bluuebunny/crossref_metadata_2025 huggingface dataset:
Basic knowledge in child protection– evaluation of an online-course for webbased transfer of interprofessional basic knowledge in child protection
Authors: Bittner J. , Maier A. , Fegert J.M. , Rassenhofer M. , Hoffmann U.
Published: September 2022

Introduction

Insufficient or faulty cooperation between the various child protection professions can have an extremly negative impact on the well-being of the concerned children. Communication problems that were revealed when dealing with cases of child abuse show the importance of adequate cooperation and common language of the involved professions in child protection.

Objectives

An online-course adressing medical-therapeutic professionals, youth welfare as well as judiciary and police was developed to impart skills and knowledge in child protection to create interdisciplinary understanding and improve cooperation between the involved professions.

Methods

The acquisition of competencies, the transfer of learning content into everyday work and the quality of the online-course are determined using an online-survey before starting (t1) and after completing (t2) the course. T1-assessment is currently being evaluated with 1034 datasets, t2-assessment will take place 03/2022.

Results

Intended target groups could be accessed and participated in the online-course, although the ratio of medical-therapeutic participants was greater than of judiciary professionals. Specific results of T1- and T2- assesssment and comparing analyses are expected in March 2022 and will be presented.

Conclusions

Based on existing online-courses developed by the Universityhospital Ulm, the suitability of online-education for training professionals in the field of child protection could be proven. If comparable effects can be shown for this online-course, there is an increase in evaluated offers of high quality. These enable comprehensive and low-threshold access to the subject of interdisciplinary communication and cooperation in child protection for involved professionals.

Disclosure

No significant relationships.
Decision-analytic modeling for health economic evaluation in child and adolescent psychiatry using inpatient equivalent treatment - design of a doctoral thesis
Authors: Bieniek K. , Neumann A. , Buchberger B.
Published: September 2022

Introduction

Despite the high prevalence of psychiatric disorders among children and adolescents, services are often accessed too late or not at all. Inpatient-equivalent treatment can be a good option here, as it can counteract structural barriers by enabling treatment from home. Although national and international studies highlight the benefits, this form of treatment is offered by only a few psychiatric facilities.

Objectives

The aim is to provide a decision-making aid for the introduction of outreach treatments with regard to cost-effectiveness. Based on this, the question will be answered whether telemedicine can be an option for the distribution of rare (human) resources.

Methods

1) Based on a systematic review, the best available evidence will serve for deriving hypotheses and providing assumptions for the decision-making model. 2) Decision analytic modeling will be used to determine the cost-effectiveness of inpatient-equivalent treatment compared to conservative inpatient treatment. 3) An additional systematic review will provide information on the use of telemedicine in inpatient equivalent treatment.

Results

The following questions need to be discussed: 1)Is there an indication for all psychiatric diseases and age groups? 2) Are there ethical considerations that need to be taken into account, especially in the use of telemedicine? What incentives need to be set for psychiatrists to opt for inpatient-equivalent treatment?

Conclusions

The results of the study may help to raise awareness of inpatient equivalent treatment among decision-makers. Furthermore, fears could be reduced, since admission to a psychiatric facility can mean a stigmatizing intervention in the lives of young patients.

Disclosure

No significant relationships.
Affective disorder associated with post-traumatic epilepsy, misdiagnosis and under treatment: A case report
Authors: Giourou E. , Theodoropoulou A. , Yfantis S. , Prodromaki O. , Georgila E. , Gourzis P.
Published: September 2022

Introduction

A history of traumatic brain injury (TBI) is often associated with acquired epilepsy, which is associated with psychiatric co-morbidity, that when undetected might lead to misdiagnosis and mistreatment.

Objectives

The objective is to present the case of a 47-years-old male with a history of TBI and undetected acquired epilepsy, with a subsequent treatment resident mood disorder that was lead to a full clinical remission once epileptic activity was controlled using anti-seizure monotherapy.

Methods

After compulsory admittion to our inpatient psychiatric unit because of suicidal ideation and persistent aggressive behavior with volatile mood swings, the patient was fully evaluated and his psychiatric and medical histories were recorded. A brain CT scan and EEG were performed. Laboratory tests excluded other medical co-morbidity.

Results

The patient had a previous history of TBI and subsequent multiple episodes of mood disorders that failed to reach full remission even if treated with antidepressives and antipsychotics for adequate time and dosage according to current quidelines. EEG was positive for epileptiform activity with sporadic slow theta waves and right frontotemporal epileptic-like features while the patient was free of clinical seizures. Carbamazepine was initiated and titrated up to 1200mg daily leading to the full remission of the initial clinical symptoms along with the EEG findings’ improvement. The patient remained stable with his functionality at its utmost recovery during the two-years follow-up evaluations.

Conclusions

TBI induced epilepsy might be under-diagnosed in the absence of clinical seizures leading to the mistreatment of the associated psychiatric disorders that could be the only clinical presentation of the underlying pathology.

Disclosure

No significant relationships.
The Wabanaki Approach to Treating Opiate Use Disorder among Indigenous North Americans
Authors: Mehl-Madrona L. , Mainguy B.
Published: September 2022

Introduction

Addictions are prominent among indigenous people in North America in relation to historical and contemporary trauma.

Objectives

We describe the approach emerging in our services for the five indigenous tribes of Maine (the Wabanaki Confederacy) for culturally sensitive treatment of opiate use disorder.

Methods

In our auto-ethnographic approach, we introduce or re-introduce participants to cultural beliefs, values, and methods for treating addictions, inclusive of narrative methods (storytelling) which receive greater acceptance by indigenous and marginalized peoples. Indigenous philosophy states that we see the world using the stories that we have absorbed or constructed to explain our perceptions. Using substances is a story that is connected to poverty and adverse childhood events. We create new stories to develop a sense of agency, the sense that one’s actions can make a difference in one’s life.

Results

We present the lessons learned and the results of our using this approach with a tribal population in Maine. Some key concepts include (1) reframing the person’s self-story about being addicted within a threat-power-meaning network, (2) working with stories about the spirit of the addiction and the consequences of ingesting spirit-laden substances without knowing their songs and protocols, (3) constructing future-self-narratives that explore right relationships and meaningful conduct, (4) constructing stories about the intergenerational transmission of addictions and exploring the question of “whom will be the recipient of your addiction?”

Conclusions

We come to understand that the client sets their goals and defines what recovery means for them, which is the heart of a harm reduction approach.

Disclosure

No significant relationships.
Depression and other correlates of adult Attention Deficit Hyperactivity Disorder (ADHD) symptoms among Hungarian university students
Authors: Müller V. , Pikó B.
Published: September 2022

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and/or impulsivity. It is one of the most common disabilities in college populations and comorbidity with depression is frequently reported.

Objectives

The aim of the study is to shed light on depression as comorbidity and other intrapersonal correlates of ADHD in young adults.

Methods

Participants were Hungarian university students (N=420; M=24.5, SD=5.0 years). Criteria of the ADHD group were based on the Adult ADHD Self Report Scale V1.1 (ASRS-V.1.1) screening tool. The participants filled in the Beck’s Depression Inventory, the Hyperfocus Scale, Flow State Scale, Academic Persistence Scale, Satisfaction With Life Scale, General Self-Efficacy Scale, and the Connor-Davidson Resilience Scale.

Results

We found that in the group of students who had ADHD symptoms, depression score was significantly (p<.001) higher (M=18.38, SD=5.87) than the control group’s scores (M=14.56, SD=4.45). Frequency of severe depression was 13.4% (moderate: 33.5%) while in the control group: 1.6% and 17.6% respectively. Participants reporting ADHD symptoms (N=164, 39%) also reported lower levels of resilience (M=23.40, SD=6.96), relative to their non-ADHD peers (M=27.69, SD=6.48). Significant differences were found in the areas of self-efficacy, depression, flow and hyperfocus as well, and ADHD symptoms contributed to lower level of life satisfaction (β=-0.24, p<.001).

Conclusions

Our findings suggest that university students reporting symptoms of ADHD may be assisted with strategies that are focused on increasing protective factors (i.e., resilience, self-efficacy, flow) to prevent depression and improve their life satisfaction and quality of life.

Disclosure

No significant relationships.
From a Pathophysiological Concept to a New Drug
Authors: Németh G.
Published: September 2022

Although antipsychotics were discovered over fifty years ago, it took another decade until dopamine antagonism was demonstrated as central to their clinical effectiveness. Since accumulated evidence implicates the dopamine system in the pathophysiology of schizophrenia, all licensed first-line treatments operate primarily via antagonism of the dopamine D2 receptor. However, dopamine D2 receptor blockade does not effectively treat negative, cognitive and affective symptoms and, in a significant proportion of patients, it does not improve positive symptoms either. Therefore, additional neurochemical targets were considered. The “revised dopamine hypothesis” proposes that positive symptoms emerge due to hyperactive dopamine transmission in mesolimbic areas, while hypoactive dopamine transmission via the mesocortical pathway in the prefrontal cortex is linked to negative, cognitive, and partly affective symptoms. In this context, the role of D3 receptors were recognised. However, there is also evidence for the involvement of other neurotransmitter systems, suggesting that dopamine signalling relies on a suite of receptors that are thought to either facilitate or inhibit neurotransmitter activity through several interconnected neural circuits. Furthermore, there seem to be clusters of symptoms that cross the boundaries of disorders. Symptoms having similar pathophysiology at neurotransmitter level can be treated with the same drug or class of drugs. Thus, one particular drug might be effective in more than one indication. This lecture aims to illustrate the process of a new drug development by explaining how the underlying pathophysiology on receptor level impacts clinical studies and vice versa.

Disclosure

Employee of Gedeon Richter Plc.
Comorbidity of mental disorders with medical diseases in “Ali Mihali” Psychiatric Hospital, Vlora (2010-2020)
Authors: Shaska E.
Published: September 2022

Introduction

The term comorbidity or dual diagnosis in this case refers to phsychiatric disorder and one or more medical diseases. The purpose of this study is to emphasize the importance of identifying medical diseases in psychiatry.

Objectives

Medical diseases that develop most in comorbity with psychiatric disorders Identification of gravity of comorbidity symptoms Clinical progression Treatment efficacy/ Interaction of psychotropic medications with other medications.

Methods

Methodology: A regular clinical study strategy has been adopted, with adults aged 19-75 females and males diagnosed with mental disorders and one or more medical pathologies, including neurological diseases during a 10-year period (2010-2020) in ”Ali Mihali” Psychiatric Hospital, Vlora.

Results

They showed that medical diseases, such as: hypertension, diabetes mellitus, urinary infections, gastrointestinal disorders, acute and chronic bronchitis, severe brain injury often develop in comorbidity with mental disorders. Mental disorders that develop most in comorbity are: schizophrenia, schizoaffective disorder, delusional disorder, mood disorder. Treatment of these disorders is difficult due to the gravity of symptoms, interaction of medications, and side effects they have.

Conclusions

Mental disorders in comorbidity with medical diseases are usually hard to treat. For this reason, it is imperative to diagnose them the soonest possible. When mental and medical disorders are comorbid, their coexistence has grave symptoms, chronic progression, which affects functioning, quality of life, and increases health care costs.

Disclosure

No significant relationships.
Diagnostic Fluidity: Inter- and Intra-Disease Considerations
Authors: Krueger R.
Published: September 2022

Traditionally, psychopathology has been classified based on the publications of authoritative bodies, such as the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (APA’s DSM). Recently, researchers have expressed an interest in basing classification more on data, as opposed to authority. This movement led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) consortium. Working from data, the HiTOP approach emphasizes dimensions of human individual differences that are arranged hierarchically, as opposed to categories that are arranged based on traditional DSM chapter rubrics. In this talk, I will describe the origins and status of the HiTOP approach, as well as current and future HiTOP directions and priorities.

Disclosure

No significant relationships.
Marfan syndrome and schizophrenia : a case report and literature review
Authors: Dhakouani S. , Kammoun R. , Aissaoui C. , Karoui M. , Ellouz F.
Published: September 2022

Introduction

Marfan syndrome is an autosomal dominant systemic disorder with connective tissue defects in multiple organ systems. Cardinal manifestations of this syndrome involve the cardiovascular, the skeletal and the ocular system. Interestingly, many cases of patients with Marfan syndrome and schizophrenia have been reported.

Objectives

Discuss the etiological link between Marfan syndrome and schizophrenia

Methods

Presentation of a clinical case illustrating the comorbidity between schizophrenia and marfan syndrome. A search was conducted in PubMed database using the terms : schizophrenia AND Marfan syndrome.

Results

Ms JW a 36-year- old single women, she had schizophrenia since the age of 20 years, she was hospitalized in our service for psychotic relapse in a context of treatment discontinuation. She had a personal history of persistence of the ductus arteriosus for which she had been operated during her childhood, a scoliosis operated and multiple pathological fractures. On mental status examination, she was distressed and hallucinated, She had disorganized thought processes and a paranoid delirium. On physical examination, she had features suggestive of Marfan syndrome such as crowded teeth, a high arched palate, arachnodactyly , hyperlaxity and a high myopia. We don’t dispose genetic evaluation for marfan syndrom because of the nonavaibility of facilities to perform genetic analysis. Several studies have indicated that psychiatric symptoms might be part of the clinical profiles of marfan syndrom. However, their relationship and underlying pathogenesis are not easily clarified.

Conclusions

Co-occurrence of marfan syndrom and schizophrenia might be explained by some shared etiological pathways between both disorders.

Disclosure

No significant relationships.
Behavioral phenotype of Noonan-like syndrome with loose anagen hair
Authors: Bouayed Abdelmoula N.
Published: September 2022

Introduction

Noonan-like syndrome with loose anagen hair (NSLH MIM 607721) is associated to mutations in PTPN11, RAF1, BRAF and SHOC2 genes.

Objectives

Here, we report behavioral phenotype of a child suspected to have NSLH.

Methods

A 2-years-old Tunisian child harboring severe pulmonic valvular stenosis was referred to our genetic counselling for genetic assessment. Medical dysmorphology, cytogenetic analysis as well as genetic exploration of RAS-MAPK pathway genes were conducted.

Results

The child had short stature and ectodermal features including ichthyotic skin and thin-soft nails. He has specific hair appearance associated to NS features. In fact, he had a small nasal tip, thick lips and sticking-out rotated ears. He harbored typical nasal voice and loose anagen hair with ungrowing thin hair, sparse and pale scalp hair and eyebrows. He showed cognitive deficits with mental retardation and hyperactive behavior. Considered as having NSLH, cytogenetic analysis revealed a 46,XY formula, but molecular screening of PTPN11, RAF1, BRAF, RIT1 and SHOC2 genes was negative.

Conclusions

Mutations within the RAS‐MAPK signaling pathway affect neurophysiologic activity in brain regions underlying attention and executive functions. Children with rasopathies demonstrated higher rates of attention deficit-hyperactivity (ADHD) and autism spectrum disorders. However, no studies have examined specifically the aspects of behavioral attention in the various types of Rasopathies. A recent study demonstrated that ADHD seems to be higher in children with NSLH and SHOC2 mutation, which is the case of our patient. We suggest that assessment of inattentive and hyperactivity symptoms in children should consider Rasopathies with specific molecular screening.

Disclosure

No significant relationships.
Neural Basis of Societal Risk for Mental Illness: Focus on Ethnic Minority Position and Racial Prejudice
Authors: Meyer-Lindenberg A.
Published: September 2022

Background Urban birth, urban living, and ethnic minority status are established risk factors for schizophrenia, but the mechanisms are unclear. Previous evidence suggests a causal role of social exposures and adverse experiences, but experimental evidence is scarce. Methods We combine multimodal neuroimaging with ecological momentary assessment, geolocation and geospatial analysis in an epidemiological longitudinal sample in Germany. Results We find that established risk factors converge on the perigenual cingulate-amygdala-ventral striatal pathway as shown by structural and functional imaging, supporting a role for the ventral-striatal system in psychosis risk. Using a combination of PET and fMRI data in migrants, we suggest a mechanistic link to psychosis by increased dopamine release and synthesis in striatum secondary to prefrontal dysregulation. Importantly, the regulatory system identified overlaps with that implicated in racial stereotyping and prejudice. Moreover, an experiment measuring information flow during an exchange between migrants and non-migrants indicates that during a trust interaction, cultural distance governs the exchange. Conclusions This work shows a convergent risk circuit related to minority position and migration that could guide primary prevention of schizophrenia through reduction of manifestation risk by contextual intervention.

Disclosure

No significant relationships.
Anxiety, depression and tinnitus: a cross-sectional study about 60 cases
Authors: Karoui M. , Kchaou A. , Amri G. , Nefzi H. , Kammoun R. , Ellouz F.
Published: September 2022

Introduction

Tinnitus is an auditory perception of a “phantom” nature with highly changing features. There is an established correlation between anxiety, depression, sleep disorders and tinnitus.

Objectives

To evaluate the prevalence of sleep disorders and emotional disorders during tinnitus and their correlation to the severity of the symptomatology

Methods

A descriptive cross-sectional study of 60 patients consulting for subjective tinnitus. For each patient we collected epidemiological data and performed an ENT and general examination, an audiometric and psychoacoustic evaluation and a psychometric evaluation. To evaluate the severity of the tinnitus we used the visual analog scale VAS and the subjective tinnitus severity test (STSS). Disability was assessed by the Tinnitus Handicap Inventory (THI). Anxiety and depression were assessed by: the Hamilton anxiety Rating scale and the Beck depression inventory.

Results

The prevalence of emotional disorders was: 21.7% for depression, 48.33% for generalized anxiety disorder, 11.67% for dysthymia, 5% for agoraphobia 16.67% for panic disorder and 1.67% for social phobia. The intensity of tinnitus was correlated with more panic disorder (p=0.008). Subjective severity of tinnitus was correlated with disability (p=0.0001), awareness of tinnitus in relation to sleep duration (p=0.006) and disturbed sleep (p=0.047). Disability was correlated with subjective tinnitus severity (p=0.0001), panic disorder (p=0.0007), generalized anxiety disorder (p=0.033), and poor sleep quality (p=0.005).

Conclusions

Our results emphasize the importance of emotional disorders as well as sleep disorders in chronic “tinnitus”. These disorders should be systematically investigated and eventually treated in order to optimize the management of the patients.

Disclosure

No significant relationships.
Hypomagnesemia In Patients OF Critical Care And Alcohol Withdrawal Syndrome: A Review
Authors: Chowdhury M. , Ponieman B.
Published: September 2022

Introduction

Magnesium is one of the crucial electrolytes that plays a significant role in maintaining various cellular and metabolic processes. Studies demonstrate that Hypomagnesemia is evident in patients of critical care unit and alcohol withdrawal syndrome. Low Magnesium level is associated several dreadful complications as such higher mortality, cardiac arrythmias, septic shock, prolonged ICU stay, increased need for intubations and delayed weaning from ventilation etc. Prescribing Magnesium with cautious supervision might prevent these alarming sequels. Value to determine Hypomagnesemia regarding critical patients is extremely significant to determine timing for possible interventions.

Objectives

To review the impact and significance of low serum Magnesium level on prognosis of patients with critical care unit and alcohol withdrawal syndrome.

Methods

To evaluate our reseach topic, we search through “Pubmed” and “Google Scholar” database using key words “Hypomagnesemia”, “Critical care” and “Alcohol withdrawal syndrome”, articles popped up. We select 5 articles on the basis of internal and external validity.

Results

Level of Magnesium determination is extremely crucial to steer proper management in ICU, CDU, and critically ill patients. Studies reflecting most of the patients in critical care and alcohol withdrawal syndrome suffer from Hypomagnesemia. Most recent studies demonstrate that a level below 0.75 mmol/L is considered Hypomagnesemia for total Mg and level below 0.42 mmol/L for ionized Mg.

Conclusions

Hypomagnesemia is associated with dire consequences and fatal outcomes for critical patients in terms of mortality,prolonged ICU stay,septic shock as well as need for mechanical ventilation.Supplementing Mg with careful monitoring could prevent lethal aftermath while treating patients of AWS and critical care.

Disclosure

No significant relationships.
Less is more
Authors: Alayón R. , Canalda A. , Albertini R. , De Gomar J.M. , Moro N.
Published: September 2022

Introduction

Very few research about atrioventricular blocks (AVB) and use of antipsychotic drugs has been made, although it may play an important role in the outcome of any patient affected by psychosis and AVB.

Objectives

To describe a case and review clinical data about AVB progression and neuroleptic treatment.

Methods

We describe a 37 years old inmate male patient who suffered from a first degree AVB and Schizophrenia, being long term treated with neuroleptics (risperidone 9mg/day, switched to paliperidone 9mg/day). Our patient presented very mild symptoms of asthenia and dizziness. An EKG was performed, showing AVB progression to Mobitz Type I1. No structural pathology was assessed by ecocardiography. Holter EKG showed also episodes of third degree AV block. Electrophysiology studies were performed showing a supra-hisian AV Block.

Results

Lower doses of Paliperidone were used (6mg) and maintened until nowadays. Control EKG showed regression to a known first degree AVB.

Being asymptomatic and studies revealing a supra-hisian AVB, no pacemaker was needed.

Conclusions

There is only a few cases described in scientific literature, and very limited data about AVB and neuroleptic drugs, although it is described as possible side effect using risperidone at higher doses. We suggest monitoring EKG to patients affected by AVB, using high doses of neuroleptic drugs. There is no data available about paliperidone metabolites and a possible progression of AVB.

We suggest more studies are needed to better understand and prevent side effects of neuroleptic drugs.

Disclosure

No significant relationships.
Racism and the Social Defeat Hypothesis of Psychosis
Authors: Selten J.-P. , Termorshuizen F.
Published: September 2022

Introduction

The social defeat hypothesis of psychosis posits that an outsider status or subordinate position is a common denominator of several psychosis risk factors, leads to elevated striatal dopamine function and thereby to an increased risk for the disorder. The purpose of this paper is to examine whether this hypothesis offers a good explanation for the increased psychosis risk for migrants from developing countries. Method: Review of literature. Results: The outsider status and subordinate position of many migrants from developing countries in Europe, and of Africans in particular, is evident. It is also clear that racism contributes to this situation. An interpretation of racism as psychotogenic is supported by findings of increased risks for other discriminated groups, such as homosexuals, individuals with a low IQ or a hearing impairment. The single study that examined dopamine function in migrants reported indeed elevated stress-induced dopamine release and dopamine synthesis capacity (Egerton et al., 2017). Recently, we examined the time course of the RR of treatment for psychosis for all migrants to the Netherlands (Termorshuizen & Selten, submitted). Contrary to our expectations, the RR for migrants from sub-Saharan Africa was already increased in the year of arrival (RR=2.5; 2.0-3.1), particularly for those aged 10-20 years (RR=6.1; 2.9-12.6). Conclusion: The social defeat hypothesis accords well with a psychotogenic effect of racism, but replications of the dopamine study are needed. The finding of an increased risk for Africans in the year of arrival suggests that racism is not the single cause of their increased risk.

Disclosure

No significant relationships.
A case of dissociative identity disorder and attention deficit hyperactivity disorder comorbidity
Authors: Aydın E.F. , Koca Laçin T.
Published: September 2022

Introduction

Dissociative identity disorder(DID) is characterized by the existence of two or more distinct identities which involve changes in consciousness, emotion, memory, and behavior. It is associated with childhood traumatic experiences and other psychiatric disorders. Comorbidity in DID can lead to complex clinical presentations, poor treatment responses. Thus, it is crucial to identify patients with comorbidity and take them into the treatment plan.

Objectives

We aim to report a case of DID and Attention-Deficit/Hyperactivity Disorder(ADHD) comorbidity.

Methods

A case report is presented alongside a review of the relevant literature regarding “dissociative identity disorder” and “attention deficit hyperactivity disorder”.

Results

We describe the case of a 39-year-old woman with DID, onsetting at age 25, who had consistently responded poorly to long-term psychotherapy and pharmacological treatment. She presented with anxiety, distinct personality states, alterations in memory, consciousness and behavior problems in functioning, and high Dissociative Experiences Scale(DES) scores. Throughout the interviews, we noticed that she had limited attention, excess movements. After a detailed evaluation, diagnosis of ADHD is established, using the Diagnostic Interview for ADHD(DIVA) and ADHD Self-Reporting Scale(ASRS). Methylphenidate was prescribed in addition to previous medication. İmprovement in the severity of both ADHD and DID symptoms was presented with lower scores in DES and ASRS after the introduction of methylphenidate with progressive dose adjusting till 60mg/day.

Conclusions

Although previous studies demonstrated ADHD symptoms are related to dissociation, there is no well-established strategy for this. We believe that this case report provides a better approach to the comorbidity of ADHD and DID.

Disclosure

No significant relationships.
An explorative study to assess the psychosocial impact of infertility on female Infertile Patients
Authors: Ghosh Dastidar B.
Published: September 2022

Introduction

The primary aim of our study was to assess the psychoscial impact of infertility amongst female infertile patients. We selected infertile women visiting the gynaecological OPD of R.G.Kar Medical College and Hospital - one of the busiest and most reputed government hospitals in eastern India. Most of the research on psychological aspects on infertility has been done in the developed rich nations of the world, our study is one of the very few to have been conducted in a developing nation like India.

Objectives

Incidence of depression , psychopathology and anxiety in female infertile patients in comparison to control fertile group. Impairment in quality of life Impact of other variable factors

Methods

Source of data : RGK Medical College, Kolkata, India

Sampling technique : Consecutive Random Sampling

Tools for data collection: Beck’s Depression Inventory, Beck’s Anxiety Inventory, SF36, SCL 90, Mini International Neuropsychiatric Interview, Self Reporting Questionnaire, Socio Demographic Proforma.

Data Analysis: The data was collected and analyzed by means of descriptive and inferential statistics.

Inferential statistics- Data analyzed by using SPSS. The relationship between continuous and binary explanatory variables with SF36, SCL 90, BDI and BAI scores were assessed using unpaired t test.

Results

Statistical analysis by independent t test shows significant increased levels of depression, anxiety, significant difference in psychopathology and quality of life in the 2 study groups.

Conclusions

Infertility has a significant impact on psychosocial well being of infertile patients, Greater collaboration is required between psychiatrists, psychologists and infertility specialists to assist infertile couples.

Disclosure

No significant relationships.
Building bridges between body and mind: liaison psychiatry
Authors: Bravo Herrero S. , Moreno Alonso I. , Sánchez Artero M.J. , Matas Ochoa A.M.
Published: September 2022

Introduction

As liaison psychiatrists, it is very important to mantein a good relationship with other medical specialties in order to obtain the best result for our patients. Most of the times, the somatic process affects direct or indirectly to mental healt and vice versa, so our cooperation is extremely important for the patient’s welbeing.

Objectives

With this study we try to find special considerations and necesities of every specialty that count on us in our hospital. We have design this batebase with the aim of discovering which are the main problems that suffer the admitted patients, which doubts face our colleagues when evaluate mental health patients, etc. Thus, our team could help other physicians properly or so we could stablish a proper liaison in order to make things easier.

Methods

A database has been created with all the patients evaluated by our liaison psychiatry team during half a year. We have taken into account sex, age, referral specialist, mental health diagnosis (after our evaluation), previous mental health follow-up, if they are on psycopharmacology treatment, if they requiere psycopharmacology treatment and if they requiere follow-up once discharged.

Results

22,9% were kid/adolescent patients. 25,8% were elderly people (>70 yo). 47% were men (of which, 6% were trans men), 53% were women. 22,9% suffered from adjustment disorder, 14,1% had no acute mental health problem, 11,76% presented substance abuse. Main petitions were made from Internal Medicine (30%)

Conclusions

With this information we can explore other specialists’ and admitted patients’ needs and concerns and focus our effort in solving them.

Disclosure

No significant relationships.
Management of patients with conversion disorder
Authors: Baati I. , Ben Abdallah M. , Arous A. , Hentati S. , Guermazi F. , Jdidi J. , Masmoudi J.
Published: September 2022

Introduction

Conversion disorder (CD) is largely managed by primary care physician. A good knowledge of this disorder and a mastery of adequate therapeutic means will allow patients to recover promptly and reduce recurrences.

Objectives

To evaluate the management of CD by primary care physicians.

Methods

This cross-sectional and descriptive study involved 90 primary care physicians in the region of Sfax (Tunisia). We submitted a self-administered anonymous questionnaire to physicians to explore their practice towards patients with CD.

Results

Among the 90 doctors contacted, 54 (60%) responded to our questionnaire. Their age ranged from 25 to 70 years, with a median of 41 years. The sex ratio was 0.92. The average number of years of practice was 15 years (SD = 9.7). Half of the physicians reported that the consultation of a patient with CD lasted between 15 and 30 minutes. Faced with a first episode of CD, 61.1% of the doctors decided to treat the patient alone and 18.5% preferred to take the advice of a psychiatrist. In the case of a recurrence, 59.2% chose to refer the patient immediately to a psychiatrist. The use of pharmacological treatment was indicated by 64.8% of participants. Half of the doctors stated that they had difficulties in managing patients with CD.

Conclusions

According to our results, the management of CD by primary care physicians remained restrictive and difficult. It is therefore necessary to encourage primary care physicians to express the difficulties they encounter and to turn to their psychiatric colleagues for help.

Disclosure

No significant relationships.
An Impulsive Suicide Attempt in a Patient with No Psychiatric History and a Recent COVID-19 Diagnosis: A case report
Authors: Kim J. , Jackson C. , Raai H.
Published: September 2022

Introduction

The coronavirus disease 19 (COVID-19) pandemic has prompted concerns regarding increased suicide rates and exacerbation of underlying mental illness symptoms. •There is evidence suggesting neurocognitive changes as well as immune response in COVID-19 infection may increase a patient’s propensity for suicidal ideation. • Patients who are diagnosed with COVID-19 may be affected by psychological factors of anxiety, stress related to having this novel virus as well as depression, post-traumatic stress disorder and sleep disorders throughout treatment and post-treatment of continued concerns. •The combination of psychiatric, neurological, and physical symptoms associated with COVID-19 may elevate suicide risk

Objectives

We present a case of a female with no prior psychiatric history who impulsively attempted suicide after a recent COVID-19 diagnosis and subsequent quarantine. Will explore possible link between increase of suicidal ideation and COVID-19 infection.

Methods

A case report.

Results

Link between increase of suicidal ideation and COVID-19 infection has not been clearly established but there have been reports, as in our case, of the possible vulnerability to mental illness and new onset suicidal ideation that COVID-19 survivors may experience. It may be useful to screen all patients for depressive symptoms after a COVID-19 infection. Early identification and treatment of depression in recovered COVID-19 patients will help to improve psychological impact on COVID-19 survivors and potentially reduce suicide rates.

Conclusions

As COVID-19 infection may trigger new onset mental illness, exacerbate symptoms of underlying mental illness, and may increase suicidal ideation, further research is needed to evaluate links between COVID-19 infection and depression with suicidal ideation

Disclosure

No significant relationships.
Old Age Psychiatry and Prison
Authors: Tort V. , Perez-Pazos J. , Perez-Sanchez E. , De Gomar-Malia J.M. , Peraire-Miralles M.
Published: September 2022

Old age population is growing steadily during last decades (WHO 2017). Old population suffer from more morbidity including mental disorders (De Lorito,2018). This fact also applies for prison population (Yortons 2006) and in the lasts years has been an increasing interest for this topicThe aging of the world population is reflected in the penitentiary setting, with a progressive increase of elderly inmates. These prisoners present complex clinical processes with multiple comorbidities, requiring a specialized approach. In the 2020, the old age population in prison (considered over 60 years old) is around 5% in Catalonia (377 inmates,), same proportion (5%) in Spain.If we consider the cut-off point 50 y.o. (as other research) the proportion is 12% Our aims are to describe sociodemographical and clinical characteristics of old age inmates (over 50 y. o.) who required to be admitted to psychiatric unit in Catalan prisons between 2016 and 2020. The asample of this study will be around 150 inmates admitted in our unit. Elderly inmates present a high prevalence of substance abuse (especially alcohol), affective symptoms (depression) and cognitive deterioration. Likewise, is observed a significant presence of personality disorders, anxiety, post-traumatic disorders, psychotic disorders, and physical comorbidities. Prisoners over 50 have a different profile from the rest of the prison population. They suffer more physical and mental illnesses, so they require specific health and social approach. It would be advisable to adapt clinical care by optimizing resources, developing prison psychogeriatrics and establishing specific evaluation and treatment method

Disclosure

No significant relationships.
Homicide and Suicide in the Elderly
Authors: Zeppegno P. , Gramaglia C.M.
Published: September 2022

Homicide and suicide are complex phenomena raising questions and interest which go far beyond the medical and psychiatric field, as they represent a challenge for an understanding which is, first of all, human. In older adults, homicide and suicide may present together in the homicide-suicide phenomenon. The most common motive underlying this behavior in intimate partner relationships is the so-called “mercy killing”, where the perpetrator kills the partner to eventually allow relief from declining health conditions, and then commits suicide. Actually, older adults account for a disproportionately high number of suicide deaths and approximately 55% of late-life suicides are associated with physical illness, notwithstanding psychiatric comorbidity. Physical illness is more likely to eventually lead to suicidal behaviour when it represents a threaten for the individual’s independence, autonomy, self-esteem and dignity, and when it impacts on quality of and pleasure with life, sense of meaning, usefulness and purpose in life. As the current historical period is one marked by opportunities which have allowed a rapid increase of life expectancy and longevity, it clearly emerges the need to balance benefits and harms of curative and palliative therapies, especially for painful, terminal illnesses. The expression of suicidal thoughts in older adults, as well as behaviours suggesting “silent” or indirect suicidal attitudes, should be carefully investigated and clinicians should try to decode the possible communicative role of suicidal behaviour while avoiding premature conclusions about the “rationality” of patients’ decision to die.

Disclosure

No significant relationships.
Acute Ekbom’s syndrome in a patient with acute urethritis
Authors: Martínez Muelas A. , Paiva Pajares D. , López Isern M. , Ivanov P. , Sánchez Pérez M.
Published: September 2022

Introduction

Delirium of parasitosis was first described by Karl Ekbom in Sweden in 1938. It is a hallucinatory monothematic delirium characterized by the unwavering conviction of having the skin infested with insects or parasites. Multiple etiologist has been described such as psychiatric and neurological disorders, substance intoxication or other medical conditions. We present a case of debut of Ekbom’s syndrome in an individual recently diagnosed with acute urethritis on antibiotic treatment.

Objectives

To report a case of a patient with a debut of Ekbom’s syndrome and acute urethritis.

Methods

A 40-year-old man with no previous psychiatric history is admitted psychiatric emergency room accompanied by his wife for intense anxiety and isolation at home. During the examination, the patient explains a lot of fear of a series of bugs such as bees and small parasites that invade him. The onset of symptomatology coincides with a diagnosis of chlamydia urethritis and the initiation of treatment with ceftriaxone 500mg IM + Azithromycin 1g VO. Complete physical examination is performed without alterations. Toxicological, biochemistry, hormonal and vitamin study did not show any alterations.

Results

Antipsychotic treatment was started with Olanzapine up to 10mg/day and supportive treatment with benzodiazepines. The patient showed rapid improvement. At discharge, he is asymptomatic from the urological and psychopathological point of view.

Conclusions

Ekbom’s syndrome is a multifactorial disorder. The patient was diagnosed of an acute psychotic disorder due to another medical condition and/or treatment with antibiotics.

Disclosure

No significant relationships.
The impact of COVID-19 on the quality of life of older adults: a cross-sectional study in Athens, Greece
Authors: Argyropoulos K. , Tagkalaki Z. , Argyropoulou A. , Avramidis D. , Jelastopulu E.
Published: September 2022

Introduction

The COVID-19 has affected both physical and mental health of the elderly.

Objectives

The purpose of the present study was to estimate the impact of the second lockdown in Greece, on both quality of life and mental health in older people.

Methods

A cross sectional study was conducted among older adults who visited a primary care physician, from 1st of March to April 30th. An anonymous questionnaire was administered to collect basic sociodemographic data and implementation of hygiene precaution measures. The 5-item World Health Organization Well-Being Index (WHO-5) to measure well-being, the Generalized Anxiety Disorder Assessment (GAD-7) instrument was used to assess the anxiety levels and Geriatric Depression Scale (GDS-15) depressive symptoms of the responders, respectively. Statistical analysis was performed with SPSS v.24.0

Results

222 elderly took part in the study. 62.6% were female. According to the WHO-5, 37.4% present poor quality of life. GDS-15 reveals that 70.7% of the participants screened positive for moderate depression and 1.8% with severe symptoms. GAD-7 results estimated 32.9% of the participants to suffer from serious anxiety disorder and 37.4% from moderate. GAD-7 and GDS-15 were strongly associated (p <0.05) with female gender, low educational level and with comorbidities (coronary disease, diabetes mellitus and skeletomuscular diseases). Health precaution measures were negative correlated with mental health of the elderly. However, in participants with frequent contact with family and friends, lower anxiety levels were detected.

Conclusions

Our results highlight that older adult has experienced negative impact on both quality of life and mental health during 2nd Covid-19 lockdown in Greece.

Disclosure

No significant relationships.
COVID-19-related stigma among the non-infected general population from Iran
Authors: Nadoushan A.H. , Faghankhani M.
Published: September 2022

Introduction

COVID-19-related stigma has been raised as a crisis since the beginning of the pandemic. We intended to develop a valid and reliable questionnaire to measure COVID-19-related stigma, attributed by the non-infected general population, and applied it in Tehran from September to October 2020.

Objectives

This study measures the COVID-19-related stigma attributed by the non-infected general population using a valid and reliable questionnaire specific to COVID-19-related stigma.

Methods

A preliminary questionnaire with 18 items was developed. The score ranged from 18 to 54 while the higher score indicating a higher level of COVID-19-related stigma. Out of 1064 randomly recruited Tehran citizens without a history of COVID-19 infection, 630 participants, who completely responded to the questions on a phone call, entered the study.

Results

The content validity was established with a scale content validity index of 0.90. Item CVI and Item content validity ratio were higher than 0.78 for all items. Internal consistency was confirmed with Cronbach’s alpha of 0.625. Exploratory factor analysis revealed seven latent variables, including “blaming and penalty-seeking behavior”, “social discrimination”, “dishonor label”, “interpersonal contact”, “spreading rumors and myths”, “overvalued idea”, and “apathy toward the patients”. The mean (SD) of the score was 25.1(4.71) in our study. 86.8% of participants reported a low level of stigma with a score below 31. 13.2% of them demonstrated a moderate level of stigma, and none of the participants showed a high level of stigma.

Conclusions

we found a low level of stigmatizing thoughts and behavior in Tehran, which may be due to social desirability bias.

Disclosure

No significant relationships.
Psychological resilience and anxiety in response to COVID-19
Authors: Ionescu T. , Boscaiu V. , Fetecau B. , Tudose C.
Published: September 2022

Introduction

In Romania, the first case of COVID-19 was detected on 26 February 2020 and the number of cases has been rising afterward.

Objectives

The goal of this study was to assess anxiety and resilience regarding the COVID-19 pandemic and to analyse possible protective measures and risk factors.

Methods

This is a cross-sectional study and data were collected March and April 2021. Participants filled in the Zung Self-Rating Anxiety Scale and the Connor-Davidson Resilience Scale.

Results

The sample consisted of 440 participants who presented to the general practitioner (female-65.7%) and the most representative age group was 35-64 years old; 18.4% of the participants stated that they were infected; 56.6% reported that they do not know anyone in their entourage who was infected/ has died of COVID-19 (group A), 32.9% knowing people with an infection in their close social environment (group B) and 10.5% had close people who died (group C). Almost half of the respondents (49,3%) scored above the cut-off point of the anxiety index (mild 38.6%, moderate 9.9%, severe 0.8%). As we expected, there is a strong negative correlation between anxiety levels and resilience (Pearson Correlation=-.551, p<0.01). If groups A and B had similarities regarding anxiety levels (44.97 and 44.23), those knowing someone who died of COVID-19 (group C) had a higher anxiety level (47.81%) (p<0.05).

Conclusions

The recent COVID-19 pandemic has caused an understandable surge in anxiety among the general population. Low level of resilience is predictive of the phenomenon of having high anxiety in the face of the death of others.

Disclosure

No significant relationships.