bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between lymphocytes, hippocampus volume and depressive symptoms in drug – naïve First Episode Psychosis
Authors: Toll A. , Bergé D. , El-Abidi K. , Legido T. , Pérez-Solà V. , Mané A.
Published: September 2022

Introduction

The role of the white blood cells, which form the peripheral immune system and are crucial in inflammatory processes, has been laid aside in the context of brain structural changes in schizophrenia.

Objectives

Determine how blood cells are associated with some brain structures volumes in first episode psychosis (FEP) and their relationship with clinical variables at baseline and 1 year follow – up.

Methods

Fifty drug-naïve FEP treated between April 2013 and July 2017 at the ETEP Program at Hospital del Mar were included. Inclusion criteria were: 1) age 18-35 years; 2) fulfillment of DSM-IV-TR criteria for brief psychotic disorder, schizophreniform disorder, schizophrenia or unspecified psychosis; 3) no previous history of severe neurological medical conditions or severe traumatic brain injury; 4) presumed IQ level > 80, and 5) no substance abuse or dependence disorders except for cannabis and/or nicotine use. All patients underwent an assessment at baseline and at one-year follow-up, including sociodemographic and clinical variables (substance use, DUP, PANSS, GAF and CDSS). Fasting blood samples were obtained before administering any medication at baseline. Structural T1 MRI was performed at baseline and brain volumes were quantified though FreeSurfer software. SPSS program was used for statistical analyzes.

Results

Lymphocytes have a positive correlation with right and left hippocampus at baseline. Moreover, lymphocytes have a negative correlation with depressive symptoms at baseline and 1 year follow – up.

Conclusions

Lymphocytes may have a protective effect in some brain structures in FEP patients at baseline, especially those implicated in depressive symptoms.

Disclosure

No significant relationships.
Early Psychosis Intervention Programme in a Healthcare Area of Málaga: a descriptive study
Authors: Sánchez Martínez E. , Gómez Sanchez-Lafuente C. , Mulero Garcia A.B.
Published: September 2022

Introduction

The first years after a first-episode psychosis are crucial, and a comprehensive approach is essential.

Objectives

Our objective is to observe the characteristics of patients attending Early Psychosis Intervention Programme in (PITP) of the Mental Health Clinical Management Unit (UGC) of the Hospital Regional Universitario de Málaga between the years 2016-2020.

Methods

Data for this retrospective study were derived from 135 patients included in the PITP database between the years 2016-2020 from the Mental Health UGC of the Hospital Regional Universitario de Málaga. Descriptive analysis was performed using SPSS 25.0. For the comparison of variables, Student’s t was used for quantitative variables and Chi square for dichotomous ones.

Results

68% of the patients were men, compared to 32% women. The mean age of the patients at the beginning of the Programme was 30.76 years. 85% were 40 years or younger. 67.4% lived with their family of origin. 58.5% of the patients have had at least one hospitalization in Psychiatry. 45.9% of the patients were smokers, 33.3% consumed alcohol and 59.3% consumed other drugs. From the patients who started the Programme, 38.5% continue with the follow-up, 22.2% were discharged and 39.3% abandoned it. More results will be presented on the poster.

Conclusions

In conclusion, the patients included in the PITP of our UGC present characteristics compatible with the current bibliography. The high percentage of withdrawal from the Programme stands out, this being a very important point to address and improve.

Disclosure

No significant relationships.
Electrophysiological characterization of schizophrenia-associated variants in NaV1.2 sodium channel
Authors: Suslova M. , Hautvast P. , Gaebler A. , Lampert A.
Published: September 2022

Introduction

A major pathophysiological hypothesis of schizophrenia states an increased activity of glutamatergic neurons leading to an imbalance of neural excitation and inhibition (E/I-imbalance). One potential molecular mechanism of E/I-imbalance is a dysfunction of voltage-gated sodium channels, which are crucial for the generation of action potentials, the fundamental event of neuronal excitation. Indeed, patients with schizophrenia exhibit an increased burden of rare exonic variants of sodium channel genes, but the literature describing their electrophysiological effect is scarce.

Objectives

The aim of this project is to assess the functional impact of three mutations of the Sodium Voltage-Gated Channel Alpha Subunit 2 (SCN2A) gene / NaV1.2 channel which were identified in four patients with schizophrenia, using a heterologous expression system.

Methods

Three variants of the human SCN2A gene (R850P, V1282F and S1656P) were created using site-directed mutagenesis. HEK293T cells transfected with either the mutant or wild type constructs are being investigated by voltage-clamp technique, applying activation, steady-state fast inactivation, use dependency and ramp protocols.

Results

All three mutated constructs were successfully created. Preliminary recordings from the V1282F mutant indicate a shift of both the activation and steady-state fast inactivation to the hyperpolarized direction.

Conclusions

In a subgroup of patients, E/I imbalance may be a consequence of Nav1.2 mutations leading to increased excitability of glutamatergic neurons. By integrating insights from different mutations we aim to identify traits of a potentially shared disease pathway which may provide a basis for the development of novel therapeutics.

Disclosure

No significant relationships.
The relationship between white matter integrity of superior longitudinal fascicle and cognitive functions in chronic schizophrenia
Authors: Tyburski E. , Podwalski P. , Mak M. , Michalczyk A. , Kucharska-Mazur J. , Samochowiec J. , Sagan L.
Published: September 2022

Introduction

Some evidence suggests that disruption of integrity in the superior longitudinal fascicle (SLF) may influence cognitive functions in chronic schizophrenia (CS) but the results are inconclusive.

Objectives

Using diffusion tensor imaging tractography, we investigated the differences in fiber integrity between patients with CS and healthy controls (HC) together with the relationship between fiber integrity and cognitive functions.

Methods

Forty-two patients with CS and 32 HC took part in the study. Assessment of cognitive functions was performed using Measurement and Treatment Research to Improve Cognition in Schizophrenia.

Results

showed group differences, left and right in fractional anisotropy (FA) and mean diffusivity (MD) of the SLF, where patients showed less integrity than controls. Patients performed worse attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition tasks than HC. However, when premorbid IQ and level of education were controlled for, the differences were no longer statistically significant in verbal learning and social cognition. In patients with CS, a positive correlation was found between FA of the left SLF and attention/vigilance and working memory. Moreover, in this group there was a negative correlation between MD of the left and right SLF and working memory and social cognition.

Conclusions

These findings provide evidence that SLF disruption appears in patients with CS and might account for impairment of cognitive functioning. This research was funded by the Polish Minister of Science and Higher Education’s program named “Regional Initiative of Excellence” number 002/RID/2018/2019 to the amount of 12 million PLN.

Disclosure

No significant relationships.
Catatonia; A Case Study and Literature Review
Authors: Ogunlela A. , Raai H.
Published: September 2022

Introduction

Catatonia is a state of apparent unresponsiveness to external stimuli in a person who is awake. More common in patients with unipolar major depression or bipolar disorder. Common signs: immobility, rigidity, mutism, posturing, excessive motor activity, stupor, negativism, staring, and echolalia. We will discuss a case of a 23 year old male with schizophrenia presented with catatonia and decompensation of his schizophrenia in the context of medication non-compliance. We will discuss findings from litrature pertaining to catatonia and treatment strategies.

Objectives

- To discuss catatonia, its incidence in different psychiatric disorders. - To discuss literature pertaining to catatonia. - To discuss different treatment strategies

Methods

- Case study

Results

- Signs of catatonia: immobility, mutism, withdrawal and refusal to eat, staring, negativism, posturing, rigidity, waxy flexibility/catalepsy, stereotypy, echolalia, or echopraxia, verbigeration. - Diagnosis: Clinical, Lorazepam challenge. Bush-Francis Catatonia Rating Scale (BFCRS) - BFCR scale is used as the screening tool. If 2 of the 14 are positive, prompts further evaluation and completion of the remaining 9 items. - Differential Diagnosis include; Neuroleptic Malignant Syndrome, Serotoninergic Syndrome, Malignant Hyperthermia, Akinetic Mutism, Delirium, Parkinson’s disease. - Lorazepam can be scheduled at interval doses until the catatonia resolves. - ECT in combination with benzodiazepines is used to treat malignant catatonia. - Possible complications are Physical trauma, malignant catatonia (autonomic instability, life-threatening), dehydration, pneumonia, pressure ulcers due to immobility, muscle contractions, DVT, PE

Conclusions

Psychiatrists need to be diligent in evaluating patients with Catatonia for other comorbid psychiatric conditions, addressing these conditions and conducting a thorough assessment and prompt treatment.

Disclosure

No significant relationships.
Capgras syndrome and poor facial emotion recognition
Authors: Zrelli M. , Bergaoui E. , Staali N. , Moalla M. , Lansari R. , Larnaout A. , Melki W.
Published: September 2022

Introduction

Capgras syndrome is a disorder of personal identification characterized by the delusional belief that one or more persons close to the subject have been replaced by physically identical doubles.

Objectives

To deepen our knowledge of the Capgras syndrome

Methods

A case report about a Capgras syndrome.

Results

We report the case of a 46-year-old female patient who was admitted in February 2021 for incoherent speech and behavior disorder against her family members. Three years ago, she started to have hypochondriacal concerns. A week before her admission, she threatened her husband with a knife and she was convinced that her daughters were dead and that they had been replaced by clowns. She had a Capgras delusion with a hallucinatory and interpretative mechanism against her daughters, she reported olfactory and cenesthetic hallucinations. Biological explorations and brain CT were normal. The PANNS scale showed a positive scale of 36, a negative scale of 39, the general psychopathology scale of 53. She had a total score of 30/40 on The Penn emotion recognition test. The patient had difficulty in recognizing low intensity emotions (0 or 1) and 50% of the false responses were for the neutral emotion with responses tending towards anger first and then sadness.

Conclusions

Capgras syndrome remains poorly described in the literature and the hypotheses concerning its origin often oscillate between neuropsychological and psychodynamic. With the recent advances in neuroscience, it would be interesting to deepen its physiopathology in order to place it in a more modern nosological framework.

Disclosure

No significant relationships.
Convergent validity and ecological validity of the Test of Visual Perceptual Skills-4th Edition in people with schizophrenia
Authors: Chiu E.-C. , Lee Y.-C. , Lee S.-C.
Published: September 2022

Introduction

Visual perceptual deficit commonly occurs in people with schizophrenia. The Test of Visual Perceptual Skills-4th Edition (TVPS-4) is a motor-free visual perceptual measure, which includes seven subtests: visual discrimination, visual memory, spatial relationships, form constancy, sequential memory, visual figure-ground, and visual closure. However, convergent validity and ecological validity of the TVPS-4 is largely unknown, which limits its use in clinical and research settings.

Objectives

The purpose of this study was to examine convergent validity and ecological validity in people with schizophrenia.

Methods

Ninety-nine people with schizophrenia were assessed the TVPS-4, the Mini Mental State Examination (MMSE), the Behavioral Assessment of the Dysexecutive Syndrome (BADS), and the Activities of Daily Living Rating Scale III (ADLRS-III). To evaluate convergent validity, Pearson’s r were calculated among the TVPS-4 and two cognitive measures (the MMSE and the BADS). To evaluate ecological validity, we computed correlation (r) between the TVPS-4 and the ADLRS-III.

Results

The TVPS-4 total score showed moderate correlations with two cognitive measures (r=0.65-0.70). The seven TVSP-4 domains revealed moderate correlations with two cognitive measures (r=0.42-0.69). Moderate correlation (r=0.56) was found between the TVPS-4 total score and the ADLRS-III. Moderate to high correlations (r=0.33-0.61) were noticed among the seven TVPS-4 domains and the ADLRS-III.

Conclusions

The TVPS-4 has good convergent validity and ecological validity in people with schizophrenia. The multiple domains of the TVPS-4 are useful to comprehensively identify visual perception deficits in people with schizophrenia. The TVPS-4 can adequately exhibit the degree of living independently in people with schizophrenia.

Disclosure

No significant relationships.
cognitive complaints in schizophrenia: characteristics and relationship with insight
Authors: Bouhamed M. , Hentati S. , Bouaziz A. , Guermazi A. , Sallemi R. , Masmoudi J.
Published: September 2022

Introduction

Patients with schizophrenia suffer from cognitive difficulties expressed in the form of complaints as well as poor insight. The interaction of these two factors makes the management of these patients more difficult.

Objectives

To assess subjective cognitive complaints in a population of schizophrenics and study its relationship to insight.

Methods

Our study was a cross-sectional, descriptive, and analytical study of 72 stabilized schizophrenics followed up at the outpatient clinic. Subjective cognitive complaints were assessed by the SSTICS, clinical symptoms by the PANSS, and insight by the SAI-E.

Results

The mean age of our population was 46.83± 11.6 years. The patients had a low socio-economic level in 70.1%. They were unemployed in 46.9% , consumed alcohol in 23.6%, and consumed tobacco in 58,6% of the cases. the total score on the PANSS scale was 46. They had an average score of 25 on the total SSTICS score and 20,1 on the SAI-E. Cognitive complaint scores were significantly correlated with improved insight (p=0,00),low socio-economic level (p=0.04),alcoholism (p=0.001) and smoking (p=0.01)

Conclusions

Cognitive complaints in schizophrenia could be influenced by the level of clinical insight and reflect a deep malaise, requiring a more targeted and optimized management

Disclosure

No significant relationships.
What Not To Do to Thrive in your Career?
Authors: Sartorius N.
Published: September 2022

What not to do to thrive in your career The presentation will examine options that are usually available to psychiatrists during their training and early in their career and propose criteria which should be used to select or discard them. Among the criteria proposed – in addition to personal interest - should be the amount of time that engaging in a particular pursuit might take, the potential gain of the engagement later on in one’s career, the likelihood of expanding the circle of friends and acquaintances and several others.

Disclosure

No significant relationships.
The first psychotic episode with religious delusion in adolescence and young adults: premanifest stage
Authors: Kaleda V. , Popovich U. , Romanenko N. , Gedevani E.
Published: September 2022

Introduction

The study of the premanifest stages of the first psychotic episode with religious delusion is relevant due to the lack of clarity in differentiating normal religiosity from pathological and, as a consequence, a relatively longer period of an untreated psychotic state, which negatively affects both the course of the disease and its outcomes. Another important factor is the high risk of antisocial, autoaggressive and suicidal behavior at different stages of the disease.

Objectives

The aim of the study is to identify the conditions for the formation of religious delusion in adolescence and young adults, to analyze the correlations between religiosity at the pre-manifest stage and the subsequent manifest psychotic episode with religious delusions of different content.

Methods

The 57 male patients at a young age (16-25 years) with a manifest psychotic episode (F20, F25 according to ICD-10) with religious delusion (delusion of sin (21,6 %), delusion of demonic possession (29,4 %), antagonistic and messianic delusion (39,2 %), oneiroid with religious content (9,8 %)) were studied with the clinical-psychopathological, psychometric (PAS) methods. The religiosity of patients in premorbid was assessed with the Duke University Religion Index (DUREL) questionnaire.

Results

Of greatest importance in the formation of psychotic episode with religious content is hereditary burden, premorbid personality structure, high scores on the PAS scale.

Conclusions

The presence or absence of religiosity in premorbid doesn’t matter to formation of psychotic episode with religious delusion.

Disclosure

No significant relationships.
Late onset schizophrenia and delusional disorder: activity of platelet energy, glutamate, and glutathione metabolizing enzymes
Authors: Pochueva V. , Savushkina O. , Boksha I. , Tereshkina E. , Prokhorova T. , Sheshenin V. , Vorobyeva E. , Burbaeva G.
Published: September 2022

Introduction

Alterations of glutamate, energy and glutathione metabolism contribute to the pathogenesis of psychotic disorders

Objectives

Revealing clinical-biological correlations in patients with late onset schizophrenia and delusional disorder by determining clinical parameters and activity of platelet enzymes of energy, glutamate, and glutathione metabolism.

Methods

27 women of 45-80 years old were studied, with late onset schizophrenia or delusional disorder. Activity of platelet cytochrome c-oxidase (COX), glutamate dehydrogenase (GDH), glutathione reductase (GR) and glutathione-S-transferase (GST), and scores by PANSS, HAMD, MMSE, and CGI-S were evaluated twice: before and after the 28-th day of treatment. Activity of COX, GDH, GR, and GST was measured once in 23 women of 44-81 years old comprising the control group.

Results

As compared with controls, only GDH activity was found significantly decreased (before and after treatment, p<0.001). Clusterisation of patients by enzymatic activities resulted in 3 clusters significantly different by COX, GDH and GST. Significant correlations were found between enzymatic activities and scores by psychometric scales: in the cluster 1 (n=9) baseline COX activity correlated with scores by PANSS positive subscale (R=0.9, p=0.001) and with scores by MMSE (R=-0.9, p=0.002); in the cluster 2 (n=12) GR activity after treatment negatively correlated with scores by PANSS (R=-0.9, p=0.001), PANSS negative subscale (R=-0.8, p=0.004), and CGI-S (R=-0.9, p=0.001).

Conclusions

The revealed correlations between enzymatic activities and clinical parameters give hope on detection of useful biochemical markers which, after enlargement of patients’ group with late onset psychotic disorders, would be validated for prediction of the pharmacotherapy efficiency and outcome of treatment.

Disclosure

No significant relationships.
First episode-psychosis: Short- and long-term outcomes and related features predicting the transition to schizophrenia
Authors: Jabeur M. , Gassab L. , Boughamoura S. , Mhalla A. , Zaafrane F. , Gaha L.
Published: September 2022

Introduction

The occurrence of a first episode-psychosis in adolescents or young adults represents a difficult struggle with an uncertain and divergent outcome, since the clinician does not have at his disposal the clinical elements sufficient to predict these different disease trajectories.

Objectives

Our aims are to describe the socio-demographic, clinical characteristics and the short and long-term outcomes of a first episode-psychosis and to identify the predictive factors of the transition to schizophrenia.

Methods

We conducted a retrospective study about 117 patients hospitalized for a first episode-psychosis in the Psychiatric Department of Monastir (Tunisia). Sociodemographic and clinical features were collected using a pre-established
form.

Results

First-episode psychosis affected young male subjects with low educational level. Stressors were present in 54.7%. An 8-week prodromal phase preceded the onset of the disorder in 59%. The disorder course included diagnosis of: Brief psychotic disorder (32.5%), schizophrenia (31.6%) and bipolar disorder (18.8%). The short-term outcome was characterized by a complete remission rate of 58.1% at 3 months and 37.6% at 6 months. The long-term outcome was marked by a high rate of lost to follow-up: 70.8% after 5 years. The transition to schizophrenia was linked to the presence of delirium of influence and the absence of favorable course at 3 months.

Conclusions

Our results led to the identification of the profile of patients with a first episode-psychosis and the factors correlated with a diagnosis of schizophrenia. Indeed, the determination of risk factors would make it possible to adapt earlier the care.

Disclosure

No significant relationships.
Treatment and Qualitative Research of Schizophrenia
Authors: Ammon M.
Published: September 2022

Introduction

The author demonstrates the psychodynamic understanding of schizophrenia and describes the ensuing personality-structural psychotherapy. Schizophrenia from a psychodynamic understanding is a disease in the core of the identity with disturbances of the personality functions of identity, ego-demarcation, aggression, fear, narcissism, perception, cognitive abilities and the body- ego. It is the concern of the author to investigate how schizophrenically structured patients and their family members experience the group dynamic field in which the patients grew up and its relations to the illness. The following five topics: contact and experiences within the family of childhood, body care and physical contact, kindergarden and school life, puberty, and contacts outside the family have been investigated.

Objectives

The aim is to show how the family settings and backgrounds are conducive to developing schizophrenia

Methods

The author chosed for her investigation the method of biographical interviews, introduced by Witzel (1985). This method of interviewing is problem centered, object and process oriented. The analysis of the exhaustive tape-recorded interviews was made by using the method of qualitative analysis based on the grounded theory.

Results

Schizophrenia from psychodynamic understanding is a disease in the core of the identity with disturbances of the personality functions of identity, ego-demarcation, aggression, fear, narcissism, perception, cognitive abilities and the body- ego.

Conclusions

It is the concern of the author to investigate how schizophrenically structured patients and their family members experience the group dynamic social energetic field in which the patients grew up and its relations to the illness

Disclosure

No significant relationships.
The association between area-level residential instability and gray matter volume changes
Authors: Ku B. , Addington J. , Bearden C. , Cadenhead K. , Cannon T. , Compton M. , Cornblatt B. , Druss B. , Keshavan M. , Mathalon D. , Mcglashan T. , Perkins D. , Seidman L. , Stone W. , Tsuang M. , Woods S. , Walker E.
Published: September 2022

Introduction

Area-level residential instability (ARI), an index of social fragmentation, has been shown to explain the association between urbanicity and psychosis. Urban upbringing has been shown to be associated with decreased gray matter volumes (GMV)s of brain regions corresponding to the right caudal middle frontal gyrus (CMFG) and rostral anterior cingulate cortex (rACC).

Objectives

We hypothesize that greater ARI will be associated with reduced right posterior CMFG and rACC GMVs.

Methods

Data were collected at baseline as part of the North American Prodrome Longitudinal Study. Counties where participants resided during childhood were geographically coded using the US Censuses to area-level factors. ARI was defined as the percentage of residents living in a different house five years ago. Generalized linear mixed models tested associations between ARI and GMVs.

Results

This study included 29 HC and 64 CHR-P individuals who were aged 12 to 24 years, had remained in their baseline residential area, and had magnetic resonance imaging scans. ARI was associated with reduced right CMFG (adjusted β = -0.258; 95% CI = -0.502 – -0.015) and right rACC volumes (adjusted β = -0.318; 95% CI = -0.612 – -0.023). The interaction terms (ARI X diagnostic group) in the prediction of both brain regions were not significant, indicating that the relationships between ARI and regional brain volumes held for both CHR-P and HCs.

Conclusions

Like urban upbringing, ARI may be an important social environmental characteristic that adversely impacts brain regions related to schizophrenia.

Disclosure

No significant relationships.
Schizophrenia and Multiple Sclerosis: Common pathways, common risk-factors
Authors: Jemli H. , Ouali U. , Madouri S. , Aissa A. , Jomli R.
Published: September 2022

Introduction

Schizophrenia (SCZ) is a severe mental disorder that is among the leading causes of disability worldwide. Multiple sclerosis (MS) is a chronic inflammatory neurological disease with a major impact on the quality of life of young adults. Despite the distinct nature of these two disorders, research studies have identified similarities in underlying pathological mechanisms and risk factors.

Objectives

To illustrate, through a case report, the central role of inflammation in schizophrenia and its relationship with multiple sclerosis.

Methods

Case Report of a 31-year-old male patient with schizophrenia who has been diagnosed with multiple sclerosis.

Results

Mr M. is a 31 year old patient who was diagnosed with schizophrenia at age 17. Between the ages of 25 and 27, the patient had two severe psychotic relapses each one requiring inpatient treatment. At that time, he experienced predominantly severe positive symptoms and persistent suicidality. He was initially prescribed amisulpride up to 600mg, followed by haloperidol up to 45mg daily. Due to poor clinical response, the patient was put on clozapine 400mg/d and has been stabilized since 2017, with outpatient checkups. The patient has reported vertigo and trouble walking in August 2021. He has been referred to the Neurology Department. Clinical, biological and imaging findings were highly suggestive of Multiple sclerosis and the patient has received short courses of intravenous corticosteroids.

Conclusions

This case report highlights the possible association between Multiple Sclerosis and schizophrenia. Further research is needed to clarify the role of inflammation in the central nervous system in schizophrenia and the overlap with Multiple Sclerosis.

Disclosure

No significant relationships.
The importance of blood count and oxidative stress in the drug-naïve first episode schizophrenia
Authors: Rog J. , Dzikowski M. , Juchnowicz D. , Waszkiewicz N. , Zalewska A. , Maciejczyk M. , Karakula-Juchnowicz H.
Published: September 2022

Introduction

Schizophrenia (SZ) is associated with changes in haematological parameters related to low-grade inflammation state and could be amplified via oxidative stress (OS) related mechanisms. Although studies confirm this relationship, the results could be cofounded by patients’ treatment.

Objectives

The study aimed to assess the connection between venous blood count and OS in drug-naïve first-episode SZ patients.

Methods

The study consisted of 24 SZ drug-naïve patients during first episode of psychosis (median age: 22 years), and 31 healthy individuals (HC) as a control group (median age: 28 years). The examination included clinical data, OS parameters (enzymatic and non-enzymatic antioxidants), peripheral blood counts.

Results

We did not find differences between SZ and HC in blood count parameters (p>0.05). In patients group, white blood cells (WBC), neutrophils and neutrophils-to-lymphocyte ratio (NLR) were positively related with the severity of positive symptoms (R=0.59, R=0.53, R=0.50; p<0.05, respectively). WBC was related to superoxide dismutase (SOD-1) levels (HC: R=-0.36, SZ: R=0.70; p<0.05). Neutrophils were positively related to catalase (CAT) (R=0.52; p<0.05) and ferric reducing antioxidant power (FRAP) (R=0.61; p<0.05), but only in the patients’ group. There was a positive relationship between NLR and CAT (R=0.45; p<0.05) in the SZ group.

Conclusions

The results indicate potential connection and interplay between OS and blood count parameters in the onset of psychotic episode. Further studies on a larger group of patients are needed.

Disclosure

No significant relationships.
The effect of COVID-19 pandemic on admissions for cannabis-induced psychotic disorder
Authors: Elias De Sousa A. , Machado A.S. , Andrade F. , Roque Gonçalves M. , Vieira-Coelho M.
Published: September 2022

Introduction

Cannabis-induced psychotic disorder (CIPD) is defined by the development of psychotic symptoms during or briefly after intoxication with cannabis or withdrawal from cannabis. The social measures and restrictions implemented following the COVID-19 pandemic might have had an impact on cannabis availability, as suggested by patients from our clinical practice, reporting a shortage of the substance.

Objectives

To compare sociodemographic, clinical characteristics and admission rates of inpatient treatment for cannabis-induced psychotic disorder in COVID-19 pandemic period and pre-pandemic period.

Methods

Retrospective observational study of inpatient admissions for CIPD in a psychiatry inpatient unit of a tertiary hospital. The statistical analysis was performed using SPSS software, version 27.0.

Results

Our sample included 120 inpatient admissions, corresponding to 80 patients. Compared to 2018 and 2019, in 2020 there was an overall reduction of 21.5% in inpatient admissions (n=618, 549 and 458, respectively). The number of admissions for CIPD in 2018, 2019, 2020 and 2021 up to september were, respectively, 29, 32, 10 and 31 (5.2%, 6.1%, 2.2% and 7.2% of respective annual admissions). We found no statistically significant differences regarding sociodemographic and clinical characteristics in patients admitted for CIPD during 2020.

Conclusions

These results suggest a disproportionate reduction of inpatient admissions due to CIPD in 2020, followed by an expressive increase in the number of admissions in 2021up to september. This might be related to cannabis availability returning to regular levels. However other factors must be considered, such as the delay of treatment due to reduced accessibility to health care.

Disclosure

No significant relationships.
Negative symptoms and social and occupational functioning differentiate systematic paraphrenia from schizophrenia: results from a cross-sectional study
Authors: Fernandes L.A. , Trancas B. , Maia T. , Borja Santos N.
Published: September 2022

Introduction

Kraepelin’s systematic paraphrenia (SP) has been historically used to identify a group of patients in the psychosis-spectrum with good global functioning and reduced impairment in volition and emotions.

Objectives

Cross-sectional study comparing a group of patients with SP with another with schizophrenia (SZ).

Methods

We consecutively recruited SP cases from a single centre. SZ cases were selected to match those in the SP group in terms of age and sex. We diagnosed SP using the Munro Criteria and SZ using ICD-10. We collected standard sociodemographic and clinical data. All patients were under follow-up in a community mental health team at the time of the study. We used PANSS total score (PANSS-TS) to assess disease severity and its subscales to evaluate positive (PANSS-P) and negative (PANSS-N) symptoms, and general psychopathology (PANSS-GP). We applied SOFAS to assess social and occupational functioning.

Results

We recruited 32 patients, 16 with a diagnosis of SP and 16 with a diagnosis of SZ. The two groups did not differ in terms of sociodemographic data. SP cases showed lower values for PANSS-TS (SP: mean=51.63±12.49; SZ=77.76±14.12; p<0.001), PANSS-NS (SP: mean=15.50±5.97; SZ: mean=26.06±5.39; p<0.001), and PANSS-GP (SP: mean=24.31±5.51; SZ: mean=37.13±5.62; p<0.001). Groups did not differ in terms of positive symptoms. SOFAS scores were significantly higher in SP (SP: median=68, interquartile range (IQR)=19; SZ: median=41, IQR=24; p<0.01). PNSS-NS negatively correlated with SOFAS only in the SP group (r=-0.716; p=0.002).

Conclusions

SP differs from SZ in negative symptoms and social and occupational functioning. These findings suggest clinical features can differentiate SP from SZ.

Disclosure

No significant relationships.
Folie à deux: contagious mental illness? Report of a clinical case
Authors: Costa A. , Jesus S. , Almeida M. , Alcafache J.
Published: September 2022

Introduction

Folie à deux is a clinical condition that was first described in 19th century. It is a psychotic disorder in which two closely associated individuals share a similar delusional system. However, folie à deux is still a matter of study and debate today as it remains a challenge for psychiatrists.

Objectives

The aim of this article is to report a clinical case of folie à deux, between na inducer son and an induced mother. Review the nosological significance of folie à deux and to explore the disorder among patients with psychosis.

Methods

Search in the PubMed/MedLine and Medscape databases with the following key words: folie à deux; shared psychosis; shared delusion.

Results

We presente a case of folie à deux between na inducer son 28 years old and the induced, his mother. They were found to be sharing similiar delusional beliefs. The patient has assumed the role of “man of the house” since his father’s death.

Conclusions

Many years after it was first described, folie à deux is still an interesting and challenging disorder to psychiatrists. Its recognition and correct referral for a rare diagnosis, such as folie a deux, are extremely important.

Disclosure

No significant relationships.
Paliperidone palmitate-induced enuresis: a case report
Authors: Cruz S. , Cunha E Costa N. , Morais A. , Mendonça M. , Trindade R. , Xavier S.
Published: September 2022

Introduction

Schizophrenia is a severe mental illness that requires long-term treatment with antipsychotics and the intramuscular (IM) long-acting injectable (LAI) formulations may enhance treatment adherence. Some antipsychotics have been associated with enuresis, including atypical antipsychotics such as risperidone(6.2%), quetiapine(6.7%), olanzapine (9.6% ) and clozapine (20.7%) [1]. Although oral paliperidone has been related to urinary incontinence, there is only 1 report of urinary incontinence linked to monthly paliperidone palmitate [2]. [1] Harrison-Woolrych, M., Skegg, K., Ashton, J., Herbison, P., Skegg, D.C., 2011. Nocturnal enuresis in patients taking clozapine, risperidone, olanzapine and quetiapine: comparative cohort study. British Journal of Psychiatry 199, 140–144. doi:10.1192/bjp.bp.110.087478 [2] Karslıoǧlu, E.H., Özalp, E., Çayköylü, A., 2016. Paliperidone Palmitate-induced Urinary Incontinence: A Case Report. Clinical Psychopharmacology and Neuroscience 14, 96–100. doi:10.9758/cpn.2016.14.1.96

Objectives

To establish an association between paliperidone palmitate and enuresis.

Methods

Case report and a narrative review of the literature.

Results

The patient was a 25-year-old healthy man when he was diagnosed with schizophrenia. Doctors prescribed paliperidone palmitate (LAI) 200mg monthly and he started to complain of enuresis. He was clearly suffering with this unpleasant and embarrassing adverse effect so the LAI was reduced to 150mg. Enuresis remained, so it was prescribed oxybutynin 20 mg/day and the patient improved.

Conclusions

We reported a case in which enuresis is likely to be associated with high-dose paliperidone LAI (with no clinical evidence of an organic cause). To treat it, the most effective strategy was oxybutynin 20 mg/day. This case is also important to show the impact of this symptom, which is not actively investigated.

Disclosure

No significant relationships.
Sexuality in the Muslim community during Ramadan
Authors: Sayari N. , Maamri A. , Hajri A. , Haoua R. , Zalila H.
Published: September 2022

Introduction

Ramadan is a holly month for Muslims. Able-bodied adults fast and abstain from sexual activities from dawn to sunset. These hasty lifestyle changes have a major impact on the sexual life of the Muslim community.

Objectives

To assess the impact of Ramadan on sexual activity in a Tunisian community.

Methods

A cross-sectional study was conducted among married Muslim volunteers in Tunisia. The data was collected with an anonymous self-completed questionnaire, one week before Ramadan (W-1) and the fourth week of Ramadan (W4).

Results

We included 100 person in this study. The sample consisted of 59 females and 41 males. The average age was 40.3 years. During Ramadan, sexual intercourse happened more often on weekends (p=0.009) and mostly during the second part of the night (p ˂0.001). Data suggest a disturbed sex life with less satisfaction about sexual life compared to W-1 (p<0.05). Monthly sexual intercourse frequency dropped from 5.76 coitus/month on W-1 to 3.27 on W 4 (p<0.05) and Duration of sex from 9.45 minutes to 6.85 minutes (p˂0.001). Couples communicated less about sex (p=0.004). Sexual abstinence was more frequent (p=0.016). Preliminaries were less performed (P=0.01) and were shorter (p˂0.001).Oral sex was less frequent as well as some sexual positions: fellatio (p=0.01) and cunnilingus (p=0.002), sexual positions of Andromache (P=0.002), posterior vaginal (P˂0.001) and lateral (P=0.001). The participants used less pornography (p=0.007).

Conclusions

This study demonstrated the deleterious impact of the lifestyles changes in Ramadan on the sexual life. Better sexual and religious education is recommended to prevent sexual dysfunctions.

Disclosure

No significant relationships.
Factors associated with changes in sexual behavior during Ramadan
Authors: Sayari N. , Maamri A. , Hajri A. , Haoua R. , Zalila H.
Published: September 2022

Introduction

Previous studies have shown that the month of Ramadan has a negative impact on the sexual life of fasters. Sexuality during Ramadan seems monotonous, rather poor, leaving little room for foreplay, sensuality and diversification of the sexual repertoire.

Objectives

To examine the socio-demographic and religious factors associated with the change in the sexual lives of fasters

Methods

A cross-sectional study was conducted among married Muslim volunteers in Tunisia. The data was collected with an anonymous self-completed questionnaire, one week before Ramadan (W-1) and the fourth week of Ramadan (W4).

Results

We included 100 participants in this survey.The analytical study found a negative correlation between age and the frequency of coitus during Ramadan (r= -0.2, p= 0.04). The lenth of the marriage was associated with less communication about sexual satisfaction during Ramadan (P=0.01). Rural origin was associated with less tenderness (p=0.03) and shorter foreplay (p=0.03). Wearing the veil was associated with sexual abstinence in women during Ramadan (p=0.038) and not wearing it was associated with the cessation of oral sex (p=0.04). The practice of prayer was correlated to a lesser diversification of sexual positions (p=0.01) and to the withdrawal of certain sexual positions: posterior vaginal (p=0.01), lateral (p=0.02), Andromache (p=0.004).

Conclusions

Changes in the expression of sexuality during Ramadan are not consistent with religious dictates. These findings suggest that the perception of sexuality and its practices are motivated by tradition and culture much more than religion.

Disclosure

No significant relationships.
A Multidimensional Evaluation of Intimacy
Authors: Sears M. , Mcmahon L. , Crosby C. , Freihart B. , Meston C.
Published: September 2022

Introduction

Supportive, nurturing relationships facilitate good health, well-being, and life satisfaction. Intimacy is crucial for developing successful relationships as it strengthens bonds between partners through the exchange of personal details, love, and affection. Despite the importance of intimacy in developing strong relationships, the extant research often conflates affection, trust, and sexual acts with intimacy or only considers one aspect of an intimate relationship (i.e., physical or sexual touch) .

Objectives

The current study aimed to clarify what elicits feelings of intimacy in men and women in order to develop a more nuanced conceptualization of intimacy for use in future research and clinical practice.

Methods

In Study 1, women and men nominated over 2,700 items that “elicited feelings of intimacy” for them. Examples of nominations included: trust, communication, touch, attraction, and sex. Trained raters condensed duplicate items and created a final list of unique nominations for use in Study 2. Study 2 identified the factor structure of the nominated items by having a new sample of participants rate the extent each item elicited intimacy for them.

Results

Data collection is ongoing but will be completed by December 2021. Results will be updated with an addendum after data analysis.

Conclusions

will focus on gender differences in the factor structure of intimacy, how future research can avoid conflating this important construct with other relational aspects, and how a deeper understanding of intimacy can benefit treatment in clinical contexts and strengthen relationships more broadly.

Disclosure

No significant relationships.
Chemsex, G&T, and The Club Drugs Clinic Ireland
Authors: Santlal K. , Fenton F. , Mccarron P. , Egbuta U. , Keenan E.
Published: September 2022

Introduction

Chemsex refers to the intentional consumption of specific substances, Gamma Hydroxybutyrate/Gamma Butyrolactone (GHB/GBL), Crystal Methamphetamine and/or Cocaine to facilitate or enhance the sexual experience. However, there was a plethora of associated problems ranging in severity to complex, life-threatening situations. Since its inception in 2014, The Club Drugs Clinic Ireland, the first outpatient-based clinic for GHB/GBL Detoxification in Ireland, had evolved to include managing problematic chemsex.

Objectives

The Chemsex Working Group Ireland is a collaborative response from governmental and non-governmental agencies. Details of current medical and psychiatric management along with preliminary outcome findings on detoxification, relapse risk and associated factors will be presented.

Methods

Data collected include socio-demographic variables, gender and sexuality, detoxification setting, relapse history and attendance for counselling or aftercare. Descriptive analyses were conducted on referral counts, drug trends, success of first treatment episode, subsequent relapse rate, and uptake of counselling and aftercare.

Results

There have been over 200 referrals to the Club Drugs Clinic Ireland. A number of predisposing and precipitating factors, contributed to the relapse rate (up to 70%) both in Ireland and internationally. The salutogenic, biopsychosocial-based model of addiction recovery produced the best outcomes. This integrated Dual Diagnosis Psychiatry, Sexual Health Medicine, Emergency Medicine and external services for a more comprehensive care.

Conclusions

The pattern of referrals reflects population trends in chemsex, despite the COVID-19 restrictions. While detoxification is largely successful, the high relapse rate highlights the challenge of maintaining abstinence. In order to competently address problematic chemsex, service coordination across various medical professions and ongoing monitoring of the substances consumed is quintessential.

Disclosure

No significant relationships.
Sexual functioning in patients with cancer
Authors: Guermazi A. , Hentati S. , Masmoudi R. , Guermazi F. , Baati I. , Feki I. , Masmoudi J.
Published: September 2022

Introduction

Sexuality is a growing field in the context of the management of chronic diseases and cancer in particular. Cancer treatments and the traumatic nature of the cancer experience frequently elicit considerable sexual difficulties.

Objectives

To assess the prevalence of sexual dysfunction (SD) in patients with cancer, and to determine the associated factors.

Methods

This was a cross-sectional study, conducted over 1 month, involving 100 cancer patients followed in the oncology department at the Habib Bourguiba University Hospital in Sfax (Tunisia). General, clinical and therapeutic data were collected using a pre-established questionnaire. Sexual function was assessed with the “Female sexual Function Index” and the “International Index of Erectile Function”.

Results

These results showed that half of the patients were female, and 70% of them were married. Their mean age was 51.96, and 68% of them were unemployed. Unemployment in men and treatment with chemotherapy were statistically associated with erectile dysfunction (p=0.049 and p= 0.001 respectively). treatment with radiotherapy was statistically associated with decreased desire in men (p=0.048). Depression correlated with a decreased orgasm (p=0.032) and erectile dysfunction (p=0.043) in men, mean score of IIEF (p= 0.019) and with a decreased sexual arousal (p=0.006) in women.

Conclusions

Sexual dysfunction is common in cancer patients. They can be of iatrogenic or psychological origin and can depend on the dynamics of the couple relationship. Training to raise awareness of the importance of sexuality first among cancer patients should be considered given the lack of communication between doctors and patients regarding sexuality issues.

Disclosure

No significant relationships.
Sexual dysfunction and quality of life among Tunisian patients with schizophrenia
Authors: Guermazi A. , Smaoui N. , Jardak D. , Feki R. , Gassara I. , Omri S. , Maalej M. , Zouari L. , Ben Thabet J. , Charfi N. , Maalej M.
Published: September 2022

Introduction

Sexual dysfunction (SD) is prevalent among psychiatric patients than general population.

Objectives

To assess the SD and quality of life (QOL) of patients with schizophrenia, and to identify the factors associated with it.

Methods

This was a cross-sectional, descriptive and analytical study, which began in December 2019, conducted with 60 subjects followed for SCZ or SAD, at the psychiatry outpatient unit of the Hédi Chaker University Hospital in Sfax (Tunisia). General, clinical and therapeutic data were collected using a pre-established questionnaire. The Arizona Sexual Experiences Scale (ASEX) and the 36 item Short-Form Health Survey (SF-36) were used to evaluate subjective sexual dysfunction and QOL respectively.

Results

Patients enrolled had SCZ in 78.2% and SAD in 21.8% of cases. The mean age was 47.2 years. Psychiatric family history, the presence of personal somatic illnesses and tobacco use were found in 43.6%, 61.8% and 67.3% of cases, respectively. The average score of ASEX was 18.21. QOL was altered in 73.3% of participants with an SGM of 53.29. The psychic component was more altered than the physical one with average scores estimated respectively at 48 and 58.44. Participants with SD were more likely to have tobacco consumption (p= 0.025), history of suicide attempt (p=0.023) and they are treated by a combination of several treatments (p=0.025). Impaired QOL was not statistically correlated with SD (p=0.5)

Conclusions

The physicians should pay attention to SD during the assessment and treatment of patients with schizophrenia.

Disclosure

No significant relationships.