bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychiatric disorders in professional drivers and fitness for work
Authors: Ayed W. , Bahri G. , Mersni M. , Brahim D. , Houissa L. , Youssef I. , Mechergui N. , Bani M. , Bensaid H. , Yaich I. , Bensaid C. , Bram N. , Ladhari N.
Published: August 2024

Introduction

The driver’s job is a safety job requiring a meticulous neuropsychological assessment, which can affect the decision on fitness to drive. Professional driving benefits from codified regulations concerning neuropsychological disorders.

Objectives

To describe the socio-professional characteristics of drivers with psychiatric illnesses

To specify the impact of these pathologies on decisions on fitness for work

Methods

Retrospective descriptive study of drivers with psychiatric disorders who consulted the occupational pathology and fitness for work department of the Charles Nicolle Hospital for fitness for work assessment during the period from January 2016 to January 2023.

Results

Out of 98 drivers who consulted our department for an aptitude assessment, nine (n=9) patients had a psychiatric disorder. The average age was 45±7 years. They were all men. They were bus (n=7), light car (n=1), and lorry (n=1) drivers. They belonged to the transport (n=7) and service (n=2) sectors. Length of service ranged from one year to 35 years. The pathologies presented by the patients were: anxiety-depressive disorder (n=7) , bipolar disorder (=1) and drug-addiction (n=1). They were being treated with antidepressants (n=7), anxiolytics (n=3), and thymoregulators (n=1). The medico-legal decision was to avoid professional driving (n=7) and to avoid professional driving at night (n=2).

Conclusions

psychiatric illnesses can compromise fitness to work. The role of the occupational physician in the primary and secondary prevention of people at risk is important.

Disclosure of Interest

None Declared
Attitude of tunisian psychiatry residents toward internet searches for patient informations
Authors: Ben Youssef Y. , Lagha M. , Boudriga S. , Methni M. , Ben Romdhane I. , Homri W. , Labbane R.
Published: August 2024

Introduction

In the age of digital information, the volume of personal information available online continues to grow. Examining patients’ online profiles has become common for various reasons especially in psychiatry, despite ethical concerns. Therefore, it is interesting to explore the attitudes of tunisian psychiatric residents in this regard.

Objectives

This study aimed to identify the purposes that make psychiatry residents consult their patients’ profiles on social media and to evaluate the consequences of being friends with them or following them on the treatment course and on the doctor-patient relationship.

Methods

This was a cross-sectional descriptive study from August to September. A questionnaire on Google form was distributed to psychiatry Tunisian residents.The study evaluated the frequency and causes of patient profiles consultation on social networks, its role and impact in the doctor-patient relationship

Results

The study population included 53 psychiatry residents with a mean age of 28 (+-5) years and a sex ratio of 0.127. Among the responders, 53 % were in their first or second year of residency. And the predominant workplace was El Razi Hospital : a university hospital.

For the frenquency of patient profiles consultation on social networks : 87% of treating psychiatrists declared consulting their patients’ profiles on social media at least once. The purposes of consulting patient’s profiles noted in our study were: looking for signs of pre-morbid functioning (n=32), looking for clinical features of the current episode (n=30). They do it also to verify the informations provided by the patient (n= 18) ,have an idea of their private lives (marital status ,employment, hobbies,..)(n=11) ,or locate a family member (n=5). It can be also out of curiosity (n=21). And this made the psychiatry residents empathetic towards the patient (n=10) .

But, in 91% of cases, patient’s permission was not taken .

Moreover, 4 of treating psychiatrists declared being friends with their patients or following their profiles on social media. Two of them regret it. The friend or follow request was an initiative from the patient, in all cases.

Conclusions

The attitudes of psychiatry residents regarding the consultation of patients’ profiles on social networks were not clear. However, as the boundaries of the digital doctor-patient relationship remain undefined, it is imperative to develop clear guidelines and educational resources.

Disclosure of Interest

None Declared
Perceived stigma and associated factors among family caregivers of patients with severe mental disorders
Authors: Masmoudi R. , Abid W. , Ben salem E. , Ouali R. , Feki I. , Baati I. , Masmoudi J.
Published: August 2024

Introduction

Giving care to someone who is experiencing mental distress is a difficult and challenging task that could be detrimental to the caregiver’s overall quality of life. Stigma associated with mental illness is one of the most important mental health issues faced by these caregivers.

Objectives

Our aims were to assess perceived stigma among family caregivers of patients with severe mental disorders and to identify its associated factors.

Methods

We conducted a descriptive and analytical cross-sectional study among family caregivers of patients followed at the psychiatry outpatient clinic of the Hedi Chaker University Hospital in Sfax, during the period from February 2022 to July 2022.

A structured interview questionnaire was designed to collect socio-demographic data of both patients and their caregivers. We used the Stigma Devaluation Scale (SDS) to assess stigma.

Results

A total of 90 family caregivers of severely mentally ill patients were included: 26 men and 64 women, with an average age of 50.68 ±11.67 years.

Patients’ parents accounted for 40% of family caregivers. The majority of family caregivers (83.3%) had no more than secondary education. Married people represented 70% of cases.

The median age of patients was 42 years. Schizophrenia was the diagnosis in 68.9% of cases. The mean duration of illness was 16.23 years.

Daily assistance lasted from 4 to 8 hours in 30% of cases and more than 8 hours in 66.7% of cases.

The mean score (SDS12) for family-focused stigma was 13.12 ± 2.34 with ranges from 8 to 18.

Perceived stigma scores were significantly higher among caregivers caring for non-married patients (p=0.04), with an age <50 years (p=0.04), and with a higher level of education (p=0.02).

Long duration of providing care (> 8 hours per day) (p=0.05) and insufficient information about the illness (p=0.02) were significantly associated with perceived stigma.

Conclusions

The clinicians managing patients with severe mental disorders must focus on stigma and psychological distress among the caregivers and plan intervention strategies to reduce stigma.

Disclosure of Interest

None Declared
Exploring Child-Parent Relationship Therapy -CPRT- Impact on Externalised Behaviours of Foster Children Experienced Complex Trauma: A Case Study
Authors: Hatam S. , Moss S. , Cubillo C. , Parsafar S. , Berry D.
Published: August 2024

Introduction

Many foster children experience traumatic events that result in a wide range of disruptive behaviours, such as temper tantrums, superficially charming, no sincere remorse, and so forth. These problematic behaviours are challenging to the implementation of holistic therapeutic interventions.

Objectives

The purpose of the current study is to explore the effectiveness of employing Child-Parent Relationship Therapy (CPRT) on externalised behaviours of a traumatised child at home and in social interactions.

Methods

This study used a case study to explore the influence of CPRT on externalised behaviours of traumatised foster children. The case study focused on the externalised problematic behaviours of an Australian Aboriginal child fostered under long-term care at 18 months by a Caucasian family. The foster parent and the foster child received a 10-session structured CPRT across ten weeks. The child’s externalised behaviours were evaluated through the Child Behaviour Checklist (CBCL) form.

Results

The findings describe the process of a 10-session structured CPRT with a foster child who exhibits externalised disruptive behaviours because of abandonment and complex trauma. The themes in the foster parent’s role and the play therapy approach relate to traumatic events and attachment issues. The results indicated a slight reduction in these behaviours. According to the follow-up interview, the child still showed aggressive behaviours in social interactions but not at home. Interviews with the foster parent indicated both the parent and child require additional support and further sessions of CPRT.

Conclusions

This case study identified an improvement in externalised behaviours for foster children with experience of complex trauma and abandonment after a 10-session CPRT. Further research is required to explore the effectiveness of a longer-term session of CPRT alongside additional support services for foster parents.

Disclosure of Interest

None Declared
A Machine Learning Model for Predicting Major Depressive Disorder Using Diffusion-Tensor Imaging Data
Authors: Lee J. H. , Lee D.-K.
Published: August 2024

Introduction

Major Depressive Disorder (MDD) stands as a prevalent psychiatric condition within the general population. Despite extensive research efforts, the identification of definitive diagnostic biomarkers for depressive disorders remains elusive. Currently, machine learning methods are gaining prominence in the diagnosis of medical illnesses.

Objectives

This study aims to construct a machine learning-based prediction model for Major Depressive Disorder (MDD) by harnessing diffusion tensor imaging (DTI) data.

Methods

The DTI datasets comprising MDD (N=83) and Healthy Control (N=70) groups were procured from the cohort study of Anxiety and Depression conducted at the National Center for Mental Health in South Korea. A machine learning method using a decision tree algorithm was employed to select relevant brain regions and establish a robust diagnostic model. Features associated with white matter (WM) tracts were chosen through recursive feature elimination.

Results

Demographic characteristics, including age, sex, and handedness, displayed no significant differences between the MDD and Healthy Control groups. However, the total score of the Beck Depression Inventory was notably higher in individuals with MDD compared to Healthy Controls. A diagnostic model was crafted using the decision tree algorithms to distinguish between the two groups. The model demonstrated the following classification performance metrics: accuracy (65.6% ± 8.5), sensitivity (66.6% ± 12.5), and specificity (64.7% ± 13.6). Furthermore, through recursive feature elimination, specific neuroanatomical features tied to brain structures such as the inferior cerebellar peduncle, posterior thalamic radiation, cingulum (hippocampus), uncinate fasciculus, and tapetum were identified.

Conclusions

Despite of limited performance of classification, a machine learning-based approach could provide insights into the development of a diagnostic model for MDD using neuroimaging data. Furthermore, these features, derived from DTI-derived data, may have implications for understanding the neural underpinnings of major depressive disorder.

Disclosure of Interest

None Declared
Use of low-dose Aripiprazole to lower the antipsychotic medication - induced hyperprolactinemia.
Authors: Argitis P. , Karampas A. , Peyioti M. , Koukouras T. , Demetriou M. , Karavia S. , Chaviaras Z.
Published: August 2024

Introduction

Hyperprolactinemia (HPL) is a condition associated with disturbing consequences. Antipsychotic medications are one of the main causes of nontumoral hyperprolactinemia. Prolactin release in the hypothalamic tuberoinfundibular tract is increased through dopaminergic inhibition, which occurs more frequently with high- potency typical antipsychotics (40%–90%). Less commonly than typical antipsychotics, atypical antipsychotics can also result in hyperprolactinemia. In the presence of symptoms, clinicians frequently struggle with the decision of whether to stop using the suspected offending agent, lower the dosage, switch to another medication, or even add a full or partial dopamine agonist to the patient's current treatment. The issue is exacerbated by the fact that finding a suitable agent for each patient is sometimes a challenging task.

Objectives

Due to the partial D2 receptor agonistic activity of aripiprazole, there is enough dopaminergic tone to continue the inhibition of prolactin release. Aripiprazole has been recommended in literature either as an adjunctive treatment in low doses or as a switch in therapy.

Methods

In the Psychiatric clinic of the General Hospital of Corfu, a low-dose (5mg/day) of aripiprazole is being used as adjunctive therapy in patients with antipsychotic-induced hyperprolactinemia. More specifically in total 42 subjects, 19 male and 22 female, with a mean prolactin level of 862ng/ml, were introduced to the prior therapy. We whereupon conducted prolactin measurements to evaluate the response at the first, the third, and the sixth month of treatment.

Results

Of the 42 subjects, 38 responded with an average reduction of prolactin to the level of 530ng/ml (mean reduction 38,5%).

Conclusions

Having noticed the beneficial effect of low-dose Aripiprazole in patients with antipsychotic-induced hyperprolactinemia, we consider it appropriate that the literature recommendations concerning this additional use of aripiprazole should not be overlooked in clinical practice.

Disclosure of Interest

None Declared
Short-term olfactory deprivation reorganizes brain activity
Authors: Tukaiev S. , Zyma I. , Makarchuk M.
Published: August 2024

Introduction

Olfactory loss (including short-term) initiates neural reorganization processes in the brain, but the central mechanisms of this largely remain unknown.

Objectives

We aim to conduct a neurophysiological study of neocortical mechanisms for the effects of olfactory sensation on functional activity of human brain under temporary obstruction of nasal breathing.

Methods

123 healthy volunteers (76 female and 47 male students aged 18 to 23 years)participated in this study.EEG was registered during the rest state (5 min), olfactory blockage (5 min), under odor stimulation with the lemon essential oil (5 min) and renewal of nasal breathing (5 min). We estimated the spectral power density and the levels of coherence of all the frequencies from 0.2 to 35 Hz.

Results

The onset of orthonasal olfactory sensory blockage was accompanied by an increase in the power of processes of local synchronization of beta frequency in the caudal regions of the brain, with simultaneous enhancement of the coherence of the theta band in parietal-occipital zones and a certain enhancement of the interfrontal and intrahemispherical left-side and right-side interactions in the beta2-subband. Thus, the sudden cessation of olfactory detection led to activation of thalamo-cortical loops and top-down control systems (search for the olfactory signal): that is an active orienting process (triangle of increase in F4-T4-P4 connections) with emotional coloring (the caudal localization of the coherence changes in the theta band). The prolongation of the nasal blockage, despite the possibility of activation of the retronasal route of odor perception and odorized air, was accompanied by a definite inhibition of distant interactions in the posterior regions of the brain in the theta-band and a significant decrease in right-brain long-distant and parietooccipital beta2-subband functional connectivity. Restoration of nasal breathing and olfactory perception is accompanied by sufficiently powerful activation of interhemispheric long and short distance information interactions in the theta1,2 and beta1 frequency bands.

Conclusions

Our data indicated that cessation and restoration of olfactory perception lead to an increase cognitive activity, the development of memory processes, the current sensory and cognitive-emotional control of behavioral reactions, focusing attention, assessment of the significant stimulus.

Disclosure of Interest

None Declared
Alzheimer’s and Parkinson’s disease drugs side effects
Authors: Batistela J. , Ropero Pelaez F. J. , Hida G. , Taniguchi S.
Published: August 2024

Introduction

Alzheimer’s and Parkinson’s disease are neurodegenerative disorders with life limiting conditions. The symptomatic pharmacological therapeutic strategies unfortunately are also related to undesirable side effects. Acetylcholinesterase inhibitors administered to Alzheimer’s disease patients increase cholinergic transmission in cortex and hippocampus.

Antiparkinsonian drugs increase dopaminergic system activity, to compensate for dopaminergic neurons’ degeneration in corpus striatum, therefore supplying the imbalance of these neurotransmitters in these degenerative areas.But undesirable the increase of these neurotransmitters in other cerebral and peripheral areas brings us important side effects

Objectives

To study Alzheimer’s cholinergic drugs and Parkinson’s dopaminergic drugs’ side effects

Methods

This retrospective study included 107 geriatric patients enrolled in a private long-term care institution. 79 patients with Alzheimer’s disease had mean age of 88.11 ± 5,78 years old, mean weight of 61.62 ± 13.10 kg. 28 patients with Parkinson’s disease had mean age of 84.93 ± 5.71 years old, weight mean 66.36 ± 2.83 kg.

Results

Alzheimer’s disease patients 41.77% (33) received. Acetylcholinesterase inhibitors (Donepezil, galantamine and rivastigmine) Psychomotor agitation and aggressive behavior 63.666% and nausea (15%) were observed in the patients treated with these drugs. The association of L-DOPA and DOPA decarboxylase inhibitors (benserazide) were administered to 53%(15) of the Parkinson’s disease patients in doses between 2.0-19.0 mg/kg/day. L-DOPA associated to catechol-O-methyltransferase inhibitor (entacapone) 3 mg/kg/day were given to 7.14% (2) patients. Bromocriptine 0.04 mg/kg/day was given to 3.57% (1) patients. Mental confusion and hallucination side effects were observed in 53.33% (8) patients treated with L-DOPA associated with the DOPA decarboxylase inhibitor (benserazide).

Conclusions

The increase of cholinergic activity due to the acetylcholinesterase inhibitors in the Nigro- striatal pathway could be related to psychomotor agitation in Alzheimer’s disease patients in a similar way to akathisia induced by neuroleptics. The increase of dopamine levels due to the administration of L-DOPA, in corpus striatum improved Parkinson’s disease symptoms although the increase of dopaminergic activity at mesocortical pathways may be related to confusion and hallucination observed in these patients. Adjustments in dosage of these drugs could provide improvement in these patients’ daily life conditions.

Disclosure of Interest

None Declared
Practice recommendations to manage Alzheimer’s disease based on the targeted behavioral and psychological symptoms
Authors: Ouazzani Housni Touhami Y. , Layoussifi E. , Benjelloun R.
Published: August 2024

Introduction

Behavioral and psychological symptoms (BPS) of Alzheimer’s disease, known as neuropsychiatric symptoms, involve a range of symptoms that include agitation, psychosis (hallucinations, delusions), affective symptoms (depression and anxiety), apathy, and sleep disturbances. These behavioral and psychological symptoms harm the patients’ daily lives and significantly burden their families. Managing BPS of Alzheimer’s disease requires a targeted approach focused on each symptom to achieve a better therapeutic response.

Objectives

Providing practice pharmacological recommendations targeted to each of the behavioral and psychological symptoms of Alzheimer’s disease.

Methods

A literature review was conducted using Medline via PubMed, Embase, PsycINFO, and Cochrane databases until September 2023.

Results

There is a consensus in the literature that non-pharmacological approaches should be recommended as the first-line treatment for most behavioral and psychological symptoms of Alzheimer’s.

Second-generation antipsychotics (risperidone and olanzapine, with improved efficacy; aripiprazole and quetiapine, with better tolerance) are recommended for severe agitation states with a risk of self or hetero-aggression, as well as for persistent psychotic symptoms in Alzheimer’s disease. The benefit-risk balance of these agents must be assessed, with close monitoring of heart arrhythmias, metabolic risk, orthostatic hypotension, and extrapyramidal symptoms. The recommendations suggest tapering antipsychotics within the first three months of their prescription. Selective serotonin reuptake inhibitors (SSRIs) such as Escitalopram, Citalopram, and Sertraline can be considered a therapeutic option for persistent affective symptoms (depression and anxiety) with significant functional impairment or suicidal risk, severe apathy, or constant agitation. Minimum effective doses are recommended for Escitalopram and Citalopram due to the risk of QT interval prolongation. There is limited evidence regarding the effectiveness of benzodiazepines, mood stabilizers, cholinesterase inhibitors, and memantine for various behavioral and psychological symptoms; the benefit-risk ratio and therapeutic response do not support the prescription of these agents. Melatonin and Mirtazapine have limited benefits for sleep disturbances, while benzodiazepines, antihistamines, and antipsychotics should be avoided.

Conclusions

The pharmacological approach should target a thorough clinical assessment of the psychopathological dimensions of behavioral and psychological symptoms of Alzheimer’s disease. The prescription should be based on evaluating the benefit-risk balance and adherence to literature recommendations for patient safety.

Disclosure of Interest

None Declared
Neuropsychiatric symptoms in frontotemporal dementia: a case report
Authors: Izquierdo De La Puente A. , del Sol Calderón P. , Fernandez Fernandez R.
Published: August 2024

Introduction

We present the case of a 70-year-old man who, after presenting atypical depressive symptoms, was diagnosed with incipient frontotemporal dementia.

Objectives

Through the presentation of the case, a brief review is made of the affective prodromes of frontotemporal dementia

Methods

The patient, who had no personal history of interest, suddenly began to present depressive symptoms consisting of marked irritability, dysphoric mood, anxious semiology with a subjective feeling of anguish, maintenance insomnia and a feeling of lack of self-control, with a tendency towards verbal heteroaggressiveness. The patient reported all these symptoms with great suffering.

After one year of treatment with venlafaxine 300g DMD and quetiapine 400g DMD, with one admission to the short-stay inpatient unit for self-harm threats, the patient had not experienced any improvement. In addition, during this year, the patient’s family began to observe small memory lapses that affected his daily functioning, making the patient progressively more dependent.

Results

In view of this clinical picture, it was decided to request an MRI and a brain PET scan, where deficits in the frontal and temporal regions were observed, and a diagnosis of incipient frontotemporal dementia was made.

Conclusions

Frontotemporal dementia is the third most common dementia in people over 65 years of age. About half of the patients debut with psychiatric symptoms, one of them being depressive symptoms. Treatment is focused on the use of psychotropic drugs with the aim of symptom management. Olanzapine or aripiprazole are effective for psychotic symptoms or acute agitation. For more subacute conditions, SSRIs or trazodone are recommended. The iACOs are not recommended, because they are ineffective and worsen neuropsychiatric symptoms.

Disclosure of Interest

None Declared
Aberrant Functional Connectivity Between Regions Involved in Belief Evaluation and Processing of Bodily Information in Patients with Somatic Delusions
Authors: Panikratova Y. , Abdullina E. , Dudina A. , Andrushchenko A. , Kostyuk G. , Romanov D. , Ilina E. , Magomedagaev M. , Iuzbashian P. , Lebedeva I.
Published: August 2024

Introduction

According to the two-factor theory of delusional belief (Coltheart. Ann N Y Acad Sci 2010; 1191 16-26), explaining the presence of a delusion requires a combination of two neuropsychological impairments. The first deficit initially prompts the delusional belief and defines its content, whereas the second deficit – aberrant belief evaluation – interrupts the rejection of a delusional belief and is common for different types of delusions. The second deficit is associated with compromised functioning of the right ventral frontal/anterior insular cortex (r-VF/AI; Darby et al. Brain 2017; 140 497-507). However, neural correlates of the first deficit in different types of delusions remain obscure.

Objectives

The aim of the study was to search for regions whose functional connectivity with r-VF/AI is different between patients with somatic delusions (SD) and persecutory delusions (PD) and to further clarify the results by comparing clinical groups with healthy controls. We hypothesized that each clinical group is characterized by aberrant functional connectivity between a region, associated with poor belief evaluation (r-VF/AI), and a region, presumably associated with a neuropsychological impairment specific to the corresponding type of delusions.

Methods

Patients with delusional disorder or paranoid schizophrenia (n = 23) and healthy controls (n = 9; 5 females; mean age 36.2 ± 1.3) underwent resting-state fMRI (Philips Ingenia 3T). Nine patients had SD (5 females; mean age 40.3 ± 7.9) and fourteen patients had PD (3 females; mean age 35.6 ± 10.2). The clinical groups were compared in terms of whole-brain functional connectivity of r-VF/AI (ROI-to-voxel analysis in CONN; RRID:SCR_009550; www.nitrc.org/projects/conn). Statistical thresholds were p < .005 voxelwise, p[FDR] < .05 clusterwise. Each clinical group was compared with controls in terms of functional connectivity between r-VF/AI and previously identified regions with between-group differences in connectivity (ROI-to-ROI analysis). Age was a covariate of no interest in all analyses.

Results

Patients with SD compared to patients with PD and healthy individuals had higher functional connectivity between the r-VF/AI and a cluster in the right precentral and postcentral gyri extending to supramarginal and superior frontal gyri (Figure 1).

Image:

Conclusions

The regions whose functional connectivity with r-VF/AI was aberrant in patients with SD are involved in the processing of tactile, proprioceptive, and visceral information. Our results coincide with a suggestion that the evaluation of beliefs related to bodily sensations is disturbed in patients with SD.

Research was supported by RFBR grant project 21-515-12007.

Disclosure of Interest

None Declared
The Effectiveness of High-frequency Repetitive Transcranial Magnetic Stimulation in Persistent Somatic symptoms Disorder: A Case report study
Authors: Albalushi M. K.
Published: August 2024

Introduction

Background:

Somatic symptoms disorders are usually comorbid with depressive disorders despite that there is little evidence for effective treatment for it. Repetitive transcranial magnetic stimulation (rTMS) have been approved by FDA for mildly resistance depression. From this point we hypothesized that rTMS delivered over the prefrontal cortex (PFC) may be useful in somatic symptoms disorder. Therefore, in our case report we want to shed light on the potential effectiveness of rTMS in somatic symptoms disorder.

Objectives

case report

Methods

case report

Results

Case Report:

A 65-year-old Omani female with multiple medical comorbidities on multiple medications. She presented complaining of multiple somatic complains in the last 2 years after visiting multiple clinics and underwent several specialists’ examinations, investigations and procedure for somatic treatments, all of them where normal.

Then patient was seen by different psychiatric clinic multiple anti-depressant and adjuvant anti-psychotic medication were try, patient still not improve.

Patient get admitted to hospital for observation and management. Initially she was preoccupying by her somatic complain kept on Fluoxetine and Olanzapine along with that topiramate was added, but still with minimal improvement. Then rTMS was added to her management plan following Intermittent theta burst (iTBS) rTMS protocol. After complete all sessions of rTMS patient was recovering from her all symptoms, no complain report from her.

Conclusions

Conclusion: our case highlights the important of investigated more thoroughly in rTMS as treatment option for Persistent Somatic symptoms Disorder.

Disclosure of Interest

None Declared
Discrepancy between subjective perception and objective cognitive performance in attention assessment within the winners project for cancer survivors. a case report
Authors: Gonzalez-Perez C. , Moran E. , Malpica N. , Alvarez-Linera J. , Melero H. , Alonso M. , Esteban M. , Perez-Martinez A. , Fernández-Jiménez E.
Published: August 2024

Introduction

Paediatric cancer survivors have a risk for neuropsychological impairment due to the disease and the treatment received. These affections have been neglected in the follow-up of these patients. It is important to identify the most valid outcomes in the evaluation of neurocognitive sequelae in childhood cancer survivors.

Objectives

This work aims to compare the results obtained between subjective perception of caregivers and objective cognitive performance based on validated attention tests.

Methods

In a randomized controlled and unblinded trial to demonstrate the benefit of video games on different neurocognitive areas in cancer survivors, we studied attention functioning before and after the intervention program. The attention deficit subscale from the Behavior Assessment System for Children 3rd edition (BASC-3), self- and parent-reported versions, and the Continuous Performance Test, 3rd edition (CPT 3) will be used as outcomes (z scores: mean = 0, S.D. = 1).

Results

We observed an improvement in attention after intervention using the CPT-3 (omissions z = 1.2; hit reaction time z = 3.4; hit reaction time block change z = 1.2 versus hit reaction time z = 3.6 without other atipycal z scores after intervention), changing the attentional pattern from “ADHD” to “slowed”. However, in the parent-reported version of the BASC-3, a worsening in the attention subscale is observed (z = 0.3 pre-intervention vs z = 1.0 post-intervention) while the self-reported version of the patient didn’t show any significant changes (z = 1.4 pre-intervention vs z = 1.1 post-intervention).

Conclusions

It is essential to use objective tests to measure neurocognitive sequelae in these patients. Subjective surveys can provide additional information, but not substitute the above.

Disclosure of Interest

None Declared
Narcissistic predispositions of self-harm in young women with and without depression
Authors: Vorontsova O. U. , Medvedeva T. I. , Boyko O. M. , Enikolopov S. N. , Kuznetsova S. O.
Published: August 2024

Introduction

Diagnostic criteria for narcissistic personality disorder primarily focus on grandiosity and significance. In psychotherapeutic work, it is important to distinguish two subtypes of pathological narcissism: narcissistic grandiosity and narcissistic vulnerability. One of the manifestations of narcissistic traits is unstable or unformed self-esteem, manifested in attempts to conform to ideals. A part of modern society perceives the female body as an object that “needs to be looked at”. Self-objectification refers to a learned pattern of self-assessment of the importance of one’s body and appearance compared to other aspects of the self. Self-observation and comparison of oneself with others is one of the manifestations of self-objectification. With acts of auto aggression, the body becomes a tool or a means to solve psychological problems. In order for this to become possible, the ability to objectify your body “to look at it from the outside” plays an important role.

Objectives

Analysis of the relationship between non-suicidal self-injurious behavior and narcissistic personality traits in young women with depression and young women without a psychiatric diagnosis.

Methods

Тhe study included 49 women divided into two groups. The first group included 24 patients with depression undergoing inpatient treatment (mean age 18.4). The second group included 25 healthy subjects (mean age 18 years). The methods: The answer to the question “Sometimes I purposely injure myself” was used as an indicator of self-harm (NSSI) (five-point Likert scale); “Ich structure test” (ISTA); “Physical Appearance Comparison Scale-Revised” (PACS-R).

Results

In the clinical group, a significant association of severity of NSSI with indicators of “deficit narcissism” was revealed (Spearman r=,534*). Correlations were found between the severity of NSSI and PACS-R (r=,344**). In the clinical group, there was no connection between “Comparison with others” and narcissistic traits. In a group of healthy subjects, significant associations of NSSI severity with “destructive narcissism” (,572**) and PACS-R (,576**) were revealed. In the clinical group, the severity of NSSI is associated with a more serious pathology - the lack of formation of “normal” narcissism, and in the healthy group it is more likely to be deformed narcissism. Self-objectification and comparison of oneself with others in the clinical group is not associated with manifestations of narcissistic traits, such connections are demonstrated in the group of healthy young women.

Conclusions

It is shown that in the clinical group of depressed young women, the severity of self-harming behavior is associated with “deficit narcissism”, and in healthy young women, first of all, with “destructive narcissism” with an increased need to compare themselves with others.

Disclosure of Interest

None Declared
Experiences and attitudes of early career psychiatrists towards ECT – an international study
Authors: Tapoi C.
Published: August 2024

Introduction

Electroconvulsive therapy (ECT) is a psychiatric intervention that has proven effectiveness and safety in various psychiatric conditions, such as major depressive disorder, prolonged or severe manic episodes and catatonia. Despite positive scientific evidence, ECT was always seen as controversial by patients, caregivers, and even some psychiatrists, which lead to a decrease in its use over the years.

Objective

To investigate the way young psychiatrists view the place of ECT in modern psychiatry by assessing their knowledge, attitude and access to training opportunities in ECT.

Methods

An anonymous survey was disseminated online among early career psychiatrists and psychiatric trainees. The questionnaire consisted of 36 multiple-choice and Likert scale questions.

Results

Most of our respondents consider ECT both an effective and a safe treatment option and would recommend ECT to their patients when indicated. Early career psychiatrists who had access to ECT training are more knowledgeable about the indications, precautions and side effects of this method, but more than half of the participants mentioned ECT training was unavailable during their residency programme. Almost all respondents stated that they are interested in enhancing their theoretical and practical competencies in ECT.

Conclusions

Early career psychiatrists have a positive attitude towards ECT but express the need of targeted education aimed at improving levels of knowledge about ECT.

Disclosure of Interest

None Declared
Pharmaco-EEG of antipsychotics’ response: a systematic review
Authors: De Pieri M. , Rochas V. , Sabe M. , Michel C. , Kaiser S.
Published: August 2024

Introduction

Response to antipsychotic medications (AP) is subjected to a wide and unpredictable variability and efforts were directed to discover predictive biomarkers to personalize treatment. Electroencephalography abnormalities in subjects with schizophrenia were reported, as well as a pattern of EEG changes induced by APs

Objectives

The aim of this review is to provide a synthesis of the EEG features that are related to APs efficacy, including both pre-treatment signatures and changes induced by APs during treatment.

Methods

A systematic review of English articles using PubMed, PsychINFO and the Cochrane database of systematic reviews was undertaken in april 2023. Additional studies were added by hand-search. Studies having as an endpoint the relationship between AP-related clinical improvement and electroencephalographic features were included. Heterogeneity prevented a quantitative synthesis.

Results

Out of 1232 records screened, 22 studies were included in a final qualitative synthesis. Included studies evaluated resting-state and task-related power spectra, functional connectivity, microstates and epileptic abnormalities. At pre-treatment EEG, the most relevant predictors of a poor response were a change in theta power compared to healthy control, a high alpha power and connectivity, a diminished beta power in resting-state. Considering EEG during treatment, an increased theta power, a reduced beta-band activity, an increased alpha activity, a decreased coherence in theta, alpha and beta-band were related to a favorable outcome.

Conclusions

EEG is promising as a method to create a predictive biomarker for response to APs; further investigations are warranted to harmonize and generalize the contradictory results of reviewed studies.

Disclosure of Interest

None Declared
Limbic encephalitis – A case report of atypical dementia syndrome with potentially therapeutic consequence
Authors: Xepapadakos F. , Kawohl W.
Published: August 2024

Introduction

Limbic encephalitis (LE) is a subacute or chronic, non-infectious inflammation of the brain, usually occurring in adulthood, with predominant involvement of mesiotemporal structures and a clinical manifestation consisting mainly of new memory impairment, affective disorder, temporal lobe epilepsy, psychoses, etc.

Objectives

To point out the importance of knowledge of potentially treatable dementia syndromes such as atypical manifestation of probably LE.

Methods

We present a clinical case of a 47-years-old woman with an atypical dementia syndrome and typical radiological findings corresponding to a LE, among others, but without the previously known immunological antibodies.

Results

According to the literature, the diverse subsyndromes of LE can be subsumed under the two main categories of “paraneoplastic” and “non-paraneoplastic”. In addition to the acute and subacute courses, there is increasing evidence for chronic, slowly progressive courses, which expand the spectrum of potentially treatable dementia syndromes. Understanding and knowledge of the broad, clinical syndrome of LE have increased dramatically in recent years. Both nosological classification through differentiated diagnosis and specific therapeutic protocols have become increasingly developed and established. Nevertheless, there are rare clinical cases with a clinical phenotype and radiological findings that correspond to LE, but are both non-paraneoplastic in origin and seronegative with respect to the previously known immunological typing by autoantibodies. This gray area of nosological entity represents a diagnostic and therapeutic challenge.

Conclusions

The authors would like to point out the importance of an adequate diagnosis of the forms of LE that have been nosologically classified so far and are partly well treatable. Limbic encephalitis is an important differential diagnosis in dementia, especially in young patients with atypical courses. There is a need for further research regarding better diagnosis and therapy of the so far immunologically unidentifiable forms of clinical LE.

Literature:

Bazir Ahmad et al., Practical Neurology 2011

Guidelines of the German Neurological Society (DGN), 2008

Leypoldt et al., Akt Neurol 2012

Prüss et al., Neurology 2012

Disclosure of Interest

None Declared
Neuroscience-based Nomenclature (NbN) and Early Career Psychiatrists: A Cross-Sectional Study on Views, Attainment and Needs
Authors: Seker A. , Cavaleri D. , Santos Martins F. , Bianchi S. , Zani D. , Zemach S. , Zohar J. , Young A.
Published: August 2024

Introduction

Anatomical Therapeutic Chemical (ATC) indication-based classification system is the World Health Organization (WHO) drug classification system and it is widely used in clinical and researh practice, however there has been questions around the scientific base of this (1, 2). Neuroscience-based Nomenclature (NbN) has been developed by representatives from 5 international organizations, with specific expertise in psychopharmacology, to address the issues around neuropsychopharmacological drug classification and improve the focus on pharmacological domains and mode of action:

ECNP – European College of Neuropsychopharmacology

ACNP – American College of Neuropsychopharmacology

AsCNP – Asian College of Neuropsychopharmacology

CINP – International College of Neuropsychopharmacology

IUPHAR – International Union of Basic and Clinical Pharmacology

References:

1. Nutt DJ. Beyond psychoanaleptics - can we improve antidepressant drug nomenclature? [published correction appears in J Psychopharmacol. 2009 Sept;23(7):861]. J Psychopharmacol. 2009;23(4):343-345. doi:10.1177/0269881109105498

2. Zohar J, Stahl S, Moller HJ, et al. A review of the current nomenclature for psychotropic agents and an introduction to the Neuroscience-based Nomenclature. Eur Neuropsychopharmacol. 2015;25(12):2318-2325. doi:10.1016/j.euroneuro.2015.08.019

Objectives

As NbN is a novel classification system that can be used as a teaching tool as well as for other purposes, we aimed to understand the experience, views and needs of the psychiatric trainees and early career psychiatrists who will shape the future of psychiatry, around drug classification systems.

Methods

The ethical clearance of the study was obtained from King’s College London. We prepared an online survey (https://forms.gle/FCSdVTFH4U5QNn5t8) with a multinational group of early career pscyhiatrists who met through the CINP and EFPT, and test-run the survey with a small group of psychiatric trainees. The online survey was then disseminated via emailing lists and groups of early careers psychiatrists as well as through social media.

Results

At the time of this abstract submission, the data collection is ongoing. Results will include analyses of the experience with different drug classifcations systems, awareness, views and attainment of NbN, stratified according to the demographic data (country, careers status, main work setting).

Conclusions

The findings from this study will shed light on the views and needs of early career psychiatrists on the topic from clinical and academic aspects, a previously unexplored perspective on drug classification systems. The findings can inform the planning of various strategies to address areas to improve the use and teaching of these tools.

Disclosure of Interest

None Declared
Combination of CBT and rTMS: what are the advantages?
Authors: Kiss-Leizer M. , Horváth A. Á. , Kabella B. , Pogány L. , Lazáry J.
Published: August 2024

Introduction

Obsessive-Compulsive Disorder (OCD) and Major Depressive Disorder (MDD) are among the ten most disabling disorders, yet only 30-40% of people with the condition seek specialist care (WHO). Considered a relatively new tool in the treatment of OCD and MDD, repetitive transcranial magnetic stimulation (rTMS) was first used by our team 1 year ago. Based on current literature cognitive behavioural therapy (CBT) is effective in 60% of OCD cases, with MDD also having a good response rate of 50-60%. The efficacy of SSRI’s has been demonstrated, but side effects can have a negative impact on adherence in the long term. Prolonged use of certain drugs has adverse reactions that lead specifically to memory impairment, which compromises suitability for psychotherapy. The same problem applies to the use of electroconvulsive therapy (ECT) in a major depressive episode.

Objectives

Our aim was to study the efficacy of combining rTMS with CBT, to gather clinical experience on how these two different methods work in practice when combined.

Methods

Patients diagnosed with therapy resistant MDD received rTMS treatment using 50Hz theta burst over 10 sessions. Therapy resistant OCD patients were treated by a 15 sessions rTMS using 1Hz single pulse. These rTMS sessions were combined with CBT, of which we would like to highlight two cases: one of them is a 34 years old woman, who has wide range of sexual, checking and contamination-related OCD symptoms and only received SSRI treatment so far. The other one is a 29 years old man, who suffers from religious obsessions, cleaning compulsions and other repetitive behaviours.

Results

The positive effects of rTMS treatment on working memory functions, attentional capacity and cooperative skills without significant additive effects suggest exciting possibilities for combining the two treatments, thus the combined treatment has been tested in clinical practice. In our own patient care, an important experience was that patients were committed to the therapy, felt safe and, unlike with medications, did not have to worry about side effects. While medication and ECT can make psychotherapy more difficult in the long term - mainly because of memory problems - rTMS facilitates it. Patients appreciate that we approach their problems in a complex way, and they perceive that the combination of the two very different methods reflects professionalism. Our poster attempts to present the experience of combining rTMS and CBT from the therapist’s perspective through two case studies.

Conclusions

Based on our experiences it is an effective approach to combine rTMS with CBT in therapy resistant MDD and OCD patients. In the light of these results the revision of the existing guidelines are considerable.

Acknowledgements

This study has been supported by the Human Resource Development Operating Programme 5.2.6 grant.

Disclosure of Interest

None Declared