bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological distress in Portuguese university students during COVID-19 pandemic: relationship with stress, sleeping and emotion regulation strategies
Authors: Sousa J. , Soares M. J. , Pereira D. , Macedo A.
Published: August 2023

Introduction

During the COVID-19 pandemic outbreak, psychological distress, anxiety and depression reached new highs associated with a number of variables such as pandemic related-stress and sleep difficulties. These later two are known to be the precipitant and risk factors for psychological distress/mental disorders, respectively, and negative cognitive emotion regulation strategies can also have a key role on psychological/mental health problems generation and maintenance.

Objectives

To study stress, sleep difficulties and the use of cognitive emotion regulation strategies by groups of students with different levels of psychological distress during the COVID-19 pandemic.

Methods

496 university students (mean age ± SD=20.99 years ± 2.27; 78.6% women) completed an online questionnaire between January and April, 2021, which included the Mental Health Inventory, the Perceived Stress Scale (PSS) and the Cognitive Emotion Regulation Questionnaire, as well as three questions from the Insomnia Scale to evaluate Difficulties in Initiating Sleep (DIS), Maintaining Sleep (DMS) and Early Morning Awakening (EMA). A Sleep Difficulties Index (SDI) was calculated by summing the scores of these three items.

Results

18.3% of the students showed high levels of psychological distress (group 1; scores 1 SD =/< Mean), 62.7% average levels (group 2), and 19% low levels (group 3; Scores 1SD =/>Mean). The group 1, compared with group 3, showed higher levels of sleeping difficulties (DIS, DMS, EMA and SDI), greater stress levels and an increased use of negative emotion regulation strategies, as well as a lesser use of positive emotion regulation strategies. Furthermore, the group 2, with average levels of psychological distress is significantly distinct from the group with better mental health when comparing these same variables.

Conclusions

Almost one fifth of the Portuguese university students report elevated levels of psychological distress during the COVID-19 pandemic. Clinical interventions to promote psychological/mental health in this population should focus on reducing stress, promoting adequate sleep habits, reducing the use of negative cognitive emotion regulation strategies and increasing the use of positive ones.

Disclosure of Interest

None Declared
Acute psychosis following corticosteroid administration for COVID-19 and Respiratory Syncytial Virus infection: A case study
Authors: Miranda Ruiz E. , Marimon Muñoz E. , Ramirez Gonzalez J. , Fariña M. , Troyano R. G. , Arroyo Ucar M. I. , Ferreiro S. , Fernandez Marquez I. , Hidalgo C. , Quispe A. , Delgado L.
Published: August 2023

Introduction

Steroids are a necessary treatment for hypoxic respiratory failure; however there are many side effects that should be taken into account. A 44- year-old-woman with asthma and no past psychiatric history was admitted due to COVID-19 pneumonia and Respiratory syncytial virus (RSV) infection, presenting hypoxic respiratory failure. After two days of intravenous methylprednisolone administration, the patient presented acute psychosis and agitation.

It has been previously described that steroid use can cause effects such as mania, anxiety, agitation, delirium and psychosis amongst other. However they are a necessary treatment in respiratory illnesses and are sometimes unavoidable.

Objectives

The aim was to examine the appropriate medical response to steroid induced psychosis in patients with acute hypoxic failure.

Methods

A bibliographical review was done in PubMed database searching recent cases of steroid induced psychosis using the words (“Steroid”, “Psychosis” and “COVID-19”).

Results

According to literature, it has been shown that partial or complete reduction of steroid use and/or use of psychotropic has been successfully used to treat steroid induced psychosis. Following the research it was decided to reduce intravenous methylprednisolone dose from 20mg/ 8h to 20mg/12h and start oral haloperidol 5mg/8h the first 24h and reducing the dose progressively as the patient recovered. After the first 24 hours the patient presented adequate response to steroids as well as partial response to antipsychotic treatment; presenting no further agitation, absence of hallucinations and partial persistence of the persecutory delusion. A couple of days later there was complete remission of the psychotic symptoms and the patient was on the way to recovery from COVID-19 and RSV.

Conclusions

There is evidence that suggests that medications such as steroids used to treat COVID-19 and other respiratory illnesses can lead to psychotic episodes. It is very important to pay attention to possible side effects when treating with steroids and evaluate the patient history as well as suggest having a follow up visit after the hospital discharge.

Disclosure of Interest

None Declared
Mental Health and Psychosocial Support in Response to Onset of the COVID-19 Pandemic: Findings from Action Against Hunger’s Emotional and Stress Management Intervention in Ivory Coast, Liberia, and Sierra Leone
Authors: Le Roch K. , Garriott A. , Phan X. , Bintu F. M. , Darciba S. P. , Koleti P. B. , Murray S. M.
Published: August 2023

Introduction

In 2020, as in the rest of the world, the COVID-19 pandemic spread in Africa and transformed people’s lives. Adding to the already existing burden of fragile health care systems, especially in low-resource settings, the pandemic response highlighted the need to address the health and well-being of populations in innovative ways. While research findings reported critical impacts on populations’ mental health, few studies assessed this progression within African countries. At the onset of the COVID-19 pandemic, Action Against Hunger (ACF), developed and delivered a brief Emotional and Stress Management Intervention (ESMI) to reduce symptoms of emotional distress and increase perceived social support through problem solving techniques and relaxation exercises among adults and youth living in vulnerable communities experiencing a relatively high prevalence of COVID-19 in urban and rural areas in Sierra Leone, Liberia and Ivory Coast.

Objectives

The primary aim of this study is to evaluate whether individuals who received ESMI experienced changes in psychological distress and social support following the intervention and the association between change in psychological distress and change in social support for each country.

Methods

This study consisted of secondary analysis of data collected via routine monitoring of activities by ACF for their ESMI programs implemented in community-based centers and health facilities from May to December 2020. Service delivery mechanisms were adapted to each context and setting (i.e., face to face vs. remote, health facilities vs. home visits, etc.). The main outcomes were psychological distress and social support measured with culturally relevant visual analogue scales. All analyses were performed separately for each country.

Results

In total, 1,412 adults and youth (11-17 years old) benefitted from the intervention across all countries and 1,350 were assessed at follow-up. As a result, changes for psychological support and social support with mean scores difference at baseline and follow up were significantly different in all countries. Correlations between changes in distress and changes in social support varied by country, and ranged from negative in Liberia, (r = -.88, p = 0.001), to positive in Ivory Coast (r = .55, p = 0.001), and null in Sierra Leone (r = -.07, p = 0.11). Across countries, the most commonly reported presenting problems were fear of infection, stigma, and socio-economic difficulties, with coping strategies differing by country.

Conclusions

At the onset of a pandemic crisis, low-intensity psychosocial support activities hold potential for reducing psychological distress and improving social support among adults and youth from vulnerable communities in the context of the COVID-19 pandemic.

Disclosure of Interest

None Declared
COVID-19 related Delusional Beliefs: A Case Report
Authors: Akyildirim Cor S. , Akcay B. D.
Published: August 2023

Introduction

A delusion is a fixed false belief based on an inaccurate interpretation of an external reality despite evidence to the contrary. The diagnosis of a delusional disorder is made when a person has one or more non-bizarre (situations that are not real but also not impossible) delusional thoughts for one month or more that cannot be explained by any other condition. In patients with delusional disorder, delusions(s) do not impact the functionality and the patient’s behavior is not overtly bizarre. Although delusional core themes tend to be the same throughout different epochs (i.e., persecution, grandiosity, guilt, religion, hypochondria, love, or jealous), clinicians commonly notice how delusions tend to rapidly incorporate popular hot topical issues. Hence, delusions are dynamic and often represent a combination of psychopathology and external events.

Objectives

The COVID-19 outbreak has affected millions of people globally and it also has a huge psychological impact. The objective of this case report is to outline the possible effect of the COVID-19 pandemic to delusional disorder in patients with healthy person.

Methods

The 40-year-old gentleman, a drum major (field commander), married, living with his wife and daughter (4,5 years old). He’s current complaints started when he did not want to have the Covid vaccine in April 2021 and therefore was exposed to mobbing at work. It is understood that the patient had irrevocable ideas about vaccine and PCR testing (radioactive lights were coming out from the PCR rod in a video he watched). For this reason, it is understood during the clinical interview that the patient was exposed to social restrictions at work and in his social life (he could not travel by public transport, plane, bus, and enter social facilities because he did not have a vaccination card or did not have a PCR test).He was admitted to our ward for the purpose of arranging his diagnosis and treatment.

Results

On our ward, the patient showed poor insight with persistence of delusions. The impression was delusinal disorder. He was treated with olanzapine up to 5 mg/day and sertraline up to 100 mg/day, with a progressive resolution of symptoms.

Conclusions

There are other case reports on COVID-19 delusional themes in patients with schizophrenia and patients with no history of mental illness, which means that this phenomenon is not exclusive to affective disorders. In this case, different from the literature, the patient has never had covid. An area of clinical concern is the potential of the pandemic’s psychological context to trigger psychotic disorders and influence their symptomatology. A review of contemporary epidemics and pandemics psychosis research found no evidence of changes in the form and content of psychotic symptoms. Further research should examine those biopsychosocial COVID-related factors that predispose to, precipitate, and perpetuate psychosis.

Disclosure of Interest

None Declared
Levels of anxiety, depression and stress among health care workers during the COVID19 pandemic: Study conducted at the University Hospital Farhat Hached of Sousse-Tunisia
Authors: Belhadj Chabbah N. , Chatti S. , Athimni Z. , Bouhoula M. , Chouchane A. , Aloui A. , Kacem I. , Maoua M. , Brahem A. , Kalboussi H. , Elmaalel O. , Mrizek N.
Published: August 2023

Introduction

During the COVID-19 pandemic, health care workers found themselves threatened by developing psychological effects.

Objectives

The objective of this study is to evaluate the impact of exposure to COVID-19 on the mental health of medical and paramedical staff at Farhat Hached Hospital in Sousse and to identify potential risk factors.

Methods

This is a descriptive cross-sectional study that included 166 health care workers of Farhat Hached Hospital of Sousse throughout 3 months. The patient health questionnaire (PHQ-9), the generalized anxiety disorder (GAD-7), and the revised event impact scale (IES- R) were used to assess depression, anxiety, and stress respectively.

Results

The mean age of the participants was 37.06 ±11.07 years with a female predominance (80.1%). The median professional seniority was 7.5 years with extremes ranging from 1 to 39 years. Nurses were the most represented (34.3%) followed by medical residents (24.7%). PHQ-9, GAD-7, and IES- R scores revealed that 51.8%, 40.4%, and 28.3% of participants had moderate or severe levels of depression, anxiety, and stress, respectively. Personal history of psychiatric disorders was significantly associated with depression (p<10-3) and anxiety (p=0.004). On the other hand, paramedical staff had a significantly higher risk of experiencing symptoms of depression (OR = 2.40 ; 95% CI [1.28-4.48] ; p= 0.006) and stress (OR = 2.03 ; 95% CI [1.01-4.11] ; p= 0.04) than medical personnel.

Conclusions

This study reported a high prevalence of symptoms of anxiety, depression and stress among health care workers. Improving mental well-being and providing psychological support to health care workers is recommended.

Disclosure of Interest

None Declared
Efficacy of brexanolone in postpartum depression
Authors: Rodríguez Mercado C. M.
Published: August 2023

Introduction

Depression whose onset in the peripartum period is commonly referred to as Postpartum Depression.Postpartum Depression affects 11.5% of women during pregnancy or postpartum.Brexanolone has been developed for the treatment of Postpartum Depression, it is a formulation of Allopregnanolone, which is administered parenterally. Several studies have found that a single Brexanolone infusion had rapid antidepressant effects for severe Postpartum Depression, with good safety.

Objectives

The objective of this review is to evaluate the effectiveness of treatment with Brexanolone in Postpartum Depression.

Methods

A systematic search was performed through Pubmed, including randomized controlled trials (RCTs).

Results

2 articles were selected that included three RCTs, in which participated 156 women diagnosed with Postpartum Depression who received an infusion of Brexanolone and 111 women with Postpartum Depression who received placebo .Compared to placebo, women who received Brexanolone had a significant clinical response, starting 24 hours after administration (RR: 1.34; 95% CI: 1.03–1.73). ), reaching its maximum action peak at 36 hours ( RR: 1.50; 95% CI 1.06–2.13; P = 0.02 ), and with a duration of effect up to the seventh day ( RR = 1.32, 95% CI: 1.01–1.73). Likewise, women with Postpartum Depression, treated with Brexanolone, had a significantly greater remission, starting at 24 hours of treatment (RR: 1.86; 95% CI: 1.03–3.34), reaching its peak maximum action at 60 hours ( RR: 2.20; 95% CI 1.31–3.70 ), and with a duration of effect up to 72 hours ( RR = 1.96; 95% CI: 1 .41–2.72).

Conclusions

The administration of a dose of Brexanolone seems to have an ultra-rapid antidepressant effect for the treatment of Postpartum Depression. The short-term and long-term therapeutic effect of brexanolone needs to be examined with large-scale randomized controlled studies.

Disclosure of Interest

None Declared
Diagnostic and psychopharmacotherapy in the general practictioner practice
Authors: Kraxner F. H.
Published: August 2023

Introduction

Due to the often long-standing and extensive doctor-patient relationship, family doctors have special access to the mental state of their patients. They are often the first point of contact, and consequently the treatment of depression often begins in the GP’s practice or even takes place entirely there. This requires dedicated knowledge on the part of the general practitioner, especially with regard to diagnostic criteria and treatment.

Objectives

The aim of this article is to describe the basic diagnostic process for the general practitioner’s practice, to give advice on the indication and implementation of psychopharmacological interventions, and to present the results. This overview summarises the most relevant connections to the diagnosis, assessment of the severity and psychopharmacotherapy of depression in general practice.

Methods

The following therapy algorithms and remarks are essentially based on the treatment recommendations of the Swiss Society for Psychiatry and Psychotherapy (SGPP) and the Swiss Society for Anxiety and Depression (SGAD) as well as the German S3 guideline of the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN).

Results

Family doctors play a central role in the treatment of depressive disorders. They are often the first point of contact for patients with depression and in about 40 percent of cases even the only contact point. The likelihood of developing a depressive episode in the course of a lifetime is 10 to 15 percent globally. Evaluations by the World Health Organisation WHO show that 9 to 23 percent of people with chronic illnesses have depression as a concomitant illness. A cross-sectional epidemiological study in Germany showed that 60 percent of patients in general medical care were not treated with antidepressants and/or psychotherapy in accordance with guidelines. In Switzerland, about half of the antidepressants are currently prescribed by general practitioners. Image 1 shows a detailled overview (in German) of the current medication.

Image:

Conclusions

Specialists in general internal medicine have a central role in recognition and treatment of depressive syndromes. Somatic causes can be ruled out by means of physical examination, laboratory and ECG/EEG/imaging. Mild and moderate depressive episodes can be treated by psychoeducation, counselling and medication. If the symptoms are mild, psychosocial support or psychotherapy alone can be considered. If acute suicidal tendencies or psychotic symptoms are identified, emergency symptoms, emergency admission to a psychiatric hospital should be considered.

The presence of other psychiatric comorbidities, resistance to therapy or complex psychiatric medication necessitate referral to outpatient specialists. Metabolic and cardiovascular side effects and interactions between psychopharmacological and internal medicine must be considered.

Disclosure of Interest

None Declared
Assessing the Efficacy of Repetitive Transcranial Magnetic Stimulation in the Management of Treatment Resistant Depression: A Scoping Review
Authors: Adu M. K. , Shalaby R. , Chue P. , Agyapong V.
Published: August 2023

Introduction

Treatment-resistant depression (TRD) is the failure to accomplish and/or achieve remission after an adequate trial of different classes of antidepressant treatments. TRD presents with significant disability and high prevalence. It results in a substantive socio-economic burden at the community and global levels. TRD. Studies comparing pharmacotherapy and electroconvulsive therapy with repetitive transcranial magnetic stimulation (rTMS) have demonstrated evidence in support of the therapeutic efficacy of rTMS in TRD.

Objectives

This comprehensive scoping review aimed to explore and garner information in the literature regarding the crucial role of rTMS and its therapeutic efficacy as a treatment modality for TRD.

Methods

Electronic data searches in PubMed, PsycINFO, Medline, Embase, and Cinahl were conducted to identify important articles on rTMS for TRD. The data search strategy was limited to articles written in English and published within the last five years, to the date of the data search (February 2022). Articles were reviewed if they reported on a completed randomized controlled trial of rTMS treatment in TRD. Articles were excluded if they were protocols of rTMS on TRD and studies with rTMS for the treatment of conditions other than TRD. The review process was reported using the PRISMA Extension for Scoping Reviews (PRISMA-ScR).

Results

In total, 17 studies met the eligibility criteria for this review. The geographical breakdown of the extracted studies consisted of North America (n = 9), Europe (n = 5), Asia (n = 2), and Australia (n = 1). The frequencies of rTMS applied in the various studies ranged from 5 Hz to 50 Hz, with stimulation intensities ranging from 80% MT to 120% MT. Overall, 16 out of the 17 studies demonstrated evidence that suggested rTMS treatment was effective, safe, and tolerated in the management of patients with TRD.

Conclusions

Overall, rTMS appeard to provide significant therapeutic benefits for patients with TRD through the reduction of depressive symptoms. However, while there is progressive evidence in support of rTMS in TRD, more research is needed to define the standardized protocols of rTMS application in terms of localization, frequency, intensity, and pulse parameters to realize its full potency in TRD.

Disclosure of Interest

None Declared
The Fall of Icarus: Post-psychotic depression - Apropros a clinical case
Authors: Jesus S. , Costa A. R. , Simões G. , Almeida M. , Tarelho A. , Garrido P.
Published: August 2023

Introduction

Depressive symptoms occur in different phases of psychosis, including prodromal, acute and post-psychotic. Post-psychotic depression (PPD) is a phenomenon that presents as a diagnostic and therapeutic challenge. Having been ascribed various descriptions in the past, PPD has been used in a broad manner to describe depressive symptoms that appear in patients with history of psychosis. PPD unveils itself as a separate nosological entity, differing from the adverse effects typically associated with antipsychotics, the negative symptoms of psychosis, and other psychiatric disorders that present with both psychotic and depressive symptoms (e.g. bipolar disorder, schizoaffective disorder, or psychotic depression).

Objectives

The authors present a case of a 64 year-old man hospitalized due to inaugural psychosis with persecutory and grandiose delusions as well as auditory hallucinatory activity, who began to develop a depressive clinical picture whilst under treatment. A brief discussion on post-psychotic depression, from its clinical presentation to its treatment and implications in prognosis is also presented.

Methods

A brief non-systematized literature review using the Pubmed platform as well as presentation of a clinical case.

Results

Depressive complaints are a common complication of psychotic episodes, with the literature estimating that approximately a quarter of psychotic patients present with PPD. Although typically described in association with schizophrenia, recent literature describes PPD occurring alongside other psychotic presentations, including first-episode psychosis. A division between affect and psychosis has been attempted in terms of psychiatric classification, however, the blurred lines between the two continue to contribute to difficulties in differential diagnosis. This becomes a challenge when distinguishing between extrapyramidal symptoms associated with antipsychotics, negative symptoms (i.e apathy, abulia and alogia) and psychiatric disorders with affective-psychotic overlap. Having only recently been considered a distinct clinical entity in psychiatric classification systems, research on its etiology, course, treatment and prognosis are scarce. In regards to the previously described patient, a depressive disorder whilst in treatment for psychosis was identified, and through early recognition of the symptoms treatment with an antidepressant was initiated with favourable response.

Conclusions

PPD is a relatively common phenomenon which is gaining more attention in recent literature. As classifications have begun to consider PPD as a distinct clinical entity, as well as unifying defining criteria, further studies can be developed so as to clarify aspects which remain to be defined. The clinician should be aware of this entity as well as the potentially confounding symptom presentations, so as to provide adequate early treatment thus contributing to improved patient outcomes.

Disclosure of Interest

None Declared
Relationship between orthorexia nervosa and self-esteem in Tunisian medical students
Authors: Abdelkefi M. , Masmoudi R. , Jbir R. , Cherif F. , Feki I. , Sellami R. , Masmoudi J.
Published: August 2023

Introduction

The effect of self-esteem in eating disorders has been investigated in several studies, but it’s still not extensively investigated in orthorexia nervosa.

Objectives

To study the prevalence and factors associated with orthorexic eating behaviors in medical students and it’s relation with self-esteem.

Methods

A cross-sectional study was conducted through an online survey among medical students of the faculty of medicine of Sfax (Tunisia). Participants completed an anonymous self-administered questionnaire. We collected their sociodemographic and clinical data. Orthorexia nervosa (ON) was assessed using the self-reported scale, ORTO-15. We used the Rosenberg’s self-esteem scale to assess self-esteem.

Results

Ninety five medical students completed the survey. The mean age was 25.8±3.4 years and the sex ratio (F/M) was 3.75. The average body mass index was 23.64±3.53 kg /m2.

Fifty-eight percent of the students (58%) reported that they were dissatisfied with their eating habits, and 27.4% tried to control their weight. Several methods of weight control were used, the most frequent (65.4%) were diet and physical exercise, none resorted to laxatives and 8.4% consulted a nutritionist.

Self-esteem was very low in 27.1% and low in 34.7% of the students.

Overall, the prevalence of orthorexia among our participants was 52.6%. The mean score of the ORTO-15 was 39.19±4.48.

Orthorexia was significantly correlated with the use of weight control measures (p=0.035) and physical activity (p=0.042).

Students with low self-esteem had higher tendency for orthorexia but with no significant correlation.

Conclusions

Our study supports a non-negligible frequency of orthorexic behaviors in medical students but future studies are needed to assess the direct effect of self-esteem on orthorexia.

Disclosure of Interest

None Declared
Binge Eating, Anxiety, Depression, and personality disorder in a Clinical sample of obese Adult in Egypt
Authors: Aboelenien S. K. I. M. , Sarhan Z.
Published: August 2023

Introduction

Obesity is a major public health problem and some developed countries have declared it ‘the modern day epidemic’. One of the major eating disorders that leads to obesity is BED, which involves consuming large quantities of high carbohydrate food. Studying the factors that cause and contribute to BED can help tackle this major health hazard and alleviate a huge burden on the nationalized health service.

Objectives

To determine the frequency of Binge Eating Disorder (BED) among obese adults, and to study its relationship to depression, anxiety, life stressors, personality and self esteem.

Methods

The sample was a randomised sample of clinically obese individuals, body mass index (BMI) of 30 and above. The sample was collected from two sites; Nutrition Clinic in Student’s Hospital, Cairo University and a Private Nutrition Centre. 250 cases were recruited over one year. All patients were subjected to a clinical interview derived from Kasr El Aini sheet , and measurement of Waist- Hip Ratio. Assessment of depression and anxiety was through Beck Depression Inventory , Hamilton Depression Rating Scale and Taylor Manifest Anxiety Scale(TMAS). Other tools used were the Eysenck’s Personality Inventory, Eating Disorder Inventory -2.

Results

BED among obese adults was 48%; 83 % of them had drive for thinness, 25% were bulimics, 45 % had ineffectiveness feeling. Also 83 % had body dissatisfaction, 8% were perfectionism seeking, 43 % showed interpersonal distrust and 25% presented maturity fears. Impulsivity was scored high in 25% , 66.6%had social insecurity and 77% had severe Extraversion. All were statistically significant. On the other hand there were no statistical significant difference between obese adults with BED and those without on TMAS. Half percent of participants with BED and 34.6 percent of participant without BED had moderate level of anxiety. In addition , there were no significant difference between obese participants with BED and those without BED according to BDI. However, 83.3% of obese cases with BED while 60 % for those without BED had manifest depression ranging from mild to severe depression.

Conclusions

Obese adults with BED have more drive for thinness, body dissatisfaction, feeling of ineffectiveness, perfectionism seeking, interpersonal distrust, maturity fears and social insecurity than non BED. Extraversion and Neuroticism are also more among BED. There were no significance different between both group in relation to Anxiety and Depression.

Disclosure of Interest

None Declared
Apparent effective Text4Hope online mental health support for male subscribers during the COVID-19 pandemic- Naturalistic randomized controlled trial
Authors: Shalaby R. , Agyapong B. , Vuong W. , Agyapong V.
Published: August 2023

Introduction

Mental illness is not uncommon among males. While the estimates of the males who are dissatisfied with their lives, die by suicide, become alcohol-dependent and drug users are high, low numbers seek mental health support.

Objectives

In this study, we aimed to assess Text4Hope, a texting mental health support service, provided to people in Alberta during the COVID-19 pandemic, and examine its effectiveness among male subscribers.

Methods

In a naturalistic randomized controlled trial design, a comparison was run between two populations of Text4Hope male subscribers; an intervention group (IG, Text4Hope subscribers who received once-daily supportive text messages for 6 weeks) and a control group (CG, Text4Hope subscribers who joined the program in the same time frame but were yet to receive text messages). The severity and the prevalence of likely stress, anxiety, and depression were examined between the two groups, using the Perceived Stress Scale (PSS-10), the Generalized Anxiety Disorder 7-item (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9), and defined the Composite Mental Health (CMH) score as the sum of these three. T-test, Chi-squared association, and binary logistic regression analyses were applied.

Results

There were 286 male subscribers to Text4Hope. The majority were above 40 years, white, employed, had postsecondary education, were in a relationship, and owned a home. Mean scores of PSS-10, GAD-7, and PHQ-9 scales and the CMH were significantly higher for the CG compared to the IG, 11.4, 28.8, 25.8, and 18.7%, respectively. Similarly, there was a statistically significant lower prevalence in IG, compared to the CG, on likely MDD (58.15 vs. 37.4%) and likely GAD (50 vs. 30.8%), with a small effect size. The IG was a significant predictor for lower odds of both likely MDD and likely GAD while controlling for sociodemographic characteristics.

Conclusions

Text4Hope is an effective tool for mental health support for male subscribers, during the COVID-19 pandemic. Compared to the subscribers who didn’t receive the service, those who received it were in a better mental health condition. Further efforts are still needed to encourage males to participate in such online services that can provide adequate support, particularly during crisis time.

Disclosure of Interest

None Declared
Workplace Violence Against Nurses Working In Mental Hospitals In Oman: a cross-sectional study
Authors: Alkalbani M. S.
Published: August 2023

Introduction

Workplace violence (WPV)has been a persistent problem that is underestimated and generally disregarded by the public and professional organisations, and it has been noticed that the highest number of these assaults are directed towards healthcare workers.

Objectives

The aim of the study is to determine the prevalence of workplace violence against nurses in psychiatry hospitals in Oman and to explore the determinants contributing to the workplace violence

Methods

This is a cross-sectional study was conducted at two tertiary mental health care hospitals (Al Masarra Hospital and Sultan Qaboos University Hospital) in Muscat, Oman between October, and December of 2021.Participants were asked to complete the Workplace Violence in the Health Sector to assess level of violence, as well as a sociodemographic survey.

Results

This study included 106 participants with 80% response rate. The Majority of participants aged between 30-39 years. Of this study, 52.8% werefemale and most of the participates are Omani (73%) and working in inpatient (80%). The highest type of violence experiences was verbal violence 86.8%followed by physical violence 57.5%. Most physical violence incidents 26.4% took place during weekdays with highest incidences happened during morning shifts (34%) followed by afternoon shift (25.5%).

Conclusions

Current study revealed a relatively high prevalence of WPV among nurses working at psychiatric hospitals in Oman. Future studies needed to explore the predictors of violent among nurse. It is important to invest in the prevention of WPV by constant training of workers in mental hospital in Oman on how to respond to violent psychiatric patients.

Disclosure of Interest

None Declared
Prevalence and Associated Factors of Post-traumatic Stress Disorder in Gangjeong Village Residents, Jeju-do, Korea
Authors: Kim M.-D. , Jung Y.-E.
Published: August 2023

Introduction

Most studies on post-traumatic stress disorder (PTSD) have involved a small sample size and a specific traumatic event, with few studies reporting on subjects who have been continuously exposed to a traumatic event. Timely assessment and treatment are crucial for individuals chronically exposed to a traumatic event.

Objectives

This study investigated the prevalence of PTSD and associated factors in all residents of Gangjeong village, who, recently, have been exposed to a traumatic event for a prolonged period.

Methods

The subjects of this study were the residents of Gangjeong village, who have been exposed to a traumatic event related to the construction of the Jeju Civilian-Military Complex Port. The survey included items related to general characteristics and PTSD symptoms, which were assessed using the Impact of Event Scale-Revised, Korean version.

Results

The prevalence of PTSD symptoms was 26.8% (95% confidence interval=23.54–30.04). Multivariate logistic regression analysis identified age, length of residence, and marital status as factors significantly associated with PTSD symptoms.

Conclusions

The prevalence of PTSD symptoms was higher among the study population than in the general population. Economically active age groups, people exposed to the traumatic event throughout their duration of residence in the village, and unmarried individuals were found to be more likely to develop PTSD symptoms. Mental, social, and financial support should be directed to the affected groups of individuals.

Disclosure of Interest

None Declared
BRUNNER SYNDROME: FROM GENETICS TO PSYCHIATRY - CASE REPORT
Authors: Falcão A. L. , Oliveira C. , Lourenço A. , Soares G. , Petta J.
Published: August 2023

Introduction

Monoaminergic neurotransmitters affect motor control, emotions and cognitive functions. Their relative abundance depends on the action of monoamine oxidase A (MAOA) which catalyses their degradation into inactive metabolites. Brunner syndrome is a rare chromosome X-linked recessive inheritance genetic disorder, which causes loss of function of the MAOA gene, leading to a relative increase in monoamines in affected individuals (typically males). It manifests with moderate intellectual developmental disturbance associated with maladaptive externalising behaviours, low frustration tolerance and marked impulsivity.

Objectives

To present a clinical case of patient diagnosed with Brunner Syndrome presenting with suicidal and homicidal ideation and to discuss it based on a non-systematic review of the literature.

Methods

Case report and non-systematic review of the literature.

Results: Case Report

Male born with neonatal asphyxia that consequently presented developmental retardation characterised by learning difficulties and emotional dysregulation. At 18 years of age, he began follow-up in Psychiatry due to self-injurious behaviours and several reactive suicide attempts (SA), being diagnosed with Intellectual Disability. At 22, he was hospitalised due to reactive depression, being discharged doing well with valproate, fluoxetine and olanzapine. Shortly after, he was arrested (aged 23-28) for attempted murder followed by SA. During imprisonment, he was diagnosed with Brunner’s Syndrome after his younger brother diagnosis. At 31, he was hospitalised for suicidal and homicidal ideation, revealing high impulsiveness and low frustration tolerance, and was discharged with compulsory psychiatric treatment. Three weeks later he was again hospitalised for symptoms recurrence having improved on Sertraline 50mg and Aripiprazole 400mg monthly.

Discussion

Although scarce, the available evidence suggests that dietary modifications and the use of selective serotonin reuptake inhibitors may improve behaviour, reduce serotoninergic symptoms and possibly reverse some neurochemical abnormalities.

Conclusions

Brunner syndrome is a rare genetic disorder with neuropsychiatric manifestations, whose course, treatment and prognosis are currently poorly known. Thus, the current treatment is empirical and further studies are needed.

Disclosure of Interest

None Declared
The Lester Tool : An audit of its use on an acute psychiatry inpatient wards.
Authors: Che Azih S. N. B. , Turley A. , Amarasinghe R. , Raju K.
Published: August 2023

Introduction

People with severe mental illness have an increased vulnerability to cardiovascular disease due to multilple biopsychosocial factors and a potential adverse effects of longer term treatment with anti-psychotic medications. Treatment of severe and enduring mental illness with antipsychotic medications is likely to cause metabolic changes leading to weight gain and dyslipidaemia, thus increasing risk of cardiovascular disease. Cardiometabolic risk screening can be done using Lester Tool which also provides recommendations for interventions.

Objectives

To identify the compliance to Lester Tool in the monitoring of cardiometabolic risk factors and intervention provided on acute psychiatry inpatients.

Methods

We carried out a retrospective audit of 30 patients on regular antipsychotic medication on an adult inpatient ward in Macclesfield, United Kingdom. Electronic records were reviewed to establish whether the smoking status, lifestyle, BMI, blood pressure, blood glucose and blood lipid were documented with evidence of interventions being provided.

Results

Of all 30 patients, none had shown compliance to all the parameters within the Lester Tool. 100% of the smoking status was documented, amongst which 78% were provided with interventions. 7% has lifestyle and diet status documented, of which 50% were given dietary advice. 80% had BMI documented, amongst which none were provided with any intervention. 90% had blood pressure documented, of which 50% were given any intervention. 40% had blood glucose documented, of which all were provided with intervention. 57% had blood lipid documented, of which none were provided with any intervention.

Conclusions

Our results have shown the need of further awareness on the usefulness of the Lester Tool in an acute inpatient ward. Our recommendation would be to regularly train and educate inpatient staff to ensure that all the necessary parameters be monitored and provided with interventions.

Disclosure of Interest

None Declared
Gender-specific anatomical correlations of schizotypy in healthy individuals
Authors: Tomyshev A. S. , Panikratova Y. , Lebedeva I. , Abdullina E. , Pechenkova E.
Published: August 2023

Introduction

Schizotypy refers to a continuum of symptoms from subclinical manifestations in the general population to severe symptoms in schizophrenia spectrum disorders. Neuroimaging studies revealed significant relationships between schizotypy and cortical anatomy in the general population. However, it remains unclear whether these structural associations has a gender specificity.

Objectives

The present study used structural MRI data to investigate the relationship between subclinical schizotypy symptoms and cortical and subcortical morphometric measures in male and female samples of healthy individuals.

Methods

164 right-handed healthy unmedicated individuals (18.0-34.9 years, 57% females) underwent structural MRI at 3T Philips scanner. T1-weighted images were processed via FreeSurfer 6.0 to quantify cortical thickness for 34 regions-of-interest (ROIs) according to Desikan atlas and volumes for 7 subcortical structures at each hemisphere. Schizotypy levels were assessed using self-report Schizotypal Personality Questionnaire, total schizotypy score and 4 factors scores (Cognitive-perceptual, negative, disorganized and paranoid factors as per Stefanis et al. Schizophr Bull. 2004; 30 335-350) were calculated. Partial correlation analysis (ppcor version 1.1, R version 4.2.1) was used to assess the associations between ROIs cortical thickness and total schizotypy or 4 factors scores including age and sex as covariates. The same analysis was performed for subcortical volumes including intracranial volume as additional covariate.

Results

In male group we revealed a positive correlation between greater thickness of the left caudal middle frontal gyrus and higher total schizotypy (r=0.42, punc=0.0003, 95% CI [0.21–0.60]) and negative factor of schizotypy (r=0.49, punc<0.0001, 95% CI [0.28–0.65]) (Image). No correlations survived correction for multiple comparisons in female sample. There were no differences in age, caudal middle frontal gyrus thickness, total schizotypy or negative factor of schizotypy scores between male and female subgroups.

Image:

Conclusions

The results suggest that the association of dorsolateral prefrontal cortex (DLPFC) and levels of schizotypy is gender specific. We showed that total and negative schizotypy positively correlated with thicker DLPFC in male but not in female sample. The present data are inverse to findings of prefrontal cortical thinning observed in schizophrenia. Such correlations suggest that thicker cortex could be a potential compensatory mechanism or could reflect alterations in trajectory of cortical thickness reductions across the lifespan.

The work was supported by RFBR grant 20-013-00748

Disclosure of Interest

None Declared
Brain Reward System And Its Volumetric Investigations In Alcohol Addiction
Authors: Tabara M. F. , Atmaca M. , Yildirim H. , Solmaz O. , Essibayi M. A.
Published: August 2023

Introduction

Alcohol use disorder (AUD) is a diagnosis that includes both addiction and abuse concepts that entered our lives with the DSM-5. The prevalence of AUD is 8.1% in men and 1.7% in women in Türkiye, and it is getting more and more common. Biopsychosocial factors play a role in the etiology of AUD.

Objectives

The brain reward system, which includes many cortical and subcortical structures, plays an active role in the initiation and maintenance of alcohol dependence. In this study, we aimed to reveal the structural changes in alcohol dependence.

Methods

15 cases with AUD and 17 healthy controls were compared in terms of total white matter, total gray matter, nucleus accumbens, amygdala and hippocampus volumes. AUDIT, MAST and alcohol addiction severity scale were administered to all participants. Magnetic resonance imaging of all participants was performed. Then, the relevant regions were painted cross-sectionally and volume measurements were made. The case group was evaluated for the diagnosis of AUD with SCID-V. Volume averages were evaluated with Student’s t test. ANCOVA was used to remove confounding factors and re-evaluate the difference between volumes.

Results

Although there were differences between volumes in the first analyzes with Student’s t test, they were not statistically significant.

Age and gender variables, which were determined by the literature to have an effect on volume measurements, were re-evaluated with the ANCOVA test. When the effects of age and gender variables were removed in the evaluation, the right hippocampus volume was found to be significantly reduced in the AUD group compared to the control group (F=5.26, p=0.03). Again, no significant difference was observed in the two groups in terms of areas other than the volume of the right hippocampus. Pearson correlation analysis was used to evaluate the relationship between scale scores, duration of alcohol use and amount taken, and volumetric measurements, but no statistically significant relationship was found.

Conclusions

Different findings have been reported in the literature regarding the examined region volumes. Our study found volumetric changes consistent with most previous studies. For more generalizable results, studies with a large number of participants are needed.

Disclosure of Interest

None Declared
Cognitive functions in people with mental disorders: focus on self-reflection, insight and mindwandering
Authors: Natale A. , Fusar-Poli L. , Sturiale S. , Placenti V. , Marino M. , Amerio A. , Rodolico A. , Concerto C. , Aguglia A. , Petralia A. , Signorelli M. S. , Serafini G. , Amore M. , Aguglia E.
Published: August 2023

Introduction

People with mental disorders may present impairments in cognitive and metacognitive functions. Self-reflection is the ability to reflect on oneself (specifically on one’s behavior, emotions, and thoughts) and insight is the awareness of one’s internal experience. Mindwandering (MW) is defined as the tendency to divert attention from current reality without a clearly defined intention. It can be spontaneous or deliberate. Several studies have investigated these alterations in patients with schizophrenia (SZ), while less is known for people with substance use disorder (SUD).

Objectives

The aim of the present study was to explore self-reflection, insight and MW in a group of patients with SZ and SUD.

Methods

The Self-reflection and Insight Scale (SRIS) and the spontaneous (MW-S) and deliberate (MW-D) mindwandering scales were administered to 25 patients with SZ, 21 patients with SUD, and 21 healthy controls (HC). Linear regressions were performed to evaluate the associations between the variables under study.

Results

Preliminary data showed that SZ and SUD patients presented lower SRIS and MW values than HC. Examining MW in detail, participants with SZ reported higher scores at than MW-D, while in people with SUD, MW-D scores were higher than MW-S scores. Linear regressions revealed that MW-D was negatively associated with self-reflection in SUD; moreover, insight scores were negatively associated with MW-S in SZ.

Conclusions

Our preliminary results confirm the importance of acting on the elements of metacognition in patients with mental disorders to improve the general outcome of the disease. A comprehensive therapeutic approach should include psychotherapeutic and social interventions aimed at increasing attention and introspection.

Disclosure of Interest

None Declared
Are we ready to be techno-digitalicus psychiatrists?
Authors: Orsolini L.
Published: August 2023

Digital mental health interventions and digital psychiatry have been rapidly implemented over the past decade, particularly with the intent to offer a potential solution in those problematic circumstances and logistic issues for which the current mental health service infrastructure is not able to adequately accommodate to the needs of most patients. Indeed, most mental health workforce does not always own an enough and appropriate theoretical either practical training in digital psychiatry and in delivering remote consultations safely and effectively. Most European countries do not have curricula-specific training requirements, either at core or higher specialty level, for psychiatry trainees to demonstrate competence in digital skills that may be considered essential to good clinical practice, including abilities and competencies needed to provide and deliver mental health interventions by using digital tools. The talk will provide an overview on the level of the current state-of-the-art of the European techno-digitalicus psychiatrist and psychiatry trainee.

Disclosure of Interest

None Declared