bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical features of bipolar disorder in adolescents with intellectual disability
Authors: Hafnaoui M. , Gadhoum R. , Abbes Z. , Hajri M. , Jelili S. , Halayem S. , Bouden A.
Published: February 2022

Introduction

Bipolar disorder in children and adolescents is distinguished by a variable and complex clinical expression. Mood is difficult to assess, mood symptoms are often masked and signs of disorganization may be in the limelight. This can be more difficult when adolescents have intellectual disability (ID).

Objectives

This work aims to describe diagnostical and therapeutical features of bipolar disorder in adolescents with ID.

Methods

Case reports about five patients who have been diagnosed with bipolar disorder associated to ID, all seen and treated in child and adolescent psychiatry department of Razi Hospital, in Tunis.

Results

The study focused on three girls and two boys, all with mild to moderate ID. Four patients had psychiatric family history of bipolar disorder and ID. Only one patient was followed since childhood for mixed ADHD. The average age of onset of bipolar disorder was 14 years. Four cases were inaugurated by manic access; the fifth was a depressive disorder followed by a manic shift under sertraline. Only one case was rapidly favorable, under 10mg of Olanzapine, without any recurrence or relapse during 18 months of follow-up. Another case was slower but also favorable, under 10mg of Olanzapine. We found resistance to usual treatments for 2 patients; these did not evolve well under conventional thymoregulators, or different antipsychotic molecules, nor with combinations of two thymoregulators + an antipsychotic. One of them benefited from a combination of clozapine and lithium with excellent response.

Conclusions

Bipolar disorder comorbid with ID in adolescents is a difficult diagnostic entity and particularly hard to manage.

Disclosure

No significant relationships.
The relationship between comorbid overweight-obesity and cold executive functions, verbal short-term memory, and learning in attention deficit hyperactivity disorder
Authors: Guler H.A. , Turkoglu S.
Published: February 2022

Introduction

Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. ADHD is a risk factor for the development of overweight and obesity. One neuropsychological factor that may play a prominent role in the relationship between ADHD and obesity is executive functioning.

Objectives

The aim of this study is to investigate the relationship between comorbid obesity/overweight and cold executive functions, verbal short-term memory, and learning in children with ADHD. This is the first study to examine relationship between verbal short-term memory-learning and obesity in patients with ADHD.

Methods

This study was conducted with 70 patients with ADHD and 30 healthy controls. In this study, patients diagnosed with ADHD were divided into two groups according to body mass index (BMI) as <85 percentile and ≥85 percentile. Cold executive functions were evaluated by Stroop Test (ST) and Cancellation Test (CT). Serial Digit Learning Test (SDLT) was administered to measure verbal short-term memory and learning capasity. In order to evaluate the severity of ADHD objectively, parents completed the Conners’ Parents Rating Scale-Revised Short Version (CPRS-RS).

Results

The ST, SDLT and CT scores were significantly lower in both groups with ADHD than the control group. The CPRS-RS subscale scores were significantly higher in both groups with ADHD than the control group. There was no statistically significant difference in ST, SDLT, CT scores and CPRS-RS subscale scores between the two groups with ADHD.

Conclusions

This study show that overweight/obesity comorbid with ADHD was not associated with cold executive functions, verbal short-term memory, learning, or ADHD symptom severity.

Disclosure

No significant relationships.
Behavior problems associated with brain heterotopia
Authors: Budisteanu M. , Papuc S. , Erbescu A. , Iliescu C. , Dobre M. , Barca D. , Tarta-Arsene O. , Motoescu C. , Dica A. , Sandu C. , Anghelescu C. , Craiu D. , Arghir A.
Published: February 2022

Introduction

Brain heterotopia represent a group of rare malformations with a heterogeneous phenotype, ranging from asymptomatic to severe clinical picture (resistant epilepsy, severe developmental delay). The etiology is multifactorial, including both genetic and environmental factors.

Objectives

In this paper we present our experience regarding behavior problems in patients with heterotopia.

Methods

A cohort of 16 pediatric patients with brain heterotopia, six females and ten males, with age at last follow-up ranging from 2 months to 24 years were investigated by clinical examination, electroencephalographic studies, brain imaging, and genomic tests. Specific psychological tests and psychiatric evaluation were performed in all children for behavior problems assessment.

Results

Six individuals presented behavioral problems: autism (three patients) and hyperkinesia with attention deficit (three patients). All of them had intellectual disability or learning problems; five patients had epilepsy, with drug-resistant seizures in four cases. In two cases the behavioral problems occurred before the onset of epileptic seizures.

Conclusions

Behavior problems are important features in patients with brain heterotopia, making the management of these patients more difficult, especially when they occur in association with drug-resistant epilepsy. Acknowledgements: This work was supported partially by grants of the Romanian National Authority for Scientific Research and Innovation CCCDI – UEFISCDI, Projects COFUND-ERANET E-RARE 3-HETER-OMICS-2 Number 87/2019 and 88/2019 within PNCDI III.

Disclosure

No significant relationships.
Cycloid psychosis
Authors: Anton R. Hernandez , Conde L. Aranguren , Gardeazábal M. Basteguieta , Ozcariz P. Antía , Zariquiey N. Cancelo , De Sousa Figueiredo N. , Salinas V. Fronda
Published: February 2022

Introduction

When we talk about cycloid psychosis we have doubts about their nosological enclave; whether they should be considered as a subform of schizophrenia or as independent psychoses.Some solutions were proposed, such as the thesis of mixed psychoses (Kretschmer) or that of intermediate forms (Bleuler, Schneider). Cycloid psychoses and bouffée delirante are recognized in ICD-10 under the name of acute polymorphic disorder without symptoms of schizophrenia (F23.0) and with symptoms of schizophrenia (F23.1).

Objectives

Clinical case

Methods

We present the case of a 16-year-old patient with no psychiatric history, with medical background of epilepsy; she was in fllow-up by Neurology and in treatment with valproate.Neurology indicates to stop treatment; it is then whwn the patient begins to appear disoriented, confused, with significant anguish and lability and regressive behaviors.She has sudden mood swings (from laughing to crying); sudden changes in emotional reaction (from distress to anger) and sudden changes in behavior (from agitation to prostration); verbiage with pressure of speech and dysprosodia; delusional ideation and incongruous affect; visual, auditive and kinesthetic hallucinations with important repercussion. We request blood and urine tests, drug test, EEG, cranial MRI.

Results

She presents fluctuating, polymorphic and unstable affective and psychotic symptoms. What is the most appropriate diagnosis? We treat the patient with antipsychotic, mood stabilizer and anxiolytic treatment.

Conclusions

Psychopathology in early ages is not so clearly defined and it can take very different forms. The diagnosis of cycloid psychosis can be useful as well as necessary to describe certain patients with similar characteristics and different from other groups.

Disclosure

No significant relationships.
Acute pancreatitis induced by valproic acid
Authors: Khouadja S. , Melki R. , Taleb C. Ben , Zarrouk L.
Published: February 2022

Introduction

Valproic acid (VPA) is a commonly prescribed medication for epilepsy, migraine and especially bipolar disorder therapy. Although the common adverse effect associated with VPA are typically benign, less common adverse effects can occur; these include acute pancreatitis.

Objectives

Describe the clinical and therapeutic characteristics of a case of acute pancreatitis induced by VPA with a review of the literature.

Methods

We report the case of a patient who presented an acute pancreatitis induced by VPA. The data was collected from the patient’s medical file. A review of the literature was performed by selecting articles from the PubMed search engine using ‘acute pancreatitis and valproic acid’ and ‘drug induced acute pancreatitis’ as key words.

Results

This is a 51-year-old male patient with a history of type 2 diabetes, dyslipidaemia and psychiatric follow-up for bipolar disorder type I on lithium. He was admitted for a resistant depressive episode. We opted for the combination of two mood stabilizers (VPA and lithium). On the third day of treatment, the patient reported epigastric pain with incoercible vomiting. Laboratory tests showed increased levels of pancreatic enzymes and a biological inflammatory syndrome. The diagnosis of acute stage A pancreatitis was made.VPA was discontinued and the patient was put on symptomatic treatment with favourable outcome after one week. The etiological investigation ruled out other causes of acute pancreatitis. As a result, iatrogenic origin was retained.

Conclusions

This case supports the idea that acute pancreatitis may be induced by VPA, it has no predictable factors.

Disclosure

No significant relationships.
Emotional, personal, cognitive and other mental disorders after removal of the tumor of the diencephalic region (in the long-term period)
Authors: Sidneva Y. , Astaf’Eva L. , Zaitsev O. , Kalinin P. , Kadashev B. , Kutin M. , Urakov S. , Voronina I. , Shkarubo A. , Fomichev D. , Andreev D. , Sharipov O.
Published: February 2022

Introduction

In the literature, there are conflicting data regarding the recovery of mental disorders, in particular, pathologies of the emotional, personality, behavioral and cognitive spheres, in patients after surgical treatment of tumors of the diencephalic region.

Objectives

To evaluate the dynamics of psychopathological disorders after removal of a craniopharyngioma.

Methods

45 patients (18–68 y.o.), operated through transcranial access. The follow-up period ranged from 3 months to 9 years (on average 2.8 + 0.4). The main method is psychopathological, supplemented by rating scales and questionnaires.

Results

In the late postoperative period, mental disorders were detected in 75% of patients (Table 1). Table 1. Dynamics of the main psychopathological symptom complexes (n = 45).Disorders (may be a combination)Before surgery (n,%)2 weeks after (n,%)18 months after (n,%)Emotional and volitional27 (60%)27 (60%)15 (33%)Cognitive - Korsakov syndrome18 (40%) 4 (9%)27 (59%) 8 (18%)18 (40%) 7 (15%)Personality21 (46%)25 (55%)23 (51%)

The table shows that emotional-volitional disorders have a clear positive dynamics by 18 months after surgery compared with the preoperative level. Korsakov’s syndrome and personality disorders are less favorable. 23 patients (52%) returned to their previous profession; 22 (48%) stopped working due to a severe degree of disability, of which 7 (15%) need constant supervision.

Conclusions

The positive dynamics of psychopathological symptoms is observed only within 1.5 years after the removal of the craniopharyngioma, in the future they remain without a tendency to improve. 22 patients (48%) stopped working. The most severe degree of disability is 15% patients.

Disclosure

No significant relationships.
Delusional disorder and tuberculosis: A clinical case
Authors: Falcão V. Podence , Avelar R. , Abreu C. , Heitor M.
Published: February 2022

Introduction

Tuberculosis is still a challenging disease, infecting around a third of the world’s population. As comorbidity with mental disorder is common, it is relevant to associate them at a diagnostic, therapeutic and prognostic level.

Objectives

We present a clinical case describing a patient with psychosis, further diagnosed with tuberculosis during psychiatric treatment. Moreover, we present a summarized revision of the state of the art.

Methods

Revision of the state of the art, drawing from PubMed and using the keywords “mental health”, “psychosis” and “tuberculosis”, in the last 10 years.

Results

Male, 61 years old, heavy smoker and alcohol drinker. Admitted for allegedly feeling “worms” in his body. After medical examination, a weight loss of 13 kg in five months and symptoms compatible with tenesmus stood out. Following diagnostic tests, the patient was diagnosed with Ekbom Syndrome and Ganglionar Tuberculosis; he was then medicated with the adequate antipsychotic and tuberculostatic agents, which resulted in overall clinical improvement.

Conclusions

This case illustrates the relationship between tuberculosis and mental disorders, in a patient with a low literacy level and a precarious socioeconomic background, known risk factors for mental disorder in patients with tuberculosis and are often associated with poor therapeutic adherence. Although proper treatment of the mental disorder is key to reducing the risk of tuberculostatic dropout, the stigma of mental disorder and tuberculosis decreases the probability of these patients seeking proper treatment. Thus, we alert the medical community for the possibility of psychiatric comorbidity in patients with diagnosed tuberculosis – and vice-versa –, allowing for an early intervention,

Disclosure

No significant relationships.
Compartment syndrome and suicide attempt
Authors: Vázquez E. Rodríguez , Meseguer C. Capella , Cerejeira J. Gonçalves , Carrasco I. Santos , De Llano De La Viuda M. Queipo , Ramírez A. Gonzaga , Valera G. Guerra
Published: February 2022

Introduction

The compartment syndrome is a pathological condition characterized by a decrease, or even interruption, of the microcirculation within a soft tissue compartment. There have been a few cases reported about compartment syndrome due to a suicide attempt.

Objectives

To present an unusual complication of an autolytic attempt

Methods

A descriptive study of a clinical case and literature review

Results

A 49-year-old woman, divorced. With no psychiatric history and no somatic antecedents. Comes to the hospital after been found lying face down on the bathroom’s floor for 48 hours, next to her two empty blister packs of lorazepam and naproxen. Her partner says they argued two days ago. Brain CT: with no abnormalities. Blood analysis: metabolic acidosis with rhabdomyolysis and kidney failure. She presents ischemic injuries in both inferior extremities with right food ischemia and with no pedal pulses. Compartment syndrome is diagnosed, being necessary a bilateral fasciotomy and later a right lower extremity amputation. Initiates referral from Vascular Surgery for self-poisoning. She refers to low mood and mild anxiety due to work and relationship issues/problems. She accepts that she self-poisoning only to attract her partner’s attention after the argument. The examination shows logical thought, emotional lability, good judgement, future-oriented without suicidal ideation. Clinical judgement: acute stress reaction.

Conclusions

The compartment syndrome is a rare complication of the suicide attempt. Our patient suffered a compartment syndrome lying on the bathroom’s floor for 48 consecutive hours without apparent trauma and no somatic antecedents. This syndrome could be developed by high naproxen and lorazepam intake.

Disclosure

No significant relationships.
To diagnose or not to diagnose your BPD patient
Authors: De Picker L.
Published: February 2022

Clinicians working in every field of psychiatry will likely encounter patients with borderline personality disorder (BPD) on a regular basis. Nevertheless, diagnostic assessment and disclosure in patients suspected to suffer from BPD can be difficult and even uncomfortable to many clinicians. In a survey among psychiatrists, 57% indicated they had failed to disclose a diagnosis of BPD at some point in their careers, citing diagnostic uncertainty and concerns about stigma as key issues.1This workshop will engage the audience in an intensive discussion of when and how to disclose a suspected diagnosis of BPD to a patient, and how to involve the patient in the diagnostic process. Dr. De Picker will demonstrate how BPD diagnostic disclosure can become a key intervention in every psychiatric setting by using a two-step process. The first step involves a review of the DSM-5 diagnostic criteria together with the patient. This is always followed by a narrative explanation using either the interpersonal hypersensitivity model or emotional vulnerability model as trait factor. With these two steps, diagnostic disclosure creates both an important validating experience for the patient and a not to be missed opportunity for psycho-education about the heritability, prognosis and treatability of borderline personality disorder which installs hope, trust and confidence. References: 1. Sisti D, Segal AG, Siegel AM, Johnson R, Gunderson J. Diagnosing, disclosing, and documenting borderline personality disorder: a survey of psychiatrists’ practices. J Pers Disord 2016; 30: 848–56.

Disclosure

Dr. De Picker reports grants from University Psychiatric Centre Duffel, Johnson & Johnson Belgium and Boehringer-Ingelheim, outside the submitted work.
Assessment of quality of life in patients with primary hypothyroidism - the main criterion of treatment effectiveness
Authors: Pityk O.
Published: February 2022

Introduction

Сurrent research suggests that the assessment of the quality of life of patients with somatic and mental pathology should be one of the main criteria for assessing the quality of treatmen. Given this view, one of the valid assessment of the performance of integrated mental health and the effectiveness of treatment should be considered as quality of life, defined by WHO. Leading mental health criteria based on such factors as adaptation, socialization and individualization.

Objectives

The aim was to investigate the quality of life of patients with hypothyroidism with non-psychotic mental disorders. We examined 132 patients with hypothyroidism. The age of patients ranged from 25 to 55 years. The main group included 108 patients with non-psychotic mental disorders, which are dominated asthenia (27.78 %), asthenic- depressive (32.41%) and asthenic-anxiety disorders (18.52%). The control group consisted of 24 patients with hypothyroidism without mental disorders.

Methods

Quality of life was assessed using a questionnaire developed by Mezzich, Cohen, Ruiperez, Liu & Yoon (1999), covering the three main components of quality of life: subjective wellbeing/satisfaction, fulfillment of social roles, external living conditions.

Results

Found a significant difference in quality of life in patients with main and control group. The average in the overall perception of life (sense of satisfaction and happiness in general) in the main group was 5.19±1.15, in the control group 7.50±2.25.

Conclusions

The main conclusion is that patients with hypothyroidism really need psychiatric consultation and treatment should include not only endocrinological influence but neuropsychopharmacological and psychological too.

Disclosure

No significant relationships.
A blank slate – apropos a clinical case
Authors: Ramos S. Freitas , Seabra M. , Horta P.Â. , Guimarães J. , Grangeia R.
Published: February 2022

Introduction

Dissociative Amnesia remains an enigmatic and controversial entity. It is classically described as responsible for autobiographic amnesia associated with a traumatic event.

Objectives

To report a clinical case and review the literature.

Methods

We collected data from the patient’s clinical file with his informed consent. We conducted a non-systematic review of the literature.

Results

A 46-years-old patient presents to the emergency department for sudden global retrograde amnesia, with multiple domain amnestic syndrome (impairing verbal and visual memory, processing speed, mental flexibility, calculus, executive functions and language). He was initially admitted for a suspected infectious meningoencephalitis, which was not confirmed. Later an autoimmune encephalitis was pursued. Brain MRI showed a nonspecific left temporal and hipocampal hyperintensity and the EEG a mild left temporal dysfunction. The autoimmune encephalitis panel was negative and the formal diagnostic criteria were not met. The neurologic examination at discharge presented only with autobiographical and semantic amnesia. On the mental state examination, he presented with depressive symptoms reactive to the situation. There was no evident traumatic event apart from a promotion received the day before the amnesia started. He was prescribed escitalopram 10 mg/day. The amnesia was maintained at 9 months follow-up.

Conclusions

Our case report illustrates a case of amnesia without evident organic or psychogenic cause, assumed as a dissociative amnesia. Further studies are necessary to clarify the pathophysiology of this condition and develop specific treatments.

Disclosure

No significant relationships.
Alprazolam addiction: The case study
Authors: Pityk O. , Karbovskyi N. , Galyga N. , Rubanets O.
Published: February 2022

Introduction

Alprazolam is an anxiolytic, a benzodiazepine derivative of the middle duration of action. It is one of the most frequently prescribed medication for the treatment of anxiety and panic disorder. Under the action of a drug, a person feels incredible ease, a sense of euphoria, absence of problems, a sense of safety.

Objectives

A 55-year woman was admitted to psychiatric clinic in Ivano - Frankivsk.

Methods

She was assesed by the clinicopsychopatological method (clinical interview) and additional methods (MRI, EEG, pathopsycological assessment).

Results

The main findings were: atactic procession, tremor of the limbs and the whole body, poor attention, speech impairment, retarded thinking, fixation and reproductive amnesia with the components of progressive amnesia, change handwriting. The mood is lowered with unstable affect, lack of insight. She reported burning and tingling of the head as a main problem. She developed amotivation, bad activity and drowsiness, bradycardia, decreased blood pressure. She took Alprazolam during a period of 1,5 year in gradually increasing doses. The last dose was 12 tablets of Alprazolam per day. The patient was consulted again in a year. She does not take Alprazolam. She takes valproate and escitalopram. She did not demonstrate severe neurological symptoms which were seen a year ago.

Conclusions

Thus, though alprazolam is one of the best anxiolytic substance it should be prescribed only by the doctor for a short course (no more than 4-5 weeks). The treatment must include psychoeducation in order to make patients be aware about possible addiction and unsafety of prolonged and uncontrolled usage of alprazolam.

Disclosure

No significant relationships.
Pharmacokinetic interactions of psychotropic medications in patients with schizophrenia suffering from atypical mycobacterial infections
Authors: Sabaté M. Betriu , González-Rodríguez A. , Guàrdia A. , Pérez-Macho E. , Pedrero A. Alvarez , Acebillo S. , Monreal J.A. , Vidal D. Palao , Labad J.
Published: February 2022

Introduction

Mycobacterium kansasii is a nontuberculous mycobacterium that causes infection associated with past or current tuberculosis disease. Clinical syndromes and radiological findings are mostly indistinguishable from that of Mycobacterium tuberculosis, thus requiring microbiological confirmation.

Objectives

We report a case of a 44-year-old man diagnosed with schizophrenia and Mycobacterium kansasii infection.

Methods

Case report and non-systematic narrative review from PubMed.

Results

Case report: Patient with schizophrenia who was admitted at the inpatient unit presenting psychotic exacerbation with high levels of excitement. Risperidone 6 mg/day and valproate 500 mg/day were initiated. He was also diagnosed with a M. kansasii lung infection, with radiological findings of past tuberculosis disease. Before the microbiological confirmation, it was necessary to start rifampicin, requiring an increase in doses of both psychotropic drugs. Review: (1)Comorbidity of mycobacterial infections and schizophrenia. Several studies have shown that people with severe mental illness have higher rates of tuberculosis compared with the general population. Although the relationship between tuberculosis and M. Kansasii infection is known, few literature is available with regard to the association of M. Kansasii and schizophrenia. (2)Interactions between antipsychotics and mood stabilizers with rifampicin. Rifampicin is mainly metabolized by CYP3A4 and transported by P-glycoprotein. Add-on with rifampicin have been reported to reduce clozapine and olanzapine plasma levels (despite both are metabolized by CYP1A2), reduce haloperidol and risperidone levels (possible role of P-glycoprotein in this interaction), as well as for valproate.

Conclusions

Treatment of comorbid infections in people with schizophrenia remains a challenge. Antibiotics used to treat mycobacterial infections can modify the pharmacokinetic of psychotropic drugs.

Disclosure

No significant relationships.
How to deal with refractory risk factors that depend on behavior?
Authors: Valido R. , Caldas F. , Ferreira P.
Published: February 2022

Introduction

Health-related behavior correlates in critical ways with the current epidemic of chronic diseases. Modifiable behaviors increase the risk of chronic disease. Despite there are well-identified behaviors, efforts at behavior change are clinically-challenging and frequently ineffective.

Objectives

We aim to establish how the current evidence and latest neuroscientific knowledge about behavioral change allow the most reliable assessment of patients with refractory health-related behaviors that negatively impact health outcomes.

Methods

We performed a literature review using Pubmed databases and UpToDate. The search included “behavioral change” and “health-related behavioral change”[MeSH Terms].

Results

Habitual behavior consists of behavioral patterns operating below conscious awareness and acquired through context-dependent repetition. Behavioral change is a complex multi-level field of intervention. The Health Belief Model allows a careful description of the patient’s perceived vulnerability, perceived disease severity, self-efficacy, and change motivation. The identification of social variables is critical since they correlated with poor health outcomes, particularly in chronic diseases. Temperament and character traits can have a strong influence on the difficulty of changing habitual behavior. Psychopathology, if present, must be addressed because it can be a notable factor of behavior instability and correlates negatively to health outcomes. Assertive and efficient communication skills in the clinical context are imperative. Motivational interviewing skills can allow effective behavioral change.

Conclusions

Interventions addressing behavior change require careful, thoughtful work that leads to a deep understanding of the nature of what motivates people. Intervention based strategies focused on behavioral change must undergo further investigation in the future.

Disclosure

No significant relationships.
Analyzing the psychological impact of the COVID-19 pandemic among turkish immigrants treated at the neuro-psychiatric center riem Munich
Authors: Herbrüggen E.D. Cindik
Published: February 2022

Introduction

Infectious diseases have been humanity’s constant problem throughout history and they have shown how vulnerable we remain. COVID-19, commonly known as coronavirus pandemic, has already triggered a variety of psychological problems including fear, anxiety, and suicidal attempts. It has been hypothesized that immigrants who lost their job and have lower income or lower education level are more worried and fearful.

Objectives

This paper aims to investigate the psychological conditions and stress level of immigrants in the NPZR. Moreover, the parameters influencing stress levels of the immigrants were analyzed.

Methods

Demographics, level of stress and current psychological conditions of participants were gathered and analyzed through a structured survey. Besides, in-person interviews were conducted to explore the responses of the participants to receive more and deeper information.

Results

The sample consists of 110 responders (45.3 % males; 51.8 % females). The findings of the study illustrated that while there was no relationship between gender of the immigrants and the level of stress, participants with low income (27.5 %) and unemployed immigrants (24.2 %) felt more worried and anxious. As time passes, the anxiety level of the participants decreased by 49.1 % but 40.9 % of the participants still experience severe anxiety.

Conclusions

The findings demonstrate that having low income or being unemployed as well as the cancellation of travel plans, are positively related with the depression level of the participants. The result of this paper show that more attention has to be given towards immigrants with low income as they are more vulnerable during the COVID-19 Pandemic.

Disclosure

No significant relationships.
Adding dimension to the diagnostic process: Demonstration of the DSM-5 checklist and PID-5 personality trait assessment scale
Authors: Egervári L.
Published: February 2022

Borderline personality disorder (BPD) is very common, with an estimated community prevalence of 1-3%, rising to 25% in psychiatric inpatients. The aim of this talk is to address the challenges clinicians face when diagnosing borderline personality disorder. The new dimensional approach to the classification of personality disorders adopted by ICD-11 diverges from the classical categorical case definitions used in the ICD-10 and DSM-IV/DSM-5 diagnostic frameworks, thereby significantly altering the concept of personality disorders. While the DSM-5 checklist is a well-known and widely used diagnostic entity by now, with the introduction of Personality Inventory for DSM-5 (PID-5) a new assessment tool has emerged, providing the possibility of a more detailed description of personality functioning and traits. PID-5 is a 220-item self-rated personality trait assessment scale, assessing 25 personality trait facets and 5 main personality trait domains. This talk will focus on analyzing the difference between categorical and dimensional diagnostic work-up, using a case presentation to demonstrate the diagnostic processes and their outcomes.

Disclosure

No significant relationships.
Psychological impact and coping strategies of medical students during university closure due to COVID-19 in a state university in Sri Lanka – an online survey
Authors: Rohanachandra Y. , Seneviratne P. , Amarakoon L. , Prathapan S.
Published: February 2022

Introduction

Loss of routine, disengagement from peers and adapting to distant learning during the pandemic may lead to psychological distress in medical students. Psychological impact of the pandemic on medical students has not been assessed in Sri Lanka

Objectives

To identify the psychological impact and coping strategies of medical students during the pandemic.

Methods

An online survey was done among 527 medical students in a state Medical Faculty in Sri Lanka. Depression Anxiety Stress Scale (DASS-21) was used to measure psychological impact.

Results

The main worries among the students was upcoming exams (74.4%, n=389) and taking a longer time than expected to complete their undergraduate medical education (68.1%, n=356). 68.7% (n=362) of the respondents experienced difficulty in working up the initiative to do things and 62.6% (n=330) had tendency to overreact to situations. Depressive symptoms were present in 40.8%, anxiety in 34% and high levels of stress were seen in 24.7%. In 10.8% depression was severe and anxiety was severe in 10.3%. Depression (p<0.01), anxiety (p<0.05) and stress (p<0.01) were significantly higher in students with a past history of psychiatric disorders. Depression, anxiety or stress was not associated with the gender, ethnicity, family income or living circumstances. The main coping strategy of the participants was engaging more with family (73.4%).

Conclusions

Given the high levels of psychological distress, supportive strategies should be designed to minimize the psychological impact in this vulnerable group.

Disclosure

No significant relationships.
Changes in moral decision-making during the COVID-19 pandemic
Authors: Enikolopov S. , Medvedeva T. , Boyko O. , Vorontsova O. , Kazmina O.
Published: February 2022

Introduction

Stress can influence moral decisions.

Objectives

The aim of the study was to evaluate whether the stress experienced by people during the COVID-19 pandemic can change moral decision making.

Methods

311 respondents took part in the Internet survey 30.03.20-31.05.20, including SCL-90-R, and a subset of moral dilemmas proposed by Greene J.D (30 dilemmas in Russian), with «footbridge dilemma» among them as a personal dilemma and «trolley dilemma» as impersonal. The relationship of utilitarian personal dilemmas choices with psychopathological characteristics was analyzed. Personal moral dilemma choices were considered separately, in subgroups with a high level of somatization (N=107) and a high level of psychopathological symptoms (N=76).

Results

The results showed an increase in personal dilemmas choices: 2.84 mean utilitarian choice in March - April and 3.17 in May (Univariate Analysis of Variance, age, gender as Covariates, p<0.01). At the beginning of the study the groups did not differ in the number of utilitarian personal choices, and at the end of the study the number of personal choices increased in the subgroup with a high level of psychopathology (4.7 utilitarian choices in May) and became statistically higher than in other groups (ANOVA with Bonferonni correction). In the subgroup with a high level of somatization, personal choices slightly decreased by the end of the survey (2.68 choices).

Conclusions

The level of stress during the COVID-19 ambiguously affects moral decisions: a higher level of psychopathological symptoms leads to an increase in utilitarian choices and a high level of somatization leads to a decrease in utilitarian choices.

Disclosure

No significant relationships.
Psychological burden and variables affected by living with a person of high risk for COVID-19 during the lockdown period in Greece
Authors: Lyrakos G. , Pilafas G. , Strongylaki N. , Menti D. , Spinaris V.
Published: February 2022

Introduction

On February 26, 2020 the Greek government established measures against the spread of COVID-19, which eventually escalated to the entire social and economic ‘lockdown’ of the state on March 23. The main message was staying home and protect the eldest who are more vulnerable to the virus.

Objectives

The aim of the present study was to test the effect of living with a vulnerable person to specific psychological factors in order to be able to create future interventions for psychological well-being of the population.

Methods

A convenient sample of 1,158 Greeks (280 males [24.2%] participated electronically during the ‘lockdown. A battery of questionnaires for stress resilience, acute stress, and satisfaction with life, well-being and effect on psychosocial health was used for the study. Analysis was performed with SPSS 24.

Results

Individuals living in the same house with a vulnerable partner of parent were found to have statistically significant higher levels in acute stress disorder (Μ=39,4±15,4) than those living without (M=37.7±15.5) (t1156=2.125 p=0.03)The same happened with the effect on psychological health with the first Group having significantly higher score in the questionnaire (M=76.6±56,9) than the second group (M=69.1±55.1) (t1156=2.330 p=0.02). Stress resilience, satisfaction with life and well-being were not affected.

Conclusions

According to our data individuals living in the same house with a vulnerable person for COVID-19 are more likely to develop acute stress and psychosocial impact. Stress reduction programs are needed in order to help this population with managing the results of the lockdown.

Disclosure

No significant relationships.
Investigating the role of socio-demographic variables to psychosomatic symptoms of a greek sample between the two domestic COVID-19 lockdowns
Authors: Pilafas G. , Lyrakos G. , Spinaris V.
Published: February 2022

Introduction

The COVID-19 outbreak resulted in two respective social and economic lockdowns in Greece. According to international findings pressure and instability may lead to the sense of losing control over the situation, and in retrospect to the escalation of psychosomatic symptoms for the general population.

Objectives

The present study examines whether five socio-demographic variables are significant to the variance of psychosomatic symptoms of the Greek population between the two domestic lockdowns.

Methods

192 participants, of whom 141 were females(73.4%) and 51 males(26.6%), provided their answers between October 5 and November 18, 2020 to the research team of the Psychiatric Unit of the General Public Hospital of Nikaia, ‘Ayios Panteleimon’, in Athens, Greece. The participants were asked about their (i)‘income’, (ii)‘occupation’, (iii)‘residence’, (iv)‘marital status’ and (v)‘education’. Psychosomatic symptoms were measured through the self-reported PSSQ-29 tool (Cronbach’s alpha= .955).

Results

Out of the five One-way Between-participants ANOVAs, none of the five socio-demographic variables showed any significant statistical difference in the level of psychosomatic symptoms.

Conclusions

The study provides some evidence against the protective and harmful role of the socio-demographic variables in psychosomatic health. It is noteworthy, that the conditions were not similar with previous studies. It might be possible that the COVID-19 worked as a phenomenon of mass panic for the Greek sample, and thus no socio-demographic background was either protective or harmful. In conclusion, the present study clearly highlights that none of them had any significant effect to the variance of psychosomatic symptoms for the general population.

Disclosure

No significant relationships.
Descriptive study on psychological first aid for COVID-19 patients’ relatives
Authors: Moreno M. García , Milas A. De Cós , Carreño L. Beatobe , Delgado M.E. Pelayo , Salvador M.T. González , De Arce Cordón R.
Published: February 2022

Introduction

The presence of psychological impact on relatives of patients admitted for Covid-19 has been described. The effectiveness of psychological first aid in critical situations has also been described. The first psychological aid describes a human response supporting another person who is suffering. This intervention is indicated for those affected by a traumatic event.

Objectives

To present a theoretical review about psychological first aid and to describe data about it on relatives of patients admitted for Covid-19.

Methods

Literature review about psychological first aid and data description of telephone intervention carried out by mental health professionals on family members of patients admitted for Covid-19.

Results

From an initial pool of 77 Covid-19 patients, 50 were selected as telephone contact with relatives was possible. Mean age was 68.9 years, 13 were female and 37 male. 90% were admitted in internal medicine department and 10% in intensive care unit. First telephone intervention in all cases was to introduce the psychiatrist in charge of the follow-up and provide contact number of psychiatry department. In 13 relatives` support, emotional ventilation and active listening was provided and 2 of them also received therapeutic guidelines. Further phone contact was required in 12 relatives. In follow-up phone calls, all relatives received therapeutic guidelines and 3 was referred to our outpatient clinic.

Conclusions

Family members of patients admitted for covid-19 may present emotional symptoms, many of them normal reactions in context of a crisis situation. A large percentage do not require a structured psychotherapeutic intervention but can benefit from a first psychological help.

Disclosure

No significant relationships.
Untangle those stethoscopes; never too early to start reflecting! Qualitative review of a reflective practice group for clinical undergraduate medical students
Authors: Jordan E. , Patel S. , Mcguire E. , Noonan P. , Mccarthy G.
Published: February 2022

Introduction

Equipping our medical students with as many tools as possible to cope with the challenges that they will inevitably face has never been more important than it is today.

Objectives

The aim of this study was to examine the effectiveness of a reflective practice (RP) group for medical students, particularly with adaptation to COVID-19 and transition to video.

Methods

A pilot programme of RP for 3rd year medical students commencing their clinical placement was run by the Sligo Medical Academy, NUIG in Ireland between January – April 2020. This group for nine students was initially run face-to-face but pivoted to an online group in March 2020 with the COVID-19 pandemic. Data was collected through one-to-one interviews with all student participants and the facilitator (n=10). Interviews were recorded and transcribed. Data were analysed using thematic content analysis.

Results

Our analysis identified four main discussion themes: transition to clinical environment, gender in the workplace, building professional identity and family and support systems. The students who continued the RP group over zoom during the COVID-19 pandemic particularly identified with the theme of support systems and solidarity. The smooth transition to zoom and its effectiveness in a time of social distancing were discussed. Identified challenges related primarily to timing of the RP group, particularly after a full day of placements or time differences for international students overseas.

Conclusions

Reflective practice programmes are not routinely offered to medical students in Ireland currently and this study gives recommendations on implementing and improving experiences of undergraduate training based on RP.

Disclosure

No significant relationships.
Prevention of substance abuse in youth: How social norms approach can help
Authors: Sönmez E.
Published: February 2022

Drug and alcohol use in adolescence is a major global public health concern. Adolescence is the highest risk period for the initiation of drinking and substance use. Since the 90s, a growing body of evidence has indicated the influence of peers’ behaviours and attitudes in the development of youth tobacco, alcohol and drug use. Based on these studies, the social norms approach has been developed, mainly applying to the Western countries. The approach argues that how a student perceives his/her peers’ health-related behaviours and attitudes (such as substance/alcohol use) does have an influence on his/her own behaviour, and negative behaviours are generally overestimated among peers. Correcting these misperceptions may contribute to the prevention of youth substance/alcohol use. The applicability and discussions on the social norms approach will be presented in this talk, with two example studies. Both studies are conducted in Turkey, which is ranked lowest in terms of alcohol use and related problems among World Health Organization Europe zone countries, despite and increasing trend in use over the past decades. In both university and high-school samples, we found that students’ misperceptions about higher peer tobacco and alcohol use facilitated their own alcohol use. We conclude that targeting social norms may be part of a generalized preventive approach with regards to drug use and is of universal value. References: 1. SÖNMEZ, E. & AKVARDAR, Y. 2015. A Social Norms Approach to Substance Abuse Prevention in Youth “The more I think you drink, the more I drink”. Bağımlılık Dergisi-Journal of Dependence, 16, 86-94 (Turkish) 2. GÜNDÜZ, A., SAKARYA, S., SÖNMEZ, E., ÇELEBI, C., YÜCE, H. & AKVARDAR, Y. 2019. Social norms regarding alcohol use and associated factors among university students in Turkey. Archives of Clinical Psychiatry (São Paulo), 46, 44-49.

Disclosure

No significant relationships.
Psychosis and COVID-19: About a case
Authors: Ponte T. , Castelao-Almodóvar S. , Sanz-Aranguez B. , Gil-Benito E. , Herranz J.
Published: February 2022

Introduction

Cases of psychosis are being reported in people infected by the SARS-CoV-2 virus. The relationship between psychosis and corticosteroids treatment is well known. However, there are relatively limited data so far correlating psychosis and SARS-CoV-2.

Objectives

To describe a case of manic psychosis in a 55-year-old woman treated with corticosteroids for COVID-19 infection. Discuss the etiopathogenic factors involved in psychosis in patients infected by COVID-19.

Methods

We present the case of a 55-year-old woman, without previous psychiatric history, who was admitted to psychiatry due to a psychotic episode with maniac symptoms. Three weeks earlier, the patient had been admitted to Internal Medicine for bilateral SArs-CoV2 pneumonia, under treatment with high doses of corticosteroids. The patient presents a verbose and salty speech, euphoric mood with hyperergia, subjective increase of capacities, insomnia and delusional ideation with mystical-spiritual content with delusional interpretations and auditory hallucinations. The patient comes from Ukraine and she has been living in Spain for 20 years. She works as a household assistant. The patient relates various psychosocial stressors throughout her life.

Results

Complementary diagnostic tests were without alterations. Low-dose antipsychotic treatment is prescribed, with a rapid recovery within a week. Finally, the patient showed complete insight of the episode and was discharged from the hospital being asymptomatic.

Conclusions

It would be interesting to publish the reported cases of psychosis and infection by COVID-19 as well as to investigate the etiopathogenic factors that may be contributing to the development of psychosis in patients infected by the virus.

Disclosure

No significant relationships.
Trait anxiety and coping strategies among healthcare professionals during the COVID-19 pandemic
Authors: Smaoui N. , Bouaziz A. , Kraiem M. , Omri S. , Feki R. , Bouali M. Maalej , Charfi N. , Thabet J. Ben , Zouari L. , Maalej M.
Published: February 2022

Introduction

The current pandemic wave of COVID-19 has become a global threat. Healthcare professionals (HCP), by being on the front line in managing this pandemic, confronted high levels of stress and traumatic experiences.

Objectives

The aims of our study were to evaluate the trait-anxiety among Tunisian HCP and its impact on coping strategies.

Methods

A cross- sectional descriptive and analytic study conducted among Tunisian HCP during November and December 2020. The data was collected by an online questionnaire distributed through social media. The trait-anxiety was assessed using the “General Anxiety questionnaire of Spielberger” (STAI-Y-B) and the “Ways of coping checklist revised (WCC-R) questionnaire” identified three types of coping (problem-focused, emotion-focused and social-support seeking).

Results

Participants were 135 HCP (71 males and 64 females) and aged from 24 to 61 years old (average age 31.98 years; SD 6.59 years). Of HCP involved in the study, 61.5% were single, 36.3% were married and 2.2% were divorced. Seventy-two of them had a trait-anxious. As a coping style, 85.2% of participants used problem-focused style, 88.9% of them used emotion-focused style and 63% of them used social support seeking style. The analysis of WCC-R showed that anxious HCP used emotion-focused coping more than non anxious HCP (p= 0.028). However, there was no significant difference in problem-focused or social support seeking coping styles and presence of trait-anxiety.

Conclusions

In our study, we find that the most anxious Tunisian HCP focused on emotions strategies. Personality traits play on attitudes of coping strategies.

Disclosure

No significant relationships.