bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of early maladaptive schemas and psychiatric disorders between sex offenders
Authors: Stepanova N. , Korzun D.
Published: September 2022

Introduction

Schema-therapy (ST) - one of the promising integrative models of psychotherapy, which shows its efficacy in many mental disorders. ST has main theoretical concepts: early maladaptive schemas (EMS), coping styles, modes and basic needs. EMS are self-defeating emotional and cognitive patterns established from childhood and repeated throughout life. Existing literature shows the connection between EMS and behavioral problems, which could be more significant for patients with personality disorders. The prevalence of personality disorders is relatively low in the general population, but it’s highly overrepresented in the forensic population, especially in groups of sex offenders.

Objectives

The aim of this study is to examine if there is a prevalence of some EMS between sex offenders and their association with a diagnosed psychiatric disorder.

Methods

Medical records and criminal case materials of 27 patients were reviewed, all of them were blamed for committing sex crimes and had to stay at the department for one month for forensic psychiatry examination. During their stay patients were examined several times and questioned with YSQ S3R.

Results

Most of the patients had psychiatric disorder: specific personality disorders (14), pedophilia (3), dependence syndrome (4), organic personality disorder (3). Some of them had several psychiatric diagnoses. The most prevalent EMS were abandonment, emotional deprivation, insufficient self-control and defectiveness.

Conclusions

These findings show the prevalence of personality disorder and several EMS in sex offenders, which could be useful for the full understanding of the concept of PD and improve the organization of medical care for these individuals.

Disclosure

No significant relationships.
The Importance of Secondary Gain - a Missing Story
Authors: Wise J.
Published: September 2022

There is a wealth of data to tell us that, when it comes to illness, not all is as it seems. Research into hidden agendas of patients [1]drives home the point that a substantial portion of patients (up to 42%) have covert motives for obtaining secondary gains associated with their patient status (e.g., financial support, help or attention from others, stimulant medication, work or study related privileges, or evasion of responsibilities. Less than 10% shared their expectations with the psychiatrist. The Accident Compensation Scheme in New Zealand, , reported a prevalence of symptom exaggeration of 20-50%. In 2017 a disorder struck in Sweden. It struck whose families had failed their last appeal for asylum. The previously unknown ’catatonia’ has many of the characteristics of a culture bound syndrome – giving voice to the voiceless/powerless. Researchers from Ireland studied the motivations of people with factitious disorder. A desire for affection was the most commonly mentioned reason for fabricating illness and as a coping mechanism for threatening life events. The analysis showed that motivation was conscious. Bianchini et al have reported on the Financial Incentive Effect. Perhaps counterintuitively one of the most important points they make is that the presence of a financial incentive is associated with worse outcomes. They found that factors othere than the injury itself control for the probabilities of return to work. How can we determine what is real? [1] Van Egmond, J., Kummeling, I., & Balkom, T. A. (2005). Secondary gain as hidden motive for getting psychiatric treatment. European Psychiatry, 20(5-6), 416-421.

Disclosure

No significant relationships.
Maladjustment of pressure settings of a programmable shunt valve by electromagnetic door locks in Forensic Psychiatry – a case report
Authors: Licht C. , Weisser R. , Schloegl C.
Published: September 2022

Introduction

Maladjustments and failures of programmable ventriculo-peritoneal shunts have been reported in patients encountering powerful electromagnetic fields, e. g. MRI.

We describe the case of a 53-year old man treated for hydrocephalus with a programmable Codman-Hakim shunt valve. During his hospitalization in Forensic Psychiatry, the patient’s valve pressure setting changed randomly despite frequent reprogramming and surveillance.

Objectives

Maladjustments and failures of programmable ventriculo-peritoneal shunts have been reported in cases in which patients have encountered powerful electromagnetic fields, e.g., MRI. Through a case, this study shows easy maladjustment of a Codman-Hakim programmable valve also by small magnetic fields from everyday life.

Methods

A 53-year old man presented with periventricular hydrocephalus due to aqueductal stenosis. The patient was treated with a left ventriculo-peritoneal Codman-Hakim programmable shunt valve. During his hospitalization in Forensic Psychiatry, the patient’s valve pressure setting changed randomly, presumably by walking through electromagnetically controlled doors of a hospital ward. With a test dummy, changes in pressure settings were tracked.

Results

Both - pressure settings of the patient’s Codman-Hakim programmable valve as well as pressure settings of a new valve - were unwantedly modified simply by walking through standard doors in a hospital ward.

Conclusions

Thus already weak magnetic fields (< 200 mT) might cause changes in the pressure settings of programmable shunt valves and therefore lead to maladjustment. Patients should be informed and pay attention to using everyday life’s devices, like rod magnets or mobile phones.

Disclosure

No significant relationships.
Psychiatric autopsy in two cases of assessment testamentary capacity
Authors: Strete G. , Turliuc D. , Hadareanu V. , Turliuc S.
Published: September 2022

Introduction

In Romania, in accordance with current law, “the will is the unilateral, personal and revocable act by which a person named testator disposes, in one of the forms required by law, for the time when he will no longer be alive”. The increasing complexity of modern financial and family structures has led to an increase in testamentary disputes, a fact reflected by the large number of forensic examinations in civil cases.

Objectives

Mental capacity are the majore concerns in the many of issues in elders but the great challenge is its retrospective evaluation, when the patient no longer exists. We focuse on the testator’s mental capacity at the time the will was written.

Methods

We present two cases of will contestation in post mortem, in which the testator’s age was 65, respectively 70 years at the time of executing the will.

Results

In the first case the testator dies one month after he signed the will, the cause of death was cardiorespiratory arrest; cervical neoplasm; In the second case the testator dies two years after he signed the will. In both cases the patients did not have a history of neuropsychiatric disorders in the family doctor’s records. The circumstances of the production of a will, including the mental state of the testators and the true wishes of the testators were reconstructed using a psychiatric autopsy, based on the documents provided.

Conclusions

The complexity and subtlety of the problems reflected in these cases highlights the need to go beyond traditional criteria and assess situation-specific factors.

Disclosure

No significant relationships.
Challenges of ageing in prisons and forensic psychiatric settings
Authors: Peixoto C. , Rego D. , Cruz M. , Peixoto B. , Bicho M. , Coelho J. , Medeiros H.
Published: September 2022

Introduction

There is a current trend towards an increase in the number of elderly prisoners due to the increase in life expectancy and the change in the attitude of society and the judicial system. The cut-off for “older offender” is defined from the age of 50, due to the lifestyle previous to prision and premature ageing.

Objectives

The authors intend to understand the challenges of aging in prison and forensic services, highlighting the psychiatric comorbidities of inmates and how these services can adapt to the needs of this population.

Methods

Non-systematic review of the literature.

Results

Studies of elderly in prisons and elderly forensic psychiatric patients are limited. Prisoners have increased physical and psychiatric morbidity and early mortality as they are more exposed to risk factors and more likely to have at least one health problem compared to older adults in the community. Compared to older people in the community, older prisoners are at higher risk for most psychiatric disorders including depression, psychosis, bipolar disorder, cognitive impairment, personality disorder and anxiety. Suicide rates are also higher among elderly prisoners. The inadequacy of the prison system to respond to the unique needs of elderly prisoners has a detrimental impact on their overall experience of incarceration. The development of specific services for elderly prisoners or the adaptation of mixed units for the elderly population is proposed.

Conclusions

The elderly population in prisons is growing and has higher risk of psychiatric pathology compared to community elders. Prison services with difficulties in identifying and meeting these needs.

Disclosure

No significant relationships.
A Lowlands Perspective on Exaggeration and Feigned Symptoms
Authors: Dandachi-Fitzgerald B.
Published: September 2022

Some patients present symptoms in an exaggerated manner [1,2]. This behavior can be assessed with specialized tests: Symptom validity tests (SVTs) to measure overreporting of symptoms, and performance validity tests (PVTs) to measure underperformance on cognitive tests. But what does it mean when patients fail on multiple SVTs and/or PVTs? Does it reflect malingering; i.e. grossly exaggerating or feigning symptoms to gain an external benefit? Could it be seen as a plea for help in some cases? Or could pain, fatigue or cognitive impairment be underlying reasons for the validity test failures? In this presentation some credible and non-credible explanations for failing on validity tests will be discussed. A tentative framework that might aid in conceptualizing poor symptom validity will be presented. References [1] Dandachi-FitzGerald, B., Merckelbach, H., Bošković, I., & Jelicic, M. (2020). Do you know people who feign? Proxy respondents about feigned symptoms. Psychological Injury and Law, 13, 225–234. [2] Merckelbach, H., Dandachi-FitzGerald, B., van Helvoort, D., Jelicic, M., & Otgaar, H. (2019). When patients overreport symptoms: More than just malingering. Current Directions in Psychological Science, 28, 321–326.

Disclosure

No significant relationships.
How to involve carers in the acute care: An online training for clinicians across four sites in England
Authors: Petkari E. , Kouroupa A. , Giacco D.
Published: September 2022

Introduction

Involving carers in the care of people with severe mental illness is known to bring positive treatment and psychosocial outcomes. However, evidence-based procedures to guide clinicians on how to involve carers in the acute care are lacking.

Objectives

To provide an online training to clinicians working in the acute care regarding the organisation of a standardised meeting with the service user and their carer within the first week of hospitalisation, and explore their views after its implementation.

Methods

We trained six clinicians across four urban and rural sites in England, asked them to incorporate the meeting in their routine care provision and interviewed them to explore their experiences.

Results

Clinicians reported training advantages such as ease of use, comprehensiveness and transferable skills, and meeting advantages such as shared goals development and acknowledgement of carer involvement value. They also mentioned challenges related to organisational/time constraints, expectations management, and distance to the hospital for carers. Clinicians suggested to further focus on carer motivation to engage, to use skills throughout admission rather than in a one-off session, and to provide a structured meeting summary. Those experiences were shared across sites, indicating similar benefits and challenges, not depending on the specific setting characteristics.

Conclusions

Providing structured training to clinicians may increase carer involvement in routine care in acute settings. Given the workload in such settings training endeavours should be brief and include skills that clinicians can apply to facilitate shared goal development and expectations management. The use of online meetings may allow increased carer participation in the acute care.

Disclosure

No significant relationships.
Ethnic inequalities in treatment with clozapine
Authors: Fonseca De Freitas D. , Patel I. , Kadra-Scalzo G. , Pritchard M. , Shetty H. , Broadbent M. , Patel R. , Downs J. , Segev A. , Khondoker M. , Maccabe J. , Bhui K. , Hayes R.
Published: September 2022

Introduction

Ethnic disparities in treatment with clozapine, the antipsychotic recommended for treatment-resistant schizophrenia (TRS), have been reported. However, these investigations frequently suffer from potential residual confounding. For example, few studies have restricted the analyses to TRS samples and none has controlled for benign ethnic neutropenia.

Objectives

This study investigated if service-users’ ethnicity influenced clozapine prescription in a cohort of people with TRS.

Methods

Information from the clinical records of South London and Maudsley NHS Trust was used to identify a cohort of service-users with TRS between 2007 and 2017. In this cohort, we used logistic regression to investigate any association between ethnicity and clozapine prescription while adjusting for potential confounding variables, including sociodemographic factors, psychiatric multimorbidity, substance use, benign ethnic neutropenia, and inpatient and outpatient care received.

Results

We identified 2239 cases that met the criteria for TRS. Results show that after adjusting for confounding variables, people with Black African ethnicity had half the odds of being treated with clozapine and people with Black Caribbean or Other Black background had about two-thirds the odds of being treated with clozapine compared White British service-users. No disparities were observed regarding other ethnic groups, namely Other White background, South Asian, Other Asian, or any other ethnicity.

Conclusions

There was evidence of inequities in care among Black ethnic groups with TRS. Interventions targeting barriers in access to healthcare are recommended.

Disclosure

During the conduction of the study, DFdF, GKS, and RH received funds from the NIHR Maudsley Biomedical Research Centre. For other activities outside the submitted work, DFdF received research funding from the UK Department of Health and Social Care, Janss
Burnout and associated factors among Tunisian medical interns and residents
Authors: Zouari A. , Guermazi F. , Tabib F. , Ben Abdallah M. , Hentati S. , Baati I. , Masmoudi J.
Published: September 2022

Introduction

Burnout is an occupational psychological syndrome induced by chronic stress defined by three dimensions: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA).

Objectives

Estimate burnout among residents and interns in Tunisia. Identify factors related to burnout.

Methods

We conducted a cross-sectional, descriptive, and analytical study between March 1 and April 15, 2021. Data collection among young physicians was done by a self-questionnaire published online. The assessment of the degree of burnout was done by the Maslach Burnout Inventory (MBI).

Results

The total number of participants was 56 of which 71.4% were women. The average age was 26.76 years. The pourcentage of the married was 21.4% of which 58.3% had children. 30.4% had parents in charge. Most of the participants worked in university hospitals and 75% of them in a medical department. Residents represented 64.3% of the participants. Number of working hours exceeded 40 hours per week in 60.7% of the cases with an average number of shifts per month estimated at 4.71±2.36. According to MBI, 94.6% of the participants had a score in favor of burnout, of which 19.6% was severe. The number of hours worked per week and the number of shifts per month were significantly associated with the presence of a burnout syndrome with respective correlation factors of 0.027 and 0.047.

Conclusions

Most residents and interns suffered from burnout with a variable degree of severity. The workload with a greater number of working hours and on-call duty favored the emergence of this burnout.

Disclosure

No significant relationships.
job satisfaction and its impact on resilience: a cross-sectional study of Tunisian interns and residents in medicine
Authors: Tabib F. , Guermazi F. , Zouari A. , Hentati S. , Baati I. , Masmoudi J.
Published: September 2022

Introduction

Preventing burnout and promoting resilience are important to the well-being of health care professionals and the quality of patient care. Indeed, it’s a promising way to mitigate the negative effects of stressors and allow professional growth.

Objectives

study the association between job satisfaction and resilience in medical interns and residents.

Methods

As part of a descriptive and analytical cross-sectional study, interns and medical residents completed an online self-questionnaire using ’Google Forms’. It collected socio-demographic data and assessed the level of job satisfaction using a 5-point Likert-type scale for each item. The Brief Resilience Scale (BRS) was used to assess the level of resilience.

Results

The total number of participants was 56, of which 64.3% were medical residents.75% of the participants worked in a medical department and most had a number of shifts per month ≥4. The average years of practice was 2.27±1.23 years. Participants expressed dissatisfaction at work with salary (69.6%), task allocation and organization (66.1%), availability of resources (66.1%), comfort (57.1%), safety (53.6%) and supervision (50%). Referring to the BRS scale, higher resilience scores were objectified in male participants (p=0.002). The level of resilience decreased with the number of years of practice (p=0.039). Good satisfaction by management and recognition at work could enhance the level of resilience (p=0.029 and p=0.043 respectively).

Conclusions

The results of our study suggest that dissatisfaction with work-related aspects may influence the level of resilience. These results deserve special attention to improve job satisfaction and preserve resilience.

Disclosure

No significant relationships.
A UK Perspective on Pain and Atypical Performance - When the Maths doesn’t Add up!
Authors: Hall V.
Published: September 2022

This presentation provides an overview of factors that can cause symptom exaggeration and/or fabrication in chronic pain. It will explore how symptom and performance validity tests can be applied to chronic pain in the context of a malingering framework and the problems of implementing this in the UK through a case example.

Disclosure

No significant relationships.
Measurement-Based Care in Treatment of Substance Use Disorders
Authors: Samokhvalov A. , Levitt E. , Mackillop J.
Published: September 2022

Introduction

Measurement-Based Care (MBC) is an emerging healthcare model with a number of potential advantages over traditional approaches for the treatment of substance use disorder (SUD). Despite SUD treatment programs being theoretically well suited for the implementation of MBC, its uptake has been minimal, which in turn limits further research, knowledge synthesis, and translation into clinical practice.

Objectives

The goal of this knowledge synthesis project is to stimulate greater consideration of MBC models in addictions programs, with three interrelated objectives: 1. To summarize the existing evidence from research literature 2. To complement the literature findings with the data from our clinical research and quality improvement projects 3. To explore potential risks and difficulties of MBC implementation in the SUD treatment programs

Methods

Narrative review. Knowledge synthesis.

Results

To date, only two published randomized controlled trials, which along with the data from our pragmatic clinical research, support the wider implementation of MBC in the substance abuse treatment settings, but also indicate the high need for larger-scale clinical trials and quality improvement programs. Potential barriers to the implementation of MBC for SUD are outlined at the patient, provider, organization, and system levels, as well as challenges associated with the use of MBC programs for clinical research. Critical thinking considerations and risk mitigation strategies are offered toward advancing MBC for SUD beyond the current nascent state.

Conclusions

The state-of-the-art of MBC in SUD care settings reviewed and the strategies for further development from adminsitrative, clinical, and research prospectives outlined.

Disclosure

No significant relationships.
Perceived barriers and facilitating factors prior to the implementation of a lifestyle focused approach in the treatment of inpatients with mental illness
Authors: Van Schothorst M. , Den Bleijker N. , De Vries N. , Van Harten P. , Deenik J.
Published: September 2022

Introduction

Despite the increasing evidence for the efficacy of lifestyle interventions for people with mental illness (MI), there has been little change in routine clinical care. There are several factors that can complicate or facilitate the implementation of a lifestyle intervention. Gaining insight into such factors can contribute to effective integration into clinical practice.

Objectives

To assess the perceived barriers and facilitating factors of healthcare professionals (HCPs) and inpatients of psychiatric wards for the use of a lifestyle focused approach, prior to its implementation.

Methods

Baseline data from an open cohort cluster randomized stepped wedge study. Barriers and facilitators with regards to the intervention, HCPs and inpatients, and the organization were assessed with the measurement instrument for determinants of innovations, online, or through a semi-structured interview.

Results

Initial results show that inpatients (N=167) experience both barriers and facilitating factors with regards to themselves and the innovation. They perceive the innovation as complex and see few personal benefits, but indicate that they consider it part of their treatment. Healthcare workers (N=77) perceive facilitating factors related to themselves and the organization, such as expected support, but were not sufficiently aware of the content of the innovation. More detailed exploration of relationships with demographic and disease-related factors are currently being conducted.

Conclusions

These findings provide insight into the perceived barriers and facilitators of inpatients and HCPs regarding a lifestyle focused approach, prior to its implementation. More insight into relationships with demographic and disease-related factors can benefit application into routine clinical care.

Disclosure

No significant relationships.
Prevalence of Maternal Psychological Distress in pregnant women who receipt prenatal diagnosis of fetal Central Nervous System (CNS) anomalies
Authors: Falamesca C. , Cappelletti S. , Vicario R. , Amante P.G. , Correale C. , Vigevano F. , Caforio L. , Grimaldi Capitello T.
Published: September 2022

Introduction

Women receiving a prenatal diagnosis of fetal anomalies are a high-risk population for psychological distress leading to mood disorders. Even so, to date we have no evidence of studies who investigated the levels of maternal anxiety and depression in pregnant women receiving a prenatal diagnosis of fetal CNS anomalies.

Objectives

The aim of this study was to assess the prevalence of anxiety and depression levels in a pilot sample of pregnant women at the Prenatal Diagnostic Unit of the Bambino Gesù Children Hospital.

Methods

We collected data among 43 women who receipt fetal brain anomaly diagnosis (mean age: 35 yrs, SD ± 6.3, range 19-48 yrs; mean week at first access 26w, SD ± 3.9, range 18-33w). Prenatal diagnosis including: ventriculomegaly (37.2%), posterior cranial fossa (23.3%), choroid plexus cysts (11.6%), anomalies of CC (7%) and other (20.9%). Pregnancies with assisted reproductive technology were 14%. We use the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorders (GAD-7) questionnaires to assess anxious-depressive symptoms.

Results

showed a rate of mild-to-severe anxious depressive symptoms by 60.5% and 48.8% respectively. In detail: 41.9% mild, 14% moderate and 4.7% of severe anxiety. Meanwhile, 41.9% mild and 7% moderate depression. The prevalence of comorbid depressive and anxiety symptoms was 39.5% among the entire sample.

Conclusions

Preliminary data showed a high prevalence of anxious depressive symptoms and comorbidity among pregnant with CNS fetal anomalies. Women receiving a fetal CNS anomaly diagnosis may need additional psychological support or counselling.

Disclosure

No significant relationships.
The validity of clinicians’ diagnoses: Is it bread and butter?
Authors: Stevens A.
Published: September 2022

Major depression has become one of the most frequent diagnoses in Germany. It is also quite prominent in cases referred for medicolegal assessment in insurance, compensation or disability claims. This report evaluates the validity of clinicians’ diagnoses of major depression in a sample of claimants. In 2015, n = 127 consecutive cases were examined for medicolegal assessment. All had been diagnosed with major depression by clinicians. All testees underwent a psychiatric interview, a physical examination, they answered questionnaires for depressive symptoms according to DSM-5, embitterment disorder, post-concussion syndrome (PCS) and unspecific somatic complaints. Performance and symptom validity tests were administered. Only 31% of the sample fulfilled the diagnostic criteria for DSM-5 major depression according to self-report, while none did so according to psychiatric assessment. Negative response bias was found in 64% of cases, feigned neurologic symptoms in 22%. Symptom exaggeration was indiscriminate rather than depression-specific. By self-report (i.e. symptom endorsement in questionnaires), 64% of the participants qualified for embitterment disorder and 93% for PCS. In conclusion, clinicians’ diagnoses of depression seem frequently erroneous. The reasons are improper assessment of the diagnostic criteria, confusion of depression with bereavement or embitterment and a failure to assess for response bias.

Disclosure

No significant relationships.
Patient adherence to out-patient psychiatric care for neurotic and affective disorders (Should I stay, or should I go?)
Authors: Soboļevs A. , Kozlova K. , Tērauds E. , Sīle L.
Published: September 2022

Introduction

Referral is not a necessity for a patient who wants to get psychiatrist consultation in Latvia. The good thing about it is the availability and the possibility to consult with highest educated mental health specialist for any person in society without barriers. On the other hand, there is an overwhelming work load for psychiatrists.

Objectives

To explore the prevalence of self-referred patients in out-patient care and the adherence to psychiatrist recommendations.

Methods

The medical documentation of all consecutive first-time out-patient center “Pardaugava” psychiatrist patients over the period of 01.01.2020. to 30.04.2020. with one year follow-up was analyzed.

Results

236 patients were included in the study, 31.2% of them were men. The average age was 49 (SD ± 22.65) years. Patients with Affective (F3X) and Neurotic (F4X) disorders were self-referred more often compared to Organic mental (F0X) disorder or other spectrum patients (83.3% and 77.5% vs 33.3% or 56.0%, p<0.001). Median appointment count was 4, higher in F4X (6) and lower in F3X patients (2). Majority of F4X patients (61,6%) did not follow the recommendations or stopped seeing psychiatrist, while only 13,7% were persistent. Сonversely, 48,4% of F3X patients followed the recommendations and only 43,5% stopped. In comparison, other spectrum patients followed recommendations in 32.0% of cases and ignored - in 56.6%.

Conclusions

Patients were actively self-referring themselves to psychiatrist. Highest adherence to psychiatrist recommendations was found in patients with affective disorders compared to other spectrum patients. In contrast, adherence was the lowest in patients with neurotic disorders.

Disclosure

No significant relationships.
Care pathways for people with major depressive disorder
Authors: Strawbridge R. , Young A. ,   Major Depressive Disorder Working Group
Published: September 2022

Introduction

Major depressive disorder (MDD) is a leading cause of disability worldwide, in part due to its high prevalence and high rates of comorbidities, recurrence, chronicity and treatment-resistance. These indicate that MDD is treated suboptimally despite a multitude of effective interventions and well-regarded best-practice treatment guidelines. To improve the management of MDD, the nature and extent of ‘gaps’ in care pathways need to be understood.

Objectives

We aimed to: 1. Identify ‘treatment gaps’ and patient needs along the care pathway, and determine the extent of these gaps (i.e. discrepancy between best- and current-practice). 2. Propose policy recommendation on how minimise treatment gaps for MDD.

Methods

Care pathway analysis: A set of relevant treatment gaps were agreed upon, a priori, based on gold-standard stepped-care guidelines. Data was gathered from a variety of sources in six countries (UK, Sweden, Germany, Italy, Portugal, Hungary). Policy recommendations: To attain expert consensus on proposed recommendations, a modified-Delphi approach was undertaken with a multidisciplinary panel of experts across Europe.

Results

Taken together, data indicated that: ˜50% of episodes are undiagnosed, lifetime delay to treatment averages ˜4 years, ˜25-50% of patients are treated at any one time, ˜30-65% are followed up within 3 months of treatment, ˜5-25% can access psychiatric services. 28 specific recommendations to optimise pathways were made to enhance MDD detection (pathway entry), increase multimodal treatment, facilitate continuity of follow-up after treatment and increase access to specialist care.

Conclusions

There are concerning treatment gaps in depression care across Europe, from the proportion of people not being diagnosed to those stagnating in primary care with impairing, persistent illness.

Disclosure

No significant relationships.
Film-based resources for grief management in medical education
Authors: Tei S. , Fujino J.
Published: September 2022

Introduction

Grief and bereavement are commonplace in clinical practice but have become a more pervasive issue because of the coronavirus 2019 pandemic. Consequently, the need for investigations, learning, and education about complicated grief and prolonged grief have been highlighted. Meanwhile, film-based teaching resources concerning grief care have been employed to complement curricula in medical education.

Objectives

To explore how the grieving experience can be better communicated and mitigated, and explain how a film-based resource can be applied to improve the understanding of this issue.

Methods

We reviewed and analyzed the meaning and cause of complicated, prolonged, disenfranchised grief, as well as related experiences (e.g., survivor guilt) featured in selected films. We discussed the interpretation of these films with medical students and faculty, based on a previously described approach [1].

Results

We recaptured the roles of empathic communications and resilience skills in grief care. They bring a sense of coherence (SOC) or meaning to life by prompting the sharing of grief experiences, helping to reconstruct and contextualize a person’s loss, and assuaging feelings of worthlessness and hopelessness. Incidentally, recent studies have suggested that complicated and prolonged grief involves alterations in brain functioning of the reward system.

Conclusions

This film-based approach utilizes vicarious experiences to better understand grief management. It allows the learner to more easily recognize that SOC, flexible situation-adjusted empathy, and the sharing of resources for improved communication to promote self-care are essential for patients, their families, as well as psychiatrists themselves. [1] Sondheimer, A. The life stories of children and adolescents. Acad Psychiatry. 2000:24(4):214–24.

Disclosure

No significant relationships.
Cardiorespiratory fitness and self-reported physical activity levels of referring mental healthcare professionals, and their attitudes and referral practices related to exercise and somatic care
Authors: Deenik J. , Koomen L. , Scheewe T. , Van Deursen F. , Cahn W.
Published: September 2022

Introduction

Physical activity (PA) interventions can improve mental and physical health in people with mental illness, especially when delivered by qualified exercise professionals. Also, the behaviour, engagement and support of referring mental healthcare professionals (HCP) seems essential, but research is scarce.

Objectives

Studying the physical fitness and PA of HCP and the relationship with their attitudes and referral practices related to PA interventions

Methods

HCP at the Dutch Association for Psychiatry conference (2019) were invited to an online questionnaire (demographic/work characteristics, stress, PA levels, knowledge/attitudes regarding PA and referral practices) and cycle ergometer test. Linear and logistic regression were used to study the strongest associations.

Results

115 HCP completed the questionnaire. 40 also completed the ergometer test. 43% (n=50) met the national PA guidelines (≥150min moderate-to-vigorous PA and ≥2x bone/muscle-strengthening exercises a week). Women, HCP in training and HCP with more stress were less active and less likely to meet PA guidelines. HCP with personal experience with an exercise professional were more active and met guidelines more often. Knowledge/attitudes on physical health and PA were positive. Patients were more often referred to PA interventions by HCP who met PA guidelines (OR=2.56, 95%BI=0.85–7.13) or had higher beliefs that exercise professionals can increase adherence to PA interventions (OR=3.72, 95%BI=1.52–9.14).

Conclusions

It’s positive that HCP report importance and relevance of PA in mental healthcare. Although there is strong evidence for PA interventions in the treatment of people with mental illness, referral to such interventions can partly depend on the PA behaviour and attitude of patients’ physician/clinician.

Disclosure

No significant relationships.
Gray matter volume and burnout severity among medical professionals
Authors: Fujino J. , Tei S. , Abe K. , Takahashi H.
Published: September 2022

Introduction

Occupational burnout has become a pervasive problem in human services. Medical professionals are particularly vulnerable to burnout, which may lead to reduced motivation, medical errors, and voluntary absenteeism. To ensure effect functioning of medical systems, better understanding of burnout among medical professionals is warranted.

Objectives

We aimed to investigate the structural brain correlates of burnout severity among medical professionals.

Methods

Nurses in active service underwent structural magnetic resonance imaging. We assessed their burnout severity using self-reported psychological questionnaires. This study was approved by the Committee on Medical Ethics of Kyoto University and was conducted in accordance with the Code of Ethics of the World Medical Association.

Results

The results reflected considerable individual differences in burnout severity in our sample. Our findngs revealed that the levels of burnout severity were associated with the regional gray matter volumes in brain areas such as ventromedial prefrontal cortex and insula.

Conclusions

Since the outbreak of the COVID-19 pandemic, medical professionals have faced even greater stress. We hope that our findings will contribute to a better understanding of the mechanisms of burnout and offer useful insights for developing effective interventions to manage stress and burnout.

Disclosure

No significant relationships.
The feasibility of an implementation fidelity tool for the monitoring of a multidisciplinary lifestyle focused approach for inpatients with mental illness
Authors: Den Bleijker N. , Van Schothorst M. , De Vries N. , Van Harten P. , Deenik J.
Published: September 2022

Introduction

Lifestyle behaviours (e.g. physical activity and dietary habits) play a major role in the well-known premature mortality caused by poor physical health in people with mental illness. There is increasing evidence for the efficacy of lifestyle interventions on both physical and mental health, and consensus about important factors for success (e.g. targeting multiple lifestyle behaviours). However, implementation remains challenging and there is little change in clinical care. Studies that include measures of fidelity (the extent to which an intervention is implemented as intended) are able to gain insight in variations in actual implementation, which may affect intended health outcomes. However, there is currently no suitable fidelity tool for our lifestyle intervention.

Objectives

A pilot study to evaluate the feasibility of a tool that assesses and monitors the implementation fidelity of a multidisciplinary lifestyle focused approach (MULTI+).

Methods

MULTI+ can be tailored to various psychiatric wards and consists of 10 essential components based on scientific evidence, existing guidelines and consensus in the field of ‘lifestyle psychiatry’. We developed a tool to assess the 10 components and thereby the implementation fidelity of MULTI+. Qualitative observational data about compliance to these components are collected in 45 psychiatric wards. Adherence is converted to a gradual score (0-50). A higher score indicates higher fidelity.

Results

Preliminary results show that the tool is feasible for use in clinical practice. Scores give insight in how various wards have implemented MULTI+.

Conclusions

These outcomes can be used to further improve and understand the implementation and effectiveness of lifestyle interventions.

Disclosure

No significant relationships.
Almost 30 years of effort to bind clinical practice and science in the field of psychiatry in Europe
Authors: Demirtas M.B. , Esen E.C.
Published: September 2022

Introduction

European Federation of Psychiatric Trainees (EFPT) is a platform for psychiatric trainees from not only Europe but also various other countries. EFPT exclusively works on binding clinical practice and science for better mental health care. Research Working Group (RWG) of EFPT works on sharing knowledge with peers by brainstorming, collaborating and coordinating projects, organizing journal clubs and workshops.

Objectives

We will focus on tele-psychiatry also known as e-mental health, a subdivision of telemedicine, provides diagnostic interview, evaluation, therapies, psycho-education and treatment. We plan The Brain-Drain follow-up study, investigates immigration of psychiatric trainees. Also educational activities have planned.

Methods

With a questionnaire on the topic of psychiatry residents’ acceptance of tele-psychiatry using The Unified Theory of Acceptance and Use of Technology (UTAUT), we will hold the first multi-national survey among psychiatry residents. The Brain-Drain study was conducted by the EFPT-RWG in the past had a promising outcome. We are currently working on the follow-up of the study. We are starting to hold events. For instance we will commence the monthly journal club. Apart from giving a platform for scientific debate, journal club will also provide a chance have a elaborate discussion with author. We will organize a workshop on how to write a case-study with Neuro-Psycho-Pharmacology Working Group of EFPT.

Results

We assume diverse attitudes overlapping different telepsychiatry exposure and regualtions, comprehensive data on immigration of trainees and sharing knowledge on practice and research.

Conclusions

Hopefully, we will have clearer understanding of changes in working environment of trainees either with new technologies or in different countries.

Disclosure

No significant relationships.
Patient safety problems in community-based mental health services: A qualitative exploration
Authors: Averill P. , Sevdalis N. , Henderson C.
Published: September 2022

Introduction

Existing research has seldom examined patient safety problems experienced by service users accessing community mental healthcare, with the growing evidence base focusing largely on safety in psychiatric inpatient settings. Accordingly, there is poor understanding of safety issues in community-based mental health services as perceived by service users, carers, and healthcare professionals.

Objectives

This study aims to explore safety problems in adult community-based mental health services, their causation, and priority areas for improving the safety of care provided in these services.

Methods

In-depth, semi-structured interviews and focus groups were conducted with users of community-based mental health services, carers, and healthcare professionals employed within these settings. Interview topic guides were designed jointly with stakeholders from these groups (N=7) and piloted (N=3). Interviews and focus groups will be transcribed, coded, and analysed using an inductive thematic analysis approach. Illustrative quotes will be extracted and used to describe the key themes that emerge from the analysis and their inter-relationships.

Results

This presentation will provide an outline of patient safety as understood and experienced by key stakeholder groups. Study findings will explicate safety issues, healthcare system factors underpinning their causation, as well as practices which could improve safety in this context.

Conclusions

This research will help to advance understanding of the nature of patient safety problems in community-based mental healthcare services for adults, based on the experiences of service users, carers, and healthcare professionals within these services. The research will address key evidence gaps and represents an important step towards identifying areas which warrant intervention to improve patient safety.

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.
The influence of reflection and self-system on the effectiveness of self-regulation of students’ mental states
Authors: Kartasheva M. , Prokhorov A. , Chernov A. , Yusupov M.
Published: September 2022

Introduction

In the modern era of instability the problems of human adaptive abilities and mental regulation have become more and more relevant. The study of the processes of mental regulation is impossible without understanding the role of the mental structures: reflection and self-system of personality.

Objectives

The purpose of the research is to study the interaction and mutual influence of the components of the self-system and reflective structures on the process of mental regulation of students.

Methods

52 first year students were offered to complete questionnaires of reflectivity (M. Grant), of self-system (S. Pantileev), as well as the authors’ method of self-regulation effectiveness of mental states. Also we used Spearman’s rank correlation coefficient.

Results

It is revealed the positive direction of the relationships between the reflection and the components of the self-system (p ≤ 0.05). Respondents with a high level of self-system are more successful in coping with the processes of mental regulation. The indicators of internal conflict lead to a decrease in the effectiveness of self-regulation (p ≤ 0.05). The ability of a person to evaluate himself and other people has a positive effect on the success of mental regulation (p ≤ 0.05). However, the excessive desire to reflect on past events is not conducive to self-regulation.

Conclusions

The applied value of the research consists in the creation of a methodology that makes it possible to increase the regulatory and adaptive abilities of students during the educational process. Acknowledgements. This work was supported by the RFBR grant No. 20-013-00076.

Disclosure

No significant relationships.
Are exercise programs relevant in psychiatric wards?
Authors: Valada I. , Caldas I. , Vieira S. , Pereira I.
Published: September 2022

Introduction

About 3% of the general population suffers from Severe Mental Illness (SMI), including schizophrenia spectrum, bipolar and major depressive disorders. In this group, the rates of cardiovascular disease, diabetes mellitus and metabolic syndrome are approximately twice as high as the general population and the life expectancy is 13-30 years inferior compared to age and sex matched controls, greatly due to medical comorbidities. Low levels of physical activity (PA) and low fitness are likely to play a role.

Objectives

To review the evidence about the effects of PA on physical health markers and psychiatric clinical symptoms of SMI patients.

Methods

We performed a literature review on the impact of exercise programs in physical and mental health of SMI patients using the PubMed and Google Scholar databases.

Results

Several studies demonstrate that PA improves a variety of physical health markers in SMI patients, such as body weight, body mass index, waist circumference, body fat percentage, cardiorespiratory fitness, systolic blood pressure and HDL cholesterol. In parallel, there is evidence to support the benefit of PA in mental health, especially due to its effect on mood. Furthermore, PA promotes cognitive functioning, sleep quality, quality of life, self-esteem and fosters social interaction. Moreover, in patients with schizophrenia, exercise seems to decrease negative symptoms.

Conclusions

Implementation of regular physical activities in psychiatric wards should be considered whenever possible, due to its positive effects on physical and mental health. The adoption of structured exercise programs in psychiatric wards is feasible, safe, and well-received by patients.

Disclosure

No significant relationships.
Rural-urban differences in accessing mental health care in Tunisia
Authors: Bergaoui E. , Zrelli M. , Staali N. , Moalla M. , Lansari R. , Larnaout A. , Melki W.
Published: September 2022

Introduction

Despite improvement of mental health outcomes over the last years in Tunisia, there are still striking rural-urban mental health inequalities.

Objectives

The aim of this study is to evaluate the rural-urban differences in accessing mental health care among patients with psychiatric disorders

Methods

A cross sectional and descriptive survey was conducted between March and April 2021 in the department of psychiatry D of Razi Hospital including 70 patients admitted or treated as outpatients. The sex ratio was 1.

Results

The participants were aged between 17 and 68. About 11.42% came from rural areas. In these areas, 75% percent had low income versus 30.64% in urban areas. (p=0.047) The percentage of celibacy in urban areas was 68.85% versus 37.5% in rural areas (p=0.042) No significant difference was observed between the level of education and living in rural or urban areas. There was no association between rural or urban origin and number of admissions or treatment adherence or use of cannabis. The mean time between symptoms onset and consulting was 8.51 years in rural areas versus 2 years in urban areas. Moreover, time between symptoms onset and admission was significantly associated with rural or urban origin (p=0.045). The mean duration was 13,33 years (±10) in rural areas versus 3.12 years (±4.13).

Conclusions

Families living in urban areas had better income and would come to psychiatric hospital earlier. Therefore, we should help patients in rural areas access to mental health facilities for a better medical care.

Disclosure

No significant relationships.