bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic characteristics of patients followed for bipolar disorder with rapid cycles: Study on a Tunisian population
Authors: Karoui M. , Amri G. , Kammoun R. , Nefzi H. , Ellouz F.
Published: September 2022

Introduction

Bipolar disorder is a frequent and particularly severe psychiatric pathology that causes significant morbidity and mortality. The rapid cycling forms are more severe in terms of their expression, evolutionary course, therapeutic responses and associated comorbidities.

Objectives

The aim of this study is to conduct a descriptive assessment of therapeutic characteristics in patients with rapid cycling bipolar disorder.

Methods

Our work involved a population of 97 patients followed for bipolar disorder diagnosed according to DSM5 criteria, including 37 patients meeting the specification “with rapid cycles”. The patients were divided into two groups: - Group of patients with bipolar disorder with rapid cycles (TBCR) - Group of patients with bipolar disorder without rapid cycling (TBNCR). We compared the therapeutic features among these two groups.

Results

The dominant polarity was depressive in patients with rapid cycles. They required more mood stabilizers. A greater proportion of them had received treatment with serotonin reuptake inhibitor antidepressants. They were more likely to use hypnotics such as antihistamines and zolpidem.

Conclusions

Rapid cycling TB is a relatively common clinical modality that should be investigated and identified.The use of antidepressants is associated with this course of the disease. Their utilization in the treatment of bipolar depression must be thoughtful and well studied

Disclosure

No significant relationships.
The IT4 anxiety project : Improving Anxiety Prevention and Management with Innovative Digital Solutions
Authors: De Moffarts V.
Published: September 2022

Technological innovations give new perspectives in many fields, including health. It was in this context that the IT4Anxiety project was born in 2019 bringing together mental health professionals and start-ups, but also universities, research centres, higher education establishments and public authorities from the North-West Region of Europe. The project is challenging our ability, as partners, to gather stakeholders from different background, medical and non-medical field, in order to support the implementation and co-conception of innovative solutions with the objective of reducing the anxiety of mental health service users. During the four years of project implementation (2019-2023), the stakeholders will have opportunities to work with the end-users, expecting to address the needs of around 3,000 mental health service users suffering from anxiety. The fifteen start-up involved in the project activities will be recruited through hackathons and calls based on identified needs. They will join the project in order to test and improve their solutions. This will create opportunities to connect the start-ups with the medical world, research codes and procedures and to give them a new perspective in the understanding of their targeted market segment. Furthermore, almost a thousand mental health professionals will be trained in e-mental health, benefiting from our training modules and an e-mental health job profile will be designed and implemented in our partner hospitals in Belgium and in Germany.

Disclosure

No significant relationships.
Attention-Deficit/Hyperactivity Disorder and Parenting: Toward a Cognitive/Schema Model
Authors: Miklósi M. , Nagy V. , Oláh S.
Published: September 2022

Introduction

Attention-Deficit/Hyperactivity Disorder (ADHD) runs in families; however, there are mixed results on the interaction effects of parent’s and child’s psychopathology on parenting qualities. Cognitive/schema therapy is a promising treatment approach for adult ADHD; we know little about the effect of cognitive factors on parenting, however.

Objectives

We aimed to fill this gap by exploring the role of dysfunctional schema modes in the associations between adult ADHD symptoms, child’s externalizing symptoms, and perceived parental competence in a dimensional approach.

Methods

A community sample of parents (N=100, mean age=38.25 years, SD=5.73) filled out online questionnaires assessing ADHD symptoms (Adult ADHD Self-Report Scale), dysfunctional schema modes (Schema Mode Inventory), perceived parental competence (Parental Sense of Competence Scale), and child’s psychopathology (Strength and Difficulties Questionnaire).

Results

In a multivariate model, higher levels of parental ADHD symptoms were related to higher levels of dysfunctional schema modes. However, neither the child’s externalizing symptoms nor the interaction term of parent’s symptoms by the child’s symptoms had any effect on dysfunctional schema modes. Furthermore, the child’s externalizing symptoms had a direct negative association with parental self-efficacy beliefs, whereas the relationship between adult ADHD symptoms and parental self-efficacy was mediated by the detached and overcompensating dysfunctional schema modes.

Conclusions

Our results suggest that the activation of dysfunctional schema modes is related to the parent’s but not the child’s psychopathology. The activation of dysfunctional schema modes may play an important role in the self-efficacy beliefs of parents with ADHD. Targeting that cognitive factors may enhance the effect of behavioral parent training programs.

Disclosure

This research was supported by National Research, Development, and Innovation Office (NKFIH) OTKA-PD-134849 grant.
Training Issue about Digital Tools : from Users & Carers to Professionals
Authors: Dulière M.
Published: September 2022

The Interreg IT4Anxiety Project gives birth to training modules in digital health. The European Interreg IT4Anxiety project, led by the CNP St-Martin, is launching a new range of training modules in digital health awareness at the Haute Ecole de la Province de Namur, the University of Applied Sciences (HEPN). Electronic medical records, teleconsultation, mobile applications, virtual reality… Digital tools are already part of the daily life of workers in the health sector. However, until now, no curriculum has included appropriate training to enable caregivers to acquire the fundamental knowledge needed to use digital tools effectively in their professional practice. Thanks to the expertise and support of its various partners in the IT4Anxiety project, the Haute Ecole de la Province de Namur will provide digital health awareness training starting in 2022. These training modules will be provided as part of the in-situ training of caregivers and are already being tested in the academic training of future nurses. In addition to discovering the potential of new technologies in the health field, health professionals and future professionals will learn to identify the appropriate use of these tools, to deploy them and to use them in their profession, in a respectful and caring relationship with a critical eye. The structure of the courses, the assessment and the feedback from the HEPN will form the basis for an international deployment of this training by the German, French, Dutch and English partners of the IT4Anxiety project.

Disclosure

No significant relationships.
“She gets out of control when she’s on her period”. Cyclic menstrual psychosis. A case report
Authors: López Rodrigo M.V. , Osca Oliver A. , Palomo Monge M. , Tascón Guerra M.F. , Pérez Fominaya M.
Published: September 2022

Introduction

Cyclical psychosis related to the menstrual cycle is an entity not included in the DSM-V and ICD-10 classifications, however there are data collected in the literature on cases that agree with this diagnosis. When reviewing cases, psychotic symptoms of sudden onset are described a few days before menstruation, with the symptoms resolving in a self-limited way when the bleeding ends. The end of psychotic symptoms is not directly related to the use of antipsychotics. The complete clinical picture is nonspecific and fluctuating. With acute onset, short duration, cyclical repetition, with psychotic symptoms (mutism, confusion, delusions, hallucinations) or a manic episode. We present the case of a 14-year-old adolescent with a history of epileptic seizures in childhood, without current treatment. She goes to the emergency department brought by her father and brother presenting psychomotor agitation, verbiage, flight of ideas, loss of the common thread in the speech, referring delusional ideas with experience of harm. His relatives report that he has not slept for a few days, with soliloquies, unmotivated laughter. They refer that the picture has been repeated in recent months during the days of menstruation.

Objectives

Knowing a diagnosis not included in the current classifications.

Methods

Imaging tests and neurological evaluations rule out organic picture.

Results

Given the periodicity of the condition, the symptoms are self-limiting at the end of menstruation, without a clear relationship with psychopharmacological treatment (although agitation improves).

Conclusions

Cyclical menstrual psychosis approximates affective disorders, especially bipolar disorder in adolescence. The role of psychotropic and hormonal treatment is debatable.

Disclosure

No significant relationships.
Cultural Factors of Suicidality
Authors: Küey L.
Published: September 2022

Suicidal behavior is a complex human behavior expressed in a spectrum of various acts. From a suicidal gesture to a completed suicide, all reflect a cry for help and need clinical and scientific attention. The process ending up with suicidal act is shaped by multi-factors, including the socio-cultural ones. Suicide is indeed related to a deep feeling of hopelessness; not to have any control over their lives and circumstances except than deciding to stay alive or dead, and so related to serious psychopathologies, as depressive and substance use disorders. Hence, it is frequently seen as a personal act or as a question of individual decision. But since Durkheim‘s ground breaking work, which still inspires suicide researchers, the cultural factors behind this socially determined phenomenon have been widely discussed. Suicide is totally a personal act and a fully socio-cultural phenomenon. The cultural factors of suicidality are among the social determinants of health/ill health. Epidemiological evidence and cross-cultural comparisons show huge differences in suicide rates across countries and even between regions of same countries, and these are constant differences. Furthermore, even the definition of suicide is effected by the social circumstances. Certain socio-cultural patterns shape how and when people commit suicide; i.e., these patterns have decreasing or increasing effect on suicide rates, which provides basis for suicide prevention. Likewise, social solidarity, high group integration and collective sensitivity may have preventive effects. This brings us to the discussion of the effects of big social turmoil or wars or pandemics on suicidal behavior.

Disclosure

No significant relationships.
Mental health in children and adolescents during the pandemic year 2020: Results from a department of child and adolescent psychiatry in Romania
Authors: Opait M. , Floricel A. , Niculae L. , Andrei E.
Published: September 2022

Introduction

Infectious diseases can disrupt the environment in which children live and have negative consequences for the well-being, development and mental health of this population.

Objectives

Our aim is to compare the number and diagnoses of patients admitted during the first COVID-19 pandemic year to patients admitted during the same period in the previous year.

Methods

Retrospective observational study of patients admitted between March 1, 2020 and February 29, 2021 and the analogous period of 2019-2020 in a child psychiatry unit. Microsoft Excel was used for descriptive statistics.

Results

In our first pandemic year, there were 47.9% less admissions to our inpatient unit (n=717), comparing to the previous year (n=1376). Regarding the outpatient-type evaluations, there were 37.7% more admissions than the previous year (n=1813). Considering the fact that the number of inpatiens was limited in 2020 due to the restrictive measures imposed, most of our patients were consulted on an outpatient basis. During the 5 weeks nationwide lockdown, 72 children were consulted, 42.8% representing psychiatry emergencies. Regarding the diagnoses made in the whole pandemic year, disorders of psychological development were the most common, with almost half of the total of admissions (44.4%). The number of autistic outpatients in the pandemic year (n=1004) was almost double than the one before (n=572).

Conclusions

Even though there was a reduction of admissions to the child psychiatry inpatient unit during the first pandemic year, we did not identify major differences regarding the discharge diagnoses comparing to the year before.

Disclosure

No significant relationships.
The Line between Psychosis and Schizotypy: a case report
Authors: Huerga García L. , Hernández Padrón E. , Casanova Gracia N. , Torres Nieves N. , Gómez Pérez P. , Garcia Gómez-Pamo F. , Dorta Gonzalez J.J. , Dorta González J.F.
Published: September 2022

Introduction

Since Kraepelin and Bleuler, schizotypy was understood as a mild expression of psychosis, a latent form with the same trajectory but different severity. They pointed characteristics such as being eccentric, unreasonable, supersticious or hipersensitive, interpersonal aversiveness (often related to suspiciousness and expectation of rejection), ambivalence, anhedonia,… and psychosis-like features that don’t usually lead to help-seeking.

Objectives

To do a case review

Methods

We report a case of a 17 years old boy with a childhood trauma history who started psychiatric consultations a year and a half ago because his “usual” (as his mother referred) strange behaviour got worse, which was perceived by his

ENT specialist. During the appointments, the patient showed suspiciousness, odd speech, inappropriate affect, tendency to social withdrawal, obsessive ruminations with sexual content and occasional perceptual experiences (such as depersonalization, derealization and auditory hallucinations).

Results

Psychosis and schizotypy are linked historically and phenomenologically, which is evidenced by their placement in non-affective psychosis in the ICD-10 and DSM-5, and it is known that the direct observation (by clinicians or family members) during the childhood and adolescence are key for a correct diagnosis. In fact, this construct reflects a phenotypic expression of vulnerability to schizophrenia, and during childhood or adolescence it may be understood as an early mental risk state.

Conclusions

In contrast to models of psychosis that mainly rely on positive features and assume a progression of them, the positive traits of schizotypy seem to be beneficial and related to a “benign or happy schizotypy” according to the articles we reviewed.

Disclosure

No significant relationships.
Obsessive-Compulsive Disorder in children. A case report
Authors: Galerón R. , Huete Naval M. , Exposito Duran E. , Mayor Sanabria F. , Regueiro Martín-Albo C. , García-Escribano Martín F.
Published: September 2022

Introduction

We present a 9-year-old girl with celiac disease who attends a Health Center referred by her pediatrician for rituals. Her mother describes rituals from early childhood that have been intensified by the death of her grandmother from pancreatic cancer. Since then, thoughts of gluten contamination and behaviors aimed at avoiding such contamination have increased. For example, not using the common household towel and not eating until all the guests have washed their hands. If the patient does not carry out these actions, she presents significant discomfort, crying and screaming until it is done. In addition, such behaviors take up a significant amount of time.

Objectives

To review the literature of Obsessive-Compulsive Disorder (OCD) in children.

Methods

Literature review of scientific articles searching in Pubmed. We considered articles in English and Spanish.

Results

Cognitive Behavioral Therapy and Sertraline up to 50mg were started. After several weeks the frequency of behaviors aimed at avoiding gluten contamination begins to decrease; as well as the anguish if these are not carried out.

Conclusions

OCD in childhood can present characteristics that differentiate it from OCD in adulthood, such as difficulty detecting obsessions and that children do not usually consider thoughts as unreal or excessive. Therefore, it is a real challenge, having to carry out an adequate differential diagnosis with other entities such as specific phobias, for adequate subsequent management.

Disclosure

No significant relationships.
Risk Factors of Suicidal Behaviour in old age
Authors: Lozupone M. , Mollica A. , Berardino G. , Bellomo A. , Panza F.
Published: September 2022

Several observational studies investigated risk factors for suicide attempts/completed suicides in older age with contrasting evidence from ongoing population-based research. The risk factors most associated to suicide attempts than other variables were: depressive disorders, methods employed to self-harm (particularly poisoning), and psychotropic drug utilization followed by psychological factors and disability. Moreover, male sex, violent methods to self-harm, any psychiatric disorder (depression, anxiety and bipolar disorders), a poor medical condition, stressors/bereavement, and living alone appeared to be more significant for predicting completed suicides in late life. There is growing evidence of a role of environmental exposures in the pathogenesis and epigenetics of suicidal behavior in older age. Little is known about the possible relationship between suicidal ideation in older age and its biopsychosocial predictors, although psychiatric disorders (among which late-life depression, LLD), play a fundamental role. LLD, distinguished as late-onset depression (LOD) and early-onset depression (EOD). Suicidal ideators accounted for 2.32% of subjects, were female, smokers and obese affected by multimorbidity. After adjusting for age, gender, education and social dysfunction, suicidal ideation was associated to LLD (EOD>LOD:OR:21.71, 95% CI:9.22-51.14). In the full random forest model, asthma was the most important contributor to suicidal ideation. Among biomarkers, interleukin (IL)-6 followed by tumor necrosis factor (TNF)-a, Apolipoprotein E e4 allele-carriers, C-reactive protein contributed most to suicidal ideation. Although EOD is a strong determinant of suicidal ideation, other non-psychiatric factors, i.e., serum inflammation biomarkers, APOE e4 allele, and multimorbidity, should be taken into account when evaluating a suicidal ideation phenotype in older age.

Disclosure

No significant relationships.
Descriptive analysis of patients admitted to a new adolescent inpatient unit in Madrid
Authors: Taracena Cuerda M. , Esperesate Pajares M. , Feito Garcia M. , Arranz Martin C. , Sánchez Sampedro E. , Jiménez Bidón A.M. , Puente García R. , Pastor Jordá C.
Published: September 2022

Introduction

Adolescent mental health problems may have increased after COVID-19 worldwide pandemic. Therefore it seems necessary to study the state of mental health inpatient adolescent units.

Objectives

Adolescent mental health problems may have increased after COVID-19 worldwide pandemic. Therefore it seems necessary to study the state of mental health inpatient adolescent units.

Methods

An observational and descriptive analysis of the sample of patients between 12 and 17 years-old, that were admitted to the inpatient mental health unit since its opening on April 2021.

Results

A total of 205 patients were admitted from April 2021 until October 2021. We have observed sex diferences within patients admitted, as the 82.9% of them were female. The mean age was 14.7, being 14.6 for girls and 15.3 for boys. The most common reason for admission (RFA) were suicidal ideation/attempt, eating disorders, affective disorders, conduct disorders/challenging behaviors and psychosis. Suicidal ideation/attempt was the most common RFA (57.07%) in both sexes, being higher among females (60.3%) than males (42.9%). Eating disorders were the second most common RFA in girls (17.7%) while psychosis (17.1%) and mood disorders (17.1%) were the second most common RFA within boys.

Conclusions

Findings on how COVID-19 affected adolescents mental health are controversial in the literature, our data suggest that there is a need of developing quality studies that analyse how the pandemic might be influencing adolescents suicidal ideation/attempt and its protective and risk factors.

Disclosure

No significant relationships.
Self-injury in adolescents: expression of subjective discontent in contemporary society
Authors: Dörr Alamos A. , Viani S.
Published: September 2022

Introduction

This research aims to enrich the reflection on the current affairs and is an invitation to think about worrying phenomena in youngsters: self-injuries or cuts. A focused study was conducted on twenty young people

Objectives

This ris a reflection oabout worrying phenomena in youngsters: self-injuries or cuts. We try to figure out the underlying cause of such behaviour

Methods

Through a qualitative methodology, using clinical interview and questionnaire, we try to find the constitutive elements of self-injuries or cuts, considering three levels of analysis: Sociocultural, individual, and family changes. We examined twenty cases

Results

It appeared in the analysis that one of the triggers of the cutting phenomenon was related to experiences of rejection of significant figures, which is lived by the young person as a situation of abandonment that generates high amounts of anguish. This distressing experience generates a sensation of lack of control, appearing as unregulated affections, which they are unable to handle or manage. The intense anxiety is carried through the body, being an act of attack to the body, provokes physical pain an emotional relief

Conclusions

Young people’s subjective perception of the maternal figure is that of a dominant, controlling and demanding personality, which hinders an adequate differentiation process. With respect to the description that the young people make of themselves, we see that they refer to a marked emotional lability and the presence of dysthymic experiences. It appeared in the analysis that one of the triggers of the cutting phenomenon was related to experiences of rejection or separation of significant figures.

Disclosure

No significant relationships.
Electroconvulsive therapy in children and adolescents
Authors: Esperesate Pajares M. , Pastor Jordá C. , Taracena Cuerda M. , Puente García R. , Jiménez Bidón A.M.
Published: September 2022

Introduction

Despite its good results and tolerability in adults, electroconvulsive therapy (ECT) is barely administered in children and adolescents, with scarce evidence in these patients.

Objectives

We aim to summarize the data available to give a clearer view of how children and adolescents might benefit from ECT.

Methods

We’ve done a bibliographic review in PubMed and Cochrane Library searching for articles that include the terms “electroconvulsive therapy” and “adolescents” and/or “children” and their variations.

Results

Current evidence supports the use of ECT in various indications as mood disorders, schizophrenia spectrum disorders, catatonia, neuroleptic malignant syndrome and self-injurious behaviours associated with autism, Tourette’s syndrome or intellectual disability. The efficacy and safety it’s comparable to adults and there are no absolute contraindications. Side-effect profile it’s also similar to the general population, reporting as the most frequent adverse effects headache, generalized body aching, and nausea or vomiting.

Conclusions

ECT is an effective and safe treatment for severe mental disorders in children and adolescents.

Disclosure

No significant relationships.
Neuropsychological profile of Turner Syndrome in relation to deficits in academic and psychosocial areas. A case report
Authors: Castellanos Villaverde T. , Izquierdo Pérez S. , Hospital Moreno A. , Louzao Rojas I. , Fernández-Jiménez E.
Published: September 2022

Introduction

Previous reviews reported an association between Turner Syndrome (TS) and a profile of deficits in some neurocognitive domains (visual-spatial domains, mathematics, and executive functions: cognitive flexibility, working memory, cognitive inhibition, and problem solving), although pointing out individual variability.

Objectives

To describe the neuropsychological profile of a patient with diagnosis of TS and psychosocial difficulties attended at the Service of Psychiatry, Clinical Psychology and Mental Health at La Paz University Hospital (Madrid).

Methods

A descriptive study is conducted on a single case of a 11-year-old woman with diagnosis of TS attended by a clinical psychologist at a child-adolescent Mental health center for social, family and academic difficulties. Neuropsychological assessment was completed in October, 2021. The Wechsler Intelligence Scale for Children-Five Edition (WISC-V) and Neuropsychological Assessment of Executive Functions in Children (ENFEN) batteries were administered.

Results

The full-scale intelligence quotient was observed in the normal range, with lower scores in non-verbal tasks. Deficits (range from z = -2.00 to -1.75) were observed in tests of working memory, processing speed and complex problem-solving tasks. The results showed great variability in other executive functioning tasks (selective attention tasks: from z = -1.75 to -0.75; and cognitive flexibility tasks: from z = -2.25 to 0.25).

Conclusions

The neurocognitive profile described in the literature was partially consistent with the results obtained in this study. The neuropsychological assessment can support the elucidation of clinical diagnostic and therapeutic factors in TS patients with relevant psychosocial or cognitive difficulties.

Disclosure

No significant relationships.
Quality of Life in Neurotypical Siblings of Children with an Autism Spectrum Disorder: Associations with Parental Social Support and demographic variables
Authors: Koukouriki E.
Published: September 2022

Introduction

Health Related Quality of Life (HRQOL) is acknowledged as an important construct in describing the individuals overall condition within the health context. In the case of families with Autism Spectrum Disorders (ASD), neurotypical siblings’ HRQOL is an important concept for this at-risk population. Social support has been identified as an important protective factor against parental psychological problems. However, possible associations between HRQOL in neurotypical ASD-siblings and parental variables, such as perceived social support, remained unexplored in the ASD-siblings’ literature.

Objectives

This study aimed to investigate any association between HRQOL in neurotypical ASD-siblings and parental perceived social support and key demographic variables.

Methods

118 parent-child-dyads from Greek ASD-families that fulfilled inclusion criteria participated in this study and answered a demographic questionnaire. Parents were administered the Multidimensional Scale of Perceived-Social-Support (MSPSS), while the children answered the Kidscreen-27. A hierarchical multiple regression was performed to test the hypothesis.

Results

Hierarchical regression showed that neurotypical siblings HRQOL (as measured with KIDSCREEN-27 total score) was associated with perceived social support from the family (std beta=0.184; p=0.027; model 1), and this association persisted after demographics entered the model (std beta=0.369; p=0.015; model 2). Thus, it was found that the sibling’s HRQOL was associated with perceived social support from the family independent of demographics.

Conclusions

The results of the present study showed that the HRQOL in ASD-siblings is associated with perceived social support from the family, pointing to the need for supporting siblings and designing effective interventions in order to prevent possible mental health problems in neurotypical siblings of ASD individuals in the future.

Disclosure

No significant relationships.
Reinforcing the new diagnosis of Complex Post-Traumatic Stress disorder (CPTSD) of ICD-11: exploring the clinical outcomes in youth exposed to complex trauma
Authors: Marques Feixa L. , Romero S. , Moya-Higueras J. , Santamarina-Pérez P. , March-Llanes J. , Muñoz M.J. , Zorrilla I. , Rapado-Castro M. , Blasco-Fontecilla H. , Anglada E. , Ramirez M. , Fañanas L.
Published: September 2022

Introduction

Youth exposed to complex trauma (CT) show an increased risk of psychiatric morbidity, including a wide range of psychiatric disorders. However, to date, there is no specific diagnosis in the DSM-5 that capture the clinical complexity of these patients. Properly, the last version of the ICD-11 includes a diagnosis termed Complex Post-Traumatic Stress Disorder (CPTSD), which considers the pattern of post-traumatic stress symptoms, plus life-impairing disturbances in self-organization (emotion dysregulation, negative self-concept and interpersonal problems). Clinical research about CPTSD, especially in younger population, is still limited.

Objectives

To explore the symptomatology of CPTSD in a sample of youth exposed to CT and its association with worse clinical outcomes.

Methods

187 youth aged 7 to 17 years participated in the EPI_young_stress_project (116 with current psychiatric disorder and 71 healthy controls). CT was evaluated following the TASSCV criteria. To identify CPTSD symptomatology, we performed an exploratory factor analysis including CBCL and TEIQue items. The global level of functioning was measured by CGAS.

Results

Preliminary results pointed that youth exposed to CT showed greater internalizing (p<.001) and externalizing (p<.001) symptomatology. Regardless of their current primary diagnosis based on DSM-5, youth exposed to CT reported more CPTSD symptomatology (p<.001). Moreover, youth with CPTSD showed greater use of psychotropic drugs (p<.001), higher and longer hospitalizations (p=.002) and worse overall functioning (p<.001).

Conclusions

The inclusion of the CPTSD in future versions of mental disorders manuals should increase the implementation of early specific trauma interventions, which may improve victims’ lives and reduce the risk of worse clinical outcomes.

Disclosure

No significant relationships.
Suicide and Ageism
Authors: De Leo D.
Published: September 2022

Suicide in old age is frequently considered the result of a rational decision. Accumulation of physical illnesses, frailty, dependence on others, loss of partner and loneliness are often seen as reasons that might justify suicidal acts. Depression is an important risk factor for suicidal behaviour even at very advanced age. However, ageistic views tend to consider depression as a normal feature of the aging process; it is possible that its presence can be overestimated or perhaps generalized more than necessary by making it the scapegoat of any situation related to suicide. In fact, adopting an attitude that involves excessive simplification of problems, where everything is attributable to ‘depression’, can induce a rigid prescriptive approach, often limited to the indication of an antidepressant drug. In this way, the appreciation of the multifactorial nature of an individual’s crisis becomes too narrow and the chances of counteracting the complexities of a dangerous suicide progression too modest. From a prospect of suicide prevention, approaching a patient carefully and prudently is always to be preferred to the disposition that considers life events as inevitable as well as all reactions related to them, including the most extreme, such as suicide. This attitude can lead to a poor involvement of the treating physicians, who might become too acceptant of the ‘unavoidability’ of the unfavourable progression of their patient. Such a passive approach may especially characterise the relationship with patients of very advanced age, where stressors of physical and non-physical nature easily aggregate, multiplying their impacting power.

Disclosure

No significant relationships.
Antisocial Personality disorder. A case report
Authors: Muñoz Martinez V. , León-Parente A. , Laura M.-D.
Published: September 2022

Introduction

Antisocial disorder is characterised by difficulty to adapt to social norms that normally rule different aspects of the person’s conduct in adolescence and adulthood. According to DSM-V, this disorder’s prevalence stands between 0.2% and 3%, and is more frequent in men.

Objectives

Numerous studies have been made about the influence between the environment and genetics for the development of this disorder, finding in several patients a punctual mutation of the monoamine oxidase gen (MAOA); although impulsive behaviour has also been associated to the 5-HT tranporte gene (5-HTT), and the protein coding gene for Tryptophan Hydroxylase TPH1

Methods

The hospital admission for these patients must be made when there’s autoregressive or hetero aggressive behaviour, suicide attempts, psychotic symptoms, or symptoms that generate important repercussions in the person’s normal functions. Nevertheless, is important to identify during the hospitalization the improvement possibilities of these patients in order to make drug or psychotherapy adjustments; in the case that we don’t observe treatment benefits, the patient will be released from the hospitalization

Results

The main treatment is psychotherapy.

Conclusions

There’s not much evidence of drug use in this disorder, however, mood stabilizers, antidepressants, atypical antipshychotics and benzodiazepines are used for rage control, impulsiveness, anxiety and aggressiveness.

Disclosure

No significant relationships.
A Literature Review of Diagnostic Applicability of ICD 11 Classification of Personality Disorders in Comparison with ICD 10
Authors: Ahmed F. , Roy R.
Published: September 2022

Introduction

Personality disorders are frequently encountered by all healthcare professionals and can often pose a diagnostic dilemma due to the crossover of different traits amongst the various subtypes. The ICD 10 classification comprised of succinct parameters of the 10 subtypes of personality disorders but lacked a global approach to address the complexity of the disease. The ICD 11 classification provides a more structural approach to aid in clinical diagnosis.

Objectives

A literature review of the diagnostic applicability of ICD 11 classification of personality disorders is presented in comparison with the ICD 10 classification.

Methods

A retrospective analysis of the literature outlining the ICD 10 and 11 classifications of personality disorders, exploring the differences in evidence-based applications of both.

Results

The ICD 11 classification of personality disorders supersedes the ICD 10 classification in describing the severity of the personality dysfunction in conjunction with a wide range of trait domain qualifiers, thus enabling the clinician to portray the disease dynamically. The current evidence available on the utility of the ICD 11 classification gives a promising outlook for its application in clinical settings.

Conclusions

The ICD 11 has transformed the classification of personality disorders by projecting a dimensional description of personality functioning, aiming to overcome the diagnostic deficiencies in the ICD 10 classification. The versatility offered by the application of the ICD 11 classification can be pivotal in reshaping the focus and intensity of clinical management of the disease.

Disclosure

No significant relationships.
Disease Burden Of Co-Occurring Borderline Personality Disorder In Patients With Bipolar Disorder
Authors: Turki M. , Abdellatif M. , Gargouri N. , Ellouze S. , Blanji S. , Daoud A. , Halouani N. , Aloulou J.
Published: September 2022

Introduction

In recent years, advances in the areas of both bipolar disorder (BD) and borderline personality disorder (BPD) have generated considerable interest in the relationship between these two conditions, since that they are commonly comorbid.

Objectives

We aimed to investigate the impact of BPD on course of illness in patients with BP.

Methods

We conducted a cross-sectional, descriptive and analytical study among 30 psychiatric outpatients diagnosed with BD in the Psychiatry « B » department, Hedi Chaker Hospital (Sfax, Tunisia). The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) was used to screen for BPD. Clinical outcomes (hospital stays, comorbidities, suicidality…) were compared between BD- patients with or without BPD comorbidity.

Results

The mean age was 41.63 years, with a sex ratio of ½. Among the patients, 2/3 were diagnosed with BD-I, while 1/3 presented a BD-II. Physical comorbidities, comorbid anxious and eating disorders were noted respectively in 36.7%; 16.7% and 43.3% of patients. Suicidal attempts were reported in 46.7% of cases. According to MSI-BPD, a comorbid BPD was noted in 30% of our sample. Patients with BD-II were significantly more likely to present BDP traits (50%) than those with BD-I (20%) (p<0.001). Patients with BPD were significantly more likely to attempt suicide (p=0.033), and to present physical comorbidities (p<0.001) and comorbid eating disorders (p<0.001).

Conclusions

Our study showed that BPD darkens the prognosis of BD, because of worse outcomes related to suicide, physical and psychiatric comorbidities. Thus, its co-occurrence complicates the management of BD.

Disclosure

No significant relationships.
Comorbidity in borderline personality disorder and adult attention deficit hyperactivity disorder in the context of impulsivity and emotional dysregulation
Authors: Tóth R. , Kenézlői E. , Bajzát B. , Balogh L. , Somogyi S. , Unoka Z. , Réthelyi J.
Published: September 2022

Introduction

In a significant proportion of people diagnosed with Borderline Personality Disorder (BPD) and adult Attention Deficit Hyperactivity Disorder (aADHD) comorbid mental disorders, such as mood, anxiety, personality and substance use disorders can be detected. BPD and aADHD present with a partial overlap in the clinical symptoms, including increased impulsivity levels and difficulty in emotional regulation. Higher impulsivity and emotional dysregulation (ED) can result in impaired global functioning or damaged social relationships.

Objectives

The aim of this study was to assess the comorbid psychiatric diagnoses of the two patient groups, and explore the possible role of ED and impulsivity in the background of the different comorbid disorders.

Methods

Data about BPD (N=49) and aADHD (N=60) patients were analyzed based on the M.I.N.I. Plus 5.0 and SCID-5-PD structured clinical interviews. Participants were further investigated with online questionnaires: e.g. Barratt Impulsiveness Scale (BIS-11) Difficulties in Emotion Regulation Scale (DERS). For measuring the influence of impulsivity and ED in the development of comorbid disorders binary logistic regression was used.

Results

Our results showed comorbidity rates similar to previous findings in BPD patients, but lower rates were observed in aADHD. Elevated levels of ED increases the risk of suicidal ideation, mood, anxiety and eating disorders. Based on our data increased impulsivity can reduce the chance of comorbid anxiety disorders.

Conclusions

The results provide insight into the pattern of comorbid disorders, role of ED and impulsivity in people diagnosed with aADHD and BPD in Hungary. Understanding their underlying mechanisms helps to establish an accurate diagnosis, which affects treatment effectiveness.

Disclosure

No significant relationships.
Functional Neurological Symptom Disorder In A Prolonged Grief Disorder Or In Depression?
Authors: Varlam C.I. , Dumitrache A.M. , Itu A. , Andreea G. , Rogojină R. , Bedreagă I. , Dragomir R. , Bădescu A. , Patrichi B.
Published: September 2022

Introduction

Functional neurological symptom disorder (FND) is characterized by the ideogenic neurologic presentation deriving from unconscious stressors or conflicts. The symptoms of FND usually begin with a psychiatric illness—most commonly depression, but with the release of the latest version of International Classification of Diseases-11 (ICD-11), a new favoring factor comes to our mind: prolonged grief disorder (PGD), the newcomer to psychopathology.

Objectives

The purpose of this case-report is to highlight the several key differences between PGD and depression, and the role of PGD in the onset of FND.

Methods

The authors report the case of a 22 years old woman with a history of frequent seizures with loss of consciousness and the absence of stimulus-response, which started soon after the death of her 31 years old brother. Psychologically, the patient presented sustained interest in the deceased, self-blame, confusion, emptiness and low mood. On a physical exam, the patient showed periocular hyperpigmentation.

Results

The emergent symptoms and signs were resistant, failed to resolve with medication alone and continued to persist across all settings. The neurological dysfunction remained present and interfered with the patient’s functioning, until applying grief-oriented psychotherapy, which was the most efficient approach.

Conclusions

In conclusion, PGD represents a favoring condition for the onset of FND and it is most often mistaken with depression. Therefore, it is crucial to distinguish between these two disorders, as there is solid evidence that treatment for depression is far less helpful than targeted grief treatment.

Disclosure

No significant relationships.
Impulsive traits and dual pathology in patients with depression and alcohol dependence, a case report
Authors: Huete Naval M. , Reyes Molón L. , Regueiro Martín-Albo C. , Galerón R. , Herrero Pellón E. , Albarracin P.
Published: September 2022

Introduction

Alcohol dependence is one of the most frequent comorbidities in depression. Multiple environmental and neurobiological factors are directly involved in these diseases. In particular, impulsivity is present in many patients with dual pathology and may play a relevant role in its causes, clinical manifestations and prognosis.

Objectives

To review the relationship between impulsive traits and dual pathology in patients with depression and alcohol dependence.

Methods

Presentation of a clinical case supported by a non- systematic review of literature containing the key-words “impulsivity”, “depression” and “alcohol dependence”.

Results

This is a case report of a 43-year-old male with a known history of alcohol dependence and recurrent depression. Interestingly, the patient has a family history of bipolar disorder and alcohol abuse disorder on the paternal side, and frontotemporal dementia on the maternal side. He currently presents a depressive episode associates associated with a significant increase in alcohol consumption. The patient has presented prominent impulsive traits since adolescence that have been aggravated in recent years. This lack of impulse control is described as one of the most relevant factors in relapses in alcohol consumption. Multiple studies correlate the lack of impulse control with a worse prognosis in both alcohol dependence (greater probability of relapses and resistance to treatment) and depression (increased suicide risk). Likewise, an increase in cognitive impulsivity has been observed during depressive episodes, characterized by an inability to inhibit behaviors that have already begun and poor planning capacity, which could lead to a worsening of alcohol abuse.

Conclusions

Impulsivity traits are related to a worse prognosis in dual pathology due to alcohol and depression, and may present common etiopathogenic mechanisms.

Disclosure

No significant relationships.