bluuebunny/crossref_metadata_2025 huggingface dataset:
Anticholinergic syndrome in a patient with schizophrenia
Authors: Marco Estrada O. , Tardon L. , Fernández T. , Navarro L. , Bioque M. , Arbelo N.
Published: September 2022

Introduction

Anticholinergic syndrome (AS) is a complication that can appear due to different drugs with antimuscarinic effects, such as antihistamines, alkaloids, antipsychotics, tricyclic antidepressives or anesthetics, and it is characterized by urinary retention, dry mouth and skin, mydriasis, low-grade fever, and confusion or coma.

Objectives

To describe a clinical case of AS admitted to our hospital.

Methods

We present a case report of a patient with schizophrenia who presented an anticholinergic syndrome. We also searched for previous studies of AS using a pubmed query.

Results

A 53-year-old male was admitted for a psychotic decompensation to another hospital in Barcelona. The usual treatment at home was amisulpride 1200mg/d, olanzapine 30mg/d and lormetazepam, and haloperidol 6mg/d and clotiapine 40mg/d were added to treat the decompensation. Then, the patient started to present mydriasis, mucocutaneous dryness, low-grade fever, slight hypertension and tachycardia, repeated retentions of urine, confusion, unintelligible speech and agitation, so he was referred to our hospital. Once he was admitted, haloperidol was withdrawn and support measures (bladder catheterization, fluid therapy, etc.) were applied. After a few days, most of the mentioned alterations were stabilized, but the psychotic symptoms, such as thought and behavioural disorganization, persisted and required electroconvulsive therapy, with subsequent improvement.

Conclusions

AS is a relatively frequent side effect of psychiatric medication, which diagnosis is clinical, so, we must be capable to identify it and initiate early treatment to prevent possible complications. The first step, as reflected in the case described, is to stop the causative drugs, and apply support measures. Additionally, physostigmine can be used, as it is an effective antidote.

Disclosure

No significant relationships.
blind or schizophrenic but not both
Authors: Fatima Zahra C. , Katir I. , Korchi A. , Belbachir S. , Ouanass A.
Published: September 2022

Introduction

Although visual impairment appears to be a risk factor for schizophrenia, early blindness may be protective , It’s a phenomenon that has puzzled even the smartest scientific brains for decades. It might surprise you: no person born blind has ever been diagnosed with schizophrenia.

Objectives

The objective of this research is to discover the relationship between schizophrenia and congenital blindness is there a protective gene ! is that visual perception constitutes an essential stage in the onset of the disease itself !

Methods

Case study of a family consisting of thirteen brothers and sisters, three of whom were blind at birth, three with schizophrenia. the study of the files of schizophrenic patients hospitalized in our structure since it opened in the 1970s

Results

Case study of a family consisting of thirteen brothers and sisters, three of whom were blind at birth, three with schizophrenia, but there is none with blindness at birth and schizophrenia. PLus on the basis of medicals files there is no case of schizophrenia with blindness at birth. Preliminary observational analysis of this clinical case suggests the following hypothesis: the presumed protective role of congenital blindness against schizophrenia. The bibliographic research has objectified three recent studies in this direction in Australia, Denmark, and the USA.

Conclusions

The relationship between schizophrenia and congenital blindness is still unrecognized and controversial

Several studies are done in this direction, but so far there is no assertion or confirmation of the hypothesis

Disclosure

No significant relationships.
Ekbom syndrome: a case report
Authors: Bosnjak Kuharic D. , Cvitanic Mazuran M. , Polšek D. , Herceg M. , Jambrosic Sakoman A.
Published: September 2022

Introduction

Ekbom syndrome is a clinical term for delusional parasitosis, a condition characterized by the belief that one’s skin is infested by invisible parasites. Despite having no medical evidence, patients strive to prove their illness and interpret different sensations and symptoms as infestation with parasites.

Objectives

Our objective was to present a case report of a patient with Ekbom syndrome with detailed clinical information and treatment complications.

Methods

We included patient’s history, psychiatric evaluation, complete diagnostic work-up, therapy and follow-up.

Results

A 60-years old female patient was admitted to her first hospital treatment in our psychiatric clinic. Upon admittance, she was extremely tense, preoccupied with the idea that bed bugs have infested her body. She showed extensive medical documentation, including numerous dermatologic reports regarding her condition, interpreting them in accordance with her delusions. In attempt to help herself and “release” the bugs, she harmed herself causing multiple skin lesions across her body and face. The treatment was complicated with secondary skin infections, ulcers, cellulitis and oedemas. Initial treatment with olanzapine was switched to risperidone due to side-effects (sedation, increase of appetite, weight gain). Gradually, with pharmacological treatment, psychoeducation and support, remission was achieved, but poor insight to her previous condition and psychiatric symptoms remained.

Conclusions

Ekbom syndrome presents a serious disorder that can be complicated with secondary somatic complications, often requiring involvement of different medical specialists. Moreover, lack of insight into the need for psychiatric treatment can lead to therapy discontinuation and relapse of symptoms.

Disclosure

No significant relationships.
A late-onset Ornitin Transcabamylase deficiency case as an organic psychosis
Authors: Mateos Sexmero M.J. , Blanco J.A.
Published: September 2022

Introduction

Ornithine transcarbamylase (OTC) deficiency is the most frequent congenital defect among the urea cycle enzymatic disorders, due to mutations a!ecting the OTC gen (Xp21.1) that are inherited with an X-linked pattern. As it happens with sex-linked genetic disorders, late-onset OTC deficiency is more prevalent among women, so that females may be asymptomatic over the years and manifest symptoms only when they are submitted under severe metabolic stress, such as pregnancy, infections or new medications. The enzymatic defect involves a blockage a!ecting the main biochemical route that converts ammonia into urea. This leads to analytic hyperammonemia and the outburst of gastrointestinal, neurological and psychiatric symptoms with variable severity.

Objectives

Expounding the importance of inborn errors of metabolism as possible causes of a psychotic episode.

Methods

Describing the case, supporting our data with a bibliographic research made on PubMed.

Results

We describe a psychiatric adult-onset OTC deficiency in a 37-year-old woman with borderline intellectual functioning and a psychotic episode in the context of an infection that was wrongly diagnosed at first as schizophrenia, until the genetic study was carried out. The woman’s familiar history shown an OTC deficiency among some family members, a mutation- carrier sister and at least two male children death by the first month of life.

Conclusions

Organic psychosis can be caused by a large number of medical diseases. A di!erential diagnosis of possible cerebral, toxic or metabolic causes of psychosis is necessary to avoid mistakes in diagnosis.

Disclosure

No significant relationships.
Impressive Response with Brexpiprazole in Ekbom’s syndrome
Authors: Hsiao J. , Shen Y.-C.
Published: September 2022

Introduction

Antipsychotics are the mainstream treatment of delusional disorder. However, limited therapeutic effect was recognized due to side effect and lack of insight.

Objectives

This article presents a case with Ekbom’s syndrome, also known as delusional parasitosis, who has significant response with Brexpiprazole.

Methods

A 58-year-old female developed her very first episode of psychosis 3 weeks before she visited our emergency department. Delusion of spiders laying eggs and bitsy spiders crawling over her body was claimed, followed by depressed mood and insomnia. The patient denied any substance use in recent months. Examination including biochemical studies, complete blood count, vitamin, and endocrine during admission were all normal. Brain image revealed senile cortical atrophy without apparent acute infarction. Cognitive abilities screening instrument (CASI) revealed total score 75, indicating borderline cognitive function. Ophthalmologist and dermatologist were consulted, and no specific abnormality was found.

Results

Brexpiprazole 2mg was prescribed. After 3 weeks of treatment, the delusion improved with less parasitosis content. We discharged the patient, and kept following her at outpatient department with Brexpiprazole 2mg for 2 months. We tried to taper Brexpiprazole to 1mg at clinic, but her delusional parasitosis relapsed within 1 month. Therefore, we titrated the medication back to 2mg, and kept some dosage for 4 months. No more relapse of psychosis or significant movement dysfunction was observed. The total treatment course was 7 months.

Conclusions

Brexpiprazole, with its D2 partial agonism, shows impressive antipsychotic effect to Ekbom’s syndrome. Little side effect was observed in clinical practice, making Brexpiprazole a worth-trying psychopharmacological management of delusional parasitosis.

Disclosure

No significant relationships.
The Navigate First Psychosis Program: A balance between the medical and recovery models in the debate about long term prophylactic antipsychotics. Mission Impossible?
Authors: Sharony L. , Josman R.
Published: September 2022

Introduction

First psychosis programs have been developed during the past 30 years to influence the prognosis of a first psychotic episode by early integrative biopsychosocial interventions, with a focus on the processes that contribute to relapse. In the process of recovery, Navigate program emphasis on enabling a connection to what is important to the person (work, studies, relationships, intimacy), thus strengthening resiliency and quality of life and reducing self-stigma. Medication is part of any intervention program, however, there is a lot of ambivalence amongst the young person and family about its continuation and many will stop the medication altogether. Moreover, although evidence for the benefits of antipsychotic medication in short-term treatment is well established, there is an ongoing debate in the professional medical literature about the need and benefit of routine prophylactic long-term antipsychotics after first psychotic episode. There is also a significant uncertainty concerning the proportion of patients that will maintain remission without antipsychotics.

Objectives

In this lecture, we will present some of the lessons that we have learned and are still learning from our clients, together with case examples.

Methods

In our Navigate Program, we have developed strategies based on literature and experience that enables the person/family to be part of the decision-making process, which at times presents dilemmas and risks but also promotes the potential for growth and transformation.

Results

How do we talk about the medication issue? Who can continue without medication or with very low dosage? How can we taper antipsychotic treatment?

Conclusions

Are we willing to take the risk?

Disclosure

No significant relationships.
Are conspiracy theorists psychotic? A comparison between conspiracy theories and paranoid delusions
Authors: Veling W. , Sizoo B. , Van Buuren J. , Van Den Berg C. , Sewbalak W. , Pijnenborg G. , Boonstra N. , Castelein S. , Van Der Meer L.
Published: September 2022

Introduction

Conspiracy theories are popular during the COVID-19 pandemic. Conspiratorial thinking is characterised by the strong conviction that a certain situation that one sees as unjust is the result of a deliberate conspiracy of a group of people with bad intentions. Conspiratorial thinking appears to have many similarities with paranoid delusions.

Objectives

To explore the nature, consequences, and social-psychological dimensions of conspiratorial thinking, and describe similarities and differences with paranoid delusions.

Methods

Critically assessing relevant literature about conspiratorial thinking and paranoid delusions.

Results

Conspiratorial thinking meets epistemic, existential, and social needs. It provides clarity in uncertain times and connection with an in-group of like-minded people. Both conspiratorial thinking and paranoid delusions involve an unjust, persistent, and sometimes bizarre conviction. Unlike conspiracy theorists, people with a paranoid delusion are almost always the only target of the presumed conspiracy, and they usually stand alone in their conviction. Furthermore, conspiracy theories are not based as much on unusual experiences of their inner self, reality, or interpersonal contacts.

Conclusions

Conspirational thinking is common in uncertain circumstances. It gives grip, certainty, moral superiority and social support. Extreme conspirational thinking seems to fit current psychiatric definitions of paranoid delusions, but there are also important differences. To make a distinction with regard to conspiratorial thinking, deepening of conventional definitions of delusions is required. Instead of the strong focus on the erroneous content of delusions, more attention should be given to the underlying idiosyncratic, changed way of experiencing reality.

Disclosure

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

Introduction

Schizophrenia (SCZ) is considered one of the most disabling mental illnesses with significant family, social and occupational repercussions resulting in impaired quality of life (QOL).

Objectives

To assess the QOL of patients with SCZ or schizoaffective disorder (SAD) and to analyze the sociodemographic and clinical factors associated with its alteration.

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 Hedi Chaker University Hospital in Sfax (Tunisia). General, clinical and therapeutic data were collected using a pre-established questionnaire. QOL was assessed with the «36 item Short-Form Health Survey» (SF-36).

Results

Patients enrolled had SCZ in 78.2% and SAD in 21.8% of cases. The mean age was 47.2 years and the sex ratio M/F was 4.5. They were single in 63.7% of cases and unemployed in 61.8%. 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 QOL score was 57.7, the average physical health score was 61.1, and the average mental health score was 54.3. Female sex (p=0.02), being single (p=0.039), lack of work activity (p=0.00), tobacco use (p=0.05), and presence of medical history (p=0.034) were statistically correlated with impaired QOL.

Conclusions

QOL in SCZ and SAD is impaired. This result encourages us to conceive of the patient in his whole life and not only from the point of view of the disease.

Disclosure

No significant relationships.
Schizophrenia with obsessive-compulsive suicidal images
Authors: Vasadi V.-M. , Capatina O. , Fadgyas Stanculete M.
Published: September 2022

Introduction

Background A 19-year old patient with a history of traumatic childhood events presents herself for suicidal behavior driven by complex auditory hallucinations, self-mutilating behavior, and obsessive-compulsive suicidal images that depicted the patient lying dead on the floor with both wrists cut open. Prior to hospitalization, over the past 10 months, the patient exhibited symptoms of low mood, anhedonia, and an overall decline in school performance which led to a diagnosis of MDD with psychotic symptoms, but treatment with Duloxetine 60mg and Olanzapine 10mg proved to be inefficient.

Objectives

Case Presentation Upon admission the patient’s mimic and behavior did not support the described sadness, she presented a circumstantial discourse with frequent thought blockages and delusions. Associated the patient also described hypervigilance and avoidance behavior towards men, flashbacks, vivid nightmares, and obsessive-compulsive self-mutilating impulses and images.

Methods

Initially, treatment was started with Olanzapine 20mg, which was augmented two months later with Sertraline 50mg and Bromazepam 3mg. This treatment led to an incomplete resolution of the obsessive symptoms, which led to the increase of Sertraline at 100mg, but at her 1-month check-up evaluation, she presented increased suicidal ideation and daily obsessive-compulsive images.

Results

The patient was lastly diagnosed with schizophrenia, and due to the persistence of the suicidal ideations and delusions and the obsessive-compulsive symptoms, the treatment plan was revised.

Conclusions

Improvement of symptoms appeared under treatment with 300mg Clozapine and 50mg Fluvoxamine. In total the patient needed 98 days of hospitalization and lasting remission of symptoms appeared only under treatment with Clozapine and Fluvoxamine.

Disclosure

No significant relationships.
Family support in treatment of patients diagnosed with schizophrenia: a case report
Authors: Jambrosic Sakoman A. , Bosnjak Kuharic D. , Zegura I.
Published: September 2022

Introduction

Schizophrenia is often accompanied by functional deterioration which can impede a person‛s everyday activities. Families are an important part in providing care for their ailed member‚ but often lack resources to deal with different challenges included in such care. Mental health professionals treating such patients sometimes neglect the importance of including their families‚ or primary caretaker in the treatment plan.

Objectives

We will present two cases of patients diagnosed with schizophrenia with prominently negative symptoms and the challenges met by their caretakers and mental health professionals in the treatment.

Methods

Patient history‚ psychiatric evaluation, psychiatric treatment‚ and the role of the family will be presented.

Results

21 years old patient came with his mother after years of not meeting the expected level of functioning. He was misdiagnosed for a couple of years. His treatment was impeded by loss in the family‚ which also affected both him and his mother. Inability to include her earlier in his treatment became a challenge. Second patient has been treated for schizophrenia with dominant negative symptoms‚ inconsistently‚ for ten years. Her family became more involved in her treatment only after she presented with positive symptoms. Their involvement was important as it resulted in patient‛s better compliance.

Conclusions

Supporting a family member diagnosed with schizophrenia can be overwhelming for the families. Including family members in the treatment early on, can be beneficial both for the patient and the family.

Disclosure

No significant relationships.
Increased risk of psychosis to ivermectin treatment
Authors: Romero Calderon A. , Marín Valdovino M. , González Meléndez A.M. , Leiva Soto J. , Garcia Baltazar A.
Published: September 2022

Introduction

Adolescence: a state of mental fragility, where psychiatric disorders may debut, where have been reported several cases of toxidermy, encephalopathy and neuropsychiatric disorder related to ivermectin treatment (excluding organicity, substance abuse or medication) (1). It has effect on the dopaminergic system with an alteration on glycoprotein P leading to high levels of ivermectin causing neurotoxicity (2). In this poster, we discuss the case of a 14 y/o´s psychosis to ivermectin

Objectives

Presentation of a clinical report

Methods

14 years old woman. Background: father with schizophrenia. Comorbility: None. Initially, presented to ER with 2 week of treatment to ivermectin 6mg for pediculosis; presenting first psychotic episode. She presented first clinical outbreak of psychosis characterized by mystical-religious, erotomaniac, harm and reference delusions, auditory and visual hallucinations adding isolation, abulia, apathy, dialogued soliloquies, and spontaneous crying. No prior psychiatric treatment.

Results

In hospitalization: elevated indirect and direct bilirubins and hiponatremia; neuroimaging studies are reported normal. Haloperidol 7.5 mg/day is indicated and parkinsonism is presented. Treatment is changed to olanzapine 15mg/day with notorious improvement. Diagnostic impression: Acute polymorphic psychotic disorder with symptoms of schizophrenia

Conclusions

Possible causes were analyzed, finding a relationship with ivermectin treatment. This case makes evident the importance of conducting in-depht evaluations and finding risks factors for psychosis.

Disclosure

No significant relationships.
Painful ejaculation induced by venlafaxine: a case report
Authors: Kulacaoglu F.
Published: September 2022

Introduction

Sexual dysfunction is a quite common side effect of antidepressant treatment. Sexual side effects may affect the person’s adherence to treatment, quality of life, and relations. Premature ejaculation is rarely seen as an adverse effect of antidepressant drugs.

Objectives

We aimed to present a clinical case of a 53-year-old man who developed painful ejaculation with the use of venlafaxine.

Methods

We made a narrative literature search in Pubmed and Google scholar with the terms of painful ejaculation induced by venlafaxine and antidepressant treatment.

Results

A 53-year-old man was admitted to the psychiatric outpatient unit with symptoms of anhedonia, decreased sleep, decreased self-esteem for the last month. The patient was diagnosed with depression and he started to take 37,5 mg venlafaxine per day. After one month, when venlafaxine dose was increased to 75mg and the patient started to complain of painful ejaculation. The pain continued from the beginning to the end of the ejaculation. The pain increased more when the venlafaxine dose increased to 150mg per day. The patient was consulted at the urology clinic. The urological examination, laboratory tests (direct microscopic examination of the urethral discharge and urethral culture), and serum prostate-specific antigen levels were normal. No pathology was found in uroflowmetry and ultrasonography of the urinary system. The dose of venlafaxine decreased and the patient started to take 20 mg of fluoxetine per day. His symptoms disappeared after venlafaxine was discontinued.

Conclusions

To literature, this is the second presentation of painful ejaculation observed during the use of venlafaxine.

Disclosure

No significant relationships.
Psychological Characteristics of Sex Offenders
Authors: Oronowicz-Jaśkowiak W. , Lew-Starowicz M.
Published: September 2022

Introduction

A significant problem for clinical judicial experts when issuing court opinions is the possibility that the assessed person may be simulating, as well as lack of examination tools that would increase the objectivity and reliability of the assessment. This presentation covers studies on psychological characteristics of perpetrators of crimes against sexual freedom.

Objectives

The participants were asked to complete psychological tools - Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, Emotion Understanding Test, Revised NEO Personality Inventory, Attachment Style Questionnaire.

Methods

The participants of the study consisted of 225 men serving sentences of imprisonment in a dozen of Polish prisons. Two clinical populations were compared: of perpetrators diagnosed and not diagnosed with sexual preference disorders. The control group consisted of offenders of crimes other than against sexual freedom.

Results

no personality and psychosocial variables were identified that would significantly differentiate offenders diagnosed and not diagnosed with parapaphilic disorder.

Conclusions

The results of this study justify the use of selected tools to complement the clinical diagnosis, allowing for obtaining additional data, independent from case files and interview, that would increase the probability of sexual preference disorders.

Disclosure

The study was approved by the ethical committee at the Institute of Psychiatry and Neurology in Warsaw and the Director General of the Prison Service. Scientific work was financed from the budget for science in the years 2017-2021, as a research project D
Mental Health Professionals’ attitudes towards trans people
Authors: Cutillas Fernández M.A. , Jiménez Barbero J.A.
Published: September 2022

Introduction

Since the emergence of the term “transsexualism” in the Ninth International Classification of Diseases (ICD-9), disciplines related to mental health have contributed to the perpetuation of stereotypical attitudes towards trans people. Recent years have shown the significant prevalence of mental pathology suffered by this group, and the need for specialized training to improve access to the health system.

Objectives

The main objectives of this research are: (a) to find and analyse the scientific evidence published which assesses the attitudes of mental health professionals towards the trans community; b) to establish the main variables that modify these attitudes, paying special attention to gender, ideology, sexual orientation and previous training or experience

Methods

A systematic review of the literature was conducted following the PRISMA recommendations.

Results

Tendency towards more positive and liberal attitudes among professionals than in the general population.

Higher values for extreme prejudice among those professionals who attributed gender diversity to a psychological, ethico-moral or religious cause.

Association of depathologising practices with belief in the psychosocial nature of diversity, clinical training and interpersonal contact with LGBT people. The following socio-demographic variables were related: being a woman, clinical psychologists, progressive political ideology, professionals who strive to know their own limitations and biases.

Conclusions

More positive attitudes than the general population but still insufficient Specific training in gender diversity and minority issues would be a key element in improving care for transgender people. The attitudes of professionals depend, in part, on the personal characteristics of the therapists.

Disclosure

No significant relationships.
BDSM: pathological or healthy expression of intimacy?
Authors: Wuyts E.
Published: September 2022

Introduction

Though BDSM interest (bondage & discipline, dominance & submission and sadism & masochism) has proven to be quite prevalent (46.8% in recent research), there is still significant stigma surrounding it, both in general society and among mental health practitioners.

Objectives

This research explores the biological mechanisms associated with a BDSM interaction in the hope to strengthen the argument that it does not belong in the psychiatric field.

Methods

The present study collected data on peripheral hormone levels, pain thresholds and pain cognitions before and after a BDSM interaction and compared these results to a control group.

Results

show that submissives have increased cortisol and endocannabinoid levels due to the BDSM interaction and that these increases are linked. Dominants showed a significant increase in endocannabinoids associated with power play but not with pain play. BDSM practitioners have a higher pain threshold overall and a BSDM interaction will result in a temporary elevation of pain thresholds for submissives. Additionally, pain thresholds in dominants will be dependent upon their fear of pain and tendency to catastrophize pain and submissives will experience less fear of pain than the control group

Conclusions

Even though this is one of the first studies of its kind, several biological processes can be associated with BDSM interactions, strengthening the hypothesis of BDSM as a healthy form of intimacy and promoting its distinction from paraphilias as they are described in the DSM or ICD classifications.

Disclosure

No significant relationships.
sexual offenders : Epidemiological and Criminological Profile
Authors: Charaa O. , Bouali W. , Brahmi L. , Haj Mohamed A. , Ben Soussia R. , Zarrouk L.
Published: September 2022

Introduction

Sexual assault is a major problem in Tunisian society. There is no definitive typology of the characteristics of those who sexually assault. A great diversity of sexual aggression behaviors and different motivations can be described.

Objectives

It is about a retrospective survey, achieved from data of Medical Expertise of the sexual offenders achieved in psychiatric departement of hospital of mahdia. This study revealed 18 cases during the period from January 2010 to December 2020.

Methods

The objective of the work was to describe the epidemiological and criminological profile of the sexual assaults.

Results

Mean age of the sample was 40 years [30-61]. Aggressors were almost exclusively males, have medium socioeconomic status and without a regular job. Fifty percent of the perpetrators had a psychiatric diagnosis: bipolar disorder (27.7%), schizophrenia (11.1%), antisocial personality disorder (5.5%) and intellectual disability (5.5%). Indecent assault (27.7%) was the most frequent aggression then the rape (22,2%). Thirty three per cent of the victims were minor.Among these expertised patients, 72% were considered responsible for their actions and only one was considered irresponsible.

Conclusions

Studies on the characteristics of sexual offenders have concluded to the profile of the young, single and unemployed male, but it can’t be a commun profile.

Disclosure

No significant relationships.
Sexual and Reproductive Health Needs Assessment & Interventions in a Female Psychiatric Intensive Care Unit
Authors: Covshoff E. , Blake L. , Rose E. , Bolade A. , Rathouse R. , Wilson A. , Cotterell A. , Pittrof R. , Sethi F.
Published: September 2022

Introduction

This quality improvement project was a collaboration between an adult, inpatient female psychiatric intensive care unit (PICU) in South London and the Sexual and Reproductive Health Rights, Inclusion and Empowerment (SHRINE) programme. SHRINE is a London-based programme delivering SRH care to any individual with serious mental illness, substance misuse and/or learning disability.

Objectives

The primary aim of this quality improvement project was to assess patients’ sexual and reproductive (SRH) needs, and the acceptability of providing SRH assessments in a female PICU setting. Secondary aims were to explore the barriers to access and the feasibility of providing SRH assessments and SHRINE interventions in the PICU.

Methods

A bi-monthly SRH in-reach clinic and a nurse led SRH referral pathway were implemented on the PICU over a seven-month period. Within a quality improvement framework, a staff training needs assessment was performed, training delivered, a protocol developed, staff attitudes explored, and patient and carer engagement sought.

Results

30% of women were identified as having unmet SRH needs and proceeded to a specialist appointment, representing a 2.5-fold increase in unmet need detection. 42% of women were assessed, representing a 3.5-fold increase in uptake. 21% of women initiated SRH interventions of which 14% had all their SRH needs met.

Conclusions

Results identified SRH needs for PICU admissions are greater than realised. Staff highlighted the acceptability and importance of SRH care, if interventions are appropriately timed and the patient’s individual risk profile considered. Providing a nurse-led referral pathway for an SRH in-reach clinic is acceptable, feasible and beneficial for PICU patients.

Disclosure

No significant relationships.
Polysomnography Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis
Authors: Bray M. , Krieg A. , Esagoff A. , Bryant B. , Salas R. , Rao V. , Peters M.
Published: September 2022

Introduction

Sleep disturbances are common following traumatic brain injury (TBI) worsening morbidity and other neuropsychiatric symptoms. Post-TBI alterations in sleep architecture require further study.

Objectives

(1) To evaluate polysomnographic measures of sleep architecture in participants with history of TBI compared to controls and as meta-analyses of pooled means. (2) To evaluate effects of timing and severity of TBI on polysomnographic outcomes.

Methods

PRISMA compliant systematic review was conducted of MEDLINE, PsycINFO, EMBASE and Scopus. Inclusion criteria: 1) reporting polysomnography in the context of TBI and 2) operationalizing TBI using clear/formalized criteria. Data were pooled in random-effects meta-analyses with outcomes expressed as mean differences (MD).

Results

In participants with TBI, sleep was comprised of 19.39% REM sleep, 8.13% N1, 51.18% N2, and 17.53% N3, as determined by meta-analyses of single means. Total sleep time was reduced in chronic (>6 months) TBI compared to acute-intermediate TBI (<6 months) (p=0.01). Compared to controls, participants with TBI differed with increased N1 sleep (MD=0.64%; 95%CI=0.02,1.25; p=0.04), reduced sleep efficiency (MD=-1.65%; 95%CI=-3.18,-0.12; p=0.03), and reduced sleep latency on the multiple sleep latency test (MD=-5.90mins; 95%CI=-10.09,-1.72; p<0.01). On sub-group analyses, participants with mild TBI differed from controls with reduced total sleep time (MD=-29.22mins, 95%CI=-54.16,-4.27; p=0.02). Similarly, participants with acute-intermediate TBI exhibited increased sleep latency compared to controls (MD=8.96mins; 95%CI=4.07,13.85; p<0.01) and differed significantly from participants with chronic TBI (X2(1,N=608)=6.54; p=0.01).

Conclusions

Sleep architecture is altered following TBI with potential implications regarding functional outcomes and recovery. These alterations appear to differ based on severity of injury and time since injury.

Disclosure

No significant relationships.
Cannabidiol (CBD) and Insomnia : Literature review
Authors: Gutierrez Higueras T. , Calera Cortés F. , Servin López E.D. , Montes Arjona L. , Sainz De La Cuesta Alonso S. , Vicent Forés S.
Published: September 2022

Introduction

Cannabidiol (CBD) is one of 113 cannabinoids identified in cannabis plants. Considered as a psycho-inactive component, recently, the Court of Justice of the European Union published a ruling in which it establishes that cannabidiol extracted from the cannabis plant should not be considered a drug under the United Nations Single Convention on Narcotic Drugs of 1961. Due to increased publicity on social media of the supposed benefits of this product, in addition to the lack of clear regulations, it is becoming a widely used treatment for sleep disorders.

Objectives

To analyse literature for the effect of CBD in sleep disturbances, emphasizing advantages and disadvantages of its use.

Methods

We carried out a literature review in Pubmed choosing those articles focused on effect of CBD in sleep disturbances.

Results

The review of the effect of CBD on sleep cycle suggest that medium to high doses increased REM sleep latency, and medium-low doses decreased REM sleep latency. No evidence of withdrawal syndrome was found with abrupt discontinuation of short-term treatment with CBD.

Conclusions

Most of the literature revised shows that the data was taken by self-questionares to CBD users. Studies suggest that a short use of medium to hight doses of CBD may improve insomnia, however, combined use with THC may result in a decrease in slow wave sleep. Longitudinal research should be done in order to understand the clinical impact of CBD on sleep.

Disclosure

No significant relationships.
Sleep characteristics in patients with substance use disorder after detoxification treatment: self-report and actigraphy data
Authors: Vetrova M. , Rybakova K. , Goncharov O. , Krupitsky E.
Published: September 2022

Introduction

Sleep problems are common in patients with substance use disorders (SUD) and have been related to poor treatment outcomes. Little is known about the sleep characteristics in patients with opioid and alcohol use disorders after detoxification program.

Objectives

To compare sleep quantitative and qualitative characteristics between patients with opioid and alcohol use disorders.

Methods

This is a secondary data analysis of the longitudinal data from the observational study in St. Petersburg, Russia. The sample included 75 patients (22.7% female) who received detoxification treatment for alcohol (n=49) or opioid (n=26) withdrawal. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and underwent daily wrist actigrahy.

Results

Good internal consistency was demonstrated for self-report and actigraphy data (r
=-0,405, p<0,01). Sleep duration and sleep onset latency were not different between alcohol and opioid groups (5.7 vs. 6.1 hours; 74 vs. 65 minutes, respectively) based on self-report data. The majority of the patients (57-100%) had sleep complaints and low quality of sleep after detoxification completion (at baseline). In both groups, the mean PSQI score had a tendency to decrease, representing better sleep quality, over the 1-week following detoxification program completion (from 12 at baseline to 10 at 1-week in alcohol group; from 13 to 12 in opioid group,
p<0,001).

Conclusions

The findings show that sleep characteristics are similar in patients with different SUD and insomnia symptoms are prevalent after detoxification, suggesting the rationale for sleep assessment before hospital discharge. Despite the positive changes in sleep quality over 1-week abstinence, patients might benefit from the therapeutic sleep interventions.

Disclosure

This work was financially supported by a research grant from Russian Foundation for Basic Research, 18-013-00481.
Improving sleep in a population at high risk of trauma: A pilot study examining self-reported sleep, psychological symptomology and actigraphy measured night-time sleep
Authors: Maguire D. , Armour C. , Lagdon S. , Ruddock M. , Moore T. , Milanak M.
Published: September 2022

Introduction

Sleep disturbances (SDs), such as insomnia or regular nightmares, are associated with multiple mental health disorders, most notably PTSD, where SDs are reported in up to 92% of cases. Examining the effect of changing sleep on psychological symptomology is essential to develop the evidence base on the contribution of sleep to mental resilience.

Objectives

To examine the effect a short skills-based sleep intervention on psychological symptomology and actigraphy measured sleep.

Methods

A 4-session sleep skills training programme was used to treat active SDs in participants likely to have experienced occupation-associated trauma, namely military and first responders.

Results

Nineteen participants were included in the study. Insomnia Severity Index (ISI) measured; difficulty sleeping, difficulty staying asleep, waking too early, sleep satisfaction, sleep interference on quality of life and total ISI insomnia score improved significantly post-treatment (M = 9.44, SE = 7.35, p <0.001). No significant difference was identified post-treatment for actigraphy-measured sleep. The severity of depression (M = 5.27, SE = 1.41, p = 0.002), anxiety (M = 5.07, SE = 1.66, p = 0.008), and PTSD symptoms among participants with likely PTSD, were significantly lower following treatment (M = 29.4, SE = 4.19, p = 0.002).

Conclusions

A short sleep skills intervention based on CBT-I was effective at reducing self-report insomnia symptoms and severity of psychological symptomology but failed to improve actigraphy sleep metrics. These findings highlight a differing contribution of night-time sleep and current insomnia symptoms to the severity of self-reported psychological symptomology.

Disclosure

No significant relationships.
Pharmacological Management of insomnia Associated with Parkinson’s Disease
Authors: Vasiliu O.
Published: September 2022

Introduction

Parkinson’s disease (PD) is a progressive neurological disorder that associates multiple psychiatric symptoms and disorders, like depression, neurocognitive impairment, sleeping disorders, etc. Insomnia is frequently detected in this population, with a prevalence of over 50% according to several studies.

Objectives

To present a case series dedicated to the treatment of insomnia in patients diagnosed with PD, who did not meet diagnostic criteria for any other psychiatric disorder.

Methods

A number of three patients (2 male, one female, mean age 65.2 years) diagnosed with PD, were evaluated for insomnia. They were all initiated on quetiapine XR 50 mg QD, and up-titrated according to the individual response. All these patients were undergoing treatment for their neurological disease, which remained stable for the next 3 months. A structured clinical evaluation was performed monthly, and safety measurements were also performed. All patients self-evaluated their insomnia severity on a 10-point visual analogic scale (VAS).

Results

After 3 months, patients reported a favorable evolution of their insomnia- VAS score improved significantly to baseline (from 7.3 to 3.3), without significant adverse events (metabolic parameters and QTc values did not change significantly during the treatment period). Daytime sleepiness was not reported as being significant by any of these patients. The mean dose of quetiapine XR used was 75 mg QD (50-150 mg QD), and the mean duration of the needed treatment for insomnia was 8.3 weeks (4-11 weeks).

Conclusions

Quetiapine XR could be useful in patients with PD-related insomnia, and the mean dose is usually below 100 mg QD.

Disclosure

No significant relationships.
Anxiety and Depression in Ireland during COVID-19 – a narrative review
Authors: Sathyanarayanan V. , Shahwar D. , Azeem M.
Published: September 2022

Introduction

Ireland has been one of the worst affected countries affected by COVID-19 in Europe. Many primary studies from Ireland have documented prevalence of anxiety and depressive disorders during the pandemic and their correlates.

Objectives

To study the prevalence range of anxiety and depression in Ireland, and their correlates during the pandemic.

Methods

We systematically searched Pubmed, PsycInfo and the WHO COVID-19 global research database using key words ( January 2020 - September 2021). We removed duplicates and extracted data into an excel database and carried out a narrative synthesis of the extracted data.

Results

From a total 127 studies, we included 22 studies that met our criteria in our narrative review. Depending on the tool used and the type of population studied, the prevalence of general anxiety disorders varied between 20% and 49.5% while prevalence of depressive disorders ranged between 20.4% and 53.8%. Younger people, health care workers, those who had to give up physical activity, people who had lost income, those who lived alone, infected by COVID-19, or had a higher perceived risk of the disease had a higher prevalence of both anxiety and depression disorders during the pandemic. There was conflicting evidence on prevalence levels among men and women and on whether they had children or not.

Conclusions

COVID-19 has had a profound effect on the mental health of the Irish population. Some population groups are more affected than the others. Addressing mental health concerns of Irish population during and post pandemic should remain as one of the top public health priorities.

Disclosure

No significant relationships.
The Moderating Effects of Social Support in the Relationship between Problem Drinking and Depression of the elderly disabled
Authors: Yoon M.S. , Yu H. , Yu M.
Published: September 2022

Introduction

In recent years, the elderly population in Korea has rapidly increased, and the proportion of the elderly over 65 years old was 14% as of 2017. In particular, as the elderly population increases, the number of elderly people with disabilities has increased by 16.3% over the past 7 years, from 30.3% in 2010 to 46.6% in 2017. Based on the dual view of the elderly and the disabled, it is necessary to pay attention to the problems of drinking and depression in these relatively marginalized groups.

Objectives

This study aimed to investigate the moderating effect of social support between problem drinking and depression of the elderly with disability

Methods

This study analyzed the 12th wave(2017) KWPS(Korean Welfare Panel Study) and Disability Study which included 195 elderly with disability aged 60 over. Collected data were analyzed by SPSS 21.0 and STATA.

Results

First, the elderly with disabilities were more likely to be depressed than the women, living without spouse, the less satisfied with health, the higher the problem drinking, the lower the social support. Second, disability factors didn’t show any influence on the depression of subject and subjective health satisfaction significantly related to the depression. Third, social support moderated the relationship between the problem drinking and depression. According to the Quantile regression analysis, in group with low social support, the more the problem drinking, the higher the depression.

Conclusions

Social support in elderly with disability was a significant factor for problem drinking and depression. The implication and limitation of these findings are discussed

Disclosure

No significant relationships.
Generalized problematic internet use, emotional regulation and self-esteem in adults
Authors: Maia B.R. , Morgado P.
Published: September 2022

Introduction

Many internationally studies, in the last two decades, found problematic internet use associated with a variety of psychosocial problems, but in Portugal this is a recent research question specially in adults.

Objectives

To explore the relationship between problematic Internet use, emotional regulation and self-esteem.

Methods

138 Portuguese subjects (77.5% females), with a mean age of 27.76 years old (SD = 8.98, range: 18-58) filled in the Portuguese versions of the Generalized Problematic Internet Use Scale-2, the Difficulties in Emotion Regulation Scale and the Rosenberg Self-Esteem Scale.

Results

Negative consequences subscale of generalized problematic internet use was positively correlated with all the emotional regulation difficulties subscales and negatively with Self-Esteem, and positively with daily hours of internet usage. A similar result was found for Self-Deficient Regulation subscale, except for Clarity subscale. Mood Regulation was correlated with Strategies, Goals and Self-Esteem. Males showed higher levels of Negative Consequences. Age and age onset of Internet use were negatively correlated with Mood Regulation, Self-Deficient Regulation and Negative Consequences. A statistically significant difference in Mood Regulation, Self-Deficient Regulation and Negative Consequences in marital status levels, and in professional situation, with higher median scores in divorced and single without a relationship and in student subjects; no significant differences were found in educational level.

Conclusions

Generalized problematic Internet use, especially their Negative Consequences, is associated with higher emotional dysregulation, low self-esteem, lower age and lower age of Internet onset, being divorced or single without a relationship and being student, and it is more prevalent in males.

Disclosure

No significant relationships.