bluuebunny/crossref_metadata_2025 huggingface dataset:
Corticosteroid induced mania with psychotic symptoms
Authors: Tavares F. Gomes , De Carvalho M. Viseu , Pinto M. , Solana C. , Batista S.
Published: February 2022

Introduction

Corticosteroids may induce psychiatric symptoms (agitation, fear, hypomania, insomnia, irritability, labile mood, pressured speech and restlessness) with incidence rates ranging from 1,8% to 57%. We present a case of corticosteroid-induced mania and psychosis.

Objectives

Non-systematic review on corticosteroid therapy induced psychiatric symptoms. Analysis and comparison of a patient’s case with the existing literature.

Methods

Case report and a non-systematic review through databases as Pubmed, UpToDate, Medscape, between 2000 and 2020.

Results

We present a female 70 year-old patient without psychiatric background, diagnosed with Rhizomelic Pseudopolyarthritis, who started treatment with prednisone 20 mg. During the third month of treatment the patient started progressively worse behavior changes (such as destruction of the neighbor’s property), developed persecutory delusions, decreased sleep and increased energy. The patient was committed to our psychiatric ward and started on diazepam 10 mg and olanzapine 15 mg per day. Despite introduction of antipsychotics, which has evidence for mood stabilization, the patient maintained the symptoms, so it was necessary to gradually reduce corticosteroids until symptomatic control.

Conclusions

Psychosis (24%), hypomania and mania (35%), are the most common psychiatric reactions to corticosteroid therapy. Several studies show that even a low dosage may induce psychiatric disturbances, most frequently during the first two weeks of treatment. However, as reported in this case, symptoms may occur at any time. Thus, a multidisciplinary team, as well as training of professionals from different specialties, such as psychiatry, rheumatology and endocrinology, are needed, since these syndromes may be confused with pure psychiatric conditions and consequently delay treatment and compromise prognosis.

Disclosure

No significant relationships.
Social media and its effect on mental health: Friend or foe?
Authors: Trivedi C. , Mansuri Z. , Vadukapuram R. , Reddy A.
Published: February 2022

Introduction

Recently, several studies have shown both positive and negative impacts of social media on mental health. However, little is known regarding the reasons for the negative impact of social media on mental health.

Objectives

To evaluate the role of social media on mental health.

Methods

We reviewed the documentary ‘The Social Dilemma’ released on Netflix in September 2020, which explored the role of social media in our life. The documentary discussed the behind the scene development of the social media world.

Results

The central message from the documentary is that all the social media applications we use are capable of hijacking the thought process of your brain and are consciously designed by the artificial intelligence technology in a way that one spends more time on them. It collects users’ data such as topics they like, follow, search, subscribe, shop, and several others. Based on this data it feeds you the information according to your taste and next time you log in on the website, you spend more time on it. This causes positive reinforcement, the more time you spend on a particular topic, the more you will be presented which results in addictive behavior.

Conclusions

It is known that social media addiction is prevalent, and it affects brain like drug and alcohol addiction. This documentary provided technological insight into this type of behavior. Though social media has its pros, it has numerous cons despite being used for right intentions. Better regulatory measures are needed to prevent psychological disorders related to social media usage.

Disclosure

No significant relationships.
Changing the system of psychiatric care in bulgaria. Recover-E project in bulgaria
Authors: Nakov V.
Published: February 2022

Introduction

Bulgaria has undergone a number of very significant political and social changes over the past 150 years that has also impacted on the delivery of mental health care. There has been a 40% reduction in the number of inpatient psychiatric beds in Bulgaria within the past 20 years leading to the current state of approximately European average bed numbers per 100 000 population. This does not appear to have been accompanied by an increased investment in ambulatory / outpatient mental health services.

Objectives

Description of the advantages and disadvantages of mental health services in Bulgaria, available staff and distribution in the country. The project RECOVER-E and its activities in Bulgaria are described.

Methods

Sources of health statistics of Bulgaria are used and analyzed. Maps and tables were used for visualization.

Results

Taking into account the situation described in this way and the EPA guidelines for change in the system, a mental health strategy has been proposed.

Conclusions

It has a long and significant legacy of underfunding of mental health services, which has undoubtedly caused significant economic damage to Bulgaria through surmountable results increasing health and social care costs, and surmountable loss of economic productivity. A significant increase in the budget allocated to mental health and related social care services.

Disclosure

No significant relationships.
UEPG Abraça Program: The importance of a psychosocial care service in the university context
Authors: Floriano L. , Brabicoski C. , Pinto E. , Monteiro L.
Published: February 2022

Introduction

In 2018, it was implanted in a Brazilian public university, the UEPG Abraça Extension Program, which has as objectives to realize psychosocial care and accompaniment, offer psychotherapies and therapeutic groups to the university community, that is, students, professors and university staff to suicide prevention, coping with mental disorders and the problematic use of alcohol and other drugs. The Program has a multi-professional team composed of nurses, social worker, psychologists and psychiatrists, in an exclusive environment, thus guaranteeing comfort and secrecy to users.

Objectives

To characterize the socio-demographic and clinical profile of users assisted by the UEPG Abraça Program and to disclose the importance of the service for the promotion of Mental Health.

Methods

Qualitative, quantitative, descriptive study, with a structured questionnaire as the research instrument. The collection took place in 2019 and the target audience were users who sought psychological care.

Results

There were 469 admissions/visits and 35 of them continued with individual visits in 2020. The majority of users were female (58%) and had the age group between 17 and 20 years. The main mental health problems identified were anxiety, self-knowledge and university-related problems such as interpersonal conflicts and difficulties in the work process. The most attended undergraduate courses were Letters, Journalism and Dentistry.

Conclusions

It is noted the importance of a psychosocial care service at university level for the care and promotion of Mental Health.

Disclosure

No significant relationships.
The enhancement of emotional skills as a resource to reduce hopelessness
Authors: Delhom I. , Melendez J.C. , Satorres E.
Published: February 2022

Introduction

Emotional Intelligence (EI) involves a set of emotional skills (attention, clarity, and emotional regulation) for the effective use of emotional information (Mayer & Salovey, 1997). The lack of emotional skills has been associated with multiple disruptive emotional phenomena, such as hopelessness. It has been observed that EI can be a predictor of hopelessness in older adults, in such a way that we can consider that the development of EI could be a relevant resource for promoting mental health in older adults.

Objectives

Implement an EI intervention to reduce levels of hopelessness.

Methods

The sample consisted of 123 healthy older adults from Valencia (Spain), randomly distributed into two groups: treatment group (N = 57) and control group (N = 68), aged between 60 and 84 years, with a mean age of 67.62 years (SD = 6.43). Of these, 54.4% were women and the remaining 45.6% were men. The Trait Meta-Mood Sclae 24 (TMMS 24) was applied to assess EI and the Beck Hopelessness Scale (BHS) to assess hopelessness.

Results

Significant differences are observed in the treatment group after the intervention (F1, 123 = 19.86; p < 0.001, h2 = 0.142), with a decrease in scores (T1= 4.72; T2=2.88). For the control group, the effects were not significant (F1, 123 = 1.06; p = 0.305, h2 = 0,009).

Conclusions

The efficacy of the intervention in EI to manage emotional states is evidenced, reducing levels of hopelessness thanks to training in adaptive emotional processing and emotional management skills.

Disclosure

No significant relationships.
Risk of severe postpartum episodes
Authors: Wieck A.
Published: February 2022

Abstract Body

The risk of mothers to develop a severe mental illness is dramatically increased in the first three months after giving birth. Childbirth has the strongest relationship with postpartum affective psychosis, a condition that is characterized by an acute onset of florid symptoms, usually within 2 weeks of delivery, and atypical features, such as rapidly fluctuating psychotic symptoms, florid motor symptoms, perplexity and high risks to the mother and her baby. Follow up data of women with a first episode suggest that some women only become ill in the context of childbirth whereas in others it is an expression of a lifelong bipolar disorder. Whether this reflects two distinct forms of the disorder or different degrees of vulnerability requires future study. The profound hormonal and metabolic as well as psychosocial changes in the perinatal period give rise to a number of hypotheses that seek to explain the pathogenesis of postpartum psychosis. Current research findings on biological and psychosocial risk factors will be discussed as well as what is currently known about responses to treatment.

Disclosure

No significant relationships.
Autoantibody profiles are associated with specific clinical features in psychotic disorders
Authors: Schubert K.O. , Falk A. Jernbom , Galletly C. , Just D. , Toben C. , Baune B. , Clark S. , Liu D. , Nilsson P. , Manberg A.
Published: February 2022

Introduction

Immune system abnormalities exist across a range of psychiatric disorders. Autoimmunity, characterized by the production of antibodies against the body’s own antigens, is a feature of immune system dysfunction and could play a role in mental disorder pathophysiology. Better understanding of the associations of auto-immunoglobulin G (IgG) repertoires with clinical features of mental illness could yield novel models of psychosis pathophysiology and markers for biological patient stratification.

Objectives

To undertake global screening for auto-IgG expression in a large cohort of people with psychotic disorders; to determine whether associations exist between autoantibody expression and clinical features.

Methods

Cross-sectional quantification of auto-IgGs in blood plasma of 461 people with established psychotic disorder diagnoses. For global screening, pooled samples of phenotypically representative patient groups were exposed to planar protein microarrays containing 42,000 human antigens. For targeted profiling, expression levels of 380 autoantibodies were quantified by suspension bead array (SBA) in each patient’s plasma.

Results

We identified highly individual autoantibody profiles with no evidence for co-expression patterns. We found 6 autoantibodies robustly associated with specific psychopathology: anti-AP3B2, detected in 5% of the cohort of whom 100% had persecutory delusions; anti-TDO2 (5% of the cohort, 100% hallucinations); anti-CRYGN (4%, 86% initial insomnia); anti-APMAP (3%, 86% poor appetite); anti-OLFM1 (2.5%, 100% above median cognitive function); and anti-WHAMMP3 (2%, 90% anhedonia and dysphoria). Examination of the auto-IgG binding site on the TDO2 protein revealed a putative pathophysiological mechanism involving the kynurenine pathway.

Conclusions

We identified 6 frequently occurring autoantibodies that were associated with specific clinical features in people with psychotic disorders.

Disclosure

No significant relationships.
Pronoia or reverse paranoid delusion: A brief exploration into a conspiracy in your favour
Authors: Jesus S. , Costa A. , Garrido P. , Alcafache J.
Published: February 2022

Introduction

Pronoia is a neologism originally coined in 1982 to describe a state of mind that is, in essence, the positive counterpart of paranoia. It is characterized by feeling that the world is conspiring on behalf of the person experiencing pronoia.

Objectives

Brief literature review.

Methods

The authors review the available literature on pronoia and present a broad overview of its description and defining characteristics. An initial search utilizing key health journal databases revealed a scarcity in available documents, therefore a generalized search utilizing the search engine Google Scholar was performed with the term “pronoia”. Relevant articles obtained from the respective bibliographic references were also consulted.

Results

The primary outcome of this work is a summary of the available literature in order to build a more comprehensive understanding on pronoia. All relevant information was collated to form a cohesive description of the condition and its characteristics. We address a gap in the literature by offering a description of the lesser prevalent concept of pronoia.

Conclusions

Our results demonstrate a scarcity in the available literature describing the pronoia phenomenon when compared to its well-documented counterpart, paranoia. Further exploration into this topic is merited so as to close the gap on paranoia’s lesser-known positive counterpart. By signalling the existence of this concept, we strive to contribute to an increased identification of a concept that is many times underdiagnosed due to a lack of attention to its existence.

Disclosure

No significant relationships.
Psychiatric symptoms of wife of military personel who died in combat: The role of meaning in life and attachment styles
Authors: Korkmaz H. , Güloğlu B.
Published: February 2022

Introduction

Traumatic experiences has a key role on the mental health of individuals. Turkish Armed Forces has been involved in various combat in and out of the country over the years. Individuals who are able to find meaning after a negative life events are better overcome their issues and return to their positive functioning. Unhealthy attachment styles has been observed more in clinical samples than healthy attachment styles.

Objectives

The aim of this study was to investigate the predictive role of attachment styles and meaning in life on psychiatric symptoms among wife of military personel who lost their lifes.

Methods

74 women who lost their husband in combat to the study. Their age was between 21 and 74, with the mean of 46.93. 60 (75.9%) participants had a child when they lost their husband. 63 (79.7%) of them hasn’t been married again. Brief Symptom Inventory, Meaning in Life Scale and Relationship Scales Questtionnare were used to collect the data. Five different regression analysis was conducted.

Results

Finding meaning in life, dismissing and preoccupied attachment sytles predicted depression (R2= 51.8%). Finding meaning in life and fearful attachment styles predicted anxiety (R2= 46.2%). Finding meaning in life and fearful attachment styles predicted negative identity (R2= 51.1%). Finding meaning in life and dismissing attachment styles predicted hostility (R2= 50.4%) and somatization (R2= 57%).

Conclusions

Meaning in life has a protective role in the development of any psychopathologies whereas insecure attachment styles are risk factor.

Disclosure

No significant relationships.
Inpatient forensic psychiatric care: Legal provision in European countries
Authors: Völlm B.
Published: February 2022

Abstract Body

Forensic psychiatry is a specialty of psychiatry primarily concerned with individuals who have either offended or present a risk of doing so, and who also suffer from a psychiatric condition. These mentally disordered offenders(MDOs) are often cared for in secure psychiatric environments or prisons. However, the organisation of these services differs greatly between countries due to different traditions and legal frameworks. Some countries, e. g., require absent or reduced criminal responsibility (at the time of the index offence) in order to enter forensic services while others determine access on the basis of current need for treatment. Numbers detained in forensic services also vary significantly as does length of stay, raising significant economic and ethical challenges. This talk will present different legal concepts determining admission to forensic-psychiatric services, data on length of stay as well as approaches to risk assessment and treatment in Europe.

Disclosure

No significant relationships.
Galactorrhea as a side effect of antidepressant drugs. A case report
Authors: Aguado A.I. Willems , Garcia L. , Rodriguez C.
Published: February 2022

Introduction

Galactorrhea wiht antidepressants SSRIs or SNRI is a rarely adverse effect. Some authors believe that the risk of galactorrhea in women who use SSRIs is 8 times higher than in patients treated with other types of drugs. Serotonin is believed to be a potent physiological stimulator of prolactin release.Prolactin stimulates the growth of the mammary glands and the galactorrhea. The SSRIs would activate the serotonergic pathways, these in turn would stimulate the release of prolactin directly in the pituitary and in the hypothalamus, inhibiting the release of dopamine and increasing the release of stimulating factors. The main inhibitor of prolactin secretion is dopamine.

Objectives

The objective is to reveal this rare complication through the report of a clinical case

Methods

A 45-year-old woman with a diagnosis of mixed anxiety-depressive disorder. Treatment with 20 mg of escitalopram was started, with a good therapeutic response, but with breast pain and swelling. She was switched to duloxetine 60 mg, with a good response and adequate tolerance. At 6 months of treatment, she begins to present breast pain and yellow-green breast discharge, with elevated prolactin levels and normal cranial MRI.

Results

She was diagnosed with functional hyperprolactinemia, and treatment with vortioxetine was started. Finally, the Prolactin levels normalize.

Conclusions

Galactorrhea is a very rare and annoying side effect that can lead to discontinuation of treatment and requires a change in the therapeutic strategy.

Disclosure

No significant relationships.
Research progress of metabonomics of blood endogenous small molecules in depression
Authors: Zhang Y. , Ding J. , Cui X.
Published: February 2022

Introduction

Depression (MDD) is a serious mental illness, which greatly affects the quality of life of patients. Nowadays, the clinical diagnosis of MDD lacks sufficient objective basis, and the effect of drug treatment is unsatisfactory. Therefore, biomarkers are very important for the risk prediction, classification, diagnosis and prognosis of MDD.

Objectives

Research progress of metabonomics of blood endogenous small molecules in depression

Methods

Metabonomics is a newly developed discipline after genomics and proteomics, and is an important part of system biology. Metabonomics provides a new approach to explore the etiology, mechanism, prognosis and screening potential biomarkers of MDD. Blood contains almost all the small molecule metabolites in the body. The changes of metabolites in blood can represent the changes of metabolites in other body fluids. Moreover, this sample is easy to obtain and has less trauma, so it is the most common biological sample in clinical detection.

Results

At present, there are many studies on the metabonomics of endogenous small molecules in MDD blood, which provides the possibility for further screening of MDD related biomarkers.

Conclusions

In this paper, the research progress of related biomarkers in MDD blood is reviewed.

Disclosure

No significant relationships.
A report of use of baclofen in intractable hiccups
Authors: Dhakad R. , Niranjan V. , Rastogi P. , Pal V.
Published: February 2022

Introduction

Hiccups are an involuntarily powerful spasm of the diaphragm, followed by a sudden inspiration with a closure of the glottis. Hiccups lasting longer than one month is termed intractable hiccups. Intractable hiccups can be caused by structural or functional disturbances of the medulla, afferent or efferent nerves to the respiratory muscles or metabolic and endocrine disorders, drugs, general anaesthesia and emotional problems.

Objectives

Authors present a case report about curing a patient of intractable hiccups using baclofen along with literature review.

Methods

A case report along with literature review forms the basis of discussion.

Results

A 30-year female diagnosed with schizophrenia stable on 2mg risperidone for 3 years presented to the outpatient department with complain of intractable hiccups for 6 months. Frequency of hiccups was around 10-12 times per minute and continued throughout the day leading to significant socio-occupational distress. patient had been receiving medical treatment for last 4 months for the same including Metoclopramide, chlorpromazine along with trying breath holding and drinking cold water but symptoms persisted. Her ECG, chest X-ray, complete blood counts were unremarkable, CT scan of brain was normal. Patient was started on baclofen 10mg thrice daily. Within 1-week patient had dramatic response and complete remission was achieved in 2 weeks.

Conclusions

Beclofen is effective in hiccups because it is an analogue of GABA, that decreases excitability and inhibits the hiccup reflex, which reduces synaptic transmission. Baclofen is used to treat hiccups, and can be used either as a first-line treatment or if patient does not respond to other medications.

Disclosure

No significant relationships.
Use of compulsory treatment by early career psychiatrists: Findings from an international survey
Authors: Chumakov E.
Published: February 2022

Abstract Body

Introduction

Early Career Psychiatrists (ECPs) are routinely at the front line of clinical practice worldwide, including the use of compulsory measures in psychiatry. However, ECPs practice in this aspect is understudied.

Objectives

The aims of the study were (i) to clarify whether ECPs experience any difficulties in the process of compulsory psychiatric care; and (ii) to find out how ECPs consider compulsory measures in psychiatry.

Methods

An online anonymous survey of ECPs around the world was conducted in July-August 2019. The final sample had 142 psychiatrists (53% female; mean age 32.3±3.1) from 43 countries. Results. 96% of the Early Career Psychiatrists who responded to this survey agree with the continued use of the current legal framework for compulsory psychiatric treatment in their country, either with or without amendments. More than half of the respondents (57%) reported difficulties in providing compulsory psychiatric care due to either challenging interactions with the courts, documentation issues or moral concerns. Over half of the participants (53%) were keen to reform the legal procedures for compulsory psychiatric care in their countries.

Conclusions

The study has shown that there is an agreement among ECPs around the world that legal compulsory psychiatric care procedures are relevant and useful in clinical practice under certain circumstances. As stakeholders, ECPs could be encouraged and involved in adding their own experience and opinions to the debate on the employment of coercion in psychiatry as an ethical and legal issue.

Disclosure

No significant relationships.
Lithium in severe affective disorders: Balancing safety with efficacy
Authors: Leite R. Almeida , Almeida M. , Borges J. , Costa A.
Published: February 2022

Introduction

Lithium has been one of the oldest substances used in psychiatric treatments and remains the first-line treatment for prevention of manic and depressive episodes of bipolar disorder (BD), but it has also a wide spectrum of side-effects.

Objectives

The goal is to review efficacy, and clinical use of lithium, such as its side effects, and its benefit-to-risk ratio.

Methods

Non-systematic literature review based on scientific databases such as PubMed.

Results

The first modern use of lithium was for the treatment of mania. Lithium has also proven useful in major depression, particularly for augmentation of antidepressants, for aggressive behavior and it has a specific antisuicide effect. Lithium’s prophylactic and antisuicidal effects are most unique. However, the use of lithium became problematic due to the serious toxicity since lithium also a narrow therapeutic index, with therapeutic levels between 0.6 and 1.5 mEq/L.

Conclusions

Awareness of the benefits and risks of lithium is essential for the use of this lifesaving agent. Lithium levels must be carefully monitored and lithium dosage adjusted as necessary.

Disclosure

No significant relationships.
Therapeutic use of psychedelic drugs in depression disorders
Authors: Trigo M.
Published: February 2022

Introduction

Depression is one of the most prevalent mental illnesses, leading to important personal distress and economic consequences. Treatment is long, often involving psychotherapy and pharmacological treatment, and relapses are frequent. Used mostly for treatment of mood disorders and alcohol dependence, drugs such as lysergic acid diethylamide (LSD) were studied in the 1950’s and showed therapeutic promise in attenuating depressive symptoms. However, in the 1960s all major psychedelic research programs were ended. Recently, there is a renewed research interest in these drugs, considering its antidepressant potential.

Objectives

To review current knowledge on the therapeutic uses of psychedelic drugs such as LSD in depression disorders.

Methods

Review of the most recent literature regarding the therapeutical potential of psychedelic drugs such as LSD in depression disorders. The research was carried out through the UptoDate, PubMed, MedLine, ScienceDirect and SpringerLink databases, using the terms “LSD”, “psychedelic drugs” and “depression disorders”, until December 2020.

Results

As in past scientific studies, data of recent clinical research shows that the use of LSD relieves distress concerning death, particularly in terminally ill oncologic patients, and addictions including alcoholism and nicotine. There is more limited data concerning the use of classic hallucinogens to treat depression and anxiety disorders.

Conclusions

Although research has shown many of the neurobiological and psychological effects of classic hallucinogens on humans, the studies that have been completed to date are not sufficient to establish clinically relevant effects. Despite further research is needed, the outcomes are encouraging, and larger, well-designed, placebo-controlled trials are now underway or being planned.

Disclosure

No significant relationships.
Extrapyramidal symptoms as a consequence of organophosphate poisoning: Insights from a clinical case
Authors: Correia J. Martins , Ramos S. Freitas , Vaz Soares M.I. Fonseca Marinho , Jesus B. , E Sousa D. Cruz , Caetano S.
Published: February 2022

Introduction

The development of an extrapyramidal syndrome (EPS) is assumed to be a potential and important consequence of organophosphate poisoning (OP). Even though its causal relationship is firmly established, the information available in the literature regarding the orientation to be given is scarce, and its approach remains shrouded in a significant degree of uncertainty. Catatonia, as a neuropsychiatric condition, may present a marked overlap with the set of extrapyramidal symptoms developed after OP. Does the overlap between the symptoms seen in catatonia and in EPS make differential diagnosis fundamental or does it have no relevance in relation to the approach to be established?

Objectives

To discuss the therapeutic approach to be implemented in the extrapyramidal symptoms resulting from OP and reflect on the overlap between catatonia and EPS.

Methods

Presentation of a clinical case and review of the literature.

Results

A 50-year-old woman with major depressive disorder developed a condition marked by exuberant extrapyramidal symptoms 3 weeks after OP. Significant stiffness, tremor, dysphagia and facial hypomimia were some of the symptoms observed. Therapy was started with amantadine 100mg daily, with complete resolution of the symptoms after 5 days. Follow-up revealed reversal of extrapyramidal symptoms, in the absence of any neuroimaging changes or any other neuropsychiatric manifestations.

Conclusions

The possible overlap between catatonia and EPS is remarkable. The two conditions, regardless of their differentiation, may benefit from an identical approach using dopaminergic drugs. The use of amantadine, even in low doses, may be an option in the rapid reversal of extrapyramidal symptoms resulting from OP.

Disclosure

No significant relationships.
Electroconvulsive therapy as life-saving in an acute catatonic syndrome associated with bipolar disorder: A case report
Authors: Leite R. Almeida , Costa A. , Borges J. , Alcafache J. , Mesquita A.
Published: February 2022

Introduction

Catatonia is a neuropsychiatric syndrome characterized by an onset of a dysfunction in psychomotor activity and/or muscle tone, which may be associated with changes in consciousness, affect, and thinking. It is characterized by negativism, wax flexibility, catalepsy, mutism echolalia, ecopraxia, or stupor. It was first described in 1874 by Kahlbaum, who characterized it as specific motor disorder associated with different psychiatric disorders. Kraepelin and Bleuler restricted catatonia to a specific subtype of schizophrenia. However, the association between catatonia and other disorders, notably mood disorders, has been reinstated, including Bipolar Disorder. Its etiology is multiple and there are two severe forms: Neuroleptic Malignant Syndrome (NMS) and Malignant Catatonia (MC). These are syndromes that present high mortality, and the health professional should be aware of its etiology, signs, symptoms, evaluation and treatment.

Objectives

The aim of this work is to present a clinical case of MC, who was sustained by literature included on scientific platforms.

Methods

Case report

Results

It is essential to recognize the different clinical presentations of catatonia, taking into account that these are psychiatric alterations in which urgent intervention is justified. In the presented case, the use of antipsychotic medication has worsened the motor function and its suspension, associated with the introduction of lorazepam, resulted in a slight improvement. The electroconvulsive therapy was the last resort, fully succeeded.

Conclusions

The relationship between SMN and Catatonia/MC remains nuclear from a psychopathological and pathophysiological point of view. Nevertheless, there is general agreement that catatonia represents a very significant risk factor for NMS.

Disclosure

No significant relationships.
Dynamics of clinical and psychological indicators of patients with anxiety neurotic disorders in the treatment of short-term individual analytic-cathartic therapy
Authors: Ilchenko E. , Karavaeva T. , Abritalin E.
Published: February 2022

Introduction

Analytical-cathartic therapy (ACTA), a modern model of psychotherapy, the theoretical basis of which is the psychology of relations of V.N. Myasishchev. ACTA is intended for the treatment of emotional disorders; the study of the dynamics of clinical and pathopsychological characteristics has not been previously conducted.

Objectives

To assess the dynamics of the clinical and pathological characteristics of patients with neurotic disorders, in whose clinical picture anxiety syndrome predominated, in the process of an individual ACTA.

Methods

A specially designed semi-structured interview, HARS, and the CGI (CGI-S - disease severity, CGI-I - improvement dynamics). The study group (N = 90) included patients with neurotic disorders, whose clinical picture was dominated by anxiety syndrome

AKTA course 12 sessions 3 times a week for 60 minutes. Psychopharmacotherapy during the period of psychotherapeutic treatment in patients was not carried out.

Results

The study of ACTA was carried out before, after treatment and in the follow-up.

The overall decrease in the HARS score was 73.8% - the high success of the therapy in relation to the reduction of anxiety.

On the CGI-I scale - improvement from minimal to significant. On the CGI-S scale, no more than mild disease severity (p <0.01). The change in the CGI scale also indicates the success of the therapy.

Conclusions

As a result of the study, clinical indicators were determined, on the basis of changes in which in dynamics the success of the treatment can be assessed. ACTA allows to clearly reduce anxiety and improve the general condition of patients with neurotic disorders.

Disclosure

No significant relationships.
Social isolation and physical distance: Experiences from a phone pal
Authors: Pinto Da Costa M.
Published: February 2022

Abstract Body

People with psychosis are commonly socially isolated, both due to their condition, and the stigma towards them. Remote volunteering over smart-phone can be a way to overcome social isolation and physical distance, promoting social inclusion. This talk will present the qualitative findings from a feasibility study – the Phone Pal – which connected in the United Kingdom patients with psychosis with community volunteers, to communicate with each other for up to 12 weeks via smart-phone (through texts, WhatsApp messages, e-mails, audio or video calls). Participants described at the end of the study their experiences of communicating with their match over the smart-phone in terms of frequency, duration and timing of communication, their communication method, content and style, and the changes of communication over time. Several participants reported a positive impact of being connected with someone, meeting a new person, feeling supported and feeling better, and a few described challenges, such as disappointment, guilt and burden. These interview findings show that some matches were able to develop a positive and friendly relationship, and were willing to continue to be in contact with each other beyond the study duration. It is hoped that this talk will generate a lively discussion, gathering further understanding about the potential benefits and challenges of remote volunteering over smart-phone for patients and volunteers, and its potential usefulness in the current pandemic times.

Disclosure

No significant relationships.
Attentional functioning after two online mindfulness-based group interventions: Acceptance and commitment therapy and a mindfulness-based emotional regulation intervention in anxiety disorders. Preliminary results
Authors: Navarro-Oliver G. , Fernández-Jiménez E. , Torrea-Araiz I. , Castellanos-Villaverde T. , Vidal-Bermejo E. , Hospital-Moreno A.
Published: February 2022

Introduction

The relationship between attentional functioning and mindfulness is an intensive field of study, mainly in face-to-face interventions. However, no neuropsychological study addressed the effect of online mindfulness-based interventions on this cognitive function.

Objectives

To assess changes on attentional functioning after two online mindfulness-based group interventions in adult patients with anxiety disorders.

Methods

This study was carried out in a Mental Health Unit in Spain (Colmenar Viejo, Madrid). Thirteen adult patients (age mean = 51.69 years, ranging from 33 to 69 years, S.D. = 11.56) with anxiety disorders completed the interventions. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. Both interventions were carried out online. The dependent variables were the scores on the TMT-A (seconds), Digit span forward and Longest digit span forward (WAIS-IV). A comparison of paired-means was conducted. Statistical significance was set at p < .05.

Results

The normality assumption was met except for Longest digit span forward. The paired t-test showed statistically significant change between pre-treatment and post-treatment on TMT-A [t(12)= 3.81; p = 0.002; Cohen’s d = 1.056; statistical power observed = 94.0%], but not on Digit span forward (p = .45). Wilcoxon signed ranks test showed no statistically significant change on Longest digit span forward (p = .56).

Conclusions

These results show a large improvement on visual attention and speed of visuomotor tracking, but not on auditive attention, after both online mindfulness-based group interventions.

Disclosure

No significant relationships.
TMT-B after two online mindfulness-based group interventions: Acceptance and commitment therapy and a mindfulness-based emotional regulation intervention in anxiety disorders. Preliminary results
Authors: Torrea-Araiz I. , Fernández-Jiménez E. , Navarro-Oliver G. , Vidal-Bermejo E. , Castellanos-Villaverde T. , Hospital-Moreno A.
Published: February 2022

Introduction

There are no studies which address the relationship between mindfulness and cognitive flexibility in interventions carried out online. This is the first study to examine the effect of two online mindfulness-based interventions on this cognitive function.

Objectives

To assess changes on cognitive flexibility after two online mindfulness-based group interventions in adult patients with anxiety disorders.

Methods

This study was carried out in a Mental Health Unit in Spain (Colmenar Viejo, Madrid). Thirteen adult patients (age mean = 51.69 years, ranging from 33 to 69 years, S.D. = 11.56) with anxiety disorders completed the interventions. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. Both interventions were carried out online. The dependent variable was the score on the TMT-B (seconds). A comparison of paired-means was conducted. Statistical significance was set at p < .05.

Results

The normality assumption was met. Statistical power observed = 70.0%. The paired t-test showed statistically significant change between pre-treatment and post-treatment (p = 0.019; Cohen’s d = 0.75), indicating improvement on cognitive flexibility.

Conclusions

These results show a statistically significant and medium/large effect-size change in cognitive flexibility after the two online interventions based on mindfulness. A larger sample size is required to confirm these results. Moreover, other studies need to examine the reliable change on this neuropsychological outcome.

Disclosure

No significant relationships.
An assessment of the content of discharge summaries at Mount Carmel Hospital, Malta
Authors: Camilleri E. , Grech G. , Farrugia Y. , Padovani J.
Published: February 2022

Introduction

Discharge summaries are the mainstay of intra and inter-departmental communication, ensuring continuity of care. Local instructions fail to provide clear guidance to foundation doctors to ensure standardised discharge summaries.

Objectives

The audit aimed to assess the inclusion of information within discharge summaries at Mount Carmel Hospital, Malta. A secondary objective was to update the current online discharge summary framework.

Methods

Stratified random sampling was used to select 120 discharge summaries, issued between October 2018 and September 2019. These were chosen out of a total of 956 discharge summaries issued during the period. The inclusion of information was analysed against the National Standard for Patient Discharge Summary Information issued by the Health Information and Quality Authority, Ireland. Data was collected and grouped into seven categories each containing multiple data points.

Results

Patient details were present in all discharge summaries while no details relating to the primary care healthcare professional were documented. The average information inclusion rate regarding admission, discharge and medications was 85%. Average clinical information was documented in 50% while that of future management and person completing discharge summary was found in 41% and 28% respectively (as per Table 1). Encouragingly, discharge summaries contained mandatory information more frequently than conditional or optional information.

Conclusions

This audit has identified deficiencies in current discharge summary practices and gives recommendations for the development of local guidelines.

Disclosure

No significant relationships.
The relation between communicative internet usage and the quality of the social adaptation in men with mental disorders
Authors: Boyko O. , Medvedeva T. , Enikolopov S. , Vorontsova O. , Kazmina O. , Omelchenko M.
Published: February 2022

Introduction

The internet is now widely used by people with mental disorders, and it is important to understand whether the internet use can affect the mental state of such people.

Objectives

The aim of the study was to assess the relation between the internet usage for communication and the quality of the social adaptation in men with mental disorders.

Methods

82 male patients with schizophrenia spectrum disorder (F20) were involved into the study (mean age 22±4.3). Methods: SCL-90R, “social circle” inventory (Susan L., Phillips), semi-structured interview of “internet usage” (“communicative internet usage” consists of communication in on-line games, use of the internet social networks for communication, use the internet to find new friends, maintaining relationships with relatives, friends, colleagues.

Results

Two groups of patients were considered: those who use internet for communicative purposes (N=61) and those who do not (N=21).According to the analysis (Mann-Witney U-test, hereinafter significance level *p<0.05), those who use the internet for communication have lower levels of psychotic symptoms (PSY) (U=446*), lower levels of “depression” (U=453*). Those who use the internet for communication have more people in social circle to spend free time (U=910,5*), having the same occupation (U=860*), having the same interests (U=867,5*) and sharing the same values (U=873*).They have more friends (U=804*), peers (U=814*), more women among friends (U=793*), more people to provide instrumental support (U=761,5*).

Conclusions

Patients, who use the internet for communications, have a lower levels of psychopathological symptoms and higher quality of social adaptation. This indicates a possible potential of the internet for mental health rehabilitation.

Disclosure

No significant relationships.
Zoanthropy in confinement
Authors: Guerra M.F. Tascon , Rodrigo M.V. López
Published: February 2022

Introduction

Zoanthropy is a mental disorder in which a patient believes to be an animal. These patients believe they have morphed into another species and began to act like such. Several types of zoanthropy have been described. Mental disorders can be triggered by stressful life events in patients with certain vulnerability. Hearing impairment as a risk factor for psychosis has been suggested in Psychiatry research. The potential mechanisms underlying this association included loneliness, diminished theory of mind, disturbances of source monitoring and top-down processing and deafferentiation.

Objectives

This case presents a patient, with no history of psychiatric diseases, who developed the delirious of being a dog during Codiv-19 quarantine.

Methods

Previously healthy, sixty-year-old woman, with poor hearing, was taken to the Hospital for altered behavior after the confinement was stated. A low back pain started which derived on walking difficulties. The transformation begun and she started walking on four legs, barked and even pooped like a dog. Physical examination was normal. Mental exam revealed presence of delusion. Blood tests and brain imaging revealed no abnormalities. A treatment based on long-acting injectable aripiprazole was started.

Results

Within 4 months of treatment, her mental state improved by attenuation of psychotic symptoms.

Conclusions

Sensory impairment and social isolation, have been associated with late-onset psychosis, but appear to exert a nonspecific influence on vulnerability. Early assessment and treatment of hearing impairment in patients with high risk of psychosis may be essential in psychosis treatment and prevention.

Disclosure

No significant relationships.
Challenges in schizoaffetive disorder therapeutic – a case report of a patient with hiperprolactinemia
Authors: Rodrigues D. , Jeremias D. , Laginhas C. , Sequeira A.
Published: February 2022

Introduction

The only FDA approval therapeutic for schizoaffective disorder is paliperidone. Hiperprolactinemia is one of the most frequent side effects induced by first generation antipsychotics (FGA) or by second generation antipsychotic (SGA), such as risperidone and paliperidone. Prolactin related symptoms (PRS) include amenorrhea, galactorrhea, gynecomastia and fluctuations in psychotic symptoms.

Objectives

To report the case of a patient with schizoaffective disorder difficult to manage due to symptom resistance and PRS, that improved symptomatology when prolactin serum levels were reduced.

Methods

Clinical-demographic data collected by clinical interview and clinical process consultation. Non-systematic literature review, searching “psychosis”; “prolactin”; “antipsychotic”; “schizoaffective disorder” on Pubmed database.

Results

We report the case of 33 years-old female, admitted to our psychiatry inpatient unit for persecutory delusions, loosening of association, auditory hallucinations, and irritability with functional impairment. Symptoms began 13 years before. She was medicated with paliperidone 100mg IM monthly, lithium 800mg daily and clozapine 225mg daily. When admitted she wasn’t adhering to oral medication. On physical examination presented some PRS. The serum presented hyperprolactinemia and lithium in non-therapeutic levels. Initially was re-introduced the previous therapeutic without improval. It was made a therapeutic switch to associate aripiprazole 400mg IM monthly and clozapine 225mg daily, and lithium 800mg daily resulting in prolactine normalization and subsequent improval of psychotic symptoms previously presented.

Conclusions

This case reports challenges in management of patients diagnosed with Schizoaffetive Disorder due to therapeutic refractoriness and side effects. PRS can be ruling, therefore impacting therapeutic choices. We propose a possible role of combination of clozapine and aripiprazole in this scenario.

Disclosure

No significant relationships.
Leukopenia and agranulocytosis in atypical antipsychotic treatment - besides clozapine
Authors: Jorge B. , Fernandes C. Pedro , Carvalho J.
Published: February 2022

Introduction

Leukopenia and agranulocytosis are reported and dangerous haematological side-effects associated with the use of antipsychotics, mostly reported for clozapine administration. However, increased case reports about severe abnormalities even during treatment with second generation antipsychotics other than clozapine.

Objectives

This review aims to compare haematological abnormalities associated with clozapine vs non-clozapine antipsychotic treatment, regarding aspects such as safety levels or the need for regular blood samples monitoring.

Methods

Pubmed and Google Scholar were searched for eligible articles, through keyword search and cross-referencing.

Results

Neutropenia is common both in patients with schizophrenia on clozapine treatment and in those never on clozapine. Cases of agranulocytosis has been described with the use of olanzapine, risperidone or paliperidone, that do not have the same monitoring regulatory process as clozapine.

Conclusions

These results highlight the challenges in identifying and managing non-clozapine antipsychotic-induced leukopenia in susceptible patients. Continued research in this domain for evidence based management of antipsychotic-induced blood dyscrasias

Disclosure

No significant relationships.