bluuebunny/crossref_metadata_2025 huggingface dataset:
DEVELOPMENT OF A CLINICAL GUIDELINE FOR FAMILY-CENTERED COLLABORATIVE CARE IN PATIENTS WITH CHRONIC MENTAL DISORDERS
Authors: Dehbozorgi R. , Fereidooni-Moghadam M. , Shahriari M. , Moghimi-Sarani E.
Published: August 2023

Introduction: Background

Chronic mental illnesses have long periods, are recurring, and require continuous care and, becoming chronic, they double the problems of patients and their family. The study’s purpose is, thus, the development of guidelines for family-centered collaborative care of patients with chronic mental illnesses referring to the medical centers (1).

Methods

This mixed methods study is based on the stages of the guideline adaptation provided by the Guidelines International Network (2).

Results

After reviewing and gathering evidence from a qualitative study on key participants and reviewing the literature, which includes a search for articles related to participatory family-centered care of patients with chronic mental disorders and a review of available books, a clinical guide Related and upstream documents of the country were 531 recommendations were extracted and sent to a panel of experts for evaluation.

Conclusion

Providing a family-centered collaborative care guideline will improve the quality of life of these individuals and their families, improve the quality of care, and reduce fragmented health care(3,4).

Objectives

Development of a clinical guideline for family-centered collaborative care in patients with chronic mental disordersMethods: This mixed methods study is based on the stages of the guideline adaptation provided by the Guidelines International Network .

Results

After reviewing and gathering evidence from a qualitative study on key participants and reviewing the literature, which includes a search for articles related to participatory family-centered care of patients with chronic mental disorders and a review of available books, a clinical guide Related and upstream documents of the country were 531 recommendations were extracted and sent to a panel of experts for evaluation.

Conclusions

Providing a family-centered collaborative care guideline will improve the quality of life of these individuals and their families, improve the quality of care, and reduce fragmented health care

Reference(s)

1) Vigo D, Thornicroft G, Atun R. 2016,Estimating the true global burden of mental illness. The Lancet Psychiatry.3(2):171-8.

2) GIN. 2010,
guideline Adaptation a source toolkit guideline international network; 95

3) Molu NG, Ozkan B, Icel S. 2016,Quality of life for chronic psychiatric illnesses and home care. Pakistan journal of medical sciences.32(2):511-5

4) WHO. 2014,
Integrating the response to mental disorders and other chronic diseases in health care systems. Geneva, Switzerland: World Health Organization; 50 p

Disclosure of Interest

None Declared
Family medicine residents’ attitudes toward mental illness
Authors: Jaoua A. , salhi M. H. , ben haouala A. , gaha L.
Published: August 2023

Introduction

The stigma of mental illness is a complex socialphenomenon that is widespread throughout the world, even amonghealth care professionals.

Objectives

Assessing attitudes towards mental illness among familymedicine residents in Tunisia

Methods

This is a descriptive cross-sectional study among of familymedicine residents enrolled at the Faculty of Medicine in Monastir(Tunisia), conducted over a period of 3 months (July 2022 to October2022). The CAMI (Community Attitudes towards the Mentally Ill)scale was used to assess the attitude towards mental illness. Sociodemographic data were collected through a pre-established questionnaire. The data were analyzed using SPSS software 26 thversion.

Results

Our population was made up of 95 family medicineresidents, divided into 28 males and 67 females. Sex ratio was 2.39. The average of age was 28 years with extremes 25 and 35 years.46.3% (n=44) of the residents were enrolled in the first year, 22.1%(n=21) enrolled in the second year and 31.6% (n=30) enrolled in thethird year. 88.4% (n=84) of the residents did a psychiatric rotationduring their training.We found that 47.4% of residents (n=45) had a positive attitudetowards mental illness.

Conclusions

Improving the attitudes of primary care physicianstowards people with mental illness is necessary to provide goodquality care to these patients

Disclosure of Interest

None Declared
Descriptive study of the consulting and coordination program between Health Center “La Barca” and Jerez Community Mental Health Unit.
Authors: Torres Laborde A. , Ivaylova Chulkova M. , Bueno Heredia A.
Published: August 2023

Introduction

Patients who receive primary medical care at the Health Center “La Barca” and its corresponding services receive mental health assistance at the Jerez Community Mental Health Unit (CMHU), which belongs to the Clinical Area of Jerez within the structure of the Andalusia Health Service. A psychiatrist from Jerez CMHU is in charge of the consulting and coordination program with Health Center “La Barca”. Any case that may require mental health assistance is brought for discussion at weekly meetings between primary care physicians and the psychiatrist at the health center, with one of the following case resolutions:

-

Maintain mental health assistance with primary care physician.

-

Refer to the Jerez CMHU for specialized care.

-

Single-appointment evaluation and assistance by the psychiatrist within primary care.

Objectives

The aim of this descriptive study was to analyze socio-demographic and clinical characteristics of the population assisted through the consulting and coordination program.

Methods

Socio-demographic and clinical data belonging to the cases brought to the program was collected between 01/06/2018 and 28/02/2020. An ad-hoc data collection survey was used for this purpose.

Results

Female/Male 53/23. Mean age: 47.13. Only 20% of the cases discussed were referred for specialized care to Jerez CMHU. 65% of the patients attended the appointments given with the psychiatrist within primary care. The most frequent diagnosis were anxiety disorders, adjustment disorders, and dysthymia.

Conclusions

A significant fraction of the cases discussed at the coordination program are resolved within this framework or through a single appointment with the psychiatrist, implying that the program achieves an important optimization of resources, all the while maintaining high quality healthcare. The data suggests that the consulting and coordination program is an improvement in terms of referral protocols within mental health care. A more detailed study would be necessary to confirm and enhance current data.

Disclosure of Interest

None Declared
An interview designed to promote mental health in organizations
Authors: Peçanha D. L.
Published: August 2023

Introduction

In a broad literature review on the subject we did not find structured interviews in the context of mental health in organizations. However, interviews are in common use in the business field. In Family Science assessment methods of families have fallen into two main categories. The first one is comprised of methods based on the evaluation of family members’ individual answers, while the second is based on the evaluation of group answers. The Structured Family Business Interview (SBFI) presented is based in important systemic studies and psychological practices with families and it belongs to the second method

Objectives

The purposes of this study is present a structured interview called the Structured Family Business Interview (SBFI) that is a theoretical and practical contribution to access and to promote mental health in organizations.

Methods

The Structured Family Business Interview (SFBI) is a structured interview comprised of six tasks which are assigned to the family as a group some of them are hypothetical or role-play type, and they are addressed to a particular family group in the family business.

The relational processes is observed first-hand by the interviewer and by a trained observer who audio-records and documents the non-verbal signals.

Results

This technique was developed and tested in family firm context. In this section we will present illustrative answers to various dimensions studied in a large research project in mental health with family businesses. Results show good indicators of the SFBI capacity to assess dynamic and systemics dimensions of the teams in family firm. Those dimensions are: communication, rules, roles, conflicts, integration and aggressiveness analyzed to promote health resources and human and organizational development. The research with several work teams indicate that it allows for a precise evaluation of the variables.

Conclusions

The Structured Family Business Interview specifically designed for family business takes into account intangible variables described in the organizational management literature like the systemic constructs that has a strong impact on the health of organizations. In addition to the specific contribution to management tools, it is expected that this interview may help to develop new studies and practices about organizational health in work and in family businesses.

Disclosure of Interest

None Declared
Mental health problems in tunisian military population
Authors: Njah D. , Kefi H. , Bouzouita I. , Baatout A. , Bencheickh C. , Eddif S. , Oumaya A.
Published: August 2023

Introduction

Military personnel can face unique risks and challenges to their mental health. High-stress situations, prolonged absences, and difficulty adjusting to civilian life can affect their mental health and hence develop psychiatric disorders , particularly major depressive disorder (MDD) and post-traumatic stress disorder( PTSD). That’s why searching for involved factors that could have an impact on these mental disorders or help predict them is crucial in the military population.

Objectives

Our objectives were to describe the epidemiological profile of military patients followed in the psychiatric department of the military hospital of Tunis (MHT) and to identify the risk factors associated to psychiatric disorders in this population.

Methods

This was a retrospective study conducted over a period of 4 weeks , in the psychiatry department of the MHT. We included in our study patients drawn at random at the outpatient clinics, all psychiatric disorders included. We analyzed the epidemiological characteristics of the patients as well as the risk factors with the SPSS software 26.0.

Results

One hundred military patients were included in our study. The mean age of the patients was 38.74(±9.73) years, 93% of them were male, 86% had a high school education, 71% belonged to middle socioeconomic category, and 59% lived in the military barracks. The mean duration of service was 17.68(±9.22) years. Active military members were assigned to weapons jobs (45%), administrative (15%), technical (24%), transportation (8%), and health (6%) specialities.We found that MDD was the main psychiatric disorder found in 64% of the patients with a mean severity of 76.9%. Besides , administrative specialities were the most frequent source of MDD (73.3%), while transportation posts were the most common cause of the PTSD (12.5%). And finally weapons specialties were the most likely to cause adjustment disorders (13.3%). In addition, we found that a long military service duration was associated with a chronic evolution of all the mental disorders (p :0.002).

Conclusions

The army is mostly affected by major depressive disorder . The position occupied by the patient seems to play a role in the type of the disorder . The seniority in the military service would be a risk factor for chronicity of the mental disorder.

Disclosure of Interest

None Declared
Brief psychotic episode in an adult without medical antecedents after suffering the indirect consequences of the Russian-Ukrainian war
Authors: Troyano R. G. , Fariña Francia M. , Marimon Muñoz E. , Fernandez Marquez I. , Miranda Ruiz E. , Arroyo Ucar M. , Ramirez Gonzalez J. , Ferreiro Gonzalez S. , Hidalgo C. , Quispe A.
Published: August 2023

Introduction

Almost nine months after the start of the war between Russia and Ukraine, millions of people have been affected physically, economically and mainly mentally. Those who have stayed in their homeland, and the ones that have chosen to emigrate to a safer place.

Objectives

The objective of this article is to assess the importance of social stressors in the onset of a brief psychotic episode, even in the absence of substance abuse or previous illnesses.

Methods

The case of a 45-year-old woman is described, known by the Pediatric Emergency Service, for being the tutor of a patient who suffered from anxiety attacks, having emigrated without her parents from Ukraine together with her 5 brothers. The psychotic episode begins when our patient gets notified that she must abandon the custody of the girl, because she will have to go to Turkey with her legal guardians. The family explains the behavioral changes that the patient made and how the clinical picture worsened.

Results

She was admitted at the Hospital’s Psychiatry Service and antipsychotics treatment started. After 5 days, the episode had completely been solved.

Conclusions

In conclusion, we highlight the importance of social problems in the development of a psychiatric pathology and the necessary elements to prevent it: family support network, fast and efficient care services and availability of hospital and pharmaceutical resources.

Disclosure of Interest

None Declared
Human endogenous retroviruses and autism spectrum disorder: Brief review of recent literature
Authors: Mota Freitas R. , Reis Gomes D. , Silveira F.
Published: August 2023

Introduction

Human endogenous retroviruses (HERVs) are genetic elements resulting from ancestral infection of germline cells. HERVs have been associated with multiple complex disorders, including neurodevelopment disorders, namely autism spectrum disorder (ASD).

Objectives

In this review, we aim to explore the relationship between endogenous retroviruses and autism spectrum disorder.

Methods

A non-systematic review of literature published in the Pubmed database in the last ten years was performed. A combination of the search terms “autism spectrum disorder”, “ASD”, “endogenous retrovirus”, “human endogenous retrovirus”, “ERV” and “HERV” was used. Articles were selected based on title and abstract review.

Results

Preclinical and human studies suggest that the abnormal expression of endogenous retroviruses can represent a biological trait of neurodevelopment disorders in affected individuals and their parents. The precise epigenetic processes that underpin this relationship remain elusive. Nonetheless, HERVs play various roles, modulate host immune response and may affect human embryogenesis. All of these factors can participate in the interplay among genetic vulnerability, environmental risk factors, and maternal immune activation that contribute for the development of ASD.

Conclusions

There is a recent, mounting body of evidence linking HERVs and ASD. Whether HERVs behave as a cofactor for the development of ASD or an epiphenomenon of neurodevelopmental disorders remains unclear. Further research is needed to assess if there is causality and evaluate the potential for HERVs to serve as biomarkers for ASD.

Disclosure of Interest

None Declared
Psychiatric Symptoms & Misdiagnosis Of Frontotemporal Dementia: A Case Report
Authors: Özmen G. , Göverti D.
Published: August 2023

Introduction

Frontotemporal dementia (FTD) is the second most common type of dementia seen between 45-65 years of age and affects the frontal and/or temporal lobes. FTD is clinically characterized by progressively the change in behavior, personality, and language dysfunctions.

Clinical features of FTD include restlessness, disinhibition, apathy, blunted affect, avolition, social withdrawal, impulsiveness, and loss of executive function. Most patients with FTD act as socially inappropriate behaviors, not talking much, compulsive-like acts, poor insight, and psychiatric features including hallucinations and paranoid delusions. According to symptoms, the diagnosis of FTD may be confused with depression, mania, or schizophrenia.

Objectives

In this case report, we wanted to draw attention that FTD should be considered in the differential diagnosis of late-onset psychosis.

Methods

A 53-year-old female, married, uneducated, and not having children patient has applied to our clinic with complaints, that started a year ago, about social withdrawal, activity, decreased sense of purpose, neglecting personal hygiene, not eating well, and acting inappropriately and impulsively.

The patient reported that she was walking out of the house for hours, having profanity speeches, and forgetfulness.

She was admitted to the psychiatry hospital a year ago and discharged with a diagnosis of bipolar disorder.

Brain MRI showed atrophy of frontal and anterior temporal structures bilaterally. PET scan demonstrated left frontal, parietal, and temporal hypo perfusion of the brain.

In our clinical observation, she had apathy, inappropriate jokes, lack of eye contact, flat affect, lack of gesturing when communicating, unable to respond to questions, and visual hallucinations.

Results

Due to the similarity of the clinical resemblance of BPAD and FTD, the diagnosis of FTD can be confusing. In this case, amnesia and sudden onset of the symptoms with rapid destruction may help the diagnosis of FTD.

Psychosis symptoms in our clinical observation also suggested the diagnosis of psychosis. However, its atypical course and early-onset psychosis symptoms brought us closer to organic pathology. Investigations of structural and functional brain imaging may help support the diagnosis.

Image:

Image 2:

Conclusions

Psychiatric symptoms in FTD may cause misdiagnosis. Organic pathologies should be kept in mind, especially in late and sudden onset symptoms.

Disclosure of Interest

None Declared
Diagnostic Challenges of Functional Cognitive Disorders
Authors: Petta J. , Falcão A. L. , Soares G. , Lourenço A.
Published: August 2023

Introduction

Functional cognitive disorders (FCD) denotes a complaint about memory function or, less commonly, another cognitive process, in the absence of relevant neuropathology and with evidence of inconsistency between symptoms reported and signs identified at assessment.

Increasing numbers of people with FCD are being identified.

Most are discharged back to primary care without a diagnosis or are given the label of mild cognitive impairment, which is not a synonym for FCD.

Objectives

There is a multitude of terms in the clinic and in the research to describe this kind of complaints. Some terms seem to minimize and normalize the state, whereas others posit an underlying cause.

Given this lack of order, it is a challenge to diagnose it and give it the proper clinical guidance.

This literature-based review aims to fill this gap.

Methods

Data was obtained through an internet-based literature search, using the databases PubMed, Cochrane Library and NCBI. The World Health Organization was also utilized. Nine articles from the last two years were included.

Results

It is listed a nosology in six categories and a selection of clinical features which may help with the discrimination of functional and neurological disease causes of memory disorders.

Conclusions

Patients presenting with complaints about memory function require standard psychiatric and neurological history and examination.

It should be emphasized that these conditions are not diagnoses of exclusion but have positive symptoms and signs that should become well-known.

Nevertheless, we remain uncertain about prognosis and treatments, both psychological and pharmacological. Its development would reduce the burden of patients in the healthcare systems.

Disclosure of Interest

None Declared
The Effects of Serotonergic Psychedelics on Neural Activity: A Meta-Analysis of Task-Based Functional Neuroimaging Studies
Authors: Shepherd J. H. , Baten C. , Klassen A. , Zamora G. , Saravia S. , Pritchard E. , Ali Z. , Kahlon S. K. , Whitelock K. , Reyes F. A. , Hedges D. W. , Hamilton J. P. , Sacchet M. D. , Miller C. H.
Published: August 2023

Introduction

Curiosity toward the effects of psychedelic drugs on neural activation has increased due to their potential therapeutic benefits, particularly serotonergic psychedelics that act as 5-HT2A receptor agonists such as LSD, psilocybin, and MDMA. However, the pattern of their effects on neural activity in various brain regions in both clinical and healthy populations is still not well understood, and primary studies addressing this issue have sometimes generated inconsistent results.

Objectives

The present meta-analysis aims to advance our understanding of the most widely used serotonergic psychedelics – LSD, psilocybin, and MDMA – by examining their effects on the functional activation throughout the whole brain among both clinical and healthy participants.

Methods

We conducted this meta-analysis by applying multilevel kernel density analysis (MKDA) with ensemble thresholding to quantitatively combine existing functional magnetic resonance imaging (fMRI) studies that examined whole-brain functional activation of clinical or healthy participants who were administered a serotonergic psychedelic.

Results

Serotonergic psychedelics, including LSD, psilocybin, and MDMA, exhibited significant effects (α=0.05) on neural activation in several regions throughout the cerebral cortex and basal ganglia, including effects that may be common across and unique within each drug.

Conclusions

These observed effects of serotonergic psychedelics on neural activity advance our understanding of the functional neuroanatomy associated with their administration and may inform future studies of both their adverse and therapeutic effects, including emerging clinical applications for the treatment of several psychiatric disorders.

Disclosure of Interest

None Declared
Risperidone and fluvoxamine; two directions of augmentation: a case report
Authors: Štracak M. , Todorić Laidlaw I.
Published: August 2023

Introduction

Only 40%–70% of patients have an adequate response to the first-line treatment of OCD with SSRIs. Antipsychotic augmentation is effective in the management of both obsessions and compulsions and these drugs are currently the first-line pharmacological augmenting agents for OCD. (Jaisoorya T, Thamby A. Antipsychotic augmentation in the treatment of obsessive-compulsive disorder. Indian Journal of Psychiatry. 2019;61(7):51)

Objectives

We present the cases of a 31-year-old man and a 21- year-old girl. A 31 -year old man experienced hygienic obsessive and compulsive symptoms with excessive showering for one year (YBCOS 20). First, he was treated with 100 mg of fluvoxamine daily which helped him gain partial remission of symptoms. After a stressful period at work and his showering compulsions got worse. Our female patient suffered from compulsive hand washing and disinfection with fear of getting contaminated by other people (YBCOS 24). She was also treated for anorexia nervosa. At the moment of referral to our outpatient clinic, she had already been taking 2 mg of risperidone daily, but still, her compulsions persisted.

Methods

Both patients were included in outpatient service treatment. They were followed up weekly, psychotherapeutically supported and their psychopharmacotherapy was titrated. In the case of our male patient, risperidone of 1 mg/day was added to the ongoing fluvoxamine of 100 mg/day. Our female patient was given fluvoxamine 50 mg/a day and gradually increased to 100 mg/day with an ongoing 2 mg/day of risperidone.

Results

After two weeks, the hygiene compulsions of the 31-year-old-man completely remitted (YBCOS 6). He stopped excessive showering and became fully functional at work and in family relations. Our female patient also continued to take risperidone in augmentation with fluvoxamine as recommended. Her compulsions improved, and she returned to her hobbies and her college lectures (YBCOS 8). They have both been advised to continue outpatient psychiatric treatment and to regularly use pharmacotherapy.

Conclusions

The condition of both of our patients improved after adding an augmentative agent to the therapy. In the first case, it was risperidone as a fluvoxamine augmentation, and in the second, fluvoxamine was added as a risperidone augmentation. The combination of these two drugs, rather than each other being used on its own, proved to be a powerful therapeutic tool in the treatment of OCD. Further clinical studies are required for a better understanding of the underlying neurobiological mechanism of this effective combination.

Disclosure of Interest

None Declared
Profile of substance use disorders in elderly psychiatric inpatients
Authors: Karoui M. , Kammoun R. , Nefzi H. , Ellouze F.
Published: August 2023

Introduction

Substance abuse is a common problem associated with significant morbidity and mortality, but is often underdiagnosed and unrecognized in geriatric patient populations.

Objectives

to determine the prevalence of substance use disorders geriatricic inpatient population.

Methods

Data from 2010 to 2020 were retrospectively reviewed from a clinical database. 148 admissions of patients older than 60 years were identified. Descriptive statistics were used to group patients with and without a diagnosis of substance use, which included intoxication, withdrawal, abuse, dependence, and substance-induced disorders.

Results

There were 148 hospital admissions for patients over 60 years of age, with a mean age of 72.38 ± 5.64 years and a mean length of stay of 13.91 ± 14.15 days. Of all admissions, 44% (n=64) were associated with at least one substance use diagnosis. In this group of 64 patients, the most frequently used substance was tobacco with associated disorders ( 65% N=42). The prevalence of other substance use diagnoses was as follows: sedative-hypnotic abuse/dependence 32% (N=21), cannabis abuse 10% (N=6), alcohol-related disorder 12.5% (N=8). Compared with patients without a substance abuse diagnosis, these patients were significantly younger, had shorter lengths of stay, were less likely to be readmitted, and were more likely to be single men

Conclusions

Given the inherent difficulties in diagnosing substance use disorders and the retrospective nature of this study, the true prevalence of substance use disorders in elderly psychiatric inpatients is likely higher than found. Cross-sectional or cohort studies are more appropriate to shed light on this condition.

Disclosure of Interest

None Declared
Comorbid somatic conditions among older patients with major mental illness: A retrospective inpatients study.
Authors: Karoui M. , Maaroufi A. , Houssem N. , Kammoun R. , Ellouze F.
Published: August 2023

Introduction

Psychiatric admissions of elderly subjects with mental disorders is a difficulty in management and treatment. This problem is essentially related to somatic comorbidities of this population.

Objectives

To compare the demographic characteristics, comorbid conditions and functional status of younger and older individuals with major mental illnesses admitted to psychiatry.

Methods

Using the records of patients admitted between 2015 and 2020 to the psychiatric department "G" of Razi Hospital, we collected the demographic characteristics, comorbid conditions and functional impairments for patients admitted to psychiatry and aged over 65 years. We compared these characteristics to those collected in the total population of admitted patients.

Results

The study population consisted of 75 elderly patients. Compared to the youngest patients there was a greater male majority, a higher rate of severe cognitive impairment, higher rates of chronic medical illnesses, such as congestive heart failure.

Conclusions

Our findings suggest an urgent need for integrated psychiatric and medical care for elderly subjects with major mental illness. Future research is needed to adapt evidence-based integrated models of collaborative mental health care.

Disclosure of Interest

None Declared
Cognitive disorders in the elderly persons and their psychometric markers
Authors: Liubov P. , Letnikova Z. , Daria E.
Published: August 2023

Introduction

Population aging is accompanied by an increase in mental disorders of late age, cognitive impairment and dementia, which makes research on their diagnosis, prevention and therapy particularly relevant.

Objectives

In order to improve the diagnosis of cognitive disorders in elderly patients, a comparative characteristic of the MMSE and MoCA psychometric scales is presented. Due to the lack of differentiation of results in the MoCA - test according to the severity of cognitive disorders, ranking was carried out to determine the scoring levels of cognitive decline.

Methods

On the clinical basis of the scientific department of gerontopsychiatry of the Moscow Research Institute of Psychiatry - branch of the V. Serbsky National Medical Research Center for Psychiatry and Narcology, 46 people over 60 years old were examined. The identified mental disorders were coded under the ICD-10 F00-F09 rubric “Organic, including symptomatic mental disorders”. Cognitive status assessment was carried out by psychometric scales MMSE and MoCA. Psychometric and statistical research methods were used. To compare MoCA and MMSE scores, an equal-percentage alignment method was used

Results

In patients examined by MMSE and MoCA, different point values were determined in assessing cognitive functions. In most observations, the MoCA- test indicators were lower than the MMSE values. The following correspondences of the score values of the scales were revealed: MOCA 23-30 - MMSE 28-30 points; MOCA 22-18 - MMSE 27-25; MOCA 17-12 – MMSE 23-20; MOCA 12-0 – MMSE 19-0.

Conclusions

Such features of the MMSE scale as insufficient sensitivity in assessing memory impairment and differentiation of non-dementia levels of cognitive impairment, regulatory functions of programming and goal-setting, lexical fluency were revealed. The advantages of the MoCA - test were the ability to assess visual-constructive and executive skills, praxis, a more accurate assessment of memory impairments, mobility of mental processes and the ability to switch, logical thinking, the possibility of topical diagnosis of brain damage. The disadvantages of the MoCA - test were the duration of its implementation, the fatigue of patients, the lack of tasks for assessing written speech and motor praxis.

The MoCA - test is a more sensitive method for detecting and differentiating cognitive impairment compared to the MMSE scale, which makes it possible to recommend it for widespread introduction into psychiatric practice. Relevant in further studies are the determination of indicators of moderate cognitive impairment as a threshold value between mild cognitive impairment (MCI) and incipient dementia, clarification of the point values of different levels of dementia.

Disclosure of Interest

None Declared
How is depression in the elderly patient diagnosed?
Authors: Fernández Fernández R. , Izquierdo de la Puente Á. , del Sol Calderón P. , Méndez González O.
Published: August 2023

Introduction

The diagnosis of depression in the elderly patient presents peculiarities that should be taken into account. Studies point out the importance of an adequate screening of suspected cases of depression in older adults by physical therapists and other non-mental health professionals (Ramos Vieira et al., 2014). In this study, we intend to find out which are the most used diagnostic methods in Mental Health research on geriatric patient.

Objectives

To analyze the diagnostic methods most used in research on the geriatric patient, specifically in articles that analyze the patient with cognitive impairment.

Methods

A bibliographic search of all articles analyzing depression in patients with cognitive impairment between 2000 and 2020 was carried out. The diagnostic method of depression in each of them has been collected.

Results

A total of 38 studies were analyzed. The most common diagnostic method continues to be the use of diagnostic criteria (ICD or DSM), which is used in 34.2% of the studies, while the Center for Epidemiologic Studies Depression Scale (CES-D) is the most commonly used test, appearing in 23.7% of the studies. The remaining tests (CIDI, GDS, HAM17, PHQ, SCID, SCL-90, SGDS) do not reach 10% each.Counts% of TotalCumulative %GDS25.3 %5.3 %CES-D923.7 %28.9 %CIDI25.3 %34.2 %Diagnostic criteria1334.2 %68.4 %EURO-D12.6 %71.1 %PHQ25.3 %76.3 %GMS-AGECTA25.3 %81.6 %HAM-1712.6 %84.2 %Others615.8 %100 %

Conclusions

The diagnosis of depression continues to be made primarily using diagnostic criteria. It is striking that the most commonly used test is the CES-D, given that the Geriatric Depression Scale (GDS) is usually the most popular scale for screening for late-life depression (Gana et al., 2017), which may be due to the fact that the studies analyzed have a more research than clinical purpose.

References

Gana, K., Bailly, N., Broc, G., Cazauvieilh, C., & Boudouda, N. E. (2017). The Geriatric Depression Scale: does it measure depressive mood, depressive affect, or both?. International journal of geriatric psychiatry, 32(10), 1150–1157.

Vieira, E. R., Brown, E., & Raue, P. (2014). Depression in older adults: screening and referral. Journal of geriatric physical therapy (2001), 37(1), 24–30.

Disclosure of Interest

None Declared
Remote consultations in London – a comparison between mental health and cardiology pathways
Authors: Pinto da Costa M. ,   NIHR ARCs (Chris Chaloner, Nirandeep Rehill, Kristoffer Halvorsud, Rosalind Raine, Fiona Stevenson, Gabriele Kerr, Thomas Beaney, Geva Greenfield, Benedict Hayhoe, Ceire Costelloe, Massar Dabbous, Gideon Gideon, Eoin Gogarty, Fiona Gaughran)
Published: August 2023

As a response to the COVID-19 pandemic, in March 2020 a shift to remote consulting for routine primary care and outpatient appointments was instructed. With the aim to inform whether and how remote consultations should continue post-pandemic, the London NIHR Applied Research Collaborations (ARCs) conducted a research-grade evaluation of the impact of this shift in London, focusing on cardiology and mental health as exemplar pathways.

Quantitative methodology aimed to explore patterns of healthcare use, efficiency, and clinical outcomes using de-identified patient-level health records datasets in North-West London and South London.

Qualitative interviews with clinicians and patients with experience in remote consultations sought to develop a more in-depth understanding of the experience of the move to remote consulting.

Disclosure of Interest

None Declared
Diagnosis announcement among mothers of children with leukemia
Authors: Dhakouani S. , Karoui M. , Hamrouni N. , kammoun R. , Ellouze F.
Published: August 2023

Introduction

The diagnosis of leukemia in a child is a difficult moment for the therapist and for the parents. Nevertheless, this moment is crucial and determining in the course of care and the therapeutic relationship.

Objectives

Determine the quality of diagnosis announcement among mothers of children with leukemia.

Methods

A cross-sectional study was conducted at Aziza Othmana hospital department of haematology in Tunisia between June and July 2021.

We have questioned the mothers about the announcement of the diagnosis: the space frame, the time provided and the availability of the doctor.

Results

We included 31 mothers, their middle age was 41 years old. Acute lymphoblastic leukemia is the most frequent type of cancer in our sample (94%).

According to 4 mothers (13.3%), the diagnosis of leukemia was not announced before the start of treatment.

The quality of the diagnostic announcement was judged to be good in 40% of cases (n=12), average in 12.7% (n=8) and mediocre in 20% of mothers (n=6).

The space frame of the announcement was perceived as appropriate with respecting confidentiality in 18 mothers (69.2%).

The time provided for the announcement was considered sufficient for 17 mothers (65.4%).

The doctor who announced the diagnosis was described as available by 69.2% of the mothers and unavailable by 30.8% of the mothers.

Conclusions

The quality of the diagnosis announcement amoung mothers of children with leukemia in our context is not optimal. Oncologists must be trained in diagnostic announcement and must be aware of the importance of this moment in the subsequent therapeutic relationship.

Disclosure of Interest

None Declared
Mental Health Impacts of Wildfire, Flooding and COVID-19: on educators: A Comparative Study
Authors: Agyapong B. , Eboreime E. , Shalaby R. , Pazderka H. , Obuobi-Donkor G. , Adu M. , Mao W. , Oluwasina F. , Owusu E. , Greenshaw A. , Agyapong V.
Published: August 2023

Introduction

Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumas in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Eighteen months after the wildfire, major depressive disorder (MDD), generalized anxiety disorder (GAD), and Post Traumatic Stress Disorder (PTSD) symptoms were elevated among school board employees in the city.

Objectives

This study aimed to compare employees of the school board and other employees of Fort McMurray in respect to the impact the 2016 wildfires, the 2019 COVID pandemic, and the 2020 floods had on their mental health.

Methods

A quantitative cross-sectional survey was conducted in Fort McMurray from 24 April to 2 June 2021. Online questionnaires were administered through REDCap and were designed to capture socio-demographic characteristics, clinical as well as wildfire, COVID-19, and flooding-related variables. Mental health outcome variables were captured using self-reported standardized assessment scales. Data were analysed with descriptive statistics, Chi-square/Fisher’s Exact tests, and binary regression analysis.

Results

Of the 249 residents who accessed the online survey, 186 completed the survey, giving a response rate of 74.7%. Of these respondents, 93.5% (174) indicated their employment status and were included in the Chi-square analysis. Most of the respondents were female (86.2%, (150)), above 40 years (53.4%, (93)), and were in a relationship (71.3%, (124)). The prevalence values for MDD, GAD and PTSD among respondents were 42.4%, 41.0, and 36.8%, respectively. There was a statistically significant difference between employees of the school board and other employees with respect to likely PTSD prevalence (28% vs. 45%, respectively, p < 0.05), although with other factors controlled for, in a binary logistic regression model, employer type did not significantly predict likely PTSD.

Conclusions

The study has established that likely PTSD symptoms were significantly higher in other employees compared to those of school board employees. Greater exposure to the traumatic events and a greater perceived lack of support from other employers might have contributed to the significantly higher prevalence of PTSD in other employees

Disclosure of Interest

None Declared
Associations between occupational stress and working conditions in a shoe and leather company
Authors: Rmadi N. , Sellami I. , Jmal Hmmami K. , Masmoudi M. L. , Hajjaji M.
Published: August 2023

Introduction

Occupational stress (OS) is one of the major health hazards of the modern workplace. Poor working conditions are major occupational stressors and have a great impact on employees’ well-being.

Objectives

This study aimed to assess the associations between OS and working conditions.

Methods

We conducted an exhaustive cross-sectional study among workers in a shoe and leather company. We used the Job Demand Control model of Karasek to measure occupational stress. Workers were asked about their perception of working conditions such as the noise, heat generated by certain tools and machines, fabric smells and uncomfortable workspaces. Data were analysed using SPSS software.

Results

The study involved 310 workers (58 men and 252 women) with an average age of 34.2 ± 10.3 years. Workers reported different concerns about working conditions. The noise was the major complaint reported by 73.7% of workers. Workspaces were uncomfortable according to 48.7% of workers. Job strain and isostrain situations were found in 56.5% and 44.5% respectively. Unpleasant smell from leather products was associated with job strain (p= 0.004, OR = 1.9, 95%; CI [1.2-3.1]) and isostrain (p= 0.043, OR = 1.6, 95%; CI [1.03-2.6]) situations. Heat generated by certain tools and machines was associated to isostrain situation (p= 0.009, OR = 2.7, 95%; CI [1.2-5.9]). Perceiving workspaces as uncomfortable was associated with isostrain situation (p= 0.004, OR = 1.9; 95%; CI [1.2-3.09]).

Conclusions

Working conditions have an important impact on workers’ mental health. Thus, improving job conditions is a key way to improve workers’ health and well-being.

Disclosure of Interest

None Declared
Dissociative Identity Disorder: a case of three Selfs
Authors: Bravo J. , Canelas da Silva I. , Buta F.
Published: August 2023

Introduction

The DSM-5 defines dissociation as “disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior”. The disorders in this group include depersonalization/derealization disorder, dissociative amnesia, and dissociative identity disorder, the last being a controversial entity.

Dissociative disorders are associated with elevated levels of disability, impaired quality of life, high economic cost, and a significantly increased risk of suicide attempts.

Objectives

In this work we present the case of a 21-year-old man that was assisted in the Emergency Room with dissociative symptoms. We intend to do a non-systematic review on the subject of dissociation symptoms, the psychiatric disorders in which they are present, identified risk factors, how to access the psychopathology features and the recommended treatment to best address them.

Methods

For a comprehensive approach of this subject we proceeded to a non-systematic review in PubMed using the following keywords “dissociation”, “dissociative identity disorder” and “dissociative disorders”.

Results

In this work we present the case of a 21-year-old man assisted in the Emergency Room describing dissociative symptoms that were suggestive of Dissociative identity disorder. He referred out-of-body experiences and a sense that he was not controlling his actions while self-injuring himself and being aggressive towards his family. He described “three Selfs”: the “Normal Self”, the “Suicidal Self” and the “Bad Self”.

Symptoms of dissociation are present in a variety of mental disorders namely depression, anxiety disorders, posttraumatic stress disorder, borderline personality disorder and eating disorders.

Dissociative disorders appear to be linked to trauma, interpersonal stress, and strongly associated with a history of chronic child abuse. An association with alexithymia, depression and suicidality were also found. Some studies found structural and functional abnormalities, particularly a reduction in grey matter volume in limbic system structures, a dysregulation of prefrontal–limbic circuitry and dysfunction of the hypothalamic–pituitary-adrenal axis.

Psychotherapy appears to be the cornerstone of treatment for dissociative disorders, namely Cognitive-Behavior therapy and Eye-movement desensitization and reprocessing.

Conclusions

Symptoms of dissociation are not only present in dissociative disorders, but they may be present in almost all mental disorders. The evaluation of possible dissociative symptoms should be a part of every psychopathological assessment. There is a need for further studies to better understand this diagnostic entity and improve the therapeutic intervention.

Disclosure of Interest

None Declared
Intranasal Esketamine administration in catatonia: a case report.
Authors: Romay J. , Sevilla C. , Hernandez P. , Lastra I. , Isidro G. , Cayon L. , Cortez G. , Anabitarte O. , Ijalba P. , Gomez Revuelta M.
Published: August 2023

Introduction

Catatonia is a complex psychomotor syndrome that often goes unrecognized and, consequently, untreated. Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications. Benzodiazepines and electroconvulsive therapy (ECT) are the most widely studied treatment methods. However, no uniform treatment method has yet been brought forward and no previous attempts to treat catatonia on a patient suffering concomitant major depressive disorder (MDD) with NMDA receptor antagonists have been documented so far.

Objectives

To describe the unknown and novel management of catatonia and MDD with intranasal esketamine, a NMDA receptor antagonist.

Methods

A 55-year-old woman with a diagnosis of long-standing recurrent major depressive disorder who was admitted to the psychiatric inpatient unit of UniversityHospital Marqués de Valdecilla (Santander, Spain) suffering a complex catatonic, mutative state framed on a severe MDD. Different ineffective therapeutic interventions were deployed during the course of her illness. After failing to improve under conventional pharmacological treatment and ECT, and given the complexity of peripheral venous access on this patient (which disabled the option for iv ketamine use), we decided to initiate compassionate treatment with intranasal esketamine.

Results

Intranasal esketamine was effective in the resolution of patient’s complex catatonic state. Clinical response from catatonia was observed after 6 intranasal esketamine administrations (2-week follow-up), reaching full catatonia and MDD remission after 12 sessions in absence of significant adverse events

Conclusions

Esketamine showed promising effectiveness for the treatment of catatonia in the context of MDD, although further research on this topic is needed.

Disclosure of Interest

None Declared
Ethics in mental health research
Authors: Pinto da Costa M.
Published: August 2023

The boundaries between innovative clinical practices and research-related experimentation can be difficult to distinguish. Whilst mental health research has increased remarkably over recent decades, ethics is required to maintain and improve the standards of mental health research. Ethics and science can be seen as opposing forces with different aims championed by different people. However, ethics should not be a barrier to scientific advancement, but rather as the way that mental health research can be conducted with broader societal support, with the expectation of bringing wider benefit to people with mental illness. Scientific advancements may also lead to novel ethical problems and raise questions in relation to oversight responsibilities. Mental health research faces several unique ethical challenges. This presentation will provide an overview of the ethical issues linked with mental health research.

Disclosure of Interest

None Declared