 14months of follow-up.

Other evaluation criteria: Percentage of patients who never visited the emergency department at the end of 14 months of follow-up, average change from baseline visit to the final evaluation as assessed by score obtained on the following scale: GSI-SCH, treatment adherence rate and tolerability.

Results

The percentage of patients who remained free of admission at the end of the 14 months follow-up was 90% in the total sample, 83% in the PP3M pre-treatment group and 100% in the PP1M pre-treatment group.

The percentage of patients who never visited the emergency department at the end of 14 months follow-up was: 81% in the total sample, 75% in the PP3M pre-treatment group and 90% in the PP1M pre-treatment group.

At the end of the study, a mean change of +0.12 (±0.11) on the ICG-SCH-SI scale in the total sample, +0.25 (±0.21) in the PP3M pre-treatment group and 0 in the PP1M pre-treatment group.

The treatment persistence rate at the 14 month of follow-up was 100% in the total sample.

Treatment was well tolerated, and no safety-related adverse events were collected. There were no tolerability-related withdrawals from treatment.

Conclusions

In our study, we found that long-term treatment with paliperidone palmitate 6-month formulation is effective and well tolerated in clinical practice conditions.

Disclosure of Interest

None Declared
Insight evaluation in a Tunisian stabilized outpatients with schizophrenia
Authors: Ajmi S. , Bouhamed M. , Makni K. , Masmoudi R. , Feki I. , Sallemi R. , Masmoudi J.
Published: August 2024

Introduction

Schizophrenia is a chronic condition that leads to major socio-professional disintegration and personal suffering. In addition to the classic clinical symptoms, these patients also suffer from poor insight.

Objectives

To assess insight in a population followed up for schizophrenia

Methods

We conducted a cross-sectional and descriptive which concerned the patients followed in the unit of outpatient post-cure consultations of psychiatry ‘A’ at the CHU Hedi Chaker of Sfax. We included 72 stabilized patients diagnosed with schizophrenia according to the DSM criteria 5. For the collection of sociodemographic and clinical data, we used a pre-established sheet. We used the schedule for the Assessment of Insight–Expanded Version(SAI-E) scale to assess clinical insight

Results

The mean age of the patients in our study was 46.83 ± 11.6 years, with a sex ratio (M/F) of 2.

They were single in 48.5%, and unemployed in 69.4%. Their level of education did not exceed primary school at 44.4% and their socio-economic level was low at 63.9%.

In our study, 72.2% of patients had no somatic history and 36.1% had a history of attempted suicide.

Using the SAI-E scale, the mean score was 20.1 with a minimum of 5 and a maximum of 28.

Conclusions

At the end of this evaluation, it is important to emphasize that insight seems to be an important prognostic factor.

Disclosure of Interest

None Declared
Do attachment styles influence the sexual function of an individual?
Authors: Rodrigues J. C. , Soares T. P. , Ribeiro L. M.
Published: August 2024

Introduction

Attachment theory, first proposed by John Bowlby and later extended by Mary Ainsworth and others, outlines how experiences of early childhood attachment with caregivers can affect one’s emotional and interpersonal relationships throughout adulthood. Typically, attachment styles are categorised into four main types: secure, anxious-ambivalent, avoidant and disorganised. Conversely, it is recognised that various biological, psychological, relational, social and iatrogenic factors elements can impact an individual’s sexual function.

Objectives

Our aim with this research was to present the most current literature on whether there is a correlation between attachment styles and sexual function.

Methods

We conducted a non-systematic review on the topic using PubMed and PsycInfo.

Results

There is evidence indicating a link between attachment styles and sexual function.

People with secure attachment styles tend to experience more positive and fulfilling sexual relationships. Such individuals typically have a more positive self-image, they feel at ease with emotional intimacy, and are therefore able to openly communicate their needs and desires. They exhibit a healthy balance between seeking closeness and maintaining independence.

Individuals with anxious attachment styles may experience heightened levels of sexual anxiety and insecurity. Concerns regarding rejection or abandonment within sexual relationships may impact their sexual function and satisfaction. These individuals usually have a negative self-image and may be more prone to seek reassurance and validation through sexual activities.

People with avoidant attachment styles may encounter obstacles in developing emotional intimacy and closeness, which can negatively affect their sexual relationships. Such individuals might experience commitment anxiety and prioritise physical aspects of sexual activity over emotional bonding, ultimately decreasing sexual satisfaction for both them and their partners.

Disorganised attachment styles are linked with challenges in regulating their emotions and behaviours in intimate situations, which can have a negative impact on sexual function and satisfaction.

Conclusions

While the literature proposes attachment styles may impact sexual function, it is important to acknowledge other factors that contribute to sexual function. In addition to biological and iatrogenic factors, individual personality, relationship dynamics, past experiences, and cultural influences all have a significant role in shaping one’s sexual behaviour and satisfaction. All of these should be addressed in order to alleviate sexual difficulties.

Moreover, attachment styles may develop and change over time through positive relationships and therapeutic interventions, potentially leading to changes in one’s sexual functioning and relationship dynamics.

Disclosure of Interest

None Declared
Geographical variation in compulsory mental health care: cause for concern and source of causal inference
Authors: Hofstad T.
Published: August 2024

Introduction

Compulsory mental health care remains a controversial practice. The many difficulties in performing Randomised Controlled Trials (RCT) on the topic means there is limited evidence to support its effectiveness. For ethical and legal reasons, compulsory mental health care should only be used when necessary. Yet, geographical variations, which can indicate both overuse and underuse, have been observed. In the funded research project “Controversies in Psychiatry” we intend to use this variation as a source of knowledge production. We propose that this naturally occurring variation mimics randomisation, and can therefore permit causal inference from registry data.

Objectives

We will estimate the causal effect of compulsory inpatient mental health care on a range of outcomes, including injuries, self-harm, and all-cause mortality; violent crime; employment vs benefit allowance; rehospitalisation and outpatient commitment.

Methods

Observed variation in register data on all episodes of compulsory inpatient mental health care in Norway between 2015-2016 (N ≈ 300 000), will serve as a source of as-random variation. Provider-preference for compulsion usage will be used as an instrumental variable (IV).

Results

Outcomes will be observed from 2017-2025. If assumptions underlying IV-analysis do not hold, the project will still provide important and complete descriptive data on long-term outcomes for a whole population.

Conclusions

Geographical variation is a cause for concern if people are treated differently depending on area of residence. But it also presents an opportunity to use differences in service provider’s preference for using compulsory care as an instrumental variable to estimate the causal effect of compulsory care on multiple short and long-term outcomes. This approach can help resolve controversies that are difficult or even impossible to investigate through RCTs. After presenting the project plan we invite to a discussion of the feasibility of using an instrument variable approach to explore if relatively low versus high rates of compulsory care produce favorable outcomes for patients.

Disclosure of Interest

None Declared
Sleep disorders among women with post-menopausal osteoporosis
Authors: Feki A. , Sellami I. , Trabelsi B. , Gassara Z. , Ben Djemaa S. , Abbes A. , Ezzeddine M. , Kallel M. H. , Fourati H. , Akrout R. , Mejdoub Y. , Baklouti S.
Published: August 2024

Introduction

Osteoporosis (OP) is characterized by low bone mass and microarchitectural deterioration of bone tissue. Recent studies have suggested that sleep may significantly influence the pathophysiology of OP.

Objectives

In the present study, we aimed to determine sleep disorders among women with post-menopausal
OP.

Methods

A cross-sectional study was conducted between January and June 2023. Patients with post-menopausal OP who visited the rheumatology department in a university hospital in Tunisia were interviewed. The Pittsburgh Sleep Quality Index (PSQI). It is a seven-component scale, including: sleep quality (C1), sleep latency (C2), sleep duration (C3), sleep efficiency (C4), sleep disturbances (C5), sleep medication use (C6), and daytime dysfunction (C7).PSQI ≤ 7 indicated normal sleep quality, and PSQI > 7 indicated poor sleep quality.

Results

Ninety-three women diagnosed with post-menopausal OP were interviewed. the number of complete questionnaires was 72. The valid rate was 77.4%. All were women. The mean age was 72.5 (±1.08). The median duration of menopause was 23 years (IIQ= [10.5-28.5]). Forty-five women were diagnosed with bone fractures (62%). Thirty-three patients (45.8%) were obese (IMC>30). The median PSQI score was 16 (IIQ = [6-18]). Forty-seven participants (65.3%) had poor sleep quality (PSQI > 7). According to the items of PSQI: the median score of sleep duration, sleep Efficiency and sleep disturbances was 1 (IIQ= [1 -2]) for each item. The median score of sleep latency was 3 (IIQ=[2-3]). For daytime dysfunction, the median score was 2 (IIQ=[0-3]).

Study analytics revealed a significant association between daytime dysfunction and the presence of bone fractures (p=10-3), the same was with sleep disturbances and bone fractures (p=10-3). Body mass index (BMI) was significantly and inversely associated with sleep quality (r= -0.313; p= 0.007). Sleep latency was significantly associated with physical activity (p<10-3).

Conclusions

In conclusion, our results suggest that sleep quality is associated with physical activity and BMI. This is consistent with the most recent evidence in the literature. These findings support expanding the scope of wellness programs to promote healthy sleep among osteoporotic women.

Disclosure of Interest

None Declared
How effective is ketogenic diet in sleep disorders ?
Authors: Kouki N. , maamri A. , kouki N. , zaafrane M. A. , Hajri A. , zalila H.
Published: August 2024

Introduction

Sleep disorders vary widely and its treatment are based on a combination of life style changes and pharmacological therapy adapted to the primer health issue. Ketogenic diet has shown not only its efficacy in different health conditions, but it is also becoming a popular health trend. Could the therapeutic spectrum of ketogenic diet cover sleep disturbances ?

Objectives

The aim of our study is to evaluate the effect of ketogenic diet on sleep disorders

Methods

To identify relevant studies ,our literature review was based on the Pubmed interface and adapted for 2 databases : science direct and google scholar. We used the following key words ( ketogenic diet [meSH terms]) and (sleep disorders [meSH terms]).

Results

Our research revealed 14 articles published between 2012 and 2022. We selected 8 which corresponded to the purpose of our review. The ketogenic diet affects sleep hemostasis indirectly. In fact, this diet is associated with weight loss and therefore reduction of metabolic and cardiovascular complications disturbing sleep quality.  From a neurobiological perspective, this regimen based on limited carbohydrates is associated with a low Tryptophan intake which is the precursor of melatonin. But on the other hand, Ketone bodies trigger adenosine activity which promotes melatonin liberation, the sleep inducing hormone.

Conclusions

Ketogenic diet modulates melatonin activity therefore affects sleep architecture. Meanwhile, Its impact on sleep disorders is still controversed due to the variation of its pathophysiological mechanisms.

Disclosure of Interest

None Declared
Suicidal impulsivity secondary to traumatic brain injury
Authors: Fernandez Logroño J. , Vazquez Arjona C. I. , Romero Mañas I.
Published: August 2024

Introduction

I present the case of a 58-year-old patient who developed frequent, unpredictable and prolonged suicidal impulsivity (more than 8 years of evolution) after one year of suffering a traumatic brain injury, with very serious suicide attempts in the context of very brief periods of dysthymia and no history of mental illness or any other accompanying psychopathology.

Throughout this admission, a progressive dehospitalization has also been carried out, with afternoon outings in the company of his wife or son up to a full weekend.

Objectives

Shortly before, frequent “déjà vu” crises had also begun. Additional imaging tests (CT and cranial MRI) had been performed privately, which had been normal, and an EEG with sleep deprivation had been requested, but the patient had not attended.

For 8 years he had started various successive antidepressant treatments that had always been ineffective or had produced agitation, which was diagnosed as akathisia, after a week of treatment. In a single previous hospital admission, with the initial diagnosis of major depressive disorder finally ruled out, he was discharged apparently asymptomatic, and was readmitted after making three new successive serious attempts at self-lysis a week after discharge.

Methods

Throughout this hospitalization (37 days), a practically invariable mental state is observed from the first day in which only rambling thoughts with very limited content stand out, with permanent and apparently credible criticism regarding previous self-harming behaviors, without appearance of new impulses or self-harming behaviors and reporting a significant decrease in the frequency and emotional impact of “déjà vu” type crises, which are now limited to the moment of waking up in the afternoon, after a brief nap, and occasionally.

Results

He was discharged from the hospital with the diagnosis of post-concussive syndrome (ICD 10-F0.78.2) and remains stable for the moment (one month later) in improvement, maintaining anxiolytic and antidepressant treatment, as well as anticonvulsants, and pending continuation of the study for part of neurology.

Conclusions

We think that this case shows how, within the immense etiological variety of suicidal behavior, there may be a cause conditioned exclusively by brain damage.

Disclosure of Interest

None Declared
Anhedonia and suicidal ideation in young people with early psychosis: findings from a 2-year Italian follow-up study.
Authors: Pelizza L. , Poletti M. , Raballo A. , Di Lisi A.
Published: August 2024

Introduction

Hedonic deficits have been extensively studied in schizophrenia, but little is known about their association with suicidal ideation in early psychosis. Along the clinical staging of psychosis, also Ultra-High Risk (UHR) individuals are characterized by hedonic deficits, which are currently considered as putative predictors of both psychosis conversion and poor social/role functioning.

Objectives

The aim of this research was to examine the relationship between anhedonia and suicidal thoughts across a 2-year follow-up period in people with First Episode Psychosis (FEP) and at Ultra High Risk (UHR) of psychosis.

Methods

Ninty-six UHR and 146 FEP, aged 13–35 years, completed the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the Beck Depression Inventory-II (BDI-II). The BDI-II “Anhedonia” subscale score to assess anhedonia and the CAARMS “Depression” item 7.2 subscore to measure depression were used across the 2 years of follow-up. Hierarchical regression analyses were performed.

Results

No difference in anhedonia scores between FEP and UHR individuals was found. In the FEP group, a significant enduring association between anhedonia and suicidal ideation was found at baseline and across the follow-up, independent of clinical depression. In the UHR subgroup, the enduring relationship between anhedonia and suicidal thoughts were not completely independent from depression severity.

Conclusions

Anhedonia is relevant in predicting suicidal ideation in early psychosis. Specific pharmacological and/or psychosocial interventions on anhedonia within specialized EIP program could reduce suicide risk overtime.

Disclosure of Interest

None Declared
Experiences of the first two pandemic years (2020 and 2021) in regards of the alteration of violent suicide attempts compared to 2016-2021. Presenting demographic features. Research made at Dr. Manninger Jenő National Traumatology Center, Hungary
Authors: Szeifert N. M. , Sebők B. , Szilágyi S. , Bérdi M.
Published: August 2024

Introduction

During the pandemic years in Hungary the completed suicide rates hasrisen significantly. Suicide rates had been decreasing until 2019 since 1986. In 2019, 1550 people dead by completed suicide, in 2020 this number increased to 1705, in 2021,1561 cases were registered. Violent suicide attempts represent the majority of completed suicides.

Objectives

In our study we were analysing the number of alteration of violent suicide attempts between 2016-2021, focusing on the trend in the first two years of the pandemic outbreak. 228 inpatients (65,4% male, 34,6% female) gone under medical treatment due to violent suicide attempts between 2016-2021 at Dr. Manninger Jenő National Traumatology Center, Budapest, Hungary.

Methods

We used an interrupted time-series analysis with Prais-Winsten regression, controlling autoagressive and seasonal effects, to estimate the effect of the pandemic years on the violent suicide attempt rates in our sample. Demographic features, risk factors for suicidal behaviours, motivation and methods were analysed by Chi-square test and cross tabulation.

Results

Comparing to the previous years, in the first two pandemic years significantly has risen the number of inpatients treated because of violent suicide attempts. After the rapid change in 2020, decreasing numbers could be observed in 2021.

Conclusions

Analyzing the numbers of violent suicide attempts between 2016 and 2021, an increase inthe number of attempts was observed during the first two pandemic years. Detailed demographic data and potential risk factors are also to be presented in the lecture.

Disclosure of Interest

None Declared
A Pilot Predictive Model for Indirect Assessment of Suicidal Ideation
Authors: Rus Prelog P. , Matić T. , Pregelj P. , Sadikov A.
Published: August 2024

Introduction

In recent years, there has been a concerning increase in suicidal thoughts and, in some countries, completed suicides, amplified by the COVID-19 pandemic. Screening for suicidal ideation (SI) in the general population is limited due to ethical, effectiveness, and feasibility concerns. Identifying individuals at risk of suicide remains a complex challenge. Our study aimed to develop a predictive model using COVID-19 data, gathering psychometric information from 1790 respondents in Slovenia via an online survey conducted between July 2020 and December 2020, with a second wave of data (ne=1200) collected from January 2022 to February 2022.

Objectives

With 9.7% of respondents reporting recent SI in the first wave of data, our primary goal was to estimate SI indirectly using SIDAS. We examined changes in habits, demographics, coping strategies, and satisfaction in key life aspects to discreetly identify potential risk factors.

Methods

We employed four machine learning algorithms (logistic regression, random forest, XGBoost, and support vector machines) and assessed model performance using the area under the receiver operating characteristic curve (AUC). Initial assessment used a held-out dataset, followed by validation with a new cohort of 1,200 users from the late COVID-19 period.

Results

Logistic regression, random forest, and XGBoost achieved comparable AUCs, reaching 0.83 on unseen data. Our analysis revealed significant associations between Brief-COPE subscales and SI. Self-Blame emerged as a strong SI indicator, followed by increased Substance Use, reduced Positive Reframing, Behavioral Disengagement, dissatisfaction with relationships, and younger age, in both 2020 and 2022 models. The model consistently performed well, even with varying population characteristics.

Conclusions

These results suggest that SI presence can be reasonably estimated using selected indicators, offering promise for developing an indirect screening tool without explicit questioning about suicidal thoughts. However, individuals flagged as at-risk should undergo clinical examination, as this model serves as an initial step in identifying SI risk factors in the context of the stressful event’s (COVID-19 pandemic) impact on mental health.

Disclosure of Interest

None Declared
The Epidemic of Non-Suicidal Self-Harm in Adolescents and Young Adults in the Kyrgyz Republic
Authors: Molchanova E.
Published: August 2024

Introduction

During the last two years, many young people and adolescents in the Kyrgyz Republic started to visit specialists due to Non-suicidal self-harm. A significant rise in the amount of such cases allowed specialists from the Republican Center of Psychiatry in Bishkek to think about an “epidemic “of self-harming behavior.  Non-suicidal self-harm (NSSH) is defined as repeated, deliberate, direct injury to the body without suicidal intent that is not socially acceptable (Nixon et al., 2002) to reduce psychological discomfort in the absence of a conscious intention to take one’s life (ICD-10 codes X60-X84, and ICD-11 codes PB80-PD3Z).

Objectives

To determine the causes of NSSH among adolescents and young adults who approached specialists in mental health sphere at Institute of Behavioral Health at the American University of Central Asia.

Methods

Over two years, forty-five adolescents and young adults under twenty-five who had committed self-harm visited specialists from the Behavioral Health Institute at the American University of Central Asia.

All the patients received either dialectical behavioral treatment or cognitive processing treatment, medication (paroxetine) was used in three cases.

Results

Thirty patients were girls under twenty-one, and fifteen were boys and young male adults. The overwhelming majority (40 people) had self-inflicted cuts, two had imposed burns with matches and cigarettes, and one had used self-suffocation without a bond. Reasons for self-harm were the following: releasing internal tension and anxiety, getting some rest from intrusive thoughts, relieving the inner pain, and a desire to “feel as a whole person.” All the patients underlined that they did not want to attract attention from their family members; moreover, they tried to hide the consequences of self-harm.

Teens and young adults (twelve patients) from Kyrgyz traditional families visited a consultant or psychiatrist after a long drive through conventional or religious healers. All of the patients knew that they were addicted to self-harm, wanted to stop a problematic behavior, and could not stop it on their own. Ten patients have been diagnosed with borderline personality disorder. Two of them also had eating disorders. Five patients had PTSD, and five had social phobia. The others had recognizable anxiety symptoms.

Conclusions

The enormous rise of non-suicidal self-harm is a phenomenon that needs further research. Those cases often resist treatment due to the “addictive” component in the pathogenesis.

Disclosure of Interest

None Declared
Deliberate self-poisoning in children and adolescents
Authors: Hmimou S. , Boukhorb S. , Irnat S. , Hadrya F. , Rhalem N. , Bellimam M. A. , Soulaymani A. , Mokhtari A. , Soulaymani-Bencheikh R. , Hami H.
Published: August 2024

Introduction

Suicide is a significant global public health issue that has a severe impact on children and adolescents.

Objectives

This study examined the epidemiological features of self-poisoning events among these groups in Morocco.

Methods

In this retrospective study, data on intentional poisoning cases among children under 15 years of age and adolescents aged 15-19 years were analyzed. The Moroccan Poison Control Center has reported these cases over a period of 34 years.

Results

During the study period, 7,111 deliberate self-poisoning cases were documented among children and adolescents, representing 30% of all reported self-poisoning cases (out of a total of 23,711 cases with known ages). The vast majority of the cases (80.8%) involved females, indicating a significant female-to-male ratio of 4.2. The patients had a mean age of 16.05 ± 2.10 years. Notably, drugs were the predominant method of self-poisoning, comprising 51.7% of the cases, followed by pesticides at 31.3%. The symptoms of poisoning manifested with significant variation, contingent on the type of toxin involved, the amount ingested, and the time passed before medical care was administered. Of the 4,711 cases with known outcomes, 144 (3.06%) were fatal. Nonetheless, the outcomes were favorable for the remaining cases, with or without lasting sequelae.

Conclusions

The ongoing prevalence of suicide and suicide attempts among children and adolescents is a prominent issue in public health. Our research emphasizes the crucial necessity to address suicide, as it remains one of the primary causes of mortality in young individuals.

Disclosure of Interest

None Declared
Enhancing Psychiatry Resident Bonding and Education using an Escape Room Challenge Activity
Authors: Lee G. , Russell G. , Farhan H. , Lin J. , Spring L.
Published: August 2024

Introduction

An “escape room” is a game requiring teamwork and problem-solving during which a series of puzzles are solved to escape a locked room. Various escape room activities have been designed for healthcare professionals, including internal medicine residents and nursing students (Anderson et al. Simulation & Gaming 2021; 52(1) 7-17; Rodríguez-Ferrer et al. BMC Med Educ 2022; 22:901; Khanna et al. Cureus 2021; 13 (9) e18314). Escape rooms provide an opportunity for social activity, an important component of resident wellness (Mari et al. BMC Med Educ 2019; 19(1):437). This abstract describes an escape room challenge designed and implemented at our psychiatry residency program quarterly wellness afternoon event, which is an afternoon session dedicated to resident wellness.

Objectives

The objective of this project was to design and implement an escape room challenge containing multiple game mechanics, including hidden roles, information asymmetry, acting, logical deduction, and spying. This activity was conducted to enhance bonding among residents while reinforcing knowledge in psychiatry.

Methods

We designed and implemented an escape room for 22 residents. Residents were divided into four teams each tasked with completing a sequence of puzzles to open the final lockbox. Two novel mechanics were added to the activity. Each team had a “clue holder” with clues to help solve all the puzzles. This team member had to conceal their identity because, if any of the other teams identified this person, the original winning team would have to give up the prize to the team that guessed the identity of this person. One member of each team was assigned a “spy” role whose mission was to make it hard for the clue holder to reveal all the clues. An anonymous post-activity survey was completed using Google Forms.

Results

The script was set in a fictional, abandoned psychiatric emergency room. The first task was a visual puzzle of a historic figure in psychiatry. The second activity involved residents guessing the psychotropic medication being acted out by another resident in the style of charades. The third activity required residents to apply developmental milestones to decode a combination lock. The fourth puzzle involved residents solving riddles by using information gathered from resident profiles on the residency program website.

Eleven (50%) residents completed the post-game survey. All residents answered true or very true that they enjoyed the game and that participation helped them better connect with their peers. Eight (73%) residents answered true or very true that they learned something from the activity.

Conclusions

An adapted escape room challenge is a novel wellness activity that enhance resident collegiality, teamwork, and bonding. All residents who completed the post-activity survey indicated that they enjoyed the activity and felt more connected to their peers afterwards.

Disclosure of Interest

None Declared
A Case of Severe Polyhydramnios During Pregnancy Associated with Long-Term Use of Lithium
Authors: Stoppa A. , Roda E. , Hernández A. S. , Roca A.
Published: August 2024

Introduction

The perinatal period poses heightened vulnerability to bipolar affective episodes. Lithium serves as first line in the management of bipolar disorder, demonstrating efficacy in stabilizing mood episodes and preventing relapses. Therefore, it also a recommended treatment during the pregnancy period. However, its use presents potential risks for both the mother and the developing fetus. Given the prevalence of bipolar disorder in reproductive-age women, it is crucial to investigate the risks associated with lithium use during pregnancy, along with its subsequent obstetric and neonatal complications.

Objectives

This report outlines a case of severe polyhydramnios in a 42-year-old primigravida patient, under long-term lithium and antipsychotic treatment. Additionally, a systematic search for similar case reports was conducted to provide an overview of the existing literature.

Methods

The patient’s medical history and perinatal medical care are documented in this case report. A systematic literature search on MEDLINE (PubMed) was conducted using Boolean operators.

Results

The patient was diagnosed with bipolar disorder type I and had a history of lithium treatment for over 20 years, supplemented later with antipsychotics. During her pregnancy, she experienced a polyuria-polydipsia syndrome and a severe polyhydramnios. She also suffered renal impairment. Together, it is indicative of a nephrogenic diabetes insipidus (NDI), likely induced by prolonged lithium treatment. As the pregnancy progressed, she experienced premature rupture of membranes at 34 weeks and 5 days. The newborn needed medical support and was admitted to the neonatal unit, without further complications.

Systematic research showed three published case reports describing nephrogenic diabetes insipidus (NDI) and polyhydramnios associated to lithium treatment.

Conclusions

Chronic administration of lithium may contribute to the development of resistance to antidiuretic hormone (ADH), leading to polyuria-polydipsia syndrome and potentially severe obstetric complications. The co-administration of lithium and antipsychotics may exacerbate these effects. Further research is needed to elucidate their combined clinical impacts.

Disclosure of Interest

None Declared
Conjugal violence in Tunisia: the characteristics of marriage
Authors: Jbir R. , Aribi L. , Chaari I. , Samet A. , Ben jemaa R. , Messedi N. , Aloulou J.
Published: August 2024

Introduction

Violence is a global phenomenon, destroying the fabric of society and threatening the lives, health and prosperity of all. In recent years, there has been an upsurge in domestic violence in Tunsia. Unfortunately, few studies have focused on the relationship within these couples.

Objectives

To describe the characteristics of marriage between Tunisian couples where domestic violence prevails.

Methods

Our study was descriptive and analytical cross-sectional, carried out with women victims of domestic violence examined in the context of psychiatric expertise.

An anonymous survey was asked to these ladies concerning the socio-demographic characteristics of the wife and spouse and the characteristics of the marriage.

Results

Our population was made up of 122 couples. The average age of ladies was 35.66 years (from18 to 64 years). As for the spouses, their average age was 41.68, with extremes of 22 and 70.

92,6% of couples had at least one child.

Professionally, (6.6%) of the husbands were inactive and 51.6% (n= 63) of couples had an average socio-economic level.

43.4% (n=53) lived in rented houses, 41% (n=50) owned their own homes, 14.8% (n=18) lived in a room with their in-laws and 0.8% (n=1) were homeless.

The average duration of marriage in our study was 11.16 ± 9.12 years and extremes of 1 and 40 years.Judicial records were found in 28.7% of assailants (n=35).The majority of women surveyed, 92.6% (n=113), were victims of three types of violence at once (verbal, psychological and physical). Sixty-two women (50.8%) were victims of four types of violence simultaneously (verbal, psychological, physical and sexual).Various causes of violence were reported, dominated mainly by claims for money, sexual problems, drunkenness and infidelity, with prevalence rates of 38.5%, 23.8%, 22.1% and 21.3% respectively.The majority of women, 66.4% (n=81), had been assaulted by their spouses during the first year of marriage. Forty-seven ladies (38.5%) were subjected to violence on a daily basis.According to the survey, 86.9% of women have been assaulted at least once before, and 38.7% of them have reported previous assaults to the police.The first person contacted after the violence was the mother, with a percentage of 48.4% (n=59).53.3% of ladies were assaulted during pregnancy, 43% of whom suffered obstetrical complications of varying severity.

Conclusions

According to our results, there is no typical profile of a couple where conjugal violence can reign.

Neither the length of the marriage nor pregnancy prevented the woman from being a victim of domestic violence.

Disclosure of Interest

None Declared
Domestic violence in Tunisia: which forms of physical violence?
Authors: Jbir R. , Aribi L. , Chaari I. , Guermazi F. , Samet A. , Bouattour N. , Messedi N. , Aloulou J.
Published: August 2024

Introduction

Domestic violence is a universal phenomenon that destroys the fabric of society and threatens the lives, health and prosperity of all.

It can take different forms, including physical abuse. This is one of the most serious form of violence, as it can range from a simple shove to homicide.

Objectives

To determine the prevalence and describe the various forms of physical violence perpetrated by husbands against their wives.

Methods

We contacted women who consulted at the psychiatric emergency of ‘Hedi Chaker hospital’,Sfax examined in the context of medical expertise on the period between May 2021 until January 2022.

A questionnaire regarding the violence was asked to responders. It included a section for collecting socio-demographic and clinical data on the woman, and a section for assessing the various forms of domestic violence.

Results

122 women were surveyed. The average age of victims was 35.66 years with extremes of 18 and 64 years. 78.7% (n=96) of ladies were of urban origin. The majority of them (44,3%) had secondary level education.

The half of the population (51.6%) had an average socio-economic level and 43.4% (n=53) lived in rented houses.

All the women of our population were married: it was the first marriage in (89.3%) and the majority (86.1%) had children.

Almost all women (95.1%; n=116) were victims of physical violence.

Different types of physical violence were reported with decreasing prevalence: slap (65,6%), punch (58,2%), strangle (46,7%), kicking (38,1%), stabbing threat (28,7%), kidnapping (4,9%), and gun threat (3,3%).

Should be noted that some women experience different forms of violence simultaneously.

Conclusions

Our study showed a high prevalence of physical violence with different shapes.

These figures must be taken into account by the authorities given the gravity of physical and psychological consequences of this form of violence.

Disclosure of Interest

None Declared
Women with borderline personality disorder and pathophilia: understanding causes of pandemic diffusion of transmissible diseases through samos syndrome
Authors: Lazzari C. G. , Rabottini M.
Published: August 2024

Introduction

When faced with perilous transmittable infections, individuals defend themselves or welcome them, such as the Samos Syndrome, a pathophilia (people attracted by illnesses). As borderline personality disorder (BPD), found in Samos Syndrome, becomes more common, so will people who reject primary protection from transmittable diseases and health behaviour as their choices. Pandemics would sinisterly draw pathophilies and persons with borderline personality disorder who migh surf pandemics risk as a parasuicidal behaviour.

Objectives

To investigate why pandemics (HIV, COVID-19) cannot be stopped. We have conducted a long-term assessment of HIV-discordant couples where a female partner, HIV-negative, voluntarily chooses to decline any prevention during stable and consensual relationships with HIV+ve partners. We also explored sociodemographic data that could explain health behaviours and condom use in HIV serodiscordant couples at risk of pandemic diffusion, those where one of the partners, usually male, already has a transmissible disease.

Methods

We used a mix of naturalistic and ethnographic approaches to understand the dynamics of Samos Syndrome. We also utilised a questionnaire to extract salient points in the sexual prevention of HIV infection. We assessed 475 HIV-serodiscordant couples.

Results

Pathophilia is defined as an excessive, abnormal desire to be sick, also known as nosophilia, from the Greek word ‘pathos’ indicating illness and ‘philia’, meaning attraction. Women diagnosed with BPD can become high diffusers during pandemics of transmissible diseases as suffering from pathophila, a form of parasuicidal behaviour. In the couples assessed, when the HIV-negative woman comes from a socially disadvantaged family, the couple uses condoms in 87% of cases (p<0.001); when she comes from a middle-high class, the couple uses condoms in 59% (p<0.001) of sexual relationships. Suppose the HIV-negative female partner has conflicting relationships with their parents. In that case, condom use is only in 40% (p<0.001) of cases, compared to 83% (p<0.001) of instances where she has a good relationship with parents. If the female partner with BPD has a higher level of education than the HIV+ve partner the frequency of use if 90% (p<0.001) of cases compared to 60% (p<0.001) of instances where she has the same level of education as the male partner.

Conclusions

The current study confirms that female persons diagnosed with BPD are at high risk of becoming high diffusers during transmissible diseases and pandemics. Parasuicidal behaviours and self-harm in BPD could increase the risk of entering into relationships with persons who are already infected by sexually communicable diseases or are at risk of diffusing viral infections (HIV and COVID-19).

Disclosure of Interest

None Declared
Prospective mortality in patients with non-fatal deliberate self-harm: a national cohort study
Authors: Qin P.
Published: August 2024

Introduction

Deliberate self-harm (DSH) is a strong indicator of psychological distress and constitutes a significant risk factor for subsequent mortalities.

Objectives

In this study we want to gain insights into cause-specific mortalities in self-harming patients and to disentangle important factors differentiating the risks so that to inform follow-up care and mortality prevention.

Methods

Retrospective data from nationwide registries were interlinked to follow all patients presenting to specialist healthcare with non-fatal DSH from January 2008 through December 2018. Data on cause of death, personal socioeconomic status, clinical features of DSH and other medical covariates were retrieved. The Fine and Gray competing risks model was used to identify significant factors impacting subsequent mortality risk by specific causes of death in the cohort.

Results

The cohort of 43153 DSH patients comprised 24286 females and 18867 males, with 45.3% being 10-34 years old, 38.1% being 35-64 years old and 16.6% above 65 years old at index DSH episode. Of these patients, 7041 died during the follow-up period, including 2290 within the first 1-year, corresponding to a mortality rate of 31.9 per 1000 person-years in the follow-up period and 54.9 per 1000 person-years in the first year. Common causes of death included suicide (n=911), other external causes (n=1020), cancer (n=896), cardiovascular diseases (n=1523), respiratory disease (n=787) and mental and substance misuse disorders (n=463), but the causes of death varied greatly by age groups and other factors. The risk of dying by suicide was highly associated with middle-age, male gender, tertiary education, psychiatric history, and DSH by injury, clear intent of self-harm, comorbid affective or personality disorder, referral to psychiatric treatmen, as well as DSH repetition during the period of follow-up. Significant risk factors for death by other external causes included male gender, old or middle age, single marital status, lowest quartile income, history of psychiatric treatment, and DSH by injury and comorbid substance misuse. For death by natural causes, the relative risk was highest among the elderly and the middle-aged, with other significant risk factors including male gender, single marital status, low education, lowest quartile income, and comorbid substance misuse. Attendance in psychiatric treatment after DSH appeared to be beneficial reducing the risk for mortality by suicide, other external causes and natural causes as well.

Conclusions

Patients with DSH represent a high-risk group for suicide, other external and natural cause mortalities. Mental healthcare is essential in follow-up care and personalized care should take into account patients´ socio-demographic background and clinical features of self-harm.

Disclosure of Interest

None Declared
Co-design of a digital violence prevention and management tool for psychiatric inpatient care: focus on supporting integration into electronic health record system
Authors: Lantta T. , Rautiainen T. , Anttila M. , Anttila J. , Ameel M.
Published: August 2024

Introduction

Violence in psychiatric inpatient settings is a global challenge. Several methods have been developed and tested to help staff prevent the occurrence of violence on the wards. One novel and effective method is eDASA+APP, originating from Australian forensic psychiatric settings (Maguire et al. Int J Ment Health Nurs 2019; 281186-1197, Griffith et al. Psychiatr Serv 2021; 72 885-890). This electronic method contains an instrument (DASA) to assess the risk for imminent violence and includes evidence-based violence risk management methods for risk levels. It is important to ensure that this electronic intervention is integrated into daily clinical practice. This can be done in co-design between all that are involved e.g., staff and experts by experience, and by encouraging them to achieve a common goal and gain benefits by working together.

Objectives

This prevention gives an overview of how the Finnish version of eDASA+APP was co-designed with healthcare staff and experts by experience, focusing on integration into the electronic patient health record system. The presentation is part of a larger research project testing eDASA+APP in Finnish psychiatric inpatient care.

Methods

Co-design workshops focusing on three major themes: 1) identifying current practices and how eDASA+APP would fit in those, 2) producing a linguistically and culturally appropriate version of eDASA+APP, and 3) preferred use of eDASA+APP in an electronic patient health record system. Notes were kept during the workshops by researchers. Qualitative material were analysed with deductive content analysis. Results from the third theme are shared in this presentation.

Results

Staff and experts by experience described that integration of eDASA+APP in electronic patient health record system is supported if it 1) brings clear and fast information to the staff about the violence risk of a patient, 2) is a visible measure that is concretely in sight in electronic patient health record system, 3) provides information about which violence prevention and management interventions have worked with a patient, 4) involves patient preferences, and 5) consist of joint decisions that have been agreed multi-professionally.

Conclusions

Integration of eDASA+APP in the electronic patient health record system has the potential to succeed if it is realized in cooperation with staff and experts by experience, is technically easy to use, and the users have an understanding of its benefits to everyone involved.

Disclosure of Interest

None Declared