bluuebunny/crossref_metadata_2025 huggingface dataset:
PTSD symptoms and coping before and during COVID-19 pandemic among help-seeking veterans: prospective cohort study
Authors: Letica-Crepulja M. , Stevanović A. , Palaić D. , Grahovac Juretić T. , Grković J. , Rončević-Gržeta I.
Published: September 2022

Introduction

The COVID-19 pandemic has threatened the mental health of individuals around the world. Ex-combatants have been repeatedly shown to be increased risk of experiencing social and psychological problems during emergencies.

Objectives

To compare the severity of overall posttraumatic stress disorder (PTSD) symptoms and PTSD clusters among help-seeking veterans before and during the COVID-19 pandemic. The second aim was to identify coping strategies used and track possible changes during the timeline.

Methods

Male war veterans receiving outpatient treatment at the Referral Center for PTSD were assessed at baseline (t1=12-18 months before the COVID-19 pandemic), during the first lockdown (March-June 2020) and 12 months after the beginning of the COVID-19 pandemic (March-June 2021). A total of 132 veterans participated in all three measurements. The Life Events Checklist for DSM-5 (LEC-5), PTSD Checklist for DSM-5 (PCL-5), and The Brief COPE were used.

Results

Exposure to COVID-19 pandemic related stressors increased over time. The great majority of participants (91.0%) followed the preventive measures. The severity of the overall PTSD symptoms significantly decreased during timeline (t1=56.9, 11.15; t2= 47.24, SD=12.87; t3= 44.1, SD=14.09). At t2, all participants still fulfilled the PTSD diagnostic criteria, and at t3, 23 participants (17.42%) did not meet all of the criteria for PTSD. The participants used adaptive coping rather than dysfunctional coping during the pandemic.

Conclusions

Despite the expectations of worsening the symptoms, help-seeking veterans with PTSD appeared to develop adaptive adjustment to the COVID-19 pandemic stressors, which is in line with the results of the recent longitudinal research and will be discussed.

Disclosure

No significant relationships.
Attempted suicide by Melatonin overdose: Case report and literature review
Authors: Gutierrez Higueras T. , Calera Cortés F. , Trives Muñoz A. , Vicent Forés S. , Sainz De La Cuesta Alonso S.
Published: September 2022

Introduction

Melatonine (N-acetyl-5-methoxytryptamine) is an endogenous neurohormone produced by pineal gland. It is related to sleep-wake circadian rhythms, and nowdays it is sold without prescription as a “natural treatment” for sleep disorders. Most common side effects of melatonin overdose are drowsiness, dizziness, fatigue, headache, confusion, nightmare, hypotension, tachycardia and hypothermia. Supportive measures and control of vital signs are essential for an early discharge of the patient.

Objectives

To present a case of an 42-year-old woman who was taken to the emergency department after voluntary ingestion of 60 tables of melatonin 2mg (Total amount 120mg), in a suicide attempt. To describe the most common side effects of melatonine overdose a the literature review.

Methods

Clinical case presentation and retrospective literature review.

Results

A 42-year-old woman who was taken to the emergency department after voluntary ingestion of 60 tables of melatonin 2mg (Total amount 120mg), about 1 hour before coming, in a suicide attempt. After clinical evalutation, gastric lavage was performed. ang 50g activated charcoal given. Drowiness and mild hypothermia (34ºC) was detected. After 12 hours of vital signs observation the patient was discharged and to psychiatry consultation, where depressive mood disorder and chronic insomnia was diagnosed.

Conclusions

Melatonin is one of the least toxic medication. Most common side effects of overdose are drowsiness, dizziness, fatigue, headache, confusion, nightmare, hypotension, tachycardia and hypothermia. Supportive measures and control of vital signs are essential for the treatment.

Disclosure

No significant relationships.
Suicide prevention actions carried out by an academic psychiatry service in Rio de janeiro city
Authors: Jaber J.
Published: September 2022

Introduction

Description of a structured work of primary prevention, based on a survey of the prevalence of suicidal behavior in the Brazilian population throughout life, performed by an academic service of psychiatry and chemical dependence. We describe a survey of the probability of suicide attempt in an academic internment service focused on psychiatry and drug addiction in the city of Rio de Janeiro.

Objectives

Raise awareness of the need to call for help and 24-hour distress hotline phone outreach. Calculate a possible demand for mental health services to patients with severe suicidal behavior aiming at the necessary equipment to attend this population.

Methods

Clarification actions through the press, development of a suicide prevention lecture program given in schools, surveillance cameras, military institutions, companies and laws, promotion of public events with music, activities, distribution of t-shirts, booklets and leaflets.Using the mental health care implementation system: identifying the patient, raising their needs and available resources, breaking resistance, advocating and treating, we raised in this institution that from January 01, 2019 to September 01, 2019, 137 patients were hospitalized with a serious suicide attempt.

Results

According to a survey of the prevalence of suicidal behavior in the Brazilian population over the course of life, where out of 100 patients, 17 had suicidal thoughts, 5 planned, 3 attempted suicide and 1 was treated in the emergency room.

Conclusions

The suicide prevention program has been very successful as the press promotes of the telephone number for immediate relief. His survey highlighted the need to create a specific suicide treatment and prevention program.

Disclosure

No significant relationships.
Antisuicidal (protective) factors in recovery from schizophrenia
Authors: Lyubov E. , Semenova N.
Published: September 2022

Introduction

Determination of antisuicidal factors (AF) in balance with risk factors for suicidal behavior (SB) is essential for treatment and prophylactic measures.

Objectives

Study AF in a sample of schizophrenic recovered patients (F.20, ICD-10) according to operational criteria R.P. Liberman et al. (2002).

Methods

The content analysis of published self-reports of a sample (n = 13) of Russian and foreign psychiatrists and clinical psychologists with psychotic experience was used as a part of a more extensive qualitative analysis of «wounded healers».

Results

In the history of > ½ (i.e., 7) ex-patients, repeated SPs (aborted suicides), as well as non-suicidal self-harm (e.g., self-cutting), were noted during the active period of the disease, and in four of them – during untreated psychosis. Following AFs can be distinguished in recovery state: clinical (absence of potentially suicidogenic residual depression or/and anxiety, according to criteria N.C. Andreasen et al. (2005) social (professional goals, coping with stigmatization), and existential (e.g., hope, gaining a whole Self
).

Conclusions

AF is an important integral component of recovery in schizophrenia as a process of personality development despite a burden of severe mental disorders.

Disclosure

No significant relationships.
A Multidisciplinary Approach to Suicide Prevention in an Outpatient Setting
Authors: De Diego Ruiz H. , De Matteis M. , Mallo Caño M. , Vicente Sánchez I. , González Hernández L.
Published: September 2022

Introduction

The incidence of suicide is much higher in people with mental health disorders, estimating that up to 9 out of 10 people who commit suicide suffer from at least one of them. For this reason, suicide is considered by many authors as the most serious complication of psychiatric disorders. The literature and the experience of clinicians support the potential usefulness of specific measures and programs aimed at its prevention.

Objectives

Congruently, throughout the last decade, consecutive strategic mental health plans in the Autonomous Community of Madrid, Spain, have included suicide prevention plans among their priorities, setting the objective of reducing suicidal behavior in the population of Madrid by implementing practical measures in the healthcare system.

Methods

In the presented work we aim to summarize the multidisciplinary therapeutic process in the context of this program and the results obtained during its years of experience.

Results

Retiro Community Mental Health Treatment Center launched a specific program in 2013 to meet these objectives. This initiative, that received the name PRISURE (Spanish acronym for Suicide Risk Prevention Program in Retiro), is an outpatient intervention program for immediate care, as the first appointment is scheduled within a week after referral. Intensive, comprehensive and multidisciplinary care is provided for patients with moderate to severe suicide risk.

Conclusions

All professional categories that work in the Community Mental Health Treatment Center actively participate. In parallel with clinical performance, these professionals also carry out coordination tasks with other entities that are dedicated to suicide prevention, as well as with patients’ and families’ associations.

Disclosure

No significant relationships.
Predictive and discriminant validity of different psychopathology and temperament scales for major psychiatric disorders – 23-year follow-up of the Northern Finland Birth Cohort 1966
Authors: Miettunen J. , Ahola A. , Jääskeläinen E.
Published: September 2022

Introduction

Several psychological and psychiatric instruments have been developed to recognize or predict different psychiatric disorders.

Objectives

We studied the predictive, and discriminant validity of different psychopathology scales and temperament traits for subsequent psychiatric diagnoses due to schizophrenia, bipolar and depressive disorders in a 23-year follow-up.

Methods

Temperament traits, perceptual aberration, physical and social anhedonia, depression and anxiety subscales of Symptom Checklist (SCL-D and SCL-A), Hypomanic Personality Scale (HPS), Schizoidia Scale, and Bipolar II Scale were completed as part of the 31-year follow-up survey of the prospective Northern Finland 1966 Birth Cohort (n = 5006). New onset psychiatric diagnoses were followed until age of 54 years using different nationwide registers.

Results

In the follow-up 28 (0.6%) individuals had diagnosis of schizophrenia, 40 (0.8%) bipolar and 405 (8.1%) depressive disorders. Several of the included scales associated statistically significantly with subsequent diagnoses. High SCL-A and SCL-D scores were strong predictors (Cohen’s d’s between 0.76 and 1.08) for schizophrenia and depressive disorders, whereas high HPS score was best predictor (d=0.67) for bipolar disorders. When comparing patient groups, schizophrenia group had low scores in reward dependence when compared with both bipolar (d=-0.80) and depressive (d=-0.66) disorders. Harm avoidance was the best trait to discriminate depressive and bipolar disorders, with higher scores in depressive disorders (d=0.48).

Conclusions

Interestingly we found that differed psychopathology scales were strong but non-specific predictors for these psychiatric disorders, whereas temperament traits were useful predictors regarding discriminating these disorders. The presented scales can be used in population samples when predicting psychiatric illnesses.

Disclosure

No significant relationships.
Testosterona and suicide
Authors: Gallardo Borge L. , Santos Carrasco I.D.L.M. , Marqués Cabezas P. , Segura Rodríguez A.I. , Medina Ojeda G.
Published: September 2022

Introduction

Testosterone is an anabolic androgenic steroid hormone involved in brain development, reproduction, and social behavior. Several studies have shown that testosterone can cause impulsivity in humans. This impulsivity could modify the mood and increase the risk of suicidal behaviour.

Objectives

Testosterone is an anabolic androgenic steroid hormone involved in brain development, reproduction, and social behavior. Several studies have shown that testosterone can cause impulsivity in humans. This impulsivity could modify the mood and increase the risk of suicidal behaviour.

Methods

Clinical case and literature review.

Results

A 33-years male (biological female), single, gypsy ethnicity, with an 11-years daughter. Psychiatric history of one admission in a hospitalization unit. Diagnosed of depressive disorder and personality disorder NOS. Intermittent follow-up in Mental Health consultations. 8 years later, he consulted due to gender dysphoria. He refered not to be feeling identified with his body for a long time. He rejected his sexual characteristics. After his mental evaluation, he was refered to Endocrinology Service. He had been prescribed with testosterone. Three days after starting the treatment, he maked anattempt of suicide with medication. The patient had not presented previous suicide attempts or ideation. With the withdrawal of the testosterone, the suicidal behaviour dissapeared.

Conclusions

Due to the association of testosterone and suicidal behavoiur, we consider that is important to pay attention to people who have just started the androgenic treatment in order to avoid a high risk of suicide. In the same way, we should focus on evaluating the hostility, impulsivity and irritability in patients strongly related to suicidal behaviour.

Disclosure

No significant relationships.
Do women with Premenstrual Dysphonic Disorder experience differences in emotion recognition during the menstrual cycle?
Authors: Vardiampasis A. , Gramandani C.
Published: September 2022

Introduction

The relationship between behavioral changes and the menstrual cycle in women at a reproductive age has been investigated in several studies; women during every menstrual cycle experience noticeable changes in levels of sex hormones which are consequently reflected on their mood and behavior. The relationship between the menstrual cycle and the emotion recognition processing has been also studied.

Objectives

The aim of this study was to examine if differences exist between women with Premenstrual Dysphonic Disorder (PMDD) and women without PMDD in Emotion recognition processing across menstrual cycle.

Methods

We examined 26 women with a PMDD and 30 women without PMDD, who have both visited the Mental Health Centre (aged 18-35 y.o., right handed, educational level >9 y., regular cycle duration). Women were clinically interviewed (DSM-V); also the Emotion Recognition Task (ERT) was administered in the luteal and the follicular phase.

Results

Women with PMDD showed significant differences in emotion recognition depending on the the luteal and the follicular phase (according to estradiol and progesterone level) whereas women without PMDD did not present significantly different responses to the emotional stimuli.

Conclusions

Our findings suggest that there is an effect of PMDD on emotional facial recognition across the two phases of the menstrual cycle. Thus, the importance of incorporating ERT in the formal clinical examination of PMDD is highlighted.

Disclosure

No significant relationships.
Is Emotion recognition processing across menstrual cycle and a history of Postpartum Depression potential risk factors for Premenstrual Dysphonic Disorder?
Authors: Vardiampasis A. , Gramandani C.
Published: September 2022

Introduction

Many women during the different phases of the menstrual cycle experience significant emotional and cognitive changes; for some, these changes can affect their everyday living. Premenstrual Dysphonic Disorder (PMDD) is a health problem that affects up to 5% of women of childbearing age. The exact cause is unknown; still, hormonal changes throughout the menstrual cycle may play a role. Women with a family history of Postpartum Depression (PPD) may be at increased risk.

Objectives

The purpose was to examine if Emotion recognition processing across menstrual cycle and a history of PPD are potential risk factors for PMDD.

Methods

We identified 34 women with a history of PPD and contacted their daughters to explain the purpose of our study. Of those meeting the criteria to participate, 38 volunteered (aged 18-30 y.o., right handed, educational level >9 y., regular cycle duration). The Emotion Recognition Task (ERT) was administered in the luteal and the follicular phase. Women found to present significant differences in emotion recognition depending on the estradiol and progesterone levels were clinically interviewed (DSM-V).

Results

Of the 16 women who have showed significant differences across the two phases of the menstrual cycle, 7 were diagnosed with PMDD (43,7%). Among the ones who have not presented differences (22), only 2 received a diagnosis of PMDD (9%).

Conclusions

This study shows that Emotion recognition processing across menstrual cycle and a history of PPD may predict which women could be at risk for PMDD, playing, therefore a key role in PMDD early diagnosis.

Disclosure

No significant relationships.
Children and adolescents exposed to maltreatment already exhibit epigenetic patterns suggestive of heightened low-grade inflammation
Authors: Palma-Gudiel H. , Marques Feixa L. , Romero S. , Rapado-Castro M. , Blasco-Fontecilla H. , Zorrilla I. , Martín M. , Castro Quintas Á. , Monteserin-Garcia J.L. , Font E. , Ramirez M. , Moreno D. , Marín-Vila M. , Moreno N. , Binder E. , Fañanas L.
Published: September 2022

Introduction

Childhood maltreatment (CM) is one of the best described environmental risk factors for developing any psychiatric disorder, while it also confers increased odds for obesity, cardiometabolic disorders and all-cause mortality. Inflammation has been suggested to mediate the widespread clinical effects of CM. Previously, Ligthart et al. (2016) identified a polyepigenetic signature of circulating CRP levels, a measure of chronic low-grade inflammation, that has been reliably associated with a wide array of complex disorders. The study of this biomarker could dilucidate the mechanistic relationship between CM and psychiatric outcomes.

Objectives

Thus, CRP-associated epigenetic modifications were explored regarding proximal exposure to CM.

Methods

Genomic DNA was extracted from peripheral blood mononuclear cells of 157 children and adolescents (7 to 17 years old). Exposure to CM was assessed following the TASSCV criteria. Genome-wide DNA methylation was assessed by means of the EPIC array. Fifty-two out of the 58 original CRP-associated CpG sites surpassed quality control and were included in the analysis. Age, sex, psychopathological status and cell type proportions were included as covariates.

Results

DNA methylation at 12 out of 52 CpG sites (23%) was significantly associated with exposure to CM (p < .05); 8 of these associations survived correction for multiple testing (q < .05).

Conclusions

This is the first study to date to explore the relationship between childhood maltreatment and an epigenetic signature of chronic low-grade inflammation. Our findings underscore the presence of immune dysregulation early after exposure to CM; further studies are needed to assess the long-term clinical implications of this signature in psychiatric patients.

Disclosure

No significant relationships.
Women’s Mental Health and Pregnancy Loss: What Should We Be Aware Of?
Authors: Fernandes Santos C.
Published: September 2022

Introduction

Pregnancy loss (PL) – by induced or spontaneous termination of pregnancy – is common, although its consequences on women’s mental health are often neglected in clinical practice.

Objectives

To understand the existence of psychiatric morbidity in women, associated with PL, as well as related risk factors.

Methods

Non-systematic review of literature through search on PubMed/MEDLINE for publications up to 2021, following the terms ‘pregnancy loss’, ‘psychiatry disorder’, ‘depression’ and ‘anxiety’.

Results

After a PL, anxiety is the most frequent symptomatology in 41% of women. Depression occurs in 22-36% of women in the first two weeks after PL, declining over time. Symptoms compatible with Post Traumatic Stress Disorder (PTSD) are found in 25% of women with PL in the first month. Women who meet criteria for PTSD are more likely to present criteria for Depressive Episode. Substance Use Disorder and Prolonged Grief Disorder are also reported, the latter having, as predictors, previous relational difficulties, poor social support and absence of descendants. Risk factors associated with significant psychopathology within PL are, for example, nulliparity, infertility, previous PL, longer gestation time, lower marital satisfaction, previous psychiatric illness, and history of abuse.

Conclusions

In clinical practice, the risk of psychopathology in women with PL should be considered. This population should be actively questioned about the presence of symptoms, as well as their persistence and impact, requiring timely and appropriate pharmacological and psychotherapeutic intervention. Perinatal Mental Health interventions show important gains in the overall health of women and their offspring.

Disclosure

No significant relationships.
Self-esteem in Moroccan women: comparison between different age groups and influencing factors
Authors: Rhaouti A.K. , Khallouk A. , Belbachir S. , Ouanass A. , Belakbir O.
Published: September 2022

Introduction

This study revolves around self-esteem which is defined as a basic human characteristic related to self-awareness, emotions, cognitions, behavior, lifestyle, general health and socio-economic factors. This fundamental data of the personality is revealed from one person to another as well as from one period to another. Many studies point out that advancing adults do not necessarily imply a decline in sense of self-worth, although skill losses are very real in many areas of psychological activity. Therefore, it seemed interesting to us to further explore this point in Moroccan women.

Objectives

Evaluate and compare self-esteem among different age groups of Moroccan women. Identify the different influencing factors.

Methods

This is a descriptive cross-sectional study using a questionnaire based on tow parts, the first based Rosenberg scale, and the second part to identify the presence of certain factors influencing self-esteem.

Results

Our researches have shown a similar results to those of some previous studies. Indeed, we found out that women experience a significant rise of self-esteem simultaneously with the increase of age. Yet, this self-esteem starts to decline in middle-aged women. Several factors can affect it; we can note on the top, the impact of relationships, education and physical health.

Conclusions

This research contributes to our understanding of Moroccan women’s self-esteem and to the identification of factors that influence it.Self-esteem is a core identity issue, essential to personal validation and our ability to experience joy. Previous researchs also suggests that self-esteem might influence economic welfare and physical health.

Disclosure

No significant relationships.
Recovery of healthy sexuality in patients with Anorexia Nervosa treated with Enhanced Cognitive Behaviour Therapy (CBT-E): results from a two-year follow-up study highlighting the role of avoidant attachment style
Authors: Cassioli E. , Rossi E. , Vizzotto C. , Malinconi V. , Vignozzi L. , Ricca V. , Castellini G.
Published: September 2022

Introduction

There is a known association between the core psychopathological features of anorexia nervosa (AN) and sexual dysfunctions, to the point that the recovery of healthy sexuality could be considered a marker of recovery. However, no studies have evaluated the role of insecure attachment in moderating this recovery during treatment.

Objectives

To evaluate the role of insecure attachment as a possible moderator of the recovery of healthy sexuality in patients with AN treated with Enhanced Cognitive Behaviour Therapy (CBT-E).

Methods

A total of 65 patients with anorexia nervosa were treated with CBT-E in a multidisciplinary environment, after filling out self-administered questionnaires for the evaluation of general (SCL-90-R) and ED-specific psychopathology (EDE-Q), female sexuality (FSFI) and adult attachment style (ECR). The assessment was repeated after one (T1) and two years (T2).

Results

At baseline, all domains of sexual dysfunction were significantly predicted by avoidant attachment. A significant amelioration of both general and eating disorder-specific psychopathology and sexual dysfunctions was observed at all follow-up evaluations with respect to baseline levels. However, only 45% of remitted patients also showed a complete recovery of healthy sexuality: this subgroup reported significantly lower avoidance scores when compared to patients who only recovered from AN. Moderation analysis indicated that sexual desire did not increase in participants with higher levels of avoidant attachment.

Conclusions

This study highlighted the crucial role of avoidant attachment in the relationship between AN and sexual dysfunctions, underlining the importance of assessing adult attachment for a better characterization and treatment. Attachment-focused interventions may be beneficial for a full recovery.

Disclosure

No significant relationships.
A Review Of Effective Interventions To Improve Emotional Risk Factors Of Anxiety, Stress, Depression In Infertile And Infertile Patients Undergoing Treatment With Assisted Reproductive Techniques
Authors: Salarian N. , Hamzehgardeshi Z. , Shahhosseini Z.
Published: September 2022

Introduction

Infertility is a major problem in life and affects the lives of infertile couples in every way

Objectives

Infertility is associated with several negative reactions and emotional problems. Review of effective interventions for improving emotional risk factors In infertile and infertile patients undergoing treatment

Methods

A comprehensive narrative review of the studies was conducted. Databases such as Web of Science, Science Direct, Cochrane Library, Scopus, PubMed/Medline, Clinical Key, and MAGIRAN were retrieved from May 10 to August 8, 2021, with no time limit. After reviewing the abstract and the full text of the articles, 32 articles were selected for writing. The methodological quality of the article was assessed based on the Cochrane Risk of Bias

Results

Interventions were divided into two subgroups of mind-body, and web-based CBT. Mind-body interventions generally show the anxiety, stress and depression reduction and Possible improvement in pregnancy rate, but most of these programs require extensive financial resources.The results of web-based,showed that using online CBT approach can greatly reduce stress and anxiety,due to increased use of the internet, non-collaborative, cheap and private treatment of web-based interventions, this method can be used as a way along with other treatments to reduce these negative reactions.

Conclusions

According to the present study CBT methods, application and Internet-based interventions can be used as appropriate counseling methods in reducing stress, anxiety and improving pregnancy outcomes in infertile patients. This information can be used as a proper source to select appropriate counseling methods for health care providers, midwives, and treatment staff involved in infertility patients.

Disclosure

No significant relationships.
Fake News and social Cognition During The SARS-COV-2 Pandemic: Initial Approach Towards understanding Belief In Misinformation
Authors: Cordoba-Delgado M. , Molina-Paredes J.
Published: September 2022

Introduction

Infodemic is a new term which refers to rapidly spreading information from both reliable and unreliable sources in the form of news and publications regarding the COVID-19 pandemic, which requires proper management strategies on its own to prevent the spread of fake news. This is especially relevant in a global state of alert where the fear of contagion is a common denominator and is reflected upon people’s behaviors within a crisis context. Van Bavel et al (2020) affirm “Emerging research is using social science to understand and counter the spread of fake news”, and furtherly emphasize on the limitations of Fact Checking as the main approach to hinder such spread

Objectives

Test the association between sociomoral cognition, religiousness and political identity, and belief in COVID-19 Fake News.

Methods

Online-based survey applied through opportunity sampling. Demographic variables political and religious orientation, RMET and B-IRI, and two dimensional utilitarian dilemmas were used and independent variables, and a selection of true and fake news in order to measure participants’ belief in the latter as a dependent variable.

Results

Morality (R2 = 0.08, p < 0.001), social cognition (R2 = 0.05, p < 0.05), and political and religious orientation (R2 = 0.1, p < 0.000001) predicted belief in COVID-19 fake news. On the other hand, no variables were found to predict belief in fake news unrelated to the pandemic.

Conclusions

Higher impartial beneficence and more years of formal education point toward an evidence-based reasoning, while religiousness and affinity with right-wing ideals has been associated with intuition-based reasoning, thus affecting judgement accuracy.

Disclosure

No significant relationships.
WHO IS THAT MAN I SEE STARING STRAIGHT BACK AT ME? - Mirror Delusional Misidentification: A Case Report And Literature Review
Authors: Mouta S. , Fonseca Vaz I. , Jesus B. , Correia J. , Fontes S.
Published: September 2022

Introduction

The delusional misidentification syndromes (DMS) are uncommon but fascinating neuropsychiatric disorders. One particularly intriguing form of DMS is called the mirror sign or mirror delusional misidentification (MDM).

Objectives

We aim to present a case on MDM and a review on MDM and its correlation with neurological lesions.

Methods

Non-systematic review of the literature and case report.

Results

A 72 years old patient was admitted to the emergency department with disorientation, behavioral changes and persecutory delusional ideation. The patient was also unable to recognize his face in the mirror, claiming to be his son. On neuroimaging tests, the patient presented with moderate diffuse cortical-subcortical cerebral atrophy associated with mild diffuse cortical cerebellar atrophy, as well as atheromatous calcifications in carotid siphons. In the MDM, the patient treats the mirror image as separate from the self. It is commonly seen in patients with dementia. Unlike Capgras syndrome, MDM is typically associated with neurological illness, particularly with neurodegenerative conditions. Findings on neuroimaging have shown a pattern of right hemisphere cortical and subcortical lesions. the most common findings included the following: generalized or localized atrophy on Magnetic Resonance Imaging, ventricular dilatation on Computed Tomography scan, and slowing on Electroencephalography.

Conclusions

Mirror delusional misidentification differs from other forms of DMS as it is seen exclusively in patients with neurological disease. While right hemisphere dysfunction appears to be a requirement for MDM, patients with this condition do not show consistent enough neuroimaging findings to allow for a localization within the right hemisphere.

Disclosure

No significant relationships.
Apathy - where do we find it and how to treat
Authors: Gomes R. , Santos C. , Descalço N. , Moutinho F.
Published: September 2022

Introduction

Although defined heterogeneously within the literature apathy is classified as a multidimensional deficit with emotional, behavioral, and cognitive domains in which there is a decrease in self-motivated/goal-directed activity. Recently conceptualized as a syndrome but lacking a universal screening tool.

Objectives

Review current knowledge on apathy and its best therapeutic approach.

Methods

Non-systematic review of literature through search on PubMed/MEDLINE following the terms “apathy”and“psychiatry”.

Results

Apathy is amongst the most frequent symptoms of dementia and highly prevalent across different forms and stages of dementia, including mild cognitive impairment (MCI) as well as other neurodegenerative and psychiatric disorders such as Parkinson’s disease (PD), Schizophrenia, Depression and Brain Injury. Individuals with apathy have higher frequencies of cognitive impairment and are less likely to be compliant/respond to treatment for comorbid illnesses. Apathy reduces quality of life, increases mortality and leads to caregivers distress - often identified as the most burdensome symptom. Once treatment should favor dopaminergic neurotransmission, psychostimulants were considered. Methylphenidate showed encouraging results as well as dopamine agonists but both with limited evidence. Atypical antipsychotics(APs) seem beneficial compared to typical APs. Antidepressants did not improve symptoms and may even worsen them. Previously reported benefits of acetylcholinesterase inhibitors (AChEIs) were not replicated in recent studies except for rivastigmine in PD. Nonpharmacological interventions are also important.

Conclusions

Apathy occurs frequently in a broad range of neuropsychiatric conditions and considering its impact on patients´ quality of life more studies are needed to find an efficient treatment. A consensus regarding definition and screening tools would allow a better approach.

Disclosure

No significant relationships.
Ketamine As A New Therapeutic Option For The Management Of Mental Disorders
Authors: Turki M. , Abidi O. , Ellouze S. , Ben Jmeaa R. , Nasri J. , Halouani N. , Aloulou J.
Published: September 2022

Introduction

Ketamine is routinely used for anesthetic induction because of its dissociative properties. Recently, it has attracted attention as a rapid-acting anti-depressant, but other studies have also reported its efficacy in the management of diverse psychiatric pathologies previously resistant to treatment.

Objectives

We aimed to review the efficacity of ketamine in the management of mental disorders.

Methods

We conducted a litterature review through pubmed database, using the following keywords: “mental illness”; “ketamine”;”depression”;”anxiety disorders”;”eating disorders”;”substance use disorders”.

Results

Ketamine has primarily been used in psychiatry for people with treatment-resistant depression. Its efficacy in reducing suicidal ideation has been previously reported. Furthermore, Ketamine may be a potential therapeutic option for patients with treatment-resistant anxiety disorders, especially obsessive compulsive disorder (OCD) and post-traumatic stress disorder. It has recently been reported a rapid onset anxiolytic activity in treatment-resistant social anxiety disorder and generalized anxiety disorder. Besides, Ketamine use in subjects suffering from eating disorders was associated with a complete remission of severe anorexia nervosa with a return to normal weight and a decrease in body preoccupations. The use of ketamine alone or in combination with other therapies was effective in reducing alcohol and substance use, prolonging abstinence, reducing craving and enhancing motivation. ketamine in combination with motivational enhancement therapy may be an effective pharmacotherapy for initiating and sustaining abstinence from alcoholics

Conclusions

ketamine shows great promise as a treatment for several mental disorders. However, its possible side effects and short duration of efficacy limit its use. Further studies exploring longer-term outcomes and administration protocols are needed.

Disclosure

No significant relationships.
What is Resilience? A Case Report of a Fully-Functional Man with Corpus Callosum Agenesis
Authors: Ferry-Bolder E. , Mak E. , Ersche K.
Published: September 2022

Introduction

Resilience has attracted much attention, not least since the pandemic. It is characterised by a person’s ability to bounce back from adversity. Although there is no exact definition of what adversity means, it assumes that the individual is aware of the event. Here, we would like to challenge this preconception by putting forward a case of an individual who shows remarkable resilience without being aware of his disadvantages.

Objectives

We present a case of a fully-functioning middle-aged man with corpus callosum agenesis of which he has been unaware. We sought to demonstrate that personality traits which have been associated with resilience may not necessarily be characteristic of a resilient individual.

Methods

T.C. is a 44-year-old individual who enrolled as a healthy participant in a research study at the University of Cambridge, which involved cognitive and personality assessments and a structural brain scan.

Results

T.C.’s psychological profile portrayed a well-balanced man who had attained a high level of education, stable employment, a healthy personal life and good community integration. T.C.’s cognitive performance fell well within normal ranges, but was superior in terms of self-control, as measured by the stop-signal task. To our surprise, he scored below-average on questionnaires of resilience and sense of coherence beliefs and reported subclinical tendencies of obsessive-compulsive behaviours.

Conclusions

Resilience does not require awareness of adversity. Our case report shows that resilience may present itself fairly normally and may go unrecognised in daily life. Hardship should not be limited to traumatic events but also include brain abnormality.

Disclosure

No significant relationships.
FALLING FOR FADS? Diagnostic and therapeutic fads in Psychiatry
Authors: Jesus S. , Costa A. , Simões G. , Alcafache J. , Garrido P.
Published: September 2022

Introduction

Psychiatry is not immune to the effects of trends and fads, which are ideas that elicit short-lived enthusiasm, are quickly adopted, and abandoned when they fail to live up to expectations. Trends meet a deeply felt need to explain, or at least name, what would alternatively be unexplainable human suffering.

Objectives

The authors aim to explore the trends and fads that have occurred in psychiatric diagnostic and treatment throughout history and assess if any modern trends can be identified as well as assessing the effects or consequences of these.

Methods

The authors conducted a non-systematized literature review with focus on those articles most pertinent to the topic in question.

Results

The literature demonstrates that fads and trends not only plague fashion and diet, but also psychiatry. Trends in psychotherapeutic options can be observed by the swing from psychoanalysis to psychopharmacological focus. Overdiagnosis is one of the consequences of these trends, and can be seen from hysteria, schizophrenia, multiple personality disorder, attention-deficit and hyperactivity disorder to gender identity disorder. These trends impact the way diagnosis are made and the treatments implemented.

Conclusions

Fads in psychiatry have occurred not only on the edge, but in the very mainstream of theory and practice. A balance is called for, with caution needed in order not to fall into the temptation of the fad, however, an open mind should also be maintained when cutting-edge treatments and theories emerge. The sensible antidote to falling for fads and trends in psychiatry is commitment to evidence-based medicine.

Disclosure

No significant relationships.
Clinical efficacy and tolerability of Esketamine: a case series
Authors: Passani C. , Ragone N. , Congedo C.M. , Barbini B. , Zanardi R. , Cavallini M.C. , Colombo C.
Published: September 2022

Introduction

Esketamine is a novel antidepressant approved by the FDA in 2019 in the form of an intranasal spray, recommended for Treatment-Resistant Depression (TRD). The intranasal spray system appears to be more manageable than intravenous ketamine infusion. It contains ketamine’s S- isomer which is four-fold more potent for the NMDA receptor.

Objectives

The aim of this case series is to describe our clinical experience in the use of Esketamine.

Methods

6 TRD patients (3 men; 3 women) were recruited in San Raffaele Turro Hospital from March 2021. All patients (2 bipolar and 4 unipolar) were diagnosed with a Major Depressive Episode according to DSM-5 criteria, resistant to at least two antidepressants. Initially, Esketamine was administrated twice weekly for one month; afterward, it was administrated once weekly for a month; finally, it was administrated once weekly or every two weeks for a month. Clinical scales (HAM-D, YMRS, SSI, HAM-A, MADRS, CADSS) were administrated to assess symptoms and sides effects before and after each administration on a weekly basis.

Results

Three patients out of six showed an improvement in depressive symptoms: two patients had remission (final HAM-D score < 8); one patient had a clinical response (final HAM-D score < 50 % respect baseline value). Three patients withdrew the treatment: two for perceived inefficacy, after 16 and 19 administrations, one for personal reasons.

Conclusions

The use of Esketamine in our TRD patients showed good effectiveness and tolerability but randomized controlled clinical trials are needed to confirm our findings.

Disclosure

No significant relationships.
Caring for carers: A virtual psychosocial supervision intervention to improve the quality and sustainability of mental health and psychosocial support in humanitarian contexts
Authors: Wells R. , Acartuk C. , Almeamari F. , Alokoud M. , Beetar A. , Eldardery H. , Elshazly M. , Faruk O. , Ginem M.R. , Hadzi-Pavlovic D. , Ilkkurşun Z. , Jahan S. , Joshi R. , Klein L. , Kurdi L. , Kurt G. , Mastrogiovanni C. , Mozumder M. , Lekkeh S. , Némorin S. , Nicholson Perry K. , Orabi M. , Qasim J. , Steel Z. , Tavakol M. , Ullah H. , Uygun E. , Wong S. , (Fischer) Yan L. , Said Yousself R. , Zarate A. , Rosenbaum S.
Published: September 2022

Introduction

Mental health and psychosocial support (MHPSS) staff in humanitarian settings have limited access to clinical supervision and are at high risk of experiencing burnout. We previously piloted an online, peer-supervision program for MHPSS professionals working with displaced Rohingya (Bangladesh) and Syrian (Turkey and Northwest Syria) communities. Pilot evaluations demonstrated that online, peer-supervision is feasible, low-cost, and acceptable to MHPSS practitioners in humanitarian settings.

Objectives

This project will determine the impact of online supervision on i) the wellbeing and burnout levels of local MHPSS practitioners, and ii) practitioner technical skills to improve beneficiary perceived service satisfaction, acceptability, and appropriateness.

Methods

MHPSS practitioners in two contexts (Bangladesh and Turkey/Northwest Syria) will participate in 90-minute group-based online supervision, fortnightly for six months. Sessions will be run on zoom and will be co-facilitated by MHPSS practitioners and in-country research assistants. A quasi-experimental multiple-baseline design will enable a quantitative comparison of practitioner and beneficiary outcomes between control periods (12-months) and the intervention. Outcomes to be assessed include the Kessler-6, Harvard Trauma Questionnaire and Copenhagen Burnout Inventory and Client Satisfaction Questionnaire-8.

Results

A total of 80 MHPSS practitioners will complete 24 monthly online assessments from May 2022. Concurrently, 1920 people receiving MHPSS services will be randomly selected for post-session interviews (24 per practitioner).

Conclusions

This study will determine the impact of an online, peer-supervision program for MHPSS practitioners in humanitarian settings. Results from the baseline assessments, pilot evaluation, and theory of change model will be presented.

Disclosure

No significant relationships.
Quality of life in patients with chronic hand eczema
Authors: Bouhamed M. , Sallemi R. , Sallemi K. , Feki I. , Masmoudi J.
Published: September 2022

Introduction

Chronic hand eczema (CHE) , inflammatory dermatitis, can lead to physical and psychosocial disability altering the quality of life of these patients.

Objectives

The objective of this study was to examine the quality of life in patients with chronic hand eczema

Methods

Descriptive study collating patients who consulted for CHE, at the Dermatology Department of the CHU Hédi Chaker Sfax, during 3 years (2018-2020). A socio-demographic, clinic , and the Quality of life Questionnaire (DLQI) were administered in this study.

Results

Our study included 12 patients (8 men and 4 women). The mean age was 46.8±11.6 years. The patients were in professional activity in 86.8% of the cases. No patient was in early retirement or disability status. The average duration of the disease was 4.5 years (1- 9 years). All patients were in remission. The intensity of pruritus at the last attack was mild (25.77%), moderate (72.23%), and severe (2%). The impact of pruritus on sleep was noted in 100%. The mean total quality of life score (DLQI) was 6.8±5.5 which means a moderate impairment of quality of life

Conclusions

This work highlights the importance of the impact of this dermatitis on the quality of life of these patients. Therefore, multidisciplinary dermatological and psychiatric management is considered necessary

Disclosure

No significant relationships.
MDD patients with early life stress deactivate the frontostriatal network during facial emotion recognition paradigm: A functional MRI study
Authors: Simon M. , Nagy S. , Kürtös Z. , Perlaki G. , Gálber M. , Czéh B.
Published: September 2022

Introduction

Early life stress (ELS) is a significant risk factor for major depressive disorder (MDD) in adults. Functional magnetic resonance imaging (fMRI) studies using face emotion processing paradigms have found altered blood-oxygen-level-dependent (BOLD) responses in the cortico-limbic network both in individuals exposed to ELS and in patients with MDD. Thus, early life stress may have a long-lasting impact on brain areas responsible for the processing of socio-affective
cues.

Objectives

By applying a facial emotion recognition (FER) fMRI paradigm, we examined the long-term effect of childhood adversity on brain activity in MDD patients with and without ELS.

Methods

MDD patients without ELS (MDD, N=19), those with ELS (MDD+ELS, N=21), and healthy controls (HC, N=21) matched for age, sex, and intelligence quotient underwent fMRI scanning while performing a block design FER task with faces expressing negative emotions. The severity of ELS was assessed with the 28-item Childhood Trauma Questionnaire.

Results

Both MDD and MDD+ELS patients were slightly impaired in recognizing sad faces. Statistical analysis of brain activity found that MDD+ELS patients had significantly reduced negative BOLD responses in the right anterior paracingulate gyrus, subcallosal cortex accumbens compared to HCs. Moreover, the MDD+ELS group had a significantly increased negative BOLD signal in the right postcentral and precentral gyri relative to the HC group. MDD+ELS patients had reduced negative BOLD response in their anterior paracingulate gyrus compared to the MDD group.

Conclusions

Our results support that adult MDD patients with significant ELS are impaired in facial emotion recognition and they display functional alterations in the frontostriatal circuits.

Disclosure

This work was financially supported by the Hungarian Brain Research Program (2017-1.2.1-NKP-2017-00002)