bluuebunny/crossref_metadata_2025 huggingface dataset:
CPAN - A novel transdiagnostic dimensional approach to the assessment of psychotic disorders
Authors: Hermán L. , Réthelyi J. M. , Tolna J. , Komoróczy E. , Császár I. B. , Baradits M.
Published: August 2024

Introduction

Classification of mental disorders evolved greatly over time, as DSM and ICD dominated both research and everyday practice in the past decades. DSM-5 was planned to represent biological features of psychiatric disorders and include results of genetic and imaging studies in the criteria. Unfortunately, this goal couldn’t be fulfilled, since, although there were promising results, evidence wasn’t strong enough to fully support the biological background of the currently used diagnostic categories. One possible explanation for this discrepancy is that biological disturbances don’t represent the somewhat artificial categorisation of these disorders. Many of the leading symptoms in psychotic disorders are nowadays considered as lying on a spectrum, such as autism, affective and psychotic spectrum disorders. Despite that, DSM-5 still describes schizophrenia, schizoaffective disorder and bipolar disorder as separate entities, however there can be major overlaps in the leading symptoms, moreover symptoms are not necessarily stable over time and can show fluctuations. It should be mentioned though that subgroups of schizophrenia in DSM-5 had been abolished and catatonia is considered as a trans-diagnostic specifier, moreover in ICD-11 certain symptoms can be added as symptoms specifiers to an existing diagnosis of primary psychotic disorder.

Objectives

Our aim was to establish a new trans-diagnostic, dimensional scale to assess the most important symptoms amongst patients with psychotic disorders. This scale is meant to represent the long-term clinical presentation and not a cross-sectional picture of a current state. We believe that long-term trajectories of these symptoms may be more connected to underlying biological features, such as genetic load (i.e. polygenic risk scores) and imaging results than the currently used diagnostic criteria. We think it is very important to create a tool, which is straightforward and short enough, so can be realistically used in everyday clinical work. This could provide important real-life data, which give us information about our patients from a different angle than the currently used diagnostic systems.

Methods

We have created the CPAN scale based on the current symptom specifiers of ICD-11 and the Clinician-Rated Dimensions of Psychosis Symptom Severity, which is an “emerging measure” for DSM-5 and also took into consideration our own clinical experience.

Results

The new tool measures 4 symptoms (catatonia, psychosis, affective symptoms and negative symptoms) on a scale of 5 (0-4). We have also put in specifiers to be able to characterize patients more precisely, and output measures (suicidal risk, functionality) to open the way for further analysis.

Conclusions

We tried to establish a novel symptom scale to help assessing patients with psychotic symptoms in everyday clinical work. Our plan is to test the validity of CPAN in the near future.

Disclosure of Interest

None Declared
Somatic comorbidities in patients with schizophrenia
Authors: Boussaid N. , Turki M. , Barkallah M. , Labyadh A. , Halouani N. , Ellouze S. , Aloulou J.
Published: August 2024

Introduction

Patients with schizophrenia have shown a high mortality rate, and life expectancy is shortened by 10-20 years. This seems to be mainly caused by metabolic and cardiovascular diseases. Several risk factors are identified, including sedentary lifestyle, poor diet, low socioeconomic status, cognitive dysfunction, and antipsychotics iatrogenicity.

Objectives

We aimed to explore somatic pathologies reported in patients with schizophrenia, and to assess risk factors predisposing to these impairments.

Methods

We conducted a retrospective descriptive and analytical study, based on clinical and psychiatric observations of 60 patients with schizophrenia, hospitalized in psychiatry “B” department, Hedi Chaker university hospital (Sfax, Tunisia), during the period between 2015 and 2017.

Results

Among our patients, 38.3% suffered from somatic comorbidities: diabetes (21.7%), hypertension (15%), coronary disease (15%), hyperlipidaemia (15%), respiratory diseases (6.7%).

Tobacco consumption was reported in 53.3% of patients. It was significantly associated with the occurrence of cardiovascular diseases (p=0.036). Alcohol abuse was noted in 16.7%, while obesity was reported in 6.7% of patients.

Significant associations were found between obesity and diabetes (p=0.001), and between organic diseases and cognitive disorganisation (p=0.022). Somatic comorbidities were more frequent in patients with low socio-economic level (p=0.015).

Among our patients, 83.3% were treated with conventional antipsychotics while 38.3% were treated with atypical antipsychotics (AAP). We showed that AAP were associated with the occurrence of organic diseases (p=0.037).

Conclusions

Physical health of patients with schizophrenia requires a serious attention. Coordinated care between psychiatrists and other healthcare professionals should monitor the physical health of these patients to prevent a premature death.

Disclosure of Interest

None Declared
Improving the Sexual Wellbeing of Patients with Psychotic Illness
Authors: Stanton N. , Angova E. , Diamantopoulos K.
Published: August 2024

Introduction

Sexual dysfunction (SD) is common in psychotic illness including schizophrenia, occurring in 30-82% of patients. It negatively impacts wellbeing and antipsychotic compliance, resulting in higher risk of relapse and hospitalisation. Due to over-reliance on spontaneous reports from patients, SD is typically under-identified which prevents investigation and treatment.

Objectives

To establish whether SD is under-identified in patients with psychosis in a general adult community mental health team; to elicit whether the Arizona Sexual Experience Scale (ASEX) improves identification; to investigate and manage identified cases of SD; to make recommendations about identification and monitoring of SD in this patient population.

Methods

A 12-month retrospective audit of patients with psychosis prescribed a long-acting injectable (LAI) antipsychotic (n=36) to identify sexual symptoms was completed. The ASEX was subsequently issued to screen for SD.

Results

Audit: 3/36 (8%) patients had documented sexual symptoms. Of the 18/36 patients that completed the ASEX: 10 (56%) exhibited SD. 4 consented to further investigation. 5 patients experienced significant difficulties with the language used in the ASEX. At the end of the project we revised the ASEX with simpler, colloquial language.

Conclusions

Implementation of the ASEX results in clear improvements in identification and monitoring of SD. Maudsley Practice Guidelines can inform investigation and management of SD. We suggest a review of NICE guidance to incorporate the above into clinical practice. Further work is needed to establish whether the revised ASEX can be developed and validated.

Disclosure of Interest

None Declared
Male gynecomastia linked to antipsychotics: a case report
Authors: Martin-Santiago O. , Martinez.Gimeno P. , Calvo-Valcarcel M. , Alario-Ruiz C. , Arribas-Simon B.
Published: August 2024

Introduction

Gynecomastia refers to the abnormal development of breast tissue in males, often posing a concerning symptom. Often, gynecomastia is associated with multiple factors, including the use of various drugs, notably certain atypical antipsychotics. Gynecomastia is a significant side effect that affects the quality of life of male patients taking antipsychotic medications. Among these, risperidone and paliperidone have been identified as the most prone to causing gynecomastia, although aripiprazole has garnered attention for its superior profile in controlling prolactin and gynecomastia. The relationship between these drugs and the development of gynecomastia lies in their ability to elevate prolactin levels, a hormone that regulates reproductive function and is involved in milk production. Several studies have shown that prolactin levels are more commonly elevated with risperidone and paliperidone prescription, thus triggering gynecomastia.

Objectives

The study aims to investigate the management of gynecomastia in male patients receiving antipsychotic medications.

Methods

This research employs a retrospective analysis of patient records to examine the association between specific antipsychotic drugs, prolactin levels, and the development of gynecomastia, while also evaluating the effectiveness of aripiprazole as an alternative treatment.

Results

We present the case of a 21-year-old male with no prior medical history who initiated treatment with oral paliperidone and later switched to 100 mg of long-acting injectable paliperidone once monthly during his initial admission for psychotic symptoms. After six months, he developed gynecomastia, which was ruled out as breast tissue and was determined to be an increase in adipose tissue. Since his hospital discharge, he has gained 25 kg (30%) in body weight, and his baseline prolactin level has decreased. This weight gain, a common side effect of several antipsychotics, was linked to gynecomastia. However, a promising approach for gynecomastia antipsychotic-associated treatment is aripiprazole, which has a milder impact on prolactin levels. In this case, during the next appointment, a switch to 400 mg of long-acting injectable aripiprazole once-monthly was made, which led to weight loss, a reduction in breast size and blood prolactin levels in the following weeks.

Conclusions

The detection and management of gynecomastia in these patients are crucial to improving their quality of life and treatment adherence. This management encompasses changes in medication, hormonal therapy, or surgery in severe cases. Physicians must be aware of this potential complication when prescribing antipsychotics and closely monitor at-risk patients. In summary, antipsychotic-associated gynecomastia in men represents a medical challenge that requires careful attention and an individualized treatment strategy for each affected patient.

Disclosure of Interest

None Declared
Mindfulness possibilities in the treatment of chronic headaches
Authors: Perczel-Forintos D. , Sal D.
Published: August 2024

Introduction

Headache is a very common health problem worldwide and in our country due to the increasing environmental damage and daily stress. The proportion of patients with headache in general practice is 4-5%, in neurology up to 30%. Chronic headache as a persistent stressor exhausts the body through central sensitisation, which can lead to the consolidation of maladaptive coping strategies such as avoidance, feelings of loss of control, catastrophising pain. This can lead to a deterioration in quality of life and depression also. The effectiveness of pharmacotherapy in coping with chronic pain is limited, so attention should be paid to modifying maladaptive pain behaviour, as recommended by the NICE guidelines. The international literature shows that mindfulness-based cognitive therapy (MBCT) has been shown to be effective in the management of chronic headache, primarily in improving quality of life, increasing self-efficacy and reducing pain catastrophisation and depression (Hunt et al., 2022).

Objectives

Our first objective was to introduce mindfulness-based cognitive therapy in Hungary to patients suffering from chronic headache. Secondly, we wanted to measure the impact of the method on quality of life, coping with pain and depression.

Methods

N=28 patients, suffering from chronic headaches (tension headache and migraine) participated in the study at the Department of Clinical Psychology, Semmelweis University (BNO: G430, G431, G442). Selection criteria were: referral from a neurologist, age 18-65. The intervention was an 8-session mindfulness-based cognitive therapy for pain (Day, 2017) led by an MBCT teacher and a clinical psychology resident. Before the intervention, all patients had an individual first interview and filled in the questonnaires. Measures: Beck Depression Questionnaire, Pain Catastrophizing Scale, Comprehensive Headache-related Quality of life Questionnaire, Five Facet Mindfulness Questionnaire, Cognitive Emotion Regulation Questionnaire.

Results

After the intervention, there was a significant reduction in the negative impact of pain on quality of life (p<0.05, Cohen’s d=0.6), pain catastrophization (p<0.01, Cohen’s d=0.74), and depression (p<0.001, Cohen’s d=0.84). In addition, several sub-factors of mindfulness increased, including non-reactivity and being non-judgemental (p<0.05, Cohen’s d=0.57), as well as adaptive cognitive emotion regulation strategies (p<0.05, Cohen’s d=0.49).

Conclusions

We can conclude, that in line with international findings, MBCT has been shown to be effective in reducing the negative impact of depressive symptoms, pain catastrophisation and headache on quality of life, and in helping people to cope with pain more adaptively, primarily through the acquisition of mindfulness skills.

Disclosure of Interest

None Declared
The Impact of Insecure Attachment on Social Functioning in Women with Schizophrenia
Authors: Walha S. , Chaari I. , Mellouli A. , Samet A. , Aribi L. , Charfeddine F. , Mseddi N. , Aloulou J.
Published: August 2024

Introduction

Attachment styles is intrinsically related to the capacity for forming close social bonds, making it a vital lens through which to understand social functioning.

Objectives

This study investigates the link between attachment styles and social functioning among women diagnosed with schizophrenia.

Methods

We carried out a descriptive and analytical cross-sectional study from May to June 2023, focusing on stabilized female patients diagnosed with schizophrenia or schizoaffective disorder. The study took place in the ‘B’ psychiatry department of Hedi Chaker University Hospital in Sfax, Tunisia. Data on attachment styles and social functioning were collected using self-report questionnaires: the Revised Psychosis Attachment Measure (PAM_R) and the Social Functioning Scale (SFS). In our study, we employed both the Wilcoxon test for paired samples and the Spearman correlation test to assess the differences and correlations between attachment scores and social functioning scores, respectively.

Results

In the study, 41 female patients were included. The participants had a mean age of 49.19, ranging from 19 to 79 years old. Attachment styles were predominantly avoidant (60.97%), followed by anxious (24.39%) and disorganized (14.63%). A significant portion, 39%, exhibited low social functioning. The domains most affected were leisure (63.41%) and employment (60.97%). Our analysis revealed negative correlations between avoidant attachment and social functioning in leisure activities (Spearman’s ρ = -0.057, p < 0.05) as well as between avoidant attachment and independence performance (Spearman’s ρ = -0.040, p < 0.05). Also, the correlation coefficient for anxious attachment and leisure activities is 0.041, demonstrating a positive association (p < 0.005).

Conclusions

These initial findings may imply a potential association between attachment styles and social functioning in schizophrenia.

Disclosure of Interest

None Declared
Determinants of hospital length of stay for patients with schizophrenia
Authors: Turki M. , Barkallah M. , Boussaid N. , labyadh A. , Ellouze S. , Halouani N. , Aloulou J.
Published: August 2024

Introduction

relapse and frequent rehospitalizations. The length of stay (LOS) of these patients has been a concern of researchers. The ability to identify determinants of LOS at admission – and, thus, identify patients who are likely to need a longer stay early on – may help treatment planning.

Objectives

We aimed to investigate socio-demographic and clinical profile of inpatients with schizophrenia, and to identify factors associated with LOS.

Methods

It was a retrospective study carried out among 90 inpatients with schizophrenia admitted to the psychiatry “B” department, Hedi Chaker university hospital (Sfax, Tunisia), during the period between January 2015 and December 2019. Data collection was performed through the patients’ medical records. Statistical analysis was performed using SPSS v.25.

Results

The mean age of our patients was 32 years. Among them, 57.78% were women. The mean LOS was 28 days. Factors found to be significantly associated with LOS were: the number of admissions (p<0.001, r=0.404), involuntary hospitalization (p=0.001), violence and disturbance of public order as a reason of admission (p < 0001) and the lack of social support (p=0.039). As for the clinical symptoms, hallucinations were significantly associated with a longer LOS (p=0.001).

Conclusions

Our findings highlighted several factors associated with a longer LOS. This may be helpful to the management of hospitalization and ensuring that any periods of liberty deprivation do not last longer than necessary to provide appropriate treatment.

Disclosure of Interest

None Declared
Differences in the dynamics of schizophrenia with the formation of episodic and persistent apathetic depressions
Authors: Barkhatova A. , Sorokin S.
Published: August 2024

Introduction

Apathy in endogenous depressions is a complex mental phenomenon (it is characterized by indifference and loss of interests, reduced incentives and motivation, decreased mental and physical activity). Apathy becomes the cause of pronounced social maladaptation and untimely seeking medical help. Different depressions vary in psychopathological features of apathy, in addition, there are also different dimensions of the general dynamics of endogenous disease.

Objectives

Study of the features of the course of schizophrenia, in which apathetic depressions develop with episodic and persistent type of dynamics

Methods

The study included 36 patients (15 men, 21 women, average age 34.9 years) with schizophrenia. In 17 cases, apathetic depressions occurred as short-term episodes, in 19 cases, depression took a persistent (close to chronic) course.

Results

Schizophrenia with an episodic type of dynamics of apathetic depressions was characterized by: the predominance of cases with early onset of the disease; alternation of apathetic and other type depressions; equal occurrence of mono- and bipolar types of desease; low severity of negative symptoms and slight changes in social and labor functioning. Apathy has always been present during the whole lenght of depression, its picture was dominated by a motivational decline. The studied cases were prognostically favorable. The features of the course of schizophrenia with chronic apathetic depression were: hyperthymic (10 out of 19 observations) and sensitive schizoid (6 out of 19 observations) premorbid personality; bipolar forms of the disease (94.7%, p < 0.05); the predominance of apathetic depression over other depression types, atypical form of depression; short duration of remissions; frequent course of the disease with the presence of only apathetic depressions (12 out of 19, 63.1%, p < 0.05); significant severity of negative symptoms. Apathy occupied only as a part of the duration of the state, as a rule, after anxiety depression. The picture of apathy was dominated by a decrease in initiative or motivation. This clinical group is the most prognostically unfavorable.

Conclusions

Schizophrenia, occurring with the presence of persistent forms of apathetic depression, has a greater impact on the functioning of patients and has a less favorable prognosis.

Disclosure of Interest

None Declared
Delusion of pregnancy - what the literature says?
Authors: Figueiredo I. M.
Published: August 2024

Introduction

Delusion of pregnancy (DP) is a false and persistent belief of being pregnant despite realistic evidence to the contrary. Being considered a rare phenomenon, more cases of DP have been reported lately, however the literature about this topic is still scarce.

Objectives

Clarify the etiology and clinical aspects of this pathology in order to diagnose and to treat it properly.

Methods

A search on Pubmed was performed using the MeSH terms “delusion pregnancy” or “pseudocyesis”. The DSM-5 and ICD-10 were also a source of information.

Results

DP can be sometimes confused with other disorders, like pseudocyesis, pseudo-pregnancy and Couvade syndrome, but it is important to differentiate all of them to have a clear view of the pathology and follow a correct approach to the problem.

DP can manifest isolatedly, but it is more commonly associated with other diseases. Etiologically, several factors can intercede: biological, psychosocial and cultural factors, iatrogenic factors and coenaesthesis processes.

Demographically, about 50% of the patients are 20-40 years old and the most common psychiatric diagnoses are schizophrenia, bipolar disorder and depression.

Concerning the treatment, it is essential to exclude non-psychiatric causes and treat those, if present. After doing so, the therapeutical approach can be non-pharmacological, using psychotherapy or electroconvulsive therapy, although the latter has inconclusive results and sometimes it only remits the comorbid depressive symptoms; or pharmacological using 2nd generation antipsychotics.

In general, there is now a good response in 50-64% of the cases (Bera and Sakar,
Indian J Psychol Med 2015;37(2)131-137) (Yadov et al,
Indian J Psychol Med 2012;34(1) 82-84).

Conclusions

DP can be a psychiatric diagnosis itself or a manifestation of other psychiatric or non-psychiatric disorder so we must be allert to make a precise differential diagnosis. Its genesis is multifactorial and that must be taken into account when thinking about its treatment approach.

In the past, the prognosis of the DP wasn’t good, but in the recent literature it was found a good response in more than half of the patients treated accordingly.

Disclosure of Interest

None Declared
Insight and cognitive complaints in stabilized outpatients with schizophrenia
Authors: Ajmi S. , Bouhamed M. , Ouali R. , Hentati S. , Feki I. , Sallemi R. , Masmoudi J.
Published: August 2024

Introduction

Schizophrenia is often considered as pathology of consciousness. Some authors have considered that patients’ self-perception of their cognitive difficulties expressed in the form of subjective complaints could represent a source of stress. These cognitive difficulties may then interfere with the interpretation of symptoms, leading to poor insight.

Insight and cognitive complaints in stabilized outpatients with schizophrenia.

Objectives

Study the relationship between subjective cognitive complaints and clinical insight in a Tunisian population with schizophrenia.

Methods

This is a cross-sectional, descriptive and analytical study carried out on 72 stabilized patients followed at the post-cure psychiatry consultation ‘A’ at the CHU Hédi Chaker in Sfax diagnosed with schizophrenia according to the DSM 5 criteria.

We used the schedule for the Assessment of Insight–Expanded Version(SAI-E) scale to assess Clinical Insight and the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) to determine subjective cognitive complaints

Results

The mean age of the patients was 46.83 ± 11.6 years, with a sex ratio (M/F) of 2. In our study, 48.5% were single and 69.4% were unemployed.

The median total SSTICS score was 25.

Using the SAI-E scale, an average score of 20.1 was objectified in our study.

In our study, the better the insight, the greater the subjective cognitive complaints were in all cognitive domains (p=0.00).

Awareness of illness was statistically associated with working memory (p=0.001), explicit memory (p=0.004), attention (p=0.001), language (p=0.01) and executive functions (p=0.001).

Conclusions

Our study highlights the relationship between awareness of illness and cognitive complaints. The clinician, faced with repetitive cognitive complaints, should assess the insight before incriminating another cause (effects of a drug, cognitive deficit, etc.).

Disclosure of Interest

None Declared
Relationships between cognitive function and activities of daily living in psychiatric nursing home patients with schizophrenia
Authors: Gu F.-Y. , Weng S.-Y.
Published: August 2024

Introduction

Schizophrenia is a common chronic disease in psychiatric long-term care institutions. Taipei City Hospital Songde Branch Psychiatric Nursing Home (TCHSBPNH) is the first public psychiatric nursing home in Taipei City. There’s not only a complete interdisciplinary care system, but also detail initial evaluation at admission of residents, including basic demographic information, cognitive assessments, activities of daily living, and so on. It is known that patients with schizophrenia are generally accompanied by cognitive impairments, which further affects their activities of daily living (ADL) performance, but we still don’t know the correlation between of them.

Objectives

This study aimed to investigate the relationships between cognitive function and ADL function of psychiatric nursing home residents with schizophrenia. The results would promote clinical intervention in ADL training for institutional patients.

Methods

39 participants with chronic schizophrenia (mean age =63.95±6.59 years) were recruited for the study from 2020 to 2021 in TCHSBPNH. We collected every resident’s assessment data, including Mini-Mental State Examination (MMSE), Barthel Index, Lawton - Brody Instrumental Activities Of Daily Living Scale (Lawton IADL scale) and Composite Physical Function (CPF) Scale. The Pearson correlation coefficient was used to examine the correlation between cognitive function and ADL.

Results

Moderate positive correlations were showed between cognitive function and ADL (p<.05). The statistic results as follow, MMSE and Barthel Index (γ=.627, p<.001), Lawton IADL scale (γ=.431, p=.006), and CPF (γ=.341, p=.034) respectively exhibited significant correlations.

Image:

Image 2:

Image 3:

Conclusions

There is a positive correlation between cognitive function and ADL in psychiatric nursing home residents with schizophrenia. The better cognitive function performance becomes, the better independent ADL functions will be. Thus, the psychiatric nursing home residents’ independent ADL training will also vary from person to person.

Disclosure of Interest

None Declared
Review of Delusional Jealousy and Its Association with Sexual Dysfunctions
Authors: Pinho S. A. , Leitão F. , Freitas J. R. , Coutinho F.
Published: August 2024

Introduction

Mental state changes can affect one’s sexual life, while sexual dysfunction can lead to relationship challenges. Delusional jealousy, also called Othello syndrome, involves a paranoid belief in a partner’s infidelity, leading to controlling and violent behaviors. It can manifest as a paranoid disorder, as a delusional symptom of psychiatric, neurological or other medical conditions, or as side effect of dopaminergic medication. Although its exact prevalence remains uncertain, it has been identified in 0.5-1.4% of psychiatry inpatients.

Objectives

To describe sexual dysfunctions associated with delusional jealousy and to explore strategies for addressing these dysfunction.

Methods

A non-systematic review of the literature available at PubMed was conducted using the keywords “Sexual Dysfunction” AND “Delusional Jealousy OR Othello Syndrome”.

Results

A number of factors, including sexual dysfunction, can trigger or exacerbate delusional jealousy. This is especially true for middle-aged men who have a history of alcohol consumption, neurological or personality disorders. Individuals with sexual dysfunction experience feelings of insecurity, projecting these concerns onto their partners and suspecting extramarital relationships. On the other hand, sexual dysfunctions such as Hypoactive Sexual Desire Disorder, Female Sexual Arousal and Orgasmic Disorders, Erectile Dysfunction and Ejaculation Disturbance may occur as consequence of Othello Syndrome. Multiple factors contribute to these dysfunctions, including increased testosterone and cortisol levels, chronic alcohol use, comorbid psychiatric conditions and antipsychotics. There are reports of increased sexual desire, especially in cases of dementia.

Conclusions

Although the evidence is limited and dated, it points to a bidirectional association between delusional jealousy and sexual dysfunction. Further studies are essential to determine the prevalence and types of sexual dysfunctions in Othello syndrome, and the causal relationship between them. Additionally, investigating gender differences is crucial, given the male-centric focus of existing studies. This research can contribute to clinical care by promoting the screening for sexual issues and their integration into delusional jealousy management.

Disclosure of Interest

None Declared
The improvement of mental and physical health of people with severe mental disorder: one-year efficacy of a lifestyle experimental intervention
Authors: Carbone M. , Mario L. , Di Vincenzo M. , Della Rocca B. , Toni C. , Cipolla S. , Martinelli F. , Sampogna G. , Fiorillo A.
Published: August 2024

Introduction

Patients with severe mental disorders have a significantly reduced life expectancy than the general population, often resulting from the increased prevalence of cardiovascular and metabolic diseases. Reasons include unhealthy lifestyle behaviours, reduced access to screening programs and adverse effects of many psychotropic drugs.

Objectives

Our goal is to assess the efficacy of a psychosocial group intervention promoting healthy lifestyle behaviors compared to a brief psychoeducational group intervention in terms of improvement of severity of psychiatric symptoms and perceived quality of life, and a series of anthropometric and hematological parameters.

Methods

This is a multicenter randomized controlled trial. Patients between 18 and 35 years of age with a diagnosis of schizophrenia and other primary psychotic disorders, unipolar depression and bipolar disorder were recruited. Exclusion criteria were inability to perform moderate physical activity, pregnancy and breastfeeding and impaired cognitive functions.

Results

401 patients were recruited and randomly assigned to receive the experimental intervention (LIFESTYLE) or a behavioural control intervention. About 57% of the sample were female, with a mean age of 45.8±11.8, and BMI of 32.5±5.5. All of them were receiving almost one psychotropic drug. At one year, we observed a reduction in HOMA-IR index (from 4.3 ± 5.5 to 3.1 ± 2.9, p<0.01) and triglycerides (from 162.5 ± 78.1 mg/dL to 131.4 ± 76.0 mg/dL, p<0.001), as well as an increase in HDL (from 46.2± 14.6 mg/dL to 50.9±26.7 mg/dL, p<0.05). Moreover, a reduction in the values of BPRS “Affectivity” (from 8.7±3.0 to 7.2±2.5, p<0.001), “Activity” (from 4.7±1.9 to 4.2±1.3, p<0.01) and “Negative Symptoms” subscale (from 7.7±3.1 to 7.0±2.7, p<0.001) was also observed, along with an improvement in perceived quality of life (MANSA total score from 4.0 ± 1.0 to 5.3 ± 0.8, p<0.01).

Conclusions

The results support the evidence that the LIFESTYLE intervention has long-lasting positive effects on physical and mental health of people with mental disorders. More efforts need to be done in order to increase the availability of these treatments in routine clinical settings.

Disclosure of Interest

None Declared
Manic episode with psychotic symptoms in a patient with Pseudologia Fantastica of years of evolution. A case report
Authors: Díaz Mayoral C. , Arroyo Sánchez E. , Setién Preciados P. , Martín de Argila Lorente M.
Published: August 2024

Introduction

Pseudologia Fantastica (PF) also called “mythomania” is a disorder centred on the tendency of the sufferer to distort reality through constant lies. These patients find it difficult to moderate their sense of self and their self-esteem. Therefore, they display significant grandiosity, which seems to defend them from intense psychological disturbance, pretending to counteract deep feelings of unworthiness, emptiness and alienation.

Notable characteristics include: normal or above average IQ, absence of formal thought disorder, poor sense of identity, poor sexual adjustment, low frustration tolerance, strong dependency needs and narcissism. The phenomenon of “imposture” (the person’s claim of achievement or having connections to famous or influential people) is frequent. The patient’s history often shows that one or both parents were experienced as rejecting figures. They are more likely to be involved in legal problems and 20% receive some form of psychiatric treatment.

The aetiology and pathogenesis of this disorder requires consideration of developmental disturbances, personal history and current life stressors.

Objectives

A case of a patient with PF is presented followed by a theoretical review on the topic.

Methods

A case is presented with a bibliographic review.

Results

We admitted a 47-year-old man to the Acute Hospitalisation Unit for a suspected “psychotic episode with clinical mania”.

He presented manic and psychotic symptoms, with delusional ideation of months of evolution, megalomaniacal and fantastic discourse, centred on his work with high-ranking government officials and other implausible events. Multiple academic, work and personal life failures, with a diagnosis of depression 15 years earlier.

During admission, he constantly confirms his history. He tends to present a rationalising discourse and a minimising attitude towards behavioural alterations. He appears cooperative and docile at certain times, while at others he is irritable, complaining and threatening.

As for medication, olanzapine was initially prescribed at a dose of 20 mg per day, which was reduced to 10 mg given the psychopathological improvement and the difficulties of adherence.

On discharge, the presumptive diagnosis was “delusional disorder and probable personality disorder with narcissistic traits, with a history of PF, which in recent months has presented a manic episode with psychotic symptoms”.

Conclusions

Their management poses challenges in terms of engaging with treatment and building a therapeutic alliance. It is important to assess the social and legal implications. Ensuring that they have stable relationships and adequate social supports is essential for successful treatment. Further exploration and research into this disorder is needed to better understand its manifestations and psychiatric consequences.

Disclosure of Interest

None Declared
Neurodevelopmental outcomes in children conceived by assisted reproductive treatment
Authors: Abdelmoula B. , Bouaziz I. , Lamine A. , Bouayed Abdelmoula N.
Published: August 2024

Introduction

Impact of assisted reproductive treatment (ART) techniques on the child’s mental development is the focus of numerous studies. Whereas several studies have found potential negative effects on ART children’s psychosocial health, others recognized that the data on the cognitive and psychosocial development of ART children are comforting.

Objectives

Here, we aim to state the current findings concerning psychological outcomes in children conceived by ART.

Methods

Using as key words “assisted reproductive” and as filter “meta-analysis”, we comprehensively reviewed the scientific literature through new meta-analysis during the five last-years resuming the main conclusions of these studies to define principal through psychological conditions in children conceived by diverse ART techniques and approaches.

Results

Our review showed that since 1978, the date of the first birth using in vitro fertilization technology (IVF), more than 10 million children are conceived by ART. Our research revealed 441 meta-analysis. After a comprehensive analysis of abstracts, only four meta-analysis were selected. Chronologically from 2019 to 2023, the first studies showed that the risk of intellectual disability and autism spectrum diseases (ASD) were higher in intra-cytoplasmic sperm injection (ICSI) children compared to conventional IVF children. The differences in the risk of neurodevelopmental disorders in children born after frozen and fresh embryo transfers were not significant. Analysis of potential cofounder effects such as multiple and preterm birth having a significant correlation with neurodevelopmental disorders suggested that ART is unlikely to cause negative impacts on children’s neurodevelopment. The findings of the most recent meta-analysis showed that the use of ART did not associate with the risk of ASD,

Conclusions

Given the multitude of factors modulating ART, from the indication and parental background to the type of used technique and approach, the results of the studies that investigated the association between ART and neurodevelopmental outcomes remain yet contradictory.

Disclosure of Interest

None Declared
The Nexus of Sleep Disorders and Violence in Patients with Schizophrenia: What do the Data Say?
Authors: Razki K. , Larnaout A. , Najar C. , Ben Aissa S. , Lansari R.
Published: August 2024

Introduction

One of the common symptoms of schizophrenia is sleep disturbances, which can have a significant impact on the quality of life of patients. Several studies suggest the existence of a complex link between sleep disorders and agressive behavior in patients with schizophrenia.

Objectives

to determine the impact of sleep disorders on aggressive behavior in patients with schizophrenia.

Methods

We conducted a cross-sectional, descriptive, and analytical study that took place over a period of one month (from 1st to 31nd March 2023) with patients consulting the post-cure of Psychiatry Service D at Razi Hospital, Tunisia. We included patients diagnosed with schizophrenia according to DSM5, and stabilized on a psychiatric plan. We used the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality over a period of one month. The Buss & Perry Aggression Questionnaire (QABP) was used to measure aspects of aggression. We used the Adult Social Relationships Scales (ASRS), part of the National Institute of Health (NIH) toolkit, assessing six domains of social relationships: perceived rejection, perceived hostility, loneliness, friendship, instrumental support and emotional support.

Results

We collected data from 40 male patients with a mean age of 42.5 ± 14.02. The mean global PSQI score was 9.23 ± 4.58.

Ten patients were on typical antipsychotics, 25 patients were on atypical antipsychotics, and the remaining five patients were on a combination therapy (both atypical and typical antipsychotics). Regarding the use of benzodiazepines, 34 patients were taking lorazepam at a dose of 2.5 to 5 mg per day. he mean QABP global score was 45 ± 12.3 out of 72.

For the subjective evaluation, all patients self-reported feeling “irritable,” “dysphoric,” “unable to communicate with others,” and “wanting to break objects” when they experienced insomnia.

We found a statistically significant association between QABP and daytime dysfunction (p=0.003).

The overall PSQI score was higher, and statistically significantly associated, in patients who reported low emotional support (p=0.018) and perceived social rejection (p=0.04).

Conclusions

An integrated approach that includes the evaluation of sleep disorders, as well as the prevention and management of violence, can play a key role in the overall improvement of the mental health of patients with schizophrenia.

Disclosure of Interest

None Declared
The impact of sleep deprivation on symptoms of anxiety, depression, stress and on the quality of life in medical staff
Authors: Pavllo M.
Published: August 2024

Introduction

Sleep deprivation is studied in medical staff, as it is a target group more exposed to chronic lack of sleep compared to the normal population.Chronic sleep deprivation has an important impact in the lifestyle of health workers and in their productivity

Objectives

The study aims to examine the impact of sleep deprivation on medical staff, who work night-shifts and / or 24 hours on the symptoms of anxiety, depression, stress and quality of life.

Methods

This is a quantitative, cross-sectional study. The research instruments used are two: the DASS-42 questionnaire for measuring the level of symptoms of anxiety, depression, stress and the quality of life questionnaire (WHOQOL-Bref

), which was validated before the study. In the study sample participated N = 199 medical staff (primary doctor, resident, nurse) from several specialties. Inclusive criteria are: medical staff, who work night-shifts and / or 24 hours; age 23 - 67 years; have not been previously diagnosed with anxiety disorder and episodes of depressive disorder.

Results

Refering to the DASS-42 scoring, the symptoms of depression in the medical staff are: normal 64.8%, mild 8.5%, moderate 21.1%, severe 4.5% and extremely severe 1%. Refering to the points collected from the DASS-42 questions on the symptoms of anxiety in medical staff, it results: normal 53.3%, mild 8%, moderate 17.1%, severe 14.1% and extremely severe 7.5%. Based on the points collected from the DASS-42 questions on stress symptoms in medical staff, it results: normal 54.3%, mild 18.6%, moderate 17.1%, severe 9% and extremely severe 1%. Also, the lower the level of stress, anxiety and depression the higher the quality of life. (p.01, p.05). Total WHO- Quality of life (F = 3.447, p≤.05) and physical health (F = 6.482, p≤.05) show significant differences between the educational level, where it is higher among medical staff with postgraduate education.

Conclusions

Working night-shifts and/or 24 hours affects the mild and moderate onset of symptoms of anxiety, depression and stress. The level of stress symptoms is perceived higher in females. The overall quality of life is perceived as average according to the Likert scale. Sleep deprivation affects free time. Medical staff have a restricted free time.The level of anxiety, depression and has a direct impact in the quality of life. The overall quality of life and physical health are rated higher in medical staff with postgraduate education.

Disclosure of Interest

None Declared
Design of a homelessness-focused suicide prevention program
Authors: Calvo F. , Giralt C. , Alfranca R. , Solench-Arco X. , Forcada I. , Font-Mayolas S.
Published: August 2024

Introduction

This project proposes a program for the promotion of mental health and prevention of suicidal behavior among individuals experiencing homelessness, with the aim of reducing suicidal ideation and suicide mortality within this vulnerable population.

Objectives

The project aims to implement an evidence-based program to reduce suicidal ideation and suicide mortality among homeless individuals. This will be achieved through two phases: a review of scientific literature and the development of the program in collaboration with experts and homeless individuals.

Methods

The first phase of the project involved a review of scientific literature to identify the most effective content and programs for improving mental health and preventing suicide. These findings were adapted for application in the program and for dissemination to professionals who will directly engage with individuals experiencing homelessness.

In the second phase, the program content was designed in collaboration with experts and validated through the input of educational professionals. Additionally, individuals experiencing homelessness actively participated in the creation of materials and the definition of the approach to be utilized. Subsequently, a four-hour training was provided to professionals working in specialized homeless shelters to guide groups of individuals experiencing homelessness.

Results

The program consists of the following components:

-

Training and Awareness: Workshops and campaigns to reduce the stigma surrounding suicide.

-

Early Detection and Risk Assessment: Staff training in recognizing suicide indicators and risk assessment protocols.

-

Psychological and Social Interventions: Crisis teams, individual and group therapy.

-

Access to Services: Mobile mental health clinics and collaborations with healthcare professionals.

-

Ongoing Support and Monitoring: Temporary housing programs and support groups.

Conclusions

The proposed program seeks to mitigate the risk of suicide among individuals experiencing homelessness through a comprehensive approach. The collaboration of experts and homeless individuals ensures that the solutions are appropriate and effective. The implementation of this program has the potential to make a significant difference in promoting mental health and preventing suicide within this vulnerable population.

Disclosure of Interest

None Declared
Anime watching in childhood may affect suicidal risk factors in adult life
Authors: Marachev M. , Rudchenko V. , Grigorieva A. , Usova L. , Mokritskaya A.
Published: August 2024

Introduction

Suicide is one of the leading causes of death worldwide being the fourth major cause of death among young people 15-29 years old. The reduction of suicide mortality is prioritized by the World Health Organization (WHO, 2019). There is a number of internal and external factors associated with suicidality (Soto-Sanz V et al., 2019; Farbstein et al., 2022.). Special attention is paid to the influence of the social media on suicidality (Cheng A. T. A. et al., 2007; Niederkrotenthaler T. et al., 2020; Sedgwick R. et al., 2019). In the Russian Federation, anime, an animation genre and a media cultural phenomenon, is increasingly popular among young people. Characters who are lonely and lost their meaning of life are common in anime. Romanticization and idealization of such characters may lead to increased attractiveness of death and thus have a negative effect on the mental health of adolescents and young adults due to their incomplete identity development (Liu Y. et al., 2022; Backer, H. A., 2023).

Objectives

We aimed to study the influence of the anime on the presence of suicidality and depression in adolescents and young adults in the Russian Federation.

Methods

We interviewed 304 people living in the Russian Federation and watching anime on the regular basis (244 women, mean age 20.9 ± 3.8 years, range 13-36 years). We collected sociodemographic data and age when a person had started watching anime. We performed Reasons for Living Inventory, RFL (M. Linehan et al., 1983), Beck Depression Inventory, BDI (Aaron Beck, 1961). We divided all participants into three groups according to their age: adolescents (13-19 years), young people (20-24 years), adults (25-36 years). In each group, we compared BDI: level of depressive symptoms, cognitive-affective subscale, subscale of somatic manifestations of depression; RFL scales: Survival coping beliefs, responsibility to family, child related concerns, fear of suicide, fear of social disapproval, moral objections between three subgroups based on the age of the anime watching start (<12 years old, 12-15 years old, ≥16 years old) using Kruskall-Wallis test and post hoc Mann-Whitney U-test for pair comparisons with Bonferroni correction for multiple comparisons. Level of significance p<0.05.

Results

In the adolescents (n=130), we did not find any differences between the three subgroups. In the young people (n=127), participants who had started watching anime in childhood (<12 years old) had higher level of depression (p= 0,014) and higher level of cognitive-affective symptoms (p= 0,006). In the adults (n=47), participants who had started watching anime in childhood had decreased moral attitudes contrary to suicide (p= 0,004). Other scales not found to differ significantly.

Conclusions

Start of the anime watching in childhood (<12 years old) was associated with increased suicidal risk factors and decreased anti-suicidal factors in the young adults.

Disclosure of Interest

None Declared