bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between inflammation and neural plasticity biomarkers in olfactory neuroepithelium – derived cells and cognitive performance in patients with major depressive disorder
Authors: Toll A. , Portella M. , Robledo P. , Barrera-Conde M. , De La Torre R. , Ginés J.M. , Diez-Aja C. , Soria V. , Lopez-Garcia P. , Pérez-Solà V. , Alvarez P.
Published: September 2022

Introduction

Inflammation and neural plasticity play a significant role in major depressive disorder (MDD) pathogenesis and cognitive dysfunction. The olfactory neuroepithelium (ON), closely related to the central nervous system (CNS), allows a non-invasive, low-cost study of neuropsychiatric disorders. However, few studies have used ON cells to ascertain them as biomarkers for MDD.

Objectives

Determine the relationship between inflammatory/neural plasticity markers and cognitive functioning in MDD patients and healthy controls.

Methods

Sample: 9 MDD patients and 7 healthy controls. Exclusion criteria: other Axis I mental disorders (patients) or any mental disorder (controls) and any inflammatory, autoimmune, or CNS diseases. Assessment: sociodemographic, clinical, and cognitive variables (CANTAB) were recorded. mRNA was isolated from ON cells and MAPK14, IL6, TNF-α, Mecp2, BDNF, GSK3, GRIA2, and FosB gene expression levels were quantified using quantitative polymerase chain reaction.

Results

MDD patients showed decreased levels of BDNF (p=0.022), GSK3 (p=0.027), and working memory (p=0.024) compared with healthy controls. In healthy controls, planning was positively correlated with NRF2, BDNF, and MAPK14 gene expression. In MDD patients no correlation between cognitive parameters and inflammation/neural plasticity biomarkers was found.

Conclusions

These results reveal that: (1) Plasticity biomarkers such as BDNF and GSK3 could be useful diagnostic tools for MDD (2) MDD is associated with working memory deficits; (3) no association could be determined between planning and NRF2, BDNF, and MAPK14 gene expression in MDD and (4) the ON is a promising model in the study of neuropsychiatric disorders.

Disclosure

No significant relationships.
Preoccupied attachment style and beliefs about medicines in patients with Major Depressive Disorder
Authors: Santarelli G. , Sanfilippo G. , Benvenuti F. , Santoro L. , Nistri A. , Ballerini A. , Ricca V.
Published: September 2022

Introduction

Attachment style is defined by the American Psychological Association as “the characteristic way people relate to others in the context of intimate relationships”. Four attachment styles have been described: secure, fearful, preoccupied, and dismissing. While the effect of attachment style on psychotherapy was widely investigated, few studies have investigated its role in determining beliefs about medicines in patients with Major Depressive Disorder (MDD).

Objectives

This study aimed to investigate the relationship between preoccupied attachment style and beliefs about medicines in patients with MDD.

Methods

27 patients admitted in the Psychiatric Unit of Careggi with diagnosis of MDD were enrolled. Working Alliance Inventory - patient version (WAI-P), Relationship Style Questionnaire (RSQ) and Beliefs about Medicines Questionnaire (BMQ) were administered. An ANCOVA model having BMQ total score as dependent variable and age, sex, RSQ preoccupied attachment subscale and WAI-P task subscale as predictors was considered. WAI-P task was intended to assess the role of agreement on therapeutic choices.

Results

The overall model was significant (F(4,22)=9,571, P<0.001) and explained 66.8% of BMQ total score variance (R2=0.668). Both RSQ preoccupied attachment subscale (B=3.331, t(22)=3.907, p=0.001) and WAI-P task subscale (B=0.238, t(22)=4.565, p<0.001) showed a positive correlation with BMQ total scores. RSQ preoccupied attachment subscale explained 44.6% of variance of BMQ total scores (partial η2=0.446), WAI-P task explained 52.3% of variance of BMQ total scores (partial η2= 0.523). Age (B=0.059, t(22)=1.588, p=0.129) and sex (F(1,22)=0.035, p=0.854) had no significant effect.

Conclusions

These preliminary data suggest a possible influence of preoccupied attachment style on beliefs about medicines in patients with MDD.

Disclosure

No significant relationships.
Sodium Oxybate: a Substitute for Alcohol?
Authors: Gual A. , López-Pelayo H. , Bruguera P. , Miquel L.
Published: September 2022

Gamma-hydroxybutyrate (GHB) is a neurotransmitter found naturally in the human brain. Sodium oxybate (SO) is the sodium salt of GHB. In 2000 GHB was classified a Schedule I controlled substance, while SO became a Schedule III controlled substance for medicinal use under the Controlled Substances Act. SO and alcohol share a similar pharmacological profile. GHB acts on GABAB receptors and extrasynaptic GABAA receptors resulting in alcohol-mimetic effects in several CNS actions. It substitutes the discriminative stimulus effects of alcohol in rats, and has cross tolerance with alcohol. All together, this leads to think of SO as a substitution therapy for alcohol use disorders. SO was initially studied in the prevention of alcohol withdrawal, and it showed similar efficacy to benzodiacepines. The studies on relapse prevention were developed later and the results are mixed and more complex to understand. While open label studies show a positive effect, RCTs have not been able to show a significant effect for the whole sample. Nevertheless, post-hoc analysis show a robust effect in the subsample of patients with high risk drinking levels, that would be the preferred target for a substitution treatment. The potential for abuse of GHB is well documented, which should be no surprise for a substitution treatment. Nevertheless, when correctly prescribed the risk of abuse of SO remains very low, as shown both in clinical trials and in the pharmacovigilance database, with more than 260000 cases documented. SO can be considered a substitution treatment, effective in patients with high risk drinking levels.

Disclosure

I was investigator in the SMO study on sodium oxybate, funded by D&A Pharma.
Psychopathological features of hysterical disorders arising as part of affective disorders and schizophrenia
Authors: Barkhatova A. , Popov S. , Sorokin S.
Published: September 2022

Introduction

Hysterical disorders were considered separately in the context of the dynamics of the course of either endogenous affective diseases or schizophrenia, without attention to the conjugation and interaction of issues of hysterical symptoms and affective or psychotic syndromes.

Objectives

To test the psychopathological structure and provide a typology of the conjugation of hysterical symptoms with other psychopathological syndromes.

Methods

120 patients (82 women and 38 men) with schizophrenic and affective disorders with associated hysterical symptoms were examined by a clinical psychopathological method.

Results

Three variants of conjugation were identified. In the group of hysterical disorders associated with affective diseases (37,1%) the structure and dynamics of hysterical symptoms directly influenced the developing affective phase: the low intensity of hysterical symptoms contributed to the development of an apatho-adynamic type of depression, and bright and spontaneous hysterical manifestations formed an anxious-hypochondriac type of depression. Hysterical disorders formed in the structure of the psychotic state (41,4%) influenced the nature, structure, dynamics and content of delusional, hallucinatory and paranoid disorders. “Caste” hysterical symptoms (21,4%) revealed a lack of connection with affective and psychotic states. Hysterical symptoms were characterized by persistence, stability, invariability of manifestations, long-term psychotherapeutic and psychopharmacological resistance.

Conclusions

Clinical and psychopathological analysis of endogenous mental diseases of the affective and schizophrenic spectrum, occurring with hysterical symptoms, showed that the parameter of the conjugation of hysterical symptoms with other psychopathological syndromes is prognostically significant.

Disclosure

No significant relationships.
Telehealth in Australia
Authors: Lakra V.
Published: September 2022

Introduction

There is a significant psychiatry workforce shortage in Australia, particularly in rural and remote communities. Given the large distances involved, telehealth – providing consultation via videoconference – has been widely accepted. Psychiatrists were among the highest users of telehealth services in Australia before the COVID-19 pandemic. However, the outbreak of COVID-19 resulted in a major transformation to service delivery across Australia. Private psychiatrists and state public mental health services had to rapidly transition to largely telehealth delivery to ensure continuity of care for consumers.

In March 2020, additional telehealth item numbers were added to the Australian Medicare Benefits Schedule (MBS) to encourage physical distancing for those accessing medical services during the pandemic.

Objectives

To provide an overview of the increase in telehealth activity since the COVID-19 pandemic.

Methods

The MBS is the list of services for which the Australian Government will pay a rebate. Key data on MBS telehealth activity since March 2020 was examined.

Results

The use of telehealth has increased during the pandemic. A survey of Royal Australian and New College of Psychiatrists (RANZCP) psychiatrists found that 93% supported retention of telehealth MBS item number numbers following the COVID-19 pandemic, noting increased accessibility for consumers. Positive feedback has been received from consumers.

Conclusions

During 2020 and 2021, the RANZCP worked with the Australian Government to ensure there were appropriate MBS telehealth services available for consumers. The RANZCP continues to work with the Government as they plan for a longer-term transformation of telehealth services beyond 2021.

Disclosure

No significant relationships.
Prevalence of high risk of ADHD among adult users of Instagram in Russian Federation
Authors: Potanin S. , Morozova M. , Rupchev G. , Burminskiy D. , Lepilkina T. , Beniashvili A.
Published: September 2022

Introduction

The problem of diagnosis and treatment of ADHD in adults in the Russian Federation remains very relevant. Unfortunately, very little time is devoted to the topic of adult ADHD in standard and advanced training programs. In connection with these problems, it is important to study the prevalence of ADHD in the Russian population.

Objectives

To determine the prevalence of an increased risk of adult ADHD on the example of Russian Instagram users.

Methods

In the professional blog of one of the authors of the article in Instagram (@gentlepsydoc), a link was posted to an anonymous survey conducted using Google docs, in which patients filled out the Adult ADHD Self-Report Scale (ASRS v1.1) in the author’s translation

Results

A total of 144 people took part in the screening, 87.5% of them were women, the average age of the participants was 35.5±12.3 years (from 20 to 56). An increased risk of ADHD according to the indicators of the ASRS scale was detected in 13.2 % of participants.

Conclusions

Among Instagram users, the prevalence of an increased risk of ADHD was higher than according to epidemiology data. This indicator could be influenced by a sample of patients, mainly consisting of subscribers of a professional blog of a psychiatrist, as well as the prevalence of women among the participants. In any case, these data speak in favor of the importance of diagnosing this condition in the Russian population, as well as including information about adult ADHD in training programs for mental health professionals.

Disclosure

No significant relationships.
Patients’ online access to psychiatric records: Providers’ experiences
Authors: Fagerlund A. , Zanaboni P. , Lintvedt O. , Kristiansen E. , Wynn R.
Published: September 2022

Introduction

Patients attending psychiatric specialist health services in Northern Norway have since 2015 had the opportunity to access their medical records online. Prior to implementation, there were some concerns in the professional field that patient accessible electronic health records might introduce some challenges.

Objectives

In this study, we asked psychiatric providers in outpatient psychiatric care about the impact of patients’ online access to documentation practices and whether they felt the access impacted the provider-patient relationship. We also examined whether the providers sought to deny patients’ access to any information.

Methods

16 qualitative in-depth interviews were performed with mental health providers working in the specialist services in North Norway. Participants had different professional backgrounds, and included doctors, nurses, psychologists and others. The interviews were audio recorded and transcribed verbatim. The data were qualitatively analyzed by means of the framework method.

Results

The providers varied in their encouragement of patients’ online access, but few expressed concerns. There had been little specific training on how to optimize the writing of notes to accomodate patients’ online acces, but several pointed out that there had been an increased focus on the importance of adapting the notes to promote understanding. Increased transparency was in general seen positively, but the service might not fit all patient categories. Very few patients were denied access. In most cases, the service could improve the patients’ understanding of the treatment and the provider-patient relationship.

Conclusions

While some voiced caveats, patients’ online access was in general seen as beneficial to the treatment and the provider-patient relationship.

Disclosure

No significant relationships.
PRESTOapp for health workers with mental health symptoms related to the COVID-19 pandemic
Authors: Primé Tous M. , Anmella G. , Segú X. , Fernández Canseco M.D.R. , Carrino C. , Villegas M. , Vicens V. , Blanch J. , Cavero M. , Vieta E. , Hidalgo-Mazzei D.
Published: September 2022

Introduction

The COVID-19 pandemic has caused a significant impact on the mental health of health workers that has brought many hospitals to launch immediate preventive mental health programs.

Objectives

(1) To adapt and enhance a smartphone app (PRESTOapp) for health workers with mental health symptoms related to the COVID-19, and (2) to demonstrate its potential effectiveness in significantly reducing anxiety-depressive and PTSD symptoms in this population. We aim to incorporate Natural Language Processing (NLP)-based techniques in a chatbot user-interface that will enable a more personalized and accurate monitoring and intervention.

Methods

An 18-months study with a 6-months preliminary phase to adapt PRESTOapp to health workers, enhance it with NLP-based techniques and chatbot user-interface, and evaluate its feasibility, and effectiveness in 12-months.

Results

PRESTOapp has the potential to provide a prompt, personalized and integral response to the mental health demand due to the COVID-19. It will help by providing an innovative digital platform, that will allow remote monitoring of the symptoms course, provide brief psychotherapeutic interventions, and detect urgent situations. If the preliminary results of this study point to a potential effectiveness of the intervention, PRESTOapp may be easily adapted to the general population.

Conclusions

PRESTOapp may be one of the key digital platforms that may help preventing and treating potentially severe mental health consequences. Considering the unresolved problem of burnout in health workers even before the COVID-19, this project will develop the necessary technology for implementing cost-effective mental health solutions, not only during the pandemic.

Disclosure

No significant relationships.
Comorbidity of Substance Use Disorders and Eating Disorders: a major concern for mental health care professionals
Authors: Tapoi C.
Published: September 2022

Introduction

During the last 30 years, many studies have shown a high prevalence of substance use among patients diagnosed with an Eating Disorder (ED). Almost 50% of the patients with ED have a history of substance use, and 35% of the patients that seek help for an addiction disorder also meet criteria for ED. Nevertheless, both substance abuse specialists and pratictioners with expertise in ED have difficulties in treating these dually diagnosed patients.

Objectives

The aim of this study is to emphasize the importance of assessing substance use in patients with ED and disturbed eating behaviors in patients with Substance Use Disorders (SUD), as well as the need for evidence-based treatment guidelines for this comorbid condition.

Methods

A literature search of published articles on substance use patterns in ED and on the therapeutic approach for this comorbid condition was performed on PubMed database.

Results

A diagnosis of Bulimia Nervosa and the presence of binging/ purging behaviors are strongly associated with substance use. Most frequently used substances are represented by nicotine, caffeine and alcohol, followed by cannabis and amphetamines. Reasons why patients with ED use substances are emotional regulation and appetite suppression. Detailed and systematic evaluation of the substances used and for other psychiatric comorbidities is mandatory. Management plan involves simultaneously treating ED and SUD.

Conclusions

The comorbidity of Substance Use Disorders and Eating Disorders is a complex entity, but nonetheless treatable. Further studies are needed to specify the patterns of substance use in Eating Disorders and their implications for treatment.

Disclosure

No significant relationships.
Assessment of physical activity level in young adults with eating disorder risk: a cross-sectional study in a non-clinical sample
Authors: Mróz M. , Brytek-Matera A.
Published: September 2022

Introduction

Physical activity (PA) level has been found to be an important correlate of eating disorders (EDs). The literature is inconclusive to whether PA is related to symptoms of EDs in non-clinical sample.

Objectives

The first study aim was to assess the level of PA in non-clinical group of young adults with symptoms of EDs. The second aim was to evaluate the association between PA level and severity of EDs symptoms.

Methods

The sample consisted of 327 young adults (Mage = 21.72±2.00;MBMI = 23.20±7.43). All participants completed the Eating Attitudes Test (EAT-26) and the International Physical Activity Questionnaire(IPAQ). Finally, 32 individuals (9.79%) of the total sample scored above clinical cut-off on the EAT-26 (≥ 20) indicating a high level of symptoms and concerns characteristic of EDs.

Results

The non-clinical group differed significantly in PA level (low-intensity, moderate-intensity, vigorous-intensity levels of PA; H(2,32)=26.19,p<0.001). There was no difference in the severity of ED symptoms between the groups of PA level. Our findings demonstrated a positive relationship between PA (IPAQ total score) and bulimic behaviour and thoughts about food (rho-Spearman=0.31,p=0.04). The highest Bulimia and Preoccupation scale scores were observed in group with vigorous-intensity levels of PA (Me=8.5).

Conclusions

Our findings indicate that the severity of ED symptoms did not differ across the PA levels in a non-clinical sample of young adults. However, PA was positively associated with bulimia and food preoccupation. Since, excessive physical could be an important risk-factor of EDs, the recommended levels of PA for health in non-clinical sample should be enhanced in effective prevention programs.

Disclosure

No significant relationships.
Body shame and disturbed eating behaviors: an ecological momentary assessment approach
Authors: Nechita D.
Published: September 2022

Introduction

There is a well-established body of investigations showing that the experience of shame is associated with eating disorders symptoms. Meta-analytical data indicate that body shame is one type of shame that seems to be especially relevant in case of eating disorders. While there are many studies which investigated the association between the predisposition to feel ashamed about one’s body and eating disturbance, there are virtually no inquires on how momentary body shame is related to disturbed eating behaviors.

Objectives

In this study we aimed to investigate the relationship between momentary body shame and disturbed eating behaviors using an intensive longitudinal design.

Methods

Females with high levels of eating disorders symptoms completed five, randomly-initiated surveys per day delivered via a smartphone application for a total of two weeks. The survey evaluated the level of body shame and disturbed eating behaviors (i.e., binge eating, purging, excessive exercises, body checking).

Results

Preliminary results indicate that higher levels of body shame are associated with higher levels of disturbed eating behaviors. The level of body shame was higher in binge eating days compared with non-binge eating days.

Conclusions

Fluctuations in body shame seem to contribute to the maintenance of disturbed eating behaviors. Implications and limitations of these findings are discussed.

Disclosure

No significant relationships.
Correlations between alexithymia, emotional instability, autism spectrum disorder and eating disorders: analysis of a case
Authors: Valtueña García M. , Peña Herrero E. , Picado Rossi M. , Pedrosa Duque C. , Valladares Rodriguez P.
Published: September 2022

Introduction

Eating disorders and borderline personality disorder can coexist with high frequency in people with alexithymia. At the same time, it has been described that alexithymia can be present in patients suffering from depression, anxiety, obsessive-compulsive disorders, PTSD and eating disorders, among others. In this sense, it has been described that alexithymia could help maintain eating disorder.

Objectives

To review the existing literature on the relationship between alexithymia, emotional instability and a family history of autism spectrum traits with the development of eating disorders. To expose, through the clinical case of a patient with eating disorders, the diagnostic complexity and evolution after the beginning of a comprehensive and multidisciplinary therapeutic plan with different mental health devices.

Methods

To review the personal and family psychopathological aspects and the clinical evolution of a patient with a diagnosis of restrictive subtype anorexia nervosa since its inclusion in a therapeutic program.

Results

This is a longitudinal study through personal biographical reconstruction and family history and subsequent follow-up of a clinical case based on the implementation of an individualized therapeutic program and the results obtained.

Conclusions

Currently there is evidence in the literature that finds a high correlation between alexithymia and eating disorders. However, these findings are believed to be influenced by other comorbid symptoms such as depression or anxiety. Furthermore, the diagnosis of ASD in people with AN is a complex process that requires a thorough clinical evaluation over time. Detailed studies are needed to determine the importance of these factors in the development of an eating disorder.

Disclosure

No significant relationships.
Early Community based Ayu-Emergency Intervention in Psychiatric Emergencies: A Community Based Participatory Research
Authors: Voegeli M. , Sharma P. , Sharma S. , Sharma B. , Goyal I. , Sharma N. , Lakshmanan S. , Venu A.
Published: September 2022

Introduction

Psychiatry emergencies in India is major challenge for emergency service providers due to rapid growth of various behavioural, higher morbidity and mortality rate. Despite, psychiatry conditions are neglected area related to stigma, share, lack of awareness, and superstitious beliefs. There is an urgent need for specialist psychiatric emergency services, which can fill the huge gap between policymakers and health service providers joined together.

Objectives

Present feasibility study has been undertaken to evaluate the safety and efficacy of combined emergency and Ayurveda medicine management of psychiatric emergencies in community-based settings.

Methods

Ayu-Emergency Care project was developed in partnership with policy makers, researchers and health care providers, a collaborative platform of emergency medicine and Ayurveda medicine (Indian Traditional Medicine) for developing whole-system perspective, where providers work in a coordinated and joined-up way. Twenty trained care providers in psychiatry emergency and Ayurveda management worked in partnership with community-based organisation.

Results

Patients with major clinical difficulties, in the acute phase were treated and managed by Ayu-Emergencypractitioners. Severe Agitation and violence relating to substance abuse, anxiety disorder and psychosis were the most common admission diagnoses. 2-weeks results indicate that Ayurveda intervention can reduce anxiety(p<0.01), aggression (p< 0.001) and agitation (p<0.01) significantly with no side effects reported. Intervention found to be clinically beneficial and cost-efficient alternative to out-of-home placements (i.e., Incarceration, psychiatric hospitalisation).

Conclusions

The study’s findings highlight safety, efficacy and feasibility of intervention. Patients both prefer and seem to benefit from community-based ayu-psychiatric care, and early-intervention community program could be a good model for such care.

Disclosure

No significant relationships.
Comparison between haloperidol decanoate and oral haloperidol on seeking psychiatric emergency care
Authors: Osaku L. , Salvadori G. , Porcu M.
Published: September 2022

Introduction

Haloperidol is a first generation, high potency, low cost and widely used antipsychotic. There are inconsistencies in the literature about comparison of effectiveness between long-acting injectable haloperidol (HDLAI) with oral haloperidol (OH), as well as the combined use of both formulations (HDLAI+OH).

Objectives

To verify whether HDLAI reduces the number of emergency visits and hospitalizations when compared to oral OH, or in combination therapy HDLAI+OH.

Methods

Retrospective observational study on a Psychiatric Emergency department, including patients aged 18 to 60 years, both genders, under continuous treatment for at least 5 months with Haloperidol for any psychiatric illness, divided into 3 groups of patients (HDLAI, OH, HDLAI+OH). Dependent variables: visits and admissions. Independent variables: sex and age. Data were checked for normality (Kolmogorov-Smirnov test) and homoscedasticity (Bartlett test). For comparison of average number of visits and hospitalizations of patients Kruskal-Wallis test followed by Dunn’s multiple comparison test was used. It was considered statistically significant if p < 0.05. This study was approved by the Ethics Committee of Maringá State University.

Results

No statistical difference between groups HDLAI and OH was found. The HDLAI+OH group presented higher means of emergency visits and hospitalizations with statistical significance.

Conclusions

It suggests the use of HDLAI can be considered an alternative as effective as oral intake. Prolonged use of associated HDLAI and oral supplementation leads to worst outcomes.

Disclosure

No significant relationships.
Peer Counseling in a Community Based Intervention for Unaccompanied Immigrant Youth
Authors: Qureshi A. , Morales N. , Collazos F.
Published: September 2022

Abstract Body

Uaccompanied migrant youth represent an at-risk population given the complexity of negotiating adolescence in a new culture, isolated from family and friends, without a secure base and subject to discrimination. In addition, many unaccompanied migrant youth have been subject to considerable trauma prior to, during, and post migration. In Spain, as in many countries, the residential, care, and mental health services are not adapted to the specific and complex needs of this population, and to that end complex not only are the youth not well served but providers are increasingly frustrated. The figure of the community health agent has been widely recognized as one that can function as an effective bridge between systems/institutions and marginalized and vulnerable populations. In this presentation we will describe an ongoing project that trains unaccompanied migrant youth who show promise in their cultural adaptation in the areas of cultural competence, mental health care and substance abuse to function as community health agents (or peer counselors) consistent with models of cultural consultation.

Disclosure

No significant relationships.
Particularities of the Theory of Mind in the Academic environment during the Covid 19 pandemic
Authors: Ursoniu S. , Bredicean C. , Giurgi-Oncu C. , Bucur A.I. , Rivis I.-A. , Serban C.L. , Papava I.
Published: September 2022

Introduction

The current period is marked by several negative aspects of the COVID 19 pandemic, which have led to a series of emotional and cognitive changes that affect our functioning. The ability to “read” the minds of others is the key aspect of social behavior, helping us understand our context.

Objectives

To identify the level of emotion recognition in Medicine students during the Covid 19 pandemic.

Methods

Throughout 2021, we evaluated 649 Romanian General Medicine students in years 4, 5 and 6, by using a Google Play application (android and iOS). We analyzed socio-demographic parameters and the affective component of Theory of Mind (The Reading the Mind in the Eyes Test). The mean scores between groups were compared with the Student’s t and the ANOVA tests.

Results

The mean score was 25.83 ± 3.36 (min 11, max 33) out of a possible maximum of 36. We noted that women have a higher capacity for recognizing emotions than men (26.04 ± 3.22 vs. 25.01 ± 3.78, P = 0.0016) without differences in terms of the study year. Also, women showed a greater ability to recognize negative emotions compared to men (16.57 ± 2.44 vs. 15.49 ± 2.75, P <0.001). No statistically significant differences were found between the two genders in terms of positive emotions’ recognition.

Conclusions

The ability to recognize emotions seems to be more developed in women, especially when it entails recognizing negative emotions. Theory of Mind abilities are important for empathy and the therapeutic relationship required in Medicine.

Disclosure

No significant relationships.
Zero violence or zero seclusion. Which is more acceptable in our hospitals?
Authors: Tong K. , Gibbons A. , Byrne O. , Conlon T. , Kennedy H. , Davoren M.
Published: September 2022

Introduction

There is an established association between serious mental illness and violence. Secure forensic psychiatric services provide care and treatment to mentally disordered offenders. The majority of patients in forensic services suffer from severe mental illnesses such as schizophrenia, with co-morbid polysubstance abuse and maladaptive personality traits. Psychiatric services are under significant pressure to reduce the use of seclusion and restrictive practices, whilst mandated to provide safe environments for patients and staff.

Objectives

To determine the number and characteristics of violent incidents in a secure forensic hospital in Ireland.

Methods

A retrospective review of all incidents in Central Mental Hospital, Ireland between 1st March 2019 and 31st August 2021 was completed. Incidents were categorised into physical assaults and other violent incidents. Demographic measures and measures of violence risk (HCR-20), functioning (GAF), programme completion and recovery (DUNDRUM tool) were collated.

Results

A total of 321 incidents took place during the period examined, of which 47 (14.6%) involved physical assaults perpetrated by patients. Between March 2020 and August 2021, numbers of assaults increased by 50% and 78% compared to the preceding six-month period respectively. The majority of assaults were committed by a relatively small group of patients. Victims of assaults were more likely to be patients (n=27, 57.4%) and more likely to be males (n=43, 91.9%).

Conclusions

Physical assaults and other violent incidents happen in forensic and general psychiatric units. Restrictive practices, used in accordance with the law, are necessary at times to prevent serious harm to patients and staff in psychiatric hospitals.

Disclosure

No significant relationships.
Which predictive variables are emphasized when violence risk assessments are performed in Norway?
Authors: Seljenes K. , Wynn R.
Published: September 2022

Introduction

Violence is considered both a societal issue and a public health issue. Due to the high economic, societal, and individual cost associated with exposure to violence, clinical risk assessment-tools are now being implemented in the public health care system as well as outside of it. To ensure early identification and prevention, various professional groups perform structured risk assessments in Norway, including police, doctors, and psychologists.

Objectives

There is a need to examine competence and organizational factors, which may affect the ability to make accurate assessments in different levels of the health service, as well as in the police who often are involved in early identification and action-taking concerning violent individuals. Based on variation in risk assessment competencies, and characteristics of different work environments, our project aims to investigate whether some factors seem to be more important than others in clinical assessments when comparing different professional groups with or without a professional background in health care.

Methods

In our study, we will be able to tell if there is a significant difference in how different professional groups emphasize different risk factors, and in which way individual factors such as formal competencies, years of experience, and personal and professional attitudes to violence affect the risk violence assessments performed.

Results

We hypothesize that retrospective, clinical, and dynamic risk-factors are interpreted differently by different professional groups, and therefore entail significant variations in assessments, and the health care provided.

Conclusions

In this planned study, we will examine variations in the practice of violence risk assessment in Norway.

Disclosure

No significant relationships.
Crisis Intervention Team of Avilés. Results after three years
Authors: González Álvarez A.M. , Lago Machado E. , Pérez Gómez L. , Lanza Quintana E. , Martínez Jambrina J.J.
Published: September 2022

Introduction

This Crisis Intervention Team was born in October 2018 with the aim of intensifying the treatment of people in psychiatric crisis situation.

Objectives

Provide an intensive and early assessment and approach in a timely manner. It also provides home care if necessary.

Methods

The team intensively performs scheduled visits, emergencys, telephone interventions and home care. It is in constant coordination with other structures of the mental health and socio-health network.

Results

A total of 83 patients have been included in our team since its inception. The youngest was 17 years old and the oldest 83 years old (exceptional case in evaluation). The mean age was 45.6 years. 67.4% were female (56 women) and 32.5% male (27 men). The delay in care did not exceed 48 hours.

200 patients were evaluated into suicide protocol, with ages ranging from 15 to 85 years, with a mean age of 45.4 years. The delay in care does not exceed 10 days.

Conclusions

This is a team that offers a rapid response, dedicates the necessary time for a correct evaluation of the risk, of the evolution and tries to establish a therapeutic alliance in record time. It is able to tolerate a certain degree of uncertainty, manage and tolerate the level of risk. He stands out for being flexible and dynamic in order to be able to adapt to the patients and theirs circumstances. This requires empathy, closeness and commitment.

Disclosure

No significant relationships.
Dissecting the Heterogeneity of Autism: Focus on Phelan-McDermid Syndrome
Authors: Lamschtein C. , Chaffer T.J.
Published: September 2022

Introduction

Autism spectrum disorders (ASD) are a group of neurodevelopmental disorders that show delays and deficits in the development of multiple brain functions, which are characterized by social communication, poor language development, and restricted and stereotyped patterns of interests and behaviours. ASD affects about 1-2 % of the population and are considered to be highly genetic in nature. Structural variations of chromosomes have been identified in some ASD individuals, most common on chromosome 7q, 15q and 22q.

Objectives

1-To present a systematic literature review of the natural history of individuals with 22q13.3 deletion syndrome, Phelan-McDermid syndrome (PMS). PMS, increase awareness of different phenotypes 2-
Correlation of clinical manifestations of PMS with hypothesized underlying biological mechanisms 3-Rational for novel treatments is inferred through translational neuroscience approaches.

Methods

We have conducted a systematic literature review of the natural history of individuals with PMS, including both cross-sectional and long-term longitudinal analyses and correlation with hypothesized underlying biological mechanisms, including roles in regulation synaptic development, function, and plasticity. This systematic review includes the basis for a promising common pathway for ASD pathogenesis and the clinical implications of novel therapeutic strategies inferred through translational neuroscience approaches.

Results

This systematic review, therefore, outlines the: (1) Pathophysiological basis and clinical manifestations of PMS; (2) PMS pre-clinical models and applications to ASD; and (3) clinical implications of novel therapeutic strategies.

Conclusions

A promising common pathway for ASD pathogenesis and rational for novel treatments is inferred through translational neuroscience approaches. Neurobiological basis for lithium treatment is indeed supported by experimental results and current clinical findings.

Disclosure

No significant relationships.
Assessment of intellectual disability in Klinefelter’s Syndrome associated with other Prenatal and Perinatal risk factors. A case report
Authors: Castellanos Villaverde T. , Hospital Moreno A. , Louzao Rojas I. , Fernández-Jiménez E.
Published: September 2022

Introduction

Klinefelter’s syndrome (KS) is considered as a genetic risk factor for intellectual disability and specifically for impairment on verbal skills. Prenatal and perinatal morbidity concurrent with this diagnosis determine the entity and typology of neurodevelopmental deficits.

Objectives

To describe the intellectual and adaptive functioning of a patient with KS and prenatal and perinatal difficulties, assessed in the Service of Psychiatry, Clinical Psychology and Mental Health at La Paz University Hospital (Madrid).

Methods

A descriptive study was conducted of a 6 year and 7-month-old boy with diagnosis of KS (karyotype XXY), extremely low weight at birth (752 gr.), Arnold Chiari type I malformation with post-hemorrhagic hydrocephalus and periventricular leukomalacia, bronchopulmonary dysplasia, intra-atrial septal defect, left kidney agenesis with iatrogenic adrenal insufficiency, and acute ventriculitis due to E. Coli. Neuropsychological evaluation was carried out in October 2021. Leiter-3 scale was selected due to the absence of expressive language; and his parents completed the questionnaire Adaptive Behavior Assessment System-II.

Results

The nonverbal intelligence quotient was observed in the very low range (full-scale IQ = 69). The result of general adaptive behavior (z = -2.83), showed very high functional disability both in the conceptual, social, and practical domains.

Conclusions

The high number of causes of disability in this patient is consistent with a high degree of functional disability. Efficient evaluation sessions of intellectual performance, adaptive functioning, and necessary supports, due to the absence of expressive language and limited receptive language, are required. A specific neuropsychological evaluation profile should be established for KS.

Disclosure

No significant relationships.
The value of cognitive behavioral therapy on quality of life in addition to pharmacotherapy in adults with ADHD
Authors: Wettstein R. , Klabbers Y. , Romijn E. , Nieuwveen J. , Kroesen H. , Wettstein K. , Dumont G.
Published: September 2022

Introduction

Treatment options for ADHD in adults consist of psycho-education, cognitive behavioral therapy (CBT), pharmacotherapy or a combination thereof. Current studies do not yet provide insights into the additive effects of CBT and pharmacotherapy regarding the quality of life in adults with ADHD.

Objectives

In this study, we investigated the effect of CBT combined with pharmacotherapy on the quality of life in adults with ADHD compared to pharmacotherapy alone.

Methods

In this multicenter prospective cohort study a total of 627 patients were included, 305 where included in the pharmacotherapy only group and 322 in de combination group (CBT and pharmacotherapy). The Adult ADHD Quality-of-Life scale (AAQoL) was conducted at baseline and at the end of treatment.

Results

No significant differences were found in gender or age between groups at baseline. The average improvement in the AAQoL total score in the pharmacotherapy group was 26.81(17.12) and in the combination group 25.45(16.33) and showed no significant difference (t(543) = 0.96, p = 0.34). At baseline the average total score in the pharmacotherapy group was 45.5(12.37) and 42.22(12.73) in the combination group (t(543)=2.86, p = 0.004). The average total score at the end of treatment in the pharmacotherapy and combination group was 72.31(12.99) and 67.67(12.45), respectively (t(543)=426, p <0.001).

Conclusions

To our knowledge, this is the first study to describe the value of CBT in addition to pharmacotherapy on the quality of life in adults with ADHD. Contrary to our expectations, there was no significant effect of CBT in addition to pharmacotherapy on the quality of life.

Disclosure

No significant relationships.
Evaluation of a home treatment approach to schizophrenia in rural Pakistan: the SOUL Programme
Authors: Raja S. , Soomro F. , Junejo B. , Wagan R. , Afghan S.S.
Published: September 2022

Introduction

Psychiatric services in LEDCs face a tripartite challenge: (i) limited financial capital; (ii) scarcity of professionals; (iii) restrictive health beliefs. Inevitably, services developed for the first-world are ill-suited here. Psychiatric services must be designed from the ground up: inspired by but not a replica of best practices in the developed world. The SOUL project in Larkana, Pakistan provides home based assessment by a psychiatrist and fortnightly treatment by a mobile nursing team for schizophrenic patients. Psychoeducation of carers and the community as well as facilitation of work for patients are core aims. This mixed-methods study evaluates the experiences of primary stakeholders - patients and their carers.

Objectives

1.Are patients and carers satisfied with the care received? 2.Has SOUL been successful in changing health beliefs? 3.How could the programme be improved?

Methods

The principal investigator accompanied the team for 4-weeks. Purposive sampling was employed. Satisfaction was assessed quantitatively using the likert based PSQ-18 questionnaire. Thereafter, qualitative data was gathered using semi-structured interviews and analysed using a grounded theory approach. A total of 27 interviews were conducted before data saturation.

Results

100% of interviewees answered ’Satisfied’ or ’Very’ Satisfied to all elements of the PSQ-18. Above all, stakeholders valued that treatment was free and highly accessible (home visits), promoting treatment adherence. They felt psychoeducation events significantly reduced community stigma and made families more likely to seek psychiatrists over faith healers. Provision of respite care was suggested as a future improvement.

Conclusions

SOUL is highly valued by stakeholders and offers an excellent example of LEDC psychiatric care.

Disclosure

No significant relationships.
Assessment of Knowledge and attitudes of psychiatric nurses toward electroconvulsive therapy
Authors: Herch N. , Lansari R. , Bennasr Y. , Melki W.
Published: September 2022

Introduction

knowledge and atittudes of psychiatric nurses should be continuously evaluated and updated to ensure a quality care in electroconvulsive therapy (ECT) unit.

Objectives

Assessment of the psychiatric nurses knowledge and attitudes towards ECT.

Methods

A cross sectional descriptive study was conducted in multiples psychiatric departments in Razi Hospital Tunisia between January and April 2021.We asked 30 psychiatric nurses using a questionnaire evaluating their knowledge and attitudes towards ECT technique and its impact on the medical care.

Results

Our study revealed a lack of knowledge on ECT among psychiatric nurses.In fact, 93% of nurses reported that schizophrenia represents the most frequent indication. Pregnancy was considered as a contraindication by all participants. ECT was not recognized as a first line treatment and Only few knew the complet medical checkup before ECT.As for their opinion about this technique, 73 % of the nurses have a positive attitude towards ECT and think that it is very effective .

Conclusions

Nurses have a major role in the progress of every ECT-session .For that, specific training can only improve their knowledge and promote more positive attitude toward ECT.

Disclosure

No significant relationships.
Paralization and online adaptation of an ongoing clinical trial in La Paz University Hospital (Madrid, Spain) during the COVID-19 worldwide pandemic
Authors: Vidal-Villegas M.P. , Andreo Jover J. , Mediavilla R. , Muñoz-Sanjosé A. , Rodríguez-Vega B. , Bayón-Pérez C. , Palao Tarrero Á. , Bravo-Ortiz M.F.
Published: September 2022

Introduction

Spain went into lockdown in March of 2020 due to the COVID-19 outbreak. We had to stop the third randomization of our ongoing clinical trial (Mediavilla et al., 2019), pausing weekly group psychotherapy for 12 people with a first episode of psychosis. Only 5 weekly sessions had been delivered, thus many were just starting to form a therapeutic link with the group. In a public health emergency context, psychotherapeutic groups are considered avoidable gatherings. However, stopping psychological therapy abruptly can make participants more vulnerable. The intervention groups were launched in an online format because we could not let anyone go without psychological support in such a difficult time.

Objectives

Communicate how we adapted an ongoing clinical trial to an online format during the lockdown in Spain.

Methods

In light of our participants’ needs and their acute deterioration the first two weeks of lockdown, we adapted our intervention. First, both arms (mindfulness-based v. psychoeducational multicomponent intervention) began online adaptations of the interventions. Second, a research assistant made weekly phone calls to provide basic psychosocial support, assure participants groups would continue, and later remind them of each online session. Third and last, the phoneline was accessible 24/7 (WhatsApp).

Results

The third randomization concluded in December. Six participants were lost in the transition to online groups. However, adherence was comparable to the previous two randomizations (4/12 completed the intervention).

Conclusions

Online psychotherapy may be used in emergencies such as a lockdown. However, the psychological mid- and long-term effects of a lockdown and online group therapy remain unknown.

Disclosure

No significant relationships.