bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Internet Use on the Parameters of Attention in Adults
Authors: Mihai A. , Rebeca-Isabela M.
Published: August 2024

Introduction

Internet use in the adult population is growing at alarming rates. The latest statistical data show an average internet usage time of 6 hours and 58 minutes (2023), an increase of 1% compared to 2021. Research studies on the influence of the excess use of internet on attention is in its prime years, and clear steps need to be made in an attempt to clarify current hypotheses and to find effective methods for prevention. Nowadays, one of the most powerful influences on attention is the use of the internet, which, more often than not, crosses the line of addiction.

Objectives

The initial hypothesis is that in the event of exposure to a high number of stimuli, the ability to switch attention to a single task may only be possible at a superficial level. The aim of this study was to assess the impact that excess internet use has on the ability to maintain attention in the adult population. The present study aims to sketch a well-established structure and direction of research in the field of attention and its effects on human functioning.

Methods

Using the DSM 5-TR diagnostic criteria for pathological Internet gaming disorder we enrolled 60 people who expressed their consent to participate in the study. We check psychiatric comorbidities using SCID II. As a method for evaluating changes in the level of attention, we used of the Stroop test. The results were analysed with the SPSS program (version 23).

Results

The results showed a marked decrease in the ability to maintain attention, without increasing the number of stimuli. Although excessive Internet use leads to changes in attention parameters, research in this area is scarce and incomplete. Currently, most of the published studies focus on a causal relationship between the pathological use of the Internet and the appearance of attention deficit/hyperkinetic disorder, especially in children and adolescents. Although the results are promising, we cannot neglect the multitude of additional consequences of excess Internet use, which these studies targeting a single pathology overlook. Moreover, using the Internet involves exposure to an ever-increasing number of stimuli, which is why switching attention and maintaining it is currently an insufficiently researched parameter. Regarding the impact of Internet use on individual functioning, there is a relatively modest number of studies in the literature that outline a correlation between excess Internet use and various psychiatric comorbidities.

Conclusions

The impact of the research on the general population could be an increased awareness of negative effects and the development of prevention programs.

Disclosure of Interest

None Declared
The neuro-psychological manifestations of COVID-19 in healthcareworkers
Authors: Ghenim A. , Kacem I. , Chouchane A. , Aloui A. , Sridi C. , Fekih A. , Hafsia M. , Maoua M. , Kahloul M. , Mrizak N.
Published: August 2024

Introduction

At the beginning of the Covid-19 pandemic, respiratory expression of SARS-CoV-2 infection was the most worrying one. Later, other symptoms appeared to be more disturbing such as neurological and psychiatric manifestations, which may be due to direct or indirect effects of this virus on the central nervous system.

Objectives

To assess the prevalence of neuropsychological manifestations of covid-19 in healthcareworkers and to identify their risk factors.

Methods

This is a cross-sectional descriptive epidemiological study, carried out in the teaching hospitals of Farhat Hached and Sahloul of Sousse. All healthcareworkers, having tested positive for SARS-COV 2 during the period from 01/09/2020 to 28/02/2021 were enrolled. The collection of socio-professional and medical data was based on a pre-established synoptic form completed during an interview with the participants.

Results

A total of 953 COVID-19 patients were enrolled in this study. The mean age was 40.1 ± 10.5 years, with a sex ratio of 0.32. In our sample, 37.9% of patients had comorbidities such as psychiatric history (4.9%) and neurological history (2.4%). The prevalence of neuropsychological manifestations of covid-19 was 72.6%. The main neuropsychological manifestations were headache (50.3%), anosmia (40.7%), dysgeusia (29.9%), sleep disturbances (0.5%), dizziness (1, 2%) and paresthesia (0.3%).

Neuropsychological symptoms of long covid were dominated by memory impairment (10.7%), anosmia (8.5%), headache (7.3%), dizziness (3.4%) and sleep disturbances (3.1%).

The occurrence of neuropsychological manifestations was significantly associated with age (OR=1.6; p<10-3), male gender (OR= 0.57; p=0.03), smoking (OR=1.7; p=0.033), history of hypertension (OR=1.6; p=0.038), history of diabetes (OR=2.4; p<10-3) and hospitalization (OR=4.03 ; p<10-3).

Conclusions

The high prevalence of neuropsychological manifestations underlines the importance of studying their pathogenesis in order to better adapt their therapeutic protocols.

Disclosure of Interest

None Declared
Dysregulated metabolic sensing of appetite in anorexia nervosa: implications of LEAP-2 regulation
Authors: Tezenas Du Montcel C.
Published: August 2024

Growing interests on the role of metabolic sensors in anorexia nervosa led to implicate metabolic sensing as consequences of anorectic sensing but also in the perpetuation of the disorder. Ghrelin is an orexigenic peptide secreted by the fundic cells of the stomach in situation of fasting and kown to initiate food intake through its activity on hypothalamic and motivation aspect of food intake. A body opf evidenc previously showed that patients suffering from anorexia nervosa display high plasma levels of ghrelin correlated with the nutritionnal status but his orexigenic signal do not seem to modify restrictive behavior. LEAP-2 (Liver Expressed Antimicrobial Peptide 2) is a recently discovered endogenous ghrelmin antagonist, increased during overnutrition and that decreases food intake in humans and animals.

We explored ghanges of ghrelin and LEAP-2 in a longitudinal cohort of 30 patients suffering from anorexia nervosa during a 4 months refeeding program. We show abnormal regulation of LEAP-2 in patients with higher levels in acute stages that decrease with refeeding. This abnormal regulation was associated with early relapse in patients. This abnormal regulation could counteract with the orexigenic signal of ghrelin in patients.

We discuss these results in light with recent evidence on the consequences of LEAP-2 increase of food intake and hedonic feeding relevant in understanding anorexia nervosa.

Disclosure of Interest

None Declared
How psychopathy is associated with the level and change of impulsivity in correctional treatment
Authors: Voulgaris A. , Briken P. , Stück E.
Published: August 2024

Introduction

Research indicates that psychopathy can hinder treatment success and can lead to dropout. Impulsivity is a complex construct that overlaps with psychopathic personality traits and is often targeted in forensic psychotherapy due to its relation to the risk of reoffending.

Objectives

Our aim was to investigate the overlap between psychopathy and impulsivity and the influence of psychopathic traits on change in impulsivity.

Methods

We conducted a pre-post-study for measures of psychopathy and impulsivity in men imprisoned for sexual and non-sexual violent offenses. All participants took part in standardized pre- and post-treatment ratings shortly after admission as well as after an average of 19 months (n=370 for pre-rating, n=168 for post-rating). Psychopathy was measured via the PCL-R, impulsivity with the BIS-15.

We calculated two-tailed Pearson correlations for BIS-15 Pre-, Post-, and Change Scores and the PCL-R. In a second step, the BIS-15 pre-post-differences were compared using independent t-Tests, effect sizes were calculated using Cohen’s d (small, medium, and large effect sizes are d = .20, .50, and .80). Further, unpaired t-tests were carried out to compare between participants with lower and higher PCL-R sum scores (median split, mdn= 15.8, M=15.5, SD=7.9).

Results

In the total population a significant reduction of self assessed impuslivity can be demonstrated for total impulsivity (p<.001, cohens d= .34) nonplanned (p<.001, cohens d= .39) and motor impulsivity (p=.004, cohens d= .23). In both groups, with higher and lower psychopathic traits, a significant reduction in total  and nonplannend impulsivity can be seen.

While the reduction in total impulsivity was 0.9 points higher in the group with higher psychopathy, the difference was not significant, t(147.8)= -1.1, p = .285. Also, the nonplanned impulsivity was showed a stronger reduction in the high PCL group, though the effect was not significant, t, t(166)= -1.2, p = .243.Table 1.

Correlationen between BIS-15 post-ratings and PCL-R

PCL-R

PCL-R Sum
Interpersonal
affective
lifestyleantisocialBIS-15 prä
(n=370)Total Impulsivity.20 **-.14 **.02.34 **.28 **BIS-15 post
(n=168)Total Impulsivity.33**.04.20**.35**.36**BIS-15 Change
(n=168)Total Impulsivity-.03-.15-.09.07.01

Note: * correlation significant für p ≤ .05; ** correlation significant für p ≤ .001.

Conclusions

We demonstrate a significant correlation between psychopathy and impulsivity, especially regarding facets 3 and 4, but also for the sum score. Neither the PCL-R sum core, nor the facets correlate with the change in impulsivity during treatment progress in the STU. In both groups, with higher and lower psychopathy, impulsivity was reduced during therapy but there was no significant difference in the change scores. Our results underline that treatment progress can be achieved also in patients with higher psychopathic traits.

Disclosure of Interest

None Declared
Service system and care pathway of forensic psychiatry patients-international research project 2023-2026
Authors: Askola R. , Louheranta O. , Seppänen A. , Lantta T.
Published: August 2024

Introduction

The Finnish forensic psychiatric service system lacks the standards and criteria guiding the quality and contents of patient care. Ensuring best recovery-oriented practices in forensic psychiatric services need to be developed at several levels.

Objectives

The purpose of this research project is to develop safe, high-quality psychiatric care. The outcome of this project is the production of quality criteria for the forensic psychiatric care and service system.

Methods

The study will be executed at the Department of Nursing Science of the University of Turku during 2023-2026. The research methods include a literature review, a survey based on validated measurement questionnaires (Downes Survey, QPC-FIP, QPC-FIPS), individual and group interviews as well as the Delphi method. The research will cover the multidisciplinary employees at adult psychiatric wards in Finland’s larger hospital districts, employees of forensic psychiatric hospitals, and patients of forensic psychiatric hospitals. International specialists and specialists within Finland from various fields (nursing, medicine, psychology) will be invited to partake in the expert panel.

Results

The research results will allow the development of the service system for forensic psychiatric patients in such a way that the identification of so-called risk patients can be improved already at the early stages of treatment, at the general psychiatric level. Moreover, the substance of care and participation during care can be created and the care following inpatient care and the patient’s transfer out of forensic psychiatric care can be developed. The research may promote the effectiveness of treatment by highlighting areas in the care chains that, when reinforced, will allow patients to receive the right kind of treatment at the right time. A proposal of standardized operating methods and quality criteria will be created for the Finnish forensic psychiatric treatment system. The research project will also reveal previously unresearched information that can be utilized in national health policy.

Conclusions

The project will promote equal prospects for wellbeing and a participatory society for citizens by exploring the views of forensic psychiatric patients and thus developing forensic psychiatric services. The project will promote sustainable employment by exploring the views of psychiatric personnel and increasing the quality and safety of psychiatric services.

Disclosure of Interest

None Declared
Sexual Experiences and Sexuality of Forensic Mental Health Patients - A Theoretical Framework
Authors: Šendula Jengić V. , Cargonja P.
Published: August 2024

Introduction

Sexuality and sexual experiences in forensic mental health patients are intricate issues at the crossroads of mental health, legal contexts, and societal perceptions. Forensic mental health patients, situated within the criminal justice system, require psychiatric treatment due to offenses committed. Understanding their sexual behaviors, experiences, and attitudes towards sexuality is pivotal for effective therapeutic interventions and rehabilitation. Various factors influence the sexuality of forensic mental health patients. Mental health disorders impact an individual’s sexual expression, and medications used to treat these conditions may affect libido, sexual functioning, and arousal patterns, posing challenges in their sexual experiences.

Objectives

Addressing the sexual needs and experiences of these individuals requires a comprehensive approach. Mental health professionals must create safe and non-judgmental spaces for patients to openly discuss their sexual concerns. Therapeutic interventions should focus on facilitating healthy sexual expression and providing education on consent, healthy relationships, and understanding boundaries. Forensic mental health professionals often receive specialized training to address the complex intersection of sexuality and mental health within legal contexts. Navigating ethical and legal boundaries while providing support to these individuals is crucial, ensuring that interventions align with legal regulations and ethical standards. Rehabilitation programs in forensic mental health facilities should integrate sex education and relationship-building skills to help patients develop a healthy understanding of sexuality. These programs aim to reduce reoffending and support the reintegration of individuals into society by promoting responsible and respectful sexual behaviors.

Methods

This study conducts a systematic literature review to comprehend the intricate nature of sexuality and sexual experiences among forensic mental health patients.

Results

Research in this area faces limitations and ethical challenges due to the sensitivity of the topic. Ethical considerations, such as confidentiality and consent, must be meticulously addressed in studies and while providing care to this population.

Conclusions

Understanding the sexuality and sexual experiences of forensic mental health patients is integral to their treatment and rehabilitation. It requires a multifaceted approach that acknowledges the complexities these individuals face due to mental health conditions, personal histories, and the nature of their care environment. Tailored and comprehensive support can promote healthier sexual behaviors, relationships, and overall well-being among this population.

Disclosure of Interest

None Declared
Food for the Mind: A systematic review of mindful and intuitive eating approaches for mental health & wellbeing
Authors: Eaton M. , Foster T. , Messore J. , Robinson L. , Probst Y.
Published: August 2024

Introduction

A growing body of literature has investigated diet and mental health, however, it is often viewed through a “weight-centric” lens, where weight loss is considered a primary outcome and motivator. This review aims to shed new insights into the connections between mental health and wellbeing, and eating behaviours that focus on internal cues and regulators and do not centralise around weight. Such “weight-neutral approaches” have been associated with improved psychological health and wellbeing, however, consolidated evidence is lacking.

Objectives

To explore eating styles that do not centralise around weight, and their relationship with mental health and wellbeing and other health outcomes.

Methods

A systematic search was performed including observational studies of adult populations, with ≥1 mental health and wellbeing or physical health outcome, and ≥1 validated measure of eating behaviour reflective of a weight-neutral approach. Outcomes were characterised into four domains (mental health and wellbeing, physical health, health promoting behaviours and other eating behaviours). Risk of bias was assessed using the Newcastle-Ottawa Scale.

Results

In total 8281 records were identified with 86 studies including 75 unique datasets and 78 unique exposures included. Eating behaviours included intuitive eating (n=48), mindful eating (n=19), and eating competence (n=11). All eating behaviours incorporated biological, physiological, and social factors, with 297 outcomes categorised for mental health and wellbeing (n=122), physical health (n=116), health promoting behaviours (n=51) and other eating behaviour (n=8). Greater intuitive and mindful eating were significantly related to lower levels of disordered eating, and depressive symptoms, as well as greater body image, self-compassion, and mindfulness. Greater intuitive eating, mindful eating and eating competence were significantly related to a lower BMI, and greater diet quality and physical activity. Eating competence and intuitive eating were significantly related to higher fruit and vegetable intake, and eating competence alone was significantly related to higher fibre intake, and greater sleep quality.

Conclusions

This review provides evidence that intuitive eating, mindful eating and eating competence are positively related to a range of mental and physical health outcomes. Considered within the biopsychosocial model, these findings enhance understanding around the impact of approaches to healthy eating patterns that are not focused on weight loss, and contributes a case towards promoting health-centric eating behaviour in mental health care. Future research should focus on experimental studies and broader population groups.

Disclosure of Interest

None Declared
Suicidal ideation, suicidal plans and suicide attempts in patients with chronic pain: a prospective qualitative research Study 1: 2011 – 2015 Study 2: 2015 - 2019
Authors: Guertzenstein E. Z. , Teixeira M. J.
Published: August 2024

Introduction

The association among suicidal ideation, plans, attempts and pain has not attracted as much attention as the association between suicidal ideation and attempts and psychiatric disorder.

Objectives

The aim of this prospective study was to establish if patients with chronic pain associated or not to psychiatric disorders with ideation and planning for a suicide attempt will aways end in a suicide act.

Methods

The patients were initially examined through structured interview, scan-schedules for clinical assessment in neuropsychiatric – version 2.0 used only to diagnose. (HDRS – 17) - Hamilton Depression Rating Scale, 17 itens version, (HAMS) Hamilton Anxiety Rating Scale, (CGI) - Clinical Global Impression: (CGI – S) Severity of illness and (CGI – I) Clinical Global Improvemnt. Pain intensity through numerical rating scale. Those were repeated throughout the research.

Patients

Study 1 - 325 patients (244W, 81M aged 19 – 58) with chronic pain, suicidal ideation or plan associated or not to psychiatric disorders.

124 had chronic pain without psychiatric disorder. 54 suicidal ideation and 70 had suicidal plan.

201 had chronic pain associated with phychiatric disorders. 7 with opioid dependence after pain and suicidal plans. 4 with adjustment disorders before pain and suicidal ideation.

3 with somatoform disorder before pain and suicidal plan. 125 had chronic pain associated with: general anxiety disorder, mixed anxiety and depression, severe panic pain before or after pain with suicidal plans or ideation. 62 patients presented chronic pain associated with depressive disorder: recurrent severe depression without psychotic symptoms; moderate recurrent depression without psychotic symptoms. Before or after the occur of pain with suicidal ideation or suicidal plans.

Study 2 -132 patients remained in treatment. (79W and 53M aged 20 to 59)

54 had chronic pain without psychiatric disorder with plans or ideation suicidal. 78 Patients had chronic pain and a psychiatric disorder. 16 became dependent on opioids after pain and suicidal plans. 36 with chronic pain associated with anxiety disorder: general anxiety disorder before or after pain with suicidal plans. 26 had chronic pain associated with depressive disorder: recurrent severe depressive disorder with or without psychotic symptoms with suicidal ideation.

Results

Study 1 - No patient attempted suicide. 54 patients with pain without psychiatric disorders considered suicidal thoughts absurd and intrusive.

Study 2 - No patient died. 51 attempted suicide

47 remained with suicidal ideation

33 did not have suicidal ideation or suicidal plans. They adapted their lives to chronic pain regardless of presenting a psychiatric illness.

Conclusions

The authors concluded that a suicidal act is not always necessarily an expression of chronic pain associated/not with psychiatric disorder.

Disclosure of Interest

None Declared
Polish psychiatrists’ experiences consulting displaced patients from ukraine in 2022
Authors: Krysta K. , Kamińska K. , Mielczarek Z. , Ciołek M.
Published: August 2024

Introduction

The ongoing conflict in Ukraine has resulted in a significant influx of refugees seeking asylum in other countries, including Poland. Among these refugees are individuals who are struggling with mental health issues. Polish psychiatrists have stepped up to provide care for these patients, despite facing a number of challenges in the process.

Objectives

This presentation aims to shed light on the experiences of Polish psychiatrists treating refugees during the war in Ukraine, highlighting the difficulties they have encountered and the strategies they have employed to provide the best possible care to their patients. The presentation also examines the impact of war on mental health, and the long-term effects on the well-being of refugees.

Methods

A questionnaire study was done among Polish Psychiatrists about the forms of support they provided for Ukrainin psychiatric patients they consulted after 24 February 2022. The responses to questionnaires were collected during psychiatric Congresses.

Results

The most commonly reported symptoms were anxiety (44.1%), followed by depression (35.3%), and panic attacks (23.5%). Other symptoms like irritability and sleep disorders were reported by 11.8% and 8.8% of the respondents, respectively. Disturbingly, thoughts of resignation and suicidal ideation were also reported, albeit at lower frequencies (8.8% and 2.9%, respectively). A small percentage (2.9%) reported no new symptoms.

The high prevalence of anxiety and depression suggests that the war has had a profound impact on the mental health of the affected population. The emergence of severe symptoms like psychotic thoughts and suicidal ideation, although less frequent, is alarming and calls for immediate intervention. It is also noteworthy that a small but significant portion of the population reported no new symptoms, which may indicate resilience or other coping mechanisms at play.

Conclusions

The war in Ukraine has led to a range of new psychological symptoms among the affected populations, with anxiety, depression, and panic attacks being the most prevalent. Immediate and long-term psychological interventions are urgently needed to address these emerging mental health issues. Further research is also required to understand the resilience factors among those who reported no new symptoms.

Disclosure of Interest

None Declared
Temperamental differences in the Subtypes of Attention Deficit Hyperactivity Disorder
Authors: Longo G. , Servasi M. , Orsolini L. , Volpe U.
Published: August 2024

Introduction

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition marked by difficulties in attention, hyperactivity, and impulsivity. Its subtypes—predominantly inattentive, predominantly hyperactive-impulsive, and combined—vary in symptom presentation and impact on daily functioning. Understanding these subtypes is crucial for tailored interventions and support.

Objectives

Our aim is to clinically characterize the psychopathological aspects of the subtypes of ADHD.

Methods

Our study is conducted on patients (>18 years) referred to the adult ADHD outpatient service of the Psychiatric Clinic of Ancona (Università Politecnica delle Marche, Italy). The Diagnostic Interview for ADHD in adults (DIVA 5.0) was used for diagnosing ADHD. The following rating scale were administered: Temperament Evaluation in Memphis, Pisa and San Diego (TEMPS-M), and Temperament and Character Inventory-Revised (TCI-R).

Results

76% (n=170) of all screened patients were diagnosed with ADHD in adulthood. 57.6% (n=98) were diagnosed with ADHD combined subtype, 35.3% (n=60) with ADHD inattentive subtype, and 7.1% (n=12) with ADHD hyperactive subtype. Only 12.9% (n=22) were diagnosed with ADHD in childhood. Based on the results obtained at TEMPS-M, 43.8% (n=32) of patients were found to have cyclothymic temperament. Subjects with ADHD combined subtype scored significantly higher mean on the irritable temperament subscale of the TEMPS-M than those with ADHD inattentive subtype (p=0.016), while patients with ADHD inattentive subtype had a significantly higher mean score on the disorderliness subscale of the TCI-R than those with ADHD hyperactive and combined subtype (p=0.010). Given the logistic regression analyses using the TCI-R, developing an inattentive type of ADHD is negatively predicted by the disorderliness subscale of the TCI-R (exp(B)=0.788, IC95%=0.669-0.929, p=0.005) and positively predicted by the extravagance subscale of the TCI-R (exp(B)=1.104, IC95%=1.009-1.208, p=0.031), the hyperactive subtype of ADHD is negatively predicted by the fatigability subscale of the TCI-R (exp(B)=0.775, IC95%=0.597-1.005, p=0.055) and the combined subtype that is positively predicted by the disorderliness subscale of the TCI-R (exp(B)=1.140, IC95%=1.011-1.287, p=0.033). Regarding temperament, through a logistic regression analysis, the inattentive subtype of ADHD is negatively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=0.904, IC95%=8.39-0.974, p=0.008), while for the combined subtype of ADHD it is positively predicted by the irritable temperament subscale of the TEMPS-M (exp(B)=1.088, IC95%=1.014-1.167, p=0.019).

Conclusions

The results show that irritable temperament is a predictor for the inattentive and combined subtype, but with different polarities. In addition, how different patterns of personality are specific to the various subtypes of ADHD are highlighted.

Disclosure of Interest

None Declared
Positive outcomes of implementing applied theatrical improvisation in communication trainings/ workshops for healthcare students in two European countries: a comparative study
Authors: Fekete J. D. , Jouin M. , Eklicsné Lepenye K. , Pótó Z. , Hainselin M.
Published: August 2024

Introduction

Effective communication has been shown to improve patients’ health outcomes. This study utilizes medical improvisation techniques to teach communication skills to different groups of health students (nurses, midwives, medical doctors, speech therapists).

Objectives

Our objective was to design and compare an interprofessional workshop that incorporates applied improvisation to train different groups of healthcare students in communication skills, resilience, dealing with failure and empathy. Medical improvisation is an innovative concept to prepare healthcare students to be more effective communicators.

Methods

Required medical improv workshops (using applied improvisational theater techniques) were held for first to third-year students in France and in Hungary. Workshop evaluations were obtained before and following the last session and at 3 months post-workshop for one cohort. The courses incorporated role plays, listening, storytelling and verbal/ nonverbal exercises to help students communicate with empathy and clarity. The two countries used the same questionnaires for assessment (Interpersonal Communication Questionnaire and Intolerance Uncertainty Scale)

Results

24 medical students participated in the Hungarian improvisation workshops, and 26 speech therapists students in the French improvisation workshops. In the finished Hungarian research over 90% of students rated the workshops as above average or excellent. Students reported a gain in insights regarding their role as a clinician (≥ 90%), an improvement in their ability to demonstrate effective communication (80–87%), and a positive impact on teamwork (91–93%). At 3 months post-workshop, students reported they had used at least 1 improvisation skill on their clinical wards. Both countries can claim promising results so far in their separate studies, our results comparing the French and Hungarian data using synchronized scales and questionnaires is currently in progress, and will be processed by the end of this year.

Conclusions

This study demonstrates that medical improvisation exercises can be scaled to different fields of healthcare students in various years of their studies and that using improv in healthcare education is universal in its short and long-term effects. Further, we found that students felt that it improved their communication. This study also provides new insights regarding specific improvisation exercises that are most useful for the clinical environment.

Keywords: Improvisation. Medical improvisation. Applied Improvisation. Medical education. Communication. Uncertainty tolerance. Soft skills training

Disclosure of Interest

None Declared
Transcranial Magnetic Stimulation and its Efficacy in Alleviating Depressive Symptoms in Patients with Suicidal Ideation
Authors: Moleon A. , Martín-Bejarano M. , Alvarez de Toledo P. , Perez I. , Narbona J. , García-Ferriol M. , Perea R. , Oropesa J. M. , Torres J.
Published: August 2024

Introduction

Suicide is a global public health issue. According to the latest available data from the National Institute of Statistics, 4,003 people died by suicide in 2021, reaching a new historical high. Approximately 90% of suicide victims suffer from one or more severe psychiatric disorders, and there is a documented 20-fold higher risk of suicide in individuals with affective disorders compared to healthy subjects (Abdelnaim et al., 2020). Repetitive transcranial magnetic stimulation (rTMS) has been established as an effective alternative or complementary treatment option for patients with depressive disorders, but little is known about its effects on suicide risk.

Objectives

To assess the efficacy of rTMS in reducing depressive symptoms in patients with suicidal ideation and behaviors.

Methods

Population and Methods: A retrospective analysis was conducted on a sample of 28 psychiatric patients (23 females; mean age 49.36 ± 16.23) with suicidal ideation identified by item 3 (suicidality) of the Hamilton Depression Rating Scale (HDRS), who were treated with rTMS. All patients received a minimum of 30 sessions, consisting of the application of a high-frequency (>10Hz) or intermittent theta burst stimulation (TBS) over the left dorsolateral prefrontal cortex (DLPFC) at an intensity of 120% of the resting motor threshold (RMT), and repeated low-frequency pulses (1Hz) or continuous TBS over the right DLPFC with an intensity of 110% of the RMT.

Results

Results: The results show a statistically significant improvement in depressive symptoms following rTMS intervention (p < 0.001). Furthermore, remission was observed in 46% of the sample (HDRS < 8).

Conclusions

Discussion: In line with recent studies (Abdelnaim et al., 2020; Hines et al., 2022) and systematic reviews (Cui et al., 2022; Bozzay et al., 2020) on suicidal ideation in the context of psychiatric disorders, the findings of this study demonstrated that rTMS achieved satisfactory results in reducing depressive symptoms and suicidal ideation.

Conclusions: This clinical study indicates preliminary promise for the prevention of suicidal acts and underscores the need for more detailed and specific research on rTMS in the field of suicide.

Keywords: rTMS, neuromodulation, depression, suicide.

Disclosure of Interest

None Declared
Frequency of early childhood trauma in psychiatric patients: an investigation with the Early Trauma Inventory–Self Report
Authors: Szeifert N. M. , Sebők B. , Szabó B. , Miklósi M. , Schmelowszky Á.
Published: August 2024

Introduction

Childhood trauma is an important public health problem but there are limitations in our ability to measure childhood trauma. Early Trauma Inventory is a self-report instrument for the assessment of childhood trauma that is valid but simple to administer.

Objectives

We aimed to assess the frequency of childhood trauma in patients of a large sample of the Crisis Intervention and Psychiatric Ward in Budapest, Hungary.

Methods

Data from 279 patients referred to Péterfy Alexander Hospital, Crisis Intervention and Psychiatric Ward, Budapest, Hungary, were analyzed. Most participants were female (n = 202, 72.4%) between the ages of 17 and 86 (M = 38.37 yrs). Half of the participants were diagnosed with major depressive disorder (n = 138, 49.5%) or anxiety disorder (n = 149, 53.4%), while 47 of the participants suffered from bipolar disorder (16.8%). One hundred thirty-eight participants had at least one suicide attempt in their life (49.5%). Childhood traumas were assessed by the Early Trauma Inventory– Self Report (ETI-SR), an instrument for the assessment of physical, emotional, and sexual abuse, as well as general traumas, which measures frequency, onset, emotional impact, and other variables. We assessed the most frequent traumas in the physical, emotional, and sexual abuse, as well as general trauma domains.

Results

Family mental illness (n = 136, 58.1%), witnessing violence (n = 129, 54.7%), divorce/separation of parents (n = 114, 48.3%), and observing death/serious injury of others (n = 112, 47.5%), were the most frequently experienced general traumas. Out of physical traumas, most of the participants experienced being slapped in the face (n = 169, 73.2%), being spanked with a hand (n = 152, 65.5%), being hit or spanked with an object (n = 93, 40.3%), and being pushed or shoved (n = 81, 33.4%). Among emotional traumas, being often put down or ridiculed (n = 170, 74.2%), the needs being failed to be understood by parents (n = 164, 72.7%), often shouted at or yelled at (n = 154, 67.5%), and being often ignored or made feel like they do not count (n = 109, 46.2%) were the most frequent. From the sexual abuse domain, being exposed to flashing (n = 72, 32.9%), being touched in intimate parts in an uncomfortable way (n = 63, 29.2%), being exposed to inappropriate comments about sex (n = 61, 28.5%), and being rubbed by someone’s genitals (n = 44, 20.3%) were the most common. Further results will be presented at the conference.

Conclusions

It is already recognized and our study also confirms that childhood maltreatment, especially sexual abuse can lead to suicidal behaviour. The precise role of particular types of childhood maltreatment and the mediators of the relationship between childhood maltreatment and suicide is yet to be investigated in more details.

Disclosure of Interest

None Declared
Adaptation of the brief psychoeducational intervention programme (BREF) for carers of patients with eating disorders
Authors: Scanferla E. , de Salle J. , Gorwood P.
Published: August 2024

Introduction

Even though international guidelines suggest that psychoeducation for carers should be provided systematically, it remains insufficiently available in psychiatry (1), including for eating disorders (EDs). The complicated interplay of factors contributing to the maintenance of EDs, including family/carer influences, highlights the importance of carer interventions within ED treatment (2). Carer interventions demonstrate positive outcomes for carers themselves, though are also hypothesised to benefit the patient indirectly. The BREF programme is a short, early and systematic single-family psycho-educational programme. The BREF programme is already proven to be effective for other mental disorders (3)

Objectives

The aim of this study is to adapt the BREF programme to the specific needs of carers of patients eating disorders (ED).The main objective was to identify the issues in the experience of the disorder that are most important to carers and which should be the focus of the BREF programme for cares of patients with eating disorders.

Methods

Twenty-eight topics relating to difficulties commonly encountered by carers of patients with eating disorders were identified by a group including mental health professionals with expertise in these disorders, patients and their relatives. The topics tested are illustrated by 2 decks of cards presented to the participants; the first concerns the problems frequently encountered by users living with ED and the other the problems frequently encountered by their carers. The 2 decks were tested by the participants to the first 15 sessions of the BREF ED programme run from January to July 2023 as part of the pilot conducted in a university-hospital department specialised in eating disorders.

Results

30 participants participanted in the study.

The 10 most frequently selected topics relating to patient problems were, in descending order: relative’s fear and anxiety; relative’s false-self functioning; ambivalence towards care; dysmorphophobia; food restrictions; relative’s hyperactivity; eating disorders; denial of symptoms; perfectionism; malnutrition. The 10 most frequently selected topics concerning the issues of carers were: social withdrawal; difficulty navigating care; fatigue/helplessness; disruption to family life as a result of the illness; guilt; right attitude to have with the ill relative; fear for your loved one’s future; fragility of the relative; not knowing/understanding the care their relative is receiving; cost of care and food expenses.

Conclusions

The priority topics highlighted in this study helped to identify relevant content for the BREF programme adapted to the context of eating disorders. This programme appears to be a promising way of responding to the concerns and information needs of carers of patients with ED. In this regard, it addresses a major shortcoming in the organisation of mental health services.

Disclosure of Interest

None Declared
Role of Different Forms and Intensities of Physical Activity in Prevention of Dementia
Authors: Singh I. , Chandra R.
Published: August 2024

Introduction

Dementia is one of the greatest health challenges worldwide. According to the World Health Organisation (WHO) factsheet, currently more than 55 million people worldwide have dementia, with over 60% living in low- and middle-income countries. Every year, there are nearly 10 million new cases of dementia. WHO Global Status Report 2021 estimated growth of 139 million people with dementia by 2050. The estimated total global cost of dementia is likely to surpass US$ 2.8 trillion by 2030. As one grows older, the risk of developing dementia, particularly Alzheimer’s Disease, progressively increases. The Lancet Commission Reports 2017 and 2020 on dementia prevention, intervention, and care identified 12 modifiable risk factors, including physical inactivity, obesity, midlife hypertension, and diabetes. Addressing these lifestyle factors may significantly reduce the risk of dementia and its progression. While no curative or disease-modifying treatment is available for dementia at his stage, addressing modifiable risk factors may have a preventive role in reducing the risk of dementia.

Objectives

The objective of the literature review is to explore current evidence on Physical Activity (PA) in reducing the risk of developing dementia and its progression. The focus is also to see the association of different forms and intensities of PA and their intensities, including aerobic, strength-based, and leisure, with the risk and progression of dementia.

Methods

Narrative review

Results

Results from the reviewed studies showed that PA was found to be associated with a reduced risk of dementia, particularly Alzheimer’s Disease. Studies comparing different intensities of PA indicate though all levels of PA decrease the risk of dementia, there is a linear relationship between the higher intensity PA and the increased beneficial effect in terms of reduced risk of dementia. Leisure-time PA also has a protective role against dementia in longitudinal studies. There is more consistent evidence in favour of aerobic PA; however, it has a ceiling effect. The combination of aerobic and strength-based experience provides optimum beneficial effects. The elderly population who started physical activity in their 80s experienced the beneficial effects of PA in reducing the risk of dementia. There is mixed evidence of the protective effect of PA on the population who have already developed cognitive impairment or have genetic vulnerabilities. The author will also include the results of any relevant study published by 31 March 2024.

Conclusions

The details of the literature results and conclusions will be discussed at the conference.

Disclosure of Interest

I. Singh Consultant of: The author declare that the review was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., R. Chandra: None Declared
A body beaten again: a narrative analysis of a series of cases of breast cancer survivors punctuated by violence
Authors: Melo V. S. D. , Soares C.
Published: August 2024

Introduction

Various mechanisms have been identified to explain the relationship between gender-based violence, screening, and cancer. Biological mechanisms, primarily related to chronic stress and allostatic load, have been associated with high rates of chronic diseases among victims of violence, impairing the functioning of the immune and endocrine systems. Victims of abuse simultaneously show less initiative for screening exams, such as mammograms, as they perceive them as invasive and retraumatizing. They also demonstrate a greater tendency toward maladaptive coping behaviors and unhealthy lifestyles, such as abusive substance use. A significant number of these patients develop psychosocial dysfunction and body image disturbance during breast cancer treatments.

Objectives

This work aims to provide a descriptive and narrative analysis of body image and psychosocial changes in women breast cancer survivors with prolonged experiences of violence, supported by a non-systematic literature review on the central aspects under study.

Methods

For the introductory literature review, a search was conducted on search engines such as Google Scholar and PubMed, with no date limitations, using the following terms (or combinations): “intimate partner violence,” “violence AND cancer,” “body image AND psychossexual adjustment AND breast cancer.” Additionally, a narrative analysis of body image and psychosocial changes in women breast cancer survivors with prolonged experiences of violence was conducted. For this purpose, participants were asked to complete two validated scales in the Portuguese language, and first-person testimonials were collected.

Results

The analysis of scale results and participant testimonials highlights a consensus on the significant impairment of psychosocial functioning and the experience of sexuality. There is evidence of avoidance behaviors in terms of affectionate and sexual contact due to feelings of fear, shame, and discomfort. The breast is valued as a sensual, erotic, and essential sexual element, and impactful changes in body image persist. However, in some cases, these changes are experienced as transformative and liberating, fostering a more generous view of the body, identity, and femininity.

Conclusions

Women with breast cancer should be screened for the possibility of being victims of violence, as this context predicts a higher likelihood of emotional difficulties during surgical treatments, including psychological distress, post-traumatic stress, body shame, and self-blame. A significant number of women, including those in this study, consider the approach to self-image and sexuality in oncology consultations deficient. Psychological programs and interventions should be developed to empower patients to adjust to the sexual changes arising from treatments and disease progression and to promote positive intimate relationships and effective communication.

Disclosure of Interest

None Declared
Factors Influencing the Mental Health of Caregivers of Children with Cerebral Palsy
Authors: Alhumaidah R.
Published: August 2024

Introduction

Cerebral palsy refers to a heterogeneous group of non-progressive neurodevelopmental disorders manifesting in infancy or childhood and varying in severity. It characterized by impaired motor function, sensation, and depressed intellectual abilities. Functional limitations in patients with cerebral palsy may result in chronic dependency, thereby compromising caregivers’ mental health and interfering with the integrity of the family structure.

Objectives

This study aimed to determine the different factors affecting the mental health of caregivers of children with cerebral palsy and to raise awareness among healthcare providers.

Methods

A cross-sectional study was conducted among caregivers of children with cerebral palsy in National Guard Health Affairs-Jeddah, Saudi Arabia, using the Depression Anxiety Stress Scale-21, a validated questionnaire assessing: depression, anxiety, and stress. This questionnaire was used to assess the mental health of the caregivers. In addition, factors reflecting child’s health condition, such as visual impairment, number of emergency department visits, and number of Pediatric Intensive Care Unit admissions were reported to investigate the impact on the caregiver’s mental health.

Results

The sample included 40 caregivers, of which 72.5% were mothers. According to the Depression Anxiety Stress Scale-21 score, 12.5% (n = 5) of the caregivers had moderate depression scores, 10% (n = 4) revealed extremely severe depression, and 10% (n = 4) showed moderate anxiety. Furthermore, 12.5% (n = 5), 15% (n = 6), and 7.5% (n = 3) of the caregivers have scored as moderate, severe, and extremely severe stress levels, respectively. Caregivers’ depression, anxiety, and stress scores were significantly (p ≤ 0.05) associated with the impact of vision of their dependent children, frequent hospital admissions, and frequent emergency department visits. Increased Pediatric Intensive Care Unit admissions in the past year were also significantly associated with higher caregiver anxiety scores.

Conclusions

To the best of our knowledge, the dimension of caregivers’ stress and anxiety and their association with the children’s dependency level is not well documented in our region. Caregivers of children with cerebral palsy reported having mental health challenges associated with the children’s vision, frequent need for acute medical care, and hospital admissions.

Healthcare workers should provide early and proactive planning of medical and social support for children and their families using a family-centered approach.

Disclosure of Interest

None Declared