bluuebunny/crossref_metadata_2025 huggingface dataset:
Technological Addictions: The New Frontier in Addiction Psychiatry
Authors: Levounis P.
Published: August 2024

Introduction

Addiction to video games, cybersex, internet gambling, social media, texting and emailing, and online auctions can be as addictive as substances. These technological addictions have real-world ramifications and lead to the loss of jobs, money, and loved ones. As technology becomes integrated into many facets of modern life, the appreciation of such addictions has become increasingly challenging. This session will explore the addictive potential of technology and discuss the legitimacy of technological addictions as psychiatric conditions worthy of medical assessment, diagnosis, and treatment.

Objectives

1.

List five forms of Technological Addictions as they appear in the scientific literature of 2023.

2.

Describe the psychology and culture surrounding Internet Gaming addiction.

3.

Distinguish between normal use and addiction.

Methods

Lecture and discussion

Results

1.

Research on the phenomenology and nosology of these illnesses helps us further elucidate the distinction between problematic and nonproblematic use of technology, especially in children and young adults.

2.

Another area of new research involves emerging technologies. By the time clinicians get a firmer grasp of today’s ailments, the technology of tomorrow—such as virtual reality and smart devices powered by artificial intelligence—will be commonplace enough to bring about a host of new problems.

Conclusions

Though data on the prevalence of technological addictions are sparse, most people use computers, tablets, and smartphones regularly with great benefits and no serious adverse consequences. We will need to be ready to guide our patients, our colleagues, and the general public on how to best handle technology with an eye on maximizing its enormous potential for fulfillment, gratification, and happiness while minimizing its significant risks for dissatisfaction, misery, and despair.

Disclosure of Interest

None Declared
Socio-demographic and clinical profile of opoid users
Authors: Bencharfa Z. , Zahir R. , El Hamoumi I. , El Omari F.
Published: August 2024

Introduction

Opioid use disorder is a pattern of problematic opioid use, leading to impaired functioning or clinically significant suffering. Morocco, a pioneer in the Arab world in the field of opiate substitution, is no exception to this rule, and has found itself confronted with a situation where opiate use is much more widespread in the north of the country. Morocco’s geographical proximity to Europe and the multiple interactions fostered by migratory population flows undoubtedly contribute not only to the spread of hard drug use, particularly heroin, but also to the diversification of consumption methods (injection drugs)

Objectives

The main objective of our work was to study socio-demographic and clinical profile of opoid users in morocco, but also their quality of life after treatment in Morocco, before concluding with recommendations for improving the overall management of the patient.

Methods

We conducted a cross-sectional, analytical study in the Addictology Department at Ar-razi Hospital in Salé, which provides oral methadone substitution therapy for around 80 patients.

Results

The total number of patients responding to the questionnaire was 60 participants.

The population of methadone-treated patients in our study was 83.33% (n = 50) male and 16.67% female (n = 10).

The most common age group in our study was between 31 and 45 (71.67%). 36.67% were married (n=22), 80% (n=48) lived with their family, 83.34% (n=50) had a secondary school education or higher, while the vast majority 63.33% (n=38) had no fixed occupation.

96.7% (n=58) of participants were of Moroccan nationality, against only 3.3% who were foreigners (n=2).

The main indication for methadone withdrawal in our patients was heroin use (66.67%), followed by Codeine, then Tramadol. The daily doses of methadone delivered ranged from 04 to 200 mg/patient, with an average of 75 mg.

The main adverse effects reported by our patients were libido disturbance, constipation, fatigue and sleep disturbance.

63.33% (n=38) of patients continued to use other psychoactive substances on a regular basis, mainly tobacco, followed by cannabis.

13.33% (n=8) reported persistent craving, and the vast majority claimed to be supported by a family member (70%, n=40).

Conclusions

For several years, quality of life has been a major preoccupation of healthcare professionals in a bio-psycho-social approach. In this vision of care, quality of life should now be part of the clinical criteria for monitoring patients on methadone.

Disclosure of Interest

None Declared
Clinical Characteristics and Aggression in Unipolar and Bipolar Course of Affective Disorders
Authors: Smirnova L. , Roshchina O. , Seregin A.
Published: August 2024

Introduction

The diagnosis and treatment of depression are complex due to its diverse forms. Recent focus in clinical practice has been on identifying markers for mono- and bipolar depression, as early diagnosis significantly impacts treatment.

Objectives

To identify clinical characteristics of unipolar and bipolar depressive disorders and assess their correlation with aggression levels in patients.

Methods

We studied patients at the Mental Health Research Institute of Tomsk NRMC: ICD-10 codes: Bipolar Affective Disorder (BD) (n=28), Recurrent Depressive Disorder (RDD) (n=33). Patients with BD were older (49 (33; 52) years) than those RDD (40 (31; 51) years) (p=0.018). The current depressive episode duration was shorter for BD (3 (2; 7) months) compared to RDD (5 (2; 12) months) (p=0.018). Gender distribution was comparable (p=0.568). We measured clinical symptoms (depression, anxiety, anhedonia) using psychometric tools (HAM-D, HAM-A, SHAPS) at admission and after 3 weeks of therapy. Aggression was assessed with the Buss-Durkee Hostility Inventory (BDHI) at admission.

Results

Patients with RDD demonstrated a higher severity of depressive symptoms upon admission (Table 1).
Table 1.

Clinical Characteristics of Unipolar and Bipolar Depression Course

Severity of Symptoms
Bipolar Depression
Unipolar Depression

р (U-test)HAM-D on admission19 (15.5; 24)22 (18; 26)0.044HAM-D after 3 weeks4 (2; 6)4 (3; 7.75)0.219HAM-A on admission16 (12; 25)19.5 (13; 26.75)0.098HAM-A after 3 weeks3 (2; 6.5)4 (3; 7.75)0.219SHAPS on admission5 (1.25; 9)3 (0; 10)0.7SHAPS after 3 weeks1 (0; 4)1 (0; 3)0.44

The severity of some aggressive patterns was higher in patients with bipolar disorder (Table 2).
Table 2.

The severity of aggressiveness in unipolar and bipolar depression.

BDHI subscale
Bipolar Depression
Unipolar Depression

р (U-test)Aggressiveness index19 (13; 24)18.5 (12; 24)0.745Hostility index9 (7; 13.75)9 (7; 11)0.139Assault Hostility4 (2; 6)4 (2; 6)0.618Indirect Hostility5 (5; 6)4 (4; 6)0.015Irritability6 (4; 8)5 (3; 7)0.081Negativism2 (1; 4)2 (1; 4)0.262Resentment5 (4; 6)5 (3; 6)0.113Verbal Hostility7 (6; 8)6 (5; 8)0.008

As a result of the study, no statistically significant correlations were found (p>0.05, Spearman’s test).

Conclusions

The conducted research did not yield convincing data that would allow us to make judgments about specific clinical patterns in the course of unipolar and bipolar depression. Thus, the problem of searching for unique biological markers of the courses of affective disorders remains relevant. Support by the Russian Science Foundation grant No. 23-75-00023.

Disclosure of Interest

None Declared
Carbamazepine-induced toxidermia: Case report and a literature review
Authors: Jbir R. , maalej M. , Omri S. , Charfi N. , Feki R. , Gassara I. , Smaoui N. , Zouari L. , Ben Thabet J. , Maalej M.
Published: August 2024

Introduction

Carbamazepine is effectively used in treatment of bipolar disorder for its thymoregulatory virtues, but it can induce numerous side effects, including skin eruptions that can be severe sometimes.

Objectives

To study the relationship between toxidermia and treatment with carbamazepine.

Methods

We report the case of a patient who developed a toxidermia following the intake of carbamazepine.

Results

Mr. AD, 19 years old, with medical history of diabetes, has been diagnosed with bipolar disorder since the age of 17. He was initially treated with risperidone with an irregular follow-up.

He was hospitalized in our department for a manic episode with psychotic features with agitation and refusal of treatment.

The patient was put on injectable treatment 15 mg/day of Haloperidol and 20 mg/day of diazepam.

After 5 days in hospital, we switched to the oral route, gradually increasing haloperidol doses to 30mg, reducing diazepam doses and introducing carbamazepine for thymoregulatory purposes.

Carbamazepine was progressively increased up to a dose of 800mg per day.

Fourteen days after the introduction of carbamazepine, the patient presented a generalized rash requiring the discontinuation of this medication. He was treated with an anti-histamine and local corticosteroids, on the advice of dermatologists.

In the days following discontinuation of carbamazepine, skin lesions regress and then disappear.

Biologically, we observed a rise in eosinophilic polynuclear cells to 580, followed by a gradual decrease after stopping the treatment.

A pharmacovigilance opinion was sought, concluding that carbamazepine was responsible for the toxidermia, given the delay in onset and the favorable evolution after discontinuation of the incriminating treatment. Moreover, this undesirable effect is well described in the literature.

Hence the contraindication to further use of carbamazepine in Mr. AD.

In addition, the patient was put on sodium valproate with good tolerance.

Conclusions

Each prescribed drug must be considered as potentially capable of causing cutaneous reactions as an adverse effect. Both the prescriber and the patient must be made aware of this phenomenon. The attitude can be modulated on a case-by-case basis, after specialist advice, depending on the severity of the rash and the disease to be treated.

Disclosure of Interest

None Declared
Sleep disorders in patients with bipolar disorder: age and tobacco consumption correlates
Authors: Razki K. , Najar C. , Ben Aissa S. , Oumaya M. , Bouzid R.
Published: August 2024

Introduction

Sleep disruptions are frequently observed in individuals with bipolar disorder and have been linked to various unfavorable consequences, such as an elevated risk of relapse and lower quality of life. Nonetheless, the impact of sociodemographic factors on the development and progression of these disruptions remains largely unexplored. Gaining insight into the relationship between sleep disruptions and sociodemographic factors is essential for designing effective interventions and enhancing clinical outcomes for individuals affected by bipolar disorder

Objectives

The objective of this study is to examine the association between sleep disorders in patients with bipolar disorder II (BDII) and sociodemographic characteristics.

Methods

This is a cross-sectional, descriptive, and analytical study that was conducted over a one-month period from October 1 to October 31, 2022, with patients attending the follow-up unit of the mental health department at Nabeul Hospital ,Tunisia.The study employed a questionnaire as a tool for data collection, and participants provided voluntary and informed consent before responding. The protection of participant confidentiality and anonymity was carefully observed during all stages of the study.

Results

In this study, we enrolled patients who satisfied the following eligibility criteria: age range of 18 to 60 years, a confirmed diagnosis of type II bipolar disorder based on DSM V criteria, and psychiatric stability as demonstrated by no hospitalization within the preceding 6-month period.

Our study included a sample of 40 male patients diagnosed with type II bipolar disorder. The participants had a mean age of 36 ± 13.2 years, and the majority were unmarried and living with their families or alone. Over two-thirds of the participants had attained a university level of education, while a large proportion of the patients, specifically 80%, reported being regular smokers.

The results of the study revealed that the mean global score on the Pittsburgh Sleep Quality Index (PSQI) was 7.28 ± 3.35, indicating an overall low quality of sleep. The majority of the participants, that is 65% (26), had poor sleep quality scores (> 5), while 45% (18) reported experiencing poor sleep (PSQI ≥ 8).

Our analyses further demonstrated that there was a significant association between tobacco consumption and PSQI scores (p=0.003). Additionally, we found that participants who were above 40 years old had a higher likelihood of experiencing sleep disturbances (p=0.0017).

Conclusions

According to the findings of our study, it appears that patients diagnosed with type II bipolar disorder may experience impaired sleep quality, which can be influenced by age and tobacco consumption. These results underscore the need for a holistic approach to patient care that addresses both the biological and sociodemographic factors that can impact sleep in this population.

Disclosure of Interest

None Declared
Developmental organization of the graphic gesture with a pre-scruptural task to assess handwriting
Authors: Vaivre-Douret L. , Lopez C.
Published: August 2024

Introduction

The literature mainly focused on spatio-temporal and kinematics parameters of tracing letters or words using digitizing tablets, no recent research has previously studied the developmental prerequisites of the organization of handwriting.

Objectives

We aimed to aimed to investigate and validate the developmental organization of the graphic gesture with a pre-scruptural task.

Methods

122 typically developing right-handed elementary school children (grades 1st to 5th) aged from 6 to 11;3 years old were recruited. The axe postural and arm gestural features were video-recorded with analysis in 2D reconstruction. Spatial (length, size, regularity, slope of the line…), temporal (drawing time, pause time) and kinematic measures (velocity, peak velocity) were collected with a digital pen independent connected to an analysis software tool. External validity was studied in relation with the standardized handwriting scale BHK. The child has to draw a line of cycloid loops (from left to right drawn in an anti-clockwise direction) across the width of an A4 size unlined half sheet of white paper (containing non-visible watermarks to provide the location of the pen) free to move on the table, after observing the dynamic model on the iPad placed in front of him.

Results

Five main patterns of inter-segmental displacement gestures were found for the production of the line of loops with a significant developmental progress from grades 1st to 5th. Findings showed significant economic rotation movement with forearm rotation around the elbow in 4th and 5th grade, with the elbow tending significantly to be static on the table (p = 2.43e-16), wrist on the table and (p =0.02) and in half-supine position (p =0·001), tri-digital grasp of the pen (p =3.81e-08). Moreover, the mean pressure applied on the pen decrease at 4 and 5th grades and it is correlated to deleterious spatial-temporal and kinematic parameters.

Conclusions

The results of our study provide the first developmental grade and age-related normative data in the developmental genesis of the graphomotor gesture and with the spatio-temporal /kinematic measures. The more mature the gesture, the more there is a decrease in degrees of freedom of movement and stabilization of the joints that is fixed, as well as the presence of a distal flexion movement extending fingers in synergy with the rotation of the arm around the elbow. Furthermore, the task of copying of loops in ecological settings appears to be a good predictor for legibility and writing speed. Those data can account for the mechanisms of motor programming necessary to the automatization of the future gesture of handwriting.

Disclosure of Interest

None Declared
Anxiety, Depression, and Stress on School-Aged Children and Adolescents in 2021: An Urgent Need for Comprehensive Intervention and Support
Authors: Romero A. , Petro M. , Ruiz E. P.
Published: August 2024

Introduction

In the year 2021, there was a notable increase in behaviors associated with anxiety, depression, and stress among school-aged children and adolescents, possibly attributed to the pervasive effects of social isolation and confinement measures.

Objectives

This study conducted a thorough analysis of cases involving students aged 11 to 17 years who exhibited risk factors, anxious and depressive symptoms, and mood disturbances.

Methods

This study focused on students aged 11 to 17 years and employed a comprehensive approach to assess the impact of anxiety, depression, and stress. Cases were meticulously analyzed, and key categories were established to characterize the multifaceted challenges faced by the students. These categories included the availability of family support, utilization of psychopharmacological treatment, engagement in psychological therapies, participation in psychopedagogical interventions, and patterns of school absenteeism.

Results

The analysis revealed a concerning prevalence of anxiety, depression, and stress-related symptoms among the student population. Many students exhibited risk factors that warranted immediate attention, including social isolation, disrupted routines, and uncertainty about the future. Furthermore, a significant portion of students displayed anxious and depressive symptoms, often leading to altered mood and behavioral challenges. In the context of family support, it was apparent that students with robust familial backing tended to cope more effectively with the psychological strain induced by the pandemic. However, a noteworthy number of students lacked adequate family support systems, exacerbating their mental health struggles. Students in need of such interventions benefited significantly from their implementation, demonstrating improved emotional well-being and a reduction in symptom severity. Nonetheless, the accessibility of these services remained a concern, with disparities in access evident among different demographic groups. Psychopedagogical interventions played a pivotal role in addressing issues related to school absenteeism and facilitating a smoother transition to remote learning. Students who engaged in these interventions showed positive progress in terms of school attendance and academic performance.

Conclusions

The findings of this study underscore the urgency of a holistic approach to addressing anxiety, depression, and stress in school-aged children and adolescents. It is imperative that consultations with child and adolescent psychiatry specialists be conducted promptly and in a manner that considers the unique contextual factors influencing each student’s mental health. Moreover, efforts should be directed toward enhancing family support, expanding access to psychopharmacological treatment and psychological therapies, and promoting the implementation of psychopedagogical interventions.

Disclosure of Interest

None Declared
Antipsychotic use in under 25’s - think carefully!
Authors: Collins D. , Holdsworth R. , Nebunu T. , Beezhold J.
Published: August 2024

Introduction

Antipsychotic use for adolescents (defined here as under 25 year olds) must be done with caution, giving due thought to advantages and potential side effects. Antipsychotics are extremely useful and effective drugs, but have side effects and many of these are problematic.

It has been noted that Risperidone is often used for this age group, despite the UK guidance being cautious about its use.

Objectives

To assess the extent of Risperidone prescribing in Norfolk/Suffolk for this patient group and to consider the monitoring of this.

Given that bone mass density is set down in teens – mid 20’s, this is a particularly concerning issue when given to this age group. Additionally, distressing side effects and issues with fertility shoudl be considered. If risperidone is used, Maudsley is very clear that this must be monitored: baseline/annual prolactin levels done, and action should be taken if these are elevated and/or the patient symptomatic.

Methods

1)

Evaluate numbers of adolescents, under 2ndry care Mental health service who have been prescribed Risperidone

2)

Consider who prescibed it and the indication

3)

to consider if routine monitoring had been completed (specifically, baseline prolactin and then annual prolactin levels)

4)

to consider if these patients had developed side effects

Results

Almost 20% of 18-25 years olds, due to be seen in Youth Community Service had been prescribed Risperidone. Of these, only 44% had had prolactin levels done, despite the guidance. This equates to the over half not having prolactin checked. 60% of patients reveiwed had symptoms of hyperprolactinemia. Indications for use included emotional dysregulation/EUPD, psychosis, ADHD, OCD/ASD and depression

Conclusions

Risperidone should be used with extreme caution in this patient group. Medication can be very useful for some young people experiencing distressing symptoms but, as Hippocrates advises, “do no harm” and seek not to cause iatrogenic harm.

Given that many of the young people seen by mental health services are experiencing emotional dysregulation (not necessarily an abnormal state in adolescent, when much is in flux), it is tempting to consider medication as one means of trying to alleviate distress. There is no clear treatment for dysregulated feelings, and most would accept that psychological support is more appropriate.

Disclosure of Interest

None Declared
Application of the identity disorder questionnaire AIDA+LoPF in adolescents with affective pathology and schizotypal disorder
Authors: Zvereva M. , Zvereva N.
Published: August 2024

Introduction

To assess the difference in the personality functioning of adolescents with schizotypal disorder and affective disorders, we used the AIDA + LoPF questionnaires, which are well established as questionnaires for identifying identity disorders in adolescents. We hypothesized that adolescents with affective pathology are much more likely to have identity disorders than adolescents with schizotypal personality disorder. Clinical assessment of diseases was carried out by psychiatrists using ICD-10

Objectives

Adolescents with affective disorders -10 (F31), schizotypal disorder adolescents – 11 (F21). Age 12-18

Methods

AIDA+LoPF questioners by authors K. Goth & K. Schmeck, Russian version by M. Zvereva & S. Voronova & N. Zvereva

Results

The table presents statistical analysis data using the Mann-Whitney non-parametric test
Table 1.

Significant scales of the AIDA questionnaire

SCALES AIDAU-CRITERIA
PTOTAL SCORE: IDENTITY INTEGRATION AIDA86,0000,02Consolidating emotional self-experience
84,0000,03COHERENCE86,5000,02CONSISTENCY IN SELF CONCEPTS88,5000,01AUTONOMY, EGO-STRENGTH
88,0000,02INTEGRATING COGNITIVE SELF-EXPERIENCE
88,0000,02Table 2.

Significant scales of the LoPF questionnaire

SCALES LOPFU-CRITERIA
PIdentity89,0000,01Coherence (Ego-strength)88,0000,02SELF-DIRECTION
89,0000,01SELF CONGRUENCE88,0000,02PURPOSEFULNESS86,0000,02

Conclusions

We have obtained preliminary results that show a difference between the identity disturbance of adolescents with affective pathology and those with schizotypal disorder. Adolescents with affective pathology are much more likely to have various types of identity disorders than adolescents with schizotypal disorder. To clarify this, a larger sample and a wider range of disorders are required

Disclosure of Interest

None Declared
Pineal gland cyst and ADHD in a juvenile patient: a case report
Authors: Kovačević A. , Rančić N. , Mastelić T. , Ćurković M. , Barišić I. , Lozina I. , Rogulj M. , Lasić D. , Glavina T.
Published: August 2024

Introduction

The role of the pineal gland in psychiatric disorders is poorly investigated. There are studies, primarily on adult patients, that indicate a higher presence of pineal gland abnormalities in patients suffering from depression, schizophrenia and attention-deficit/hyperactivity disorder (ADHD). When it comes to ADHD, there is speculation about the role of melatonin and the influence of the pineal gland on the dopaminergic system. Data on the association between pineal gland cysts and ADHD in juvenile patients are particularly scarce.

Objectives

Due to all of the above, our goal is to present the case of a nine-year-old male patient who has a confirmed cyst of the pineal gland and is being treated for ADHD.

Methods

The patient was examined by a neuropediatrician, EEG and brain MRI were performed. He was also examined by a psychologist and by a psychiatrist. Endocrinological, hematological, rheumatological, pulmonological treatment and karyotyping were performed.

Results

MRI of the brain revealed a cyst of the pineal gland with an anteroposterior diameter of 1 cm without significant compression. The EEG was mildly slowed and paroxysmally dysrhythmic for the age, ie. paroxysms of high-voltage delta waves were described. The EEG findings after sleep deprivation were paroxysmally altered with rare focal changes in the right temporoparietal region. Through psychological analysis, it was determined that specific deficits persist in the area of verbal understanding, perceptual organization and visual processing, information processing speed, numerical reasoning, attention and short-term memory. On the level of visuomotor perception and coordination, deviations are observed by organic type. He is motorically more active, impulsive, emotionally immature, easily distractible.

Conclusions

The etiology of ADHD is poorly researched, and so is the role of the pineal gland, its cyst and melatonin. There is scant knowledge for other psychiatric disorders, but primarily from researches on adult psychiatric patients. Additional researches are definitely needed on this topic, especially in the field of child and adolescent psychiatry.

Disclosure of Interest

None Declared
Paraphrenia – current psychopathological and diagnoses landmarks
Authors: Lukacs E. , Nirestean A. , Grebenisan L. M. , Sima Comaniciu A. , Strete E. G.
Published: August 2024

Introduction

Paraphrenia, classically known as a chronic delusional-hallucinatory psychosis, currently has an uncertain nosological status, not being included in DSM-5 either. It can be integrated into the group of schizophrenic and delusional psychoses, but with obvious distinctive attributes. Currently, in the context of the increase in the incidence of childhood autism, the psychopathological pictures from the spectrum of psychoses in adulthood are also diversifying. Paraphrenic clinical pictures retain their specificity regarding the subject’s functioning in life roles and the absence of cognitive impairment despite the absurdity of delusional ideas while maintaining a good insertion in reality.

Objectives

We refer to patients who can be classically classified in the diagnosis of paraphrenia, with the aim of bringing back into question the validity and authenticity of this nosological entity.

Methods

The case descriptions aim to highlight the common clinical-evolutionary attributes and the distinctive ones between paraphrenia and other schizophrenic and delusional psychoses, emphasizing the differentiations corresponding to the involvement of personality and the ability to function in life roles.

Results

It is confirmed that in the case of subjects who can be classified as paraphrenic, fundamental personality structures are preserved, a good adaptation in roles with insignificant cognitive deterioration phenomena, a well-preserved insight but with a high potential of unpredictability so characteristic of the world of psychoses.

Conclusions

We believe that paraphrenia remains a psychopathological and clinical entity within which, although opposites coexist, the reporting and adaptation to objective reality is preserved - thanks to “double accounting”. From this perspective, paraphrenia confirms its distinct nosological status.

Disclosure of Interest

None Declared
The impact of the severity of Obstructive Sleep Apnea syndrome on quality of life
Authors: Fki A. , Ben lazreg A. , Bouchech R. , Ben Cheick R. , Sakly G.
Published: August 2024

Introduction

The negative impact of obstructive sleep apnea syndrome (OSA) on the quality of life of affected individuals is one of the serious consequences of this pathology. Consideration of this quality of life as one of the therapeutic objectives is essential.

Objectives

to evaluate the impact of the severity of OSA on quality of life in affected patients

Methods

We conducted a cross-sectional study involving 40 patients diagnosed with OSA by polysomnography in the Sleep unit, department of Neurophysilogy at Sahloul university hospital in Sousse, Tunisia. This study was based on a generic questionnaire (SF-12) to assess the quality of life.

Results

The mean age was 49.7 ± 7.87 years with a sex ratio of 1.10. The mean apnea-hypopnea index (AHI) was 29.72. OSA was mild, moderate and severe in 40%, 22.5% and 37.5% of cases respectively. The majority of our patients had an impaired quality of life with an ave[1]rage score of 42.78. There was a positive linear relationship between physical and mental components of the SF-12 and AHI (p= 0.026 and p=0.019 respectively). Mental component of the SF-12 was significantly associated with treatment with CPAP (continuous positive airway pressure) (p=0.014).

Conclusions

Our study has shown that the severity of OSA has an impact on different domains of quality of life. The management of this disease should not be limited to controlling the disease but should aim for overall patient satisfaction.

Disclosure of Interest

None Declared
Reconceptualising depression along the endogeneus-reactive spectrum: are different genes involved in depression depending on presence vs absence of exposure to stress?
Authors: Gonda X.
Published: August 2024

Depression is a complex and highly heterogeneous disorder with an omnigenic and multifactorial background. This diversity is obvious not only in its symptomatic manifestation but also in its neurobiological underpinnings which is one potential factor contributing to the high observed rate of treatment resistance. Thus, subtyping depressions, understanding their distinct neurobiological and genetic background, and potentially developing biomarkers aiding their differential diagnosis may bring us one step closer to more effective treatment. The present talk will overview the different etiological factors contributing to the emergence of depression along an endogenous-reactive continuum, the contributory roles of different types of stress, different genes involved in distinct processes, and the potential consequences of conceptualising, diagnosing and treating depressions developing in the context or independently of current stress.

Disclosure of Interest

None Declared
Anxiety disorder and depressive disorders in teens
Authors: Belabbes I.
Published: August 2024

Introduction

Anxiety and mood disorders are frequent causes of consultation in child psychiatry. In pediatrics, they can be the cause of life-threatening or psychological complications, such as suicidal ideation, anxiety attacks, scarification or suicide attempts.

Objectives

Discuss the clinical and therapeutic features of anxiety-depressive syndromes.

Methods

We shed light on anxiety-depressive syndromes through the study of complex clinical cases encountered in child psychiatric hospitalization.

Results

We report a case series of 10 patients, the majority of whom were female. The age range was 12 to 17 years. Clinical features included emotional manifestations such as sadness, tantrums and anxiety, as well as cognitive symptoms such as memory and concentration problems, with dark or suicidal ideation, and occasional endangerment behaviors such as scarification or suicide attempts.

Treatments range from psychosocial interventions, including therapeutic mediation, psychotherapy and social support, to pharmacological treatment with antidepressants, hypnotics, neuroleptics and, rarely, mood regulators.

Conclusions

The frequency and severity of anxiety-depressive syndromes in the absence of adequate care underlines the importance of screening, early diagnosis and treatment of children with these disorders.

Disclosure of Interest

None Declared
“Unraveling the Diagnostic Dilemma: Unusual Presentation of Huntington’s Disease with Predominant Psychiatric Symptoms and Late-Onset Motor Manifestations”
Authors: Ibrahim M. I. M. M. N. , Iderapalli M.
Published: August 2024

Introduction

Huntington’s Disease is a neurodegenerative disease inherited in an autosomal dominant fashion.The underlying genetic defect is unstable CAG trinucleotide repeat expansion with a repeat length longer than 36 resulting in pathological aggregation of abnormal protein causing cell death.

The clinical symptoms encompass 3 main domains-motor,cognitive and psychiatric.The psychiatric symptoms often in atypical form appear decades before other symptoms causing significant impact on patient’s functioning and quality of life.

Here, we discuss an unusual presentation of Huntington’s Disease causing diagnostic dilemma.

Objectives

Case report discussing the unusual presentation of Huntington’s Disease.

Methods

Case: Mr X is a 61 year old Caucasian male.He had an uneventful birth and early childhood attaining milestones appropriately. He experienced childhood adversity in the form of sexual abuse between ages 2-14 years. His mental health difficulties started following sexual abuse when he attempted to end his life by hanging and overdosing at age 15. He got married twice, both of which broke down. There is a history of significant alcohol abuse between ages 40-50. Following this, he had a myocardial infarction and a stroke requiring stenting.

He presented to Psychiatric Outpatient Services in 2011 with auditory hallucinations, social anxiety with panic attacks, OCD type rituals, claustrophobia and feeling hot all the time. He was started on an antipsychotic medication for psychosis ,but clinically deteriorated. He started having anger outbursts, marching on the spot ,and head banging. He was diagnosed with Huntington’s Chorea in 2021 after he had developed chorea. He currently has low mood and is head banging for hours.

Results

Psychiatric symptoms in HD can span a variety of domains but most common are symptoms of frontal lobe dysfunction-disinhibition, poor attention, irritability, impulsivity and personality change. Apathy, emotional blandness and social withdrawal are also prominent features.

Mr X had strong family history of Paranoid Schizophrenia (aunt and cousin).There was no family history of HD. His mental health problems started early in life with DSH, Depression and Harmful use of Alcohol. He presented predominantly with psychotic symptoms like auditory hallucinations, social anxiety, paranoia. Motor symptoms started late which he incorporated into voluntary movements like head banging which made it difficult to differentiate from deliberate self harm.

Conclusions

Psychiatric symptoms constitute the core of HD. Studies have shown that though depression and personality change are typical of HD, there are number of other psychiatric symptoms that can impair quality of life. Early diagnosis and treatment of these symptoms will help patients and families to cope better with severe symptoms of this progressive disease.

Disclosure of Interest

None Declared
Fitness Fiesta!
Authors: Rivera-Rideau Petra R.
Published: August 2024

As a fitness brand, Zumba Fitness has cultivated a devoted fan base of fifteen million participants spread across 180 countries. In Fitness Fiesta! Petra R. Rivera-Rideau analyzes how Zumba uses Latin music and dance to create and sell a vision of Latinness that’s tropical, hypersexual, and party-loving. Rivera-Rideau focuses on the five tropes that the Zumba brand uses to create this Latinness: authenticity, fiesta, fun, dreams, and love. Closely examining videos, ads, memes, and press coverage as well as interviews she conducted with instructors, Rivera-Rideau traces how Zumba Fitness constructs its ideas of Latinx culture by carefully balancing a longing for apparent authenticity with a homogenization of a marketable “south of the border”-style vacation. She shows how Zumba Fitness claims to celebrate Latinx culture and diversity while it simultaneously traffics in the same racial and ethnic stereotypes that are used to justify racist and xenophobic policies targeting Latinx communities in the United States. In so doing, Rivera-Rideau demonstrates not only the complex relationship between Latinidad and neoliberal, postracial America but also what that relationship means for the limits and possibilities of multicultural citizenship today.
Control of fate specification within the dorsal head of Drosophila melanogaster
Authors: Teeters Gary , Weasner Bonnie M. , Ordway Alison J. , Weasner Brandon P. , Kumar Justin P.
Published: August 2024

During development, unique combinations of transcription factors and signaling pathways carve the nascent eye-antennal disc of the fruit fly Drosophila melanogaster into several territories that will eventually develop into the compound eye, ocelli, head epidermis, bristles, antenna and maxillary palpus of the adult head. Juxtaposed patterns of Hedgehog (Hh) and Decapentaplegic (Dpp) initiate compound eye development, while reciprocal domains of Dpp and Wingless (Wg) induce formation of the antennal and maxillary palp fields. Hh and Wg signaling, but not Dpp, contribute to the patterning of the dorsal head vertex. Here, we show that combinatorial reductions of the Pax6 transcription factor Twin of Eyeless and either the Wg pathway or the Mirror (Mirr) transcription factor trigger a transformation of the ocelli into a compound eye and the neighboring head epidermis into an antenna. These changes in fate are accompanied by the ectopic expression of Dpp, which might be expected to trigger these changes in fate. However, the transformation of the field cannot be replicated by increasing Dpp levels alone despite the recreation of adjacent Hh-Dpp and Wg-Dpp domains. As such, the emergence of these ectopic organs occurs through a unique regulatory path.
Reduced connexin-43 expression, slow conduction and repolarisation dispersion in a model of hypertrophic cardiomyopathy
Authors: Lim Seakcheng , Mangala Melissa M. , Holliday Mira , Cserne Szappanos Henrietta , Barratt-Ross Samantha , Li Serena , Thorpe Jordan , Liang Whitney , Ranpura Ginell N. , Vandenberg Jamie I. , Semsarian Christopher , Hill Adam P. , Hool Livia C.
Published: August 2024

Hypertrophic cardiomyopathy (HCM) is an inherited heart muscle disease that is characterised by left ventricular wall thickening, cardiomyocyte disarray and fibrosis, and is associated with arrhythmias, heart failure and sudden death. However, it is unclear to what extent the electrophysiological disturbances that lead to sudden death occur secondary to structural changes in the myocardium or as a result of HCM cardiomyocyte electrophysiology. In this study, we used an induced pluripotent stem cell model of the R403Q variant in myosin heavy chain 7 (MYH7) to study the electrophysiology of HCM cardiomyocytes in electrically coupled syncytia, revealing significant conduction slowing and increased spatial dispersion of repolarisation – both well-established substrates for arrhythmia. Analysis of rhythmonome protein expression in MYH7 R403Q cardiomyocytes showed reduced expression of connexin-43 (also known as GJA1), sodium channels and inward rectifier potassium channels – a three-way hit that reduces electrotonic coupling and slows cardiac conduction. Our data represent a previously unreported, biophysical basis for arrhythmia in HCM that is intrinsic to cardiomyocyte electrophysiology. Later in the progression of the disease, these proarrhythmic phenotypes may be accentuated by myocyte disarray and fibrosis to contribute to sudden death.
Violência sexual infantojuvenil no Brasil
Authors: Teixeira Martins Marcos Vinicius , De Araújo Pereira Gilberto
Published: August 2024

Objetivo: construir um panorama diagnóstico da violência sexual infantojuvenil assistida no sistema de saúde no Brasil. Métodos: estudo transversal, analítico, realizado com dados do Ministério da Saúde a respeito da violência sexual infantojuvenil no Brasil, no período de 2010 a 2021. Foram conduzidas análises de estatística descritiva e multivariadas, por meio das técnicas de Análise de Correspondências Múltiplas e de Clusterização Hierárquica. Resultados: observou-se grande importância associada à presença de vítimas do sexo feminino, solteiras, adolescentes, que têm práticas sexuais apenas com homens, em ambiente residencial, na ausência de ex-cônjuge, patrão, madrasta ou cuidador no momento da ocorrência. Notou-se também, importância associada aos casos de recorrências, à coocorrência de violência física e psicológica, bem como relacionada à participação de pais, namorados e conhecidos como violentadores. Além disso, identificou-se que as ocorrências em via pública parecem estar mais associadas a vítimas de baixa escolaridade. Conclusão: a violência sexual infantojuvenil no Brasil se estabelece, portanto, como um importante problema social, cultural, de segurança e saúde pública. Foi possível explorar os principais parâmetros associados às ocorrências no país, permitindo, assim, a possibilidade de sua aplicação em ferramentas e serviços de assistência.
Views and practices on medical cannabis of unlicensed providers in Thailand: a qualitative study
Authors: Assanangkornchai Sawitri , Saingam Darika , Thaikla Kanittha , Talek Muhammadfahmee
Published: August 2024

Background Despite the legalization of cannabis use for medical purposes in Thailand in February 2019, illicit providers are still widespread and accessible. This study aimed to understand why people still chose to receive medical cannabis treatment or products from unlicensed or illegal providers. The practices of unlicensed or illegal providers in provision of medical cannabis products or treatment services were also examined. Methods Qualitative in-depth interviews were conducted among medical cannabis providers and users, including 36 unlicensed and 7 licensed providers and 25 users in 2019-2021. Snowball sampling was used to recruit participants until saturation of data was achieved. Interviews included open-ended questions about the providers’ practices and attitudes towards medical cannabis. Interviews were recorded and transcribed, and thematic analysis was performed. Results Overall, six reasons were identified to answer why unlicensed/illicit providers were still popular, including: 1) easy accessibility; 2) familiarity with the unlicensed providers before the legal scheme became available; 3) favorable characters (kind, supportive, non-judgmental) of unlicensed providers; 4) affordable treatment fees; 5) trust in the quality of the medicines; and 6) lack of knowledge and negative attitudes towards cannabis from healthcare professionals. Most providers started their career as medical cannabis providers by using it themselves or with their relatives and being satisfied with the results. They used cannabis products to treat all diseases, including skin, eyes, HIV/AIDS, non-communicable diseases and all kinds of cancers. Additionally, they believed that it was effective, with no or minimal adverse effects. Conclusions This study suggests that some patients will continue receiving medical cannabis treatment and products from unlicensed or illegal providers. More attention should be paid on increasing the capacity of medical cannabis service systems within public health hospitals, and the certification of unlicensed providers, so as to integrate them into a regulated system.
Paying reviewers and regulating the number of papers may help fix the peer-review process
Authors: L. Seghier Mohamed
Published: August 2024

The exponential increase in the number of submissions, further accelerated by generative AI, and the decline in the availability of experts are burdening the peer review process. This has led to high unethical desk rejection rates, a growing appeal for the publication of unreviewed preprints, and a worrying proliferation of predatory journals. The idea of monetarily compensating peer reviewers has been around for many years; maybe, it is time to take it seriously as one way to save the peer review process. Here, I argue that paying reviewers, when done in a fair and transparent way, is a viable solution. Like the case of professional language editors, part-time or full-time professional reviewers, managed by universities or for-profit companies, can be an integral part of modern peer review. Being a professional reviewer could be financially attractive to retired senior researchers and to researchers who enjoy evaluating papers but are not motivated to do so for free. Moreover, not all produced research needs to go through peer review, and thus persuading researchers to limit submissions to their most novel and useful research could also help bring submission volumes to manageable levels. Overall, this paper reckons that the problem is not the peer review process per se but rather its function within an academic ecosystem dominated by an unhealthy culture of ‘publish or perish’. Instead of reforming the peer review process, academia has to look for better science dissemination schemes that promote collaboration over competition, engagement over judgement, and research quality and sustainability over quantity.
Case Report: Managing Odontoma and Molar-Incisor-Hypomineralization Challenges in Orthodontics
Authors: Alhazmi Nora , Albawardi Khalid , Aleraij May , A. Alqahtani Maram , O. Alsharif Faisal , Shujaat Sohaib
Published: August 2024

This report presents the successful orthodontic management of a case of odontoma associated with impaction of the mandibular right permanent canine and Molar-incisor-hypomineralization (MIH). Although case studies have reported the management of odontomas and MIH as separate entities, there is a lack of evidence regarding the comprehensive management of patients presenting with a combination of odontoma, dental impaction, and MIH. A 15-year, 7-month-old female patient complained of the appearance of her smile and the delayed eruption of her mandibular right permanent canine. She was diagnosed with Angle’s Class I molar relationship and Class II canine relationship with the maxillary permanent right lateral incisor in a lingual crossbite. Furthermore, she had mandibular right permanent canine impaction, retained mandibular right primary canine, and MIH in the permanent anterior teeth and first molars. The management involved the removal of the odontoma to allow for orthodontic traction of the lower permanent right canine. After that, the esthetic appearance of the teeth was improved through restorative treatment.
Murciélagos y viento, vínculo con tiento
Authors: González-Gallina Alberto , Villegas-Patraca Rafael , Cabrera-Cruz Sergio A.
Published: August 2024

Los murciélagos son los únicos mamíferos voladores, esta característica los hace vulnerables ante los parques de energía eólica en el mundo y, en ocasiones, provoca la muerte de muchos individuos en cada una de ellas.
Integrating cardiac palliative care into clinical practice—part one: the gap between evidence and practice
Authors: Millerick Yvonne , Welstand Jenny
Published: August 2024

Healthcare providers in England have a legal responsibility to provide equitable palliative care services that meet the needs of the populations they serve, yet integrated palliative and heart failure care remains largely absent from routine clinical practice. This is the first in a series of three articles on cardiac palliative care. The authors explore the gap between evidence and practice, describing the barriers to the integration of palliative and heart failure care in routine clinical practice. These barriers include uncertainty, unpredictability, a poor understanding of what palliative care is and what it has to offer, time constraints and poor communication. This article argues that these factors prevent the realisation of the ethos of right care, right place, right time.