bluuebunny/crossref_metadata_2025 huggingface dataset:
Depressive symptoms and related factors in elderly diabetic patients
Authors: Omezzine R. Gniwa , Bouali W. , Sriha A. Belguith , Zarrouk L.
Published: February 2022

Introduction

Diabetes is a major public health problem in Tunisia. Its prevalence increases with age. In addition, depression, at the top of mental disorders list, mainly remain undiagnosed, in particular in the elderly and consequently untreated.

Objectives

The aim of this study was to estimate depressive symptoms and related factors in elderly diabetic patients.

Methods

This is a cross-sectional study, conducted among type 2 diabetic patients aged ≥ 60 years old, attending Mahdia’s primary health center, from January 2019 to March 2019. Depressive symptoms were assessed by using the Geriatric Depression Scale (GDS).

Results

95 diabetic patients were recruited. The average age was 75 ± 7.4 years and the sex ratio was 0.9. In our sample, 68.4% of patients were categorized according to having depressive symptoms. The proportion of participants with mild and severe depression symptoms were 25.3% and 43.1%, respectively. Analytical results demonstrate many factors which were significantly associated with depressive symptoms: female gender, living alone, history of hypertension, presence of complication, and using insulin (p < 0.05).

Conclusions

Our study shows that depressive symptoms are common in elderly subjects with diabetes, and there have been many significant risk factors associated with it. So there is need for physicians to detect, confirm, and treat depression in elderly diabetic patients.
Depression after acute traumatic injuries in children
Authors: Sidneva Y. , Valiullina S. , Lvova E.
Published: February 2022

Introduction

Acute traumatic injuries in children are diverse: skeletal trauma, traumatic brain injury (TBI), spinal injury (SCI), amputations, combined trauma and others. Severe injuries lead to severe disability and desadaptation of the child. It is known that children tolerate hard the awareness and acceptance of their new state.

Objectives

To study emotional disorders after traumatic injuries in children at early stages of rehabilitation.

Methods

159 children up to 18 y.o.: 80 (TBI), 60 (SCI), 19 (amputation, skeletal injury, electro-trauma). Methods: psychopathological, psychological; scales, questionnaires.

Results

In children after severe and moderately severe TBI, depression was detected in 43% as a consequence of injury and recovery of mental activity. In children with SCI, depression was detected in 48% as a reaction to stressful situation. In children with amputation, severe skeletal injury, electro-trauma depression was in 60%, both as a consequence of organic recovery of mental activity and as a reaction to psycho-traumatic situation. In the acute period, children had comprehensive interdisciplinary rehabilitation. Neuropsychiatrist recommended neuropharmacotherapy with antidepressants from the group of serotonin reuptake inhibitors (sertraline), GABA preparations. For psychological support, gestalt correction techniques were used.

Conclusions

After acute trauma, depression in children occupies a significant place in clinical picture. Genesis of depressive disorders can be caused both by organic damage to brain structures and by reaction to psychotraumatic situation. In order to improve rehabilitation effectiveness, to make patient’s returning to usual living environment easier as well as to improve the quality of life, interdisciplinary approach is needed since early stages of rehabilitation and after.
Unusual drug-resistant psychotic state with epilepsy manifestations, cognitive deterioration and muscular atrophy - case report
Authors: Bazhmin M.
Published: February 2022

Introduction

This article will focus on the case of patient whose disease manifested after episode of dehydration at 16 years of age and within 8 years led to his death. During the eight years of illness, the patient suffered from polymorfic psychotic states accompanied by various types of epileptic seizures, including absence and grand-mal seizures, resistant to drug therapy. In addition, he suffered from multiple motor disorders, skeletal and mimiс muscle atrophy, as well as progressive cognitive decline from very high level of cognitive functions to level of moderate deterioration. Despite repeated evaluations, there was no unequivocal diagnosis of his disorder.

Objectives

Male, born in 1994, without a known hereditary pathology in the field of neurology or psychiatry. Pregnancy and childbirth proceeded without features and the early stages of cognitive-motor development were marked as normative, with the exception of a single epileptic seizure at the age of 3 years (according to the description of the parents). Until the age of 16, the patient was not under the supervision of a neurologist or psychiatrist, developed on a par with his peers, successfully attended school with high marks in the exact sciences, and went in for sports.

Methods

Case report

Results

Case report

Conclusions

A patient is considered with a non-standard course of psychosis and epilepsy, which was accompanied by multiple neurological and psychiatric symptoms.In Israel there are only 13 patients with a resemble clinical picture and there is no diagnosis or group of diagnoses in ICD, DSM or any neulogical classificatin tha can describe his disease.
Emotional outcomes in tunisian stroke survivors
Authors: Charfi N. , Elleuch S. , Smaoui N. , Bouali M. Maalej , Zouari L. , Dammak M. , Mhiri C. , Thabet J. Ben , Maalej M.
Published: February 2022

Introduction

Depression and anxiety are recognized as common psychiatric complications of stroke, yet little is known about their clinical correlates and their impact on functional outcome.

Objectives

To assess the prevalence of anxiety and depression during the first year post-stroke; To determine their relationships with clinical and functional variables.

Methods

We conducted a cross-sectional study, which included 147 patients, followed for stroke that had occurred over the past year. We used the HAD scale in its Arabic version for screening for anxiety and depression and the modified Rankin scale to assess the degree of disability due to stroke.

Results

Anxiety was detected in 55.1% of patients and depression in 67.3% of them. These emotional disturbances were more common during the first six months post-stroke. Depression was more common among male gender (p=0.003). Older age and more than secondary educational attainment correlated with post-stroke anxiety (p respectively 0.013 and 0.002). Post-stroke anxiety and depression were significantly more common in case of infarcts involving the territory of the Sylvian and the anterior cerebral artery (p respectively 0.01 and 0.001). Depression was significantly associated with the presence of motor deficit on the initial neurological examination (p<0.001) and subsequent neurological sequelae (p<0.001). Anxiety and depression were significant predictors of functional disability during the 12 months post-stroke (p=0.007).

Conclusions

Anxiety and depression impair functional ability after stroke. These data may help identify the patients at greatest risk of poor emotional outcomes and thus help in planning appropriate interventions.
Predicting one-year outcomes in first-episode psychosis
Authors: Lindgren M. , Keinänen J. , Kemppainen A. , Karpov B. , Kieseppä T. , Suvisaari J.
Published: February 2022

The outcome of first-episode psychosis (FEP) varies and may be predicted by several baseline measures. In the Helsinki Early Psychosis Study, young adults with FEP (n=97) from the Helsinki area in Finland were broadly assessed as soon as possible after first psychiatric contact for psychosis. Age- and gender-matched population controls were also assessed (n=62). The participants were followed up via appointments and medical records. We present both published and unpublished results on predictors of 12-month clinical, functional, and metabolic outcomes. More severe cognitive deficits at the beginning of treatment predicted several outcomes such as occupational status and functional level – beyond baseline positive and affective symptom levels, but not when negative symptoms were accounted for. More severe baseline obsessive-compulsive symptoms were predictive of a lower rate of remission, whereas a higher level of anxiety symptoms predicted better functional outcome, when the severity of positive symptoms was adjusted for. Adverse childhood experiences measuring cumulating psychosocial stress did not predict occupational status or functional level when positive and negative symptoms and neurocognition were controlled for, whereas in controls having experienced school bullying was associated with lower functioning. Insulin resistance in early psychosis appeared as an early marker of increased vulnerability to weight gain and abdominal obesity in young adults with FEP. Further, increased waist circumference predicted worsening low-grade inflammation, increasing further the cardiovascular risk. In sum, we have found different types of prognostic markers in FEP. Identifying the individuals at risk of less favorable outcomes could affect treatment choices in FEP.

Disclosure

No significant relationships.
Comorbid anorexia nervosa and schizophrenia
Authors: Lobo C. De Andrés , Adame C. Vallecillo , Aparicio T. Jiménez , De Llano De La Viuda M. Queipo , Ramírez A. Gonzaga , Valera G. Guerra , Carrasco I. Santos , Cerejeira J. Gonçalves , Meseguer C. Capella , Vázquez E. Rodríguez
Published: February 2022

Introduction

Although schizophrenia and anorexia nervosa are very different disorders, when they occur in the same patient it can be difficult to distinguish whether the alterations in body image are due to psychotic symptoms or correspond to a comorbid eating disorder. It is also relevant to know how they can interact with each other.

Objectives

Presentation of a clinical case of anorexia nervosa in the context of a patient with a previous diagnosis of paranoid schizophrenia.

Methods

Bibliographic review of the relationship between schizophrenia and alterations in the perception of body image by searching for articles in Pubmed.

Results

We present a 48-year-old woman who resides with her mother and a sister. Diagnosed with paranoid schizophrenia and eating disorder. She had previously been admitted to hospital twice. Since 2004, she has been followed up in mental health consultations. The patient reports constant weight changes. A year ago she began to feel overweight and began to restrict her intake and to exercise, having lost 20 kg. She reports psychotic symptoms in the past, that she now denies. Various scales show moderate impact of weight on personal perception of psychosocial adjustment, an impulse to thinness and a significant distortion of body image, perceiving herself as heavier than she is and wishing she was lighter.

Conclusions

In schizophrenia, confusion in bodily experiences and states is not uncommon. The possible interactions between the symptoms of schizophrenia and anorexia nervosa complicate the adequate care of these patients. Further research on comorbidity of these two disorders is necessary.
Depression, distress and their association with patterns of psychoactive substance use during the COVID-19 emergency state in latvia
Authors: Vrublevska J. , Šibalova A. , Aleskere I. , Rezgale B. , Smirnova D. , Fountoulakis K. , Rancans E.
Published: February 2022

Introduction

The WHO warned that the COVID-19 pandemic could have psychiatric consequences such as elevated levels depression, increased alcohol and drug use, and other behaviours that exert a strong influence on health. In Latvia a state of emergency was announced on March 12th, was extended twice and lifted on June 10th.

Objectives

To estimate the prevalence of depression and distress in the general population of Latvia and association with substance use during the state of emergency.

Methods

The nationwide representative online study in the general population of Latvia was conducted in July 2020 during three week period. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to determine the presence of distress/depression. The structured questionnaire to determine psychoactive substance use was applied. Proportions of independent variables across the study groups were compared using Chi-square
test.

Results

The study sample included 2608 respondents. The prevalence of depression and distress was estimated at 5.7% (95%CI 4.92 – 6.71) and 13.5% (95%CI 6.85 – 8.91), respectively. Patients with depression (28% vs. 7.4%, p <0.001) and distress (30.9% vs. 7.4% p <0.05) smoked more tobacco compared to respondents without distress/depression. Those with depression or distress were significantly more likely to consume more alcohol during the emergency state than people without depression or distress (14.0% and 17.7% vs. 6.6%, p <0.001). The changes in the use of other psychoactive substances in those who had depression or distress were not statistically significant.

Conclusions

Preparing support systems to mitigate mental health consequences is needed urgently.
Association between complete corpus callosum agenesis and recent-onset schizophrenia: A case report
Authors: Abassi B. , Fekih-Romdhane F. , Maktouf H. , Cheour M.
Published: February 2022

Introduction

Corpus callosum agenesis (CCA) is a rare congenital disorder in which there is a partial or complete absence of the corpus callosum. Within the framework of an anatomoclinical approach to schizophrenia, a few studies have focused on its association with neurological disorders, including CCA.

Objectives

In this perspective, we report a rare case of an adolescent with intellectual disability, with whose complete CCA was revealed by a recent-onset schizophrenia.

Methods

A case report and literature review.

Results

The teenager M.A. is from a first degree consanguineous marriage. He had no family history, no special habits and no history of seizures. Since early childhood, he had had a psychomotor acquisition delay and relationship difficulties that tended to worsen later. At school, he was teased by his peers and failed 4 times in different rows. At the age of 15, he dropped out of school. Verbal and physical aggressiveness, soliloquy, unmotivated laughter and vague ideas of persecution suddenly appeared, hence his psychiatric consultation one month later. Neuropsychological tests indicated current low Intelligence Quotient (60). Brain imaging revealed complete ACC (see Figure 1). He was diagnosed with schizophrenia and put on antipsychotic treatment at adequate doses and durations, with poor therapeutic response.

Conclusions

Our observation provides additional support for neurodevelopmental models of schizophrenia, and confirms literature data indicating that severe structural brain abnormalities would lead to early onset psychotic symptoms which are often refractory to pharmacological treatments
Molecular lipids in prediction of psychosis and the associated cardiometabolic co-morbidities
Authors: Oresic M.
Published: February 2022

Lipid metabolism has been an area of increased interest in psychosis research, not only due to its link to metabolic comorbidities, but also due to its putative role in the pathophysiology of psychosis. Lipid disturbances are observed already in the period preceding the onset of psychosis. For example, we performed mass spectrometry based lipidomics in a cohort of individuals at clinical high risk for psychosis (the EU-GEI study) and found that the individuals who transitioned to psychosis within a 2-year follow-up period displayed decreased levels of ether phospholipids. This finding may be of direct (patho)physiological relevance, as ether phospholipids (particularly plasmalogens, a major subgroup of ether phospholipids) are highly enriched in the brain, are supplied to the brain by the liver, have many structural and functional roles, and may act as endogenous antioxidants. Accumulating evidence also suggests that lipid disturbances play a crucial role in the development of metabolic comorbidities associated with psychotic disorders. Our lipidomic studies have shown that psychotic patients who rapidly gain weight during follow-up have elevated triglycerides (TGs) with low double bond count and carbon number at baseline. These TGs are known to be associated with non-alcoholic fatty liver disease (NAFLD) and with increased risk of type 2 diabetes. In conclusion, although the mechanisms linking dysregulation of lipid metabolism with the pathophysiology of psychosis are currently poorly understood, findings by us and others suggest that metabolic abnormalities are evident in people who are vulnerable to psychosis, and to the associated metabolic comorbidities.

Disclosure

No significant relationships.
This girl is on fire
Authors: Vázquez P. García
Published: February 2022

Introduction

Burning mouth syndrome (BMS) is a chronic condition characterized by a burning sensation of the oral cavity and is often associated with taste disturbances and xerostomia.

Objectives

To study the psychotropics as part of the possible etiologies of this síndrome.

Methods

A 67-year-old woman complained of burning pain in the tongue and oral mucosa, taste disorder, and sensory impairment. Slight improvement after treatment with Gabapentine 300mg (1-0-0). The pain is constant, with sharp characteristics. Improves when eating, the ability to taste is preserved. Subsequently, treatment with 2% lidocaine rinse (3-4 times / day) is tested, with temporary pain relief. Lorazepam 1mg (1-0-0), without improvement. Patient in follow-up by the Neuropsychiatry consultation for 3 years, due to major depressive disorder in treatment with Quetiapine 100mg (0-0-1).

Results

In the first consultation the treatment is modified, adding Duloxetine 60 mg (1-0-0) and Alprazolam 0.5mg (1 / 2-1 / 2.0), and reducing the dose of Quetiapine to 75 mg and then 50mg. In the subsequent consultation, one month later, she only manages to reduce the neuroleptic dose by half, without noticing clinical improvement. After two months, she has completely removed the quetiapine, and completely disappearing the burning mouth sensation, improving his affective clinic in the same way.

Conclusions

There are a large number of drugs that produce xerostomia, in intimate relationship with the burning mouth. Among those we can find antihistamines, neuroleptics, antihypertensives, and benzodiazepines. In many cases, correcting or eliminating these etiologic agents does not improve or stop the initial symptoms, but sometimes, it does.
Peculiarities of the psychological state of patients with chronic non-infectious liver diseases
Authors: Koval I. , Khaustova O. , Skurat K.
Published: February 2022

Introduction

The prevalence of chronic liver diseases (CLD) is over 30 million people worldwide, they are associated with significant health care costs, loss of productivity of patients, and has a significant impact on the quality of life associated with health.

Objectives

The research objective was to determine current views on the psychological state of patients with CLD.

Methods

A qualitative and quantitative analysis of the content of scientific Ukrainian and English literature published from 2014 to 2020, which sets out different views on the psychological state of patients with chronic liver diseases using the PubMed and Google Scholar databases. Only concept analysis, meta-analysis, and systematic reviews published in English, presented in the scientific literature were included.

Results

The information on the peculiarities of the psychological state of patients with CLD was generalized. Based on the research, we can conclude that this group of patients is characterized by low mood, chronic fatigue, low level of social adaptation, increased anxiety, and reduced efficiency.

Conclusions

Studies by different scientists from different countries agree that patients with chronic liver disease are characterized by the above symptoms. Some emphasize psychoneurophysiology and associate these symptoms with chronic inflammation, which occurs as liver damage progresses. Other researchers suggest that it is due to the quality of life of these patients and the severity of the disease. However, the scientific community has yet to find out what exactly caused this.
Epistemic injustice in a case of cyclic vomiting syndrome. A case report
Authors: Del Campo A. Cerame , Limeres P. Coucheiro , Soler A. Franco
Published: February 2022

Introduction

We present the case of a 19-year-old female patient treated in our hospital due to an outburst of persistent vomiting. The patient had a diagnosis of Cyclic Vomiting Syndrome (CVS), a year before the diagnosis the patient had been labeled as a somatizer and admitted into the department of psychiatry. Given her psychiatric record and the fact that CVS is a rare diagnosis we were consulted on arrival.

Objectives

CVS is an infrequent disorder of unknown etiology which shares similarities with migraine headaches. It is characterized by episodes of vomiting followed by periods of remission without active symptomatology with no organic pathology to account for the symptoms. Epistemic injustice (EI) is defined by Miranda Fricker as “a damage done to someone in their capacity as a knower”. She defined two forms of EI: testimonial and hermeneutical injustice.

Methods

A case report is presented alongside a review of the relevant literature regarding CVS and epistemic injustice.

Results

On arrival at the emergency department she tried explaining her condition, but her testimony was disregarded on the basis of her psychiatric record. It was only after the on-call psychiatrist explained the condition when she received the appropriate abortive treatment, after which she was admitted to the internal medicine department where she was followed by the liaison psychiatrist.

Conclusions

CVS is a disabling disease still unknown to most clinicians in spite of the increasing quality evidence about its identification and treatment. The case highlight how cases of newly identified disease can suffer from testimonial and hermeneutical injustice.
Cross-sectional study of clinical and linguistic characteristics mental disorders in HIV infection
Authors: Neznanov N. , Khalezova N. , Burmistrova N. , Tabulina A.
Published: February 2022

Introduction

Current epidemiological data on the pandemic prevalence of HIV in the world expand the boundaries of the problems associated with the threat of unpredictable spread of infection and the frequency of mental disorders that accompany HIV infection.

Objectives

Somatogenic mental disorders are determined by the fact that the central nervous system (CNS) is one of the reservoirs for HIV. HIV is indirectly a neurotropic virus and can cause associated neurocognitive impairment (HAND)

Methods

In study were used clinical-linguistic examination method for determining linguistic markers for mental disorders in HIV patients who did not receive specific antiviral therapy.

Results

As a result, it was found that 50% of HIV-infected patients not suffering from addiction syndromes or surfactant abuse have mental disorders, which are characterized mainly by disorders of adaptive reactions and mild cognitive impairment. 57.7% of HIV-infected people who do not use surfactants showed a high level of social adaptation. For patients who do not use surfactants, and who have undergone a commission examination before starting ART, the leading psychopathological syndromes are anxiety, anxiety-hypochondria. 44.2% of patients did not have obvious psychopathological symptoms.

Conclusions

Structure of emotional experiences was revealed in patients who recently learned about the burden of a serious chronic disease with the corresponding fear of death and self-stigmatization. Identified linguistic markers are additional signs that can be used by physicians and psychiatrists to diagnose both cognitive impairment and emotional impairment in patients with HIV infection.

Conflict of interest

No significant relationships.
Link between cognitive impairment and metabolic syndrome in middle-aged patients
Authors: Neznanov N. , Piotrovskaya V. , Burmistrova N. , Tabulina A.
Published: February 2022

Introduction

Metabolic syndrome (MS) is associated with an increased risk of developing a cognitive vascular disorders and dementia.

Objectives

The associations of cognitive disorders (CD) with components of methabolic syndrome (MS) such as : body mass index, lipid spectrum, arterial hypertension and glucose level (GL) in middle age subjects were study.

Methods

The 271 patients with MS according IDF criteria, (aged 30 – 60 years) were examend. Current mild cognitive impairment (MCI) was confirmed by psychodiagnostic interview according to the criteria of ICD-10. All patients passed through: MMSE test, Cognitive Failures Questionnaire, Wechsler memory scale, Symbol Coding and Category Fluency test. Level of blood glucose and plasma indicators of lipid spectrum were assessed in the blood samples with «Abbott» kits. To assess the results the NCEP criteria were used.

Results

All 271 subject were divided into 2 groups, group A – with CD and/or MCI (212 subjects) and the group B -without affective disorders (49 subjects). Using the Mann-Whitney test significantly strong connection between high levels of total cholesterol (TC), cholesterol low density lipoprotein (LDL-C), lipoproteins of very low density (VLDL), the GL and MCI in group A were obtained. Optional subjects with sings of PH, MS and MCI had a fairly high level of VLDL and LDL-C in comparison with subjects without MCI.

Conclusions

The meaning of the relationship between metabolic syndrome and mild cognitive impairments in middle-aged people is in increasing in the level of LDL and VLDL that can provoke MCI in middleage subjects with MS.
Kleine-levin syndrome
Authors: Freitas R. Mota , Valadas M.T.
Published: February 2022

Introduction

Kleine-Levin Syndrome (KLS) is an extremely rare disorder of unknown etiology. It affects mainly male adolescents and is thought to follow a relapse-remitting course. During episodes of illness, a wide array of neuropsychiatric symptoms may present and a psychiatric diagnosis might be incorrectly made.

Objectives

We aim to review the literature on the clinical manifestations of KLS, as well as the current evidence regarding this disorder’s management.

Methods

We performed an updated review in the PubMed database using the terms “Kleine-Levin Syndrome”. The included articles were selected by title and abstract.

Results

KLS usually presents with recurrent episodes, lasting days to weeks, of severe hypersomnia, cognitive impairment, major apathy and derealization, among other neuropsychiatric symptoms. Although it was previously thought that complete normalization occurred between episodes, recent evidence suggests that around one third of patients have mild cognitive impairment and there are alterations in brain blood flow during the asymptomatic periods. During episodes of illness, management comprises environmental measures as well as drug therapy. Corticosteroids and amantadine have been successful in stopping episodes and lithium may be useful in a preventative role, however, there are no randomized controlled trials focusing on KLS treatment.

Conclusions

KLS remains an elusive entity since it is an extremely rare disorder with unclear etiology, course, and no consensual treatment. Further research is warranted in this area, namely randomized controlled trials. It is important for the practicing psychiatrist to be aware of this illness in order to recognize it and adequately manage it.
Early intervention in psychosis: An innovation trigger in a challenging environment
Authors: Sile L. , Rancans E.
Published: February 2022

In theory and practice early intervention has an indisputable role in the treatment of patients with psychotic disorders, however modern psychiatrists face challenges in their clinical work to find the balance between the best practice and available treatment options in their environment. One of the biggest challenges remains the implementation of high-cost treatment approaches in healthcare systems of middle-income countries. Moreover, one very important aspect to consider when implementing early intervention is to prepare your team for resistance against the innovation. In countries where psychiatric treatment is more hospital-oriented and out-patient care is limited to short face-to-face visits with psychiatrists, the system is rigid and unwilling to step up to more expanded treatment option, such as a team approach of more than 6 members to treat one patient. In Latvia we started our early intervention programme in 2019 (LAT-EIP), 34 patients enrolled, and 27 finished the programme. When we compared results between standard treatment and LAT-EIP, psychiatrist out-patient visits were comparable to LAT-EIP, but the rate of rehospitalization and assigned disabilities at 12 months follow-up differ dramatically: in LAT-EIP 7.4% had been readmitted and 7.4% were assigned with disability vs 36.1% and 34.4% of patients in standard treatment group, respectively, p<0.05. Nevertheless, the only hospital which continues to provide early intervention is the one which first established it. This presentation will try to explain step-by-step what enhances and what holds back innovation in psychiatry in one middle-income countries.

Disclosure

No significant relationships.
“This is not a doctors thing, it is witchcraft” - A case report of acute psychosis concomitant to primary hyperparathyroidism
Authors: Lopes L. , Moura B. , Pereira S.
Published: February 2022

Introduction

Primary hyperparathyroidism (PHPT), usually caused by a parathyroid adenoma, is characterized by a pathologically high secretion of parathyroid hormone and consequent hypercalcemia. PHPT has a high prevalence among elderly patients and might be responsible for neuropsychiatric symptoms.

Objectives

We aim to report the rare manifestation of acute psychosis accompanying a PHPT diagnosis, and to discuss the neurobiological relationship between hyperparathyroidism, hypercalcaemia and neuropsychiatric symptoms.

Methods

We present a clinical case based on patient’s history and clinical data, along with a literature review on PHPT neuropsychiatric symptons.

Results

We present the case of a 68-year-old man diagnosed with PHPT in November 2019. He was brought up to psychiatric evaluation for the first time in May 2020 upon behavioral changes (aggressiveness and bizarre rituals). The patient described the sensation of burns scattered throughout the body since January 2020, felling anxious and frightened, sleeping poorly and progressive social isolation. He presented delusional ideas of mystical and paranoid content. No significant cognitive impairments were found. The patient’s psychosis was partially responsive to atypical antipsychotics. He’s waiting for surgery. Hypercalcaemia might manifest as mood disorders, cognitive changes and rarely as acute psychosis. Although there is not yet a clear mechanism to explain it, high calcium levels seem to cause neurotoxicity and neurotransmission dysfunction. Restoration of normal calcium levels tend to resolve neuropsychiatric symptoms, but in PHPT parathyroidectomy is usually recommended.

Conclusions

Neuropsychiatric symptoms are responsible for great disability, and demand an organic in-depth investigation. A multidisciplinary team approach must always be considered in the management of such conditions.
Raised preoperative monocyte chemoattractant protein-1 as the independent predictor of delirium after cardiac surgery. A prospective cohort study
Authors: Kaźmierski J. , Miler P. , Pawlak A. , Jerczyńska H. , Frankowska E. , Woźniak J. , Woźniak K. , Brzezińska A. , Wilczyński M.
Published: February 2022

Introduction

Delirium is a frequent and serious complication of cardiac surgery. However, the knowledge regarding pathogenesis of postoperative delirium is limited.

Objectives

To investigate whether increased levels of monocyte chemoattractant protein-1 (MCP-1) and hyper-sensitive C-Reactive Protein (hsCRP) are associated with postoperative delirium in cardiac surgery patients.

Methods

Patients were examined and screened for major depressive disorder (MDD) and cognitive impairment one day preoperatively, using the Mini International Neuropsychiatric Interview and The Mini-Mental State Examination Test. Blood samples were collected pre- and postoperatively for hsCRP and chemokine levels. Following surgical interventions, the Confusion Assessment Method for the Intensive Care Unit and the Memorial Delirium Assessment Scale with the cut-off score 10 were used to diagnose delirium.

Results

Postoperative delirium screening was found positive in 34% (61 of 177) of patients. Both, pre- and postoperative hsCRP, and preoperative MCP-1 levels were associated with postoperative delirium in univariate comparisons; p=0.001; p=0.0004; p < 0.001, respectively. However, according to a multivariate stepwise logistic regression analysis only MCP-1 concentration raised before surgery was independently associated with postoperative delirium, and related to advancing age of participants (Spearman’s Rank Correlation 0.192; p=0.0103). According to ROC analysis, the most optimal cut-off for MCP-1 concentration in predicting the development of delirium was 371.81 ng/ml with sensitivity of 77.0% and specificity of 58.6%.

Conclusions

The present study suggests that raised preoperative MCP-1 concentration is independently associated with delirium after cardiac surgery. Preoperative monitoring of pro-inflammatory markers combined with regular surveillance may be helpful in the prediction and early detection of postoperative delirium in this patient group.
The trough of disillusionment: A critique of the “transition” paradigm
Authors: Gülöksüz S.
Published: February 2022

I will attempt to address the issues surrounding the CHR concept in light of novel data and briefly discuss emerging alternatives. The root problem of the CHR early invention strategy is the exertion of reducing early nonspecific (pluripotent) psychopathology to a unidimensional model restricted only to positive psychotic symptoms, which define the binary categories of CHR and “transition” in help-seeking populations. This major conceptual handicap undermines the validity and clinical utility. The core predictor of the “transition” rate is the degree of the risk-enrichment and not the CHR status. Even with a significant pretest risk enrichment, the prognostic accuracy is mediocre. The incidence and “transition” rates of CHR in the community are very low; therefore, CHR does not represent a cost-effective clinical target—prevention paradox. CHR succeeding early pluripotent psychopathology is already late for intervention. “Transition” is not a categorical progression but a unidimensional shift in psychotic symptoms, and therefore, influenced by the fluctuation of psychotic symptoms, leading to both false positives and underestimation of nonpsychotic psychopathology. There exists no evidence for a specific effect of any intervention in preventing “transition”; therefore, CHR is not an ideal treatment target. Binary “transition” outcome does not represent a valid phenotype for research as “transition” rates are primarily driven by the sampling heterogeneity. The multidimensional psychopathology and functioning are more clinically relevant, overarching, and service-user-centered measures to define individual risk and outcome. Guided by the public health perspective, a universal early intervention framework, underscoring improved access to care, may represent a better strategy.

Disclosure

No significant relationships.
Early changes in brain structure, functional connectivity and neuropsychiatric symptoms after HCV infection cure with direct-acting antivirals
Authors: Cavero M. , Mariño Z. , Navines R. , Pariente J. , Moreno E. Muñoz , Bartres C. , Nacar L. , Lens S. , Rodriguez-Tajes S. , Cañizares S. , Bargallo N. , Forns X. , Martin-Santos R.
Published: February 2022

Introduction

Hepatitis C virus (HCV) infection is known to be associated with neuropsychiatric manifestations as part of the disease. Previous neuroimaging studies showed brain connectivity dysfunction among HCV-infected patients

Objectives

To assess, by MR in resting state, the potential structural and connectivity changes before (BL) and after HCV eradication (FU12) with direct-acting antivirals (DAA), along with clinical parameters.

Methods

Twenty-one HCV-patients, aged≤55 years, without psychiatric history, nor advanced liver disease, and eligible for DAA, and 25 healthy controls were included. Evaluations were performed at BL and FU12. Brain volume and local gyrification index (LGI) were assessed in MR-T1, and functional connectivity by seed-based analysis (left insula). Depression (MADRS/PHQ9) and neurotoxicity symptomatology (NRS) were assessed. We compared patients between BL/FU12, and controls by means of paired/independent T-test analysis.

Results

Substained virologycal response was obtained in all patients (100%). Depressive and neurotoxicity symptomatology improved after cure (p<0.01). HCV-patients showed a reduced volume in a right latero-occipital area compared to controls (CWP<0.005) in both BL and FU12. This difference was smaller between FU12 and controls. LGI was higher in FU12-HCV compared to BL-HCV. fMRI connectivity showed a high association between insula and occipital/parietal territories in patients than controls, being higher among BL-HCV and controls. Differences were limited to occipital areas among FU12-HCV and controls.

Conclusions

Neuropsychiatric symptomatology improved after cure. Left insula is altered among HCV-patients in structured and connectivity (mainly occipital areas). After cure differences with controls were reduced, suggesting a partial restoration of brain connectivity.
Digital solutions for mental health care during the COVID-19 pandemic: A systematic qualitative review and swot analysis
Authors: Vukovic I. Sarajlic , Valeriani G. , Mijaljica G. , Thunström A. Osmanovic , Gonzales A.
Published: February 2022

Introduction

Since its early stages, the Covid-19 outbreak has posed immense challenges for effective, scalable and rapid interventions. Telehealth approaches have been considered as key part of an effective pandemic response.

Objectives

The aim of this systematic review was to evaluate the role of digital solutions in fighting the mental health needs during COVID-19 outbreak.

Methods

This review was conducted through searching four databases including PubMed, Scopus, Web of Science, and Science Direct. Inclusion criteria included studies clearly defining any use of telehealth services in all aspects of mental health care during COVID-19 outbreak, published from December 31, 2019 to October 31, 2020, written in English language and published in peer-reviewed journals. Narrative synthesis was undertaken to summarize the findings according a SWOT (strengths, weaknesses, opportunities, threats) analysis.

Results

62 studies met the inclusion out of the 278 search results. Data converged on: strengths in minimizing the risk of Covid-19 transmission, reduction of travel time and costs, comparable effectiveness to in-person care; weaknesses i.e. decreased ability to detect non-verbal cues, lower therapeutic alliance, possible technical connection problems; opportunities in improving the healthcare system and expanding its accessibility for patients also for the future; threats such as privacy and legal issues, and risk to overlook vulnerable populations (e.g. elderly, marginalized ethnic minorities).

Conclusions

In the midst of a global mental health emergency, telehealth may represent a “virtually perfect” solution. However, further implementations facing issues of quality, justice and healthcare equity are required to ensure that all patients receive the care they need.
For control of COVID-19: the development of regular mass testing of COVID-19 in old age psychiatry wards
Authors: Baek J. , Lennon S.
Published: February 2022

Introduction

COVID-19, was declared a pandemic by World Health Organisation on March 11, 2020. Older people with dementia or those with multimorbidity are more vulnerable to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the development of COVID-19. Given absence of a vaccine or treatment, prevention is the fundamental aspect of COVID-19 control. This requires early identification of contagious people with COVID-19 and isolation keeping them apart from non infected group of people. Early identification of infection in elderly with dementia or functional psychiatric condition is often difficult, due to difficulty in obtaining history or evaluating medical symptoms.

Objectives

1) To establish the current standards of interventions provided at the unit to control COVID-19, with current recommendation by Government guidance. 2) To address difficulties in early identification of people of COVID-19 in Old Age Psychiatry wards. 3) To introduce sustainable interventions aimed at controlling COVID-19 risk, targeted to this group.

Methods

Trust guidance for COVID-19 testing on the ward and guidance of isolation were reviewed. Literature review of currently available scientific evidence for testing for controlling COVID-19 was conducted.

Results

We have created a bi-weekly mass testing guidance for Old Age Psychiatry inpatient wards with clear guidane of when to start isolation and when to stop isolation.

Conclusions

There is no specific interventions to target older adult within our service currently and it was felt that it is necessary to develop a sustainable mass testing programme for this group of people for control of COVID-19.
Depression and anxiety consequences of the COVID-19 pandemic: A longitudinal cohort study with university students
Authors: Conceição V. , Rothes I. , Gusmão R. , Barros H.
Published: February 2022

Introduction

For young people, just as in the general population, COVID-19 caused many changes in their lives. The literature review has shown an increased risk for mental illness symptoms as a consequence of the pandemic.

Objectives

With this study, we aimed to evaluate the impact of COVID-19 pandemic in university students’ anxiety and depression symptoms.

Methods

This study is part of a larger longitudinal research on university students’ mental health with the Portuguese version of The Patient Health Questionnaire (PHQ-9) and the Portuguese version of the Generalised Anxiety Disorder (GAD-7) data with evaluations on January, May and October 2019 and June 2020, as well as socio-demographic information.

Results

341 university students (257 females and 84 males) were included in this study, with a mean age of 19.91 (SD=1.58). In June 2020, the mean for perceived well-being loss was 60.47% (SD=26.56) and 59.54% (SD=28.95) for mental health loss. In the PHQ-9, the proportion of students with scores equal or above 15 ranged between 22.6% and 25.5% in 2019, however, in June 2020, the proportion was significantly higher (37.0%). The proportion of GAD-7 scores above the cut-off 10 ranged between 46.0% and 47.8% in 2019, and, in 2020, 64.5% of the students scored 10 or above. Compared with preceding trends, PHQ-9 scores were 3.11 (CI=2.40-3.83) higher than expected, and GAD-7 scores were 3.56 (CI=2.75-5.37) higher.

Conclusions

COVID-19 had a negative impact on depressive and anxiety symptoms in university students, in line with the literature and confirming the vulnerability of young people in such uncertain times.
Past, present and future of psychiatry
Authors: Sartorius N.
Published: February 2022

Over the past few decades, psychiatry and mental health sciences have reached several major goals. The importance of mental health and the huge contribution to the burden of disability produced by mental and neurological disorders has been recognized by all and most recently also by the United Nations. Treatment technology has developed and permits the effective management of most mental disorders. Progress has also been made in the recognition of human rights of people with mental illness and those who care for them. More has to be done in these areas but there are also new tasks that are before psychiatry. These include the addition of primary prevention of mental disorders to previous efforts to ensure secondary and tertiary prevention of mental health problems; the development of appropriate ways of work in order to cope with problems of comorbidity of mental and physical disorders; and a fundamental reorientation of training in psychiatry and related sciences.

Disclosure

No significant relationships.
The impact of the COVID-19 pandemic on the mental health of healthcare professionals and associated factors: A review of literature
Authors: Sellami S. , Mami H. , Kacem M. , Hriz E. Ben , Fraj S. Ben , Bouzid R.
Published: February 2022

Introduction

The COVID-19 pandemic represents a stressful event for humanity. The spread of this disease mainly affects health professionals and interests them closely.

Objectives

Identify the impact of the COVID-19 pandemic on the mental health of healthcare personnels and associated factors exposing them to increased psychological fragility.

Methods

The current article is a narrative review of the existing literature. A search on electronic database like PubMed was undertaken using the search terms “coronavirus mental health healthcare workers”. 20 articles were included in this review.

Results

Studies revealed that health care workers have prensented considerable psychiatric symptoms such as anxiety, depression, PTSD, stress, insomnia, somatization, mental and physical exhaustion, addiction and obssessive compulsive symptoms. The prevalence of these symptoms varies from study to another with almost a more notable prevalence of anxiety and depressive symptoms. The following factors that predispose to developing mental distress were noted: being a frontline health worker, having direct contact with infected patients, working in a city with a high infection rate, female sex, isolation, being a suspected case, stigmatization, change of organization, lack of materials, lack of information, lack of communication, lack of support, fear of contamination or of contaminating loved ones, having an organic pathology.

Conclusions

This notable impact of the pandemic on the mental health of healthcare workers alerts us as colleagues and civil society to the ultimate need for an urgent adequate and up-to-date intervention to alleviate this distress.