bluuebunny/crossref_metadata_2025 huggingface dataset:
The psychopathological trajectories to delusion in Schizophrenia: the affective and schizotypal pathways
Authors: Borrelli D. , Ottoni R. , Maffei S. , Fascendini N. , Marchesi C. , Tonna M.
Published: September 2022

Introduction

Delusions are a key feature of schizophrenia psychopathology. From a phenomenological approach, Jaspers (1913) differentiates between “primary” or true schizophrenic delusions, defined as an unmediated phenomenon that cannot be understood in terms of prior psychological origin or motivation, and “secondary” delusions, understandable from the patient’s mood state or personality. Primary delusions have been considered the hallmark of reality distorsion dimension in schizophrenia, disregarding a possible affective patwhay to delusional belief.

Objectives

The present study was aimed at elucidating the psychopathological trajectories to delusion in schizophrenia through the investigation of both affective and schizotypal trait dispositions.

Methods

Seventy-eight participants affected by schizophrenia were administered the Peters Delusional Inventory (PDI), the Positive and Negative Affective Scale (PANAS), the Experience of Shame Scale (ESS), the Referential Thinking Scale (REF), the Magical Ideation Scale (MIS) and the Perceptual Aberration Scale (PAS).

Results

The severity of delusional ideation (PDI) was positively related to both affective (PANAS positive dimension, ESS) and schizotypal traits (MIS, PAS and REF). Moreover, referential thinking (REF) mediated the relationship between “magical ideation” (MIS) and delusions severity (Fig. 1), whereas experience of shame (ESS) was a moderating factor in the between referential thinking and delusion severity (Fig. 2).

Conclusions

The study findings suggest that in schizophrenia patients, severity of delusions is underpinned by an intertwining of both affective and schizotypal pathways.

Disclosure

No significant relationships.
Differences in physical activity in subjects with psychosis versus a control group
Authors: Montejo A.L. , Buch B. , López M.J. , Arias M.T. , Corrales M.D. , Dominguez E. , Matos C. , Cortés B. , Santana Y. , Valrriberas I. , Matías J. , Prieto T. , Gómez-Marcos M. , García-Ortiz L. , Acosta J.M.
Published: September 2022

Introduction

Psychiatric illnesses are related with a reduced life expectancy and an increase of mortality rates (around 60%) mainly associated with cardiovascular diseases [1]. The high prevalence of obesity, metabolic syndrome, diabetes mellitus and tobacco use among these patients undoubtelly predispose to the impairment in physical health and mortaility increase. Regular physical activity in the general population is associated with a decrease in cardiovascular risk but litle is know about iss influence in some chronic and severe mental disorders like schizophrenia [2].

Objectives

To quantify the physical activity performed by a sample of subjects with psychosis, borth males and female, compared to a control group.

Methods

A sample composed of 141 patients with schizoprenia was compared to 103 healthy subjects as a control group. The International Physical Activity Questionnaire - Short Form (IPAQ) scale was applied to all participants. The time (minutes) of physical activity performed in a week (METs) was collected by each participant [3].

Results

The differences in the total physical activity Mets for the patients with schizophrenia were highly significant (p = 0.001), showing a lower degree of physical activity compared to the control group. A higher and significant percentage of sedentary lifestyle among the psychiatric group (64.5%), compared to 35.5% in the control group was found.

Conclusions

The group of pateints with Schizophrenia showed a significant higher sedentary lifestile including less physical activity. This finding could be highly related with a higher risk of cardiovascular disease and deterioration of the physical health.

Disclosure

No significant relationships.
Athens multifamily therapy after a first psychotic episode: Online therapy during the COVID-19 pandemic
Authors: Selakovic M.
Published: September 2022

Introduction

The Athens Multifamily Therapy Project (A- MFTP) aims to provide systemic multifamily group therapy to youths who experienced a first psychotic episode (FEP) and their families

Objectives

Since 2017, we run five groups of five-four families, with a duration of ten months and frequency every two weeks. Participants were recruited from the longitudinal study, Athens FEP Project, which aimed to investigate the involvement of genetic and environmental determinants on psychosis risk.

Methods

During the Covid-19 pandemic, the provision of therapy to the current groups continued through online sessions. Participants were asked to answer qualitative questions on the perceived effectiveness of the therapy on their life as well as on the presenting problem(s) at three time points: middle, end of therapy and 6-month follow-up.

Results

All members highlighted the significance of the reciprocity in the group communication. They mentioned that “sharing” and “exchanging” experiences helped them listen to others and felt heard by them. They moved from feeling fear and embarrassment when discussing the diagnosis and the aftermath, to feeling safety and comfort talking about their difficulties. Qualitative analysis showed no difference in participants’ perception of multifamily therapy as helpful between live therapy and online therapy.

Conclusions

Results suggest that MFT can be a viable way to provide early intervention in FEP even in at online modality.

Disclosure

No significant relationships.
Outpatients with psychotic disorders still need physical health-promotion
Authors: Larsen-Kaasgaard D.M. , Stryhn L. , Sorensen M.K. , Munk-Jørgensen P. , Hjorth P.
Published: September 2022

Introduction

Premature death of people living with non-affective psychotic disorders are related to life-style somatic comorbidities. Current health-promoting treatment and care programs does not target people living with psychotic disorders and therefore prevention and treatment do not embrace the accompanying challenges.

Objectives

To identify and explore outpatients with non-affective psychotic disorders who are not offered existing municipal health-promoting treatment and care programs despite having a need.

Methods

Two hundred and six eligible outpatients from multiple sites of the Psychiatric Services in the Region of Southern Denmark were invited to participate. At last, 165 outpatients met the criteria and agreed to participate. A screening scheme was used to identify socio-economic characteristics, life-style related somatic comorbidities, medication status and consumption of cigarettes, drugs and alcohol. In outpatients’ medical records measured values and blood samples were obtained.

Results

Almost four-fifths of the outpatients were in need of health promotion out of whom more than half were not offered a municipal health-promoting treatment and care program. One or more of the investigated somatic comorbidities was found in more than one-third of the outpatients. 15% had type-2-diabetes mellitus and 10% had cardiovascular disease. Two-fifths of the outpatients were smokers. Mean number of cigarettes per day was 19 (SD=10) for smokers. Mean BMI for men was 29 kg/m2 (SD=7) and 34 kg/m2 (SD=8) for women.

Conclusions

In general, the outpatient’s state of health was poor. Many outpatients were not offered a municipal health-promoting treatment and care program despite having a need.

Disclosure

No significant relationships.
Can pleiomorphic psychotic symptoms with movement disorders mask wilson’s disease?
Authors: Marques J. , Bajouco M.
Published: September 2022

Introduction

Wilson’s disease is a rare (1:30,000) autosomal recessive disorder of copper metabolism that is caused by mutations in the adenosine triphosphatase copper transporting beta (ATP7B) gene, located on chromosome 13. The reported percentage of patients with psychiatric symptoms as the presenting clinical feature is 10%-20%.

Objectives

To present and discuss a rare case admitted in the First Psychotic Episode Inpatient Unit (UIPEP) with pleiomorphic psychotic symptoms and low serum copper and ceruloplasmin and high 24h urine copper.

Methods

The data was collected through patient and family interviews, as well as from his medical record. We searched Pubmed using MeSH terms: psychotic disorders AND Hepatolenticular Degeneration.

Results

A twenty-two years old male, without known psychiatric history presented in the Emergency Department with a myriad of psychotic symptoms: motor stereotypes/mannerisms, paranoid delusions and auditory hallucinations. He was admitted in UIPEP, started low-dose antipsychotic medication with good response. As part of the implemented protocol, he did a battery of exams, including Brain CT-scan, EEG, ECG and blood and urine analysis, in which low serum copper and ceruloplasmin stood out, leveraging the suspicion of Wilson´s disease. Therefore, 24h urine copper was done, with 140 mcg/d (reference range < 40 mcg/d). Brain MRI was normal and no Kayser–Fleisher rings were seen by a consulting ophthalmologist.

Conclusions

Without proper treatment, Wilson’s disease is a progressive and fatal disease. Therefore, it’s of upmost importance to recognize the clinical signs that raise suspicion of this disorder, especially recent onset in young adult of miscellaneous psychotic symptoms with movement disorders.

Disclosure

No significant relationships.
Is it psychosis? Heads or tails. A case report
Authors: Rodado León B. , Huete Naval M. , García Carpintero A. , Jiménez Cabañas M. , Bermejo Pastor A. , Pérez Lombardo M.
Published: September 2022

Introduction

Psychotic disorders usually come with diagnosis difficulties, especially when the clinical presentation is recent or if there are organic factor associated. Regarding this, we propose the clinical case of a man 47 years old without psychiatric history, who is brought to the hospital after being run over by the subway. At his arrival, he verbalizes delirious thoughts of persecution and harm.

Objectives

The objective is to emphasize the importance of making an appropriate somatic study in psychosis cases, especially when we don’t know the time of setting or we can’t make a psychiatric interview in optimal conditions.

Methods

The study included a blood test including methemoglobine, cranial tomography, serologies and a heavy metals test. We reviewed the scientific literature in Pubmed and Web of Science about the possible association between the psychiatric and the dermatological symptoms.

Results

During his admission, the patient recognizes delusional thoughts of harm since he was young and he was so frightened because of this that he tried to commit suicide in the subway. Moreover, he also thinks that silver can heal any disease, so he has licked silver coins for years. The final diagnosis was schizophrenia, and argyria due to a chronic silver intoxication.

Conclusions

Heavy metals intoxications can be associated to acute psychotic disorders, so we must take them into account. As well, schizophrenia can cause bizarre believes which can lead to the intoxication.

Disclosure

No significant relationships.
Correlates of late-onset antipsychotic treatment resistance
Authors: Fonseca De Freitas D. , Agbedjro D. , Kadra-Scalzo G. , Francis E. , Ridler I. , Pritchard M. , Shetty H. , Segev A. , Casetta C. , Smart S. , Morris A. , Downs J. , Christensen S. , Bak N. , Kinon B. , Stahl D. , Hayes R. , Maccabe J.
Published: September 2022

Introduction

There is emerging evidence of heterogeneity within treatment-resistance schizophrenia (TRS), with some people not responding to antipsychotic treatment from illness onset and a smaller group becoming treatment-resistant after an initial response period. It has been suggested that these groups have different aetiologies. Few studies have investigated socio-demographic and clinical differences between early and late onset of TRS.

Objectives

This study aims to investigate socio-demographic and clinical correlates of late-onset of TRS.

Methods

Using data from the electronic health records of the South London and Maudsley, we identified a cohort of people with TRS. Regression analyses were conducted to identify correlates of the length of treatment to TRS. Analysed predictors include gender, age, ethnicity, positive symptoms severity, problems with activities of daily living, psychiatric comorbidities, involuntary hospitalisation and treatment with long-acting injectable antipsychotics.

Results

We observed a continuum of the length of treatment until TRS presentation. Having severe hallucinations and delusions at treatment start was associated shorter duration of treatment until the presentation of TRS.

Conclusions

Our findings do not support a clear cut categorisation between early and late TRS, based on length of treatment until treatment resistance onset. More severe positive symptoms predict earlier onset of treatment resistance.

Disclosure

DFdF, GKS, EF and IR have received research funding from Janssen and H. Lundbeck A/S. RDH and HS have received research funding from Roche, Pfizer, Janssen and Lundbeck. SES is employed on a grant held by Cardiff University from Takeda Pharmaceutical Comp
Electroconvulsive therapy in treatment resistant schizophrenia: Old beacon of hope when nothing else works
Authors: Adão C. , Quintão A.A. , Velosa A. , Trindade P. , Almeida C.
Published: September 2022

Introduction

Electroconvulsive therapy (ECT) is one of the oldest psychiatric treatments used to this day. It is particularly useful in cases of schizophrenia resistant to treatment with antipsychotics. 49% of patients with schizophrenia experience little or no response with one trial of antipsychotics, 71% do not achieve remission and up to 20% of patients are also resistant to clozapine.

Objectives

Description of a clinical case where ECT is used in the treatment of resistant schizophrenia and review of the literature.

Methods

Description of a clinical case. Non systematic review of the literature, searching the terms “treatment resistant”; “schizophrenia”; “ect” in the databases Pubmed, Medline, Cochrane and Uptodate.

Results

Male, 38-year-old patient, diagnosed with schizophrenia for 20 years, with history of multiple hospitalizations, institutionalized for 9 years. Treated with risperidone 50 mg intramuscular fortnightly, clozapine 750 mg daily, aripiprazol 30 mg daily and diazepam 10 mg daily. He presented with increased delusional intensity for a year. Hospitalized for treatment with ECT, submitted to 12 sessions with bitemporal stimuli, with effective convulsions. MoCA, PANSS and BPRS were applied before and after treatment, with an increase of 25% in MoCA and a decrease of 47.3% and 57.9% respectively, in the psychotic symptoms scales.

Conclusions

We present a case of schizophrenia resistant to treatment with multiple antipsychotics, including clozapine. ECT was used, with clinically demonstrated efficacy. In the future, it might be interesting to study in detail the mechanism of action of this treatment with the goal of deepening the knowledge of the neurobiology of schizophrenia.

Disclosure

No significant relationships.
Schizophrenia And Polycystic Ovary Syndrome: A Case Report
Authors: Turki M. , Abidi O. , Ellouze S. , Ben Abdallah F. , Youzbechi F. , Halouani N. , Aloulou J.
Published: September 2022

Introduction

Patients with Polycystic ovary syndrome (PCOS) have increased vulnerability to psychiatric disorders, particularly a tendency to depression and anxiety, as well as schizophrenia. The association between PCOS and psychiatric disorders is a topic of research given the possibility of common potential mechanisms as well as the clinical similarity between the adverse effects of atypical antipsychotics and the symptoms of PCOS.

Objectives

We proposed to investigate the etiopathogenic relationship between schizophrenia and PCOS as well as the therapeutic particularities.

Methods

We report a case of schizophrenia occurring in a patient with PCOS. Then, we conducted a literature review using “PubMed” database and keywords “psychosis”, “schizophrenia”, “Polycystic ovary syndrome” and “antipsychotic drugs”.

Results

She was an 18-year-old patient, diagnosed with PCOS since 2018. She has been followed in the psychiatry outpatient department since 8 months for psychotic symptoms (hallucinatory syndrome with thoughts of self-aggressiveness, delusional syndrome with mental automatism…). She was prescribed olanzapine (5 then 10 mg/day). However, after a weight gain (4 kg per month), this drug was switched by Risperidone (2 then 4 mg/day). The evolution was marked by the appearance of galactorrhea. Thus, the Risperidone was switched to Aripiprazole. Then, we noted a significant improvement on the psychiatric features and a better clinical tolerance.

Conclusions

For women with PCOS and psychosis, treatment with antipsychotic drugs can worsen PCOS symptomatology and lead to negative consequences for a woman’s reproductive potential and her quality of life. Therefore, the psychosis management must take these particularities into account, in order to improve the prognosis of both diseases.

Disclosure

No significant relationships.
Smoking in patients with schizophrenia : “No smoking without fire”
Authors: Abassi B. , Khelifa E. , Nourchene K. , Bouguerra I. , Mnif L.
Published: September 2022

Introduction

More than half patients with schizophrenia are smokers. Heavy smoking has been correlated to more severe positive symptoms, a higher number of hospitalizations and a less efficiency of antipsychotics. Unfortunately, abstinence is difficult to achieve in these patients, therefore it is importance of understanding the link between smoking and psychosis.

Objectives

Analyzing the complex relationship between schizophrenia and nicotine’s effects on the human brain.

Methods

The study was a review of literature over the past 10 years based on the pubmed database.

Results

Smoking might be a precipitating factor in the development of schizophrenia since it preceded the onset of this illness for several years.Shared genetic background was also emphasized establishing a complex biological link between nicotine and schizophrenia.

In another approach, the “self-medication hypothesis” has been proposed suggesting a beneficial effect of nicotine on both cognitive impairment and negative symptoms in schizophrenia, related to the regulation of the dopamine and nicotinic receptor systems. But this conclusion is controversial since other studies concluded to a more neurocognitive impairment in smokers compared to controlled population.

Conclusions

Smoking in schizophrenia is a complex “phenomenon” that remains, so far, misunderstood. Greater differences might exist between heavy and light smokers making it more difficult to point out the exact effect of nicotine on the brain. Smoking cessation therapies taking into account the specificity of patients with schizophrenia should be more developed.

Disclosure

No significant relationships.
A case report of inhibition and severe desnutrition: negative symptoms in resistant schizophrenia
Authors: Coucheiro Limeres P. , Díez Valle B. , Cerame A. , Lozano Serrano C. , Navas Collado E.
Published: September 2022

Introduction

The appearance of inhibitory symptoms encompassed in what are known as negative symptoms is part of the usual symptoms of schizophrenia. Sometimes this inhibition reaches a significant severity, so it is essential to know its approach.

Objectives

Case report and literature review regarding the treatment of resistant schizophrenia with a predominance of negative symptoms

Methods

We present the clinical case of a 28-year-old man diagnosed with schizophrenia at 23 years old, whose onset was characterized by delusional ideas of harm (poisoning) and delusions with a mystic-religious theme that lead him to reduce his intake until requiring a first admission for severe desnutrition. Subsequently, after two more admissions, the patient presents selective reduction in food intake, decrease in daily activity and apathy without positive symptoms.

Results

Throughout the treatment, several lines of antipsychotic treatments have been tried at the maximum tolerated dose (haloperidol, oral paliperidone and depot, aripiprazole and clozapine up to a dose of 600 mg). Clozapine resistance required testing various augmentation strategies (Venlafaxine, Lamotrigine and Electroconvulsive therapy) with low results. Finally, to complement the treatment, the patient was transferred to a mid-stay unit where psychosocial treatment with a multidisciplinary approach was started. This has allowed more continuous follow-up and thus a partial improvement of the clinic.

Conclusions

Numerous studies describe numerous augmentation strategies for clozapine-resistant schizophrenia with negative symptoms. However, the results are still inconclusive, needing more research. Meanwhile, we want to highlight the importance of complementing the treatment with psychosocial approaches.

Disclosure

No significant relationships.
Early Career Psychiatrists in Education and Academia in Europe – Challenges and Ways Forward
Authors: Baessler F.
Published: September 2022

Academic research and publications can serve as important drivers of career development for early-career psychiatrists. However, the current focus on clinical teaching during the postgraduate program leaves much less room for scholastic training for young professionals. Combined with a lack of standardized European curricula despite automatically recognized qualifications in European Union countries, early-career psychiatrists encounter challenging job prospects across Europe, often faced with the hard choice of pursuing careers in clinical practice or opt for academia. In recent years, academia has attracted more and more young psychiatrists eager to contribute as researchers, teachers and/or administrators within academic and higher education institutions. What are the challenges they face and how they can overcome them to combine clinical work, teaching and research? The component of teaching and research varies widely in European psychiatry training and mostly early-career psychiatrists are unaware about the importance of publications, formal qualifications, stipends, international experiences, participating in studies, writing grant applications, etc, for their academic career. Often, they are not clearly informed about the advantages/disadvantages of pursuing an academic career and learn at a later stage about the important steps towards a successful career combining clinical work, research and teaching. In this session, we will share a brief insight into the challenges of academia and the possible ways forward with some real-life experiences of the speaker, who is leading several interdisciplinary research projects at the Heidelberg University Hospital along with handling patients and family at the same time. An interactive discussion and exchange of knowledge is desired.

Disclosure

No significant relationships.
Effect of Semaglutide versus placebo on psychotic symptoms and quality of life - a pre-specified secondary analysis of HISTORI: A randomized clinical trial in people with pre-diabetes and schizophrenia
Authors: Uhrenholt N. , Ganeshalingam A. , Arnfred S. , Frystyk J. , Gæde P. , Bilenberg N.
Published: September 2022

Introduction

Life expectancy of people with schizophrenia is reduced by 10-20 years compared to the general population. The excess mortality is part due to an increased prevalence of cardiovascular disease, prediabetes and obesity, which are in part due to antipsychotic treatment. Gaining weight is associated with reduced quality of life and also among the most frequently reported reasons for the discontinuation of treatment. Lifestyle changes have a time limited effect, and therefore, interest has focused on Glucagon-Like Peptide 1 receptor agonist treatment. Semaglutide, currently used to treat type 2-diabetes in doses up to 1.0 mg once-weekly, has shown promising results regarding weight loss in doses up to 2.4 mg once-weekly. It may also be able to reduce the risk of developing diabetes and cardiovascular disease.

Objectives

The HISTORI Trial aims to reduce risk of developing diabetes and cardiovascular disease in people with schizophrenia, prediabetes and overweight and to investigate for an indirect effect of Semaglutide on psychotic symptoms and quality of life through a weight loss.

Methods

A 30 weeks randomized, placebo-controlled, double-blinded study with once-weekly injections of Semaglutide 1.0 mg. Primary inclusion criteria are age 18-40 years, schizophrenia, prediabetes, overweight and treatment with antipsychotics. Questionnaires and interviews regarding psychotic symptoms, quality of life, medication adherence and physical activity will be applied either monthly or every third month.

Results

will not be ready for the congress. A poster outlining the feasibility challenges will be presented.

Conclusions

Perspective: Through weight loss, Semaglutide may indirectly be able to improve quality of life, medication adherence and psychotic symptoms.

Disclosure

No significant relationships.
Pharmacogenetic testing in schizophrenia in real clinical practice: before or after antipsychotic -induced adverse drug reactions development?
Authors: Abdyrakhmanova A. , Shnayder N. , Nasyrova R.
Published: September 2022

Introduction

Schizophrenia is socially significant mental disorder characterized by early onset and high time and financial expenditure on treatment. Antipsychotics (APs) are highly effective against positive and negative symptoms, but at same time have a wide range of adverse drug reactions (ADRs). APs efficiency and safety are variable and depend on characteristics of genetically determined mechanisms (transportation, biotransformation, and elimination).

Objectives

Investigation role of pharmacogenetic testing (PhGT) on example of clinical case of severe ADRs in 47-year-old woman with schizophrenia.

Methods

Patient’s medical history analysis; clinical observation; biochemical serum analysis; therapeutic drug monitoring; PhGT.

Results

The clinical case of a woman with schizophrenia who has been noted to be unresponsive to APs for some years after schizophrenia onset. She was found to be homozygous for nonfunctional SNVs CYP2D6*4 and CYP2C9*2, heterozygous for CYP1A1*2A, which was reason for complete shutdown of isoenzymes 2D6, 2C9 and 1A1 activity and development of ADRs in use of initial doses of several APs, as well as for an increase in severity of ADRs with schizophrenia positive symptoms aggravation with an even slower titration of APs daily dose not only with polytherapy, but also with monotherapy. So, not recommented APs for patient: aripiprazole, haloperidol, zuclopenthixol, cariprazine, quetiapine, paliperidone, risperidone, thioridazine, sertindole, asenapine, alimemazine, chlorpromazine, etc. (CYP2D6); haloperidol, clozapine, olanzapine, perphenazine, promazine (CYP2C9); carefully: haloperidol, olanzapine, perospirone (СYP1A1).

Conclusions

This rare case demonstrates PhGT importance before APs therapy, because the patient had very high risk AP – induced ADRs. She needed PhGt before APs use, but not after severe ADRs during 12 years.

Disclosure

No significant relationships.
A case report of Acute and transient psychotic disorder precipitated by Reiki practise
Authors: Danacı S. , Asdemir A.
Published: September 2022

Introduction

ATPD is defined in the ICD‐10 as a polymorphic, predominantly delusional, or schizophreniform psychotic condition characterized by an acute onset (≤2 weeks) and rapid remission (expected within 1–3 months), which is often associated with acute stressful life events. A woman in her 30s was brought to the emergency department in an acute psychotic state. Her mental health had deteriorated rapidly following her attendance to Reiki training two weeks ago (Reiki is a form of alternative medicine called energy healing). She presented as agitated, confused and had disorganised thoughts. She had paranoid, referential, misidentification and bizarre delusions.

Objectives

This paper reports the case of a 37-year-old woman with stress-induced new-onset psychosis instigated by Reiki practise.

Methods

A female patient is described who developed an acute and transient psychosis with polymorphic symptomatology after meditating. Physical examinations, paraclinical testing, and neuroimaging excluded an organic cause of symptoms.

Results

In this case, we wanted to present an example of acute and transient psychosis episodes in which individuals with low psychosis threshold experienced recipient factors such as insomnia, dopaminergic agent (modafinil), practising reiki and meditation.While the family history of the patient, fragile personality structure suggest that the threshold of psychosis may be low; physical fatigue, insomnia, which is common in all 3 episodes, may have triggered acute psychosis.

Conclusions

Our patient recovered completely within 1week after a brief admission and treatment with haloperidol. The real question here is whether the patient needs psychotropic medication for life.

Disclosure

No significant relationships.
Voices change my name
Authors: Vallecillo Adame C. , Jiménez Aparicio T. , De Andrés Lobo C. , Gonzaga Ramírez A. , Queipo De Llano De La Viuda M. , Guerra Valera G. , Santos Carrasco I. , Gonçalves Cerejeira J. , Rodríguez Rodríguez B. , Fernández Lozano M. , Mateos Sexmero M.J. , Navarro Barriga N. , De Uribe Viloria N. , Medina Ojeda G. , Rodriguez Andrés L.
Published: September 2022

Introduction

We present the clinical case of a patient where the psychotic clinic coexists with gender dysphoria. This scenario can be the result of a change in gender identity derived from the psychotic process or appear independently of it.

Objectives

We want to explain the importance of knowing how to act with a patient in whom these two processes coexist.

Methods

20-year-old woman, with no history of mental health. She comes to the emergency department for behavioral alteration. The family observes strange behaviors, unmotivated laughter, soliloquies and aggressive episodes. Abandonment of studies, hobbies and radical physical change. Delusions of prejudice and self-referential delusions. Possible phenomena of echo and diffusion of the thought. Auditory hallucinations talking to her in male gender, since then she presents doubts about her sexual identity and manifests her desire to change sex. Altered judgment of reality.

Results

During admission, we started treatment with an antipsychotic with good tolerance and she was referred to mental health team, where psychopharmacological treatment was adjusted with good response. In the following medical appointments the psychotic clinic disappeared at the same time that sexual identification was completely restored and made a critique of the behavior and experiences.

Conclusions

This case highlights the importance of assessing the chronology of symptoms, the patient’s criticality, the response to antipsychotic treatment and the need to exclude the psychotic background of the desire for gender reassignment before making a therapeutic decision.

Disclosure

No significant relationships.
Sexuality among elderly patients with dementia: Are we aware of their needs?
Authors: Santa Marinha L. , Nombora O. , Basto M. , Felgueiras P. , Horta A.
Published: September 2022

Introduction

Sexuality is one of the basic needs in human life and its positive effects for the wellbeing are undeniable. People with dementia, despite cognition and functioning impairments, still pursue intimacy as part of their expression of basic human instincts.

Objectives

We aim to address the subject of sexuality among patients with dementia, emphasizing the physiological, environmental and legal barriers.

Methods

We conduct a non-systematic review of recent evidence on dementia and sexuality, using PubMed/Medline database.

Results

People with dementia face several difficulties expressing their sexuality. First, they struggle with physiological barriers to enjoyment of sexuality, such as ageism, apathy and limited free mobility. Secondly, either at home or in long-term care facilities, privacy is usually abolished. For care facilities, the Sexuality Assessment Tool supports the normalization of sexuality and self-audit policies that promote resident rights for privacy and assistance. Moreover, expression of sexuality in elderly can be misinterpreted as disinhibition, leading to unnecessary use of psychotropics to cease these behaviors. Additionally, legal barriers regarding consent arise when a partner loses the ability to consent sexual activity, questioning agreement and mutual desire. The Lichtenberg and Strzepek Decision Tree for Capacity to Participate in Intimate Relationships can be helpful to address this issue.

Conclusions

Sexuality in older people remains neglected in clinical intervention. Besides the urgent need to deconstruct stereotypes, families and staff must be sensitized to understand the changes in expression and perception of sexuality among people with dementia, rather than being indifferent or medicate what can be perceived as disinhibited/distorted expressions of normal needs.

Disclosure

No significant relationships.
The original anticonvulsant meta-Cl-benzhydrylurea (m-CL-BHM) induces of the liver monooxygenase system and stimulates the neuroimmune response in behavioral disorders of alcoholic origin
Authors: Shushpanova Т. , Novozheeva T. , Gutkevich E. , Pustovaya A. , Garganeeva N. , Belousov M. , Podyablonsky A. , Markova E. , Knyazeva E. , Shushpanova O. , Kolomiets N. , Safronov S. , Boev R.
Published: September 2022

Introduction

The anticonvulsant m-Cl-BHM is promising for the pathogenetically directed thrapy does not cause negative effects.

Objectives

Investigation of the effect of m-Сl-BHM on “immunochemical homeostasis” in rats with experimental alcoholism.

Methods

m-Cl-BHM was injected at a dose of 100 mg/kg (1/20 LD50) for 5 and 30 days into the stomach of male Wistar rats who preferred alcohol according to the screening conditions and kept for 10 months. in free access to a 15% ethanol solution, which made up the group of “heavy drinkers” (HD). Phenobarbital was administered at a dose of 25 mg/kg (1/20 LD50).

Results

The features of the monooxygenase system of cytochrome P450 of the liver and ECT in the lymphoid organs of rats were studied at different periods of administration of m-CL-BHM -5 and 30 days. to HD rats. m-CL-BHM has an inducing effect on the monooxygenase system of the liver, causes phase changes in the lymphoid organs and ECT. Long-term administration of m-CL-BHM caused a depletion of the cellular composition of lymphoid organs, a decrease in ECT of spleen cells and peritoneal exudate, these changes were less pronounced compared with phenobarbital. The activation of the immune system inversely regulates the production of enzymes of the cytochrome system, since the concentration of low molecular weight targets is sharply reduced with the help of antibodies. m-Cl-BHM metabolites conjugated to endogenous macromolecules form a full-fledged stimulus for the immune system.

Conclusions

Neuroimmune response to the introduction of m-CL-BHM is significant in behavioral disorders associated with alcoholism and the correction of this condition.

Disclosure

No significant relationships.
Prevalence of Facebook Addiction in a Teenage Population: About 110 Cases
Authors: Faouel N. , Ben Soussia R. , Gharbi M. , Kacem M. , Haj Mohamed A. , Bouali W. , Zarrouk L.
Published: September 2022

Introduction

Facebook use among Teenagers has become a very common phenomenon. Its use can resuly in Facebook addiction .

Objectives

To estimate the prevalence of problematic Facebook use among a sample of school-going adolescents.

Methods

This is a cross-sectional and descriptive study carried out among 110 school-going adolescenthe at 2 state colleges in Sidi Bouzid. We used a pre-established self-questionnaire containing 2 parts: a part exploring the socio-demographic data of the adolescent and a psychometric part: Bergen Facebook addiction Scale.

Results

Study participants had a mean age of 14.4 years with extremes of 12 to 17 years. The sex ratio (M / F) (46/64) of the participants was 0.71.In our population, 13 students (11.8%) were smokers. Two students (1.8%) consumed alcohol. Cannabis use was noted in only one student.The majority of students (102), or 92.7%, had been online for more than a year.The daily Facebook connection time was more than 4 hours for 20.9%. Boredom was the number one reason for logging into Facebook for 82 students (74.5%) followed by curiosity for 45 students (40.9%). Fifteen students (13.6%) were addicted to Facebook (score> 10 on the Bergen Addiction Scale.

Conclusions

Facebook can be a useful and interesting tool to maintain and develop a network of relationships and create new ones. Its problematic use or addiction to Facebook has become a new scourge of public health. Faced with the negative impact of this addiction, It would be necessary to rationalize this use.

Disclosure

No significant relationships.
Cannabis and Cognitive Deficiency
Authors: Brahim S. , Henia M. , Haj Mohamed A. , Chetoui R. , Zarrouk L.
Published: September 2022

Introduction

Acute and chronic exposure to cannabis have been associated with neurocognitive deficits in executive function, including inhibitory control processes.

Objectives

To research memory deficiency in the young consumers of cannabis in Tunisia.

Methods

this is a transversal descriptive study conducted during two months (January and February 2020). The research involved about 137 participants in the emergency department at the university hospital of Mahdia

Results

In our study population, there was a noticeable male predominance of 71%. Hence, the age structure ranged between 18 years old and 35 years old. Among the latters, 65.9% were single, and 29.7% experienced school failure. In this sample, 23.2% had a psychiatric history. The average age of the first use of cannabis was between 18 and 25 years old in 70% of cases. Besides, a high percentage of association of other substances was found among cannabis users as follows: use of tobacco 74.6%, alcohol 72.5% ecstasy 41.3%, and cocaine 25.4%. The use of cannabis was considered as a means of indulgence for 66.7% of the study population, as an anxiolytic for 26.8%, and as a sedative for 23.9%. Additionally, the effect of cannabis use on working memory deficiency according to the functional impact assessment scale was: no deficiency in 19% of cannabis users, minimal in 34%, mild in 32%, moderate in 9%, fairly severe in 4%, very severe in 1%, and extreme in1% of cases.

Conclusions

The assumption of the effect of cannabis on memory and cognitive deficiency remains controversial and leads us to suggest further in-depth study of this subject.

Disclosure

No significant relationships.
Association between Psychiatric disorders & Substance use disorder in rehabilitation center of Islamabad: A cross-sectional study
Authors: Berkat A. , Abidi M.
Published: September 2022

Introduction

The prevalence of substance use disorder has rapidly increased recently. It is believed that the occurrence of mental disorders is strongly associated with substance use.

Objectives

To identify prevelance of different psychiatric mobidity & symptomatology as Comorbidity amon the diagnosed patients of Substance Use Disorder

Methods

This study was conducted from June till December 2021. A total of 486 PDUs were recruited for this study. A self-administered questionnaire was distributed among PDUs admitted at the Rehabilitation Centre during the period of the study. The questionnaire inquired about the demographic details of the PDUs, their substance history and the occurrence of any MDs.

Results

The mean age of the PDUs was 25.9 + 6.0 years. A total of (95%) men and (5%) women reported their gender. There were single (74.7%), married (23.1%), divorced (1.4%) and separated (0.7%) PDUs. A large majority of the PDUs (n = 159, 55.6%) had been using different drugs for more than three years. The various MDs reported among the PDUs were delusion (n = 100, 35.2%); paranoia (n = 51, 17.8%); mania (n = 36, 12.6%); depression (n = 156, 54.5%); (n = 100, 35.2%); auditory hallucinations (n = 73, 25.7%); visual hallucinations (n = 106, 37.3%) and anxiety (n = 46, 16.2%). Among 164 cannabis users, hallucinations (n = 35, 21.3%; p = 0.04) was the only significant MD.

Conclusions

Delusion and paranoia were amongst the most highly prevalent MDs reported. The occurrence of auditory hallucinations, mania and paranoia were significantly associated with cannabis, heroin and cocaine use, respectively.

Disclosure

No significant relationships.
Gambling disorder risk factors in a population of online sports betting players in Sfax
Authors: Ellouze A.S. , Ben Thabet J. , Maalej M. , Feki R. , Gassara I. , Smaoui N. , Omri S. , Zouari L. , Charfi N. , Maalej M.
Published: September 2022

Introduction

Online sports betting (OSB) is frequently associated with gambling disorder (GD). In Tunisia, no study on this has been done so far.

Objectives

To detect GD in a population of Tunisian OSB players, and to identify its risk factors.

Methods

This was a cross-sectional study of 58 male OSB players in the city of Sfax. The GD was assessed by a questionnaire relating to the DSM-V criteria. Depression, anxiety and stress were assessed using the DASS scale, gambling motivations using the GMQ-F scale, and impulsivity using the UPPS-P scale.

Results

The mean age was 37.4 ± 8.29 years. The prevalence of JAP was 53.4%. On univariate analysis, the factors associated with GD were university level of education, the practice of other gambling, daily gambling, gambling spending > 300 Dinars / month , gambling duration > 3 years, the frequency of winning >1 win /6months , the occurrence of a Big Win, total GMQ-F score, coping motivation , and financial motivation. In the multivariate study, GD risk factors were gambling spending > 300 Dinars / month (p = 0.011; ORa = 223.16), financial motivation (p = 0.022; ORa = 3.967), pathological stress (p = 0.036; ORa = 224.388) and inversely associated with the age at onset of gambling (p = 0.026; ORa = 0.751) and the UPPS score (p = 0.011; ORa = 0.6).

Conclusions

Our results push us to deepen our knowledge and our studies concerning this problem in our country and to reflect on the management and prevention measures.

Disclosure

No significant relationships.
Perception of current life situation and coping strategies in patients at the Narcological Clinic in Azerbaijan
Authors: Bityutskaya E. , Baghirova-Karimli N. , Lebedeva N.
Published: September 2022

Introduction

Studies show that coping skills are factors in successful rehabilitation.

Objectives

The research is aimed to study the drug users` perception of the current life situation and their coping strategies.

Methods

Patients at the Free Narcological Clinic in Azerbaijan (n=46; 37 men, 9 women, aged 18 to 59) participated in our study after 10-12 days (stage 1) of a rehabilitation program. We used a structured interview, projective drawings (“The image of change”, “My difficult life situation”), and a questionnaire, “Appraisal Criteria of the Difficulty of a Life Situation”. The control group consisted of 35 non-drug users. Content analysis and t-test were used.

Results

While the majority of patients (77%) failed to describe any coping strategy they use in difficult life situations, all of them assessed their difficult life situation as under control—an outlook that was significantly more optimistic than the evaluation of the control group (р=0.009). The most frequently mentioned life goals were avoiding the problem (39%) and regaining health (37%). However, analysis of obstacles to achieving life goals shows that 49% of drug users mentioned no obstacles or indicated that “there are no obstacles”. Drug addiction as an obstacle is mentioned in only 4% of the responses; “environment of drug addicts” occurs as the main obstacle in 20%.

Conclusions

Drug users in stage 1 of the rehabilitation program have an unrealistic sense of control, few coping strategies, and do not perceive drug addiction as posing а serious obstacle to achieving their life goals. Funding: The study was funded by RFBR, project number 20-013-00838.

Disclosure

No significant relationships.
The impact of gaming addiction on Health-Related Quality of Life in adults
Authors: Neily C. , Maalej M. , Gassara I. , Feki R. , Smaoui N. , Zouari L. , Ben Thabet J. , Omri S. , Charfi N.
Published: September 2022

Introduction

Although gaming addiction has received a great deal of attention from researchers, few studies have evaluated its effect on health related quality of life in adults

Objectives

To study the relationship between gaming addiction and perceived health status

Methods

We conducted a cross-sectional, descriptive and analytical study.Data were collected using a self-administered questionnaire on social networks targeting adults between 18 and 40 years. We used the gaming addiction scale (GAS) in its validated Arabic short version. we also used the 36-Item Short Form Health Survey questionnaire (SF-36) in its validated Arabic version

Results

One hundred and nine participants were included. The mean age was 29.6 ±10.3. Males accounted for 60.6% of the study population. A history of anxiety or depression was found in 4.6 % of participants and 3.6% had an organic affection .The mean GAS score was 13.11± 6.08. According to this scale, 25.7% were addicted gamers. We found a significant difference between the group of participants considered addicts and those who were not in the following items: vitality (p=0.002), mental health (p=0.004) and role limitation due to emotional health (p=0.05). We found a correlation between the GAS score and role limitation due to physical problems ( p= 0.41), role limitations due to emotional problems (p=0.004 ), vitality( p=0.005) and mental health ( p= 0.001).

Conclusions

Our data showed significantly lower health related quality of life related to higher exposure to games especially in the psychological health.In future researches, the effect of gaming addiction on other domains of quality of life can be investigated

Disclosure

No significant relationships.
Gender differences in a clinical sample of 60+ year old patients receiving treatment for alcohol use disorder
Authors: Tryggedsson J. , Andersen K. , Bogenschutz M. , Nielsen A.
Published: September 2022

Introduction

Gender differences have been found in treatment-seeking older adults with AUD, concerning areas such as quality of life, drinking patterns, and prevalence of AUD. However, little is known about how these gender differences may relate to treatment.

Objectives

To investigate gender differences in quality of life, problematic areas at treatment start, and subsequent choice of treatment, in a clinical sample of 60+ year old patients receiving treatment for AUD.

Methods

We will utilize data from the Elderly Study; a multi-national (USA, Germany, and Denmark), single-blind randomized controlled trial. Participants (n=693) were randomized to brief, outpatient treatment based on motivational enhancement therapy alone (4 sessions) or motivational enhancement therapy followed by a community reinforcement approach age-adapted to older adults (up to 8 sessions). The latter was a module-based treatment where participants chose which module(s) they deemed most relevant. Modules focused on coping with aging, building sober networks, mood management, etc. The gender differences at baseline will be described by means of descriptive statistics (e.g. one-way analysis of variance, χ2 statistics, etc.). Gender differences, including choice of modules, will be investigated by means of multivariate statistics, e.g. generalized linear models. Analyses will be controlled for relevant confounders such as age, country, education, work situation, marital status, family and friends, type of housing, etc.

Results

Will be presented at the EPA Congress.

Conclusions

Will be presented at the EPA Congress.

Disclosure

No significant relationships.