bluuebunny/crossref_metadata_2025 huggingface dataset:
Suicide prevention project with young people in the Rocinha slum in Rio de Janeiro
Authors: Jorgejaber C. , Soares V. , Zanelatto P. , Muniz A. , Hollanda A. H. G.
Published: August 2024

Introduction

The 2019 WHO report on suicide warned of a serious public health problem. It was found that suicide is a serious problem for global public health, causing approximately 703 thousand deaths every year. Self-extermination is among the leading causes of death worldwide, with more deaths than from malaria, HIV/AIDS, breast cancer, war and homicide. More than one in every 100 deaths (1.3%) in 2019 were the result of suicide.Suicide is the fourth leading cause of death in older adolescents (15–19 years). Risk factors are multifaceted and include harmful use of alcohol, which includes abuse during childhood, stigma against seeking help, barriers to accessing care and means of suicide.The total number of deaths due to self-extermination registered in the adolescent population in the period from 2016 to 2021 was 6,588. According to the WHO director-general, “attention to suicide prevention is even more important now, after many months of living with the pandemic and many of the risk factors, such as loss of employment, financial stress and social isolation, still very present.” Therefore, suicide prevention work with young adolescents in Rocinha, one of the largest slums in Rio de Janeiro, is extremely important, given the increase in suicide rates and mental health problems in this age group. This approach must be thoughtful, culturally sensitive, and involve a range of strategies to address the complex issues affecting adolescents in the community. The Community of Rocinha was chosen to host this prevention project.

Objectives

Create a preventive event by surveying participants’ opinions, integrating, welcoming and deconstructing stigmas about suicide.

Methods

This study investigated, in a population of 140 young adolescents with cultural differences in a theater class, their level of knowledge regarding relevant information about suicide. A structured questionnaire was presented and answered before and after a lecture, resulting in a class at the end, carried out by the young participants themselves. The scenes were filmed and a film produced. This dynamic process also included the distribution of a shirt alluding to the fact, making the participants multiplier references.

Results

The results of the lecture showed a significant improvement in mental health awareness and willingness to seek help among young people, totaling a 20% increase in knowledge.

Conclusions

Students attended the event in significant numbers, taking into account that the slum had a curfew due to armed conflict. The results of the lecture showed a significant improvement in mental health awareness and willingness to seek help among young people, totaling a 20% increase in knowledge. The young people reported a feeling of support and belonging to the community, highlighting the importance of the debate in a final lecture given by them.

Disclosure of Interest

None Declared
Copings and suicidal ideation in men from the clinical and control groups
Authors: Medvedeva T. I. , Boyko O. M. , Vorontsova O. U. , Enikolopov S. N.
Published: August 2024

Introduction

Suicidal ideation is often an indicator of suicidal risk. However, suicidality is one of the most stigmatized themes thus suicidal ideation can be difficult to diagnose using direct questions. So, it’s impotent to look for psychological traits those may be linked to suicidal ideation. This can be useful for the diagnostic of suicidal risk and prevention of suicidal behavior. The identification of copings that correlate with suicidal ideation and do not depend on mental health allows finding universal ways to reduce suicidal risk.

Objectives

The aim of the study is to find “copings” which have universal impact on suicidal ideation in men.

Methods

The data were obtained using the study of 193 men (clinical group: 67 men with F20, F31, F33 diagnosis aged 17 to 34 (mean age 21,1±4,25); control group: 126 men aged 18 to 63 (mean age 40,04±14,71) who never asked for psychiatric assistance. 3 questions about suicidal ideation (estimate of frequency of last week with Likert’ scale from 0 - “not at all” to 4 -“extremely”), COPE (Carver, 1989). Correlation analysis (Spearman) were used.

Results

The table consists correlation that are statistically significant for both groups.Control group
question
Denial
Behavioral disengagement
Mental disengagement/self-distraction

Substance useVentingFeeling hopeless about the future,218*,177*,237**,208*,304**Thoughts of ending your life,189*,217*,240**,189*---Thoughts of death or dying,117---,290**,215*,301**Clinical groupFeeling hopeless about the future,494**,177*,478**,208*,375**Thoughts of ending your life,347**,217*,363**,342**---Thoughts of death or dying,353**---,302*,323**,249*

* - p≤0,05; ** p ≤0,01

Conclusions

Our results demonstrate that avoidant copings (Denial, Behavioral disengagement, Mental disengagement /self-distraction) link to suicidal ideation in all men regardless of their mental state. This can be explained by general pathological effect of avoidant copings of people lives: its hinder an identification and settlement of the everyday problems and its contribute to worsening of the situation. This underlines the importance of promotion more active copings as part of prevention antisuicidal work. The “Substance use” coping comforts for a while and anyway helps to formation suicidal ideation through worsening a mental and physical states, increase impulsivity. All this shows that work aimed the substance use prevention constitutes a suicidal ideation prevention work. Increased frequency of use of a Venting coping can leave men in emotional storm state that carries risk of suicide. This points to the importance of wide popularization of affordable ways to the calm, reduce of the power of emotion.

Disclosure of Interest

None Declared
Understanding the role of mental pain in suicidal individuals: from clinical to neuroimaging perspective.
Authors: Pompili M.
Published: August 2024

Introduction

In the attempt to shed light on the phenomenology of suicide, this contribution focuses on the role of mental pain as a main ingredient of suicide.

Objectives

Previous studies have shown that mental pain, childhood negative experiences, and maltreatment are associated with suicide risk. Neuroimaging studies demonstrated that such emotional pain shares the same neuroanatomical circuit of somatic pain. Furthermore, concepts related to death, failure, or other unfortunate circumstances activate specific cerebral areas in a suicidal individual compared to a non-suicidal subject.

Methods

The author, through a multicenter investigation, conducted a sizeable clinical study on mental pain related to psychiatric disorders and suicide risk. With this aim, a dataset of more than 2200 psychiatric patients is explored to investigate suicide risk, mental pain, childhood trauma, and the role of depressive symptomatology. Implications emerging from neuroimaging studies are investigated.

Results

A framework emerges about the role of childhood traumatization in mediating between suicide risk and mental pain; furthermore, when individuals experience high mental pain and high depressive symptomatology, regardless of the diagnoses, they are exposed to higher suicide risk.

Conclusions

Such results are presented in light of neuroimaging studies’ role in identifying how mental pain and brain activation are detected in suicidal individuals. Therefore, this contribution aims to understand better mental pain’s role in clinical practice and research activities.

Disclosure of Interest

None Declared
Statistical model of the dynamics of suicides in ukraine before a full-scale war
Authors: Khaustova O. , Omelyanovich V.
Published: August 2024

Introduction

The problem of suicides is one of the most critical problems of the public health care system. In Ukraine, official data on the number of deaths and their causes were released by the State Statistics Service only in 2021, on the eve of a full-scale military invasion. This made it possible to conduct statistical analysis and build a mathematical model of the seasonal dynamics of suicidal activity in Ukraine.

Objectives

Develop a statistical model of the dynamics of the number of completed suicides, considering regions of Ukraine and months. For this, a time series of the number of suicides from 2005 to 2021 was created, a mathematical and statistical analysis of the dynamic characteristics of the time series was carried out, and a forecast of the dynamics of the number of completed suicides was built.

Methods

Time series analysis using autocorrelation analysis with the calculation of Leung-Box statistics and the method of seasonal exponential smoothing were applied.

Results

Autocorrelation of the absolute indicators of the number of completed suicides made it possible to construct correlograms for each separate region of Ukraine. In order to ensure the statistical reliability of the autocorrelation coefficients, the number of lags was equal to 50, based on the fact that k ≤ n/4, where k is the maximum number of lags, and n is the number of observations. The correlograms of the regions that characterized the built statistical model of the dynamics of changes in the number of completed suicides were clustered in the form of four groups. The calculation of the coefficient of determination indicated that a high proportion of the total variation for Ukraine as a whole (R2=0.656) and for its individual regions (R2=0.731±0.051) can be explained using the model we built, and the model itself should be evaluated as consistent. Based on the developed model, it was established that the period from March to May, July and, to a lesser extent, January is characterized by the highest number of suicides.

Conclusions

The constructed statistical model of the dynamics of suicides in Ukraine is coherent and statistically reliable. It can be used for forecasting, provided corrections are made, taking into account the social changes of wartime. The study of chronobiological aspects that drew attention during the analysis is promising for further targeted scientific research and may be of practical interest for the creation of national suicide prevention programs in Ukraine.

Disclosure of Interest

None Declared
Understanding collective suicides in Morocco: A 35-year epidemiological study
Authors: Boukhorb S. , Hmimou S. , Irnat S. , Hadrya F. , Rhalem N. , Bellimam M. A. , Soulaymani A. , Mokhtari A. , Soulaymani-Bencheikh R. , Hami H.
Published: August 2024

Introduction

Suicide is a major public health concern, ranking among the leading causes of death worldwide.

Objectives

This study investigated the epidemiological features of collective suicide incidents in Morocco.

Methods

We performed a retrospective analysis of suicidal poisoning cases recorded by the Moroccan Poison Control Center (MPCC) over a 35-year period.

Results

During the study’s duration, the MPCC recorded 168 suicide cases. The mean age of those involved in these incidents was 23.9 years, with a female-to-male ratio of 1.57. The majority of those affected were adolescents and young adults, specifically between 15 and 34 years of age. Pesticides and drugs were the most commonly used methods of suicide and accounted for 31.1% and 20.1% of the cases, respectively. The majority of incidents occurred in the home environment and were primarily caused by oral exposure. The symptoms of poisoning varied according to the consumed substance, amount ingested, and elapsed time until medical treatment. The symptoms included disturbances in the neurological, gastrointestinal, respiratory, and cardiovascular systems. Of the 100 cases with known outcomes, one person died due to poisoning, whereas the remaining cases survived, although some enduring complications.

Conclusions

Suicide accounted for 1.3% of global mortality, ranking as the 17th most common cause of death in 2019, according to data from the World Health Organization (WHO). This trend emphasizes the urgent need for continuous efforts at all levels to address and mitigate this rapidly growing issue.

Disclosure of Interest

None Declared
“Where are we headed?” To better understand the career paths and barriers psychiatrists, psychologists, and psychotherapists face in Hungary. An outline of a quantitative and qualitative study
Authors: Bitter I. , Péley B. , Bérdi M. , Henrietta B. , Farkas K. , Gergics E. , Nagy P. , Pál K. , Ungvári B. , Szabó P. , Tiringer I. , Fülöp M. , Szőnyi G.
Published: August 2024

Introduction

Becoming a psychiatrist, clinical psychologist or psychotherapist involves a complex set of skills that require extensive training. Clinical practice development and professional and personal identity formation are closely intertwined and continue throughout one’s career. Individual and environmental factors influence dropout. The beginning stages of training are incredibly challenging for trainees and can be a time of vulnerability as they face early professional hurdles. We propose that certain educational factors, such as inadequate practical training and insufficient emotional support during professional dilemmas, play a crucial role in manifesting burnout or other symptoms, potentially leading to stagnation in one’s career.

Objectives

The main objective of our study is to identify causes of disruption and/or discontinuation of the training/residency programs in psychiatry, clinical psychology, and psychotherapy. Our study also aims to highlight the causes of chronic exhaustion among trainees in mental health professions.

Methods

The research team has developed a comprehensive questionnaire including two validated psychometric scales, the Effort-Reward Imbalance Questionnaire (ERI, Siegrist et al. Soc Sci Med 2004; 58 1483-99, Salavecz et al. J Men Psychosom 2006; 7 231–246) and the Mental Health Test (MHT, Vargha et al. J Men Psychosom 2020; 21 281–322). A quantitative analysis (Braun et al. Qual. Res. Psychol. 2006; 3 77–101) will be performed on the responses, following which interviews will be conducted with previous volunteers who participated in the study. The interviews will be evaluated through content analysis. Our survey is prepared with the involvement of all significant training centers in Hungary. The study was approved by the United Ethical Review Committee for Research in Psychology (EPKEB, approval numbers: 2021-109, 2023-101).

Results

The participants’ main characteristics and the questionnaires’ results will be summarized with standard statistical methods, while the interviews will be analyzed with the help of qualitative methods.

Conclusions

Based on the results of the described study, we aim to investigate the educational system’s impact on the career development and commitment of psychiatrists, psychologists, and psychotherapists in Hungary. Additionally, the research will yield valuable perspectives on how these factors affect the mental well-being of these professionals. Ultimately, the results could help address areas of concern and improve mental health professionals’ training.

* Presenting author

** The two authors contributed equally.

Disclosure of Interest

None Declared
Perceived stigma evaluation among residents in psychiatry
Authors: Masmoudi R. , Ajmi S. , Guermazi A. , Cherif F. , Sallemi R. , Masmoudi J.
Published: August 2024

Introduction

The nature of psychiatry as a specialty dealing with mental health and emotional well-being may contribute to the perceived stigma. These misconceptions and biases can impact the way psychiatry residents perceive their profession, their own self-esteem, job satisfaction, and overall well-being.

Objectives

Our goal was to evaluate the experience of stigma among psychiatry residents.

Methods

A descriptive cross-sectional online survey was conducted in January 2022 among psychiatry residents at Hedi Chaker University Hospital in Sfax, Tunisia.

The Clinician Associative Stigma Scale (CASS) was used to assess stigmatization experiences.

Results

A total of 34 residents participated in this survey. Their average age was 27.94 years ± 2.43, with 91.2% being female. Of the participants, 61.8% were adult psychiatry residents, and 39.2% were child psychiatry residents. Additionally, the choice of adult psychiatry or child psychiatry specialty was self-determined in 91.2% of cases. The participants had an average of 2 years of experience in psychiatry. They reported a personal medical or surgical history, a personal psychiatric history, and a family history of psychiatric disorders in 32.4%, 8.8%, and 50%, respectively. The average CASS score was 47.09 ± 8.32.

The mean scores for the “discomfort with disclosure” factor, the “stereotypes about mental health professionals” factor, the “negative stereotypes about individuals with serious mental illness” factor, and the “negative stereotypes about effectiveness” factor were respectively 8 ± 3, 9.44 ± 2.57, 15.62 ± 5.7, and 11.35 ± 3.33.

Conclusions

Our study highlighted that residents in psychiatry suffered stigma. Special attention should be given to reducing this phenomenon in this population.

Disclosure of Interest

None Declared
Professional quality life of psychiatry residents in Tunisia
Authors: Masmoudi R. , Ajmi S. , Guermazi A. , Guermazi F. , Baati I. , Masmoudi J.
Published: August 2024

Introduction

The professional quality of life for psychiatry residents is a complex and multifaceted aspect of their careers. However, the demanding nature of their work can place significant stress on their own psychological well-being. Balancing the need to care for patients while also managing personal and professional responsibilities can be challenging. Nevertheless, psychiatry residents have the opportunity to make a profound impact on the lives of their patients and find fulfillment in their work.

Objectives

To assess the prevalence of burnout (BO) and secondary traumatic stress (STS) among psychiatry residents.

Methods

We conducted a descriptive online cross-sectional survey in January 2022 among psychiatry residents practicing at Hedi Chaker University Hospital in the Sfax region in Tunisia. Professional life quality was evaluated using The Professional Quality of Life Scale - 5 “ProQOL-5”.

Results

The total number of residents was 34, of which 91.2% were female. Their mean age was 27.94 years±2.43. They were single in 67.6%. They were residents in adult psychiatry in 61.8% and in child psychiatry in 39.2%. For 91.2% of them, the specialty of adult or pediatric psychiatry was their own choice. The individuals had been practicing psychiatry for an average of two years. They reported a personal medical or surgical history, a personal psychiatric history, and a family history of psychiatric disorders in 32.4%, 8.8%, and 50%, respectively.

On the ProQOL-5 scale, we found that 88.2% of the residents had a moderate level of compassion satisfaction, 67.6% had a moderate level of burnout, and 52.9% had a moderate level of secondary traumatic stress.

Conclusions

Our study showed a moderate professional life quality among psychiatry residents, hence the importance of implementing intervention strategies.

Disclosure of Interest

None Declared
Are we braver today in using antidepressants perinatally?- own clinical experiences
Authors: Matić K. , Vuk Pisk S. , Ivezić E. , Grošić V. , Filipčić I.
Published: August 2024

Introduction

Affective disorders are among the most common mental health problems in women of reproductive age. A life-changing condition, such as pregnancy, may trigger or intensify symptoms of affective disorders, rather than pregnancy being a protective factor for the development of the disorder, as previously thought. Previous research indicates that 18% of women suffer from perinatal depression. One in 7-10 pregnant women and 1 in 5-8 midwives develops a depressive disorder, which is more than half a million women a year. Untreated perinatal depression has significant repercussions for both mother and child. Given that there are no controlled randomized studies during pregnancy, and the results of previous research on the harmfulness of the use of psychotropic drugs are contradictory, we need to nurture an individualized and integrative approach to the use of psychotropic drugs in pregnant women and in the postpartum period. The goal of this lecture is to point out the necessity of treating perinatal depressive disorder with an emphasis on the need to work on dilemmas and selected sources of information by pregnant women themselves, as well as health professionals. In the end, I must emphasize the importance of choosing an adequate psychopharmaceutical in that sensitive period for a woman, nurturing an individual approach as well as the latest knowledge.

Objectives

The aim of this research is to examine the attitudes of psychiatrists, GP doctors, gynecologists and pregnant women about prescribing and taking pharmacotherapy during pregnancy.

Methods

The research will be conducted at the psychiatry clinic, the gynecology clinic and in health centers through semi-structured questionnaires, which will be filled out by psychiatrists, gynecologists, doctors and pregnant women.

Results

Preliminary results (given that the research is still ongoing) indicate that most psychiatrists avoid prescribing drugs during pregnancy, and if they decide to do so, then diazepam is prescribed. The views of gynecologists, family medicine doctors and pregnant women are still pending.

Conclusions

This lecture aims to point out the factors contributing to the fear of prescribing psychotropic drugs perinatally, based on our own research, which included psychiatrists, gynecologists, family medicine doctors, and pregnant women.

Disclosure of Interest

None Declared
Deliberate self-harm and suicide in people with immigrant background: how can reason for immigration and country of origin differentiate the risks?
Authors: Qin P.
Published: August 2024

Introduction

A growing body of research have devoted into suicide and deliberate self-harm in immigrant population, but no study has examined how reason for immigrating to the host country differentiates the risks.

Objectives

To gain firm insight into suicide and deliberate self-harm among peopel with immigrant background.

Methods

Norwegian registers were interlinked to identify all individuals who died by suicide in 1992-2018 and who received emergency treatment for non-fatal deliberate self-harm (DSH) in 2008-2018, and to construct the respective databases via a nested case-control design. Rates and relative risks of suicide and DSH were assessed according to immigrant background, country of birth and reasons of immigration, and in the context of personal socioeconomic status.

Results

People with an immigrant background accounted for 11.6% of all suicides in 1992-2018 and 17.9% of all DSH incidents treated in hospital emergency departments in 2008-2018. The rates of both suicide and DSH were highest in people born abroad with two Norway-born parents (mean rate: 19.4/100 000 for suicide and 280.9/100 000 for DSH) and lowest in the second-generation immigrants. Compared with the native Norwegians, suicide risk was significantly higher for those foreign-born with two Norway-born parents (HR=1.50) and those born in Norway with 1 one foreign-born parent (HR=1.20), but was significantly lower for the first- and second-generation immigrants. The associated risks remained almost unchanged when the data were adjusted for personal differences in education, marital status, income and place of residence in Norway. The analyses on deliberate self-harm exhibited similar patterns of results as for suicide, although the estimated reduced risks in the first- and second-generation immigrant is somewhat smaller. Evidently, the risks for suicide and DSH varied significantly by reason of immigration and country of origin. Immigrants coming for education had the lowest risk for suicide and self-harm, and those coming for work the second lowest. The risks for immigrants coming for family unity were lower than the natives, but significantly higher than counterparts coming for job or education from the same country. Among immigrants coming to Norway as a refugee or asylum seeker, the risk of suicide was comparably high as those coming for work, but the relative risk for self-harm was significantly higher. The increased risks associated with the mixed immigration background tended to be slightly higher in females than in males, and were likely confined to adoptee population.

Conclusions

Risks for suicide and deliberate self-harm in people with an immigrant background differs significantly by reason of immigration and country of origin. The findings should be taken into account in efforts of mental healthcare and suicide prevention targeting immigrant population.

Disclosure of Interest

None Declared
Home Treatment and Perinatal Psychiatry: An Alternative to Acute Psychiatric Wards
Authors: Marti Bonany J. , García Hernández D. , Romar Navia R. , Tolosa Merlos D. , Casanovas Martínez F. , Llimona Sánchez C. , Pérez Oms A. , De Iturbe Catania G.
Published: August 2024

Introduction

Women experiencing severe perinatal mental health problems require specialized services and care. Perinatal mental disorders are common and can contribute to maternal mortality, affecting neonatal, infant, and child outcomes. Home treatment can prevent hospital admissions and promote strategies within the patient’s support network.

Objectives

Our aim is to describe a clinical case in perinatal psychiatry managed by a Psychiatric Home Treatment Unit.

Methods

We present a case of perinatal psychotic depression in a 26-year-old pregnant woman.

Results

We describe the case of a patient with no prior history of mental health issues. She was 25 weeks pregnant when she first sought psychiatric help in July 2023 and was diagnosed with depressive disorder with psychotic symptoms. She reported symptoms such as low mood, psychomotor inhibition, delusional guilt thoughts, and auditory hallucinations beginning three weeks before her initial visit. Due to her clinical presentation, the patient was admitted to the hospital, where pharmacological treatment was initiated with Olanzapine 5 mg, Sertraline 50 mg, and Lorazepam 1.5 mg. She remained in the hospital for four days, during which she showed gradual improvement but did not achieve full recovery.

Considering the improvement observed, home treatment was proposed and accepted by the patient and her relatives. During home treatment, she continued to exhibit persistent depressive and psychotic symptoms, including low mood, inhibition, and delusional thoughts of ruin and catastrophe. Therefore, her treatment was adjusted, with Olanzapine increased to 10 mg, Sertraline raised to 100 mg, and Lorazepam reduced to 0.75 mg. Over time, significant improvement in her clinical symptoms was noted. Throughout the follow-up period, she reported no significant side effects from the pharmacological treatment. After a month of follow-up in our department, she was discharged with outpatient care provided by a specialized community perinatal psychiatric unit.

Conclusions

We illustrate the possibility of home treatment for perinatal psychiatric disorders. The potential benefits of remaining close to one’s support network and developing coping strategies can be advantageous during the course of illness. Further studies should be conducted to explore these potential benefits.

Disclosure of Interest

None Declared
Postpartum Psychosis and Maternal Filicide- Case Report and Literature Review
Authors: Ali O. , Islam S. , Raai H. , Troneci L.
Published: August 2024

Introduction

Postpartum period is defined as the 12 weeks following the birth of a child as per ACOG guidelines. This period is crucial for women to physically and emotionally adapt to major changes in their lives. If concerns are not addressed properly it can result in fatal outcomes such as filicide and suicide in context of untreated mental illness with postpartum onset. Postpartum psychosis is considered a psychiatric emergency and literature shows that up to 4.5% of patients with depressive symptoms with psychosis commit filicide. However, postpartum psychosis is not recognized as a formal psychiatric disorder in DSM-5, leading to a delay in identification and treatment of the condition in a timely fashion.

Objectives

The primary purpose of the case report is to inform the clinical picture and the legal implications associated with postpartum psychosis, a poorly understood and underdiagnosed psychiatric illness and to emphasize the importance of considering other psychiatric illnesses with peripartum onset that affect maternal and pediatric population wellbeing.

Methods

A comprehensive review of literature using databases, such as PubMed and Google Scholar as well as observation of the patient in the Emergency Department by the psychiatry team.

Results

We present the case of a female in her 20s, mother of two toddlers, with a history of PTSD and postpartum depression, who was brought to our Emergency Department for stabbing her children in the context of a psychotic episode. The patient endorsed persecutory delusions and religious preoccupation, stating that she was experiencing “demonic energy inside” and that demons were speaking through her sons. Upon further assessment, it was noted that symptom onset was during the peripartum period, initially with depressed mood, and later with psychotic features. Organic causes of psychosis were ruled out with an extensive workup. Patient was transferred to an inpatient forensic unit for further stabilization. From a legal perspective, literature review shows that mothers may face the death penalty in the US in contrast with other countries such as England for instance. In the context of the current case, the plausible diagnoses are MDD with psychotic features or the first psychotic episode with peripartum onset that was left untreated resulting in a fatal health and legal outcome.

Conclusions

As postpartum psychosis is not currently recognized as an independent diagnosis under the DSM-5, further attention is warranted for such critical psychiatric condition that afflicts the lives and well-being of the maternal and pediatric populations globally. Postpartum psychosis affects mothers despite their past psychiatric history, socioeconomic status, educational level, and supportive network. Thus, it is essential to target proper and timely identification of symptoms and address those to prevent filicide and maternal suicide.

Disclosure of Interest

None Declared
Tell me who you’re coming with, I’ll tell you what you have!
Authors: Castro Sousa B. , Correia Z. , Ramos J.
Published: August 2024

Introduction

Psychiatric care is unique in its scope and complexity, as it involves the assessment and treatment of a wide variety of pathologies and, as these patients seek treatment, it is imperative to understand who accompanies them in clinical consultations and how the presence of these companions influences the treatment path. The dynamics between psychiatric patients and their companions in consultation, is extremely important as it can have significant implications for the effectiveness of treatment and the well-being of the patient.. Therefore, the presence of companions can take different forms, varying according to the diagnosis and needs of each person.

Objectives

Thus, the authors intend, through carrying out a research study, to fill a critical gap in the understanding of presence of companions in psychiatric consultations, exploring the diversity of companions and their profiles in relation to patients psychiatric patients with specific diagnoses. Furthermore, they intend to understand how their presence impacts the process of adherence to the treatment.

Methods

To achieve this, they defined a two-year follow-up period, where they examined in detail the composition of companions in psychiatric consultations, including who they are, their relationship with the patient and how this relationship varies according to different psychiatric diagnoses.

Results

The presence of companions in psychiatric consultations is expected to prove to be a significant facet in the field of mental health, providing valuable insights into the dynamics of consultations and the treatment of patients with different psychiatric diagnoses. In this study we highlight how the presence of companions varied in relation to psychiatric diagnoses and how this influenced the process therapeutic. One of the main results was the identification of the different types of companions who were present at the consultations psychiatric disorders, reflecting the diversity of available social support and highlighting the importance of understanding the available support networks. A notable variation in the presence of companions in relation to psychiatric diagnoses was also observed, emphasizing the variations monitoring needs according to the nature of psychiatric disorders, suggesting the need for management strategies personalized treatment. This study also highlighted the influence of the presence of companions on doctor-patient communication and on adherence to treatment, in which the presence of family members often facilitated communication, allowing for a better understanding comprehensive history of the patient.

Conclusions

In conclusion, this study contributes to a more holistic understanding of mental health care provision, highlighting the importance to consider not only the patient, but also the support context in which they are inserted

Disclosure of Interest

None Declared
Facilitating effect of the hypnotically altered state of consciousness on decision-making in a situation modeling real-life
Authors: Kovács Z. A. , László S. , Albert A. , Janka Z. , Szendi I.
Published: August 2024

Introduction

Numerous studies have shown a link between hypnotic susceptibility, the hypnotically altered state of consciousness, and the intensity of experienced emotions (De Pascalis et al., 1987; De Pascalis, Marucci, & Penna, 1989; Bryant & McConkey, 1989; Crowson, Conroy, & Chester, 1991; Crawford, Kapelis, & Harrison, 1995). One of the most suitable experimental psychological methods for modeling real-life decisional conditions is the Iowa Gambling Task (IGT) (Bechara, Tranel, & Damasio, 2000). Hypnosis has the potential to provide several benefits in decision-making, although there is limited scientific research on the subject.

Objectives

The main goal of this study was to determine if a hypnotically altered state of consciousness could affect decision efficacy in a real-life modeling situation.

Methods

Forty-eight healthy students (including 28 females and 20 males) from the University of Szeged participated in both the delayed punishment and delayed reward versions of the Iowa Gambling Task under alert and hypnotic states.

Results

During the mid-phase of the tasks while in hypnosis, notably higher performance levels were recorded compared to the alert state. In a simulated real-life scenario, the delayed reward had a more pronounced effect on decision-making efficiency than the delayed punishment. It became evident that the efficient decision-making strategy evolved more rapidly under hypnosis than in an alert state.

Conclusions

The hypnotic state of consciousness in an experimental decision situation modeling real life may accelerate the development of somatic markers, leading to earlier correct decision-making.

Disclosure of Interest

None Declared
Exploring Exercise Intervention as a Therapeutic Catalyst within the Mental Health and Addiction Program in Nova Scotia: A Proof-of-Concept Study
Authors: Obeng Nkrumah S. , da Luz Dias R. , Eboreime E. , Agyapong B. , Sridharan S. , Agyapong V. I. O.
Published: August 2024

Introduction

Many mental health conditions, including anxiety, mood disorders, and depression, can be effectively treated at a relatively low cost. Exercise interventions can be a therapeutic strategy, but even though exercise has consistently been shown to improve physical health, cognitive function, and psychological well-being, as well as reduce depression and anxiety symptoms, this intervention is often neglected in mental health care services.

Objectives

The study aims to assess the feasibility of incorporating an Exercise Intervention Program (EIP) as a therapeutic pathway within the Mental Health and Addictions Program (MHAP) in Nova Scotia, as well as to evaluate the effectiveness of the program on mental health outcomes and incremental costs, and the patient acceptability and satisfaction with the program.

Methods

This proof-of-concept study has a pragmatic, prospective, controlled observational design with an embedded one-phase qualitative component. Patients with a primary diagnosis of depression or anxiety attending the Rapid Assessment and Stabilization Program (RASP, Halifax, Nova Scotia, Canada) will be offered to receive 60-minute exercise sessions three times per week, per 12 weeks. Patients with similar mental health conditions that have opted to wait for Cognitive Behavioral Therapy (CBT) with the community provider and declined from the EIP will be part of the control group. A certified recreational therapist will conduct the EIP. Participants of both groups (EIP and control condition) will be assessed at baseline and then weekly for four weeks, six weeks and then at 12 weeks post-enrollment. Primary outcomes include differences in the mean change in functional (well-being, resilience, and recovery) and symptom variables (depression, anxiety, and suicidal risk), which will be assessed through online validated scales/questionnaires. Service variables (patient acceptance and satisfaction) and health care utilization (crisis calls, emergency department visits, hospital admissions and readmissions, length of stay for each admission) will comprise the secondary outcomes.

Results

The results of the study will provide information about the effectiveness of EIP in the treatment of anxiety and depression compared to those only wait-listed to receive CBT or counselling from a CMHA provider. The study will also inform about the acceptability and satisfaction of the EIP, as well as the incremental cost-effectiveness of the intervention compared to the control condition.

Conclusions

This proof-of-concept study will demonstrate the effectiveness of EIP as an adjunctive or alternative therapeutic option for the treatment of anxiety and depression in patients seeking mental health support from the MHAP in Nova Scotia.

Disclosure of Interest

None Declared
Factors Driving the Emigration Intentions of Young Tunisian Medical Professionals
Authors: Haouari W. , Omri S. , Labyadh A. , Feki R. , Gassara I. , Charfi N. , Ben Thabet J. , Maalej M. B. , Smaoui N. , Zouari L. , Maalej M.
Published: August 2024

Introduction

Emigration has a substantial impact on Tunisia’s healthcare sector. Graduates, including medical students at different educational levels, as well as general practitioners and specialists, often choose to emigrate. Some do so to pursue further studies abroad, while others seek careers and settlement primarily in Europe. This phenomenon exerts a significant influence on the quality of healthcare systems in their home countries.

Objectives

To evaluate the inclination to emigrate among medical residents employed in Tunisian healthcare institutions and to identify the factors associated with this intention.

Methods

This is a descriptive cross-sectional study conducted among medical residents undergoing their training in various healthcare facilities in Tunisia. The study employed an online questionnaire to assess the degree of satisfaction with various aspects of their professional life and the socio-economic situation in the country, as well as their intention to emigrate. Satisfaction levels were measured using a 4-point Likert scale, ranging from “very dissatisfied” to “very satisfied”.

Results

A total of 50 physicians participated in the survey. Among them, 72% were female, 80% were single, with an average age of 27.72 years at the time of the study. Regarding their professional status, 84% worked in university hospitals, 16% specialized in surgery, 40% specialized in medicine, and 44% were family physicians. The majority were students from the Faculty of Medicine in Sfax (56%), with 30% in Monastir, 8% in Tunis, and 6% in Sousse. The study found that 68% of medical residents expressed an intention to emigrate. Among the participants, 74% were dissatisfied with their working conditions, and 68% were dissatisfied with workplace safety. Additionally, 84% were dissatisfied with their salaries, 40% with their workload, 54% with supervision, and the quality of training provided in their hospitals. The political situation in the country and social security were considered unsatisfactory by 92% and 90% of the participants, respectively. Among the potential reasons studied to explain this emigration phenomenon, working conditions were a factor in 54% of cases, salary in 56%, training in 36%, and quality of life in 56%.

Conclusions

The emigration of young Tunisian medical professionals is driven by a range of factors, including working conditions, salaries, training opportunities, and quality of life. To counteract this phenomenon, it is crucial to enhance these aspects in order to retain these talented individuals in the country and thereby bolster the Tunisian healthcare system.

Disclosure of Interest

None Declared
A thematic analysis of the introduction of smart-hub technology to a rural Psychiatry of Old Age Service during Covid-19 lockdowns
Authors: Patel S. , Gannon A. , Cryan M. , Dolan C. , McDonald C. , Houghton C. , McCarthy G.
Published: August 2024

Introduction

The use of smart technology in supporting older adults is a growing field of research. However, there is little qualitative research on the experiences of patients utilizing this technology, particularly those attending psychiatry services.

Objectives

To explore the experiences of staff and patients utilizing smart-hubs implemented during the Covid-19 pandemic to provide remote audio/visual communication and smart AI personal assistant technology for the management of patients in a rural Psychiatry of Old Age service.

Methods

Smart hubs were installed in patient homes and in the Psychiatry of Old Age base during the Covid-19 pandemic when lockdown restrictions limited in-person service provision. Patients and staff utilized the smart hubs for its assistive technology and to engage with each other. Semi-structured qualitative interviews were conducted of 10 staff and 15 patients at 6-12 months following the introduction of the smart hubs and thematic analysis was conducted to generate themes.

Results

Three themes were generated from the thematic analysis: 1) Openness to SMART hub technology, 2) Getting set-up and 3) Keeping SMART. The majority of participants did not have much experience using smart technology prior to the intervention. However, many participants reported that they would be comfortable using technology. The Covid-19 pandemic contributed to the rapid adoption of this intervention within the service with mixed views regarding the smart hub prior to implementation. The role of key individuals such as staff and family was highlighted in supporting older persons with setting-up the smart hub. Technical needs included the need for a strong internet connection and technical limitations were driven by privacy, cost and regional considerations. Many patients were able to utilize the smart hub independently to access interests, therapeutic activities and as a memory aid. The smart hub offered a novel way to connect to services and families and was also seen as a companion by some patients and staff to help address loneliness and isolation. The majority of participants found the use of smart hubs acceptable and were willing to utilize the smart hub in the future as an adjunct to face to face psychiatric interventions. However, suggestions for future use included the need for additional training as users felt that there was more they could do with the smart hub, continued support to manage any challenges and improved information leaflets to better engage users.

Conclusions

Smart hub technology offers an alternate means of providing remote and inclusive psychiatric care to older patients unable to access services in person and at risk of deterioration without intervention in the community.

Disclosure of Interest

None Declared
Longitudinal amygdala resting state functional connectivity develops differently in adolescents with internalising disorders compared to healthy peers
Authors: Roelofs E. , Bas-Hoogendam J. M. , van der Wee N. , Vermeiren R.
Published: August 2024

Introduction

Longitudinal neuroimaging studies focused on adolescents with internalising psychopathology (i.e. with clinical anxiety and/or depression) are scarce, even though anxiety and depression are highly prevalent mental illnesses in adolescence. Often linked to comorbidity with anxiety disorders, a large proportion of depressed adolescents displays more severe symptoms and poorer response to treatment. Previous longitudinal resting-state fMRI (RS-fMRI) studies of intrinsic functional connectivity (iFC) in depressed adolescents point to dysregulation of underlying neural networks such as the corticolimbic network, including among others the amygdala and frontal regions, which are involved in emotion processing and regulation.

Objectives

This naturalistic study investigates longitudinal changes in resting-state iFC in adolescents with internalising disorders, compared with healthy peers.

Methods

23 treatment naïve adolescent patients with clinical depression and comorbid anxiety (INT) and 24 healthy controls (HC) participated in RS-fMRI scans at baseline and after three months. Questionnaires measuring anxiety and depression were completed at both timepoints. Imaging analyses were conducted using independent component analysis (ICA) to extract 7 networks, being the default mode, frontoparietal (bilateral), affective, salience, executive control and dorsal attention network. Additional iFC of amygdala subregions, being laterobasal (LB) and centromedial (CM), was investigated using seed-based analyses. To investigate changes over time between groups, voxelwise analyses were conducted using FSL’s PALM.

Results

No significant results within ICA defined networks were found. iFC between the left LB amygdala and left frontal pole significantly increased over time in patients and decreased in HC. iFC between the right LB amygdala and right pre- and postcentral gyrus also significantly increased over time in patients and decreased in HC, and was significantly associated with reduction in depressive symptoms within patients.

Conclusions

This study provides initial evidence that iFC between the laterobasal amygdala and frontal regions develops differently over time in adolescents with internalising disorders compared to healthy peers and that it is associated with reduction in depressive symptoms.

Disclosure of Interest

None Declared