bluuebunny/crossref_metadata_2025 huggingface dataset:
TMS use in Depressive disorder in Youth
Authors: Wadhwa A. , Sareen A. , Saade Y.
Published: September 2022

Introduction

Trans-cranial magnetic stimulation (TMS) as a non-invasive method of altering brain activity (1) has widened the array of therapeutic options available for various psychiatric disorders.

Objectives

Trans-cranial Magnetic stimulation (TMS) as a non-invasive method of altering brain activity has widened the array of therapeutic options available for various psychiatric disorders. •A large number of studies have shown therapeutic benefits in a wide range of patient population with majority of studies in adults. •TMS is used increasingly for the treatment of child and adolescent depression. •Yet, the scarcity of studies and lack of published guidelines for this population is notable. •As TMS use is expanding in this population, an overview of the use of TMS in children and adolescents with depression may provide much needed and timely perspective on this neuropsychiatric intervention.

Methods

We searched all published studies using PubMed database, on TMS use in depressive disorders in children and adolescents. A total of 13 studies were found to have reported use of TMS in depression in children and adolescents.

Results

We found various case series, open label studies as well as sham controlled blind studies indicating that TMS has been effective in treating depression in children and adolescents. No significant side effects were found in our review.

Conclusions

Studies have shown that TMS is an effective treatment option for depressive disorders in children and adolescents. Initial studies look promising but implications in large pediatric population may be different and there is a need for more double blind, controlled trials with larger sample size.

Disclosure

No significant relationships.
Something inside my head
Authors: Jiménez Aparicio T. , Medina Ojeda G. , De Andrés Lobo C. , Vallecillo Adame C. , Gonçalves Cerejeira J. , Santos Carrasco I. , Guerra Valera G. , Gonzaga Ramírez A. , Queipo De Llano De La Viuda M. , Navarro Barriga N. , Fernández Lozano M. , Rodríguez Rodríguez B. , Mateos Sexmero M.J. , De Uribe Viloria N.
Published: September 2022

Introduction

Electroconvulsive therapy (ECT) is a medical treatment for those patients with high suicide risk or refractory psychiatric disorders. It is currently a safe technique, and its effectiveness has been widely demonstrated.

Objectives

Presentation of a clinical case about a patient with drug-resistant delusional disorder and high suicide risk, who eventually received ECT treatment.

Methods

Bibliographic review including the latest articles in Pubmed about ECT procedure, effects and use.

Results

We present a 45-year-old man, who visited different doctors several times by reporting he had the feeling of “having a brain tumor or a vascular disorder”, so he requested imaging tests (computed tomography and magnetic resonance). These tests were absolutely normal, but he kept thinking something was wrong, and eventually attempted suicide by hanging (his family founded him before it was too late). The patient was admitted to hospital, and started psychopharmacological treatment, with minimal response. He desperately insisted that he had “something inside his head”. At this point, it was proposed to start ECT, and the patient accepted. After 6 bilateral ECT sessions, he was visibly more relaxed and less worried, and he no longer presented autolytic ideation. He was still a little bit suspicious about the feeling of having a neurological disease. Currently, the patient runs a follow-up consultation.

Conclusions

Electroconvulsive therapy is a safe and effective technique for those patients with high suicide risk. It may be useful to perform imaging tests in certain cases, for detecting intracranial pressure, acute hemorrhage, tumors… A follow-up of these patients must be performed

Disclosure

No significant relationships.
Electroconvulsive therapy for Patients with Intellectual Disability. When and how?
Authors: Azevedo F. , André R. , Donas-Boto I. , Jeremias D. , Almeida C.
Published: September 2022

Introduction

Intelectual disability is an illness with an important burden on patients and caregivers, especially when severe and when comorbidities such as other psychiatric disorders are present. There are case reports of treatment resistant self-aggression, agitation, epilepsy, catatonia and psychosis successfully treated with electroconvulsive therapy although controlled studies were not found.

Objectives

This work reviewed the current evidence for the use of electroconvulsive therapy in the management of patients with intellectual disability as well as its ethical and methodological implications.

Methods

Non-systematic review of the literature with selection of scientific articles published in the past 20 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “electroconvulsive therapy”, “intellectual disability”.

Results

Patients with intellectual disability can have incapacitating comorbilities that greatly impair quality of life, and may require withdrawl from the community Treatment often differs from the general population as psychotropic medication can worsen other comorbilities. Electroconvulsive therapy can be a relevant treatment option for comorbidities in this population due to its safety profile. Ethical considerations should be taken into account, especially with non-verbal patients or when adequate representatives have not been chosen or cannot be reached. Different legal challenges may be present on different countries.

Conclusions

Electroconvulsive therapy and intellectual disability share the burdens of heavy stigma and low investment. Intellectual disability and it’s commorbidites present both a diagnostic and treatment challenge. Electroconvulsive therapy is an important weapon capable of restoring patients to their families and diminishing the burdens of caregivers and healthcare systems

Disclosure

No significant relationships.
Cardiac surgery patient: differentiating targets for psychotherapy
Authors: Nikolaeva O. , Karavaeva T. , Nikolaev E. , Zakharova A. , Dulina G. , Hartfelder D.
Published: September 2022

Introduction

Differentiation of targets for psychotherapy allows determining certain ways and priorities in psychological treatment of a patient.

Objectives

To work out a multi-level system of psychotherapeutic targets for clinical groups of cardiac surgery patients (CSPs).

Methods

Clinical and psychological analysis of 152 CSPs who were to undergo different types of cardiac surgery treatment.

Results

We have established four levels of psychotherapeutic targets: a patient’s response to surgery, psychopathologic manifestations, personality’s dysfunctional characteristics, and social interaction specificities. Towards CSPs with open-heart coronary artery bypass grafting, the targets appeared to be as follows: low expectations from surgery, low hopes for recovery, low level of satisfaction with life, depressive disorders with somatic manifestations, cognitive abnormalities, anxiety manifestations, manifestation of hostility, rejection of the past, inclination for fatality, reduced vitality, reduced social activity, expectation of help from closest people.Towards CSPs indicated to open-heart aortic valve repair surgery, psychotherapeutic targets were as follows: high expectations from surgery; moderate fear of death; not feeling well; low spirits; depressive disorders with somatic and cognitive-and-affective manifestations; cognitive abnormalities; anxiety manifestations; manifestation of hostility; rejection of the past; reduced hedonism; expectation of help from closest people; reduced social activity. Towards CSPs indicated to minimally invasive surgery, we set such targets as: moderate expectations from surgery; apparent fear of death; depressive disorders with somatic manifestations; anxiety manifestations; cognitive abnormalities; rejection of the past; expectation of help from closest people; reduced social activity.

Conclusions

Psychotherapy of CSPs that includes the established targets can contribute to personalized approach in a patient’s treatment.

Disclosure

No significant relationships.
Diagnosis of subjects damaged in Buddhist groups by means of the Symptom Checklist (SCL-90)
Authors: Anders A.I.M.
Published: September 2022

Introduction

At present, the mental health of members in international Buddhist organizations is often damaged by decontextualized concepts and misleading meditation training. As the treatment of resulting mental diseases presents therapeutic challenges, currently diagnostic and related therapeutic considerations are crucial.

Objectives

Since subjects predominantly reported having received several diagnoses, with depression, anxiety disorder, and post-traumatic stress disorder being the most frequently assigned, a diagnostic assessment device was employed for further differentiation.

Methods

The questionnaire SCL-90 was used to evaluate the nine dimensions: interpersonal sensitivity, depression, anxiety, paranoid ideation, psychoticism, somatization, obsessive-compulsive disorder, hostility and phobic anxiety.

Results

In a pilot group of eight German-speaking subjects of different Buddhist groups the general psychological burden (GSI) was significantly elevated in six of them. However, the intensity of responses in precisely those two individuals in whom it was not increased was far below the norm (PSDI). Furthermore, seven of the subjects had an above-average number of symptoms indicating burden (PST). All of them showed a heightened level of interpersonal sensitivity and for most of the subjects anxiety, depression, paranoid ideation and psychoticism were above the mean value of the norm group.

Conclusions

As for psychiatric treatment and psychotherapy, extended research with a larger group of such subjects and at the beginning of their treatment is crucial. Particularly, hypotheses on the causes of their social insecurity, depressivity, paranoid thinking as well as psychoticism based on the distorted concepts and neologisms these persons were exposed to (e.g. ‘karma-purification
’) as well as their ways of ‘meditation-training’ seems to hold core relevance.

Disclosure

This research was funded by the German Federal Ministry of Education and Research, funding reference number: 01UL1823X.
Embitterment and Aggression in Psychotherapy Patients
Authors: Linden M.
Published: September 2022

Introduction

Embitterment is an emotion which is known to everybody in reaction to injustice, humiliation, and breach of trust. In greater intensity it can cause severe suffering for the affected person and the social envirnment, can result in lasting impairment, and even lead to dysfunctional behavior, including aggression. Embittered patients need therapeutic help and are regularly seen in psychotherapy. The problem is often not properly recognized, because of the multiple accompanying symptoms and accusations against the environment.

Objectives

Goal of the present study was to learn about the prevalence of embitterment in psychotherapy patients

Methods

Outpatients in routine psychotherapy filled in the PTED scale (post-traumatic embitterment disorder selfrating scale), the K-FAF (short assessment of aggression) and the SCL-90 (symptom-checklist-90). Additionally, sociodemographic data were available.

Results

Included were 118 patients, of whom 22% showed a relevant severity of embitterment, 23.7% a relevant score for reactive aggression, and 54.2% a relevant score for irritable aggression. There was a significant correlation between the PTED scale and the aggression scale.

Conclusions

The data show that embitterment and related aggression are frequent phenomena in psychotherapy patients. Therapists should be aware of this emotion and take proper action to diagnose embitterment and aggressive ideation, which are often covered by other complaints. Special treatments are needed, as the aggressive and negativistic features of embitterment complicate the psychotherapy process.

Disclosure

No significant relationships.
antipsychotics and metabolic syndrome
Authors: Jomli R. , Jemli H. , Ouali U. , Ouertani A. , Madouri S.
Published: September 2022

Introduction

Patients treated for chronic mental disorders and who receive atypical antipsychotics are in most cases at risk of gaining weight, the excess of which is complicated in the long term by metabolic syndrome (MS). The management of these patients is effective if it includes Therapeutic Education.

Objectives

Describe the therapeutic education program developed for patients on antipsychotics who have metabolic syndrome

Methods

In this work, we present the educational program that we have developed for patients undergoing psychiatric treatment with atypical antipsychotics, who have been stabilized for at least 3 months and who suffer from SM.

Results

It is a program that starts with the inclusion consultation and educational diagnosis with the first step of clinical (weight, abdominal perimeter and BMI), biological (blood sugar, HbA1C, cholesterol, HDL, triglycerides) and psychometric (SF12, MAQR, food and physical activity diary) assessments. Our initial program includes 6 sessions and 2 maintenance sessions at 1 month and 3 months after the 6th session. The objectives were divided between information about DM, motivation to eat a balanced diet, physical activity and improvement of quality of life. We also included stress management and positive psychology activities. Assessments are repeated at the end of the initial program and at the last maintenance session.

Conclusions

Our program was developed according to the Geneva therapeutic education recommendations. We plan to apply it to groups of patients in our department

Disclosure

No significant relationships.
Current trends in the use of psychodrama and drama therapy in the treatment of mental disorders
Authors: Ciołek M. , Kamińska K. , Nowak M. , Krysta K.
Published: September 2022

Introduction

Psychodrama and Drama therapy enable patients to establish contact with the threat of stepping into a given role. This gives the opportunity to learn how to control it, which leads to better expression of oneself and better communication with the environment. Those qualities are crucial in the treatment of mental disorders. Despite the variety of literature describing the methodology, clinical trials using these forms of therapy are relatively rare.

Objectives

To describe the current trends in psychodrama (PD) and drama (DT) research over the last 6 years.

Methods

We have implemented a systematic approach to literature review, consistent with the PRISMA declaration. We searched through major medical databases: PubMed, Web of Science, Scopus by Elsevier and Science Direct for peer-reviewed articles published between 2015 and 2020. We have included studies using all types of methodology: mixed, quantitative and qualitative and also case studies. The risk of bias was assessed for randomized clinical trials, consistent with the PRISMA declaration.

Results

Using our search strategy we have identified 24 publications with 454 participants. Most of the subjects were adults, only four studies focused on children. Overall, these studies looked at the effects of PD i DT on more than 25 different outcomes. Therefore theatre - based therapies research reports promising results across all methodologies. Although, most of the interventions have small groups of clients and are not randomized.

Conclusions

Current reports on the effectiveness of PD and DT still need to be verified on a larger group of patients.

Disclosure

No significant relationships.
Individual placement and support in young people with severe mental illness: an Italian experience
Authors: Pelizza L.
Published: September 2022

Introduction

Individual placement and support (IPS) has a considerable body of evidence for its effectiveness in helping people with mental disorder to obtain and maintain competitive jobs in the labour market. IPS closely follows 8 main principles (such as it aims to get people into competitive employment, it is open to all those who want to work, it tries to find jobs consistent with people’s preferences, it works quickly, it brings employment specialists into clinical teams, it provides time unlimited, individualised support, benefits counselling is included). However, little data in young adults are currently available, especially in Europe.

Objectives

Aim of this study was to evaluate the beneficial effect of IPS in Italian young adults with severe mental illness, examining the main competitive employment outcomes and drop out rates during a 3-year follow-up period.

Methods

54 participants were recruited from patients receiving psychiatric treatment in adult Community Mental Health Centers of an Italian Department of Mental Health. Together with drop out rates, we examined job acquisition, job duration (total number of days worked), total hours per week worked and job tenure (weeks worked on the longest-held competitive job).

Results

A crude competitive employment rate of 40.7% and a crude drop out rate of 22.2% over the 3-year follow-up period were found. However, 66% of 42 clients who remained in the program over 3 years gained competitive employment at some time during the 3-year period.

Conclusions

This research shows the feasibility of an IPS intervention model in the public mental health care system in Italy, especially for a young adult target population.

Disclosure

No significant relationships.
Experience of using telecare in carrying out a program of psychosocial rehabilitation of patients with schizophrenia and their relatives during the Covid-19 pandemic
Authors: Mitikhin V. , Solokhina T. , Kuzminova M.
Published: September 2022

Introduction

During the Covid-19 pandemic, patients with mental illness turned out to be one of the most vulnerable groups of the population, since the forced self-isolation regime was a decrease in the availability of psychiatric care. During this period, the use of telemedicine increased to provide timely assistance.

Objectives

To analyze the experience of telecare in program of psychosocial rehabilitation of patients with schizophrenia and their relatives and to evaluate its effectiveness.

Methods

80 schizophrenia patients in remission of varying quality and 41 relatives participated in rehabilitation program. To assess the effectiveness of telecare, PANSS, SF-36, URICA, PHQ-9, ISI, PSS-10, GAD-7 scales were used.

Results

Psychosocial interventions through telecare were carried out for 12 months. Patients and relatives participated in video sessions on Zoom and Skype Internet platforms, as well as in instant messengers. Rehabilitation program for patients included psychoeducation, skills training, art-therapy, music therapy, bibliotherapy, psychological counseling. Relatives were provided with psychoeducation and psychological counseling. The analysis showed that the use of telecare contributed to increase in the availability of psychotherapeutic assistance, the participation of patients with low motivation and prompt problem solving. Within the studied period, only 5% of patients (4 persons) developed relapses, two patients (2.5%) were hospitalized. Patients and relatives showed a high level of satisfaction with the care provided, positive dynamics of psychological indicators.

Conclusions

The effectiveness of psychosocial rehabilitation program through telecare has been proven. The possibility of carrying out various psychosocial interventions in online format has been shown.

Disclosure

No significant relationships.
Psychoeducational family intervention for bipolar I disorder: medium and long-term efficacy
Authors: Marone L. , Marzolo S. , Raia M. , Giallonardo V. , Del Vecchio V. , Sampogna G. , Luciano M. , Fiorillo A.
Published: September 2022

Introduction

Bipolar disorder (BD) is associated to high personal and social burden, impaired social functioning and high levels of disability. Recent studies have showed that relapse rates are significantly reduced in those patients whose families receive psychoeducational interventions. Even though most of available evidences are related to the short-term efficacy of psychoeducational family interventions (PFI). No evidence is available on medium and long-term efficacy.

Objectives

This study aims to assess the efficacy after one and five years of PFI in BD in terms of: 1) improvement of patients’ symptoms and global functioning; 2) improvement of relatives’ objective and subjective burden and coping strategies.

Methods

A multicenter, controlled, outpatient trial has been conducted in BD patients and their key relatives, recruited in 11 Italian mental health centers. Patient’s clinical status, social and personal functioning, burden of illness, and relative’s burden and coping strategies were assessed with specific instruments at baseline, after 1 year and after 5 years.

Results

137 families were recruited, 70 allocated to the experimental intervention. After one year, an increasing positive effect on patients’ clinical status, global functioning and objective and subjective burden was found. Moreover, were observed a reduced number of relapses and of hospitalizations after five years, compared to the control group. A reduction in the levels of family burden and an improvement of their coping strategies were also observed.

Conclusions

Positive effects of the experimental intervention persist over the mid and long-term period. PFI should be provided in mental health centres to patients with BD and their relatives.

Disclosure

No significant relationships.
Comparative study of treatment adherence, treatment-related attitudes, and background factors in schizophrenia spectrum and bipolar patients
Authors: Janicsák H. , Grenda Z. , Dudas D. , Soos A. , Sztyehlik M. , Gazdag G.
Published: September 2022

Introduction

Previous research confirmed high rates (20-89%) of non-adherence to medication among psychotic and bipolar patients. Results suggests that positive attitude to treatment has the highest influence on patients’ adherence and significant differences between treatment related attitudes and treatment adherence of psychotic and bipolar patients were found.

Objectives

The aims were to compare treatment related attitudes and treatment adherence between psychotic (schizophrenia spectrum) and bipolar patients; to evaluate the relationship between treatment related attitudes, illness perceptions and health locus of control in psychotic and bipolar populations.

Methods

Treatment attitude was evaluated with the Drug Attitude Scale (DAI). Treatment adherence was rated by doctors on Clinical Global Impression (CGI) Scale. Illness perceptions were evaluated with the Illness Perception Questionnaire for Schizophrenia (IPQS) and health locus of control with the Multidimensional of Health Locus of Control Scale –Form C (MHLC) at the end of inpatient care.

Results

Number of participants was 51. Data indicated more positive treatment attitude in bipolar patients than in psychotic patients. MHLC scores indicated significant role in symptoms control for chance (p=0,042) and „powerful” persons (p=0,011) in psychotic patients. IPQS scores indicated that bipolar patients rather have perceptions about treatment influencing symptoms than psychotic patients. Treatment related attitudes were strongly influenced by perceptions about controllability of symptoms by treatment.

Conclusions

Bipolar patients had more positive treatment attitude and perceptions about effectiveness of treatment on symptoms. This illness perception about controllability of symptoms by treatment was the strongest determinant of positive treatment attitude in this study.

Disclosure

No significant relationships.
Profile of patients referred to the active rehabilitation unit in the health area of Soria (Spain)
Authors: Martínez Gallardo R. , Palomar Ciria N. , Valiente Peña B. , Hernandez Vicente N.
Published: September 2022

Introduction

Realizamos un estudio prospectivo en 15 pacientes, diagnosticados de psicosis, según el DSM V, y que son usuarios de una Unidad de Rehabilitación activa, estos pacientes utilizan las modalidades de hospitalización residencial o el programa de hospitalización parcial.

Objectives

El objetivo principal fue establecer el perfil del paciente (retrato de robot), que utiliza este tipo de dispositivo.

Methods

Se lleva a cabo un protocolo de evaluación que incluye la entrevista de evaluación psicopatológica (DSMV) y las escalas: impulsividad (Barrat), agresividad (Burke), calidad de vida (Woqol bref
), actitud ante la medicación (DAI), Avd ( RAI), riesgo de suicidio (Plutchick), riesgo de caídas (Downton), funcionalidad (EEAG) y hábitos de consumo (DAU).

Results

Con todos estos elementos y teniendo en cuenta la edad y sexo de los pacientes, intentamos establecer el tipo de perfil de paciente del área de Rehabilitación activa de nuestro servicio, luego luego de mediciones periódicas de todas estas variables estableceremos la influencia de Terapia de rehabilitación en la mejora o empeoramiento de nuestros pacientes.

Conclusions

CONCLUSIONES El perfil de tipo del paciente incluido en una Unidad de Rehabilitación Activa está compuesto por un varón de 42 años, con consumo esporádico de toxinas, con rasgos de personalidad donde predomina la agresividad, con un perfil bajo de efectos adversos y con conciencia parcial de la enfermedad. y mala adherencia a la medicación Cabe señalar que sus niveles en la escala de calidad de vida son altos, incluso comparables o en ocasiones superiores a los de la población general según la escala Woqol bref.

Disclosure

No significant relationships.
Qualifying as an Academic Child and Adolescent Psychiatrist During a Pandemic: Top Tips for Trainee Led Training and Research Activities
Authors: Seker A.
Published: September 2022

Combining clinical and academic roles during psychiatric training can be challenging but equally enriching. However, the Covid-19 pandemic has complicated many aspects of psychiatric training, including changes of service provision, clinical duties, training activities and academic opportunities. In this interactive Workshop session, tips and strategies for balancing academic and clinical responsibilities during psychiatric training will be discussed based on real-life experiences and literature recommendations. The impact of the pandemic and what skills could be useful to flexibly tackle the challenges that come with an ongoing public health crisis while working to satisfy academic and clinical requirements in a set period of time will also be considered. The speaker will also include additional resources to improve such soft skills for participants.

Disclosure

No significant relationships.
Prevention and monitoring of metabolic syndrome in patients with severe mental ilness - presentation of our study protocol
Authors: Lopes J. , Reis T.
Published: September 2022

Introduction

Cardiovascular diseases are the leading cause of death in individuals with SMI. The sedentary lifestyle that usually guides these individuals associated with the use of some psychotropic drugs increases the risk of adverse events related to these pathologies

Objectives

Presentation of the Study Protocol for the Implementation of a Psychoeducational Group directed to Prevention and Monitoring Metabolic Syndrome (MS) in patients with SMI

Methods

It is intended to implement a psychoeducational program, which includes a 30-minute walk, focused on healthy lifestyle habits, for 16 weeks.

It is intended to include SMI individuals, from a convenience sample, who present any of these criteria: Excess weight; At risk or diagnosed with DM; Sedentary lifestyle; Smoker. Data regarding socio-demographic, clinical and motivational for and about physical activity will be collected from the intervention group. Patients who refuse to join the study will only receive information about lifestyle changes at the beginning and will continue with their usual care.

Results

According to available literature, it is expected that the monitoring and control of these parameters will translate into a benefit in reducing cardiovascular risk factors and optimizing the treatment of MS, contributing to the empowerment of patients in managing their disease and increasing their quality and years of life.

Conclusions

The impact of lifestyle changes proved to be effective and are sometimes lasting, with objective gains in quality of life of these patients. The main measure to face this issue, improve the well-being and physical health of these individuals, is to reduce weight and increase baseline physical activity.

Disclosure

No significant relationships.
Development of an EORTC Quality of Life Module for Renal Cell Cancer Patients: Phase I
Authors: Wintner L. , Beisland E. , Beisland C. , Van Hemelrijck M. , Holzner B.
Published: September 2022

Introduction

In light of rising incidence rates and a mostly late diagnosis, renal cell cancer (RCC) patients are heavily burdened by both their disease and treatment. The structured assessment of their quality of life using patient-reported outcome (PRO) measures is important in order to provide them with appropriate interventions to maintain or improve their quality of life. Available questionnaires are predominantly symptom indices or were developed without conducting patient interviews.

Objectives

Hence, we report on the ongoing phase I development of an EORTC module for RCC patients, which will be used together with the EORTC QLQ-C30 core questionnaire.

Methods

Following the EORTC Quality of Life Group’s Module Development Guidelines, a systematic literature review was conducted. Based on this review, issues were extracted and presented to healthcare professionals (HCPs) and patients for relevance assessment.

Results

133 publications (14 on the development of RCC-specific PRO measures, 3 qualitative studies, 37 randomised controlled trials, 79 quantitative studies) were identified from which 150 unique issues were extracted. The issue list was reviewed by 14 HCPs (8 clinicians, 3 nurses, 2 psychooncologists, 1 physiotherapist) from 3 countries (Austria, Norway, United Kingdom) and rated regarding their relevance. An additional 13 issues were mentioned in the HCP interviews and included in the issue list.

Conclusions

The extended list of issues is currently used to interview patients. Data collection is expected to be completed by the conference, thus the poster will present the combined relevance scores (HCPs and patients) and the issues selected for the preliminary module to be tested in phase 3.

Disclosure

This study is funded by the EORTC Quality of Life Group (Grant 007/2019).
Measuring Restrictiveness in Forensic Mental Health in Germany - Translation and Adaptation of a Questionnaire
Authors: Walde P. , Völlm B.
Published: September 2022

Introduction

A feeling of restrictiveness is often associated with coercive practices, such as seclusion or restraint. In addition to these obvious procedures more subtle practices can also feel restrictive. Its registration and monitoring is of special importance in forensic mental health care since feelings of restrictiveness can lead to adverse events like increased aggression and suicidal intentions.

Objectives

To enable the registration of the experience of restrictiveness in forensic mental health settings in Germany, the Forensic Restrictiveness Questionnaire was translated from English into German.

Methods

Method: We used the TRAPD approach presented by Harkness (2003). This approach combined the expertise of professional translators and clinical experts and enabled adaptation at an early stage. The developed version underwent a cognitive pretest with a small patient sample to check for comprehensibility and interpretation of the questions in line with the original authors intention.

Results

A preliminary translation of the FRQ was developed. Translators combined their expertise from linguistic and clinical practice as well as their knowledge about English and German culture to produce a translation as close as possible to the original questionnaire with necessary adaptations. Remaining uncertainties, e.g., regarding comprehensibility of long phrases or uniform interpretation of certain wordings or questions, were addressed in the cognitive pretest with patients. The version produced can be used for validation.

Conclusions

Conclusion: The TRAPD approach produced a comprehensible and well adapted German translation of the FRQ. This version underwent a cognitive pretest by a small patient sample and is now ready for validation.

Disclosure

No significant relationships.
Italian validation of the Guilt And Shame Proneness Scale: preliminary results
Authors: Faccini F. , Rogier G. , Cavalli R. , Velotti P.
Published: September 2022

Introduction

Background: Recently, a new instrument, the Guilt And Shame Proneness Scale has been developed and showed promising psychometric properties. However, the Italian version of the Instrument has not still been validated. In addition, despite the growing number of studies on the topic, the knowledge regarding the role played by guilt, shame and rivalry in the relationship between pathological narcissism facets and suicidal ideation.

Objectives

To validate the Italian version of the Guilt And Shame Proneness Scale and to extend the knowledge regarding the relationships between guilt, shame, pathological narcissism and suicidality.

Methods

We administrated, to a sample of Italian adults, the Italian versions of the GASP, the Pathological Narcissism Inventory, the Beck Suicide Inventory and the Narcissism Admiration and Rivalry Questionnaire.

Results

The structural equation model testing the factorial structure of the Italian version of the GASP obtained a good fit. In addition, invariance among gender as well as other invariance tests were tested successfully. Finally, regression and mediation analyses showed that the subscale Shame Social withdraw mediate the relationship between Narcissism grandiosity and suicidal ideation. In contrast, rivalry and social withdraw in response to shame were no more predictive of suicidal ideation controlling for pathological narcissism levels.

Conclusions

The Italian version of the GASP appears promising to deepen the investigation of the pathological personality topic.

Disclosure

No significant relationships.
Childbirth hospitalizations in Bipolar disorder patients: a nationwide study protocol
Authors: Araújo G. , Gonçalves-Pinho M. , Ferreira A.R. , Fernandes L. , Freitas A.
Published: September 2022

Introduction

Bipolar disorder (BD) is usually diagnosed in adulthood, around childbearing age. Research has shown that BD has deleterious effects on pregnant women and birth outcomes. However, few nationwide studies using administrative data have approached this at-risk population focusing specifically on childbirth.

Objectives

This study aims to characterize hospitalizations of women with BD in the peripartum period regarding sociodemographic and clinical variables and to investigate the impact BD has on hospitalization outcomes.

Methods

An observational retrospective study will be performed using an administrative database that comprises routinely collected hospitalization data from all mainland Portuguese public hospitals. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes will be used to identify all women’s admissions for childbirth purposes (V27.X) and codes 296.XX (except 296.2X, 296.3X, 296.9X) will be used to ascertain BD. Episodes will be assigned to one of two mutually exclusive groups (with vs without BD). Multivariate methods will be used to compare both groups concerning key variables and outcomes. This work will comply with the RECORD statement recommendations.

Results

Descriptive and analytical statistics will be conducted in order to describe and characterize this group of patients. Results will be presented as crude and adjusted odds ratio quantifying the risk associated with BD in pregnancy, childbirth and hospitalization outcomes. Findings will be disseminated via publication in peer-reviewed journals.

Conclusions

With this nationwide analysis, we expect to contribute to a better understanding of the demographic and clinical profile of pregnant women with BD and to encourage timely medical and psychological interventions during gestation and childbirth.

Disclosure

No significant relationships.
Finishing General and Adult Psychiatric Training During COVID-19 and Getting Prepared to Become a Post-Pandemic Psychiatrist in Central Europe
Authors: Zaja N. , Seker A.
Published: September 2022

The ongoing pandemic has brought many changes to the lives of almost all people around the world. Medical professionals have also experienced significant changes at their workplace, with many of them engaged in treating COVID-19 patients instead of working in a field of medicine they have trained to work in. Trainees of all medical specialities have often been the first ones to join the effort in combating the pandemic and psychiatric trainees were no exception. The pandemic has brought their training to a halt and the majority of psychiatric educational activities have initially been postponed or canceled, with clinical rotations between different institutions almost non-existent. In a search for more space to treat COVID-19 patients, psychiatric wards were often the first ones to be repurposed. Epidemiological measures have lowered the number of patients a trainee could see each day and have also made clinical supervision less available. However, the introduction of online communication platforms as a new standard of interaction has helped mitigate many of the issues and enabled resuming most of the educational activities. Since trainees were usually more experienced in online communication than senior doctors, their skills were very valuable in establishing telepsychiatric services. Even though the pandemic has created many obstacles in psychiatric training, it has also proved that training is very much about learning and implementing new skills, as well as adapting to new circumstances.

Disclosure

No significant relationships.
The effect of intranasal oxytocin application and mindfulness-based group therapy for patients with schizophrenia spectrum disorders – A study protocol
Authors: Zierhut M. , Von Eisenhart-Rothe V. , Graesser S. , Hartter N. , Wohlthan J. , Hahne I. , Bergmann N. , Ta T.M.T. , Bajbouj M. , Hahn E. , Boege K.
Published: September 2022

Introduction

Research indicates improvements in negative symptoms and empathy for schizophrenia spectrum disorders (SSD) after mindfulness-based interventions (MBI). Current treatment approaches for SSD remain limited regarding their effectiveness on negative symptoms and sociocognitive deficits. After oxytocin (OXT) administration, especially in a positive social context, an increase in empathy could be shown. The effect of mindfulness in combination with OXT has not yet been examined.

Objectives

This study investigates the additional effect of OXT administration combined with MBI on empathy and negative symptoms in patients with SSD.

Methods

An experimental, randomised, triple-blinded, placebo-controlled study is proposed. Based on power calculations, 140 participants with SSD will be recruited at Charité – Universitätsmedizin Berlin. A dose of intranasal oxytocin with 24 I.U. or placebo will be administered 45 minutes before each session. Following each administration, a total of four MBI interventions will take place for two weeks. Empathy as primary outcome will be measured using validated psychometric questionnaires. Outcomes, including negative symptoms and OXT plasma levels, will be measured at baseline and post-intervention. A 2x2 mixed-model ANCOVA design with time as within- and group as between-subject factor will be calculated to assess empathy and negative symptom changes.

Results

The study hypothesises that applying intranasal oxytocin in combination with MBI will increase empathy and reduce negative symptoms in patients with SSD.

Conclusions

Findings could provide insight into enhancing therapies like MBI by utilising OXT as a possible supplementary treatment option. Findings could therefore pave the way for a personalised psychiatric medicine treatment for individuals with SSD.

Disclosure

No significant relationships.
A Link Between Gut Microbiota and Schizophrenia
Authors: Sá Couto J. , Pão Trigo M. , Da Luz B. , Rodrigues J. , Ventura Gil T.
Published: September 2022

Introduction

Microorganisms distributed in our tissues and fluids make up the human microbiota. During our lifetime, gastrointestinal microbiota acts as an important modulator of brain development and, in turn, adult behavior and health. Immune response may be triggered by gut microbiota, releasing mediators that penetrate the blood-brain barrier (BBB).

Objectives

Understanding if gut microbiota can influence schizophrenia pathogenesis. Clarifying how gut microbiota can influence schizophrenia treatment, and vice-versa.

Methods

PubMed database search, with “gut microbiota and schizophrenia” keyword expression. Eight articles published in the last ten years were selected among the most recent best match results. Reference lists of articles were reviewed to identify additional articles.

Results

There could be an association between the development of gut microbiota starting during pregnancy and schizophrenia pathogenesis, through an immune-mediated process. Schwarz et al. (2018) investigated the differences in faecal microbiota between individuals with first-episode psychosis and controls. They found psychotic patients to have an increased amount of Lactobacillus bacteria. Yuan et al. (2018) studied microbiota changes in patients with schizophrenia, before and after treatment. Individuals diagnosed with schizophrenia had less faecal Bifidobacterium, Escherichia coli and Lactobacillus. After treatment with risperidone, there was a significant increase in the amount of fecal Bifidobacterium and E. Coli.

Conclusions

Microorganisms living inside our gastrointestinal tract are vital for proper central nervous system (CNS) development. Patients with schizophrenia have anomalies in the composition of the microbiota. It remains unclear if microbiota changes after treatment further influence the course of the disease.

Disclosure

No significant relationships.
Polypharmacy and relapse of schizophrenia: are they related?
Authors: Softic R. , Osmanovic S. , Becarevic N.
Published: September 2022

Introduction

Polypharmacy can be the cause of deliberate discontinuation of medication and consequent relapse of schizophrenia.

Objectives

To establish the one-year rate of relapse in the patients with schizophrenia with regard to monotherapy or polypharmacy.

Methods

The sample of all hospitalized patients with schizophrenia in a five-year period was analyzed. Descriptive statistics were used.

Results

Total of 87 participants (57 women), the median age was 43 years. Antipsychotic monotherapy was used in 31 (35.6%) of the participants. In one year period, 32 (36.8%) of all participants had a relapse. Prior to relapse, significantly more participants were treated with polypharmacy (p<0,05).

Conclusions

Antipsychotic polypharmacy is related to a higher rate of relapse in patients with schizophrenia.

Disclosure

No significant relationships.
Self-perceived functional impairment or disability in Delusional Disorder – Case Reports
Authors: Basto M.D.R.D.R.F.D. , Certo A. , Nombora O. , Horta A. , Mendes E. , Venâncio Â.
Published: September 2022

Introduction

Delusional disorder (DD) is a psychotic disorder with an estimated prevalence of less than one percent,traditionally characterized by systematized delusional ideas with no cognitive deterioration.However, some studies have been reporting impairment of neurocognitive system (social cognition,learning and memory, expressive language,complex attention, executive function) that might have an impact functionality both in social and work domains..

Objectives

This work aims to review clinical evidence on self-perceived functional impairment or disability in DD and to present two clinical cases evaluated at a psychiatric unit.

Methods

We report two clinical cases based on patients’ history and clinical data, and reviewed clinical records using PubMed® database with search terms of “Delusional Disorder”,“Cognition Impairment in Persistent DD”.

Results

We present two clinical cases of patients who were admitted to psychiatric unit after developing psychotic symptoms namely persecutory delusions about neighbors.A persistent delusional disorder was established and antipsychotic treatment was initiated.The 74-years-old men presented deficits in executive and memory processes; ended up institutionalized after two months of being discharged.The 47-years-old woman, despite remaining as a lawyer, noticed a decrease in work capacity and so she ended up being responsible for less demanding cases.Cases of delusional disorder showed a poor performance in most cognitive tests and some of the cognitive deficits seem to affect functionality namely memory, expressive language and attention.

Conclusions

Although classical literature has not systematized an association between DD and personality deterioration,there are some evidences of loss of functionality and cognitive commitment in this disorder.This suggests the importance of cognitive interventions to improve functional prognosis in this clinical population.

Disclosure

No significant relationships.
The prevalence of self-harm behavior in schizophrenia spectrum disorders: a systematic review and meta-analysis
Authors: Lorentzen E. , Mors O. , Kjaer J.N.
Published: September 2022

Introduction

Non-suicidal self-injury (NSSI) is intentional self-inflicted destruction of body tissue without suicidal intention, whereas deliberate self-harm (DSH) is self-inflicted destruction of body tissue regardless of intent. In clinical samples of patients with schizophrenia spectrum disorders (SSD) the estimates of prevalence and severity of self-harm behavior vary considerably.

Objectives

The aim of this study is to investigate the prevalence of NSSI and DSH, respectively, in individuals with SSD.

Methods

In adherence with PRISMA guidelines, a search of electronic databases (Pubmed, PsycInfo, and EMBASE) was conducted by two independent reviewers. Studies were included if the participants were diagnosed with SSD and DSH/NSSI were quantified by questionnaire or interview. Studies solely including patients with schizoaffective disorder, a severe intellectual disability, or autistic spectrum disorder were excluded. Meta-analysis of prevalence will be undertaken for NSSI and DSH, respectively. Further, the review will examine psychopathological correlates to DSH/NSSI, self-harming methods utilized in DSH/NSSI, and severity of DSH/NSSI.

Results

Following duplicate removal, 1891 abstracts were initially identified through the database searches. 148 abstracts were included in screening of full-text articles of which 33 met the eligibility criteria. Nine authors were contacted for the purpose of obtaining additional data. Preliminary results found that the observed lifetime prevalence of NSSI ranged from 14.1% to 57.1%, whereas the observed lifetime prevalence of DSH ranged from 12.9% to 68.0%.

Conclusions

Understanding how SSD and self-harming behavior are associated could identify subgroups of patients with SSD that are responsive to different pharmacological and psychosocial treatment approaches.

Disclosure

No significant relationships.