bluuebunny/crossref_metadata_2025 huggingface dataset:
Community-based participatory research initiative to assess the scope of alcohol use within the community of refugees from Burma in the greater Denver area
Authors: Franks A. , Arlas N. , Harrison M. , Officer L. , Fuller B. , Le D. , Hunt D.
Published: August 2023

Introduction

For over fifty years, minorities in Burma have faced severe persecution and violence, forcing them to flee their homeland. In the past ten years there has been an influx in the number of refugees resettled in Denver, Colorado. Refugees often struggle to navigate the complexities of the American health care system and adapt to life in a foreign culture. The development of programs and partnerships to assist refugees in their pursuit of health and integration is essential to building stronger communities.

Objectives

This community based participatory research (CBPR) project was developed in collaboration with the refugee community from Burma living in the Denver area. After regular meetings with a group of motivated teenagers and young adults from this community to form our Youth Advisory Board (YAB), they identified alcohol use and misuse as a health concern within their community. With this identified issue, the project aimed to gather data from community members that could be leveraged to create, implement, and evaluate a culturally competent intervention to effectively address risky alcohol use in this community.

Methods

Data collection involved formal one-on-one, semi-structured, audio-recorded interviews with community members. Participants were recruited voluntarily at health information nights held by the student researchers at their local apartment complex. The interviews were conducted by one medical student researcher with one translator present and were transcribed afterward. The interview data was analyzed using Immersion Crystallization methodology.

Results

Initial results from the community meetings with the YAB, local organizations, formative community surveys, and key informant interviews highlighted the vulnerability of the refugee population, scarcity of culturally appropriate resources for alcohol abuse, and urgency of addressing problematic alcohol use. The analysis of the ten audio-recorded surveys showed several themes including negative consequences of alcohol use, specifically negative impacts on familial relationships, employment, and financial resources, and a perceived personal responsibility for managing one’s own alcohol consumption.

Conclusions

This project corroborates current literature regarding the scope and breadth of hazardous alcohol use within the community of refugees from Burma. Our data has expanded our understanding of the values of community members including the influence of religion and family on behaviors, and the negative impact on employment as the most impactful negative consequence. These findings need to be shared with the community to move forward in mapping the most effective and appropriate interventions.

Disclosure of Interest

None Declared
Psychopathology without Borders: Transcultural psychiatry and implications in clinical presentation and practice
Authors: Jesus S. , Costa A. R. , Simões G. , Gomes A. I. , Tarelho A. , Garrido P.
Published: August 2023

Introduction

Existing as an emerging topic in the field and undergoing constant evolution, Transcultural Psychiatry addresses how social and cultural factors influence mental illness. During the second half of the twentieth century, phenomena such as globalization, massive migrations and immigration, occurring in ever increasing frequency, continue to bring this topic to the forefront of discussion as challenges in the treatment of patients from varying cultural backgrounds emerge. Viewed from the biopsychosocial perspective, culture delineates a framework for the evaluation of various expressions of emotion and behaviour as well as defining the limits of what counts as disorder. As border restrictions are lifted, cases which present with these particularities are bound to increase, necessitating an increased attention to the influence that cultural and social factors play in the psychopathological clinical pictures which may present to the practitioner.

Objectives

The authors aim to briefly explore the concept of transcultural psychiatry and its importance in clinical presentation and practice with recourse to various clinical cases of international patients hospitalized in a Portuguese Psychiatry ward during a two-year period.

Methods

A brief non-systematized literature review was performed based on works most pertinent to the topic discussed. As compliment to the topic, a discussion of various clinical cases of hospitalized international patients is presented.

Results

Culture has been demonstrated to contribute to psychopathological presentations in a variety of forms, solidifying the old adage that ‘no man is an island’ and giving reason to the biopsychosocial approach applied in clinical practice. The impact of sociocultural factors is such that the DSM-5-TR includes in its classification culture-specific syndromes. The cases discussed demonstrate the various nuances necessary not only in exploring psychopathology, but also in implementing appropriate standards of care.

Conclusions

Transcultural psychiatry rises as a relatively recent topic as well as raising important philosophical, theoretical and technical challenges for mental health practitioners. Although existing as a subspecialty, each mental health practitioner should strive to be transcultural, taking into consideration the influence that these factors exert on mental illness. The patient should be evaluated with consideration to their cultural background, as well as not neglecting how the culture of the practitioner may influence the interpretation of psychopathological presentation.

Disclosure of Interest

None Declared
Caregiver burden in parents of children with neurological impairement and its relation with depression
Authors: Mellouli A. , Zouari S. , Smaoui N. , Bouchaala W. , Gassara I. , Jallouli O. , Feki R. , Ben Ncir S. , Kamoun F. , Maâlej M. , Charfi Triki C.
Published: August 2023

Introduction

Caregiving negatively affects the psychological and physical health of the caregivers, especially in parents of children with neurological impairement (NI).Furthermore, the behavior and demands of the patient make the caregivers encounter increased stress levels and negative thoughtsabout the future that may lead to depression in caregivers.

Objectives

To assess the relationship between caregiver burden and symptoms of depression in parents of children with NI.

Methods

A total of 33 caregivers of children with NI, participated in this cross-sectional, descriptive and analytical study, carried out in Child Neurology Department of the University Hospital in Sfax (Tunisia), between February and April 2021.

The Zarit-Caregiver-Burden-Scale (Zarit-CBS) and the Beck Depression Scale were administered.

Results

The average age of the caregivers (27 mothers and 6 fathers) was 38,33 years ± 6,53 years. Among the parents, 81,81% didn’t exceed the secondary educational level and75,75% of them had an irregular occupation.

The average age of the children (21 boys and 12 girls) was 7,58±4,29 years.Near to the half of them (51,51%) had intellectual disability.Over 54.54% of the children had a functional independence, while 21.21% required help in walking and 24.24% were unable to walk.

The intervention was based on motor rehabilitation (57,57%), adequate equipment (24,24%), ergotherapy (45,45%) and speech therapy (60,6%).After the intervention, 63,63% of children had an improvement and 30,3% had a stationary state.

The mean score of Zarit-CBS was 52,45±14,26. The caregiver burden was noted in 96,96%.

The mean score of Beck was 9,33±5,48. The depression was noted in 78,78%.

The total Zarit-CBS score had positive correlation with Beck scores (p=0.038).

Conclusions

There is a positive relationship between the caregiver burden and depression symptoms. Thus, effort should be made to relieve caregiver burden in parents of children with NI.

Disclosure of Interest

None Declared
Anxiety and depression among patients with spondyloarthritis
Authors: Feki A. , Mejdoub Y. , Mnif I. , Sellami I. , Gassara Z. , Bendejemaa S. , Ezzeddine M. , Kallel M. H. , Fourati H. , Akrout R. , Masmoudi M. L. , Yaiich S. , Baklouti S.
Published: August 2023

Introduction

Ankylosing spondylitis (AS) is an inflammatory rheumatic disease characterized by spinal and/or peripheral involvement, enthesitis, dactylitis, and several extra-articular manifestations. Chronic inflammation often leads to reduced spinal mobility and functional disability. The frequency of psychological problems has increased in AS patients.

Objectives

The objective of this study was to determine the prevalence of symptoms of anxiety and depression among AS patients and explore the underlying associated factors.

Methods

The Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and other clinical measures were collected during the clinical trial. We evaluated also the hospital anxiety and depression scale (HADs). P values < 0.05 were considered statistically significant.

Results

Sixty-two patients with AS were included in the study. The average age was 41 years [18-65]. The diagnostic delay varied from one year to 26 years with an average of 4 years. Twenty-nine years is the average age of onset of symptoms with a standard deviation of 10 years. The mean duration of the disease was 10 ± 8 years. At baseline, the mean BASFI score was 53.9 ± 2 and BASDAI was 4.5± 2.

Clinically significant symptoms of anxiety and depression were present in 48.4% and 54.8% of patients, respectively. Depression was noted with a mean HADS depression of 10,5 ± 5,2. Anxiety was noted with a mean HADS anxiety of 11,3 ± 4,6.

In univariate analysis, anxiety was associated with the low educational level of patients (p = 0.038) and with CRP level (p= 0.041). There was a significant association between depression and anxiety (p=0.000). There was no relationship between these psychiatric disorders and disease activity, treatment modalities or functional status (p>0.05)

Conclusions

In patients with Ankylosing spondylitis, the prevalence of risk of mental disorders is high.

Anxiety and depression are common in AS and even alter the quality of life.

Patients should be regularly screened for these disorders.

Disclosure of Interest

None Declared
Risk factors for psychiatric readmission among inpatients with major depressive disorder: A patient-chart based study
Authors: Al-Haboobi H. , Ioannou M. , Ben Saleh M. , Bakken Wold A. E. , Berg S. , Patraskovic S. , Szabó Z. , Steingrímsson S.
Published: August 2023

Introduction

Major depressive disorder (MDD) is a common and severe mental disorder. Although inpatient care may be needed in some cases, little is known on which factors are associated with risk for readmission.

Objectives

To identify risk factors associated with an increased risk of readmission within 90 days, after being discharged from psychiatric inpatient care for depression.

Methods

A medical record review is ongoing based on consecutive inpatients admitted in 2019-2021 at Sahlgrenska University Hospital, in Sweden. Inclusion criteria are MDD-diagnosis, admission > 7 days, no admission during the past half-year. Exclusion criteria are blocked medical record, patients who expired within 90 days after discharge. Time to first readmission for discharged patients was examined within 90 days. Clinical and sociodemographic characteristics were compared between readmitted and no-readmitted patients.

Results

To date, 446 cases have been included with a readmission rate of 19.5%. In a subgroup of 182 patients (admitted between April 2020 and March 2021), psychotic subtype of depression seems to be protective to re-admission (p < .003) while comorbid eating (p < .017) and neurodevelopmental disorder (p < .029) seem to be associated with high risk. At the congress, results from the whole cohort will be presented.

Conclusions

Medical record reviews can give good clinically relevant data for prediction of readmission. Comorbidities and depression subtypes may affect the risk for readmission.

Disclosure of Interest

None Declared
Open-Label placebo for the treatment of unipolar depression: Results from a randomized controlled trial
Authors: Nitzan U.
Published: August 2023

Introduction

The response to placebo is robust in studies of various antidepressant treatments. The strong placebo response, combined with the absence of side-effects, has prompted suggestions to use the ethically sound open-label placebo (OLP) as a treatment for depression.

Objectives

The aim of the present study was to assess the efficacy of OLP in the setting of a randomized controlled trial for the treatment of unipolar depression.

Methods

Thirty-eight patients (28 females, 73.7%) were randomized to either an eight-week treatment with OLP (n=18) or four week of treatment as usual (TAU) followed by four weeks of OLP (n=20). Clinical and socio-demographic measures were assessed at baseline, after four weeks, and at the end of the trial. Response to treatment was determined using the Quick Inventory of Depressive Symptomatology (QIDS SR-16).

Results

There was an overall decrease in depression levels over time, F(2,35) = 3.98, p = .028). A significant group x time interaction was found only among non-geriatric patients (<65y) with an early onset of depression (<50y), F(2,22) = 3.89, p = .036]. Post-hoc tests indicated a significant decrease during the first four weeks, but only in the OLP group, t(11) = 2.29, p = .043.
Table 1:

Demographic measures of OLP and TAU patients.

MeasuresOLP (n = 18)TAU (n =20)Statistical analysesAge (years) [Mean ± SD]48.17 ± 16.8651.65 ± 17.68t(36) = -0.62, p = .539Education level (years) [Mean ± SD]15.61 ± 3.6614.22 ± 2.62t(34) = 1.31, p = .200Gender (male/female) [no.]4 / 146 / 14X2(1) = 0.30, p = .587Age of onset (years) [Mean ± SD]34.19 ± 15.8232.45 ± 17.72t(36) = 0.32, p= .752Number of depressive episodes (no.) [Mean ± SD]2.58 ± 2.616.64 ± 9.16t(21) = -1.47, p = .156Number of hospitalizations (no.) [Mean ± SD]0.12 ± 0.330.17 ± 0.38t(33)= -0.40, p = .689

Notes

OLP = Open label placebo; SD = Standard deviation; TAU = Treatment as usual.

Image 3:

Conclusions

Our findings support the possibility that OLP is an effective treatment for the relatively young population of patients suffering from depression. Additional studies are warranted in order to explore the use of open-label placebo in clinical work.

Disclosure of Interest

None Declared
ARIPIPRAZOLE INDUCED COMPULSIVE EATING DISORDER: A CASE REPORT
Authors: Turki M. , Samet A. , Sahnoun F. , Jemil F. , Ellouze S. , Halouani N. , Aloulou J.
Published: August 2023

Introduction

Aripiprazole is a newer atypical antipsychotic with a favorable side-effect profile, especially a low propensity to result in metabolic syndromes.It is effective at treating bipolar disorder, the positive symptoms of schizophrenia and has the potential to treat negative and cognitive symptoms.

However, prior studies suggested that aripiprazole seem to be associated to a risk of inducing certain impulse control behaviors, such as uncontrollable gambling, hyper sexuality, as well as compulsive eating.

Objectives

We proposed to assess the evidence for compulsive eating associated with the use of aripiprazole.

Methods

We report a rare case of new onset aripiprazole induced compulsive eating behavior in a patient with bipolar disorder. Then, we conducted a literature review using“PubMed” database and keywords “Aripiprazole”, “Impulse Control Behaviors”, “Compulsive Eating”.

Results

He was a 21-year-old patient, diagnosed with bipolar 1 disorder. He was prescribed Aripiprazole, after a neuroleptic malignant syndrome induced by haloperidol (which was prescribed during the first episode psychosis).

One month following the treatment initiation, the patient complained of eating excessively. He was not able to control his eating and gained 30 Kg over the period of 4 months. Metabolic assessment showed a hypercholesterolemia.

Conclusions

Aripiprazole is a promising novel antipsychotic in mental diseases. However current evidence associates compulsive behaviors like eating with the use of Aripiprazole, probably due to the drug affinity to 5-HT receptors. More studies are needed to confirm this rare side effect.

Disclosure of Interest

None Declared
E-tool for mental health coping: usability and effectiveness study of a biofeedback approach on a digitized diaphragmatic breathing strategy
Authors: Maçorano R. , Canais F. , Perdigão A. , Gonçalves I. , Parreira M. , Ribas M. , Ferreira H. A.
Published: August 2023

Introduction

One of the most common somatic responses of the human body to a mental health issue consists of alterations of the breathing rate. Typically, when an individual is under stress, tends to have a more rapid shallow breathing - instead of resorting to the diaphragm to help the air in and out the lungs, ends up conducting a thoracic breathing, leading to extended fatigue or dizziness.

Objectives

The aim of this project is to assess the accuracy and efficacy of measuring the breathing rate through abdominal breathing movements, via the smartphone’s sensors, and applying it to personalize a digitized diaphragmatic breathing strategy. The main hypothesis under testing is that the digitization of this strategy with the personalization to the subject’s own response is efficient as a valuable tool for mental health coping.

Methods

A tool was developed and integrated with a mobile app that aggregates mental health coping strategies, based on the digitalization of positive psychology techniques. The tool included the diaphragmatic breathing exercise and the personalization to the user through biofeedback. Such biofeedback was based on the user’s abdominal movements and directly impacted the course of the strategy. The tool is under testing, counting so far with 25 subjects resident in Portugal.

Results

The usability and effectiveness metrics of the solution will be assessed on the first contact of the subject with the app, and segmented by different subject profiles. Mental health metrics will also be assessed, namely anxiety levels - using the smartphone sensors and standard psychiatric scales. The results will be compared with a control group, in which the subjects will only perform the self-assessment, without using the breathing exercise.

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Conclusions

We have yet to draw conclusions from the project; however, we aim to achieve the first results in due time.

Disclosure of Interest

None Declared
Phenibut intoxication in a patient on methadone substitution therapy: A case report
Authors: Ceranic Ninic K. , Celofiga A.
Published: August 2023

Introduction

Phenibut is a synthetic γ-aminobutyric acid (GABA) agonist used to treat symptoms of mental disorders like anxiety and insomnia. The substnce is licensed and widely used in Russia. Its recreational use is increasing in many countries as it is easily accessible online. In a recent years, several case reports of phenibut intoxication and withdrawal have been published worldwide.

Objectives

We present a case report of intoxication with phenibut in a patient with psychoactive substances use disorder on regular methadone substitution therapy.

Methods

A 40-year-old male was hospitalized for the first time in the psychiatrc ward due to intoxication with phenibut. Before admission, he was confused, with incoherent speech. Bradypnea and somnolence were observed. A urine screening test was positive for methadone and benzodiazepines, while there was no information on phenibut intake at that time. After receiving naloxone, the patient became, agitated and haloperidol was introduced.

Results

The main symptoms of phenibut intoxication, which have also been described in other cases, are cardiovascular effects, insomnia, anxiety, agitation, hallucinations, and reduced level of consciousness. In our case, a more heterogeneous clinical picture of intoxication was observed, due to the simultaneous use of methadone and other PAS.

Conclusions

The availability of various synthetic substances available online is constantly increasing. Their use is most common in the population with substance use disorders, in patients on substitution therapy and in patients with mental disorders in general. The clinical picture of intoxication can thus be very diverse and atypical, which requires increased attention from clinicians.

Disclosure of Interest

None Declared
Mental Health in the digital area: what every doctor should know
Authors: Molina-Ruiz R. M.
Published: August 2023

The use of social networks is an integral part of our daily life as a means of communication. Patients manage information mostly from the internet, that strongly influence their beliefs and behaviors toward illness. Scientific dissemination through these kinds of platforms has expanded enormously in recent years, varying between them in style, contents and type of interaction with the users, that make necessary an individualized analysis. The use of Instagram goes beyond sharing photos and free comments, and it has been used extensively in different fields of medicine, such as mental health. This tool has enormous potential as a means of more effective communication and prevention and it is very valuable as a tool for psychoeducation and prevention in mental health. However, in the era where “information is easy to get but knowledge is difficult to find”, professionals of mental health should get involved and adapt to new scenarios of communication.

Disclosure of Interest

None Declared
What does a Peer Support Worker do in a Forensic Mental Health Clinic for Addicted Offenders?
Authors: Walde P. , Völlm B.
Published: August 2023

Introduction

Peer support work can be an effective way to support patients and their participation in psychiatric treatment. Unlike in general psychiatry there is less experience with peer support work in forensic mental health inpatient settings. Characteristics different from general psychiatry, e.g., regarding patient structure and background, might lead to different tasks of peer support workers and subjects of conversation.

Objectives

We aim to present an overview of tasks and conversation topics of a peer support worker in a forensic mental health setting for addicted offenders during an 12 month period. We address tasks on regular and irregular basis and the most frequent conversation topics.

Methods

We used the anonymized work documentation about weekly working activities and conversation notes of the peer support worker to extract information. Extracted data were thematically analyzed and clustered into themes for tasks and conversation topics.

Results

Results reveal several recurring and routine tasks, like joining ward rounds and changes of shift or leading a recovery patient group along with one-to-one conversations with patients according to their request. These topics were expanded by irregular tasks like group discussions for special occasions, e.g., after incidents. During one-on-one conversations, patients addressed topics, e.g., about their substance use history, thoughts and issues about their therapy or ways to achieve their goals in the future.

Conclusions

Peer support is a well-accepted offer that can contain various different tasks in groups and in one-on-one settings as well. Although the peer support worker is seated on one ward, there are many requests from other wards, too. There also exists a broad range of conversation topics, some might be also present in general psychiatric wards and others that might be more unique to forensic settings. The broad range of tasks and acceptance of peer support make it necessary to provide corresponding resources like peer support staff and payment.

Disclosure of Interest

None Declared
Examining the operationalizability of findings from homicide investigations
Authors: Nathan R. , Caplan R. , Gill-Mullarkey M.
Published: August 2023

Introduction

Investigations into health and social care services offered to people who have died by suicide or who have committed a homicide have the potential to facilitate improvements in future practice. Such improvements are, however, dependent on the operationalizability of the recommendations of these investigations. Operationalizability in this context means the potential of the recommendations to alter the thinking/actions of practitioners involved in the areas of practice to which the recommendations relate. Critically, the proposed learning must make sense to practitioners in a multiplicity of single instance episodes of practice when the future is unknown. Although common content themes identified by investigations have been reported, no study has yet specifically examined how the framing of recommendations in investigation reports affects their operationalizability.

Objectives

Primary objective: to pilot a novel approach to the thematic analysis of investigations into serious incidents which focuses on the operationalizability of recommendations for day-to-day practice. Secondary objective: to explore the operationalizability of the specific recommendations arising from a recent UK review of child homicides.

Methods

A publicly available UK national review of child homicides by parents under social care services was subjected to a two-stage thematic analysis (firstly, to identify the types of thinking/acting that were scrutinised; and secondly to characterise the ways in which these thoughts/actions were appraised). The frame of reference for the thematic analysis was that of a practitioner involved in typical instances of practice where there is uncertainty about outcomes (i.e. real-life practice).

Results

Stage 1 - Four types of thinking/acting were identified: (i) information gathering, (ii) interpretation, (iii) judgement formation, and (iv) decision to act (figure 1).Stage 2 - The thoughts/actions were appraised according to three key themes: (a) occurrence of thoughts/actions at a pivotal moment, (b) erroneousness of thoughts/actions, and (c) thoroughness of thoughts/actions.

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Conclusions

With regard to the specific report analysed, the recommendations were found to have differing degrees of operationalizability. For instance, examples of ‘erroneous thinking/acting’ were more readily applicable to future practice (since they can be operationalised in terms of general principles). However, the notion of ‘pivotal moments’ is less useful, since the labelling of moments as ‘pivotal’ is dependent on a knowledge of the outcome and therefore would not have been readily identified contemporaneously in these cases (or, by extension in future similar cases prior to any serious incident). This pilot demonstrates that the novel approach used is a feasible way to examine not just the content, but also the utility, of investigation recommendations.

Disclosure of Interest

None Declared
Psychological and sexological characteristics of rape perpetrators - first report
Authors: Kowalczyk R. M. , Daren A. , Hejmej A. , Lesniak M. , Waszynska K.
Published: August 2023

Introduction

For many years, the crime of rape has been the focus of attention of numerous representatives of criminal law doctrines, psychologists and sexologists, and is also part of the considerations of courts and penitentiary centers.

Statistical reports made available by the police clearly indicate that in recent years the problem of sexual crime has been growing, especially crimes consisting in committing a forbidden act such as rape or sexual murder.However, complete and objective data on the prevalence of sexual offenses are very difficult to obtain. Data from the judiciary statistics reveal only a narrow part of the problem of rape.

Objectives

The project involves the analysis of the collected research results, the result of which will be the preparation of a report - a psychological and sexological profile - the characteristics of the convicts. The indicated analysis will be the result of research conducted in several penal facilities in the territory of Poland, including: Kraków, Warsaw, Poznań and others. on a research group comprising about 15% of the total number of prisoners for this crime.

Methods

The source of data on sexual offenders will be data obtained as a result of direct examinations of persons charged with rape, forensic psychiatric opinions, forensic psychological opinions and sexological opinions issued in their cases based on psychiatric and sexological tests commissioned by the court. The research material comes from the files of the perpetrators made available for the purposes of the study by the Central Board of the Prison Service. The authors of the project created a comprehensive perpetrator questionnaire containing a range of data including items on life line, origin, education, work, sexual preferences, sexual life, sexual initiation, psychiatric diagnoses and disorders of sexual preferences and personality.

Results

A preliminary review of the available material gives grounds to conclude that the data it contains is comprehensive and has enormous scientific value. The created tool (based on a comprehensive analysis of the material) by the research team also includes items on the course of the act itself, the method of searching for victims, the method of persuading or forcing victims to submit to sexual activities, the repetition of the act and, finally, the perpetrator’s relationship to the criminal act committed by him.

The final report will be presented at the EPA conference.

Conclusions

The presented report will allow to get to know the characteristic elements of the psychological and sexological profile is a necessary condition for developing an effective strategy of social rehabilitation interactions.

Disclosure of Interest

None Declared
Emotional-psychological concerns of Turner’s patients regarding social discrimination
Authors: Bouayed Abdelmoula N. , Abdelmoula B. , Sellami S.
Published: August 2023

Introduction

Turner syndrome characterized by total/partial and/or homogeneous/mosaic X chromosome monosomy is associated with various physical health concerns, including facial dysmorphism, short stature, infertility, and other organ defects such as heart, kidney, bone, skin, … as well as variable degrees of cognitive impairments. Besides, social skills, communication and relationships are usually disordered.

Objectives

The aim of this study was to report social challenges of Turner syndrome particularly related to discrimination regarding physical and cognitive impairments.

Methods

A retrospective analysis of clinic data and karyotypes were carried out for the patients diagnosed with Turner syndrome among patients who consulted at our genetic counselling at the medical University of Sfax, during the last two decades.

Cytogenetic analysis were carried out using conventional methods and RHG banding with analysis of at least 20 metaphases and 3 karyotypes for each patient. Social challenges were recorded for each patient during pre-cytogenetic consultation and oriented questioning.

Results

We identified 23 cases referred with a cytogenetic diagnosis of monsomy X. The karyotyping was indicated for dysmorphism, primary or secondary amenorrhea, female infertility and recurrent pregnancy losses. Homogeneous X chromosome monosomy was recorded in 13% of cases, whereas mosaic forms with and without structural X/Y abnormalities were more frequent (82%). The mean age of patients in the study was twenty years. When the 45,X population was the predominant one (56,5%), dysmorphism and primary amenorrhea were constant. In the mosaic forms, clinical traits of Turner syndrome were insignificant. Discrimination based on physical appearance, intellectual disability, and failure to conceive were the three types of social challenges revealed by patients of our study. Parents of Turner patients were also concerned at the psychological level. They in fact revealed their emotional distress face to stressful experiences of their children with Turner syndrome regarding the social discrimination they encountered particularly in schools.

Conclusions

Social challenges related to discrimination based on physical appearance, intellectual disability, and failure to conceive in Turner syndrome lead to depression, low self-esteem and anxiety.

Disclosure of Interest

None Declared
Formal Caregivers in Intellectual Disability Facilities
Authors: Martins B. , Silva I. A. , Cardão J. , de Matos A. H. , Agostinho C.
Published: August 2023

Introduction

Caring for individuals with intellectual disabilities is a passionate, but challenging profession. Whether working in residential homes or in occupational facilities, its staff deals with the ordinary issues of teamwork, but also with these clients behavioral comorbidities. It often includes self-harming and aggression towards others – namely towards the staff itself. This is particularly relevant since a high turnover of staff implies the loss of people who are familiar with the needs and specificities of those clients. The quality of care provided may also be affected.

Objectives

To investigate whether, or not, formal caregivers are at greater risk of occupational health issues, and what their main determinants are.

Methods

Research in Medline for intellectual disability caregivers. Only the relevant articles, published in English, were considered.

Results

Among formal caregivers of people with intellectual disabilities, job dissatisfaction and job strain were found to be especially relevant and were associated to the following variables:

• Younger workers or those with less professional experience

• Personality and individual maladaptive coping strategies

• Poor organizational support

• Conflicting, ambiguous, or overloaded professional roles

• Unclear work tasks

The incidence of Burnout Syndrome was also described as relevant among these workers and was associated not only to aggression towards the worker, but also to the fear of aggression.

Conclusions

Caring for people with intellectual disabilities, in a residential or in an occupational context, implies heavy emotional and physical demands and a high prevalence of job dissatisfaction, Job Strain and Burnout Syndrome. In addition to the high risks to the quality of life and health of caregivers, there are consequences for the quality of the care that is provided. For this reason, guaranteeing proper work conditions should be considered part of the Social Institutions main goals. Yet, we lack specific, controlled studies that properly evaluate what measures could indeed help institutions to prevent occupational (and mental) health distress among their staff.

Disclosure of Interest

None Declared
Seeing voices? The importance of raising awareness on Deaf Mental Health
Authors: Conde Moreno M. , Ramalheira F. , Couto Bártolo M.
Published: August 2023

Introduction

Data regarding mental health problems in the prelingual deaf population is scarce. There is evidence that factors related to minority stress can contribute to mental illness in that population. In psychiatry, communication is key, however, most clinicians are not trained to communicate with the Deaf. Moreover, psychiatrists are often not aware of particularities in the psychopathology of these patients.

Objectives

We aim to review important aspects of psychiatric evaluation of prelingual Deaf patients.

Methods

Non-systematic review of recent literature regarding Deaf mental health and mental illness.

Results

Data regarding prevalence of mental illness in the Deaf population is mostly obtained from small studies and suggest an increased burden of mental illness and significant barriers to mental health care. Psychiatry research regarding Deaf patients is about 40 years behind research on the hearing population. While communicating with a Deaf patient, clinicians should consider the preferred communication modality. Sign-language interpreters should have specific mental health training, although that is not the case for many countries. Clinicians should keep communication simple, use short sentences, concrete examples and visual aids.

The mental status examination will have particularities, such as: 1) facial expressions have a specific role in sign languages and may not relate to affect; 2) There is a need to distinguish between language dysfluency and thought disorder 3) voice hallucinations may manifest as somatic or visual hallucinations; the occurrence of pure auditory hallucination in the prelingual Deaf is controversial. 4) the Deaf have little access to health information and are likely to demonstrate poor literacy on mental health matters.

Conclusions

More studies regarding the mental health issues of the Deaf population should be conducted. Raising awareness among clinicians about the needs of Deaf population is an important step to improve their access to help and treatment.

Disclosure of Interest

None Declared
Development and testing of a Shared decision making ExpeRience in mENtal hEalth (SERENE) measure
Authors: Chmielowska M.
Published: August 2023

Introduction

Shared decision making (SDM) is a health communication approach focusing on patient-clinician interactions around treatment decisions, with the goals of improving clinical and functional outcomes and providing personalized care. Moreover, decision making may need to be negotiated between, and communicated to, multiple health and social care practitioners, as well as patients and their social networks (SNs). The skills for sharing and discussing personal information with patients, and their SNs, can be hard to embed in mental health services. Compared to physical health, SDM in mental health is characterized by inconsistent definitions, models, and measurement, and evidence for the effectiveness of SDM interventions is inconclusive. Therefore, there is a need to define what is considered an effective SDM approach in mental healthcare, and to determine the core elements and steps required for its successful implementation in mental health populations.

Objectives

To better understand the concept and role of patients’ social networks in treatment decision-making in mental health.

Methods

A two-phase process (compliant with the International Patient Decision Aid Standards) will be used to develop the first polyadic SDM measure of patient experience to support a wide range of models of mental health care. The new measure of patient experience will focus for the first time on the patient’s perception of individual qualities/behaviour of a patient, clinician, caregiver, and their interaction. Phase I of this thesis involved reviewing the existing SDM interventions and SN interventions in mental health, as well as reviewing the existing instruments used to measure SDM in mental health research and practice. Phase II will involve developing and revising the new measure of SDM using stakeholder feedback in an iterative process. Stakeholders will include patients, their caregivers, and clinicians recruited from community mental health services in England.

Results

To define SDM and the most relevant aspects of it, data from the literature review and exploratory focus groups will be evaluated together. A pool of draft questions will be generated, covering all aspects of the identified themes. These questions will be further refined following discussions with people with lived experience of mental illness (i.e., peers) and academics who have the relevant expertise in SDM and psychometric measure development. This will establish content validity and ensure wording clarity, to be accessible for all English language requirements.

Conclusions

The new SDM measure will ensure effective evaluation of SDM experiences of people with mental illness. It will be an important step forward in advancing the study and application of SDM in mental health care. It will lay the foundation for further research into the needs of patients and their SNs regarding SDM in mental healthcare.

Disclosure of Interest

None Declared
Impact of multiple sclerosis on mental health: A Cross-Sectional Study
Authors: Chemingui S. , Mersni M. , Yousfi I. , Mechergui N. , Brahim D. , Bahri G. , Ben Said H. , Youssef I. , Ernez S. , Ladhari N.
Published: August 2023

Introduction

When we think of multiple sclerosis (MS), we usually talk about the sensory and motor symptoms of the disease and their impact on the functioning of the individual affected. However, this disability can lead to a wide range of symptoms, including psychological and cognitive manifestations that also have a significant impact on the quality of life of patients

Objectives

To estimate the incidence of psychiatric disorders in patients with MS.

Methods

A cross-sectional descriptive study that interested MS patients referred to the occupational pathology consultation of the Charles Nicolle Hospital, during the period from July 1, 2020, to September 30, 2022. The data collected concerned the characteristics of the disease. The detection of psychiatric disorders was studied through a validated self-questionnaire GHQ-12 (General Health Questionnaire).

Results

The study population consisted of 26 cases. The average age was 38 ± 9 years. A predominance of females was noted in 77% of cases. Eight patients (31%) were smokers. Nine cases (47%) had a relapsing-remitting form and six cases (32%) had a primary progressive form. All patients were on disease-modifying therapy. The average duration of the disease was 6 ± 3 years. The average duration of work during the illness was 4 years [one year-12 years]. The average duration of work stoppage in the last 12 months of activity was 63 days [2-240 days], of which 54% was long-term sick leave. The mean GHQ-12 score was 4.38 [0-10]. Twenty patients (77%) had psychological disorders.

Conclusions

This study shows the high frequency of psychiatric disorders in our MS patients. The role of the neuropsychologist is therefore often crucial in the care of these patients.

Disclosure of Interest

None Declared
Intracranial hemorrhage in a patient with depressive anxiety disorder about a case
Authors: Palomo Monge M. , Lopez Rodrigo M. V. , Garcia Montero C. , Osca Oliver A. , Fons V. R. , Duque Dominguez A.
Published: August 2023

Introduction

We present the case of a 69-year-old patient who went to the emergency department due to an episode of aggressiveness and behavioral alteration, presenting irritability and nervousness, of about 2 days of evolution according to her family member. Given that the patient had previously presented chronic behavioral disorders and had previously been followed up in psychiatric consultations, psychiatry was notified after an initial evaluation by the emergency physician.

Objectives

Somatic personal history: NAMC. HTA. Not DM, not DL. Former smoker of 20 cigarettes/day. Recurrent intracranial hemorrhage secondary to amyloid angiopathy and suspected amyloid vasculitis. Last admission to the neurology service in June 2022, also presenting symptomatic epileptic seizures and secondary behavioral alterations. Mastocytosis. Post-traumatic vertebral fracture. Non-anticoagulated paroxysmal atrial fibrillation. Surgical: Left ear surgery. appendectomy. Hysterectomy + oophorectomy.

Personal psychiatric history: In follow-up since May 2021 referred from neurology for emotional lability, episodes of anger and fear. Diagnosed with anxiety-depressive disorder secondary to a medical illness.

Current psychiatric treatment: Oxcarbazepine 800mg 0-0-1, trazodone 100mg 0-0-1, aripiprazole 10mg 1-0-0.

Methods

Current illness: The patient goes to the emergency room brought by her husband. During the interview she minimizes her aggressive behaviors or even does not remember them. She is disoriented in time, with very striking memory failures. Her husband comments verbal aggressiveness if he contradicts her in something, sometimes even presenting physical aggressiveness with her relatives. They report that in the last psychiatric consultation a little over 1 month ago, aripiprazole was withdrawn due to an increased risk of cardiovascular events.

After the examination of the patient, she was referred back to the emergency department for a new assessment and to rule out the organicity of the current condition, given that the patient had cardiovascular risk factors, due to the suspicion of a new episode of intracranial hemorrhage.

Results

sychopathological examination: Vigil, conscious, disoriented in time, partially in space. Collaborative, calm during the interview. Coherent, structured speech, with obvious memory failures. Labile, irritable mood. Verbal and physical heteroaggressiveness at home, not during the interview. No structured or planned autolytic ideation at this time. Appetite and sleep preserved.

Conclusions

An urgent head CT was requested, with the result of a small intraparenchymal bleeding in the left frontal location, and she was admitted to the neurology department, with a diagnosis at discharge of: small left frontal haematoma, suspected amyloid vasculitis, and secondary behavioral alteration (vascular dementia).

Disclosure of Interest

None Declared
LIVING IN A DOLL HOUSE: A CASE REPORT AND LITERATURE REVIEW OF REDUPLICATIVE PARAMNESIA
Authors: Pinto J. M. , Faria I. , Gouveia C. P. , Andrade J.
Published: August 2023

Introduction

Reduplicative paramnesia (RP) is a very rare content-specific delusional misidentification syndrome (DMS). RP entails the delusion that a place, an object, or an event has been duplicated or exists in two different places at the same time. RP is thought to result from an organic rather than psychiatric cause distinguishing it from other DMS. It has been suggested that damage to the right frontal and temporal lobe plays a crucial role, although other areas involved in visuospatial processing have also been reported.

Objectives

The aim of this study is to review the literature and report a clinical case of RP.

Methods

We describe a case of an 81 year old woman admitted in a Neurology ward, with a 2 week clinical presentation of temporo-spatial disorientation, behavioural changes, persecutory delusions and reduplicative paramnesia phenomena concerning her house. She had previous history of a stroke 3 years prior to admission and, about one year before, the patient also started to present cognitive decline in the context of Parkinson’s dementia. One month before admission, treatment with Rotigotine was started and later suspended when the aforementioned clinical manifestations started. Upon admission it was diagnosed an urinary tract infection and treatment with antibiotics was started. Two days afterwards, the patient recovered orientation and her usual behaviour, but persecutory delusions and RP persisted. She then started treatment with low dose Olanzapine. Following 2 weeks of treatment the psychotic symptoms fully remitted, including RP.

Results

We underline CT-scan and EEG relevant findings upon admission. In the CT-scan sequelar lesions in left frontoparietal junction, right posterior frontal cortex, left inferior occipital cortex, bilateral cerebellar hemispheres, left caudate nucleae and thalamus were identified. The EEG showed a preserved posterior alpha rhythm associated with slow discontinuous right temporal and mainly left parieto-temporo-occipital activity, indicating dysfunction in these locations.

Conclusions

In line with literature our patient had lesions in the right frontal and temporal lobe. She also presented lesions in other areas involved with visuospatial processing. Particularly the involvement of the left hemisphere reported in our case seems to be an exception. Other factors potentially played a role triggering this episode, namely the cognitive compromise due to dementia interposed with infectious disease, and the rotigotine treatment as well. Another aspect worth mentioning in our case was the remission of symptoms with the use of Olanzapine, even though only a few cases in literature have fully remitted with treatment with antipsychotics.

Disclosure of Interest

None Declared