bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospects for immunotherapy of depression based on cell technologies
Authors: Markova E. , Knyazheva M.
Published: February 2022

Introduction

Cell technologies actively used in the treatment of many diseases. These technologies are based on manipulating the patient’s cells outside the body, as a result of which cells acquire a higher therapeutic potential.

Objectives

No doubt the essential role of immune cells and their biologically active products in the pathogenesis of depression, which allows to view the modulated immune cells as model objects for developing new approaches to immunotherapy for depression.

Methods

(CBAxC57Bl/6) F1 depressive-like male mice, developed under the long-term social stress, were undergoing the transplantation of syngeneic immune cells with in vitro caffeine-modulated functional activity. Recipient’s behavior, immune and nervous systems functional activity were studied.

Results

It was found that immune cells isolated from depressive-like mice and treated in vitro with caffeine change their properties and after intravenous administration to syngeneic depressive-like recipients have a significant positive psycho- and neuroimmunomodulatory effects, affecting the main depression pathogenetic mechanisms: behavioral editing (reduction of anhedonia, stimulation of exploratory behavior and activity in the forced swimming test); hippocampal neurogenesis stimulation against the background of increased BDNF; modulation of cytokine production by brain cells, indicating a decrease in neuroinflammation; modulation of the immune system functional activity (stimulation of the immune response, splenocytes proliferation, reducing systemic inflammation, decrease spleen tryptophan catabolism).

Conclusions

The results serve as an experimental substantiation of a fundamentally new approach to immunotherapy of depression based on the introduction of immune cells with functional activity modulated outside the body and open up the possibility of developing new methods of immunotherapy of depressive states in humans.

Disclosure

No significant relationships.
Looking at Self-Disorders through the Minnesota Multiphasic Personality Inventory (MMPI): An empirical exploration of the MMPI-derived Self-Disorder Scale
Authors: Monducci E. , Colafrancesco G. , Perrotti G. , De Vita G. , Quadrana L. , Ferrara M.
Published: February 2022

Introduction

Trait-like anomalies of subjective experience have been empirically identified as schizophrenia-specific markers of vulnerability in several clinical and genetic high-risk populations. Recently, Parnas and colleagues have identified and preliminarily explored a composite score (i.e. Self-Disorder Scale, SDO) within the Minnesota Multiphasic Personality Inventory (MMPI) that approximates such construct). SDO differs from the MMPI psychoticism scale, and includes presents items very similar to Self Disorder investigated by EASE (Examination of Anomalous Self-experience).

Objectives

This study is a confirmatory analysis of the correspondence of Self-Disorder Scale (SDO) of the MMPI with some items of EASE, in a population of adolescents. These items are present in psychotic and in at risk mental state subjects.

Methods

We administered MMPI and EASE to 34 help seeker adolescent patients and correlate all dimensions of MMPI with EASE total score and its domains.

Results

MMPI SDO scores significantly correlated with schizophrenia-spectrum diagnosis and high-risk mental states.

Conclusions

SDO is an MMPI analogous of Self Disorders and can be used as a useful screener to detect patients at potential risk for schizophrenia spectrum disorders, that could be further explored with the EASE.

Disclosure

No significant relationships.
Revisiting hysterical psychosis: A case report
Authors: Barbosa D. , Almeida B. , Mota M.
Published: February 2022

Introduction

Holiender and Hirsch defined hysterical psychosis in 1964 and, while hysteria has a contemporary equivalent in somatoform/dissociation disorder, hysterical psychosis remains set adrift in the nosological understanding of psychiatric disorders.

Objectives

To present a case report of a hysterical psychosis and to review this nosological construct.

Methods

Clinical interview, consultation of clinical records and review of literature using the Pubmed platform.

Results

The authors present a case of a 38 year-old woman, admitted in a psychiatric emergency department for bizarre behavior, restlessness, auditory (pseudo)hallucinations and emotional lability, starting 1 week after a personal development retreat. This is the second episode of this nature, the first being a 15-day hospitalization 7 years ago, with rapid stabilization, extensive examination and restitium ad integrum. The patient initiated Olanzapine and was referred to an outpatient clinic, with rapid stabilization and restitium ad integrum throughout follow-up. Given the episode and patient characteristics, a hysterical psychosis diagnosis may be accurate, taking into account the acute onset and course, the pleomorphic nature of symptoms and the presence of a disturbing life event. The authors propose reviewing the concept of hysterical psychosis regarding its clinical implications and debating its therapeutic and prognostic utility.

Conclusions

Hysterical psychosis may not be a mere historic footnote and encompasses an entity with distinctive diagnostic, prognostic and therapeutic characteristics. While its etiology may not be understood, its clinical implications ensure the need for future research.

Disclosure

No significant relationships.
Bed for three
Authors: Adame C. Vallecillo , Aparicio T. Jiménez , De Andrés Lobo C. , De Llano De La Viuda M. Queipo , Valera G. Guerra , Ramírez A. Gonzaga , Carrasco I. Santos , Cerejeira J. Gonçalves , Meseguer C. Capella , Vázquez E. Rodríguez
Published: February 2022

Introduction

Charles Bonnet syndrome (CBS) is characterized by the presence of visual hallucinations without other sensory-perceptual disturbances or evidence of organic mental disorder nor functional psychosis.

Objectives

Review differential diagnosis of BCS, searching articles in Pubmed.

Methods

62-year-old woman, undergoing treatment with Sertraline and psychotherapy for three months because of anxious-depressive synthoms. Pathological myopia and retinal detachment in 2012, blind left eye, retaining 33% vision in the right eye. She comes to the emergency room feeling really anxious, she says that for a year now she has had the feeling that her husband is cheating on her with another woman, and she claims with certainty that she sees a woman in her bed at night, as well as flashes of light evidencing her presence. She has also begun to hear voices through the telephone wires. She and her family deny memory loss or other cognitive impairments. We performed a Nuclear Magnetic Resonance with normal results. Family claims good conygal relation until these synthoms began and no signs of cognitive impairment.

Results

The patient lives as real these hallucinations which haven´t appeared during admission. We started treatment with an antipsychotic and a benzodiazepine, with great improvement of anxiety and development of some insight. Executive impairment was observed.

Conclusions

The results obtained, make us think that, although our patient has an important visual loss, it is more a psychiatric pathology. Here lies the importance of a multidisciplinary approach among ophthalmologists, neurologists and psychiatrists in order to avoid misdiagnosis and that the patient can benefit from proper treatment.

Disclosure

No significant relationships.
The role of perinatalcare in early life trauma prevention
Authors: Kurimay T. , Szederkenyi J. , Hortobagyi A.
Published: February 2022

Abstract Body

Mental health support for parents, infants and children as an interdisciplinary, cross-sectoral task has existed for decades in many European countries. A highlighted goal of integrated services (medical, social and educational) is to support competent parenting and the positive parent-child relationship, for the optimal development including mental health of infants and children. In clinical practice, the role of psychiatrists is often linked to healing and rehabilitation, even though we also have an important role in prevention. The mental support, treatment and prevention of psychiatric disorders during the pre-, peri- and postnatal period are often not considered being preventive measures. The perinatal period is the most sensitive and at the same time one of the most important stages of our lives. The traumas suffered during this period affect both the mother and the newborn, in fact it affects the family as a whole. Models for the prevention of early trauma appear at the level of social community and, inter alia, health and social care. Traumas are closely linked to social determinants of health. Gene environment interactions also allow for the transgenerational transmission of trauma. The presentation introduces individual and family levels of interdisciplinary care, good practices and programs the knowledge of which may be important to psychiatrists. How the practicing psychiatrist can contribute to trauma prevention and how to understand the development of resilience. The presenter will detail good practices, and highlight the possibilities for all clinicians on ways to work in their respective field with a trauma preventive approach.

Disclosure

No significant relationships.
First episode psychosis and the use of psychostimulants - a case report
Authors: Teixeira T. , Martins S. , Carvalho V.
Published: February 2022

Introduction

Stimulants are considered the mainstay of treatment for attention-deficit/hyperactivity disorder (ADHD), and most patients are put on a long-term regimen with these psychostimulants. However some children treated with psychostimulants have reported psychosis as an adverse effect.

Objectives

Understand the capacity of psychostimulant medications to induce psychotic symptoms and determine the frequency of such reactions in adolescents and young adults.

Methods

Non-systematic review of the literature in English, through research in PubMed. Additionally, a clinical case is exposed, which was treated at the psychiatric inpatient unit of the Tamega e Sousa hospital center.

Results

Some patients, including some with no identifiable risk factors, can develop drugrelated signs or symptoms of psychosis or mania, such as hallucinations, at usual doses of frequently used ADHD drugs. Age of onset of psychosis can be significantly earlier in individuals with a history of stimulant use. In our clinical case, a young man of 18 years, previously diagnosed with ADHD, was medicated with atomoxetine two months prior being admitted to our psychiatric unit. There was no reported history of a similar psychiatric condition, and no risk factors were identified. At admission, he had bizarre behavior, with allucinatory activity and delusions of persecution. Atomoxetine was suspended and started oral antipsychotic, with improvement of symptoms and stabilization of the clinical condition.

Conclusions

In adolescents and young adults with ADHD undergoing stimulant therapy, any psychotic symptoms or mood changes need to be carefully assessed at regular intervals by the physicians and the caregivers, in order to observe change in the symptoms.

Disclosure

No significant relationships.
Effects of the moderate stress exposure on the short-term memory capacity: An experimental study in fire cadets
Authors: Bityutskaya E. , Lebedeva N. , Tsalikova Y.
Published: February 2022

Introduction

Future firefighters are selected and trained to perform well under pressure and stress.

Objectives

The research is focused on the experimental study of fire cadets’ memory capacity under stress.

Methods

The study follows Solomon Four Group Design with two variables: stress stimuli (exposure/non-exposure), fire cadets (n=50)/civilian students (n=40). Two series of The Digit Span Test measurements (DST) were performed. Heart rate, EMG, systolic wave amplitude, pulse transit time were measured during the experiment to determine the respondents’ stress levels.

Results

Memory capacity in fire cadets under stress (n=30) significantly increased (Wilcoxon match-pairs rank test, р = 0.001; 1st DST series, neutral stimuli: M=6.53, SE=0.17, SD=0.96; 2st DST series, stressful stimuli: M=7.3, SE=0.21, SD=1.16), the obtained effect size was medium (Cohen’s d = 0.7232). There was no significant change in memory capacity in civilian students under stress (n=20, Wilcoxon test, р=0.452; 1st DST series, neutral stimuli: M=6.78, SE=0.23, SD=1.02; 2st DST series, stressful stimuli: M=6.7, SE=0.23, SD=1.04). Moreover, there was no significant change in memory capacity in fire cadets that were not under stress (n=20, Wilcoxon test, р = 0.628; 1st DST series, neutral stimuli: M=6.88, SE=0.16, SD=0.70; 2st DST series, neutral stimuli: M=6.78, SE=0.16, SD=0.73). Systolic wave amplitude in the stress-exposed groups changed more pronouncedly in students (Mann–Whitney test, z=-2.131; p = 0.033) compared to cadets.

Conclusions

In most of the fire cadets, moderate stress exposure resulted in a memory capacity increase.

Disclosure

No significant relationships.
Looking beyond electroconvulsive therapy: A case report
Authors: Barbosa D. , Sousa A. , Machado A.S. , Moreira R. , Mota M.
Published: February 2022

Introduction

Electroconvulsive therapy (ECT) is considered a gold-standart treatment of severe and treatment-resistant depression. Lack of response to ECT often causes distress in psychiatrists regarding the next therapeutic decisions.

Objectives

To present a case report of a patient with psychotic depression with partial response to ECT.

Methods

Clinical interviews and review of literature using the Pubmed platform.

Results

The authors present a case of a 60 year-old woman admitted for severe depressive episode with psychotic symptoms. Due to lack of response to multiple antidepressive and antipsychotic treatments, 15 sessions of ECT were performed with improvement of behavioral and psychotic symptoms. However, endogenous depressive symptoms with functional impairment persisted. It was then initiated Bupropion 300mg/day resulting in vast improvements on drive, energy and activity levels with restored functionality. Previously to ECT, Bupropion was not considered a valid option due to the psychomotor restlessness that was present. This case exposes the limitations of ECT and the therapeutic conundrums that arise when there is partial response. The symptoms expressed in the patient after ECT course correlate with deficits in noradrenergic and dopaminergic pathways that are involved in endogenous depression. The use of Bupropion, with its effect on noradrenaline and dopamine receptors, may offer a therapeutic lifeline in these cases.

Conclusions

ECT still stands as a gold-standart for severe depressive disorder, especially when several psychopharmacological therapies have failed. In cases of partial response to ECT, the neurobiological correlates of clinical presentation can guide the therapeutic management towards improved outcomes.

Disclosure

No significant relationships.
Internet and psychosocial interventions: What is the evidence?
Authors: Riper H.
Published: February 2022

Abstract Body

Digital mental health, before, during and after the
COVID-19 pandemic Over the last two decades the digital landscape of mental health care research and service innovation has gained momentum. This period is characterized by many successes’ stories but brilliant failures as well. Today, e-mental health is like a two-headed Janus. One side of his face illustrates the birth of innovative technologies that entered mental health service provision. In parallel, the evidence-base for the application of these new technologies, such as internet-based treatments for depression, has been established with effect sizes comparable to those of face-to-face treatments. The other side of his face shows, however, that eMental-health has not yet lived up to its’ full potential as its actual delivery, evaluation and implementation in routine care has proven to be a much longer and bumpier road than expected. The question addressed in this presentation will be ‘what does the future hold’? Acknowledging that futures are difficult to predict Heleen Riper nevertheless provides insights into how we may overcome some of these bumps by combining the best of two worlds, i.e. blending digital and face-to-face components into one integrated treatment approach. She will illustrate these new developments by virtue of the results of the H2020 European Comparative Effectiveness Study for Major Depression and current experiences with especially videoconferencing during the Covid-19 pandemic.

Disclosure

No significant relationships.
On gender and cognitive flexibility. The REM-ACT study: Acceptance and commitment therapy versus a mindfulness-based emotional regulation intervention in anxiety disorders. A randomized controlled trial
Authors: Fernández-Jiménez E. , Vidal-Bermejo E. , Torrea-Araiz I. , Castellanos-Villaverde T. , Navarro-Oliver G. , Hospital-Moreno A.
Published: February 2022

Introduction

Research is needed to explore whether cognitive flexibility may account for potential gender differences after mindfulness-based interventions.

Objectives

To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on cognitive flexibility according to gender.

Methods

This study was carried out in a Mental Health Unit in Spain (Colmenar Viejo, Madrid). Firstly, 80 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 64 patients decided to participate (mean age = 40.66, S.D. = 11.43; 40 females). Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2x2 mixed ANOVA (pre-post change x intervention type x gender) was conducted, with Sidak-correction post hoc tests. The dependent variable was the score on TMT-B.

Results

A natural logarithmic transformation was conducted to correct violation of normality and homoscedasticity assumptions. No statistically significant differences were observed on age or gender between interventions. No statistically significant interaction effect was observed between pre-post change x intervention x gender [F(1, 52) = .014, p = .907]. An interaction effect was observed between pre-post change x intervention [F(1, 52) = 4.180, p = .046; statistical power observed = 52%]: while TMT-B improved after ACT (p = .001; Cohen’s d = 0.607), there were no changes after MER (p = .367; Cohen’s d = 0.097).

Conclusions

These medium effect-size results confirm previous findings of our research team indicating cognitive flexibility improves after ACT but not after MER.

Disclosure

No significant relationships.
Enhancing a nutrition and self-management: An intervention program via teletherapy for teenager with ADHD. A pilot case study
Authors: Ahmed T. , Salem E.
Published: February 2022

Introduction

Several ADHD teenagers had difficult behavioral problems during countries closing down due to Covid-19 pandemic. One of these negative outcomes that parents cannot control children’s behavior toward desired unhealthy food and the impulsive consequences. It was a great opportunity to convention a teletherapy program as a tool of intervention seeking for help to reduce uncontrolled self- management and nutrition, which may affect all sorts of childhood growth, development, health and behavior. Furthermore, it can affects daily life and academic success.

Objectives

We tried through our study to enhance the teletherapy as a therapeutic tool, during the first and second phase of Covid-19 pandemic, trying to help parents and patient to overcome the impulsive behavior by using a specific therapy technique based on nutrition and behavioral therapy

Methods

Our case study is a young girl aged 12:4 Yrs. In middle bilingual Arabic/ American School. The therapeutic program designed via teletherapy program using multi-media and thru multi phases sessions, to increase focus attention, emotional control and reduce impulsivity.

Results

The outcomes of the enhancing nutrition and behavior teletherapy program, showed significant improvement for the specific goal. Sensible change in the girl’s impulsive behavior, more focusing, emotional control and more accepting about health nutrition habits.

Conclusions

The important finding that intensive, focused nutation and self-management techniques provided via teletherapy as solitary program brought benefits to individual’s, family and reduced impulsivity outcomes. In addition, family education to become an expert at learning simple techniques in daily life can brining a sense of pleasure for long life wellbeing.

Disclosure

No significant relationships.
The psychosocial rehabilitation of the offending psychiatric patients: Looking the good practices
Authors: Riolo A. , Battiston C. , Lusina A. , Sindici C. , Albert U.
Published: February 2022

Introduction

The Italian law 81/2014 has given a strong push to the design of therapeutic-rehabilitative paths for psychiatric patients who are offenders. This innovation requires a constant organizational effort on the part of mental health services to enforce the law. The rehabilitation team is represented by different professionals like psychiatrists, psychologists, nurses, psychiatric rehabilitation technicians, educators, social workers and others. They must be able to work in an integrated way among them and with private social sector.

Objectives

It is in our interest to reach an agreement between different professionals working in the rehabilitation-forensic field about good practices.

Methods

We have prepared a survey to identify good practices in the field of psychosocial rehabilitation of the offender psychiatric patient, involving different professionals who have expertise.

Results

This audit revealed, in everybody’s opinion, that these offending citizens have received a security measure capable of having greater control over their actions in a therapeutic-rehabilitative perspective but it is fundamental to educate them also to exercise their own safety for a social shared culture. Ensuring the safety of the offender during the therapeutic-rehabilitative path is as important as responding to a society’s need for social security.

Conclusions

Satisfying a society’s need for security, established by the Judge and the Law, all this cannot separated from the active exercise of security of the offending psychiatric patient towards himself, through psychoeducation. The safety towards others and towards oneself can constitute a good practice in the field of psychosocial rehabilitation.

Disclosure

No significant relationships.
Schizophrenia: Four new hypotheses
Authors: Jorge B. , Fernandes C. Pedro , Mangas M. , Carvalho J.
Published: February 2022

Introduction

Schizophrenia is a chronic and debilitating psychiatric disorder. Affecting social, emotional, perceptive, and cognitive domains, its clinical phenotype can be subdivided into positive and negative symptoms, and those of cognitive impairment. As the knowledge base behind the social and environmental origins accumulates, the etiological and neuropathophysiological mechanisms behind them remain elusive.

Objectives

To review the latest developments in potential etiological hypotheses linked to schizophrenia.

Methods

A non-systematic review was performed, searching Pubmed for articles published between the years of 2019 and 2020.

Results

(1) Common genetic variants alter brain glycosylation and may play a fundamental role in the development of schizophrenia. The strongest coding variant in schizophrenia is a missense mutation in the manganese transporter SLC39A8, which is associated with altered glycosylation patterns in humans, resulting in modification of a subset of schizophrenia-associated proteins. (2) Failure of oligodendrocytes and astrocytes to differentiate contributes to several of the key characteristics of schizophrenia, including hypomyelination and abnormalities in glutamate and potassium homoeostasis. (3) Diglossia was hypothesized as a risk factor, as it could constitute a neurodevelopmental insult. This relationship may be mediated by the reduced lateralization of language in the brain. (4) The first brain-wide resting state effective-connectivity neuroimaging analysis proposed going beyond the disconnectivity hypothesis, drawing attention to differences between back projections and forward connections, with the backward connections from the precuneus and posterior cingulate cortex implicated in memory stronger in schizophrenia.

Conclusions

These novel insights may be a promising step in the right direction, presenting not only new approaches towards the complex pathogenesis of schizophrenia, but also eventual early interventions.

Disclosure

No significant relationships.
Combined use of clozapine and cariprazine in treatment-resistant schizophrenia, is it a good choice?
Authors: Darriba H. Becerra
Published: February 2022

Introduction

Treatment-resistant schizophrenia (TRS) affects 30% of people with a diagnosis of schizophrenia, and is defined as nonresponse to at least two trials of antipsychotic medication of adequate dose and duration. Clozapine is the only evidence-based treatment for TRS. Cariprazine may be considered significantly more efficacious than risperidone in improving negative symptoms of schizophrenia.

Objectives

To describe the experience of using cariprazine in combination with clozapine in patients with refractory schizophrenia and negative symptoms.

Methods

Qualitative design. We present a case report study of a 47-year-old male with a diagnosis of TRS, treated in our outpatient mental health clinic for twenty years. The patient experiences crystallized delusional ideas of harm, self-referential, paranoid and mystical-messianic content, phenomena of theft and thought reading, egodistonic auditory hallucinations. No substance use disorder was observed. He made several suicide attempts in the context of intense suffering and psychotic anguish. Clozapine 400mg/day was instituted after no response to treatment with amisulpride, paliperidone, olanzapine or aripiprazole. The intensity of positive symptoms was reduced (experiences of damage, commenting and insulting auditory hallucinations, self-referentiality), as well as the emotional and behavioral repercussions. Persistent negative symptoms appeared such as apathy, abulia, clinophilia, anergy, social isolation, affective flattening, impairing his functionality.

Results

Neuroimaging and periodic blood tests results were normal. Oral cariprazine was added in ascending doses up to 4.5mg with good tolerance. The patient showed remission of apathy, enhancement of behavioral activation, socialization and motivation to perform occupational activities.

Conclusions

Combinations of clozapine with partial agonists may improve the quality of life in refractory schizophrenia.

Disclosure

No significant relationships.
Management challenges in a schizophrenic patient with multiple brain abscesses: A case report
Authors: Naval M. Huete , Albarracin P. , Galeron R. , Herrero E. , Deike L. Gallego
Published: February 2022

Introduction

Cerebral abscesses are rare, occurring in approximately 0.3–1 per 100 000 patients. Mortality rate still remains as high as 22%. Very few cases of acute psychotic episodes associated with brain abscess have been reported.

Objectives

To present a case report of a patient with schizofrenia associated with multiple brain abscesses, focusing on clinical features and managing challenges.

Methods

Presentation of a clinical case supported by a non-systematic review of literature containing the key-words “brain abscess”, “psychosis” and “schizophrenia”

Results

This is a case report of a male 44-year-old patient with a known history of schizophrenia since the age of 18 and with multiple brain abscesses diagnosed 2 month ago. He was admitted to our inpatient service after discontinuation of her medication resulting in an acute psychotic episode. Antibiotic therapy with rifampicine, metronidazole, trimethoprim and sulfamethoxazole was started. Also, administration of clozapine was initiated (up to 400mg/day) with partial improvement, so aripiprazole was added (up to 45 mg/day), with insufficient response. We suspected of a drug interaction between rifampicine (known potent broad inducer of drug-metabolizing enzymes) and antipsychotic medication, so we decided to change aripiprazole to amisulpride 1200 mg/day, which CYP-catalyzed metabolism appears to be minor. A significant improvement in positive symptoms and mood was observed. The patient has since had no delusions or hallucinations and is living independently at home.

Conclusions

This clinical case highlights the possible association between brain abscesses and relapses in schizophrenia. It is of utmost importance to be aware for possible drug interactions between antibiotic therapy and antipsychotic medication.

Disclosure

No significant relationships.
Women substance use in india: An important but often overlooked aspect
Authors: Tripathi R.
Published: February 2022

Introduction

Substance abuse has traditionally been considered as a disease of men. Women were believed to have some kind of immunity in terms of “social inoculation”. However, due to change in societal norms and beliefs, substance use is currently increasing among women also.

Objectives

To focus on female substance use in India

Methods

In India, traditional use of various substances by women during religious festivals is not unknown. Chewing tobacco is a common practice among many women across the country. Cultural use of alcohol has been known in some tribal populations but gradually the use is increasing. There is major difference in pattern of male and female substance use including initiation, progression, recovery and relapse. Women experience greater medical, physiological and psychological impairment and experience loss of control sooner than males. Teatment needs of female substance users is different and requires a gender specific comprehensive strategy which will require medical services, mental health services, services for family and child and employment opportunities.

Results

Currently, there is no Indian policy for women substance use. However, Government of India has started a convergence program which includes National AIDS Control program (NACP), National rural health mission (NRHM) and reproductive or sexually transmitted infection (RTI/STI) to combat some aspects.

Conclusions

India is in great need of a policy or at least a standard operative protocol for management of female substance use disorder which may include screening for substance use disorder for all females accessing health sector, counselling, referral to addiction services, formation of a treating team and after –care.

Disclosure

No significant relationships.
The predictor role of metacognition and emotion recognition in internet gaming disorder among late adolescents
Authors: Aydın O. , Ünal-Aydın P. , Arslan Y. , Güçlü M. , Çakiroğlu S.
Published: February 2022

Introduction

Internet gaming is acknowledged as a common leisure activity among adolescents yet only a little known about the pscyhodevelopmental roots. Emotion recognition and metacognition which are proved to be determinants in behavioral disorders may be considered salient factors in also internet gaming disorder (IGD).

Objectives

The research to date has focused on psychological comorbidities rather than risk factors (e.g. dysfunctional metacognitive beliefs, emotion recognition deficits), whereas, improved early intervention would be more likely if risk factors were well defined, especially before the onset of the illness. The objective of this study was to investigate these areas by analyzing associations between metacognitive beliefs, emotion recognition, and IGD among late adolescents with tendency for pathological gaming behavior.

Methods

806 high school students were recruited and instructed to take Internet Gaming Disorder Scale (IGDT), Meta-Cognitions Questionnaire for Children and Adolescents (MCQ-C) and Reading the Mind in the Eyes Test - Children’s Version (RMET).

Results

Mean comparisons corresponding to IGD risk potential showed that positive meta-worry and superstitious, punishment, and responsibility beliefs of MCQ-C were significantly higher in the risky group, whereas; RMET neutral subtest was significantly higher in the non-risky group. Additionally, a positive correlation was found in all subtests of MCQ-C, RMET positive emotions and IGD. Regression analysis revealed that RMET positive subtest and positive meta-worry of MCQ-C predict IGD risk.

Conclusions

The findings of the study partially corroborated the early results found among early adolescents; however, they also indicated the requirement of distinct therapeutic approach for cognitive interventions of IGD in late adolescence period.

Disclosure

No significant relationships.
Adolescents’ attitudes towards e-cigarette in Tunisia
Authors: Maalej R. , Zgueb Y. , Aissa A. , Ouali U. , Nacef F.
Published: February 2022

Introduction

E-cigarette use has increased over the last years. Many studies have examined teenagers’ attitudes towards smoking, but did not examine adolescents’ attitudes towards e-cigarettes.

Objectives

The aim of this study was to examine high school students’ attitudes regarding e-cigarette safety, addictive properties and social norms and to compare e-cigarettes perceptions among e-cigarette users and non-users in Tunisia.

Methods

A survey was conducted with a sample of 234 students in Mohamed Ali high school in Sfax, a town in South of Tunisia, in February 2020. Socio-demographic data and questions about vaping and attitudes towards e-cigarettes were used to evaluate students’ perceptions towards e-cigarettes.

Results

Among high school students aged 15 to 20, 58,8% have ever used e-cigarette, 38,3% had done so within the previous 30 days and 20,5 % were regular users of vapes. 53.8% of students believed that e-cigarettes are harmful. 78.4% of them thought they were less harmful than regular cigarettes and 50.5% thought they could be addictive, 45.4% of students believed e-cigarette smoking decreased anxiety and a third thought it made them sociable (33.3%) and confident (30.6%).Adolescents who used e-cigarettes had significantly more favorable e-cigarette attitudes than non-users: they believed they were less harmful than tobacco (p=0,019), they were not addictive (p=0,005), they decreased anxiety (p=0,001) and they made the user sociable (p<0,001) and confident (p=0,01).

Conclusions

Our results suggest the need to provide teenagers with the correct information about e-cigarettes risks, and the balance risk-benefit of their use.

Disclosure

No significant relationships.
Alendronate overdose/intoxication: Suicidal attempt in a case report
Authors: Higueras T. Gutiérrez , Cortés F. Calera , Forés S. Vicent , De La Cuesta Alonso S. Sainz
Published: February 2022

Introduction

Alendronate is a nitrogen-containing biphosphonate that inhibits osteoclastic bone resorption. Lethal dose (LD50) was aproximately 626mg/kg in male rats, and 552mg/kg in female. Signs and Symptoms of overdose clammy skin, CNS depression, dysphagia, hiccups, miosis, respiratory depression, seizures and wheezing. Supportive therapy and monitor of urine flow, calcium and phsophorous level is essential for the management of voluntary overdose.

Objectives

To present the case of a 76-year-old woman who made a suicide attempt by ingestion of 8 tablets of 70 mg of alendronate.To describe the treatment of alendronate poisoning and the follow-up parameters for the control of complications.

Methods

Clinical case presentation through retrospective review of clinical notes and non-systematic literature review.

Results

A 76-year-old woman was taken to the emergency department after voluntarily ingesting 8 alendronate tablets (70 mg per tablet) 1 hour ago reporting “suicidal thoughts”. After clinical evaluation, gastric lavage, administration of activated charcoal, and IV ranitidine were used. After 24-hour observation and after psychiatric evaluation, the patient was discharged.

Conclusions

Hypocalcaemia, hypophosphataemia and upper gastrointestinal adverse reactions, such as upset stomach, heartburn, oesophagitis, gastritis, or ulcer, may result from oral overdose. In case of overdose with alendronate, milk or antacids should be given to bind alendronate. Giving milk or antacids, to bind the bisphosphonate and minimize absorption, has been suggested for oral overdose. Due to the risk of esophageal irritation, vomiting should not be induced and the patient should remain fully upright. For decontamination is recomended activated charcoal and gastric lavage.

Disclosure

No significant relationships.
Suicide postvention in psychiatry
Authors: Castro L. , Desport C. , Freitas J.
Published: February 2022

Introduction

During their career and sometimes during their training psychiatrists have to deal with the suicide of patients and have also to help other colleagues and families to cope with the situation. Suicide postvention should be integrated in psychiatric training and better implemented in both psychiatric and community contexts.

Objectives

To discuss the concept of suicide postvention in Psychiatry. To discuss the importance of addressing suicide postvention in psychiatric settings including during specialized training of Psychiatry residents.

Methods

MEDLINE and PubMed databases searches for peer-reviewed studies, published in the last ten years, using combinations of the key-words suicide postvention and psychiatry. Selection of the relevant studies according to the study aims.

Results

The literature search retrieved a total of 44 papers. All the articles that didn´t refer to the studied topic were excluded. Relevant articles discussing suicide postvention were selected, comprising a total of 22 articles. The reviewed papers discuss different contexts and strategies of suicide postvention that will be explored and critically discussed.

Conclusions

Addressing the topic of suicide postvention and implementing support programs and training in this field is crucial to psychiatry trainees, psychiatrists and other mental health professionals that integrate multidisciplinary teams, patients and their families and also to the community as a whole. Future research in this field can help to improve suicide postvention across different settings.

Disclosure

No significant relationships.
Anxiety disorders and childhood exposure to emotional abuse: The mediating role of disgust
Authors: Innocenti M. , Santarelli G. , Gironi V. , Faggi V. , Giaquinta N. , Angeletti L. Lucherini , Castellini G. , Ricca V.
Published: February 2022

Introduction

Several studies demonstrate that disgust, defined as a revulsion response aimed at distancing an individual from a potentially harmful or noxious stimulus, is linked to post-traumatic stress following sexual trauma even when accounting for associated fear and anxiety. One of the suggested mechanisms implicated in this association is a feeling of mental contamination. Recent neuroimaging studies demonstrated that exposure to contamination activates the insular cortex. In addition, disgust sensitivity correlates with the activation of the insular cortex.

Objectives

We aimed to investigate the psychopathological role of the emotion of disgust in the developement of anxiety symptoms in patient with an history of abuse.

Methods

We enrolled 84 patients admitted in Psychiatric Unit of Careggi with diagnosis of Anxiety Disorders. We administered to them: Zung Anxiety Scale (ZSAS), Childhood Trauma Questionnaire (CTQ), Disgust Propensity and Sensitivity Scale-revised (DPSS-r).

Results

Results showed a significant mediation of the association between CTQ emotional abuse scores and total ZSAS scores via DPSS disgust sensitivity scores in patients with anxiety disorders (p=0.022). Total effect and indirect effect of emotional abuse on severity of anxiety symptoms were significant (total effect = 0.494; p=0.051, indirect effect: 0.256, p=0.022), while there was no significant direct effect from emotional abuse to anxiety symptoms in the total model (direct effect: 0.237, p=0.356). The model explained 18% of variance in anxiety symptomatology (R2=0.18).

Conclusions

Such preliminary data suggest a possible mediating role of disgust in development and maintenance of childhood abuse-related anxiety, making it a potential target for psychotherapy.

Disclosure

No significant relationships.
Prospective early warning signals to detect transitions to manic and depressive episodes in bipolar disorder
Authors: Bos F. , Schreuder M. , Doornbos B. , Snippe E. , Bruggeman R. , Van Der Krieke L. , Haarman B. , Wichers M. , George S.
Published: February 2022

Introduction

For patients with bipolar disorder, early recognition of impending mood episodes is crucial to enable timely intervention. Longitudinal digital mood monitoring using ecological momentary assessment (EMA) enable prospective study of early warning signals (EWS) in momentary affective estates prior to symptom transitions.

Objectives

The present study examined in a unique longitudinal EMA data set whether EWS prospectively signal transitions to manic or depressive episodes.

Methods

Twenty bipolar type I/II patients completed EMA questionnaires five times a day for four months (average 491 observations per person), as well as weekly symptom questionnaires concerning depressive (Quick Inventory for Depressive Symptomatology) and manic (Altman Self-Rating Mania Scale) symptoms. Weekly data was used to determine transitions (i.e., abrupt increase in symptoms). Prior to these transitions, EWS (autocorrelation at lag-1 and standard deviation) were calculated in moving windows over 17 affective EMA states. Kendall’s tau was calculated to detect significant rises in the EWS indicator prior to the transition.

Results

Eleven patients reported one or two transitions to a mood episode. All transitions were preceded by at least one EWS. Average sensitivity for detecting EWS was slightly higher for manic episodes (36%) than for depressive episodes (25%). For manic episodes, EWS in thoughts racing, being full of ideas, and feeling agitated showed the highest sensitivity and specificity, whereas for depression, only feeling tired showed high sensitivity and specify.

Conclusions

EWS show promise in anticipating transitions to mood episodes in bipolar disorder. Further investigation is warranted.

Disclosure

No significant relationships.
Multicentre evaluation of perinatal pharmacological management in women with bipolar disorder
Authors: Dias M. Casanova , Jones I. , Wieck A.
Published: February 2022

Introduction

The pharmacological management of women with bipolar disorder in the perinatal period is challenging. This population has a high recurrence rate, but some medications can be a concern in pregnancy and breastfeeding. Little is known about prescribing practices in perinatal services, and the impact of medication on recurrence rates.

Objectives

To describe 1. the use of medication in women with bipolar disorder in the perinatal period and 2. the impact of medication on the rate of recurrence.

Methods

Clinical data was collected from pregnant women with diagnosis of bipolar disorder in the nine participating centres and who were not experiencing an episode of illness entering the postpartum period. Data were analysed for association using χ2 tests and logistic regression.

Results

In this sample of 167 women, 55% were taking medication at delivery: 37% antipsychotics, 15% mood stabilisers, 25% antidepressants. In 12 cases medication was reduced before delivery. 42% experienced a recurrence, with 30% being a manic/psychotic episode. There was no significant association between taking medication and recurrence c2(1)=0.72, p=0.79. There continued to be no association when adjusted for severity (previous admissions, age at first treatment, bipolar subtype) and type of medication OR 0.57 95%CI [0.08; 4.29], p=0.59.

Conclusions

A high number of bipolar women are taking medication before delivery and in the majority antipsychotics are prescribed. The postnatal recurrence rate in both medicated and unmedicated women is high. Further work is needed in larger samples to provide clinical guidance for women and their clinicians.

Disclosure

No significant relationships.
Childhood behaviours and adverse economic and social outcomes – can we improve detection and prevention?
Authors: Vergunst F. , Tremblay R. , Nagin D. , Vitaro F. , Cote S.
Published: February 2022

Introduction

Disruptive behaviours underpin the most prevalent and costly psychiatric disorders in youth including ADHD and conduct disorder. Yet the association between childhood behavioural problems and economic and social outcomes in adulthood are rarely examined in a population-based samples where early detection and prevention may be possible.

Objectives

To examine the association childhood behavioural problems and economic and social outcomes from age 18-35 years across three studies.

Methods

This study daws on 30-year Canadian birth cohort (n=3017) linked to government tax return records. Behavioural assessments – for inattention, hyperactivity, opposition, aggression, anxiety and prosociality – were prospectively obtained from teachers when children were aged 6-12 years. Regression models were used to link behavioural assessments in kindergarten (age 5/6 years) to earnings at age 33-35 years (Study 1) and to trajectories of welfare receipt (Study 2), while behaviour at age 10-12 years was linked to trajectories of partnering. Children’s IQ and family background were adjusted for.

Results

Inattention, aggression-opposition (males only) and low low-prosociality in kindergarten were associated with lower earnings at age 33-35 years (Study 1), inattention, aggression-opposition and low prosociality in kindergarten predicted following a chronic welfare receipt trajectory from age 18-35 (Study 2), and inattention, aggression-opposition, anxiety and low-prosociality at age 10-12 years were associated with increased likelihood of being unpartnered and with partnership dissolution from age 18-35 years (Study3).

Conclusions

Behavioural assessments made by schoolteachers can identify children at risk of adverse economic and social outcomes in adulthood. The implications of for early screening and prevention will be discussed.

Disclosure

No significant relationships.