bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of music type in ketamine-assisted group therapy on treatment-resistant mental health conditions: a prospective observational study
Authors: Sattler K. E. , Walia T. , Tsang V.
Published: August 2024

Introduction

Currently, Ketamine is the only safe, effective, and widely used psychedelic-like medicine in Canada. It has demonstrated notably efficacy in providing relief to those experiencing treatment resistant mental health conditions. Pairing Ketamine treatment with psychotherapy, known as Ketamine Assisted Therapy (KAT), has been shown to yield more enduring outcomes. Work by Greenway et al. has demonstrated that playing music following ketamine administration for patients with bipolar disorder can help the patient feel more in control and reduce discomfort (Greenway et al. International Clinical Psychopharmacology 2021; 36 218-220).

Objectives

The primary objective is to evaluate and compare the subjective clinical efficacy of two different types of music during ketamine-assisted group therapy. This will be explored through various validated psychiatric questionnaires, including the PHQ-9, GAD-7, and PCL-5. The secondary objective is to compare the objective changes in brain activity between the two music types. This will be evaluated using EEG data collected from MUSE headband before and after each ketamine-assisted therapy session.

Methods

This study is a crossover trial of 32 participants undergoing ketamine-assisted therapy for treatment-resistant mental health conditions. Half of participants will undergo a KAT session with a “weightless” music playlist followed by a session with a “grounding” music playlist. The other half will do the same, in reverse order. All participants will complete several psychiatric questionnaires within 7 days of each session over email. Before and after each session, participants will play a simple game to test executive function while wearing a headband to measure EEG activity.

Results

The absolute and relative changes to the scores of the questionnaires will be examined between participants and music conditions. The change in brain activity from pre-session to post-session will be compared between the different music conditions as well. As this is a crossover trial, any changes in outcomes due to order effects will be controlled for. Relevant demographic and medical factors will also be controlled for.

Conclusions

To date, no studies have explored the influence that different types of music have on patients experience with KAT in a group therapy setting. With the results of this study, we hope to fine tune and improve the use of music in future KAT administration.

Disclosure of Interest

None Declared
Exploring participant’s experiences in a multifamily therapy group on schizophrenia : a qualitative approach
Authors: Amiot O. , Genis C. , Champlon L. , Said S. , Baziret L.
Published: August 2024

Introduction

Prevention of relapse in schizophrenia is a major public health issue. A recent network meta-analysis investigating interventions for relapse prevention in schizophrenia found that the efficacity of family psychoeducation and systemic integrated interventions were superior to treatment as usual at 12 months (Bighelli I, Leucht S et al. Lancet Psychiatry 2021). Other studies also found that multi-family therapies (MFT) were superior to treatment as usual and family psychoeducation in preventing relapses at 2 and 4 years (McFarlane WR, Lukens EP et al. Archives of General Psychiatry.1995). Considering this, we developped in our community center an MFT program based on systemic approach and psychoeducation.

Objectives

Investigate the subjective experience of participants of an MFT group focusing on schizophrenia.

Methods

A qualitative study was designed to explore personal experience of participants using the Interpretative Phenomenological Analysis (IPA) method in order to analyse participant’s feedback during semi-directive interviews. By using IPA, participants are experts of their experience. Eight participants took part in this study: 4 patients and 4 parents.

Results

Within all participant’s feedback around 10 different themes emerged. We identified three major themes which we have described as: “Affiliation to the group”, “Framework of Discovery”, “Benefits of MFT”.

According to “Affiliation to the group”, all participants report movements of adhesion or rejection towards the group. This theme has been subdivided into two sub-themes: “Temporality”, and “Identification/differentiation”. These sub-themes revealed inter-individuals’ differences.

According to “Framework of discovery”, the MFT group has been identified as a secure place allowing self and other’s discovery place. This theme has been divided into two sub-themes: “discovering skills” and “improving oneself and relatives’ understanding”. Participants experience taking a step back and decentering oneself from usual personnal position.

According to “Benefits of MFT”, participants report the feeling of belonging to a group, the impact on self-esteem, on mentalization skills, and on the reflexion on family members’ experience of the disease.

Conclusions

This study is, to our knowledge, the first qualitative study examining the subjective experience of members who participated in a psychoeducational and systemic MFT group focusing on schizophrenia. It provides insight into the families’ experience, both from the patient’s and from each family member’s perspective. Results highlight that participants seized the MFT group as a learning space at several levels: personal, intra-family and inter-family.

These data could enlighten professionals working with families on the potential apprehensions of participants, their representations of the group and what process MFT could initiate.

Disclosure of Interest

None Declared
Differential diagnosis in chronic psychosis: a case report
Authors: Alcalde-Diosdado Crespi C. , Almodóvar Rivera M. D. P. , Vílchez Español F.
Published: August 2024

Introduction

A colombian woman aged 62, with previous diagnosis of paranoid schizophrenia. She retired from working 2 years ago, when she started taking care of her sick husband full-time.

Objectives

To describe a chronic psychosis case and discuss the treatment options and differential diagnosis.

Methods

We used the face-to-face interviews during her last hospitalization and her electronic medical history.

We also made a brief research about the effectiveness of risperidone depot in Pubmed.

Results

Psychiatric history

She’s had 3 hospitalizations, all of them coincided with stressful vital situations. The first one occurred when she was dealing with a job issue. In the second one she was having an economic conflict with her husband. And the third one has coincided with worries about her retirement pension and her caregiver burden.

Current episode

She came to my hospital emergency department distressed because she thought her husband and her were victims of an international drug trafficking plot. She said a colombian drug cartel had sent 9 prostitutes to her village in order to steal from them, by pretending they were cleaning assistants, as a reprisal against her husband, who used to be a military in Colombia . She explained the nature of this event with great details. Also, she said the electric company was involved and they had tried to intoxicate her.

The psychopathological exploration was altered with a correct speech in its form but incoherent in its content. She presented a highly structured delusional plot of prosecution. No major affective disorders were detected. She suffered from reactive insomnia and anxiety.

Evolution

At first, it was torpid, she felt perspicacious and angry about the admission. Later, as the antipsychotic started to work, the symptoms improved and she became calm and collaborative. She has never criticized the delusion plot, but it was encapsulated, and the affective resonance disappeared.

We tried oral aripiprazole and paliperidone but retired both due to bad tolerance. Then we tried risperidone, with good tolerance and response, and started her current monthly treatment with Risperidone 100 mg depot.

After one year, she has kept stable with no relapses and good adherence to the treatment.

Differential diagnosis

The patient meets every diagnostic criteria of Delusional disorder (F22), as she has never experienced hallucinations and the functionality has not significantly decreased through the years. Also, she doesn’t meet the second criteria for Schizophrenia (F20).

Conclusions

It is important to explore the evolution of a psychotic disorder in order to differentiate between a schizophrenia and a delusional disorder, as the prognosis differs significantly.

Using Risperidone monthly depot can be a good option for treating a psychotic disorder (Sampson et al. Cochrane Database Syst Rev 2016. 14;4(4)).

Disclosure of Interest

None Declared
Identifying Challenges in Social Functioning Among Women with Schizophrenia
Authors: Walha S. , Chaari I. , Samet A. , Ben Ghanem C. , Aribi L. , Charfeddine F. , Mseddi N. , Aloulou J.
Published: August 2024

Introduction

Schizophrenia spectrum disorders profoundly impacts social functioning, affecting interpersonal relationships, work interactions, and self-care. This disorder often leads to cognitive, perceptual, motor, and emotional challenges that result in social withdrawal.

Objectives

The aim of the study is to identify the specific challenges in social functioning faced by women diagnosed with schizophrenia spectrum disorders.

Methods

We conducted a descriptive cross-sectional study among stabilized female patients with schizophrenia or schizoaffective disorder, in the ‘B’ psychiatry department at Hedi Chaker University Hospital in Sfax, Tunisia, from May to June 2023. We collected both sociodemographic and clinical data from the participants. The Social Functioning Scale (SFS) and Global Functioning Scale (EGF) were used to assess social and global functioning, respectively.

Results

Forty-one patients were included: 65.9% had schizophrenia, and 34.2% had schizoaffective disorder. The mean age was 49.19 years, ranging from 17 to 79 years. More than a third (39%) of our patients had significant impairment in global functioning (EGF<50). The average total score on the social functioning scale was 13.65, with a range from 6.29 to 20.29. Additionally, 39% of our patients exhibited low social functioning, and 51.21% had a high withdrawal score. The most impacted domains were leisure (63.41%) and employment (60.97%), followed by interpersonal behavior (58.53%), prosocial activities (48.78%), independence competence (41.46%), and lastly, independence performance (36.85%).

Conclusions

Social skills training is crucial for enabling women with schizophrenia to function well in their environment.

Disclosure of Interest

None Declared
Breaking the Taboo: Unveiling the Prevalence and Predictors of Female Sexual Dysfunction in Tunisia
Authors: Razki K. , Larnaout A. , Najar C. , Ben Aissa S. , Lansari R. , Melki W.
Published: August 2024

Introduction

Female sexuality is a complex and multifactorial domain that can be influenced by a variety of psychological, biological, relational, and sociocultural factors. However, sexual dysfunctions in women remain a taboo subject in many cultures and are often underestimated, underdiagnosed, and undertreated. In Tunisia, few studies have been conducted to assess the prevalence of sexual dysfunctions in women and their predictive factors.

Objectives

to determine the prevalence of sexual dysfunctions in a group of Tunisian women and to identify the predictive factors of these dysfunctions.

Methods

This is a cross-sectional, descriptive, and analytical study, over a period of three months, from September to December 2022, conducted online via a pre-established questionnaire to collect various sociodemographic data, personal history, psychoactive substance consumption, weight, and height. We used the Female Sexual Function Index (FSFI) scale to evaluate sexual functioning in participants. We recruited sexually active Tunisian women over 18 years of age who agreed to anonymously respond to the questionnaire. The form was disseminated on social networks, in groups that focus on women, with a rate of three publications per week.

Results

We collected data from 90 women with a mean age of 35 ± 12.84 years.

More than half of our population (60%, n=54) had at least one sexual dysfunction.

The most common sexual dysfunctions reported were arousal disorders (31.3%), followed by desire disorders (26.8%) orgasm disorders (12.4%).

We found that several factors were significantly associated with sexual dysfunctions : Women over 45 years of âge (p<10-3), who are divorced (p=0,02), have a low socioeconomic status (p=0,04), and report having experienced traumatic romantic/sexual expériences (p<10-3) were found to have a higher prevalence of sexual dysfunctions.

According to our results, cannabis consumption had a negative impact on lubrication (p<10-3) and orgasm (p=0.003) among our study respondents. Personal psychiatric history also had a negative influence on arousal (p=0.02) and sexual satisfaction (p=0.01).

Conclusions

By identifying sexual dysfunctions early and treating them effectively, we can improve the quality of life of those affected and avoid serious consequences on their physical and mental health. It is therefore crucial to promote a proactive approach to sexual health and encourage healthcare professionals to approach sexuality openly and comprehensively.

Disclosure of Interest

None Declared
Relationship between sleep and sexual functioning in Indian females
Authors: Tripathi R. , Deedwania P. , Koparkar A.
Published: August 2024

Introduction

Sexual dysfunction is a taboo. It is a subject in many countries that negatively affects quality of life and may often be responsible for psychopathological disturbances. There is a little research on effect of sleep on female sexual response and behaviour.

Objectives

The aim of the study was to assess prevalence of sexual dysfunction and sleep problems in adult females visiting OBGY OPD in a tertiary health care institution in a developing country and to observe the correlation between both.

Methods

A cross-sectional observational study was conducted in a tertiary health care center in India. Female Patients presenting to Department of Gynecology and Obstetrics for any complaints were assessed for their sexual functioning and sleep profile

Results

The mean age of the sample was 33.5 (6.2) years. All the female participants were married. Most of the participants were housewife and were living in a joint family. Almost 27 percent of the sample reported having sleep problems. The median sleep latency was 30 (15,60) minutes. The subjective total sleep time was 356.5 (60.3) minutes. The mean PSQI score was 4(2,6). The mean FSFI score was 26 (3.2). More than 50 percent of the females reported mild sexual problems and 10 percent reported mild to moderate problems. Most of the females didn’t have any symptoms suggestive of depression. Only two females reported moderate depression.

Conclusions

Depression and anxiety have more effect on sexual functioning.

Disclosure of Interest

None Declared
Knowledge, perceptions and attitudes of medical doctors toward elderly sexuality in Tunisia
Authors: Jemli H. , Aissa A. , Ouali U. , Ezzaibi Jemli R.
Published: August 2024

Introduction

The sexual health of the elderly presents certain particularities to be taken into consideration in the doctor-patient rapport. The aim of our study was to assess physicians’ knowledge and attitudes towards sexuality in the elderly in Tunisia and to determine variables associated with the level of knowledge and the nature of attitudes in this population.

Objectives

The aim of our study was to assess physicians’ knowledge and attitudes towards sexuality in the elderly in Tunisia and to determine variables associated with the level of knowledge and the nature of attitudes in this population.

Methods

A descriptive and analytical study was conducted among specialists and medical residents of all specialties, practicing in Tunisia and recruited anonymously online. We included questions on socio-demographic data, medical specialty and medical training of physicians as well as a French translation of the Aging Sexual Knowlesge and Atttidues Scale (ASKAS). We determined correlations between the socio-demographic and medical training variables and the ASKAS score among participants.

Results

We included 74 physicians in the study. Sixty-two percent of the doctors surveyed sometimes asked elderly patients about their sexuality (N=46) and the rest of the doctors never mentioned the subject during a medical consultation (N=28). The major obstacles reported when discussing sexuality with the elderly were: a feeling discomfort related to sexuality considered a taboo subject (77%), lack of information and skills (51%) and the duration and setting of the medical consultation considered inadequate (45%). The mean score for the knowledge subcategory of the Aging Sexual Knowledge and Atittudes Scale (ASKAS) was 68.49±5.5 and for the attitudes subcategory was 83.74±4.2. These results indicated a moderate level of knowledge and moderate to negative attitudes.

There was a significant and negative correlation between age and the ASKAS knowledge subcategory score (r= -0.75, p=0.026), as well as a significant positive correlation between the knowledge and attitudes subcategories scores and sexology training (p<0.001).

The correlation between the knowledge score and the attitudes score was significant, positive, and good (r=0.788, p<0.001): the lower the level of knowledge, the more negative the attitudes regarding elderly sexuality.

Conclusions

There are several gaps in the knowledge and perceptions of Tunisian physicians regarding the sexuality of older subjects. Theoretical teaching and practical anti-ageing training for health professionals are needed.

Disclosure of Interest

None Declared
A systematic review of effectiveness and safety of some herbal compounds as treatment for primary insomnia
Authors: Barbosa M. , Fonseca A. R.
Published: August 2024

Introduction

Sleep related disorders affect around 30% of people all over the world, and evidence shows that 10% require therapeutic intervention. Insomnia represents the most common disturbance of sleep, defined as the experience of poor sleep for at least 1 month. Most of primary insomnia can be prevented by a proper lifestyle and sleep hygiene rules. Regardless, hypnotic drugs and widely prescribed, and most times, long-term used, which is not recommended because of its negative side effects.

Objectives

Review the scientific evidence about effectiveness of plant extracts for insomnia, natural products with practically no side-effects, and thus be possible to reduce or even avoid the use of hypnotic drugs.

Methods

The Medline database through the Pubmed search engine was used with the following keywords: “insomnia” and “herbal compounds”.

Results

Valerian activity on sleep disturbances has been attributed to the presence of isovaleric acids and valepotriates with reported calming action and GABA reuptake inhibition with sedative effects. Considering the data presented in the literature, despite controversial and conflicting, several studies showed that valerian (160-600mg/day) improved sleep quality and reduced sleep latency and duration; also valerian seems more effective for chronic insomnia than acute episodes.

Hop has different properties: calming, sleep inducing, gastric secretion stimulating and spasmolytic.

Increasing GABAergic activity seems to be the main mechanism of action, thus inhibiting the central nervous system and also has demonstrated binding affinities to some of the melatonin and serotonin receptor. It’s sedative characteristics have been confirmed in a clinical trial in association with valerian, where sleep latency and quality were improved. However, monotherapy studies showed no relevant effectiveness in sleep.

Kava Kava plant showed promising results, in rats and humans, with decrease sleep latency, better sleep quality and recuperation after sleep. However, raised concern about its potential of hepatotoxicity.

There is also promising evidence of the lavender efficacy for sleep disorders in a wide variety of populations and diseases, it was actually mentioned to be as effective as lorazepam in adults with anxiety and sleeping problems. With studies with dose of 80mg it was observed a reduction in sleep awakenings, sleep duration and overall sleep quality and anxiety.

Conclusions

There is a clear preference from the patient to natural compounds, and with almost nonexistent side effects, some herbal derivates are showed to have positive effectiveness in mild insomnia, but nonetheless much more studies on this field are needed.

Disclosure of Interest

None Declared
Sleep satisfaction, and its correlates with stress, health and happiness in university students: cultural and gender issues
Authors: Nikolaev E. L. , Fakhraei S. S. , Nikolaeva T.
Published: August 2024

Introduction

Sleep plays an important role in preserving mental health. University students’ learning activity, habits and cultural background may negatively affect the duration and quality of sleep.

Objectives

To determine the correlations of sleep satisfaction with the level of stress, health and happiness in university students of different gender and cultural backgrounds

Methods

We have surveyed 134 university students (77 domestic students and 57 foreign students). The numbers of male and female students were the same (67 students).To determine the levels of stress, health, happiness, and sleep quality satisfaction, we used a self-rating questionnaire (Nikolaev, 2023).

Results

The general indicator of sleep satisfaction with all the respondents made up 6.22±2.4 points. We have not revealed any valid statistic differences between the satisfaction levels of males and females, domestic and foreign students (p>.05). The males have shown a higher level of stress than females (р=.0004). The higher level of health assessment was revealed by foreign students as compared with domestic students (р=.0137), and by males in comparison with females (р=.0.0054). We did not determine any cultural and gender differences in other parameters. (p>.05). According to the final correlation analysis, all the respondents showed that their level of sleep satisfaction was positively correlated with the level of health (r=.40) and happiness (r=.37), but negatively with the level of stress (r=-.23). Similar interrelations were seen in the male group (r=.40; r=.36; r=-.28). Females revealed correlations of their sleep satisfaction with health (r=.38) and happiness (r=.38), but there was no evidence of correlation with the level of stress (p>.05).

Conclusions

University health development programs aimed at improving their students’ sleep quality, which take into account the complex of cultural and gender issues, may help enhance the students’ health potential.

Disclosure of Interest

None Declared
Suicide planning type interventions as an evidence based alternative for no-suicide contracts
Authors: Garbacka A. , Bzowska M.
Published: August 2024

Introduction

Suicidality is a common concern in psychiatric patients and one of the leading causes of death in adolescents and young adults. (Adolescent health. (2019, November 26) WHO). Some mental health professionals engage in a no-suicide contract with their patients. In this type of intervention, the patient usually agrees to not harm or kill himself/herself. There is an increasing body of evidence to support brief interventions, such as group of safety planning-type interventions (SPTIs) (McCabe et al. MC Psychiatry, 2018, May 3; 18(1)). Safety planning is derived from cognitive therapy and cognitive behavioral therapy used for suicide prevention.

Objectives

Our objective was to summarize and critically analyze current evidence of effectiveness of SPTIs and no-suicide contracts in suicide prevention.

Methods

We conducted a literature review to compare no-suicide contract to safety-planning interventions in suicide prevention.

Results

Although no-suicide contracts may work for some individuals, there is not enough quantitative evidence to support such contracts as clinically effective tools. A recent meta-analysis has shown that SPTIs were associated with reductions in suicidal behaviors although no effect was identified with frequency of suicidal thoughts (Nuij et al. (2021, April 30). The British Journal of Psychiatry, 219 (2), 419–426).

Conclusions

Based on the evidence and straightforward implementation of SPTIs in different clinical settings it may to be a more effective alternative to no-suicide contracts.

Disclosure of Interest

None Declared
Suicide across time and cultures: from a philosophical debate to network analysis
Authors: Tapoi C. , Chancel R. , Baltzis S. , Cikrikcili U. , Cenci D. , Lopez Castroman J.
Published: August 2024

Introduction

Suicide is a multifaceted subject that encompasses a broad spectrum of perspectives, spanning philosophy, the arts, social sciences, neuroscience, neuropsychiatry, and public health. The history of suicide is intricately intertwined with the history of humanity itself, and examining the shifting attitudes towards suicide holds significant implications for the field of suicide prevention.

Objectives

The objective of this paper is to offer a timeline of the social perspectives about suicidal behavior throughout history in order to showcase the influence of cultural and contextual factors.

Methods

This poster is based on the Massive Open Online Course (MOOC) “Focus on Suicidal Behaviour” provided by the European Psychiatric Association. We performed a brief overview of the chapter on history of suicide and updated data on this topic with recent literature findings.

Results

In antiquity, suicide was sometimes regarded as justifiable, whether to preserve honor or protest injustices. However, during the Middle Ages, suicide was primarily seen as a criminal act, violating the rules of the Christian religion. The Renaissance brought about a shift in the perception of suicide, as it began to be depicted in art as a heroic or philosophical act. Moving into the Romantic period, suicide took on a tragic and noble connotation, often seen as an escape from unbearable suffering.

The 19th century marked a significant turning point when the social context started being recognized as a crucial factor in the development of suicidal behavior. In the 20th century, suicide was increasingly considered a public health problem. In the 21st century, the discourse on suicide has become multifaceted. On one hand, network analysis has enabled the development of an integrated model of suicide, emphasizing the complex interactions among various risk and protective factors. On the other hand, ethical and moral debates persist regarding assisted suicide and its indications.

This summary primarily centers on the historical context of suicide within Europe. However, attitudes toward suicide vary significantly across cultures. For instance, in China, suicide rates are higher for women than for men, while Japan has historically displayed a relatively tolerant attitude toward suicide, particularly within the military. In contrast, Islamic countries consider suicide a major sin and implicitly associate it with stigma.

Conclusions

The understanding of suicide evolves over time and is deeply influenced by cultural contexts. Familiarizing ourselves with the historical perspectives on suicide is essential for comprehending this complex social and personal phenomenon. Such knowledge forms the foundation for the creation of effective prevention strategies.

Disclosure of Interest

None Declared
The Impact of Patient Suicide on Adult and Child Psychiatry Residents in Tunisia
Authors: Ines Y. , Ben Said C. , Bram N.
Published: August 2024

Introduction

Adult and child psychiatry residents encounter unique stressors in their training distinct from those in other medical specialties. Patient suicide has been identified as one of the most distressing experiences during psychiatric training.

Objectives

This study represents the first Tunisian investigation aiming to assess (1) the impact of patient suicide on psychiatry residents and (2) the limitations of the institutional support system in dealing with such cases.

Methods

A Google Forms questionnaire was distributed via email to all residents, gathering socio-demographic data, assessing traumatic impact using the PTSD Checklist for DSM-5 (PCL-5), and soliciting open-ended responses regarding personal experiences and expectations of the institutional support system.

Results

Fifty-three residents participated in the study. Among them, 29 residents had encountered patient suicide, with 12 directly involved. Symptoms of PTSD were detected in three residents. The physician directly involved in treating the suicidal patient reported the highest PCL-5 score. The majority of residents (27 out of 29) expressed the need for a structured support and training program tailored to healthcare professionals dealing with suicide.

Conclusions

The findings suggest that psychiatric residents may require additional training and support to effectively address the complex issue of patient suicide. Implementing specific training programs could significantly enhance their ability to manage such situations.

Disclosure of Interest

None Declared
Can high-sensitivity C-reactive protein be a routine trans-diagnostic biomarker for thoughts of death and suicidal attempts?
Authors: Cavallo L. , Orsolini L. , Volpe U.
Published: August 2024

Introduction

Several studies have shown an association between suicidal behavior and increased C-reactive-protein (CRP) levels (Ghayour-Mobarhan M. et al. Comb Chem High Throughput Screen 2022; 25 1047-1057) although most studies evaluated the association between CRP levels and suicidal ideation in depressed patients (Olié E. et al. Eur Neuropsychopharmacol 2015; 25 1824-31).

Objectives

Our study assessed baseline high-sensitivity CRP (hsCRP) levels in a cohort of adult inpatients affected by severe mental illness (SMI) and their association with Mini-International Neuropsychiatric Interview-5 subscale suicidality (MINI-5-s).

Methods

A naturalistic, observational, cross-sectional study was carried out by retrospectively recruiting 127 adult SMI inpatients, excluding patients with an organic pathology. HsCRP levels were assessed at the ward admission. To assess the suicidal behaviour all patients filled the same day the MINI-5-s.

Results

The number of patients with hsCRP>3mg/l were significantly higher among those with thoughts of death (p=0.002) and suicidal attempt (p=0.026). No statistically significant associations were observed between hsCRP levels and other suicidality dimensions.

Limitations: Small sample size, heterogeneous diagnoses, lack of diagnostic sub-analysis, cross-sectional design, and lack of a healthy control group.

Conclusions

The study reveals a transdiagnostic association between inflammation, thoughts of death and suicidal attempt in SMI inpatients. Our preliminary findings could support a routine introduction of hsCRP measurement, due to its relatively low cost, possible utility in trans- diagnostically suicide risk assessment. Large-scale clinical trials would be recommended to evaluate the effects of early anti-inflammatory therapy in patients with death ideation and/or suicidal attempt and concomitant low-grade hsCRP elevation. HsCRP could potentially represent an early biomarker for suicidal risk.

Disclosure of Interest

None Declared
Supervision an essential tool in medical (and psychiatric) training
Authors: Van Der Gaag R. J.
Published: August 2024

Introduction

Supervision is an essentail tool in medical training and especially in psychiatry and psychotherapy. It emcopasses two distinct aspects namely: coaching in the workplace aimed at developping competences (pyramid of Miller) and on the other side a safe place to reflect on ones personal development as a professional. This mentoring should be distinguised from the personal training psychotherapy. The mentoring supervisor will take the doctor’s pledge as a starting point of professional development. But will also encourage the resident to become aware of elements of transference and counter transference in his/her clinical work, helping to foster empathy “maximal understanding with respect for professional distance. This, not only for the benefit of the patient and his/her security, but also in order to take care of one’s own health and developing a sound balance between work and private life.

Too often supervision is taken for granted once the resident has become a consultant. Along with examples of the techniques and the pitfalls of supervison, the presenters will plea for training and intervision as part of the development of the supervisor!

Objectives

Raise awareness for the competences needed to become a valuable supervisor and the place supervision in its two aspects (coaching and place of reflection) should take in the training of medical doctors and especially psychiatrists

Methods

-

an inventory of the place of supervision in training in psychiatry throughout Europe

-

looking into competences needed in order to develop a sound professional attitude

-

looking into the competencies needed to become a valuable supervisor

Results

-

supervision is differently defined and given in training in psychiatry throughout Europe

-

the competences needed in order to develop a sound professional attitude are defined in the Doctor’s Pledge (World Medical Association 2017) but should be refined according to the specialty with special attention to aspects of psychiatry alien to other specialities

-

along with Teaching the Teachers - special trainings are available to become a supervisor

Conclusions

Supervision is an essential tool in medical/psychiatric training, but it needs to be taken seriously in terms of developing the competences needed but also maintaining them in intervision with the colleagues of the training staff

Disclosure of Interest

None Declared
Psychiatry training in Hungary, difficulties and advantages
Authors: Van Der Wijk I. A.
Published: August 2024

Introduction

While in theory our training program is quite satisfactory, in practise it often falls short. The first two years give a more general knowledge, including spending time at internal, ICU and neurological wards as well as attending a month-long course about communication, palliative care and basic legal principals important in healthcare. The second three years provide the opportunity to engage in profession-related rotations, like psychotherapy, psychiatric rehabilitation and addictology.

Objectives

The design in itself is clear, but the supervision for its enactment is insufficient. This leads to regional differences between the four faculties of our country, not everyone is able to partake in the supposedly mandatory rotations (mostly because of shortcomings in staff
) and the organization of our theoretical education varies greatly in each region to the point of non-existence in one area, since the COVID-19 pandemic started. The personal supervision of each psychiatry trainee also leaves much to be desired both on professional and – in psychiatry very important – mental levels. Competence and responsibility limits are often vague, and, especially in country hospitals, to much is expected of the resident (i.e. doing a nightshift alone, without direct supervision).

Methods

It is a positive thing that in theory there are standards in place, the problem is that they are more viewed as guidelines, than demands to be met. Nevertheless, some of the faculties provide well-organized education (even subdivided per year of training) and/or take rotations outside of the ‘home ward’ seriously. The opportunity to gain a basic knowledge in psychotherapy is also beneficial and a good aspect of our training. Easily accessible or even obligatory participation in psychotherapy for ourselves during our training however, is lacking.

Results

The decreasing number of psychiatry trainees sadly is a worldwide trend and Hungary is no exception. This poses more difficulties, i.e. making it harder to let a resident go on ‘outside’ rotations, especially from wards already struggling with staff shortages. Because of the latter, there is also little time to teach the trainees appropriately and pay them the attention they need.

Conclusions

All in all, there is much potential in our training program and its standards, also leaving room for substantial improvement in realizing the practical aspects. The decline in numbers of psychiatry trainees is worrisome and calls for more general intervention on a European or even global level.

Disclosure of Interest

None Declared
BDNF plasma concentrations, cognitive test performances and lifetime suicide ideation in psychotic disorders: a secondary analysis
Authors: Paribello P. , Manchia M. , Isayeva U. , Collu R. , Federica P. , Scherma M. , Pisanu C. , Meloni A. , Zai C. C. , Congiu D. , Squassina A. , Fratta W. , Fadda P. , Carpiniello B.
Published: August 2024

Introduction

Psychotic disorders present a significant lifetime risk for suicide. Past estimates suggest that up to 25-50% of individuals with schizophrenia (SCZ) may attempt suicide during their lifetime. A growing body of literature indicates that the level of cognitive performances may be associated with a differing level of lifetime suicide attempts, albeit inconsistently depending on the diagnostic category and study setting. However, the vast majority of the literature in the field is composed of cross-sectional studies, limiting the overall interpretation of the available evidence.

Objectives

In the present study, we probed the possible association of BDNF plasma levels, cognitive functions assessed through the Brief Assessment of Cognition in Schizophrenia (BACS) and lifetime suicide ideation and/or attempts (LSI+LSA). More specifically, we tested whether such association would persist during the 2 years follow-up divided in 5 different timepoints at 6-month intervals, if present.

Methods

The present study represents a secondary analysis of a previously described cohort (Manchia et al. Brain Sci. 2022 Dec 4;12(12):1666). The sample comprised 105 subjects with SZC or schizoaffective disorder. We employed the 1) Wilcoxon test for non-parametric data 2) linear modelling to test the possible association of BACS-defined cognitive task performances with LSI+LSA. We also investigated if either BDNF plasma levels or four tested BDNF SNP genes would mediate this association.

Results

From a total of 105 subjects, data relevant to the analysis were available for 89 subjects. We observed a significant association between BACS-Letter fluency task (BACS-LF) with LSI+LSA, persisting even when adjusting for gender, duration of untreated psychosis, total Positive and Negative Syndrome Scale score, age, chlorpromazine equivalents of antipsychotic therapy and for the effect of time. The association remained significant even when adjusting with the Bonferroni-Holms method for multiple comparisons (p=0.002). No association was found either for BDNF plasma levels or the tested BDNF genes for the tested outcomes.

Conclusions

In our sample, higher BACS-LF performances appeared to be associated with a higher lifetime risk of LSI+LSA. This report adds to the previous literature suggesting that different cognitive performance levels may represent one of the many chronic risk factors associated with LSI+LSA, and that may ultimately complexly interact with more proximal ones.

Disclosure of Interest

None Declared
Evaluation of a Simulation Based Training Course for Non-Consultant Hospital Doctors (NCHDS) in Psychiatry
Authors: Corrigan K. , Crudden G. , Doherty A.
Published: August 2024

Introduction

Simulation-based training (Sim) is an established method of teaching in medical education and can help bridge the gap between medical theory and clinical practice. While sim is well-established in medical and surgical specialties, it is less well developed in psychiatry. Psychiatric emergencies often occur out of hours when there are fewer senior staff available on-site. Sim offers a safe setting for development of essential clinical skills with carefully delivered feedback.

Sim can be high-cost involving specialized simulation facilities, especially when utilising high-fidelity equipment. Even lower-fidelity techniques requiring standardized patients (SPs) require funding for actors and this can be a barrier to utilising Sim.

Objectives

We piloted a Sim course to NCHDs working in psychiatry in a tertiary university hospital with the aim of improving trainee skills and confidence in managing psychiatric emergencies on-call including risk assessment, involuntary admission and acute behavioural disturbance. A low-fidelity approach was taken with minimal use of SPs.

Methods

A sim handbook developed by Irish Centre for Applied Patient Safety and Simulation (ICAPSS) was used for reference in developing the simulation modules. Three modules were delivered in a structured manner over three hours; involuntary admission, risk assessment and management of acute behavioural disturbance. Each module involved the simulation exercise (20 minutes) followed by debrief (20 minutes). The facilitated debrief involved open discussion and prompted reflective learning. Anonymous, paper-based questionnaires were used to collect feedback on participants’ experience of the training.

Results

There were 12 attendees and ten participants completed the feedback. All participants (100%, n=10) agreed or strongly agreed that sim helped them to learn and all agreed that the topics covered were relevant to their clinical role. All participants (100%, n=10), indicated that they enjoyed the workshop. Eighty percent (n=8) agreed or strongly agreed that they would like to do more sim-based workshops. The supportive environment and debrief sessions were reported as the most enjoyable aspects of the workshop.

Conclusions

Participants unanimously agreed that the training was useful to them in their clinical roles and helped them to learn. Sim was effective in teaching high risk complex psychiatric cases to psychiatry NCHDs and consideration should be given to expand this teaching method within postgraduate psychiatry training in Ireland.

Disclosure of Interest

None Declared
Maternal mental health and trajectories of Preterm Behavioural Phenotype in infants born after a threatened preterm labour
Authors: Andreu J. , Buesa J. , Almansa B. , Zapata C. , Lizarán M. , Gómez N. , Ghosn F. , Moreno A. , Campos L. , García-Blanco A.
Published: August 2024

Introduction

Infants born preterm usually show a Preterm Behavioural Phenotype, which includes mixed symptomatology characterized by lack of attention, anxiety and social difficulties, with a 3-4 times greater risk of disorders in further childhood. Critically, this behavioural pattern is also observed in infants born after a threated preterm labour (TPL), regardless of the presence of prematurity. It is known that the course of this Preterm Behavioural Phenotype shows high variability. Nevertheless, the predictors of this Preterm Behavioural Phenotype prognosis remain unknown.

Objectives

This study aimed to explore the predictors of change of Preterm Behavioural Phenotype symptomatology during preschool ages in order to improve prognosis.

Methods

In this prospective cohort study, 117 mother–child pairs who experienced TPL were recruited. Preterm Behavioural Phenotype symptoms were assessed at age 2 and 6 using Child Behaviour Checklist. Gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress were included as predictors in a regression model.

Results

Whereas increased internalizing problems were associated with a previous trauma history (p = .003), increased externalizing symptoms were linked to prenatal and postnatal maternal anxiety (p = .004 and p = .018, respectively).

Conclusions

Identifying modifiable risk factors, such as the history of maternal traumas and anxiety at TPL diagnosis and postpartum is recommendable to enhance better prognosis of Preterm Behavioural Phenotype in the offspring.

Disclosure of Interest

None Declared
Is relevant postpartum maternal psychopathology on the prognosis of psychomotor development in infants born after a threatened preterm labour across preschool ages?
Authors: Andreu J. , Buesa J. , Ghosn F. , Moreno A. , Campos L. , Almansa B. , Zapata C. , Lizarán M. , Gómez N. , García-Blanco A.
Published: August 2024

Introduction

Threatened preterm labour (TPL) is associated with long-lasting neurodevelopmental challenges, independent of prematurity. For instance, it is known that infants born a TPL show delayed communication and socio-individual skills, regardless of the gestational age at birth. Furthermore, TPL constitutes an adverse prenatal event that can induce maternal anxiety or depression, even during postpartum period, which can produce a deleterious effect of the prognosis of infant’s psychomotor development.

Objectives

This study aimed to explore the influence of maternal psychopathology as well as other peripartum variables on the course of psychomotor development in children born after a TPL between the ages of 2 and 6.

Methods

In this prospective cohort study, 117 mother–child pairs who experienced TPL were recruited. Psychomotor development was assessed using the Ages & Stages Questionnaires-Third edition at age 2 and 6. A regression model was carried out, including gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress as predictors.

Results

Low gestational week at birth emerged as the most relevant factor in the course of increased communication delay (p < 0.001). However, parental psychopathology during prenatal or postnatal stages was not a relevant factor in the prognosis of Communication skills or Socio-Individual development.

Conclusions

Gestation age at birth rather than parental psychopathology during peripartum period was the most relevant predictor of the course of psychomotor development between 2 to 6 years of age. Further studies should examine other potential modifiable predictors to moderate the impact of gestational age on psychomotor development.

Disclosure of Interest

None Declared
The relationship between perfectionism and self-esteem among trainee doctors
Authors: Ellouze S. , Boussaid N. , Mellouli A. , Turki M. , Miledi E. , Halouani N. , Aloulou J.
Published: August 2024

Introduction

Perfectionism is often seen as a beneficial trait for trainee doctors since it means they have high standards and a drive for success. However, it demands a flawless level of performance regardless of one’s physical or mental health and well-being. Consequently, perfectionism is now viewed from a different perspective.

Objectives

We aimed to study the impact of perfectionism among doctors in training on their self-esteem.

Methods

We conducted a cross-sectional descriptive and analytical study among trainee doctors. The following psychometric instruments were used: The “Work Addiction Risk Test” and the “Rosenberg Self-Esteem Scale”.

Results

We included 99 doctors in training. Their mean age was 27.6± 2.2 years. The sex ratio (♂/♀) was 0.33. Most participants were single (63.6%) and of middle socioeconomic level (86%). Tobacco use was reported in 6.1% of cases, and alcohol use in 4.1% of cases. Among all participants, 58 % had low or very low self-esteem. The mean score of Rosenberg Self-Esteem Scale was 30±5.13 and the mean score of the big three perfectionism scale short form was 41.11±13. Higher self-esteem scores was significantly associated with lower self-critical perfectionism scores.

Conclusions

Our results point to the negative impact of self-critical perfectionism on self-esteem. In fact, perfectionism can hold you back, both personally and professionally. Perfectionists see their own self-worth as tied to what they achieve, and they believe that others judge them on this as well. They can never live up to the standards they set for themselves, and this can lead to a downward spiral of self-criticism and blame.

Disclosure of Interest

None Declared