bluuebunny/crossref_metadata_2025 huggingface dataset:
Adjunctive Therapy of Text4Support for Treatment-Resistant Depression Patients Receiving Repetitive Transcranial Magnetic Stimulation. A Multicenter Randomized Controlled Pilot Trial
Authors: Adu M. K. , da Luz Dias R. , Agyapong B. , Flynn M. , Hassan S. , Sridharan S. , White M. K. , Agyapong V.
Published: August 2023

Introduction

Despite several treatment strategies for treatment-resistant depression (TRD) exist, including the use of repetitive transcranial magnetic stimulation (rTMS), new therapeutic options are being introduced. Text4Support is a form of cognitive behavior therapy that allows patients with depression to receive daily supportive text messages that seek to correct or alter negative thought patterns through positive reinforcement. Text4Support is deemed a useful augmentation treatment strategy for patients with TRD. It is however currently unknown if adding the Text4Support intervention will enhance patients with TRD’s response to rTMS treatments

Objectives

This study aims to assess the initial comparative clinical effectiveness of rTMS when used with and without the Text4Support program as an innovative patient-centered intervention for the management of participants diagnosed with TRD.

Methods

This study is a multicentered prospective, parallel-design, two-arm, rater-blinded randomized controlled pilot trial. In total, 200 participants diagnosed with TRD will be randomized to one of two treatment arms (rTMS alone and rTMS with Text4Support). Participants in each arm will be made to complete evaluation measures at baseline, 1,3, and 6 months. The primary outcome measure will be the mean change to scores on the Hamilton Depression Rating Scale. Patient service utilization data and clinician-rated measures will also be used to gauge patient progress. Patient data will be analyzed with descriptive statistics, repeated measures, and correlational analyses.

Results

The result of the study is expected to be available 18 months after the start of recruitment. We hypothesize that participants enrolled in the rTMS plus Text4Support intervention will achieve superior outcomes compared with participants enrolled in the rTMS treatment alone.

Conclusions

The concomitant application of the combination of these two treatment techniques has not been investigated previously. Therefore, we hope that this project will provide a concrete base of data to evaluate the practical application and efficacy of using a novel combination of these two treatment modalities.

Disclosure of Interest

None Declared
Helping the forcely displaced persons - situation in Hungary
Authors: Szekeres G. T.
Published: August 2023

In recent years, the state-funded side of the Hungarian psychiatric system has been struggling with a serious lack of resources. During the pandemic the level of organization, which was also not perfect, continued to deteriorate. Immediately after the breakout of Ukrainian war the civilians started to make significant efforts to support refugees. From the beginning our Association joined activities of Solidarity Network organized by EPA. We made efforts among other things to find Ukrainian-speaking psychiatrists to tackle the language barriers, connect the needs with the offers psychologists. When a refugee is admitted to a psychiatric unit as a patient, they receive all mental health care as any Hungarian citizen would. Overall however, mental care is insufficiently organized and the patient pathways for refugees - as those of the population - are not well-defined. The coordination between government services and civil organizations helping refugees is unsatisfactory. There is no steady support system that could provide regular, professional mental health care for those in need, thus a mental triage process is also missing to uncover the perhaps less severe mental problems, that nevertheless might require professional attention. Consequently there also seems to be a lack of assistance in trauma processing. There are some official civil organizations (e.g. Maltese Charity Service, Hungarian Red Cross) that are doing all they can for the refugees, but most of their staff is not professionally equipped to provide mental health care or to reliably identify when it is needed. When refugees show symptoms of a severe nature (psychosis, mania, severe depression, suicidal thoughts) they reach out to the professional mental health care system, but refugees struggling with less obvious mental health problems generally stay out of sight of professional psychiatric or psychological care.

Keywords

civilian efforts, unmet needs, lack of human resource

Disclosure of Interest

None Declared
Intranasal esketamine + Intensive CBT: a 12 months follow-up of two complicated cases of Treatment Resistant Depression at high suicidal risk
Authors: Martiadis V. , Raffone F. , Cerlino R. , Testa S. , Russo M.
Published: August 2023

Introduction

Treatment Resistant Depression (TRD) is a complex, heterogeneous and multifactorial clinical condition that affects patients’ quality of life, their psychosocial functioning as well as suicidal risk. Intranasal esketamine is a new add-on treatment specifically approved for TRD.

Objectives

The aim of the study was to evaluate the efficacy and safety of intranasal esketamine treatment combined with intensive Cognitive Behavioral psychotherapy (CBT), together with treatment satisfaction, in two complex clinical cases of TRD with high suicidal risk in a 12 months follow-up.

Methods

Two male patients, 67 and 63 years old, with TRD, defined by at least two therapeutic failures with SSRI/SNRI and positive screening for high suicidal risk at the Columbia Suicide Severity Rating Scale, were selected for treatment with intranasal esketamine + CBT as an add-on to SSRI/SNRI antidepressant therapy. Psychopathological assessment were made by means of Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Columbia Suicide Severity Rating Scale (C-SSRS), Clinical Global Impression (CGI), Short Form Health Questionnaire (SF-36 items) at T0, every 7 days for the first 3 months, then every month. Treatment satisfaction was evaluated by means of the Client Satisfaction Questionnaire (CSQ-8), administered by trained nursing staff at 1, 3, 6 and 12 months. CBT specifically focused on depression was administered by a certified psychotherapist, weekly for the first 4 months, fortnightly for the next 3 months, monthly for the remaining 3 months.

Results

After 2 administrations of esketamine the total HAM-D score was reduced by an average of 10 units and the suicidal risk was progressively reduced to zero according to C-SSRS. After 12 months one of the two patients reached and actually maintains clinical remission; the other one maintains a condition of mild depression; both without suicidal ideation and with a significant increase in perceived quality of life. Treatment was well tolerated, with mild and temporary adverse effects, self-limited to the administration sessions. CBT has contributed to increasing insight, cognitive resources, social interaction and self-esteem, and has made it possible to structure and carry on new life projects. The variation of the mean scores for CSQ-8 shows that esketamine + CBT treatment was considered as very satisfactory throughout the observation period.

Conclusions

Intranasal esketamine associated with intensive CBT sessions showed to be effective, safe and satisfactory in the real world clinical management of two complex cases of TRD with high suicidal risk, improving quality of life, social functioning and eliminating suicidal ideation within 12 months follow-up. Satisfaction with the treatment contributed to strengthening adherence and improving the operator-patient therapeutic relationship.

Disclosure of Interest

None Declared
You are not alone…Polish Psychiatric Association supporting Ukraine
Authors: Samochowiec J.
Published: August 2023

Immediately after Russia commenced aggression against Ukraine, the Polish Psychiatric Association publicly called for humanitarian support for Ukraine and initiated meetings with representatives of Psychiatric Societies operating in Ukraine in order to identify current needs in the war-stricken areas and coordinate
aid.

The PPA allocated its financial resources to humanitarian aid and, through the EPA, appealed for condemnation of military operations as well as support for Ukraine by individual NPAs.

According to the UHNR data over 4 million displaced people, refugees, came to Poland so far and some of them benefited from such help.

The Polish Psychiatric Association supports the initiatives of non-governmental organizations supporting refugees and monitors and responds to the needs reported by the Ukrainian side on an ongoing basis. At present, the PPA activities focus on the following priorities:

1. Need-adapted-help: Provision of customized aid - not only medications but also power generators, technical equipment. And so, the PPA shipped to Ukraine some basic equipment, sleeping mats, bedding, mattresses, backpacks, cleaning products, personal hygiene products, as well as tools for renovation and construction.

2. Awareness - highlighting the consequences of Russia’s aggression on people with mental disorders in Ukraine and its impact on the entire population (PTSD, grief
). Inviting and lobbying for dissemination of personal reports of Ukrainian health care workers and patients at international conventions, forums, events

3. Empowerment of personnel - strengthening competences required in provision of assistance in war-related disorders, training, projects of activities both across Poland and Ukraine

4. Supporting and responding to the needs reported by local psychiatric assistance centers facilitating and strengthening the competence of personnel in helping refugees

Disclosure of Interest

None Declared
Mental health information-seeking behaviors and e-health literacy in Tunisian community adults
Authors: Chaibi L. S. , Fekih-Romdhane F. , Ben Said Saffar C. , Cherif W. , Cheour M.
Published: August 2023

Introduction

Due to the convenient and easy access to the Internet, there is an increasing tendency to seek online health information instead of formal help-seeking. To date, there is a very little amount of research on online help-seeking behaviors for mental health problems, with no studies having been performed in Tunisia.

Objectives

We aimed to explore mental health information-seeking behaviors and e-health literacy in a sample of Tunisian community adults.

Methods

We performed a cross-sectional descriptive study among adults from the general population. All participants were administered the Barriers to Access to Care Evaluation scale (BACE-30), the Columbia Suicide Severity Rating Scale (SIS-5), the Depression Anxiety Stress Scales (DASS-21), and the eHealth Competency Scale (eHEALS).

Results

A total of 44.2% participants reported having searched the Internet for mental health-related information during the last 12 months. Google was the most used tool by participants when searching for mental health related information. The main topics searched were symptoms and management (n=49%), followed by finding a diagnosis (n=47%), researching for medications and physicians (n=41%). We conducted a multivariate analysis to identify factors related to participants’ e-health literacy. A higher depression score (p=0.037), lower levels of education (p=0.011), and perceived barriers to access to care (p=0.004) were substantially linked to worse e-health literacy.

Conclusions

While a high proportion of participants reported mental health information-seeking behaviors, those with higher depression and who perceived more barriers to care access exhibited lower e-health literacy. These findings may have practical clinical implications.

Disclosure of Interest

None Declared
Cyberbullying: Study of a series of 96 Moroccan adolescents and young adults
Authors: El Hilali Y. , Manoudi F.
Published: August 2023

Introduction

Cyberbullying is a form of virtual harassment through the Internet, cell phones and social networks. Its psychopathological consequences are serious, including the risk of suicide.

Objectives

The aim of this study is to determine the prevalence of cyberbullying in a sample of Moroccan adolescents, as well as the associated comorbidities.

Methods

This is a descriptive cross-sectional study of cyberbullying among Moroccan adolescents and young adults aged 12 to 20 years old. The data collection was done by a survey on Google Form sent on social networks

Results

A number of 120 forms were completed by high school students, followed by secondary school and university students, of which 96 were valid. The average age was 16 years with a sex ratio of 0.25. Fifty-nine percent of the youth spent more than two hours daily on the Internet and 73% admitted having been bullied online at least once while 19% said it happened often. The profile of harassers included strangers, followed by acquaintances and schoolmates. The platforms where harassment was most present were Facebook, Instagram and WhatsApp. The most frequent types of cyberbullying were private hate messages, humiliating comments about physical appearance and messages with sexual connotations. After the harassment, 65% of victims did not tell anyone; 68% of victims felt angry, and one in five felt suicidal. Among the most common comorbidities were adjustment disorder, anxiety and depressive symptoms, aggressive behavior, and suicidal ideation. Half of the youth felt that cyberbullying had impacted their school or family life.

Conclusions

Parents, educators, and health professionals need to be aware of the risks of virtual communication, and the link between cyberbullying and mental health disorders, and to develop national intervention and prevention programs.

Disclosure of Interest

None Declared
Quantifying computational mechanisms in psychotherapy
Authors: Huys Q.
Published: August 2023

Despite extensive research, the cognitive processes mediating the impact of psychotherapeutic interventions remain poorly understood, and as a result difficult to quantify. Identifying such mechanisms is likely to be extremely helpful: it could help target interventions better, could support dosing therapy through monitoring, and could heighten the speed at which new interventions can be developed. Mechanisms research in psychotherapy has described a number of key difficulties to achieving this. In this and the next talk, we ask whether advances in cognitive computational neuroscience might provide some support. Specifically, the question is whether precise cognitive probes might identify specific mechanisms of interventions. In support of this, I will first describe a pilot study in participants undergoing an adapted behavioural activation therapy. I will then move to present results from two strands of experiments examining whether interventions derived from components of cognitive-behavioural therapy (CBT) are able to shift computationally-derived measures of their proposed psychological substrates. Findings from both strands will be discussed with respect to challenges in developing brief, reliable, engaging, and user-acceptable measures of cognition. Overall, this outlines some early new results in using computational methods to understand therapeutic processes in the psychotherapy for depression.

Disclosure of Interest

Q. Huys Grant / Research support from: Koa Health, Consultant of: Aya Technologies and Alto Neuroscience
Socio-demographic characteristics and clinical profile among suicide attempters
Authors: Ouali R. , Masmoudi R. , Guermazi F. , cherif F. , Feki I. , Chakroun O. , Derbel E. , sellami R. , Masmoudi J. , Rekik N.
Published: August 2023

Introduction

Suicide is a real public health problem. Like many other countries, Tunisia seems to be experiencing an amplification of the phenomenon. Suicide attempts are much more frequent and are estimated to be around 20 times the number of suicides

Objectives

The objective was to describe the sociodemographic characteristics and clinical profile of suicide attempters in patients hospitalized in the emergency room.

Methods

This study was carried out with patients admitted to vital emergencies for attempted suicide over a period of 6 months.

A pre-made questionnaire was used to collect sociodemographic and clinical data. We used the SIS “suicide intention scale” to assess the intent of the suicide attempt and the PHQ9 “PATIENT HEALTH QUESTIONNAIRE” to assess the presence and severity of depressive symptoms.

We excluded Patients with major cognitive impairment, which prevents understanding of the questionnaire.

Results

Our sample consisted of 101 patients. Of the participants, 69.3% were female. Their age varied between 18 and 65 years with an average age of 30.93 years. The socioeconomic level was low in 23.8% of cases. The level of education did not exceed secondary school for 91% of suicides. Almost half of suicide attempters (45%) have been professionally inactive. Participants included in our study were single in 51.5% of cases. Participants had a family history of attempted suicide in 15% of cases. Prior psychiatric follow-up was found in 34% of suicides attempts. More than a third (36.6%) of participants had moderate to severe depression according to the results of the PHQ-9. Recurrences concerned 44% of suicides attempt in our survey and the average number of previous suicides attempts was 3.9. Suicidal intent was rated strong in 47% of suicides attempts .

Conclusions

Suicidal behavior is one of the leading causes of death and disability worldwide. In our study, more than 1 in 3 suicide attempters had depression. Further research is needed to identify suicide risk factors and to examine the relationship between the presence of mental illness and suicidal attempt

Disclosure of Interest

None Declared
Post-war Azerbaijan: Burnout in mental health professionals working with war-affected populations
Authors: Aliyeva R. , Guliyeva G. , İsmayilov F.
Published: August 2023

Introduction

Burnout is a result of emotional exhaustion and lack of motivation after prolonged exposure to chronic emotional and interpersonal stressors at work. (Black et al. SAGE 2020, 609-611)

For the past decade, it has been one of the actual areas of research globally. (Ahola et al. Journal of affective disorders, 88, 2005; 55–62; Ahola et al. Journal of affective disorders,104,2007; 103–110, Shirom, A. Work Stress, 19, 2005; 263–270, Toker et al. The Journal of Applied Psychology, 97, 2012; 699–710.) However, a small number of studies exploring burnout have been conducted in Azerbaijan.

The requirement for supportive interventions for workers with an aim to improve the quality of care and prevention of burnout related to health and sociocultural problems such as difficulties in their personal life, job-shifts has led us to conduct this study.

Above all, the Second Karabakh war that took place in 2020 increased the population of patients that are in urgent need of psychiatric and psychological support.

Objectives

The purpose of this study is to examine the level of burnout among all mental health workers who have been closely working with veterans and families of deceased soldiers. Similarly, the study is intended to evaluate the impact of various factors, such as secondary traumatic stress, effort-reward imbalance, and socio-demographic variables leading to burnout.

Methods

The study design is cross-sectional. 22-item Maslach Burnout Inventory (MBI) is used to measure the level of burnout. Intrusion, avoidance, and arousal symptoms triggered by indirect exposure to traumatic events are evaluated by the 17-item Secondary Traumatic Stress Scale (STSS). 22-item Measurement of the effort-reward imbalance (ERI) is used to define the level of effort, reward, and over-commitment. Demographic questionnaires consist of age, sex, marital status, professional background, years of employment, workload in hours.

Results

The sample size has been estimated as 200 participants. Associations between occupational exhaustion, depersonalization, personal accomplishment assessment, intrusion, avoidance, arousal, effort, esteem, job promotion, job security, overcommitment and professional background, workload in hours will be explored in the current study.

Conclusions

The findings upraised will promote elaborating personalized approaches toward burnout prevention treatment.

Disclosure of Interest

None Declared
Criminological characteristics of sexual assault perpetrators: a Tunisian study
Authors: Chamseddine A. , Charfi N. , Bouattour O. , Feki R. , Gassara I. , Smaoui N. , Omri S. , Zouari L. , Ben Thabet J. , Maâlej Bouali M. , Maâlej M.
Published: August 2023

Introduction

In Tunisia, Sexual assaults constitute a pervasive problem that concerns the health care system and the country’s judicial authorities alike.

Objectives

The aims of our study were to estimate the incidence of sexual assault encountered in the context of forensic psychiatric assessment and to assess the criminological profile of sexual assault perpetrators.

Methods

We conducted a retrospective study of a series of sexual assault perpetrators examined in a forensic psychiatric assessment in the psychiatry C department at Hedi Chaker university Hospital in Sfax, from January 2010 to December 2021.

Results

Over the period of 11 years (2010 to 2021), we collected 374 forensic psychiatric assessment files. Among them, 49 were those of sexual assaults (13.10%). It was a rape assault in 54.4% of cases. Aggravating circumstances have been noted in 87% of cases. These were mainly assaults on minors (54.3%) and assaults associated with physical violence (38.4%).

The victim gender was female in 63% of cases, with an average age of 21 years 9 months. and was among the relatives of the sexual assault perpetrator in 28.3% of cases.

Conclusions

Rape seems to represent a non-negligible proportion of the offenses motivating a forensic psychiatric assessment in Tunisia. Sexual assaults against minors are frequent, despite undeniable under-reporting.

Disclosure of Interest

None Declared
FORENSIC NEUROFEEDBACK AND PREFRONTAL WORKOUT, A SURVEY
Authors: Lancia I. S. , Festa G. M. , Candia M. E. , Colone L. M.
Published: August 2023

Introduction

The logic behind the neuropsychological rehabilitation of the impulsive criminal is to treat the behavioral manifestations of these individuals as the product of a real pre-frontal syndrome, capable of causing deficits in the planning of behavior, in self-regulation, in the inhibition of impulsiveness and more generally in social and interpersonal skills. With the term prefrontal workout, literally “prefrontal workout” Eagleman (2011) refers to a real form of rehabilitation intended for subjects characterized by strong impulsive tendencies. Neurofeedback is used in prefrontal training. This technique mainly uses electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) as indicators of brain function.

Objectives

The premise of prefrontal training is that through rehabilitation, and therefore repeated practice, the frontal areas of our brain can be trained in order to improve the “control” of subcortical circuits and limbic areas responsible for impulsive and potentially destructive behavioral forces. Although this rehabilitation proposal does not specifically concern deviant individuals, it is intended for subjects with impulsive tendencies and difficulty in repressing a stimulus-seeking behavior, skills that fall within the category of frontal functions.

Methods

It is possible that similar strategies can also be used effectively against deviant individuals, working to improve their ability to inhibit a behavioral tendency and reinforcing everything with real-time feedback. There is a very high incidence of attention deficit, hyperactivity disorder and related symptoms among people convicted of crimes, and a great many criminal acts involve impulsive behavior or loss of emotional control such as anger. Better control of behavior and emotions are among the most commonly reported outcomes of neurotherapeutic treatment.

Results

Research and clinical experience also demonstrate the positive effects of neurofeedback with alcohol and drug abuse and depression, both common accompaniments of criminal behavior ( Fielenbach S. 2019; Margarita R. 2016; Konicar L. 2015).

Conclusions

Certainly, research in this field is at a preliminary stage, and the limitations of these techniques are numerous. There are, for example, several doubts about which is the best strategy for the patient to use to control mental activity and inhibit, for example, the search for the substance to which one is addicted. Although promising, the literature highlights sometimes conflicting results: in this regard, see the meta-analysis by Cortese and colleagues (2016) and the document published by Youcha and colleagues (2008).

Disclosure of Interest

None Declared
16p13.11 microduplication including NDE1 gene in autism spectrum disorder: A case report
Authors: Moustakil S. , Guillaume P. , Letessier-Selvon A.
Published: August 2023

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by the deficit in communication and social interaction as well as restricted and repetitive interests and behaviors. In addition to the involvement of the environmental component in ASD, it is currently established the significant contribution of genetic factors such us the 16p13.11 duplication. We report the case of a patient carrying this anomaly in whom an ASD was diagnosed, the genetic study of the parents objectified the same anomaly in a clinically healthy father.

Objectives

This case report aims to expand the clinical findings associated to this genomic abnormality and provide further knowledge of the pathogenic involvement of this duplication.

Methods

Our patient, aged 4 years and 10 months, presented developmental peculiarities from birth. The difficulties became more evident with the language delay, the deficit of social interactions and the appearance of motor stereotypies as well as sensory specificities. The diagnosis of ASD was confirmed by the passation of the ADI and the ADOS.

Further genetic exploration with a CGH-Array request was performed due to a normal 46 XY karyotype. She objectified a 16p13.11 duplication comprising 25 genes including NDE1. The assessment was completed by the search for potentially associated malformations, particularly cardiac and skeletal. We continued the family investigation with genetic samples for the parents and the siblings finding the same anomaly in the father who does not present any particular phenotype.

Results

The 16p13.11 duplication is associated with a variable clinical spectrum including behavioral disorders, attention deficit/ hyperactivity disorder, intellectual disability, cardiac and skeletal malformation, epilepsy as well as ASD and language delay presented by our patient. Eight annotated genes are present in this region including NDE1, the candidate gene for the neurocognitive phenotype. This microduplication can be found in the normal population, but it is increasingly detected in patients with ASD, schizophrenia or presenting cognitive disorders due to incomplete penetrance that can explain the presence of the duplication despite the absence of any disorders in the patient’s father.

Conclusions

The link between the 16p13.11 duplication and ASD is increasingly recognized in the literature. The heterogeneity of its clinical expression and especially its incomplete penetrating make genetic counseling difficult. Collaboration between child psychiatrists and geneticists remains essential to detect, link their clinical evaluation and optimize care.

Disclosure of Interest

None Declared
Factors influencing Family Medicine Residents attitudes toward mental illness
Authors: Jaoua A. , Salhi M. H. , Ben Haouala A. , Gaha L.
Published: August 2023

Introduction

Stigmatization of mental illness by health care professionals is notuncommon, and it represents a source of suffering for patients inaddition to the primary illness.

Objectives

To research factors influencing family medicine residents perceptions of psychiatric pathologies.

Methods

This is an analytical cross-sectional study among family medicineresidents enrolled at the Faculty of Medicine in Monastir (Tunisia),conducted over a period of 3 months (July 2022 to October 2022). TheCAMI (Community Attitudes towards the Mentally Ill) scale was usedto assess the attitude towards mental illness. Sociodemographic datawere collected through a pre-established questionnaire. The data wereanalyzed using SPSS software 26 th version. Percentage comparisonson independent series were performed using the Pearson chi-squaretest.

Results

Our population was made up of 95 family medicine residents, dividedinto 28 males and 67 females. Sex ratio was 2.39. The average of agewas 28 years with extremes 25 and 35 years. 47.4% of residents(n=45) had a positive attitude towards mental illness. The associationbetween this positive attitude and a previous management of apatient with a mental illness was significant (pless than0.05). On the otherhand, there was no significant association neither with the existenceof a personal or family psychiatric history nor with the passagethrough a psychiatric internship of the residents towards mentalillness.

Conclusions

The management of patients with mental illness canreduce the stigmatization of mental illness by health professionals.Measures to raise awareness and create empathetic attitudestowards the mentally ill during physician training are needed toimprove the quality of front-line care.

Disclosure of Interest

None Declared
The relationship between psychiatric symtoms and childhood trauma
Authors: Almeida M. G. , Virginio M. E. C. , Almeida J. R. A.
Published: August 2023

Introduction

Recent evidences suggest that situations of abandonment, neglect and abuse are risks factores for onset of psychopatology in adulthood. This association occus in that traumatic events in the early stages of development and may trigger severe and disabling psychiatric disorders in adults.

Objectives

The presente study aimed to evaluate the associations between the occurence and severity of chidhood trauma and the development of psychiatric disorders in hospitalized teenagers of the Hospital Psychiatric Vida Londrina/Pr.

Methods

The sample was consisted of 14 psychiatric patients, evaluated for severity of psychiatric symtoms by the Back Scale for Suicid Ideation (BSI); Beck Depression Inventory (BDI); Beck Anxiety Inventory (BAI); Back Hopelessness Scale (HAD) and the Barratt Impulsiveness Scale (BIS-11).

Results

In the sample studie, 84% of the teenegers reports that they had some type of childhood trauma. The results indicate that traumas are associated mainly with the development of mood disorders and also with increasin severity of psychiatric symptoms, specially the depressive symptoms, hopelessness, suicidal ideation and impulsivity. Teenagers with emocional neglect, emocional abuse and physical neglect demonstrated having five times more risk of personality disorder. Individuals who suffered physical abuse; sexual abuse and physical neglect presentes at three times more risk of commiting suicid attemps.

Conclusions

These data demonstrate the relevance of trauma childhood as a trigger for psychiatric symptoms.

Disclosure of Interest

None Declared
Increased violence and aggression levels during the SARS-Cov-2 pandemic; data from three London acute psychiatric inpatient facilities.
Authors: Bonaccorso S. , Ajnakina O. , Ricciardi A. , Ouabbou S. , Wilson J. , Theleritis C. , Badhan M. , Metastasio A. , Stewart N. , Barczyck M. , Johansson F. , Tharmaraja T. , Schifano F.
Published: August 2023

Introduction

The COVID-19 pandemic has significantly impacted mental health services, with the literature reporting an increase in the incidence of psychiatric admissions.

Objectives

The aim of this study was to assess the impact of the pandemic on clinical presentations, characteristics of admission and incidents occurring in three acute inpatient mental health facilities in the UK.

Methods

This was a retrospective study comparing data from the first and third UK lockdown to the five years prior to the pandemic. Data was acquired from electronic clinical records and addressed two acute psychiatric inpatient wards and one psychiatric intensive care unit. Key outcomes of comparison were clinical presentations, number of admissions, length of hospital stay, number of incidents and characteristics of incidents.

Results

Compared to the previous 5 years, a higher number of incidents characterized by violence and aggression were reported during the first (56.8% vs 44.3%, x2=16.56, df=1, p<0.001) and third lockdown (100.0% vs 86.2%, x2=36.40, df=1, p<0.001). An increase in non-psychotic disorders was observed in the first lockdown (20.0% vs 13.1%, x2=4.76, df=1, p=0.029), whilst increased first episode psychosis (19.7% vs 11.3%, x2=8.1, df=1, p=0.004) and schizophrenia spectrum disorders (74.4% vs 57.2%, x2= 7.6, df=1, p=0.006) were diagnosed during the third lockdown. There were no significant changes in the diagnosis of mood disorders in both lockdowns compared to previously. The median length of inpatient stay significantly reduced during the first lockdown (28 days vs 36 days, x2= 7.66, df=1, p=0.006).

Conclusions

Increased inpatient incidents may be explained by the impact of the pandemic on staffing levels and resources, combined with increased emotional distress amongst patients in the face of uncertainty. The pandemic may have increased substance misuse potentially linked with the increased incidence of first episode psychosis.

Disclosure of Interest

S. Bonaccorso: None Declared, O. Ajnakina: None Declared, A. Ricciardi: None Declared, S. Ouabbou: None Declared, J. Wilson: None Declared, C. Theleritis: None Declared, M. Badhan: None Declared, A. Metastasio: None Declared, N. Stewart: None Declared, M. Barczyck: None Declared, F. Johansson: None Declared, T. Tharmaraja: None Declared, F. Schifano Speakers bureau of: Prof. Fabrizio Schifano is a member of the European Medical Agency
Grapheme-Color Synesthesia and enhanced Working Memory for the materials that induce synesthetic experiences
Authors: Ayobi M. , Molchanova E.
Published: August 2023

Introduction

This study investigated the influence of synesthetic experiences on working memory and hypothesized that Grapheme-Colour Synaesthesia causes enhanced working memory for the materials in the congruent condition.

Objectives

The current study uses the existing experiments conducted within the field of Synaesthesia as a basis in order to find out whether synaesthesia influences working memory for the letters, words, and days of the week that elicit synesthetic experiences

Methods

Experimental research design was used to identify the extent of the causal relationship between Synaesthetic and non-Synesthetic experiences and enhanced working memory in both Synesthetes and non-Synesthetes. A short screening questionnaire, Stroop task, and N-back task was used to measure the relationship between the two variables for quantitative measurement. (Radvansky, 2011), This study uses materials such as Stroop task and n-back task from Robinson’s (2015) work, Radvansky’s (2011), and Terhune et al. (2013) work. However, certain changes in the methodology of the current study makes it easier and efficient to conduct this study with a different population.

Results

Grapheme-Color synesthetes (Mean= 1276.682 milliseconds) appear to take less amount of time in responding correctly to the incongruent stimulus in the Stroop Task than non-Synesthetes (Mean= 1487.89 milliseconds). Secondly, Grapheme-Color Synesthetes (Mean=1170.929 milliseconds) have a significant difference in accuracy of responding in the congruent condition of the Stroop Task with the non-Synesthetes (Mean= 1491.159 milliseconds). Further evidence from the N-back Task also demonstrated a significant relationship between the variables in both incongruent and congruent conditions; Grapheme-Color Synesthetes (Mean= 2621.390 milliseconds) showed a significant difference in correctly responding to the nonmatching stimulus in N-back Task with Non-Synesthetes (Mean= 2854.351 milliseconds). Similarly, Grapheme-Color Synesthetes (Mean=1330.130 milliseconds) showed a large difference in responding correctly to the matching stimulus in the N-back Task with Non-Synesthetes (Mean= 2301.071 milliseconds). Grapheme-Color Synesthetes were faster in responding correctly than non-Synesthetes in all conditions.

Conclusions

Regardless of what have been concluded as a result of the current study, it is difficult to reach at any conclusions taking into account the oppositions about working memory of Grapheme-Color Synesthetes in different studies. Therefore, the data suggest that future studies should further test the capacity of working memory in Grapheme-Color Synesthetes.

Disclosure of Interest

None Declared
VITAMIN D – A KEY FACTOR IN THE TREATMENT OF ASD PEOPLE?
Authors: Robea M. A. , Balmus M. I. , Nicoara M. , Ciobica A.
Published: August 2023

Introduction

Autism spectrum disorder (ASD) is a disorder with social, communication and behavioral disturbances that start from early childhood. There are many difficulties in diagnosing people with ASD. The diagnostic criteria are in terms of behavior descriptions, and as methods of intervention the most used is the applied behavior analysis (ABA). Although, the treatment of autism is not based on drugs, there are a number of reports that sustains the vitamin supplementation. For example, the deficiency of vitamin D (VD) was often outlined in the serum of the ASD people. Nowadays, zebrafish (Danio rerio) plays an important role in the modeling era; being one of the main organisms used in animal studies.

Objectives

In this study, we aimed to describe the influence of VD in autistic people, and the possibility of vitamin investigation through animal models studies.

Methods

For analyzing this subject specific scientific databases were screened using certain keywords as: ”autism spectrum disorder”, ”vitamin D”, ”treatment”, ”deficiency”,”animal models” and ”zebrafish”. Inclusion criteria were studies that (1) investigated a behavioral intervention, (2) used animal models for ASD modelling, (3) reported vitamin D results, and (4) were published within the last 20 years.

Results

The majority of the studies supported the importance of an adequate level of VD in the body, mainly due to its implication during pregnancy and early brain development. The few existing data bring information about the positive impact of its administration in ASD children; in which a considerable improvement in typical symptoms was observed. For further knowledge about VD activity in ASD it was suggested the animal modelling, especially zebrafish organisms due to its numerous advantages (high similarity of its genome with the human one).

Conclusions

VD deficiency during pregnancy and early brain development is a real risk factor besides genetic predisposition. Moreover, the use of animal models for investigating the effect of VD is required for a better understanding of the vitamin mechanism in ASD people.

Acknowledgement: *R. M.-A. and B. M.-I. are supported by the Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program.

Disclosure of Interest

M. Robea Grant / Research support from: Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program., M. Balmus Grant / Research support from: Project POCU/993/6/13/153322 ”Suport educațional și formativ pentru doctoranzi și tineri cercetători în pregătirea inserției în piața muncii” of the European Social Fund through the Human Capital Operational Program, M. Nicoara: None Declared, A. Ciobica: None Declared
Evolution of some liver function markers after treatment in patients with schizophrenia and bipolar disorder
Authors: Sellami S. , Maalej M. , Ayadi M. , Naifar M. , Maalej M. , Ayadi F.
Published: August 2023

Introduction

The prevalence of alterations of liver function tests in patients with schizophrenia and bipolar disorders is not well known. These alterations are often considered as side effects of medication

Objectives

Our study aimed to evaluate and compare liver function before and after treatment in patients with schizophrenia (SCZ), schizo-affective disorder (SCA) and bipolar disorder (BD).

Methods

This was a prospective study among patients with SCZ, SCA and BD according to DSM-5 criteria. Patients, from the “C” psychiatry department of Hedi Chaker University Hospital in Sfax, were assessed during both acute and remission phases in their illness. The acute phase (T0) assessment was made in drug-free patients from june 2016 to july 2018. As for the remission phase (T1), it was made between november 2019 and march 2020. Blood tests were performed in the Laboratory of Biochemistry at Habib Bourguiba University Hospital in Sfax. Clinical and biological parameters of patients were compared with those of healthy controls. Biological assessment consisted mainly in Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) and Albumine.

Results

Thirty patients were included in our study. Their mean age was 35.83 ± 12.24 years and they were all males. They suffered from SCZ in 33.33% of cases, from SCA in 26.66% of cases and from BD in 40% of cases. Psychoactive substance use was common among 80% of patients. In the remission phase, 90% were polymedicated with use of antipsychotics in 83% of cases and mood stabilisers in 53% of cases. Table 1 shows the evolution of the studied liver function markers in our patients.Table 1:

evolution of some liver function markers in patients

MarkersT0T1pAST (UI/L)Patients33,22 ± 23,1819,34 ± 4,97<0,001Controls22,27±6,91<0,05e,bALT (UI/L)Patients19,59 ± 13,213,17 ± 11,390,003Controls20,63±11,08<0,05e,a,bAlbumine (g/l)Patients42,35±4,8647,79±3,18<0,001Controls46,19±3,95>0,05

a: significant difference between patients with SCZ (T1) and controls; b: significant difference between patients with BD (T1) and controls; e: significant difference between patients (T1) and controls

Conclusions

Our results showed an improvement of liver function in patients with SCZ and BD after treatment. This suggests that liver function alterations are due to these diseases rather than the medication.

Disclosure of Interest

None Declared
Obsessive-compulsive disorder comorbid with rheumatoid arthritis: case report and review of literature
Authors: Amani H. S. , Rim M.
Published: August 2023

Introduction

Obsessive-compulsive disorders are complex pathologies causing a major psychosocial handicap. However, their association with a disabling somatic pathology such as rheumatoid arthritis makes management more difficult.

Objectives

To investigate through a case analysis and a review of literature the association between obsessive-compulsive disorder (OCD) and rheumatological disorders.

Methods

We reported a case of a woman with a long history of obsessive compulsive disorder who presented rheumatoid arthritis and we conducted a review of literature through search on Pub-Med/MEDLINE following the terms “obsessive-compulsive disorder”, “rheumatoid arthritis”, “association”, “inflammation”.

Results

Case presentation: A 62-years old woman who had been followed at the psychiatric consultation for 20 years for OCD. She had been stabilised on clomipramin at a dose of 100 mg per day until 2012 and since then she had been lost to follow-up with the notion of poor compliance with the treatment. She re-consulted in August 2022 for worsening psychiatric symptoms such as phobic obsessions with delusional beliefs, verification compulsions, sleep disorders and multiple somatic complaints including diffuse arthralgia and chronic arthritis evolving for 6 months.

The patient was put on risperidone 2mg with anxiolytic without improvement. She was referred to the rheumatology consultation where the diagnosis of very active rheumatoid arthritis was retained, hence she was put on 20mg of prednisolone per day with methotrexate.

The evolution was marked by the accentuation of obsessions and compulsions with the appearance of depressive elements, hence the introduction of fluoxetine 40 mg per day, the increase in the dose of risperidone to 4 mg with the anxiolytic with an improvement on the somatic and psychiatric symptoms.

Conclusions

Literature had shown that patients with this OCD usually suffer from inflammatory or rheumatological comorbidities. This association could complicate the management of these patients.

Disclosure of Interest

None Declared
Developing as an independent practitioner in psychiatry
Authors: Wise J.
Published: August 2023

Dr Wise will help the audience familiarise themselves with the attitudes, atributes and skills neccessary to establish and maintain a practice outside of a state-supported environment, to develop and grow a career, and reduce the risk of burn out.

Disclosure of Interest

None Declared
Antiandrogenic treatment of obsessive compulsive neurosis: A case review
Authors: Huerga García L. , Careno Baez I. , Oropeza Hernández G. , Marcos Rodrigo A. , Delgado Torres C. , Garriga Rocío G. , Gómez Pérez P.
Published: August 2023

Introduction

Obsessive-compulsive disorder (OCD) is a mental disorder in which patients who suffer from it have repetitive and undesirable thoughts, feelings, ideas, sensations (obsessions) and behaviors that drive them to do something over and over again (compulsions).

Often the person tries to get rid of the obsessive thoughts through compulsions, but this only provides short-term relief. Not carrying out the obsessive rituals can cause enormous anxiety and suffering.

Objectives

To describe a 23-year-old male patient, who suffers from anxiety and mood symptoms, reacts to ego-dystonic obsessive ideas and sexual content, of months of evolution, and who manages to calm down through compulsive masturbation or watching sexual videos on the internet. All this clinic negatively interferes with their quality of life, asking the patient for medical help to calm these ideas.

Methods

We carried out a review in Pubmed with the terms Antiandrogens and TOC, in order to make a better description of the clinical case.

Results

After several treatment attempts (Sertraline, Paroxetine, Clomipramine, Clomipramine + SSRI), reaching maximum doses according to clinical guidelines, and with poor therapeutic response, it was decided to discuss the case with the endocrinology department of our hospital, deciding to start treatment with antiandrogens, in order to alleviate the persistent intrusive ideas of a sexual nature. The administration of antiandrogens in men can cause a decrease or increase in the development or involution of secondary sexual characteristics in men, reducing the activity or function of accessory sexual organs, and hyposexuality, with decreased sexual desire or libido.

After several weeks, there was improvement in the obsessive symptoms with a decrease in compulsive rituals. However, after the 3rd mo, some symptoms reappeared, but not with the same severity and intensity as before treatment. In addition, we cannot ignore the adverse effects that have occurred, such as involution of secondary sexual characteristics. However, and taking into account the negative repercussion that this clinic had on the patient’s quality of life, the benefit obtained exceeded the risk, having noted clear improvement with this therapy, and maintaining evolutionary controls by both psychiatry and endocrinology.

Conclusions

Patients suffering from obsessive-compulsive disorder can be effectively treated with anti-androgenic pharmacological agents with various modes of action. The most effective group of such agents is the long-acting analogues of the gonadotropin-releasing hormone. The objective of this review is to elucidate the possibility of using such powerful anti-androgenic agents in the treatment of obsessive-compulsive disorder.

Disclosure of Interest

None Declared