bluuebunny/crossref_metadata_2025 huggingface dataset:
Principles of a personalized approach in psychosocial interventions for cardiac surgery patients
Authors: Nikolaeva O. , Babokin V. , Trofimov N. , Fakhraei S. S.
Published: August 2024

Introduction

Cardiac surgery patients, former cardiac patients, face additional sources of stress connected with surgical intervention.

Objectives

To devise the main principles of a personalized approach in psychosocial interventions for cardiac surgery patients.

Methods

We have devised these principles based on the analysis of contemporary scientific literature and the operational experience of the Cardiology Clinic of the Chuvash Republic located in the city of Cheboksary.

Results

A personalized approach in psychosocial interventions for cardiac surgery patients is used at all levels of medical support. It implies taking into consideration in every specific patient a unique correlation of their clinic-anamnestic peculiarities, clinic-psychological risk factors of the condition’s gravity and their psychological resources. At the same time, all the psychological interventions must focus on the personality and comply with the clinic specificity of the actual somatic and mental condition of the cardiac surgery patients. The underlying principles of the personalized approach in psychosocial interventions for cardiac surgery patientsinclude the principles of accessibility, openness, continuity, collaboration, integration, differentiation, variation, participation, awareness and prevention.

Conclusions

Relying on the personalized approach in psychosocial interventions for cardiac surgery patientsallows working out a personalized treatment and rehabilitation course for an individual patient.

Disclosure of Interest

None Declared
Transcranial magnetic stimulation for obsessive-compulsive disorder - preliminary results of an observational study
Authors: Mangas Palma I. , Borges J. , Palha E. , Salgado H. , Alves P. , Sousa Martins P. , Moreira R.
Published: August 2024

Introduction

Obsessive-compulsive disorder (OCD) has a high prevalence and causes a significative reduction in functionality and quality of life.

First and second line treatment is ineffective in a variable percentage of patients. In such cases transcranial magnetic stimulation (TMS) may be considered.

Objectives

The goal of this study is to evaluate the impact of TMS treatment on obsessive-compulsive, anxious and depressive symptomatology in patients with OCD.

Methods

A prospective observational study was conducted, including all patients diagnosed with OCD who underwent TMS in the Psychiatry department of Centro Hospitalar Universitário de São João since March 2023.

Symptomatology was assessed using the Yale Brown Obsessive-Compulsive Scale (Y-BOCS), the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D) before and after treatment.

Statistical analysis was performed using the SPSS-Statistics program. A significance level of 0.05 was considered.

Results

As of October 31, 2023, nine individuals with OCD completed treatment with TMS, 33% male and with a median age of 40 years (range 33-57).

The median Y-BOCS score pre-TMS was 30 (range 20-33) and post-TMS 28 (range 16-34). The median difference was 2.5 (range -5-14) and was not statistically significant (p=0.128).

The median score on the HAM-A pre-TMS was 21 (range 9-41) and post-TMS 18 (range 11-24). The median difference was 0 points (range -4-21) and was not statistically significant (p=0.345).

The median HAM-D score pre-TMS was 26 (range 14-40) and post-TMS 19 (range 10-32). The median difference was 2.5 (range -3-20) and was not statistically significant (p=0.225).

Conclusions

Preliminary findings suggest that the impact of TMS on obsessive-compulsive, anxious, and depressive symptomatology in patients with OCD does not appear to be clinically or statistically significant.

Further results are necessary to confirm this trend.

Disclosure of Interest

None Declared
Factors associated with psychotropics adverse effects in elderly psychiatric inpatients
Authors: Abid W. , Turki M. , Ben jmeaa B. , Zribi A. , Megdiche M. A. , Ellouze S. , Halouani N. , Aloulou J.
Published: August 2024

Introduction

Adverse effects (AEs) of psychotropic drugs are more frequent and potentially more dangerous in elderly subjects (ES), probably due to a greater frequency of somatic comorbidities, as well as polymedication.

Objectives

The aims of this study were to determine the prevalence of AEs of psychotropic treatment among ES hospitalized in psychiatry, and to identify the associated sociodemographic and clinical factors.

Methods

We conducted a retrospective and descriptive study. It concerned male patients aged at least 60 years, hospitalized in the psychiatry B department at CHU Hedi Chaker (Sfax, Tunisia) between 2018 and 2022. We collected demographic and clinical data from their medical records using a pre-established
form.

Results

We included 30 patients. The average age was 64 years. Addictive behaviors were reported in 60%, and somatic histories were noted in 53.3% of patients. The three most frequent psychiatric diagnoses were schizophrenia (43.3%), bipolar disorder (33.3%) and depressive disorder (13.3%). Among our patients, 10% experienced adverse psychotropic drug reactions: orthostatic hypotension 6.7%; neurological AEs 3.3%. Univariate analysis showed no significant relationship between sociodemographic variables and psychotropic drug AEs. Patients with bipolar disorder were more likely to develop AEs of psychotropic treatment (p=0.04).

Conclusions

Our results suggest that special attention should be paid to avoiding psychotropic medication AEs in psychiatric inpatients ES. Indeed, extra precautions need to be taken in this population due to their reduced ability to report their symptoms.

Disclosure of Interest

None Declared
Cytoprotective mechanism of cerebro-cognitive reserve
Authors: Sidenkova A.
Published: August 2024

Introduction

Consideration of the reserve problem would be incomplete without an analysis of the cytoprotective mechanism. The predominant molecular hallmark of aging and degeneration is the accumulation of altered gene products. Moreover, several conditions, including protein, lipid, or glucose oxidation, disrupt redox homeostasis and lead to the accumulation of unfolded or misfolded proteins in the aging brain in case of AD, and other neurodegenerative diseases that have as a common denominator abnormal protein production, mitochondrial dysfunction and oxidative stress. Some authors classify aging, pathological aging, and neurodegeneration as “protein conformational diseases”.

Objectives

scientific publications

Methods

analytical review

Results

The central nervous system has evolved a conserved unfolded protein response mechanism to cope with the accumulation of misfolded proteins. As one of the main intracellular redox systems involved in neuroprotection, the vitagene system becomes a potential neurohormetic target for novel cytoprotective interventions. Vitagens encode the cytoprotective heat shock proteins (Hsp) Hsp70 and heme oxygenase-1, as well as thioredoxin reductase and sirtuins. The cellular stress response is the ability of a cell to withstand stressful conditions, including the heat shock response. The production of heat shock proteins, including protein chaperones, is necessary for the folding and repair of damaged proteins, which promotes cell survival to avoid apoptosis.«Molecular chaperone» are proteins that function as part of an ancient defense system in our cells. They promote cell survival by sequestering damaged proteins and preventing their aggregation. Chaperone complexes are involved in the regulation of mitochondrial functions, assembly of the cytoplasmic proteolytic system of brain cells. The cellular response to stress requires the activation of survival pathways that are under the control of protective genes called vitagens. Vitagens are involved in the production of heat-shock protein molecules, glutathione, and bilirubin. They have antioxidant and anti-apoptotic activity and provide protection against oxidative stress.

Conclusions

Studies have shown that the heat shock response contributes to the maintenance of cellular homeostasis, the establishment of a cytoprotective state in a wide range of human diseases, including inflammation, cancer, aging, and neurodegenerative disorders. Endogenous proteins can be manipulated by food or pharmacological compounds, which represents an innovative approach to therapeutic intervention in neurodegenerative disorders, actually influencing reserve mechanisms and adaptive capacity.

Disclosure of Interest

None Declared
Exploratory study of a meditation intervention program on Portuguese breast cancer survivors
Authors: Torres A. , Ribeiro C. , Costa S. R.
Published: August 2024

Introduction

Cancer patients, namely breast cancer survivors, are highly vulnerable to psychological morbidity. Noninvasive interventions are incentivized to promote the mental health and quality of life of cancer survivors. Recent studies provided evidence supporting the use of meditation as a promising adjuvant tool for improving the mental health and quality of life of cancer survivors.

Objectives

The present study aims to carry out a clinical trial to evaluate the effects of an online group of meditation program of Kundalini Yoga on breast cancer women, through a longitudinal and randomized research design, in the following variables: psychological morbidity, self-compassion, spirituality, and quality of life.

Methods

This study had the participation of 35 participants distributed randomly for 3 equivalent groups (N=11 EG, N=13 ACG, N=11 PCG), with the diagnosis of breast cancer, aged between 34 and 78 years.

The sample of women with breast cancer was randomly selected from a breast cancer support association.

The protocol was applied online individually on pre-test, post-test, and 1-month follow-up moments, in 3 comparison groups: 1) the Experimental Group(EG), who practiced yoga Kundalini meditation; 2) the Active Control Group(ACG) that practiced relaxation; 3) the waiting list Passive Control Group(PCG). Intervention sessions were carried out for the EG and the ACG, in an online format, lasting about 30 minutes, weekly, for 8 weeks. Statistical analyses were considered at a 0.05 significance level. All analyses were performed with IBM SPSS, version 27.

Results

The results showed that the group that did yoga kundalini meditation (EG) had benefits, unlike the control groups, in the variables of emotional functioning, global spiritual well-being, and personal well-being. There were statistically significant differences in the overall self-compassion score when comparing the 3-time points in all groups. The sub-scale of self-kindness and transcendental well-being shows an increase significantly between the 3 moments in the active control group. The passive control group performed significantly worse over time in the self-kindness.

Conclusions

Based on preliminary results, the Experimental Group (EG) exhibited improvements in Self-Compassion, Spirituality, and Emotional Functioning (as evaluated by the QLQ C-30) following eight consecutive weeks of online Kundalini Yoga Meditation practice. These findings contribute to the growing body of evidence supporting meditation’s potential to enhance life quality and spiritual well-being in individuals with breast cancer. These preliminary findings suggest that further research in this promising field is warranted.

Disclosure of Interest

None Declared
Emotional meanings attributed to sexual experiences reported by Brazilian Men with Head and Neck Cancer seen at a Public University Oncologic Outpatient Service: A Qualitative Study
Authors: Sant’Ana R. S. E. , Lima C. S. P. , Turato E. R.
Published: August 2024

Introduction

“What can and what cannot I do in a sexual relationship?” |In this way, a middle-aged man with HNC - Head and Neck Cancer, under chemotherapy or radiotherapy, asks. This doubt is raised to the oncologist, radiotherapist, nurse or psychotherapist. Apparently, his concern is objective, considering he has a severe diagnosis and important treatments. However, underlying the manifest doubt, there are symbolic constructions in his mind that generate anguish. The health professionals’ response must go beyond information. They also must understand the symbolic emotional meanings associated with the patient’s speech. This attitude will bring a psychotherapeutic effect to the ill man.

Objectives

To interpret symbolically sexual and emotional experiences reported by male patients diagnosed with HNC under outpatient treatment in a public specialized clinical unit.

Methods

We used the CQM - Clinical-Qualitative Method (Turato. Portuguese Psychos. J, 2000 2(1): 93-108). For data collection, the main researcher used the Semi-Directed Interview with Open-ended Questions In-Depth and Field Notes. The employ of the Seven Steps of the CQCA - Clinical-Qualitative Content Analysis (Faria-Schützer et al. Cien Saude Colet. 2021; 26(1): 265-274) brings us to discussion categories. The sample was closed with 12 patients according to the information saturation strategy (Fontanella et al. Cad Saude Publica. 2008; 24(1): 17-27). The interviews were conducted by the first author of this abstract, a male nurse, as part of his master’s research at a postgraduate course in Oncology. The findings were validated by peer reviewers from the Lab of Clinical-Qualitative Research at the State University of Campinas.

Results

Two categories were chosen for this presentation: ‘The dyad perceived in the felt body and the experienced body’, and ‘The body re-signified between the sexual and affective dimensions’. The body symbolized before and after the illness experiences a movement in phenomenological consciousness that leads to external changes in its attitudes. The patient needs now to ask himself and others what this body can - or cannot - do. The severely ill body imposes new meanings for life and sexuality. It does not cancel the wish but asks for a new channelling of your psychic/sexual energies.

Conclusions

These findings indicate that patients with HNC want to talk about sexuality and ask about the risks of sexual activity, contrary to what the common view supposes. Traditional Balint groups met with the multidisciplinary team can be beneficial for doctors and nurses to deal with their own emotional limitations. Furthermore, the Consultation-Liaison Psychiatry, under the approach of psychosomatic medicine, focuses on the care of patients with behavioural and emotional manifestations, together with the work of the oncologists.

Disclosure of Interest

None Declared
“Esketamine” in Borderline Personality Disorder: focud on suicide ideation
Authors: Olivola M. , Mazzoni F. , Arienti V. , Civardi S. C. , Carnevale Miacca G. , Leali P. , Santilli F. , Guffanti A. , Brondino N.
Published: August 2024

Introduction

Borderline personality disorder is often associated with comorbid conditions such as eating disorders, mood disorders, and substance use disorders. The prevalence of BPD and major depressive disorder (MDD) are about 5.9% and 8%, respectively, but up to 80% of patients with BPD experience one or more episodes of MDD in their lifetime. BPD is associated with suicidal behaviors and self-harm, thei are also fifty times more likely than the general population to attempt or die by suicide, Up to 10% of BPD patients will die by suicide

Objectives

Our aim is to verify if Esketamine could be effectiveness in treating patterns of behavior that have proven to be socially disruptive like self harm, suicidal attempts in patients with BPD. Suicidal ideation is a major risk factor for suicide in patients with TRD and BPD. The interval between the onset of suicidal ideation and suicide attempt is often very short, highlighting the need for urgent intervention and the development of new rapid-onset antidepressant therapies.

Methods

We recruited 25 adult subjects referred to the outpatient clinics of Pavia suffering from TRD with current Moderate-Severe Depressive Episode (scoring ≥ 22 on the MADRS). Of them 9/25 patients has a BPD. Study duration was 8 weeks.The following evaluation scales were administered before the first drug administration (T0) and repeated after one week (T1), four weeks (T2) and eight weeks (T3) of treatment: Montgomery Asberg Depression Rating Scale (MADRS), Columbia-Suicide Severity Rating Scale (CSSRS), and The Zanarini Rating Scale for BPD subgroup patients. We also collected sociodemographic and clinical information. Dosages and frequency of esketamine administration during the study period, adverse events and reasons for discontinuation were also recorded.

Results

A significant reduction of depressive symptoms was found at T1 and T2 compared to T0. Suicidal ideation disappeared as early as T1 and was maintained at T2, expecially in the BPD group. In the subgroup with borderline disorder we saw more improvement in impulsive (Self-mutilation and/or suicidal efforts; two other forms of impulsivity) and affective categories ( Inappropriate anger / frequent angry acts; chronic feelings of emptiness; mood instability) in Zanarini Rating Scale.

Conclusions

Our findings support the safety and tolerability of esketamine in TRD and BPD comorbidity sample. It is noteworthy that esketamine has an action on various pathways that are considered defective in borderline patients. Glutamate plays a key role in personality traits such as impulsivity, aggression, and suicidal behavior. Treatment with esketamine could reduce the number of suicide attempts and help reduce the self-harm of BPD.

Disclosure of Interest

None Declared
Mental health support through transcendental cinema. “Mulholland Drive” By D. Lynch as an example of a mindfulness meditation session
Authors: Nowocień J. K. , Szejko N.
Published: August 2024

Introduction

Regular practice of mindfulness has proven effectiveness in the treatment of affective disorders (Cash and Whittingham, 2010), increases the level of satisfaction in life (Brown and Ryan, 2003), as well as the level of self-esteem (Rasmussen & Pidgeon, 2010). Using “Mulholland Drive” (2001) by David Lynch as an example, we will prove that transcendental cinema, through the unique slow character, the means of expression used and the emphasis placed on the metaphysical experiences of the characters, in which D. Lynch forces us to participate, makes the screening similar to a meditation session.

Objectives

The aim of this work is to indicate a new direction of research, linking cinema with psychoanalysis, philosophy and psychiatry and proving that a screening of transcendental cinema can be treated as a mindfulness meditation session.

Methods

This work is based on the film “Mulholland Drive” by D. Lynch and the understanding of transcendental cinema according to Paul Schrader. Using J. Kabat Zinn’s scientific publications, we analyze cinema in terms of a meditation session and using the approach of first generation analysts (S. Freud, C. Gustav Jung, S. Spielrein) in terms of a therapeutic process based on psychoanalysis.

Results

“Mulholland Drive” subjects the protagonist to a therapy session: the woman lives guided by the unconscious, a dream that seems real and finally at the end she reaches her own true self. On screen, she undergoes successfully the therapeutic process. The transcendental cinema focuses on metaphysical sensations, has elongated scenes, creates dead time, viewer remains in the frame even when the character comes out of it, and strives for kenosis - the reduction of sensory experience. All of these qualities are crucial in mindfuless: focusing on emotions and feelings experienced in the moment, non-judgmental and calmly concentrating on single stimuli. This similarity allows us to treat a transcendental film show in the category of a meditation session.

Conclusions

Recognizing the similarity between the philosophy of mindfulness and transcendental cinema allows us to conclude that a film screening enriches us not only with knowledge about disorders and the therapeutic process, but is in itself a supportive element for mental health. Our work is the first to analyze cinema in the context of mindfulness meditation. In our opinion, culture should be more widely analyzed as a tool to support mental health and the development of one’s own identity.

Disclosure of Interest

None Declared
Uncovering the Connection: PTSD and Road Accidents
Authors: Bellafqih S. , El Fatmaoui Y. , Belbachir S. , Ouanas A.
Published: August 2024

Introduction

Post-Traumatic Stress Disorder (PTSD) is a psychiatric disorder that can occur after a traumatic event. It results in mental suffering and physical complications that profoundly alter personal, social, and professional life.

One can develop PTSD after experiencing a frightening event, for example: rape, the death of a loved one, war veterans, or following a car accident. In Morocco, traffic accidents cause, on average, nearly 3,500 deaths and 12,000 serious injuries per year.

Objectives

Our main purpose is to evaluate the incidence of post-traumatic stress disorder in patients who are victims of traffic accidents and to identify key risk factors in the general population.

Methods

This is a descriptive cross-sectional study through a questionnaire shared on social networks including a socio-demographic description, a clinical description, and the “Peri-traumatic Distress Inventory (PDI)” Scale to evaluate the risk of developing PTSD.

Results

This study is based on 48 participants with 82.8% of females and 17.2% of men. The average age was 27.6. Most of the participants lived in urban areas (93%), a majority had higher education (93.1%), and 41.4% of the candidates had a physical impact of the accident.

According to PDI scale, 65% showed PTSD and the average score was 20.3. A score of 15 and above indicates significant distress.

Conclusions

Our results confirm the presence of PTSD in victims of accidents. We propose a clinical reflection on the possible improvement of the care of people suffering from PTSD following a public road accident.

Disclosure of Interest

None Declared
Teaching stress reduction techniques including biofeedback for managing stress in medical students
Authors: Krishnan R. , Kósa K.
Published: August 2024

Introduction

Medical students have been under immense pressure throughout their studies, impacting their mental health and academic performance. Stress reduction is a fundamental skill that all students require to manage their studies and lives efficiently. Biofeedback devices providing information about physiological states have been shown to aid stress reduction. Methods to reduce stress should be taught to medical students to help them tackle the challenges of medical school.

Objectives

Our goal was to teach stress reduction methods such as extracurricular activities and paced breathing aided by biofeedback training and its application in simulated healthcare situations to medical students.

Methods

15 medical students who completed medical physiology were recruited for an elective course of 7 sessions on practical techniques in stress management. One credit was offered to those who completed the course requirements consisting of participation in sessions and individual biofeedback training.

Sessions (classes) consisted of presentations on good sleeping and eating patterns, group simulations of stressful hospital environments, visiting a science centre with interactive displays, an orchestra performance, and nature walks. Before biofeedback training, heart and respiration rates were taken individually by a biofeedback device during the first week of the course. Data was processed using a code created in statistical software. Heartbeats per minute and heart rate variability (HRV) for every 10 seconds were calculated and plotted on a graph. Two measurements were taken with each student: a baseline measurement for 10 minutes and another measurement during controlled breathing paced at 6 breaths per minute for 15 minutes, of which the first 10 minutes were used for calculation and plotting. Students provided narrative feedback in an essay submitted after the course was completed.

Results

5 males and 10 females from years 2-5 registered for the elective, and 12 participated in individually scheduled sessions. Heart beats per minute decreased, whereas HRV increased during paced breathing sessions in 83% of them. Most students reported feeling calm and drowsy during the sessions, and 2 students fell asleep by the end.

Feedback from 11 students showed that the music session and the science centre visit were the highlights throughout the elective. Improvements recommended were to have a consistent time slot for all sessions and fewer simulations.

Conclusions

In concert with the literature, biofeedback training seems to be a feasible and effective method for relaxation in medical students. This method could be offered as part of mental health services for students. Data could be used to follow students’ progress and identify those requiring extra support. Providing them with avenues to de-stress while emphasizing activities outside medicine could boost their confidence and improve their coping skills.

Disclosure of Interest

None Declared
Early-onset obsessive-compulsive disorder: sociodemographic and clinical characterization of a large outpatient cohort
Authors: Benatti B. , Girone N. , Vismara M. , Bucca C. , Dell’Osso B.
Published: August 2024

Introduction

Obsessive-compulsive disorder (OCD) is a prevalent and disabling condition characterized by a wide variety of phenotypic expressions. Several studies have reinforced the hypothesis of OCD heterogeneity by proposing subtypes based on predominant symptomatology (Mataix-Cols et al., 2005), course (Tukel et al., 2007), and comorbidities (Mahasuar et al., 2011). Early-onset OCD could be considered a neurodevelopmental subtype of OCD, with evidence of distinct neurocircuits supporting disease progression (Park et al., 2022).

Objectives

The aim of the present study is to evaluate the sociodemographic and clinical differences between the early-onset and late-onset subtypes in a large patient cohort.

Methods

Two hundred and eighty patients diagnosed with OCD were consecutively recruited from the OCD Tertiary Clinic at Luigi Sacco University Hospital in Milan. Sociodemographic and clinical variables were analyzed for the entire sample and compared between the two subgroups (EO: early-onset, age <18 years [40%]; LO: late-onset, age ≥ 18 years [60%]).

Results

The EO group showed a higher frequency of male gender (65.5% vs 34.5%, p< .001, see Figure 1a), a higher presence of lifetime psychiatric comorbidities (75.7% vs 24.3%, p =.025), and higher rates of Tic and Tourette disorders (7.2% vs 0%, p=.006) compared to the LO group. Additionally, in the EO subgroup, a longer duration of untreated illness was observed (9.05 ± 10.0 vs 5 ± 7.17; p<.001, see Figure 1b), along with a lower presence of insight (33.3% vs. 66.7%, p =.024). No significant differences emerged in the Yale-Brown Obsessive-Compulsive Scale scores between the groups.

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Conclusions

The early-onset OCD subtype highlights a more severe psychopathological profile compared to the late-onset group. Exploring distinct manifestations and developmental trajectories of OCD can contribute to a better definition of homogeneous subtypes, useful for studying risk factors and defining targeted therapeutic strategies for treatment.

Disclosure of Interest

B. Benatti Speakers bureau of: Angelini, Lundbeck, Janssen, Rovi, N. Girone: None Declared, M. Vismara: None Declared, C. Bucca: None Declared, B. Dell’Osso Grant / Research support from: Angelini, Lundbeck, Janssen, Pfizer, Otzuka, Neuraxpharm, and Livanova, Speakers bureau of: Angelini, Lundbeck, Janssen, Pfizer, Otzuka, Neuraxpharm, and Livanova.
The relationship between bornout, somatic symptoms and work stress among hospital medic staff.
Authors: Török I. A. , Németh-Rácz K. , Kelemen E. , Szabóné Frank E. , Szendi I.
Published: August 2024

Introduction

The mental health for workers in the healthcare industry have been put through challenges.The first evaluation happened during the first wave of the pandemic, the second one, with grater sample size, have been conducted in Spring 2022.The healthcare system makes it less plausible to release stress adequately. The attitude of repression by the people makes the rise in stress-levels less knowledgeable This time the somatic symptoms makes the stress-levels steady shown. Our goal, to make visible, to categorise and recognise the somatic symptoms and the psychological symptoms, thus predicting the burn-out phase.

Objectives

The attitude of repression by the people makes the rise in stress-levels less knowledgeable This time the somatic symptoms makes the stress-levels steady shown. Our goal, to make visible, to categorise and recognise the somatic symptoms and the psychological symptoms, thus predicting the burn-out phase.

Methods

Methods:

Participants: 497 medic workers

-

PPS - Perceived Stress Scale - Type d personality scale -

-

Workplace Stress Questionnaire and Symptom List (Hungarian Hypertonia Society)

-

Beck Depression Questionnaire (9-item)

-

Oldenburg Burn-Out Questionnaire Results: From the questionnaire answers we counted

-

WHO Well-being Scale (5-item)

Results

12% of the people reached levels above the significant stress-level and 26% reached the mild-depression level. The burn-out levels have been significantly higher in the region of disappointment. Regarding the results of the somatic symptoms, depression and stress levels it had a leading factor, which was exhaustion.

The most frequent co-occurences of the 20 somatic and psychological symptoms of the Hungarian Hypertension Society Symptom List were also used in this study to refine the analysis. The factor analysis highlited 3 sypmtom clusters out of the 20 symptoms with the following co-occurrences (fatigue, concentration disturbance, headache, feeling of tension, palpitation, dizziness, inner tremor, distressing thoughts, sweating and nausea) The symptoms formed a total of 6 factors, of which 2 were found to be predictive of burnout and depression. The factors of muscle tension, fatigue, lack of concentration, feeling tense showed the strongest correlation with the measured varibles (burnout r=0,447, depression r=0,343, D-scale, negative mood r=0,369, p=0,000 at significance levels.)

Conclusions

The attention for the somatic complaints have a high attention between the workers, it’s part of the work culture to give more and more sacrifices, to hide the psychological effects, and deem them as weaknesses. Regarding the health of the worker it’s necessary to be more informative, to show more bearable physical symptoms to define and prevent the burn-out periods.

Disclosure of Interest

None Declared
Investigation of cytokine imbalance in schizophrenia, assessment of the possible role of serum cytokine levels in predicting treatment response, prognosis and psychotic relapses
Authors: Bodnár K. , Hermán L. , Zsigmond R. I. , Réthelyi J.
Published: August 2024

Introduction

Schizophrenia, a multisystem chronic psychiatric disorder of unknown etiology, is associated with several immune dysfunctions, including abnormal levels of circulating cytokines. Exsisting evidence shows a potential causative role for cytokines in schizophrenia symptom development. Furthermore, disease duration, symptom severity, aggressive behavior, and cognitive deficits are correlated with levels of certain cytokines. Despite the development of new antipsychotics, the negative and cognitive symptoms of schizophrenia often do not respond adequately to pharmacotherapy.

Objectives

Research questions and hypotheses: 1. Can there be a cytokine or cytokines among the different cytokine levels detected in schizophrenia that can be used as biomarkers of treatment response? 2. Can changes in cytokine levels indicate the occurrence of psychotic relapse? 3. Can changes in the cytokine level play a role in predicting the prognosis of the disease? The secondary objectives of the planned research, in addition to the above, are to clarify the knowledge gathered so far about the relationship between cytokine level changes and the clinical symptoms associated with them.

Methods

We investigate cytokine levels, blood samples are taken on hospital admission. Based on the publications, we mainly focus on the Il-2, Il-4, Il-6 and Il-10 levels, which can serve as possible predictive biomarkers relating to treatment response. We will also assess the possible role of abnormal cytokine levels and their association with symptoms severity and their potential clinical implications. The severity of the symptoms is monitored with the PANSS.

Results

15 schizophrenic patients who were hospitalized due to a psychotic relapse have been included. Blood samples were taken to measure cytokine levels, the PANSS scale was recorded during a psychotic relapse. We have included 9 healthy, age- and gender-matched healthy controls in the study, from whom blood samples were taken to measure cytokine levels. Preparation for measurement of cytokine levels is underway. Patient involvement is ongoing.

Conclusions

A better understanding of cytokine imbalance in schizophrenia patients can potentially help in early diagnosis, novel therapeutic target indentification and development, patient stratification for choosing the best therapeutic protocol, and predicting prognosis, relapse and treatment response.

Disclosure of Interest

None Declared
Haematological alterations in the context of olanzapine treatment
Authors: Serra B. , Ramis D. , Catalán R. , Llorca V.
Published: August 2024

Introduction

Haematological alterations, especially in the red blood cell series, are a rare adverse effect of olanzapine treatment. A 64-year-old female patient with a diagnosis of long-standing schizophrenia was admitted to the psychiatric room for psychotic decompensation and leukopenia in control laboratory tests. She had a history of mild psoriasis, allergy to sulphonamides and infectious bursitis nine years earlier secondary to neutropenia due to clozapine. On previous admission, episodes of anaemia and neutropenia related to increased doses of olanzapine were observed. On current admission, a new episode of anaemia and neutropenia occurred with doses of up to 20 mg/day of olanzapine, hemoglobin levels of 63g/L ann neutrophil count of 0,8*10^9 neutrophils/l were detected.

Objectives

Report a very rare but serious adverse effect in patients treated with olanzapine.

Methods

Haematological analysis were periodically carried out from 2009 to 2023.

A complete study was carried out with parameters of haemolysis, autoimmunity, a pharmacogenetic study and a myelogram.

Results

The autoimmunity and haemolysis study excluded an autoimmune or haematological illness that could justify the haematological alterations.

The myelogram showed normal cellularity.

The pharmacogenetic study showed no relevant alterations.

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Conclusions

The case was classified as a non-immune haemolytic anaemia secondary to olanzapine and improved with withdrawal of the drug.

Disclosure of Interest

None Declared
A Comparison of medication management with separate psychotherapy to medication prescribing with psychotherapy
Authors: Mehl-Madrona L. , Mainguy B.
Published: August 2024

Introduction

Little research has been conducted on outcomes in mental health care by intensity of level of service.  Mental health care has evolved in the United States to psychiatrists or psychiatric nurse-practitioners overseeing medications in 15-minute appointments while non-physicians provide the psychotherapy.

Objectives

We wished to compare these two models when one psychiatrist worked in two settings, providing the medication management alone model in one setting and the medication + psychotherapy model in the second setting.

Methods

All patients were seen by the same psychiatrist at (1) a community mental health center (CMHC) and (2) a private practice (PP) providing services to the same type of patients over 2 years. Patients were assessed with the My Medical Outcomes Profile (MYMOP2) and the Brief Psychiatric Rating Scale (BPRS). In the CMHC, patients were seen for a 15 – minute visits every 1 to 3 months. Patients were offered psychotherapy, ranging from 1/2 hour monthly to 1 hour every other week. Some patients received weekly psychotherapy due to an interest by the clinician. In the PP, patients were seen every 1 to 4 weeks by the psychiatrist who also provided psychotherapy when that was desired. Visits ranged from 15 to 75 minutes. Other practitioners could have also provided psychotherapy. Analysis was conducted for patients who completed at least four outcome ratings. Multi-level modeling techniques as implemented in SPSS were used to determine if patients improved over time.

Results

There were no differences in age, socioeconomic status, type of insurance, and type of diagnosis among the two groups. Follow-up occurred for two years. On average, no improvement occurred in outcome measurements in the CMHC setting while statistically significant improvement occurred in the PP setting. The cost of care was statistically significantly greater in the CMHC setting, due to the facility fees billed and collected for each patient (and approved by the government) of $176 additional per visit.

Conclusions

Further work can be done on establishing minimal levels of service delivery that can produce improvement for large populations in community settings. Since it is unlikely that we can generate control groups of no treatment, perhaps analyses like this one, comparing treatment models, can establish a benchmark from which we can understand the necessary level of treatment. The PP setting may have afforded more attention for patients than the CMHC setting, though at a lower cost to the government. The psychiatrist believed that he wanted patients to improve equally in both settings, but he could have been more enthusiastic in the setting in which he also did psychotherapy and therefore had better relationships with patients. On the other hand, this may be the point – better relationships with patients may be associated with better outcomes.

Disclosure of Interest

None Declared
Experiences and attitudes of early career psychiatrists towards ECT – an international study
Authors: Tapoi C. , Noël C. , de Filippis R. , Gurrea Salas D. , Mieze K. , Almeida D. , Pushko A. , Wilkowska A. , Gołębiewska M. E. , Alexander L. , Pinto da Costa M.
Published: August 2024

Introduction

Electroconvulsive therapy (ECT) is a psychiatric intervention that has proven effectiveness and safety in various psychiatric conditions, such as major depressive disorder, prolonged or severe manic episodes and catatonia. Despite positive scientific evidence, ECT was always seen as controversial by patients, caregivers, and even some psychiatrists, which lead to a decrease in its use over the years.

Objectives

To investigate the way young psychiatrists view the place of ECT in modern psychiatry by assessing their knowledge, attitude and access to training opportunities in ECT.

Methods

An anonymous survey was disseminated online among early career psychiatrists and psychiatric trainees. The questionnaire consisted of 36 multiple-choice and Likert scale questions.

Results

Most of our respondents consider ECT both an effective and a safe treatment option and would recommend ECT to their patients when indicated. Early career psychiatrists who had access to ECT training are more knowledgeable about the indications, precautions and side effects of this method, but more than half of the participants mentioned ECT training was unavailable during their residency programme. Almost all respondents stated that they are interested in enhancing their theoretical and practical competencies in ECT.

Conclusions

Early career psychiatrists have a positive attitude towards ECT but express the need of targeted education aimed at improving levels of knowledge about ECT.

Disclosure of Interest

None Declared
Virtual Reality as Exposure Therapy in the Treatment of Blood-Injection-Injury Phobias
Authors: Halouani N. , Boussaid N. , Turki M. , Barkallah M. , Ellouze S. , Aloulou J.
Published: August 2024

Introduction

Virtual Reality (VR) is a transformative technology that facilitates the development of immersive virtual environments. Its application is steadily growing within Cognitive Behavioral Therapy (CBT) techniques, notably in virtuo exposure therapy. This is particularly evident in the treatment of specific phobias, with a specific focus on addressing blood-injection-injury phobias.

Objectives

The objective of our study is to design a treatment protocol for patients suffering from blood phobia based on VR.

Methods

We used the following scales:

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Fear Survey Schedule-III (FSS-III) and the Injection Phobia Scale (IPS) for psychometric evaluation of the intensity of avoidance fear.

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Questionnaire on cybersickness: to identify potential adverse effects of exposure to virtual reality.

To conduct a functional analysis of phobias, we used the SECCA grid and the SORC grid.

Results

The therapeutic protocol stages of VR for a patient suffering from Blood-Injection-Injury Phobia (BIIP) are as follows:

1.

Collection of sociodemographic and clinical data.

2.

Functional analysis to identify triggering factors, contributing factors, and consequences of behavior. The SECCA or SORC grid can help in conducting this functional analysis.

3.

Psychometric evaluation of the intensity of avoidance fear using the three scales: FSS-III, IPS, and the cybersickness scale.

4.

Patient education on the mechanisms of the phobia.

5.

Setting of objectives.

6.

Therapeutic contract.

7.

The Protocol :

8.

Cognitive approach: identification of automatic thoughts and replacement with more rational thoughts.

9.

Behavioral approach: Progressive exposure, controlled immersion of the patient in virtual environments corresponding to situations that trigger their phobia. This exposure is coupled with relaxation.

The treatment continues with regular follow-up to ensure the consolidation of progress and to adjust strategies.

For relapse prevention, simple measures ,like personalized exercises to be done by the patient, can favor the long-term maintenance of the acquired skills.

Conclusions

Virtual reality exposure therapies (in virtuo) are as effective as in-vivo therapies. Besides, they offer a significant advantage over the latter as they facilitate access to stimuli or anxiety-provoking situations that are difficult to access or control in the real world.

Disclosure of Interest

None Declared
Family intervention in schizophrenia: A case report
Authors: Arroyo Sánchez E. , Díaz Mayoral C. , Setién Preciados P.
Published: August 2024

Introduction

Schizophrenia is a chronic mental illness that has a lifetime prevalence worldwide of about 1% regardless of culture, social class and race. This implies that it affects a large number of families. Family therapy has been used for years as a promising approach to intervene with people suffering from such pathology. It has been shown that families with a high level of hostility, critical comments and over-involvement are related to a higher number of relapses in the family member diagnosed with schizophrenia.

Objectives

The objectives are to examine whether systemic interventions could help to decrease the emotion expressed in these family members and thus decrease the number of relapses of patients as an alternative to pharmacological treatment.

Methods

A case report and a literature review on the impact of family therapy in patients with a diagnosis of schizophrenia. The search strategy included keywords such as “family intervention”, “schizophrenia” and “systemic therapy”. Selection criteria included randomized controlled trials (RCTs) and meta-analyses published between 2010 and 2021. Studies focused on the impact of family intervention on symptom management, relapse prevention and general functioning were included.

Results

The findings consistently demonstrated the effectiveness of family intervention in improving outcomes for people with schizophrenia. These interventions generally involved psychoeducation, communication skills training, problem-solving techniques, and emotional support for family members. Results showed significant reductions in symptom severity, decreased relapse rates, improved adherence to pharmacological treatment, and better overall functioning among people who received family intervention compared with those who received only standard care. In addition, family intervention was associated with reduced caregiver burden, improved family communication, as well as increased knowledge about schizophrenia and its management.

Conclusions

Family intervention has become a valuable adjunctive treatment for people with schizophrenia. The findings of this review highlight its positive impact on symptom management, relapse prevention, and overall functioning. Family intervention offers a holistic approach that recognizes the importance of involving and supporting the family system in the treatment process. This intervention provides families with the tools and resources necessary to effectively cope with the challenges associated with schizophrenia and promotes a supportive and nurturing environment for the individual. Future research should focus on long-term outcomes and implementation of the family intervention in routine clinical practice.

Disclosure of Interest

None Declared
The Effect of Physical Activity on Postural Abilities in Menopausal Women
Authors: Feki A. , Sellami I. , Ellouze F. , Yahya M. , Baklouti S. , Elleuch M. H.
Published: August 2024

Introduction

Menopause marks a significant physiological transition in a woman’s life, often accompanied by various health challenges. Understanding the impact of physical activity on postural abilities in menopausal women is crucial for promoting their overall well-being during this transformative stage.

Objectives

The aim of our study was to investigate the effect of a physical activity program on postural abilities, psychological well-being, and the quality of life of menopausal women.

Methods

Nineteen menopausal women, averaging 56±3 years of age, participated in a 12-week Zumba-style physical training program, consisting of three 50-minute sessions per week. The exercise regimen incorporated aerobic workouts, muscle conditioning, balance exercises, and flexibility training, predominantly inspired by Latin dances. Postural balance was evaluated using a stabilometric force platform, measuring the average velocity of the center of pressure (COPvm) under open eyes (OE) and closed eyes (CE) conditions on both firm and soft surfaces. Quality of life and mood were assessed using the SF-36 questionnaire (Short Form Survey-36) and the BMIS score (Brief Mood Introspection Scale). Assessments were conducted before (pre-test) and after (post-test) the 12-week training period.

Results

The findings revealed a significant decrease in COPvm values in the post-test for both conditions (on a firm surface: OE p=0.05, CE p=0.01; on a soft surface: OE p=0.001, CE p=0.05). Additionally, improvements in mood (p=0.05) and quality of life (p=0.05) were observed compared to baseline values.

Conclusions

This study underscores the positive impact of Zumba-style physical training on postural abilities, mood, and quality of life among menopausal women. These results suggest that such exercise programs hold promise in reducing the risk and incidence of falls associated with menopause

Disclosure of Interest

None Declared