bluuebunny/crossref_metadata_2025 huggingface dataset:
A complex polymorphous psychosis or a cycloid psychosis with a different onset?
Authors: Becerra Darriba H.
Published: August 2023

Introduction

Acute and transitory psychotic disorders comprise a polymorphous picture such as Leonhard’s cycloid psychoses, which alternate episodes of affective symptoms such as psychosis between two poles (anguish/happiness, incoherence/stupor, or akinesia/hyperkinesia).

Objectives

To describe a case report of a 20-year-old man, in outpatient psychiatric follow-up, after debuting at age 18 with a severe depressive episode of endogenomorphic characteristics without psychotic symptoms, with subsequent complete remission. Two years after clinical stability, he required prolonged hospitalization due to polymorphous psychotic syndrome of abrupt onset in a context of previous continuous use of cannabis and cocaine. Suspicion towards parents, bizarre behaviors, rushing desires, unmotivated laughter, fixed gaze, bewilderment, anguish with a feeling of imminent death, alternates with euphoria and senseless purchases.

Methods

We present the case report of this patient with a mental examination of conscious, scattered attention with marked distractibility, confusion and experiences of strangeness, memory gaps, subjective sensation of well-being with tachypsychia, which fluctuates with thymic oscillations and alternates with episodes of marked indefinite anguish, intense anxiety with delusional fear of the death of him or his family. Little systematized ideas of reference and prejudice based on intuitions or delusional occurrences in their environment. Megalomaniac and religious-messianic ideation. No sensory perception disturbances. Disintegrated course of thought, with frequent illogical associations, ambivalence of thought, affectivity and psychomotricity. Motor restlessness and behavioral disorganization. Global insomnia. Judgment of reality and superior functions diminished. No auto/heteroaggressiveness.

Results

Various psychoactive drugs were tested for two months, obtaining a response only with valproic acid 1500mg, pregabalin 450mg and olanzapine 15mg, presenting slow improvement in a situation of absence of consumption, with a predominance of symptomatic polymorphism, decreasing fluctuation between episodes of expansiveness and psychotic anguish, remitting disorganization and motility alterations, persisting poor awareness of the disease and cognitive complaints. He was referred for follow-up at the mental health center where his gradual recovery continued.

A differential diagnosis of polymorphous psychosis is proposed, compatible with a cycloid psychosis of the anxiety-happiness type with marked affective symptoms, precipitated by substance use.

Conclusions

Cycloid anxiety-happiness psychosis stands out for intense and fluctuating anxiety, oscillating with feelings of happiness, ecstasy, and placidity, mystical-religious delusions, and preoccupation with death, which may comprise a different psychotic debut.

Disclosure of Interest

None Declared
Testostérone and Positive Dimension in Schizophrenia
Authors: Bouguerra I. , Khelifa E. , Adouni A. , Sellaouti Y. , Ben Ammar H. , Mnif L.
Published: August 2023

Introduction

Schizophrenia is characterised by a loss of contact with reality due to the presence in its symptomatology of a delusional and/or hallucinatory syndrome, also called positive symptoms and/or a dissociative syndrome, which reflects the negative component of the disease. Few studies suggest a probable link between testosterone and the symptomatic dimension of schizophrenia, but this subject remains poorly documented.

Objectives

The purpose of this study was to describe Testosterone profile in male patients with schizophrenia who are naïve to antipsychotic treatment or have been off it for at least two months and to investigate the relationship between testosterone levels and disease severity.

Methods

This was a descriptive, cross-sectional study of fifty male patients hospitalized for a psychotic relapse who were naïve or discontinuing treatment for at least two months. Patients were assessed using a semi-structured questionnaire and The Positive and Negative Syndrome Scale (PANSS). A blood sample was taken to measure testosterone level.

Results

The age of the patients included ranged from 17 to 65 years, with an average of 36.4±11.51 years. The PANSS score ranged from 50 to 195 with a mean of 116.76 +/- 31.817. Testosterone values ranged from 2.01 to 10.03 ng/ml with a mean of 4.74± 2.01 ng/ml. The majority had normal testosterone levels (94%) ; only 4% had high values and 2% had low values. A positive correlation was found between the positive component of PANSS and elevated testosterone (p=0.011). For the other subscales, no correlation with testosterone levels.

Conclusions

The present study is in favour of a testosterone aggravation of the mostly positive clinical signs of the disease in a significant way. Hormone assays could thus be a specific marker of certain patient profile with a particular evolution.

Disclosure of Interest

None Declared
Borderline personality disorder in Irish Travellers: a cross-sectional study of an ultra-high-risk group
Authors: Tong K. , Costello S. , McCabe E. , Doherty A. M.
Published: August 2023

Introduction

Irish Travellers are recognised as a minority ethnic group in Ireland. While mental health services are available to Travellers, these services are often perceived as inadequate at addressing the mental health needs of this population. Studies have shown that there is a higher prevalence of mental disorders in the Traveller community in Ireland compared to the general Irish public. However, it is unclear if Travellers are at a higher risk of developing personality disorders, particularly borderline personality disorder.

Objectives

This study will examine the prevalence of borderline personality disorder and other mental disorders in Travellers attending a community mental health service in Tuam, County Galway. This study will also investigate the biopsychosocial interventions delivered to this cohort and the clinical outcome following the interventions.

Methods

This is a cross-sectional study. Travellers who were active caseloads on the register of the community mental health service in Tuam were included in this study. Chart reviews were carried out on all samples included in this study.

Results

A total of 59 active patients were included in this study. The Traveller community formed 14.4% (59 out of 410) of the active caseloads of the Tuam mental health service. There were more male than female Travellers who attended the service. Mean age was 36 years old. The most common mental disorder in this study cohort is depressive episode (F32). This is followed by mixed anxiety and depressive disorder (F41.2). A significant minority (9, 15.3%) of the study participants were given a diagnosis of borderline personality disorder. 9 study participants await diagnostic clarification. Nearly one-fifth (18%, n=9) of the study participants with a diagnosis had been given a diagnosis of borderline personality disorder. Over 50% of the study participants were on at least 3 different medications from at least 2 different classes of psychotropics.

Conclusions

This study shows that there is a significant overrepresentation of Travellers attending the community mental health service in Tuam. The findings from this study can be used to plan future service development projects to better meet the needs of this unique population.

Disclosure of Interest

None Declared
Outpatient management of REM sleep behavior disorder case in Brunner syndrome
Authors: Cesari E. , Ochandiano I. , Mena J. I. , Salmeron S. , Gaig C.
Published: August 2023

Introduction

Brunner syndrome is a recessive X-linked disorder characterized by impulsive aggressiveness and mild mental retardation associated with Monoamine Oxidase – A (MAOA) deficiency (Brunner et al. Science 1993; 262 578-580).

Objectives

To present a REM sleep behavior disorder (RBD) case in a patient with Brunner syndrome.

Methods

The present study is a case report of a patient followed in our hospital’s outpatient care. We also searched for previous case reports of sleep disorders and other clinical features in Brunner syndrome using a pubmed query.

Results

A 46-year-old Spanish male, diagnosed with Brunner syndrome due to the mutation c.1438A>G/iVS14-2 A>G, a loss-of-function mutation in the X-linked MAOA gene. He suffers from mild mental retardation and psychotic disturbances treated with SSRI and antipsychotic drugs. The patient was referred to our outpatient care to assess his sleep abnormal behaviors. He had been presenting with episodes of sleep-related vocalization and complex motor behaviors during sleep for the last 3 years, correlating with dream mentation. His relatives recounted episodes of talking, screaming, gesturing, kicking, falling out of bed and crying during sleep. Dream content referred by the patient was often related to persecutions, attacks and fights.

Polysomnography revealed vocalization and gesticulation during REM sleep compatible with the diagnosis of RBD. The addition of clonazepam to his treatment at doses of 1-3 mg per day achieved significant clinical response of the sleep disorder.

Conclusions

The clinical presentation suggested the diagnosis of RBD case in a patient with Brunner syndrome. Although sleep disorders are not one of the most important or frequent clinical features in Brunner syndrome, they are described in the literature and can significantly affect the patient’s quality of life. To our knowledge, this is the first report about clinical management of RBD case in Brunner syndrome.

Disclosure of Interest

None Declared
Another Tragic Pandemic Strikes: It Is Suicide
Authors: Petta J. , Falcão A. L. , Soares G. , Lourenço A.
Published: August 2023

Introduction

Another pandemic besides COVID-19 stalks the land. This one takes a heavy toll on the young.

Suicide occurs throughout the lifespan and is the second leading cause of death among 15-29 years old globally.

Objectives

The objective of this review is to highlight for another tragic pandemic, with main emphasis on the preventable character.

Methods

Data was obtained through an internet-based literature review, using the research platform Pubmed and the World Health Organization website. Seven articles from the last two years were included.

Results

Improved surveillance and monitoring of suicide attempts and self-harm is a core element of suicide prevention and desirable worldwide.

A public health surveillance system based on medical records would provide and disseminate data that would guide and prioritize the best interventions in each context and contribute to an effective overall suicide prevention strategy.

Conclusions

Close to 800 000 people die due to suicide every year, which is one person every 40 seconds.

According to current data, for each adult who died by suicide there may have been more than 20 others attempting suicide.

Effective and evidence-based interventions can be implemented to prevent suicide and suicide attempts.

Disclosure of Interest

None Declared
Personal beliefs versus evidence-based decisions: vaccination behavior and doubts about antidepressants of students of medicine are affected by conspiracy theories
Authors: Pisl V. , Kestlerova D. , Losak J. , Skorkovsky T. , Vevera J.
Published: August 2023

Introduction

When medical professionals are obliged to adhere to lege artis and evidence-based decision-making, they need to interpret available evidence. As a complex cognitive process, however, such interpretation may be affected by socio-cognitive biases and predispositions. For instance, the conspiracy mentality (the general readiness to believe in conspiracy theories) or biological determinism (the belief that human lives are determined biologically) affect attitudes to antidepressant medication and vaccination in the public. Little is known about the effects of these variables on the decision-making of clinicians or students of medicine.

Objectives

The study examines the effects of conspiracy mentality (CM), covid-related conspiracy beliefs (CCBs), and biological determinism (BD) on the doubts students of medicine have about antidepressants and on their uptake of the booster dose of COVID-19 vaccine.

Methods

CM, CCBs and BD were measured in May 2022 in a sample of 179 students of medicine (115 females), using the Conspiracy Mentality Questionnaire by Bruder et al. (2013), set of items measuring CCBs developed by Imhoff and Laberty (2021), and the Biological Basis scale by Bastian and Haslam (2006), respectively. The doubts about antidepressants were measured by the Antidepressant Conspiracy Scale by Natoli et al. (2021) tapping participants’ beliefs that drugs and antidepressants specifically are ineffective and promoted and prescribed for financial gains. Logistic and linear regression models were used to predict respondents’ vaccine uptake and doubts about antidepressants.

Results

Booster vaccine uptake was predicted by BD (OR = 1.45; p < .05) and CCBs (OR = .73; p < .05), together explaining 7% of the variance. Booster vaccine uptake was not predicted by CM.

Doubts about antidepressant medication were predicted by CM (b = .17, p < .001) but not BD (p = .89), together explaining 10% of the variance.

Conclusions

The doubts students of medicine have about antidepressants and their vaccination behavior was predicted by their biological determinism, belief in conspiracy theories and general conspiracy mentality. Although the relationships were weak, they support claims that health-related beliefs and behaviors of students of medicine are related to their implicit beliefs and socio-cognitive predispositions. These personal factors may therefore affect their professional decision-making and should be addressed in medical education.

Disclosure of Interest

None Declared
Gambling disorder and other behavioral addictions: mechanisms, recognition and treatment
Authors: Goudriaan A.
Published: August 2023

Gambling disorder was reclassified as a first behavioral addiction in the DSM-5 in 2013. In 2018, gaming disorder was included in the ICD-11. In this presentation, research findings regarding the psychological and neurobiological mechanisms in gambling disorder and other behavioral addictions are highlighted. Specifically, neural and behavioral responses regarding reward expectation, reward outcomes, and the role of specific mechanisms in gambling like near wins, and in gaming, like lootboxes are highlighted. Besides the recognition of gambling disorder, the broader perspective of gambling harms is highlighted and related to psychosocial, financial, and health consequences. The perspective of interaction between human design factors (e.g. psychological and neurobiological mechanisms, such as decision making, reward processing) and gambling design factors (e.g. near wins, multiline betting) is reviewed. Evidence with regard to psychological and pharmacological interventions are discussed and future directions for research perspectives are discussed.

Disclosure of Interest

A. Goudriaan Grant / Research support from: Anna Goudriaan received grants from the Dutch Foundation for Scientific Research (NWO and ZonMw) and from VCVGZ Foundation
Apelin-13 and Asprosin in Adolescents with Anorexia Nervosa and Their Association with Psychometric and Metabolic Variables
Authors: Jowik K. , Dmitrzak-Węglarz M. , Pytlińska N. , Jasińska-Mikołajczak A. , Słopień A. , Tyszkiewicz-Nwafor M.
Published: August 2023

Introduction

Anorexia nervosa (AN) is a widespread, metabo-psychiatric disorder with high relapse rates, comorbidity, and mortality. Many regulatory proteins and neurohormones studied to date play essential roles in the etiopathogenesis of eating disorders and the maintenance of psychopathological symptoms. Nevertheless, the regulatory and pathophysiological mechanisms of AN are still poorly understood.

Objectives

The present study aimed to investigate the plasma levels of asprosin (ASP) and apelin-13 (APE-13) in malnourished (AN1) and partially cured (AN2) adolescent patients with AN. Correlations between protein levels and several dimensions of AN symptomatology, such as eating disorder, depressive, and obsessive compulsive symptoms, were investigated.

Methods

Sixty-four patients aged 11–18 years admitted to the Department of Child and Adolescent Psychiatry in the acute phase of AN participated in the study. Between the 1st and 3rd days of admission, patients with AN (AN1) underwent psychometric evaluation, height and weight assessment, and 15 mL of blood was drawn. The same procedures were repeated at a second time point about 11.2 ± 2.3 weeks later, after partial normalization of body weight on the day of discharge (AN2). The control group (CG) normal-weight girls with no history of psychiatric disorders, recruited from among the students of a local school. The Eating Attitudes Test (EAT-26), Beck Depression Inventory (BDI) Hamilton Depression Scale (HAMD) and Yale–Brown Obsessive Compulsive Scale (CYBOCS), were used to assess eating disorder symptoms, depression, obsessions and compulsions. Patients were included in a nutritional rehabilitation program. Daily caloric intake was 2000–2500 kcal and was gradually increased to 3500–4000 kcal depending on weight gain (1.0–1.5 kg per week).

Results

APE-13 levels were higher in the AN1 group than in the post-realimentation and the CG group. APE-13 levels were independent of insulin and glucose levels. Plasma ASP levels increased with increasing body weight in patients with AN, correlating with the severity of eating disorder symptoms in emaciation.

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Conclusions

The presented data suggest that APE-13 and ASP may be AN’s biomarkers-regulation of eating behavior by APE-13 and ASP, the close relationship between them and emotional behavior, and changes in neurohormone levels in patients with eating and affective disorders seem to support these hypotheses. Moreover, their plasma levels seem to be related to the severity of psychopathological symptoms of eating disorders.

Disclosure of Interest

None Declared
Estimating accelerated biological ageing using machine learning and metabolomics data in people with mental disorders
Authors: Mutz J. , Lewis C. M.
Published: August 2023

Introduction

Accelerated biological ageing might contribute to the higher prevalence of age-related diseases and excess mortality amongst individuals with mental disorders. Recent advances in machine learning and the collection of high-dimensional molecular “omics” data allow for the quantification of biological age.

Objectives

The aim of this study was to use machine learning methods to predict biological age from nuclear magnetic resonance spectroscopy metabolomics data and to identify psychiatric traits associated with accelerated biological ageing.

Methods

The UK Biobank is a multicentre community-based observational study that recruited >500,000 middle-aged and older adults. 168 metabolomic measures were quantified using the Nightingale Health platform. Phase 1 release of these data included a random subset of 118,462 UK Biobank participants. Metabolomic age delta (MetaboAgeΔ) was defined as the difference between predicted biological age and observed chronological age. We estimated group differences in MetaboAgeΔ between individuals with and without mental disorders and examined whether polygenic scores for mental disorders predicted MetaboAgeΔ.

Results

Up to 110,780 participants with complete data on all metabolomic measures were included in the analysis. Individuals with a history of mental disorders had higher MetaboAgeΔ values than people without a mental illness. For example, MetaboAgeΔ suggested that the difference between predicted biological age and observed chronological age was about two-years greater amongst individuals with bipolar disorder than amongst people without mental illness. Polygenic scores for mental disorders were positively correlated with MetaboAgeΔ.

Conclusions

These findings suggest that individuals with a history of mental disorders or with higher polygenic scores for mental disorders were biologically older than their chronological age.

Disclosure of Interest

None Declared
Cost-effectiveness of psychotherapies and pharmacotherapies for mental disorders
Authors: McCrone P.
Published: August 2023

Mental health problems have a substantial economic impact across the world. Those who have their problems detected may receive therapies (usually medication or psychological) or who packages of care (for example, early intervention or residential support). Some problems are transient while others will remain across the life course. Costs are closely associated with care received and it may be that costs need to rise in order to provide adequate support. Economic costs also occur due to lost opportunities such as work and leisure. This talk will summarise recent estimates of the cost of mental health problems in a number of countries.

Establishing total costs does not tell us how to use limited resources. This requires the use of economic evaluation methods such as cost-effectiveness and cost-utility analyses. There is a growing evidence base from such evaluations for many psychological and pharmacological interventions and recent key findings will be discussed. The need for long-term, life course approaches to economic evaluation of mental health interventions will be proposed.

Disclosure of Interest

None Declared
Pain flashbacks: The role of intrusive pain symptoms in posttraumatic chronic pain
Authors: Tsur N. , Katz C.
Published: August 2023

Introduction

Findings demonstrate the high comorbidity of posttraumatic stress disorder (PTSD) and chronic pain following exposure to trauma. In exposure to child abuse (CA) in particular, findings imply that CA survivors are at a higher risk of suffering from chronic pain. However, the underlying mechanisms of these processes are yet to be uncovered.

Objectives

This study examined a new mechanism pertaining to the potential role of intrusive pain flashbacks for explaining the link between CA, C/PTSD, and chronic pain following interpersonal trauma.

Methods

A community sample of 430 women (Sample A), and a sample of 164 women who were exposed to CA (Sample B) completed questionnaires assessing pain flashbacks, CA, C/PTSD symptoms, the experience of pain during the trauma, and chronic pain.

Results

The findings showed that 8.9% of Sample A (N = 36), and 23.1% of Sample B (N = 37) reported experiencing pain flashbacks. In both samples, participants who experienced pain flashbacks reported more severe C/PTSD (p<0.001), compared to participants who experienced flashbacks without pain and those who did not experience pain flashbacks. Participants who experienced pain flashbacks reported more pain during CA (p = 0.001), which corresponded with the pain flashbacks areas (Figure 1). Finally, pain flashbacks were correlated with a higher risk of suffering from chronic pain in Sample B (p=0.002).

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Conclusions

The findings of this study reveal that pain flashbacks are associated with more rampant CA and are linked to greater psychopathology. The findings call for further investigation of the role of pain flashbacks in explaining the link between exposure to trauma, C/PTSD and later chronic pain.

Disclosure of Interest

None Declared
Mentation processes such as excessive mind wandering, rumination, and mindfulness mediate the relationship between ADHD symptoms and anxiety and depression in adults with ADHD
Authors: Kandeğer A. , Odabaş Ünal S. , Ergün M. T.
Published: August 2023

Introduction

Excessive mind wandering is a common feature of ADHD in adulthood also referred to as mental restlessness and ceaseless mental overactivity. ADHD is a predisposing factor for many psychiatric symptoms, especially negative emotions such as depression and anxiety. Rumination is thought to be a mediator for depression in individuals with ADHD. The above-mentioned mental processes may reduce the ability of individuals with ADHD to be mindful.

Objectives

This study investigates whether the mentation processes (excessive mind wandering, rumination, mindfulness) mediate the relationship between ADHD symptoms and anxiety, and depression in adults with ADHD.

Methods

Medication-free 175 individuals with ADHD who were referred to the Adult Neurodevelopmental Disorders Clinic, Department of Psychiatry, Selçuk University were invited to the study. After initial diagnostic examination including The Structured Clinical Interview for DSM-5 (SCID 5), all participants completed a test battery that included a sociodemographic form, the Adult ADHD Severity Rating Scale, the Hospital Anxiety Depression Scale, the Mind Excessively Wandering Scale, the Ruminative Response Scale, and the Freiburg Mindfulness Inventory. The data of 159 patients whose ADHD diagnosis was confirmed, who did not have any mood episodes and psychotic symptoms at the time of inclusion of the study, and who filled out the forms completely, were included in the analysis. The study was approved by the Selçuk University Local Ethics Committee.

Results

Participants ages ranged from 18 to 39 (mean of 22.93 ± 4.36), and 57.2% (n = 91) were women. Also, their 48.6% (n = 77) reported that they alcohol use, and 21.1% (n = 34) had substance use history. According to SCID 5 interview, participants 64.2% had comorbid psychiatric conditions. Pearson correlation analysis revealed that ADHD symptoms, rumination, excessive mind wandering, anxiety, and depression scores were significantly positively correlated with each other, but all were negatively correlated with mindfulness. Linear regression analysis showed mindfulness association with rumination, excessive mind wandering, anxiety, and depression scores, but not with ADHD symptoms. Thereupon, a conducted mediation regression analysis showed that ADHD symptoms indirectly worsened depression and anxiety through increased rumination and excessive mind wandering, and decreased mindfulness ability (Figure 1).

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Conclusions

Adults with ADHD have distressing mentation patterns which worsened their anxiety and depression. Mindfulness-based cognitive behavioral therapy modalities may help improve excessive mind wandering and rumination in ADHD. Our findings should be warranted in future studies of functional brain connectivity patterns that may serve as a mentation endophenotypes in ADHD.

Disclosure of Interest

None Declared
Study of mentalizing ability in borderline personality disorder: relationship with impulsivity
Authors: Galvez-Merlin A. , de la Higuera-Gonzalez P. , Lopez-Villatoro J. M. , de la Torre-Luque A. , Diaz-Marsa M. , Carrasco J. L.
Published: August 2023

Introduction

Borderline personality disorder (BPD) is a severe mental disorder characterized by affective, behavioral and relational instability, along with interpersonal hypersensitivity and unstable affective relationships (APA 2013). Poor interpersonal functioning could be associated with critical deficits in the ability to mentalize in these patients, together with high levels of impulsivity. Although most studies have described hypermentalization deficits among BPD patients (Bora Psychol Med 2021;51 2541-2551), existing literature is still scarce on this aspect, as well as its relationship with the impulsive behavior.

Objectives

1) to assess specific mentalizing deficits in BPD compared to healthy controls in a complex ecological mentalization task; 2) evaluate the relationship between mentalization and impulsivity in BPD.

Methods

63 patients diagnosed with borderline personality disorder and 31 control subjects were studied using the Movie for the Assessment of Social Cognition -MASC- (Dziobeck et al. J Autism Dev Disord 2006; 36 623-636) and the Barratt Impulsivity Scale -BIS-11- (Patton et al. J Clin Psychol 1995; 51 768-774), as well as other sociodemographic and clinical factors. The clinical research study was approved by the Clinical Research Ethics Committee of the Hospital Clínico San Carlos (Madrid, Spain).

Results

The results showed significant differences in the scores related to correct mentalization, hypomentalization, and non-mentalizing responses between patients and controls, with BPD patients showing worse performance. A significant negative relationship was also observed between impulsivity scores and correct mentalizing responses in BPD patients.

Conclusions

The results showed a deficit in the ability to mentalize in BPD patients, compared to control subjects, characterized by a hypomentalization and an absence of mentalization. Likewise, this deficit in mentalization ability was related to greater impulsive behavior in patients. These results would be consistent with the hyperarousal hypothesis in BPD, which would reduce inhibitory control, causing mentalization deficits (Euler et al. J Pers Disord. 2021; 35 177-193). Future studies will try to associate specific impulsive behaviors associated with the characteristics of hypomentalization and absence of mentalization observed in our results.

Disclosure of Interest

None Declared
Impact of Somatic and Addictive Comorbidities on the Quality of Life of Patients With Schizoaffective Disorder: A cross-sectional study
Authors: Asgharzadeh M. , Bouali W. , Khouadja S. , Ben Soussia R. , Younes S. , Zarrouk L.
Published: August 2023

Introduction

Schizoaffective disorder is a mental health disorder frequently associated with somatic and addictive comorbidities. This association can be dangerous as it may change the expression of the disease and its prognosis and may even affect the quality of life (QOL) and the overall functioning of patients.

Objectives

This study aimed to investigate the impact of somatic and addictive comorbidities on QOL and the overall functioning of patients with schizoaffective disorder.

Methods

This paper is a cross-sectional descriptive study conducted at the Department of Psychiatry within outpatient settings over six months. We evaluated the QOL using the SF-36 and Global Assessment of Functioning scale (GAF). We included all patients suffering from a schizoaffective disorder and excluded patients with associated mental impairment, those we could not assess because of another disability, and those with missing records.

Results

Fifty-two patients with schizoaffective disorder met our inclusion criteria with an average age of 38. This study found somatic comorbidities in 30.8% of patients, where diabetes ranked first (13.5%), followed by high blood pressure (9.6%). We noted addictive comorbidities in 63.5% of patients, with tobacco, alcohol, and Cannabis being the most consumed substances, with respective rates of 57.7 %,28.8 %, and 13.5%.

The QOL assessment revealed an impaired QOL score in 80.8% of patients, whereas 65.4% had a GAF score lower than 70 indicating a deterioration of functioning level. Our results showed that dimension D1 (physical activity) of the SF-36 was strongly influenced by somatic comorbidities, according to an analytical investigation of the association between these two variables (p = 10-4). We also found that the deterioration in the patient’s global functioning was not significantly related to somatic comorbidities (p = 0.28). Furthermore, our studies showed no association between impaired quality of life and substance abuse.

Conclusions

Somatic comorbidities and substance abuse have a detrimental effect on patients with pre-existent schizoaffective disorder, and the goals of patient care with a schizoaffective illness go beyond the remission of clinical symptoms to the improvement of quality of life and socio-professional functioning.

Disclosure of Interest

None Declared
Violence and psychosis: Clinical evidences from an Early Intervention Program
Authors: Mentxaka O. , Recio-Barbero M. , Arana-Arri E. , Segarra R.
Published: August 2023

Introduction

Psychotic disorders are frequently linked to a public perception of dangerousness and propensity to engage in violent acts. Despite efforts to demystify these disorders, the evidence on the relationship between violence and psychotic disorders is mixed. Together with media coverage of violent crime associating violence with the occurrence of a mental disorder, such a situation has contributed to the social stigmatisation of people with severe mental disorders and the consequent discrimination that this scenario entails. Despite efforts to demystify such disorders, the association between violent behaviour and psychosis remains unclear.

Objectives

This study aims to explore the incidence and main clinical characteristics associated to violent offences recorded in a cohort of patients presenting a First-Episode Psychosis (FEP).

Methods

Patients presenting with an affective or non-affective first psychotic episode were recruited from the First Episode Psychosis Intervention Program (CRUPEP) cohort between 2009 and 2016. The main clinical variables were collected, including medical-forensic records of patients registered at the Basque Institute of Forensic Medicine (BIFM), to retrieve any violent acts in which patients with FEP were involved, either as victims or as offenders.

Results

Overall, 79.5% (n=182) of CRUPEP patients had no violent record of crime or offence recorded in the BIFM. Annual crime rates for the 2009–2016 period show a decreasing trend in both the general population (IRR=0.981 (95%CI=0.978–0.983) p<0.001) and in patients with FEPs (IRR=0.019 (95%CI=0.012–0.028) p<0.001); this pattern is more pronounced the FEP group. Victimisation accounted for the vast majority of reported incidents; nevertheless, patients who have committed violent offences were mostly involved in intrafamily violence

Conclusions

Patients with FEP were not involved in a higher number of crime rates than the general population. The types of violent acts committed by FEP patients were heterogeneous, with extreme violence being particularly uncommon.

Disclosure of Interest

None Declared
Outcome Measurement and Evaluation as a Routine practice in alcohol and other drug services in Belgium (OMER-BE)
Authors: Migchels C. , Zerrouk A. , Matthys F. , van den Brink W. , Fernandez K. , Antoine J. , Vanderplasschen W. , Crunelle C. L.
Published: August 2023

Introduction

There is a variety of specialized outpatient and residential Alcohol and Other Drugs (AOD) services, but research on outcomes of these services is limited. Given the chronic, relapsing nature of AOD problems, there is a need for longitudinal research on outcomes after treatment in various AOD services.

Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) are hardly used in the AOD field but provide excellent tools and a framework to monitor progress and outcomes in these services based on experiences of service users.

Objectives

The objectives of the OMER-BE study are to:

1. Assess and compare patient characteristics at baseline in various treatment modalities

2. Test and prepare the routine measurement of PROMs and PREMs in AOD services using a self-report tool

3. Assess patient-reported experiences qualitatively in various treatment modalities for AOD patients

The overall goal is to continuously assess and improve AOD services.

Methods

We have set up a naturalistic, longitudinal cohort study for which we will engage and follow up 250 AOD users as they present themselves in selected AOD services in four different treatment modalities (outpatient non-pharmacological treatment, outpatient substitution treatment, residential psychiatric treatment and therapeutic communities for addictions).

Sociodemographic and clinical factors and PROMs will be assessed at baseline. PROMs and PREMs will be assessed at 45-, 90-
and 180-days follow-up. The questionnaires that will be used during the baseline and follow-up assessments are based on the ICHOM Standard Set for Addictions (ICHOM SSA, 2020), a set of brief validated questionnaires to measure and monitor treatment outcomes routinely in AOD services.

Following the 6-month follow-up we will perform a qualitative study in a subset of N=20 participants (5 per treatment modality). These participants will be invited to take part in an in-depth interview with one of the researchers, where the following topics will be discussed: treatment history, recovery experiences, helping and hindering factors in recovery, and experiences with different treatment modalities.

Results

47 participants have been recruited in the OMER-BE study up until October 2022. 38 (81%) of the participants were born male, 9 (19%) were born female. The average age of participants is 33, with ages ranging from 19 to 47 years old.

Preliminary findings will be presented at the congress.

Further recruitment of study participants up to a total of 250 will be undertaken until the end of 2023.

Conclusions

The OMER-BE study aims to assess and improve AOD services by using a self-report tool, measuring PROMs and PREMs.

Disclosure of Interest

None Declared
“Unspecified organic personality and behavioral disorder due to brain damage from HHV-6 encephalitis in child. case report and literature review”
Authors: Oliva Lozano A. , Morillas Romerosa M. A. , Herrero Ortega P. , Garde Gonzalez J. , Orgaz Álvarez B. , Curto Ramos J. , Alcamí Pertejo M.
Published: August 2023

Introduction

We present a case of a 15 year-old boy diagnosed with Unspecified Personality and Beheavioral Disorder Due to Brain Damage from a Human Herpes Virus-6 Encephalitis.

Objectives

To describe a case of an Unspecified Organic Personality and Behavioral Disorder secondary to brain damage from Human Herpes Virus-6 (HHV-6) Encephalitis in an 11 year-old childand to review recent literature, in order to improve clinical practice.

Methods

Clinical case report and brief review of literature. A bibliographic research was made in the database PubMed, using the terms “Viral Encephalitis” AND “Neuropsychiatric symptoms”; “Viral Encephalitis” AND “Behavioral Disorder”; “Long-Term Neurological Morbidity” AND “Viral Encephalitis”.

Results

15 year-old boy diagnosed with Unspecified Personality and Beheavioral Disorder Due to Brain Damage from a Human Herpes Virus-6 Encephalitis, secondary to immunosupression in the context of haematopoietic progenitor transplantation (HPT) at 11 years old. MRI showed supratentorial ventriculomegaly, atrophic changes in encephalon and right hippocampus with subcortical retraction secondary to previous encephalitis. Clinically, main changes appeared in behavior, presenting a serious frontal syndrome with high disinhibition, what implied severe social and academic difficulties. During the outpatient follow-up, the behavioural disorder is being pharmacologically treated with Risperidone 1,5mg per day with a partially favorable evolution. The patient presented intolerance to olanzapine, with an episode of low level of conciuosness after taking it.

Bibliographic research results indicate that the gold standard treatment for behavioral disturbances are antipsychotics. Risperdidone is proven save for treatment in children. Results point out also the importance of an early multidisciplinar intervention, involving family training, rehabilitation resources and curricular adaptations.

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Conclusions

Viral encephalitis may have serious neuropsychiatric consequences, especially during childhood while the brain development is not finished. When the neurological damage affects the frontal lobes of the brain, behavioural and personality disturbances are expected and an early multidisciplinar intervention should be considered. Antypsichotics are the gold standard pharmacological treatment for behavioural disturbances. During the scholar period, special curricular adaptations should be done in order to reduce study-related stress.

Disclosure of Interest

None Declared
Post traumatic stress disorder among patients who survived COVID 19
Authors: Trabelsi I. , Youssef R. , hwichi O. , Loghmari A. , Yaacoubi H. , Bouassida K. , Boukadida L. , Jaballah R. , Ben Salah H. , Zorgati A. , Boukef R.
Published: August 2023

Introduction

Research on past coronavirus outbreaks, including Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), indicates a high likelihood of symptoms and psychiatric disorders in survivors, including symptoms of stress. post-traumatic stress disorder (PTSD) and post-traumatic stress disorder (PTSD)

Objectives

This study therefore set out to highlight the impact of COVID-19 infection on mental health by screening them for posttraumatic stress

Methods

It is a retrospective study that includes patients who were tested positive with COVID 19 (RT PCR using a nasopharyngeal test ) and who have seeked medical care at emergencies during a month . The post traumatic stress score disorder: PCL-5 was calculated on day 30 and day 90. The evolution of the patients health state (Recovery or deterioration) was marked. All data were analyzed by SPSS.

Results

we included during the study period 200 patients complying with the inclusion criteria. Post traumatic stress was diagnosed in 146 patients (73% of patients). Post-traumatic stress was diagnosed in rather elderly patients; the average age was 51.8 years with a female predominance (57.5%). 63.6% of patients with PTSD had a cough; 35.7% had dyspnea; 49.7% were febrile, 43.9% had arthromyalgia, 15% had anosmia.The disappearance of the signs was after 8.3 days on average, it lasted longer (14.6 days) in the patient who developed PTSD.In this series, 47.3% of patients diagnosed with PTS infected their relatives

Conclusions

This study contributes to a better understanding of the factors that determine the impact of traumatic events such as a pandemic on people’s mental health.Post traumatic stress disorder is so common among COVID 19 patients and it has a huge influence on the evolution of their health state . This is why all health workers have to fight against COVID and its effects on both physical and mental health . Highlighting the fact that a psychological assistance is highly recommended in the management ofCOVID19 patients in order to improve their prognosis

Disclosure of Interest

None Declared
The analysis of risk factors for fear and aggression during global crisis – a study based on Polish students among the Covid-19 pandemic.
Authors: Kawalec A. , Wilczyński K. M. , Janas-Kozik M.
Published: August 2023

Introduction

Although the Covid-19 pandemic ceased in the numbers of the affected patients, especially the ones with severe manifestation of the disease, its influence on health still remains, affecting not only the somatic but also mental wellbeing. This global crisis impacted almost every person, but not equitable – the mental distress consisted of many, often synergic, risk factors which are not easily identifiable. The analysis of causal elements for aggression and fear deriving from the pandemic was conducted among Polish students, enabling thorough examination.

Objectives

The aim of the study was to analyse the risk factors contributing to the deterioration of mental health, especially presented as elevated fear and aggression levels.

Methods

Examination of fear and aggression levels was conducted on the group of Polish students using Fear of Covid and STAXI-2 questionnaires. Initially, 906 participants took part in the first round of the study. Four rounds were conducted, finally extracting a group of 231 participants tested in the four different time points of the pandemic in Poland, during the second and the third waves of the pandemic.

Results

Among the studied factors that have impact on the decline in the state of the mental health, statistically significant were female sex, being overwhelmed by the amount of news found in various media – a phenomenon called “infodemic” - altogether with poor health condition, both of the participants’ and their relatives. Obtaining vaccination was a factor that lowered aggression in participants, but only the ones that were primarily eager to get one.

Conclusions

The present deterioration of mental health in society was largely fuelled by the initial disturbance arising from global pandemic, general lockdown and financial crisis bound with it. The discrimination of risk factors for inefficient resilience was not possible on such a huge scale before. Unfortunately, as new challenges arise, the knowledge about the social groups most prone to mental crisis is necessary, as this is the only way to elaborate the proper procedures and guide a successful diagnostic process and treatment.

Disclosure of Interest

None Declared
Using neurocognitive models to optimise the treatment of depression
Authors: Murphy S.
Published: August 2023

Conventional antidepressants, such as SSRIs, are an effective treatment for many patients with depression. However, for a significant proportion of patients SSRIs either lack efficacy or are poorly tolerated. Even when SSRIs are effective in treating mood symptoms, there are often residual symptoms that are not well treated, including cognitive impairment and anhedonia. The development of novel treatment for depression is particularly challenging given the limited predictive validity of animal models. Human neurocognitive models of antidepressant action can help to bridge the translational gap and allow rapid investigation of novel compounds in healthy volunteers and people with depression. In this talk, using the 5-HT4 receptor as an example of a novel target of interest, I will outline how these objective neurocognitive models can be used as a translational tool to understand antidepressant treatment mechanisms, guide treatment selection and test novel putative antidepressants early in development.

Disclosure of Interest

S. Murphy Grant / Research support from: Zogenix, UCB, Janssen, Consultant of: Zogenix, Sumitomo Danippon, Janssen, UCB, Speakers bureau of: Zogenix
Capacity of the health facilities to manage Alzheimer’s and related dementia diseases in Mukono district: Challenges and recommendations
Authors: Jephthah D. , Ddumba I.
Published: August 2023

Introduction

With the projected increase in the number of older persons in both low and middle-income countries, the burden of Alzheimer’s and related dementia diseases (AD/ARDs) is projected to increase as well. However, the health systems are inadequately prepared to offer optimal care for patients with AD/ARDs, despite the growing disease burden.

Objectives

The aim of this study was to assess the capacity of the health facilities to optimally manage Alzheimer’s and related dementia diseases in the Mukono district

Methods

We conducted a cross-sectional between August and December 2018. A survey of 32 facilities (3 hospitals, 2 health center IV (HCIV), 15 health center III (HCIII) and 6 health center II (HCII), and 6 Private health facilities) in Mukono district. We conducted a thorough assessment of medical records, interviewed heads of the facilities, and a questionnaire was administered to 46 health workers. The study assessed the service provision for AD/ARDs, Knowledge of AD/ARDs management, challenges, and opportunities.

Results

Out of 32 health facilities assessed, 4 in 10 (42%) facilities reported managing (diagnosing/treating) clients with AD/ARDs, and the majority (90.2%) were run by Non-Physician Health Workers (NPHW). Only 2 in 10 had guidelines for managing AD/ARDs. Less than half (46.4%) had AD/ARDs medicines in stock (mainly Haloperidol) and all of the private facilities lacked essential medicine to treat AD/ARDs. All health center IIs lacked drugs for AD/ARDs. A significant knowledge gap in assessing and diagnosing AD/ARDs was observed among all the health workers. All health workers highlighted the need for additional training in AD/ARDs. A multitude of client and health provider challenges were observed in this study

Conclusions

Health facilities in Mukono district are inadequately prepared to offer optimal services for the management of AD/ARDs. AD/ARDs drugs, knowledge gap, and human resources for health presented a great challenge. In order to address the inadequately capacity to manage AD/ARDs, emphasis should be dwelt on strengthening the health facilities.

Disclosure of Interest

None Declared