bluuebunny/crossref_metadata_2025 huggingface dataset:
Hydroxychloroquine induced QT prolongation in a schizoaffective patient being treated for a COVID-19 infection: A Case Report
Authors: Amazan R. , Korenis P. , Gunturu S.
Published: September 2022

Introduction

Hydroxychloroquine an antimalarial medication has been approved in March 2020 by FDA for treatment of hospitalized patient with COVID-19 infection. Even thus, its efficacy has been controversial, it still being used worldwide. This medication also causes some serious side effects. Here we present a case of a woman with a very long history of treatment resistant schizoaffective disorder, on clozapine, who develops QT prolongation after receiving hydroxychloroquine for the treatment of COVID-19 infection.

Objectives

Despite the controversy, this case aims to shed light on the importance of monitoring QTc via EKG in patient receiving hydroxychloroquine7. More importantly to avoid antipsychotic while patient is receiving this medication since both hydroxychloroquine and most antipsychotic can increase QTc.

Methods

This case report was written by reviewing chart of the patient and also via direct interaction and interviews with the patient.

Results

This case report showed and increased in QTc interval after receiving hydroxychloroquine, which is also reported by others including Moussa Sleh et al in their article on Effect of Chloroquine, Hydroxychloroquine, and Azithromycin on the Corrected QT Interval in Patients With SARS-CoV-2 Infection4. The increase in Qtc could have been worse if Clozapine was not stopped during this time.

Conclusions

COVID-19 pandemic has caused more than 700000 deaths around the globe and more than 150000 deaths in the United States of America. Psychiatric patients are also getting hospitalized and receiving treatment with hydroxychloroquine. Holding anti-psychotics and monitoring of QTc via EKG resulted crucial in limiting the adverse effect of QT prolongation of both medications.

Disclosure

No significant relationships.
Diagnosis and treatment of tremor in psychiatric patients
Authors: Van Harten P.
Published: September 2022

Introduction

Tremor is the most common movement disorder in adults. Due to the visibility, feelings of shame are often present. Many (psycho)pharmacological drugs can induce tremor or increase its severity as a side effect. Sometimes the burden of this side effect is greater than the burden of the psychiatric problem.

Objectives

Knowledge of the different kinds of tremor in psychiatry, and the drugs that may be responsible. Differential diagnosis Treatment of tremor in psychiatry.

Methods

A literature search on the most recent insights into classification, diagnosis, differentiation and treatment was carried out with emphasis on drug-induced tremor and its treatment.

Results

The basic classification is resting, action and intention tremor. Tremors may be due to neurological and metabolic syndromes. Differentiation can often be made according to the time of onset, relation with starting or increasing the dosage of the medication and the course. Rest tremor is often related to antipsychotics and antiemetics and action tremor to lithium, antidepressants, valproic acid, and other anticonvulsants, but also to many drugs used in somatic conditions. The development of intention tremor should alarm the doctor because it could be an intoxication. Treatment of drug-induced tremor consists of reducing the dose or discontinuing the drug in question or switching to another drug with less risk of tremor. If this is not effective, adding a tremor suppressant may help (propranolol, primidone in action tremor and anticholinergics or amantadine in resting tremor.

Conclusions

Tremor is a common side effect of many (psycho)pharmacological agents and treatment is often possible.

Disclosure

No significant relationships.
Effectiviness and safety of antidepresants in bipolar depression
Authors: Jupe T. , Zenelaj B.
Published: September 2022

Introduction

Depressive episodes are associated with higher morbidity, mortality (mostly suicidality. Despite the high prevalence and the devastating impact of this condition, there is a long‐standing debate about its treatment, particularly about the use of antidepressants. International guidelines and expert consensus recommend to avoid AD for bipolar depression, or to use AD with caution and as second line treatment only if the depressive episode shows poor response to mood stabilizers (MS) and to some second generation antipsychotics (SGA) (cariprazine, lurasidone, quetiapine and olanzapine combined with fluoxetine) in monotherapy and in combination. Contrary to the advice of guidelines and experts, 50%–80% of acute bipolar depressive episodes are treated with AD in everyday clinical practice.

Objectives

To evaluate the effectiveness and the safety of AD acute treatment in patients with bipolar depression

Methods

Literature review (PubMed)

Results

Short‐term safety, switching and suicidality did not differ significantly, and no suicide attempt was observed. Concerning long‐term safety, patients with bipolar depression had a significant reduction of depressive and total recurrences during the first year.

Conclusions

Acute AD treatment of bipolar depression is effective in the short term and safe in the short‐ and long‐term

Disclosure

No significant relationships.
Risperidone induced neutropenia in a 75-year-old man
Authors: Nistor D. , Horosan L. , Giurgiuca A.
Published: September 2022

Introduction

We discuss the case of a 75-year-old man with no psychiatric history, presenting with complex auditory hallucinations, both commentary and imperative, delusions of persecution and prejudice, severe anxiety, modified behaviour, and altered sleep patterns.

Objectives

The patient was started on oral risperidone, with favourable evolution of symptoms after reaching a daily dose of 3 mg/day. After three weeks of treatment, the laboratory results showed a low number of neutrophils. Interdisciplinary approach and examinations which included both clinical and paraclinical evaluation concluded that another cause of neutropenia was highly unlikely.

Methods

The patient was switched to olanzapine, with gradually increasing doses up to 10 mg/day. A significant improvement of the neutrophils’ level was noticed, with a return to normal parameters after a few days. Nevertheless, the clinical course was unfavourable, with reoccurrence of auditory hallucinations and delusions in two weeks’ time. Decision to rechallenge was made, with careful monitoring of the blood test results, particularly neutrophil levels. Risperidone was started at low doses of 0.5 mg/day and gradually increased up to 2 mg/day.

Results

Seven days after risperidone reinitiation laboratory tests showed normal absolute neutrophil count. However, another week later, neutrophils fell again out of the normal range.

Conclusions

The patient was discharged with haloperidol, with adequate control of symptoms and no adverse reactions.

Disclosure

No significant relationships.
Dealing With Clozapine-Induced Sialorrhea
Authors: Sá Couto J. , Da Luz B. , Pão Trigo M. , Rodrigues J. , Ventura Gil T.
Published: September 2022

Introduction

Clozapine is the first atypical antipsychotic. It is used in refractory schizophrenia. It has a heavy side effect burden, including weight gain, dizziness, blurred vision, and sialorrhea. Not only is sialorrhea bothersome, but it can also have with serious consequences, such us aspiration pneumonia, neutropenia, agranulocytosis, myocarditis, and may be responsible for low self-esteem, leading to low treatment compliance and discontinuation.

Objectives

Identifying the mechanism behind clozapine-induced sialorrhea. Finding how frequent clozapine-induced sialorrhea is compared to other antipsychotics. Finding effective ways to prevent clozapine-induced sialorrhea.

Methods

PubMed database search, with “clozapine sialorrhea” keyword expression. 12 Articles published in the last ten years were selected among the 112 best matches. Reference lists of articles were reviewed to identify additional articles.

Results

Clozapine is a muscarinic M1-5 receptor antagonist, explaining its anticholinergic effects. Due to its strong anticholinergic action, sialorrhea is a paradoxical side effect. To prevent it, several drugs can be used, such us scopolamine, pirenzepine, sublingual atropine solutions, clonidine, botulinum neurotoxin, and others. Sialorrhea was relatively more frequently reported in clozapine (1.1%) compared with other antipsychotics (0.31%). Mubaslat and Lambert (2020) found that drops of atropine reduce the rate of saliva secretion significantly better than placebo. Uzun, et al. (2019) observed the adjunction of N‐acetylcysteine allowed a significant decrease of the severity of sialorrhea and was well tolerated.

Conclusions

Although effective in refractory schizophrenia, clozapine side effects, namely sialorrhea, can be bothersome and may affect treatment adherence. Fortunately, we have tools at our disposal to help patients better handle it.

Disclosure

No significant relationships.
When less is more: deprescription in a long-stay hospital. A case report
Authors: De Hita Santillana R. , Cerame A. , Costa M.L.
Published: September 2022

Introduction

We present the case of a 54-year-old man diagnosed with mixed histrionic / obssesive personality disorder admitted in a long-stay hospital. Symptoms began at 40 years of age, predominantly anxiety and agoraphobia alongside somatic complaints. During his admission, the symptoms markedly fluctuated. The patient alternated periods in which he presented confusion with others of irritability, disinhibition, and stereotyped movements. Moreover the patient spent long periods of time in bed with little or no communication with other patients or staff.

The different pharmacological approaches which were carried out and their consequences are analyzed.

Objectives

It is a common practice to increase the number of prescribed drugs or their doses when symptoms worsen. The result is polymedication and higher doses above maximum levels in the technical sheet. Reducing medication is rarely considered as a strategy.

Methods

A case report is presented alongside a review of the relevant literature regarding different long-term pharmacological treatments and their side effects.

Results

The suspension of the antipsychotic treatment which had been administered for years represented a significant improvement. Withdrawal of Olanzapine resulted in a significant improvement.

Conclusions

It is important to review the prescription of each medication in time, as well as to consider their possible side effects.

Disclosure

No significant relationships.
Clozapine cessation
Authors: Ktari H. , Ouertani A. , Madouri S. , Aissa A. , Zgueb Y. , Ouali U. , Jomli R.
Published: September 2022

Introduction

Approximately 30% of individuals diagnosed with schizophrenia suffer from treatment-resistant or refractory schizophrenia. The gold standard for treatment is clozapine. However, a significant number of patients discontinue clozapine treatment and this carries a poor prognosis.

Objectives

This study explores patients’ motives for cessation of clozapine therapy and its prevalence.

Methods

A longitudinal, retrospective and descriptive study on a period of 20 years, at the psychiatry department A of the Razi hospital in Tunisia. Data was collected from the medical files of patients trated by clozapine using a pre-established sheet.

Results

The studied sample included 64 patient records. Treatment with clozapine was stopped spontaneously or following a medical decision in 37 patients (57.8%). The total number of clozapine stops in these 37 patients was 70. Indeed, each one of these patients had stopped treatment at least once. Clozapine was discontinued by some patients in the study sample for poor compliance(45.9%), for adverse side effects of treatment (16.2%) and by treating physicians for poor response treatment (8.1%). Clozapine was discontinued by 11 patients for hematological adverse reactions, representing 27.9% of the total number of clozapine discontinuations. Withdrawal of clozapine was indicated in 2 cases of agranulocytosis(18.2%), in 2 cases of moderate neutropenia(18.2%), in 3 cases of eosinophilia (27.2%), in 3 cases of thrombocytopenia (27.2%) and in 1 case of severe anemia (9.2%).

Conclusions

Clozapine discontinuation was essentially caused by poor patients’ observation and hematological adverse reactions appearance.Future research should seek to further investigate clozapine cessation factors in order to better benefit from the medical virtues of this molecule.

Disclosure

No significant relationships.
Effects of psychotropic switches on weight change: a prospective cohort study
Authors: Piras M. , Ranjbar S. , Dubath C. , Laaboub N. , Grosu C. , Gamma F. , Von Plessen K. , Von Gunten A. , Conus P. , Eap C.
Published: September 2022

Introduction

Many psychotropic drugs can induce weight gain with differences in their metabolic risk profiles (i.e. high, medium or low-risk).

Objectives

To compare the weight evolution of patients switching versus patients keeping their psychotropic drugs with different risk-profiles.

Methods

Data for patients switching or keeping the same drug were obtained from the Psyclin (from 2007 to 2015) and Psymetab (2007- 2019) cohort studies, conducted at the Lausanne University Hospital, Switzerland. Patients either switched from a high to a low-risk, a high to a medium-risk, a medium to a low-risk drug, or for a drug with the same risk category. Patients not switching either kept a high, medium or low-risk drug. The evolution of weight is currently being analyzed using a linear mixed-effect model.

Results

Preliminary results showed that switching from a high to low-risk molecule had the strongest impact on weight changes. The analysis being ongoing, the quantitative results will be presented at the congress.

Conclusions

Switching from a high-risk to a low-risk molecule is likely to have the strongest impact on weight changes.

Disclosure

No significant relationships.
Altered interpersonal distance regulation in autism spectrum disorder
Authors: Farkas K. , Pesthy O. , Guttengéber A. , Weigl S. , Komoróczy E. , Szuromi B. , Réthelyi J. , Németh D.
Published: September 2022

Introduction

Interpersonal distance regulation is an essential element of social communication. Its impairment in autism spectrum disorder (ASD) is widely acknowledged among practitioners, but only a handful of studies reported empirical research. However, these studies did not measure the alterations of vegetative functions related to interpersonal distance.

Objectives

We introduced a new experimental design to systematically measure interpersonal distance along with heart rate variability (HRV) in adults with ASD and tested the modulatory effect of intentionality, eye contact, moving activity, and attribution.

Methods

Twenty-two adults diagnosed with ASD and 21 matched neurotypical controls participated in our study from 2019 October to 2020 February. Our new experimental design combined the modified version of the stop distance paradigm with HRV measurement controlling for eye contact between the experimenter and the participant to measure interpersonal distance in incidental and intentional conditions.

Results

Our results showed greater preferred distance in ASD in the intentional (W=103, p=0.002) but not in the incidental condition. These results were altered with eye contact and the participant’s role (active vs. passive) in the stop distance task (F(1,41)=6.150, p=0.017). Moreover, we found lower baseline HRV (t
=-2.060, p=0.023) and reduced HRV reactivity in ASD; however, these vegetative measurements could not predict preferred interpersonal distance.

Conclusions

Our study highlights the importance of interpersonal distance regulation in ASD and the need for comprehensive experimental designs to grasp the complexity and underlying factors of distance regulation in typical and atypical populations.

Disclosure

No significant relationships.
Sharing is caring: a review on Oxytocin role in human behaviour and clinical implications
Authors: Ramalheira F. , Conde Moreno M.
Published: September 2022

Introduction

Oxytocin, also known as the love molecule, was discovered in 1906 because of its effects on uterine contractions. It exists in all mammals and is partly responsible for delivery. Nonetheless, it seems that oxytoxin also takes part in something as important to nursing as the physical changes in childbirth – the behavioural predisposition to form human bonds and to care for others.

Objectives

Present a review on Oxytocin and its functions in human behaviour and possible clinical implications

Methods

Pubmed and Google Scholar search using the keywords “oxytocin”, “behaviour”, “oxytocin in humans” and “psychiatry”.

Results

Besides acting as a peripheral hormone following posterior hypophisis secretion, oxytocin can be diffused through several brain areas, acting as a neuropeptide in neurochemical circuits that promote sexual behaviour, maternal and caring behaviour towards newborns, and other subtle social processes like vinculation, social memories formation, aggressiveness towards strangers and anxiety reduction. These evolutionary advantages constitute the roots for feelings of love and social phenomena like solidarity and affection. Oxytocin is increased in response to sex hormones, during pregnancy and social interactions, especially mother-child contact; additionally, is associated with endorphin release and feelings of well-being. Several studies associate the oxytocinergic system to multiple clinical implications, such as Anxiety Disorders, PTSD, Depression, Autism, Borderline and Anti-social Personality Disorder.

Conclusions

Oxytocin has an important role in shaping social behaviours and in the development of secure interpersonal bonds. In the future, it can be a possible target for some psychiatric conditions; however, more research is required to prove therapeutic outcomes.

Disclosure

No significant relationships.
Outstanding Seizure Characteristics With Etomidate and Ketofol
Authors: Özden H.C. , Gurel S.C.
Published: September 2022

Introduction

Electroconvulsive therapy (ECT) is administered following general anaesthetic induction with methohexital, thiopental, etomidate, alfentanil, remifentanil, propofol or ketamine. One approach for idealizing the induction anaesthesia for ECT is combining two agents (e.g. ketamine-propofol) with synergistic anaesthetic properties and non-additive anticonvulsive and hyperdynamic effects.

Objectives

To establish any superiority between ketamine-propofol (ketofol) combination and etomidate in terms of seizure characteristics and hemodynamic measures.

Methods

We have combined our previous case series (etomidate vs thiopental) with new data regarding propofol and ketofol. ECT stimulus duration, stimulus frequency, the stimulus charge applied, duration of central seizure time, number of stimulation trials, plus anaesthetic used in the individual sessions were retrieved. A total number of 1092 sessions (239 sessions with etomidate, 233 with thiopental, 275 with propofol, and 345 with ketofol induction) were included in the linear mixed-effects model analysis.

Results

Etomidate was superior in terms of seizure duration compared with thiopental. There was no significant difference in seizure durations between ketofol, propofol and thiopental, however, number of failed stimulation trials within a session increased significantly with propofol use compared with etomidate and ketofol. The required amount of charge (stimulation dosage) was significantly lower when ketofol was used, compared with thiopental. Additionally, within the ketofol sessions only the propofol dose significantly increased the amount of required dose.

Conclusions

Etomidate and ketofol displayed certain superiorities in terms of seizure characteristics when used as induction anaesthetics for ECT. Therefore, both etomidate and ketamine used in combination with propofol may be considered to be the gold standards of ECT anaesthesia.

Disclosure

No significant relationships.
Group therapy in Schizophrenia. What’s the evidence?
Authors: Azevedo F. , Silva L. , Quintão A.A. , Moura N. , Duarte P.
Published: September 2022

Introduction

The American Psychiatric Association and NICE’s Guidelines for schizophrenia recommend psychosocial interventions as adjuvants to pharmacological treatment, highlighting the role of cognitive behavioral therapy for psychosis, psychoeducation, family intervention, cognitive remediation, autonomy training, social skills training, and supported employment. Although highly recommended in their individual forms current guidelines make no definitive statement about their group applicability.

Objectives

The goal of this work was to critically review the evidence of group interventions in schizophrenia

Methods

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “schizophrenia”, “group therapy”.

Results

Group therapy has shown important benefits in different conditions over the years, likely through mechanisms such as peer motivation, controlled confrontation, increased insight and even a tendency to homogenous results between group participants through peer influence. These results have been reproduced in schizophrenia though the benefits of applying group concepts to structured psychosocial interventions is still under study.

Conclusions

Recent evidence suggests some evidence-based interventions can be applicable in group form, namely social skills training, cognitive remediation, psychoeducation, and multifamily groups, synergizing the already known benefits with newer therapy models and decreasing costs for patients and healthcare systems. Adequate controlled studies between individual and group therapy will shed further light on this matter.

Disclosure

No significant relationships.
Impact of Dialectical Behavior Therapy Prolonged Exposure protocol on trauma-related symptoms in Egyptian women with Borderline Personality Disorder
Authors: Esmaiel M. , Abdelhamied M.
Published: September 2022

Introduction

Although around 50% of individuals with borderline personality disorder (BPD) suffer from trauma-related disorders, literature lacks a specific treatment for these serious co-occurring problems. Dialectical Behavior Therapy Prolonged Exposure (DBT PE) is a recent protocol developed by Melanie Harned, integrating (PE) into standard (DBT). The protocol has showed promising results in treating comorbid PTSD in BPD patients. The current study, however, was the first trial to apply DBT PE protocol in Egypt.

Objectives

To investigate the efficacy of (DBT PE) protocol in reducing trauma-related symptoms (psychological trauma symptoms and trauma-related cognitions) among Egyptian women with BPD.

Methods

Sixteen women diagnosed with BPD and trauma-related symptoms, were recruited from “DBT clinic”, a private outpatient clinic in Alexandria, Egypt and randomly divided into equivalent (Therapeutic & Control) groups. The therapeutic group received DBT PE protocol while the control group received Treatment as usual (TAU). Participants were assessed pre and post-intervention using: The short version of the Borderline Symptom list, The Trauma Symptom Checklist-40, and The Posttraumatic Cognitions Inventory. The therapeutic group started treatment with standard comprehensive DBT concurrently with DBT PE protocol (14 individual sessions, 120 minutes/ week), according to readiness criteria suggested by the treatment developer.

Results

Patients who received DBT PE protocol showed significantly lower degrees of psychological trauma symptoms and trauma-related cognitions compared to patients in control group.

Conclusions

Despite being applied for the first time in Egypt, DBT PE protocol proved to be an effective intervention in reducing trauma-related symptoms in a sample of Egyptian BPD patients without any need to modify the original protocol.

Disclosure

No significant relationships.
Socrates’ “maieutics” and the ethical foundations of psychotherapy
Authors: Doerr O.
Published: September 2022

Introduction

The noun “maieutics” derives from maia (mother, midwife) and the related verbs “maieusis” and “maieonuai” mean “giving birth” and “easing childbirth”. Socrates’ maieutics aspires to give birth to the truth in the youth. Since homeric times psychotherapy has been part of medical act. Initially, the physician’s word had a magical character. Plato rationalized this in many of his dialogues, specially in “Charmides”.

Objectives

The search of the essential characteristics of this therapeutic method described by Plato, as well as its ethical implications

Methods

Hermeneutic method

Results

The consequences for doctor-patient relationship in general and psychotherapy in particular are: 1. Remedy and “epodé” (charm) must be applied in every doctor-patient relationship. 2. The body can only be healed if the soul is cured first by a charm. 3. The openness of the patient’s soul to the physician and the physician’s beautiful speech to the patient will enable the latter to reach the state of “sophrosyne” (temperance), condition of possibility of true health.

Conclusions

In the discussion of the meaning of “sophrosyne”, Socrates questions disciples’ propositions and concludes that the only thing one can be sure of is that “sophrosyne” is a way of searching virtue (arete). Later, in Theaetetus, Plato adds another element: temperance is a “homoiosis theó”, that is, the assimilations of patient to God. With this Plato seals the ethical character of psychotherapy for ever.

Disclosure

No significant relationships.
Last Steps as a Trainee, First Steps as a Consultant Specialist
Authors: O’Loughlin C.
Published: September 2022

The transition from being a senior trainee to a qualified specialist presents a variety of challenges under normal circumstances, with the pandemic further disrupting the experience of trainees. This presents an environment where the acquisition of key competencies, both clinical skills and wider capabilities, becomes more demanding for trainees and where training organisers need to re-evaluate their programmes to consider the different opportunities available. This introduction to the interactive session will consider how the experience in the United Kingdom led to new ways of delivering training, the challenges faced and consider the key skills new specialists need to be effective clinical leaders as they move into a senior role.

Disclosure

No significant relationships.
Interdisciplinary approach to pediatric rehabilitation - The MDT method
Authors: Vashdi E.
Published: September 2022

Introduction

Interdisciplinarity involves the combining of two or more academic disciplines into one activity (e.g. a research project). It is about creating something new by crossing traditional boundaries between academic disciplines or schools of thought, as new needs and professions emerge, and thinking across them. The roots of interdisciplinarity can be found hundreds of years ago however, In the twentieth century it became a more academic movement.

Objectives

Interdisciplinarity also involves integrated thinking, borrowing ideas and metaphors, collaboration, flexibility in thinking, innovation and complex problem solving. The traditional professional model is usually disciplinary. Complex problems sometimes demand interdisciplinary solution. There is a constant dispute between the disciplinary and interdisciplinary approaches.

Methods

The MDT (Multidimessional therapy) method is part of the transdisciplinary approach. This is the next step after interdisciplinarity in which there are no boundaries between disciplines and the role of a primary therapist is established.

Results

The MDT is a system that implements the integrative therapy perception, and strives for optimal integration of all developmental areas, disciplines, methods, goals, schools, activities etc. So the child is seen as a whole and all developmental areas are considered in unison. The integration takes place at different aspects of therapy: evaluation, analysis process, case management, team work, disciplines and methods, therapist, goals and exercises.The MDT uses variuos integrative tools evaluation such as analysis process, primary therapist or integrative goals and exercises.

Conclusions

This lecture will present the structure and uniqueness of the system and the approach in order to introduce the beneficiary aspects of the integrative model in treatment of complex cases.

Disclosure

No significant relationships.
20 years of daily hospital for non-psychotic disorders, organisational structure and treatment modalities
Authors: Caratan S. , Kocijan Lovko S. , Ivrlač A. , Goršić L. , Matoš T.
Published: September 2022

Introduction

Anxiety and depressive disorders are among the most prevalent psychiatric disorders, yet there aren’t many studies adressing treatment modalities in daily hospitals.

Objectives

The aim of our study is to present organisational structure and treatment modalities in Daily hospital for non-psychotic disorders in University Psychiatric Clinic “Sveti Ivan“, Zagreb, Croatia.

Methods

All patients in Daily Hospital attend 6 months programme. The treatment programme consists of psychodynamic group psychotherapy, cognitive-behavioral therapy, occupational therapy, antistress and mindfulness workshops, psychoeducational workshops, cinema therapy and sociotherapy. Along with clinical follow-up, all the patients are given sociodemographic questionnaire designed for our programme, World Health Organisation Quality of Life Questionnaire (WHOQoL BREF) and The Depression, Anxiety and Stress Scale 21 (DASS-21).

Results

At discharge moderate to significant improvement was observed in different aspects of functioning among most of the participants, verified by clinical follow-up as well as by results obtained through questionnaires.

Conclusions

Our data show that patients with anxiety and depressive disorders can be efffectively treated by such comprehensive treatment approach.

Disclosure

No significant relationships.
Facial emotion recognition deficits in first-degree relatives of patients with bipolar disorder: a systematic review protocol
Authors: Calçada C. , Ferreira A.R. , Fernandes L.
Published: September 2022

Introduction

Bipolar Disorder (BD) is one of the most challenging and severe psychiatric disorders. Considerable research in BD patients points to deficits in Facial Emotion Recognition (FER) as a potential BD endophenotype. Accordingly, such deficits have also been found in unaffected BD first-degree relatives, but no study has been conducted to synthetize this evidence.

Objectives

To conduct a systematic review of studies exploring FER deficits in first-degree relatives of patients with BD.

Methods

PRISMA 2020 recommendations will be followed. PubMed, Scopus, Web of Science and SciELO electronic bibliographic databases will be searched, as well as grey literature. Reference lists of the included studies will be hand-searched for additional eligible studies. Search strategy will include key-terms in accordance with the pre-established PICOS definition. No restrictions will apply regarding study design, setting, publication date nor language. Outcomes of interest will be FER deficits. Retrieved studies will be screened for eligibility by two independent reviewers using a two-phase approach. The methodological quality of primary studies will be assessed and data extracted independently using a standardized extraction form.

Results

will be described using narrative and tabular approaches. Studies heterogeneity will be verified and if adequate a meta-analysis will be conducted. Findings will be disseminated through a peer-reviewed publication.

Conclusions

It is expected that this systematic review will support the hypothesis that FER deficits may constitute a potential candidate for a BD endophenotype, which will not only improve the understanding of BD neurobiology, but also enable its identification in earlier stages, allowing timely treatments and better patients’ outcomes.

Disclosure

No significant relationships.
Oppel – Kundt illusion manifestation among people with schizophrenia spectrum disorders
Authors: Pečkutė A. , Leskauskas D. , Bulatov A. , Diržius E.
Published: September 2022

Introduction

Various studies have reported differences in early visual processing, gain control and integration for patients with schizophrenia spectrum disorders (SSD). However, Oppel – Kundt (OK) illusion is not studied well enough among subjects affected by SSD. We decided to study the illusion to get more insights in visual perception for individuals with SSD.

Objectives

To investigate the OK illusion manifestation among people with SSD.

Methods

In the prospective study were included 15 patients, who were diagnosed with SSD and 15 matched comparison group (CG) without any mental, neurological diseases or visual impairment. OK figures used in the experiments consisted of three white spots presented horizontally against the black background. We used 3 different types of distractor stimuli – either straight one or two-sided line or circle. Using computerized equipment in OK figures the subjects were asked to adjust the unfilled part of the stimulus to be equal in length to the filled (referential) one. ANOVA, T-test and post hoc Bonferroni correction were used for statistical analysis.

Results

People with SSD tended to make bigger mistakes when evaluating OK figures with the statistical difference which was the most eminent for the subgroup of individuals affected by paranoid schizophrenia. The manifestation of the illusion in the SSD group was contrariwise (respectively to zero point) to the CG group.

Conclusions

OK illusion tended to manifest stronger for patients with SSD, this tendency was mostly expressed for the patients diagnosed with paranoid schizophrenia. The manifestation of OK illusion among persons with SSD was diametrically opposite to that seen for the healthy individuals.

Disclosure

No significant relationships.
Vigo Insight Monitoring Scale in Schizophrenia (VIMS): validation in a sample of patients with schizophrenia
Authors: Vazquez Noguerol Mendez R.
Published: September 2022

Introduction

Lack of awareness of the disease is one of the most frequent symptoms (<80%) of schizophrenia, and it is accepted to have different aspects: cognitive, related to compliance, specific symptoms, and temporary. The detection of those dimensions of insight affected, allows to select and prioritize the objectives and therapeutic strategies to improve it.

Objectives

To develop a multidimensional scale for monitoring insight in schizophrenia patients

Methods

A scale with 9 insight dimensions has been developed: appreciation of symptoms, acceptance of the cause, clinical and functional repercussions, limitations and level of competence, expected evolution and prognosis, terapeutic, and other factors. risk of decompensation. Each dimension is weighted from 0-4 points, and the result is expressed numerically and graphically. The scale was administered to 60 patients with schizophrenia on three occasions. The initial one by two psychiatrists consecutively, and the third three months after stable treatment. Other clinical and sociodemographic variables were also collected.

Results

In the analysis, reliability, internal consistency, and intra- and interobserver reliability, logical, content, criterion and construct validity were assessed, obtaining satisfactory results in Cronbach’s coefficients and Pearson’s correlation (> 0.7 and > 0.8).

Conclusions

The scale has good reproducibility, validity, sensitivity and utility characteristics, which allow its use in patients with schizophrenia.

Disclosure

No significant relationships.
Therapeutic challenge in delusional disorder: a case report and literature review
Authors: Trindade P. , Laginhas C. , Adão C. , Canas-Simião H. , Ribeirinho Marques A. , Caetano R.
Published: September 2022

Introduction

Delusional disorder (DD) is defined by the presence of one or more delusions, of at least one month’s duration, in the absence of prominent hallucinations or other symptoms of schizophrenia. Although functioning may not be markedly impaired, the delusion(s) or its ramifications may have a significant impact in the patient’s life. With a life-time prevalence of 0.18%, DD is still neglected in terms of approved treatment recommendations.

Objectives

We present the case of a patient diagnosed with DD and discuss the treatment of DD according to current evidence.

Methods

Relevant clinical information was extracted from the patient’s clinical process. A non-systematic review was made in Pubmed database with the terms “Delusional Disorder” and “Treatment”.

Results

Male, 76 years old, divorced, living alone, autonomous. First admitted at age 62 in our inpatient psychiatry ward for a persecutory delusion regarding his neighbors. He was discharged with the diagnosis of DD and started a follow-up in a mental health community team. He abandoned treatment and psychiatric consultation after 9 years. During 17 years he moved home more than 10 times due to a progressive dynamism of the delusion, leading to recent marked behavior changes towards his neighbors. He is again admitted in our inpatient psychiatry ward.

Conclusions

This case illustrates the impact that untreated DD can have on its patients. Although consensus using antipsychotics, there are still insufficient studies to make evidence-based recommendations to treat people with DD. Further research is needed in this sense.

Disclosure

No significant relationships.
Could Computational Approaches Challenge How we Understand and Tackle Mental Disorders Stigma?
Authors: Gargot T.
Published: September 2022

Most psychiatric disorders (between 50% and 90%) remain untreated although effective treatments exist (Kohn et al., 2004). Stigma is frequent toward patients and mental health professionals (Rüsch et al., 2005). It impairs access to care especially during the early signs, amplifying the treatment gap, mainly due to a shortage of resources. How the brain makes prior internal models of the world could explain why we all stigmatize. The Bayesian brain hypothesis describes the optimal combination of priors, coming from our evolution, our memory and our perceptions, to make decisions (Parr et al., 2018). This can be intuitively understood by visual illusions, but also medical categorical diagnostic reasoning (Medow, 2011). These priors allow to simplify the world and categorize people (Sherman et al., 1998). Beyond cognitive modelling, Computational approaches also led to the development of several electronic devices, from apps to social robots, (Gargot et al., 2021). Patients reported that it was easier to self-disclose toward an avatar, that cannot judge, than toward a therapist (Hang and Gratch, 2010). These technologies could improve early, scalable as well as efficient access to care (Andersson et al., 2019). Empathy is the best strategy to tackle stigma. What is it exactly? Good therapist-patient synchronization of brains (Czeszumski et al., 2020) and bodies (Ramseyer et Tschacher, 2011) could foster better communication and thus empathy. There is an urgent need to promote research in empathy (Belzung, 2017), non-specific factors in psychotherapy mechanisms (Miller et Moyers, 2021) and psychotherapy online training resources (Gargot et al., 2020).

Disclosure

Thomas Gargot was paid by the French ministry of research (Doctoral school), French ministry of health (médaille d’argent, CCA-AHU) for a PhD and CCA position. During his PhD, he prepared several scientific presentations with Dr Asselborn. This work led
A novel approach to patients with schizophrenia and type 2 diabetes showing low treatment compliance
Authors: Argitis P. , Karampas A. , Bringiotti P. , Karavia S. , Pikou O. , Kakavitsas F.-E.
Published: September 2022

Introduction

Patients with schizophrenia usually demonstrate low compliance to medication. This could be a component of the disorder or a fact that they are not being properly cared.

Objectives

To prevent this in, we tried to treat these patients with long term action antidiabetic agents, in order to achieve better compliance.

Methods

HbA1C measurements of patients suffering from schizophrenia and at the same time receiving oral antidiabetic treatment were conducted. 62 patients were found that fell under the criteria of non regulated type 2 diabetes and at the same time presented less than 70% complied with their antidiabetic pharmaceutical treatment. We modified the antidiabetic treatment of these patients, with the introduction of dulaglutide.

Results

Without intervening with their nutritional habits there was a decline in HbA1C measurements from the average rate of 9,4% to the average rate of 7,6%, as well as an average 6,31% reduction of their body weight.

Conclusions

Due to the improvement of the general medical condition of these patients, the answer to the question whether these patients should be treated with a long term antidiabetic medicines, is positive. The arrival of new long term action antidiabetic medicines in the near future, promises to improve the life quality of schizophrenic patients furthermor.

Disclosure

No significant relationships.
Homeostasis Model Assessment of IR (HOMA-IR) and Metabolic Syndrome (MetS) in First Episode Psychosis
Authors: Garcia De Jalon E. , Aranguren Conde L. , Aquerreta Unzue A. , Gutiérrez Talavera G. , Corrales Rodriguez A.
Published: September 2022

Introduction

Metabolic syndrome (MetS) is common in chronic psychosis but also exists in the early stages. HOMA-IR is an independent predictor of cardiovascular diseases and has already been described in first episode of psychosis.

Objectives

To determine whether HOMA levels differ according to MetS at each time assessment over 2 years.

Methods

MetS and HOMA levels are determined at baseline and at 6, 12, 18 and 24 months in a sample of 50 patients participating in the PEPsNa Early Intervention Programme during two years of follow-up. Adult Treatment Panel III (ATP III) criteria are used to define MetS. Insulin resistance measured with the Homeostatic Model Assessment (HOMA-IR) is computed with the formula fasting plasma glucose (mg/dL) times fasting insulin (mIU/mL) divided by 405. Mann-Whitney U Test are used to compare HOMA variable according to presence of metabolic syndrome.

Results

The results showed that HOMA levels differed statistically significantly between patients who met MetS criteria and those who did not at 12 (p<0.046) and 24 (p<0.004) months of treatment.

Conclusions

Given the small sample size the results of our study indicate that there is a sustained relationship over time between HOMA levels and Metabolic Syndrome (MetS) and that the HOMA IR may be useful in identifying those patients with an increased metabolic and cardiovascular risk.

Disclosure

No significant relationships.
Do Women have More Barriers for Professional Development?
Authors: Kilic O.
Published: September 2022

Women consistently fare worse than men in different professional metrics in terms of salary, promotions, grant money, and scholarly publishing. In clinical and management leadership roles, a similar trend of underrepresentation for women exists. It has been shown in academic publishing that women progressed to senior author positions at a slower pace, resulting in their ongoing underrepresentation as senior writers. Previous literature has shown that one of the most effective strategies for promoting women to leadership positions is the collaboration with men to identify attitudinal and institutional barriers, since gender equality is not only a “women’s concern.” To address this, a cross-sectional, multinational survey was disseminated in English (SurveyMonkey) to psychiatric trainees and psychiatrists across Europe. This study aims to explore the perspectives of female and male psychiatrists on the obstacles they face in their careers. The survey covered items on self-promotion, current institutional environment, and networking along with contextual information- age, gender, professional degree, current field, and years of professional experience in the current field. We hope that the presentation of these findings will serve as a springboard for future educational activities to address concerns connected to the gender gap. The speaker will present the comparison of female and male psychiatrists’ barriers and challenges they face during their professional development. This talk is hoped to elicit discussion in preparation for future action and inform a roadmap for addressing issues related to the gender gap with subsequent educational events.

Disclosure

No significant relationships.
Clinical specificities of depression with overvalued ideas in slow progressive schizophrenia
Authors: Barkhatova A. , Kolyago O.
Published: September 2022

Introduction

Despite the high interest in affective aspects of endogenous depression, the question of overvalued ideas remains unclear.

Objectives

To determine the clinical features of depression with overvalued ideas in the context of slow progressing schizophrenia.

Methods

The study involved 102 people, including 62 women and 40 men diagnosed with slow progressing schizophrenia, with moderate or severe depression, with the predominance of overvalued ideas (F21 in ICD-10). The control group had 110 people with similar distrubution by sex and age all diagnosed with a depressive state formed in the context of slow progressing schizophrenia, without overvalued ideas. Research methods were mainly clinical-psychopathological and clinical-catamnestic.

Results

In the majority of observations (62.5%) in the comparison group, showed a uncomplicated form of depression, only limited to affective level. In the (37.5%) left, depression was characterized by a structural polymorphism, in addition to affective disorders, there were other psychopathological syndromes observed. In the main group, an inverse relationship was observed: uncomplicated depression in 29.2% of cases, while the overwhelming majority of cases (70.8%) experienced atypical depressions, disharmony of the affective triad, as well as an increase in the concomitance of neurotic and psychopathic symptoms were observed.

Conclusions

The cohort of patients with slow progressive schizophrenia with depression is heterogeneous, while the features of the course of the disease correlate both with the presence or absence of overvaluated formations in the picture of depression, and with the features of the modification of the overvaluated ideas during the disease.

Disclosure

No significant relationships.