bluuebunny/crossref_metadata_2025 huggingface dataset:
Involvement of the intestinal microbiota in the formation of neurodegenerative disorders
Authors: Sidenkova A.
Published: August 2023

Introduction

Increased life expectancy, increased prevalence of neurocognitive disorders, various aspects of the concept of “age” and pathogenic the influence of late age on the formation of cognitive deficit was the basis for this study. Bi-directional communication between the brain and the intestine is continuous and supported by the mechanisms that carry out the work of the axis “brain-gut”. Increased life expectancy, increased prevalence of neurocognitive disorders,various aspects of the concept of “age” and pathogenicthe influence of late age on the formation of cognitive deficit was the basis for this study. Bi-directional communicationbetween the brain and the intestine is continuous and supported by the mechanisms that carry out the work of the axis“brain-gut”

Objectives

Studied relationships between microbiota of the gastrointestinal tract and CNS diverse and dynamic, including in relation to to age and the aging process. Studied relationships betweenmicrobiota of the gastrointestinal tract and CNSdiverse and dynamic, including in relation toto age and the aging process.

Methods

Microbiotic a person’s profile is age-specific. Changes in microbial middle age increase mental, cognitive problems in the elderly and senile age.

Results

Dysbiosis of the intestinal microbiota in AD triggers neuroinflammation, which contributes to the accumulation of Aβ in brain structures and pathological cleavage of the tau protein, which leads to disruption of the functions of microglia, hippocampus, and synaptic transmission. The emergence of a two-way connection through the vagus nerve system between the formations of the digestive tract containing microbiota and the CNS with the formation of a “vicious circle” with the development of age-related pathological processes in the CNS. The diverse and multilevel process of aging in its pathological form embraced the active participation of mental adaptation.

Conclusions

Involvement of the microbiota in the pathogenesis of the disease Alzheimer’s suggests that the correction intestinal microflora may have potential value for the prevention of cognitive damage and / or be included in the therapeutic complex, which requires further study and analysis. Involvement of the microbiota in the pathogenesis of the diseaseAlzheimer’s suggests that the correctionintestinal microflora may have potentialvalue for the prevention of cognitive damage and / or be included in the therapeutic complex, whichrequires further study and analysis

Disclosure of Interest

None Declared
Depression and Decay - A Case of Major Depressive Disorder with Psychotic Features in an Elderly Patient with Cancer
Authors: Wee Yun Qing E.
Published: August 2023

Introduction

Major Depressive Disorder is a common psychiatric diagnosis among elderly patients with cancer. More than 10% of cancer patients suffer from Depression, which negatively impacts their quality of life. Mood symptoms are treated pharmacologically with antidepressant medications, while psychotic symptoms are treated with antipsychotic medications. Electroconvulsive Therapy may be initiated early for psychotic depression.

Objectives

The objective of this case is to present a patient with Major Depressive Disorder, who developed psychotic symptoms after a diagnosis of malignancy, and to suggest early initiation of Electroconvulsive Therapy for treatment.

Methods: Case Report

Ms G is a 68-year-old female who presented with low mood, worries, poor sleep, anhedonia and suicidal ideation. She complained of abdominal bloatedness and was reviewed by Gynaecology, who discovered a large ovarian mass, likely malignant in nature. Within days of the diagnosis, the patient developed nihilistic delusions, believing that her body was decaying and filled with poison. She was distressed and worried that the poison would spread to others around her. Risperidone was initiated and uptitrated, with limited improvement. As early surgical removal of the ovarian tumour was advised, it was essential that the patient’s mental state be quickly stabilised. She was hence initiated on Electroconvulsive Therapy (ECT). The patient underwent a total of 11 sessions of ECT. She was initially started on daily sessions, and the frequency gradually tapered.

Results

The patient’s mental state improved. She was then continued on oral medications, and discharged home well to proceed with her Gynaecological surgery.

Conclusions

This is a case of Major Depressive Disorder with psychotic symptoms that emerged after a diagnosis of malignancy. This case illustrates the importance of routine screening for psychotic symptoms, including nihilistic delusions, in elderly patients with Major Depressive Disorder who are newly diagnosed with cancer. It may be beneficial to consider early Electroconvulsive Therapy when treating such patients.

Disclosure of Interest

None Declared
Elderly depression in front-line health services:A descriptive and evaluative
cross-sectional study
Authors: Mahfoudh K. , Ouertani A. , Aissa A. , Maddouri S. , Ouali U. , Jomli R.
Published: August 2023

Introduction

Depression is a common pathology in the elderly, often unrecognized and mostly
affiliated to the consequences of aging,especially in front-line services. It induces somatic
and functional impact and even a suicidal risk.

When unrecognized or neglected, depression can reduce life expectancy and increases
the use of healthcare and the institutionalization.

Objectives

-Determine the point-prevalence of depression in the elderly in a front-line heath
service in Tunis.

-

Identify risk factors of depression in the elderly.

Methods

A descriptive and evaluative cross-sectional study on a sample of patients aged 65 or
more, in a tunisian front-line service of general health care regardless of the medical
reason.

Sociodemographic and clinical forms along with the PHQ-9 scale (Patient health
questionnaire-9)

-

validated in tunisian dialect- were used.

Results

Thirty patients have participated in our study (21 men and 9 women). The average age
was 73.23 years. Chronic pathologies were found in 96.66% of cases.

The found risk factors are: female sex in 70% of cases, loneliness and isolation in
10% of cases, widowhood in 50% of cases, grieving in 6.6% of cases and somatic comorbidity in
96 .66% of cases.

The overall prevalence of depressive symptoms was 53.33%. This is correlated with
advanced age and female sex (57.14% in women vs 33.33% in men).

The depressive symptomatology found, was mild in 18.5% of cases, average in 62.5% of
cases and moderately severe in 18.5% of cases.

Conclusions

Depression is a frequent pathology in the elderly with multiple risk factors. The
aging of the Tunisian population on one hand and the change of the social model (family
nucleus) on the other, encourage the early detection of depression in the elderly and the
training of the health professionals in order to limit its prevalence.

Disclosure of Interest

None Declared
You Look Good Enough to Eat: A Brief Exploration of Human Cannibalism and Mental Illness
Authors: Jesus S. , Costa A. R. , Simões G. , Gomes A. I. , Garrido P.
Published: August 2023

Introduction

Although evidence of cannibalism in humans dates back millennia, for most civilized societies, it is an unthinkable act of violence and strictly taboo. It is commonly relegated to the domain of horror films and literature, often associated with the likes of Jeffrey Dahmer or Hannibal Lecter. However, for some, this theme encompasses a pathological or sexual realm. Vorarephilia or sexual cannibalism is, at its simplest level, a psychosexual disorder characterized by the erotic desire to be consumed by, or to personally consume, another human being´s flesh.

Objectives

The authors aim to review human sexual cannibalism as a concept and its eventual relationship to mental illness with recourse to the description of cases of human cannibalism documented in the literature.

Methods

A brief non-systematized literature review utilizing various databases including Pubmed and Google Scholar, as well as complimentary literature and case reports when pertinent to the theme was performed.

Results

Although cannibalism is a common phenomenon in the animal kingdom, its expression in humans is assumed to be a minority occurrence and relegated to stories of a more primal past. Pathological cannibalism is an extremely rare occurrence and has been described in association with severe psychotic mental illness and extreme forms of significant paraphilia. Sexual cannibalism appears as a rarity in humans and although the majority with this paraphilia do not partake in actual human consumption, remaining a fantasy-based desire, cases of cannibalism have been reported and tried.

Conclusions

Eating the flesh of one’s own species is probably one of the few remaining taboos in modern human societies. In humans, cannibalism is a rare occurrence and has been associated with mental illness. Due to the rarity of this phenomenon, with few cases documented in the literature, the underlying etiology, as well as potential environmental and individual risk factors are still to be defined, indicating a potential for further study.

Disclosure of Interest

None Declared
UNTIL IT BURSTS OR ALL OF US BURST. A SCHIZOTYPICAL CASE.
Authors: Rodríguez Rodríguez B. , Navarro Barriga N. , Fernández Lozano M. , Mateos Sexmero M. J. , Andreo Vidal M. A. , Calvo Valcárcel M. , Martínez Gimeno P. , Pando Fernández M. P. , Aparicio Parras A. , Guillén Soto M. D. L. Á. , Jiménez Aparicio T. , Vallecillo Adame M. D. C. , de Andrés Lobo C. , Gonzaga Ramírez A. A. , Guerra Valera G. , Queipo de Llano de la Viuda M. , Esperesate Pajares M.
Published: August 2023

Introduction

Schizotypal disorder is conceptualized as a stable personality pathology (Cluster A) and as a latent manifestation of schizophrenia. It can be understood as an attenuated form of psychosis or high-risk mental state, which may precede the onset of schizophrenia or represent a more stable form of psychopathology that doesn’t necessarily progress to psychosis.

Objectives

To exemplify the continuum of psychosis

Methods

Review of scientific literature based on a relevant clinical case.

Results

39-year-old male living with his parents. He started studying philosophy. He is a regular cannabis user and has an aunt with schizophrenia. He’s admitted to psychiatry for behavioral disturbance in public. He refers to having been hearing a beeping noise in his street for months, what he interprets as a possible way of being watched due to his past ideology. Without specifying who and why, he sometimes shouts “until it bursts” to stop the noise and he thinks that his neighbours alerted the police about his behavior. During the interview he alludes to Milgram’s experiment, saying that throughout history there have been crimes against humanity and those who pointed them out were labeled “crazy”. His father refers that he has always been “strange” and with certain extravagant revolutionary ideas and thoughts. He doesn’t maintain social relationships and dedicates himself to reading and writing.

Conclusions

It’s important to understand psychosis as a continuum to advance the understanding of etiology, pathophysiology and resilience of psychotic disorders and to develop strategies for prevention and early intervention

Disclosure of Interest

None Declared
Mindfulness Practices in borderline personality disorder: A review of the literature
Authors: Mariem C. , Gros M.
Published: August 2023

Introduction

Borderline personality disorder (BPD), also known as emotionally unstable personality disorder is a severe disorder of emotional regulation. In people with BPD, mood swings are extreme, relationships are uncertain, and emotions are difficult to control, suicide and self-destructive behaviors are extremely common. medical treatment can certainly reduce the symptoms and suffering of people with BPD, but it is still not enough. The treatment is mainly based on psychotherapy especially Dialectical behavior therapy (DBT) focuses on the concept of mindfulness, or paying attention to the present emotion.

Objectives

To assess the current level of evidence for mindfulness in BPD.

Methods

a systematic review was performed using the database PubMed / Medline, using the following keywords: “MCBT”; “DBT”; “Mindfulness Therapy”;” BPD”; “Borderline personality”.

Results

Research shows that the mindfulness therapy approach teaches skills for controlling intense emotions and reducing self-destructive behaviors. Decentering appears to play a crucial role in the treatment as a primary mechanism of action in this therapy.

Conclusions

results suggest that the Mindfulness therapy is a main component for BPD treatment.

Disclosure of Interest

None Declared
Military psychological trauma: The contribution of EMDR
Authors: Falfel D. , Kefi K. , Bechikh C. , Kefi H. , Edhiff S. , Oumaya A.
Published: August 2023

Introduction

The treatment of psychological trauma is an integral part of the health care provided to military patients in Tunisia. For patients with PTSD several therapeutic options are proposed to patients as EMDR but there are various barriers to the use of EMDR . It seems that being patients consider the therapy which necessitate recognition and expression of emotional distress as a weakness. Added to that patients may be judged negatively by others and experiencing social rejection and isolation which limited the use of EMDR in a military setting.

Objectives

The aim of this study is to study the contribution of the EMDR associated to pharmacological treatment in PTSD among military patients comparing to patients who received only medication .

Methods

The study was conducted since 2021 during ten months at the military hospital concerned two groups of patients with PTSD the first one composed of four military patients with PTSD who received 11 sessions of EMDR associated to medication and the second one four patients exposed to the same trauma under medication only. The evolution oftroubles were assessed using PCL-5 scale and medication compliance was assessed by psychometric scale MARS .Other data was gathered from medical files .

Results

The first group of four military patients who were followed for PTSD since a year under pharmacological treatment presented sleep disorders with flaschbaks and nightmares , . The patients consulted for a depressive disorder and asocial isolation with feelings of insecurity about others. Psychiatrists proposed to associate 11 sessions of EMDR . At the end of sessions the evolution was interesting with regression of symptoms and remission comparing to the second group who presented relapses ten months later.

Conclusions

To improve symptoms of PTSD The use of EMDR is not systematic in a culture where emotional expression is restrictive in an environment that favors the intellect over the emotions. However EMDR can help the military patients with PTSD to link cognition to the emotions. PsychiatristS should propose this therapy as well as possible to patient with severe trauma to avoid relapse .

Disclosure of Interest

None Declared
Healthy mental higher education students’: Presentation of a project
Authors: Torres A. , Costa J. , Carvalho P. , Loureiro M.
Published: August 2023

Introduction

The prevalence of mental disorders in Higher Education Students (HES) is high and has shown a worrying growth. However, only a small percentage of HES in need of psychological support request it, due to the stigma related to mental illness, requesting informal help from friends and family. Training and increasing Mental Health Literacy (MHL) have been stated as appropriate strategies to reduce stigma and increase the demand for professional psychological support. However, with the increase in the demand for help, the difficulty of providing an adequate response from psychological support of HE services also increases. Therefore, procedures that develop socio-emotional skills in the HES and strategies that enhance the responsiveness of these services are necessary.

Objectives

Taking in consideration the literature review in this field, we develop a project to improve the mental health of HES. The project objectives’: a) the reduction of stigma related to mental disorders through the promotion of MHL in the academic community; b) the promotion of mental health and socio-emotional skills of HES; c) increasing detection and active search for professional mental health support, and d) the implementation of psychological intervention based on a stepped care model that provides an adequate response to most of the students’ mental health needs, according to individual needs.

Methods

The project proposes to perform the following methods: a) training in mental health open to the academic community, which will aim to train volunteers to be Gatekeepers, in order to promote awareness, detection and referral of students in need of professional psychological support; b) implementation of a Student Observatory, with tracking of psychopathological symptoms, supported on the Web; c) implementation of a psychological intervention program based on a stepped care model, which will include the following progressive phases by severity: 1) digital self-help manual; 2) web-based self-help groups; 3) psychological intervention groups supported by the Web; 4) face-to-face intervention groups and 5) individual psychological intervention.

Students will be assessed before and after each step of care, with the following psychological instruments: Mental Health Inventory (MHI); Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7).

Results

The implementation of the presented methods expect to achieve improvements on HES’ mental health, namely improvement of MHI, reduction of PHQ-9 and GAD-7 after each step of the psychological care.

Conclusions

The project presented encloses evidence-based interventions, with inspiration on psychoeducation and cognitive behavioral approaches, and it is expected to contribute to the improvement of mental health of HES. The results will be collected and disseminated. We encourage other researcher and clinicians to perform studies about the mental health of HES.

Disclosure of Interest

None Declared
Assessing and Supporting Mental Health Outcomes Among Adolescents in Urban Informal Settlements in Kenya and Uganda
Authors: Mbithi G. , Abubakar A.
Published: August 2023

Introduction

Mental health problems among adolescents have been on the rise particularly among adolescents in sub-Saharan Africa (SSA) due to impoverished living conditions and a high burden of chronic diseases including HIV/AIDs. COVID-19 pandemic has further exacerbated the risk and placed additional stress on adolescents’ mental health. While the burden might be high, there are fewer mental health services in the region.

Objectives

To evaluate the psychological and mental well-being of adolescents living in and co co-design with civil society organizations (CSOs) interventions aimed at enhancing mental health and psychosocial well-being.

Methods

Firstly, we conducted a formative phase to assess the burden of various mental health problems in Kenya. We conducted a cross-sectional survey in which we assessed the mental health status of 1541 adolescents using standardized tools. The participants comprised in and out of school adolescents, adolescents with disability, and those living with HIV/AIDS. Furthermore, we undertook a qualitative study through FGDs and KIIs to identify the factors contributing to mental health problems.

Secondly, we aim to adapt interventions that seek to promote mental health. Finally, we aim to implement effective mental health interventions targeting over 2000 adolescents living in Kenya’ informal settlements.

Results

We found the prevalence of depression to be higher among out-of-school adolescents at 36.0% compared to school-going adolescents at 20.6%. Furthermore, out-of-school adolescents had statistically significantly higher anxiety scores as well at 27.7 % when compared to their school-going counterparts at 19.1%. In-school adolescents had a better quality of life scores, lower pandemic anxiety scores, and lower emotional scores compared to their out-of-school counterparts. Results from regression models indicated that being out of school, having a COVID-19 infection, having poor relationships with parents and peers, loneliness, and living in an unsafe neighborhood were factors associated with poor mental health outcomes. During the qualitative interviews, participants noted that COVID- 19 brought about financial stress, joblessness, led to early pregnancies, involvement in commercial sex work by adolescents, school dropouts, lead to stress, and depression among other issues.

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Conclusions

Adolescents, especially those out of school are at a high risk of poor mental health outcomes due to exposure to a host of psychosocial risk factors. We have identified two interventions that we are keen to implement: the Shamiri Wellness Intervention (https://www.shamiri.institute/the-shamiri-intervention) and the Mental Health Literacy Programme (http://mentalhealthliteracy.org/). We hope that by working with CSOs, the study will support the development of their capacity to offer mental health services that are sustainable, and contextually appropriate.

Disclosure of Interest

None Declared
Architecture and mental health wellbeing versus architecture therapy for mental disorders
Authors: Bouayed Abdelmoula N. , Abdelmoula E.
Published: August 2023

Introduction

Architecture is a particular art as well as a transversal science that evolves according to multiple variables that call upon, aesthetics, sociology, political science, technology, history, cultures, economy, tourism, as well as the satisfaction of human needs and the physical/psychological health. It addresses the four senses of human and it humbly configures man’s environment, constitutes the set or the framework in which he evolves and in which he becomes an actor, both overwhelming and magical as Aldo Rossi says (1981).

Objectives

We aim through this review to show how does architecture affect human mental health wellbeing and what can we do to create a therapeutic architecture.

Methods

We comprehensively review the scientific literature using Pubmed database and other search platforms such as Google scholar to state the relationship between architecture and human mental health wellbeing and to delineate the meaning of architecture therapy in the field of mental disorders.

Results

Our bibliographic research revealed that Architecture and mental health are directly linked and that the concept of therapeutic architecture or architectural therapy has been generated in 1984 by Roger Ulrich, Professor of Architecture at the Centre for Health Design in Sweden to designate the influence of the environment on the healing and recovery process of patients. In fact, Architecture has the ability to create meaningful spaces. Churches, mosques and cathedrals planned centuries ago are a testament to architectural wonders, as they evoke a sense of magnificence, royalty, glory, serenity and tranquility. The intriguing details of these spaces were meant to induce positive feelings and emotions and are considered architectural masterpieces to this day, as they continue to fascinate humans around the world. In the other hand, many studies showed the positive effect of nature (therapeutic horticulture) and exposure to the outdoors; towards distraction from stress and anxiety levels of patients in a Health care setup. Recent studies analyzed how Architecture and interior design (safety and security, noise and external stressors, space and interior layout, nature, lighting and atmosphere, art, community, etc…) are important not only for the well-being of patients in health care centers, but also for humans in general in their living environments.

Conclusions

Mental health is impacted by different aspects of architecture and design. Incorporating elements such as natural lighting, open floor plans, private and open community spaces, artwork, safety procedures, and nature/views of nature, provides a supportive environment for the mental well-being and the treatment of mental disorders.

Disclosure of Interest

None Declared
Haloperidol-induced facial and upper limbs oedema: a case report study
Authors: Khayeche S. , Saguem B. , Majdoub R. , Nakhli J.
Published: August 2023

Introduction

Haloperidol is one of the first-generation antipsychotics which is used widely around the world and still has its place in psychotic disorders along with his documented antimanic properties.

It acts by blocking essentially dopaminergic receptors but also serotonergic and alpha-adrenergic receptors.

Haloperidol has many side effects, especially extrapyramidal symptoms. Oedema associated with haloperidol is a rare side effect.

Objectives

The aim of this presentation is to describe the case of a young female who developed a rare side effect of haloperidol.

Methods

we conducted a review of literature on different data base about this side effect in order to discuss its potential underlying mechanisms.

Results

Here we report a case of a 24-year-old female with the history of bipolar disorder type 1, and an allergy to chlorpromazine. She was admitted to our psychiatric department for a manic episode with psychotic features and was initially treated with 50 mg of Haloperidol in addition to 30 mg of valium per day. She developed pronounced oedema of the face and upper limbs after two weeks of treatment. All of the paraclinical examinations including blood cell count, liver function tests, renal function tests, serum electrolytes, ECG, urine test didn’t show any abnormalities. We solicited the opinion of both nephrology and pharmacovigilance and concluded to an allergic oedema.

The symptoms disappeared 10 days after the discontinuation of haloperidol which suggested a potential incrimination of this drug

As far as we know, there are very few reports of allergic oedema with haloperidol in the literature. Potential underlying mechanisms will be discussed.

Conclusions

Through this case study, we aimed to focus attention on this very rare but still possible side effect.

Disclosure of Interest

None Declared
Prodromal stage and clinical features of late-onset schizophrenia and schizophrenia-like psychosis
Authors: Pochueva V. , Sheshenin V.
Published: August 2023

Introduction

The early diagnostic of schizophrenia and other psychosis is very important for the early therapeutic interventions.

Objectives

The aim is to describe the connection between the prodromal stage of psychosis and clinical features.

Methods

74 patients with late-onset psychosis (mean age 64,33±9, 2 male; age of onset 55,3±11,2): late-onset schizophrenia (LOS) (n=49, mean age 63,0±8,47, age of onset 53,9±9,56), late-onset schizoaffective disorder (LOSaD) (n=17, mean age 62,4±6,5, age of onset 54,6±10,6, 2 male), late onset delusion disorder (LODD) (n=8, mean age 76,6±4,3, age of onset 65,2±17,0). Psychopathological, statistical methods were applied.

Results

Allocated 4 types of prodromal stage – 1st without psychopathological signs (n=24, 33%), 2nd – with affective signs like disturbances of mood, anxiety (n=18, 24%), 3rd – with paranoid signs like acute stress-related paranoid reactions without medication; 4th - with schizoid signs with overvaluated ideas. In the 1st group next syndromes prevailed: with secondary persecutory mood-congruent delusions (n=10, 41,7%); with auditory second-person pseudohallucinations with sistematyzed persecutory delusions (n=9, 37,5%); with only systematized persecutory delusions (n=1, 4,1%); with bizzarre delusions (n=3, 12,5%) and with polymorphic symptoms, include different hallucinations, catatonia disorders and with some oneiroid state signs (n=1, 4,1%). In this group 9 patients were diagnosed with LOS (37,5%); 12 patients with LOSaD (50%) and 3 patients with LODD (12,5%). The 2nd group was presented with auditory second-person pseudohallucinations with sistematyzed persecutory delusions (n=5, 27.7%), with secondary persecutory delusions with delusion mood (n=11, 61%), with systemized persecutory delusional - 5.5% (n=1) and with catatonia (n=1, 5.5%). In this group 12 patients were diagnosed with LOS (66%), 5 patients with LOSaD (28%) and 1 patient with LODD (5.5%). In the 3rd group these syndromes prevailed: with auditory second-person pseudohallucinations with sistematyzed persecutory delusions (n=7, 63%), with secondary persecutory delusions with delusion mood - in 2 cases (18.2%), with bizarre delusions - in 2 cases (18.2%). 12 patients were diagnosed with LOS (n=10.91%) and 1 patient with LODD (1.9%). The 4th group was presented with auditory second-person pseudohallucinations with sistematyzed persecutory delusions (n=5, 23.8%), with secondary persecutory delusions with delusion mood (n=3, 14.3%), with bizarre delusions (n=6, 28.6%), with systemized persecutory delusions (n=1, 4.7%), with catatonia (n=2, 9.5%) and with polymorphic symptoms (n=4, 20%). 18 patients were diagnosed with LOS (85.7%) and 3 patients - with LODD (14.3%).

Conclusions

There are different types of prodromal stage in late-onset psychosis that concluded with clinical features.

Disclosure of Interest

None Declared
Treatment of tardive dyskinesias with vitamin E: A case series
Authors: Senol B. , Akarca F. N. , Ekinci R. N. , Goka E.
Published: August 2023

Introduction

Tardive dyskinesia is usually persistent, irreversible involuntary movement of the tongue, lips, face, trunk and extremities in patients taking long-term dopaminergic antagonist drugs. Although it is mostly associated with the use of neuroleptics, cases of tardive dyskinesia existed before the discovery of these agents. Patients with schizophrenia and other neuropsychiatric disorders are particularly at risk for tardive dyskinesia because they are exposed to neuroleptics and anticholinergic agents for longer periods than healthy individuals. Free radicals are thought to be probably involved in the pathogenesis of tardive dyskinesia. Vitamin E is a fat-soluble antioxidant, and it is thought to be effective in the treatment of antipsychotic-associated tardive dyskinesia, as it has a cytotoxic free radical-binding effect.

Objectives

In this poster presentation, it was aimed to evaluate the clinical results of the treatment of tardive dyskinesia with high-dose vitamin E in four inpatients with serious mental illness and long-term antipsychotic use. In addition, the treatment of tardive dyskinesia will be discussed in the light of current literature data.

Methods

In the case report, there are three patients with schizophrenia and one with mild mental retardation. They were treated with 1600 IU of vitamin E per day. The patients continued their vitamin E treatment for 90 days. The severity of tardive dyskinesia of the patients was measured by Abnormal Involuntary Movement Scale (AIMS).

Results

At the end of the 90 day treatment, the AIMS measurements of the subjects decreased 72,7%, 73,3%, 72,2% and 80% respectively.

Image:

Conclusions

In our clinic, we observed that patients using long-term typical antipsychotics were prescribed antipsychotics in unindicated situations or in high doses, patients with high risk for tardive dyskinesia were not taken into consideration when planning treatment, and we encountered cases of tardive dyskinesia despite the widespread use of atypical antipsychotic drugs in hospitalized patients. The use of benzodiazepines is restricted especially in elderly individuals due to their side effects and the risk of addiction in long-term use. Although the clinical importance of vitamin E is unknown, it is preferred because it can be used with a low risk of side effects, considering that it can prolong bleeding time. Although the results of a review of tardive dyskinesia treatment do not suggest that vitamin E reliably improves tardive dyskinesia symptoms, our experience shows that patients benefit from vitamin E treatment. In this regard, there is a need for studies that will be conducted with a large sample and compare the effectiveness of vitamin E with the treatments known to be effective in tardive dyskinesia.

Disclosure of Interest

None Declared
Lithium neurotoxicity – a case report and review of the literature
Authors: Almeida Rodrigues C. , Carvalho A. , Martins Costa F. , Silva de Melo V.
Published: August 2023

Introduction

Lithium, a mood stabilizer, is a commonly prescribed and effective treatment for bipolar affective disorder. It´s excreted almost exclusively by the kidneys with a half-life primarily determined by renal function. Chronic intoxication results from an insidious accumulation of lithium in a chronically medicated patient (due to a reduction in renal function secondary to volume depletion, a new medication, et cetera). Patients often present with neurologic findings, including tremor, ataxia, dysarthria, confusion and neuromuscular excitability.

Objectives

The objective of this report is to describe a clinical case of lithium neurotoxicity (myoclonus and encephalopathy), along with a review of the literature on the topic.

Methods

We describe a case of lithium neurotoxicity, along with a brief non-systematic review of the literature on lithium toxicity. We conducted a PubMed bibliographic search using keywords such as “lithium intoxication”, “lithium neurotoxicity”, “lithium encephalopathy” and “lithium intoxication treatment”.

Results

A women aged 81 was brought to the emergency department by her daughter following 1 week of asthenia, diarrhoea, periods of confused speech and involuntary movements. In the previous week, the patient had been diagnosed with COVID-19. Her past medical history is significant for bipolar affective disorder, hypertension, diabetes mellitus, dyslipidemia and asthma. The patient has been treated with following drugs: lithium carbonate (no recent change of dose and previous serum levels around 1mmol/L), quetiapine, lisinopril, metformin, simvastatin, formoterol and budesonide. On the first examination, she had an exuberant multifocal myoclonus. Posteriorly, she became somnolent, with language impairment (verbal perseveration, echolalia) and dysarthria. Investigations revealed renal impairment (creatinine 1,5 mg/dL, blood urea nitrogen 42 mg/dL) and supratherapeutic lithium levels (lithium serum level 1,7 mmol/L). Computed tomography scan of the brain was negative for acute injuries. The electroencephalogram showed triphasic waves (1-1,5 Hz). Encephalopathy secondary to lithium intoxication was diagnosed (probably in the context of acute kidney injury precipitated by hypovolaemia – diarrhoea). Lithium was stopped and intravenous isotonic fluids were given. After 1 week, her myoclonus resolved and over the following week the other signs resolved as well. The patient was later discharged to her daughter’s home, with follow-up neurology and psychiatry visits.

Conclusions

Both reversible and irreversible neurotoxicity related to lithium have been reported, specially occurring alongside chronic intoxication. If not addressed, impaired consciousness can lead to coma and death. A high clinical suspicion is needed for prompt diagnosis and treatment (intravenous fluids and sometimes haemodialysis are warranted).

Disclosure of Interest

None Declared
Persistent hiccup as an adverse effect of amisulpride in a patient with first episode of psychosis.
Authors: Retsou I. , Antoniadis D.
Published: August 2023

Introduction

A 28-year old male patient was admitted involuntarily to the 4th PICU of the Mental Health Hospital of Thessaloniki, due to severe psychotic symptoms and disorganised behaviour. Upon mental health examination the symptoms included auditory hallucinations, tangible speech, delusional ideas of somatic and persecutory type and significant neglect of his personal hygiene. The onset of his psychotic illness was 3 years prior, with two hospitalizations in the UK, and several unsuccessful attempts of outpatient monitoring.

Objectives

The study of persistent hiccup as an adverse effect of antipsychotic medication.

Methods

Monitoring for adverse effects during admission.

Results

On the 8th day of admission, oral olanzapine 10 mg was commenced at night. On the 9th day, olanzapine was increased to 20 mg per day. Discontinuation of intramuscular medication occurred on the 16th day. After presenting no clinical improvement for 27 days with the administration of olanzapine as monotherapy, amisulpride at 2ml per day was initiated alongside the Olanzapine. In the context of medication titration, amisulpride reached 8ml per day, equivalent to 800mg per day after 2 months of hospitalisation.

Conclusions

Apart from minor constipation, no other gastrointestinal health problems were reported in his records. The onset of the hiccups occurred along the dosages of 800mg/day of amisulpride and 20mg/day of olanzapine.

There was a satisfactory response to treatment evidenced by a 30% reduction on the Positive scale of the PANSS, however, the hiccups did not recede.

Disclosure of Interest

None Declared
DOCTOR, I’M PREGNANT. Psychopharmacological treatment of depression in pregnant women. A clinical case of a pregnant woman and major depressive disorder
Authors: Queipo De Llano De La Viuda M. , Guerra Valera G. , Vallecillo Adame C. , De Andrés Lobo C. , Jiménez Aparicio T. , Fernández Lozano M. , Santos Carrasco I. D. L. M. , De Uribe Viloria N.
Published: August 2023

Introduction

Depression during pregnancy can appear with a prevalence of up to 11% of pregnant women. Psychotherapeutic treatment in these cases is considered the first option, but treatment with antidepressants is sometimes required in these cases.

Objectives

To present a clinical case of a pregnant patient diagnosed with depression.

Methods

Literature review of the psychopharmacological treatment of depression during pregnancy and possible complications.

Results

A 25y Year old woman, 22 weeks pregnant, who lives with her partner. She has no background in mental health. Paternal aunt diagnosed with type I Bipolar Disorder. She goes to the Mental Health Center for evaluation, due to anxiety and depressive symptoms of 4 weeks of evolution, she refers sadness and apathy, continuous crying, somatic anxiety and obsessive ruminations in relation to childbirth and inability to care for your child. Suicidal ideation as a resolution of her discomfort. She presents with global insomnia and a significant loss of appetite, with a weight loss of 3 kg. Treatment with sertraline 50 mg/day was started, with good tolerance and clinical response

Conclusions

The psychopharmacological treatment of antenatal depression is a challenge for the psychiatric professional. In all cases, an adequate balance must be made between the risks and complications for the fetus and the psychopathological stability of the pregnant woman. Among the main risks of untreated depression are: preterm delivery and low birth weight, an increased risk of suicide and alterations in the development during the baby’s infancy. The most used antidepressants are the SSRIs, with sertraline being a good option. Paroxetine has been associated with cardiac defects in the newborn. There are studies with tricyclics and duals but no specific teratogenic pattern has been seen. They are associated with an increased risk of spontaneous abortion. Exposure during the third trimester may be associated with obstetric complications.

Disclosure of Interest

None Declared
Mydriasis caused by ESCITALOPRAM: A case report
Authors: Bouattour N. , Bouattour W. , Messedi N. , Charfeddine F. , Aribi L. , Aloulou J.
Published: August 2023

Introduction

Serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants thanks to the overall safety and tolerability spectrum. However, they can cause different side effects that not all of them are well identified.

Objectives

We intend to clarify the clinical presentation of mydriasis caused by Escitalopram.

Methods

Reporting the case of a patient suffering a major depressive disorder, that presented a mydriasis after adjusting her antidepressant medication. Then, we conducted a literature review using “PubMed” database and keywords “Mydriasis”, “escitalopram”, “SSRI”,” side effects”.

Results

A 29-year-old female with no past clinical history, presented in May 2021 a severe depression requiring an antidepressant treatment. Under 10 mg per day of escitalopram there was a partial remission of the symptoms, leading to increase the dose by another 10 mg. One month after taking 20 mg/day, she consults before the appointment suffering from a blurry vision and photophobia. Ophthalmologic examination showed a bilateral reactive half-mydriasis, eye pressure was 14 mmHg and fundus examination was normal. Iatrogenic origin of mydriasis was suspected. A gradual interruption of the medication lead to disappearance of the latter. A pharmacological investigation concluded to the suspension of escitalopram and to be vigilant if an antidepressant medication would be needed.

Conclusions

Mydriasis is an uncommon side effect caused by SSRI that needs to be kept in mind by clinicians. Therapeutic patient education can help to detect abnormal side effects and treat them if needed.

Disclosure of Interest

None Declared
Psychotherapy program as an additional treatment method for patients with rheumatoid arthritis, multidisciplinary approach
Authors: Matic A. , Gudelj Gračanin A. , Tonković I. , Mužinić Marinić L. , Morović-Vergles J.
Published: August 2023

Introduction

Chronic diseases, with the development of medicine, the extension of life expectancy and the reduction of dying from infectious diseases, have become a leading public health problem. Rheumatoid arthritis (RA) is a chronic, progressive, multifactorial, autoimmune, systemic inflammatory disease of connective tissue, and sufferers are at greater risk of developing psychological disorders, depression and anxiety being the most common. Optimal treatment of RA should include periodic screening of somatic and psychological comorbid disorders and diseases with a multidisciplinary approach to treatment.

Objectives

Presenting a psychotherapy program as an additional method of treating patients with rheumatoid arthritis.

Methods

In University Hospital Dubrava, a psychotherapy program was organized for patients with rheumatoid arthritis, which took place once a week for 12 weeks, and consisted of autogenic training, education about the disease and group psychotherapy. The program would begin with autogenic training held by a clinical psychologist, and the main goal was to achieve psychophysical relaxation. This was followed by an education on rheumatoid arthritis, in which a clinical rheumatologist was involved, and the goal was to provide basic information about the disease, thereby achieving better cooperation with health care personnel and a more active role in their own treatment. In the end, there would be a time-limited dynamic group psychotherapy conducted by a psychiatrist/psychotherapist with the basic therapeutic effects of group therapy.

Results

As a result of a 12-week psychotherapy program for somatic patients, which was held in a clinical hospital, patients’ anxiety and depression decreased, the experience of pain decreased, and there were positive changes in the perception of the quality of life.

Conclusions

A multidisciplinary approach is recommended in treating patients with rheumatoid arthritis and psychotherapy progam can be used as an additonal way of treatment.

Disclosure of Interest

None Declared
Psychosomatics and mentalization
Authors: Delgado Campos A. M. , Alcindor Huelva P. , Alvarez Astorga A. , Rubio Corgo S. , Pérez Vicente E. , Arrieta Pey M. , Diaz Gordillo C. , Del Sol Calderón P. , Martín Martín A. C.
Published: August 2023

Introduction

We have investigated the relationship between the Psychosomatic Classification method (Marty) and the Rorschach Test, with respect to the diagnosis of psychosomatic disorders, within the framework of the degree of mentalization measured by both.

Objectives

A) To verify statistical coincidence with respect to the degree of mentalization (risk of generating psychosomatic disorders in a subject) between the Rorschach Test and the diagnostic technique Psychosomatic Classification, by P. Marty. B) To test the hypothesis: Patients diagnosed with infertility, whose degree of mentalization is good, will have a greater probability of achieving a successful pregnancy throught Assisted Reproduction Techniques.

Methods

Two evaluation tools were used: a) Psychosomatic Classification based on the criteria established by this diagnostic method; b) The Rorschach test (based on the evaluation of 29 indicators, selected according to their greater relevance in the generation of somatic symptoms).

A sample of 120 patients (women) diagnosed infertility at the Assisted Reproduction Unit (U.R.A.) at Hospital Universitario 12 de Octubre in Madrid was recruited. The method of ‘statistical correlation of coincidence’ between the results of the two diagnostic instruments used was used. Once both tests had been assessed by the “inter-judge” method and the quantitative values of the selected items had been weighted, the KAPPA statistical method was applied to establish the “correlation of coincidence” between the results of the two assessment instruments.

Results

Considering that the KAPPA method takes values between “0" and ”1" and that between 0.6 and 0.8 the agreement or coincidence is considered good, and above 0.8 very good, the result applied to the hypothesis is 0’76 (’good’).

Conclusions

A) Using the Rorschach Test and P. Marty’s Psychosomatic Classification in a complementary manner, these two instruments together provide high reliability, with respect to the degree of mentalization (a subject’s risk of suffering psychosomatic disorders). B) The degree of mentalization has a significant impact on the success or failure in the application of Assisted Reproduction Techniques in infertile women.

Disclosure of Interest

None Declared
The concept of love in the patchwork family and it’s use in psychotherapy
Authors: Miętkiewicz R. , Kałaczyńska-Miętkiewicz M.
Published: August 2023

Introduction

The authors - both active psychotherapists and at the same time happily married couple - present bravely a unique case study : theirs own patchwork family. The dwelve deeply into family systems dynamic, analyze the relationship between grandparents, parents and children. The standard roles of father and mother are taken into examination, especially after the youngest baby is born. With wit and humor, the authors define the new working paradigm of patchowork love.

Objectives

Define the new concept of love in patchwork family and redefine the traditional roles.

Methods

Case study.

Results

The result - the new concept of a fully functioning patchwork family with redefined love concept and new roles - enables better understanding and richer life.

Conclusions

We should always seek for love in the families, which come to psychotherapy / psychiatry office for help. Understanding the dynamic of love in the patchwork family is crucial to providing high quality help.

Disclosure of Interest

None Declared