bluuebunny/crossref_metadata_2025 huggingface dataset:
PTSD in jewish holocaust survivors’ as a risk factor in the development of mental health conditions in their offspring
Authors: Cooper S.
Published: February 2022

Introduction

Transgenerational transmission of trauma (TTT) describes the residual ‘presence of the past’ through generations. This phenomenon has an established evidence base with Holocaust survivors (HS) and their offspring, who are hypothesised to be at a greater risk of psychiatric conditions. This advanced literature review explores the relationship between Post Traumatic Stress Disorder (PTSD) in survivors and mental health conditions (MHC) in survivor’s offspring.

Objectives

The objective is to review the literature, looking for evidence of TTT and exploring the mechanisms of action of such phenomenon.

Methods

An advanced search was performed in three databases; Medline, Ovid PsycInfo and the Yehuda Schwarzbaum Online library using the following search terms; (Post Traumatic Stress Disorder OR PTSD) AND (Holocaust OR Shoah) AND (Offspring OR Children)’. 190 articles were identified and a following 163 were excluded. 26 studies were reviewed.

Results

Parental PTSD is circumstantially influential in parenting and attachment quality. Unfavourable attachments in offspring are associated with psychiatric conditions. Furthermore, poor health behaviour can be transmitted; for example, poor diet is an independent risk factor for depression. Psychopathology may pass intergenerationally; parental PTSD increases the risk of developing PTSD in response to one’s trauma. Parental PTSD can also result in impaired cortisol function and epigenetic changes.

Conclusions

PTSD in HS is an important risk factor for development of MHC in offspring. However, this does not mean all offspring develop MHC. The variability in offspring proneness to psychiatric conditions may reflect specific vulnerabilities. Further research is pertinent for an understanding of TTT. The poster will discuss clinical value.
New insights on affective morbidity and childhood maltreatment
Authors: Kumari V.
Published: February 2022

Childhood maltreatment (physical, sexual or emotional abuse, and physical or emotional neglect, by a parent, caregiver or other adult) is a major problem of global significance. Children who suffered maltreatment of any kind are known to experience a range of mental health problems, including depression, anxiety, psychosis, substance abuse, eating disorders, suicidal symptomatology and personality disorder. These problems often emerge in childhood and last through adulthood to old age. Furthermore, people with a history of childhood maltreatment show a worse-than-usual response to standard treatment approaches to improve their mental health. There is growing evidence that emotional abuse, one of the most prevalent forms of childhood maltreatment, may have the most wide-ranging impact of all maltreatment types on mental health outcomes as it appears to be a transdiagnostic risk factor for several psychiatric disorders, and found to me more strongly associated with development of affective disorders than physical abuse or neglect. There is a need to move beyond simple association studies and shift the research focus on sophisticated multimodal studies to fully understand the psychobiological mechanisms underlying affective morbidity, as well as the protective factors that might promote resilience, in the face of (specific forms of) childhood maltreatment.

Disclosure

No significant relationships.
Anticipating transitions in mental health in at-risk youth: A large-scale diary study into early warning signals
Authors: Schreuder M. , Wigman J. , Smit A. , Hartman C. , Wichers M.
Published: February 2022

Introduction

Transitions in mental health, such as the onset or sudden progression of psychopathology, are difficult to foresee. If mental health behaves like other complex systems, drops in mental health may be anticipated by early warning signals (EWS), which manifest in the dynamics of time series data.

Objectives

This study aimed to establish the sensitivity and specificity of EWS as personalized risk markers for sudden drops mental health.

Methods

Individuals (N=122, mean age 23.6 ±0.7 years, 57% males) at increased risk for psychopathology completed daily questionnaires on mental states for six consecutive months. Transitions in mental health were identified by change point analyses. EWS, operationalized as rising trends in the autoregressive coefficient of 36 negative mental states, were identified using generalized additive models.

Results

EWS were found for 59% of individuals with a drop in mental health, and for 47% without such a drop (sensitivity: 0-.12; specificity: .88-1). There were considerable individual differences in the prevalence, strength, and timing of EWS.

Conclusions

EWS might be informative of impeding transitions, yet they are also highly conservative. Present findings may inspire future research into the prerequisites for detecting EWS in the context of mental health, for instance with respect to the stability of pre- and post-transition phases, the magnitude of transitions, and the timescale at which EWS manifest. An improved understanding of the dynamics that govern psychopathology could ultimately allow us to determine whether a specific individual at a specific moment in time is at risk for a sudden onset or progression of mental health problems.
N-acetyl-cysteine administration during foetal life improves social behaviour and restores hippocampal bdnf levels in adolescent mice prenatally exposed to a high-fat diet
Authors: Musillo C. , Berry A. , Collacchi B. , Pieroni E. , Lepre M. , Creutzberg K. , Begni V. , Riva M.A. , Cirulli F.
Published: February 2022

Introduction

Maternal obesity may affect foetal programming representing a risk for adult mental health. Oxidative stress and inflammation associated with maternal obesity can alter the maturation of neuronal circuits affecting behaviour and mood.

Objectives

We investigated the emotional phenotype of male and female mouse offspring born from a high-fat diet (HFD) fed dams. We also tested the efficacy of N-acetyl-cysteine (NAC – an antioxidant) in preventing the negative effects of HFD. We focused on adolescence, an age of main vulnerability for the onset of psychopathology.

Methods

Female C57BL/6N mice were fed HFD for 13 weeks and, after 5 weeks, were also exposed to NAC (1 g/kg b.w.) via drinking water, until delivery. The neurodevelopment of offspring was assessed through the homing test. Emotionality was assessed in 35-45-day-old adolescent mice through elevated-plus-maze (EPM) and social interaction tests (SIT). Transcriptomic analysis of hippocampal tissue were performed to identify mechanisms of action of both HFD and NAC.

Results

NAC was effective in moderating body weight gain in HFD-fed dams. Neither HFD or NAC affected offspring development. Regardless of sex, prenatal HFD reduced exploration and decreased sociability, in EPM and SIT respectively. Prenatal HFD decreased hippocampal levels of BDNF in female offspring. Prenatal NAC administration prevented social anxiety and restored BDNF levels in the HFD group.

Conclusions

Data indicate long-term effects of maternal obesity on dams’ weight, offspring’s behaviour and hippocampal BDNF levels. These effects may be mediated by changes in oxidative stress as NAC was effective as a preventive agent. ERANET-NEURON-JTC 2018 (Mental Disorders) Project “EMBED”.
Emotional intelligence as a factor in the efficient self-regulation of functional states under work strain
Authors: Zlokazova T. , Kuznetsova A.
Published: February 2022

Introduction

Self-regulation of emotions is viewed as one of the key skills in various socionomic professions (Kuznetsova & Titova, 2016; Spencer & Spencer, 2008), including psychology. Emotional intelligence (EI) can be seen as a vital competence for counseling psychologists, as well as a factor in an efficient human functional state’s (HFS) self-regulation under stressful work conditions.

Objectives

This study aims to assess the EI level in psychologists involved in a long-term relief programme for people affected by an industrial accident, and to reveal interrelations between EI and the efficiency of acquisition of new self-regulation skills.

Methods

The training course was designed for psychologists (n=15) in order to develop new stress-management counseling skills. It included: progressive relaxation, ideomotor and visualization exercises; autogenic formulae. Data were obtained from HFS evaluation questionnaires (Leonova, Zlokazova, Kachina & Kuznetsova, 2013), and the EI inventory (Manoylova, 2004).

Results

The mean EI level was high among the psychologists, although there were variations. Data confirmed rapid progress in the acquisition of self-regulation skills, and demonstrated a prolonged effect of stress (p=0,052) and fatigue (p<0,001) reduction (Friedman’s test). The EI level showed correlations (Spearman’s test) with HFS measures: by the end of the course psychologists with a higher EI reported higher psychological comfort (p<0,05) and lower acute fatigue (p<0,01) after relaxation exercises.

Conclusions

Although the sample size was small, the data, obtained from described above unique group of counseling psychologists, helped reveal the link between EI and efficient HFS self-regulation.
Does the crisis intervention team (CIT) training improve police officers’ knowledge, attitude, and mental health stigma?
Authors: Veluri N. , Mansuri Z.
Published: February 2022

Introduction

The Crisis Intervention Team (CIT) training was developed to educate police officers regarding the complexity of mental health (MHI) issues, and better prepare them for crisis encounters with persons with mental illness (PwMI).

Objectives

To determine if CIT training improves police officers’ knowledge, attitude, and stigma about mental health issues.

Methods

A systematic review followed the PRISMA protocol and was conducted on the PubMed database (Figure 1). Search strings were “crisis intervention team training,” “crisis intervention team,” “CIT,” “effectiveness,” and “police.” Inclusion eligibility required primary studies using surveys that measured the CIT training outcomes (i.e., knowledge, attitude, and stigma). Literature/narrative reviews or opinions were excluded.

Results

The comprehensive meta-analysis software version 3.0 was utilized during analysis. Randomized odds ratios using a 95% confidence interval (CI) were obtained. Officers’ scores for knowledge, attitude, and stigma about MHI were taken before and after the survey. The Control group consisted of officers without CIT training. The CIT trained officers displayed an improvement in knowledge (OR 2.35, CI: 1.51– 3.67), attitude (OR 2.55, CI: 1.36–4.78), and stigma (OR 3.11, CI: 1.88–5.17). The results were statistically significant, with a p-value of less than 0.001 (Figure 2).

Conclusions

CIT trained police officers displayed a significant improvement in their knowledge, attitude, and reduced stigma towards PwMI. Although our study displays CIT training’s positive effects, previous studies reported a nullified effect of CIT in reducing arrests and the use of force during police officers encounters with PwMI. Future researchers must explore this gap, mainly focusing on gender and race bias.
The challenges in schizophrenia treatment in real-life: The uncomfortable truth
Authors: Rancans E.
Published: February 2022

Certain percentage of the first-episode schizophrenia patients presents with negative symptoms, which persists over the year and influence treatment outcomes (Galderisi et al. 2013). Treatment of negative symptoms has been a significant continuous clinical challenge. Majority of recently published guidelines recommend antipsychotic monotherapy as the standard of care, recommending antipsychotic combination therapy only after a failed trial with clozapine (George A. Keepers et al. 2020; Faden et al. 2020). However, real-life forces clinicians to look for possible combinations of medications early on, especially to tackle negative symptoms. The systematic review of global prescribing practices covering four decades found the pooled median rate of antipsychotic combination therapy approximately 20% (Gallego et al. 2012). One of the largest retrospective studies every conducted (n = 62,250) assessed rehospitalisation rates and the long-term use of antipsychotic polypharmacy in schizophrenia. Antipsychotic combination treatment was associated with an approximate 10% lower relative risk of psychiatric rehospitalisation compared with antipsychotic monotherapy (Tiihonen et al. 2019). Real-world effectiveness study of antipsychotic monotherapy vs. polypharmacy in schizophrenia from Eastern Europe is also supporting this approach (Katona, Czobor, and Bitter 2014). At the same time antipsychotic combination therapy can increase the total antipsychotic dose burden, frequency of adverse effects, potential drug-drug interactions and incur additional costs. In our recent naturalistic study in schizophrenia outpatients (n=120) with insufficient effectiveness of previous antipsychotics therapy on negative symptoms, we were able successfully switch therapy form several different antipsychotic combinations to monotherapy and gain clinical benefits (Rancans et al, 2020).

Disclosure

No significant relationships.
Gut microbiota and its implications for psychiatry
Authors: Ochoa A. Matas , Quiroga A. Rodriguez , De Velasco R. Martinez , Garcia P. Nava , Arguis C. Banzo , Alonso I. Moreno
Published: February 2022

Introduction

In recent years there has been increasing interest in knowing the function of the microbiota, especially its role in the gut-brain axis. The microbiota is the set of millions of microorganisms that coexist in a symbiotic way in our body and are located in the digestive tract mainly. Numerous evidences show that the microbiota could modulate the information directed to the brain and therefore the pathogenic basis of numerous psychiatric and neurological disorders.

Objectives

A better understanding of the microbiota and its interaction with the brain and mental health.

Methods

Review of recent literature about the implications of the gut microbiota in psychiatry.

Results

The connection between the microbiota and the central nervous system (gut-brain axis) occurs through the vagus nerve, the systemic pathway (through the release of hormones, metabolites and neurotransmitters) and the immune system (through the action of cytokines). Changes in the microbiota are associated not only with gastrointestinal diseases, but also with disorders such as depression, anxiety, autism, anorexia, attention deficit and hyperactivity, Alzheimer’s disease and Parkinson’s disease. As some research indicates, changes in diet and composition of the microbiota can reduce the risk of suffering these diseases or reduce their symptoms. Other therapeutic alternatives postulated are the use of probiotics or fecal microbiota transplantation.

Conclusions

Despite growing interest in the microbiota in the last few years, little is known about the mechanisms underlying this communication. More research is expected to contribute to the design of strategies that modulate the gut microbiota and its functions in order to improve mental health.
Immune heterogeneity of non-psychotic mental disorders
Authors: Zozulya S. , Androsova L. , Otman I. , Vetlugina T. , Nikitina V. , Klyushnik T.
Published: February 2022

Introduction

Current studies indicate the involvement of inflammation in the pathogenesis of chronic non-infectious diseases, and therefore it is of interest to study the role of inflammation markers in non-psychotic mental disorders (NPMD).

Objectives

To identify a number of inflammatory markers in serum of patients with NPMD.

Methods

73 patients with NPMD were examined (F43.2; F06.6). The comparison group consisted of 76 patients with endogenous psychosis (EGP) (F20.0; F25.0). The control group included 80 healthy people. The serum activity of leukocyte elastase (LE), α1-proteinase inhibitor (α1-PI) and the level of autoantibodies (aAb) to neuroantigens were determined.

Results

Three groups of patients with different variants of inflammatory response to the pathological process were identified. In group 1 (23.3%), all indices corresponded to the control values, which indicated the absence of the pathological process in brain. In group 2, there was a significant increase in activity both LE and α1-PI compared to control (p<0.05). This type of immune reaction characterized a balanced inflammatory response. It was found in 52% of patients with NPMD and in all patients with EGP. The aAb level also exceeded the control values (p<0.05). Group 3 (24.7%) showed an increase in α1-PI activity (p<0.05), but not in LE activity compared to control. Insufficient LE activity reflects a decrease in the functional activity of neutrophils.

Conclusions

The immune heterogeneity of NPMD according to the level of inflammatory markers was identified. 52% of patients with NPMD have a pronounced activation of inflammatory reactions accompanied by increased levels of aAb to neuroantigens.
Lying in psychiatry: A review
Authors: Valadas M.T. , Freitas R. Mota
Published: February 2022

Introduction

Lying can be defined as stating a deliberate falsehood with the intent to deceive. It is part of our everyday life but it can be pathological, without motivation and a symptom of psychiatric illness. Although pathological lying has been debated for a century, it remains a controversial issue in Psychiatry.

Objectives

We aim to perform a review regarding pathological lying and related issues.

Methods

We performed an updated review in the PubMed database and GoogleScholar using the terms “pathological lying”, “compulsive lying”, “mythomania” and “pseudologia fantastica”. The included articles were selected by title and abstract. We also consulted reference textbooks.

Results

We described the difference between normal and pathological lying and debated the different types of pathological lying, such as compulsive lying, mythomania and pseudologia fantastica.

Conclusions

Recognizing lying is crucial for a skilled patient interview and distinguishing between pathological and non pathological lying may be decisive for an accurate differential diagnosis.
Visual hallucinations in parkinson’s disease: Experience from a portuguese level 3 hospital
Authors: Quarenta J. , Teixeira T. , Martins S.
Published: February 2022

Introduction

Parkinson’s disease is a neurodegenerative pathology characterized by motor and non-motor symptoms. Hallucinations, especially visual ones, are frequent in this context, with an estimated prevalence of 16 to 40% and associated with a less favorable prognosis. These hallucinations can range from coarse formations to well-defined structures.

Objectives

To assess the prevalence of visual hallucionations in a sample of patients diagnosed with Parkinson’s Disease.

Methods

A cross-sectional descriptive study conducted in a Neurology Department of a Level III portuguese hospital. The sample included patients with Parkinson’s Disease observed in an outpatient Neurology appointment between October 1 and December 9, 2019.

Results

In the period considered, 100 patients with Parkinson’s disease were observed, 65% male, with an average age of 69 years. In 11% of the patients visual hallucinations were reported, of which about half were well defined. All of them had no previous history of visual hallucinations and were under dopaminergic medication.

Conclusions

The results show an inferior prevalence when comparing to the literature, albeit still frequent. Therapeutic adequacy has a well recognised impact at a functional level and prognosis. Therefore we stress the importance of a regular follow-up of these patients, recommending a rigorous and comprehensive clinical review.
From mid-career professor to chairperson: What remains similar what is different?
Authors: Falkai P.
Published: February 2022

For a Mid-career Professor in Germany, there are defined clinical and teaching responsibilities. One can focus either on one’s research or on clinical work and teaching. When tasks are becoming more demanding or significant overarching decisions need to be taken, there is always a chairperson to be asked or to help delegate tasks. As chairperson, one is mostly independent from other persons except for the dean of the medical faculty. One is however, at least in Germany, the chairpersons fully responsible for keeping up teaching, patient care, research as well as running the department. The Chairperson is measured by the achievements of these four tasks. It need special attention to keep up a balanced time schedule to cover clinical care, research, teaching and departmental management. A good chairs means working together with your staff on long-term goals, developing the department fruitfully and trying to fulfil these goals.

Disclosure

No significant relationships.
Clozapine-associated eosinophilia with multiple systemic involvement - case report and review of literature
Authors: Orlović I. , Sugnet T. , Peco M. , Zatezalo V. Golubić , Karlica H. , Karlović D.
Published: February 2022

Introduction

Due to its mood-stabilizing properties, clozapine is known for reducing symptom severity in manic episodes of treatment-resistant bipolar disorder as well as in treatment-resistant schizophrenia. However, its use may be hindered by potential adverse effects, including hematologic ones, such as non-dose-dependent eosinophilia. The mechanism of the underlying process probably involves a type-I hypersensitivity reaction, which can manifest as either transient asymptomatic eosinophilia or as eosinophilia with multiorgan dysfunction.

Objectives

We present the case of a patient diagnosed with manic episode of schizoaffective disorder who developed eosinophilia, with severe systemic manifestations, in response to clozapine therapy. A review of literature will be conducted in order to provide further insight into the phenomenon.

Methods

Case report and literature review.

Results

The incidence of eosinophilia reported in literature ranges between 0.2% and 62%, with its appearance about three weeks after clozapine initiation. Although clozapine is an antipsychotic that normally requires frequent monitoring due to the potential side effect of agranulocytosis, we would like to place emphasis on the possible risk of eosinophilia, in connection with potential fatal complications. As described in this report, eosinophilia could long remain unrecognized due to subsequent multiorgan involvement, including lymphadenopathy, leukocytosis, lymphopenia, anemia, liver enzyme elevations, as well as pleural effusion, all of which were described in our patient.

Conclusions

Clozapine-associated eosinophilia may be used as an early marker of possible clozapine-induced systemic complications and it may warrant prompt discontinuation of the causing drug, as suggested by the literature.
Benzodiazepines prescribing in anxiety : Between practice and guidelines
Authors: Lagha M. , Ouali U. , Nacef F.
Published: February 2022

Introduction

Benzodiazepines (BZD) are psychotropic drugs prescribed in psychiatry for their anxiolytic, hypnotic and sedative properties. Several guidelines aimed to limit the chronic use of BZDs. However, BZDs prescribing that does not comply with international recommendations remains widespread, estimated in France at 30% for anxiolytic BZDs.

Objectives

The aims of our study were to evaluate BZDs prescribing practices in the treatment of anxiety and to assess their compliance with international recommendations.

Methods

This is a cross-sectional study conducted through a Google-forms self-administered questionnaire,intended for psychiatrists and psychiatric residents, over a period of two months, from April 1 to May 31, 2019.

Results

One hundred physicians practicing in psychiatry answered our questionnaire. The response rate was 28%. The most prescribed BZD for anxiolytic purposes was Prazepam (76.2%). Clonazepam was prescribed for anxiolytic purposes in 10.5% of cases. Of the 105 participants, 48 indicated that they prescribed BZDs for anxiolytic purposes in states of acute stress (45.7%), 28.6% prescribed them for the treatment of mild to moderate anxiety manifestations in anxiety disorders. For the treatment of anxiety without panic attacks, 20% indicated that they prefer a short half-life BZD, 80% a long half-life BZD. The maximum duration of BZDs prescription for anxiolytic purposes was 12 weeks (62%), and 6 months in 10% of cases.

Conclusions

BZDs are often prescribed in psychiatry for their anxiolytic property, sometimes in a way that does not comply with the recommendations of good practice, with regard to the prescribed molecules, their indications and the duration and modalities of prescription.
The way forward: Insights and suggestions from an early career psychiatrist
Authors: Pinto Da Costa M.
Published: February 2022

People with psychosis are commonly socially isolated, both due to their condition, and the stigma towards them. Remote volunteering over smart-phone can be a way to overcome social isolation and physical distance, promoting social inclusion. This talk will present the qualitative findings from a feasibility study – the Phone Pal – which connected in the United Kingdom patients with psychosis with community volunteers, to communicate with each other for up to 12 weeks via smart-phone (through texts, WhatsApp messages, e-mails, audio or video calls). Participants described at the end of the study their experiences of communicating with their match over the smart-phone in terms of frequency, duration and timing of communication, their communication method, content and style, and the changes of communication over time. Several participants reported a positive impact of being connected with someone, meeting a new person, feeling supported and feeling better, and a few described challenges, such as disappointment, guilt and burden. These interview findings show that some matches were able to develop a positive and friendly relationship, and were willing to continue to be in contact with each other beyond the study duration. It is hoped that this talk will generate a lively discussion, gathering further understanding about the potential benefits and challenges of remote volunteering over smart-phone for patients and volunteers, and its potential usefulness in the current pandemic times.

Disclosure

No significant relationships.
Vns as alternative treatment for maintenance ect in a patient with treatment resistant depression - a case study
Authors: Migchels C. , Sienaert P.
Published: February 2022

Introduction

Vagus Nerve Stimulation (VNS) is a neuromodulatory intervention which involves attaching an electrode to the vagus nerve. Studies investigating VNS as an acute treatment method for treatment resistent depression have shown very limited results, however there are data suggesting that VNS might have a beneficial effect on a longer term. There are also studies that suggest that a history of response to ECT might indicate a higher response rate to VNS. VNS was suggested as treatment for a patient who received maintenance ECT for treatment resistant unipolar depression during 9 years. 3 months after VNS was implanted, ECT was stopped due to the Covid-19 pandemic. In this case study we will review the patient’s response to treatment with VNS and the sudden stop of long-term ECT treatment.

Objectives

To review the response to acute and maintenance ECT and VNS in this patient diagnosed with treatment resistant unipolar depression, and to compare this to the data suggesting VNS as an alternative treatment method for maintenance ECT in patients with treatment resistant depression.

Methods

Using the extensive data collected during the patient’s treatment, we will review the clinical response and side-effect burden of this patient to acute and maintenance ECT and to VNS.

Results

The patient showed a vast improvement in depressive symptoms a few months after start of VNS treatment, while long-term maintenance ECT was stopped.

Conclusions

This patient’s response to VNS supports the data suggesting VNS as an alternative treatment method for maintenance ECT in patients with treatment resistant depression.

Conflict of interest

This patient received VNS treatment as part of a study conducted in our centre (UPC KULeuven) with support of Livanova. Me nor my supervisor (prof. Sienaert Pascal) are directly involved in this study. I have received no financial or other compensation fr
Predictors of response to electroconvulsive therapy and its importance in the treatment of patients with obsessive-compulsive disorder
Authors: Correia J. Martins , Vaz Soares M.I. Fonseca Marinho , Ramos S. Freitas , Jesus B. , E Sousa D. Cruz , Caetano S.
Published: February 2022

Introduction

Electroconvulsive therapy (ECT) presents itself as a highly effective therapeutic approach in various psychiatric conditions, especially affective disorders and catatonia. Although obsessive-compulsive disorder (OCD) is not an established indication for ECT, there are several positive results that have been replicated, giving us an account of its potential applicability.

Objectives

To emphasize the importance of defining predictors of response to ECT in OCD.

Methods

The authors’ clinical experience is combined with the review of clinical cases, available in the literature, related to the application of ECT in OCD.

Results

Personal or family history of affective pathology and obsessions of sexual content were identified as potential predictors of response to ECT in patients with obsessive and compulsive symptoms.

Conclusions

Although preliminary and based solely on case reports, the replicability of results should promote special attention to situations in which OCD is marked by particular characteristics that favor the response to ECT. In this way, it would be possible to prevent the dragged consumption of health resources and minimize the expected chronicity associated with this clinical condition.
Electroconvulsive therapy in the psychiatric depatement of the Mahdia EPS over two years
Authors: Brahim S. , Bouali W. , Henia M. , Abid A. , Chabbouh M. , Zarrouk L.
Published: February 2022

Introduction

The electroconvulsive therapy is an ancient therapeutic technique used in the traitment of certain psychiatric diseases.

Objectives

discuss the technical aspects, indications, therapeutic response and tolerance of ECT

Methods

This was a descriptive retrospective study that interested all patients who were hospitalized in the psychiatric department of the Mahdia University Hospital in 2017 and 2018 and were benefited from ECT sessions

Results

The number of patients who received ECT was 34, representing 4.33% of patients, 25 men and 9 women with an average age of 39, the number of ECT sessions was 785. The major diagnosis was bipolar disorder in 47,1% of patients, followed by schizophrenia in 35,3% and major depressive disorder in 14,7 %. Resistance to treatment and major suicidal risk were the main indications. All sessions were performed in a bilateral temporal mode. the initial energy delivered varied between 50 and 101 millicoulombs. The duration of the crise obtained was predominantly between 21 and 30 seconds. The average number of sessions during the attack phase was 13.88, whereas it was 2.5 sessions during the consolidation phase. The mean scores of the psychometric evaluations showed a marked improvement, especially in the mania scores (65.89%) and the beck depression inventory (63.55%). Only four incidents were reported in all patients. Only five patients (14,7%) had side effects and the most marked effect was anterograde amnesia.

Conclusions

Mental health programs in Tunisia should promote the generalization of this method throughout the Tunisian territory, given the efficacy demonstrated in mood disorder, several psychoses and other psychiatric pathologie.
Emotional experiences reported by psychologists attending patients with suicidal crises in a service in northeastern Brazil: A qualitative study
Authors: Turato E. , Guerra L. , Oliveira C.A. , Gondinho B. , Leme P.A.
Published: February 2022

Introduction

Contextualization: Emotional experiences of psychologists related to the care of suicide crises are important since the health professional has been trained to save lives. It makes him apprehend the aggressive side of suicide and symbolize it as an attack. When the patient’s desire to liveceases, the professional may feel confused, since his/her profession/vocation was confronted.

Objectives

AIM: To explore and interpret the meanings of emotional experiences reported by psychologists who care for patients in suicide crises.

Methods

Strategies: clinical-qualitative design, semi-directed interviews with open-ended questions in-depth. Six clinical psychologists from a Brazilian city participated, with a sample closed by information saturation. Interviews audio recorded, full transcribed and categorized by Qualitative Content Analysis. Results were peer-reviewed in meetings in a Qualitative Research Study Group.

Results

Findings: Three emerging categories - (1) Ambivalent emotions as challenges for clinical management, (2) The non-paralyzing experience of emotions, (3) The management that is learned in practice.

Conclusions

Considerations: assistance to patients with a suicidal crisis can generate ambivalent emotions, not always paralyzing. When recognized and elaborated can assist in clinical practice. It can be tools that will support qualified approaches, especially in relation to suicide. As a public health problem, it demands a combination collective actions with effective individual clinical approaches.
Case report of a dissociative identity disorder
Authors: Pinilla R. , Rodriguez C. , Ordoñez B. , Hermosillo R.
Published: February 2022

Introduction

Patients with dissociative identity disorder (DID) present two or more identities, where one of them is the main one. Although it is a widely questioned diagnosis, it is currently found in the main DSM-5 and ICD-10 diagnostic manuals.

Objectives

Present a case of dissociative identity disorder.

Methods

46-year-old woman who attended the CSM referred for her MAP due to anxiety-depressive symptoms. Throughout the interviews the patient brings up to 4 identities with alterations in memory, consciousness, multiple dissociative symptoms, sound thinking, constant fluctuations in mood. She is separated, has two children, takes care of them, although she is not able to maintain work functionality. The patient is seen once a week for 45 minutes. Psychotherapeutic treatment is carried out, the objective of which is to establish a safe therapist-patient bond to favor the integration of their parts, and pharmacological treatment, which was carried out with haloperidol, lorazepam and desvenlafaxine.

Results

Throughout sessions, the anxious symptoms diminished, being able to carry out psychotherapeutic work. Dissociative symptoms were slightly reduced, partially integrating some of the identities. There was a slight stabilization in mood and decrease in psychotic symptoms.

Conclusions

There is no well-established treatment for DID. Combined therapy (psychotherapy and pharmacological) may be an option for these patients. The therapeutic framing of the sessions, working the link, and the low-dose antipsychotic treatment were favorable.

Keyword

dissociative identity framing link
The failure of adherence of the antiretroviral therapy is a field of work for the psychologist to HIV possitive patients in intensive care units
Authors: Vasilescu C. , Largu M. , Lacatusu G. , Dorobat C. , Manciuc C.
Published: February 2022

Introduction

HIV infection is currently considered a worldwide pandemic.

Objectives

The objective of this paper is to outline the profile of HIV – positive patients in intensive care units, regarding the psycho-emotional and viral parameters.

Methods

We realized a retrospective study for a period of 36 months, evaluating HIV positive patients in intensive care unit in the “Sf. Parascheva” Infectious Diseases Clincal Hospital Iasi, Romania.

Results

From 1st of Janury 2011 to 31st of December 2013, the HIV/AIDS Regional Centre of Iasi recorded 2649 hospitalizations, of which 18 cases required intensive medical care, 10 males and 8 females. The number of days of hospital admission varied between 4.5 and 32 days in the Intensive Care Unit. Initialy the psychological interview was conducted for 16 of the 18th patients, 2 cases were with severely deteriorated health status that didn’t allowed communication. From them, 7 survived and they were evaluated at discharge from IIntensive Care Unit and also monitored long term, that revealed an increase in adherence to Antiretroviral Therapy and a change in lifestyle.

Conclusions

HIV positive patients that requires intensive care showed a marked immunological collapse due to abandonment of the therapy or late detection. In order to fully accomplish the needs of the HIV positive patient, the infectious diseases specialist must collaborate with the psychologist.
Athens multifamily therapy project
Authors: Selakovic M.
Published: February 2022

Introduction

The Athens multifamily therapy project (A- MFTP) provides systemic multifamily group therapy to youths who experienced a first psychotic episode (FEP) and their families.

Objectives

The participants were recruited from the ongoing longitudinal Early Psychosis Intervention Study –ELPIS, Athens FEP Project, which aims to investigate the involvement of genetic and environmental determinants on psychosis risk.

Methods

A group of five families with a child who had experience FEP, attended two multifamily group sessions per month, in the time period from September 2017 to Jun 2018. Parents and offspring participated to the sessions, which were conducted by two co-therapists. Assessment of patients’ psychopathology was based on PANSS at baseline, end of therapy and 6-month follow-up. All participants fulfilled an instrument assessing family factors (SCORE-15) and the Reflective Functioning Questionnaire (RFQ) at the same three time points. Furthermore, participants were asked to give written opinions regarding the therapeutic process at the middle phase, the end of therapy and six months follow - up.

Results

A qualitative analysis identified the emerging themes and patterns, focusing on the language and the meaning constitutes. Communication techniques, emotional processing and problem solving were the main learnings for the members of the group. They highlighted the impact of the group processes on family communication and individual understanding, while the development of a “new family” emerged from the group relationships.

Conclusions

A- MFTP seems to be a promising service aiming to improve mental health and wellbeing of participants, to contrast chronicity and to contribute to early intervention services for psychoses in Greece.
Recovery from borderline personality
Authors: Duarte D.
Published: February 2022

Introduction

Recovery is much broader than experiencing remission of symptoms. It is understood as the experience of a subjectively significant and satisfying life, even if some symptoms of mental illness persist. The recovery process from borderline personality disorder (BPD) is complex and includes recognizing the need for change and developing greater self-acceptance.

Objectives

Provide an overview of personal recovery from BPD.

Methods

The authors did a non-systematic review in pubmed with the words: “borderline personality disorder” and “Recovery”.

Results

BPD is a serious mental disorder characterized by a pattern of instability in interpersonal relationships, self-image and affections, marked by impulsiveness and (para) suicidal behaviors. Unemployment and difficulties in obtaining and maintaining employment are highly prevalent on BPD and add social exclusion and deterioration of physical and mental health. Recent long-term follow-up studies offer a optimistic scenario, indicating high rates of clinical remission (not equivalent to full recovery). Most psychotherapies, such as dialectical behavioral therapy (DBT) or mentalization-based therapy, have proven their effectiveness in treating emotional dysregulation, impulsivity and interpersonal difficulties. Teams working with people with BPD should develop comprehensive multidisciplinary care plans. The care plan should identify long-term goals that should be realistic, and linked to the short-term treatment aims and develop a crisis plan that identifies potential triggers that could lead to a crisis.

Conclusions

Cognitive rehabilitation and psychoeducational interventions can be effective in individuals with BPD. These interventions can be easily implemented in mental health settings and offer benefits for improving overall functioning, which often remains affected after clinical remission in long-term follow-up.
Stigmatisation of schizophrenia, psychosis and autism in flemish newspapers
Authors: Thys E. , Struyven C.
Published: February 2022

Introduction

Stigma is a major burden and impediment for treatment and recovery in serious mental disorders, especially psychotic disorders. Therefore, it has been proposed to replace the term schizophrenia by psychosis susceptibility or psychosis spectrum disorder.

Objectives

We have assessed stigma in the media through a 10-year survey of Flemish daily newspapers (2008-2017) by comparing the way schizophrenia and autism are portrayed. We added the term psychosis for the years 2013-17 to assess its suitability as a less stigmatising alternative.

Methods

Via the websites of the seven Flemish newspapers, we searched for all articles published between 01 Jan 2008 and 31 Dec 2017 containing the keywords autism, schizophrenia, and related terms. The collected articles (n = 5,337) were then graded to their stigmatising content. We added the term psychosis for the years 2013-17.

Results

In the collected articles the coverage of autism was mostly positive, whereas the coverage of schizophrenia was predominantly negative. The contrast was very substantial (p < 0.0001) and stable over the years. The portrayal of psychosis turned out to be mostly positive in the broadsheet newspapers and mostly negative in the tabloid papers.

Conclusions

The social stigma attached to schizophrenia and psychosis is poignantly reflected in the Flemish newspapers. The fact that a comparable disorder such as autism is depicted in a much more favourable way than schizophrenia indicates that a more positive image of schizophrenia is not only desirable but also achievable. Psychosis gives mixed results, a finding up for discussion.
Psychiatric stigma in patients with comorbid hiv infection
Authors: Khobeysh M. , Lutova N.
Published: February 2022

Introduction

HIV-positive patients with schizophrenia spectrum disorders experience burden of double stigma. Comorbid pathology may alter structure of stigma and shall be considered in development of individual destigmatization programs.

Objectives

Study of psychiatric stigma features in HIV-positive and HIV-negative patients with schizophrenic disorders.

Methods

ISMI (Ritsher et al., 2003), PDD (Link et al., 1991) – to study stigma in 70 patients divided into three groups with respect to their diagnosis (I — F20.x, II — F21.x, III— F2x+HIV); BPRS (Overall & Gorham, 1962) – to assess psychiatric status, RSAS (Eckblad et al., 1982) – to assess anhedonia. Dispersion analysis (Kruskal and Mann–Whitney tests), Spearman and Pearson correlation were used.

Results

Patients with comorbid HIV-infection showed increased level of perceived stigma, although they resisted the stigma internalization better than others did (Table 1).

Patients with schizotypal disorders and patients at early stages of HIV infection experienced the most alienation and frailty to internalization of stigma (Tables 1, 2).

Correlation relationship between social anhedonia and perceived stigma (r=0.5, p<0.05) observed in patients with HIV infection.

Conclusions

Comorbid HIV infection in psychiatric patients contributes to the psychiatric stigma structure. Differentiated approaches in rehabilitation of HIV-positive mental patients should be used.
Preliminary data on the psychometric proprieties of the italian version of the reflective functioning questionnaire
Authors: Velotti P. , Rogier G. , Zobel S. Beomonte , Ciavolino E. , Beyer S. , Fonagy P.
Published: February 2022

Introduction

Assessing mentalizing abilities is a complex issue. Only recently an instrument assessing mentalizing capacity as a whole, the Reflective Functioning Questionnaire (RFQ), has been developed.

Objectives

To reach the purpose of our study, we investigated the psychometric proprieties of the Italian version of the RFQ.

Methods

The study was conducted on a sample including a group of violent offenders and a group of community participants. All subjects fulfilled the RFQ, the Personality Inventory for DSM-5 (PID-5) and the Aggression Questionnaire (AQ).

Results

The theoretical model was defined and analysed by using Partial Least Squares–Path Modelling with high-order construct definition. Data showed good psychometric proprieties of the Italian version of the RFQ. Also, specific patterns of correlations were identified between the RFQ subscales and both PID-5 and AQ scores. Offenders significantly differed from controls only in relation to one subscale of the RFQ.

Conclusions

Data supported the factorial structure of the RFQ found in the original validation study. Results also support the existence of a second-order variable, mentalizing, resulting from the convergence of hypomentalizing and hypermentalizing.
Longitudinal association between daytime sleepiness and cognitive decline in dementia: A study protocol
Authors: Silva J. , Ferreira A.R. , Fernandes L.
Published: February 2022

Introduction

Dementia is a major cause of disability worldwide. About 25%-40% of patients with mild to moderate dementia are affected by sleep-awake cycle disturbances, including increased daytime sleepiness and insomnia. However, little is known about the specific impact of excessive daytime sleepiness on the cognitive decline of dementia patients.

Objectives

To evaluate the impact of daytime sleepiness on the cognitive decline of dementia patients. Additionally, longitudinal associations with functional impairment and neuropsychiatric symptoms will be explored.

Methods

A longitudinal study will be conducted in a psychogeriatric consultation. Patients will be consecutively invited according to predefined eligibility criteria. Those aged ≥65 years, with dementia diagnosis or Mini-Mental State Examination (MMSE) <24, and with a knowledgeable caregiver, will be included. The exclusion criteria are: a caregiver <18 years, terminally ill, incapable to communicate or with a known diagnosis of insomnia, sleep related respiratory disorders, central hyperinsomnia, restless legs syndrome or sleep paralysis. Participants will undergo an assessment with a comprehensive protocol including: Montreal Cognitive Assessment (MoCA), Barthel and Lawton Index, Epworth Sleepiness Scale (ESS), Neuropsychiatric Inventory (NPI) and Global Deterioration Scale (GDS). Participants will be re-assessed 6 months after the initial evaluation. The Health Ethics Committee of Hospital Universitário de São João granted the study authorization (nº 260/2020).

Results

Findings will be disseminated via publication in peer-reviewed journals and presentations at national and international scientific conferences.

Conclusions

This study will address key questions on the relation of daytime sleepiness and dementia outcomes, in order to undertake corrective and preventive non-pharmacological and pharmacological approaches.