bluuebunny/crossref_metadata_2025 huggingface dataset:
Multidimensional assessment of personality disorders using different theoretical models: a comparison of the Young Schema Questionnaire, the SCID-5-AMPD structured diagnostic interview, and the PDS-ICD-11 self-report questionnaire
Authors: Pribula V. , Biliczki J. , Király L. , Pongracz F. , Ruscsak P. , Vadon N. B. , Renko T. A. , Erdelyi-Hamza B. , Szocs H. , Vizin G. , Gonda X.
Published: August 2024

Introduction

There has been a recent shift in the conceptualisation of personality disorders in diagnostic systems such as DSM-5 or ICD-11, from a categorical approach towards a dimensional approach reflecting severity in general or severity of dysfunction and related pathological traits. In addition, several psychotherapeutic approaches work with their own model of personality pathology, which similarly capture symptoms of personality disorders and their underlying processes in a more subtle way from multiple aspects, and along different constructs.

Objectives

The aim of our study was to investigate similarities and differences between conceptualisations of personality disorder and instruments used for evaluation based on the BNO-11 Personality Disorders Severity Questionnaire (PDS-ICD-11), Module I. of the Structured Diagnostic Interview for the DSM-5 Alternative Personality Model (SCID-5-AMPD) measuring level of personality function, and the Young Schema Questionnaire assessing early maladaptive schemas.

Methods

Hospitalized borderline patients were assessed using the Young Schema Questionnaire, the PDS-ICD-11, and Module I. of the SCID-5-AMPD assessing personality function level. Data are analysed using correlation and linear regression models.

Results

Only part of the results are shown. The PDS-ICD-11 Severity Index and Self-function Index showed significant (p<0.05) and strong correlations with the Abandonment (r=0.98, r=0.94), Vulnerability to harm and illness (r=0. 92, r=0.98), Insufficient Self-Control (r=0.91, r=0.88) and Negativism/Pessimism (r=0.95, r=0.90) schemas. The mean score and all domains of the SCID-5-AMPD Module I (level of personality function) showed significant strong correlations with the Vulnerability to harm and illness schema (AMPD-Average r=0.87; AMPD-Identity r=0.86, AMPD-Objectivity r=0.81, AMPD-Empathy r=0. 77, AMPD-Intimacy r=0.80, p<0.05); moreover, a strong significant correlation was found between the Abandonment schema and AMPD-Average (r=0.81, p<0.05), AMPD-Identity (r=0.98, p<0.05), and AMPD-Intimacy domains (r=0.77, p<0.05).

Conclusions

The main indicators of measures that operationalise a dimensional approach to personality disorders show distinct patterns of strong overlap with some of the maladaptive schemas but cover only a part of the schema domains. For a careful diagnosis and psychotherapeutic plan, the combined use of these measures can provide in-depth and multifaceted information.

Disclosure of Interest

None Declared
Сhronotype and health related quality of life among undergraduate university students
Authors: Nikolaev E. L. , Poverinov I. , Alhasan M.
Published: August 2024

Introduction

Chronotype represents genetically determined behavioral characteristics of a person’s twenty-four-hour activity. Research shows that a person’s chronotype is interrelated with their mental health. Are there similar connections with general health and health related quality of life?

Objectives

To establish how various chronotypes are represented in university students and if there are any interrelations between chronotypes and health‐related quality of life

Methods

We used SF-12 Health Survey и Morningness–Eveningness Questionnaire (MEQ) by Horne and Ostberg to survey 305 university students of both genders.

Results

The results showed that the majority of the students (71.2%) have an intermediate chronotype. The second goes a moderate morning chronotype (17.7%), the third – a moderate evening chronotype (9.8%). Definite morning and definite evening chronotypes were revealed in less than 1% of the students. SF-12 Health Survey scale indicators that assess quality of life corresponded to standard scores for the given group of the respondents. We have revealed valid relations in correlational interconnections of the achieved parameters. Thus, the morning chronotype is most consistently associated (p<0.01) in undergraduate university students with higher indicators of health related quality of life including General Health (r=.23), Vitality (r=.21), Role Physical (r=.18), Role Emotional (r=.17), Physical Functioning (r=.16), Social Functioning (r=.13). Mental Health and Bodily Pain in university students are not connected with the chronotype (p>05).

Conclusions

Therefore, this research establishes that the majority of the students are related to the intermediate chronotype, and the morning chronotype corresponds to higher levels of most indicators of health related quality of life excluding the level of mental health.

Disclosure of Interest

None Declared
The impact of eating habits on mood disorders (A prospetive study to show the importance of food on preventing mental heath disorders )
Authors: Baabouchi N.
Published: August 2024

Introduction

Adopting a traditional healthy eating pattern is strongly associated with a more stable, adaptive, and serene mood. In contrast, adopting a modern and industrialized diet is linked to a higher incidence of anxiety and depressive disorders.

To prevent mood disorders, a varied diet rich in colorful fruits and vegetables is recommended. Studies show that the consumption of vegetables, whole grains, and fruits can help prevent the risk of major depression and anxiety disorders by more than 35%. A well-rounded plate, rich in micronutrients (trace elements, vitamins, minerals), is essential for the proper functioning of our brain and its emotional areas.

Our brain requires significant amounts of iron, zinc, magnesium, and vitamins B, E, D, and K. Unfortunately, our modern diet often lacks sufficient intake of these essential micronutrients. A deficiency in iron or zinc is associated with a significantly higher risk of major depression, and a lack of magnesium is a potential source of anxiety disorders.

Choosing a diet rich in micronutrients (whole grains, cereals, fresh fruits, and vegetables) can address potential deficiencies and contribute to a more adaptive and balanced mood. Similarly, carefully selected dietary supplements can prove to be effective.

Objectives

it shows the importance of alimentation and her role on Primary and secondary prevention in depressive disorders.

Methods

This poster is a prospective study done on 100 random people via a multi choice quizz, to see the impact of their food on their mental health .

Results

in the making

Conclusions

Food should today be universally considered as a potential risk factor or protective factor in depressive disorders. Since the recent decades, nutritional psychiatry has developed a field of research promising The International Society For Nutritional Psychiatry Research (ISNPR) who is a collective of doctors and researchers with the common objective of advance research and communication of nutritional medicine in the field of psychiatry. Cross-sectional epidemiological studies finding an association between diet quality and mental health in longitudinal studies, a step has been taken. The observational data have been widely replicated and documented in several meta-analyses and are supported by prospective studies studying the effectiveness of improving nutritional quality in the treatment of depression. It now appears necessary that in the near future psychiatrists must receive training on the impact of diet in psychiatric disorders including depression, and get into the habit of taking an interest in the eating habits of their patients, as well as their microbiota .

Disclosure of Interest

None Declared
Dimensions of Psychological Resilience Among Mental Health Professionals in Greece: A Postdoctoral-based Literature Review
Authors: Kalmanti A. , Smyrnis N. , Michopoulos I. , Yotsidi V. , Moraiti V. , Porfyri G. N.
Published: August 2024

Introduction

Resilience is defined as the process and outcome of successfully adapting to difficult or challenging life experiences, and adjustment to external and internal demands, including challenges in family or relationship dynamics, serious health concerns, financial pressure or work-related stress. Employees’ creative self-sufficiency, work environment, as well as the interpersonal relationships developing in the workplace which constitute basic parameters of professional satisfaction can potentially affect both psychosomatic resilience of the employees as well as their performance at work. Exploring the available bibliography, it was revealed that the mental health professionals’ community has not been sufficiently examined in terms of emotional resilience.

Objectives

To examine the dimensions of psychological resilience among mental health professionals.

Methods

In the context of a postdoctoral research which is conducted on a sample of the Greek population- personnel working in mental health hospital and community-based settings -a review of 35 articles from 1985 to 2023 on PubMed and Google Scholar was proceeded regarding psychological resilience among mental health professionals.

Results

Creative self-sufficiency and professional satisfaction were found to be positively correlated with resilience among mental health professionals. Additional factors have been found to influence mental resilience among mental health professionals, such as individual personality traits, coping style, perceived social support, a sense of security, and organizational support.

Conclusions

This review contributes to the evolving understanding of resilience, particularly regarding mental health prοviders. The positive correlation between creative self-sufficiency and professional satisfaction highlights the importance of fostering these dimensions to enhance mental resilience through implementing emotional capacity-building practices, social skills counseling, as well as mindfulness-based interventions.

Disclosure of Interest

None Declared
Intereleukine-6 and Interleukine-1β levels in post-traumatic stress disorder, depression and healthy controls: a preliminary report
Authors: Dell’Oste V. , Fantasia S. , Andreoli D. , Pedrinelli V. , Palego L. , Betti L. , Giannaccini G. , Carmassi C.
Published: August 2024

Introduction

Patients with Post-traumatic stress disorder (PTSD) or mood disorders, as depression, often showed dysregulation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, resulting in increased levels of pro-inflammatory cytokines and heightened activity of the immune system that may cause alterations in the structure and function of brain regions through direct neurotoxic effects, oxidative stress, changes in levels of neurotransmitters and decreasing some neurotrophins. Among the most studied pro-inflammatory cytokines in this field there are Intereleukine-6 (IL-6) and Interleukine-1β (IL-1β); however, scant and conflicting data are currently available in the literature about their use as potential biomarkers, and even less on possible comparisons in PTSD and depression.

Objectives

The aim of the present study was to evaluate circulating levels of IL-6 and IL-1β in patients with PTSD and to compare them with those of subjects with depression and healthy controls.

Methods

A sample of 45 subjects, including 15 subjects diagnosed with PTSD (PTSD group), 15 with depression (DEP group), and 15 healthy controls (HC group) were recruited at the Psychiatric Clinic of the Department of Clinical and Experimental Medicine, University of Pisa. HC group included subjects recruited on a voluntary basis. The psychiatric diagnosis was assessed by the Structured Clinical Interview for DSM-5-Clinician Version (SCID-5-CV), the Impact of Event Scale-Revised (IES-R) and the Trauma and Loss Spectrum-Self Report lifetime version (TALS-SR). A peripheral venous blood sample was collected to perform the biochemical assays. The analyses of IL-6 and IL-1β were performed with a dedicated enzyme-linked immunosorbent assay (ELISAs) achieved at the Laboratory of Biochemistry of the Department of Pharmacy, University of Pisa.

Results

No statistically significant gender or age differences emerged in the three groups. There were no statistically significant differences in IL-1β levels among the three groups. Conversely, the PTSD group showed higher levels of IL-6 compared to the DEP and to the HC ones, with a statistically significant difference in the post-hoc analysis among the PTSD and DEP groups with respect to the HC one (p<0.05).

Conclusions

Our results suggest the key role of a chronic low-grade inflammatory state in PTSD and in depression, probably related to a dysregulation in HPA axis and cortisol release, with an increase in proinflammatory cytokines including IL-6 that seemed to be more pronounced in PTSD.

Disclosure of Interest

None Declared
You are what you eat: diet, microbiota and mental health
Authors: Matas Ochoa A. M. , Rubio Corgo S. , Durán Cristóbal I.
Published: August 2024

Introduction

In recent years, there is a growing interest in microbiota and how certain dietary patterns affect our brain.

We know that diet has an important impact in physical and mental health. The mecanism that underlies is already unknown, but there is emerging evidence that diet modulates brain gut microbiota and has implications in mental problems.

Objectives

The aim of this poster is highlight the importance of diet in mental health and the link with microbiota.

Methods

Review of recent literature about diet, microbiota and psychiatry. The studies were collected of the electronic databases PubMed.

Results

New researches highlight the importance of adequate nutrition for mental health. Several studies link healthy diet with a minor risk of mental illnesses or with the improvement of depressive symptoms. Likewise, poor dietary habits could aggravate cognitive decline and increased risk of developing anxiety, depression or other mental illnesses.

It has been shown that a diet rich in fiber, polyphenols and micronutrients improve gut microbial composition and can reduce metabolic endotoxemia and neuroinflammation, and this has been associated with improvements in brain health. Also, prebiotic and probiotics have positive effects.

Therefore, dietary interventions could be a complementary therapeutic approach for patients with mental problems. This is what nutritional psychiatry focuses on.

Conclusions

Microbiota as a potential therapeutic target for mental illness is a hot topic in psychiatry, but also, its interaction with dietary change or the use of probiotics and prebiotics. This action is easy to implement in our clinical practice and could be part of a biopsychosocial treatment to improve or prevent some psychiatric disorders.

Nutritional psychiatry is a new field that needs to be developed and the knowledge in microbiota, diet and mental health could help. Hopefully, the research about this topic continues expanding.

Disclosure of Interest

None Declared
Emotionally charged events as a trigger for the acute development of psychotic symptomatology. A case report
Authors: Del Sol Calderon P. , Izquierdo de la Puente A. , Fernández R. , García Moreno M. , Delgado C.
Published: August 2024

Introduction

A 21-year-old male presented to the emergency room due to strange behavior

Objectives

Show how emotionally intense events can be a stress factor leading to dissociative or psychotic symptoms.

Methods

Case report and literature review

Results

The patient is in Spain after having attended the meeting with the Pope at the World Youth Day in Portugal. He is an engineering student who, in the week prior to the trip, had high levels of stress related to exam time. He also explained that he had recently had conflicts with his partner. In the psychocopathological examination of the patient, a global insomnia of 3 days of duration stands out. In addition, a disorganized and disjointed speech focused on high concern that something bad could happen to his family and partner. In the interview he appears restless, nervous, with a perplexed contact. The patient’s companion says that he has been very worried and obsessed about his relationship with his partner, with constant doubts about asking her to marry him. It is decided to start olanzapine, receiving up to 15 mg per day. In the following interviews he shows better contact and a more organized speech.

Conclusions

It is known that emotionally intense situations can be a trigger for the development of psychotic symptoms. There are different manifestations of these stressful situations such as physical symptoms like fainting or but mental symptoms are also described such as dissociative amnesias, or less frequent as in this case psychotic symptoms. They are usually of sudden onset and early remission with good response to anxiolytics or antipsychotics.

Disclosure of Interest

None Declared
Sodium Oxybate-Induced secondary mania with psychotic symptoms: a case report and literature review
Authors: Cárdenes Moreno C. , Yelmo-Cruz S. , Pérez Sagaseta de Ilurdoz I. , Tascón-Cervera J. J. , González-Rodríguez G. P. , Gallego-Restrepo M.
Published: August 2024

Introduction

Sodium oxybate, an effective treatment for narcolepsy-associated daytime sleepiness and cataplexy, has been extensively. Despite its therapeutic benefits, sodium oxybate is not without its risks, and adverse psychiatric effects have been documented. This case report highlights a rare manifestation of sodium oxybate-related secondary mania with psychotic symptoms in a patient with narcolepsy, emphasizing the importance of recognizing and managing such adverse events. Additionally, we provide a brief review of similar cases reported in the literature.

Objectives

This report aims to describe the presentation, evaluation, and management of sodium oxybate-induced secondary mania with psychotic symptoms in a patient with narcolepsy. We also discuss the potential mechanisms underlying this adverse reaction and its clinical implications. Furthermore, we summarize findings from previous studies that have reported cases of secondary mania associated with sodium oxybate use.

Methods

We present the case of Mr. X, a 48-year-old male diagnosed with “Narcolepsy with cataplexy,” who had been receiving sodium oxybate treatment for 11 years. He was admitted to the hospital following a mild head injury and the emergence of a manic episode with psychotic features. Comprehensive clinical evaluation, including medical history, toxicology screening, and neuroimaging, was conducted.

Results

Upon evaluation, Mr. X exhibited hyperactivity, restlessnes, grandiose delusions, paranoid delusions related to hospital staff, and decreased need for sleep. Notably, he had been consuming sodium oxybate excessively. Sodium oxybate was discontinued, and low-dose olanzapine was initiated. Within 24 hours, his manic and psychotic symptoms resolved. He admitted to overusing his medication, and his family reported a recent increase in his activity level. A review of the literature revealed similar cases of sodium oxybate-induced secondary mania with psychotic symptoms.

Conclusions

This case underscores the importance of vigilance for psychiatric side effects of sodium oxybate, particularly in patients with a history of substance abuse or potential overuse. Secondary mania associated with medications is a rare but significant clinical entity. Prompt recognition and intervention are crucial for patient safety and well-being. Further research is needed to elucidate the mechanisms underlying such reactions and to establish guidelines for their prevention and management.

Disclosure of Interest

None Declared
Brief psychotic disorder treatment with Olanzapine in a patient with Phelan-McDermid syndrome
Authors: Retsou I. , Antoniadis D.
Published: August 2024

Introduction

The patient is a 50-year-old female, with multiple admissions in the PICU. At her first admission, at the age of 30 she presented the following main symptoms :mutism, negativism, crying and loss of bladder and bowel control. After collecting her complete family history, it was determined that her mother and one of her brothers were diagnosed with mild intellectual disability. Concerning her childhood history, she presented with late milestones as an infant and toddler and difficulties throughout primary education. Little information concerning her adult life was given, since the patient remained mute during the entirety of her first hospitalization.

Objectives

Determination of the efficacy of olanzapine in a patient with Phelan-McDermit syndrome with mild intellectual disability and psychotic symptoms such as auditory hallucinations, delusional ideas and disrupted behavior.

Methods

PANSS Test, intellectual capacity test, genetic testing.

Results

PANSS Scale Score at the 1st day of admission:100

PANSS Scale Score at the last day: 79

Intellectual capacity test: mild intellectual disability

Genetic testing results: Phelan-McDermit syndrome

Conclusions

After 20 days, symptoms showed mild recession in responce to 20mg of olanzapine. In a period of 12 months, the patient showed no signs of relapse and she was not readmitted in the PICU.

Disclosure of Interest

None Declared
Syndrome of Irreversible Lithium-Effectuated Neurotoxicity: Silent, but not innocent
Authors: Bicho M. S. , Coelho J. M. , Peixoto B. , Cruz C. , Baião P. , Ferreira I.
Published: August 2024

Introduction

Lithium is one of the main drugs used in Bipolar Affective Disorder. However, it has a narrow therapeutic window, which requires close monitoring and progressive dose adjustment, according to serum levels, clinical response and the appearance of side effects. The term ‘SILENT’ explains descriptively persistent neurological sequelae related to lithium salt intoxication when symptoms persist for more than 2 months after stopping treatment. SILENT Syndrome is more common in females, at ages ranging from 21 to 77 years and is characterized mainly by avermian-type cerebellar disorder, persistent extrapyramidal syndrome, brainstem dysfunction and dementia of varying severity. It can also result in apraxia of the body, changes in the coordination and balance, dysarthria, as well as intentional and kinetic cerebellar tremor, involuntary movements of orofacial dyskinesias or resting tremor.

Objectives

The authors intend to review the relevant and current literature in order to extend the knowledge about this condition and find the best conducts for clinical practice.

Methods

Non-systematic literature review.

Results

Complications from the use of lithium known in the medical literature include mainly nephrotoxicity, endocrine alterations and neurotoxicity. The neurotoxic effects of lithium usually occur at high serum concentrations. However, they can also occur with lithium in the therapeutic range, and memory, attention and ataxia impairment may be some of the permanent sequelae. The etiopathogenesis is unclear, but demyelination has been detected in multiple brain regions, mainly in the cerebellum. The mechanism of lithium-induced cerebellar injury is believed to be mediated by the entry of calcium into the cells of this organ. The main factors that predispose to greater side effects and risk of toxicity are patients with decreased renal function, advanced age, use of diuretics, dementia, pregnancy, low sodium intake and physical illness with vomiting and/or diarrhea.

Conclusions

Lithium is a drug used mostly in affective disorders and given the narrow therapeutic window, it requires close monitoring in order to avoid side effects that can be permanent. In this way, it is important to review the factors that increase the lithium toxicity and make recommendations about it.

Disclosure of Interest

None Declared
Abilify Maintena 400 mg (aripiprazole once-monthly), two-injection start (TIS) regimen: the experience of the Psychiatric Unit (SPDC) of Rimini
Authors: Rapagnani M. P. , Veronesi L. , Magnani M. , Sartini F.
Published: August 2024

Introduction

The single-injection start regimen for aripiprazole once-monthly 400 mg (AOM 400) in patients with schizofrenia requires a single intramuscular injection in the gluteal or deltoid site and 14 days of concurrent oral therapy. Based on a population-pharmacokinetic model, the European Medicines Agency and Canada has recently approved a simplified starting strayegy of aripiprazole once a month with single-day regimen of two injections at separate gluteal and deltoid injection sites, together with a single 20 mg dose of oral aripiprazole on the 1st day.

Objectives

The aim of the study is to evaluate the two injection start (TIS) regimen in inpatients in the Psichiatric Unit (SPDC) of the Hospital of Rimini.

Methods

We retrospectively reviewed medical records of patients, from February 2021 to April 2023, that have more than 18 years, who received the newly approved 2-injection start regimen as part of their standard care, evaluating if exist changes in clinical indicators, safety and tolerability of this regimen.

We valuated retrospectively the days of hospitalization after the aripiprazole 400 mg TIS and the number of emergency room access, analyzing the “repository of AUSL della Romagna” and discharge letters and the “CURE” program of the Psychiatric Service of Rimini.

Results

We evaluated 24 patients from February 2021 to April 2023, 11 male (45,8%), 13 female (54,2%); average age 37,95, average lenght of stay in hospital was 11,75 days. 10 patients with diagnosis of psychosis/schizophrenia (41,7%), 6 patients with bipolar disorder (25%), 4 patients with personality disorder (16,6%), 2 patients with substance induced psychosi (8,3%), 1 patients with delusional disorder (4,2%), 1 patient with schizoaffective disorder (4,2%). 6 patients had the two-injection start regimen in 2021 (25%), 13 patients in 2022 (54,2), 5 patients in 2023 (20,8%); 20 patients did not have admission in hospital after the TIS (83,3%), 4 patients had 1 or more admission after the injection (16,7%). 3 patients (12,5%) had accesses in emergency-room after Abilify Maintena. 15 patients (62,5%) continue therapy; 9 patients (37,5%) had suspended the injection for drop-out or because of change of therapy not correlated at adverse effects (1 female patient had suspended treatment after the two-injections due to pregnancy). Just 1 patient that continue Abilify Maintena 400 mg had 2 accesses in the emergency-room.

Conclusions

The coadministration of 2 injections of 400 mg aripiprazole was not associated with safety concerns beyond those expected with a single-injection start regimen. From the study it appears that the long-acting therapy with Alibify Maintena 400 mg once-monthly helps to stabilize the patient to prevent hospitalization and accesses in emergency-room.

Disclosure of Interest

None Declared
Importance of the type of pharmacological treatment in patients with severe mental disorder
Authors: Lucas M. , Romero P. , Sirvent N. , Roig R. , Bajén J. , Aliño M. , Escobar C. , López C.
Published: August 2024

Introduction

The use of long-acting treatments is a common clinical practice in psychiatry. No disease insight and the risk of treatment discontinuation in a significant portion of our patients, increase the demand for psychiatric emergency and hospital admissions. Treatment adherence must be facilitated, taking into account possible side effects and patient´s subjective satisfaction.

Objectives

-Evaluate the type of long-acting intramuscular treatment in selected patients. -Evaluate the differences in treatment satisfaction between different types of long-acting intramuscular treatments as well as frequency of psychiatric emergency and hospital admissions in the last year.

Methods

We select patients with different severe mental disorders who stay in a Medium Stay Unit, Sociosanitary Community Residence, Supervise house and Residence for the elderly in Albacete (Spain); all of them, with intramuscular neuroleptic treatment (zuclopenthixol dihydrochloride, aripiprazole long acting, palmitate paliperidone monthly, 3-monthly and 6-monthly) at least 1 year.

We evaluate their sociodemographic characteristics, the satisfaction questionnaire with the treatment (TSQM-9) and the rate of psychiatric emergencies and admissions after current intramuscular treatment in last year.

Results

We have selected 57 patients with an average age of 45.86. 78.94% with a diagnosis of schizophrenia, 12.28% with schizoaffective disorder, 5.26% bipolar disorder and 3.5% unspecified psychotic disorder.

We can see in the graphics below that the longer duration of the intramuscular treatment, the greater satisfaction in all the items of the TSQM-9 questionnaire.

31% of the patients with zuclopenthixol dihydrochloride treatment, have gone to psychiatric emergencies and 28% of psychiatric admissions in the last year.18% of the patients with aripiprazole long acting, 17% with paliperidone palmitate long acting-monthly and 12% de 3-monthly have gone to psychiatric emergencies and 15%, 12% and 12% needed psychiatric admissions respectively. Patients with palmitate long acting-monthly have not emergencies or psychiatric admissions in the last year.

Image:

Image 2:

Image 3:

Conclusions

-

The longer long acting of the intramuscular treatments, the better patient satisfaction.

-

With the longer duration treatment (Palmitate paliperidone LD 6 month), we have lower psychiatric emergencies and hospital admissions.

Disclosure of Interest

None Declared
Psychological vulnerability and problematic psychotropic drug use among medical residents: exploring the relationship
Authors: Ktari H. , Sellami S. , Ben Thabet J. , Omri S. , Feki R. , Gassara I. , Smaoui N. , Zouari L. , Maalej M. , Maalej Bouali M. , Charfi N.
Published: August 2024

Introduction

Psychological vulnerability and problematic psychotropic drug use among medical residents are critical and intricate areas of study in the field of healthcare and mental well-being. This topic looks into the potential links between the psychological vulnerabilities experienced by medical residents, which are frequently associated with the demanding nature of their profession, and their use of psychotropic drugs in a way that poses problems or risks. Exploring this relationship is critical for understanding the mental health challenges that medical residents face and developing effective strategies to support their psychological well-being.

Objectives

to identify the psychological factors linked to problematic psychotropic drug use in medical residents.

Methods

We conducted a cross-sectional descriptive and analytical study among Tunisian medical residents between August and September 2022. We used a self-administered questionnaire with a data collection form, the DAST-10 (Drug Abuse Screening Test) scale, and the DASS-21 (Depression, Anxiety, and Stress Scale) in an online survey. Data was analyzed using the 20th version of the SPSS software.

Results

The sample consisted of 80 medical residents. Among them, 23.8% (n=19) had reported a previous use of psychotropic drugs, and 15% (n=12) a misuse (without a prescription and/or without following the prescription). The DAST-10 revealed that 6 residents (31.6%) had problematic use of psychotropic drugs.

A high level of stress on the DASS-21 scale was associated with a problematic use (p=0.01) and a misuse (p=0.01) of psychotropic drugs. Furthermore, residents with high stress levels were more likely to demonstrate problematic use of psychotropic drugs (p=0.004). Such problematic use was correlated with personal history of anxiety disorders (p=0.01).

Furthermore, residents with problematic psychotropic drug use had higher anxiety and depression scores on the DASS-21 scale (p>0.05).

Conclusions

Our findings revealed a concerning prevalence of psychotropic drug use among medical residents and an association with high stress levels. This result emphasizes the need for targeted interventions to support young doctors’ mental health.

Disclosure of Interest

None Declared
Elevated herpesvirus antibody levels linked to schizophrenia and bipolar disorder
Authors: Andreou D. , Steen N. E. , Jørgensen K. N. , Ueland T. , Wortinger L. A. , Mørch-Johnsen L. , Yolken R. H. , Andreassen O. A. , Agartz I.
Published: August 2024

Introduction

Previous research has implicated herpes simplex virus 1 (HSV1) and cytomegalovirus (CMV) in severe mental illness (SMI) with conflicting results. Both pathogens have high universal seroprevalence, are neurotropic and after the primary infection typically establish a persistent latent infection with periodic reactivations. Increased immunoglobin G (IgG) concentrations are considered to be attributable to an increased infection severity with more frequent reactivations or host immune system alterations.

Objectives

We assessed the HSV1 and CMV IgG concentrations in previously infected (seropositive) patients with SMI and healthy controls (HC). We hypothesized that seropositive patients would show higher IgG concentrations than seropositive HC.

Methods

We included 765 patients, 515 with schizophrenia (SZ) and 250 with bipolar disorder (BP), and 541 HC. HSV1 and CMV IgG seropositivity and concentrations were measured with immunoassays. 355 patients, mean age 33 years, 45% females, and 238 HC, mean age 35 years, 44% females, were HSV1 seropositive (HSV1+) while 447 patients, mean age 33 years, 50% females, and 296 HC, mean age 34 years, 47% females, were CMV seropositive (CMV+). In our main analysis among seropositive participants, we investigated the main effect of patient/control status on HSV1 and CMV IgG concentrations.

Results

There were no significant differences in CMV or HSV1 seropositivity frequencies between patients with SZ, patients with BP and HC. Among seropositive participants, patients had higher HSV1 (p<0.001) and CMV (p=0.018) IgG concentrations than HC; stratifying by diagnosis, both patients with SZ (p=0.001) and patients with BP (p=0.001) had higher HSV1 IgG concentrations than HC, while patients with SZ, but not BP, had higher CMV (p=0.045) IgG concentrations than HC (Image). For HSV1, higher IgG concentrations were associated with higher general (p=0.017), negative (p=0.041) and positive (p=0.028) psychotic symptom scores.

Image:

Conclusions

Seropositive patients with SMI showed higher HSV1 and CMV IgG concentrations than seropositive HC suggesting that patients suffer a more severe infection or exhibit an altered immune response when contracting the pathogens. For HSV1, higher IgG concentrations were linked to more psychotic symptoms.

Disclosure of Interest

D. Andreou: None Declared, N. E. Steen: None Declared, K. N. Jørgensen: None Declared, T. Ueland: None Declared, L. Wortinger: None Declared, L. Mørch-Johnsen: None Declared, R. Yolken: None Declared, O. Andreassen Consultant of: Consultant to HealthLytix, Speakers bureau of: Received speaker’s honorarium from Lundbeck and Sunovion, I. Agartz Speakers bureau of: Received speaker’s honorarium from Lundbeck
Quality Improvement Programme on Implementing Co-Production in Care Programme Approach in an In-Patient Rehabilitation Psychiatric Unit to Enhance Patient Engagement and Positive Step-Down Discharges
Authors: Tahseen H. , Hassoulas A. , Umla-Runge K.
Published: August 2024

Introduction

This quality improvement (QI) programme was proposed to integrate co-production principles into rehabilitation psychiatry, focusing on enhancing patient-centred care and promoting positive step-down discharges within the mental health system. The backdrop of the QI programme was the essential role of rehabilitation psychiatry in aiding the recovery and reintegration of individuals with mental health challenges, and sub-optimal audit results about patient’s attendance and positive step-down discharges at an in-patient psychiatric unit.

Objectives

The QI programme aimed to implement and explore Co-production, a transformative approach involving patients and healthcare professionals as equal partners.

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To promote co-production in psychiatric in-patient service

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To improve patient experience in the CPA meetings

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To reduce anxiety associated with the CPA meetings and discharge planning

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To assess staff’s limitations and barriers in promoting co-production.

Methods

The QI programme was divided into phases, including diagnostic, problem-solving, and evaluation. It employed diagnostic tools such as the fishbone cause and effect diagram and the 5-Why Technique for root cause analysis. The project’s aim was aligned with the Model of Improvement, guided by the three fundamental questions. Change ideas were developed using driver’s diagram and were then evaluated through PDSA cycles. Quantitative analysis utilized paired t-tests to assess the significance of changes, and qualitative analysis focused on patient perspectives gathered through the co-produced CPA questionnaire. Emerging themes from the questionnaire responses were integrated into the project’s trajectory through narrative synthesis. Predictions were formulated to measure project success: 50% patient attendance in the next CPA meetings, 70% positive step-down discharges, and improved Hamilton Anxiety Rating Scale (HAM-A) scores.

Results

The iterative Plan-Do-Study-Act (PDSA) cycles demonstrated the evolving impact of interventions on patient engagement and discharge outcomes. Implementation of patient information leaflets, staff training, and a CPA agenda template led to increased attendance and positive step-down discharges. Analysis of HAM-A scores revealed a substantial decline in anxiety levels for almost all participants, suggesting the effectiveness of the interventions. Discharge outcomes were influenced by patient engagement and tailored interventions. Patient responses revealed themes such as challenges during transitions to community care, empowerment from shared decision-making, and diverse experiences in communication with healthcare professionals.

Conclusions

The CPA agenda template improved patient experiences by enhancing communication and patient-centeredness.

Disclosure of Interest

None Declared
Two Sides of the Same Coin? A Comparison between Internet-based and Paper-based Data Collection for Autism Quotient and Depression, Anxiety and Stress Scale
Authors: Sönmez D. , Abidi Y. , Jordan T. R.
Published: August 2024

Introduction

The utilization of internet-based data collection in mental health research has gained popularity for its convenience and affordability. However, concerns often arise regarding the validity and reliability of data collected via the internet. The Autism Spectrum Quotient (AQ) is a self-report questionnaire to measure the traits associated with autism spectrum disorder (Baron-Cohen et al. J Autism Dev Disord, 2001; 31 5-17) and the online usage of AQ is common and conducted with large numbers of participants across many studies. However, the effect of using internet-based data collection for AQ rather than conventional paper-based procedures is unknown.

Objectives

To address this issue, we conducted a study comparing the effectiveness of internet-based and paper-based data collection procedures for both the AQ and Depression Anxiety Stress Scale-21 (DASS-21, Lovibond & Lovibond, Behav Res Ther 1995; 33 335–343), which is also a prevalent mental health measurement in the literature and often used for online data collection (Zlomke, Comput Hum Behav 2009; 25 841-843). In addition, to compare internet-based and paper-based methods more fully, we included another variable (type of supervision) where a researcher was either present or absent during the completion of the questionnaires.

Methods

A power analysis was conducted, and a minimum of 90 participants were needed to reach a medium effect size of .30 with an adequate power of .80 at a= .05. Accordingly, 96 participants were used and randomly assigned across 4 data collection groups: internet-based (supervision, no supervision) and paper-based (supervision, no supervision). In addition to a Demographic Form, AQ, and DASS-21 were used to obtain the data. Three independent variables were used in the current study: type of presentation (internet-based and paper-based) and type of supervision as between factors, and type of assessment as a within factor.

Results

Using a 2 x 2 x 2 mixed design ANOVA, no significant main effects were found for any independent variables (all p > .33) or interaction (all ps > .17).

Conclusions

The results of using AQ and DASS-21 were not altered by using internet-based or paper-based data collection procedures, suggesting that both methodologies are equally valid for this purpose. Moreover, these effects were also unaffected by the presence or absence of a researcher during data collection, suggesting that supervision by an authoritative figure does not alter the responses made.

Disclosure of Interest

None Declared
Is treatment adherence linked to self-compassion in schizophrenia?
Authors: Laabidi S. , Abidi O. , Aissa A. , Hosni R. , Ouali U. , Jomli R.
Published: August 2024

Introduction

Self-compassion is defined as the ability to be open to and touched by one’s suffering and to relate to it with kindness and non-judgmental awareness. Although identifying factors related to treatment adherence remains an important challenge in patients with schizophrenia spectrum disorders, self-compassion has rarely been investigated in this population. Further studies are needed to investigate whether self-compassion training can improve treatment adherence in this population.

Objectives

The objective of the present study was to investigate the relationship between self-compassion and treatment adherence in patients with schizophrenia spectrum disorders.

Methods

thirty stabilized adult outpatients with schizophrenia (n=18), schizoaffective disorder (n=11), brief psychotic disorder (n=1) per DSM-5 criteria were included. Self- compassion was assessed using the 26-item Self-Compassion Scale (SCS). Treatment adherence was assessed using the Medical Adherence Rating Scale (MARS). Socio- demographic characteristics, including age, gender, academic level, and mean daily antipsychotic dosages were collected.

Results

There was no significant difference in SCS scores and MARS scores as a function of gender, age, or academic level. The results of the present preliminary study suggest a positive correlation between the SCS total scores and the MARS scores. It was found that higher levels of self-compassion are related with higher levels of treatment adherence in patients with schizophrenia spectrum disorders and lower levels of self- compassion are associated with discontinuation of medications without a psychiatrist’s recommendation. This connection was present in all diagnostic groups.

Conclusions

The results of the present preliminary study suggest that self-compassion and treatment adherence are closely related. Improving self-compassion in patients with schizophrenia spectrum disorders may improve their level of treatment adherence. Further studies are needed to investigate whether self-compassion training programs could be useful as an extension of standard psychoeducation and cognitive behavioral therapy to improve treatment adherence in this population.

Disclosure of Interest

None Declared
Achieving functional remission in schizophrenia: a pilot study
Authors: Bošnjak Kuharić D. , Jambrošić Sakoman A. , Lovrić Makarić Z. , Savić A. , Papić A. , Herceg M.
Published: August 2024

Introduction

Many patients with schizophrenia are unable to achieve adequate levels of psychosocial functioning and quality of life despite of the remission of illness symptoms. According to previous reports, only one-third of patients with symptomatic remission reach functional remission. While current pharmacotherapy options seem to be relatively effective for different symptoms of schizophrenia (e.g. positive symptoms), more specific psychosocial interventions that could enable functional remission are yet to be developed.

Objectives

Our objective is to investigate differences in psychopathology, quality of life, functioning, and achieving functional remission before and after specific group treatments developed in our clinic.

Methods

We will conduct a prospective study including a consecutive cohort of female patients older than 18 years of age, which fulfilled the criteria for schizophrenia and schizoaffective disorder according to the International Classification of Disorders, 10th revision. Exclusion criteria are intellectual disabilities, mental disorders due to known physiological or neurological conditions, lactation or pregnancy, treatment with medications that can provoke psychosis, alcoholism, and other addictions. Patients will be recruited after finished hospital treatment or during individual outpatient controls. The Recovery Helm will be used at the beginning of the treatment, to make individual treatment plan and include patients in specific programs including day hospital treatment and/or outpatient group programs: psychoeducation, relaxation, metacognitive training, and social skills training. Besides collecting sociodemographic data, pre- and post-treatment assessment will include the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF), the Quality of Life Scale (QLS), and the “Functional Remission of General Schizophrenia” (FROGS) scale.

Results

We will analyze the changes in psychopathology levels, quality of life, functioning, and achieving functional remission between the two assessment points, taking into account different treatment possibilities.

Conclusions

Evaluation of current available programs can help with recognition of specific needs of patients with schizophrenia and provide guidelines for further development of treatment programs that could be helpful in achieving functional remission.

Disclosure of Interest

None Declared