bluuebunny/crossref_metadata_2025 huggingface dataset:
Anxiety among healthcare professionals during the COVID-19 pandemic: Predictive role of social support
Authors: Bouaziz A. , Smaoui N. , Kraiem M. , Bouali M. Maalej , Omri S. , Feki R. , Thabet J. Ben , Zouari L. , Charfi N. , Maalej M.
Published: February 2022

Introduction

The COVID-19 pandemic may cause elevated levels of anxiety in healthcare professionals (HCP). Identifying factors that could help maintain mental health especially social support could be helpful in facing this stressful situation.

Objectives

The aim of this study was to asses the relationship between the trait-anxiety and perceived social support among Tunisian HCP in the current pandemic wave of COVID-19.

Methods

A cross- sectional descriptive and analytic study conducted among Tunisian HCP during November and December 2020. The data were collected by an online questionnaire. The trait-anxiety was assessed using the “General Anxiety questionnaire of Spielberger” (STAI-Y-B). We used the “Social Support Questionnaire” to measure availability and satisfaction regarding perceived social support.

Results

Participants were 135 HCP, and aged from 24 to 61 years old (average age 31.98 years). The sex ratio was 1.1 (71 males and 64 females). Of HCP involved in the study, 61.5% were single, 36.3% were married and 2.2% were divorced. The average scores of availability and satisfaction regarding perceived social were 7.79 (SD=3.56) and 28.41 (SD=6.75), respectively. Seventy-two of the HCP had a trait-anxious. Analysis showed that social support satisfaction scores were significantly lower in trait-anxious HCP (p<0.001). However, there was no significant difference in the score of availability according to trait-anxiety (p=0.49).

Conclusions

Our study highlighted the existence of a deficit on perceived social support satisfaction among trait-anxious Tunisian HCP. Perceived social support as a determinant of trait anxiety should be the focus of social work in this period.

Disclosure

No significant relationships.
Perceived characteristics of life situations during the COVID-19 pandemic
Authors: Bityutskaya E. , Kheruvimova A. , Mirzamedova T. , Skvortsova A. , Spitsyna A. , Lebedeva N.
Published: February 2022

Introduction

The COVID-19 pandemic situation is seen as an intense stressor. However, people process it differently.

Objectives

This study aims to examine the connection between life situation perception and the desirability of life changes the pandemic caused.

Methods

Adult participants (n=144; 01.04.2020–01.06.2020) answered open-ended questions about their current life situation experience and rated the desirability of life changes on a 10-point scale (see table 1). Content analysis and Pearson’s χ2 criterion were used.Table 1Changes’ desirability-5-4-3-2-1+1+2+3+4+5Group 1Group 2Group 3Group 4Rejecting changesAccepting changes

Results

We annotated the participants’ responses. The content of life situations was categorized into restrictions, losses, difficulties (negative responses), acquisitions (positive responses), neutral, and ambivalent responses. Life goals were categorized into an approach to the desired outcome, avoidance of hassles, preservation of status quo, self-development, and return to prepandemic life. χ2 analysis confirms the differences between content-types and goal-types categories in 4 groups of participants: χ2(15)=43.62; p=0.002 (content); χ2(12)=27.23; p=0.01 (goals). The desirability of changes was positively linked with the ambivalent responses and responses containing self-development goals or approach-to-desired-outcome goals; and was negatively linked with the responses containing restriction-type situations and avoidance goals. Only the respondents accepting changes reported acquisitions; only the respondents rejecting changes reported a return to prepandemic life goals.

Conclusions

Perceived characteristics of life situations are closely connected with the desirability of life changes during the pandemic. Funding: The reported study was funded by RFBR, project number 20-013-00838.

Disclosure

No significant relationships.
COVID-19 psychological impact in patients with depressive disorder: Differences based on their age
Authors: Gil E. Martín , Valtueña-García M. , González-Blanco L. , Santo F. Dal , Moya-Lacasa C. , Vázquez C. Álvarez , Martínez-Cao C. , García-Alvarez L. , García-Portilla M.P. , Saiz P.A. , Bobes J.
Published: February 2022

Introduction

COVID-19 pandemic and lockdown have provoked a considerable psychological impact in Spain. Some studies have reported greater psychological impact in the younger population. To date, no previous study has focused on depressive disorder (DD) patients based on their age.

Objectives

To describe the psychological impact on DD according to age.

Methods

Cross-sectional study of an online survey available from 19 to 26 March 2020. Out of a total of 21207 respondents, 608 (2.9%) reported suffering from DD (mean age ±SD = 41.2 years±14.07 [18-82], 80.6% women). The subsample (608) was divided according to age, “youngsters” <45 (57.4%)/ “elders” ≥45. DASS-21 and IES scales were employed. Statistical analyses: Chi-square, t-Student test.

Results

Both groups did not differ (p>0.05) in sex, having COVID-19 symptoms, having family/friends infected, or income changes. While youngsters were single more frequently (68.8% vs 14.3%, χ² = 179.7, p<0.001), elders had somatic illness more frequently (64.8% vs 39.7% χ² =30.401, p<0.001). Youngsters obtained higher scores in depression (4.69 vs 4.1, T=5.413, p<0.001), anxiety (2.86 vs 1.97, T=5.249, p<0.001) and stress (4.48 vs 3.17, T=6.355, p<0.001) DASS-21 subscales, as in intrusive (3.42 vs 3.05, T=1.984, p=0.048) and avoidant (4.64 vs 4.11, T=3.056, p=0.002) IES scores.

Conclusions

Despite the group of elders with depression being more vulnerable to severe COVID-19 disease and presenting more frequently somatic comorbidities, younger depressive patients suffered more from depressive, anxiety, stress and avoidant symptoms and intrusive thoughts, in line with previous reports in the general population.

Disclosure

No significant relationships.
Telework during COVID-19 outbreak: Impact on mental health among Italian workers
Authors: Bertino V. , Nisticò V. , D’Agostino A. , Gambini O. , Demartini B.
Published: February 2022

Introduction

Since February 2020, the outbreak of COVID-19 has spread to several countries worldwide, including Italy, leading to an uptake of telework.

Objectives

We aim to evaluate the psychopathological impact of teleworking during the COVID-19 pandemic in Italy, identifying mental health determinants among home-based workers.

Methods

804 participants completed an online survey, including the psychometric scales “Depression, Anxiety and Stress Scale – 21 items” (DASS-21) and the “Insomnia Severity Index” (ISI). Teleworkers were also asked to provide information about their current work routine, home environment and clinical history.

Results

At the DASS-21, 30% of the participants presented pathological levels of depression, 20.8% of anxiety and 30.7% of stress. At the ISI, 5% appeared to suffer from insomnia. Respondents with psychological and physical frailties, greater social isolation or inadequate working spaces manifested higher levels of psychiatric symptoms. Moreover, we also find a correlation of these symptoms with occupations in education. Telework was broadly appreciated and 87% of respondents expressed a willingness to maintain access to this arrangement.

Conclusions

Our results document that about a third of our sample manifested psychopathological symptoms while teleworking during the COVID-19 outbreak in Italy. However, telework itself does not seem to be directly associated with increased psychiatric symptoms, which were instead exacerbated by COVID-19-related stressful circumstances, as well as by constitutional and social determinants of health. Going forward, authorities should promote adequate measures in order to guarantee a healthy approach to teleworking.

Disclosure

No significant relationships.
Transcultural validation of the “regulation of emotions questionnaire” among Tunisian university students
Authors: Bouguira E. , Ouali U. , Alaya M. Ben , Zgueb Y. , Nacef F.
Published: February 2022

Introduction

The regulation of emotions is a psychological process covering the capacity of inhibiting, maintaining or modulating emotions to create a coherent psychological functioning and to enable the individual to live in adequacy with his or her environment.

Objectives

The aim of the study was to develop an Arabic version of the “Regulation of Emotions Questionnaire-2” (REQ-2T) from Phillips & Power, 2007, and to validate it in a sample of Tunisian university students.

Methods

This is a validation study conducted in a sample of 384 Tunisian university students to whom we administered the REQ-2T, the DASS-21 questionnaire and a sociodemographic questionnaire. We tested face and content validity, reliability, and construct validity of the Arabic version of the REQ-2.

Results

Face and content validity were satisfying. The internal consistency was average, with Cronbach’s alpha coefficient ranging from 0.44 to 0.65. The inter-dimensional correlation reflected statistically significant and logical correlations within the REQ-2T. Temporal stability was satisfying with a variable concordance of 0.65. Exploratory analysis revealed four factors similarly to the original version of the questionnaire. Statistically significant correlations were found between the REQ-2T and its external validator (DASS-21).

Conclusions

The REQ-2T demonstrated good psychometric properties, thus this scale can be reliably used as a measure of emotion regulation in the Tunisian population.

Disclosure

No significant relationships.
Why does transcultural consultation matter?
Authors: Quintão A. , Santos C. , Urzal M.D. , Donas-Boto I. , Azevedo F. , Lemos M.M. , Coelho F. , Vian J.
Published: February 2022

Introduction

Psychiatrists should be aware of the new challenges and needs that globalization poses.

Objectives

To highlight the need for a culturally sensitive approach to mental health.

Methods

Non-systematic review of “cultural consultation” on PubMed.

Results

Most people assume a direct connection between pathophysiology and clinical symptoms. However, evidence shows that the translation of pathophysiology and psychopathology into specific symptoms is mediated by cognitive processes and social interactions, which reflect models/practices specific to our culture. Patients focus on specific aspects of being sick, reinforced by cultural narratives or to fit expectations. Thus, people from different cultural backgrounds might have trouble communicating; cultural idioms of distress can be misinterpreted. The role of structural violence bestowed upon cultural minorities, which leads to discrimination and social exclusion, has extensively been studied as a risk factor for mental illness. Furthermore, ignoring cultural differences and diversity has been shown to contribute to healthcare disparities, hampering access to care and diminishing the quality of care received. In Canada, the Cultural Consultation Model provides cultural expertise, either by evaluating patients (preferably accompanied by the referring doctor, a translator and cultural mediator) for 1-3 sessions, providing recommendations to the referring doctor; or providing consulting to a referring doctor or organisation, through general guidance or discussion of specific cases.

Conclusions

In an evergrowing globalization process, we will inevitably have more contact with patients from culturally distinct backgrounds. To provide the best care, we must be aware of the ways in which culture can shape symptom expression, and take into account cultural explanations and preferences.

Disclosure

No significant relationships.
Value-meaning formations in mentally ill patients with a religious worldview
Authors: Borisova O. , Kopeyko G. , Gusev V. , Gedevani E. , Vladimirova T.
Published: February 2022

Introduction

It is necessary to consider the religious worldview and spiritual needs of patients with mental illness in the course of psychotherapy and rehabilitation.

Objectives

The explication of value-meaning formations (VMF) in mental patients with a religious worldview.

Methods

G. Kelly’s methodology of personal constructs (Method of Triads, Hinkle’s laddering technique, the assessment repertory grid by F.Fransella&D.Bannister) and statistical analyses were applied.

Results

1. The structure of the value-meaning formations (VMF) of patients with religious worldview was characterized by its integrity, which is prerequisite for coping. 2. Opposite, patients with absence of religious belief had substantial destruction of integrity and plurality of relationships between VMF. 3. The content of the VMF of mental patients with religious worldview and healthy believers had similarities. 4. In the content of VMF meta-values were: 1. active aspiration to God and the realization of own existence; 2. material well-being in the earthly world; 3. “unselfish” ability to get along without causing harm; 4. feeling of inner confidence.

Conclusions

Mental disease affects VMF of believers and unbelievers in different way. In unbelievers, the structure of VMF in the course of disease significantly changes. In believers, the disease does not destroy the basis of VMF and allows to keep safe the key elements. The stability of VMF in the believers may be explained by the meaningfulness of life. The concepts of “health” and “disease” are included in the worldview of believers, in the general context of their spiritual, psychic and physical life.

Disclosure

No significant relationships.
They are not real patients
Authors: Aparicio T. Jiménez , De Andrés Lobo C. , Adame C. Vallecillo , De Llano De La Viuda M. Queipo , Valera G. Guerra , Ramírez A. Gonzaga , Cerejeira J. Gonçalves , Carrasco I. Santos , Meseguer C. Capella , Vázquez E. Rodríguez
Published: February 2022

Introduction

Cognitive depressive disorder (or depressive pseudodementia) is a condition defined by functional impairment, similar to dementias or other neurodegenerative disorders, in the context of psychiatric patients. It is important to consider a differential diagnosis in patients with cognitive impairment.

Objectives

Presentation of a clinical case of a patient with depression with psychotic symptoms who presents cognitive impairment.

Methods

Bibliographic review of the differential diagnosis between cognitive depressive disorder and real dementia by searching for articles in PubMed.

Results

We present a 51-year-old woman, previously diagnosed with adjustment disorder (with mixed anxiety and depressed mood) and unspecific anxiety disorder, who was admitted to the hospital due to delusional ideation of harm and Capgras syndrome, ensuring that her relatives had been replaced and the rest of the patients were not real patients, but actors who conspired against her. The MRI (Magnetic Resonance Imaging) was strictly normal (tumors or acute injuries as stroke or hemorrhage were discarded), and a MoCA (Montreal Cognitive Assesment) test was performed to screen any cognitive impairments (obtaining a score of 19/30, with language fluency and abstraction particularly affected). It would be convenient to repeat the test when this episode and the psychotic symptoms are resolved or improved.

Conclusions

1. Some patients may have cognitive impairment in the context of a mood disorder. 2. A differential diagnosis and follow-up of these patients should be performed to assess prognosis, reversibility and treatment. 3. Depressive cognitive impairment may precede the development and establishment of a dementia or neurodegenerative picture.

Disclosure

No significant relationships.
Hyperoxia in depression
Authors: Belmaker R. , Bloch Y. , Shvartzman P. , Romem P. , Bersudsky Y. , Azab A.
Published: February 2022

Introduction

Several studies of normobaric hyperoxia in some neurological conditions have demonstrated clinical benefits. Oxygen enriched air may increase oxygen pressure in brain tissue and have biochemical effects such as on brain erythropoietin gene expression, even in patients without lung disease.

Objectives

This pilot, randomized, double-blind study examined the efficacy of normobaric hyperoxia as a treatment for depression.

Methods

Fifty-five consenting patients aged 18-65 years with mild to moderate depression were included in the study. Participants underwent a psychiatric inclusion assessment and a clinical evaluation by a psychiatric nurse at baseline, 2 and 4 weeks after commencement of study intervention. Participants were randomly assigned to normobaric hyperoxia of 35% fraction of inspired oxygen or 21% fraction of inspired oxygen (room air), through a nasal tube, for 4 weeks, during the night. Patients were rated blindly using the Hamilton Rating Scale for Depression (HRSD); Clinical Global Impression (CGI) questionnaire; Sheehan Disability Scale (SDS).

Results

The present study showed a significant improvement in HRSD (p<0.0001), CGI (p<0.01) and in SDS (p<0.05) among patients with depression who were treated with oxygen-enriched air, as compared to patients who were treated with room air. In CGI, 69% of the patients who were treated with oxygen-enriched air improved compared to 23% patients who were treated with room air.

Conclusions

This small pilot study showed a beneficial effect of normobaric hyperoxia on some symptoms of depression.

Disclosure

No significant relationships.
Physical training for patients with depression and anxiety - a randomized controlled study
Authors: Zhai Q. , Freund-Levi Y. , Horn A. , Fridenberger A.-C. , Lager E. , Montgomery S. , Persson J.
Published: February 2022

Introduction

Pharmaceutical treatment and psychotherapy constitute the most common treatment methods for depression and anxiety. Physical training has been shown to have comparable effect to cognitive behavioral therapy in treatment of mild to moderate depression and anxiety. Physically active individuals also show lower risks to develop depression and relapse in depression.

Objectives

The objectives are to evaluate how physical activity can affect depressive and anxiety symptoms, by examining biomarkers in the blood and from the gut and also by measuring cognitive functions. Hopefully, this can lead to new treatment strategies for patients with depression and anxiety.

Methods

102 patients are randomized to two groups and undergo 12 weeks intervention as add-on to standard outpatient psychiatric treatment. The first group will participate in physical training three times per week and the other group will receive relaxation therapy on a weekly basis. Daily activity intensity will be measured before and at the last week of intervention with an accelerometer. Blood and faeces sample collection, symptom grading by clinician together with self-rating scales and cognitive screening will be performed at baseline, week 12 and one year of follow-up. The cognitive screenings are performed digitally in cooperation with Mindmore.

Results

The RCT is currently recruiting patients at the Department of Psychiatry of Örebro University Hospital.

Conclusions

The project aims to be holistic in its approach, combining the defining clinical psychiatric symptoms in patients who have both depression and anxiety with the finding and evaluation of new biomarkers from blood and gut to improve cognitive functions.

Disclosure

No significant relationships.
Esketamine in patient with treatment resistant depression: Outcome of the temporary authorization for use programme in France
Authors: Wattinne E. Gaudre , Mekaoui L. , Rothärmel M. , Codet M.A. , Bouju S.
Published: February 2022

Introduction

Esketamine nasal spray has been developed for patients with treatment resistant depression.

Objectives

A cohort Temporary Authorization for Use (ATUc) allowed to collect for a 6-month period the first data in real life

Methods

On 02/08/2019 the French National Agency for Medicines and Health Product Safety granted an early access program for Esketamine nasal spray framed by a specific protocol for patients without therapeutic alternatives. Each treatment request was approved based on inclusion and exclusion criteria. Clinical evolution, treatment management and safety were then spontaneously reported by psychiatrists.

Results

From 09/23/2019 to 03/25/2020, 66 patients were treated. The median age was 53 years and 41 (62.1%) were females. At treatment request, 52 patients (79%), presented a severe current depressive episode based on clinical judgment. The median duration of the disease was 12.2 years and the current episode was 2.6 years. Since the beginning of the current depressive episode, all patients (66) were prescribed ≥2 antidepressants (mean 4.2). Esketamine was initiated in a complete hospitalization setting in 27 patients (55.1%) and in day hospitalization in 22 patients (44.9%).Safety profile was consistent with the one described during clinical study. The most frequently adverse events reported (>10%) were dizziness, sedation, sleepiness, anxiety and dissociation. Most of them appeared after treatment administration and were transient.

Conclusions

ATUc ended on 12/18/2019 after Marketing Authorization granted by European Medicines Agency. Data reported by French psychiatrists are the first collected in this specific population and provide descriptive information on patient characteristics, burden of disease; Esketamine management and practical use at hospital level

Disclosure

Data analysis performed by RCTs and poster conception coordinated by Medergy and funded by Janssen
Lifetime depression and age-related changes in body composition, cardiovascular measures, grip strength and lung function
Authors: Mutz J. , Lewis C.
Published: February 2022

Introduction

Individuals with mental disorders, on average, die prematurely and may experience accelerated biological ageing.

Objectives

We examined sex-specific associations between age and physiological measures in individuals with lifetime depression and healthy controls.

Methods

UK Biobank recruited >500,000 participants, aged 37-73, between 2006–2010. Generalised additive models (GAMs) were used to examine associations between age and multiple cardiovascular, body composition, grip strength and lung function measures. Analyses were conducted separately in males and females with lifetime depression compared to healthy controls.

Results

Analytical samples included up to 342,393 adults (mean age = 55.87 years, SD = 8.09; 52.61% females). We found statistically significant differences between individuals with lifetime depression and healthy controls for most physiological measures, with standardised mean differences between -0.145 and 0.156. There was some evidence that age-related changes in body composition, cardiovascular measures, lung function and heel bone mineral density followed different trajectories in individuals with lifetime depression. However, these differences did not uniformly narrow or widen with age. For example, BMI in females with lifetime depression was approximately 1.1 kg/m2 higher at age 40 and this difference narrowed to about 0.4 kg/m2 at age 70. In males, systolic blood pressure was approximately 1 mmHg lower in individuals with lifetime depression at age 45 and this difference widened to about 2.5 mmHg at age 65.

Conclusions

Evidence of differences in ageing trajectories between individuals with lifetime depression and healthy controls was not uniform across physiological measures and differed by sex.

Disclosure

JM receives studentship funding from the Biotechnology and Biological Sciences Research Council (BBSRC) and Eli Lilly and Company Limited. CML is a member of the Scientific Advisory Board of Myriad Neuroscience.
Deprescribing process in demented patients: What is the rationale?
Authors: Stoppe G.
Published: February 2022

Polypharmacy is rather a rule than an exemption in the elderly. This applies also to the demented population, whether they live in private homes or in nursing homes. The application of multiple drugs increases the risk to develop delirium, to promote falling and to hasten cognitive decline, What can be done to reduce these risks? First of all, drugs should be given on the basis of an appropriate assessment. Pain e.g. may be misunderstood as challenging bevhaviour. Side affects might be misunderstood as newly occuring symptoms. Drugs should be prescribed with a written protocol, what the drug is expected to do. If this does not occur, the drug should be deprescribed. In addition, antidepressants should be deprescribed. Many demented patients receive more than two of them, mostly for years. Depresciption follows the evidence, that antidepressants are not much helpful in dementia. They may induce hyponatriamia, too. The deprescription of benzodiazepines requires patience and a long tapering-out. And overall, what about the antipsychotics? They shall be given at a minimum dosage and duration. That means, that drug pauses should be established regularly. And finally, what about the antibiotics, antihypertensive drugs and more? Having in mind, that severe dementia is mostly a state, where the priniciples of palliative medicine should be applied, also many of these drugs can be deprescribed.

Disclosure

No significant relationships.
The role of the gut-brain axis in depression and anxiety disorders
Authors: Trigo M.
Published: February 2022

Introduction

There is a bi-directional biochemical communication pathway between the gastrointestinal tract and the central nervous system, referred to as the “gut–brain axis”. Studies show that bacteria in the gastrointestinal tract, including commensal, probiotic, or pathogenic, can affect brain’s function. Since there is a symbiotic relationship between gut microbiota and the brain, changes in its composition can lead to dysbiosis, which plays a role in many psychiatric disorders, such as depression and anxiety, and therefore becomes a potential therapeutic target.

Objectives

To examine data from recent studies regarding the gut-brain axis and its relationship with psychiatric disorders, such as depression and anxiety.

Methods

Review of the most recent literature regarding the gut-brain axis and its relationship with depression and anxiety disorders. The research was carried out through the MedLine, PubMed, UptoDate, ScienceDirect, SciELO and SpringerLink databases, using the terms “gut-brain axis”, “depression” and “anxiety”, until December 2020.

Results

There is a relationship between dysbiosis of microbiota and some psychiatric disorders, particularly depression. Symbiosis may be restored by purposefully manipulate the gut microbiota using therapies such as probiotics, therefore enhancing beneficial bacteria in the gastrointestinal tract and improving symptoms of depression.

Conclusions

Although probiotics can be used in the treatment of depression, further research is needed in order to carefully determine parameters such as the duration of treatment, dosage and drug interactions. Nonetheless, a better understanding of the gut-brain axis may arise new approaches on how we prevent and treat mental illnesses.

Disclosure

No significant relationships.
Non bulimic shitty meal
Authors: Costa A. , Jesus S. , Alcafache J.
Published: February 2022

Introduction

Coprophagia is a relatively rare phenomenon characterized by the ingestion of feces, and it is usually classified as a rare form of pica. It has been associated with multiple organic causes or mental disorders such as brain tumors, alcoholism, mental retardation, dementia, schizophrenia, depressive disorders or fetishism.

Objectives

Case report and reflection on its etiology

Methods

A Pubmed search was performed with the MeSH terms “Coprophagy” and “pica”. Relevant articles obtained from the respective bibliographic references were also consulted.

Results

A 56-year-old man with a history of psychiatric follow-up with a diagnosis of schizophrenia and cognitive impairment, assessed for behavioral changes such as cat feces intake. After possible organic causes were excluded, treatment with supportive psychotherapy and pharmacologically began with a selective serotonin reuptake inhibitor, fluoxetine, along with treatment for schizophrenia.

Conclusions

According to literature, coprophagia often occurs associated with other medical or neuropsychiatric conditions. Although the etiology, pathophysiology and management remains unclear, several pharmacologic treatments have been attempted with some degree of success. We describe a case of unusual behavior, coprophagia, associated with cognitive impairment and schizophrenia that responded favorably to fluoxetine although without complete remission, in order to contribute to a future nosological redefinition.

Disclosure

No significant relationships.
Vomitophobia in atypical anorexia nervosa
Authors: Bryukhin A. , Lineva T. , Okonishnikova E.
Published: February 2022

Introduction

In atypical anorexia nervosa, one of the causes of restrictive eating behavior is prolonged vomitophobia, which leads to a pronounced degree of alimentary exhaustion.

Objectives

To study the existence and prevalence of vomitorium atypical anorexia nervosa

Methods

Psychopathological, anamnestic, psychological

Results

It was found that in atypical anorexia nervosa, vomitophobia is observed in 30% of cases. The initial stage is a psychotraumatic situation unrelated to eating behavior. In the future, the pathological fear of vomiting is fixed, which is due to the presence of personal deviations and anxiety disorders. The initial stage of an eating disorder is a psychotraumatic situation that is not directly related to eating behavior. However, after Psychotrauma, there is anxiety with its subsequent somatization and vegetative dysfunction of the gastrointestinal tract. In the future, the pathological fear of nausea and vomiting is fixed, which is due to the presence of significant personal characteristics and persesting of anxiety disorders. Dysmorphophobic experiences appear as you lose weight and have an inverted character-discontent with thinness, exhaustion.

Conclusions

The presence of massive vomitorium leads to restrictive eating behavior. Therefore, there is a need to differentiate this pathology from typical anorexia nervosa with vomiting and from hypochondriac disorders. Against the background of adequate complex therapy with food rehabilitation, anti-anxiety medication, psychotherapy, atypical anorexia nervosa with vomitophobia undergoes a fairly rapid reverse dynamics with the appearance of a critical attitude to the existing pathological eating behavior. The prognosis in these cases is quite favorable.

Disclosure

No significant relationships.
Psychodynamic phenomena in obese patients
Authors: Mustač F. , Bjedov S. , Matovinović M. , Jaksic N. , Vuksan-Ćusa B. , Marčinko D.
Published: February 2022

Introduction

Obesity is one of the leading problems of today’s society. According to WHO, 650 million people worldwide are obese, which is 13% of total population (in Croatia 21.5%). There are various psychodynamic theories that interpret the psychological aspects of obesity.

Objectives

The aim of this paper is to present psychodynamic and contemporary psychiatric concepts that explain the interrelated phenomena presenting in obese patients.

Methods

The review of the literature included the investigation of the existing studies in the field of modern psychiatry, as well as previous knowledge in the field of psychodynamics.

Results

Obesity is associated with the emptiness of not recognizing one’s own emotions from hunger, and the need for constant replacement. The everyday life of the obese is filled with shame, an uncomfortable perception that is so intense that can be unbearable. The emptiness and shame which overwhelm and create discomfort cannot be fulfilled by constant food intake and are associated with pathological narcissism (grandiose or vulnerable), which in turn is associated with more regressive behaviour. Thus, obesity may sometimes be associated with addictive behaviours, and a cognition that a bad pattern of rewarding behaviour through food has been adopted in parallel with poor self-control.

Conclusions

Relationship between psychodynamic phenomena and obesity is complex and multidimensional. Further research is needed in order to ameliorate our understanding of these connections.

Disclosure

No significant relationships.
Pro-Ana and Pro-Mia keywords, their google search trend
Authors: Jordan G. Lladó , García M.D.C. Díaz , Sánchez P. Mediavilla , Díez B. Lozano , Del Barrio J.A. Gómez , Ayesa-Arriola R.
Published: February 2022

Introduction

Eating Disorders (ED) have increased both in number of cases and diagnoses in recent years, partly due to the ease of searching on the Internet. This “community” as they call themselves has a proper language, which makes them easier to connect.

Objectives

To know the search frequency of Pro-Ana and Pro-Mia terms in Spanish in the Google search engine.

Methods

A manual screening was carried out based on the word analysis of Pro-Ana and Pro-Mia blogs to obtain their search frequency in Spanish. Using the Google Trends tool, a total of 19 word combinations related to ED and their advocacy were reviewed in the time period from 01/01/2019 to 01/12/20. Some of them such as: “carrera de kilos” (kilos race), “princesa de cristal” (glass princess), “princesa de porcelana” (porcelain princess) and “dieta ABC” (ABC diet) among other terms.

Results

From 2019 to 2020 there has been an increase in the searches related to Eating Disorders (41.63%), ABC diet (9.72%), porcelain princess (25.52%) and kilos race (38.53%). There has also been a decrease in the search for thinspo ana (30.9%), tips ana (4.15%), blog mia (13.09%) or blog ana (0.79%).

Conclusions

Search trends change over time as they meet the evolving needs. In several media we can find a clear increase in ED during this 2020 due to the confinement related to COVID-19. This is something that we can also relate to this increase in searches for some terms.

Disclosure

No significant relationships.
Bariatric surgery exclusion: Psychiatric causes
Authors: Martín C. Vilella , Vázquez P. García , Rodríguez I. Gonzalez , Sevillano S. Nuñez , García A. Serrano
Published: February 2022

Introduction

The psychopathological causes that advise against a bariatric surgical procedure include any state that puts at risk the modification of habits and beliefs regarding eating behavior, wich condition weight loss and health improvement.

Objectives

To Study the psychiatric profile of patients rejected for bariatric surgery at the Complejo Hospitalario Asistencial de León (León, Spain).

Methods

Retrospective observational study. All patients for whom bariatric surgery procedure has been contraindicated for psychopathological reasons are included. 145 patients were evaluated in the context of the protocol for bariatric surgery. The following diagnostic scales were used as support: Salamanca Questionnaire, Plutchik Impulsivity Scale, Attitudes towards change in patients with eating disorders (ACTA), Bulimia Investigatory Test Edinburgh e, and European Quality of Life-5 Dimensions.

Results

41 Patients were rejected for psychiatric reasons (28.28%). The most frequent diagnoses are impulse control disorder (39%), followed by eating disorder (27%). Other diagnoses found are: depressive disorder (10%), adjustment disorder (5%), personality disorders, intellectual disability and generalized anxiety disorder (3%) 78% of them are women.

Conclusions

Uncontrolled psychiatric pathology is a contraindication to bariatric surgery. Impulse control disorder and eating disorder are related to overweight and obesity, so a diagnosis and treatment are necessary prior planning surgical procedure. Psychopathological variables determine the success of bariatric surgery procedures and it is mandatory to consider them in the process.

Disclosure

No significant relationships.
Psychiatrical assessment of civil status of recipients of inpatient social services in two regions of Russia
Authors: Rusakovskaya O. , Petrov A. , Korensky N. , Romashkina N.
Published: February 2022

Introduction

In 2019 national survey - personal examination of persons, living in residential facilities for mentally disabled people - was executed under the instruction of the Government by specialists of V.Serbsky National Medical Research Centre. For 2559 legally incapacitated residents the procedure of rehabilitation of full or diminished capacity was recommended. For 16132 legally capable residents the procedure for recognising their incapacity was recommended (Kekelidze ZI et al., 2020).

Objectives

To compare the recommendations on legal capacity in two regions with different systems of inpatient social services.

Methods

Full-sized noncontrol observational descriptive screening study.

Results

In table 1 the recommendations on legal capacity in two regions are presented.Table 1. Recommendations on legal capacityRegion 1Region 2Residents, were examined3837 (100%)1859 (100%)Legally incapacitated residents3671 (95,7%)1347 (72,5%)Partly legally capable residents17 (0,4%)0 (0%)Legally capable residents149 (3,9%)512 (27,5%)Rehabilitation of full or diminished capacity was recommended (% of incapacitated)186 (5%)31 (2,3%)Deprivation of legal capacity was recommended (% of legally capable)12 (8%)29 (5,7%)

Conclusions

Differences in quantity of residents, for whom rehabilitation of full or diminished capacity was recommended, depend on characteristics of the systems of institutional care in the regions. In the first region a complex system of rehabilitation and deinstitutionalization has been organised. In the second region such system is just organising. Among legally capable and those, for whom rehabilitation of capacity was recommended, there were residents, able to live independently or under community-based services.

Disclosure

No significant relationships.
Electroconvulsive therapy and informed consent in compulsory treatment – an ethical dilemma
Authors: Cunha C. , Pereira R. , França G. , Silva J.
Published: February 2022

Introduction

Given the effectiveness and overall safety in several psychiatry conditions, electroconvulsive therapy remains a widely used procedure in current medical practice. Informed consent is still a requirement for the use of ECT both in voluntary and compulsory treatment; however, since severe mental illness can affect decision-making capacity and insight of the need for treatment, this requirement often constitutes an obstacle to its use. In addition, stigma around ECT still contributes to treatment refusal.

Objectives

To summarize the most recent evidence published about ECT and discuss the ethical and legal implications of its use, enlightened by the empirical description of a clinical vignette.

Methods

Review of literature on the ethical and legal issues involving the ECT use in patients on compulsory treatment, considering the efficacy, risks, the mental health legislation in Portugal, and several international directives.

Results

Informed consent is the basic tenet in the contemporary physician-patient relationship. In principle, ECT can only be administered to patients who prior consent to the treatment. In contemporary practice, providing the best medical assistance and respecting the patient’s autonomy are two fundamental principles. However, we often face an ethical dilemma, when severely ill patients, whose insight, the ability for self-determination and decision-making capacity may be impaired, refuse a potential beneficial treatment as ECT.

Conclusions

The use of ECT in severe mental illness is still hampered by legal and ethical constraints. A future revision of the law could protect patients from being excluded from a treatment that may change the course of the disease.

Disclosure

No significant relationships.
Psychological induction of the child: Cognitive, emotional and behavioral diagnostic markers
Authors: Kalashnikova A.
Published: February 2022

Introduction

One of the tasks of the forensic assessment of family disputes is to establish the fact that a child is set up by one parent against another.

Objectives

Identification of diagnostic markers of psychological induced state in a child due to purposeful actions of a parent living together with him.

Methods

A continuous one-step analysis of the results of forensic assessments on family disputes was carried out in respect of 48 girls and 67 boys aged 3 to 15 years (mean age 7.9 ± 4.5 years). The objective materials presented by the court were analyzed in comparison with the results of a structured interview. The statistical significance of any differences were evaluated using the non-parametric Mann-Whitney (U).

Results

Persistent negative attitude to one of the parents was found in 14% of children. Markers of the induced state at the cognitive level were identified: negative semantic attitudes (U=477.1; p=0.014), distorted image of the rejected parent (U=509.5; p=0.023), transformation of memories (U=389.5; p=0.001). At the emotional level: persistent negative attitude to one of the parents when idealizing the second (U=371.1; p=0.001), emotional involvement of the child in the family conflict (U=556.6; p=0.048). At the behavioral level: declaring a stable set of stereotypical “adult” phrases (U=387.3; p=0.001), regressive behaviors and manifestations of stress in the presence of a rejected parent (U=601.5; p=0.04). Markers on all three levels must co-exist.

Conclusions

There are diagnostic markers of the induced state in a child, which verify the forensic conclusion about the negative impact on his mental state of the parent-inducer.

Disclosure

No significant relationships.
Relationship between the sexual abuser and the victim
Authors: Tumbev L. , Chumpalova P. , Stoimenova-Popova M. , Valtchev V. , Tumbeva E.
Published: February 2022

Introduction

Although much of society believes that the sexual aggressor is unknown to the victim, this is not supported by the literature. In most cases, the rapist is a known, former or current intimate partner of the victim or even a family member.

Objectives

189 persons accused of perpetrators of sexual crimes and who were subject to forensic psychiatric evaluation for the period from January 2010 to December 2019 in the territory of Central Northern Bulgaria were examined.

Methods

The current research uses sociological methods to gather information - interviews, observations, research of forensic and medical documents,

Results

In the study group, 62% of the victims were known to the perpetrator of the sexual crime, 11% were part of the nuclear family and 8% were members of the extended family of the perpetrator.

Conclusions

Our data supports data from previous studies

Disclosure

No significant relationships.
Characteristics of offenders referred for psychiatric forensic examination
Authors: Felhi R. , Hamdi G. , Ammar H. Ben , Ridha R.
Published: February 2022

Introduction

Forensic psychiatry is facing major challenges related to criminal responsibility with an increasing number of offenses and the entanglement of several factors affecting offenders differently.

Objectives

The aim of this study is to determine the characteristics of offenders referred for forensic psychiatric examination.

Methods

We studied the medical files of all the offenders referred to the forensic psychiatry unit in Razi hospital for an examination between January 2010 and October 2020.

Results

The number of people who have undergone a forensic psychiatric examination was 256. Three files were not usable due to lacking data. The offenders were men in 95.7% (242) of the cases. Their average age was 35 years with a range of 17-53 years. They were mostly single (64%) with primary education (58.1%). Forty percent of the studied population were unemployed and 70% of them lived with their parents. Drug abuse was found in half of the cases and the average number of taken drugs is two illicit substances per person. A criminal record was found in 43% of the cases with an average number of two offenses per person. Offenders were found to suffer from schizophrenia in 29% of the cases, personality disorder in 17% of the cases and from intellectual disability in 16.6% of the cases. No psychiatric disorder was found in 24% of the cases

Conclusions

Despite having in common many vulnerability factors, such as low educational level, unemployment and drug abuse, an important number of offenders referred for forensic psychiatric examination weren’t affected by a psychiatric disorder.

Disclosure

No significant relationships.
The application of a stress reduction intervention in patients with chronic diseases in Greece
Authors: Lyrakos G. , Tsironi M. , Aslani E. , Spinaris V.
Published: February 2022

Introduction

This is the presentation of a postdoc research protocol under the supervision of University of Peloponnese, regarding the application of a program for stress reduction. Τhe intervention consisted of a psychoeducational session explaining the stress effect in the brain and the way that relaxation breathing is working, a training session on relaxation breathing and 2 more sessions, one with relaxation breathing and one with trigger points acupressure in the back of the patients.

Objectives

The objective of the study was to test the effectiveness of relaxations techniques in patients with chronic diseases in a Greek General Hospital.

Methods

Out of 335 participants, 153 were found to have high stress levels in the DASS scale and the stress VAS scale that was used for the intervention. 151 of them (49(32, 5%) males), agreed to participate in the intervention with relaxation breathing and 99 in the acupressure session. Diagnosis of the participants were: anxiety disorder (18.5%), Thalassaemia Major(31.1%), Crohn (26.5%), Kidney failure (9.9%) and major depression (13.9%). Analysis was performed with SPSS 24.

Results

The results in DASS stress scale revealed that 54.3 % of the sample had very severe and 24.3% severe stress levels while 58.9% had very severe anxiety levels in DASS anxiety scale. Pair sample t test show statistically significant differences before and after the application of breathing relaxation t150=24.725 p=0.001, as well in the application of acupressure t98=15.901 p=0.001.

Conclusions

According to the results of the present intervention, relaxation techniques can be very helpful as complimentary treatments for patients with chronic diseases

Disclosure

No significant relationships.