bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review to assess the use of psilocybin in the treatment of headaches
Authors: Bhanot S. , Lin M. C. Q. , Bains S. , Monroe A. , Tsang V. W. L.
Published: August 2023

Introduction

Psilocybin is a naturally occurring psychedelic compound whose effects have been seen in studies for treatment of depression, anxiety and pain management. Given its structural similarities to 5-hydroxytryptamine, a monoamine controlling brain modulation of pain input, preliminary studies sought to test serotonergic interactions of psilocybin with headaches.

Objectives

Explore efficacy of psilocybin as treatment for individuals with headaches, including migraines, essential headaches, cluster headaches and unclassified head pains.

Methods

Studies were found from six major databases, with inclusion criteria consisting of participants with any type of headache using psilocybin as a treatment. Each study was independently screened by two reviewers at two stages, with inconsistencies reviewed by a third, senior reviewer.

Results

The systematic review evaluated eight articles. Benefits of macrodosing were explored in one study which reported higher levels of pain relief in comparison to microdosing and conventional pain medications. Top benefits of microdosing as reported by participants included convenience, perceived safety and reduced side effects when compared to hallucinogenic doses of psilocybin. Participants across five studies reported improvements to their headaches as characterized by changes in frequency, intensity, duration and remission period. Reported improvements were clinically significant in the six studies and statistically significant in three papers. With psilocybin intervention, two studies reported a decrease in headache attack frequency, three studies reported a decrease in intensity, and one study indicated a decrease in duration. The greatest benefit reported was for psilocybin taken during a remission period, with the average length of that remission period between headaches extending for 91% of participants. One study focused on the dosages of psilocybin in relation to its efficacy, indicating that there was more headache pain relief amongst macrodosers, with a difference of 12.3% of participants experiencing pain reduction 3 days after dosage in comparison to microdosers. 18% of participants who experienced essential headaches also experienced hallucinations as a result of ingested psilocybin. Others showed a temporary increase in symptoms of anxiety and pain - 5.3% with microdosing and 14.1% macrodosing. One study observed an increase in average arterial pressure after ingestion.

Conclusions

Six of eight screened papers showed that psilocybin was clinically significant in the treatment of headaches as captured through self-reports. While the first controlled study for psilocybin use for headaches was detailed in this study, psilocybin remains illegal in many countries, presenting a need for further regulated research.

Disclosure of Interest

None Declared
The pathogenesis of formal thought disorder – towards an integrative view
Authors: Dornelles E. , Telles-Correia D.
Published: August 2023

Introduction

Formal Thought Disorder (FTD) is a cluster of symptoms and signs, and can be summarized as a multidimensional construct, reflecting idiosyncrasies in thought, language, and communication in general. The inquiry into its etiology is complicated by the ambiguity of the construct itself, and many theories regarding its pathogenesis have been put forward. Two main neurocognitive models, however, have been garnering attention in mainstream FTD research: the “dyssemantic” and the “dysexecutive” hypotheses. These concepts have been classically pitted out against each other as mutually exclusive, but recent studies have proposed a more integrative view.

Objectives

In this presentation, we aim to explore the two main models for explaining FTD pathogenesis, and to show how an integrative model which accounts for both the dyssemantic and dysexecutive deficits seen in patients with FTD might be better at explaining its etiology.

Methods

We conducted a systematic review of the available literature according the PRISMA 2020 statement. We began by researching the Pubmed and Cochrane databases using the following search string: ((“Formal thought disorder*”[Title/Abstract]) AND (dysexecutive[Title/Abstract])) OR ((“Formal thought disorder*”[Title/Abstract]) AND (dyssemantic[Title/Abstract])) OR ((“Formal thought disorder*”[Title/Abstract]) AND (pathogenesis[Title/Abstract])) OR ((“Formal thought disorder*”[Title/Abstract]) AND (etiology[Title/Abstract])). 20 articles were retrieved, along with 2 ongoing trials. We screen for a total of 12 included articles. We also included 17 articles from citation searching, resulting in a final count of 29 included articles. We then summarized the main findings.

Results

Two influential hypotheses explaining the neurocognitive pathogenesis of different FTD symptom are the “dyssemantic” and “dysexecutive” hypotheses. The “dyssemantic” model emphasizes abnormalities in language-processing related brain regions and functional networks. Some studies suggest that the dysfunctions might involve higher-order semantics and the syntactic component. The “dysexecutive” hypothesis suggests that impaired planning and monitoring might lead to poorly formulated or prone-to-error speech. Recent studies, however, have suggested that FTD might be related to a combination of both executive dysfunction and impaired semantic processing, which would then combine in different proportions and yield the different FTD manifestations.

Conclusions

While disfunctions in both semantic and executive cognitive faculties have been independently explored as potential explanations for the pathogenesis of FTD, a more integrative picture has surfaced in recent research. It proposes that FTD might actually be the reflections of a combination of different proportions of disfunctions in the executive and/or linguistic processes. More research is needed, with better defined FTD dimensions, in order to further explore this model.

Disclosure of Interest

None Declared
External and Internal Shame in people with migraines
Authors: Georgiadis I. , Fountas K. , Malli F. , Dragioti E. , Gouva M.
Published: August 2023

Introduction

Migraine often leads to reduction of social power and prestige of the patients, hence leading further emotions of shame.

Objectives

Exploring the role of external and internal shame in people with migraines.

Methods

The sample consisted of 180 people, more specifically 140 people from the general population and 40 people who have been diagnosed with migraine and receiving treatment for migraine, who completed the following questionnaires voluntarily and anonymously: a) Migraine Experience Questionnaire and Headache Impact Test-6 (HIT-6), b) the Other As Shamer scale (OAS) c) the Experience of Shame Scale (ESS), and socio-demographic and self-reported questionnaire.

Results

Patients scored higher level external Shame (OAS) rates (31.28 ± 6.98) than people from the general population who scored lower external Shame (OAS) rates (16.89 ± 10.00) with a statistically significant difference between them (p = 0.000). Also, patients scored lower-level internal shame (ESS) rates (45.58 ± 6.91) than people from the general population who scored higher internal shame (ESS) rates (53.36 ± 15.62) with a statistically significant difference between them (p = 0.003).

Conclusions

Patients with symptoms of migraine show statistically higher level of external shame and lower level of internal shame and further study is considered necessary.

Disclosure of Interest

None Declared
Diagnostic stability of 346 patients with borderline personality disorder based on retrospective clinical records
Authors: Henriques-Calado J. , Schumacher M. M. , Gama Marques J.
Published: August 2023

Introduction

State-of-the-art research highlights that borderline personality disorder have high rates of comorbid Axis I disorders, which imply uncertainty in establishing an accurate diagnosis and can be some of the most challenging patients for clinicians and researchers.

Objectives

This study seeks to observe the diagnostic stability in borderline personality disorder patients, in order to increase empirical knowledge through a retrospective look at the historical line of diagnoses.

Methods

A twenty-year retrospective study at a psychiatric hospital, searching at the electronic clinical records for all patients with borderline personality disorder diagnosis, under the code 301.83 from World Health Organization’s International Classification of Diseases, 9th Revision (WHO ICD9). A 346 patients’ sample was identified aged between 18 and 83 years (Mage=44.14 years, SD=11.18; predominantly female 73.70%; Mschooling=9.31years; Madmissions=4.72times, SD=9.21; 2nd-5th comorbid diagnosis, a 75.72% sample with three diagnosis); excluding organic cerebral syndrome and no comorbidity besides drug abuse, or no comorbidity at all.

Results

As a general observation, the following diagnoses are indicated: 44.09% major depressive disorder, 33.16% affective disorder, 13.05% schizophrenia, and 9.70% mania. As a spectrums disorders analysis (Figure 1), differential percentage occurrences are identified in patients with borderline personality disorder.

Image:

Conclusions

Based on clinical diagnoses records of borderline personality disorder patients, some spectrums disorders are highlighted, to be reported in descending order of incidence: depressive, affective, schizoaffective and schizophrenia spectrums.

Disclosure of Interest

None Declared
An empirical staging model for schizophrenia using machine learning
Authors: Clara M.-C. , Sánchez-Lasheras F. , García-Fernández A. , González-Blanco L. , Sáiz P. A. , Bobes J. , García-Portilla M. P.
Published: August 2023

Introduction

One of the great challenges still to be achieved in schizophrenia is the development of a staging model that reflects the progression of the disorder. The previous models suggested have been developed from a theoretical point of view and do not include objective variables such as biomarkers, physical comorbidities, or self-reported subjective variables (Martinez-Cao et al. Transl Psychiatry 2022; 12(1) 1-11).

Objectives

Develop a multidimensional staging model for schizophrenia based on empirical data.

Methods

Naturalistic, cross-sectional study. Sample: 212 stable patients with Schizophrenia (F20). Assessments: ad hoc questionnaire (demographic and clinical information); psychopathology: PANSS, CDS, OSQ, CGI-S; functioning: PSP; cognition: MATRICS; laboratory tests: C-Reactive Protein (CRP), IL-1RA, IL-6, Platelets/Lymphocytes (PLR), Neutrophils/Lymphocytes (NLR), and Monocytes/Lymphocytes (MLR) ratios. Statistical analysis: Variables selection was performed with an ad hoc algorithm developed for this research. The referred algorithm makes use of genetic algorithms (GA) to select those variables that show the best performance for the patients classification according to their global CGI-S. The objective function of the GA maximizes the individuals correct classification of a support vector machines (SVM) model that employs as input variables those given by the GA (Díez-Díaz et al. Mathematics 2021; 9(6) 654). Models performance was assessed with the help of 3-fold cross-validation and these process was repeated 10,000 times for each one of the models assessed.

Results

Mean age(SD): 39.5(13.54); men: 63.5%; secondary education: 59.50%. Most patients in our sample had never been married (74.10%), and more than a third received disability benefits due to schizophrenia (37.70%). The mean length of the disease was 11.98(12.02) years. The best SVM model included the following variables: 1)Clinical: number of hospitalizations, positive, negative, depressive symptoms and general psychopathology; 2)Cognition: speed of processing, visual learning and social cognition; 3)Functioning: PSP total score; 4)Biomarkers: PLR, NLR and MLR. This model was executed again 100,000 times applying again 3-fold cross-validation. In 95% of the algorithm executions more than a 53.52% of the patients were classfied in the right CGI-S category. On average the right classification was of 61.93%. About specificity and sensitivity the average values obtained were of 0.85 and 0.64 respectively.

Conclusions

Our staging model is a robust method that appropriately distributes patients according to the severity of the disorder. Highlights the importance of clinical, functional and cognitive factors to classify patients. Finally, the inflammatory parameters PLR, NLR and MLR have also emerged as potential biomarkers for staging schizophrenia.

Disclosure of Interest

None Declared
Social inclusion: a fundamental PROM for evaluating recovery-oriented global mental health programmes
Authors: Puschner B.
Published: August 2023

Social inclusion is a multidimensional concept, referring to ample participation in key social, cultural, economic and political activities. Since the turn of the century, social inclusion has become a guiding principle in policy recommendations of many international (United Nations, WHO, EU) and national bodies, aiming to improve the lives of people with mental ill-health. More recently, social inclusion has been increasingly used as an outcome measure, to test the effectiveness of complex interventions, especially in the field of global mental health.

This presentation will focus on: (1) current definitions and controversies in research on social inclusion for and with people with mental ill-health; (2) measuring social inclusion; and (3) the evidence-base of interventions to improve social inclusion. Special attention will be given to recovery-oriented interventions in global mental health such as peer support.

In summary, over the last years, impressive conceptual and methodological advances have been made to transform policy rhetoric into meaningful and effective interventions. However, challenges remain, including consensus on culturally appropriate measurement of social inclusion, and balancing the roles and responsibilities of all stakeholders (service users, mental health service providers, wider society) across the entire exclusion-inclusion continuum to promoting social inclusion and mental health.

Disclosure of Interest

None Declared
Collaborating with the people who experience psychosis: From subjects to partners
Authors: Semenova N. D.
Published: August 2023

Introduction

Despite the critical role of motivation in psychosocial treatment and rehabilitation, as well as functional outcomes in schizophrenia, service user voices are not always present in setting research agendas on this topic. This is important since the service user’s involvement in the research process helps prioritize research questions (Wykes et al., 2015).

Objectives

We have begun a consultation process to bridge the gap between research and practice on ‘motivation in schizophrenia.’ The study’s main objective was to produce the means to increase motivation in schizophrenia from the perspective of users.

Methods

In the current study, we asked the service users about the priorities for ‘motivation and schizophrenia’ research and also suggested involving service users in research itself as partners. Expert Panels with peer leaders previously involved in psychosocial rehabilitation programs took place. A total of 12 Panels (group meetings) were held during the year with three users (schizophrenia spectrum outpatients) aged 45, 47, and 50, male. The reports were analysed using content analysis to generate main themes and findings (Braun & Clarke, 2006).

Results

The users’ elements of motivation may differ from organizationally defined ones; this may be related to different opinions and ethical standards among clinicians on patients’ autonomy and right to refuse treatment. A discussion of the topics patients have developed to improve the motivation, engagement, and management of patients with schizophrenia in psychosocial treatment and rehabilitation is presented.

Conclusions

The approach successfully generated items for questionnaires that usesr participants declared with a sence of pride in and ownership of. It is, therefore, possible to create measures of motivation that users feel reflect their understanding and experiences. The outcome of this research is that other Russian researchers will be inspired to follow the same patrnership path and encourage service users to participate rather than be subjected to research.

Disclosure of Interest

None Declared
Biomarkers as Proxies for Cognitive Reserve: the role of high density lipoprotein cholesterol in first episode of psychosis
Authors: Magdaleno Herrero R. , Murillo-García N. , Yorca-Ruiz Á. , Neergaard K. , Crespo-Facorro B. , Ayesa-Arriola R.
Published: August 2023

Introduction

The proxies used to compose cognitive reserve (CR) in first episode of psychosis (FEP) have varied in the literature. The development of FEP is linked to the peripheral pathways of the central nervous system (Leboyer et al. Psychopharmacology 2016; 233(9) 1651-60) Furthermore, schizophrenia has been linked to the metabolic system, indicating that alterations in the levels of biological parameters, in particular high-density lipoproteins (HDL) (Gjerde et al. Eur Arch Psychiatry Clin Neurosci 2020; 270(1) 49-58) cause worse global functioning and cognitive impairment (Adamowicz et al. J Clin Med 2020; 9(2) 537). Despite this knowledge, no research has considered the introduction of biomarkers as proxies for CR.

Objectives

The present study aimed to create a quantifiable and objective CR index that adjusts for the multifactorial nature of FEP.

Methods

We included 668 patients who had FEP and 217 healthy controls who were assessed for sociodemographic information and levels of biological parameters: waist circumference, hypertension and levels of HDL, triglycerides and glucose. The main analyses were multiple regression analysis, principal component analysis (PCA) and exploratory factor analysis (EFA).

Results

Regression analyses showed that HDL was the top performing biological parameter in a model containing years of education and unemployment (F=11.80; p<0.001) while also outperforming other parameters in a correlation analysis with a composite of the same variables (r= 0.21; p<0.001). In EFA analyses combining all possible components, we found that the most optimal proxies for the composition of biological CR were years of education and HDL. The results using PCA indicated that biological CR would have a greater explanatory power for the phenomenon than classical CR, increasing 7.27% of the explanation for FEP patients and 16.08% for healthy controls.

Conclusions

This article proposes an objective and quantifiable method to measure CR, taking into account endogenous and exogenous factors. This index, introducing biomarkers as proxies could provide a more accurate CR score for FEP patients.

Disclosure of Interest

None Declared
Chemsex behaviours, sexual response and sexual health
Authors: Curto Ramos J. , Azqueta I. , Heredia M. T. , Molina Prado R. , De Ema López I.
Published: August 2023

Introduction

The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.

Objectives

The objective of this study was to understand the impact of chemsex on sexual health and sexual response by the participantes of a sexual health program for chemsex users in two Substance Use Disorder Clinics in Madrid.

Methods

Qualitative research approach. We analyze an anonymous survey with chemsex users with open answer questions about the impact of chemsex practice on sexual response and sexual health. Data analysis was based on thematic analysis of content.

Results

Several differences were identifed between chemsex and sober sex. In sober sex it can take longer to feel aroused, sexual desire is more context-dependent and more easyly controled. They connect easily with other people needs when they had sober sex. They described difficulties with consent with some sexual practices when they were on drugs. Shame and guilt was associated with chemsex. They describe more arousal, more independent of the erotic context, longer sexual intercourse and delayed ejaculation when they had sex under the influence of drugs.

Conclusions

Chemsex is a phenomenon that needs a multidisciplinary approach and mental and sexual health must be taken into account including sexological perspective. Interventions that provide sexual counselling and sexual therapy for chemsex users must be developped.

Disclosure of Interest

None Declared
Is parity a protective factor in depression and IPV?
Authors: Vargas B. R. , Valdez V. , Santana C.
Published: August 2023

Introduction

IPV is a public health issue that is often linked to depression. Parity has often been mentioned as a protective factor against depression and suicide attempts. Despite this, parity in Latin America may not be related to positive outcomes for victims suffering from IPV as the stress of taking care of the children can result in a burden and worsen the symptoms of depression for the victim.

Objectives

Determine the impact of Parity in victims suffering from IPV and Depression.

Methods

A descriptive observational study was conducted, at the main Gender Violence Prosecutor’s office: Florida, Guayaquil-Ecuador. UCSG pre-medical students collected the information using Beck test for Depression. The total sample was 239: 195 women, 44 men. It was classified by groups, gender, marital status, children and severity of depression.

Results

The data analyzed showed a higher percentage of Depression from IPV when parity is present.

Severe Depression: Women with children 57 (29%), 8 men with children (18%). Women without children 22 (11%), men without children 6 (14%).

Moderate depression: Women with children 28 (14%), 4 men with children (9%). Women without children 5 (3%), men without children 2 (5%).

Mild Depression. Women with children 25 (13%), 7 men with children (16%). Women without children 6 (3%), men without children 2 (5%).

Conclusions

Although some studies report having children as a protective factor in depression, this did not happen in this study. Financial violence is very common, so the mother does not receive any economic support from the father and has to take care of the children on her own. Social and hormonal factors also play a role, especially in women as they have more children. We believe that mental health clinicians should pay more attention to victims of IPV who have several children, especially in Latin America.

Disclosure of Interest

None Declared
Impulsivity and cannabis use disorder among tunisian sample
Authors: Olfa B. , Rim S. , Reehab O. , Syrine A. , Abdelmajid Z. , Farah C. , Rim M. , Ines F. , Jawaher M.
Published: August 2023

Introduction

In the past few years, there has been a considerable amount of evidence that cannabis use can cause structural and functional brain abnormalities.Structural imaging studies of cannabis users have revealed reduced prefrontal cortex volumes and white matter damage that may be involved with impulsivity.
Objectives: To Determine the level of dependence on cannabis among cannabis users consulting the detoxification center of Sfax, Tunisia To assess in addition the impact of cannabis on impulsivity and motor control.

Methods

This is a cross-sectional, descriptive and analytical study that was conducted over a period of 13 months between September 15, 2020 and October 1, 2021 among cannabis users consulting the detoxification center of Sfax, Tunisia.A short form of the Barratt Impulsiveness Scale (the BIS-15) and a Cannabis Abuse Screening Test (CAST) were used to assess impulsivity and to determine cannabis abuse.
Results: Thirty Eight cannabis users agreed to participate in this study. The distribution of CAST scores showed that 36 users (94.7%) had problematic cannabis use at the time of the study. The mean BIS 15 score was 38.2. In our sample, The level of impulsivity was highest in people with a high level of cannabis dependence. A higher level of impulsivity was found in younger subjects. However, a greater level of impulsivity was found in subjects with a lower socio-economic level. Concerning employment status, unemployment was significantly correlated with a higher level of impulsivity.

Conclusions

Impulsivity is often associated with a variety of problematic behaviors such as aggressive behavior, smoking, drug abuse, pathological gambling or compulsive buying.

A higher frequency of cannabis use and earlier age of onset use have been shown to be associated with the highest rates of impulsivity.

Therefore, cannabis addiction represents a real public health problem, both because of the serious complications and heavy repercussions that it causes.

Disclosure of Interest

None Declared
Obsessive-compulsive disorder after long-term cannabis use – case report
Authors: Nistor D. E. , Corban M. , Horosan L.
Published: August 2023

Introduction

Obsessive-compulsive disorder (OCD) is characterised by intrusive thoughts and repetitive behaviours that considerably impact general functioning. Recent evidence links the endocannabinoid system to OCD neurobiology, and several case reports describe significant improvement after using dronabinol (synthetic tetrahydrocannabinol) in patients with severe OCD. Nevertheless, to what extent this new information can change our perspective on pharmacological treatment in OCD is unclear.

Objectives

We present the case of a patient with obsessive-compulsive symptoms triggered after increased long-term cannabis use. Our purpose is to emphasise the necessity of continuous research and a better understanding of the correlation between OCD and cannabis derivates before formulating treatment recommendations.

Methods

We used psychiatric assessments to evaluate the patient’s symptoms and evolution over time and exclude other possible causes that could have triggered the disorder.

Results

Our patient is a 37-year-old man who has been frequently brought to the hospital by the police in the last 11 years for psycho-motor agitation after cannabis use. This year, he came to the hospital by himself, complaining about intrusive thoughts that required motor and mental repetitions to reduce anxiety. His obsessions were mainly about the need for symmetry and exactness and his checking compulsions about his mother’s health. The symptoms required more than half a day and caused functional impairment. A detailed history did not outline any obsessive-compulsive symptoms before the previous year. The patient denies using new drugs, and we did not identify other medical conditions that could better explain the symptoms. However, he admits to increasing the doses and frequency of cannabis use during the last year. After two weeks of cannabis abstinence and Sertraline treatment, his symptomatology improved significantly, with a reduction of more than 50% in the time spent daily on mental and motor compulsions, reduced anxiety, and a noticeable increase in overall functionality. In addition, the Yale-Brown Obsessive Compulsive Scale result decreased from 35 on the first day to 17 on discharge.

Conclusions

Recent studies support the use of cannabis derivates for treating OCD symptoms. However, this case report outlines that prolonged cannabis use could also trigger OCD. Therefore, further studies are necessary to identify not only the potential benefits but also the potential risks of using cannabinoids as a pharmacological intervention.

References

Nicolini H et.al.CannabisUseInPeopleWithOC.FrontPsychiatry.2021May10; 12:664228.doi:10.3389/fpsyt.2021.664228.PMID:34040556;PMCID:PMC8141625

KayserR.R. et.al.TheEndocannabinoidSystem:ANewTreatmentTargetforOCD? CannabisandCannabinoidResearch.Jun2019.7787.doi10.1089/can.2018.0049

GoodmanWK et.al.1989.YBOCS:Archives of General Psychiatry,1006–1011.doi10.1001/archpsyc.1989.01810110048007

Disclosure of Interest

None Declared
Misuse of psychotropic medications among hospitalized patients
Authors: Azraf F. , Tounsi A. , Sabir M. , El Omari F.
Published: August 2023

Introduction

Psychotropic drugs are sometimes taken outside of any medical context and can be diverted or even trafficked. This phenomenon affects more adolescents and young adults, more specifically those who are already struggling with other consumption problems. This vulnerable population is thus exposed to several negative health and social repercussions.

Objectives

The objective of our work is to determine the sociodemographic characteristics of the patients, the main drugs used, the dose, the route of administration, the mode of obtaining the drug and the intentionality of the use.

Methods

It is a retrospective study spread over 1 year on a series of patients who were hospitalized in the service of addictology at the psychiatric hospital Ar-razi of Salé. The data collection was carried out from the medical files and an exploitation form.

Results

A total of 141 patients were hospitalized during this period of which 53 37.5 had a diverted use of medication. Our sample is characterized by a predominance of female patients (90%) with a median age of 33 years. The most misused drugs were benzodiazepines (85.7%), analgesics (11.7%), hypnotics (9.4%) and antihistamines (1.9%). Misuse is related to exceeding doses (up to 40 times the maximum dose of the AMM) and duration of treatment, to use or obtaining drugs without a prescription 79.2 , to the route of administration and to drug addiction. 11.3 of patients were dependent on a single drug; 88.7% of patients had a co-addiction: tobacco 86.8%, cannabis 77.3%, alcohol 58.5%, cocaine 34.5%, solvents 15 , heroin 1.8% or a history of addiction. Hospitalization was only related to drug misuse in 11.3% of cases. The effects sought: anxiolysis 58.5%, euphoria 30.2%, analgesic 5.7%, disinhibition 3.8%, increased performance 1.9%

Conclusions

The misuse of psychotropic drugs is a well-known public health problem. However, this phenomenon remains unknown and neglected in Morocco.

Disclosure of Interest

None Declared
Sexual motivations for engaging in chemsex behaviours
Authors: Curto Ramos J. , Heredia Soriano M. T. , Azqueta I. , De Ema Lopez I. , Molina Prado R.
Published: August 2023

Introduction

The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.Objectives: The objective of this study was to understand the sexual motivations for chemsex practice o a group participantes of a sexual health program for chemsex users in two Drug Substace Use Disorder Clinics in Madrid.

Methods

Qualitative research approach. We analyze an anonymous survey with chemsex users with open answer questions about the motivations for chemsex practice. Data analysis was based on thematic analysis of content.

Results

Different qualitative studies have examined the motivations for engaging in chemsex. The participants identified two main raisons: pleasure and losing inhibitions. We analyed the inhibitions described by participants: difficulties with arousal, ejaculation, social interaction in sexual context, difficulties in situations that require intimacy, sexual practices that make them feel guilt/shame (for example BDSM) problems with “erotic” self-esteem: rejection of non-normative bodies or towards non- normative gender expression perceived as undesirable.

Conclusions

Understanding the sexual motivations for engaging in chemsex seems necessary to develop and multidisciplinary approach. Mental health proffesionals should consider sexual counselling and sexual therapy for chemsex users in their treatment.

Disclosure of Interest

None Declared
Toxic encephalopathy after an overdose of cocaine : a case serie
Authors: Zouari R. , Nabli F. , Ben Mohamed D. , Saeid M. Z. , Ben Sassi S.
Published: August 2023

Introduction

cocaine is a widely used illegal drug, known for its fast ability to induce euphoria and arousal. However, cocaine exposure can contribute to several mental and physical effects. Cocaine induced brain damage can be divided into 3 mechanisms: direct effect leading to toxic encephalopathy, secondary to vascular damage causing vasculitis, stroke and vasospasm, and tertiary effect due to hypoxia through a cardiovascular collapse.

Objectives

Here, we report 2 young men who developed a subacute encephalopathy with different clinical and radiological presentation after a cocaine overdose

Methods

a case serie

Results

we present two men aged respectively of 28 (P1) and 42 years-old (P2). Both had a history of alcohol consumption and toxicomania (mainly cocaine) during the past year. They manifested, 2 weeks following a cocaine overdose, with gait disorder and confusion. On examination, P1 was apathic and confused. He had a subcortical frontal syndrome with gait apraxia and grasping reflex, along with a quadri-pyramidal syndrome. While patient P2 developed a cognitive decline, parkinsonism with dystonic posture of the trunk and the right limbs, and a pseudobulbar syndrome. Brain MRI was performed in both patients and showed a bilateral multifocal leukoencephalopathy (P1) and the presence of bilateral hyper T2 and FLAIR weighted images affecting basal ganglia, the mesencephalon and the periventricular cerebral white matter. Cerebrospinal fluid (CSF) analysis showed no pleocytosis and normal proteinorrachia. Electroencephalogram was also normal. Infectious differential diagnosis including Human Immunodeficiency Virus (HIV) and syphilis were excluded and metabolic screening including copper analysis, serum and CSF lactate were normal. The urine toxic screening, performed 20 days following the drug overdose, was negative. Both patients were treated with benzodiazepine and fluids without significative improvement. They were discharged with major cognitive and motor impairment.

Conclusions

cocaine toxicity is associated with high morbidity and mortality. Usually, cocaine abuse can lead to cardio-vascular, pulmonary and nervous complication. Neuropsychiatric sequelae are uncommon with less recovery potential. To date, there is no drug to prevent or cure cocaine addiction. The key is to educate the patient when he or she presents to the emergency department. Patients should be urged to seek drug counseling.

Disclosure of Interest

None Declared
Alcohol use: prevalence and associated factors in a sample of Tunisian students
Authors: Ben Soussia R. , Faouel N. , Bouali W. , Gharbi E. , Ben Fredj M. , Zarrouk L.
Published: August 2023

Introduction

The use of alcohol, in particular its harmful use and alcohol dependence, represent a public health problem of interest to all age groups. Indeed, alcohol is responsible for a heavy burden of disease and a considerable socio-economic burden.

Objectives

To determine the prevalence of alcohol use and the main factors associated with it in a sample of Tunisian students.

Methods

This is an analytical cross-sectional study carried out during the 2020/2021 academic year with a sample of Tunisian students. We used an anonymous self-administered questionnaire distributed online via social networks. Our questionnaire included a section focusing on socio-demographic characteristics and the AUDIT test (Alcohol Use Disorders Identification Test) to detect alcohol addiction.

Results

Our study enrolled 772 students .The average age of the study population was 23.29 ±3.25.Two hundred ninety-nine students (38.7%) consumed alcohol. The mean age at first use was 18.44 (3.09). Fifty-two alcohol users (17.4%) presented a risk of alcohol dependence. The first consumption contexts were mostly “between friends” (57.4%) and “party time “(23.5%).The main effects sought were the effect of disinhibition (64.5%) and social integration (41.1%) were predominant responses. The determining factors of alcohol consumption were age (p<10-3), male gender (p<10-3), and the presence of grade repetition (p<10-3), wealthy socioeconomic level (p<10-3), and participation in community life (p<10-3).

Conclusions

Alcohol use and especially alcohol dependence may have harmful effects on student’s life. It is relevant to screen this addiction to better its prevention.

Disclosure of Interest

None Declared
Does antipsychotic therapy prevent the development of chronic psychotic disorders in people addicted to ilegal psychoactive substances
Authors: Kasper S. S. , Čustović A.
Published: August 2023

Introduction

Acute psychotic disorders are increasingly being diagnosed in people addicted to PASA part of these patients develops chronic psychotic disorders for reasons that still insufficently known.

Objectives

The aim of the study was to determine preventive potential of antipsychotics in the development of chronic psychotic disorders as well as possible side effects of theur use.

Methods

The prospective retrospective qualitative study conducted in the period Septmeber 2017-September 2022.Data from medical records and electronic databases were used in the study.A structured questionnare for conductin research,a clinnical psychatic inteview,MMPI 202,tests to determine of ilegal PAS in body flluids.

Results

According to the results of the study adequate treatment of the underlying desease,fewer or complete abscence of relapses,social and psychoteraapeutic support had the greater effects.In the group of opiate addicts an adequate dose of supstitution therapy it often played a crucial role.

Conclusions

In experimental conditions the hypotesis about the preventive effect of antipsychotics on the development of psychotic disorders in peoplle addicted to PAS.On the contrary a whole series of new questions has beenopened.

Disclosure of Interest

None Declared
The general practitioner in charge of addictive behavior
Authors: Bouali W. , Omezzine Gniwa R. , Faouel N. , Ben Soussia R. , Zarrouk L.
Published: August 2023

Introduction

Recent reports confirmed that more than 22% of adult world population are suffering from addiction. Tobacco and alcohol use remain the most prevalent addictive behaviors reported in Tunisia. The management of addiction is a multidisciplinary team concept. This entity may be underdiagnosed due to perception default at the first line of management.

The aim of this study was to identify the limiting factors for addictive behavior approach in general practitioner (GP) clinic.

Recent reports confirmed that more than 22% of adult world population are suffering from addiction. Tobacco and alcohol use remain the most prevalent addictive behaviors reported in Tunisia. The management of addiction is a multidisciplinary team concept. This entity may be underdiagnosed due to perception default at the first line of management.

Objectives

The aim of this study was to identify the limiting factors for addictive behavior approach in general practitioner (GP) clinic.

Methods

A cross-sectional study involved 84 GPs in the city of Monastir, Tunisia. Self‐reported questionnaire was designed to survey the prevalence of patients with detectable addictive behavior among the outpatient GP clinic visitors.

Results

The participation rate was 93.3% (84/90). The prevalence of addictive behaviors was variable (38-59.5%). Tobacco use was the most common addiction (91.7%). More than seventy percent of questioned GPs were regularly consulting patients with known addictive behavior. The diagnosis was incidental in 7% of cases. Sixty percent of patients had predisposing factors for addiction. Diagnostic with screening difficulties for addictive behavior were independently related to doctor’s age >40 (OR = 6.51; p = 0.005), exercise in private clinic (OR= 6.46; p=0.004). Thirty-three percent of GPs were more involved in addiction monitoring. The use of assessment scales was noted in 15%. Young physician age (OR=5.20; p=0.002) and the absence postgraduate diploma in addictology (OR=9.66; p=0.01) were significantly associated addiction management avoidance.

Conclusions

This study aimed to assess of the attitude of GP in Monastir city regarding the addictive behaviors of their patients. The diagnosis and the management of addiction is not standardized for these health practitioners and this will not contribute to the battle against this social entity.

Disclosure of Interest

None Declared
Prevalence and associated factors to Post-Traumatic Stress Disorder (PTSD) and Social Anxiety Disorder (SAD) among health workers in the emergency room
Authors: Amamou B. , Betbout I. , Ben Haouala A. , Ben Mbarek M. , Merchaoui I. , Jebali R. , Zaafrane F. , Gaha L.
Published: August 2023

Introduction

post-traumatic stress disorder (PTSD) is a mental health illness that can develop after being exposed to one or more traumatic events. This is a serious, long-term emotional response to extreme psychological trauma. As for public health emergencies, it demands large-scale coordination among many staff, and participants, especially medical workers, are exposed to high levels of stress, which can easily lead to psychiatric illnesses such as social anxiety disorder (SAD). Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity, yet little is known regarding the nature of this relationship.

Objectives

The aim of this study is to investigate the prevalence of PTSD and SAD among health workers in the emergency ward and study the relationship between PTSD and SAD and the associated factors to both disorders among health workers in the emergency ward to suggest some solutions to reduce their effects.

Methods

This is a quantitative descriptive cross-sectional study conducted among medical and paramedical health professionals in the emergency rooms of the university hospital of Sahloul and Hached and the regional hospital of Msaken in Tunisia. The data was collected by a questionnaire that included demographic questions and Yes/No questions, as well as several scales to assess the degree of social nxiety (Liebowitz Social Anxiety Scale) and posttraumatic stress disorder (Post-traumatic stress disorder checklist for DSM-5 (PCL-5)).

Results

In our study, 81 healthcare workers completed the survey. Of the total responding participants 67.9% were females. We noticed that the example was young (58%), also 59.3% had <1 year of experience. The population was slightly predominated by paramedical staff (56.8%), it also had a low married percentage of 38.3. Among the participants 17.3% smoke tobacco, 12.3% drink alcohol, and 3.7% are under cannabis use. We found that 7.4% of the participants had a psychiatric illness.

In our study, 38% scored positive for PTSD and for SAD 13.58% had marked social anxiety, 12.35% had severe social anxiety and 3.7% had very severe social anxiety, this is associated rather with the female gender, the younger (age range 20-30 years) and the paramedical staff.

PTSD and SAD are more pronounced among those with the fewest years of experience.

We obtained a positive Pearson Correlation between PTSD and SAD (r=0.513).

Conclusions

Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity, especially in the healthcare field. Overall, researchers reveal that the link between PTSD and SAD is complicated, owing to a variety of factors such as a person’s genes, trauma history, and psychological vulnerabilities so large-scale epidemiological investigations are required.

Disclosure of Interest

None Declared
Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report
Authors: Pozuelo Moyano B. , Tzartzas K. , Kokkinakis I.
Published: August 2023

Introduction

The disease burden due to non-specific, functional, and somatoform disorders is high. An unknown part of these medically unexplained symptoms belongs to factitious disorders. When it comes to deciding whether a patient is able to work, it is essential to differentiate a somatoform disorder from a factitious disorder.

Objectives

The aim is to highlight, on the one hand, the differences between somatoform disorder and factitious disorder and, on the other hand, the potential impact of misdiagnosis in medical expertise regarding eligibility for a disability income.

Methods

A case report of Ms A. a 42-year-old Caucasian woman. She worked as a 100% fiduciary accountant until the age of 32 when she was placed on medical leave due to persistent trigeminal neuralgia. Subsequently, she developed total blindness, accompanied by distress in a crucial emotional context. A diagnosis of factitious disorder was retained by an expert psychiatrist, with severe consequences for her, such as disability income suspension and family conflict. We evaluated Ms. A. in our multidisciplinary medical expertise service for a disability income review.

Results

The patient reported a total absence of light perception in both eyes (subjective), not confirmed by objective ocular examination and spécific neuro-ophthalmological examination.

Psychiatric examination revealed that Ms. A. had been sexually assaulted at age of 7 and sexually abused for a year by her teacher at age of 14. Regarding the identity of the first abuser, she describes that she “can’t see his face” and that the multiple sexual assaults during her teenage years took place in the classroom after school, with the teacher “pulling down the window shades so it was totally dark.” She explains that, defensively, to avoid thoughts related to the traumatic experience, she was heavily invested in her studies. But, at the age of 30, after separation with her first boyfriend, diffuse pain and progressively total blindness appeared.

We concluded the diagnoses of pain disorders related to psychological factors and a dissociative neurological symptom disorder with visual disturbance.

Conclusions

Blindness not explained by a physiologic process may accompany trauma and psychological distress, with the search for the link between the onset of symptoms and significant unconscious psychic conflicts being crucial in the psychiatric investigation. A new diagnosis of dissociative neurological symptom disorder with visual disturbance (6B60.0) is included in the ICD-11. It is characterized by visual symptoms such as blindness, tunnel vision, diplopia, visual distortions, or hallucinations that are not consistent with a recognized disease of the nervous system, other mental, behavioral, or neurodevelopmental disorders. Differentiating this pathology from factitious disorder or simulation is essential from an insurance medicine point of view, but also for its treatment.

Disclosure of Interest

None Declared