bluuebunny/crossref_metadata_2025 huggingface dataset:
Dismantling task-sharing psychosocial interventions to personalize care for people affected by common mental disorders: developing a taxonomy of active ingredients and ranking their efficacy
Authors: Papola D. , Patel V. , Barbui C.
Published: August 2024

Introduction

The global burden associated with common mental disorders is high, especially for people living in low resource settings. Although psychosocial interventions delivered by locally available lay or community health workers are effective, mechanisms of intervention response are poorly understood. One of the greatest barriers is that psychosocial interventions are administered as complex, multi-component “packages of care”.

Objectives

Our aim is to systematically review all the randomized controlled trials (RCTs) that have tested the efficacy of psychosocial interventions delivered through the task shifting modality to treat people suffering from common mental disorders (depression, anxiety, and related somatic complaints) in low resource settings, dismantle the intervention protocols creating a taxonomy of active intervention components, and re-evaluate their efficacy.

Methods

We will use the component network meta-analysis (cNMA) methodology. The major benefit of cNMA is the possibility to disentangle intervention components and explore their effectiveness separately or in various combinations (even in disconnected networks). cNMA increases statistical power by combining direct and indirect comparisons while fully respecting the randomized structure of the evidence. According to the additive cNMA model which we will implement, adding a component “c” to a composite intervention “X” will lead to an increase (or decrease) of the effect size by an amount only dependent on “c”, and not on “X”. We will denote the corresponding component specific incremental standard mean difference (iSMD) so that iSMDc = SMD(X+c) v. (X). Combining these component-specific iSMDs will allow the estimation of SMD between any two composite interventions.

Results

A network of comparisons and a hierarchy that includes all intervention components expressed as iSMD, indicating the added benefit of adding a component to an intervention, will be presented. By selecting the most effective components it will be possible to outline a novel task shifting psychosocial intervention to be tested in future RCTs.

Conclusions

These findings will set the basis for further investigations in the field of precision medicine. This project is funded by the European Union’s HORIZON EUROPE research programme under grant agreement No 101061648.

Disclosure of Interest

None Declared
Urban planning, noise pollution and mental health outcomes
Authors: Abdelmoula E. , Abdelmoula B. , Bouayed Abdelmoula N.
Published: August 2024

Introduction

In large cities around the world, many sources of noise including traffic, domestic, construction, and industrial activities, contribute to urban noise pollution, which is now, a major concern in public health as declared by the WHO, for more than a decade (in 2011).

Objectives

The aim of this study was to try to find potential recommendations and references in terms of urban planning, particularly with the emergence of smart cities, to combat the problem of noise pollution and related mental health hazards.

Methods

We conducted a comprehensive review of the scientific literature using the following keywords: cities, smart cities, noise, pollution and mental health.

Results

Our research found that the continuous exposure to high noise levels could lead to psychological and physiological problems, such as hearing disorders, high blood pressure, heart disease, inconvenience and sleep disorders. While recent evidence indicates that road traffic noise has a negative impact on mental health and that aircraft noise significantly increases the risk of depression, there are not enough studies to date to properly assess the relationship between urban noise pollution and mental health hazards such as anxiety, mood disorders, sexual disturbance, cognitive impairment, learning disabilities, dementia, etc. In the field of urban planning, there is also a lack of reliable data on individual exposure to environmental noise in space and time, and on its effects on mental health.

Conclusions

Various noise mitigation strategies in urban renewal plans are proposed, such as the implementation of noise mapping to provide the detailed spatial distribution of noise levels in urban areas, their sources and time intervals, noise barriers along traffic arteries, vegetation and landscaping. New infrastructure projects involving new expressways and high-speed trains as well as the widening of major roads in their central areas are also suggested.

Disclosure of Interest

None Declared
Natural soundscapes, urban design and psychological well-being
Authors: Abdelmoula E. , Abdelmoula B. , Bouayed Abdelmoula N.
Published: August 2024

Introduction

While the acoustic environment in the cities correlates with various health-related problems, health benefits of natural sounds are proven. These positive effects of the sounds of nature should probably be taken seriously in urban design and urban renewal projects.

Objectives

The aim of this study was to review the paradigm of natural soundscapes in the cities, psychological effects of natural soundscapes and the potential urban recommendations for such architecture design.

Methods

We conducted a comprehensive review of the scientific literature using Web databases with the following keywords: natural soundscapes, natural sound, urban design, and mental health.

Results

Our research found that improving the urban environment soundscape for the well-being of city dwellers has become one of the most pressing challenges of modern times. In a growing number of published studies, positive psychological effects of natural soundscapes are explored using various methods such as questionnaires, biofeedback sensors coupled with virtual reality experiences in laboratories, and quantification of the prevalence of restorative acoustic environments in parks. In a recent study (2023), Jian Kang from the United Kingdome, reported that “by taking psycho-acoustical, neural and physiological, and contextual factors into account, the European Research Council Soundscape Indices project will adequately reflect levels of human comfort, to integrate side-by-side with (and eventually replace) decibel-based metrics into existing (international) regulations”. The same paper highlighted how the transition from fighting noise pollution to creating soundscapes is key.

Conclusions

Architects should develop mandatory guidelines regarding the spatial planning focusing on managing natural soundscapes in cities. Various sites such as green urban public spaces that offers exposure to natural sounds should be an integral part of the urban environment. These areas must be with a high abundance of natural sound (geophony and bio phony) and a low anthropogenic sound to enhance human physical and psychological health.

Disclosure of Interest

None Declared
A multivariate meta-analysis of peripheral cytokine levels in obsessive compulsive disorder
Authors: Chen Y. , Li Q. , Wang Y. , Wang Y. , Long F. , Li F.
Published: August 2024

Introduction

Obsessive-compulsive disorder (OCD) is a common psychiatric disorder. It is considered that dysregulation of cytokine levels is related to the pathophysiological mechanism of OCD. However, the results of previous studies on cytokine levels in OCD are inconsistent.

Objectives

To perform a meta-analysis assessing cytokine levels in peripheral blood of OCD patients.

Methods

We searched in PubMed, Web of Science, and Embase from inception to March 31, 2023 for eligible studies. We conducted multivariate meta-analysis in combined proinflammatory cytokines (interleukin-6 [IL-6], IL-1β, IL-2, tumor necrosis factor-α [TNF-α], and interferon-γ [IFN-γ]) and combined anti-inflammatory cytokines (IL-10 and IL-4) respectively, and calculated the same meta-analysis in each cytokine. We also performed sensitivity analysis and publication bias tests, as well as subgroup analysis (i.e. different age groups, varied cytokine measurement methods, medication treated or naïve, and presence of psychiatric comorbidities) and meta-regression analysis (variables including patients’ sex ratio, age, age at symptom onset, illness duration, scores of Y-BOCS, family history of psychiatric disorders, and BMI).

Results

17 original studies (13, 13, 10, 5, 4, 3, 2 studies for IL-6, TNF-α, IL-1β, IL-10, IL-2, IL-4, and IFN-γ, respectively), 573 patients (mean age, 25.2; 50.3% female) and 498 healthy controls (HC; mean age, 25.3; 51.4% female) were included. The results showed that the levels of combined pro- or anti-inflammatory cytokines and each signle cytokine were not significantly different between OCD patients and HC (all P>0.05), with significant heterogeneities in all analyses (I2 from 79.1% to 91.7%). We did not find between-group differences in cytokine levels in all subgroup analyses. Meta-regression analysis suggested that age at onset (P=0.0003) and family history (P=0.0062) might be the source of heterogeneity in TNF-α level. Sensitivity analysis confirmed that all results were stable, except for IL-4 where different cytokine measurement methods may be the contributing factor. Egger test did not find publication bias.

Conclusions

Our study showed no difference in cytokine levels between OCD patients and HC, but age at onset and family history may affect TNF-α level. Confounding factors such as age at onset, family history, and cytokine measurement methods should be controlled in future studies to further explore the immune mechanism of OCD.

Disclosure of Interest

None Declared
Central effects of peripherally administrated immune cells modulated by a psychoactive substance in aggression
Authors: Markova E. , Serenko E. , Knyazheva M. , Akopyan A. , Tikhonova M. , Amstislavskaya T.
Published: August 2024

Introduction

It is known that the formation of aggressive behavior is accompanied by neurodegenerative and neuroinflammatory changes. Immune cells have a regulatory effect on the central nervous system functions, including regulation of behavior.

Objectives

We first demonstrated that ex vivo chlorpromazine - modulated immune cells have a positive aggressive behavior editing effect. The aim of the study was to investigate the influence of the indicated cells on some central mechanisms underlying the development of aggressive reactions.

Methods

(CBAxC57Bl/6) F1 aggressive male mice, developed in conditions of chronic social stress, were undergoing the transplantation of syngeneic spleen lymphocytes with ex vivo chlorpromazine-modulated functional activity. In recipients the immunohistochemical analysis was performed assessing the expression of the microglial marker Iba1. The levels of brain-derived neurotrophic factor (Bdnf
) and cytokines was assessed by ELISA. For histological examination Nissl staining was applied.

Results

Aggressive behavior editing after the chlorpromazine-modulated immune cells transplantation registered against the background of some structural and functional changes in the brain. It was found an increase in the density of pyramidal neurons in CA1 and CA3 hippocampal regions and augmented level of Bdnf. The decreased expression of microglial activation marker Iba1, accompanied with decreased levels of pro-inflammatory cytokines (IL-1β, IL-2, IL-6, INF-γ) and increased  anti-inflammatory (IL-4) cytokine was found. Visualization of functionally active lymphocytes pre-treated with chlorpromazine in the brain parenchyma of aggressive recipients suggests a direct effect of injected lymphocytes on CNS.

Conclusions

The effect of chlorpromazine - modulated immune cells that edits aggressive behavior is realized by stimulating neurogenesis, neuroplasticity and reducing neuroinflammation.

Disclosure of Interest

None Declared
Case-series of patients treated with anti-NMDAR encephalitis at Semmelweis University
Authors: Herman L. , Réthelyi J. M. , Sipos I. , Zsigmond R. I.
Published: August 2024

Introduction

Anti-NMDAR encephalitis is an autoimmune disorder, characterized by neuropsychiatric symptoms, such as mood instability, psychosis, catatonia, dyskinesia, seizures and vegetative lability. Psychiatric symptoms usually occur in the initial phase, therefore almost half of the patients are first observed at a psychiatric unit, however in later phases the patients’ condition often show progression with the characteristic neurological symptoms, such as perioral dyskinesia and seizures. Although, early recognition and treatment is essential to reach good outcomes, delay in the diagnostic process often happens due to the unspecific early symptoms and the lack of knowledge of this disorder amongst psychiatrists.

Moreover, there are cases, where neurological symptoms do not appear, which can lead to diagnostic failure and mismanagement of these patients. Since anti-NMDAR encephalitis is a rare condition, it is important to treat such cases in specific centres, where sufficient knowledge and multidisciplinary approaches are available.

Objectives

Our aim was to gather all patients’ data treated with anti-NMDAR encephalitis at two departments (Neurology and Psychiatry) of Semmelweis University. We wanted to analyse psychiatric manifestations of the disorder in details and follow these symptoms long term, with special interest on the cognitive symptoms.

One of our aims was to follow-up these patients and measure antibody titres in their serum, to be able to asses, whether there was any association between prolonged serum positivity and cognitive impairment.

Methods

We have retrospectively analysed data of previous cases and prospectively followed up recently hospitalised patients.

Neurocognitive assessment had been conducted by the same psychologist, all the patients were followed up by the same interdisciplinary team, including a neurologist and two psychiatrists. Laboratory tests (autoimmune antibody essays) were conducted by the Immunological Laboratory at Semmelweis University.

Results

Altogether, 13 female patients were treated with anti-NMDAR encephalitis in the past ten years at Semmelweis University. All of them received plasma exchange, iv. steroids and azathioprine. 8 out of the 13 needed ventilation and intensive care treatment. 2 of these patients have mild psychiatric symptoms as residual symptoms, and 1 of them is still in the recovery stage, currently experiencing mild cognitive symptoms.

Only two patient had ovarian teratomas out of the 13, which is a lower number than expected from previous studies.

4 out of 12 had positive antibody titre at follow up, one patient is still at recovery stage, however her antibody titres are still very high.

Conclusions

Semmelweis University is one of the largest centre treating patients with anti-NMDAR encephalitis in Hungary. We had altogether 13 patients in the last ten years, with very good outcome, since all of them recovered, although 2 have residual symptoms.

Disclosure of Interest

None Declared
Clinical and immunological features of prolonged and chronic endogenous manic and manic-delusional states in the structure of endogenous diseases
Authors: Zozulya S. A. , Rumyantseva E. B. , Sizov S. V. , Oleichik I. V. , Klyushnik T. P.
Published: August 2024

Introduction

The relevance of studying the clinical and immunological characteristics of prolonged and chronic endogenous manic and manic-delusional states is conditioned by their high prevalence, insufficient understanding of pathogenetic mechanisms, and the need to develop adequate therapeutic approaches.

Objectives

To study the clinical and biological correlations between inflammatory markers of blood plasma, the severity of manic symptoms and psychopathological characteristics of patients with prolonged and chronic endogenous manic and manic-delusional states.

Methods

70 female patients aged 18 to 55 years (mean age 33.6±5.9 years) with prolonged and chronic endogenous manic and manic-delusional states within different nosologies (F31.1-2, F25.01, F25) were examined. Psychometric assessment was performed using the PANSS, YMRS, and GAF scales. The control group consisted of 55 mentally and somatically healthy women of the corresponding age.

Leukocyte elastase (LE) activity, α1-proteinase inhibitor (α1-PI) activity, and the autoantibody levels to astrocytic protein S-100B and myelin basic protein (MBP) were determined in blood plasma.

Results

The increase in the level of immune system activation of different degrees (according to the complex of inflammatory and autoimmune markers) associated with the severity of the patient’s condition within the examined nosologies was revealed.

The highest level of immune activation, characterized by an increase in the activity of both LE and α1-PI (p<0.01), and the level of autoantibodies to S-100B and MBP (p<0.05), was characteristic of patients with chronic endogenous manic and manic-delusional states in the framework of schizophrenia. Manic symptoms within different nosologies had clinical features, however, no differences in the severity of these symptoms on the YMRS scale were revealed (p>0.05).

Positive correlations were found between LE activity and the PANSS subscale of general psychopathological symptoms (R=0.3, p=0.006) and the PANSS total score (R=0.3, p=0.03). The level of antibodies to S-100B correlated with the PANSS negative subscale score (R=0.3, p=0.04). A negative correlation was found between LE activity and the level of social functioning of patients according to the GAF scale (R=-0.3, p=0.02).

Conclusions

The immune profile of patients with prolonged and chronic manic and manic delusional states within endogenous psychiatric disorders is determined mainly by nosologic affiliation, which is also related to the clinical features of manic states.

Disclosure of Interest

None Declared
The Application of Pharmacogenetic Testing in Psychiatry for Treatment-Resistant Disorders: Optimal Timing and Implementation, a literature review
Authors: Pjevac M.
Published: August 2024

Introduction

Treatment-resistant psychiatric disorders present a significant clinical challenge, often requiring trial-and-error approaches to find effective therapeutic interventions. Pharmacogenetic testing has emerged as a promising tool to guide medication selection and dosing, potentially reducing the time to achieve remission and alleviating the burden of persistent symptoms. However, the optimal timing and integration of pharmacogenetic testing into psychiatric practice remain underexplored.

Objectives

Pharmacogenetic tests can identify individuals with genetic variants that may predict their response to psychotropic drugs, thus enabling a more personalized approach to treatment. Evidence suggests that early application of pharmacogenetic testing, particularly after the first failed medication trial, can substantially improve outcomes for patients with treatment-resistant disorders. Such timely intervention can inform drug choice and dosing, averting protracted periods of ineffective treatment and minimizing exposure to unnecessary side effects.

Methods

This review synthesizes current literature on pharmacogenetic testing in psychiatry, with a focus on its application in treatment-resistant mood disorders, schizophrenia, and other non-responsive psychiatric conditions. We examine the genetic polymorphisms that influence drug metabolism, efficacy, and the risk of adverse effects, particularly considering cytochrome P450 enzymes and receptor gene variations.

Results

Pharmacogenetic testing holds significant promise in psychiatry, especially for treatment-resistant disorders, by aligning genetic profiles with medication selection to enhance therapeutic efficacy. While cost and access remain barriers, the benefits of early testing support its integration into standard care protocols. Further research is needed to establish clear guidelines and to expand the genetic targets relevant to psychiatric pharmacotherapy.

Conclusions

Adoption of pharmacogenetic testing after the initial treatment failure offers a pragmatic balance between the practical limitations of universal screening and the clinical imperative to alleviate the substantial morbidity associated with treatment-resistant psychiatric conditions.

Disclosure of Interest

None Declared
Successful treatment of Premenstrual dysphoric disorder with irritable bowel syndrome using sulpiride
Authors: Alageel A. A.
Published: August 2024

Introduction

Premenstrual dysphoric disorder (PMDD) is prevalent, more severe than premenstrual syndrome(PMS), and a challenging disorder. The first line of treatment is pharmacotherapy. Non-pharmacological therapy includes aerobic exercise, consumption of complex carbohydrates and frequent meals, relaxation training, light therapy, sleep deprivation, and cognitive-behavioral therapy could be helpful

Objectives

To our knowledge, there have not yet been any studies on this treatment option for PMDD with IBS

Methods

a case report

Results

A lady suffering from PMDD and irritable bowel syndrome (IBS) did not respond to antidepressants, painkillers, and melatonin. She used to sit at home and in her room these days, waiting for the PMDD severity to decrease. Her condition reached remission after taking a small dosage of sulpiride and stopped on the last day of the period. The patient is satisfied with the result since concerns about antidepressants are addressed and avoided. This case provides a new approach to using low-dosage sulpiride temporarily every month in patients with both PMDD and IBS

Conclusions

Premenstrual dysphoric disorder is a challenging condition. The symptoms of PMDD are not continuous, and somatic symptoms are a significant component of both the diagnosis and the patient’s suffering. Choosing a suitable medication based on pros and cons contributes to successful treatment and patient satisfaction. This case provides a new approach to using low-dosage sulpiride in patients with both PMDD and IBS, but more studies are needed to confirm its efficacy and safety.

Disclosure of Interest

None Declared
Hyperammonemic encephalopathy in a 46 year old patient treated with valproic acid as treatment for borderline personality disorder: a case report.
Authors: Setién Preciados P. , Arroyo Sánchez E. , Díaz Mayoral C. , Gimillo Bonaque J.
Published: August 2024

Introduction

Valproic acid (VPA) has been used in clinical practice since the 60’s, with a relatively favourable safety and efficacy profile. Pancreatitis, hepatotoxicity and teratogenicity are the most significant adverse drug reactions. VPA is also known for causing hyperammonemia, which may be asymptomatic or can present with encephalopathy. VPA-induced hyperammonemic encephalopathy (VHE) is a serious but reversible condition, which requires high clinical suspicion for diagnosis. It may occur acutely or after chronic use of VPA.

Objectives

Review how frequent is for valproic acid to cause hyperammonemic encephalopathy, signs to watch out for and how it can be treated.

Methods

Presentation of a patient’s case and review of existing literature, in regards to encephalopathy caused by valproic acid as a result of ammonia elevation.

Results

In the case displayed here, the patient is diagnosed of hyperammonemic encephalopathy after being treated with valproic acid as treatment for borderline personality disorder.

Reviewing literature, cases of hyperammonemia are rarely reported as VPA-induced, probably because this increased level of ammonia in blood can vary between asymptomatic, and clinically relevant levels. Symptomatology due to VPA-induced hyperammonemia include: lethargy, impaired consciousness, focal neurological signs and symptoms and increased seizure frequency. More rare described symptoms are: aggression, ataxia, asterixis, vomiting and coma.

There are multiple treatment modalities for patients diagnosed with VHE, the primary treatment being the discontinuation of VPA. Other treatments frequently used are Lactulose and Carnitine.

Conclusions

VHE is a rare occurrence, however can have fatal outcomes if not recognized and managed in time. Physicians should be vigilant while initiating Valproate therapy to patients. Clinicians should consider the possibility of VHE in patients with unexplained altered mental status, regardless of the duration of VPA therapy. A timely diagnosis is essential to prompt effective treatment, thus ensuring the patient’s safety and decreasing the length of hospitalisation and the cost of care in hospitals.

Disclosure of Interest

None Declared
Non MRI Guided Accelerated Intermittent Theta Burst Stimulation is Effective in Patients with Treatment Resistant Depression and Suicidality
Authors: Zayed A. E. , Bassiony M. M. , Youssef U. M. , Salah Eldeen G. M. , Elgohary H. M. , Sehlo M. G. , Hefny O. A.
Published: August 2024

Introduction

The U.S. Food & Drug Administration (FDA) has cleared SNT (Stanford Neuromodulation Therapy) for treatment of major depressive disorder (MDD) in adults who have failed to achieve improvement from at least two prior trials of antidepressants. SNT protocol requires both structural and functional connectivity MRIs which is limited by high cost and lack of availability, its use without neuronavigation is still considered an off label use and need more investigation.

Objectives

1-To investigate efficacy of SNT like accelerated off-label protocol without Neuronavigation in treating patients with TRD and suicidality.

2-To investigate durabiliy ( up to one month ) of SNT like accelerated off-label protocol without Neuronavigation in treating patients with TRD and suicidality

Methods

Two cases diagnosed as treatment resistant unipolar depression with suicidal ideations received accelerated intermittent theta burst stimulation (a iTBS); with figure of eight coil administered to the left dorsolateral prefrontal cortex (DL-PFC) determined using Beam method. Stimulation was at 90% MT for 1800 pulses with an intersession interval of fifty minutes. Patients received ten sessions every day for five consecutive days for a total of fifty sessions (90,000 pulses). The following scales were applied at the baseline and at the end of each day of five treatment days:The Montgomery and Asberg Depression Rating Scale (MADRS) The Beck Depression Inventory, Columbia Suicide Severity Rating Scale (C-SSRS) and Young Mania Rating Scale (YMRS).

Results

The two cases at the end of the fifth day were completely improved regarding both suicidal ideations and depression without emerging of hypomania. Follow up was done weekly for one month with durable results.

Conclusions

SNT protocol without neuronavigation needs to be well investigated in suppressing both suicidality and depression in patients with TRD.

Disclosure of Interest

None Declared
Multifamily group evaluation with Score 15 questionnaire
Authors: Gamo Bravo B. , Gonzalez Laynez M. E. , Bañon Gonzalez S. M. , Ogando Portilla N.
Published: August 2024

Introduction

The multifamily group that has been underway since April 2019 in Alcobendas, Madrid is described. A group that serves people diagnosed with mental disorder and their families, with the aim of improving their health and quality of life. It is about facilitating and improving the basic communication of relational aspects and healthy bonds. It is intended to offer a space where you can think together about the experiences lived in your own family with the rest of the group

Objectives

Assess the evolution and improvement of the patient and family members with the Score 15 questionnaire, The Score is a way of giving users a voice about the therapy process, not about the contents of their problems, but about their perception of the effectiveness of therapeutic work and for professionals it is an opportunity to obtain important feedback from their work.

Methods

Using the Score !5 questionnaire on all participants in the group at time zero and after 12 sessions

Results

Improvement in the family description items, and in the quantitative improvement in scoring of the following questions: What degree of severity would indicate? Do you think therapy will be helpful/has it been helpful to you?

Conclusions

Family therapy in the modality of Multifamily Groups provides an improvement in intrafamily communication, its links and therefore in the rest of social communication, facilitating the exit from loneliness and misunderstanding and in turn broadens the understanding and understanding by therapists

Disclosure of Interest

None Declared
Family systemic therapy in patients with eating disorders
Authors: Setién Preciados P. , Díaz Mayoral C. , Arroyo Sánchez E.
Published: August 2024

Introduction

Eating disorders are a group of pathologies in which negative beliefs about food, body type and weight are associated with conducts that include food restriction, binge eating, excessive exercise, induced vomiting and the use of laxatives. They can be really severe, affecting quality of life and lead to multiple physical and psychiatric complications, even with a deadly fate.

Objectives

Presentation of a patient’s case with an eating disorder and the intervention with her family, as well as, doing a review of the family interventions in these kinds of patients.

Methods

Presentation of a patient’s case and review of existing literature, in regards to the use of family therapy in patients with eating disorders and its effects.

Results

As in the patient’s case, there are a lot of studies that support the evidence of improvement using family therapy in patients with eating disorders. However, the difficulty to isolate the necessary variables in order to do studies about psychological treatments, complicates finding scientific evidence that supports the clinical evidence that we see in our patients day by day with these types of interventions.

Conclusions

There are studies that support the efficacy of these types of family interventions. However, there needs to be a more thorough investigation with the objective of finding the more precise optimal family intervention, and specifically, determining for who and under what conditions, certain types of family interventions would be more effective.

Disclosure of Interest

None Declared
REVIEW OF MEDICATION INCIDENTS IN MENTAL HEALTH SERVICE
Authors: Gomes T. C.
Published: August 2024

Introduction

In this review, medication incidents accross different mental health care facilities was reviewed and nuances, challenges, and advancements in the administration and management of psychiatric medications was noted. Through gaining a better understanding of the complexities surrounding these incidents, valuable information can be gathered that will enhance patient safety, improving healthcare practices, and fostering a deeper understanding of the critical intersection between mental health care and medication management.

Objectives

To identify the most frequent types of medication errors or patterns of medication errors in a mental health service accross different settings including inpatient, outpatient, liaison and long term residential unit

Methods

This is a multicentre project as it covers medication incidents in mental health care in a regianal area in Ireland. It includes an acute psychiatric Unit, the General Hospital and patients admitted in medical and surgical wards and as well long term residential care. Using the National Incident Management System we collected National Incident Report Forms (NIRF) relating mental health care provided and medication prescribed within a region in Ireland. From these we selected the ones were medication hazard was noted. Data collection happened between July 2020 and July 2021. A statuystical analysis was then performed to identify any patterns to medication errors.

Results

A total of 22 incidents were included. On review of these, it was noted, among other findings, that here was a significant increase in the frequency of medication errors during the month of December. It was also noted errors ranged from medication being given to the wrong patient, medication being given twice and medication being missed.

Conclusions

Minimising medication errors requires a comprehensive, multidisciplinary approach that involves healthcare providers, patients, and healthcare systems. Healthcare organizations should foster a culture of safety where medication errors are seen as preventable and where providers are encouraged to report errors without fear of retaliation.

Disclosure of Interest

None Declared
The level of consciousness and mental reactions of children after acute brain injury (interdisciplinary rehabilitation)
Authors: Martyshevskaya D. , Zakrepina A. , Sidneva Y.
Published: August 2024

Introduction

The process of recovery of mental reactions in children after acute traumatic brain injury is determined by complex methods with an interdisciplinary approach. Studies of emotional, communicative and behavioral reactions are based on an assessment by a psychiatrist and a teacher-defectologist.

Objectives

to study mental reactions and identify predictors of positive recovery of consciousness after acute brain injury in children in early rehabilitation.

Methods

psychiatric and pedagogical examinations; also - neuroimaging data and others.

Results

Three groups of children were identified, depending on the different severity of emotional, communicative and behavioral indicators:

Group 1 (11%): The level of consciousness is minimal positive. Reactions: stable gaze fixation; emotional reaction to sound (smile) and the face of an adult; short-term tracking of the gaze of the object; the ability to touch an object and hold it; sits himself.

Group 2 (33%): The level of consciousness is minimal positive / negative, with an advantage of positive. Reactions: unstable gaze fixation; emotional reaction and involuntary movements to sound; reflex seizure of an object; sits with support.

Group 3 (56%): The level of consciousness is minimal negative. Reactions: no emotional reactions, low motor and sensorimotor activity.

Conclusions

predictors of emotional-communicative and behavioral indicators of recovery of the level of consciousness were identified: sensory and motor, cognitive and socially-oriented (orienting reactions to the voice and face of an adult, tracking the gaze of an object, sensory and motor activity, etc.). These predictors are the basis for choosing a rehabilitation program with interdisciplinary support and a treatment strategy.

Disclosure of Interest

None Declared
The Recovery concept in Assertive Community Treatment: Truth or Fake?
Authors: Martínez Jambrina J. J. , Fernández L. I. , García A. R. F. , González C. C. , Martínez C. P. , Llorca A. F. , Díaz R. A. , Ortola F. V. , Guzmán N. S.
Published: August 2024

Introduction

The concept of “Recovery” in the context of psychiatric rehabilitation has undergone significant evolution throughout history. This abstract delves into the question of the truth or falsity of this concept, examining diverse perspectives and arguments surrounding its application.

Objectives

The primary aim of this abstract is to critically analyze the concept of “Recovery” in psychiatric rehabilitation and ACT from both favorable and critical perspectives, considering its historical evolution, and highlighting key distinctions between the theories of Mike Slade and William Anthony.

Furthermore, it addresses the significance of measuring and evaluating the fidelity of healthcare practices to this mode

Methods

To conduct this analysis, an exhaustive review of current scientific literature was undertaken.  Emphasis was placed on the importance of measuring and evaluating the fidelity of healthcare practices to this model.

Results

Slade and Anthony’s theories emphasize different aspects of recovery, while implementation models translate these theories into clinical practice and services. Additionally, the discussion highlights the significance of measuring and evaluating the fidelity of healthcare practices to this model.

Assertive Community Treatment (ACT) programs have increasingly recognized the importance of the “recovery” concept in promoting the empowerment and self-determination of individuals with severe mental illnesses. This discussion examines how ACT programs have adopted recovery-oriented principles, the ways in which they implement these principles, and the potential benefits and challenges associated with their integration.

Conclusions

The distinctions between Mike Slade and William Anthony’s theories and the implementation models underscore the importance of a precise and differentiated understanding within the field of psychiatric rehabilitation.

The integration of the “recovery” concept within Assertive Community Treatment (ACT) represents a significant shift towards person-centered care in psychiatric rehabilitation. Further research and evaluation are essential to assess the effectiveness and long-term impact of this integration.

References

1.

Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11-23.

2.

Slade, M. (2009). Personal recovery and mental illness: A guide for mental health professionals. Cambridge University Press

3.

Kortrijk, H. E., Mulder, C. L., Drukker, M., Wiersma, D., & Duivenvoorden, H. J. (2020). The effects of assertive community treatment on service use in a homeless population in the Netherlands: A randomized controlled trial. Administration and Policy in Mental Health and Mental Health Services Research, 47(3), 378-387

Disclosure of Interest

None Declared
Cognitive Speech Therapy Protocol directed to Autistic Spectrum Disorder (PROFOCO-ASD): construction stage
Authors: Stlpen M. V. , Avejonas D. R. M. , Dias D. C.
Published: August 2024

Introduction

Autism Spectrum Disorder (ASD) is considered a neurodevelopmental disorder characterized by changes in cognitive aspects that influence the process of social communication development in these individuals. The Speech-Language Pathologist is the professional qualified to evaluate and intervene in cases of language impairment, however, there are few accessible cognitive assessment instruments. The Cognitive Speech Therapy Protocol (PROFOCO) is a questionnaire to assess cognitive aspects directed to children with a clinical diagnosis of Autism Spectrum Disorder (ASD).

Objectives

The present study aims to present the construction phases of the Cognitive Speech Therapy Protocol aimed at Autistic Spectrum Disorders (PROFOCO-ASD), with emphasis on the panel of experts.

Methods

The Cognitive Speech Therapy Protocol was prepared as a PhD thesis in the area of Rehabilitation Sciences at the Faculty of Medicine of the University of São Paulo (FMUSP). This is a questionnaire to investigate cognitive aspects aimed at children between 2 and 12 years old, diagnosed with Autism Spectrum Disorder, to be applied by a speech therapist and answered by parents or guardians. The construction of the protocol took place in 4 stages: experience of the authors, review of updated literature, a pre-test applied in person to 10 parents and guardians of children with ASD and the panel of experts where the protocol was analyzed by 3 specialists from area of speech therapy linked to USP AND UNIFESP, with experience in language and in the construction of protocols as criteria for selection, which analyzed the content of the questions, the vocabulary, the structure of the protocol and the answer

Results

The authors’ experience in the construction process made it possible to observe the need to introduce issues involving the adequate state of brain regulation, conditions for reception, analysis and storage of information and conditions for programming, regulation and execution of activities. The updated bibliographic review made it possible to elaborate each question based on scientific evidence. The pre-test made it possible to analyze the understanding of the proposed questions, the vocabulary used and the time required for application. The expert panel provided an analysis of the content and vocabulary, leading to relevant changes in its general context, demonstrating the importance of the expert panel phase in the development of a reference protocol.

Conclusions

The present study demonstrates the importance of the expert panel phase in structuring a screening instrument, since a different perspective from people involved in the language area can give more clarity to the questions, as well as the vocabulary used, ease of A protocol capable of being understood by a population in different contexts, its vision also evolves, in different regions.

Disclosure of Interest

None Declared
Quality of life and objective-subjective functionality in individuals with schizophrenia
Authors: Lisincki A. M. , Csizmadia L. , Szabó F. Á. , Réthelyi J. , Jekkel É.
Published: August 2024

Introduction

Chronic mental illnesses can significantly impact an individual’s quality of life and lead to functional disabilities. Scientific interest in overall quality of life and health-related quality of life has been gradually increasing, especially in the context of chronic diseases where the relationship between patients’ long-term functionality and symptom development is not always linear.

Objectives

Our research aimed to investigate the factors influencing subjective-objective well-being and in patients diagnosed with schizophrenia and schizoaffective disorder. Specifically, we examined the effects of anticipated discrimination on patients’ quality of life, satisfaction with health care, and overall functionality.

Methods

We recruited 25 patients from Semmelweis University Department of Psychiatry and Psychotherapy in Budapest, Hungary. To be eligible, patients had to meet the diagnostic criteria for schizophrenia or schizoaffective disorder according to DSM-5, cooperate with pharmacotherapy, and meet remission criteria (Andreasen et al., Am J Psychiatry 2005; 162 441-449). We collected socio-demographic data and clinical history, utilized the Mini International Neuropsychiatric Interview (M.I.N.I.) and the Positive and Negative Syndrome Scale (PANSS) to identify our clinical sample and assess the severity of symptoms. Objective and subjective functionality and well-being were measured using the Lancashire Quality of Life Profile (LQoLP). Self-reported medication adherence were measured with Morisky Medication Adherence Scale (MMAS-8). Additionally, we assessed anticipated discrimination (QUAD), and satisfaction with healthcare (CACHE).

Results

Our findings have unveiled a cross-sectional association between higher self-reported medication adherence and improved quality of life among patients with schizophrenia. Moreover, increased adherence levels, as well as greater satisfaction with healthcare, were linked to enhanced objective and subjective functionality and overall well-being. Additionally, the anticipation of discrimination was found to be associated with reduced quality of life and functionality.

Conclusions

The overall quality of life and objective-subjective functioning in patients diagnosed with schizophrenia and schizoaffective disorder can be influenced by various factors. Further research is needed to gain a better understanding of the factors associated with higher quality of life in patients.

Disclosure of Interest

None Declared
Patient satisfaction with 6-month paliperidone palmitate versus other long-acting injectable antipsychotics
Authors: Pérez-Balaguer A. , García del Castillo I. , Gómez-Esteban B. , Vicente-Burguillo M. , Vizcaíno-Herrezuelo H. , Castelao-Almodóvar S. , Arce de la Riva A. , Neira-Serrano F.
Published: August 2024

Introduction

Long-acting injectable antipsychotics (LAIs) offer advantages for schizophrenic patients compared to oral antipsychotics: less frequent dosing, lower relapse rates, better adherence, and lower healthcare costs. LAIs include paliperidone, aripiprazole, olanzapine, risperidone, and zuclopenthixol. Paliperidone palmitate is the only antipsychotic with two formulations with an administration interval longer than one month (3-monthly and 6-monthly), which could be better for the patient and help ensure treatment continuity, especially in cases of limited access to the health care system.

Objectives

To assess the satisfaction of patients under treatment with 6-month paliperidone palmitate compared to other long-acting injectable antipsychotics with a higher frequency of administration.

Methods

We analyzed the satisfaction level of a sample of patients receiving treatment with LAIs at the Mental Health Center of El Escorial. All patients had a diagnosis of schizophrenia or other psychotic disorders (according to DSM-5). Patients who met the inclusion criteria completed the Treatment Satisfaction Questionnaire for Medication (TSQM), a generic questionnaire of treatment satisfaction that measures four dimensions: side effects, treatment efficacy, comfort of use, and overall satisfaction. Other clinical and socio-demographic variables were collected, as well as the type of injectable, dose, and frequency of administration.

Results

Data from approximately 30 patients will be analyzed and discussed later.

Conclusions

Less frequent administration of LAIs may result in greater patient satisfaction and be just as beneficial clinically. Treatment satisfaction is positively associated with an improvement in psychotic symptoms and seems to be related to better adherence.

Disclosure of Interest

None Declared
Impact of negative signs on therapeutic compliance in patients with schizophrenia
Authors: Ballouk H. , Boukidi H. , Taleb K. , Belbachir S. , Ouanass A.
Published: August 2024

Introduction

Schizophrenia is characterized by a heterogeneous clinical expression. Schizophrenic symptoms fall into three main dimensions: positive, negative, and disorganized. Negative symptoms may be primary or secondary to positive symptoms.

Therapeutic compliance is essential in the management of mental illnesses and in particular schizophrenia. The associations between poor compliance and negative symptomatology are little studied even though it is found in several patients suffering from schizophrenia and is associated with a poor functional prognosis.

Objectives

The objective of this study is to evaluate the link between negative symptoms and medication adherence in patients with schizophrenia.

Methods

This is a cross-sectional study with a descriptive and analytical aim carried out among patients in whom a diagnosis of schizophrenia was made according to the diagnostic criteria of the DSM-5.

Data will be collected using an anonymous hetero-questionnaire including patients’ personal and sociodemographic data, as well as the negative symptoms subscale of the PANSS and Medication Adherence Rating Scale (MARS) which assesses therapeutic compliance.

Results

In total, we obtained a sample of 109 patients. The median age of the population is 37 years (+/- 8.2), the age varies between 18 and 64 years. The majority of patients were single, i.e. 79.6%. On average, patients had good compliance with the MARS with a mean score of 6.3 ± 1.9 [0;10]. A negative correlation between the negative symptoms subscale of the PANSS and the MARS was found significant (p=0.003), with a moderate effect.

Conclusions

This study showed that the negative signs of schizophrenia have an impact on therapeutic compliance. Therefore, it would be useful to enlarge the sample and study this association in depth in order to be able to improve these signs to ensure good care and better quality of life for these patients.

Disclosure of Interest

None Declared