bluuebunny/crossref_metadata_2025 huggingface dataset:
I can’t stop using cocaine and my son is going to be taken away from me
Authors: Osca Oliver A. , Ros Font V. , López Rodrigo M.V. , Palomo Monge M. , Tascón Guerra M.F. , Pérez Fominaya M.
Published: September 2022

Introduction

The use of psychoactive substances in pregnancy has a similar profile to the general population, in which ethyl alcohol and tobacco are the most widely used drugs, followed, to a much lesser extent, by marijuana and cocaine. Cocaine is a powerful stimulant of the Central Nervous System. Like other smokable cocaines, PBC is highly fat soluble and rapidly crosses the blood-brain barrier, causing maternal-fetal harm when consumed during pregnancy. Being its pathophysiological mechanism the vasoconstriction of uterine and fetal vessels. Obstetric complications related to this toxic mechanism of action include: increased risk of spontaneous abortion, premature detachment of the normal inserted placenta, and intrauterine growth restriction.

Objectives

We present how was the management of a 26-year-old woman, polytoxic, unemployed, living in a “squatting house”, referred from the Gynecology and Obstetrics service to the Addictive Behavior Unit, due to fetal alterations seen in ultrasound follow-ups. Presenting the fetus: delayed intrauterine growth, and bilateral ventriculomegaly with dilation of the left ventricle.

Methods

We report this case to social services and we started doing a weekly poison check. Presenting positive controls for both: cannabis and cocaine.

Results

Due to the physical, psychological and environmental situation of the patient, the withdrawal of custody of her child is being considered.

Conclusions

These types of cases must be treated in a multidisciplinary way, with awareness of the disease and the consequences of continuing to consume must be addressed.

Disclosure

No significant relationships.
The role of PACAP/PAC1R in PTSD: effects on fear extinction via the ventromedial hypothalamus
Authors: Andero R.
Published: September 2022

Introduction

The incidence and severity of posttraumatic stress disorder (PTSD) is higher in women than men because of environmental and biological factors. Specific mechanisms in the PACAP-PAC1R (pituitary adenylate cyclase-activating polypeptide and its type I receptor) system may confer PTSD risk in women. Interestingly, while the PACAP (ADCYAP1) - PAC1R (ADCYAP1R1) system is expressed highly in the hypothalamus, no relationship has been described for this pathway in the hypothalamus with fear processing or in PTSD.

Objectives

We studied whether the estrous/menstrual cycle at the moment of trauma predicts PTSD and the involvement of the PACAP neurons in the amygdala and hypothalamus during traumatic stress.

Methods

Mice: DREADDs, immunohistochemistry and behavior. Humans: fear-potentiated startle and questionnaires.

Results

Here, we show that acute stress immobilization (IMO) produces fear extinction impairments in female mice. Also, IMO elicits Adcyap1 and Adcyap1r1 mRNA upregulation in the hypothalamus, PACAP/c-Fos downregulation in the medial amygdala (MeA), and PACAP/FosB/ΔFosB upregulation in the ventromedial hypothalamus dorsomedial part (VMHdm) after fear extinction. We also found that women with the risk genotype of ADCYAP1R1 rs2267735 SNP show impaired fear extinction. In mice, DREADD-mediated inhibition of the MeA neurons projecting to the VMHdm during IMO rescues both PACAP upregulation in VMHdm and the fear extinction impairment. We ruled out contributions from inherent hormonal states showing that the menstrual or estrous cycle phase at the moment of trauma does not result in a vulnerable phenotype.

Conclusions

Our data suggest that the PACAP-PAC1R hypothalamic system may be a novel candidate to treat and prevent PTSD symptoms including fear dysregulations.

Disclosure

No significant relationships.
Smoking in patients hospitalized for schizophrenia: Prevalence and management challenges
Authors: Bencharfa Z. , Amara Y. , Belbachir S. , Ouanass A.
Published: September 2022

Introduction

Smoking is the leading cause of preventable death in the world. Studies have shown that the frequency of its use in schizophrenic patients is significantly higher than in the general population,which hinders both treatment strategies and the efficacy of antipsychotics.

Objectives

The objectives of our study are to highlight the prevalence of smoking in this population,to assess their nicotine dependence as well as to support the difficulties of their management.

Methods

We conducted a cross-sectional study of 92 male patients, hospitalized at Ar-razi Hospital in Salé, using the Fagerström scale, associated with a questionnaire that included age, marital status, educational level, somatic comorbidities, current treatment, other substances used, withdrawal attempts, age of first cigarette, family history of smoking, and finally,number of cigarettes per day before and after psychiatric diagnosis.

Results

All our patients were male,the average age was 31 years, 84.8% of our patients were single, 73.9% were without a profession, only 23.9% were under classic neuroleptics while 4.3% were under Clozapine, the most of our patients were also using Cannabis,52.2% attempted a withdrawal, with an average duration of 6 months.69.6% of our patients had a family history of smoking and only 21.7% had somatic comorbidities.The average daily consumption was 12 cigarettes per day before the onset of psychiatric symptoms, rising to 18 cigarettes per day after the psychiatric diagnosis.

Conclusions

The frequency of smoking in schizophrenic patients is high. Unfortunately, these patients remain poorly aware of the harms of smoking, hence the need to integrate a smoking control strategy into the management of schizophrenia.

Disclosure

No significant relationships.
A Young man with Delirium Tremens, Pellagra and Alcoholic neuropathy. Case report and review of pharmacological treatment
Authors: Díez Valle B. , Coucheiro Limeres P.
Published: September 2022

Introduction

We present the case of a 36-year-old male with chronic alcoholism who suffered Delirium Tremens and other complications during hospital admission and who recovered thanks to treatment with benzodiazepines and antiepileptics using a cross tapering strategy.

Objectives

Presentation of a case and review of the available literature on the pharmacological treatment of alcohol withdrawal.

Methods

A 36-year-old man was hospitalised for extensive dermatological lesions suggestive of Pellagra. He acknowledged a daily consumption of six litres of beer, was homeless and had a poor and unvaried diet. After 48 hours, the patient began to present hyperreflexia, disorientation and delusions of harm and was diagnosed with Delirium Tremens.

Results

The case was managed jointly by Internal Medicine and Psychiatry. High doses of Chlorazepate (up to 400 mg daily), Tiapride (up to 600 mg daily) and Thiamine (300 mg daily) were prescribed. After 5 days of treatment, the patient started to improve but severe pain appeared in the lower limbs suggestive of alcoholic neuropathy. Gradually the treatment was replaced by Pregabalin (up to a dose of 1200 mg daily) which was effective in calming the late withdrawal and partially controlling the lower limb pain.

Conclusions

Benzodiazepines remain the first-line agent for severe withdrawal, while some antiepileptic drugs have proven useful in mild-moderate withdrawal and relapse prevention. Switching to antiepileptic drugs during follow-up should be considered because of the lower risk of dependence and respiratory depression, as well as the positive effects on the “kindling” phenomenon.

Disclosure

No significant relationships.
Substance Related and Addictive Disorders in Sports with a Focus on the Football Sector: a Narrative Review
Authors: Toparlak S. , Gurrea Salas D.
Published: September 2022

Introduction

Football is the world’s most-watched and played sport. Even though sports psychiatry is steadily gaining importance, the stigma on mental illness in sports, especially football, and the limited number of articles on this topic means there is a pressing need for more study in this area. This narrative review begins to fill this gap. This review summarises the work on addictive disorders in sports, with a close focus on football, as well as mentioning some initiatives that are advancing our understanding of how mental illnesses in sports can be addressed.

Objectives

This view also contributes to understanding the reasons behind mental illness and sports, and raises awareness.

Methods

This review was conducted by searching for the keywords ‘addiction’ and ‘football’ on three different database search engines, namely, PubMed, Cochrane Library, and Medline. We found 26 articles based on this literature search with these keywords from 2005 to 2020. After data extraction, we cited 10 of them considering the specificity of addiction disorders in the football industry. 16 additional articles found by backwards citation chaining are also included in this review.

Results

The articles reviewed here investigate addictive disorders within the football sector by looking at the incidence of particular addictive disorders, their underlying reasons and their consequences. This piece concludes by showing the need for more research and new initiatives regarding addictive disorders within the target group of footballers.

Conclusions

A holistic, multidisciplinary and biopsychosocial approach is essential to provide long term solutions considering different factors contributing to addictive disorders in the football sector.

Disclosure

No significant relationships.
Seizures and alcohol withdrawal: A literature review
Authors: Gonçalves M. , Félix F. , Romão J. , André R. , Sereijo C. , Ismail F.
Published: September 2022

Introduction

Seizures occur in about 3% cases of alcohol withdrawal. They usually appear within 48 hours after abrupt cessation, and are characterized by a reduction in seizure threshold secondary to adaptation to alcohol. More than 50% of individuals will experience a new seizure and in 5% of these cases, progression to a sustained epilepticus status can occur.

Objectives

The aim is to do a review of the literature on alcohol withdrawal and the onset of seizures in individuals with alcohol addiction.

Methods

A literature review was conducted using the PubMed search database.

Results

Alcohol is a central nervous system (CNS) depressant and chronic consumption causes neuroadaptation in order to maintain homeostasis. This adaptation involves the upregulation of excitatory neurotransmitters systems and the downregulation of inhibitory ones. When consumption is abruptly discontinued, the depressive contribution of alcohol to a previously established balance is disrupted, resulting in withdrawal symptoms associated to a generalized CNS’ hyperexcitability state.Critical episodes increase the risk of delirium tremens, a fatal condition in 20% of untreated cases. Thus, the treatment and prevention of seizure recurrences is essential: the clinical guidelines of the American Society of Addiction Medicine 2020, offer an action proposal. Pharmacological therapy after seizures is the preferential treatment: intravenous administration of fast-acting benzodiazepines (lorazepam and diazepam) is the first line treatment.

Conclusions

It is essential to monitor signs and symptoms that alert us to the appearance of seizures associated to alcohol withdrawal, effectively treat these cases, prevent recurrences, and provide a quality follow-up for these patients.

Disclosure

No significant relationships.
Anxiety and Depression Disorder Among Young Cannabis Users in Tunisia
Authors: Brahim S. , Henia M. , Haj Mohamed A. , Chabbouh M. , Zarrouk L.
Published: September 2022

Introduction

The use of cannabis is likely to increase as regulations on its consumption are diminishing throughout the world.

Objectives

to identify the prevalence of anxiety and depression symptoms in a group of cannabis users in Tunisia.

Methods

this a transversal descriptive study about 137 participants in the University Hospital Of Mahdia during 2 months.

Results

In our study population , the consumers were young adults aged between 18 and 35 years old ,of whom 40.8% were professionally active, 23.2% had psychiatric history. Moreover, the use of other substances was regular among users as follows: tobacco among 74.6% of users, alcohol among 72.5% of users, ecstasy among 41.3% of users, cocaine among 25.4% of users. The use of cannabis was considered as a means of exultation for 66.7%, as an anxiolytic for 26.8% and as a sedative for 23.9%. Overall, the effect of cannabis use on anxiety and depression on the HAD scale showed the following results: probable anxiety in 53% of cases, probable state of depression in 72% of time.

Conclusions

The correlation between cannabis use, anxiety and depression remains unclear. Equally concluded, the assumption of self-medication by cannabis stills a topic of discussion.

Disclosure

No significant relationships.
Schizoaffective disorder induced by substance abuse: a case report
Authors: García Carpintero A. , Rodado León B. , Bermejo Pastor A. , Jiménez Cabañas M. , Ponte López T.
Published: September 2022

Introduction

We present the case of a 33-year old man that suffer chronic cocaine and cannabis use since adolescence and at age of 25 develops depressive symptoms and later psychotic symptoms not congruent with mood state. He met criteria for schizoaffective disorder at that moment and was treated with antidepressants and antipsychotic drugs, improving symptomatology even without stopping completely substance use.

Objectives

To study the relationship between schizoaffective disorder and cannabis and cocaine use, including the neurobiological disturbance secondary to these drugs that can lead to the development of this disorder and the relevance of diagnosing it in context of active substance use.

Methods

We carried out a literature review of scientific papers in Medline data base. We used the following terms: “Schizoaffective disorder” “cocaine use” and “cannabis use”. We considered English and Spanish papers for the last 5 years.

Results

After 4 months of cocaine withdrawal and 1 month of cannabis withdrawal, the patient progressively improved depressive and positive psychotic symptoms. However, we reported the persistence of negative symptoms as psychomotor slowdown and cognitive and affective flattening.

Conclusions

The use of cocaine and cannabis is related to depressive and psychotic symptoms in intoxication and can also precipitate chronic psychotic and affective disorders. Induced schizoaffective disorder has not been widely described in literature. Our patient could be a case of schizoaffective induced disorder, but we should consider other pathogenic factors, differential diagnosis and clinical evolution in permanent withdrawal to confirm this diagnosis.

Disclosure

No significant relationships.
Effectiveness of an Alcohol Screening and Brief Intervention for Low-Income Clients Drinking at a High-Risk Level in Social Service Settings
Authors: Kim Y. , Chung S.K. , Choi E.S. , Park S.Y.
Published: September 2022

Introduction

Alcohol screening and brief interventions (ASBIs) for risky drinkers are known to reduce alcohol consumption and alcohol-related harm. The present study was the first to investigate the effectiveness of an ASBI for high-risk drinkers of low socioeconomic status (SES) in the Korean community social service setting.

Objectives

This study aims to evaluate the effectiveness of an ASBI for clients in community social service settings in South Korea.

Methods

A total of 153 clients in social service agencies participated in this study. Clients in the experimental group received alcohol use screening and two sessions of brief motivational interventions (MI). Clients in the comparison group received alcohol problems screening test only. Primary outcome variable was the amount of weekly alcohol consumption, which was measured once before the intervention and three times after the intervention.

Results

When analyses were conducted separately for participants from the self-sufficiency centers and those from the community welfare centers, there was a significant time and group interaction effects. The amount of weekly alcohol consumption of the experimental group was gradually reduced over time. However, the amount of the comparison group was reduced at the four-week follow-up but was increased both at the eight-week and 12-week follow-ups.

Conclusions

This study demonstrates the need to provide training and education in the ASBI to social service workers working with the underprivileged, as such training would increase the identification of alcohol-related risks of the people most vulnerable to alcohol-related problems.

Disclosure

No significant relationships.
Internet Use Related to Suicidal Thoughts and Help-Seeking – Preliminary Results of a Study with Depressive Patients
Authors: Voros V. , Szabo Z. , Torma E. , Nagy A. , Fekete J. , Tényi T. , Fekete S. , Osvath P.
Published: September 2022

Introduction

Suicide-related Internet use is becoming more common, and many research study its potential risks and benefits.

Objectives

Data on suicidal thoughts and Internet use of patients with depressive disorders were collected to assess their suicide-related Internet use and its relation to help-seeking preferences.

Methods

Semi-structured interviews were completed to assess Internet use patterns and suicidal thoughts among patients treated with depressive disorders, and preferred forms of help-seeking were also examined.

Results

113 patients completed the interviews, most of them spend more hours a day using the Internet. More than 80% came across suicide-related contents while browsing, a quarter reported specific search for suicidal contents. In case of suicidal thoughts, three-quarters of depressed patients would seek help from a mental health professional, two-thirds from their partners, half from friends, and nearly one-third from parents, other relatives or from GPs. Most patients would prefer offline (personal) help for their psychological problems and suicidal thoughts, online methods were less preferred, with only one-fifth choosing these options. However, a third of them also considered it probable that they would not ask anyone for help.

Conclusions

Despite of the frequent use of the Internet, online help-seeking is less common in depressive patients. However, in the times of pandemic, online help facilities may provide an opportunity to prevent suicidal behavior for those, who have suicidal thoughts and use the Internet regularly, especially searching for suicide-related contents. In the future, further research is needed to develop more effective online suicide prevention programs and applications.

Disclosure

No significant relationships.
Cancer diagnosis and suicide outcomes: prevalence and risk meta-analysis
Authors: Peviani G. , Casu D. , Mansi W. , De Prisco M. , Madeddu F. , López-Castroman J. , Fornaro M. , Calati R.
Published: September 2022

Introduction

Available meta-analytic evidence suggests an increased risk of suicide among cancer patients, although most of the reports focused on the sole suicide death (SD) outcome and they are usually hampered by significant between-study heterogeneity.

Objectives

The present meta-analysis aimed at assessing the prevalence and risk rates of SD, suicide attempt (SA), and suicidal ideation (SI) among cancer patients.

Methods

Systematic search up to April 2021 of observational studies documenting cancer and suicide outcomes associations. Pooled prevalence estimates, odd ratios (ORs), risk ratios (RRs), and hazard ratios (HRs) of SD, SA, and SI were computed according to the random-effects model. SD prevalence underwent cumulative and sub-group analyses for different variables. Risk estimates underwent sensitivity analysis for study design.

Results

Overall, thirty-nine studies were included. A higher risk of SD based on HR, SA based on OR and HR, and SI based on each measure was recorded among cancer patients versus controls. OR and RR of SD were not significant. Pooled prevalence rates of SD, SA and SI among cancer patients were 1.9% (1.1-3.1%), 1.4% (0.3-7.1%), and 9.1% (5.8-14.0%), respectively. Although high between-study heterogeneity held upon sensitivity and sub-group analyses, the overall message brought by risk analyses likewise held true. Age, country, study design, cancer type, sample size, cases type and comparison affected SD prevalence estimates in cancer patients. SD prevalence decreased over time.

Conclusions

Cancer patients face higher risk for SA and SI versus controls. SD’ results were controversial. Cancer patients have higher prevalence rates of suicide outcomes compared to the general population.

Disclosure

No significant relationships.
Metabolic disturbances are associated with psychiatric readmission: results from a Swiss psychiatric cohort
Authors: Laaboub N. , Gholam M. , Dubath C. , Grosu C. , Piras M. , Von Plessen K. , Von Gunten A. , Conus P. , Preisig M. , Eap C.
Published: September 2022

Introduction

High BMI has been associated with psychiatric rehospitalisation.

Objectives

We aimed to replicate this finding in a large Swiss psychiatric cohort and to examine whether other metabolic disturbances are independently associated with psychiatric readmission.

Methods

Data on 16’727 hospitalizations of 7’786 patients admitted between January 1st, 2007 and December 31st, 2019 at the Department of Psychiatry of the Lausanne University Hospital, were collected. Metabolic syndrome was defined according to International Diabetes Federation definition. Generalized Linear Mixed Models were used to investigate the associations between psychiatric readmission and metabolic syndrome and/or its five components.

Results

The readmitted population (N=2’935; 37.7% patients) had higher BMI, and were more likely to have central obesity, hypertriglyceridemia, and hypertension. Multivariate analyses confirmed that having a BMI ≥ 25 kg.m-2 was associated with psychiatric readmission (25 kg.m-2≤ BMI< 30 kg.m-2: OR = 1.88; 95%CI [1.55-2.29]; BMI≥30 kg.m-2: OR = 3.5; 95%CI [2.85-4.30]) when compared to patients with 18.5≤BMI<25 kg.m-2. Interestingly, novel factors associated with readmission were identified including metabolic syndrome (OR = 1.57, 95%CI [1.05-2.33]), central obesity (OR = 1.81, 95%CI [1.33-2.46]), hypertriglyceridemia (OR = 1.59; 95%CI [1.38-1.83]), HDL hypocholesterolemia (OR = 1.22; 95%CI [1.06-1.40]) and hyperglycemia (OR = 1.58; 95%CI [1.35-1.85]).

Conclusions

Metabolic syndrome, central obesity, hypertriglyceridemia, HDL hypocholesterolemia, hyperglycemia and obesity were associated with psychiatric readmission. Possible causes will be presented and discussed (e.g. reduced adherence to treatment in patients with metabolic disorders, multiple psychotropic treatments in non-responders increasing the risk of metabolic worsening).

Disclosure

No significant relationships.
Formation of reflexive skills as prevention of suicidal behavior in adolescents
Authors: Galiautdinova N. , Galyautdinova S. , Galyautdinova L.
Published: September 2022

Introduction

An important task of psychiatrists and psychologists is the prevention of suicidal behavior in adolescents.

Objectives

Highlighting the stages of the formation of reflexive skills for the development of training sessions on the prevention of adolescent suicide.

Methods

Analysis of the results of theoretical and empirical studies of reflection and suicide by psychiatrists and psychologists.

Results

Reflexive skills are a system of deliberate actions aimed at understanding and evaluating “I” and one’s own behavior. Theoretical analysis made it possible to distinguish three stages in the formation of reflexive skills. EMOTIONAL - evaluation of “I” as the basis of positive emotions. COGNITIVE - understanding (awareness) of one’s own capabilities for solving a problem. OPERATIONAL - solving a problem based on an assessment of the “I” and an understanding of their capabilities.

Conclusions

The identification of three stages of the formation of reflexive skills, as prevention of adolescent suicide, makes it possible to develop an effective training program for adolescents at risk in the Centers for psychiatric and psychological assistance.

Disclosure

No significant relationships.
Specialized Treatment applied for suicide prevention
Authors: Jaber J.
Published: September 2022

Introduction

Suicide can be defined as a deliberate act performed by the individual, whose intention is the death, in a conscious, intentional, even if ambivalent way, using a means that he believes to be lethal. They are also part of what we usually call suicidal behavior: thoughts, plans and attempted suicide.

Objectives

Prevention is a critical step in treating suicidal behavior. Create strategies to reduce and treat the ideation, planning and suicide attempt.

Methods

Based on a large increase in the number of people who present ideas, plan and attempt suicide, the Clinic created techniques for the treatment of inpatients: Life Appreciation Group, Groups applying Cognitive Behavioral Therapy, Group Dynamics, Lectures, Art Therapy and Physical activities .

Results

The actions are developed by a multidisciplinary team that is divided by applying the various techniques and participating in all the proposed activities.

Conclusions

Patients who remained hospitalized fully complying with the suggested treatment and left with medical discharge had full benefit, unlike some cases of patients removed by the family against our indication.

Disclosure

No significant relationships.
Incidence rates of suicide attempts and self-harm in Europe. What can we learn? A systematic review and meta-analysis
Authors: Jakobsen S. , Christiansen E. , Andersen P. , Lauritsen J. , Stenager E.
Published: September 2022

Introduction

Definitions used for suicide attempts and self-harm have been discussed for many years and is used differently in European countries, sometimes even interchangeably. Therefore, it is difficult to compare relevant rates across nations.

Objectives

This study aims at estimating the rate of suicide attempts and self-harm in chosen European countries in the more recent years when distinguishing between applied definitions.

Methods

A systematic search for relevant articles published between 2010-2020 will be performed in databases such as PubMed, Embase, PsycINFO, and Web of Science. Only articles in English or Danish will be included. Data will be collected for all age groups above 15 years of age. The prevalence of suicide attempts and self-harm will be calculated by a random effect model. Subgroup analyses will be performed to compare the rates according to age.

Results

from the performed systematic review and meta-study will be presented at the conference.

Conclusions

The conclusion will be presented when results have been analysed.

Disclosure

No significant relationships.
Suicidal risks in state of alcoholic drunkenness
Authors: Baranskaya L. , Babyshkina Y.
Published: September 2022

Introduction

The last two decades have seen the timeliness of studying the connection between suicides and drunkenness

Objectives

To evaluate the significance of suicidal risk factors in patients who had committed suicides while being under the effect of alcohol so as to be able to forecast suicidal risks and prevent suicides within this group

Methods

The authors have carried out an analysis of medical documentation of suicides committed in the Sverdlovsk region. The data on suicides has been taken from forensic expertise acts. The following factors have been taken into account: age, gender, social status of suicide victim, supplementary somatic pathology, and concentration of alcohol in the victim’s blood

Results

Alcoholic addiction is a behavioral indicator of suicidal risk. The level of suicidal activity in persons with the syndrome of alcoholic addiction is much higher than within the general populace. The age of 25-49 is the peak of suicidal attempts among patients with chronic alcoholism. Genuine suicides prevail during the first stage of chronic alcoholism. The patients are inclined to demonstrate pathological suicidal reactions to social misplacement that show themselves in the form of conflicts within the family and at work. In addition to genuine suicidal attempts made by males in the state of abstinence

Conclusions

The results received confirm the role of the alcoholic factor in the formation of suicidal behavior and have the aim of elaborating new forms and methods to help prevent suicides committed in the state of alcoholic drunkenness

Disclosure

No significant relationships.
Moral Injury and Suicide Ideation Among Combat Veterans: The Role of Trauma-Related Shame and Collective Hatred
Authors: Levi-Belz Y. , Zerach G. , Schwartz G. , Halperin E.
Published: September 2022

Introduction

Exposure to potentially morally injurious events (PMIEs) among combat veterans has been acknowledged as a significant stressful combat event that may lead to mental health problems, including suicide ideation (SI). Several studies have examined the risk and protective factors that can explain the conditions in which PMIEs may contribute to the development and maintenance of SI. However, the contribution of social-emotional factors has yet to be examined.

Objectives

In the current study, we examined the association between PMIE-Self and SI among combat veterans and explored the mediating role of trauma-related shame and the moderation role of collective hatred in this association.

Methods

A volunteer sample of 336 Israeli combat veterans was recruited, completing self-report questionnaires in a cross-sectional study.

Results

indicated that PMIE-Self was positively associated with SI, and trauma-related shame mediated this association. Moreover, collective hatred moderated both their direct (PMIE -SI) and indirect (PMIE-Shame-SI) association. Notably, collective hatred had an inverse role for each of the associations. Thus, collective hatred was found to comprise both a risk and a protective factor for SI following PMIE-Self.

Conclusions

The current findings highlight the crucial contribution of trauma-related shame and collective hatred to the association between moral injury and suicidality. Moreover, the findings demonstrate that even years after their military service release, combat veterans exposed to PMIEs may still feel consumed by painful memories and maintain premonitions of a foreshortened future. Furthermore, the findings help to better understand the dynamics of collective hatred and the challenge of modifying it.

Disclosure

No significant relationships.
Reflections on the production and use of interviews as a learning tool in educational podcasts for medical undergraduates
Authors: James S. , Awolesi T. , De Souza S.
Published: September 2022

Introduction

The therapeutic interview is one of the cornerstones of psychiatric practice. When practitioners are skilled in the art of interviewing, patients are allowed to share their narratives and explore their emotions, while the clinician can diagnose and treat more effectively. Discussions with colleagues can be used to share knowledge and experience. As part of a student project undertaken in Summer 2021, two students were tasked with producing a series of educational podcasts to be used for psychiatric training. Both students chose to complete several interviews with professionals in psychiatry. In this study, they will reflect on the efficacy of interviews as a learning tool, their experiences of podcast interviewing, and the transferable skills that they learned.

Objectives

To reflect on the use of interviews within podcasts and how this can be transferred to practice.

Methods

Based on the literature review, medical students conducted interviews with specialist clinicians in order to gain information around patient treatment. They then reflected on this experience.

Results

The practice of interviewing allowed for the development of a range of skills. It improved communication with senior professionals, provided a deeper knowledge of different psychiatric fields, and developed the written skills needed for the creation of engaging questions.

Conclusions

Interviews are a useful tool in educational podcasts and producing these helped medical students gain specialist insight and learning into different medical fields not thoroughly covered in the undergraduate curriculum. Producing the podcasts helped to develop the key skill of interviewing and communicating with more senior colleagues.

Disclosure

No significant relationships.
Sexual health in Tunisian women after menopause: There is a need to improve it to sustain emotional and mental wellbeing
Authors: Abdelmoula B. , Sellami S. , Bouaziz I. , Khouaja E. , Bouayed Abdelmoula N.
Published: September 2022

Introduction

Maintaining sexuality is important to the well-being of women, particularly after menopause and benefits of sexual satisfaction in terms of emotional well-being and quality of life have been well demonstrated.

Objectives

This study aims to assess the sexual health behaviors in Tunisian women during and after menopause and the awareness of Tunisian partners about the role of the quality of their sexuality regarding their physical and psychological wellbeing.

Methods

We comprehensively review the scientific literature using Pubmed database to state Tunisian literature regarding sexual behaviors and function in women during and after menopause. Interviews with twenty Tunisian women after menopause about sexual health have been conducted.

Results

Our bibliographic research revealed a poor literature with only two papers responding to our inquiry but among a specific female population investigated after experiencing breast cancer “Female sexuality in premenopausal patients with breast cancer on endocrine therapy and sexuality after breast cancer: cultural specificities of Tunisian population”. Interrogated women reported a poor sexual satisfaction as well as sexual difficulties in the partner or with him. In fact, there is an important wrong understanding of the female anatomy and physiology by both partners, for the female sexual satisfaction. There is also many wrong cultural ideas about menopause and sexuality.

Conclusions

Currently, sexuality in Tunisian women during and after menopause is influenced by ageing, by previous sexual function and experiences, the male domination in partner’s sexual practices and the sexual functioning in the partner. In general, there is an unfavorable body image and disturbed sexual health.

Disclosure

No significant relationships.
Maternal function and clinical implications: case report
Authors: Cuevas Iñiguez I. , Molina Liétor M.D.C.
Published: September 2022

Introduction

Multiple authors have criticized the lack of attention that classical theoretical models have paid to motherhood as a milestone of great influence on the psychic structure of women. However other models have developed theories that take into account factors such as: motherhood implies “dying as a daughter” or the oscillations between the “desire of the mother” and the “desire of the woman”.

Objectives

This case report aims to describe a case of severe difficulties achieving maternal function.

Methods

Case report and literature review.

Results

A 27 years old woman, born in Ethiopia. The patient reported history of childhood trauma (intrafamiliar sexual abuse, child neglect). Depressed mood and pasive autolytic ideation since childhood. The patient was adopted when she was 11 years old and moved to Spain. The pacient had difficulties with bonding with her adoptive family. At the age of 24, she got pregnant “to have my own family and not being alone.” During pregnancy, she begins to present poorly structured paranoid ideation. After birth, the patient began to present autolytic ideation, dissociative symptoms and suicide attempts.

Conclusions

For the patient, her desire to be a mother, marked from the beginning by the phantom of appropriation, later led to rejecting it. Various factors could affect: her motherhood resignified the relationship with her family of origin, as well as having imagined that her daughter would complete her lack: the birth could have underlined her traumatic history, marking the bond with her daughter by indifference and the lack of libidinal investiture.

Disclosure

No significant relationships.
Gender Matters: the Need for a New Approach to Psychopathology
Authors: Van Der Gaag R.J. , Van Wijngaarden-Cremers P.
Published: September 2022

Introduction

Treatment of mental problems is based on classification categories. Yet most patients display far more complex problems than discribed in those categories. In child psychiatry boys are overrepresented whereas in adults women are in the majority when it comes to mental health problems. This raises the question whether gender and diversity shouldn’t be taken more into account in order to come to better classifications and understanding of developemental psychopathology

Objectives

To look into the influences of gender, genetics, stress, child rearing and social determinants on the development of psychopathology

Methods

A literature search was performed with genetics, gender, stress and social determinants as keywords was in order to question the specificity and validity of current categories of psychopathology.

Results

The search yielded 26 articles. Interestingly this supports the hypothesis that the focus on phenotypical classifications is misleading and that gender plays an important role in the expression of endophenotypes (psychophysiological and neuropsychological). Moreover in many cases gender is not taken in to account enough in studies and that gender biased conclusions (when the reseach has included more men than women for different reasons) are extrapolated to easily to the other sexe, assumoing that the outcomes are universal

Conclusions

The categoral approach to psychopathology has stimulated research in a very productive fashion. Yet now we should think beyond categories in mental health and have the courage to adapt our clincial practice to endophenotypes taking into account the permanent interaction between individual and enviironment. Which implies a more gender specific approach to (psycho)pathology

Disclosure

No significant relationships.
Mental Confusion of Neurological Etiology in 41 cases
Authors: Brahim S. , Bouali W. , Younes S. , Kacem M. , Zarrouk L.
Published: September 2022

Introduction

The confusional state is the clinical expression of a temporary acute cerebral decompensation. It is expressed by a global, fluctuating and reversible alteration of cognitive functions. It is a frequent reason for consultation in the emergency room.

Objectives

To determine the epidemiology, neurological etiologies and their risk factors.

Methods

Retrospective study based on the files of 41 hospitalized patients with confusional syndrome.

Results

We collected 41 patients. The mean age was 72.9 years. The sex ratio was 1.25. The antecedents found were arterial hypertension and diabetes in 10 patients, a history of stroke was ischemic in 21 cases and hemorrhagic in 6 cases, cerebral metastasis in 5 cases, hepatic encephalopathy in 6 cases and a toxic cause in 4 cases. Mental confusion was acute in 23 patients and subacute in 18. The confusional manifestations observed were essentially temporospatial disorientation in 27 patients, obnubilation in 22 cases, difficulty in paying attention and concentrating in 24 cases, and vague and slow verbal expression in 11 cases. A metabolic disorder was found in 15 patients, such as hyperkalaemia (7 cases) and hyperglycaemia (8 cases). Etiological treatment was instituted with recourse to sedative treatment in 18 patients due to agitation. The evolution was marked by a total regression of confusion in 11 cases, lacunar amnesia in 7 cases, prolonged mental confusion in 6 cases and death in 3 patients.

Conclusions

Elderly subjects are at risk due to the vulnerability of brain structures to pathologies and treatments associated with this period of life. Early treatment can improve the prognosis.

Disclosure

No significant relationships.
Efficacy of tPBM on ADHD symptoms and Executive Function Deficits in Adults with high-functioning Autism Spectrum Disorder
Authors: Ceranoglu T.A. , Cassano P. , Hutt Vater C. , Green A. , Dallenbach N. , Disalvo M. , Biederman J. , Joshi G.
Published: September 2022

Introduction

Executive function (EF) deficits are often associated with Autism Spectrum Disorder (ASD), even in the absence of Attention Deficit Hyperactivity Disorder (ADHD) diagnosis. To date, no approved medication treatments exist for EF deficits associated with ASD.

Objectives

To assess the efficacy of transcranial photobiomodulation (tPBM) on EF in adults with ASD.

Methods

Adults (18-59) with high-functioning (HF)-ASD received twice a week tPBM for 8 weeks in an open-label single group design. ASD and EF deficits were assessed by clinician-rated Clinical Global Impression Scale and patient-rated scales of Behavior Rating Inventory of Executive Function-Adult (BRIEF-A).

Results

Eleven participants were enrolled. Ten participants completed the study. Nine participants who completed the study had comorbid ADHD diagnosis. All 10 participants were included in efficacy analyses of EF deficits. Statistically significant improvements in executive function deficits were found in BRIEF-A total score and in subdomains of Inhibition, Emotional Control, Planning and Organization, Organization of Materials, Behavioral Regulation, Metacognitive Index and Global Executive Control. All participants were found to have mild to moderate improvement in their ADHD symptom severity per clinician rated CGIs. Statistically significant improvements in ADHD symptoms were noted in self-rated scales. No adverse events required changes in tPBM protocol.

Conclusions

tPBM is a safe and feasible treatment approach that has the potential to treat core features of ASD. Further research is necessary and warranted.

Disclosure

This work is funded by Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder and the MGH Pediatric Psychopharmacology Council Fund.
Virtual reality-based and eye tracking-assisted attention refocusing training for adult Attention-Deficit/Hyperactivity Disorder
Authors: Selaskowski B. , Asché L. , Wiebe A. , Kannen K. , Aslan B. , Sanchéz D. , Lux S. , Philipsen A. , Braun N.
Published: September 2022

Introduction

Neurofeedback regimes in the treatment of adult ADHD are commonly EEG-based and have several shortcomings, including a weak signal-to-noise ratio, low transfer rates from laboratory to everyday environments and ambiguous evidence in respect to adequate brain signals of interest.

Objectives

To investigate, if an eyetracking-based real-time feedback in a virtual environment can enhance attentional performance, as measured by behavioral, EEG and eyetracking parameters.

Methods

Overall, n=18 adult patients with ADHD and n=18 healthy controls (HC) performed a continuous performance task (CPT) in a virtual seminar room, while distracting virtual events occurred. In case the participant’s gaze drifted away from the task an automated audiovisual feedback indicated the participant to refocus on the task. Three 20-minutes blocks were presented in counter-balanced order, that differed in respect to whether real feedback, sham feedback or no feedback was additionally provided.

Results

Mixed ANOVAs with within-subject factors ‘Condition’ (real feedback, sham feedback, no feedback) and ‘Phase’ (distractor phases vs. non-distractor phases) and a between-factor ‘Group’ (ADHD patients vs. HC) revealed better task performances in HC than ADHD patients in respect to omission errors (p = .023), mean reaction times (p = .042) and reaction time variabilities (p = .007; cf. Figure 1). Moreover, omission errors turned to be higher during distractor-present than distractor-absent trials (p = .007), especially in ADHD.

Figure 1.

CPT results. DP=distractor-phases, NDP=non-distractor-phases

Conclusions

While the virtual CPT turns out to discriminate well between patients with ADHD and HC, the behavioral results do not indicate an attentional performance enhancement based on the gaze-dependent feedback.

Disclosure

No significant relationships.
The impact of the covid-19 pandemic on the risk of social stigma
Authors: Sacco M.A. , Scalise C. , Zibetti A. , Aquila V. , Abenavoli L. , Ricci P. , Aquila I.
Published: September 2022

Introduction

Social stigma indicates a process of negative connotation of a person which results in discrimination. The victim of stigma experiences a condition of social exclusion that negatively affects his relationships. The COVID-19 pandemic has spread the fear of being “contaminated”, which has led to the discrimination of a part of population.

Objectives

The purpose of this work is to analyze which people have suffered from stigma due to the COVID-19 pandemic by examining the negative effects on their health during this period.

Methods

A literature review of peer-reviewed articles was performed on Pubmed NCBI database by inserting the keywords: stigma and COVID-19 in the period 2020-2021.

Results

The data showed that the categories most at risk were positive patients and their families; healthcare workers in COVID-19 wards; Asian people. Discrimination has included avoidance attitudes, physical or verbal abuse, hypersurveillance in public places. Negative effects on victims included anxiety, depression, feelings of rejection and shame, self-harm and suicide. COVID-19 patients attempted to hide the disease by avoiding access to hospital; health personnel developed risk of burnout; Asian restaurants experienced a drop in reservations, even after quarantine period.

Conclusions

Social stigma is a public health problem and greater efforts are mandatory to reduce it including correct information, with the help of social and mass media; social interventions aimed at generating empathy; avoiding the use of negative language focused on stereotypes that could generate fear or discrimination. Such interventions are crucial to reduce discrimination in such a fragile period as COVID-19 pandemic.

Disclosure

No significant relationships.
The conundrum of Identitive Dissociative Disorder: about a case
Authors: Albarracin P. , Herrero Pellón E. , Galerón R. , Huete Naval M. , Serván B.
Published: September 2022

Introduction

We present the case of a 22 year old male with a history of two hospitalizations in the Psychiatric ward of our hospital with psychotic symptoms that led to a diagnosis of schizophrenia, whose later evolution arose doubts about such a diagnosis and provoked a re-examination of the case, eventually leading to a diagnosis of Dissociative Identity Disorder.

Objectives

To present a complex case of Identity Dissociative Disorder disguised by a myriad of psychotic-like symptom and to review the links between this kind of disorders and a personal history of trauma.

Methods

We performed an extensive review of the scientific literature available regarding the topic of Dissociative Identity Disorder, using sources both in English and Spanish languages.

Results

Our patient experimented two admissions into our Psychiatric ward due to acute psychopathological symptoms (auditive pseudohallucinations and visual hallucinations attributed by the patient to two different people who could influence on his behaviour), then linked to a début of a Paranoid Schizophrenia. The follow-up of the patient in a Day Clinic related to our hospital revealed a close relationship between the described symptoms and a personal history of trauma, as well as a lack of effect of the antipsychotic medication prescribed, and the clinical case eventually evolved to the development of two distinct identities within our patient, leading to a new working diagnose of Identity Dissociative Disorder.

Conclusions

Identitive Dissociative Disorder is a complex, underestimated entity of difficult diagnosis with deep roots in personal traumatic history and whose multifaceted presentation may entail a challenge to clinicians.

Disclosure

No significant relationships.