bluuebunny/crossref_metadata_2025 huggingface dataset:
Personal recovery, clinical recovery and patient-rated measures
Authors: Slade M.
Published: August 2023

This talk will cover two common areas of confusion. First, the relationship between personal recovery and clinical recovery will be described, using recent meta-analytic evidence. It will be argued that personal recovery is not the same as clinical recovery, and that there is now an established policy and practice consensus that supporting personal recovery is the primary aim of mental health systems. Traditional clinical recovery-oriented treatments which target for example symptomatology or relapse prevention can for many people with mental health issues contribute to their recovery at points in their lives, but for others different approaches are needed. This variation in clinical need is addressed in the second area – patient-rated measures. The rationale for measures of experiential knowledge will be given. A distinction will be drawn between Patient-rated outcome measures (PROMs) and Patient-rated experience measures (PREMs), and between peer-developed patient-generated PROMs (PG-PROMs) compared with those developed by non-peer research teams. It will be argued that modern mental health systems should be judged by their impact on recovery, as measured using PROMs and PREMs in preference to staff-rated measures.

Disclosure of Interest

None Declared
Evaluation of addictive behavior in depressive disorders
Authors: Tounsi A. , Bencharfa Z. , Chebli H. , Sabir M. , El Omari F.
Published: August 2023

Introduction

The comorbidity between depressive disorders and addiction is far from being random. Through substances, users try to ameliorate their feelings of sadness, reduce present anxiety. The phenomena of tolerance and dependence quickly worsen the situation, and make any attempt at withdrawal more difficult.

Objectives

The objective of this study is to analyze the addictive behavior in patients diagnosed with depressive disorder.

Methods

This is a retrospective descriptive study carried out by analyzing hospitalization records in the addictology department of the psychiatric university hospital Ar-Razi in Salé over a period of one year (from August 2020 to August 2021). The diagnoses are established according to the DSM 5 diagnostic criteria.

Results

Of 141 patient records initially entered, nine records were not usable and 54 patients had a diagnosis of depressive disorder constituting 40.9% of admissions to the service. The average age was 37.9 years (16; 69).

Among our depressed and substance-using patients, the most frequent comorbidity was personality disorders (29.6%) followed by anxiety disorders (11.1% of cases). Thirty-five percent of patients reported at least one suicide attempt in the past and 11.1% had experienced sexual abuse.

The average age of onset of addiction in our sample was 17.8 years (11; 31). The most used substance was tobacco (n=44) followed by alcohol (n=43), cannabis and then benzodiazepines.

Conclusions

The relationship between depression and substance use remains complex. Although depressed patients often turn to drugs in search of a state of well-being, withdrawal from these substances can also aggravate or cause the depression.

Disclosure of Interest

None Declared
Could we predict an episode of delirium tremens? Case report
Authors: Tounsi A. , Bencharfa Z. , Azraf F. , Sabir M. , Elomari F.
Published: August 2023

Introduction

Delirium tremens is one of the most serious complications associated with alcohol withdrawal. It affects a percentage of 5 to 20% of users and is not related to the duration of consumption nor to the quantities taken. An early diagnosis will facilitate a quick treatment without putting at risk the vital prognosis.

Objectives

Our objective is to identify the different indicators mentioned in the existing literature and to compare these to the clinical and paraclinical data of our patients

Methods

We present through clinical vignettes, the cases of two patients hospitalized in our department of addictology for a cure of alcohol withdrawal and who presented an episode of delirium tremens.

Results

everal clinical and paraclinical parameters have been linked to statistically significant differences in the published reports related to this subject. Thrombocytopenia remains the common element between the different publications and was the case in our two patients.

Clinically, the presence of a previous episode of delirium or seizure during withdrawal , as well as tachycardia (>100 bpm) and low number of quit attempts were significantly related to the occurrence of delirium tremens. The majority of the predictors identified were paraclinical and included: hyponatremia, hypokalemia, elevated ALT and homocyctein levels, low pyridoxine levels, and the presence of structural brain damage.

Conclusions

the literature on predictors of delirium tremens remains poor. more studies are needed to confirm the data already mentioned

Disclosure of Interest

None Declared
Prescription drug abuse in migrants from Middle Eastern and North African countries: a review
Authors: Portela C. , Oliveira C. , Gonçalves M.
Published: August 2023

Introduction

In recent years, there has been a rise in misuse of low-cost prescription pills across Middle Eastern and North African (MENA) countries. In Algeria, Tunisia and Morocco, for example, the consumption of prescription medications has dramatically increased, particularly amongst young and marginalized groups. Drugs such as clonazepam and pregabalin are extremely popular in these regions, as they are relatively inexpensive and perceived as safe. With the migration of MENA citizens to Europe, it is likely that mental health services will come across substance use disorders related to these medications.

Objectives

The authors aim to analyse prescription medication misuse reports from MENA countries, specifically pregabalin and clonazepam, and review the pharmacological, neurobiological and social factors that contribute to their potential for abuse.

Methods

Narrative review of articles referenced on PubMed and Google Scholar.

Results

Pregabalin and clonazepam are widely used in psychiatry and neurology. Pregabalin is an alpha 2 omega ligand with supposed GABA-mimetic properties. Anecdotal reports suggest that pregabalin, used recreationally in amounts up to 3-20 times the therapeutic doses, possesses both sedative and psychedelic effects. Experimenters are mainly individuals with a history of recreational polydrug use, who are aware that pregabalin is not included in standard drug monitoring tests, with this molecule being used in some instances as a legal substitute of common illegal drugs. Clonazepam is a benzodiazepine that combines high potency and a long duration of action and is said to cause euphoria at doses over 8mg. It is very popular and affordable, placing consistently in the top three of benzodiazepines sales across the globe. Clonazepam has potential for tolerance build up and severe withdrawal symptoms. These medications are frequently used together and in combination with other substances such as alcohol and opiates, increasing the risk for respiratory failure and death.

Conclusions

Prescription medications such as pregabalin and clonazepam are extremely accessible, inexpensive and highly addictive substances, whose abuse is well disseminated across MENA countries. With migratory flows from this region, the prevalence of misuse of these drugs in Europe is expected to increase. Therefore, physicians should be aware of their potential for abuse and carefully evaluate patients’ previous history before prescribing these medications.

Disclosure of Interest

None Declared
Depressive disorder comorbid with problematic alcohol use
Authors: Berrada H. , Chebli H. , Azraf F. , El Omari F.
Published: August 2023

Introduction

Alcohol use disorder is a real public health problem in the world, it consists of a pathological mode of consumption which is characterized by a loss of control and craving. Depressive disorder and alcohol use disorder are among the most frequent mental pathologies and are often associated.

The links between these two disorders can be of several types: Alcohol Induced Depressive Disorders, Primary Depressive Disorders and Secondary Alcohol Dependence. They can also have two-way relationships or be favored by common factors.

Objectives

The objective of our work is to analyze the causal links between alcohol use disorder and depression.

Methods

provide an update via two clinical vignettes and a review of the literature the relationship between alcohol use disorder and depression

Results

The causal relationships between alcohol dependence and psychiatric disorders can be of several types which are not mutually exclusive: primary alcohol dependence, secondary psychiatric disorders, induced by alcohol. This is the case for the majority of depressive disorders encountered in alcohol-dependent patients; primary psychiatric disorders and secondary alcohol dependence; alcohol dependence and anxiety and/or depressive disorders are favored by common factors, in particular personality disorders, encountered in approximately 40% of alcohol-dependent patients. Whatever the direction of causation, alcohol dependence and psychiatric disorders worsen each other over time.Depression and alcohol use disorder are among the most frequent mental pathologies and are often associated.The optimal management of patients with dual diagnosis is so-called “integrated” management, simultaneously combining alcohol and psychiatric therapeutic approaches.

Conclusions

Alcohol consumption impairs the prognosis of depression, increases the risk of suicide, impairs social functioning and increases recourse to the healthcare system.The optimal management of patients with dual diagnosis is so-called “integrated” management. Psychotherapeutic (individual and systemic), drug and psychosocial approaches would be necessary to maximize therapeutic success.

Disclosure of Interest

None Declared
Drug-Induced Psychosis: Causes, Symptoms, and Treatment
Authors: Jupe T. , Myslimi E. , Giannopoulos I. , Zenelaj B.
Published: August 2023

Introduction

A relationship between drug abuse and the onset of psychotic symptoms is strongly supported. A struggling clinical dilemma is how to clearly identify a substance-induced psychosis from a primary psychotic illness or a psychotic illness with comorbid substance use.

Objectives

In this review, the presence of associated psychotic symptoms and the differences in clinical presentation will be analyzed for each substance.

Methods

Α bibliographical review was performed using the PubMED platform. All relevant articles were found using the keywords: substance-Induced Psychoses, symptoms, treatment

Results

Present review shows a picture of the complex relationship between psychotic symptoms and the use and abuse of illicit drugs. Furthermore, in most cases, chronological criteria are not sufficient to prove a direct causal effect between the substance and psychosis. The subjects who presented psychotic symptoms after substance abuse seemed to have a higher risk of the development of a primary psychotic illness.

Conclusions

Psychosis due to substance abuse is a common issue in clinical practice and the propensity to develop psychosis seems to be associated with the severity of use and dependence.

Disclosure of Interest

None Declared
Clinical Characteristics in Panic Disorder Patients in Emergency Department
Authors: Nam B.
Published: August 2023

Introduction

Panic disorder is a widespread mental illness associated with the use of high levels of emergency care. However, the clinical characteristics of patients with panic disorder in the emergency department are not known.

Objectives

This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack.

Methods

A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher’s exact test was used. Collected data was analyzed using R 4.03.

Results

Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (x2=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (x2=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%.

Conclusions

The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

Disclosure of Interest

None Declared
Digital Trauma Load: from Online Videogaming to the new forms of digital social networking
Authors: Orsolini L.
Published: August 2023

The digital revolution is evolving at an unstoppable pace. The dissemination of interconnected networks, the growth and spread of new digital technology across all ages at different levels, has rapidly led to an increasing usage of the Internet, smartphones and digital social networking, particularly among young people. Smartphones, social networking and digital videogaming platforms are currently being used as primary means of online access, source of information and as preferred mode for social communication and peer interaction. However, despite digital world is progressively replacing the ‘physical world’ concerning socialization process and communication modalities, there is poor attention on the ‘digital trauma load’ experienced by individuals belonging to the Z and alpha generations in term of potential impact of digital instruments on mental health.

Disclosure of Interest

None Declared
Conversive and Factitious disorders: Differential diagnosis based on a case report
Authors: Fernández Lozano M. , Santos Carrasco I. , Vallecillo Adame C. , Queipo de Llano de la Viuda M. , Jimenez Aparicio T. , De Andrés Lobo C.
Published: August 2023

Introduction

Conversive disorder is characterised by the presence of one or more involuntary neurological symptoms that are not due to a clear medical pathology. On the other hand, consciously simulated illnesses fall into two diagnostic categories: factitious disorders and malingering, which are differentiated by both the motivation for the behaviour and the awareness of that motivation. Factitious disorder behaviours are motivated by an unconscious need to assume the sick role, whereas malingering behaviours are consciously driven to achieve external secondary gains.

Objectives

Study of the differences between conversion disorder and factitious disorder and their repercussions from a case of difficult diagnosis.

Methods

Bibliographic review of scientific literature based on a relevant clinical case.

Results

We present the case of a 14-year-old male patient. Adoptive parents. Studying in high school. Social difficulties since childhood. He comes to the emergency department on several occasions referring stereotyped movements and motor tics in the four extremities with left cervical lateralization. Increase of these symptoms in the last month, so it was decided to admit him to the pediatric hospital. After observation and study of the patient’s movements with normal complementary tests he should return home. The following day he returned to the emergency department after an episode of dizziness, mutism and emotional block. It was decided to admit him to Psychiatry for behavioral observation and differential diagnosis.

Conclusions

In the assessment of patients it is essential to make an appropriate diagnosis taking into account the patient’s symptomatology and the patient’s background and life context. Conversion disorder is the unintentional production of neurological symptom, whereas malingering and factitious disorder represent the voluntary production of symptoms with internal or external incentives. They have a close history and this has been frequently confounded. Practitioners are often confronted to medically unexplained symptoms; they represent almost 30% of neurologist’s consultation. The first challenge is to detect them, and recent studies have confirmed the importance of “positive” clinical bedside signs based on incoherence and discordance. Multidisciplinary therapy is recommended with behavioral cognitive therapy, antidepressant to treat frequent comorbid anxiety or depression, and physiotherapy. Factitious disorder and malingering should be clearly delineated from conversion disorder. Factitious disorder should be considered as a mental illness and more research on its physiopathology and treatment is needed, when malingering is a non-medical condition encountered in medico-legal cases.

Disclosure of Interest

None Declared
Stigma of mental illness in the gypsy ethnic group
Authors: López Rodrigo M. V. , Osca Oliver A. , Palomo Monge M. , Ros Fons V. , D´Hiver Cantalejo Y.
Published: August 2023

Introduction

The Roma population constitutes the largest ethnic minority in Spain (more than 2% of the population), with our country having the third largest total population of Roma in the world. The concept of health and disease varies with the sociocultural context. It is important to know the cultural characteristics to exercise good clinical practice. The stigma surrounding mental illness is widely known, and is even stronger in the Roma community, leading to marginalization and shame.

Objectives

We present a case of a gypsy woman misdiagnosed from the age of 8 with hebephrenic schizophrenia.

Methods

Patient frequents the emergency department with symptoms of predominantly anxiety, including episodes of psychomotor agitation, self-harm, verbalization of visual hallucinations of a mystical-religious nature. In treatment with antipsychotics since diagnosis, with no therapeutic adherence. It is observed during all the episodes how the anxiolytic treatment, even, sometimes, the verbal restraint, make the symptoms subside. Psychotic symptoms over the years are ruled out.

Results

Due to the diagnosis, this patient has been relegated from the gypsy community, she has not married or had children (an important milestone in gypsy culture), this has generated an exponential increase in anxiety symptoms and home problems.

Conclusions

It is important to know the cultural traits to which the patients we treat in consultation belong, and how the disease can affect their lives, and a simple diagnosis can be a source of greater anxiety.

Disclosure of Interest

None Declared
Problematic Use of Pornography: Clinical Presentations, Diagnosis and Interventions
Authors: Virani S.
Published: August 2023

The COVID-19 pandemic has caused immense psychosocial strain worldwide. Excessive use of the internet during these psychologically trying times, fueled by physical isolation as a result of lockdowns, translated into dysfunctional behaviors. A growing body of evidence suggests an unprecedented increase in internet use and consumption of online pornography during the pandemic, and possibly even directly caused by it. This presentation will focus on the the statistics, variations in diagnostic criteria, clinical presentations and interventions for problematic online pornography use. Practical solutions will be offered to show how foresightedness with utilizing existing tools and therapies and exercising appropriate amounts of caution could go a long way in addressing the challenges that lie ahead in the post-pandemic
era.

Disclosure of Interest

None Declared
Aggression and its association with childhood trauma in euthymic bipolar disorder patients
Authors: Mellouli A. , Masmoudi R. , Ouali R. , Guermazi F. , Feki I. , Sellami R. , Masmoudi J.
Published: August 2023

Introduction

Aggression and negative behaviours are used to be present in individuals with bipolar disorder, who are sensitive to life events. Thus, many studies investigated the emergence of impulsivity and aggression in the developmental process and revealed its relationship with childhood adversities.

Objectives

The aim of this study was to determine the relationship between childhood trauma and aggressive behaviour in euthymic patients with bipolar disorder.

Methods

It was a cross-sectional descriptive and analytical study involving patients diagnosed with bipolar disorder and followed in the psychiatric department at the University Hospital ofSfax (Tunisia).

All subjects completed the Childhood trauma questionnaire (CTQ) and the Buss–Perry Aggression Scale (BPAS). Euthymiawas defined as a score on the Montgomery-Åsberg Depression Rating Scale (MADRS) not higher than 14 and by a score on theYoung Mania Rating Scale (YMRS)not higher than seven.

Results

We included 35 patients. Their mean age was 46.69 ± 12.01 years with a sex ratio (M/F) =0.45. Most of them lived in urban areas (91.42%) and had a moderate socioeconomic level(88.57%).

The most frequent trauma type was physical neglect with 74.28%, followed by emotional abuse (42.85%), emotional neglect (42.85%), physical abuse (37.14%) and sexual abuse (31.42%).

The mean score of CTQ was 58.57 ±9.51. Theaverage total score of BPAS was 82.26 ±14.57.

The mean scores of subscales of BPAS were 25.49±4.59 for physical aggression, 13.74±3.51for verbal aggression, 19.14±6.22 for anger and 23.89±5.57 for hostility.

A statistically significant and positive correlation was determined between CTQ and BPAS (p=0.011). The score of BPAS was significantly correlated with physical abuse (p=0.003) and physical neglect (p=0.014).

Conclusions

The relationship between CTQ and BGHA scores suggests the possibility that childhood trauma may be one determinant of aggression in patients with bipolar disorder. Considering the childhood trauma history in the evaluation of these patients may prevent their aggression and thus their psychosocial functioning.

Disclosure of Interest

None Declared
Effectiveness of mood stabilizers in prophylactic treatment of bipolar disorder
Authors: Khattech D. , Aissa A. , Ouali U. , Zgueb Y. , Jomli R.
Published: August 2023

Introduction

Prophylactic treatment during bipolar disorder aims to prevent recurrences and to improve the functional level.

Objectives

Our aim was to compare the clinical effectiveness of lithium versus sodium valproate in the prophylactic treatment of bipolar disorder type 1

Methods

Retrospective, longitudinal, comparative study conducted among 162 patients followed for bipolar disorder type 1 hospitalized at the Psychiatry A department of Razi Hospital. The Alda scale and time to recurrence were used to compare the clinical effectiveness of the mood stabilizers.

Results

A difference between the two groups of patients was noted for some variables. Lithium prescription was associated with educational level, number of depressive episodes, suicide attempts, previous prescription of other thymoregulators, depressive polarity of the index episode and use of atypical antipsychotics.

The prescription of Valproate was associated with educational level, unipolar mania, manic predominant polarity, manic polarity of the index episode, presence of psychotic features, prescription of long acting antipsychotics and higher doses of antipsychotics.

The study of response by Alda scale showed no significant difference in the mean score of the scale nor in the rate of responders. We noted a higher rate of recurrence in patients on Valproate considering the whole duration of the study. The recurrence rate after one year was higher in patients on Lithium, the recurrence rate after two years was comparable in both groups. Survival curves showed earlier recurrences in patients on Lithium.

Conclusions

The efficacy of the two mood stabilizers was comparable. The recurrences occured earlier under Lithium.

Disclosure of Interest

None Declared
Cyclothymia, bipolar disorder and multiple sclerosis: A case report
Authors: Paz Otero M. D. P. , Lozano Bori E. , Sánchez Rodríguez J. , Puyal González S. , Fernández Fariña M. , Mayor Sanabria F. , Francos Ajona A.
Published: August 2023

Introduction

We present the case of a 49-year-old woman who was diagnosed with multiple sclerosis at the age of 19 and suffers from an affective disorder that has been evolving for years. This condition, for which she has been followed by psychiatry and psychology for more than ten years, consists of alternating periods of hypomania lasting weeks and phases in which frank depressive symptomatology predominates, with no phases of euthymia in between and with a predominance of severe deterioration of her functionality at both poles.

Objectives

(1) We will review the term cyclothymia and explore the concept of “cyclothymic temperament” advocated by some authors, in order to be able to understand the dimension of the present case and reformulate its approach.

(2) The relationship between multiple sclerosis and bipolar spectrum disorders will be covered, reviewing the current knowledge in this regard and relating it to the patient’s symptomatology.

Methods

A review of the patient’s clinical history will be carried out, taking into account her life history, the complementary tests performed as well as the multiple therapeutic approaches tried over the last few years.

Likewise, a bibliographic review of the available scientific literature will be carried out in relation to the diagnosis of cyclothymia or bipolar disorder type II, the controversial term “cyclothymic temperament”, and the relationship that these diagnoses have with the diagnosis of Multiple Sclerosis.

Results

(1) Our patient could fit into what many authors define as a cyclothymic temperament, fulfilling, in certain episodes, the criteria that the manuals propose for bipolar disorder type II.

(2) 2.1 The prevalence of bipolar affective disorder in MS is approximately twice as high as in the general population (rates of 0.3-2.4%). 2.2 Patients with MS have higher scores in cyclothymic and hyperthymic temperament than the control group. 2.3 Certain drugs generally used in BD also seem to have a beneficial effect on MS.

Image:

Image 2:

Conclusions

The reformulation of the concept of cyclothymia would allow us to recognize in our patient a basic temperament of long evolution that would be the substrate on which different factors have subsequently influenced, such as antidepressant drugs or multiple sclerosis. In addition, it is necessary to know the association between BD and MS, in order to be able to offer an adequate treatment, contemplating some pharmacological options such as Lithium or some Atypical Antipsychotics, given the beneficial effect both for the affective disorder and for the neurological process.

Disclosure of Interest

None Declared
C-reactive protein levels and cognitive functions in patients with bipolar disorder
Authors: Elleuch O. , Maalej M. , Guidara W. , Naifar M. , Maalej M. , Ayadi F.
Published: August 2023

Introduction

The pathophysiology of bipolar disorder (BD) is complex and remains uncertain to this day.

Several hypotheses have been suggested, including the involvement of inflammatory mechanisms in its pathogenesis and in eventual cognitive impairment. C-reactive protein (CRP) is one of the most commonly used inflammatory markers. High-sensitivity CRP (hs- CRP) is a more sensitive marker.

Objectives

We aimed to examine hs-CRP levels in patients with BD, and to investigate its relationship with cognitive functions.

Methods

We conducted a cross-sectional study between June 2016 and July 2018 on drug-free BD patients. These participants were hospitalized at the “C” Psychiatry department of HediChaker University Hospital in Sfax-Tunisia which accepts only male patients. The diagnosis of BP disorder was established according to DSM-5 criteria.

We used the Montreal Cognitive Assessment (MoCA) scale to assess cognitive functions in our patients, and blood samples were collected to analyze hs-CRP levels.

Results

Our study included 33 patients whose median age was 33 years, with an interquartile range of 27.5-44 years. The majority (90.3%) were diagnosed with type I of bipolar disorder and 9.7% were diagnosed with type II. At the time of the study, 82.4% had a maniac episode and 17.6% had a depressive one.

The median MOCA scale score was 24 with an interquartile range of 19-26, and the analysis of hs-CRP values revealed a median level of 2.1 (interquartile range: 1.2-7.3).

There was no significant correlation between hs-CRP levels and MOCA scores nor its domains. Table 1 shows the results of this correlation analysis.Table1:

correlation results between hs-CRP levels and MOCA domains

MOCA
Visuospatial and executive functions
naming
attention
language
abstraction
memoryorientation
hs-CRPr=0.1570.031-0.092-0.0200.0990.0710.055-0.151p=0.4150.8730.6360.9180.6100.7140.7750.435

We also did not find any significant difference in hs-CRP levels between patients with depressive and maniac episodes.

Conclusions

Our study showed no significant relationship between inflammation and cognitive impairment in bipolar disorder. Further research is needed to better investigate the role of inflammatory processes in this disorder.

Disclosure of Interest

None Declared
Psychological trauma and digital interventions: myth of reality?
Authors: Frankova I.
Published: August 2023

The war in Ukraine caused many people to flee within Ukraine and across Europe. Trauma, separation from family and prolonged uncertainty increase the risk of posttraumatic stress disorder and depression among Ukrainians. The element of time is a critical aspect of intervention in stress-related disorders as an identical intervention may be beneficial or harmful if given at different times, focussing on primary, secondary or tertiary prevention. Recent studies showing the importance of timing of intervention in prevention of PTSD lend further support to the concept of the “golden hours” or “window of opportunity”. Dr. Iryna Frankova will present lessons learned from implementation of this psychological first aid digital intervention of low intensity during the ’golden hours’ following escalation of the war in Ukraine. During the talk she will provide guidance on what should and should not be done for the end users, as well as strengths and limitations of the chatbot intervention.

Disclosure of Interest

None Declared
Fitness to work decision for bipolar disorder patients : about 4 cases
Authors: Ayed W. , Chebbi S. , Ayadi A. , Ayari S. , Kebir H. , Magroun I.
Published: August 2023

Introduction

Bipolar disorder or manic-depressive psychosis is a severe recurrent psychiatric disorder that, if left untreated, can lead to severe social harm, disability and neurotrophic changes in the brain. However, social and psychological factors play a key role in the onset and progression of the disorder. Therefore, a bio-psycho-social therapeutic approach in the form of an integrated model of “Collaborative Care” is recommended.

Objectives

Determining the main factors interfering with the decision of fitness to work in bipolar disorders according to work requirements.

Methods

Clinical cases including health professionals (HP) was carried out. Cases were examinated at a specialized occupational health Clinics including HP between 2018 and 2022. Data was collected from medical records and by questioning patients directly in case of missing data.

Results

Four HP were included in the study. All suffering from bipolar disorder. The average age was 37 years [28,49]. All were women. Two were divorced and one single. Two anesthesia technicians, a nurse and a cleaner. Two were smokers. Two were transferred to another department because non psycho-education of colleagues at work, dealing with patients, verbal and physical agressivness and cognitive disorders. The two anesthesia technicians were judged unfit for work because of their work responsability and the need for the integrity of all cognitive faculties in the workplace.

Conclusions

In order to decide the fitness to work, occupational physician must consider both bipolar disorder impact and workplace exigency. The adequacy between disease stability and others security is iteratively revised.

Disclosure of Interest

None Declared
Clinical characteristics and functional improvement of patients admitted to a Child and Adolescent Autism Spectrum Disorders (ASD) Day Therapeutic Unit
Authors: Alvarez A. , Santamaria N. , Bote V. , Lamborena C. , Medina R. , Monreal J. A. , Sanchez B. , Hervas A.
Published: August 2023

Introduction

The ASD Day Therapeutic Unit of the HUMT is an interdisciplinary reference center specialized in ASD, for the care of children and adolescents with this pathology, that offers care by programs with the aim of achieving functionality altered.

Objectives

The main objective of this study is to know the clinical characteristics of the patients admitted to our center and to offer preliminary data on the functional improvement achieved in a pilot program that works by processes.

Methods

This is a prospective clinical study of patients with ASD, treated at the ASD Day Therapeutic Unit of the Hospital Universitario Mutua Terrassa (HUMT), since februay 2022 till nowadays. We compare the clinical improvement and functionality acquired through the evaluation through various scales: Conners scale, SRS, BRIEF and CBCL.

Results

Our sample is made up of 19 patients with ASD who are admitted to the HUMT ASD Day Hospital. 13 belonged to the intensive care program, 5 to recovery of low-functioning functionality, and 1 to the differential diagnosis program. 84.21% (n=16) have preserved cognitive capacity. The median age is 13.1 years. 73.7% of the sample are men.

We observed that 89% of patients admitted to our unit presented comorbid symptoms with ADHD. more than 78.9% present isolation, anxiety/depression, altered thinking and attention difficulties. 13/19 present a SEVERE RANGE of affectation upon admission, in social area. Facing discharge, the CBCL shows us a general improvement in behavior and comorbidity in the total scale. The SRS shows us an improvement in social awareness, social communication, social motivation, repetitive behavior and stereotypes and in the total score.

Conclusions

Specific interventions in social skills, autonomy, social understanding, daily routines, and sensory integration in patients with ASD improve core symptoms, as well as associated behavior.

Specific interventions and working on social relationships during admission improve comorbidity derived from ASD.

More studies are needed to specify the most efficient interventions to improve the quality of life in children and teenagers with ASD.

Disclosure of Interest

None Declared
Reading assessment in ADHD and dyslexia in Brazilian teenagers
Authors: Seabra A. G. , Brito G. R. , Carreiro L. R. R.
Published: August 2023

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) and Dyslexia are among the most frequent developmental disorders in school-aged students, and both often cause an impact on scholar reading performance. Therefore, it is fundamental to trace the differential profile in reading performance in such diagnoses. Competent reading occurs through the interaction of several cognitive processes, such as decoding, fluency, and oral and reading comprehension, that should be assessed in an evaluation.

Objectives

The study aimed to characterize the performance of students with ADHD and dyslexia.

Methods

We assessed 25 adolescents, aged between 11 and 14 years old, from 6th to 9th year of middle school of public and private schools in Brazil, divided into two groups: the group with ADHD (16 students) and the group with dyslexia (9 students). The diagnoses were established by a multidisciplinary center and there were no comorbidities for any case. The instruments used were: Comprehension Test of Words and Pseudowords II (TCLPP II) to assess decoding (indicate if the word is correct or incorrect); Reading Fluency Test (TFL) to assess fluency in single words and in text reading; Cloze Reading Comprehension Test (TCCL) to measure reading comprehension; and the WISC vocabulary subtest to assess auditory comprehension.

Results

Non-parametric analyzes revealed statistically significant differences in measures of textual comprehension, especially in the tasks that involved decoding and fluency processes, evidencing superior performance of the group with ADHD in these tests. Participants with dyslexia had a significantly higher performance in relation to the number of word omissions, that is, they had lower omission errors. There was no significant difference between groups in auditory comprehension.

Conclusions

A differential profile was found in reading performance, consistent with the cognitive deficits classically pointed out in the literature for each diagnosis: phonological deficits in dyslexia, with problems in decoding and fluency; and attentional deficits in ADHD, with omission errors. In the comprehension measures, dyslexic group had significant lower performance than ADHD in the Cloze Reading Comprehension Test, but there was no difference in the Vocabulary subtest-WISC. An explanatory hypothesis is that, to understand the text, it is necessary to recognize the words previously, whereas, in the WISC, it is not necessary to read, since the questions are oral. These results corroborate the hypothesis that deficits in reading comprehension in dyslexia are more related to difficulties in word recognition and fluency skills than in general listening comprehension.

Financial support: CAPES Proex [grant 0426/2021, no. 23038.006837/2021-73]; CNPq [grant 310845/2021-1]

Disclosure of Interest

None Declared
Adolescents’ quality of life in the light of mentalization and emotion regulation
Authors: Tamás B. , Szabó B.
Published: August 2023

Introduction

According to research there is a negative association between emotion regulation, mentalization difficulties and quality of life among adolescents, but former research did not examine the relationship between these 3 constructs in a Hungarian adolescent sample.

Objectives

The aim of our study was to examine the relationship between mentalization and emotion regulation with quality of life among 14- to 18-year-old adolescents.

Methods

In our non-clinical, cross-sectional study 122 adolescents with informed consent answered a list of demographic questions, then completed the Reflective Function Questionnaire (RFQ-H), the Emotion Regulation Difficulties Questionnaire (DERS) and the Quality of Life Scale (ILK). In our mediator model we chose RFQ-H as the independent, DERS as the mediator and ILK as the dependent variable.

Results

The first model was significant (F(1,120) = 28,79 p < 0,001, R2= 0,19), there was a significant relationship between mentalization disfunction and emotional regulation difficulties (a=0,39, p<0,01, β=0,44). The second model was significant as well (F(2,119= 30,48 p < 0,001, R2= 0,34), though the direct effect between mentalization difficulties and low quality of life was not significant (c’=0,02, p=0,73, β=0,03), the direct effect between emotion regulation difficulties and low quality of life was significant (b=0,58, p<0,01, β=0,57). The indirect effect between mentalization disfunction and low quality of life mediated by emotional regulation difficulties was also significant ab = 0,22 [0,13 – 0,33], β =0,25 [0,14 – 0,36]).

Conclusions

Our results - taking the limitations into account - imply that emotional regulation mediates the relationship between mentalization and quality of life among the present-day, non-clinical, Hungarian adolescent sample, which could have practical implications.

Disclosure of Interest

None Declared
Fear in children: what is the importance of gender
Authors: Pires-Lima C. , Figueiredo M. H. , Guedes V.
Published: August 2023

Introduction

When we were children we all remember hearing expressions like: “Do not be afraid.”, “What are you afraid of?”, “You are strong, you are not afraid!”. This primary emotion is introduced in our development associated, most of the time, with a negative connotation. However, we know that fear, as a normal response to a real or imagined threat, is an integral part of human development (Sequeira, 2011).

The existence of research on fears is relevant for the definition of developmental patterns, characteristics such as frequency and intensity, but also for the identification of risk factors that may be at the genesis of the development of anxiety disorders (Ollendick, King & Murris, 2002).

Objectives

In Portugal, studies on fears are scarce, contrary to what happens in other countries (Sequeira, 2011).

Methods

The study sample consists of 121 students from the 1st cycle of basic education, 65 (53.7%) attending the 3rd year of schooling and 56 (46.3%) attending the 4th year of schooling, 66 ( 54.5%) were female and 55 (45.5%) were male, aged between 7 and 10 years old (M=8.5; SD=0.61).

For each child, an adult, parents or parental figures also participated in the study, most of which were the mother (89.3%) and the remaining participants were the father (7.4%), father and mother (1.7%), grandmother (0.8% ) and brother (0.8%).

Results

Fears are more frequent in females than males.

Conclusions

In general, anxiety disorders tend to be more prevalent in girls than in boys (Ollendick, King & Murris, 2002).

Disclosure of Interest

None Declared
Circulating immune cell composition and activation status associate with brain white matter microstructure in bipolar depression
Authors: Benedetti F.
Published: August 2023

Bipolar disorder (BD) has been consistently associated with alterations in the immune system. Evidence suggests a condition of systemic low-grade inflammation due to decreased adaptive, increased innate immunity, with higher levels of circulating cytokines, higher macrophage/monocyte inflammatory activation patterns, and higher neutrophils to lymphocyte counts; and with a dynamic pattern of premature immunosenescence and partial T cell defect starting early in adolescence, involving a reduction of naïve T cells and an expansion of memory and senescent T cells. Quantitative analysis of circulating inflammatory markers suggested persistent low-grade inflammation.

A growing literature suggests that the immune system plays a core role in maintaining brain homeostasis, with both adaptive and innate immune support, ensured by cell trafficking across the blood brain barrier, being essential for brain maintenance and repair in healthy conditions, and disrupted in brain disorders including BD. Measured in peripheral blood, these markers of altered immuno-inflammatory setpoints parallel activation of microglia and disruption of white matter (WM) integrity in the brain.

Studies in the field are in its infancy, but findings by our group showed that: circulating Th17 cells correlated with higher FA, while regulatory FOXP3+ cells correlated with higher RD and MD, and with lower fMRI neural responses in the right dorsolateral prefrontal cortex; higher circulating cytokine-producing NK cells were fostered by ongoing lithium treatment and directly correlated with better FA, and inversely with RD and MD, also partially mediating the known benefits from lithium on WM; and activation status and expression of killer proteins by cytotoxic CD8+ T cells negatively associated with WM microstructure, thus suggesting that CD8+ T cells can leave the blood stream to migrate into the brain and induce an immune-related WM damage in BD.

Implications of these findings for neuroprogression, clinical outcomes, and new treatment strategies of the disorder will be discussed.

Disclosure of Interest

None Declared
Maternal stress and postnatal hospitalization of the baby
Authors: Chiha K. , Khemakhem K. , Regaieg C. , Ben Touhemi D. , Ayadi H. , Hmida N. , Gargouri A. , Moalla Y.
Published: August 2023

Introduction

Postnatal hospitalisation is an extremely traumatic event for both mother and baby. Such a situation reflects a psychological dysfunction with a risk of developing a post-traumatic stress disorder.

Objectives

To study the level of stress in mothers of babies hospitalised during the postnatal period in the neonatal unit and to identify the risk factors associated with the persistence of high levels of stress 3 months after discharge.

Methods

This was a longitudinal, descriptive and analytical study conducted between April and September 2021. The sample consisted of mothers of babies hospitalized in the neonatology department of Sfax-Tunisia for a period ranging from 5 to 15 days. Socio-demographic data were collected using a pre-designed form. The level of stress was assessed using the 22-item “Impact of Event Scale-Revised” (IES-R), validated in Arabic.

Results

The sample consisted of 86 mothers with a mean age of 32.17 years.

Severe stress symptoms were found in 77.90% of the mothers during their babies’ hospitalisation. They persisted in 8.90% of the young mothers 3 months after discharge from hospital.

Certain factors were significantly associated with the persistence of a high level of stress in mothers 3 months after the discharge of their babies, such as the occurrence of postpartum complications (p=0.012), the absence of visits to the baby’s intensive care unit (p=0.047) and a living environment with a single parent (p=0.034).

Conclusions

The present study shows that the level of stress is quite high among mothers of babies hospitalised in neonatology during the postnatal period and that this symptomatology can last for months after discharge.

Prevention and reduction of stress induced by postnatal hospitalisation through parental guidance and psychological support for mothers strengthens interactions and the mother-baby bond.

Disclosure of Interest

None Declared