bluuebunny/crossref_metadata_2025 huggingface dataset:
Sense of Agency and Its Disturbances: A Systematic Review Targeting the Intentional Binding Effect in Neuropsychiatric Disorders.
Authors: Di Luzio M. , Moccia L. , Conte E. , Modica M. , Ambrosecchia M. , Ardizzi M. , Lanzotti P. , Kotzalidis G. , Janiri D. , Di Nicola M. , Janiri L. , Sani G. , Gallese V.
Published: August 2024

Introduction

The sense of agency (SoA) indicates a person’s ability to feel her/his own motor acts as actually being her/his, and through them to exert control over the course of external events. Disruptions in SoA may profoundly affect the individual’s functioning, as observed in several neuropsychiatric disorders.

Objectives

This is the first article to systematically review studies that investigated intentional binding (IB), a quantitative proxy for SoA measurement, in neurological and psychiatric patients.

Methods

Eligible were studies of IB involving patients with neurological and/or psychiatric disorders. The research adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Results

We included 15 studies involving 692 individuals. Risk of bias was low throughout studies. Eligible studies dealt with data from 357 patients with neuropsychiatric disorders matched with 335 HCs. Of included patients, 95 were with schizophrenia (SCZ), 30 with a putative prodromal psychosis (PP), 21 with borderline personality disorder (BPD), 66 with Parkinson’s disease (PD), 38 with an autism spectrum disorder (ASD), 29 with functional movement disorders (FMDs), 25 with Gilles de la Tourette syndrome (GTS), 52 with anorexia nervosa (AN; 22 with active disorder and 30 after they had recovered), and 10 with Cortico-Basal syndrome (CBS).

Temporal binding was calculated in eleven studies using variations of the experimental procedure introduced by Haggard et al. (Haggard et al. Nat Neurosci 2002;5 382-385)(Figure 1, A), while four studies utilized a different paradigm named interval estimation (IE)(Figure 1, B).

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Conclusions

Abnormally increased action-outcome binding was found in schizophrenia and in patients with Parkinson’s disease taking dopaminergic medications or reporting impulsive-compulsive behaviours. A decreased IB effect was observed in Tourette’s disorder and functional movement disorders whereas increased action-outcome binding was found in patients with cortico-basal syndrome. The extent of IB deviation from healthy control values correlated with the severity of symptoms in several disorders. Inconsistent effects were found for autism spectrum disorders, anorexia nervosa, and borderline personality disorder. Findings pave the way for treatments specifically targeting SoA in neuropsychiatric disorders where IB is altered.

Disclosure of Interest

None Declared
Benzodiazepines and risk of dementia – Is there a reason for alarm?
Authors: Andrade R. P. L. , Castro N. , Vaz R. , Martins J. , Abreu J. , Almeida E. , Santos I. , Cunha F. , Afonso H.
Published: August 2024

Introduction

The population ageing is a reality associated with an increase in prevalence of Dementia. The use of benzodiazepines is often postulated as a risk factor in these syndromes.

Contrary to recommendations for its short-time use, long-term and chronic use are common, with an estimated 8,7% of elderly people in the US taking benzodiazepines.

Objectives

To clarify the most recent evidence on the use of benzodiazepines and the risk of developing dementia.

Methods

Non-systematic review of literature, using PubMed as database and filtering the results for meta-analysis.

Results

Four articles were included in this review.

Zhong G et al. concluded that risk of dementia increased in consumers of benzodiazepines and it was associated with higher doses.

In turn, AlDawasari A et al., when trying to clarify the use of different sedative-hypnotic drugs, found and increased risk with the consumption of benzodiazepines. After exclusion of articles with confounders and adjustment for protopathic bias, the risk was not maintained.

Lucchetta RC et al. concluded that the risk exists but without inferring differences between doses or duration of action.

Finally, Penninkilampi R e Eslick GD investigated this association, after controlling for the protopathic bias, concluding, contrary to AlDawasari et al., that the association benzodiazepines consumption and dementia do not result from this bias.

Conclusions

We cannot draw robust and concrete conclusions between benzodiazepines consumption and the pathogenesis of dementia because not only is the literature limited, but results are also heterogeneous.

However, these prescriptions must be carried out cautiously, especially in the elderly, due to the known adverse effects associated with them.

Disclosure of Interest

None Declared
Differential diagnosis between frontotemporal dementia and bipolar disorder, review and case report
Authors: García Moreno M. , De Cos Milas A. , Beatobe Carreño L. , Del Sol Calderón P. , Izquierdo de la Puente A.
Published: August 2024

Introduction

Dementia can present with psychiatric symptoms even before the cognitive impairment, which makes difficult to establish an adequate diagnosis. There have described symptoms of this type in vascular dementia, frontotemporal dementia, Alzheimer disease and Lewy bodies dementia. Frontotemporal dementia has a prevalence of 9-20% and it`s the third in frequency among degenerative dementia. It appears before the age of 65 years old and is more common in men. Two variants have been described, linguistic and behavioral. The behavioral one has usually an initial psychiatric presentation, with behavioral disorders, disinhibition and personality changes. Therefore it`s important to make an adequate differential diagnosis with late onset bipolar disorder.

Objectives

To review about frontotemporal dementia and its differential diagnosis with late onset bipolar disorder.

Methods

We carry out a literature review about frontotemporal dementia and its differential diagnosis with late onset bipolar disorder, accompanied by a clinical description of one patient with behavioral disturbance and language disorder.

Results

A 59-year-old female was admitted to the short-term hospitalization unit from the emergency department due to behavior disorder. She had no relevant personal or familiar psychiatric history up to two years before when she received diagnosis of bipolar disorder. She presented behavioral disorganization, psychomotor restlessness, verbal aggressiveness, verbiage, insomnia and decreased intake. Psychopathological examination became difficult due to her language disorder since she presented an incoherent speech with paraphasias and loss of the common thread. Neurological study guided diagnosis to frontotemporal dementia even though they left the psychopharmacological treatment to our discretion. Olanzapine 5 mg twice a day was initiated, and behavioral improvement was observed. However, the patient maintained a significant functional impairment.

Conclusions

Psychiatric presentation is frequent in dementia, even before cognitive failures which makes essential an exhaustive differential diagnosis. It`s important to consider the diagnosis of frontotemporal dementia in those patients who debut with behavioral disturbance in the 50s. Psychopharmacological treatment is only symptomatic so functional recovery should not be expected.

Disclosure of Interest

None Declared
Navigating Neurocognitive Territory: Late-Onset Bipolar Disorder Insights
Authors: Cotovio D. V. , Agostinho F. , Resende M. R. , Lousada R. S. , Nogueira R. S. , Silva F. A. , Melo M. M.
Published: August 2024

Introduction

Affective disorders are associated with cognitive deterioration, manifested by an increased risk of developing dementia. Late-onset bipolar disorder (BD) establishes a dynamic interaction between dementia and BD, considering its particular manifestations in old age.

Objectives

Provide a comprehensive overview of the clinical and epidemiological attributes specific to late-onset BD, elucidating its interplay with dementia.

Methods

We conducted a literature search on PubMed in August 2023, using the following terms: late-onset bipolar disorder AND dementia. Only systematic reviews and meta-analysis were included with no year or language restrictions. Three articles were eligible for this review: two systematic reviews and one meta-analysis.

Results

Late-onset BD can be defined as a secondary condition and may result from an expression of lower vulnerability to BD, when compared to early-onset BD. On the other hand, late-onset BD may be conceptualized as a subtype of pseudodementia, or even considered a risk factor for dementia. In fact, this particular association with dementia supports the existence of a specific class of BD, i.e. BD type VI. Such diagnostic overlap might be explained by common factors that have been associated with both BD and dementia, such as cardiovascular risk factors, systemic inflammation, stress and levels of baseline cognitive reserve. Despite the commonalities, other aspects, such as family history and prior history of a mood disorder, may help to make the differential diagnosis between late-onset BD and dementia.

Conclusions

There is a diagnostic challenge between dementia and the neurocognitive decline associated with BD, particularly in the case of a late-onset BD. Although the available evidence is limited, current evidence demonstrates that BD can indeed be seen as a risk factor for dementia. Therefore, cognitive impairment in individuals with BD should not be overlooked.

Disclosure of Interest

None Declared
Major depressive episode in the elderly. Use of maintenance ECT: a case report.
Authors: Izquierdo De La Puente A. , del Sol Calderón P. , Fernandez Fernandez R. , Garcia Moreno M.
Published: August 2024

Introduction

We present the case of an elderly patient with a severe depressive episode who, in order to maintain psychopathological stabilisation, receives ECT on an outpatient basis.

Objectives

The objective is to briefly review the use of ECT as a maintenance treatment for severe depression in the elderly.

Methods

Patient aged 76 years, multipathological, with a history of hypertension, DM and LBP. Femoral head fracture, myelodysplastic syndrome, severe osteoporosis with vertebral crushing, requiring rescue treatment with tramadol, and renal failure.

She came for consultation, reporting depressive symptoms of months’ duration, together with delusions of ruin and nihilism. Despite antidepressant and stabilising treatment with duloxetine at daily doses of 120mg, extended-release quetiapine 600mg, lorazepam 2.5mg and mirtazapine 45mg, the patient began to show negative behaviour towards accepting food, clinophilic behaviour and abandonment, which led to her being admitted to the short-term hospitalisation unit.

Results

Due to the severity of the depressive symptomatology, it was decided to start ECT, administering a total of 12 sessions, which were effective, and outpatient follow-up was resumed. However, after a week, the patient again began to show marked apathy and abulia, as well as complete anorexia lasting more than 24 hours, which led to a new admission. It was then that it was decided to maintain the ECT treatment, on an outpatient basis, as maintenance treatment, together with pharmacological treatment.

Conclusions

ECT is indicated in severe depression, with or without psychotic symptoms, with malnutrition and organic pathology. According to studies, it has a beneficial response of more than 60%. However, the rate of receiving depressive symptomatology in a severe episode is high, despite ECT, so studies and clinical practice recommend maintenance ECT. It is usual to start with weekly sessions, and progressively space them out to maintain the minimum that guarantees stability.

Disclosure of Interest

None Declared
Network Analysis of the Relationships Between Symptoms, Functioning, and Sleep/Fatigue in Colorectal Cancer Patients
Authors: Sim J. , Yu J. , Yun Y.
Published: August 2024

Introduction

Among the various patient experiences, cancer-related fatigue and sleep disturbances emerge as pivotal aspects that can substantially impact individuals’ quality of life. There exists a relative scarcity of research focusing on the intricate relationship between symptoms, functioning, fatigue, and sleep disturbances in colorectal cancer (CRC) patients.

Objectives

In this context, the current research endeavors to apply advanced statistical methodologies to elucidate the complex relationships between symptoms, functioning, fatigue, and sleep disturbances. By exploring the intricate web of patient characteristics, clinical factors, psychosocial elements, this study aims to construct a holistic model that not only captures the nuances of colorectal cancer patients’ experiences but also uncovers potential avenues for intervention and support.

Methods

In our cross sectional study, we administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the Quality of Life Questionnaire Colorectal Cancer Module (QLQ-CR29) to 987patients who were surgically-treated for CRC from the tertiary hospital from 2013 through 2018. To confirm the relationship between symptoms of CRC patients, univariable logistic regression was used to examine the potential relationship between independent variables and the occurrence of fatigue and sleep disorders. Least Absolute Shrinkage and Selection Operator (Lasso) was used for variable selection. The selected variables were then applied to a multivariate logistic regression analysis to examine the most influential predictors of fatigue and sleep disturbance. Finally, gaussian graphical models (GGM) were used to identify potential interactions between characteristics, symptoms, functioning, with fatigue, and sleep disturbances in CRC. In this study, Directed Acyclic Graph (DAG) was used to identify causal dependancy and path of variables.

Results

About 10.4% of study participants reported experiencing fatigue. Sleep problems were reported by 15.8% of the study participants. Multivariable logistic regression analysis using Lasso showed that sleep problem (odds ratio [OR]=2.34; 95% CI, 1.03-5.31), physical, role, and emotional functioning, pain, dyspnoea, and appetite loss were significant predictors of fatigue, while emotional functioning, dyspnoea, and appetite loss were significant predictors of sleep problem. The variables that were directly linked to fatigue were role functioning, emotional functioning, dyspnoea, appetite loss, body image and trouble with taste. The variables that were directly linked to sleep problem were emotional functioning and appetite loss.

Conclusions

In conclusion, there were complex relationships between symptoms, functioning, fatigue, and sleep disturbances. The symptom network of CRC patients showed different patterns toward fatigue and sleep.

Disclosure of Interest

None Declared
Can Ecological Momentary assessments be used to investigate the person-environment interactions in people with psychosis?
Authors: Myin Germeys I.
Published: August 2024

Psychotic experiences show a dynamic pattern over time, often in interaction with the environment. In my talk, I will discuss how Ecological Momentary Assessment (EMA) or Experience Sampling Methodology can be used to assess psychotic symptoms in the flow of daily life. I will focus on the assessment of both positive and negative symptoms, where I will discuss both how we can measure such symptoms as well as what the dynamic patterns look like in everyday life. Furthermore, I will also focus on how ESM can be used to transfer psychological treatment to daily life using an app. I will discuss the INTERACT trial, a trial in people at the early stages of psychosis, where we investigated the effect of Acceptance And Commitment Therapy in Daily Life, compared to Treatment As Usual.

Disclosure of Interest

None Declared
Personality disorders and addiction A study of 54 patients
Authors: Bensalah Y. , Tbatou L. , Sabir M. , Elomari F.
Published: August 2024

Introduction

Personality disorders are very often comorbid with addictions and are known to have a negative impact on the development of substance use disorder.

Objectives

Evaluate the prevalence of personality disorder in patients with problematic use of psychoactive substances followed at Ar Razi hospital Determine the relationship between different personality disorders and the clinical aspects of psychoactive substance use

Methods

This is a descriptive and analytical cross-sectional study carried out among 54 patients followed at Ar-Razi hospital Salé in Morocco for problematic use of psychoactive substances from June 1 to September 15, 2023 (Diagnosis assessed by DSM 5) Data collection was done using a questionnaire including clinical and socio-demographic characteristics and data on addiction to psychoactive and behavioral substances. The psychometric scale used to assess personality disorder: Personality Disorder Questionnaire (PDQ-4+)

Results

We recruited 54 patients with age ranges from 18 to 45 years, with a male predominance. The average age at the start of psychoactive substance use was 15 years. Tobacco is the most used substance followed by cannabis Antisocial, histrionic and borderline personality disorders were the most common in our population. There was a statistically significant difference between specific personality disorder and the presence of severe psychoactive substance use disorder

Conclusions

The frequency of personality disorders is high among subjects with problematic use of psychoactive substances. It is necessary to take care of them simultaneously (integrated care) in order to improve the prognosis

Disclosure of Interest

None Declared
Virtual Insanity: Perspectives from a Political Digital Ethnographer of Young Adults Using Social Media for Mental Health
Authors: Bailie A.
Published: August 2024

To contribute to this debate I offer perspectives from my PhD research which critically examines the contemporary U.K politics of mental health and illness amongst young adults via social media. My work examines the way in which social media, like Instagram and Tiktok allows young adults to explore, express and share their selfhood and identity around ideas of mental health and illness through videos, posts and online interactions. Through this work I have engaged with digital services, psychologists and medical professionals on the subject of using technology for the treatment, engagement of and knowledge of mental health and illness. I have additionally engaged with some work on the role of the Metaverse for treating mental illness, and how this could work, but also the limitations of virtual spaces. Exploring debates in digital sociology adds evidence to these arguments and can support the understanding of the political ramifications of using technologies in the clinical space. Arguing that these new developments in language and social practices around mental health and illness via social media need to be further explored, acknowledged and addressed in social science and this can be supported by work in the field of psychiatry. Overall, my contribution to the debate will be to offer political and digital social perspectives on the use of technology and highlight some of the biases and drawbacks of utilising AI to treat mental health and illness.

Disclosure of Interest

None Declared
Specifics of socialization of children with autism spectrum disorders
Authors: Akhmetzyanova A. , Artemyeva T. , Minullina A.
Published: August 2024

Introduction

One of the important tasks of modern education is the adaptation of children with autism spectrum disorders to the social space, which allows them to ensure their personal development and self-realization.

Objectives

Study of the specifics of the socialization of children of preschool age with autism spectrum disorders.

Methods

The study involved 27 preschool children with autism spectrum disorders attending an educational institution for children with disabilities; 6 were girls and 21 were boys; 20 children with intact speech and 7 children with speech disorders. The following methods were used: “Map of manifestations of activity by A.M. Shchetinina, N.A. Abramova; “Map of observations of the manifestations of communicative abilities in preschool children” A.M. Shchetinina, M.A. Nikiforova; “Emotional faces” N.Y. Semago.

Results

It was found that children with autism spectrum disorders have the greatest severity of such activity indicators as “is in a good mood” (1.67), “shows stubbornness” (1.56) and “shows great mobility” (1.56). Among the manifestations of communicative abilities in preschool children, the most developed parameter is: “sincere in his statements, in the manifestation of his feelings” (2,07). At the same time, the lowest expression of communication skills (0.96) in children with autism spectrum disorders is observed in terms of: “has organizational skills”, “the child seeks to understand the other, his thoughts, feelings”; “observant, sees and realizes the characteristics of other children and adults”. The least pronounced indicator is observed in the indicator of initiative; children do not show initiative in communication, have difficulty understanding and supporting the initiative of another child in an interaction situation. Children have a low level of operational communicative actions and skills: children are not expressive in communication, do not master verbal means of communication and are not able to maintain contact with communication partners.

Conclusions

The results obtained in the study confirm the need to develop and implement psychological and pedagogical programs aimed at developing social skills in preschool children with autism spectrum disorders. This paper has been supported by the Kazan Federal University Strategic Academic Leadership Program.

Disclosure of Interest

None Declared
Post-traumatic stress disorder after childbirth: A Tunisian study
Authors: Sghaier N. , Ben Soussia R. , Bouchahda H. , Belhadj I. , Ben Garouia H. , Khiari H.
Published: August 2024

Introduction

Childbirth is a special time for every woman, bringing pregnancy to an end and marking the birth of a new baby. This transitional event presents countless physical and psychological changes. Post-traumatic stress disorder (PTSD), the result of particularly intense stress, is often linked to the perception of childbirth as a traumatic event, requiring optimized follow-up and screening.

Objectives

The aim of this current study is to estimate the prevalence of post-partum post-traumatic stress disorder in a sample group of Tunisian women and to determine factors associated with childbirth-related post-traumatic stress disorder.

Methods

This is a longitudinal prospective descriptive study conducted among women hospitalized for childbirth in the obstetrics and gynecology department and those who consulted the prenatal outpatient clinic at Taher Sfar Mahdia Hospital. The duration of the study is 7 months, from March 15, 2020 to September 15, 2020. Data collection was based on a pre-established questionnaire determining the various socio-demographic and clinical characteristics. Psychometric assessment was carried out using the Posttraumatic Stress Disorder Checklist Scale (PCL-S).

Results

We enrolled 120 women with a mean age of 28.2± 5.3 years. Few women had a psychiatric history of depression (1.2%) or anxiety (3%), and 29% had a pathological obstetric history. Nevertheless, 12.5% of patients were hospitalized during pregnancy. Eighty-seven patients expressed anticipatory fear of childbirth, and 102 women had good marital and social support. Almost half of deliveries (48.3%) were vaginal, and almost a third (27.5%) were emergency caesarean sections. Level 3 pain was reported in 73.3% of cases. Psychometric assessment revealed a prevalence of PTSD of 5.8%, with PTSD symptomatology in 18.4% of women. PTSD was statistically associated with low level of education (p=0.02), postpartum complications (p=0.05) and gender of newborn (p=0.01).

Conclusions

Postpartum PTSD is a major public health problem affecting the healthy development of the newborn, the overall mental and physical recovery and well-being of the mother.Our findings suggest several intervention points for healthcare practitioners, including careful prenatal screening of past trauma history, social support, pain management and expectations about the birth, within a multidisciplinary approach.

Disclosure of Interest

None Declared
Challenges that early career psychiatrists can face on compulsory treatment
Authors: Chumakov E.
Published: August 2024

The delivery of mental health care worldwide often involves compulsory treatment, a practice encountered by early career psychiatrists from the outset of their training. Despite its prevalence, little research has explored the challenges faced by trainees and early career psychiatrists when compelled to administer treatment without patient’s consent. This presentation will synthesize research data and offer personal reflections on the author’s experiences.

Challenges that early career psychiatrists can face regarding compulsory treatment can be categorized into personal, professional, and institutional. Personal challenges encompass the emotional stress associated with applying coercive measures, coping with negative emotions, and managing service users’ attitudes toward treatment without consent. There is also concern that compulsory treatment may elevate the risk of emotional burnout. Professional challenges involve the administrative burden associated with organizing compulsory treatment, often exacerbated by the formalization of the process as a bureaucratic procedure in many European countries. Additionally, dealing with legal processes, including interactions with lawyers and courts, can pose significant difficulties, even though it is clearly done to protect the rights of the persons receiving care. Institutional challenges encompass the overall policy of providing compulsory psychiatric care in the psychiatrist’s home country and the specific practices of coercive measures in a given treatment facility. Furthermore, the lack of dedicated time for ethics of coercion during training is a common issue.

In the current landscape of mental health care, early career psychiatrists must undergo training to handle coercive measures. While these measures are sometimes unavoidable, ethical principles must guide their administration. Additionally, access to supervision/mentoring is crucial for early career professionals facing challenging cases.

Disclosure of Interest

None Declared
Under-attribution in self-agency on pre-reflexive task connected to positive schizotypal traits among healthy students
Authors: Szendi I. , Domján N. , Pásztor H. , Jenei T. , Bóna O. , Kovács C. , Pejin A. , Pajkossy P. , Szőllősi Á. , Racsmány M.
Published: August 2024

Introduction

The aim of this study was to identify low-risk traits of schizophrenia among healthy undergraduate student volunteers, and the investigation of these traits with regards to their specificity in contrast to individuals with a latent disposition towards bipolar disorder. Self-agency, as a phenomenon closely related to psychomotor functioning, provides a unique opportunity for the investigation of subjective self-perception.

Objectives

The implicit self-agency performances that are considered illness- (or risk state-) specific were compared between groups to find early markers of a specific schizotypic developmental path.

Methods

In a sample of 710 healthy university students, with the help of screening questionnaires, we were able to successfully form two risk groups, in one of them the emphasis on cyclothymia (CTF: Cyclothymia factor group, N=25), and in the other (PSF: Positive schizotypy factor group, N=26) the tendency to unusual experiences and paranoid thinking emphasis was typical. We assigned a properly matched control group (N=29) displaying both features on average. We focused on the implicit aspect of self-agency, using the well-known paradigm of intentional binding, as well as the self-developed device that exclusively tests the pre-reflexive feeling of movement initiation, the sense of self-agency.

Results

During the examination of intentional binding, although the specific predictive and retrospective component indicators did not show any significant difference for either group, the association of the sound alone could induce a binding effect in the control group. In the predictable frequency condition, there was a strong significant effect (W = 65.00, p = .007, rrb = -.60), and in the non-predictable condition a trend-level effect. Remarkably, this binding effect did not develop in either the CTF or PSF groups, indicating an implicit agency impairment in both risk groups. However, during the examination of sense of self-agency, we observed a disturbance specifically among healthy college students with positive schizotypal traits, in the form of falsely attributing their movement initiation to external influences. The percentage of this ‘miss’-type answering differed between groups, H(2) = 7.68, p = .021, ε2 = .10. The Dwass-SteelCritchlow-Fligner pairwise comparisons showed that this difference was due to the PSF Group showing a significant difference from the Control Group (W = -3.83, p = .019), but not from the CTF group, and the CTF Group also did not differ from the Control Group.

Conclusions

Thus, in premorbid conditions, in at-risk groups of non-help-seeking individuals, or in cases of early detection of prodromal abnormalities, objective confirmation of suspected susceptibility to schizophrenia may be aided by, among other things, instrumental assessment of self-agency.

Disclosure of Interest

None Declared
Vitamin D, vitamin B12, folate, homocysteine, and major haemato-chemical parameters in patients with mood disorders
Authors: Marazziti D. , Gurrieri R. , Mucci F.
Published: August 2024

Introduction

The potential involvement of the immune and inflammatory systems has been extensively studied in mood disorders (MDs). Despite these findings and despite the fact that the pathogenetic role of altered immunologic and metabolic profiles in MDs is being confirmed in many current studies, there is still a lack of consensus about it, due to controversial results.

Objectives

The present study aimed to appraise peripheral metabolic parameters (blood glucose, lipoproteins, triglycerides, uric acid, blood urea nitroge [BUN], transaminases and others9 and plasma/serum levels of essential nutrients (vitamin D, B12, folate and homocysteine) in a group of inpatients affected by MDs, as compared with healthy controls.

Methods

Methods. Ten ml of venous blood was drawn from fasting subjects. The metabolic parameters and vitamins were measured according to common clinical-chemistry methods.Comparisons for continuous variables were performed by the Student’s t-test for variables that follow a normal distribution, and by the Wilcoxon-Mann-Whitney test for variables not normally distributed. The correlations between biological markers were explored by calculating the Pearson’s correlation coefficient or Spearman rank correlation.

Results

Most patients showed loer circulating vitamin D levels, in respect to both control subjects (P< .0001) and the normative cut-off values. This finding was paralleled by increased serum homocysteine concentrations i (P<.0001), indicating an imbalance in their methionine metabolism. Homocysteine levels were negatively correlated with vitamin D, vitamin B12 and folate in control subjects, but not in patients. In addition, patients displayed higher blood glucose and lower BUN than controls, indicating an impaired protein-to-carbohydrate metabolism and/or altered nutritional/dietary status.

Conclusions

We provide herein further support to the notion that MD patients are a population where vitamin deficits, dysmetabolism and/or dietary defects are common feature, and, s such, they might be more vulnerable to a variety of somatic illnesses than the general population. This cross-sectional investigation, albeit preliminary, might contribute to improve the characterization and the monitoring of the clinical status of mood disorder patients, as well as to identify new molecular targets for more tailored treatments ad of more pointed health-care intervention,

Disclosure of Interest

None Declared
Teacher well-being: Perceived stress, psychosocial risks, and burnout in Morocco
Authors: Guider H. , Hadrya F. , Lafraxo M. A. , Boumaaize Z. , El Madhi Y. , Soulaymani A. , Mokhtari A. , Hami H.
Published: August 2024

Introduction

Teachers encounter various challenges that can significantly affect their professional well-being. This issue stands as of paramount importance, for it not only wields influence over job satisfaction but also carries weighty implications for the quality of education provided.

Objectives

This study aims to investigate the factors that affect teachers’ well-being, specifically examining the relationship between perceived stress, psychosocial risks, and burnout among public high school teachers in Tetouan, Morocco.

Methods

A questionnaire survey was conducted among 258 teachers, resulting in a response rate of 57%. Three distinct instruments were used to collect data: The Perceived Stress Scale (PSS) to evaluate perceived stress levels, the Job Content Questionnaire (JCQ) to assess psychosocial risks at work, and the Maslach Burnout Inventory (MBI) for burnout measurement. We examined the bivariate correlations among these three concepts.

Results

The results demonstrate significant associations among the studied factors. Perceived stress has a positive correlation with emotional exhaustion (r=0.51; p<0.01) and depersonalization (r=0.56; p<0.01), and a negative correlation with personal accomplishment (r=-0.31; p<0.01). Additionally, emotional exhaustion has a positive correlation with psychological demand (r=0.38; p<0.01). Depersonalization shows a positive correlation with psychological demand (r=0.18; p<0.05), but a negative correlation with decision latitude (r=-0.30; p<0.01) and social assistance (r=-0.24; p<0.01). Conversely, personal accomplishment presents a positive correlation with decision latitude (r=0.58; p<0.01) and social assistance (r=0.50; p<0.01).

Conclusions

This study underscores the importance of decision latitude and social assistance in promoting personal accomplishment and mitigating burnout among teachers. Nonetheless, further research is required to substantiate these results and determine the fundamental cause and effect relationships.

Disclosure of Interest

None Declared
The short- and long-term effects of yoga on relaxation states measured by the Smith Relaxation States Inventory 3
Authors: Renkó T. A. , Schmelowszky Á.
Published: August 2024

Introduction

The beneficial effects of yoga have been researched for decades, and in some countries it is also used in health care to maintain physical and mental health. Its effectiveness in the treatment of stress and anxiety, as well as in achieving a relaxed state, is supported by numerous studies.

Objectives

In the present research, our aim was to investigate the direct and subclinical effects of yoga, where the subjects did at least 10 minutes of yoga a day for two weeks. Our hypotheses are that the participants experience relaxation, mindfulness and positive emotions significantly (1) more often and (2) more intensely as a result of yoga.

Methods

We included 25 average population, healthy people between the ages of 18 and 30, who exercised at least 10 minutes of yoga a day for two weeks with the help of a mobile app. We used the Smith Relaxation States Inventory (SRSI3) and its disposition-measuring version (SRSI3d), which examine 19 relaxation states (R-states) presumably related to relaxation, divided into 4 categories: basic relaxation, mindfulness, positive energy and transcendence. During the statistical analyses, the values taken at the beginning of the research, before practice, were compared with the values taken directly after the last practice using the Wilcoxon test. Bonferroni correction was used to correct the first-order error that increases when testing several hypotheses simultaneously.

Results

Immediately after practicing yoga, the participants had significantly higher basic relaxation (M0=2.74, M1=4.24, p<0.0001), awareness (M0=2.71, M1=2.89, p<0.0001) and positive energy (M0=3.88, M1= 4.81, p<0.0001) and in the long term they experienced significantly more relaxation (M0=3.12, M1=3.94, p<0.0001), awareness (M0=3.41, M1=4.40, p<.0001), positive energy (M0= 4.39, M1=5.14, p<0.001) and transcendence (M0=3.23, M1=4.05, p=0.001).

Conclusions

Based on our results, yoga can be an effective additional tool in maintaining and improving health, but also in improving the condition and quality of life of mental and somatic patients.

Disclosure of Interest

None Declared
Exploring predictors of Treatment Attendance in Patients with PTSD and Comorbid Personality Disorders: Secondary Analysis of a Randomized Controlled Trial
Authors: van den End A. , Snoek A. , Aarts I. , Lommerse N. , Dekker J. , Beekman A. T. F. , Thomaes K.
Published: August 2024

Introduction

Posttraumatic stress disorder (PTSD) and personality disorders (PD) often co-occur and treatment dropout remains a challenging problem for both disorders. The literature on predictors of treatment dropout is highly mixed and few reliable predictors have been identified for both PTSD and PD treatments separately, let alone for concurrent PTSD and PD treatment.

Objectives

The aim of the present study was to identify predictors of treatment attendance among a wide range of variables in patients with PTSD and comorbid PD who received trauma-focused treatment with and without concurrent PD treatment.

Methods

Data were used from the prediction and outcome study in comorbid PTSD and personality disorders (PROSPER), a study consisting of two randomized clinical trials (RCT) testing the effectiveness of trauma-focused treatment (eye movement desensitization and reprocessing or imagery rescripting) with versus without concurrent PD treatment (dialectical behavior therapy or group schema therapy). 256 patients with PTSD and comorbid personality disorder participated in the study. The potential predictors included demographic (e.g. work status), patient severity (e.g. PTSD severity), patient-therapist (e.g. working alliance) and therapist (e.g. therapist experience) variables. The ordinal outcome variable was treatment attendance (0, 1-7, 8-11, 12+ trauma-focused treatment sessions). Relevant predictors were identified by a series of ordinal regression analyses (threshold for inclusion p < .10). Relevant predictors were then entered together in a final ordinal regression model. Multiple imputation was used to handle missing data.

Results

The final model included ten predictor variables and provided a good fit for the data (pooled R2Nagelkerke = .29). Higher education level (OR = 1.22, p = .009), self-rated PTSD severity (OR = 1.04, p = .036) and working alliance (OR = 1.72, p = .047) were associated with a larger number of attended sessions. Higher levels of inadequate social support from a friend (OR = 0.90, p = .042) and being randomized in the concurrent treatment condition (OR = 0.52, p = .022) were associated with a smaller number of attended sessions.

Conclusions

In terms of treatment attendance rates, the results suggest that trauma-focused treatment is preferred over concurrent trauma-focused and personality disorder treatment for patients presenting with PTSD and PD. Clinicians should further be aware of the risk of lower treatment attendance for patients with a lower educational background and those reporting inadequate social support. Enhancing working alliance may protect against early treatment termination. Finally, patients with higher levels of PTSD severity at baseline may need a larger number of treatment sessions.

Disclosure of Interest

None Declared
Urinary retention induced by psychotropics: A case report
Authors: Smaoui E. , Mnif D. , Reguaieg N. , Guermazi F. , Sakka S. , Baati I. , Masmoudi J.
Published: August 2024

Introduction

Neurological bladder is considered a functional disability that has a significant impact on the quality of life and psychological state of patients. Psychotropic drugs, in turn, can worsen the urinary dysfunction caused by this disease.

Objectives

Our objective is to illustrate, through the case of a patient suffering from a neurological bladder decompensated by the treatment of a characterized depressive episode, the link between these two pathologies.

Methods

We report the case of Ms. M.W., aged 51, with a history of high blood pressure stabilized under nebivolol and a neurological bladder diagnosed 10 years ago with episodic pollakiuria, admitted to the psychiatric department for repeated suicide attempts. She had never used psychoactive substances and had no family psychiatric history. The patient presented depressive symptoms evolving for 5 months. The diagnosis of a characterized depressive episode with melancholic features was made and the patient was treated with sertraline. From the first intake of the drug, the patient presented acute urinary retention (UR) requiring the placement of a permanent bladder catheter. The urinary symptoms improved upon stopping the treatment. Sertraline was changed to olanzapine and escitalopram. The patient stopped the treatment after one month because of the worsening of urinary symptoms requiring the installation of a suprapubic catheter. The urinary problem, together with the cessation of treatment, were responsible for a worsening of psychiatric symptoms leading to multiple suicide attempts. Given the advanced stage of the neurological bladder demonstrated by the urodynamic tests, our patient was treated with paroxetine, quetiapine and oxazepam along with psychotherapeutic education. The evolution was characterized by improvement in psychiatric symptoms and the urinary symptoms were stable.

Results

The lack of improvement after treatment discontinuation could be explained by an underlying neurological bladder manifesting with pollakiuria. The current literature on UR induced by psychotropic treatments is quite rare limited in case reports. This effect occurs especially when selective serotonin reuptake inhibitors (SSRIs) are prescribed in combination with other antipsychotics. Unlike first generation antipsychotics, atypical antipsychotics have muscarinic receptor antagonist properties which can induce UR. Among atypical antipsychotics, olanzapine has been shown to have the greatest antimuscarinic effects. Regarding SSRIs, they are associated with a lower risk of UR than other antidepressants and sertraline had the highest risk of UR.

Conclusions

SSRIs can induce UR particularly in combination with atypical antipsychotics. Coordination of care across multiple specialties and understanding the side effects of psychotropic medications can enable faster diagnoses and adequate management.

Disclosure of Interest

None Declared
A case report of Paliperidone palmitate-induced anaphylaxis
Authors: Pereira S. , Pais J.
Published: August 2024

Introduction

Paliperidone Palmitate (PP) is an atypical antipsychotic, approved by the FDA for acute and maintenance treatment of schizophrenia and schizoaffective disorder.

It has a relatively safety profile, and reported cases of paliperidone palmitate-induced angioedema or anaphylaxis are uncommon.

Objectives

We intend to present a case of paliperidone palmitate-induced anaphylaxis to alert clinicians regarding this rare, but possible complication.

Methods

Non-systematic review of the literature and report of a case study.

Results

Long-acting injectable Paliperidone Palmitate (LAIPP) is a safe and effective alternative to oral Paliperidone, with less incidence of disease relapse related to medication non-compliance.

Substance use disorder (SUD) is highly prevalent in first-episode psychosis (FEP), and it is associated to decreased treatment compliance, which impairs the outcomes of these patients. Therefore, several authors have been recommended long-acting injectable antipsychotics (LAI-AP), such the LAIPP, as a first line for treatment of FEP-SUD patients.

The most common side effects associated with LAIPP are injection site reactions, extrapyramidal symptoms, hyperprolactinemia, sedation, hypersalivation, orthostatic hypotension, tachycardia, and weight gain. Hypersensitivity reactions have rarely been reported and may be dose-dependent.

We report a case of a 20-year-old female, without medical history and no history of allergies, who was medicated with once-monthly LAIPP at dose 100 mg for the maintenance treatment of a first psychotic episode associated with cannabis abuse.

Approximately 24 hours after the first monthly injection dose, she was admitted in the emergency room (ER) presenting an increasing angioedema associated with stridor, requiring endotracheal intubation and administration of adrenaline, clemastine and hydrocortisone during the assessment in the ER.

After clinical stabilization, she was transferred to the internal medicine ward, and following a full recovery, she was discharged 6 days later while being medicated with Olanzapine 15 mg/day, Lorazepam 3 mg/day and Sertraline 50 mg/day. LAIPP was suspected as the etiology of the anaphylaxis reaction due to temporal relationship of its onset with therapy administration and by the exclusion of other potential causes. Consequently, LAIPP was discontinued at discharge.

Conclusions

This report shows the possibility of a late and potentially life-threatening anaphylactic reaction to LAIPP. So, all physicians should be aware of this potential complication, which requires timely recognition and management.

Disclosure of Interest

None Declared