bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of maternal pre-pregnancy body mass index and gestational weight gain on behavioural outcomes in term normal birth weight children: UK birth cohort study
Authors: Dachew B. A. , Adane A. A. , Alati R.
Published: August 2023

Introduction

Existing evidence in the association between maternal pregnancy and pre-pregnancy weight and behavioural outcomes in children.

Objectives

This study aimed to examine these associations at six developmental time-points between ages 3 and 16.

Methods

We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), an ongoing population-based longitudinal pregnancy cohort study in Bristol, United Kingdom (UK). Data on behavioural outcomes were measured at ages 3.5, 7, 9, 11 and 16 years using the Strengths and Difficulties Questionnaire (SDQ). Over 7960 (at 3.5 years of age) and 4400 (at 16 years of age) mother-child pairs were included in the final analysis. Logistic regression analyses were used to examine the associations.

Results

Pre-pregnancy BMI and gestational weight gain were associated with total behavioural difficulties in children across all age groups. In separate analyses using each SDQ subscale, however, we found that pre-pregnancy underweight was associated with emotional problems at ages 7 (OR = 1.66, 95% CI; 1.20 – 2.29), 11 (OR = 1.49, 95% CI; 1.02 – 2.18) and 16 (OR = 1.74, 95% CI; 1.16 – 2.60) years and hyperactivity/inattention problems at age 16 (OR = 1.96, 95% CI; 1.27 – 3.05). We also found an association between guideline-discordant gestational weight gain and peer relationship problems at age 9 and pro-social behaviour at ages 9 and 11.

Conclusions

Our findings highlight that pre-pregnancy underweight than overweight, obesity or gestational weight gain may influence the emotional health of children and adolescents.

Disclosure of Interest

None Declared
Therapeutic update in the treatment of disruptive disorder with emotional dysregulation in children and adolescents : review of the literature
Authors: Belhadga H. , Elmaataoui Z. , Kisra H.
Published: August 2023

Introduction

Disruptive Mood Dysregulation Disorder (DMDD) is a new disorder that has been added to the category of mood disorders in the fifth Diagnostic and Statistical Manual of Mental Disorders to distinguish chronic non-periodic irritability from the periodic irritability of bipolar disorder. The main characteristic of DMDD is chronic and severe irritability. Because it is a new diagnostic entity, little research has been done on it and the literature on the subject is still expanding.

Objectives

The purpose of this review article is to gather information on new therapies for the treatment of this disorder in children and adolescents.

Methods

The studies related to the treatment of DMDD were collected and analyzed. This study retrieved related articles from PubMed, SpringerLink, ScienceDirect, NCBI, The American Journal of Psychiatry, and EBSCO. Use keywords “disruptive” AND “mood” AND “dysregulation” AND “disorder” OR “Treatment” AND “DMDD” OR “Drug” AND “mood” AND “disorder” OR “Treatment” AND “SMD” OR “Treatment” AND “BP” OR “Treatment” AND “ADHD” OR “Antidepressant” OR “Mental”AND “Stabilizer” OR “temper” AND “outburst” OR “aggressive” AND "antipsychotics.

Results

To date, no medication has been approved by the FDA to treat EDD. Because there are no treatment standards, drug therapy focuses on the primary symptoms of EDD, such as severe chronic irritability, temper tantrums, and comorbidities, such as ADHD. Currently, medications used by clinicians to treat patients with EDD include antidepressants (fluoxetine, sertraline, citalopram), stimulants (methylphenidate), anxiolytics mood stabilizers (sodium valproate) and antipsychotics (haloperidol, risperidone, aripiprazole in combination with methylphenidate in ADHD-EDD comorbidity), atomoxetine, guanfacine, and amantadine.

To date, no medication has been approved by the FDA to treat EDD. Because there are no treatment standards, drug therapy focuses on the primary symptoms of EDD, such as severe chronic irritability, temper tantrums, and comorbidities, such as ADHD. Currently, medications used by clinicians to treat patients with EDD include antidepressants (fluoxetine, sertraline, citalopram), stimulants (methylphenidate), anxiolytics mood stabilizers (sodium valproate) and antipsychotics (haloperidol, risperidone, aripiprazole in combination with methylphenidate in ADHD-EDD comorbidity), atomoxetine, guanfacine, and amantadine.

Conclusions

As a new diagnosis, treatment guidelines for DMDD are still unclear. Preliminary results from this study suggest that clinicians tend to prescribe a variety of psychotropic medications. This heterogeneity in treatment choices may reflect the fact that these patients are on a bridge between disruptive behavior disorders (including ADHD) and mood disorders. The relative merits or demerits of these treatment choices should be evaluated in further studies.

Disclosure of Interest

None Declared
The impact of anxiety and depression across childhood and adolescence on adverse outcomes in young adulthood: a UK birth cohort study
Authors: Morales-Muñoz I. , Mallikarjun P. , Chandan J. , Thayakaran R. , Upthegrove R. , Marwaha S.
Published: August 2023

Introduction

Little is still known about the long-term impact of childhood and adolescent persistent depression and anxiety on adulthood.

Objectives

To investigate the impact of persistent anxiety, depression, and comorbid anxiety and depression across childhood and adolescence on the development of multiple adverse outcomes in young adulthood.

Methods

This study used data from 8,122 participants in the ALSPAC cohort, in the UK. The Development and Wellbeing Assessment (DAWBA) was administered to capture child anxiety and depression symptomatology. We focused on the DAWBA generalized anxiety and mood subscales at 8, 10 and 13 years, and created a measure of comorbid anxiety and depression symptoms (i.e., anxiety + depression) at each time point. Further, a range of mental and physical health, and functional problems were assessed at 24 years. Latent Class Growth Analyses was used to detect trajectories of anxiety, depression and comorbid anxiety and depression, separately; and logistic regression to examine how persistent anxiety, depression or both associated with adverse outcomes at 24 years.

Results

All three classes with persistent anxiety, depression or both associated with presenting any mental health and functional problem at 24 years. However, persistent high anxiety was not associated with any physical health problem at 24 years. Finally, high levels of comorbid anxiety and depression was the domain that exerted the greatest negative impact at 24 years.

Conclusions

Children and adolescents with comorbid anxiety and depressions are at highest risk for suffering from more adverse outcomes at 24 years, compared to those presenting anxiety and depression alone.

Disclosure of Interest

None Declared
The impact of nonpsychotic postpartum psychiatric disorders (NPPDs) on offspring
Authors: Stojanov J. , Stanković M. , Stojanov A.
Published: August 2023

Introduction

Non-psychotic postpartum psychiatric disorders (NPPDs) are among the most common underdiagnosed mental disorders with a preserved reality test after delivery.

Objectives

NPPDs have been shown to have an association with infant growth, attachment, sleep, temperament and ultimately offspring’s emotional, behavioural, cognitive and social development.

Methods

Most prevalent NPPDs are postpartum mood and anxiety disorders, as well as obsessive–compulsive disorder, post-traumatic stress disorder and eating disorders.

Results

The high methodological quality of the reviewed studies strengths the association between NPPDs and different disorders in the neurodevelopmental period with a negligible impact on mental status in adolescence and adulthood. NPPDs showed an effect on offspring’s emotional, behavioural, cognitive and social development, due to common developmental mechanisms.

Conclusions

Timely accurate identifying and treating NPPDs, by using NPPDs symptoms screening tools could reduce the incidence of mental disorders in offspring. Although neurodevelopmental disorders and mental disorders related to pregnancy as separate diagnostic categories have been insufficiently researched, the potential impact of postpartum mental disorders on children’s development is an extremely unexplored field that should be focused on in further scientific research.

Disclosure of Interest

None Declared
Comments on the position UEMS paper “Maintaining Human Rights and recovery principles when Coercive Practices are considered”
Authors: Ivezic S. S.
Published: August 2023

Prof. dr. sc. Slađana Štrkalj Ivezić, psychiatrist, University psychiatric hospital Vrapče, Croatia

The aim is to present the importance of educating psychiatrists to acquire competencies relate to knowledge, attitudes and behavior in holistic understanding of patients, implementation of principles of recovery and respect for human rights and use of alternative interventions to coercion in order to eliminate or reduce coercive practice such as involuntary hospitalizations and coercive measures. All the necessary competences such as clinical assessment, skills to form therapeutical relationship and application of evidence base interventions that can prevent or significantly reduce the use of coercive measures: de-escalation; availability of a comfort room with sensory modulation; a trained response team; joint crisis intervention, advance directives and successful multimodal strategies will be presented including the elimination of potential environmental triggers of aggression in the hospital setting. The training and education of psychiatrists on human rights, recovery and alternatives to coercive practice can abolish or significantly reduce coercion.

Disclosure of Interest

None Declared
Parents of children who are victims of trauma, allies or adversaries?
Authors: Ben Youssef H. , Bourgou S. , Gadhoum R. , Rezgui H. , Ben Hamouda A. , Daoud M. , Charfi F. , Belhaj A.
Published: August 2023

Introduction

trauma affects not the child but the whole family. how would the parents’ reaction to trauma influence the child’s resilience capacities?

Objectives

study the mental health status of parents of children consulting the trauma and resilience unit.

Methods

Descriptive and retrospective study of 20 consultants in the trauma and resilience unit at Mongi Slim hospital between January and April 2022. The evaluation of depressive symptoms in children was made by Children's Depression Inventory (CDI). The Hamilton Depression and Anxiety Scales were used to assess anxiety and depressive symptomatology in the parents of the consultants.

Results

The mean age of the children was 10.46±3.24.

The traumatic event was related to an assault in 75% of cases, 45% of which were intrafamilial, road accident and death of a relative in 10% respectively, 5% domestic violence.

Five consultants had a CDI score ≥8 and 15 had a score >10. Only parents of children with a CDI score>19 had moderate to severe symptoms according to hamilton scales.

The diagnosis of adjustment disorder was made in 45% of cases, post-traumatic stress disorder 20%, acute stress disorder 10% other 15%

Conclusions

The parents’ reaction to the tragedy would play a modulating role on the children’s resilience capacities. less anxious and depressed parents would help their child build his/her coping mecanisms.

Disclosure of Interest

None Declared
The metabolic syndrom and the prescription of psychotropic drugs in children and adolescents: three clinical cases
Authors: Elmaataoui Z. , Belhadga H. , Kisra H.
Published: August 2023

Introduction

Antipsychotics have shown their interest in several pathologies of the child and the adolescent. However, in this vulnerable population, they are not without adverse effects. Depending on the type of molecule used, classical neuroleptics or second generation antipsychotics, but also within these own classes, the profile of tolerance and adverse effects differs. In this sense, children treated with psychotropic drugs have a higher risk of developing metabolic syndrome compared to children who do not take this treatment.

Objectives

The aim of this work is to discuss the metabolic syndrome in children treated with psychotropic drugs and this through three clinical vignettes.

Methods

we conducted our study through an analysis of three clinical cases

Results

It is about three children followed in the service of child psychiatry of the hospital Ar-razi of salé, aged respectively 11, 13 and 14 years, these children were put under psychotropic drugs for various mental disorders and developed during the evolution of metabolic side effects in particular a dyslipidemia, a diabetes of type 2 revealed by a diabetic ketoacidosis and a hyperprolactinemia.

Conclusions

Systematic monitoring and preventive programs targeting weight gain and metabolic side effects should be an integral part of the overall management of adolescents on psychotropic medications.

Disclosure of Interest

None Declared
Definitions and scope of the mental health burden of global climate change
Authors: Vergunst F. , Williamson R. , Mazzazza A. , Berry H. , Olff M.
Published: August 2023

Introduction

Climate change is increasing the frequency of extreme weather events – such as heatwaves, droughts, floods, and wildfires – and undermining the mental health and wellbeing of global populations, but the dimensions and scope of this burden remain under-studied.

Objectives

To identify the distinct but overlapping mental health domains that are being impacted by climate change-related stressors and how these domains relate to and interact with one another.

Methods

A narrative synthesis of conceptual and empirical studies of climate change and mental health.

Results

We find strong empirical evidence that climate change is already harming mental health across multiple mental health domains, including through increased rates of psychiatric disorders (e.g., PTSD, depression, anxiety), sub-clinical psychological distress, harmful substance use, self-harm/suicidal behaviors, and worry about the observed and anticipated impacts of climate change. Most of the mental health burden is likely to occur in the form of sub-clinical symptoms, including lowered resilience and subjective well-being, while negative psychological states (e.g., eco-anxiety) are likely to constitute a smaller proportion of the overall burden. We argue that the mental health burden can be helpfully conceptualised within a dual-continuum model that considers the presence/absence of psychiatric diagnosis on the one hand, and high/low psychosocial wellbeing on the other.

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Conclusions

Climate change is already harming the mental health of global populations across multiple functional domains. Defining and tracking the scope of this growing burden is essential so that effective preventive and adaptive action can be taken.

Disclosure of Interest

None Declared
depressive disorder and herpes zoster oticus: a case report
Authors: Chebli H. , FARH A. , belbachir S. , ouanass A.
Published: August 2023

Introduction

The herpes zoster oticus results from the reactivation of the varicella zoster virus, a DNA virus of the Herpesviridae family with strictly human-to-human contamination, affecting the geniculate ganglion of the facial nerve. The manifestations of shingles and post-herpes signs are associated with psychiatric manifestations such as anxiety, insomnia and depressive disorder. Shingles and depressive disorder share common features, such as decreased cellular immunity and a high prevalence in the elderly

Objectives

Is there a correlation between the intensity of depression and the comorbidity of herpes zoster and depression? Is there an explanation for this association? Can adequate therapy of the infection prevent the occurrence of the depressive disorder? Does the existence of this comorbidity affect the response to antidepressants?

Methods

case report and litterature

Results

case report

Conclusions

We will try to answer these questions in this work while illustrating by the case of a patient having been touched by this comorbidity and while being based on what was published in literature.

Disclosure of Interest

None Declared
“Alcohol use and suicide in Lithuania: proximity shouting out loud”
Authors: Jokūbonis D.
Published: August 2023

In the recent past, the standardized suicide mortality rate (SMR) in Lithuania was more than double the global SMR and nearly one and a half higher than in the EU. Herewith Lithuania has high male-to-female SMR ratios e.g., at 7.1 in 2016. Autopsy studies in Lithuania revealed that approximately two thirds of men and one third of women who died by suicide had a blood alcohol con-centration level above 0.04 g/dL. Although suicide is a complex phenomenon, heavy alcohol use has been considered as it’s important risk factor though the relationship was never systematically studied before in Lithuania. Experts have suggested that gender differences in excessive alcohol consumption can explain the gender disparity in suicide mortality and linked tackling the harmful use of alcohol as an opportunity for suicide prevention. Alcohol control policies may cause immediate effect on excessive alcohol consumption at both the population and individual-level and may be capable of impacting suicide mortality rates by altering alcohol use patterns at both domains. Implementation of alcohol taxation policy in Lithuania provided an opportunity to evaluate it‘s impact on suicide mortality in a country comparable to other high income countries with a comparable health care and medical education systems.

Disclosure of Interest

None Declared
Infliximab induced severe depression and suicidal thoughts in patient with bipolar disorder
Authors: Ulual P. , Burhan H. S. , Güçlü O.
Published: August 2023

Introduction

Infliximab is a tumor necrosis factor-alpha (TNF-α) inhibitor commonly used in the treatment of autoimmune disorders such as rheumatoid arthritis and ankylosing spondylitis. An increased risk of opportunistic infections, malignancy, and neurodegenerative diseases have been widely documented as adverse effects of IFX therapy. Few reports exist serving the notice of new-onset psychiatric symptoms linked to IFX treatment, such as suicidal behaviors in adults and elderly patients, as well as psychosis in an adolescent. Psychiatric side effects while under IFX treatment are reported to be rare.

Objectives

Here, we present a case of a female with bipolar disorder who developed a long-standing depressive episode with suicidal thoughts after her fourth infusion of infliximab for her ankylosing spondylitis

Methods

Retrospective life chart was created, including infliximab infusion.

Montgomery Asberg Depression Scale was applied at time of hospitalisation and discharge.

The Naranjo Adverse Drug Reaction Probability Scale was applied.

Results

A 55 year old female with ankylosing spondylitis and bipolar disorder was treated with IFX for 8 months. During this period, a total of 4 infusions were administered and AS symptoms were well responding to the treatment. Patient describes the onset of depressive symptoms such as anhedonia and insomnia after the infusion of third IFX infusion, gradually progressing to loss of function and suicidal thoughts and hospitalization in a psychiatry clinic.

The patient had a history of bipolar disorder for 10 years with recurrent manic and depressive episodes, 4 hospitalisations and 1 cure of ECT.

Patient was on sertraline, maprotiline and diazepam at the time of hospitalization. We started treatment with aripiprazole, quetiapine and valproate, followed for 4 weeks as an inpatient, consulted with rheumatology treatment options and neurology for demyelinating disorders, no pathology was discovered. Rheumatology suggested the continuation of IFX infusion under psychiatric control. Fifth dose of IFX infusion was administered and patient was discharged after euthymic mood was established and insomnia and suicidal thoughts were deteriorated. Upon follow up, depressive symptoms recurred and lamotrigine was added for augmentation.

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Conclusions

Although there is very scarce evidence that IFX causes psychiatric symptoms, there are few clinical trials too, showing evidence that TNF-alpha inhibitors may improve depressive symptoms. While we need more information and evidence to support the ideas of TNF alpha inhibitors effects on human neuropsychology, it is of great importance for especially patients with psychiatric history to be closely watched while administering the product, at least to minimize unintended adverse events.

Disclosure of Interest

None Declared
Varenicline induced auditory hallucinations in a young female with bipolar disorder: a case report
Authors: Bhanot S. , Tsang V. W. L. , Jia L.
Published: August 2023

Introduction

Creating appropriate and sustainable treatment plans for patients with concurrent disorders presents a challenge to psychiatrists and addiction medicine specialists alike. Although varenicline has been found to be one of the most effective medications for smoking cessation and abstinence, caution is needed when starting patients on this medication. In this case, a young female provisionally diagnosed with bipolar I disorder was hospitalized for a manic episode in the context of substance abuse and medical noncompliance. She also endorsed a long history of smoking, alcohol, cocaine, cannabis and ketamine use. In addition to being stabilized for bipolar disorder, the patient was started on varenicline for smoking cessation on Day 14 of admission.

Objectives

This case report highlights the potential risk of de-stabilization in a vulnerable youth with newly diagnosed bipolar I disorder and precarious social circumstances, in attempts to further concurrent approaches to psychiatric care.

Methods

In addition to qualitative observations, the main objective exam used to track patient progress through the duration of her hospitalization was the mental status exam (MSE). This is standard practice for psychiatric care and qualitatively assessed factors related to a patient’s behavioral and cognitive functioning. Important factors assessed for this patient include appearance and behavior, speech, affect and mood, thought form, thought content, perceptual abnormalities, insight and cognition.

Results

Perceptual abnormalities, including auditory hallucinations, were not recorded at admission and the patient’s symptoms of mania were resolving clinically on Day 18. Two days after starting varenicline, the patient developed auditory hallucinations, paranoia and referential beliefs. However, her insight was intact, and she had minimal thought-form disorganization. The patient also reported hearing auditory hallucinations of a derogatory nature, with her mood appearing more distressed during varenicline use. Symptoms were found to be resolved shortly after the discontinuation of varenicline on Day 18 and the patient appeared to be less distressed on following days. In this case, these symptoms were not in keeping with her bipolar diagnosis and thought to be secondary to varenicline after the consideration of potential alternative contributors.

Conclusions

The occurrence of side effects as a result of varenicline use in patients with diagnosed mental health conditions is rare and underlying psychiatric illness is not labeled as an absolute contraindication in the prescription of varenicline. However, it is important to advocate for increased guidance and research on the treatment of substance use disorders in patients with bipolar I disorder.

Disclosure of Interest

None Declared
Online pornography use during the COVID-19 pandemic: a review
Authors: Portela C. , Dionísio R. , Sousa S. M. , Gonçalves M.
Published: August 2023

Introduction

The Coronavirus (COVID-19) pandemic and the regulations enforced to control it caused significant alterations in daily routines worldwide. Lockdowns, remote working and schooling favoured virtual interactions and increased “free-time”, with the internet posing as a preferential means of distraction. Statistics from pornographic websites have shown a rise in traffic during lockdown periods, with problematic use of pornography (POPU) emerging as a potential mental health concern.

Objectives

The authors aim to summarize current knowledge on the effects of the COVID-19 pandemic on online pornography use.

Methods

Narrative review of articles referenced on PubMed and Google Scholar.

Results

The increased exposure to the internet during the pandemic, combined with psychosocial factors such as social isolation, diminished physical contact and intimacy may have contributed to the reported surge in online pornography use. Other associated factors include emotional distress and less availability of other addictive substances and behaviours during confinement periods. Besides the spike in pornography consumption, other aspects were also affected, such as time of usage, search keywords and type of content, with an increase in engagement in illegal pornography. In susceptible individuals, these circumstances may lead to the development of POPU, characterized by impaired control, excessive time spent and perceived negative consequences. Currently, there is a lack of consensual diagnostic criteria for POPU, hindering the detection of these patients and timely management.

Conclusions

Behavioural addictions are an emerging mental health problem, particularly the ones related to internet use. In the aftermath of the pandemic, considering the reported rise in online pornography use, an increase in POPU prevalence is expected. Therefore, more accurate and consensual diagnostic criteria are required, as well as a greater amount of evidence on the treatment of this disorder, in order to improve the approach to these patients.

Disclosure of Interest

None Declared
The impact of SARS-Cov-2 pandemic on mental health in medical staff
Authors: Bacaiteanu C.-B. , Bucatos B.-O. , Romosan A. , Bondrescu M. , Daescu A.-M. C. , Romosan R. , Papava I. , Laza R. , Dehelean L.
Published: August 2023

Introduction

SARS-Cov-2 pandemic resulted in a great amount of mental health suffering both in patients, families and medical staff.

Objectives

To assess the personal impact of SARS-Cov-2 management in hospital health care staff.

Methods

The study included 300 participants, comprising medical staff, 150 of which directly treated patients with SARS-Cov-2 infection, whilst the rest did not. Participants were asked to fill in online self-assessment scales: PSS-10 (Perceived Stress Scale), BAI (Beck Anxiety Inventory), BDI (Beck Depression Inventory), and SSOSH (Self Stigma of Seeking Psychology Help Scale). The data were collected at the end of 2021 during the COVID-19 pandemic with the Omicron variant.

Results

238 (79.3%) women and 62 (20.7%) men responded to the online assessment. Participants working in COVID wards had higher scores for anxiety and depression (χ²=12.21, p=0.007). The intensity of depression and anxiety (BDI / BAI) depends on the professional degree (higher in senior specialists and specialists than in nurses and residents), working in shifts (χ²=8.77, p=0.01) and recent contact with patients infected with SARS-Cov-2 (χ²=76.10, p<0.0001). Regarding PSS-10 total scores, participants that had contact with 1-10 SARS-Cov-2 patients during the past month had significantly higher scores than those who did not. SSOSH showed that participants who had more than 5 on-calls per month had significantly higher scores than the participants who had one on-call per month (p=0.008). Logistical regression showed that participants who had higher BDI scores had a probability of 136.67 times higher (95% CI [16.42; 1137.53]) to present high stress levels.

Conclusions

Respondents who had higher scores in the BDI (and not other assessment scales) had by far the highest probability of developing high stress levels.

Disclosure of Interest

None Declared
Impact of COVID 19 on sleep quality: a study of 154 patients
Authors: Halouani N. , Gdoura D. , Guermazi A. , Turki M. , Moussa N. , Ellouze S. , Aloulou J.
Published: August 2023

Introduction

In addition to psychological distress, neurological and neurocognitive manifestations, the COVID19 pandemic and its medium- and long-term consequences combine other risk factors to alter sleep.

Objectives

To screen for COVID19 sleep disorders and to identify epidemiological and clinical factors correlated with this disorder in post COVID19 patients.

Methods

This is a descriptive and analytical cross-sectional study that took place during the period from the 1rst of March to the 15th of May 2021 with 154 patients who were hospitalized at the COVID unit19 at the Hedi Chaker Hospital in Sfax Tunisia.

The sleep evaluation, made by telephone, was performed using the “Insomnia Severity Index” scale.

Results

The mean age was 66.62 ± 13.34 years. Male patients represented 60.4% of the study population.

In our study, the prevalence of anxiety, depression and post-traumatic stress disorder was 24.7%, 11% and 13.6% respectively.

The mean score of the sleep disorder severity index was 3.94 with extremes of score ranging from zero to 24. Thirty-six patients (23.4%) had insomnia, which was severe in 2.6% of patients.

We found a significant association between gender and sleep disorders. Thus, women were more likely to have insomnia.

A significant association was found between insomnia, anxiety-depressive disorders and post-traumatic stress disorder.

No significant association was found between disease characteristics and sleep disorders.

Conclusions

In post COVID, patients suffer from an important sleep disorder. Indeed, the management of these sleep disorders in post Covid-19 is essential to improve the quality of life of these people.

Disclosure of Interest

None Declared
“We weren’t used to seeing our colleagues hospitalized”: A clinical-qualitative study on reports from an intensivist clinical team at a Brazilian university public hospital
Authors: Turato E. R. , Santos F. S. , Guerra L. M. , Gasparotto A.-P. D.-C. , Aoki R. N. , Cavalcante J. M.
Published: August 2023

Introduction

The care relationships of physicians and nurses with patients with Covid-19 had pointed to a scenario explorable from a psychological point of view due to the peculiarities of this pandemic. How do clinicians feel, when caring for their co-workers, in a context that was not so common to see colleagues occupy the patient’s place? What emotional experiences arise from this reality? The results of the present study sought to point out how to handle this caring relationship, in an exceptional context.

Objectives

To interpret emotional meanings reported by physicians and nurses on their experiences of working at COVID-19 intensive care units during the height of the pandemic.

Methods

Clinical-qualitative design of Turato. Data collection with semi-directed interviews with open-ended questions in-depth applied to a sample of six professionals, closed by theoretical information saturation according to Fontanella, in a Brazilian university general hospital. Trigger question: “Talk about the psychological meanings of your experience in face of management of patients with COVID-19 at ICU”. Data treatment by the Seven Steps of the Clinical-Qualitative Content Analysis of Faria-Schützer. Theoretical framework from Medical Psychology using Balintian concepts.

Results

We raised initially 4 categories. Three categories were presented preliminarily in this congress, version last year. In this opportunity, we show this special category of analysis that emerged during the deepened discussion of the final results: “The feeling of insecurity: from technique to affective dimension”.

Conclusions

The care relationships between the health professional and the patient hospitalized in the Covid-19 ICU pointed to peculiar transference and countertransference psychodynamic mechanisms between both. Before the pandemic, the care relationship seemed pragmatic and protocolar. During the pandemic, this relationship seemed “more subjective”, building a strongly emotional dimension, as health professionals also began to care for their colleagues in the profession. The egoic defense mechanisms, such as projective and introjective identification were reported as intense.

Disclosure of Interest

None Declared
The prevalence and associated factors of moderate to severe depression symptoms among Fort McMurray residents during the COVID-19 Pandemic
Authors: Obuobi-Donkor G. , Eboreime E. , Shalaby R. , Agyapong B. , Owusu E. , Adu M. , Mao W. , Agyapong V. I. O.
Published: August 2023

Introduction

The Coronavirus disease (COVID-19) pandemic affected the mental health of many individuals, especially vulnerable communities, who have experienced multiple traumas.

Objectives

To examine the prevalence and associated factors of likely major depressive disorder (MDD) among inhabitants of Fort McMurray.

Methods

A study adopted a cross-sectional design, and questionnaires were distributed online. Sociodemographic, COVID-19-related, and clinical data were obtained. The Patient Health Questionnaire (PHQ-9) scale was used to assess likely MDD. SPSS version 25 used employed to analyze the data.

Results

The prevalence of likely MDD among participants was 45%. Participants who desire mental health counselling are more likely to exhibit depression symptoms during the COVID-19 pandemic (OR = 5.48; 95% CI: 1.95–15.40). History of depression (OR = 4.64; 95% CI: 1.49–14.44) and hypnotics (OR = 5.72; 95% CI: 1.08–30.30) were more likely to experience depression symptoms during the pandemic than other participants without a history. Participants who received absolute support from the employer (OR = 3.50; 95% CI: 1.24–9.82) were protective against depression symptoms amid the pandemic.

Conclusions

Clinical factors and employer support are associated with depression symptoms during the pandemic. Communities that have experienced multiple traumas need to reduce any psychopathology, and governmental bodies need to implement holistic policies to increase support to individuals during traumatic eras like the CVID-19 pandemic.

Disclosure of Interest

None Declared
The dermatology life quality index among healthcare workers during the COVID-19 pandemic
Authors: Sellami I. , Abbes A. , Aicha H. , Halweni H. , Feki A. , Masmoudi M. L. , Jmal Hammami K. , Hajjaji M.
Published: August 2023

Introduction

During the COVID-19 pandemic, there has been a peak of occupational dermatoses associated with Personal Protective Equipment (PPE) among healthcare workers (HCWs). The resulting dermatological damage might have an impact on the quality of life.

Objectives

We aimed to evaluate the dermatological life quality of the HCWs due to PPE use.

Methods

The study was conducted in a group of HCWs from Hedi Chaker hospital in Sfax, Tunisia. Data were gathered between march and may 2021 using a self-administered questionnaire including socio-professional characteristics, evaluation of skin lesions, evaluation of the infection-prevention practices and the Arabic version of the Dermatology Life Quality Index (DLQI).

Results

Our sample was composed of 190 HCWs. The respondents’ mean age was 32.5 ± 6.5 years and 54.7% were female. The average job tenure was 6.6 ± 5.8 years. Doctors represented 22.1 %, nurses 13.6% and cleaning staff 64.3 % of participants. The prevalence of skin lesions due to PPE among HCWs was 51.6%. The mean time of mask use was 15.4 ± 9.1 hours. The daily hand washing frequency was >10 times/day in 85.3 % of participants. The mean DLQI score was 3.3 ± 4.3. According to this index, it was found that these skin lesions had no effect, small effects, moderate effects and very large effects on the lives of 43.9%, 34.7%, 12.2%, and 9.2% of participants, respectively. The DLQI was correlated with hand washing frequency (p = 0.014, r = 0.204) and the time of mask use ( p = 0.038, r = 0.172).

Conclusions

Skin lesions among HCWs are frequent during the covid-19 pandemic. These lesions influence the quality of life of the HCWs. This risk gets higher with excessive preventive measures. It is critical to provide training on the prevention of skin lesions associated with PPE wearing and hand hygiene before and during the period of use of preventive measures.

Disclosure of Interest

None Declared
Comparison of Glycated Hemoglobin Levels in Diabetic Psychiatric Patients, Before and During the Covid-19 Pandemic
Authors: Anagnostaki M. E. , Anagnostaki I. , Papaspiropoulou G.
Published: August 2023

Introduction

The current SARS Covid-19 pandemic has negatively affected primary care and health system services provided to chronically ill patients, such as patients with Diabetes Mellitus

Objectives

The comparison of glycemic regulation as demonstrated by the levels of glycated hemoglobin HbA1c % in Psychiatric patients monitored at the Psychiatric Hospital of Attica before the pandemic (9/2018 -2/2020) and during its progression (3/2020-2/2022)

Methods

The study was done retrospectively and included 543 diabetic patients who were examined in Outpatient Clinics during the aforementioned time intervals. HbA1c % levels were measured in peripheral blood and at least two measurements were averaged for each patient. The statistical method used to compare the mean value of HbA1c % was the paired t-test and the level of significance was p<0.05.

Results

The mean of the mean values of HbA1c % before the pandemic was 7.22% while (sd 6.6-7.9) while during the pandemic period it was 8.56% (sd 7.1-9.9). The t score was calculated as 3.3 with a significance level of p=0.0165 (p<0.05).

Conclusions

n the present study, a statistically significant increase in the HbA1c % of the Diabetic patients of the Psychiatric Hospital over the last two years is found, which indicates a worsening of the glycemic control of this particular group of patients. It is worth noting that 24 out of 543 (4.4%) missed a scheduled follow-up visit, while the greater variation in HbA1c % values during the second period indicates the varied way the pandemic affected the behavior of psychiatric patients

Disclosure of Interest

None Declared
Hospital architecture matters – rethinking the role of mixed sex wards and family rooms in psychiatric hospitals
Authors: Jovanovic N.
Published: August 2023

Hospital built environment can affect patient clinical outcomes, patient satisfaction with care and treatment, staff performance and wellbeing, and carers/visitors’ engagement with services. Little is known about which urban planning, architecture and interior design characteristics can make environments therapeutic or detrimental for users.

We hope that the audience attending this presentation will i) get a good understanding of the impact of the hospital-built environment on patients, staff and visitors/carers and ii) understand which design elements can improve patient satisfaction with care.

As hospitals are among the most expensive facilities to build, their design should be guided by research evidence. In this presentation, we will review existing research evidence in this field and present our study of 18 psychiatric hospitals in Italy and the United Kingdom. Our findings indicate that out of several hospital built environment characteristics, two have the power to increase patient satisfaction with care.

These are (availability of
) mixed-sex wards and rooms to meet family off wards.

We will show vignettes to further explore the role of mixed-sex wards and family rooms and discuss how to implement them when renovating, adapting or building mental health care facilities.

Disclosure of Interest

None Declared
THE ASSOCIATION BETWEEN COVID-19 ANXIETY AND WELLBEING AMONG UNIVERSITY STUDENTS IN BOSNIA AND HERZEGOVINA
Authors: Ünal Aydın P. , Trtkovic S. , Aydın O. , Ulus I. S. , Ürek E. , Yağmur K. S. , Kılavuz B. Ç.
Published: August 2023

Introduction

As of September 2022, over 600 million COVID-19 cases have been reported worldwide. Implemented measures and novelty caused by the epidemic caused wellbeing complaints, including depression and anxiety. One particularly inflicted group are students, who were switched to online education. Many universities have decided to start with face-to-face lecturing again, but as the pandemic is still ongoing, the fear of potentially catching COVID and risking one’s wellbeing are still high.

Objectives

The study’s aim is to explore the influence of COVID-19 anxiety on wellbeing among university students.

Methods

A total of 844 university students participated in a 5-minute paper-pen survey, completing self-report scales including a sociodemographic form assessing relevant information regarding COVID-19, The Covid-19 Anxiety Syndrome Scale (C-19ASS) and the Short Warwick-Edinburg Mental Wellbeing Scale (SWEMWBS). Bivariate correlation and multiple linear regression analyses were performed to assess the associations between the variables.

Results

A negative moderate association was found between COVID-19 anxiety and wellbeing, indicating that presence of anxiety related to COVID-19 may predict a lack of wellbeing among university students.

Conclusions

As a negative association between COVID-19 anxiety and wellbeing was found, we can speculate that the existence of anxiety related to COVID-19 may predict student’s wellbeing. Knowing this, different psychological/wellbeing interventions, trainings and techniques, may be utilized to improve the wellbeing of the student population during and after these trying times, to try and minimize the negative effects of the pandemic on the student population.

Disclosure of Interest

None Declared
Post-COVID syndrome or persistent COVID and depression
Authors: Castelao-Almodovar S. , Ojea Quintana R. , Arrieta Artigas A. , Arce de la Riva A. , Tejero Soriano B.
Published: August 2023

Introduction

Since the start of the COVID19 pandemic, numerous patients have exhibited symptoms related to the viral infection once the acute phase has resolved. The most frequent are fatigue or weakness, cognitive difficulties, insomnia, and anxiety or depression. It has been observed that the persistence of these symptoms is more common in cases of severe infections.

Objectives

We expose a case that exemplifies it; A 60-year-old man suffering from severe COVID19 infection during 2021, with bilateral pneumonia and secondary pneumothorax. Three months after the acute episode, he continues to present related symptoms, such as dyspnea, asthenia, arthromyalgia, nausea, hyporexia, memory lapses, anxiety and depressive mood with apathy, anhedonia and suicidal ideas.

Methods

The patient starts follow-up in Mental Health and antidepressant treatment with Vortioxetine 10mg. In the following months he presented significant improvement consisting in decrease of the asthenia, dyspnea, arthromyalgia and especially in anxious symptoms and depressive mood, disappearing the apathy, anhedonia and suicidal ideation. However, the persistence of memory failures draws attention, which remain in a similar degree or with slight subjective improvement.

The exploration and complementary test were the following:

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Chest CT: Hydropneumothorax, parenchymal infiltrates, alveolar consolidations, left lamellar pneumothorax.

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Head CT, complete analysis, microbiological and cytological studies without relevant resolution.

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Assessment by the Rehabilitation and Neurology service.

Results

This case exposes the existence of a post-COVID syndrome, where the symptoms related to the infection persist, including anxious-depressive symptoms of moderate-severe intensity. The different diagnoses that were considered were the following: Post-COVID syndrome, Adjustment disorder with mixed anxious-depressive symptomatology, Depressive episode.

Conclusions

We consider that in this case and in others that are similar, which are increasingly common in routine clinical practice, the etiopathogenesis of the syndrome is of interest. We found that it is difficult to discern the origin of the symptoms, not being able to differentiate an adaptive difficulty to the infection situation (added to the COVID pandemic context), versus a more organic affectation that improves when receiving pharmacological treatment, as in this case with antidepressants.

Disclosure of Interest

None Declared
REPATRIATION OF A PSYCHIATRIC PATIENT FROM BRAZIL TO CHINA
Authors: Bragatto A. S. , Vourlis V. M. , Moesch J. , Timmermann F. , Brito J. , Reis B.
Published: August 2023

Introduction

Developing or presenting with a serious mental illness whilst working offshore may result in substantial barriers to treatment, rehabilitation and repatriation to one’s home country, especially amid changes in border control practices over the COVID-19 pandemic. Further difficulties arise arise in relation to language and cultural barriers.

Objectives

Our aim was to explore the experience of providing safe and effective treatment for a psychiatric patient from another country, culture and language using a non-medical interpreter.

Methods

In this report, we describe the case of a 26-year-old Chinese citizen, a cargo ship crew member, who docked at the Port of Santos-Brazil in june 2021 with severe psychiatric disturbance.

Results

Following the hospital assessment, the patient was admitted in the psychiatric ward and started the diagnostic research and treatment. After stabilization of the psychopathological condition, he was repatriated to his country of origin uneventfully. This case shows that treating and communicating with people who do not share the same language is challenging, in particular in a psychiatric context. The use of an interpreter is essential in the assessment process, but there are challenges in accessing and using these services.

Conclusions

With a detailed multi-disciplinary rehabilitation plan a patient with serious mental illness can be rehabilitated in order to facilitate the repatriation in humanized ways and respecting all health protocols of COVID-19 pandemic.

Disclosure of Interest

None Declared