bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient safety in community-based mental healthcare: A systematic scoping review
Authors: Averill P. , Vincent C. , Reen G. , Sevdalis N. , Henderson C.
Published: September 2022

Introduction

There is limited existing research about patient safety issues in mental healthcare. A lack of evidence is particularly pronounced in relation to safety in community-based mental health services, where the majority of care is provided. To date, reviews of mental health patient safety literature have focused primarily on inpatient care settings.

Objectives

This systematic scoping review will aim to identify and synthesise literature about the types of patient safety problems in adult community-based mental health settings, the causes of these problems, and evaluated safety interventions in this care context.

Methods

A systematic search was conducted on 19th June 2020 and refreshed on 23rd October 2021, across five databases: Medline, Embase, PsycINFO, Health Management Information Consortium, and Cumulative Index to Nursing and Allied Health Literature. The search strategy focused on three key elements: ‘mental health’, ‘patient safety’ and ‘community-based mental health services’. Retrieved articles were screened at title, abstract and subject heading level, followed by full-text screen of longlisted articles.

Results

In this presentation, the findings of this systematic scoping review will be described, based on synthesised literature about safety incidents, broader care delivery problems, their causes, and evaluated patient safety interventions to address these issues.

Conclusions

This study will offer learning opportunities about the safety problems, contributory factors, and safety interventions in adult community-based mental health services, as described in the evidence base. Review findings will also help to ascertain gaps in existing research, which should be addressed in future studies.

Disclosure

NS is the director of London Safety and Training Solutions Ltd, which offers training in patient safety, implementation solutions and human factors to healthcare organisations and the pharmaceutical industry. The other authors have no competing interests.
Application of a decision support system for providing better mental health care: the case of the Basque Country (Spain)
Authors: Almeda N. , García-Alonso C. , Salvador-Carulla L.
Published: September 2022

Introduction

Decision Support Systems (DSS) are appropriate tools for guiding policymaking processes in Mental Health (MH) management, especially where a balanced and integrated care provision is required.

Objectives

To assess the performance of a MH ecosystem for identifying benchmark and target-for-improvement catchment areas according to the Balanced Care model.

Methods

The MH provision, distinguishing inpatient, day and outpatient main types of care, has been assessed in the Mental Health Network of Gipuzkoa (Basque Country, Spain) using a DSS, integrating Data Envelopment Analysis, Monte-Carlo Simulation and Artificial Intelligence. 13 catchment areas, defined by a reference MH centre, are the units (universe) for the analysis. The indicators for MH ecosystem performance were: relative technical efficiency, stability and entropy, for identifying both benchmarking and target-for-improvement areas. The analysis of the differences between the two groups can be used to design organizational interventions.

Results

The Mental Health Network of Gipuzkoa showed high global efficiency scores, but it can be considered statistically unstable (small changes in variable values can have relevant impacts on its performance). For a global performance improvement, it is recommended to reduce admissions and readmissions in inpatient care, increase workforce capacity and utilization of day care services and, finally, increase the availability of outpatient care services.

Conclusions

This research offers a guide for evidence-informed policy-making to improve MH care provision in the main types of care and provide aftercare. The characteristics of the area to be improved are critical to design interventions and assess their potential impact on the MH ecosystem.

Disclosure

No significant relationships.
Mental Health and economic effects: correlation between unemployment and psychoactive drugs
Authors: Ramos J.
Published: September 2022

Introduction

Mental Health is an invisible part of public health, and a determinant of it by affecting the human, social and economic capital of countries. Is one of the main causes of disability worldwide and, when left untreated, they can lead to increased costs and premature mortality. In 2019 they represented 22% of the disability burden in DALY in the European Union. Regarding the effects of economic recessions studies suggest that they have detrimental effects on mental health. And can became a reality in the current pandemic scenario.

Objectives

To reflect on the studies carried out that debate the effects of previous economic crises on mental health, particularly the 2008-2013 crisis. It aims to list not only the possible intervention strategies in the area as well as the barriers to their implementation.

Methods

Classic review of the topic through the international literature and the state of the art on available platforms. Establish a proxy between the unemployment rate and the number of packages (antidepressants and anxiolytics consumed) in homologous periods as a representative capacity of the impact of the crisis on mental health.

Results

The number of packages of antidepressants and anxiolytics behave differently. the antidepressants have greater consumption when unemployment decreases.

Conclusions

Several studies describe that the increase in the unemployment rate, indebtedness and social exclusion are empirically proven as consequences of the economic crises and predisposing factors for mental pathology. However, this does not translate into a proxy for the consumption of antidepressant packages with the increase in the unemployment rate. It may be due to the non-prioritization of mental health.

Disclosure

No significant relationships.
Scalable psychological interventions for Syrian refugees: Preliminary results of a randomized controlled trial on the peer-refugee delivered Problem Management Plus (PM+) intervention in the Netherlands
Authors: De Graaff A. , Sijbrandij M. , Cuijpers P.
Published: September 2022

Introduction

In the past decade, millions of Syrians have sought refuge in neighboring countries and Europe. Refugees are at increased risk for the development of common mental disorders (CMD), such as depression and posttraumatic stress disorder (PTSD), but only a small percentage access mental health services. Problem Management Plus (PM+) is a brief, scalable intervention targeting symptoms of CMDs that can be delivered by non-specialist helpers in communities affected by adversity, such as refugees.

Objectives

The aim of this randomized controlled trial (RCT) is to evaluate the effectiveness of PM+ among Syrian refugees in the Netherlands.

Methods

Adult Syrian refugees and other Arabic-speaking refugees of 18 years and older with self-reported psychological distress (K10 >15) and functional impairment (WHODAS 2.0 >16) are included. Participants are randomized into PM+ or care as usual. Follow-up assessments are conducted at one-week, three-month and twelve-month follow-ups. Clinical outcomes are symptoms of depression/anxiety (HSCL-25), PTSD (PCL-5), and functional impairment (WHODAS 2.0).

Results

By November 2021 [recruitment ends by December 2021], 214 participants were screened for eligibility and 184 participants were included. Participants are M=36.5yrs old (range 18-69yrs), and 73 participants are female (39.7%). We will present preliminary results for the effects of PM+ on depression, anxiety, PTSD, and functional impairment at one-week follow-up, as well as barriers and facilitators for implementing PM+ in a European country.

Conclusions

After positive evaluation of peer-refugee delivered PM+, the Arabic manual and training materials will be made available through WHO to encourage scaling-up.

Disclosure

No significant relationships.
Bipolar disorder and grey matter heterotopia : a case report
Authors: Bergaoui E. , Zrelli M. , Staali N. , Moalla M. , Lansari R. , Melki W.
Published: September 2022

Introduction

The grey matter heterotopias are a relatively common group of conditions characterized by interruption of normal neuronal migration from near the ventricle to the cortex. Subependymal grey matter heterotopia, also known as periventricular heterotopia, is the most common form.

Objectives

To search a link between bipolar disorder and grey matter heterotopia

Methods

A case report of a woman with grey matter heterotopia who is diagnosed as bipolar

Results

A 34 year old woman was admitted at Razi psychiatric hospital 3 months after childbirth. She was agitated, logorrheic with multiple projects and insomniac. The diagnosis was a manic episod with a marked score of 28/44 at The Bech-Rafaelsen Mania Scale (MAS). The patient was treated with 4 mg of risperidone and 1000 mg of sodium valproate with partial remission after two weeks. One month after her discharge, she had depressive mood, asthenia, anhedonia and insomnia. She had a score of 19 at Hamilton Depression Rating Scale (HDRS). She was switched from risperidone to olanzapine 15mg/j with partial remission after two weeks. In front of persistent symptoms with labile mood, she took lithium 1000 mg/j. She was complaining of a headache and a fluctuating heaviness of the right upper limb. At brain imaging, she had periventricular nodular heterotopia. The patient was adressed to neurology department.

Conclusions

Grey matter heterotopia can cause a variety of neuropsychiatrc symptoms which can lead to diagnosis difficulties. Therefore, in front of atypical symptoms or drug-resistance, patients should be referred for brain imaging.

Disclosure

No significant relationships.
A narrative approach to trichotillomania
Authors: Gonçalves Cerejeira J. , Santos Carrasco I. , Gonzaga Ramírez A. , Queipo De Llano De La Viuda M. , Guerra Valera G. , De Andrés Lobo C. , Jiménez Aparicio T.
Published: September 2022

Introduction

Trichotillomania is an obsessive-compulsive spectrum disorder characterized by recurrent and uncontrolled hair pulling. This behavior causes significant anxiety as well as low self-esteem in people who suffer from this disorder. There is still no therapy of proven efficacy in the treatment of trichotillomania. Psychotropic drugs and cognitive behavioral psychotherapy have been tried in the management of this disease, but the relapse rate is high. Narrative therapy is an innovative type of postmodern psychotherapy and in our literary search we have not found data related to its use in the treatment of trichotillomania.

Objectives

To present a novel therapeutic approach to a highly resistant disorder, trichotillomania.

Methods

Case report and literature review.

Results

We present a case of a 39-year-old woman diagnosed with trichoticolomania twenty years earlier. She tried several types of psychotherapies for manage her hair-pulling problem, all related with relapse only a few days after finishing the sessions. We have carried out a total of 5 narrative therapy sessions spread over 3 months. No relapses have been observed during the subsequent 9-month follow-up period.

Conclusions

Based on our experience, we believe that Narrative Therapy is a good and still unexplored alternative for people diagnosed with trichotillomania.

Disclosure

No significant relationships.
Herpes Simplex-1 and Toxoplasma gondii in Obsessive-Compulsive Disorder: clinical and brain imaging correlates
Authors: Maia A. , De Souza Queiroz J. , Barahona-Correa B. , Oliveira J. , Oliveira-Maia A.J.
Published: September 2022

Introduction

Obsessive-compulsive disorder (OCD) is a chronic, prevalent, and highly impairing psychiatric illness. While its aetiology remains unknown, several infectious agents have been associated to obsessive-compulsive symptoms, including herpes simplex virus 1 (HSV-1) and Toxoplasma gondii.

Objectives

To evaluate the serostatus for HSV-1 and Toxoplasma gondii in sample of patients with OCD, as well as its clinical and brain imaging correlates.

Methods

Twenty-six patients with OCD and 30 healthy controls recruited in Lisbon were assessed for sociodemographic and clinical characteristics using the Yale-Brown Obsessive-Compulsive Scale-II (YBOCS-II) and the Beck Depression Inventory-II (BDI-II). Seropositivity for HSV-1 and Toxoplasma gondii was assessed in serum using ELISA, and volumes of cortical and subcortical structures were assessed using T1-weighted magnetic resonance imaging.

Results

YBOCS-II and BDI-II scores were significantly higher in patients, while age, sex, smoking status, and seropositivity for HSV-1 and Toxoplasma gondii were similar between the two groups. Among OCD patients, those seropositive for HSV-1 had significantly lower volumes of total white-matter, total grey-matter, left and right putamen, while for HSV-1 seropositive healthy controls, only the last two were significantly smaller. In multiple regression analyses to control for age, associations between HSV-1 and brain volumes were conserved, while the effect of age was not significant. No significant differences were found in brain volumes of patients with OCD according to seropositivity for Toxoplasma gondii.

Conclusions

Our preliminary results suggest that in patients with OCD, seropositivity to HSV-1 is associated with smaller volumes of total white- and grey-matter in the brain.

Disclosure

No significant relationships.
Assessment of obsessive and compulsive symptoms in patients with schizophrenia
Authors: Ajmi S. , Ellouze S. , Abdelkefi M. , Turki M. , Halouani N. , Aloulou J.
Published: September 2022

Introduction

Obsessive-Compulsive Symptoms (OCS) are common in patients with schizophrenia, with a prevalence of 3.5% to 25%.

Objectives

The aim of our study was to assess the frequency of OCS in patients with schizophrenia, and to study the clinical and evolutionary characteristics of schizophrenia and OCS comorbidity.

Methods

We conducted a cross-sectional, descriptive, and analytical study. Thirty schizophrenic patients were recruited in the department of psychiatry B of Hedi Chaker university hospital of Sfax. We used the Yale-Brown Obsession-Compulsion Scale (Y-BOCS) to assess obsessive and compulsive symptoms, at the end of hospitalization, after clinical remission of schizophrenic symptoms.

Results

The mean age of patients was 41.2, that of disease onset was 27.3. Most of patients were male (86.7%) and unemployed (81.3%). A personal history of suicide attempts was found in 16.6% of patients. The average number of hospitalizations was 8.83. OCS were noted in 36% of patients with a Y-BOCS mean score of 5.5. Patients with OCS had significantly more frequent alcohol use (p = 0,008), a higher number (p = 0.03) and longer duration of hospitalizations (P = 0,034) and are more frequently treated with atypical antipsychotics (p = 0.001).

Conclusions

Our results show that patients with schizophrenia frequently present OCS. This comorbidity has a negative impact on the evolution and the prognosis of the disease, as well as the functioning of patients. Therefore, it should be investigated in order to ensure better care and promote the socio-professional reintegration of these patients.

Disclosure

No significant relationships.
OCD symptom dimensions and treatment: a new dimension?
Authors: Soares Da Costa I. , Moreira R.
Published: September 2022

Introduction

Background: Obsessive-compulsive disorder (OCD) is a condition that includes distressing obsessions and repetitive compulsions. Usually presents with a wide range of symptons normally grouped into different clusters or dimensions. clinical impression and some empirical data suggest that certain groups of symptoms or clusters are more responsive to treatment than others, thus it can help clinicians to better guide initial treatment choices and management of individual patients

Objectives

Objetictive: to describe the symptom dimensions in a clinical database that includes patients accompannied in an obssessive conpulsive disorder consultation in a tertiary hospital in Portugal and to point out some differences in treatment outcomes.

Methods

We searched Pubmed and Cochrane Library database for english language articles.

Results

To date it appears that pharmacotherapy and CBT are an effective treatment for the various OCD dimensions, although not all dimensions have been adequately studied or respond well to treatment. Knowing a specific symptom profile may have implications in treatment components that clinicians should be aware of.

Conclusions

More research will be needed to determine the best tailor treatments to each patient’s profile and Modifications to treatment may be needed. Clinical implications and directions for future research are discussed.

Disclosure

No significant relationships.
Obsessive-Compulsive Disorder and suicide: what do we know up until now?
Authors: Salvadori G. , Osaku L. , Porcu M.
Published: September 2022

Introduction

Obsessive-Compulsive Disorder (OCD) was recently (in 2015) associated with suicidal risk, regardless of depression or other mental disorders, but it is a disorder with great heterogeneity, and the subtypes involved in this risk have not yet been clarified.

Objectives

To verify which patterns of OCD symptoms are more associated with suicidal risk, other possible risk factors and better treatment options evidenced in the literature.

Methods

Literature review with predefined search criteria and keywords in electronic databases (Pubmed, Virtual Health Library and Cochrane) between 2015 and 2020. Identification, analysis, calculation and synthesis of the results were carried out in a descriptive and qualitative manner.

Results

Twenty five articles were included. Obsessions of unacceptable thoughts pattern, perfectionism traits and alexithymia are important predictors of suicidal risk. Compulsions were not associated with suicide. Depression is the comorbidity with the greatest impact on suicidal ideation. Better socioeconomic status, education, and female gender are protective factors for mortality. The method chosen for attempts is preferably non-violent (drug intoxication). Treatments derived from cognitive behavioral therapy are currently being investigated further, and in addition to the evidence for the use of selective serotonin reuptake inhibitors, antipsychotics have been used as an adjuvant.

Conclusions

Unacceptable thoughts play an important role in suicide resulting from OCD, and the absence of compulsive behavior may be correlated to suicide risk. Treatment directed at cognitions seems relevant. Further studies are needed to clarify the appropriate approach in this subtype of the disease.

Disclosure

No significant relationships.
When depression envelops frontotemporal dementia: The differential diagnostic frame through a case report
Authors: Altunoz U. , Menstell J. , Ziegenbein M.
Published: September 2022

Introduction

Frontotemporal dementia (FTD) is common in presenile population. The overlapping symptoms with other psychiatric disorders can lead to wrong/late diagnosis which cause delays/difficulties regarding case-management. Especially, long-standing and/or late-onset depression can descriptively envelop bvFTD (behavioral-variant) and leads to unnecessary treatments and increased distress. It’s important to implement a descriptive diagnostic algorithm which will help clinicians to distinguish the phenomenology of these disorders.

Objectives

This presentation aims to call attention of the clinicians/researchers to an elaborated effort concerning differential diagnosis of two common disorders with overlapping features through a case-study of a 59-year-old male patient.

Methods

One case from an inpatient unit of a psychiatric clinic in Lower Saxony, Germany will be reported.

Results

Case: The patient was referred to our acute-psychiatric-ward from the day-clinic-unit because of treatment-resistant, severe and long-lasting depressive symptoms. He was depressed, desperate, hopeless, listless and had suicidal thoughts. During the first days of treatment, symptoms like apathy, bad hygiene, weird eating-behavior, urinary incontinence, lack of empathy, language disorders and other behavioral symptoms were evident. Brain-MRI yielded frontotemporal lobar atrophy. Trail-Making-Test and Frontal-Assessment-Battery showed pronounced impairment of executive functions. Mini mental state examination and DemTect yielded light to moderate memory dysfunction. Diagnostic Criteria for Probable bvFTD (International-Consensus-Criteria) were fulfilled.

Conclusions

The diagnosis of bvFTD enabled a rapid assignment of a legal representative and relieved the long-lasting discomfort of the patient and his family that was caused by multiple unsuccessful treatment trials against depression. The differential diagnostic frame between bvFTD and depression will be discussed in view of the current literature.

Disclosure

No significant relationships.
Electronic smart-hub based intervention during COVID-19 in a rural Psychiatry of Old Age service in North-West Ireland
Authors: Patel S. , Gannon A. , Cryan M. , Dolan C. , Mcdonald C. , Houghton C. , Mccarthy G.
Published: September 2022

Introduction

The COVID-19 pandemic caused significant disruptions in services and necessitated innovation to continue care provision to the vulnerable population of older adults with psychiatric needs.

Objectives

The objective of this study was to examine the experiences of staff and patients using a hands-free electronic smart-hub (eSMART hub) intervention to keep patients connected with psychiatry of old age following COVID-19 restrictions.

Methods

A risk stratification register was created of all patients known to the Psychiatry of Old Age service in the North-West of Ireland to identify those at highest risk of relapse. These patients were offered a smart-hub with remote communication and personal assistant technology to be installed into their homes. Smart-hubs were also installed in the team base to facilitate direct device to device communication. Semi-structured qualitative interviews were conducted with 10 staff members and 15 patients at 6-12 months following the installation of the smart-hubs.

Results

The smart-hubs were utilized by the POA team to offer remote interventions over video including clinician reviews, regular contact with key workers and day-hospital based therapeutic interventions such as anxiety management groups and OT led physical exercises. Patients also used the personal assistant aspect of the hub to attend to personal hobbies such as accessing music and radio. Positive feedback related to companionship during isolation and connectivity to services. Negative feedback was mainly related to technology, particularly internet access and narrow scope of communication abilities.

Conclusions

Electronic smart-hub devices may offer an acceptable avenue for remote intervention and communication for isolated high-risk older persons.

Disclosure

The smart hub devices used in this study were donated by Amazon. However, the company was not involved in any other aspect of the study and the researchers have no significant financial interest, consultancy or other relationship with products, manufactur
An old way of forgetting
Authors: Rebeca Coelho J.P.
Published: September 2022

Introduction

During the last decades, the incidence of syphilis is on the rising, particularly in the United States of America and Europe. Neurosyphilis is a disease that has a vast differential diagnostic. With that in mind, clinicians have some difficulties to identify it rapidly. A case of a 57-year-old man is presented, with a brutal change in his behavior, associated with a dementia-like syndrome. He is diagnosed with neurosyphilis.

Objectives

The main goal is to present his clinical psychiatric symptoms and diagnosis procedure, the treatment that he received and his clinical outcome in the psychogeriatric department.

Methods

The treatment was based in an integrated framework of pharmacology and psychotherapy.

Results

The patient was able to slowly recover and to get back home, we a solid structure to make the follow up.

Conclusions

This clinical vignette represents a growing number of adult patients that present themselves for the first time with dementia-like symptoms. It is important to remember, that many diseases are capable of mimicking dementia and their exclusion before admitting a diagnosis of dementia is mandatory.

Disclosure

No significant relationships.
Psychological impact of pediatric cancer : a cross-sectional study among thirty parents
Authors: Zouari A. , Homri W. , Mokrani A. , Meddeb K. , Mezelini A. , Labbane R.
Published: September 2022

Introduction

The diagnosis of pediatric cancer is a traumatic event that is considered to be one of the most adverse situations the child and his family can experience. The psychological impact of this diagnosis on the parents has triggered a great scientific attention in these recent years.

Objectives

Estimate the prevalence of depression and post-traumatic stress among parents of children with cancer.

Methods

Our study was cross-sectional over a period of 1 month in the medical carcinology department at the Salah Azaeiz Institute. We used the Beck Depression Scale II and the Post Traumatic Stress Disorder Cheklist-Civilian assessements.

Results

Thirty parents participated in our study. Most of whom were mothers (73%). The educational level was primary in 63% of cases and socio-economic level was average in 60% of parents. 40% of parents were assessed within six months after diagnosis. Prevalence of depressive disorder and post-traumatic stress disorder were 73% and 57% respectively. The low educational level was correlated to the presence of these two disorders. Similarly, the low educational level was correlated to the presence of depressive disorders (p=0.008). The number of children in the family was also associated to the presence of post-traumatic stress disorder (p=0.029).

Conclusions

The prevalence of depressive and post-traumatic stress disorders was high among parents of children diagnosed with cancer. The low socio-economic and educational level and the large number of children in the family are risk factors for psychological distress. Psychosocial support should be offered to parents of children with cancer to optimize the management of this disease.

Disclosure

No significant relationships.
Coping strategies among mothers of children with leukemia in Tunisia
Authors: Dhakouani S. , Karoui M. , Jammeli S. , Kammoun R. , Ellouz F.
Published: September 2022

Introduction

The diagnosis of leukemia in a child is traumatic life experience that negatively affects parents and especialy the mother which is the “caregiver” who assists and coordinates all stages of treatment.

Objectives

To determine the prevalence of psychological distress among mothers of tunisian children with leukemia and to investigate their coping strategies.

Methods

A cross-sectional study was conducted at Aziza Othmana hospital department of pedo-oncology in Tunisia between June and July 2021. HADS scale was used to estimate the prevalence of anxiety and depression and coping strategies were measured via arabic version of the brief cope scale.

Results

We included 31 mothers, their middle age was 41 years old. In this study we didn’t include mothers with psychiatric history. Acute lymphoblastic leukemia was the most frequent type of cancer in our sample (94%). The middle age of the children was 10 years old and all of them were under chemotherapy. Clinically significant levels of anxiety and depression were reported by 58% and 49% of mothers, respectively. In our study, 81% of the participants practiced prayer and all mothers turned to religion as a coping strategy. Approach coping styles (especially acceptance and planning) were more frequently used than avoidant coping styles (especially substance use and denial).

Conclusions

Mothers are profoundly affected by a child’s cancer diagnosis, they should have early assessment of their mental health needs to have access to appropriate interventions.

Disclosure

No significant relationships.
Psychiatric manifestations of paraneoplastic syndromes
Authors: Lemos M. , Lourenço A. , Ribeiro M.
Published: September 2022

Introduction

Paraneoplastic syndromes (PS) result from indirect effects of neoplasms. In 50% of the cases the symptoms precede the diagnosis and run independently. PS may involve the peripheral or central nervous system, resulting in symptoms from sensory neuropathies to several neuropsychiatric manifestations.

Objectives

To review the psychiatric manifestations of paraneoplastic syndromes affecting the nervous system.

Methods

Selective literature review via PubMed search, using the keywords “paraneoplastic syndromes”, “endrocrine paraneoplastic syndromes”, “neuropsychiatric manifestations”, “limbic encephalitis”.

Results

The prevalence of PS varies with the type of cancer (<1% for breast and ovarian cancers; 3-5% for small cell lung cancer; 20% for thymomas). The general mechanisms behind PS are related to the production of substances by the tumor that directly or indirectly cause distant symptoms, the depletion of substances or the host response to the tumor. Frequently there are autoimmune phenomena involved, with the production of antineuronal antibodies that recognise various antigens at the nervous system. Paraneoplastic neurological disorders include limbic encephalits that can present subacutely with symptoms of depression, irritability, hallucinations, cognitive impairment associated with sleep alterations, confusion and seizures. Others include psoclonus-myoclonus ataxia syndrome, neuromyotonia and cramp fasciculation syndrome. Metabolic and endocrine paraneoplastic syndromes (hypercortisolism, carcinoid tumors, pancreatic cancer) can result from the production of cytokines and hormones by the tumor and produce mood disorders, confusional states and psychosis.

Conclusions

PS can be related to various neuropsychiatric manifestations affecting consciousness, cognition, mood and perception. The recognition of this association can alert for the possibility of a cancer diagnosis specially when facing a patient with unusual clinical presentation.

Disclosure

No significant relationships.
What should General Adult Psychiatrists know about Reproductive Counselling of Women with Severe Mental Illness?
Authors: Kurimay T.
Published: September 2022

A notable part of psychiatry is prevention. Our job, as psychiatrists, is not only to treat mental disorders, but also to prevent them. Treating mothers in postnatal period reducing the negative consequence of depression for child development, for example. General adult psychiatrists face the challenge of having patients, who receive psychiatric health care, while also planning to have a child. Many professionals may find themselves in a situation, when they feel clueless on what to advise regarding pharmacotherapy and realistic expectations on having a child. The presentation will focus on some crucial topics. What should counselling include when planning pregnancy, highlighting differences among first and second or further children. Potentials risks and harms on the fetus / new-born baby will be introduced with emphasis on pharmacological/chemical agents, infectious effects and social, relational and family stressors. What the guidelines are for Covid-19 vaccination and pregnancy. Relative and absolute contraindications of planned pregnancy will be discussed. The crucial question of artificial/therapeutic abortion; are there any psychiatric conditions, when a psychiatrist can/should suggest it? The advantage and knowledge of perinatal mental health guideline papers, bio-ethical aspects will be discussed, along with the consequences of untreated mental illness. Advantage of breastfeeding and an up-to-date view on what should be psychiatrists’ aim will be introduced. Why is it inevitable to cooperate with GPs, obstetric- and gynecology colleagues and further medical professionals? The essential aspect and advantages of involving fathers and extended family members in this approach also will be explained.

Disclosure

No significant relationships.
Developing a Systematic Training Programme in Women’s Mental Health
Authors: Mcdonald L.
Published: September 2022

This presentataion outlines the development of a post-membership masterclass programme in Perinatal Psychiatry, funded by Health Education England and delivered through the Royal College of Psychiatrists. The masterclass programme renges from 5-15 days and there are separate programmes for consultants, SAS doctors and senior trainees in psychiatry. The course is delivered by experts in the area and contains a mix of didactic teaching and small group work. The programme was developed to meet the workforce needs of rapidly expanding perinatal mental services throughout England. The programme also helps facilitate the needs of perinatal psychiatrists from Ireland and from the devolved nations of the UK (Scotland, Wales and Northern Ireland).

Disclosure

No significant relationships.
Psychometric Properties of the Arabic Big Five Inventory-2 Short Form among Undergraduates in Kuwait
Authors: Alansari B. , Alali T.
Published: September 2022

Introduction

The BFI-2-S assesses the domain level of the Big Five with three prototypical facets of each domain capturing approximately 91% of the total variance in the full BFI-2 domain scales and approximately 89% of the predictive power of the BFI-2 facets in German adaptations and their original American versions.

Objectives

The study aims to investigate the psychometric properties of the Arabic adaptation of the BFI-2 short form.

Methods

The Arabic version of the BFI-2-S a 30-item with 15 and NEO Five-Factor Inventory (NEO–PI-R) were administered to 1560 (576 males, 984 females) Kuwait University undergraduates with a mean age = 22.75 ± 3.81. The internal consistency reliability, factor structure, and convergent validity of the BFI-2-S with NEO–PI-R were assessed.

Results

Cronbach’s alpha was satisfactory for N (0.79), E (0.73), O (0.73), A (0.76) and C (0.77). Results revealed significant gender differences in O, C & E with a favor for males and in N a favor with females. PCA showed that BFI-2-S five factors explains 64.38% of the total variance. However, the high mean correlations between the BFI-2-S and NEO–PI-R scales, with coefficients of (0.67) for the N, (0.66) for the E, (0.56) for the C, (0.61) for the A, and (0.58) for the C. The convergence between each BFI-2-S domain correlated substantially with the relevant NEO-PI-R domain scales, with the average correlation being .62.

Conclusions

The findings support the psychometric properties of the Arabic adaptations of the BFI-2-S as useful instruments for assessing the Big Five.

Disclosure

No significant relationships.
The relation between Complex PTSD and Borderline Personality Disorder – a review of the literature
Authors: Ramos B. , Santos Martins F. , Elias De Sousa A. , Soares Da Costa I. , Andrade F.
Published: September 2022

Introduction

Adults diagnosed with Borderline Personality Disorder (BPD) likely have a history of psychological trauma. There has been research about the connection between Complex Post-Traumatic Stress Disorder (c-PTSD) and BPD.

Objectives

This paper provides a review of the relationship between complex trauma and key features of BPD.

Methods

Review of the literature from 2015 to present, using search engines such as Pubmed and Google Shoolar, using the following keywords: borderline personality disorder, complex post-traumatic stress disorder, trauma

Results

Traumatic victimisation and compromised primary caregiving relationships have been hypothesized to be key aetiological factors in the subsequent development of BPD. c-PTSD was defined as a syndrome with symptoms of emotional dysregulation, dissociation somatisation and poor self-esteem, with distorted cognition about relationships, following traumatic interpersonal abuse. It was proposed as an alternative for understanding and treating people who had suffered prolonged and severe interpersonal trauma, many of whom were diagnosed with BPD. Although, the boundaries between c-PTSD and BPD remain vague. Currently, the main difference is the assumption that symptoms of c-PTSD are sequelae of exposure to traumatic stress, which is not inherent in the current DSM-5 definition of BPD. Furthermore, to date, the neurochemistry and neurostructural changes seen in c-PTSD, BPD and PTSD do not clearly differentiate the three conditions.

Conclusions

BPD and PTSD are relatively distinct with regard to the precise qualitative definitions of their diagnostic features, but nevertheless have substantial potential overlap in their symptom criteria.

Disclosure

No significant relationships.
Limitations of Mechanistic Model of Explanation in Biological Psychiatry
Authors: Salcedo Gómez M. , García Aguilar C.
Published: September 2022

Introduction

The National Institute for Mental Illness (NIMH) launched in 2008 a project based on ‘precision medicine,’ called Research Domain Criteria (RDoC). This precision medicine approach, novel in the context of psychiatry, proposes to identify the “fundamental components of behavior,” determining their range of variations from normality to abnormality and identifying their instantiations at different levels of the biological mechanism. To achieve its goal, an essential task of the RDoC initiative has been to identify and classify psychological constructs associated with psychopathology and to cut them off at a finer degree of granularity, presumably in order to have a greater chance of finding the biological mechanisms which implement every resultant part.

Objectives

Our work aims to show the limitations that psychiatry faces when assuming the mechanistic model of explanations. We will show how, if we accept the phenomenon of multiple realization, it is not plausible to expect that the RDoC initiative will be successful in their enterprise to track single or precise causal mechanisms for every construct identified at the cognitive level.

Methods

Philosophical argumentation

Results

No results.

Conclusions

We conclude that an approach that aims to identify single functional units and to dig down at a “fundamental level” to find their neural or genetic implementation should not only be reconsidered in terms of the phenomenon of multiple realization, but also leaves a gap in our understanding of the complex structures that are found at the cognitive-functional level and whose dysfunctions would be of great explanatory relevance concerning mental disorders.

Disclosure

No significant relationships.
Specifics of attitudes towards traditional Chinese medicine in dental students
Authors: Nikolaev E. , Petunova S.
Published: September 2022

Introduction

Traditional Chinese medicine (TCM), conceived in the womb of Chinese culture, is gaining more and more popularity in the world. What views on its possibilities do dentists studying in Russia have?

Objectives

Our goal is to establish the peculiarities of the attitude to TCM that are characteristic of dental students and correlate them with their psychosocial qualities.

Methods

We surveyed anonymously 106 dental students of Ulianov Chuvash State University using the Attitude to TCM Survey (E. Nikolaev) and the Sociocultural Health Questionnaire (E. Nikolaev). To analyze the interrelations, we used a correlation analysis.

Results

More than two thirds of the respondents (72.6%) know about TCM, 20.8% consider it more effective than conventional medicine. Respondents with a higher level of stress show more interest in TCM (r=.27, p<.05), those who smoke hookah have less interest (r=-.25, p<.05). Students who less often work out in a gym are ready to turn to TCM (r=.23, p<.05). Students who are less often engaged in sports are more inclined to go to China for TCM treatment (r=.19, p<.05). They also less often agree that TCM can help Russian people (r=-.22, p<.05). Stronger belief in the possibilities of TCM correlates with deeper trust in private medicine (r=.22, p<.05). We did not find any correlations with the level of health.

Conclusions

A more positive attitude to TCM in dental students is correlated with less physical activity, higher stress, as well as deeper trust in private medicine.

Disclosure

No significant relationships.
Tailored Immersion: Implementing Personalized Components Into Virtual Reality for Veterans With Post-Traumatic Stress Disorder
Authors: Van Veelen N. , Boonekamp R. , Schoonderwoerd T. , Emmerik M. , Nijdam M. , Bruinsma B. , Geuze E. , Jones C. , Vermetten E.
Published: September 2022

Introduction

With the application of virtual reality (VR), tailored interventions can be created that mirror the traumatic experiences of veterans with post-traumatic stress disorder (PTSD). Visual elements can be mimicked, and auditory and other senses stimulated. In doing so, the degree of immersion can be adjusted to optimize the therapeutic process. Objectively measuring the sensory immersion is key to keep subjects within their personal window of tolerance. Based on this information the therapist can decide manipulate the sensory stimulation embedded in the treatment.

Objectives

The objectives of this study are to explore the different immersive design aspects of VRET that can be modified to influence the experienced presence in veterans with PTSD, and to discuss possible methods of measuring the emotional response facilitated by immersive design aspects and experienced presence.

Methods

Four design aspects are discussed: system, sensory cues, narrative and challenge. We also report on a user experiment in three veterans that informed on quality and depth of immersion.

Results

Believability of the neutral virtual environment was important for maintaining the veterans’ presence within the VR experience. The immersive design aspects that were personalized and supportive in the narrative of the veteran such as music and self-selected images appeared to have a strong influence on recall and reliving of the traumatic events.

Conclusions

Finally, in order to increase the therapeutic effect in veterans with PTSD, the highlighted design aspects should be recognized and tailored to maximize immersion in virtual reality exposure therapy.

Disclosure

No significant relationships.
Finding meanings in Late onset Post Traumatic Stress Disorder – a review of the literature
Authors: Ramos B. , Soares Da Costa I. , Elias De Sousa A. , Andrade F. , Santos Martins F.
Published: September 2022

Introduction

About a decade ago, the idea of a Late-Onset Post Traumatic Stress Disorder (LO-PTSD) emerged, in order to characterize the later-life emergence of symptoms related to early-life warzone trauma among aging combat Veterans.

Objectives

This paper provides a review of the changes happened during the onset of a late form of PTSD and how can mental health professionals intervene.

Methods

Review of the literature from 2015 to present, using search engines such as Pubmed and Google Schoolar, using the following keywords: Late-Onset Post Traumatic Stress Disorder, triggers, prevention, intervention

Results

At first, there was hypothesized that aging-related challenges (role transition and loss, death of family members and friends, physical and cognitive decline) might lead to increased reminiscence, and possibly distress, among Veterans who had previously dealt successfully with earlier traumatic events. However, recent studies have proposed that in later life many combat Veterans confront and rework their wartime memories in an effort to find meaning and build coherence. Through reminiscence, life review, and wrestling with issues such as integrity versus despair, they intentionally reengage with experiences they avoided or managed successfully earlier in life, perhaps without resolution or integration. This process can lead positively to personal growth or negatively to increased symptomatology.

Conclusions

Therefore the role of preventive intervention in enhancing positive outcomes for Veterans who reengage with their wartime memories in later life should be reconsidered.

Disclosure

No significant relationships.
Predictors of rehospitalization in Psychotic Patients after their first hospitalization
Authors: Álvarez P. , Palau A. , Russo C. , Nieto E.
Published: September 2022

Introduction

It is important to determine those clinical factors that imply a greater risk of rehospitalization in psychotic patients

Objectives

To determine the rate and predictors of rehospitalization in psychotic patients after their first hospitalization

Methods

We include all Psychotic patients admitted for first time in their life in our Psychiatric Unit between 2009 and 2019 (N=359) , including all diagnosed according DSM-IV of Schizophrenia or other Psychotic disorders -Multiple clinical, sociodemographic and biological variables of the basal hospitalization were recorded With the SPSS program we compared the variables between patients who needed any hospitalization in the follow-up until 31th December 2019 and those who do not. We use the Chi square ( qualitative variables) and the Student T ( quantitative variables)

Results

109 psychotic inpatients had at least one rehospitalizations (30,4%). The qualitative variables significantly associated with rehospitalization were : cannabis in urine at admission (P<0.03), and treatment with risperidone (P<0.014). Instead treatment with long acting paliperidone was associated with absence of rehospitalization (P<0.005) .The quantitative variables relationed significantly with multiple rehospitalization were : lower age (P<0,015) lower HDL cholesterol levels (P<0.02) and higher years of follow-up after discharge (P<0.000)

Conclusions

1-More of 30% of psychotic patients need rehospitalization after their first hospitalization in a mean of follow up of 5,8 years 2-Lower age, longer follow-up period and treatment with risperidone are significantly associated with rehospitalization , instead treatment with long acting paliperidone are significantly associated with absence of rehospitalization

Disclosure

No significant relationships.
Nutritional Psychiatry: Knowledge, Attitudes and Clinical Practice of Mental Health Professionals
Authors: Michielsen P. , De Smet D.
Published: September 2022

Introduction

In 2016 the United Nations launched their “Decade of action on nutrition” promoting a healthy and sustainable food pattern. The International Society for Nutritional Psychiatry Research held its first International Conference in 2017. Current evidence in this area consists mainly of association studies, while interventional studies with food supplements or altered diet patterns are starting to emerge.

Objectives

To our knowledge practice based research on promoting healthy food and investigating the role of medical professionals is scarse in general and especially so in psychiatry. Hence, our research questions were: 1. What is the attitude of mental health professionals with regard to promoting healthy food in their patients. 2. What is the subjective knowledge and attention in training schemes on this topic.

Methods

We conducted a self-made online questionnaire using a 5 point Likert Scale. Surveys were sent out to 50 mental health professionals of our institution, including psychiatrists, psychiatric residents, General Practitioners and Mental Health Nurse Practitioners. Results were analysed with descriptive statistics.

Results

40 (80%) of the respondents returned the questionnaire. 65% of respondents considered promoting healthy food as a key task for themselves in their daily practice. 45% of respondents believed their patients would be reluctant to follow advice on healthy diet. 62% had sufficient knowledge on the subject to give professional advice, while 65% answered this topic received insufficient attention during their training.

Conclusions

In this survey we found the role of promoting healthy diet deserves more attention in mental health practice and training. Smartphone applications may ameliorate treatment adherence.

Disclosure

No significant relationships.