bluuebunny/crossref_metadata_2025 huggingface dataset:
Compulsory hospitalization in child psychiatry: clinical and sociodemographic profile of Tunisian inpatients
Authors: Sahli L. , Abbes Z. , Halayem S. , Bouden A.
Published: August 2023

Introduction

The department of child psychiatry in Razi Hospital is the unique psychiatric unit in Northern Tunisia offering full-time hospitalization for minors with mental health disorders.

Objectives

The aim of our study was to explore the clinical and therapeutic characteristics in compulsory admissions of minors in the department of child psychiatry in Razi hospital between 2011 and 2019.

Methods

We conducted a retrospective study of medical records of inpatients admitted to the hospitalization unit of the child psychiatry department in Razi Hospital in Tunisia between 2011 and 2019.

Results

Over the nine years, the total number of compulsory admissions was 74 inpatients, aged from 11 to 16 years old. The number of compulsory admissions increased from 03 in 2011 to 22 in 2019. Most of the inpatients were boys (sex ration=1.46). The mean age was 14, 1 year old. Heteroagressiveness was the reason for admission in half of the cases followed by risk behaviors (30.1%) and suicidal behaviors (18.6%). The diagnosis of conduct disorder was found in 33.3% of the cases followed by a normal psychiatric examination in 11.8% of the cases. Mood disorders were found in 9.8% of the cases. Parental psychoeducation (100%), individual psychotherapy (91%) and family therapy (88,2%) were the treatment of choice for the inpatients. The prevalence of psychiatric medication was 45.1%. The most important forms of medication used were neuroleptics (42.3% of medicated patients) and mood stabilizers (30.7%). Child protection delegates were involved in 86,4% of the cases for social intervention.

Conclusions

Minors admitted in an involuntary mode to psychiatric unit have their own specifities in terms of clinical and therapeutic characteristics. More theoretical and empirical research is needed regarding the involuntary admission of minors.

Disclosure of Interest

None Declared
Motivation of medical employees in the context of the COVID pandemic
Authors: Trifu S. , Trifu A. C. , Ciubară A.
Published: August 2023

Introduction

The Covid-19 pandemic has restructured the entire health care system. As systems of care were overwhelmed, many health professionals in related professional areas became increasingly involved in providing medical aid. We highlight a comparative analysis between two psychiatric wards of the same hospital, with qualified medical staff, with similar levels of competence, one of the wards caring for patients exclusively with major psychiatric pathologies, and the other patients with associated SARS-COV2 infection.

Objectives

Considering that motivation at work depends on a multitude of factors, in our case, stress related to contamination, situational anxiety generated by psychiatric patients who arepartially inside on COVID infection, can decrease the motivation to perform a quality psychiatric medical act. Resilience and organizational civic behavior are instead variables with the role of maintaining professional motivation at an optimal level and enhancing dedication.

Methods

We applied questionnaires aimed at motivation at work in relation to the dependent variables: stress, anxiety, resilience and civic organizational behavior in two different departmentsof the psychiatric hospital, a ward where patients were admitted positively confirmed COVID 19, versus a ward with non-COVID psychiatric patients.

Results

Psychiatric medical staff are trained to treat predominantly psychomotor agitation, violent behavioral syndromes, suicide attempts, psychotic illnesses. 95% of the employees of theCOVID support department stated that they prefer to take care of 10 agitated patients, than one patient with COVID. The stress came in most cases from: insufficient supportequipment, insufficient doctor to coordinate nurses, lack of experience with somatic patients, fear of contamination generated by non-compliance with protective measures by psychiatric patients.

Conclusions

Resilience and civic organizational behavior kept staff motivation at an optimal level, but lower than would have been appropriate. Also, motivation at work was lower compared tothe non-COVID psychiatric ward.

Disclosure of Interest

None Declared
The Impact of COVID-19 on Forensic Rehabilitation in Austria
Authors: Koch M. , Dvorak A. , Hobersdorfer M. , Yeghiazaryan L. , Rabl U. , Komorowski A.
Published: August 2023

Introduction

In general, forensic psychiatric patients experience major restrictions of freedom. To mitigate the risk for the coronavirus disease 2019 (COVID-19), even more restrictions were implemented in Austrian mental health institutions in 2020. Besides potential deterioration of psychopathological symptoms, exaggerated freedom-restricting measures may limit the forensic rehabilitation of offenders.

Objectives

Given that rehabilitative efforts and social visits were suspended for more than a year, this study aimed to evaluate the impact of the COVID-19 pandemic on the psychosocial rehabilitation of forensic psychiatric patients.

Methods

This retrospective longitudinal observational study evaluated institutional data before and after the enactment of freedom-restricting measures in an Austrian forensic mental health institution. Data were obtained from 97 offenders treated at the institution Justizanstalt Göllersdorf during two time periods (January 2019 – March 2020 and March 2020 – May 2021). Statistical differences between both periods were assessed by means of Wilcoxon signed-rank tests. Study outcomes included the number of visits by relatives and legal guardians as well as rehabilitative activities.

Results

After the outbreak of the pandemic, access to penal institutions was limited for external visitors, which led to a decrease in visits by relatives (1440 vs. 394, p < .001) and legal guardians (286 vs. 122, p = .003). Further, the total number of one-day temporary releases of patients (64 vs. 3, p < .001) and group excursions (103 vs. 10, p < .001) decreased in the second study period.

Conclusions

Focusing on social contacts and rehabilitative activities, this study highlights the impact of the current pandemic in forensic psychiatry. While COVID-19-related protective measures may reduce the risk for disease transmission, enforced quarantine and other restrictions of freedom impair the rehabilitation of forensic psychiatric patients. This implies the necessity for guidelines to uphold an appropriate standard of care during future pandemics.

Disclosure of Interest

None Declared
Psychosocial factors and coping strategies associated with alcohol use during the COVID-19 pandemic
Authors: Papadopoulou A. , Skyftou K. , Efstathiou E. , Gkikas K. , Kaloudi E. , Bali P. , Papazachos K. , Tsaklakidou D. , Efstathiou V.
Published: August 2023

Introduction

The investigation of alcohol use and its correlates during the ongoing COVID-19 pandemic is of utmost importance.

Objectives

This study aimed to examine alcohol use during COVID-19 pandemic, while nationwide lockdowns were in effect in Greece, and its relationship with demographic, clinical, and psychosocial factors.

Methods

The study included 378 individuals (225 women) with a mean age of 30.22 years who completed an online questionnaire during the third wave of the pandemic while restriction measures were in effect (March to April 2021). Participants completed Alcohol Use Disorders Identification Test (AUDIT), Fear of COVID-19 Scale (FCV-19S), Depression, Anxiety and Stress Scale (DASS-21), Coping Orientation to Problems Experienced Inventory (Brief-COPE) and the Multidimensional Scale of Perceived Social Support (MSPSS).

Results

According to the results, alcohol use was negatively associated with COVID-19 fear (p = 0.011), and positively associated with anxiety (p = 0.024), depression (p<0.001) and avoidance-focused coping strategies (p = 0.003). Furthermore, perceived social support emerged as a significant protective factor against alcohol use. Men presented higher alcohol use levels compared to women (p = 0.002). Additionally, individuals identified as problematic users, based on AUDIT scores, displayed increased levels of anxiety (p = 0.028) and depression (p = 0.017) and used avoidance-focused coping strategies to a greater extent (p<0.001). Of note, higher alcohol use was observed in participants who lived alone (p<0.001) and in those whose work status had changed during the pandemic (p = 0.004).

Conclusions

Our findings highlight the importance of identifying individuals with problematic alcohol use, as well as recognizing crucial psychosocial factors related to alcohol use especially during the pandemic.

Disclosure of Interest

None Declared
Post-traumatic stress disorder and post COVID 19 syndrome
Authors: Halouani N. , Gdoura D. , Bouattour N. , Turki M. , Moussa N. , Ellouze S. , Aloulou J.
Published: August 2023

Introduction

Patients hospitalized in the case of COVID19 have had to face a complex and potentially very stressful situation. In this context a screening program for psychological distress in patients with COVID19 is necessary.

Objectives

To screen for post-traumatic stress disorder post COVID19 and to identify the epidemiological and clinical factors correlated with this disorder in post COVID19 patients.

Methods

A descriptive and analytical cross-sectional study that took place during the period from 1st March to 15th May 2021 with 154 patients who were hospitalized at the COVID19 unit at Hedi Chaker Hospital Sfax.

We used a pre-established form to record sociodemographic, clinical and therapeutic data. The post-traumatic stress disorder was assessed by the “Impact of Event Scale-Revised”.

Results

The mean age was 66.62 ± 13.34 years with a male predominance of 60.4%. In our sample, 77.9% of the patients had a somatic history, of which hypertension was the most frequent pathology (46.1%). The average length of hospitalization was 9.5 days ± 6.3. The form was considered severe in 27.9 cases.

According to the IES-R scale, twenty-one patients (13.6%) had post-traumatic stress disorder, with a predominance of women (57.1%).

A significant association was found between marital status and post-traumatic stress disorder. Thus, married or widowed patients are more likely to develop PTSD.

In the present study, we did not find statistically significant associations between the clinical characteristics of the disease (severity of the disease, length of hospitalization, functional signs) and post-traumatic stress disorder.

Conclusions

Psychological support interventions in surviving patients of COVID 19 is necessary aiming to increase resilience, manage coping strategies and decrease the deleterious impact of the pandemic on mental health.

Disclosure of Interest

None Declared
Investigating Changes in the Psychological Health Before and During the COVID Pandemic:
A Comparison Study among Turkish Immigrants living in Germany
Authors: Cindik-Herbrüggen D. E. D.
Published: August 2023

Introduction

It was stated in other studies that the prevalence of anxiety, depression, and anger
increased among the general German population throughout the pandemic (Beutel et al., 2021;
Rossi et al., 2020; Smith et al., 2021). Besides, there has been an increase in mental
problems among individuals with psychiatric disorders and the immigrant population in
society. Migrants are considered a vulnerable group during the outbreak due to low
socio-economic status, job losses, and language difficulties.

Objectives

This paper aimed to investigate changes in the psychological health of Turkish
immigrants living in Germany during the COVID-19 pandemic. Furthermore, sociodemographic
differences as a key factor were analysed in this study. Individuals with lower incomes were
expected to suffer more from mental health problems.

Methods

The participants of this research were mainly first and second-generation Turkish
immigrants. They were pre-screened for a previous history of mental disorders and screening
was performed with SCL-90-R. Of all 177 participants who completed the questionnaire between
October 7, 2019, and February 2020, they were recruited again between August 10, 2020, and
December 10, 2020, during the pandemic.

Results

According to the findings, a significant difference was found for depression (t=-5.36,
p<.001), anxiety (t=-3.01, p<.001), and hostility (t=-3.70, p<.001) between the mean
scores of the participants before and during COVID-19 pandemic. It was found that the
increase in depression and anxiety symptoms during the coronavirus pandemic was higher among
participants with low-income levels (p<.001).

Conclusions

The mental health of our study participants worsened during the current COVID-19
pandemic. Turkish immigrants reported having higher depression, anxiety, and hostility scores
in comparison with previous test scores conducted before the outbreak. Participants with low
income were at the highest risk for COVID-19-related depression and anxiety.

Disclosure of Interest

None Declared
Organic and psychiatric symptoms of “Long COVID” among Tunisian patients: a cross sectional study
Authors: Zaouali F. , Chaouch A. , Boubaker F. , Bouchareb S. , Mrabet H. E. , Ben Mabouk A. , Touil I. , Boussofara L. , Knani J. , Boudawara N. , Alaya W. , Sfar M. H.
Published: August 2023

Introduction

Long COVID is a condition characterized by long-term health problems persisting or appearing after the typical recovery period of COVID-19. Physical symptoms such as respiratory, neurological and musculoskeletal complaints were initially described in the foreground. A little after, psychological disorders have been widely reported.

Objectives

The aim of this study was to screen for somatic and anxio-depressive disorders of Long COVID.

Methods

A cross sectional descriptive study included the patients consulting within a minimum of 1 month after a COVID-19 infection. It was conducted at Taher Sfar university hospital of Mahdia over a period of one year from March 2020 to March 2021. A questionnaire and physical examination were used to look for physical symptoms and the Hospital Anxiety and Depression scale (HAD) was used to screen for anxio-depressive disorders.

Results

We recruited 137 patients. The median age was of 60 years with a sex ratio M/F at 0.073. Obesity was the most frequent comorbidity (36%) followed by diabetes (35%) and hypertension (32%). More than a quarter of patients was hospitalized (30%) during the acute phase, while the others (70%) were confined at home. The median stay duration at home or hospital was of 10 days with extremes ranging from 0 to 21 days. The most frequent post-COVID symptoms were dyspnea, mood disorders, myalgia, arthralgia, dry cough, sleep disorders and anorexia in 45%, 30%, 30%, 20%, 16%, 15% and 14% of cases, respectively. Pulmonary auscultation was normal in 86% of our patients, for the others we noted crackles, ronchi and wheezing among 9%, 1% and 1% of patients. The median oxygen saturation was 97% with a range from 93 to 99%. The majority of our patients (120) had saturation more than 95% in ambient air. The median HAD score was situated at 19 [8, 33]. Anxio-depressive disorders were present 61% of cases. A severe depression was noted among 24% of patients. and a severe anxiety among 28% of them.

Conclusions

Our study highlighted a high prevalence of anxio-depressive disorders (62%) which exeeds the prevalence described in the literature. The systematic use of the HAD scale among consultants could be the explanation. Thus, psychological screening and support should be considered when managing patients having a history of COVID-19 infection. Citizens should comply with the relevant legal provisions making vaccination compulsory as it was found that COVID-19 vaccination reduced long COVID risk.

Disclosure of Interest

None Declared
Psychiatric consequences in hospitalized patients affected by COVID-19 (RECOVER-PSY)
Authors: Wiedenmann F. , Fior G. , Bergamelli E. , Del Giudice R. , Gambini O. , D’Agostino A.
Published: August 2023

Introduction

COVID-19 had a significant impact on the mental health of the affected population. Such multifactorial risk for a deterioration of mental health suggests the need to identify groups of patients with psychiatric vulnerability and to establish strategies of intervention based on scientific evidence.

Objectives

The aim of the study was to identify psychiatric outcomes one year after recovery and possible associations between these and the clinical, anamnestic, and sociodemographic variables.

Methods

The Mini International Neuropsychiatric Interview was employed to assess current and lifetime mental illness in a cohort of 100 patients discharged between March and April 2020 from COVID-19 wards of the San Paolo Hospital in Milan, Italy. The Kendall rank correlation coefficient was administered to measure the ordinal association between clinical-demographic variables and the psychiatric diagnoses of patients. Bivariate correlation was used to explore the association between psychiatric outcomes and the sample characteristics.

Results

Almost one third of subjects screened positive for a diagnosis of a new psychiatric disorder, and a novel onset of psychiatric morbidity did not differ significantly in patients with and without a positive history of mental illness (42 and 58%). New psychiatric disorders were grouped into stress reactions, anxiety-group disorders and mood disorders. Concerning demographic characteristics, advanced age represented a protective factor against the onset of new psychiatric disorders (rτ = -0,203, p =0,008). Despite a lower risk of contracting the infection, women in our cohort were more vulnerable to psychiatric post-Covid symptoms (rτ =0,190, p =0,029). The correlation between the onset of new psychiatric disorders and some pre-admission vulnerability factors, such as an overweight condition (rτ =0,185, p =0,026) and a positive medical history for cigarette smoking (rτ =0,203, p =0,026), were statistically significant. Moreover, subjects who reported taking a therapy to control the infection prior to hospitalization were more likely to receive a new psychiatric diagnose (rτ =0,269, p =0,005). Of note, variables related to the severity of hospitalization such as oxygenation intensity, days of hospitalization, or requirement of intensive car were not associated with new psychiatric diagnoses.

Conclusions

The onset of psychiatric disorders shows a relevant frequency in patients hospitalized for COVID-19, suggesting that mental health services should structure adequate screening and diagnosis methods. Three levels of intervention can also be expected to reduce the overall risk and burden of psychiatric morbidity: increasing awareness regarding modifiable risk factors; guaranteeing a minimal level of mental health support to patients hospitalized for COVID-19; providing personalized interventions with respect to gender and age groups.

Disclosure of Interest

None Declared
Immunometabolic depression: from conceptualization towards implementation
Authors: Penninx B. ,   Immunometabolic depression: from conceptualization towards implementation
Published: August 2023

The burden on society by depression is undisputable, partly due to a chronic course pattern and depression’s large heterogeneity that contributes to non-response to standard treatments. Using data from the Netherlands Study of Depression and Anxiety (NESDA, www.nesda.nl), Penninx will illustrate both points. When examining the course of depression, especially when also considering the transitions into other affective disorders over time, chronicity is clearly more the rule than the exception (Verduijn et al. BMC Med 2017). Considering depression’s heterogeneity could lead to precision psychiatry approaches that help reduce depression’s chronicity. Immuno-metabolic dysregulations seem to vary as a function of depression heterogeneity: dysregulations map more consistently to “atypical” neurovegetative symptoms reflecting altered energy intake/expenditure balance (hyperphagia, weight gain, hypersomnia, fatigue and leaden paralysis). Findings are confirmed when utilizing genome-wide gene expression as well as DNA information (Milaneschi et al. Biol Psychiatry 2020). Preliminary treatment studies suggest that the presence of immuno-metabolic dysregulations in depression moderates antidepressant effects of standard or novel (immunomodulatory) interventions. An immuno-metabolic depression dimension could dissect depression’s heterogeneity and potentially match depressed subgroups to treatments with higher likelihood of clinical success.

Disclosure of Interest

None Declared
Intergenerational concordance of brain structure between depressed mothers and their never-depressed daughters
Authors: Minami F. , Hirano J. , Ueda R. , Takamiya A. , Yamagishi M. , Kamiya K. , Mimura M. , Yamagata B.
Published: August 2023

Introduction

Parents have significant genetic and environmental influences, which are known as intergenerational effects, on the cognition, behavior, and brain of their offspring. These intergenerational effects are observed in patients with mood disorders, with a particularly strong association of depression between mothers and daughters.

Objectives

The main purpose of our study was to investigate female-specific intergenerational transmission patterns in the human brain among patients with depression and their never-depressed offspring.

Methods

We recruited 78 participants from 34 families, which included remitted parents with a history of depression and their never-depressed biological offspring. We used source-based and surface-based morphometry analyses of magnetic resonance imaging data to examine the degree of associations in brain structure between four types of parent-offspring dyads (i.e. mother-daughter, mother-son, father-daughter, and father-son).

Results

Using independent component analysis, we found a significant positive correlation of gray matter structure between exclusively the mother-daughter dyads within brain regions located in the default mode and central executive networks, such as the bilateral anterior cingulate cortex, posterior cingulate cortex, precuneus, middle frontal gyrus, middle temporal gyrus, superior parietal lobule, and left angular gyrus. These similar observations were not identified in other three parent-offspring dyads.

Conclusions

The current study provides biological evidence for greater vulnerability of daughters, but not sons, in developing depression whose mothers have a history of depression. Our findings extend our knowledge on the pathophysiology of major psychiatric conditions that show sex biases and may contribute to the development of novel interventions targeting high-risk individuals.

Disclosure of Interest

None Declared
Obsessive-Compulsive Personality Disorder and Death by Suicide
Authors: Overholser J. , Gomez S. , McGovern C. , Silva C. , Stockmeier C.
Published: August 2023

Introduction

The risk of suicide may be elevated in the presence of personality pathology. Adults with Obsessive Compulsive Personality Disorder (OCPD) may be vulnerable to depression and suicidal thoughts.

Objectives

To identify factors associated with suicide in cases of OCPD.

Methods

Psychological autopsy procedures were used to gather detailed information about adults who died by suicide and natural causes. A total of 75 deceased adults were evaluated using psychological autopsy procedures. Family members were interviewed about a recently deceased adult, using structured diagnostic interviews (SCID and SIDP-IV). Diagnostic summaries, coroner’s reports and police records were reviewed by a psychiatrist, a psychologist, a social worker, and a neuroscientist until agreement was reached about final diagnosis. The final sample included 40 adults who met criteria for OCPD (18 had died by suicide; 20 had died by natural causes). An additional 40 cases were examined in which evidence of PD was absent (19 had died by suicide; 18 had died by natural causes).

Results

The diagnosis of a Major Depressive Disorder was significantly more common in suicide completers with OCPD compared to suicide completers without OCPD (X2 = 6.74, p < .01) or cases of natural death with OCPD (X2 = 12.70, p < .001). Suicide completers with OCPD displayed many symptoms of depression, more often than suicide completers without OCPD or cases of natural death with OCPD (see Table 1). As compared to the cases of natural death, both groups of suicide completers were more likely to have previously attempted suicide prior to their final act (X2 = 8.52, p < .05).
Table 1.

Comparison of four groups using psychological autopsy procedures to identify the presence of diagnostic criteria for a Major Depressive Episode at the time of death.

OCPD SuicideOCPD Natural DeathNo PD SuicideNo PD Natural DeathX2Sad mood82.4%36.8%78.9%50.0%11.38 **Sleep disturbance82.4%38.9%73.7%46.7%9.53 *Feelings of worthlessness60.0%38.9%84.2%17.6%17.49 ***Reduced concentration58.8%27.8%57.9%14.3%9.89 *Recurrent suicidal ideation88.2%26.3%78.9%0.0%35.57 ***Loss of pleasure82.4%38.9%73.7%40.0%10.80 **Psychomotor changes50.0%33.3%61.1%26.7%5.04Reduced energy64.7%44.4%63.2%33.3%4.12Change of appetite70.6%26.3%42.1%31.3%8.37 *

Note:

*

= p < .05;

**

= p < .01;

***

= p < .001

Conclusions

Adults with OCPD appear vulnerable to a Major Depressive episode, and the combination of MDD with OCPD creates a significant risk for death by suicide. It is important to appreciate the influence of personality disorder or depression and suicide risk.

Disclosure of Interest

None Declared
Five-factor personality dimensions and their associations with early maladaptive schemas
in individuals with major depressive disorder
Authors: Koutra K. , Mavroeides G. , Basta M. , Vgontzas A.
Published: August 2023

Introduction

Major depressive disorder (MDD) is the third leading cause of disease burden,
accounting for 4.3% of the global burden of disease. Personality traits, as described in the
Five-Factor Model, are consistently associated with individual’s well-being and mental
health. Early Maladaptive Schemas (EMS) are self-perpetuating dysfunctional cognitive
structures that have been linked with psychological health and play a significant role in
developing and maintaining psychological distress. Both personality traits and EMS have been
extensively studied as contributors to MDD symptoms.

Objectives

To our knowledge, very few studies have attempted to link personality to EMS in
clinical samples. The present study aimed to investigate the association between EMS with
personality traits of Five-Factor Model in a clinical sample of patients with MDD in Crete,
Greece.

Methods

Two hundred and two patients with a clinical diagnosis of MDD (81.7% females, aged
47.75±14.06 years) participated in the study. The Traits Personality Questionnaire was used
to measure personality traits in terms of neuroticism, extraversion, openness, agreeableness,
and conscientiousness dimensions. The Young Schema Questionnaire-Short Form 3 (YSQ-SF 3) was
used to evaluate 18 EMS which are grouped in five domains: disconnection and rejection,
impaired autonomy and performance, impaired limits, other-directedness, and overvigilance and
inhibition.

Results

Significant associations between EMS and personality traits were found. Specifically,
a higher level of all EMS domains was found in patients with MDD scoring higher in
neuroticism and lower in extraversion, conscientiousness and agreeableness (apart from the
association of agreeableness with other-directedness which was non-significant). Openness was
negatively related to other-directedness.

Conclusions

Although causal inferences cannot be made due to the cross-sectional design of the
present study, our findings are in accordance with Schema Therapy that affirms a relationship
between innate temperament and EMS. Future research should examine whether psychological
interventions focusing at healing EMS will contribute to alteration of personality
traits.

Disclosure of Interest

None Declared
A case of outpatient treatment in a 58-year-old woman with hoarding disorder and hallucinations.
Authors: Gonzalez-Mota A. , Gonzalez-Gil A. , Basanta-Patiño M. T. , Colomer-Sagaste M.
Published: August 2023

Introduction

In hoarding disorder the patient has a strong tendency to collect and accumulate objects with or without value and great difficulty in destroying them.

In this case, a 58-year-old woman diagnosed with a hoarding disorder 5 years ago, came to a psychiatry clinic due to frequent auditory hallucinations related to episodes of acute stress. She received treatment in an outpatient mental health unit which consisted of psychopharmaceuticals and cognitive behavioural therapy. The patient achieved a partial remission of the hallucinations and a clinical improvement of the accumulation symptoms.

Objectives

The main objective of this study is to describe the psychiatric and psychological treatment of this patient. We also performed a review of the available literature on comorbidity of the symptoms of Diogenes syndrome and psychotic symptoms.

Methods

A close follow-up of the psychopathology of this patient was carried out and we did a database search in PubMed to document the case, with the keywords: “hoarding disorder”, “psychotic disorder”, “comorbidity”, “hallucination”, with the inclusion criteria: In the last ten years, Spanish and English language.

Results

The patient, who was being treated with sertraline 100 mg, started treatment with olanzapine 10 mg and with a psychotherapeutic plan with different objectives: stabilization of symptoms, reduction of hoarding behaviours, letting go of objects, as well as coping with stressful situations. Cognitive behavioural techniques such as psychoeducation, exposure with response prevention and cognitive therapy were included in the psychological treatment.

After one year of treatment the hallucinatory symptoms have remitted and the patient’s daily functioning has improved. The most resistant symptoms are those of accumulation that are slowly decreasing but the patient has stopped collecting objects from the street.

Conclusions

More studies of the treatment of hoarding disorder and more investigation of its possible comorbidities are needed.

Disclosure of Interest

None Declared
Prevalence of neuropsychiatric disorders in internally displaced persons with dementia during wartime in Ukraine
Authors: Dzis M. , Rakhman L.
Published: August 2023

Introduction

During the second wave of Russia-Ukraine war, around 8 million were internally displaced. Negative mental health impact of the war cannot be underestimate. Among internally displaced persons (IDPs), particularly vulnerable category is people with neurocognitive deficits. Stress associated with displacement may cause a change not only in cognitive functions, but also affect the onset or evaluation of behavioral and psychological symptoms.

Objectives

to study the prevalence of neuropsychiatric disorders in hospitalized patients with dementia, who were internally displaced and to compare with general population frequency.

Methods

64 IDPs with dementia (moderate and severe neurocognitive deficits) who were examined during March-September 2022. Cases of newly arrived persons were taken into account, after 1 to 30 days had passed since their relocation. The diagnosis was verified based on the ICD-10 criteria (F00-F01). The degree of neurocognitive deficit was determined using the MMSE and MoCA tests. Affective pathology was studied using the HAM-D, HAM-A, PHQ-9, AES scales. Psychotic symptoms and behavioral disorders were studied based on clinical examination and medical records. The study was conducted in Lviv Regional Psychiatric Hospital.

Results

among the examined patients, 60 (94% of all examined) had neuropsychiatric disorders. Among this sample, neuropsychiatric symptoms (an isolated symptom or a combination of two or more symptoms) occurred with the following frequency: apathy 16 (26.7%), anxiety49 (81.7%), depressive symptoms 32 (53.3%), agitation and aggression 41 (68.3%), hallucinatory symptoms 8 (13.3%), delusional disorders 34 (56.7%), wandering and disorientation 18 (30%), refusal of food and medicine 12 (20%)

Image:

Conclusions

In this study the frequency of occurrence of certain neuropsychiatric syndromes among IDPs with dementia differed from the studied average frequency of occurrence of the same symptomatology among the general population. In particular, anxiety symptoms among IDPs with dementia occurred 42% more often than on average among patients with dementia in the general population (with a frequency of 81% vs 39%), agitation and aggression - 28% more often (68% vs 40%), and delusions - 16% more often (57% vs 31%). At the same time, symptoms such as apathy (by 19%) and refusal to eat (by 14%) were observed less often among IDPs with dementia than among dementia patients from the general population

Disclosure of Interest

None Declared
Transcranial magnetic stimulation in late-aged people with depressive disorders
Authors: Liubov P. , Egorova D.
Published: August 2023

Introduction

One of the most common mental disorders in the elderly is depression.

Because of the high frequency of side effects of pharmacotherapy and the comorbid medical illnesses, there are not many ways to treat it.

Non-drug therapies, such as repetitive transcranial magnetic stimulation (rTMS), could help overcome the limitations of standard drug therapy for this type of mental disorders.

Objectives

Development of approaches to improving improve the provision of psychiatric care to elderly patients using rTMS.

Methods

30 patients over the age of 60 with anxiety-depressive spectrum disorders meeting criteria F30-39, F06.3, F06.4 (ICD-10) and a control group with similar criteria that were not treated with rTMS, were recruited from the psychiatric department at a university hospital (Moscow Scientific Research Institute of Psychiatry). Clinical, psychopathological, anamnestic, psychometric (Montgomery-Asberg scale (MADRS), Hamilton scale (HARS), Mini-mental state examination scale (MMSE) instrumental (electroencephalography) research methods were used. Patients of the experimental group underwent 15 sessions of low-frequency rTMS on the right dorsolateral prefrontal cortex (RDLPC). Conditions for the application of 1200 pulses were as follows: frequency - 1 Hz; intensity - 120% of the threshold of motor response (RMT) of the subject; pulse number - 1200; pulse sequence - 300; sequence duration - 300 seconds; sequence interval - 60 seconds; and stimulation time - 23 minutes. Subsequently, the patients were re-examined using the above-mentioned scales to assess their mental state in dynamics.

Results

Analysis of the collected data shows an increase in the number of respondents and the frequency of achieving remission in the experimental group compared to the control group. No severe side effects of rTMS were observed.

Conclusions

rTMS may be a safe method of adjuvant therapy in groups of elderly patients with anxiety-depressive spectrum disorders. Further studies will be needed to clarify the results.

Disclosure of Interest

None Declared
Low dose Amantadine and Escitalopram combination in Atypical Parkinsonian disorders- A Retrospective chart review
Authors: Tripathi S. M. , Chutia P.
Published: August 2023

Introduction

The response to conventional antiparkinsonian medications is elusive in atypical parkinsonian disorders. Improvement in parkinsonian symptoms in atypical parkinsonian disorders has been reported with anecdotal use of Amantadine. The role of serotonergic control over the nigrostriatal pathway led to the use of Escitalopram.

Objectives

To examine the efficacy of low dose Amantadine and Escitalopram combination treatment in atypical parkinsonian disorder

Methods

A retrospective chart review of Atypical Parkinsonian disorder patients who received the combination of low dose Amantadine and Escitalopram and had follow up assessment available for a minimum of four months were studied. The primary outcome measure was change in Progressive Supranuclear Palsy rating scale, Unified Multiple System Atrophy rating scale score and Clinical Global Improvement Scale Change score in follow up visits.

Results

A total of 8 patients with a mean age of 68.5 years, 6 with a diagnosis of Progressive Supranuclear Palsy(PSP) and 2 with a diagnosis of Multiple System Atrophy(MSA) met the selection criteria for the study. Patients were treated with the dose of Amantadine 50mg twice daily and Escitalopram 5mg once daily. The symptom domain to respond first was autonomic symptoms followed by gait, mentation, limb and bulbar symptoms. Amantadine has unique dopaminergic and NMDA antagonist properties. Serotonin has a role in modulation of the autonomic functions and nigrostriatal circuitry. Thus, combining Escitalopram with Amantadine can help ameliorate the array of symptoms in atypical parkinsonian disorders.

Conclusions

The PSP and MSA patients responded to the combination of low dose Amantadine and Escitalopram as evidenced by objective rating scales and subjective clinician assessment. Further prospective trials for longer duration are needed to establish the effect size and stability of response.

KEYWORDS: steele richardson olszewski disease, shy dragger syndrome, antidepressants

Disclosure of Interest

None Declared
Workplace age discrimination and engagement: The role of emotional regulation
Authors: Miguel I. , Silva S. , von Humboldt S. , Tavares P. , Low G. , Leal I. , Valentim J.
Published: August 2023

Introduction

Gaining competitive advantage is essential to modern organizations, for which it is fundamental that workers are engaged with their work. Perceived age discrimination in the workplace is a factor that may influence workers’ engagement.

Objectives

The present study aimed to analyze the moderating role of emotional regulation in the relationship between perceived age discrimination and work engagement.

Methods

This empirical study included a sample of 452 Portuguese workers of various age groups, between 18 and 65 years-old and used the questionnaire as data collection method.

Results

Results show that perceived workplace age discrimination negatively impacts work engagement. Further, results suggest that emotional regulation exacerbates the negative relationship between perceived age discrimination and work engagement.

Conclusions

Age management strategies to address perceived age discrimination and work engagement, particularly due to the increasing proportion of older workers, are discussed.

Disclosure of Interest

None Declared
Assessment of serum high mobility group box 1 protein (HMGB1) levels and its change with treatment in patients with manic episode of bipolar disorder
Authors: Kara A. , Balaban Ö. D. , Karamustafalıoğlu N.
Published: August 2023

Introduction

There has been an increasing evidence in recent years that inflammation plays a role in the pathophysiology of bipolar disorder (BD). In addition to central inflammation, systemic immune response is thought to be associated with disease stages and course. HMGB1 protein is a member of damage-associated molecular pattern which plays a role in the regulation of cytokine release and is important for innate immunity. It has been revealed that HMGB1 levels change in many autoimmun and inflammatory diseases

Objectives

Our study was designed to compare serum HMGB1 levels of inpatients with mania and healthy controls as well as analyzing its relationship with other inflammatory markers and disease severity. Another aim of our study is to determine the changes in serum HMGB1 levels before and after treatment in manic patients.

Methods

Our study included 35 patients who were hospitalized in our hospital between November 2020 and April 2021, diagnosed with bipolar disorder, manic episode according to DSM-5 criteria, and 35 healthy controls who matched to the patient group in terms of age and gender. The sociodemographic and clinical characteristics data forms of the participants were filled in, and the patients were evaluated with the Young-Mania Rating Scale (YMRS) and the Hamilton Depression Scale (HAM-D). Serum HMGB1, CRP levels and complete blood count values were measured in healthy controls and patients before and after the treatment.

Results

The main finding of our study is that HMGB1 levels did not show a statistically significant difference in the patient and healthy control groups (p>0.05). In addition, there was no significant change in serum HMGB1 levels of the patients after treatment compared to the level before treatment (p>0.05). Our study has also revealed that manic patients had a higher level of CRP than the ones in control group at a statistically significant level. The platelet/lymphocyte and neutrophil/lymphocyte rates of the patients increased after the treatment compared to the pre-treatment period (respectively p=0,026, p=0,003).

Conclusions

The higher CRP levels in manic patients support the hypothesis of low-grade chronic inflammation, which is thought to be involved in the etiology of BD. The most important finding of this study is that there is no statistically significant difference of serum HMGB1 levels between the two groups. This can be explained by the fact that HMBG1 is one of the late mediators of inflammation and does not rise immediately during the acute period. However, since the inflammation process includes complex mechanisms involving many systems, it makes it difficult to comment on this issue.

Disclosure of Interest

None Declared
Non-Convulsive Status Epilepticus as A Complication of Electroconvulsive Therapy: A Case Report
Authors: Saltoglu T. , Senol B. , Koc G.
Published: August 2023

Introduction

Status Epilepticus is defined as a condition that can have long-term outcomes involving neuronal death and injury due to the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms that lead to abnormally prolonged seizures. Electroconvulsive therapy (ECT) is a highly effective treatment option for psychiatric disorders. Although it rarely occurs in the treatment, non-convulsive status epilepticus can be seen as a complication after ECT. Due to its rarity, this complication is not yet well understood, is challenging to diagnose, and information about treatment options is limited.

Objectives

By sharing this case report, we aim to emphasize the importance of being careful in terms of the risk of status epilepticus in patients receiving electroconvulsive therapy.

Methods

Here in we present a 29-year-old patient with no previous neurological disease and who had a history of schizophrenia. Electroconvulsive therapy was planned because the patient was resistant to antipsychotic treatment. EEG was planned for the patient who had urinary incontinence during the ninth session of ECT. Generalized slow wave activity and intermittent rhythmic delta activity were observed in the EEG, therefore it was found suspicious for NCSE, and the patient was planned to perform an EEG again by administering diazepam to confirm the diagnosis. After diazepam, the patient whose EEG tracing was clearly improved was admitted to the neurology intensive care unit. He was followed up for 48 hours with continuous 4 mg/hour/day midazolam and continuous bedside EEG in the neurology intensive care unit. Concomitant lamotrigine was started at 100 mg/day. Significant improvement in EEG, sinusoidal alpha, and beta waves with the eye open was observed at the 48th hour, and the patient was transferred back to the psychiatry service. Lamotrigine treatment was increased up to 200 mg/day and clozapine treatment was adjusted to 350 mg/day in the psychiatry service. In the patient whose EEG was requested again before discharge.

Results

The diagnosis of NCSE post-ECT can be laborious; the symptoms may not be characteristic and clear, and usually not distinguish from symptoms of confusion, delirium, or psychiatric illness, hence the follow-up psychiatrist should be careful. In suspicious cases, EEG should be taken, especially in patients at risk for seizures. These risky conditions include previous seizure history, and lithium or clozapine use.

Conclusions

The diagnosis of NCSE after ECT is a demanding condition. Particular attention should be paid to factors that will lower the seizure threshold. In cases with ECT treatment with clozapine, intermittent clozapine blood levels can be quantified and medication interactions and smoking can be considered. When the cases are examined, the common aspect of most of them is that the treatments have good results.

Disclosure of Interest

None Declared
Non-invasive brain stimulation and cognitive function in patients with major depressive disorder or bipolar depression: systematic review and meta-analysis
Authors: Mutz J. , Kiebs M.
Published: August 2023

Introduction

Non-invasive brain stimulation protocols are effective treatments for depressive episodes. Although the cognitive adverse effects of electroconvulsive therapy (ECT) are well documented, evidence regarding the cognitive effects of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) is mixed.

Objectives

The aim of this study was to synthesize research on the cognitive effects of non-invasive brain stimulation protocols and to differentiate between studies of major depressive disorder (MDD), bipolar depression and mixed populations.

Methods

Following a systematic literature search of multiple electronic databases, a series of meta-analyses were conducted to estimate standardized mean differences (SMD) between pre- and post-treatment cognitive functioning across nine cognitive domains. Where possible, SMDs were estimated separately for MDD, bipolar depression and mixed populations. In studies that included both patients with MDD and bipolar depression, the percentage of patients with a diagnosis of bipolar depression was tested as a potential moderator.

Results

More than 150 treatment arms were included in the analyses. For ECT, we observed a small decline in language functioning and a decrease in autobiographical memory scores. There was no evidence of pre-post differences across other cognitive domains. For rTMS and tDCS, small to moderate cognitive improvements were observed for several cognitive domains, for example for executive functioning. Across most analyses, between-study heterogeneity was high and could not be accounted for by differences between MDD, bipolar depression or mixed populations.

Conclusions

There was limited evidence that differentiation between studies of MDD, bipolar depression and mixed populations accounted for between-study heterogeneity in analyses of pre-post differences in cognitive functioning. Given that most studies included both patients with MDD and bipolar depression, this finding should be treated as preliminary. Across all the treatment protocols examined, more data are needed to investigate the cognitive effects of non-invasive brain stimulation in patients with bipolar depression.

Disclosure of Interest

None Declared