bluuebunny/crossref_metadata_2025 huggingface dataset:
German-style board games in the mental development of children
Authors: Konovalova A. , Gasimov A. , Maslova K.
Published: September 2022

Introduction

Play activity has been studied from a scientific point of view relatively recently. Until the middle of the twentieth century, any games were considered only as a way of leisure and/or a tool for transmitting cultural experiences.

Objectives

The research is aimed at studying play activity as a factor of mental development of a child.

Methods

The method of work is a bibliographic analysis.

Results

In psychology, the interest in the role of games in the psychological development of a child is primarily associated with the works of Z. Freud, J. Piaget, L.S. Vygotsky, D.B. Elkonin, who showed the importance of children’s imitation games: role-playing, directing, event-based (classification of E.O. Smirnova).

Since the 90s of the XX century, this hobby is becoming ever more common. At first, modern board games were created by adults for adults, and then there appeared board games specially designed for adults to play with children (family games) and for playing children’s groups.

Most of the board games popular with parents belong to the German school. Such games are characterized by relatively simple rules, a short or medium duration of the game, no direct confrontation between players and a low randomness in the course of the game (for example, Carcassonne, Catan, Ticket to Ride, etc.).

Conclusions

German-style board games develop children’s communication skills, voluntary activity, abstract and formal-logical thinking, symbolic function, attention, the ability to cooperate (in cooperative games), imagination, and many games develop the child’s outlook and enrich the ideas about the world around and options for social interaction.

Disclosure

No significant relationships.
A study of reasons why teenagers living in the countryside become alcoholics at an early age
Authors: Baranskaya L. , Babyshkina Y.
Published: September 2022

Introduction

Irreversible damage is caused to the physical and psychic health of teenagers who become alcoholics at an early age. They later become addicted to alcohol which factor leads to the risk of development of chronic diseases, medical and social consequences

Objectives

Monitoring of subjective reasons and widespread frequency of drinking alcohol by teenagers living in the countryside aged 13-17

Methods

One thousand sixty two teenagers volunteered to take part in the study: 55.0% female and 45.0% male. Anonymous survey was used. The forms made up by the Center of Monitoring of Detrimental Habits among Children and Teenagers (Moscow, Russia)

Results

The results of the study undertaken made it possible to see the main reasons for the early formation of drinking habits and the age at which teenagers start to drink. The main reason is the socially widespread myth that alcoholic drinks of a high quality are not detrimental to health at all. One third of the teenage respondents think so. The 42.3% of the young men and 65.3% of the girls show that first drank alcoholic drinks were in the family. Teenagers living in the countryside start to drink at the age of 13 to 17 including. The peak for females is 15-16, for males it is 13-16

Conclusions

Taking into account the significant role of the family in the formation of early drinking habits of teenage males and females living in the countryside and the stable attitudes in family traditions would not help form in teenagers a motivated refusal to drink alcohol

Disclosure

No significant relationships.
Vegan diet as a possible cause of mental and physical disorders due to vitamin B12 deficiency in an adolescent patient
Authors: Gruber E. , Martic Biocina S.
Published: September 2022

Introduction

Recent studies show that a vegan diet causes a deficiency of vitamins (especially B12) and minerals. This can lead to severe physical and mental illnesses. On the other hand, the vegan diet is recommended as a preventative measure against cardiovascular diseases and is a growing trend among young people in developed countries for ideological reasons such as animal welfare and climate protection.

Objectives

To show the importance of anamnesis of nutrition and vitamin B12 status in treatment of varied mental and physical symptoms in an adolescent.

Methods

The poster shows the case study of an adolescent girl who sought psychological help for nightmares and symptoms of anxiety and depression, as well as physical symptoms in the form of disturbed menstruation, fatigue and weakness, lethargy, dizziness, undifferentiated abdominal pain with nausea, and weight gain. All of which affected her academic success at university and daily functioning. An anamnesis showed that she has been following a vegetarian diet for 4 years and a vegan diet for two months.

Results

Laboratory tests showed a deficiency of vitamin B12 (130 pmol/L) and 25-Hydroxy-Vitamin D(D3+D2) (47 nmol/l) and slightly elevated TSH levels (4,2x10-3 IU/L). These tests can explain the patient’s symptoms. Other laboratory results were in the normal range. A treatment with psychological therapy and vitamin supplements was commenced. Discussion reviews, among else, recent literature findings on correlation of vitamin B12 deficiency and a vegan diet.

Conclusions

Nutrition and vitamin B12 status should be investigated during anamnesis of adolescent patients presenting with varied mental and physical symptoms.

Disclosure

No significant relationships.
Personal autonomy development and family functioning of Russian and Azerbaijan adolescents
Authors: Zakirova E. , Poskrebysheva N. , Babkina A.
Published: September 2022

Introduction

The development of adolescent’s autonomy is influenced by both: family and culture. Cross-cultural studies show different autonomy development trajectories and culture-specific family organization tendencies. The comparison of autonomy development in different cultures can help in clarifying universal and culture-dependent aspects of autonomy development.

Objectives

The present research studies adolescent’s autonomy in context of family functioning in Azerbaijani (Baku) and Russian (Moscow) adolescents.

Methods

Family Environmental Scale (FES), Method of unfinished sentences to study adolescent’s autonomy fields («I feel independent when…»), The Separation-Individuation Test of Adolescence (SITA) were used in the study with 201 adolescents, aged from 13 to 18.

Results

Family functioning of adolescents from Moscow is less achievement oriented (U-test, p=0,000), family life is less organized (p=0,000) and controlling (p=0,000). Adolescents in Baku consider the value of independence in families higher (p=0,01).

Context analysis of unfinished sentences shows universal categories of autonomy representation (autonomy in specific activities, autonomy as possibility to be alone) and culture specific representations: adolescents from Moscow describe autonomy more like «independence from others», whereas adolescents from Baku describe autonomy as «the presence of others nearby».

Engulfment Anxiety shows negative correlations (р<0,01) with family cohesion (r=0, -0,474), conflict (r=-0,466) and independence (r=-0,326) for all adolescents, with expressiveness (r=-0,490) and achievement orientation(r=-0,286) by Moscow adolescence and with intellectual-cultural (r=-0,249) and recreational family orientation (r=-0,278) by Baku adolescents.

Conclusions

Autonomy development in families has universal aspects (positive effects of cohesion, etc.), but Moscow adolescents are less focused on others and family in their autonomy development.

Disclosure

No significant relationships.
Association of childhood externalizing, internalizing and comorbid symptoms with long-term economic outcomes
Authors: Vergunst F. , Commisso M. , Geoffroy M.-C. , Temcheff C. , Scardera S. , Poirier M. , Côté S. , Vitaro F. , Turecki G. , Tremblay R. , Orri M.
Published: September 2022

Introduction

Externalising and internalising problems are common in school-aged children. Few studies have examined the association between comorbid externalising and internalising symptoms and adult-life economic participation.

Objectives

To investigate associations of childhood externalising, internalising, and comorbid internalising-externalising symptoms with earnings and welfare receipt in adulthood.

Methods

We used group-based trajectory modeling to identify profiles of children with externalising, internalising, and comorbid symptoms from age 6-12 years. We estimated associations of the identified profiles with participants’ employment earnings at age 33-37 years and welfare receipt from age 18-35 years obtained from tax return records. The child’s IQ and family socioeconomic background were adjusted for.

Results

Four profiles were identified: no symptoms (45%), externalizing (29%), internalizing (11%) and comorbid symptoms (13%). Relative to the no-symptom profile, participants in the comorbid profile earned US$-18,323 less annually (95%CI=-20,925 to -15700) at age 33-37 years and were significantly more likely to receive welfare across follow-up (RR=6.30, 95%CI=5.4 to 7.2). Similarly, compared to the no-symptom profile, participants in the externalising profile earned US$-7,256 less per year (95%CI=-9,205 to -5,307), while participants in the internalising profile earned US$-9,716 less (95%CI=-12,358 to -7,074). Significant interactions by sex were observed. For participants in the comorbid profile, males were more likely to have lower earnings while females were more likely to receive welfare, relative to the no-symptom profile.

Conclusions

Children exhibiting comorbid externalising and internalising symptoms are at high risk of poor economic outcomes in adulthood. Early detection, prevention and management is crucial to improve the life chances of this vulnerable population.

Disclosure

No significant relationships.
Public Mental Health Approaches for Building Resilience in Communities
Authors: Jung-Sievers C. , Coenen M.
Published: September 2022

Crises such as the corona pandemic, but also climate change associated events such as extreme weather events are major stressors for people on an individual, but also on a population level. Such crises often lead to highly burdened individuals with reduced quality of life, decreased well-being, mental health problems and an accumulation of psychiatric illnesses, especially in vulnerable population groups. These create a high demand and need for low intensive (psychosocial) support and primary and clinical care that can often no longer be adequately met by the existing infrastructure. However, good mental health and mental health care is a necessary prerequisite for people to lead fulfilling and productive lives and for communities and their settings (such as families, schools and workplaces, etc.) to function well. Therefore efficient supporting (public mental health) approaches are urgently needed. This presentation will introduce and discuss public mental health approaches and their effectiveness with a focus on mental health promotion and prevention. The implementation and dissemination of these approaches may help to further strengthen psychological resilience in communities to be better prepared for coping with acute crises and long-term stressors.

Disclosure

No significant relationships.
Attention Deficit Hyperactivity Disorder following Hypothalamic Hamartoma Surgery : An unusual manifestation
Authors: Khivsara A. , Goya D. , Nebhinani N.
Published: September 2022

Introduction

Psychiatric symptoms are a common comorbid feature of hypothalamic hamartoma(HH) with epilepsy. They are a significant challenge for patient and their families. Most common psychiatric symptoms are externalizing behaviors such as aggression and defiance.

Objectives

To outline an atypical presentation of HH in form of development of ADHD post-surgery.

Methods

A 6-year old child born out of non-consanguinous marriage, with history of hyperemesis gravidarum and depression in mother in ante-natal period, delivered by NVD at term(did not cry at birth and was hospitalized for 3 days) with birth weight of 2.25 kg, currently presented to Neurology with global developemental delay and history of gelastic seizures since 3 years of age. Patient was diagnosed with pituitary hamartoma(through MRI) and precocious puberty that time and was operated for it after which he started having behavioural issues like irritability, aggression, hyperactivity and lack of appropriate social behaviour with peers along with defiance towards parents. Child was then refered to Psychiatry. On MSE patient did not interact with interviewer and was noticed to shout loudly when confronted for using mobile phone. MRI brain(2 months back) showed post-op changes with cystic lesion in suprasellar region. IQ assessment showed borderline intelligence.

Results

Patient was started on Risperidone(upto 1.5 mg) which lead to some improvement. However antiepileptics are being rationalized to prevent behavioural issues secondary to epilepsy

Conclusions

Patients of HH with epilepsy, present with varied psychiatric symptoms which usually improve after surgery. However we came across a child with worsening of psychiatric symptoms after he was operated for above lesion.

Disclosure

No significant relationships.
Health-related quality of life of adolescents living with HIV treated at the HIV Clinic at the National Institute of Pediatrics at Mexico City
Authors: Montoya Moya D.B. , Molina D. , Ordoñez Ortega J.
Published: September 2022

Introduction

ATR for children has successfully increase survival to adolescence. Health-related quality of life (HRQoL) is relevant to evaluate the impact of the disease on well-being in adolescents living with HIV (ALH). Kidscreen-52 questionnaire is validated in mexican adolescents to measure HRQoL

Objectives

To evaluate health related quality of life in a sample of 22 mexican ALH

Methods

A sample of ALH in treatment at the HIV Clinic during 2021, were evaluated with Kidscreen-52 by a child psychiatrist. Statistics included non parametric tests and Cohen “d” and “r” size effect to compare T means between ALH and Kidscreen-52 standardized scores.

Results

Mean age:14.4+2.5. Gender: 11(50%)boys, 11(50%)girls. ALH showed significantly lower scores in all domains. Girls reported lower scores in physical well-being(p=0.047) and autonomy (p=0.023). Orphan ALH had lower scores in mood and emotions (p=0.021)KIDSCREEN-52ALH MEAN/SDKIDSCREEN-52 MEAN/SDCOHEN’S”d”“r”PYSICAL WELL-BEING18.45+3.942.6+6.6- 4.4-0. 91PSYCHOLOGICAL WELL-BEING23.04+6.0351.2+8.7- 3.7-0. 88MOOD25.3+6.1344.8+7.5- 2.8-0. 81SELF-PERCEPTION20.27+3.2247.3+7.6- 4.6-0. 91AUTONOMY18.09+4.946.6+9.4- 3.8-0. 88SOCIAL SUPPORT AND PEERS24+5.151.0+9.4-3.5-0. 87PARENTS AND HOME LIFE20.95+6.248.6+9.4- 3.4- 0.86FINANCIAL RESOURCES9.04+3.2144.7+7.3- 6.3-0. 95SCHOOL ENVIROMENT19.73+7.1353.3+7.9- 4.46-0. 91SOCIAL ACCEPTANCE12.91+2.1146.3+9.6- 4.8- 0.92

Conclusions

- HRQoL were significantly lower in ALH. -Girls showed significantly lower scores in physical well-being and autonomy. - ALH orphans showed significantly lower scores in mood and emotions domain

Disclosure

No significant relationships.
Tension-Type Headache in Early Adolescents: Exploring the Predictive Role of Anxiety and Alexithymia
Authors: Bizzi F. , Charpentier Mora S. , Riva A. , Tironi M. , Nacinovich R.
Published: September 2022

Introduction

Primary Headache, including Tension-Type Headache (TTH), represents one of the most common somatic disorders in children and adolescents with a strong impact on quality of life. Several risk factors, as environmental, familiar, and psychological features, including personality traits, are related to the development of Primary Headache. However, studies on specific subgroups of TTH are relatively few in early adolescents.

Objectives

Therefore, this cross-sectional pilot study aims at exploring the role of anxiety and alexithymia in early adolescents with and without TTH.

Methods

A sample of 70 early adolescents (Mage=14.59, SD=1.85; 71% females) consisting of a clinical group (31 with TTH) enrolled in an Italian Child Neuropsychiatry Clinic and a comparison group (38 without TTH) enrolled in schools, matched on gender and age, completed: 1) Multidimensional Anxiety Scale for Children (MASC) to detect the Total levels of Anxiety, also in their factor of Physical Symptoms, Social Anxiety, Harm Avoidance, and Separation Anxiety; 2) the Toronto Alexithymia Scale (TAS-20) to detect the Total levels of Alexithymia, also in their factor of Difficulty to Identifying and to Describing Feelings and Externally Oriented Thinking.

Results

TTH outcome positively correlated with Harm Avoidance (rho=.68, p<.001) and Total Alexithymia (rho=.72, p<.001). In a logistic regression, Harm Avoidance and Total Alexithymia predicted 69% of the variance in TTH outcome (p<.032).

Conclusions

This disorder may be a maladaptive strategy to cope with problems and feeling emotions, then early adolescents could be fostered in the acquisition of more adaptive emotion regulation abilities.

Disclosure

No significant relationships.
QT Prolongation: Psychotropic medication versus illicit drugs
Authors: Florian A. , Florian C. , Ignat A. , Voinea C. , Popescu L. , Ganea G. , Gherghe C. , Mateescu L.
Published: September 2022

Introduction

Countless substances used for their psychotropic effects may induce adverse cardiac effects, such as QT prolongation. This category of substances holds illicit drugs as well as medications, with their effects influenced by dosage, concomitant use and patient specific factors. The appraisal of cardiac consequences is essential as delayed repolarization may lead to the rare but potentially deadly polymorphic ventricular tachycardia.

Objectives

The goal of this presentation is to underscore the cardiac risks associated with both medication use and substance abuse in order to ensure the suitable psychopharmacological treatment, especially in particular situations of drug using patients.

Methods

The subject of the presentation is a 17-year-old female adolescent hospitalized in our clinic, with multiple substance abuse, as seen in qualitative multidrug test (cannabis, amphetamines, ecstasy, barbiturates, benzodiazepines), previously under complex treatment prescribed by an adult psychiatrist (3 atypical antipsychotics, 1 selective serotonin reuptake inhibitor, 1 anticonvulsant, 1 benzodiazepine). Specialty literature has been reviewed concerning the cardiac effects of both the abuse substances and the psychiatric medications.

Results

Multiple drugs involved may cause a myocardial repolarization delay, the patient having a QTc of 508 msec at the admission. Consequent to parenteral fluids and treatment managing, ECG revealed a decrease to 379 msec 7 days later in the stay. This finding could not be viewed solely as caused by drug use, psychiatric medication or individual factors, but rather as their aggregation.

Conclusions

Psychotropic substances use may lead to QT prolongation, which calls for close cardiac supervision whenever patient’s behaviour warrants or when pharmacologic intervention is required.

Disclosure

No significant relationships.
Wernicke Encephalopathy: A case report
Authors: Jiménez Cabañas M. , Ruiz Guerrero F. , Bermejo Pastor A. , Mayor Sanabria F. , Fernández Fariña M. , Saiz González M.D.
Published: September 2022

Introduction

We report a case of a 56-year old woman with a history of depressive disorder between 2012 and 2017 achieving full remission after treatment with antidepressants and anxiolytics. In the year 2021 was presented to the emergency department manifesting alteration of behavioral patterns, ataxia, mental confusion and horizontal nystagmus. A chronic alcohol abuse was also discovered while interviewing. She also exhibited low mood, anterograde amnesia and confabulations that improved rapidly after following treatment with thiamine.

Objectives

Reviewing clinical manifestations and treatment of Wernicke encephalopathy and the development of Korsakoff syndrome.

Methods

We systematically reviewed articles using PubMed.

Results

Wernicke encephalopathy is a well-known complication of thiamine deficiency, mostly associated with alcohol use disorder. Classically, the syndrome comprises changes in mental status, gait ataxia and ophthalmoplegia. However, the full triad has been described in only 10-17 % of cases, which in our the case is report. After the diagnosis was established and was treated with thiamine, a rapid improvement in the patient´s clinical status was observed. Cognitive impairment was later identified, taking into account the possibility of a Korsakoff syndrome characterized by irreversible brain damage and subsequent loss of anterograde memory. In our patient, this specific diagnosis was dismissed due to the clinical improvement after thiamine treatment.

Conclusions

It is relevant to emphasize the importance of a precise diagnosis and treatment of patients with Wernicke Encephalopathy to avoid the development of a Korsakoff syndrome.

Disclosure

No significant relationships.
Behavioural Variant of Frontotemporal Dementia or Mood Disorder?
Authors: Mesquita B. , Paulino S. , Fraga A. , Facucho-Oliveira J. , Espada-Santos P. , Albuquerque M. , Costa M.
Published: September 2022

Introduction

The behavioural variant of frontotemporal dementia (bvFTD) is a devastating neurodegenerative syndrome with its peak in the early sixties at about 13 per 100,00. The diagnosis of bvFTD relies on clinical assessment as patients present executive and behavioural deficits, like apathy, loss of motivation and personality changes. Current diagnosis criteria lack specificity and symptomatic overlap between bvFTD and primary psychiatric disorders (PPD) pose a diagnostic conundrum, with half of bvFTD patients previously receiving a psychiatric diagnosis.

Objectives

The goal is to discuss the syntomatic overlap of these two entities.

Methods

Brief non-systematic literature review on the topic, illustrated by a case-report presentation.

Results

A 69 year old men, retired and single, is committed for thought and behavior disorganization and insomnia. He presented expansive mood but also temporal and spatial disorientation and periods of incongruous speech. This patient’s clinical presentation could both entice a diagnosis of bvFTD but also of an affective disorder, especially since it has been reported that neuropsychiatric presentations, like late-onset psychosis or mania, can be the initial presentation of this form of dementia, particularly in patients with C9orf72 mutations, who often display persecutory or grandiosity delusions.

Conclusions

This clinical case exemplifies the difficulty that lies in differentiating cases of bvFTD from late-onset idiopathic mood or psychotic disorders. It is important to consider that on cognitive assessment patients with bvFTD score significantly worse on executive function tests that PPD patients No disease- modifying therapies are available for patients with bvFTD, therefore drug treatment should focus on the most disruptive or taggable behaviours.

Disclosure

No significant relationships.
Drug–drug interactions and clinical considerations with co-administration of antiretrovirals and psychotropic drugs
Authors: Petrykiv S. , Arts M. , De Jonge L.
Published: September 2022

Introduction

Psychotropic medications are frequently co-prescribed with antiretroviral therapy (ART). Hepatic metabolism both of AP and ART involves the cytochrome P450 enzyme system, potentially leading to a multitude of pharmacokinetic (PK) interactions and serious adverse side effects. The magnitude and clinical impact of PK-interactions can vary significantly.

Objectives

The scope of this review is to summarize the currently available data regarding drug-drug interactions (DDI) between AP and ART, and to provide recommendations for their management.

Methods

A formal search of Embase, Cochrane and Medline was performed, searching for human studies from inception till 2017 on PK-interactions between AP and ART and reporting clinical toxicity as outcomes. Authors also provide their expertise on magnitude and clinical relevance of DDI using PK interaction chart.

Results

Ten case reports including total of 13 patient were analyzed, comprising following AP: aripiprazole (N=2), risperidone (N=4), quetiapine (N=3) and lurasidone (N=1) in combination with various ART regiments. Significant PK-interactions were to occur in cases when aripiprazole was combined with ritonavir and/or cobicistat or efavirenz and/or darunavir; risperidone with indinavir of ritonavir; quetiapine with ritonavir and atazanavir/ritonavir; lurasidone with atazanavir. Adverse events occurred in combinations of aripiprazole with ritonavir/darunavir, risperidone with ritonavir or indinavir, quetiapine with atazanavir and lurasidone with atazanavir.

Conclusions

Psychotropics and antiretrovirals may be used safely, particularly when known DDIs are proactively managed. Clinicians should be aware of the pharmacokinetic and pharmacodynamic properties of these agents to best direct therapy and to provide optimal patient care

Disclosure

No significant relationships.
Epidemiological profile of patients with epilepsy attended in an emergency in a psychiatric hospital in 2020
Authors: Faria F. , Tarifa B. , Maritan B. , Antonio L. , Ricci M. , Filho G.
Published: September 2022

Introduction

According to the Global Burden of Disease study (WHO, 2010), epilepsy is ranked as the second most impacting neurological disorder worldwide, in terms of disability-adjusted life years, and is often associated with psychiatric comorbidities, stigma and high economic costs. This frequent association between epilepsy and mental disorders is a fact, however, they are often underdiagnosed and undertreated in patients with epilepsy, which further reduces the quality of life of this population and induces the demand for psychiatric emergency care.

Objectives

To give the comorbid relevance between epilepsy and mental disorders, this study aims to identify the main psychiatric illnesses associated with patients with epilepsy treated at the emergency of a psychiatric hospital in 2020. In addition to establishing the clinical and epidemiological factors related to this association.

Methods

All patients diagnosed with epilepsy (G40), according to the International Classification of Diseases, who underwent emergency care at the HABM, São José do Rio Preto, São Paulo, in 2020. Epidemiological and clinical data were collected.

Results

There were 7258 consultations, with only 27 as cid G40. 71.4% were male, 55% single and age between 42-49 years old. 47.6% indicated psychiatric comorbidities (cid F06). 23.8% patients with both disorders were attended by psychiatrist.

Conclusions

The concomitant occurrence of psychiatric disorders and epilepsy has significant relevance. However, it is known that the diagnosis of psychiatric disorders in epileptic patients is sometimes late, poorly conducted or even underdiagnosed. Therefore, knowing the profile of patients with epilepsy allows us to identify the factors associated with the concomitant of psychiatric disorders.

Disclosure

No significant relationships.
Dimensions of alexithymia and their links to anxiety and depression
Authors: Ben Abdallah M. , Baati I. , Tabib F. , Guermazi F. , Hentati S. , Farhat N. , Masmoudi J.
Published: September 2022

Introduction

Anxiety and depression are among the most common psychiatric comorbidities in multiple sclerosis (MS) patients. These disorders could lead to significant emotional disturbances.

Objectives

To study the different dimensions of alexithymia in patients with MS and determine their relationship with anxiety and depression.

Methods

Our study, descriptive and analytical, focused on patients followed for MS at the neurology department in Sfax (Tunisia). In addition to collecting sociodemographic data, we used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depressive symptoms and the Toronto Alexithymia Scale (TAS-20) to assess alexithymia and its three dimensions: difficulty identifying emotions (DIE), difficulty differentiating emotions (DDE), and externally oriented thinking (EOT).

Results

This study included 93 patients followed for MS. Our results showed a prevalence of 58.1% for alexithymia, 38.7% for anxiety and 26.9% for depression. The median score of the dimension DIE was 22. The median score of the dimension DDE was 17. The mean score for the dimension EOT was 26.96 ± 4.18. Alexithymic patients were more anxious and depressed (p = 0,002 and p < 10-3, respectively). Both dimensions DIE and DDE were associated with anxiety (p = 0.001 and p = 0.022, respectively) and depression (p < 10-3 and p < 10-3, respectively). Non-depressed patients had a higher score on the EOT dimension (p = 0.003).

Conclusions

Our results showed a relationship between depression, anxiety and alexithymia, hence the importance of looking for alexithymia in MS patients with anxiety or depressive symptoms.

Disclosure

No significant relationships.
Fatigue in multiple sclerosis and its relation with depression
Authors: Ben Abdallah M. , Baati I. , Guermazi A. , Guermazi F. , Hentati S. , Farhat N. , Masmoudi J.
Published: September 2022

Introduction

Fatigue is one of the most common and disabling symptoms of multiple sclerosis (MS). It can be defined as a subjective lack of physical and mental energy.

Objectives

To study the prevalence of fatigue in patients with MS and to determine the factors related to it, including depression.

Methods

This was a cross-sectional, descriptive and analytical study, which took place in the neurology department in Sfax (Tunisia). It focused on patients with MS in remission phase. We used the Expanded Disability Status Scale (EDSS) to determine the degree of disability caused by MS, the Chalder Fatigue Scale to evaluate the fatigue, and the Hospital Anxiety and Depression Scale (HADS) to assess depressive symptoms.

Results

The 93 patients included in the study had a mean age of 36.59 ± 10.69 years. The socio-economic level was low to medium in 52.7% of cases. The EDSS score ranged from 0 to 8 (median = 3.5). The total number of relapses ranged from 1 to 30 (median = 3.5). MS patients had fatigue in 72.4% of cases and depression in 26.9% of cases. Patients with a low to medium socio-economic level were more fatigued (p=0.027). High number of MS relapses, severity of disability on the EDSS, and presence of depression were associated with fatigue (p=0.014, p<10-3 and p=0.001, respectively).

Conclusions

In MS patients, fatigue is a common symptom. Patients with reduced physical activity and greater MS-related disability have more severe fatigue, which negatively affects psychosocial functioning, increasing the risk of depression.

Disclosure

No significant relationships.
Psychiatric comorbidity in epilepsy and difficulties in treatment: A case report
Authors: Fernández Fariña M. , Mayor Sanabria F. , Regueiro Martín-Albo C. , Expósito Durán M.E. , Francos Ajona A.
Published: September 2022

Introduction

We present the case of a 36-year-old male with depressive states, impulsive traits and fits of anger (including episodes of self and heteroagressiveness) since early childhood, in the context of traumatic family history and the beginning of an epileptic disease. These symptoms have been maintained over the years, in addition to other variable and recurrent symptoms, such as severe anxiety, somatizations or serious depressive symptoms.

Objectives

To highlight the possible influence of epilepsy in the course of mental illnesses, especially depression, as well as the increased difficulty in management.

Methods

We collected the complete medical history of a patient with an important history of mental health in addition to epileptic disease since childhood and we carried out a review of the comorbidity between these diseases and their treatment.

Results

The epileptic disease of our patient may have influenced the behavioural alterations and the depressive symptoms since childhood, as well as the personality traits with aggressiveness and impulsiveness. There is an added difficulty in treating this case given the possible interactions between antiepileptic and antidepressant medications.

Conclusions

This case highlights the importance of taking into account the influence of this comorbidity on the prognosis of patients. Knowing the interactions and side effects of drugs is essential for good clinical management.

Disclosure

No significant relationships.
Eating problems in ADHD: self-regulatory or inattentive/impulsive
Authors: Araújo A. , Batista M. , Pascoal M.D. , Pereira A.T. , Ventura F. , Madeira N. , Macedo A.
Published: September 2022

Introduction

ADHD is a risk factor for impulsive/compulsive eating problems (EP). In, bulimia nervosa and compulsive eating disorder, EP are frequently preceded by negative affect and experienced as loss of control. Clarifying the underlying causes (eg., ADHD symptoms and/or psychological distress) of EP in ADHD would allow the development of targeted interventions.

Objectives

To a) compare levels of EP between ADHD patients and a community sample, and b) test if ADHD symptoms and psychological distress predict EP, in ADHD patients.

Methods

Adults with ADHD (n=32; age=23.78+/-6.12; 69% males) from the Neurodevelopmental Outpatient Unit of Coimbra and healthy participants (n=30; age=36.90+/-13.23; 57% males) answered an online survey including the Portuguese versions of the Adult ADHD Self-Report Scale Symptom Checklist, the Parkinson’s Disease Impulsive-Compulsive Disorders Questionnaire-Current Short and the Depression, Anxiety and Stress Scale.

Results

The ADHD group reported experiencing more EP than healthy individuals (18/32 vs. 4/30; χ2=12.458, p<.001). ADHD patients with EP suffered from severer ADHD inattentive, hyperactive, and global symptoms and higher levels of psychological distress (p<.001 to p=.027). Logistic regression model testing if ADHD and psychological distress symptoms predicted EP, in ADHD, explained 38.8% of the variance and showed that the only significant predictor was ADHD symptoms (B=.121, SE=.051, p=.017).

Conclusions

Our results indicate that EP are associated with severer ADHD clinical pictures. EP arose secondarily to ADHD symptoms, instead of serving as means to alleviate psychological distress. Clinicians should be mindful that, in ADHD patients, EP follow specific motivations, i.e., impulsivity and inattention, and may respond to combined cognitive-behavioural/executive training strategy.

Disclosure

No significant relationships.
Comorbid Opioid Use Disorder in Body Dysmorphic Disorder
Authors: Kim J. , Alli-Balogun O. , Gill G. , Korenis P. , Mitra S.
Published: September 2022

Introduction

Body Dysmorphic Disorder (BDD) is a severe and common disorder that consists of distressing or impairing preoccupation with nonexistent or slight flaws in one’s physical appearance. People with BDD typically describe themselves as looking ugly, unattractive, deformed, or abnormal, whereas in reality they look normal or even very attractive.

Objectives

Case Study

Methods

Case Study

Results

Mr. X is a 31 year-old male with history of Opiate (heroin, oxycodone) use disorder currently on maintenance (Buprenorphine-Naloxone) treatment. On admission, urine toxicology was positive for opiates and other drugs.CIWA score was 11. He was started on Lorazepam taper, Mirtazapine, Fluoxetine, and was started on Suboxone soon after. His cravings decreased and he was admitted for Rehab. He reports that anxiety associated with his “body image” related to ears, shape of head, eyebrows since he was in high school which made him “feel uncomfortable” going to school and concentrating in his classes. His coping mechanism was covering his head with hats, shaving eyebrows, substance use, and receiving an otoplasty.

Conclusions

According to Houchins et al (2019), alcohol is the predominant substance used in BDD. It is interesting to note that only 6% of BDD patients had Opioid Use Disorder, but as this case demonstrates, can be a debilitating comorbidity that raises the risk for suicidality or hospitalization. However, little research has been done on the treatment of OUDs in patients with BDD or on the treatment of BDD in patients with an SUD, and this is an area of research that could benefit the modern population greatly.

Disclosure

No significant relationships.
Management of Parkinson’s disease challenged by co-morbid drug abuse
Authors: Simas J. , Delgado A. , Guedes R. , Silveira C. , Soares C.
Published: September 2022

Introduction

Parkinson’s disease (PD) is a neurologic degenerative condition with complex neuropsychiatric manifestations which can be challenging to manage and greatly impact quality of life and prognosis.

Objectives

The description of this case aims to highlight the complex interaction between PD, drug-abuse and impulse control disorder (ICD).

Methods

Clinical information was obtained through patient interviewing and medical records consulting. A literature review on the topic was conducted.

Results

We report the case of a 52-years-old male with PD diagnosed at the age of 45, presenting with rigidity of right limbs and freezing of gait. He had a history of multiple substance-abuse: hashish, heroin and cocaine, with cessation of all substances by the age of 40. The patient responded well to antiparkinsonian medication initially, but needed frequent adjustments and developed ICD secondary to dopamine agonists, presenting pathological gambling and hypersexuality. At 47 he restarted using cocaine stating that it diminished the motor symptoms. Motor symptoms worsened and became partially responsive to medication. Pharmacologic options were limited due to ICD. He developed dopamine dysregulation syndrome, abusing dopaminergic drugs and requesting multiple prescriptions. Deep brain stimulation surgery was proposed, but the patient was deemed unfit for the procedure after two separate psychiatric evaluations, mainly because of behaviour and social problems in relation to sustained cocaine abuse and personality disorder. Attempts to stop drug abuse were unsuccessful despite several interventions by addiction psychiatry.

Conclusions

Co-occurrence of PD, substance-abuse and personality disorder poses as a therapeutic challenge conditioned by pharmacological iatrogenesis and behavioural disturbances, requiring a multidisciplinary and individualized approach.

Disclosure

No significant relationships.
A Case of Adult Attention Deficit Hyperactivity Disorder with Non-Organic Psychosis Comorbidity
Authors: Akyıldırım Çor S. , Duman M. , Uzun Ö.
Published: September 2022

Introduction

Although ADHD is the most frequently diagnosed psychiatric disorder in childhood, the majority of adults with ADHD are not diagnosed and 90% of the cases remain untreated. One of the main reasons that may lead to the missed diagnosis of ADHD in adults may be the high rate of comorbid psychiatric conditions masking the main symptoms.

Objectives

In this study, it was aimed to present a case who was followed up with the diagnosis of ADHD since childhood and developed psychosis after a recent traumatic life event.

Methods

A 19-year-old male patient was consulted because of his complaints of persecution delusions, and disorganized speech that started 2 years ago. IIt was learned that the first psychiatry application of the patient was 10 years ago with complaints of impulsivity, aggression, increased psychomotor movements, and methylphenidate treatment was started during this period. The patient, whose current clinical picture was evaluated as psychosis, was discharged after the symptoms subsided with paliperidone depot 100mg/month treatment after hospitalization. It is understood that his psychotic complaints completely regressed in the follow-ups.

Results

It is stated that approximately 80% of adult ADHD cases have at least one accompanying psychiatric disorder. However, there are limited studies in the literature on the relationship between psychotic disorders and ADHD.

Conclusions

Recent studies indicate that beyond the fact that ADHD is a feature of the schizophrenia prodrome, ADHD diagnosis may be associated with an increased risk of psychosis in the future. Therefore, this association can be better clarified in further studies on comorbidities.

Disclosure

No significant relationships.
QT Prolongation-induced Seizures Masquerading as Depression with Mixed Features
Authors: Capilla Crespillo A. , Salvat Pujol N. , Palao Vidal D. , Pinzón-Espinosa J.
Published: September 2022

Introduction

Severe mental disorders experience premature mortality mostly from physical causes. When a patient with a history of bipolar disorder is admitted to the emergency room (ER) for psychiatric symptoms, these are routinely interpreted as a psychiatric disturbance. However, a careful history should be performed to correctly interpret key clinical information to rule out somatic etiology and establish adequate diagnosis.

Objectives

To describe a patient whose presenting symptoms were misdiagnosed as psychiatric relapse, rather than serious somatic comorbidity debut.

Methods

A 70-year-old man, with a history of type I bipolar disorder and multiple cardiovascular conditions, was admitted to the ER for self-referred nervousness, depressed mood, insomnia, and suicidal thoughts. Symptoms had greatly worsened the previous week to his consultation with paroxysmal episodes of severe anxiety, feelings of strangeness, and sensations of unpleasant odors.

Results

During observation, the patient was found lying down with loss of consciousness, urinary incontinence, and amnesia of the event. Generalized tonic-clonic seizures were observed by neurologists while mental status examination was being performed. After symptoms were oriented as having a neurological etiology, the patient suffered cardiac arrest and defibrillation was required. After admittance to the intensive care unit and inpatient cardiology care, the patient was discharged from the hospital with the diagnosis of ventricular fibrillation due to drug-induced QT prolongation. There was no evidence of mixed depression or seizures once the cardiac dysfunction was identified and treated.

Conclusions

The psychiatric symptoms were the clinical manifestation of a generalized seizure-like activities that were attributed to transient cerebral hypoperfusion secondary to ventricular fibrillation.

Disclosure

No significant relationships.
Functional Neurologic Symptom Disorders: Bridging the Chasm between the Psychoanalytic and Neuroscientific Understandings
Authors: Deka A. , Banayan D.
Published: September 2022

Introduction

Since before the time of “Anna O”, the functional neurologic symptom disorder (FNSD) has captivated psychiatry. While the definitive psychopathological mechanism for this phenomenon remains elusive, it is nevertheless of great value for patients and clinicians alike to develop a more nuanced understanding of FNSD. It is necessary to make an enquiry into the mechanism by bridging the psychoanalytic and neurobiological theories.

Objectives

1.Elucidate psychoanalytic concepts to FNSD 2.Elucidate neuroscientific aspects of FNSD 3.Reconcile the chasm between the two concepts

Methods

Comprehensive review of literature at the interface of psychoanalytic and neuroscientific theories of FNSD

Results

Emerging evidence have found putative explanations to account for FNSD. Orbitofrontal cortex, anterior cingulate gyrus, dorsolateral prefrontal cortex and striatothalamocortical circuits have been implicated. Number of total studies remain small with each study having few participants. This necessitates a degree of caution in interpreting results. Thus far, mechanisms such as signal rerouting or hypoactivation of specific frontal regions appears to play a material role in FNSD. Neuroscience may be approaching to providing evidence that psychological defenses may have neurobiological correlates that can be measured in certain conditions. However, a definitive answer remains elusive.

Conclusions

The expanding narrative of a relatively nascent dialogue between neuroscience and psychoanalysis remains not only clinically relevant, but also promotes a holistic view of patients with psychiatric illnesses. Through our discussion, psychoanalytic theory is woven into the current neurobiological framework for FNSD, which we believe will assist clinicians provide empathic care and help patients develop a more adaptive and meaningful explanatory paradigm of their lived experience.

Disclosure

No significant relationships.
Somatic comorbidity and physical frailty in elderly with medically unexplained symptoms
Authors: Arts M.
Published: September 2022

Introduction

Reported prevalence rates of medically unexplained symptoms (MUS) in people aged ≥65 years range between 1.5 and 18%. People with MUS often describe a low quality of life and frequently suffer from co-morbid anxiety and depressive disorders. In our pilot study on older patients with MUS, the level of somatic comorbidity as well as frailty parameters were significantly higher among patients with MUS which was partially explained by a somatic origin compared to patients with MUS for which no explanation at all was found.

Objectives

The objective of this study was to examine the level of frailty and somatic comorbidity in older patients with medically unexplained symptoms (MUS) and compare this to patients with medically explained symptoms (MES).

Methods

Frailty was assessed according to Fried’s criteria (gait speed, handgrip strength, unintentional weight loss, exhaustion, and low physical activity), somatic comorbidity according to the self-report Charlson Comorbidity Index and the number of prescribed medications.

Results

Although MUS-patients had less physical comorbidity compared to MES-patients, they were prescribed the same number of medications. Moreover, MUS-patients were more often frail compared to MES-patients. Among MUS-patients, physical frailty was associated with the severity of unexplained symptoms, the level of hypochondriacal beliefs, and the level of somatisation.

Conclusions

Despite a lower prevalence of overt somatic diseases, MUS-patients are more frail compared to older MES-patients. These results suggest that at least in some patients age-related phenomena might be erroneously classified as MUS, which may affect treatment strategy.

Disclosure

No significant relationships.
Secondary Gerstmann syndrome, a case report
Authors: Orozco Aguirre A.L. , Marín Valdovino M. , Ruíz Santos M.A. , González Meléndez A.M.
Published: September 2022

Introduction

Gerstmann syndrome is a rare neurological disorder that consist primarily of 4 neuropsychological signs that include acalculia (impairment in performing calcultaions), digital agnosia (dificulty discriminating their own fingers), agraphia (impairment or dificulty to write by hand); and left-right disorientation (impairment of distinguishing left from right.

Objectives

Presentation of a case report of a patient with Gertsmann syndrome secondary to breast cancer metastasis.

Methods

We analyze the case of a 79 years-old female with a history of breast cancer in remission, with a severe depressive episode of 8 months of evolution, dysphoria, apathy, decrease in the ability to carry out basic activities of daily life, acute personality changes and sleep disruption. 15 days previous to the first examination the patient suffers gait disturbances, falling from her own height, memory impairment, suicide ideation and nomination aphasia.

Results

At the examination we encounter digital agnosia, acalculia, agraphia, right-left disorientation, right hemiparesis. MRI are taken founding 3 tumor lesions in the left and right frontal lobe, 2 solid lesions with a necrotic appearance in the right parietal lobe, one of them in the angular gyrus of the parietal cortex. CT scan found a solid tumor-like lesion in the left pulmonary apex. CA-125 antigen 429.5 U/mL. She was sent to continue her treatment with oncology, receiving radiotherapy.

Conclusions

The psychiatric abnormalities secondary to Gerstmann syndrome make the relatives of this patient seek psychiatric care, requiring multidisciplinary work to reach an accurate diagnosis. Gerstmann syndrome is a rare neurological condition that can mimic lots of other clinical pictures.

Disclosure

No significant relationships.