bluuebunny/crossref_metadata_2025 huggingface dataset:
rTMS efficacy in major depression disorder: comparing two reviews
Authors: Yasmine S. , Hanen B. A. , Fatma B. O. , Amal A. , Emira K. , Leila M.
Published: August 2023

Introduction

Transcranial magnetic stimulation (TMS)is perhaps the most popular of the newbrain stimulation techniques because its clinical effects are produced without the need for a craniotomy (as with deep brainstimulation (DBS)) or seizure induction(as with electroconvulsive therapy (ECT)).Recently ,TMS is typically used to improve depression symptoms when other depression treatments haven’t been effective.

Objectives

This is a review that discuss the efficacy of the antidepressant effect of TMS.

Methods

A narrative review was conducted basedon a search in pubmed using thekeywords: “rTMS” and “depression”.

Results

One of the reviews studied proved the efficacy of rtms in the treatment of depressionbut there is still a clinical need for the complementary use of antidepressants.Although rTMS is more expensive than conventional antidepressants, it remains more interesting for patients who have not found benefits with pharmacological treatments.The other review also demonstrated the antidepressant effect of rTMS and that this effect, once completed, appears to be as long-lasting as that of antidepressants. TMS is also a promising new therapy and a powerful research tool. The body of TMS literature suggests that daily, left prefrontal TMS for 3–6 weeks has antidepressanteffects that are clinically meaningful (30% remission), with low side effects and nodrug-drug interactions. Furthermore, TMS shows promise in several other psychiatricdisorders, particularly treating acute and chronic pain.

Conclusions

Even though The Food and drug administration (FDA) has accorded RTMS’ initial clearance of the first device in 2008 ,additional researches are still needed.The TMS coil location, stimulation intensity and frequency, and dosing strategy have to be more precise for better results.

Disclosure of Interest

None Declared
How do men differ from women? Case-Control study on clinic and personality characteristics of eating disorders
Authors: Ruiz Guerrero F. , Gonzalez Gómez J. , Cobo Gutierrez C. , Castro Fuentes L. , Hernández Jimenez C. , Romay González J. , Gómez del Barrio A.
Published: August 2023

Introduction

A review of the literature shows how female sex is a crucial factor in the development of ED, being the proportion of women and men 10 to 1 regardless of the location of the sample (Duncan, Ziobrowski & Nicol, 2017) and different clinical subtypes (AN, BN) (Swanson et al., 2011). However, male population has always been less studied, some works find that only 1% of the articles published in AN is aimed at the study of males (Galusca, 2012).

Nowadays it is accepted that the etiopathogenesis of these disorders is multifactorial and in addition to female gender other risk factors have been identified, such as neurobiological alterations, psychological predictors, personality traits, low self-esteem, extreme perfectionism or thinness values focused on body and figure. On the other hand, certain impulsive behaviours such as self-harm, substance use, physical activity or diets are factors that may be confused as predisposing or as symptoms of the pathology itself (Connan et al., 2003, Treasure, Stein and Maguire, 2015).

Recently, Kinasz, Accurso, Kass and Le Grange (2016) have compared the clinical characteristics that differentiate men (59) from women (560) in a sample of children and adolescents between 6 and 18 years-old, finding that males presented an earlier start of the ED and not appreciating differences in the duration of the disease, income, episodes of purgue and psychiatric comorbidity of anxiety, behaviour disorders or impulsivity.

Objectives

The aim of this study was to evaluate gender differences in clinical characteristics, levels of depression, previous obsessiveness and personality dimensions in eating disorders (ED) compared with controls.

Methods

A total of 80 participants was divided into 4 groups, 20 men and 20 women with ED and 20 men and 20 women without ED (healthy control), matched by age and socioeconomic status. The design of the study was case-control, and data was collected through clinical interview and a battery of cuestionaires.

Results

Men with ED only differ in vigorous physical activity (measured by IPAQ) from controls and women with pathology. Regarding personality traits, men and women with ED do not differ among them, although they do differ in novelty search and harm avoidance respect to their controls.

Conclusions

Behaviors such as physical activity in males frame a slightly different way of reducing their discomfort, however, clinical implication indicates that the treatment may be similar according to gender.

Disclosure of Interest

None Declared
Eating disorders. What about males?
Authors: Strada Herrera G. , Pérez Sobrino C. , Díaz Marsá M.
Published: August 2023

Introduction

Eating disorders (ED) historically been adressed as illnesses that only affect young adolescent females. ED’s in males have been documented in literature as early as the 1960’s; yet men continue to be under represented on research on the topic. For decades, the Diagnostic and Statistical Manual of Mental Disorders (DSM) perpetuated the invisibility of males by including amenorrhea as a diagnostic criterion. It was not until 2013 that male inclusion was endorsed thorught the removal of that criterion. It is estimated that one in four people affected with and ED is male.

It is estimated that one in four people affected with and ED is male. The proportion of males reporting lifetime prevalence of Binge eating disorder (BED) was far greater than for Anorexia nervosa (AN) or Bulimia nervosa (BN); the female versus male ratio of BED prevalence was 3:1. AN is the most life-threatening ED, but is least frequently seen in male populations; researchers suggest this is because most men are not interested in the emaciated, thin look.

Objectives

This poster aims to recognize the presence of ED’s in males and raise awareness on this topic.

Methods

Case report and literature review

Results

We present the case of a 50-year-old man with long-standing AN, who had never undergone mental health follow-up. He is referred to psychiatrist by his primary care provider (PCP) due to depressive symptoms. His medical history included vitamine D insufficiency and osteoporosis. At the age of 19 he was obese (BMI 35) and from the age of 23 he started to present dietary restriction after a social event. He had never self-induced vomiting, use of laxatives, binge eating or compulsive exercise. He reported no history or current substance use disorder. BMI at first consultation was 17,6 and showed fear of weight gain. Antidepressant therapy was started and patient was referred to a specialized therapist, nutritionistand nurse.

Conclusions

Overall, the findings demand clinicians develop awareness about ED in males to advance illness management and enhance long-term prognosis. In our case, the delay in receiving treatment has probably led to greater morbidity and chronicity. PCP’s play a key role in detection of ED’s as the often act as a first point of contact for men accesing the health care system. While assesing and ED, the PCP should include general questions on eating habits in their intake interview. Once an a ED is suspected, the first few minutes of the encounter are crucial to gain trust and buy-in from the patient. Once buy-in from the patient is gained, a complete physical exam and diagnostic work-up is required. Priority referrals to the following professionals are critical: psychiatrist, therapist, dietician or nutritionist, and ED specialist if available.

Disclosure of Interest

None Declared
Digital approaches for predicting posttraumatic stress and resilience: promises, challenges, and future directions
Authors: Schultebraucks K.
Published: August 2023

Digital technologies and advances in computational methods have become key drivers of innovation in many medical fields. In precision psychiatry, accurate and reliable measures of mental health are critical for informing patient care and clinical research. There has been growing concern over the limitations of traditional mental health assessments that are typically grounded in nosology defined by the DSM and are based on interviewer-led assessments or patient self-report questionnaires. Whereas such gold-standard clinical assessments can be cost-prohibitive, insensitive to change, and prone to subjective biases, the use of digital technologies provides an opportunity to improve the practical feasibility as well as the inter-rater and test-retest reliability of repeated mental health assessments. The key promise of this approach is to unlock the clinical potential of digital technologies in ways that foster research of high clinical relevance and impact on clinical care. I will discuss these promises and challenges for the future use of machine learning approaches for predicting and monitoring post-traumatic stress and resilience.

Disclosure of Interest

None Declared
Effectiveness of tailored digital health interventions for mental health at the workplace: A systematic review of randomised controlled trials
Authors: van der Feltz-Cornelis C. M. , Byrne T. M. , Shepherd J. , Merecz-Kot D. , Sinokki M. , Naumanen P. , Hakkaart-van Roijen L. ,   C. Empower
Published: August 2023

Introduction

Mental health problems in the workplace are common and have a considerable impact on employee wellbeing and productivity. Mental ill-health costs employers between £33 billion and £42 billion a year. According to a 2020 HSE report, roughly 2,440 per 100,000 workers in the UK were affected by work-related stress, depression, or anxiety, resulting in an estimated 17.9 million working days lost.

This study is part of the EMPOWER study. The European Intervention to Promote Wellbeing and Health in the Workplace (EMPOWER) consortium’s aim is to create an individualised digital tool that promotes employee wellbeing, mental health, and work productivity. It has received funding from the European Union’s Horizon 2020 research https://ec.europa.eu/programmes/horizon2020/en/home) and innovation program under grant agreement No 848180.

Objectives

We performed a systematic review of randomised controlled trials (RCTs) to assess the effect of tailored digital health interventions provided in the workplace aiming to improve mental health, presenteeism and absenteeism of employees.

Methods

We searched several databases for RCTs published from 2000 onwards. Data were extracted into a standardised data extraction form. The quality of the included studies was assessed using the Cochrane Risk of Bias tool. Due to the heterogeneity of outcome measures, narrative synthesis was used to summarise the findings.

Results

Seven RCTs (eight publications) were included that evaluated tailored digital interventions versus waiting list control or usual care to improve physical and mental health outcomes and work productivity.

The results are promising to the advantage of tailored digital interventions regarding presenteeism, sleep, stress levels, and physical symptoms related to somatisation.

There is less evidence for addressing depression, anxiety, and absenteeism in the general working population, but they significantly reduced depression and anxiety in employees with higher levels of psychological distress.

Conclusions

Tailored digital interventions seem more effective in employees with higher levels of distress, presenteeism or absenteeism than in the general working population. However, so far, there are not many studies in this domain. Given the promising results, tailoring of digital interventions based upon employee input should be a focus in future research.

Disclosure of Interest

None Declared
Predicting adherence in routine internet based cognitive behavioural therapy for depression: Retrospective cohort study
Authors: Jensen E. K. , Mathiasen K. , Riper H. , Lichtenstein M. B.
Published: August 2023

Introduction

On average, thirty percent of patients in internet based treatments do not complete the treatment program. The majority of studies predicting adherence have focused on baseline variables. While some consistent predictors have emerged (e.g. gender, education), they are insufficient for guiding clinicians in identifying patients at risk for dropout. More precise predictors are needed. More recently, studies on prediction have started to explore process variables such as early response to treatment or program usage.

Objectives

To investigate:

i)

How much variance in adherence is explained by baseline symptoms and sociodemographic variables?

ii)

Can we improve the model by including early response and program usage as predictors?

iii)

What is the predictive accuracy of the most parsimonious regression model?

Methods

Data will be extracted from the Danish ‘Internetpsychiatry’ clinic, which delivers guided internet based cognitive behavioural therapy for depression. Sociodemographic data is collected upon application, and symptoms of depression and anxiety are measured at the start of treatment. Further, symptoms of depression are measured between each session of the online treatment program. Early response to treatment will be conceptualized as the individual regression slope of depression scores for each patient, during the first four weeks of treatment. Program usage data will be collected from the online treatment platform (e.g. number of words per message to therapists, time spent on each session during the first four weeks, number of logins during the first four weeks).

Predictors for adherence will be examined in a hierarchical logistic regression. Models will be compared using ANOVA. The most parsimonious model will be determined using the Aikake Information Criterion. Receiver operating characteristic curve analyses will be used to classify the accuracy of the model.

Results

Analyses have not yet been conducted. Results will be available for presentation at the conference.

Conclusions

Determining more accurate predictors for adherence in internet based treatments is the first step towards improving adherence. Research findings need to be translated into clinically useful guidelines that may inform clinical decision making. Findings from this study could potentially be implemented as a system that monitors patients’ program usage and symptom development and signals therapists if a patient is at risk for dropout.

Disclosure of Interest

None Declared
Digitalized Clinical Data, Evidence and Transparency - Digitalization in Depression Treatment in the DECIDE Project
Authors: Wiegand H. F. , Momtahen N. , Frenschkowski E. , Pantle V. , Riedinger D. , Pilz M. , Panholzer T. , Scherrer A. , Lieb K.
Published: August 2023

Introduction

Routine psychiatric treatment in Germany suffers from a lack of information exchange in a sectored care system, long and complex treatment courses, insufficient evidence orientation with increasingly complex clinical knowledge, a lack of qualified personnel, and lack of patient involvement. How can a digital solution counteract these problems?

Objectives

First, discussion of problems in the care system and second, presentation of the concept and challenges of the DECIDE project, a Decentralized digital Environement for Consultation, data Integration, Decision making and patient Empowerment

Methods

The project plan and first results will be presented of

1.

surveys of patients and mental health professionals needs and concerns about digital solutions

2.

focus groups

3.

the software solution for mental health professionals and the connected app soltion for patients

Results

Improtant functions of the DECIDE solution for mental health professionals should include:

-

digitize clinical data to represent longitudinal treatment trajectories and plans and, in the face of increasingly complex knowledge, implement a transparent decision support system based on current guidelines for depression and important comorbidities in a disinterested way secure and transparent data exchange and access in practitioner networks involve patients in this exchange via app/web solution based on patient guidelines for transparency, empowerment and collaborative decision making review improved treatment algorithms in the long term using artificial intelligence based on digitized data lean data collection and compatibility with billing, appointment management, findings management and medication plan solutions.

Conclusions

In psychiatry and psychotherapy digitization of clinical data for transparent exchange between practitioners and patients, presentation of progressions and treatment plans, and evidence-based decision support have a great potential. However, standardization, compatibility and collection of complex data remain a challenge.

Disclosure of Interest

None Declared
An Internet-Based Cognitive Behavioral Intervention for Adolescents With Anxiety Disorders: a Study Protocol for a Randomized Controlled Trial
Authors: Skaarnes H. , Sørensen N. M. , Lomholt J. J. , Thastum M. , Mathiasen K.
Published: August 2023

Introduction

Anxiety disorders are the most prevalent mental health conditions among children and adolescents. However, it is estimated that less than 25% of all children and adolescents with an anxiety disorder receive professional help. Thus, it is of utmost importance to develop novel interventions that aim to increase treatment accessibility.

Objectives

The aim of this study is threefold, to determine the effectiveness of CoolMinds, an iCBT intervention for adolescents with anxiety disorders. In addition to investigate predictive factors and the networks between symptoms, severity and change from pre- to post- treatment.

Methods

The study is designed as a three-armed randomized controlled trial comparing iCBT with planned feedback, iCBT with on-demand help and a waitlist control, with 56 patients in each group. The participants in the two treatment conditions will receive 12 weeks of iCBT, while participants in the waitlist control wait for 12 weeks, before receiving iCBT with planned feedback. The participants in the two iCBT conditions will be randomized to get a booster session or not, 12 weeks after finishing treatment. The participants are adolescents between the age of 12 and 17 years and their parents. The families must live in the Region of Southern Denmark, and the adolescents must have a principal anxiety diagnosis according to DSM-5 criteria. The primary outcome measure are the Youth Online Diagnostic Assessment - child and parent versions. Outcomes will be evaluated at baseline, post-treatment and at the 3-, 6- and 12-month follow-ups. Symptoms of anxiety and depression are also measured between each session with PHQ-9 and S-SCAS.

Results

The results from this study will be submitted to high-status international and peer-reviewed journals, as well as be presented at national and international conferences.

Conclusions

This study will allow us to determine the efficacy of iCBT in adolescents with anxiety, where parent involvement is emphasized as part of the treatment. The results from this study intends to enhance accessibility of evidence-based treatment for adolescents with anxiety.

Disclosure of Interest

None Declared
Generative models as computational assays for psychiatry
Authors: Frässle S.
Published: August 2023

Psychiatry faces fundamental challenges with regard to mechanistically guided differential diagnosis, as well as prediction of clinical trajectories and treatment response. This has motivated novel approaches that aim to develop “computational assays” for inferring patient-specific disease processes from neuroimaging data, which can then be incorporated into decision making in everyday clinical practice. Such computational assays are often based on generative models, which describe how measured data may be caused by a particular mechanism. Combining generative models with machine learning allows translating the inferences from computational assays into patient-specific predictions, an approach referred to as generative embedding.

Here, I illustrate the clinical potential of generative embedding for the exemplary case of a generative model of whole-brain effective (directed) connectivity: regression DCM (rDCM). First, I introduce rDCM to the audience and highlight its relevance for understanding the pathophysiology of psychiatric disorders. I then provide an initial demonstration of the clinical utility of rDCM. Specifically, we assessed the ability of rDCM for predicting future episodes of depression in never-depressed adults, using a large dataset (N=906) of resting-state fMRI data from the UK Biobank. Over a 3-year period, half of the participants showed indications of at least one depressive episode, while the other half did not. Using nested cross-validation for training and a held-out test set (80/20 split), we found that a generative embedding procedure based on rDCM in combination with a support vector machine enables statistically significant predictions of future depressive episodes, both on the training (accuracy: 0.63, area under the curve (AUC): 0.66, p<0.001) and test set (accuracy: 0.62, AUC: 0.64, p<0.001). Interpreting model predictions based on SHAP (Shapley Additive exPlanations) values suggested that the most predictive connections were widely distributed and not confined to specific networks.

In summary, generative models of brain connectivity in general, and rDCM in particular, show initial promise to serve as computational assays for psychiatry. Our analyses suggest that (i) fMRI-based generative embedding approaches have some capacity for early detection of individuals at-risk for depression and (ii) achieving accuracies of clinical utility may require combination of fMRI with other data modalities.

Disclosure of Interest

None Declared
Relatives experience in moroccan psychiatric emergency
Authors: Tounsi A. , Zineb B. , Chebli H. , Laboudi F. , Ouanass A.
Published: August 2023

Introduction

In terms of care, family has a major role to play in the evolution of psychiatric illness.

Our aim in this work is to determine the family experience during the hospitalization of their sibling in the emergency room of the psychiatric university hospital Ar-Razi in Salé.

Objectives

Our aim in this work is to determine the family experience during the hospitalization of their sibling in the emergency room of the psychiatric university hospital Ar-Razi in Salé.

Methods

Our work was carried out with families of patients admitted to the emergency department of the psychiatric university hospital Ar-Razi in Salé.

The data collection was carried out with the help of a questionnaire including several items.

Results

Sixty-five family members were included in this study. Their relatives hospitalized in the psychiatric emergency department were male in 70% of cases with an average age of 32.4 years.

-

In 76% of the cases, the family member interviewed was the one who requested hospitalization;

-

55% of those interviewed were parents.

The analysis of relatives’ feelings during the hospitalization showed:

-

Feelings of guilt were related to feelings of fear of exclusion and worries.

-

Feelings of fear and exclusion were mostly expressed by mothers of patients hospitalized for the first time

At the end of the hospitalisation, 90% expressed relief, and 85% of family members were satisfied with their relative’s stay in the psychiatric emergency department.

Conclusions

Recognizing families as units of care and understanding their situation and experiences facilitates the post-hospitalization care process. A well-informed family about mental illness and the types of therapeutic treatments available helps optimize the treatment.

Disclosure of Interest

None Declared
Prevalence and associated factors to alcohol use in Tunisian high school adolescents: MedSPAD 2021
Authors: Mallekh R. , Rejaibi S. , Silini A. , Zid M. , Ben Slema I. , Zoghlami N. , Ben Youssef S. , Zribi M. , Ben Salah N. , Aounallah-Skhiri H.
Published: August 2023

Introduction

Despite its well-known acute and long-term harmful effects on a person’s mental health and well-being, alcohol remains the most commonly used psychoactive substance among adolescents after tobacco products in many countries.

Objectives

We aimed at studying the prevalence of alcohol use, and identify associated factors in Tunisian high school adolescents.

Methods

We used national data from the 2021-Mediterranean School Survey Project on Alcohol and Other Drugs (MedSPAD). Based on a clustered two-stage stratification sampling method, a representative sample of teenagers aged 16 to 18 years, was selected. Data collection was performed using a self-administered standardized questionnaire, assessing socio-demographic characteristics and risky behaviours, and including questions about alcoholic beverages patterns of use. Binary logistic regression model was used to assess associated factors and adjusted Odds Ratios (AORs) were presented with 95% confidence intervals (CI). Cspro software was used for data entry and all statistical analysis were performed with STATA software.

Results

A total of 6201 adolescents with a mean age of 16.8 years and a sex ratio female/male of 1.5 were enrolled.

Lifetime prevalence of alcoholic beverages consumption was 8.0%, 95% CI [7.0, 9,1] (n=6196). The prevalence of alcohol consumption during the previous year and month were 5.1 % and 1.7% respectively. Cocktails and beer were the most frequently consumed beverages.

Prevalence of alcohol use was significantly associated with tobacco, cannabis and e-cigarettes use (AOR 9.5, 6.0 and 1.9 respectively; p≤10-3), a higher frequency of nights spent away from home, school absenteeism for non-medical reasons and enrolment in the private sector.

Alcohol intoxication was reported by 2.9% of respondents during their lifetime.

Early onset was reported by 17.2% of respondents for alcohol use and 10.1% for alcohol intoxication.

Conclusions

Although the prevalence of alcohol use was relatively low among Tunisian adolescents compared to European adolescents, early onset- indicating an increased risk of developing an alcohol use disorder- warrant the implementation of primary prevention interventions through mental health promotion and life skill trainings to halt these trends and avert the raising burden of morbidity and mortality attributable to alcohol use.

Disclosure of Interest

None Declared
The impact of self-stigma in people with diagnosis of severe mental illness: a cross-sectional pilot study from a community psychiatry unit in Porto, Portugal
Authors: Pinto A. S. , Almada M. , Fonseca I. , Sousa A. , Lopes A.
Published: August 2023

Introduction

Self-stigma refers to the process in which a person internalizes negative stereotypes, beliefs, and prejudices about their mental illness, adopting a stigmatized view of themselves. Severe mental illness is one of the most socially exclusive stigmata and is associated with poor clinical and functional outcomes and social withdrawal.

Objectives

In Portugal, investigation regarding self-stigma is scarce. In this study, we aim to evaluate the impact of self-stigma among people with diagnosis of severe mental illness (SMI). For this goal we assess the prevalence of self-stigma of psychiatric patients with diagnosis SMI; and investigate the correlates of elevated self-stigma levels.

Methods

Fifty-one outpatients with SMI, were recruited from a community psychiatry unit from Porto, Portugal. After informed consent, evaluations included sociodemographic data, illness characteristics, and self-reported standardized scales. Self-stigma (ISMI), self-esteem (RSES) and quality of life (WHO-QoL) were assessed. Data analyses were performed using the SPSS version 28.0 (IBM Corp., Armonk, NY). p-values<0.05 were considered significant.

Results

From the study sample, 66.7% were male, with mean age of 44.8±11.0 and 56.9% were single. 33.3% reported living with their parents while 31.4% were living with a partner/spouse. The majority of participants had a diagnosis of schizophrenia (60.8%). Concerning the level of education, 58.8% completed basic education, but most patients were retired due to illness (62.7%). In this study, moderate to high self-stigma levels was found in 31.4% participants. Proportion of elevated self-stigma was significantly higher in unemployed/retired patients vs. those who were active (39.0% vs. 0%; P=0.021). No significant correlations were found with age, level of education, age at diagnosis, duration of illness, and number of hospitalizations. In the correlations analysis, a negative correlation between self-stigma and self-esteem (rho=-0.745; P<0.001), as well as self-stigma and quality of life (rho=-0.585; P<0.001) was found. A positive relationship between self-esteem and quality of life (rho=0.551; P<0.001) was found.

Conclusions

This study investigates, for the first time, the prevalence of self-stigma among outpatients with SMI in a community psychiatric unit from Porto. Our findings suggest a high prevalence of elevated levels of self-stigma among these patients. A significant association with being unemployed/retired was also found. Our results support previous evidence that internalized stigma is strongly associated with diminished self-esteem and impaired quality of life, in particular those aspects related to physical and psychological complaints. Targeting internalized stigma and self-esteem among patient with SMI will likely improve their quality of life, besides improving their clinical and functional outcomes.

Disclosure of Interest

None Declared
Psychological impact of workplace violence towards nurses in the emergency department
Authors: Koubaa A. , Khouja N. , Ismail S. , Bechrifa E. , Baraketi E. , Ben Jemaa A. , Hsinet J. , Benzarti A.
Published: August 2023

Introduction

Growing attention has been drawn to workplace violence in healthcare settings and toward healthcare workers. Emergency departments have always been vulnerable to workplace violence since its is usually associated to working with people in extreme distress. Healthcare workers facing numbers of situation with either verbal or physical abuse may face an impact on their mental health.

Objectives

Describe the psychological impact of workplace violence towards nurses in the emergency department

Methods

This is a questionnaire-based cross-sectional study including nurses working in the emergency department of different hospitals of Tunis. The respondents’ data were collected from March 2022 to September 2022.

Results

We included 164 nurses. They were mainly women (Sex ratio of 0.6) with a median of age was 30.7±7.6 years. Nineteen nurses had history of one or more mental disorders such as anxiety disorder (12 cases) and depressive disorder (11 cases). All nurses were victim of workplace violence, while most (104 nurses) were witness to at least one act of violence. Study population had different degrees of concern about safety in workplace, 29.8% had little to no concern while 29,9% were mildly concerned and 40.2% were severely concerned for which they felt their security compromised (14.6% often and 12.2% always). Violence in workplace had consequences on the quality of their service for 26.8% of nurses. Many (49.4%) felt prejudice on their mental health contrasting with little resort (14%) to mental health providers. Number of nurses presented nightmares (44 cases), avoidance (56 cases) or flashbacks (48 cases) about workplace violence. Psychosomatic symptoms were described by most of the study population (58.5%) such as throbbing (46 cases), nervousness (56 cases), aches (23 cases), fatigue (29 cases) or non-specific digestive signs (17 cases).

Conclusions

Workplace violence in emergency departments, first interface of the care chain, is a real problem with serious consequences. Healthcare workers are forced to provide care in situations that compromise their health and safety. Implementing a national action plan is essential in order to address this dangerous phenomenon.

Disclosure of Interest

None Declared
The psychological impact of working in an oncology center
Authors: Khouja N. , Koubaa A. , Hsinet J. , Baraketi E. , Ismail S. , Trabelsi G. , Benzarti A. , Ben Jemaa A.
Published: August 2023

Introduction

Paramedical staffs in oncology are among the most exposed to stress factors in the workplace, predisposing them to develop certain psychiatric pathologies, in particular anxiety disorders, depressive syndromes and burnout.

Objectives

The objective of this study was to study these psychosocial risk factors and to detect the psychological repercussions on this professional category.

Methods

Our cross-sectional, mono-centric, descriptive and analytical study was conducted between November 1st and 8th, 2022 at the Salah Azaiez Institute in Tunis. The screening of anxiety and depression was performed with the Hospital Anxiety and Depression Scale (HADS), the assessment of Burnout was performed with the Maslach Burnout Inventory (MBI).

Results

Fifty-four workers were included (mean age 39.72 years and sex ratio 0.22). According to the HADS scale, 68.5% had definite or doubtful anxiety symptoms, 51.8% had definite or doubtful depression symptoms. According to the Maslach scale, 59.3% had a high burnout score, 37% had a high depersonalization score and 38.9% had a low personal accomplishment score. A combination of all three was present in 7.4% of the staff. Anxiety was associated with workplace violence and lack of career prospects, depression was associated with lack of leisure activities, and burnout was associated with age, emergency management for the emotional exhaustion score, and the number of children, workload and workplace violence.

Conclusions

Working in an oncology environment seems to be associated with a number of factors that could significantly increase the risk of psychiatric pathology. Some of these factors are perfectly modifiable, which opens up prospects for targeted preventive actions.

Disclosure of Interest

None Declared
The association between child abuse and poor academic performance in public primary schools in urban Sudan
Authors: Mohammed B. A. A.
Published: August 2023

Introduction

Child abuse, sometimes referred to as child abuse and neglect, includes all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child’s health, development or dignity. Child abuse with all its forms is under reported globally in developed and developing countries. The extent of the problem is difficult to ascertain since most of the victims remain silent thus, assessing its prevalence and effects on children is crucial.

Objectives

To assess the association between child abuse with poor school performance considering related variables including family instability, home environment, and school environment.

Methods

This study included 504 participants: 168 cases and 336 controls. Controls were matched for age and gender. Both groups were tested for marital or family instability, home environment, school environment, peer and teacher maltreatment using bi-variate analysis. Test of significance of the result was estimated by confidence interval. Quantification of each factor effect and the interrelationships between all factors that affect academic performance was calculated using multivariate analysis by multiple logistic regressions.

Results

After controlling for confounding factors using a multivariate analysis model, the following was found: a significant increase in the risk of poor academic performance in children who were subjected to maternal physical neglect compared with children who were not (OR= 3.106: CI 95%=1.875-5.147), and in children subjected to maternal emotional neglect compared with children who were not (OR= 1.968: CI 95% = 1.200- 3.226). No association was found between maternal emotional/verbal or physical abuse and poor academic performance.

There is a significant increase in the risk of poor academic performance in children subjected to paternal emotional verbal abuse compared with children who were not (OR= 4.534: CI 95% = 1.833 - 11.214), but the result illustrated no association between paternal physical abuse and poor academic performance.

Conclusions

The risk of poor academic performance is significantly higher in children exposed to frequent parental conflicts or physical abuse from teachers compared with children who were not. There is a significant increase in the risk of poor academic performance in children who experienced maternal physical and emotional neglect and paternal emotional/ verbal abuse. Higher levels of parental education, feeling safe at home, and feeling happy may be protective factors.

Disclosure of Interest

None Declared
Frequency and characteristics of delusions and hallucinations in first admitted patients.
Authors: Abdelkefi M. , Baati I. , Mnif M. , Guermazi F. , Feki I. , Sellami R. , Masmoudi J.
Published: August 2023

Introduction

Delusions and hallucinations are common in schizophrenia and related psychotic disorders and they are frequently reported at the first admission to psychiatry departments.

Objectives

The study aims to examine the themes and frequency of delusions and hallucinations in first admitted patients.

Methods

Information was collected retrospectively from selected medical files of patients who were admitted for the first time to the department of psychiatry "A" of the university hospital Hedi Chaker, in Sfax, during the years 2020 and 2021.

Results

Ninety patients were included in our study. Their mean age was 34.79 ± 11.4 years, with a sex ratio (M/F) = 1.3. They reached high school in 51.1% of the cases. Half of the patients were smokers, 30% used alcohol and 16.7% used cannabis.

The average age of onset of the disorders was 30.36 years, and the duration of evolution of the illness before hospitalization was 56.54 days. The most common reason for hospitalization was environmental violence (62.5%). The diagnosis of schizophrenia was retained in 32.2% of the cases, and that of bipolar disorder in 23.3% of the cases.

At initial presentation to the ward, 72.2% of patients were found to have delusional beliefs. The most commonly held delusions were delusions of persecution (62.2%), reference (28.9%) bewitchment (27.8%) and grandiosity (26.7%) with changes of behavior in 34.4 % of the patients in response to their delusional beliefs.

Hallucinations reported by 43.3% of the patients were mainly auditory (30%), visual (20%) and 15.6% reported hearing internal voices. Olfactory hallucinations were only reported by 3.3% of the patients.

Conclusions

Delusions of persecution and reference appear to be the main delusional themes in this patient group. Auditory hallucinations were also commonly reported.

A better awareness of clinical presentations of the first admitted patients may aid early identification of the illness and engagement of the patients in the treatment process.

Disclosure of Interest

None Declared
Euthanasia and psychiatric patients: a Spanish glance to the Dutch experience
Authors: Albarracin P. , Mayor F. , Aparicio M. , Herrero E.
Published: August 2023

Introduction

The recent approval of euthanasia in the Spanish legal code and its posible extension to psychiatric patients opens an unprecedented scenario in the Iberian country. We analize the experience of the Netherlands, a country where euthanasia has been in practice for over two decades, in order to foresee epidemiological trends that could be replicated in Spain.

Objectives

To review the legislation on euthanasia in Spain and the Netherlands, as well as the epidemiological data regarding euthanasia applicants affected by mental health conditions in the Netherlands, to predict future epidemiological trends in a similar population in Spain.

Methods

We studied the legislation on euthanasia in Spain and the Netherlands, as well as the directives of the Regional Commisions for Euthanasia in the Netherlands to analize differences and similarities between the legal codes on both countries. We also sought epidemiological data regarding the application of euthanasia on psychiatric patients in the Netherlands, gathering data from seven articles in English language obtained through a search in PubMed using the MeSH terms “Euthanasia” AND “Netherlands” and “Psychiatry”.

Results

Euthanasia on psychiatric patients in the Netherlands has been a practice on the rise during the last decade, despite the elevated proportion of rejected applications and the high survival rate of this patients in later longitudinal studies. Affective disorders and personality disorders stand out as major psychiatric causes between the applicants. The Spanish legislation bears important resemblance to its Dutch predecessor, but also significant differences.

Conclusions

The available data on the application of euthanasia on mental health patients in the Netherlands show an in increasing trend regarding the execution of this practice, specially on patients who gather distinct clinical features. The data provided by the Dutch experience could have some replication in Spain, as well as anticipate possible future ethical conflicts regarding the application of this service.

Disclosure of Interest

None Declared
MEDICAL FITNESS IN WORKERS WITH PSYCHIATRIC DISORDERS
Authors: Ben Afia L. , Bahri G. , Youssef I. , Mechergui N. , Ernez S. , Brahim D. , Mersni M. , Ladhari N.
Published: August 2023

Introduction

Mental health disorders are among the most burdensome health concerns in the world; it affects more than 970 million people in 2019. These disorders deteriorate all aspects of life, especially the professional field, impacting mainly physical capability, daily functioning, and productivity among the working-age population.

Objectives

To study the socio-professional and medical characteristics of workers with psychiatric disorders and to assess the repercussions of these pathologies on work ability.

Methods

A descriptive and retrospective study included all the medical files of workers with psychiatric disorders who were referred to the occupational medicine department at Charles Nicolle Hospital for a medical opinion of fitness for work during the period from January 1, 2014, to December 31, 2020.

Results

The average age of the 224 cases collected was 41.74± [25-60 years] with a sex ratio of 0.67. The average professional seniority was 13.4 years±8.27 years. The most common occupational sectors were health (38.1%) and communication (20.2%). The patients were mainly suffering from either an anxiety-depressive disorder (36.6%) or psychosis (11.6%). These included 21 cases of bipolar disorder, 21 cases of schizophrenia, two cases of chronic hallucinatory psychosis and 3 cases of delusional psychosis. Forty-three patients were fit to continue working, 133 patients were fit with restrictions and twenty-six were unfitted to work.

A professional reclassification was recommended for 37 patients in positions with a lower mental load. One employee suffering from advanced schizophrenia was offered early retirement on grounds of disability. Permanent unfitness was pronounced in 11.6% of cases.

Conclusions

The impact of mental disorders on cognitive abilities can be so significant as to result in temporary or permanent unfitness for work. However, the decision of medical fitness for work for the same psychiatric pathology may vary from one individual to another and from one workstation to another.

Disclosure of Interest

None Declared
Unethical psychiatrist’s communication toward patients serving a prison sentence – a case report
Authors: Rossini Gajsak L. , Zibar L.
Published: August 2023

Introduction

An institutional ethical committee receives patients’ complaints regarding ethical side of physicians’ work, behavior and communication.

Objectives

This case report presents an example of unethical communication by a psychiatrist toward patients serving a prison sentence, who sought a psychiatrist’s examination. The main objectives were to evaluate the physician’s insight into objections as well as adherence to ethical rules and regulations defined by ethical code, law and other related acts. Identity and other identification data have been modified in relation to the real case for confidentiality.

Methods

The case of a written anonymous complaint to the institutional ethical committee and the psychiatrist’s statement on the patients’ accusations were taken as data source.

Results

Prisoners seeking psychiatrist’s help complained about the behavior of their attendant prison psychiatrist and stated that he insulted and humiliated them, shouted at them, was telling them horrible things (like “you are going to dye slowly”), was talking about them behind their back, ignored their disturbances, listened to several patients at the same time and revealed their diagnoses in front of other patients. The physician denied all the accusations in his feedback report, but stated that there have been conflicts with these patients. He concluded that he wondered why he could not communicate with them more roughly, that there was too much work to do and a lack of time. Furthermore, he worked too much for a small fee and he did not respect their problems while they constantly asked for something, and thus that they made a burden to the health system. Finally, he would not have even respond to an anonymous report.

Conclusions

In the presented case, there were many violations of ethical regulations and legal provisions. The psychiatrist made serious mistakes and misjudgments about numerous regulations of the Law on medical practice’s Article 21 regarding medical confidentiality (“Official Gazette” no. 117/08), Physician’s Oath Latest Version 2017, amended at the 68th Assembly of the World Medical Association as well as the Croatian Code of Medical Ethics and Deontology („Official Gazette” no. 55/08, pages 1-7, Article 1, paragraphs 1,2,3,4,5,6, Article 2, paragraphs 1,2,14, Article 8, paragraphs 1,2, Article 9, paragraph 12, Article 10, paragraphs 1,2) regarding obligation to preserve the noble tradition of the medical profession by maintaining high standards of professional work and ethical behavior toward the patient, respecting the patient’s rights in physical and mental aspects, taking care of his personal dignity and securing a medical secret. Additional efforts must be made by various stakeholders in health care so that ethical postulates are more strongly embodied in everyday physician’s work, without arbitrary interpretations.

Disclosure of Interest

None Declared