bluuebunny/crossref_metadata_2025 huggingface dataset:
Anticipatory competence of adolescents with movement disorders in the prevention of deviations
Authors: Akhmetzyanova A. , Artemyeva T.
Published: August 2024

Introduction

Anticipation is the most valuable component of the regulatory side of human behavior. Adolescence is a sensitive period in relation to the formation of an anticipatory and prognostic system, which in turn provides an opportunity to assess causal relationships and evaluate the consequences of actions taken.

Objectives

Study of the anticipatory viability of adolescents with long-term disorders in the prevention of deviations.

Methods

The study involved 46 adolescents aged 11-15 studying at a specialized boarding school for children with disabilities. The observational method was used as well as the author’s methodology “Studying the anticipatory solvency of adolescents” Akhmetzyanova A.I., Artemyeva T.V.; “Diagnostic questionnaire for identifying propensity to various forms of deviant behavior for students of educational institutions” developed by the Department of Psychiatry of the Military Medical Academy named after S.M. Kirov.

Results

The subjects had difficulty predicting the passage of time, with its adequate and rational distribution, including planning their own activities. Adolescents with musculoskeletal disorders had difficulty making a pragmatic and realistic forecast of possible events in communication with other people, as well as predicting the emotional states of interaction participants. Adolescents with movement disorders were characterized by an inadequate assessment of themselves as a subject of professional activity, fixation on the movement disorder, and high levels of anxiety and neuroticism. The subjects showed a tendency to suicidal behavior due to risk factors such as high levels of anxiety associated with self-esteem and anxiety in interpersonal relationships, high affectivity and demonstrativeness, social pessimism and negative prediction of the future. During the correlation analysis, the relationship between spatio-temporal and speech-communicative anticipatory consistency with indicators of deviant behavior - delinquent behavior and deviant behavior was revealed.

Conclusions

The data obtained in the study will allow specialists to timely identify and prevent the development of deviant behavior, as well as build a route for correctional classes with each child.. This paper has been supported by the Kazan Federal University Strategic Academic Leadership Program.

Disclosure of Interest

None Declared
Philosophy of transcendental cinema and its applications in psychiatry. The case of lost highway by david lynch
Authors: Nowocień J. K. , Szejko N.
Published: August 2024

Introduction

Thanks to Paul Schrader, transcendental cinema was distinguished from the slow cinema trend. What distinguishes it from it are the precise psychological portraits of the characters and the aptly reproduced world of internal experiences. Transcendental cinema draws from the philosophy of existentialism, presenting the assumptions of the human psyche. In D. Lynch’s cinematography, we can find faithful representations of mental disorders, such as dissociative fugue, depersonalization, mania or psychosis. Based on the “Lost Highway” (1997), we will prove that D. Lynch, with his cinematography, not only provides knowledge about mental disorders, but also gives patients humanity and dignity. The series also resembles a meditation session in the style of mindfulness, which, when practiced, helps a person affected by mental illness in his recovery process.

Objectives

The aim of this work is to indicate the accurate record of the inner characters’ experiences in D. Lynch’s cinematography, which provides us with knowledge about mental disorders of an individual. By creating a visual image that affects many senses, transcendental cinema sensitizes us and makes us aware of the suffering of a patient affected by mental disorders. The session, while drawing on the philosophy of mindfulness, becomes a meditative session, therapeutic for both us and the protagonist.

Methods

In this research we use the approach proposed by Paul Schrader and David Lynch to analyze analyze transcendental cinema as an art that combines philosophy, cinematography and psychiatry. As a representation of the experiences of a person outgoing the therapy basen on psychoanalysis.

Results

Many studies indicate the positive impact of mindfulness meditation on physical and mental health. Through long scenes, transcendental cinema draws attention to individual stimuli reaching our body, non-judgmental noticing them, focusing on one thought and one sensation, draws from the philosophy of mindfulness, becoming a meditative session in itself. Therefore, a film screening provides us with knowledge about the internal experiences of a psychiatric patient, indicates the form of therapy and at the same time leads us through a therapeutic meditation session.

Conclusions

We believe that the transcendental cinema represented by David Lynch can be treated not only as a representation of mental disorders and the suffering associated with them, but also as a meditative, healing and liberating session. Not only for the person affected by the disorder, but also for us as viewers.

Disclosure of Interest

None Declared
Quality of life in children and adolescents with beta thalassemia
Authors: Tsagkou A. , Evangelou E. , Vlachou E. , Zartaloudi A. , Dousis E. , Dafogianni C. , Polikandrioti M. , Koutelekos I.
Published: August 2024

Introduction

Children and adolescents with thalassemia suffer from chronicity of the disease and its treatment, including transfusion dependence and complications of iron overload.

Objectives

To investigate the quality of life of children and adolescents with Beta Thalassaemia.

Methods

This study is a cross-sectional study conducted at the Greek public Children’s Hospital. PedsQL ™ 4.0 Generic Core Scale (Greek version) was used to evaluate HRQOL in 41 thalassemia patients aged between 5 and 18 years and in 41 healthy controls of the same age range. For the analysis, the Statistic Package (SPSS ver.24) was used. Using Spearman’s correlation coefficient, t-test and MannWhitney tests were used, while for variables with three or more levels the Anova and Kruskall-Wallis. In order to investigate the relationship between two quantitative variables, Spearman’s correlation coefficient was used, while the relationship between two qualitative variables was used to control x2. As a statistical significance level, α = 5% was defined.

Results

Of the 41 children with beta Thalassemia who participated in the study, 48.8% (n = 20) were boys and 51.2% (n = 21) girls. The mean age of children was 10.02 ± 4.10 years. For healthy children who participated in the study 51.2% (n = 21) were boys while 48.8% (n = 20) were girls. The mean age of the children was 9.63 ± 3.77 years. Children with Beta Thalassaemia have a lower quality of life in Physical Health and Activity(<0,001), Emotional Health(0,031), School Activities(0,008), Psychosocial Health(0,014), and the overall PedsQL 4.0 (<0,001)questionnaire compared to healthy children. Children between the ages of 5 and 7 have higher levels of quality of life in physical health and activity than older children(<0,001). In addition, children aged 5 to 7 have higher quality of life and overall PedsQL 4.0 score than older children(0,033) Children receiving combination therapy show better quality of life than children receiving subcutaneous therapy (total PedsQL 4.0 <0,001).

Conclusions

Children and adolescents in all five categories had a better quality of life, after improved iron chelating methods and other psychosocial interventions.

Disclosure of Interest

None Declared
Evaluation of adherence to treatment in patients with anxious-depressive syndrome.
Authors: Jiménez Aparicio T. , Fernández Lozano M. , Merizalde Torres M. , Rodríguez Campos A.
Published: August 2024

Introduction

Treatment-resistant depression can pose a major challenge to mental health professionals, both in identifying cases and in devising consequent therapeutic strategies (1). However, it is not uncommon that the lack of response to antidepressant treatment is actually due to non-adherence to it in many cases (2).

Objectives

In this context, it would be interesting to know the rate of abandonment of antidepressant treatment in patients with anxious-depressive symptomatology, since the patient’s evolution may depend entirely on this.

Methods

To this end, the psychiatry service of the Hospital Clínico Universitario de Valladolid has collected data on adult patients who come for a first consultation in the mental health team, referred for presenting symptoms of anxiety and depression.

These data have been recorded over the last 2 years, including different socio-demographic and clinical variables. Subsequently, a descriptive analysis was carried out, the preliminary results of which are presented below.

Results

We started from a sample of 222 patients at the present time: 69 men and 153 women, which is in accordance with previous data on the prevalence of anxiety disorders and depression by gender (3).

Antidepressant treatment was prescribed (from psychiatry or primary care) in 80% of them. A review 6 months later showed that up to 1/3 of these patients (34%) had abandoned treatment on their own before completing this period, as can be seen in the first graph (image 1), which is contemplated in several guidelines and recommendations in the scientific literature (4). No major differences were observed between genders for treatment indication or treatment abandonment.

On the other hand, 61% of the patients in the sample had been treated with benzodiazepines. Among them, up to 74% were still taking these drugs 6 months later (image 2). This result is striking, since in reality, the duration of treatment with benzodiazepines should be much shorter, according to the latest reviews (5).

Finally, cross-checking these data, it was observed that for 116 patients (52% of the total) the initial treatment included antidepressants and benzodiazepines. At 6 months, 18 of these patients (16%) had voluntarily discontinued the antidepressant, but continued with benzodiazepines.

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Image 2:

Conclusions

It is very important to review adherence to treatment in all patients, especially in those cases in which the persistence of symptoms makes us think of a possible resistant depression. For this reason, it would be advisable to try to establish an adequate doctor-patient relationship that allows trust in the therapist and communication between both and leads to a favorable evolution.

Disclosure of Interest

None Declared
The Nefashot Initiative’s Journey: Transforming from Local Activism into a Diverse Community Promoting Mental Health through Arts and Culture
Authors: Regev S. , Diller R.
Published: August 2024

Introduction

Nefashot, meaning ‘Souls’ and ‘People’ in Hebrew, emerged from a local group of impassioned activists. Our core mission is to promote mental health awareness through cultural and artistic expressions, bridging gaps in open and inclusive conversations.

Objectives

In our early years, our primary goal was to infuse MH discussions into public spaces through art. However, as our community has evolved, so too have our objectives. Today, we recognize the profound impact of these connections and discussions, both within and beyond our dynamic community. We’ve come to understand that belonging to this community is, in itself, a catalyst for change. This shift in perspective has allowed us to fully embrace the transformative potential of community engagement and direct our activities.

Methods

At the heart of our approach is the nurturing of a profound sense of belonging within our diverse community. We achieve this through two vital activities: (1) Ongoing Community Communication: Within our dynamic community, which includes individuals dealing with mental health challenges, professionals, family members, friends, and allies, communication is paramount to our unity. We maintain an open and continuous dialogue through a dedicated WhatsApp group. This platform facilitates connection, sharing of experiences, and mutual support, strengthening the bonds that unite us in our shared mission. (2) Community-Driven Event Production: Beyond our annual ‘Osim Nefashot’ week, held around World Mental Health Day, we seize opportunities throughout the year to organize events or collaborate with larger events like International Women’s Day in March or Book Week in June. Encouraging active participation in event planning and execution not only amplifies the voices of our members but also deepens their sense of belonging within our ever-evolving community.

Results

Our hallmark is a sustainable process, welcoming new creators, forging connections, and expanding our influence while retaining core members. This renewal and continuity enable us to reach new audiences and expand mental health awareness through art and culture. Our growth is showcased, with 90 events organized last year.

Conclusions

Nefashot’s transformation from activists to a diverse community is an ongoing journey requiring commitment and deliberate steps. Our allocated resources and activities ensure each participant, from creators to venues to attendees, plays a vital role in advancing mental health awareness. We remain dedicated to nurturing inclusivity and promoting mental well-being through art and culture.

Disclosure of Interest

None Declared
Variables Predicting Psychological Help Seeking Attitudes: Self-Stigma, Mental Health Literacy, and Depression/Anxiety
Authors: Gündoğdu H. , Aslan K. , Ayhan H. C. , Aktaş C. M.
Published: August 2024

Introduction

Psychological help-seeking attitudes are influenced by various factors, including self-stigma, mental health literacy, and levels of depression and anxiety. Several studies have examined the relationships between these variables and help-seeking attitudes, shedding light on the predictors of seeking psychological help. Self-stigma, or the internalization of negative attitudes towards seeking psychological help, has been found to significantly impact help-seeking attitudes. Individuals who experience higher levels of self-stigma are more likely to hold negative attitudes towards seeking help. Additionally, mental health literacy, which refers to knowledge and understanding of mental health issues, has been identified as another important predictor of help-seeking attitudes. Individuals with higher mental health literacy are more likely to have positive attitudes towards seeking psychological help. Depression and anxiety, two common mental health concerns, have also been found to influence help-seeking attitudes. Research has shown that individuals with higher levels of depression and anxiety symptoms are more likely to express intentions to seek counseling for psychological and interpersonal concerns. These mental health concerns can serve as motivators for individuals to seek professional help. Furthermore, cultural and demographic factors can also play a role in shaping help-seeking attitudes.

Objectives

This study was planned to examine the variables predicting psychological help seeking attitudes: self-stigma, mental health literacy, and depression/anxiety

Methods

The sample of the study was determined by purposive sampling method. The study was conducted with individuals who willing to participate the study and above 18 years age.

Individuals who saw the online advertisement and click on the study’s link were be brought to the study’s home page on Online Surveys. Should they wish to proceed, they will be brought to an information page detailing the purpose of the study, how their confidentiality and anonymity will be preserved and how their data will be treated.

Socio-Demographic Data Form, Mental Health Literacy Scale, Self-Stigma of Seeking Psychological Help Scale and Attitudes Towards Seeking Psychological Help Scale were used. Data analyses was planned to run via Statistical Package for the Social Sciences version, 27.0.

Results

The analysis of the data is still ongoing in detail by the researchers. The findings and relational implications of the study will be presented.

Conclusions

In conclusion, self-stigma, mental health literacy, and levels of depression and anxiety are important variables that predict psychological help-seeking attitudes. Understanding these factors can inform the development of interventions and strategies to promote help-seeking behaviors and reduce barriers to seeking psychological help.

Disclosure of Interest

None Declared
Physical activity and self-esteem in domestic and foreign medical students
Authors: Nikolaev E. , Zakharova A. , Dulina G. , Hartfelder D. , Petunova S. , Grigorieva N. , Lazareva E. , Maksimova N. , Litvinova E. , Vasilieva E. , Fakhraei S. S.
Published: August 2024

Introduction

It is a well-known fact that regular physical activity (PA) has a positive effect on a person’s somatic health. Does PA have similar correlations with self-esteem in medical students of different cultural backgrounds?

Objectives

To determine the intensity and correlations of PА and self-esteem in domestic and foreign undergraduate medical students

Methods

We carried out a survey of 305 domestic and 241 international medical students of both genders at Ulianov Chuvash State University. For this aim we used the Sociocultural Health Questionnaire (E. Nikolaev)

Results

We have established that with the same duration of the sessions the average frequency of physical activity (PA) of foreign medical students is higher than that of domestic students (p=.001). The latter more often exercise in gyms (p=.001) and consume bodybuilding supplements (p=.01). Foreign medical students’ self-assessment of their health (p=.001) and sportiness (p=.001) is higher than that of domestic students (7.90 vs 6.98 и 6.72 vs 5.82 correspondingly). Higher frequency of PA correlates in domestic medical students with higher self-assessment of their successfulness (r=.47), attractiveness (r=.46), and confidence (r=.43); while in foreign students – of their sportiness (r=.49), confidence (r=.25), sociability (r=.23). Longer sessions of PA by domestic medical students are interrelated with higher self-assessment of their intellect (r=.35), confidence (r=.34), happiness (r=.34); while in foreign students – of sportiness (r=.47), health (r=.36), and successfulness (r=.36).

Conclusions

The revealed data testify to the fact that PA of both domestic and foreign medical students closely correlates with positive assessment of their own personality.

Disclosure of Interest

None Declared
Interleukin-15: a possible link between anorexia nervosa and schizophrenia
Authors: Lederer P. , Mihaljević-Peleš A. , Begovac I. , Tripković M.
Published: August 2024

Introduction

Interleukin-15 is a cytokine that induces or enhances differentiation, maintenance, or activation of several T-cell subsets (including NK, NKT, Th17, Treg, and CD8+ memory cells) and also plays an important role in regulating visceral (intra-abdominal or interstitial) fat breakdown and myofibrillar protein synthesis (hypertrophy). It is also involved in modulating serotonergic activity in the brain by modulating the transmission of GABA and serotonin, which may be the basis for mood and memory disorders, as well as activity levels, sleep, and thermoregulation. Both anorexia nervosa (AN) and schizophrenia (SCH) represent two distinct and serious psychiatric disorders in which some of these symptoms may overlap and where neuroinflammation plays an important role which is yet to be precisely determined.

Objectives

This article summarizes recent findings and highlights interleukin-15 as a possible link between anorexia nervosa and schizophrenia.

Methods

A review of the current literature in the field of psychoneuroimmunology.

Results

In recent years, research has shown elevated levels of IL -15 in the serum of patients suffering from anorexia nervosa and schizophrenia.It is also interesting to note that IL -15 has structural similarities to IL -2, which previous studies have also shown to be elevated in patients with schizophrenia.

Conclusions

These associations, so far suggesting an important role of inflammation and its mediators, need further investigation in light of possible genetic overlap between anorexia nervosa and schizophrenia identified in genome-wide association studies (GWAS).

Disclosure of Interest

None Declared
Going through the adolescence with disabled sibling: resilience as a protective factor for the occurrence of internalizing and externalizing disorders in adolescents
Authors: Lipowska M. , Łada-Maśko A. , Lipowska K. , Sajewicz-Radtke U. , Radtke B. M.
Published: August 2024

Introduction

Presence of the disabled child in the family poses many challenges for their siblings, especially in adolescence. Children with disabled siblings often receive less attention from family and friends, experience a sense of injustice and anger towards sick siblings, as well as they are more likely to experience various somatic complaints and higher levels of depression and anxiety. However, research shows that resiliency could be a protective factor associated with the functioning of children and adolescents in certain life events, such as sibling’s disability, referring to good adaptation despite facing emerging adversities.

Objectives

Therefore, the aim of the current study was to examine the role of resilience as a possible protective factor for the occurrence of internalizing and externalizing disorders in adolescents having disabled sibling.

Methods

175 diads of a healthy adolescent and one of its parents (N = 350) participated in the study. Participants were divided into two groups - 119 diads in the group with disabled sibling (Madolescent’s age = 16.70; SD = .66) and 56 diads in the group with a healthy sibling (M adolescent’s age = 16.64; SD = .75). The following measures were used in the study: Resilience Measurement Scale (SPP-18) and Child Behavior Checklist for Ages 6-18 (CBCL/6-18).

Results

The results showed no statistically significant differences in any of the measured resilience factors (optimistic attitude and energy, persistence and determination in action, sense of humor and openness to new experiences, personal competences and a tolerance for negative affect), in adolescents with disabled sibling, comparing to the control group. However, adolescents with disabled sibling were found to have a significantly higher risk of the occurrence of both, externalizing and internalizing disorders compared to adolescents with healthy siblings. Furthermore, findings of the study also confirmed that personal competences and a tolerance for negative affect predicts lower risk of the occurrence of internalizing disorders in adolescents having disabled sibling.

Conclusions

Our findings highlights that resilience may have important role in reducing the risk of the clinical problems occurrence in adolescents having disabled sibling. Therefore, comprehensive psychological support enhancing their personal growth and competence should be provided in the above group.

Disclosure of Interest

None Declared
False-Positive Urine Drug Screening in a Patient on Quetiapine
Authors: Ying J. , Tan M. Y. G.
Published: August 2024

Introduction

Urine drug tests are commonly used in psychiatry settings, mainly for the purpose of screening for substance abuse and excluding drug-induced psychiatric disorders. When carefully interpreted, these tests offer critical information for clinical judgement. However, certain psychotropic medications can trigger false-positive results in common urine drug screenings. For example, aripiprazole has been reported to cause false-positive urine amphetamine test results, and haloperidol has been associated with false-positive urine drug tests for lysergic acid diethylamide (LSD). It is clinically significant to recognize some false-positive urine drug results and interpret certain results cautiously in clinical settings.

Objectives

We present a case of false-positive urine drug screening for tricyclic antidepressant (TCA) in a patient on quetiapine and aim to highlight the importance of accurate result interpretation in urine drug tests.

Methods

Details of the case were described. Information was gathered based on medical records.

Results

Mr. A, a 25-year-old construction worker, first presented at our hospital’s emergency room on a Saturday in January 2023. He was brought by the police because he was aggressive and mentioned his colleagues were monitoring him. Being a foreigner, he did not have any prior medical records in our hospital. Urgent blood tests were performed, and organic causes were ruled out. He was started on quetiapine and lorazepam in the emergency room and was then admitted to our hospital.

A urine drug test was ordered on the following Monday, the third day of his admission. Surprisingly his urine drug screening revealed positive results for TCA and benzodiazepines. Initially as the patient was psychotic and could not give reliable history, we considered a few differential diagnoses, such as schizoaffective disorder and major depressive disorder with psychotic features, based on the presumption that TCA had been prescribed by the psychiatrist in Mr. A’s home country. After further treatment, Mr. A became less psychotic and was able to share that he had a past psychiatric history of schizophrenia, but he had stopped antipsychotic medications four months ago.

Conclusions

This case report described a false-positive urine drug test for TCA while the patient was taking quetiapine. In this case, initially other diagnoses, such as schizoaffective disorder, were considered based on the incorrect assumption that patient was taking TCA.

False positive urine drug results can be confusing and misleading for clinicians. This report underscores the possibility of such false positives arising from quetiapine and emphasizes the critical importance of careful result interpretation.

Disclosure of Interest

None Declared
A case of delirium following treatment with low dose mirtazapine and pregabalin
Authors: Manolis T. A. , Argyropoulos D. , Kokras N. , Politis A. M.
Published: August 2024

Introduction

Pregabalin is a gamma-aminobutyric acid analogue used for the treatment of neuropathic pain, partial-onset-seizures, fibromyalgia, and anxiety disorders. Mirtazapine is an atypical antidepressant used in major depression and often prescribed off-label for insomnia. Delirium, an acute confusional state, is a very rare adverse reaction of both medications.

Objectives

We report a case of an elderly patient treated with low dose pregabalin and mirtazapine who developed drug-induced delirium which resolved rapidly upon withdrawal of both drugs

Methods

A 75-year-old woman was admitted for symptoms of anxiety, various bodily complaints (dysphagia, headache, tinnitus, weakness) and sleep-onset insomnia over the preceding 2 months. On admission, examination revealed an apparently anxious, uneasy and emotional looking patient. Mini mental state examination, as well as clock drawing and copying were normal, suggesting absence of cognitive impairment. Physical examination was unrevealing except for high blood pressure recordings (150/90 mmHg). Laboratory testing indicated creatinine at 1.19 mg/dl, with a creatinine clearance moderately decreased at 38 ml/min. Upon admission, she was placed on pregabalin 25 mg bid and mirtazapine 30 mg ¼ tablet qd.

Results

Three days after admission, pregabalin was increased to 25 mg tid. On the same day and about 2 hours after the night dose, the patient acutely developed delirium: she presented confusion, disorientation, incoherence, restlessness and deterioration of her anxiety. On physical examination she was afebrile with no hypertonia or ataxia. An urgent brain magnetic resonance imaging was grossly unrevealing. Pregabalin and mirtazapine were discontinued, as a drug-induced delirium was suspected. She received as a symptomatic treatment lorazepam progressively up to 4 mg qd. Symptoms of delirium resolved rapidly, and she was discharged days later with full functional recovery

Conclusions

Cases of delirium have been described following treatment with pregabalin, but in significantly higher doses. Pregabalin relies heavily on renal clearance for its excretion and the dose should be adjusted in patients with creatine clearance below 60 ml/min. As our patient had a moderate decrease in renal clearance, we prescribed a dose within suggested limits, but in combination with mirtazapine led to the appearance of a drug-induced delirium. In conclusion, combined therapy with low-dose pregabalin and mirtazapine seems to account for the development of delirium in our patient as based on its temporal association with the initiation of this drug combination and its prompt resolution upon withdrawal of these two agents

Disclosure of Interest

None Declared
Risperidone Induced DRESS Syndrome: A case report
Authors: Ilgin S. E. , Yanartaş Ö. , Akça E.
Published: August 2024

Introduction

DRESS (Drug Reaction with Eoshinophilia and Systemic Symptoms) syndrome, also called DIHS (Drug-Induced Hypersensitivity Syndrome) is a rare drug-induced systemic hypersensitivity reaction that can be potentially life-threatening (Choudhary et al. J Clin Aesthet Dermatol 2013; 6 -7). Risperidone is an antipsychotic drug with significant antagonist activity at the 5-HT2 and the D2 receptors. It has been reported that risperidone may be effective in controlling agitation, delusion, hallucination, and withdrawal behavior in geriatric patients (Yunusa & El Helou. Front Pharmacol 2020;11:596).

Objectives

The aim of this study is to demonstrate the case of developed DRESS syndrome following the use of risperidone.

Methods

The 81-year-old female patient was admitted to the Dermatology Clinic due to skin rash, high fever and leukocytosis following the use of risperidone. The patient was consulted to Psychiatry.

Results

In her history it was determined that risperidone 0.5 mg/d was started to the patient with depression due to agitative symptom. On the 4th day of treatment, targeoid lesions, starting from the back and spreading first to the trunk and then to the extremities, were observed. Further laboratory examinations revealed that the fever was measured at 39.5 C°, liver enzymes were elevated (ALT= 119 IU/ lt, AST= 124 IU /lt), and significant leukocytosis (WBC =12.000) was present along with the lesions. The patient was planned to be hospitalized to Dermatology Clinic on the 5th day and risperidone was stopped. The patient’s agitation increased and following the risperidone discontinuation thereupon the lesions tended to fade and desquamation began. After the treatment of the DRESS syndrome, aripiprazole was given to the patient for agitative symptom. The level of agitation symptoms decreased, and the patient tolerated aripiprazole well without any observed side effects.

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Conclusions

When initiating medication for the elderly population to address agitation, considering such rare side effects can prevent the patient from being hospitalized due to DRESS syndrome. To the best of our knowledge, this is the first case report associated with DRESS syndrome and risperidone treatment thus, it is necessary to be very careful when starting psychotropic medication for elderly patients.

Disclosure of Interest

None Declared
Multicausal disruption of complement system activity in schizophrenia: abnormal transcription of C4, complement control proteins and microglia specific genes in brain and blood
Authors: Rey R. , Fiorito A. , Ibrahim E. C. , Fakra E. , Sescousse G. , Tamouza R. , Leboyer M.
Published: August 2024

Introduction

The synaptic pruning process is based on the joint action of the complement system and microglia. In schizophrenia, accumulating evidence support that abnormal synaptic pruning during adolescence may be due to an altered Complement system activity. While this hypothesis is supported by C4 overexpression in various brain regions of individuals with schizophrenia, such alterations should be replicated and extended to other brain regions. Moreover, transcriptional studies of genes encoding regulators of the complement system activity (complement control proteins, CCP) and microglia-specific genes are lacking. Furthermore, it remains unknown whether brain and peripheral expression of such genes are related.

Objectives

To explore expression of C4 as well as 4 CCP encoding genes and 10 microglia-specific genes at the brain and peripheral levels in individuals with schizophrenia as compared to healthy controls.

Methods

We analyzed candidate gene expression from 9 Gene Expression Omnibus datasets obtained from 333 individuals with schizophrenia and 306 healthy controls (HC). We first compared expression of the candidate genes between individuals with schizophrenia and HC in postmortem brain samples from 7 different brain regions. Then, the same comparison was made in 4 different peripheral tissues.

Results

Regarding the complement system, we observed C4 overexpression in the DLPFC, parietal, temporal cortex and associative striatum of individuals with schizophrenia. We report distinct altered expression patterns of CCP genes in the DLPFC, hippocampus and cerebellum of individuals with schizophrenia. Only CD46 expression was altered in the blood of individuals with schizophrenia. Regarding microglia, we report an underexpression of several microglia-specific genes in the cerebellum, associative striatum, hippocampus and parietal cortex of individuals with schizophrenia vs. HC. At the peripheral level, we observed a mixed altered expression pattern in the whole blood of individuals with schizophrenia.

Conclusions

Firstly, our results suggest that the CCP-mediated regulatory mechanisms of the Complement system are impaired in the brain of individuals with schizophrenia, potentially contributing to an excessive Complement system activity (CSA). Secondly, our results support the hypothesis of a widespread underexpression of microglia-specific genes in brain tissues of individuals with schizophrenia. Functionally, the observed transcriptional alterations may be related to the synaptic pruning impairment. Alternatively, they may translate a compensatory mechanism for neuroinflammation. In the whole blood, the altered transcriptional pattern may represent a potential peripheral signature of SZ.

Disclosure of Interest

None Declared
Synchronization of accelerated intermittent Theta-Burst-Stimulation (aiTBS) with VNS in difficult-to-treat depression (DTD)
Authors: Kavakbasi E. , Klass S. B. , Baune B. T.
Published: August 2024

Introduction

Patients with difficult-to-treat depression (DTD) need multimodal treatment with combination of psychotherapy, pharmacotherapy and neuromodulation. In severe cases, combination of neuromodulatory techniques may be considered to achieve symptom relief.

Objectives

To describe a novel treatment approach, which combines VNS in synchronization with accelerated intermittent Theta-Burst-Stimulation (aiTBS) over three weeks in two cases with difficult-to-treat depression.

Methods

In this presentation we describe two cases of DTD, which have been implanted with VNS and did not respond to aiTBS previously. Patients then were offered a synchronized treatment regimen, where each stimulus train of aiTBS was synchronized with ON-time of VNS. To start each train simultaneously with VNS ON-time, we set treatment cycle of each aiTBS and VNS to 19 sec. Patients received 2400-3000 TBS pulses daily for 3 weeks over left dorsolateral prefrontal cortex (DLPFC) at 100% of resting motor threshold.

Results

In the first patient the MADRS score decreased from 37 to 26 (-30%) and in the other patient there was a decrease of MADRS score from 20 to 9 (-55%), which corresponded to remission after 3 weeks of treatment. The synchronized treatment procedure was well-tolerated in both cases. As both patients experienced significant improvement, we planned maintenance treatment in both cases.

Conclusions

Synchronization of aiTBS with VNS is a novel treatment approach in patients with DTD, which can lead to improvement even if patients previously did not respond to aiTBS without synchronization with VNS.

Disclosure of Interest

None Declared
Attitudes and Perceptions of Early-Career Psychiatrists Towards Electroconvulsive Therapy (ECT) in Poland: A Call for Enhanced Training and Guidelines
Authors: Gołębiewska M. E. , Wilkowska A. , Cubała W. J. , Pinto da Costa M.
Published: August 2024

Introduction

In Poland, the therapeutic modality of Electroconvulsive Therapy (ECT) boasts a history spanning over seven decades. Despite its documented therapeutic efficacy and safety profile, its integration into clinical practice remains suboptimal. Recent data elucidates a marked paucity in the utilization rate of ECT in Poland. Therefore, it is imperative to discern the barriers impeding its broader adoption of this potentially life-saving treatment.

Objectives

The aim of this study is to investigate the attitude of early career psychiatrists towards ECT and its place in clinical practice in Poland.

Methods

A web-based, anonymous survey was conducted, targeting early career psychiatrists in Poland. The questionnaire, part of an international study, consisted of 36 multiple-choice and Likert scale questions.

Results

The majority of respondents emphasised the importance of further educational opportunities related to ECT, seeing it as a safe, effective, and possibly lifesaving procedure. Most of them benefited from ECT training during their residency, however less than a half had the opportunity to administer ECT themselves. They exhibited an interest to introduce ECT into their therapeutic repertoire, depending on the provision of requisite financial and infrastructural support.

Conclusions

There is a palpable eagerness among early career psychiatrists in Poland to enhance their proficiency in ECT. A robust curriculum, encompassing both theoretical discourse and hands-on ECT training, is paramount for all psychiatry trainees. Concurrently, there is a pressing need to formulate national ECT guidelines within Poland, which could potentially ameliorate apprehensions surrounding this procedure.

Disclosure of Interest

None Declared
Neuroinflammation in Recent Onset Mental Health Disorders – Developing Multi-level Signatures of Early-stage Depression and Psychosis in Young Adults
Authors: Popovic D. , Weyer C. , Ruef A. , Dwyer D. , Griffiths S. L. , Lalousis P. A. , Koutsouleris N. , Upthegrove R.
Published: August 2024

Introduction

An early and comprehensive neurobiological characterization of severe mental disorders could elucidate mechanistic pathways, aid the development of novel therapeutics, and therefore enable timely and targeted intervention in at-risk youth and young adults. Therefore, we present an unsupervised transdiagnostic machine learning approach to investigate shared and distinct patterns of early-stage depressive and psychotic disorders on multiple clinical and neurobiological levels.

Objectives

To derive multi-level neurobiological and clinical signatures of early-stage affective and psychotic disorders in adolescents and young adults.

Methods

From the multicenter prospective European PRONIA cohort, we acquired data from 678 individuals (51% female) comprising young, minimally medicated in- and outpatients with clinical high-risk (CHR) states for psychosis, with recent-onset depression (ROD) or psychosis (ROP), and healthy control (HC) individuals. Within repeated nested cross-validation frameworks, we employed Sparse Partial Least Squares Analysis to detect associations between blood markers and grey matter volume (GMV), followed by support vector machine prediction of these signatures using biographical, clinical, neurocognitive, proteomic, and functional data.

Results

Our results demonstrated a psychosis staging signature separating ROP from CHR individuals via GMV patterns in the cortico-thalamo-cerebellar circuitry with a blood marker set of elevated of IL-6, TNF-α and CRP (ρ = 0.272; P = 0.002). A depression signature separated ROD from HC individuals via altered GMV in the limbic system with a blood marker set of elevated IL-1ß, IL-2, IL-4, S100B and BDNF (ρ = 0.186; P = 0.021). Only the psychosis staging signature showed a distinct proteomic enrichment regarding innate immune response, abnormal neutrophil function, cellular senescence, and anti-inflammatory drugs (Balanced Accuracy (BAC) = 87.73%; Area Under the Curve (AUC) = 0.94). Childhood trauma differentially predicted psychosis and depression signatures, while past level of functioning, personality and quality of life was predictive of both signatures (BAC = 67.19-78.00%; AUC = 0.71-0.83).

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Conclusions

Psychosis and depression exhibit distinct multi-level signatures evident in early disease stages. Enhanced insight into these signatures could help delineate individual trajectories and potentially new mechanisms for pharmacological treatment.

Disclosure of Interest

None Declared
Transcranial Magnetic Stimulation-induced Mania: A Risk Worth Taking?
Authors: Pereira M. , Abreu P. , Cameira M. P. , Soares M. R.
Published: August 2024

Introduction

In the context of treatment-resistant bipolar depression, the use of neuromodulation techniques, notably transcranial magnetic stimulation (TMS), has been on the rise, particularly in the treatment of mood disorders. TMS involves the generation of a strong pulsed magnetic field through an electromagnet placed near the skull, thereby inducing an electrical field capable of depolarizing nerve cell membranes (Dolberg et al., 2001). The magnetic nature of TMS carries advantages compared to direct electric stimulation, such as fewer side effects, reduced invasiveness, and precise targeting. Nevertheless, it is not without its risks. Reported concerns include the induction of manic or hypomanic states, particularly in individuals with bipolar disorder, as well as unipolar depression (Sakkas et al., 2003; Ozten et al.,2013; Knox et al 2021).

Objectives

This review aims to assess the safety and viability of TMS as a therapeutic option and how to best optimize its clinical use.

Methods

A comprehensive literature review was conducted utilizing resources from Pubmed, Researchgate, and Google Scholar.

Results

Despite some inconsistencies and potential confounding factors, our findings suggest that TMS may not significantly elevate the risk of manic switching, especially when compared to conventional treatments like antidepressants. However, it may potentially induce manic episodes, particularly when used as monotherapy or in combination with other treatments. Variables such as treatment protocol and prior response to medication may contribute to mood switching risk. Proposed safety measures include personalized protocol design, close patient monitoring and the combination with mood-stabilizing medication.

Conclusions

Transcranial magnetic stimulation has been associated with manic and hypomanic episodes in mood disorder patients. While the evidence remains limited, it appears that certain individuals may be more susceptible to mood switching. Nevertheless, further research is needed to better elucidate variables influencing mood switching during TMS treatment and to develop effective preventative measures, especially for patients already predisposed to manic switching.

Disclosure of Interest

None Declared
Family systemic therapy: intervention in autism spectrum disorder
Authors: Díaz Mayoral C. , Setién Preciados P. , Arroyo Sánchez E. , Gimillo Bonaque J.
Published: August 2024

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by communication impairments and difficulties in social interaction. These impairments can affect relationships with family members, increase stress and frustration for both the patient and family members, and contribute to behavioral disturbances in these patients. They are frequently associated with high rates of psychiatric comorbidity.

Objectives

Given the impact of this disorder on the family unit, we set out to assess the clinical effectiveness of systemic family therapy, its influence on improving communication and coping with this disorder, strengthening relationships and mental health in these patients and their families.

Methods

A literature review was performed by searching for articles in Pubmed on May 24, 2023, focusing the terminology used on “Autism Spectrum Disorder” and “Systemic Family Therapy”. The search was limited to full text articles in English and Spanish, published in the last 10 years.

Results

Several authors have stated that systemic family therapy could be beneficial:

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Providing education.

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Reporting additional educational resources.

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Focusing sessions on improving social and communication skills, mood and coping behaviors.

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Providing therapy to all family members to cope with this disorder and what it implies. It will be very important that the patient with ASD understands his condition and can receive support from his family, working with siblings on the bonding and coping with this condition.

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Contributing to facilitate mourning the loss of the condition of “neurotypical” person, exploring emotions, feelings and belief systems, valuing the social and cultural context of the family.

Conclusions

Reviewing a variety of literature on this therapeutic approach, the authors concluded that “strategic, narrative and structural interventions can be applied from multiple approaches, especially suited to the challenges often faced by patients with ASD and their families”. Therapeutic work needs to involve different family members at different times. Therapeutic conversations will consider the child, the family and the family unit in context. Studies so far have not been able to establish whether particular systemic approaches have more favorable outcomes than others, which warrants further research.

Disclosure of Interest

None Declared