bluuebunny/crossref_metadata_2025 huggingface dataset:
Different general strategies for deprescribing in real clinical settings: From lists to collaborative care
Authors: Stuhec M.
Published: February 2022

Most elderly patients with mental disorders are treated with polypharmacy (e.g., five or more medications), and they are receiving medications that are potentially inappropriate for elderly patients (e.g., PIMs). These aspects are often excluded in the clinical guidelines, meta-analyses, and randomized controlled trials but are very important for prudent prescribing in daily practice. The most robust approach to reducing irrational polypharmacy, PIMs, and other medications-related problems in this population is a careful deprescribing process. It is the process of tapering, withdrawing, discontinuing, or stopping medications. There are some tools available to help in the deprescribing process in clinical practice, including different medication lists (e.g., Beers criteria, STOPP/START, and guidelines) and collaborative care, including clinical pharmacist or pharmacologist. Medication lists have been used in clinical trials and guidelines, where Beers criteria are used predominantly in the U.S. and Priscus list in Europe. A collaborative care approach, including a clinical pharmacist, has been established only in some countries (e.g., USA, UK & Slovenia). The results are positive with a decrease of PIMs, polypharmacy, and an increase in the patients’ quality of life. The participants will learn the general deprescribing processes supported by the evidence-based data and real clinical pharmacological tools useful for daily practice.

Disclosure

No significant relationships.
Electroconvulsive therapy in the medical comorbidities context: A case report
Authors: Giancola A. Sanz , Lietor M.D.C. Molina , Prieto M. Blanco , Llovera N. Freund , Navarro L. Nocete , Iñiguez I. Cuevas , García C. Álvarez
Published: February 2022

Introduction

Electroconvulsive therapy (ECT) is today one of the main treatments available and used in psychiatry for serious mental illnesses. Eighty years after its introduction, the ECT procedure has evolved to become a safe option based on scientific evidence. Nowadays there are no absolute contraindications for ECT, regardless of the type of population and clinical situation.

Objectives

To illustrate the electroconvulsive therapy in medical comorbidities context with a case report.

Methods

Descriptive case study.

Results

We present a 66 years old patient who suffers from a psychiatric decompensation with a diagnosis of major depressive disorder with psychotic symptoms. Due to her cardiological history (prolongation of the QT interval of possible psycopharmacological origin and a 2:1 AV block, that required the implantation of a definitive pacemaker) and partial response to psychotropic medication, the initiation of electroconvulsive therapy is proposed as the best alternative. The pacemaker was previously studied by cardiology for a very complete analysis before the procedure. It was recommended to convert it to fixed rate pacing by using a magnet. To do this, we placed it over the pacemaker during the technique. While waiting for a clinical improvement, no incidence has been produced during the sessions.

Conclusions

ECT should not be postponed as a last resort. Numerous studies conclude that ECT is globally the treatment of choice (70-85% response) in severe depressive conditions, over and above antidepressant drugs. The incidence of relevant cardiac complications on ECT is relatively rare (0.9%). Regarding the use of pacemakers, electroconvulsive therapy represents an effective and safe option for the patient.

Disclosure

No significant relationships.
Clinical aspects of deprescribing process in affective disorders
Authors: Bouckaert F.
Published: February 2022

Although depression in the elderly is often underdiagnosed and undertreated, some data show that next to this potential underuse, antidepressant prescriptions may also be overused and prescribed inappropriately. These potentially overused and inappropriate prescriptions of antidepressants are often related to polypharmacy, comorbidity and increased mortality. Deprescribing is the planned and supervised process of reducing or stopping medications that may no longer be of benefit or may be causing harm. Clinically relevant aspects and considerations of this deprescribing process in elderly patients with affective disorders will be discussed. Woodford HJ, Fisher J. New horizons in deprescribing for older people. Age and Ageing 2019;48:768-775. Hiance-Delahaye A, et al. Potentially inappropriate prescription of antidepressants in old people: characteristics, associated factors, and impact on mortality. Int Psychogeriatr 2018 May;30(5):715-726. Bobo WV, et al. Frequency and predictors of the potential overprescribing of antidepressants in elderly residents of a geographically defined U.S. population. Pharmacol Res Perspect 2019;e00461.

Disclosure

No significant relationships.
Comparative indicators of atherogenicity, body weight, gender differences in the group of depressive and non-depressive patients with cardiovascular diseases
Authors: Kornetov N. , Molodykh O. , Arzhanik A.
Published: February 2022

Introduction

Many studies show that obesity, dyslipidemia, and physical inactivity are closely related to depressive spectrum of symptoms (DSS), depressive disorder (DD). DD significantly reduces the patient’s quality of life and vital activity.

Objectives

To study laboratory and physical parameters with DSS, DD in patients with cardiovascular diseases (CVD) to determine the number of patients requiring complex antidepressant therapy.

Methods

The cross-sectional study of 127 inpatients with CVD was conducted. Depression and anxiety symptoms were evaluated using HADS, anhedonia by Snaith-Hamilton Pleasure Scale (SHAPS) and pain by visual analog scale (VAS). Acquired data was statistically processed.

Results

The non-depressive patients was observed in 67 (53.0%) and 60 (47%) with DSS in CVD patients. When clinical assessing 29 (22.5%) met the criteria for major (DD), 39 (31%) for minor DD. When comparing body mass index (BMI) in patients with depression, the indicator was 31 (28.5; 33.5), in patients without depression 30 (26; 32) p <0.2828; atherogenic coefficient in patients with depression was 2.93 (2.41; 3.575), in non-depressive patients - 2.375 (2.07; 3.07) p<0.0083.

Conclusions

More than 1/5 of patients with CVD need antidepressant therapy. >90% of all patients had a high BMI regardless of gender and the presence of depression. Depressive patients in 95% of cases were obese or overweight. Severe dyslipidemia in women with depression increases the risk of CVD. Conflict of interest: No.

Disclosure

No significant relationships.
Postpartum depression: How it differs from the “baby blues”
Authors: Trigo M.
Published: February 2022

Introduction

Despite many signs and symptoms of depression get dismissed as normal physiologic changes associated with childbirth, depressive disorders are a common complication of pregnancy and postpartum period. The so-called “baby blues” have a minor functional impact and respond well to social support, whilst postpartum depression causes significant functional compromise, requiring more aggressive therapy. There is an extreme type of postpartum depressive disorder, postpartum psychosis, when patients present psychosis, mania, or thoughts of infanticide. It is imperative to promptly recognize and differentiate these entities, in order to minimize its impact on both mother and child. Antidepressant treatment may be necessary for some women, but risks and benefits should always be considered prior to institute pharmacotherapy.

Objectives

To identify current approaches and evidence-based treatment options for postpartum depression.

Methods

Review of the most recent literature regarding postpartum depression. The research was carried out through the Cochrane, UptoDate, PubMed, MedLine, LILACS and SciELO databases, using the terms “postpartum depression”, “baby blues” and “postpartum psychosis”, until December 2020.

Results

Since both depression and antidepressant medications confer risk upon the infant, when postpartum depression develops, psychotherapy is usually the first-line treatment. Antidepressant treatment may be necessary, but its use during pregnancy and postpartum must be weighed carefully.

Conclusions

In order to better prevent postpartum depression, recommendations include the use of screening instruments as a routine clinical practice during pregnancy and referral when necessary. Maternal depression has a severe impact on both mother and child, so mental health professionals have a very important role in reducing postnatal emotional complications.

Disclosure

No significant relationships.
The application of motion capture technology in a clinical evaluation and a therapy for people with autism spectrum disorder
Authors: Baasansuren S. , Kaźmierczak D. , Świątko M. , Krysta K.
Published: February 2022

Introduction

Autism spectrum disorder (ASD) encopasses disorders with incompletely known etiology. Facial expression of people with ASD does not often reflect their emotions adequately or are strongly limited. In addition, they have a problem with joint attention. The symptoms of autism spectrum disorder are very various and have different severity that can change over time.There are still no objective methods for estimating these symptoms, which creates a huge diagnostic and clinical problem. Motion Capture technology makes the possibility of this objective assessment of the severity of initial symptoms, their change over time, as well as specificity for people with ASD.

Objectives

To assess the application of Motion Capture technology in a clinical evaluation and a therapy for people with ASD.

Methods

We analyzed literature related to the topic available at medical bases: PubMed, ResearchGate and Google Scholar. The articles which were included had been published after 2000 and have an English or Polish abstract.

Results

We included 2 trials involving 81 participants (children and adolescents): 1 trial reported on quantifying the social symptoms of autism and 1 trial on differences of facial expressions in people with and without ASD.

Conclusions

This capture of motions and the analysis of specific movements of people with autism spectrum disorder might be very useful in clinical practice, scientific research, therapy and also in creation of functioning systems at homes, schools and kindergartens. Thanks to this, people with ASD will be able to function better in society.

Disclosure

No significant relationships.
Instagram, the new ally of Pro-Ana and Pro-Mia
Authors: Jordan G. Lladó , García M.D.C. Díaz , Sánchez P. Mediavilla , Díez B. Lozano , Del Barrio J.A. Gómez , Ayesa-Arriola R.
Published: February 2022

Introduction

Nowadays Social Networks (SN) are used not only in a playful way but also as a ‘health’ means of communication. The Pro-Ana and Pro-Mia accounts or profiles -whereby Eating Disorders are advocated as a ‘lifestyle’- increased by 300% over the last decade.

Objectives

To analyze Instagram Pro-Ana and Pro-Mia accounts and compare them with Pro-Ana and Pro-Mia Blogs.

Methods

A non-computerized research of Pro-Ana and Pro-Mia Blogs and Instagram profiles was performed. Accepting a risk of Alpha=0.05 and Beta=0.15 in a two-tailed test, 29 subjects were required in each group to detect a difference equal to or greater than 0.2 units. The common standard deviation is assumed to be 0.25. Publication averages, photos, opening years, WhatsApp links and number of followers were analysed and compared. Transversal descriptive study.

Results

Blogs: 100% had no groups in other SN, 33.33% had been opened for more than 3 years, 30% included personal pictures, 16.67% contained Ana in their title, 53.3% named other Blogs. Instagram: 56.67% included personal pictures, 13.33% mentioned WhatsApp groups, 73.33% had a public profile, 43.33% contained ‘Ana’ in their user name and 53.33% had more than one hundred followers.

Conclusions

These tools are constantly adapting to the times in which they coexist. There has also been a current increase in Instagram profiles. This study shows a greater linkage to WhatsApp groups on Instagram than on Blogs, together with a higher number of followers, ease of ownership and difficulty of control.

Disclosure

No significant relationships.
Birth asphyxia and its implications for neuropsychology and brain volume in schizophrenia
Authors: Wortinger L. , Jørgensen K. , Barth C. , Agartz I.
Published: February 2022

Introduction

Newborn infants can suffer permanent brain damage as a result of birth asphyxia (ASP), a severe obstetric complication (OC). However, effects of OCs on cognitive abilities and brain structure in schizophrenia (SZ) are unknown.

Objectives

The main goals of this study were to investigate putative effects of a history of OCs on adult cognition and brain structure in SZ.

Methods

We utilized prospective data from the Medical Birth Registry of Norway to identify incidences of severe OCs in adult healthy controls (HC; n = 622) and patients with SZ (n = 607). IQ was assessed, and a subset of participants (n= 414) underwent magnetic resonance imaging.

Results

Severe OCs (27%) and ASP (14%) were equally common in SZ and HC. SZ patients with OCs had lower IQ than patients without OCs, a difference not found in HC (p = .023). Having experienced more than one co-occurring severe OC was associated with lower IQ in both groups, wherein 81% of co-occurring OCs involved ASP. ASP was related to smaller intracranial volume and brain volumes in both groups. Smaller caudate volumes were found in SZ patients with ASP compared to patients without ASP, a difference not found in HC (p = .009).

Conclusions

Our findings give support for an effect of birth ASP on brain development in both patients with SZ and HC. OC history specifically impacts IQ in SZ. Smaller caudate volumes might be particularly related to disease development. These results warrant replication in an independent sample.

Disclosure

No significant relationships.
Why is it important to involve people with lived experience in the development of the educational programs in suicide prevention?
Authors: Stensmark M.
Published: February 2022

Blekinge Family Postvention is a grief facilitator-home-visiting postvention giving early support to families after a suicidal loss since 2015. It helps families overcome shock, pain, anger, guilt, suffering and other extreme emotions caused by suicide. Such situations should be treated not as a disorder. Medication should be used only as a last resort to treat individuals not responding to early family support, followed by individual sessions if needed. Everyone needs to express feelings and thoughts on all aspects of the suddenly interrupted relation. To achieve this, a person experienced in those issues must be leading all of the meetings. The conversations should start during the first days, frequently continuing for at least 3-5 weeks depending on the family needs. Helping the family bear each other and find coping strategies ease their pain, mourning and give them hope instead of prolonged grief. In this way, the family gradually finds new ways to overcome a never-ending negative looping that eventually can cause, e.g. post-traumatic stress disorder and depression. The support to the family after suicide loss should be a governmental matter. Today all work is done voluntarily. The close relatives need debriefing right after the district doctor has stated the death or the police informed the family about suicide. The military, the police, rescue services and healthcare professionals gets debriefing when a rescue operation has failed. This presentation discusses how to organise early family support and the Ellipse project’s interviews with survivors about their experiences of needed or received support if any.

Disclosure

DISCLAIMER The E-Lifelong Learning In Prevention of Suicide In Europe (ELLIPSE)-project is co-funded by the European Union’s Programme Erasmus+ (Project ID: 2019-1-SE01-KA203-060571). The EU Commission’s support for this project does not mean that the Com
Encephalopathy caused by disulfiram
Authors: Sant’Angelo R. , Piretti I.
Published: February 2022

Introduction

Disulfiram is an alcohol detox drug that has been approved by the FDA for over 50 years. Among the various side effects that can cause there is encephalopathy. Its incidence is currently unknown, according to some authors it is estimated between 1 and 20%.

Objectives

In this article we report the case of a 48-year-old woman diagnosed with borderline personality disorder and alcohol use disorder, presenting with encephalopathy.

Methods

We discuss about our diagnostic and therapeutic approach.

Results

Fortunately, the rapid identification of this rare condition led to a favorable outcome in our patient.

Conclusions

Early detection of any acute change in mental state, especially in early stage of therapy, is important. Cessation of disulfiram is recommended in case of suspicion about disulfiram encephalopathy. This case underscores the importance of awareness of this serious complication during disulfiram treatment. If suspected early, appropriate diagnosis and treatment can prevent rapid progression.

Disclosure

No significant relationships.
Climate factors associated with help seeking of patient suffering from suicidal stress: The case of rainy days
Authors: Hernández-Calle D. , Bravo-Ortiz M.F.
Published: February 2022

Introduction

Suicidal phenomena help seeking depends on a broad array of factors, which include climatic variables. Our aim was to analyse the effect of precipitation with help seeking in patients suffering from suicidal behaviour

Objectives

Our aim was to analyse the effect of precipitation with help seeking in patients suffering from suicidal behaviour

Methods

Daily urgency visits from suicidal phenomena (including suicide attempt and ideation) were extracted from electronic medical records of Hospital Universitario La Paz from 1st January 2019 to 31st December 2019. Precipitation data (measured as accumulated litres per square meter) was obtained from a local climate station. Spearman correlation was estimated

Results

The Spearman correlation coefficient was 0.04(p = 0.48)

Conclusions

Precipitation did not influence help seeking for patients affected by suicidal phenomena

Disclosure

No significant relationships.
Neuroendocrine factors - predictors of the formation of alcohol dependence and human ecology in various ethnic populations, new approaches to therapy
Authors: Shushpanova T. , Mandel A. , Bokhan N. , Novozheeva T.
Published: February 2022

Introduction

Integrated clinical and biological approaches in the study of disorders caused by alcohol consumption in people of different ethnic groups, are important for determining effective treatment strategies.

Objectives

To study the clinical and dynamic features and the role of neuroendocrine factors of the formation and course of alcohol dependence in individuals of Tuvan ethnicity.

Methods

68 Russian alcoholics and 67 Tuvans alcoholics only men and 20 healthy male were monitored. Clinical assessment of the condition of patients was carried out with the traditional clinical description. Enzyme-linked immunosorbent assay kits were used to determine serum hormone levels in patients and volunteers.

Results

The systematic consumption of alcoholic beverages develops among Tuvans in adulthood, in contrast to Russian men who begin to drink systematically young. Alcohol dependence in people of Tuvan nationality are formed several years later than in Russians: a symptom of loss of quantitative control over use was detected in Tuvans at 36.9±9.9 years, in Russian patients at 29,8±7.5 years; the formation of withdrawal syndrome in Tuvans occurs at the age of 37.7±8.4 years, unlike Russians, in whom the withdrawal syndrome develops on average at the age of 29.6±6.0 years. The index of the ratio cortisol/progesterone in the blood of examined Russian alcoholics is almost twice as high as the index of examined healthy donors; in patients of Tuvan ethnicity, index is almost five times higher.

Conclusions

Alcohol dependence among representatives of the Tuvan ethnic group indicates a greater vulnerability to the effects of alcohol.

Disclosure

No significant relationships.
A populational review of the amyloid precursor protein gene mutations relevant to alzheimer’s disease
Authors: Balmus I.M. , Ciobica A. , Gorgan L.D.
Published: February 2022

Introduction

The genetic component of Alzheimer’s disease was previously studied and more than sixty amyloid precursor protein (APP) gene mutations were identified. However, the populational aspects of this component were scarcely discussed despite that many of the reports mentioned the demographic ancestry of the carriers or probands.

Objectives

In this short study, we aimed to review the APP gene mutations relevant to Alzheimer’s disease from a Populational Genetics point of view by evaluating the current literature for the demographic description of the carriers or families in which the mutations were identified.

Methods

In this regard, multiple genetic studies on the APP gene mutations relevant to Alzheimer’s disease were reviewed and the incidence of the mutations was analyzed considering the ancestry of the patients.

Results

We found many possible scenarios regarding the incidence of the APP gene mutations in Alzheimer’s disease patients and general population. On the one hand, we could identify several mutations which were present in more than one population (eg. V615M, V717I, V717L) and on the other hand, some mutations could be observed in certain populations (eg. E693delta, the Osaka mutation, which was until now observed in Japanese patients, while E693G was found in a Swedish family). One particular case is that of the isolated populations (eg. the Icelandic population in which an APP mutation protecting against Alzheimer’s disease is more frequent in the general population as compared to the patients).

Conclusions

We were able to identify several mutations which were characteristic to many populations, but also some population-specific features regarding the APP genotypes.

Disclosure

No significant relationships.
Training in women mental health: Challenges and future perspectives
Authors: Wieck A.
Published: February 2022

Mental disorders linked with the menstrual cycle, childbirth and the menopause are unique to women and have their specific requirements for identification, assessment, treatment and service provision as well as appropriately trained staff. Mental disorders that are linked to domestic violence, sexual abuse or victimisation and affect more women than men, also have their own specific requirements. This is increasingly being recognized by policy makers and health care planners. In the case of perinatal mental health some countries have set up specialised inpatient and community services. In the UK this was followed by the development of National competencies for different professional groups and National training programmes. This project and the current clinical training in perinatal mental health for psychiatric trainees will be described. Nationally recognized qualifications are currently being developed. Developments in other areas of women’s mental health appear less advanced. The presentation will discuss current guidelines and opportunities for training that are being offered in the UK and what we can learn from perinatal mental health for further development in these areas.

Disclosure

No significant relationships.
Psychopathology and treatment of Prader-Willi syndrome in adulthood: About a clinical case
Authors: Martinez G.M. Ruiz , Dafonte A. Alvarado , Rodriguez L. Soldado
Published: February 2022

Introduction

Prader-Willi syndrome is a congenital disease caused by a genetic alteration of chromosome 15, described by doctors Prader, Labhart and Willi in 1956. It’s a rare disease (prevalence 2.8/100,000) and it occurs equally in both sexes and in all races. This disorder produces changes in hypothalamic function that can lead to muscle hypotonia, short stature, a compulsion to eat, and a lack of satiety. At the psychopathological level, the clinic is very varied, being mainly important the psychomotor retardation in different degrees and behavioral problems;especially in the behavioral phenotype. Affective and psychotic symptoms are also frequent.

Objectives

Psychopathology and treatment analysis through a clinical case.

Methods

40-year-old patient undergoing mental health follow-up since adolescence with a diagnosis of paranoid personality disorder. No medical history of interest. He was admitted to the hospitalization unit for serious behavioral alterations in a context of probable paranoid ideation towards the neighborhood. In the psychopathological examination, marked cognitive rigidity, high impulsivity and very low tolerance to frustration stand out, showing a hostile and defiant attitude. Poorly structured paranoid ideation. Presents obsessive-compulsive behaviors (scratching). Hyperphagia and obesity.

Results

Psychometric assessment (Waiss-IV): total IQ 61 (mild mental retardation). Genetics:deletion 15 q11-q13 of chromosome 15), confirms Prader-Willi diagnosis. Remission of behavioral disorders, suspiciousness and heteroaggressive behaviors with treatment with monthly depot paliperidone (150 mg).

Conclusions

Knowledge of the clinical and morphological characteristics of this syndrome would allow an early diagnosis and treat its possible complications as soon as possible. Antipsychotic treatment is effective in the management of behavioral and psychotic symptoms.

Disclosure

No significant relationships.
Personal restoration and feelings of guilt with victims of forced displacement in the colombian caribbean
Authors: Gonzalez E.P. Ruiz , Guzman M.J. Arcos , Argel M.N. Muñoz , Urzola A. Uribe , Carvajal J.D. Velez
Published: February 2022

Introduction

Forced displacement has been shown as a direct consequence of civil wars and armed confrontations, its effects on the victims are evidenced in the material, physical health and psychosocial effects (Mendoza, 2012; Pavas & Díaz, 2019; Ramos, 2018). It is common to identify in victims the presence of a post-offense emotional discomfort, which is recommended to work as a way of forgiveness for the achievement of personal restoration (Prieto & Echegoyen, 2015).

Objectives

For this reason, the results of the study are presented, which has aimed to analyze the relationship between personal restoration and feelings of guilt with victims of forced displacement in the Colombian Caribbean.

Methods

A correlational study has been carried out with a sample of 40 (n = 40) subjects of which 52.5% are men and 47.5% women, the mean age is 57.52 (σ = 13.591), all with a history of forced displacement; to the data collection has been used the CAPER instrument of Rosales, Rivera and Garcia (2017) (α = .592).

Results

There is a positive bilateral correlation between the variables studied (r = .000; p = .829), the greater the personal restoration, the greater the sense of guilt is also manifested.

Conclusions

For therapeutic work in personal restoration with victims of forced displacement, it is important to also include the feeling of guilt, which is presented as post-offense emotional distress.

Disclosure

No significant relationships.
Engineering psychiatric education 2.0 in post-pandemic europe
Authors: De Picker L.
Published: February 2022

In the world of medical education, there is generally a lot of emphasis on following procedure and tradition, and a reluctance to challenge the norm. It takes insight and courage to question traditional approaches and paradigms: why are psychiatric training programs done the way that they are? Reverse engineering involves taking something apart and analysing its workings to figure out how it does what it does and how it can be improved. In education, reverse engineering implies one determines learning outcomes upfront and then works back from them. Applied to postgraduate psychiatric training, it requires us to determine the basic principles or core concepts resulting in the successful formation of a well-rounded psychiatrist. In times of crisis there usually is more leeway to challenge the status-quo – hence the saying “never waste a good crisis”. Indeed, if the COVID-19 crisis has taught us anything, it is that education should be meeting learners where their attention is at, and that any healthcare organisation can be transformed within weeks when given the right incentives. In this workshop, Dr. De Picker will reflect on how post-COVID European psychiatric training can reinvent itself to address long-standing concerns and unmet needs. Innovative approaches will be needed to start shaping the psychiatrists of the future.

Disclosure

No significant relationships.
Adolescents with cleft lip and palate (CLP): Stressful events and coping
Authors: Pacheco P. , Pacheco M. , Molini-Avejonas D. , Mota-Loss A.
Published: February 2022

Introduction

Individuals with CLP may present communication disorders, velopharyngeal dysfunction, dento-occlusal changes and hearing losses. Adolescents with CLP usually show greater impairment of communication. Such characteristics combined with the malformed face can impact psychosocial functioning and increase the risk of psychological difficulties. Life-stressing experiences from CLP to life events typical of adolescence, may threaten the well-being of the adolescent, and are linked to mental health and behavioral problems.

Objectives

To verify the coping of adolescents with CLP through a descriptive cross - sectional study.

Methods

Fifteen adolescents with CLP participated in the study. To evaluate them it was used the Coping scale (Lees, 2007), for the verification of coping in the families proposed by Motivational Theory of Coping. The analysis of the coping of adolescents with CLP considered two adverse contexts, namely “birth with fissure” and “have your secret told by a friend ”.

Results

In relation to the evaluation of the psychological needs of relationship, competence and autonomy faced the “birth with fissure” indicates that teens with fissures do not perceive this stressor as a threat to their basic psychological needs.

Conclusions

The adolescents with CLP who participated in the study feel more interested (perception of the challenge) in dealing with the stressor relative to the fissure than in dealing with the betrayal of a friend, who reveals a secret of his to other people.

Disclosure

No significant relationships.
Migration: A risk factor for psychosis?
Authors: Spaho E. , Alikaj V. , Dashi E. , Skendi V.
Published: February 2022

Introduction

Emigration is a complex process of social changing through which an individual moves from a certain cultural environment/context to another, aiming to achieve persistent or long-term residency, causing distress. There is sustainable evidence that incidence of all forms of psychosis is higher in migrants.

Objectives

This study aims to gather data of other research conducted in the field according to emigration as a risk factor for development of different psychosis.

Methods

Scientific articles searched in MEDLINE, regarding the incidence of mental disorders in different emigrant populations, for the period 1995 - 2015.

Results

The average relative risk of schizophrenia and of other psychosis occurrence among first generation emigrants was 2.7 (95% confidence interval [CI]=2.3-3.2). Statistical analysis performed among studies of first and second generation of emigrants, and among studies which don’t make difference between generations, results in a relative risk of 2.9 (95% CI=2.5-3.4) of mental illness.

Conclusions

The data presented in this study emphasize the impact of migration on central symptoms of schizophrenia. Emigration process, cultural and social adaptation, play an important role on the individual mental health.

Disclosure

No significant relationships.
Anti-NMDA receptor encephalitis: A case report
Authors: Tan H.L.
Published: February 2022

Introduction

Anti-N-methyl-D-aspartate receptor (anti-NMDA-R) encephalitis is well-characterised autoimmune encephalitis with prominent psychiatric manifestations, neurological manifestations like speech dysfunction, seizures, dyskinesias and other movement abnormalities, decreased level of consciousness and autonomic instability. This disorder affects primarily children and adults up to 45 years. Females are 4 times more common than males and may have association with ovarian teratoma.

Objectives

To identify anti-NMDA receptor encephalitis based on clinical features, facilitate early screening and relevant investigations to prevent delay in treatment.

Methods

A case study of 36 year old female presented with clinical manifestations of autoimmune encephalitis syndrome.

Results

Diagnosis confirmed by presence of NMDA receptor antibodies in serum and cerebrospinal fluid.

Conclusions

Early recognition of clinical features of Anti-NMDA receptor encephalitis and early initiation of treatment has shown to improve outcomes, speed recovery and reduce the risk of relapses.

Disclosure

No significant relationships.
Scissors and tweezers: A skin-picking disorder case report
Authors: Garcia S. Vilas Boas , Fernandes N. , Coelho I. , Costa R. , Durval R.
Published: February 2022

Introduction

Skin-Picking Disorder (SPD) is psychiatric condition characterized by recurrent and excessive picking of the skin. There are several attempts to stop the behavior and it causes negative consequences such as dermatological complications and functional impairment.

Objectives

The aim of this study is to describe a case report of SPD.

Methods

Data was collected retrospectively from case notes.

Results

A 30 year-old male, married with 2 children, currently on sick leave, was admitted to the Day Hospital at Centro Hospitalar Psiquiátrico de Lisboa (CHPL) with worsen skin-picking behaviour and functional impairment. During childhood the patient would “cut my toe nails the wrong way so that I could fix them”. By adolescence the patient suffered from acne and felt the need to “solve” them and take out the pus. Over the years the skin-picking behaviour spread to other areas of the body, mainly dorsal and chest areas. Before being admitted to the Day Hospital the episodes were daily and had 2-3 hours duration, using scissors and tweezers and evolving his family, asking his wife’s help with picking. He is being treated with fluoxetine 80 mg, risperidone 2 mg and N-acetylcysteine 1200 mg and Cognitive Behavioural Therapy. He is also participating in the Day Hospital activities that include occupational therapy, movement therapy, psychoeducation. After 2 months he has a few 20 minutes episodes per week, spends more time with his children and thinks about coming back to work.

Conclusions

SPD is a severe and debilitating illness that benefits from a multidisciplinary approach.

Disclosure

No significant relationships.
Revisiting the “obsessional slowness” syndrome
Authors: Fernandes C. Pedro , Mangas M. , Jorge B. , Freitas D.
Published: February 2022

Introduction

Obsessional slowness (OS) is a rare condition of disabling slow motor performance, first described in 1974, by Rachman, who documented 10 cases of “primary obsessional slowness”. Rachman argued that, although his patients with OS had Obsessive Compulsive Disorder (OCD), their motor symptoms were not related to the presence of motor-slowness-triggering obsessions/compulsions (e.g. checking and mental rituals). Whether OS truly is a distinct and “primary” entity is still a controversial issue, however.

Objectives

To present and discuss the phenomenology of OS.

Methods

Case reports of OS published in the literature, including Rachman’s descriptions.

Results

The literature on OS is extremely limited, with no published, large-scale descriptive studies or randomized controlled trials. Some authors doubt that OS is a “primary” condition, pointing out the clear overlap between OS and catatonia and emphasizing that the latter disorder also occurs in non-schizophrenic patients, for example, ones with OCD. Additionally, OCD and depression often co-occur. Thus, in severe cases, it may be challenging to disentangle the separate contribution of both disorders to psychomotor slowness. It is also crucial to exclude the possibility that a patience has juvenile parkinsonism or other causes of motor slowness before diagnosing him/her with OS, given that the diagnostic approaches and treatment strategies for OS and the aforementioned disorders differ.

Conclusions

OS seems to be a rare but often disabling motor manifestation of OCD, rather than a primary disease entity. However, some cases sit on the edge of current diagnostic criteria. Future research should help define OS more precisely.

Disclosure

No significant relationships.
Older adults’ sexual well-being and person-centered psychotherapy: A qualitative study
Authors: Humboldt S. Von , Ribeiro-Gonçalves J. , Leal I.
Published: February 2022

Introduction

A qualitative study about older adults’ sexual well-being and person-centered psychotherapy

Objectives

The objective of this study was to evaluate the main concerns related to sexual well-being revealed by older adults in person-centered therapy, using qualitative research.

Methods

Interviews with 58 older participants, aged 65 to 82 years, living in the community were submitted to content analysis.

Results

Eight main themes emerged from the results of the content analysis: Partner unavailability, family issues, physical changes due to aging, worries about hygiene, sexual dysfunctions, fear of physical abuse, communication issues and concerns about sexual transmitted diseases.

Conclusions

This study was relevant towards identifying the challenges older adults feel regarding their sexual well-being, as shared in therapy. Older adults referred their greatest challenges to be partner unavailability, family issues and physical changes due to aging.

Disclosure

No significant relationships.
Cancer and the threat of death
Authors: Regaya M. , Amamou B. , Said H. Ben , Gaha L.
Published: February 2022

Introduction

Fear of death is somehow a normal sensation. Though for those having a cancer, it could increase the burden of the disease and have negative psychological impacts. This death anxiety isn’t easily verbalized by patients, thus it’s important for caregivers to manage it to improve those patients’ quality of life.

Objectives

Assess death anxiety in cancer patients and to identify factors that may influence it

Methods

Our study was a cross-sectional descriptive study with an analytical focus on quantitative specifications. It targeted patients hospitalized at the oncology department or consultant at the day hospital of the regional hospital of Gabes, Tunisia. Participants completed a questionnaire including sociodemographic and clinical data, using HADS scale for anxious and depressive symptoms and DAS scale for death anxiety.

Results

One hundred and twenty patients were enrolled in the study. The average age of participants were 54, 9 ±11, 8 years. The majority of patients were married (68.3%) and had an average socioeconomic level (74, 2%). Our results showed that 43, 3% of patients had a high death anxiety score. Higher level of threat of death, were found in older patients(p=0.028), females (p=0.018) and for those having children (p=0,01). Death anxiety were also higher in patients having anxiety (p=0.007) and those having depression (p=0.033).

Conclusions

The degree of death anxiety among cancer patients seems important. Its assessment and resolution by the caregivers remains paramount. The identification of this death anxiety should optimize the overall care of the patient.

Disclosure

No significant relationships.
Psychometric properties of eysenck personality questionnaire-revised (EPQ-R) short scale in Arabic among undergraduates in Kuwait
Authors: Alansari B. , Alali T.
Published: February 2022

Introduction

The 48-item EPQR-S is a short version of EPQ-R widely used to assess neuroticism (N), extraversion (E), psychoticism (P) and Lie scale (L) for research purposes. The EPQR-S was chosen for the Arab population because it is a well-established Eysenck theory of personality.

Objectives

To evaluate the psychometric properties of the Arabic EPQR-S.

Methods

The EPQ-R S, the Eysenck Personality Questionnaire (EPQ) and NEO Five-Factor Inventory (NEO–FFI-3) were administered to 1842 (538 males, 1304 females) Kuwait University undergraduates with a mean age = 20.42 ± 1.42. The internal consistency reliability, factor structure, and convergent validity of the EPQR-S with EPQ and NEO–FFI-3 were assessed.

Results

Cronbach’s alpha was satisfactory for N (0.76), E (0.72), L (0.70) and low for P. (0.60). The results revealed significant gender differences in P & E with a favor for males and in N & L a favor with females. PCA showed that EPQR-S four factors explains 52.48% of the total variance. Moreover, the high correlations between the EPQR-S and EPQ scales, with coefficients of (0.92) for the N, (0.88) for the E, (0.78) for the L, and (0.76) for the P as the majority of items of the dimensions of the EPQR-S are the same with those of the EPQ. Furthermore, there were high correlations between the same scales of the EPQR-S and NEO–FFI-3, with coefficients of (0.67) for the N scales, and (0.52) for the E scales.

Conclusions

The findings support the psychometric properties N, E, L scales only.

Disclosure

No significant relationships.
Borderline personality disorder and psychotic symptoms. Report of two cases
Authors: Mata A. Hernández , Gómez A. Sotillos , Barandiarán M. Esparza , Coscujuela P. Marco
Published: February 2022

Introduction

DSM-V includes near-psychotic symptoms as new criteria in borderline personality disorder (BPD). This change makes more difficult the differential diagnosis between considering psychotic symptoms as part of the BPD or as part of a comorbid psychotic disorder.

Objectives

Recognize the difficulty of the differential diagnosis in clinical practice between BPD and comorbid diagnosis of BPD with psychotic disorders, and how it can affect the patient’s outcome.

Methods

Patients’ data is obtained from medical history and psychiatric interviews carried out during their hospitalizations.

Results

32 year-old female patient with previous diagnosis of BPD, psychotic episodes and cannabis abuse, was admitted due to paranoid ideation and aggressiveness, with massive borderline defense mechanisms (frequent displays of anger, high impulsivity, low frustration tolerance, self-destructive behavior…). Psychotic symptoms ceased two weeks after admission, and considering the patient’s individual characteristic it was believed BPD fitted more with this clinical case, although different psychotic disorders were considered. 30 year-old female patient began intensive psychiatric treatment with previous diagnosis of BPD, psychotic disorder and cannabis abuse. It was observed that the paranoid ideation and bodily experiences she suffered lasted months and were characterized by a strong belief. These two reasons were put into consideration when it was decided to judge this clinical case as a comorbid diagnosis of BPD with a psychotic disorder.

Conclusions

It is necessary to assess the difficulty of the differential diagnosis in these patients, and offer them specialized treatment depending on the diagnosis, as it can affect the patient’s outcome.

Disclosure

No significant relationships.
Social physique anxiety and physical activity
Authors: Zartaloudi A. , Christopoulos D.
Published: February 2022

Introduction

Social Physique Anxiety is defined as an emotional response that reflects individuals’ concerns regarding the way their body may be observed or judged by others.

Objectives

To explore the relationship between physical activity and social physique anxiety.

Methods

A literature review haw been made through pubmed database.

Results

Social Physique Anxiety is negatively related to participation in physical activity and commitment to exercise. Studies examining the relationship between motivation and social physique anxiety have shown that external motivations, such as improving muscle tone and body attractiveness, are directly linked to social physique anxiety. In addition, social physique anxiety is negatively related to self-efficacy. Individuals who believe that they will be judged by others to be ineffective are less likely to be engaged in physical activity programs. Social Physique Anxiety has been linked to negative effects on mental health such as low self-esteem, smoking and eating disorders.

Conclusions

Given all the negative effects of social physique anxiety, as it is responsible for a wide range of health-related behaviors, it is important to identify physical activity-related motivational mechanisms in order to reduce the impact of social physique anxiety.

Disclosure

No significant relationships.
Mental health and help seeking behaviour in first year medical students
Authors: Rutkauskas V. , Akavickas J. , Matuzaite A. , Lesinskiene S.
Published: February 2022

Introduction

Mental health challenges are common among medical students. Data shows that that they are less likely to use mental health services, regardless of experiencing frequent mental health issues.

Objectives

The aim of our study was to evaluate first year medical students’ mental health state and attitude to seeking help.

Methods

The target group was the first year medical students in Vilnius University. Anonymous questionnaire created by authors was used to evaluate socio-demographic data, self-perceived emotional state level, attitudes and accessibility to mental health services. The study involved 152 first year medical students: 97 of them were local and 55 international students.

Results

The majority of students (71.7%) reported that their studies negatively impacted their emotional condition. 14.5% of all students thought that they needed a consultation by mental health specialist, but decided not to seek help. 11.2% of students reported having used psychotropic drugs which had not been officially prescribed by a psychiatrist. 18.4% of all students thought that seeing a mental health specialist could negatively affect their future career as a doctor. 30.9% of students reported that they had used alcohol to improve their emotional state, 11.2% of students had used cannabis, 4.6% of students had used other drugs (e.g. LSD, amphetamine, cocaine) for this purpose.

Conclusions

1. Majority first year medical students think that the begining of studies have negative impact on their emotional well-being. 2. A large number of medical students unwilling to see mental health specialist. 3. Significant number of students use psychoactive substances to improve their emotional state.

Disclosure

No significant relationships.