bluuebunny/crossref_metadata_2025 huggingface dataset:
From mentee to mentor: Becoming an early career professor in psychiatry
Authors: Fiorillo A.
Published: February 2022

In the last years several social, economic and scientific changes have occurred, which have had a significant impact on psychiatric clinical practice, research and training. Some traditional syndromes seem to be disappeared, while new forms of mental health problems are coming to psychiatric consultation. The psychosocial distress caused by the current ongoing crisis due to the COVID-19 or the maladaptive use of the new technologies among the younger generation, are some good examples of psychosocial factors causing new mental health disturbances. Psychiatrists and mental health professionals are not yet well-equipped for managing these, which represent major unmet needs in modern clinical practice. Furthermore, in this evolving social context, the societal role of psychiatrists is completely changed, moving from being “alienist” working in asylums to “mental health care providers” working in the communities. The role of psychiatrists is to improve global mental health and to promote well-being in the general population according to a life-span perspective. Nowadays, early career psychiatrists report several unmet needs that we are not able to manage. In this symposium, I will describe my personal experience of moving from my role of mentee to mentor.

Disclosure

No significant relationships.
Bleeding risk between newer direct-acting oral anticoagulants and selective serotonin reuptake inhibitors. Case report and literature review
Authors: Higueras T. Gutiérrez , Cortés F. Calera , De La Cuesta Alonso S. Sainz , Forés S. Vicent
Published: February 2022

Introduction

The use of selectiveserotonin reuptake inhibitors (SSRIs) is an independent risk factor for bleeding events. Antidepressants and oral anticoagulants (OACs) are often prescribed together as depression and anxiety often coexist with cardiovascular diseases, atrial fibrillation and thromboembolic disorders. Serotonin is released from platelets in response to vascular injury, promoting aggregation. Inhibition of serotonin transporter (responsible for the uptake of serotonin into platelets) can lead into a reduced ability to form clots and a subsequent increase in the risk of bleeding. Direct oral aticoagulants (DOACs), rivaroxaban, apixaban and edoxaban are primarily metabolized via CYP3A4. The co-administration of antidepressants with inhibitory effects on CYP3A4 may theoretically interact with them.

Objectives

Presentation of a case of upper gastrointestinal bleeding after initiation of Apixaban in a patient taking Sertraline and literature review.

Methods

We carried out a literature review in Pubmed electing those articles focused on bleeding risk between newer direct oral antigulants and selective serotinin reuptake inhibitors.

Results

A 66-year-old woman sought medical assistance for generalized ecchymosis and melena. She was diagnosed with atrial fibrillation treated with apixaban 7 days ago. Concomitant treatment between apixaban and sertraline was the possible cause of upper gastrointestinal bleeding and ecchymosis. We had to switch sertraline into vortioxetine (with less dregree of serotonin reuptake inhibition) and add proton-pump inhibitor (Omeprazole) in order to decrease the risk of bleeding.

Conclusions

SSRIs increase the risk of gastrointestinal bleeding, much more in case of concomitant use of oral anticoagulants. If SSRI use cannot be avoided, monitor closely and prescribe proton pump inhibitors.
Aripiprazole-induced rosacea. Case report and literature review
Authors: Higueras T. Gutiérrez , Gajate B. Hernandez , Cortés F. Calera , Forés S. Vicent , De La Cuesta Alonso S. Sainz
Published: February 2022

Introduction

Skin and subcutaneus tissue disorders are common type of adverse drug reactions reported with a wide variety of both typical and atypical antipsychotics. Aripiprazole is a quinolinone antipsychotic that is a partial agonist at the D2 and 5-HT1A receptors and antagonist at the 5-HT2A receptors. We report a case of rosacea that developed after starting aripiprazole in a patient with schizophrenia and which remitted after the drug was stopped.

Objectives

To present a case of rosacea that developed in a schizophrenic patient after starting aripiprazole. Review of literature and search for the total number of cases reported in the european database of suspected adverse drug reactions (EudraVigilance).

Methods

We carried out a literature review in Pubmed electing those articles focused on skin ad subcutaneous skin disorders in those patients that have been taking aripiprazole. Review number of cases of skin reactions reported by the European database of suspected adverse drug reactions.

Results

A 43-year-old man previously diagnosed with schizophrenia with low adherence to different treatments. He came to our service seeking for help in order to decrease delusions with a treatment with minimun adverse reactions. We started aripirazole 10 mg every day and, after 7 days appeared signs of rosacea in his face. After discontinuation of aripiprazol, after 5 days, rosacea remitted.

Conclusions

Rosacea in our case posibly point aripiprazole as the agent that produced the skin reaction. After stopping the treatment the signs disapeared. Awareness of skins manifestations produced by aripiprazole is essential to prevents worse skin reactions.
Use of benzodiazepines in psychosis and bipolar disorder by tunisian psychiatrists
Authors: Lagha M. , Ouali U. , Nacef F.
Published: February 2022

Introduction

Benzodiazepines (BZD) are psychotropic drugs prescribed in psychiatry for their anxiolytic, hypnotic and sedative properties. Since anxiety, agitation and insomnia are common in psychoses and mood disorders, BZDs are frequently prescribed in the treatment of these pathologies. Guidelines remain rare with regard to the use of BZDs in the treatment of psychosis and bipolar disorder.

Objectives

Our study aimed to evaluate BZDs prescribing practices in psychoses and bipolar disorder and to assess the specific risks related to the use of these molecules in the population suffering from severe mental disorder.

Methods

This is a descriptive cross-sectional study conducted through a Google-forms self-administered questionnaire, intended for psychiatrists and psychiatric residents, over a period of two months, from April 1 to May 31, 2019.

Results

One hundred physicians practicing in psychiatry answered our questionnaire. The response rate was 28%. BZDs were prescribed during thymic or psychotic relapses by 88.6% of the participants. During relapses, the main indication for BZDs was anxiety (81.3%), insomnia (80.2%), and catatonia (59.4%). Among the participants, 24.8% indicated that they maintained a long-term treatment with BZDs in patients with psychosis, and 11.4%in patients with bipolar disorder. The participants estimated that the long-term use of BZDs in patients with severe mental disorder represented an increased risk of : dependence (94.3%), behavioral disinhibition (30.5%), suicide (22.9%), anger, hostility and violence (31.4%).

Conclusions

Few guidelines concern the use of BZDs in psychosis and bipolar disorder. However, this prescription remains very frequent in current practice, with clinical and therapeutic features specific to this population.
Visuomotor reaction time can predict IQ in children
Authors: Kiseleva N. , Kiselev S.
Published: February 2022

Introduction

It is well established that reaction time and IQ test scores are correlated, although the strength of this relationship is a matter of debate (Neisser et al., 1996). It was proposed that processing speed is a component of intelligence (Deary, Penke, & Johnson, 2010; Hunt, 2011). In our previous research we have not revealed the relationship between IQ and reaction time in children (Kiselev et al., 2000). However, it is possible that reaction time can predict intelligence test scores in the developmental perspective.

Objectives

This study investigated whether visuomotor reaction time in 5 year-old children predicts intelligence test scores in 8 year-old children using the longitudinal approach.

Methods

The participants were 35 children (17 males and 18 females) at the age of 5 years (5,34±0,45). We used computerized sensorimotor technique (Kiselev et al., 2009) to investigate visuomotor reaction time in children. Children completed simple, discrimination and choice reaction time tasks. The IQ of 8-year children was assessed by the WISC.

Results

The regression analysis has revealed the significant (p≤0,05) relationships between discrimination and choice reaction time tasks in 5 years-old children and non-verbal IQ performance in these children at 8 years of age. However, we did not find this relationship for simple reaction time task.

Conclusions

In view of obtained results it can be assumed that visuomotor reaction time in preschool children can predict non-verbal intelligence test scores in the developmental perspective. The received data can give new perspective in the understanding the interrelation between reaction time and IQ in children.
Working memory after and during 6 Hz transcranial alternating current stimulation
Authors: Pavlov Y. , Kasanov D. , Dorogina O.
Published: February 2022

Introduction

Transcranial alternating current stimulation (tACS) is a non-invasive brain stimulation technique allowing to induce changes in oscillatory activity. Theta activity has been reported to play a major role in maintenance of information in working memory (WM).

Objectives

The current study had the initial goal to check the effect of theta tACS on accuracy and resting state EEG in a set of match-to-sample WM tasks.

Methods

In the first experiment, we tested 31 participants in the WM task after 20-min tACS applied at Fpz and CPz at 6 Hz, 1 mA.). In the second experiment, we compared the after-effects and online effects of the stimulation in a sample of 25 individuals. Five similar 25-min blocks filled with the same working memory task were distributed over 3 days. We assessed the same group of participants in all three sessions. On the Training day, the participants performed one block without stimulation. On the Sham-Verum day (SV), the first block with Sham stimulation followed by the second block with Verum stimulation. On the Verum-Sham day (VS), the blocks order reversed.

Results

After-effects of the stimulation did not produce any significant changes either in behavior (accuracy in the task) or resting-state EEG (theta frequency band spectral power in the first experiment. In the second experiment, 6 Hz tACS delivered before the WM task was not able to produce any observable changes in working memory performance. The same hold true for online stimulation.

Conclusions

Theta frequency tACS applied to Fpz-CPz electrodes is not an efficient method to improve WM.
An hiv infection - a problem of quality of life!?
Authors: Vasilescu C. , Manciuc C. , Dorobat C. , Largu M.
Published: February 2022

Introduction

The quality of life is a multidiimensional and subjective construct, based on the patient’s experience.

Objectives

The objective of this study is to observe if at the HIV - positive patient the quality of life in relation to health is a consequence of disease and treatment and if his perception about the disease changes his ability to have a full and useful life.

Methods

We centralized the data coming from a number of 600 patients registered in the Iasi Regional Center, for a period of 12 months. The side effects reported by the patients emerged from discussions with the infectious diseases specialist and the psychologist.

Results

From 600 pacients, 59% of them were male with mean age of 21.1 years old. Approximately 14% of the patiens had stable jobs, the rest were unemployed or had part-time jobs. 38% came from foster care units of from broken homes. The average number of days of hospitalization was 4 days, 25% of them were at their first scheme, 10% in the seventh-eighth scheme. Among the antiretroviral side effects patients complained nausea and vomiting in 85% of cases, lipodystrophy symptoms in 25% of cases, diarrhea in 15% of the cases; regarding the psychological aspects, 65% of patients showed an above level of anxiety, 40% had depressive manifestations, 10% had specific obsessions-compulsions and 10% neurotic and hysterical tendencies.

Conclusions

We need a close collaboration between the infectious diseases specialist and the psychologists in order to enhance the quality of life of the HIV patient.
Ssri-treated psychiatric disorders prediction with AI
Authors: Mereu A.
Published: February 2022

Introduction

SSRI-treated psychiatric disorders (STPD), such as general anxiety disorder and major depression disorder, are common psychiatric diagnoses. Serotonin-mediated effects of solar insolation are an active topic of research. Artificial intelligence (AI) could help to better examine that complex relation.

Objectives

To investigate whether AI could predict the STPD relying primarily on average ambient temperature and annual solar insolation.

Methods

Data of age, average ambient temperature and annual solar insolation were employed to predict STPD status in 7,587 subjects using an AI. To simplify the data analysis, only individuals with white ethnicity were assessed. SPTD prevalence was 17.1%. The AI was conservatively tuned to maximize the positive likelihood ratio considering predicted and real STPD statuses. The free and open source programming language R was used for all the analyses. Dataset source: Wortzel, Joshua; Kent, Shia; Avery, David; Al-Hamdan, Mohammad; Turner, Brandon; Norden, Justin; Norden, Michael; Haynor, David (2018), “Data for: Ambient temperature and solar insolation are associated with decreased prevalence of SSRI-treated psychiatric disorders”, Mendeley Data, V1, doi: 10.17632/trs43ybh92.1

Results

Predictions obtained a positive likelihood ratio of 4.850. The results were indicative of fair performance.

Conclusions

AI might be useful to predict STPD. Furthermore, the results of this study might indicate a moderate effect of age, average ambient temperature and annual solar insolation on the probability of STPD occurrence. Finally, the AI used in this study is freely available, allowing anyone to experiment.
Assessment of cognitive function following a course of electroconvulsive therapy
Authors: Ali S. , Kamel S. , Easow J. , Blasubramanian R. , Parvathy P.
Published: February 2022

Introduction

ECT is a potentially life-saving treatment for patients with severe or treatment resistant depression. Cognitive function disturbances following ECT are generally transient, but could be of longer duration in some cases

Objectives

To assess the cognitive side effects in patients with affective disorders treated with a course of electroconvulsive therapy (ECT).

Methods

Cognitive functions of patients who undergo ECT was assessed prior to start of treatment, midway of the course of treatment and after end of the course of treatment using Montreal Cognitive Assessment (MoCA). We did a retrospective analysis of MoCA scores of 15 patients who received bilateral ECT in 2017-2018. In order to assess the efficacy of ECT in the treatment of their illness, we did a retrospective analysis of Montgomery Asberg Depression Rating Scale (MADRS) scores of 18 patients who received bilateral ECT in 2017-2018

Results

Only 7% of the patients who underwent ECT in our sample did have significant cognitive decline as per their MoCA scores. 28% of patients achieved complete remission in their depressive symptomes. 22% of patients continued on maintenance treatment. 95% of patients showed significant improvement in their symptoms following treatment with ECT where there symptoms reduced to either mild or minimal depressive symptoms.

Conclusions

Cognitive side effect was not a significant side effect in our sample of patients. We did see an improvement in cognitive function in a significant number of the sample of patients as they progressed with treatment, which coincided with improvement in their affective symptoms.
Tourette’s syndrome: Alternative approaches to a clinical case refractory to conventional therapy
Authors: Marinho Vaz Soares M.I. Fonseca , Ramos S. Freitas , E Sousa D. Cruz , Jesus B. , Castro S.
Published: February 2022

Introduction

Tourette’s syndrome is a neuropsychiatric disorder marked by motor and phonic tics frequently associated with psychiatric comorbidities, beginning in childhood. While most cases improve or resolve with age, some are refractory.

Objectives

To review new strategies for the management of Tourette’s Syndrome, following an outpatient clinical vignette.

Methods

We performed a review based on the PubMed® database.

Results

A 50-years-old female patient with a long-term outpatient psychiatric follow-up presented with motor tics appearing in adolescence, including winking and facial grimacing, as well as episodes of coprolalia. Over the years, she developed an anxiety disorder and social isolation. In addition to psychological therapy, pharmacological therapy had already been approached with the use alpha-adrenergic agonists and several antipsychotics, such as risperidone and aripiprazole, with the patient showing only partial response to pimozide. In Tourette’s syndrome, the therapy must be adequate to the patient’s individual needs. Emerging treatments for refractory cases, such as anticonvulsants, cannabinoids or antiglutamatergic drugs have been the target of several studies. Botulinum toxin injections are particularly effective in patients with focal motor tics and complex phonic tics. Non-pharmacological treatment options, such as electroconvulsive therapy and deep brain stimulation may prove effective in some cases.

Conclusions

A significant proportion of patients fail to respond to conventional strategies. Thus, new pharmacological and non-pharmacological therapies are on the horizon and may represent an important step in treatment algorithms for refractory cases in the future.
Electroconvulsive therapy practice in a general hospital in chile
Authors: Saitua V. , Schneider N. , Libuy J.
Published: February 2022

Introduction

Electroconvulsive therapy (ECT) is a current, relevant treatment for severe mental illness. In this article we describe our experience on ECT in a public hospital in Chile.

Objectives

Describe a 34 patients’ cohort who received ECT and their outcomes.

Methods

Data was extracted from ECT records between 2018-2020, patients’ evaluations before and after ECT, and case files. Data was then analyzed and described.

Results

ECT was received by 18 males and 16 females. Age ranged from 19 to 73 years (41 average). More than 75% had 12 or more years of education. Patients’ diagnoses and indications for ECT are shown in Figures 1-2

The CGI-SI scale was applied to subjects before treatment, and 85% had a score of 5 or more. On average, patients received 8.7 ECT sessions. Right unilateral electrode placement (RUL) was preferred initially for 94% of patients. Brief pulse width (0.3ms) was most commonly used (76%). Seizure duration averaged in 29 seconds. Adverse reactions presented on 32%, most being mild. One treatment had to be stopped due to confusional symptoms post ECT. After ECT, 91% of patients improved according to CGI-GI scale. 55% were assessed CGI-GI 1 “very much improved”. MoCA scale was also evaluated, showing a 2,1 point gain.

Conclusions

Schizophrenia and psychosis were the most frequent diagnosis and indication for ECT. RUL and brief pulse width were the preferred settings. This cohort suggests that ECT had an impact on markedly ill patients, based on CGI and MoCA scales.
Mindfulness-based cognitive therapy for major depressive disorder- a literature review
Authors: Vasile D. , Vasiliu O. , Mangalagiu A. , Petrescu B. , Tudor C. , Candea C.
Published: February 2022

Introduction

Mindfulness-based cognitive therapy (MBCT) is a third wave cognitive-behavioral therapy (CBT) that incorporates meditation exercises in the classical, structured intervention. Mindfulness has been associated with psychological well-being, and certain symptoms that occur in major depressive disorder (MDD), e.g. worries, ruminations, ideas of incapacity or self-devaluation, are considered potential targets for MBCT.

Objectives

To evaluate the current level of evidence for the MCBT efficacy in MDD.

Methods

A literature serach was performed in the main electronic databases, targeting clinical trials that evaluated in a randomized manner the efficacy of MCBT versus active comparators or placebo in patients with MDD.

Results

MBCT was efficient in a 10-week randomized controlled trial (RCT) versus standard treatment, and it decreased ruminations, increased patients quality of life, mindfulness abilities, and self-compassion. In another randomized, 8-week RCT, MBCT prevented relapses in MDD, with similar rates when compared to psychoeducation and standard treatment. A 26-month follow-up study evidenced the persistence of symptoms improvement detected after 12 months of the trial, when compared to active control group and treatment as usual. MCBT was compared to cognitive therapy in a randomized 8-week trial, and both treatments had similar efficacy in MDD relapse prevention.

Conclusions

MCBT may be an useful adjuvant to the current treatment in acute MDD, but it may also decrease the risk of relapse after psychotherapy termination.
Integrative psychotherapy of patients with schizophrenic spectrum disorders
Authors: Holm-Hadulla R.M.
Published: February 2022

Introduction

Psychotherapy of patients suffering from schizophrenic disorders remains controversial. There are promising descriptions of psychothereputic interventions in combination with pharmacological treatment. Some empirical studies show that different forms of psychotherapy are effective. However, there are few models to combine different psychotherapeutic strategies in a comprehensive way.

Objectives

We here propose a model of integrative psychotherapy that is based on the therapeutic alliance and the general principles of understanding and communication. It comprises interpersonal, behavioral, psychodynamic, and existential elements.

Methods

Theoretical principles of different psychotherapeutic schools are applied hermeneutically to a case of schizophrenia. Thus, general methods of psychotherapy gain contextual meaning by the analysis of an individual narrative. The patient himself assessed and approved his case report.

Results

After remission of the acute symptoms, integrative psychotherapy played the major role in the recovery of a young musician. It is shown how the therapeutic alliance and communication in a general sense interacted with behavioral, cognitive, psychodynamic, and existential techniques. It is demonstrated narratively how recovery was facilitated, adjunct to pharmacological treatment, by method-integrative psychotherapy. Basic cognitive-behavioral techniques ensured at first the stabilization of the patient. Then psychodynamic remembering, repeating, and working through became possible. Finally, existential topics and creative solutions dominated the sessions.

Conclusions

Psychotherapeutic method-integration is necessary to treat patients with various mental disorders especially schizophrenia. We propose an ABCDE-Model that comprises the following principles: Therapeutic alliance (A); behavior change (B); cognitive reflection on dysfunctional meanings and beliefs (C); psychodynamic remembering, repeating, and working through (D); and existential understanding and communication (E).
Practical strategies for reducing suicide risk among depressed adults
Authors: Overholser J. , Hernandez S.
Published: February 2022

Introduction

Suicide remains a major problem throughout society. Unfortunately, recommendations for the treatment of suicidal clients are often presented at a general level, without providing adequate detail that could guide the practicing clinician.

Objectives

The review explains three main strategies that can be used to helpr educe the risk of suicide among depressed adults.

Methods

Method: The review identified three themes derives from an integration of 30+ years of clinical experience working with depressed outpatients combined with a comprehensive review of recent journal articles on depression and suicide.

Results

First, clients may become suicidal when they focus on unfortunate events from their recent or distant past, resulting in tendencies for rumination and guilt. Therapy can help clients cultivate an attitude of contentment, promoting self-forgiveness and a sense of accomplishment. Second, suicidal clients often focus on their current struggles, frequently involving financial problems, interpersonal conflict, and social isolation. Therapy can help clients to embrace life through planned activities, reconnecting with loved ones, and repairing damaged relationships. Third, clients may struggle because of hopeless views of their future, feeling trapped in a desperate situation with no possible solution. Therapy can help clients look to the future with a more optimist attitude and a sense of control.

Conclusions

Clients can learn to search for realistic solutions to their problems, developing a renewed sense of optimism and empowerment. The risk of suicide can be reduced when therapy helps clients reduce guilt and worthlessness, increase meaningful social bonds, and instill realistic hope for the future.

Conflict of interest

No significant relationships.
Cognitive-behavioural therapy role in the prevention of psychosis
Authors: Pinho M. , Martins D. , Carvalho S.
Published: February 2022

Introduction

About 30% of individuals in ultra-high risk (UHR) of psychosis develop overt psychosis within 3 years, and about 40% of those who don’t will keep experiencing ongoing attenuated psychotic symptoms and persistent functional disability. During this prodromal period, it’s possible to prevent the transition to a first-episode psychosis.

Objectives

To conduct a short review of literature on the role of cognitive-behavioural therapy (CBT) in preventing psychosis in ultra-high risk patients.

Methods

We performed a literature search on PUBMED, using the query: “Cognitive Behavioral Therapy” [Mesh] AND “psychosis” AND “prevention”. We focused on data from systematic reviews, clinical trials and meta-analysis published on last 5 years, either in English or Portuguese.

Results

Some authors claim cognitive-behavioural therapy (CBT) as first-choice treatment in clients with ultra-high risk (UHR) for psychosis. CBT aims to normalize extraordinary experiences with education and to prevent delusional explanations. On a Japanese study, the total score of Positive and Negative Syndrome Scale (PANSS) significantly improved on post-intervention and follow-up assessments, with large effect sizes observed. Teaching families to apply CBT with their offspring may bolster therapeutic gains made in time-limited treatment. CBT showed an 83% probability of being more effective and less costly than routine care.

Conclusions

Patients with UHR for psychosis can be treated successfully with CBT to postpone and prevent the transition to a first-episode psychosis. CBT for UHR has been included in the European guidelines and awaits dissemination and implementation in mental health services.
Reception of patients admitted to a psychiatric unit
Authors: Kefi H. El , Gafsi I. , Molo M.L. Biloa , Krir W. , Brahim C. Bencheikh , Oumaya A.
Published: February 2022

Introduction

The reception of a patient in the psychiatric ward is an important step that determines the proper course of care. The welcome is the first stage of the relationship, it is essential to take the measure of the importance of this moment.

Objectives

Assess psychiatric inpatients’ knowledge of their rights and obligations.

Methods

This was a descriptive and cross-sectional study based on a self-administered questionnaire containing about twenty questions (20), which assessed the knowledge of patients hospitalized in the HMPIT psychiatry department about their rights and obligations.

Results

Twenty-five (25) patients agreed to answer the questionnaire and two (2) patients refused. Sixty percent (60%) of the patients were unaware of their rights. Sixty-eight percent (68%) of the patients did not know their duties. Forty-eight percent (48%) of the patients did not know the rules and conditions of hospitalization in psychiatry.

Conclusions

Patients hospitalized in the psychiatric ward have limited knowledge about their rights and duties and about the conditions and rules governing hospitalization. In addition to the poster on patients’ rights and duties, a welcome leaflet will provide all the information on the rules of hospitalization.
Evaluation of efficiency and quality of the multi-disciplinary team handover process in a mother and baby inpatient setting
Authors: Daud A. , Kesete B. , Sriranjan S. , Britton E. , Steel C. , Lewin J.
Published: February 2022

Introduction

At Coombe Wood Mother and Baby unit (MBU) there are daily multi-disciplinary team (MDT) handover meetings and a weekly MDT ward round attended by 7-8 team members. There are concerns that the handover is too time consuming, utilising time which could be spent on other clinical duties, and concerns regarding the relevance of information that is handed over.

Objectives

To perform a service evaluation to determine the efficiency and quality of MDT handover meetings in an MBU setting.

Methods

Data was collected from September to October 2020. A checklist was designed listing information felt to be relevant to handover and contained the following data points – ‘current situation’, ‘mental health’, ‘level of observations’, ‘risk’, ‘physical health’, ‘baby care’, ‘baby supervision levels’ and ‘tasks and responsibilities’. The start and stop times of each MDT handover meeting were noted and a record was made as to whether these topics were discussed.

Results

Mean meeting duration was 32.2 minutes (range: 13 – 45 minutes) and amounted to 2.68 hours spent in MDT handover over a 5-day working week. This equates to 21.4 person-hours (based on 8 staff) a week. 928 data points were generated. 50.7% (468) data points were recorded and commonly omitted data points were – ‘tasks and responsibilities’, ‘risk’, ‘level of observations’ and ‘physical health’. On all occasions, ‘current situation’, ‘mental health’ and ‘baby care’ were handed over.

Conclusions

The results of this service evaluation provide compelling evidence for a wider improvement project. Involving MDT staff in designing interventions will make handover meetings more meaningful.
Achievements and problems of psychosocial rehabilitation: Results of sociological research in the volga federal district
Authors: Mitikhin V. , Solokhina T. , Tiumenkova G. , Yastrebova V.
Published: February 2022

Introduction

The active development of psychosocial rehabilitation (PSR) has been taking place in Russia within latest two decades. In this regard, analysis of the accumulated experience and problems’ identification in the PSR field is relevant.

Objectives

Conducting a sociological study in the Volga Federal District (VFD) to work out measures for further PSR system development.

Methods

Sociological, statistical, original semi-structured questionnaire on PSR application, including 26 questions.

Results

63 institutions providing psychiatric care in 14 large regions of the VFD participated in the study. Achievements in the field of PSR include: introduction of new forms of rehabilitation care, modern psychosocial interventions; development of the volunteer sector and others. A number of systemic problems were also identified: more pronounced decrease in the availability of psychiatrists in VFD compared to the Russian Federation (RF) as a whole (in the VFD 0.76 psychiatrists per 10 thousand population in 2017 and 0.74 per 10 thousand population in 2018; in RF: 0.83 psychiatrists per 10 thousand population in 2017, 0.82 per 10 thousand in 2018); insufficient provision with psychotherapists, psychologists, social workers, which varies considerably in different territories (up to 10 times); insufficient use of non-profit organizations’ (NPOs) potential; lack of a unified system for assessing PSR effectiveness.

Conclusions

Measures for development of PSR were proposed: improving staffing levels and qualifications of employees, introducing psychosocial interventions with proven effectiveness; dissemination of successful experience of NPOs, development of methodological tools for assessing effectiveness of PSR, its standardization and others.
Phenomenology of psychiatric stigma: A factor of patients’ motivation to treatment
Authors: Sorokin M. , Lutova N. , Wied V.
Published: February 2022

Introduction

Psychiatric patients often are self-stigmatized and hardly involve in the treatment.

Objectives

Associations of self-stigmatizing beliefs in psychiatric inpatients and their treatment motivation.

Methods

63 inpatients; ICD-10: F2–65%, F3–13%, F4+F6–14%, F06–8%; mean age 34±13, illness duration 12±11 years. Treatment Motivation Assessment Questionnaire (TMAQ), Internalized Stigma of Mental Illness scale (ISMI); K-mean cluster analysis; dispersion analyses; p≤0.05.

Results

18 patients of cluster 1 (C1) demonstrated explicit self-stigmatization. In comparison with 25 subjects from cluster 3 (C3) stigmatized patients (C1) had higher levels of overall ISMI scores (2.9±0.3) caused by alienation (3.1±0.5), stereotype endorsement (2.5±0.5), social withdrawal (2.7±0.4), and discrimination experience (2.7±0.4). 20 patients of cluster 2 (C2) had an implicit stigma. They were more self-stigmatized (ISMI score 2.7±0.3) in contrast with subjects from cluster 3 (1.9±0.2) due to a lower level of stigma resistance (C2: 3.8±0.5 and C3 3.1±0.6 – reverse scores). Patients with implicit self-stigma (C2) had the lowest intensity of treatment motivation (Z-scores -1.2±0.6) compering with others (C1 and C3) due to the lowest TMAQ factor 1 (reliance on own knowledge and skills to cope with the disorder: -1.0±0.6) and factor 4 (willingness to cooperate with doctor: -0.9±1.0). Differences between explicitly and implicitly stigmatized patients manifested also in lower TMAQ factor 3 for the second group (awareness of the psychological mechanism of maladaptation: -0.5±0.9).

Conclusions

Despite alienation, stereotype endorsement, social withdrawal, discrimination experience some patients could sustain stigma due to cooperation with doctors and reliance on their own knowledge and skills to cope with illness.
How brazilian parents deal with the development of kids with hearing impairment diagnosis
Authors: Pacheco P. , Molini-Avejonas D.
Published: February 2022

Introduction

When parents discover that their child has hearing loss, a new reality presents itself with frustration, a huge amount of work as special care, therapies, exams, etc. Adapting to this new situation is a huge challenge to the development of both parents and children who receive this diagnosis.

Objectives

This study investigated how Brazilian parents of children diagnosed with hearing loss dealt with this situation from diagnosis to the present day.

Methods

In this study it was used the Bioecological Theory of Human Development, which considers the development of both parents and children over time. Two meetings were conducted using a focal group technique, with questions related to the diagnosis and how they faced the situation, prejudice, care of other siblings, etc.

Results

Most parents discovered the diagnosis of hearing loss of their children right after birth. Only one mother said she did not care about the diagnosis of hearing loss while most reported having suffered a lot and glimpsed a life of difficulties. Even knowing the limitations imposed by the condition of the children, no one considered hearing loss as a sickness. Parents reported that the child suffered bullying because of difficulties in speaking and most parents say they worry about their children’s school life.

Conclusions

Parenting kids with hearing impairment is challenging, and involves dealing with prejudice, fear of future, long-term therapies and high costs. Nevertheless parents make great efforts to provide a good environment minimizing the risks of having such condition.
Assessment of the effectiveness of psychosocial rehabilitation in schizophrenia patients using biological markers
Authors: Zozulya S. , Yastrebova V. , Solokhina T. , Klyushnik T.
Published: February 2022

Introduction

An important aspect of rehabilitation programmes is assessment of their effectiveness, which is carried out mainly through clinical and psycho-pathological examinations, psychometric and psychological scales and questionnaires. The use of biological markers of the schizophrenic process to assess the effectiveness of rehabilitation assistance is of considerable interest.

Objectives

To compare the clinical and socio-psychological characteristics of schizophrenia patients receiving psychosocial treatment in various forms of psychiatric care with the level of immune system activation reflecting the activity and severity of the pathological process in brain.

Methods

77 schizophrenia patients in remission of varying quality were examined, of which 52 patients (the 1st group) participated in a long-term comprehensive rehabilitation programme (3.7±2.5 years) in non-profit organization, and 25 patients (the 2nd group) received medical and rehabilitation assistance in the psychiatric day hospital (duration of treatment no more than 60 days). PANSS, HDRS, SAS-SR, SF-36, BRS scales were used. The activity of the pathological process was evaluated by the level of inflammatory markers.

Results

Both patient groups showed a similar increase in the level of inflammatory and autoimmune markers compared to control (p<0,01). The 1st group compared to the 2nd one had a significantly higher level (p<0,05) of social functioning, stress resistance, awareness of the disease, motivation, comprehensiveness, as well as less the severity of psychopathological symptoms.

Conclusions

The results indicate the effectiveness of a long-term comprehensive rehabilitation programme to stabilize clinical remission, improve social functioning and the quality of life in schizophrenia patients, despite the active pathological process in brain.
The effects of horticultural therapy on the functionality of psychotic patients employed in the green unit of the psychiatric hospital of thessaloniki greece
Authors: Kontos K. , Koutsou S. , Sismanidi A. , Theodoropoulou N. , Nikolopoulou V. , Filippiadou M. , Papazisis G.
Published: February 2022

Introduction

Horticultural therapy is used as alternative treatment option in rehabilitation programs for patients suffering from chronic mental disorders. In Greece, the Psychiatric Hospital of Thessaloniki was the first that organized a organized Rehabilitation Program approved by the Greek Ministry of Health, the “Green Unit - Monada Prasinou”.

Objectives

The purpose of this study was to investigate the effect of horticultural intervention on the functionality of patients employed in the Green Unit of the Psychiatric Hospital of Thessaloniki.

Methods

The Mini-ICF-APP Social Functioning Scale was used to evaluate the functionality of the patients. Horticulture therapy included actual gardening and other agricultural activities. The sample consisted of two groups, 22 inpatient of the Green Unit and 22 patients of outpatient units as a control group. The majority of the patients suffered from Schizophrenia spectrum disorders. Both patients’ groups were evaluated over 12 months (May 2018- May 2019).

Results

At baseline evaluation, the patients of the Green Unit patients presented higher scores only in the mobility and endurance subscale. A year later there was a statistically significant difference in all thirteen subscales. Shortly, the patients were rated as more consistent, organizational, social, flexible, responsible, more confident and enterprising, more adaptable and more able to take care of themselves.

Conclusions

The results suggest that horticulture as a therapeutic method had beneficial effects in all dimensions of patient functionality confirming the hypothesis that such programs should be a priority in the effort of psychosocial reintegration of patients suffering from chronic mental disorders.
Parent-child communication and inner dialogues in the self-awareness of children with disabilities
Authors: Burlakova N. , Karpova O.
Published: February 2022

Introduction

Analysis of problems arising in communication between parents and their children with disabilities is a part of biopsychological examination of disease.

Objectives

The study was aimed at exploring the parent-child communication in children suffering from chronic neurological disorders in order to organize the optimal psychological rehabilitation.

Methods

The study consisted of two stages: 1) CAT (Bellak) and drawing tests, performed by child; 2) experiment involving both parent and child, making up a story together (CAT-H, parallel to the task performed by the child). Parents filled in a questionnaire on their communication with the child; its results were compared to the situations of real communication. Other methods used included: observation, analysis of family situation and child’s development; coding of communicative elements; analysis of the story by the method by N. Burlakova (Burlakova, 2001). The study involved 34 persons: 17 children (aged 7–10) + 17 parents (15 mothers, 2 fathers). The dyads were studied when the children received treatment in the hospital (resided in the hospital together with the parent).

Results

1) Activity of the child together with the parent revealed several communicative patterns, which correlated differently to the estimation of communication by the parent. 2) The types of inner dialogues in children were discovered, which gave concrete expression to the inferiority feeling caused among others by the communication in the parent-child dyad. 3) The organization of the research enabled to follow the “production” of dialogues of self-awareness in children with chronical diseases.

Conclusions

The conducted research enables organization of individualized psychological and psychotherapeutical aid.
Psychoeducational groups for relatives of patients with cognitive impairment: Effect on the psychological state of caregivers
Authors: Bonany J. Marti , Casamitjana M.I. Martínez , Castellví C. Macias , Olive J.R. Fortuny , Sanz M.T. Campillo , Codina G.A. Mateu , Quetcuti R.B. Sauras , Elias M. Vallve , González R. Sánchez , Carre M. Pérez
Published: February 2022

Introduction

The Cognitive Disorders Unit carries out sessions of Psychoeducational Groups (PG) for caregivers of patients diagnosed with cognitive impairment (CI). The aim is to educate about the disease, improve the caregiver’s self-care and learn how to take better care of the sick.

Objectives

Analyze the profile of the caregivers that participate in PG and assess changes in their psychological state.

Methods

Subjects: 110 caregivers of patients diagnosed with mild-moderate CI who have participated in PG. Methodology: sociodemographic data of the caregiver and patient are collected. The following scales are passed: General-Health-Questionnaire (GHQ-12), Global-Deterioration-Scale, Barthel-Index. 5 sessions of 90 minutes are carried out every fortnight. An opinion questionnaire and the GHQ-12 are administered at the end of the sessions.

Results

86% of caregivers are women: 37% spouses and 55% daughters; mean age 57; 92% of patients live with the caregiver. 62% of caregivers present some kind of psychological disorder that is significantly reduced (p=0,0003) after some sessions. After PG: 65% of caregivers are able to further enjoy their daily activities 46% improve concentration capacity 42% improve sleeping and mood. Opinion Questionnaire Results: 98% of caregivers are satisfied with the activities, the topics addressed and their applicability.

Conclusions

The participants in PG were mostly daughters of patients, with average age 57, and living in the same household. Participation in PG improves the information and skills of caregivers, and reduces psychological disorders by improving their mood, their ability to concentrate, their quality of sleep and enjoyment of daily activities.
Horticultural rehabilitation programme: Effects on schizophrenia
Authors: Bonany J. Marti , Castellví C. Macias , Carre M. Pérez , Casamitjana M.I. Martínez , Diez E. Carrió , Arnau A. Casals , Elias M. Vallve , Hernández J. Pagerols , Olive J.R. Fortuny
Published: February 2022

Introduction

Horticultural therapy is a professional practice that is increasingly used in a lot of mental health rehabilitation programs. This therapy was introduced in the Comunitary Rehabilitation Service of INAD, considering its beneficial results in patients with severe mental disorder in combination with the usual rehabilitation program.

Objectives

We would like to study the benefits of this therapy compared to the usual in our patients.

Methods

This is an explanatory study for the purpose of establishing the association between the application of a Therapeutic Horticulture Program and the Clinical Symptomatology of Schizophrenia. A research with an experimental design Pre and Post-Test was carried out, by applying a Horticulture Program and evaluating with PANSS after 6 months its effects on the Clinical Symptomatology. The participants of the experimental group were selectively chosen. The only selection criteria were to attend the orchard at least once a week and be diagnosed with a schizophrenic disorder. The control group was chosen according to the number of members that made up the other group, with the criterion that they did not perform any outdoor activities and also had a diagnosis of schizophrenia.

Results

The comparison of the Pre and Post-Test measures in the case of the experimental group reports the presence of statistically significant differences in the scale of positive symptomatology composite scale and general scale.

Conclusions

This psychopathological improvement of those participants open a door to possible applications of this therapy as a psychosocial treatment.
Evaluation of executive dysfunction in clinical practice- pragmatic challenges and solutions
Authors: Vasile D. , Vasiliu O.
Published: February 2022

Introduction

Executive dysfunction (ED) is an important clinical dimension that need to be evaluated in neurologic and psychiatric disorders, due to this factor’s impact over patients functionality, quality of life, and overall prognosis. Working memory, inhibition, set shifting, and fluency are the most widely accepted dimensions of ED. The evaluation of these aspects in clinical practive should be more frequently implemented, because they may offer an image about the patients ability to cope with new situations, stressful events, social challenges being included.

Objectives

To determine the most appropriate methods of ED evaluation in psychiatric practice.

Methods

A literature review was conducted through main electronic databases, and papers published between January 2000 and August 2020 were included in the analysis.

Results

Wisconsin Card Sorting Test (WCST), Halstead-Reitan Neuropsychological Battery, Cambridge Neuropsychological Automated Battery (CANTAB), Wechsler Adult Intelligence Scale (WAIS), and Controlled Oral Word Association Test (COWAT) have been the most frequently cited instruments for ED evaluation. The neuropsychiatric disorders in which ED was recommended in clinical trials were schizophrenia and other psychotic disorders, neurocognitive disorders, bipolar disorders, and major depressive disorders. An integrated approach, that combines initial evaluation and periodic monitoring of symptoms severity, global functioning, quality of life, and ED severity should be considered standard-of-practice for neuropsychiatric disorders.

Conclusions

ED is an important dimension of clinical evaluation in many psychiatric disorders that is useful because the results may correlate to the patients prognosis, quality of life, and overall functional evolution.

Conflict of interest

No significant relationships.