bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient and public involvement in mobile health-based research for hay fever: a qualitative study of patient and public involvement implementation process
Authors: Fujio Kenta , Inomata Takenori , Fujisawa Kumiko , Sung Jaemyoung , Nakamura Masahiro , Iwagami Masao , Muto Kaori , Ebihara Nobuyuki , Nakamura Masahiro , Okano Mitsuhiro , Akasaki Yasutsugu , Okumura Yuichi , Ide Takuma , Nojiri Shuko , Nagao Masashi , Fujimoto Keiichi , Hirosawa Kunihiko , Murakami Akira
Published: September 2022

Background

Smartphones are being increasingly used for research owing to their multifunctionality and flexibility, and crowdsourced research using smartphone applications (apps) is effective in the early detection and management of chronic diseases. We developed the AllerSearch app to gather real-world data on individual subjective symptoms and lifestyle factors related to hay fever. This study established a foundation for interactive research by adopting novel, diverse perspectives accrued through implementing the principles of patient and public involvement (PPI) in the development of our app.

Methods

Patients and members of the public with a history or family history of hay fever were recruited from November 2019 to December 2021 through a dedicated website, social networking services, and web briefing according to the PPI Guidebook 2019 by the Japan Agency for Medical Research and Development. Nine opinion exchange meetings were held from February 2020 to December 2021 to collect opinions and suggestions for updating the app. After each meeting, interactive evaluations from PPI contributors and researchers were collected. The compiled suggestions were then incorporated into the app, establishing an active feedback loop fed by the consistently interactive infrastructure.

Results

Four PPI contributors (one man and three women) were recruited, and 93 items were added/changed in the in-app survey questionnaire in accordance with discussions from the exchange meetings. The exchange meetings emphasized an atmosphere and opportunity for participants to speak up, ensuring frequent opportunities for them to contribute to the research. In March 2020, a public website was created to display real-time outcomes of the number of participants and users’ hay-fever-preventative behaviors. In August 2020, a new PPI-implemented AllerSearch app was released.

Conclusions

This study marks the first research on clinical smartphone apps for hay fever in Japan that implements PPI throughout its timeline from research and development to the publication of research results. Taking advantage of the distinct perspectives offered by PPI contributors, a step was taken toward actualizing a foundation for an interactive research environment. These results should promote future PPI research and foster the establishment of a social construct that enables PPI efforts in various fields.
Osteoclast biology in the single-cell era
Authors: Tsukasaki Masayuki , Takayanagi Hiroshi
Published: September 2022

Osteoclasts, the only cells that can resorb bone, play a central role in bone homeostasis as well as bone damage under pathological conditions such as osteoporosis, arthritis, periodontitis, and bone metastasis. Recent studies using single-cell technologies have uncovered the regulatory mechanisms underlying osteoclastogenesis at unprecedented resolution and shed light on the possibility that there is heterogeneity in the origin, function, and fate of osteoclast-lineage cells. Here, we discuss the current advances and emerging concepts in osteoclast biology.
Embedded fuzzing: a review of challenges, tools, and solutions
Authors: Eisele Max , Maugeri Marcello , Shriwas Rachna , Huth Christopher , Bella Giampaolo
Published: September 2022

Fuzzing has become one of the best-established methods to uncover software bugs. Meanwhile, the market of embedded systems, which binds the software execution tightly to the very hardware architecture, has grown at a steady pace, and that pace is anticipated to become yet more sustained in the near future. Embedded systems also benefit from fuzzing, but the innumerable existing architectures and hardware peripherals complicate the development of general and usable approaches, hence a plethora of tools have recently appeared. Here comes a stringent need for a systematic review in the area of fuzzing approaches for embedded systems, which we term “embedded fuzzing” for brevity. The inclusion criteria chosen in this article are semi-objective in their coverage of the most relevant publication venues as well as of our personal judgement. The review rests on a formal definition we develop to represent the realm of embedded fuzzing. It continues by discussing the approaches that satisfy the inclusion criteria, then defines the relevant elements of comparison and groups the approaches according to how the execution environment is served to the system under test. The resulting review produces a table with 42 entries, which in turn supports discussion suggesting vast room for future research due to the limitations noted.
Accelerometer-based navigation vs. conventional techniques for total knee arthroplasty (TKA): a systematic review and meta-analysis of randomized controlled trials
Authors: Li Juntan , Zhang Yuqi , Gao Xiang , Dou Tianxu , Li Xu
Published: September 2022

Background

The aim of the study was to determine whether accelerometer-based navigation (ABN) can improve radiological and functional outcomes during total knee arthroplasty (TKA) compared with conventional techniques (CONV).

Method

We comprehensively searched the PubMed, Embase, Web of Science, Cochrane Library, and Clinical Trials databases. Only randomized controlled trials were selected for meta-analysis and, ultimately, 10 studies were included.

Results

The 10 studies involved 1,125 knees, of which 573 were in the ABN group and 552 in the CONV group. The results demonstrated that ABN significantly reduced the number of outliers for mechanical alignment (MA) (RR: 0.38, 95% CI: 0.27 to 0.54, P < 0.00001, I2 = 45%), achieving more accurate MA (RR: –0.78, 95% CI: –0.93 to –0.62, P < 0.00001, I2 = 76%). The results revealed that there was no significant difference in duration of surgery between the ABN and CONV groups (MD: –0.2, 95% CI: –1.45 to 1.05, P = 0.75, I2 = 48%). There was less blood loss through the use of ABN (SMD: –0.49, 95% CI: –0.93 to –0.06, P = 0.03, I2 = 75%). However, ABN group didn’t show better knee function (SMD: 0.13, 95% CI: –0.07 to 0.33, P = 0.20, I2 = 0%), though the incidence of overall complications was significantly lower (RR: 0.69, 95% CI: 0.50 to 0.95, P = 0.02, I2 = 0%).

Conclusions

The present meta-analysis demonstrated that ABN was superior to CONV in restoring MA of the lower limb. In addition, ABN reduced the loss of blood and the duration of surgery was not prolonged. However, patient-reported outcome measurements (PROMs) were not improved.
Association of primary knee osteoarthritis with DVWA SNP in a group of Egyptian population: a case–control study
Authors: Mostafa Noha Abdelhady Abdelsadek , Ibrahim Ibrahim Khalil , Mikhael Neveen Lewis , Saba Emmanuel Kamal Aziz
Published: September 2022

Background

Osteoarthritis (OA) is a highly prevalent medical condition which represents a high impact on public health. In addition, the underlying etiology still has been unelucidated. Osteoarthritis is a multifactorial disease with a high genetic predisposition. Identification of genes associated with higher OA predisposition can assist in elucidating the underlying molecular mechanisms as well as detecting possible areas for gene-targeted OA therapies. Among these genetic targets, double Von Willebrand factor domain A (DVWA) has been shown to be related to β-tubulin protein interaction which is considered a protecting factor from OA development. Studies have shown a reduction in protein binding strength with single-nucleotide polymorphism (SNP) rs11718863 in the Von Willebrand factor domain A (VWA domain). Development of weakness between β-tubulin and the wild protein has been linked with increased risk of OA development. We aimed to investigate the association between primary knee OA susceptibility and severity with DVWA rs11718863 SNP among a subset of Egyptian population.

Results

There was no statistically significant difference in the incidence of AA, AT and TT genotypes frequencies between patient group and control group (P = 0.502). There was no statistically significant difference between different genotypes of DVWA rs11718863 SNP as regards the radiological assessment of different knee joint compartments using Kellgren Lawrence scale (P = 0.960 for medial tibiofemoral compartment), (P = 0.260 for lateral tibiofemoral compartment) and (P = 0.597 for patellofemoral compartment).

Conclusions

DVWA rs11718863 SNP was not demonstrated to influence OA susceptibility and severity among the studied Egyptian population subset. Larger sample size with inclusion of more genetic variants of DVWA SNP would be necessary to support the presence or absence of any relationship between DVWA SNP and OA.
“Adding new Molecular Insights to a given Endophenotype: the Relevance of Epigenetics in Environmental Stress Response”
Authors: Rusconi F. , Romito E. , Toffolo E. , Forastieri C. , Battaglioli E.
Published: September 2022

Molecular psychiatry research needs a deeper characterization of emotional and cognitive neural underpinnings, along with a broader recognition of trauma-related circuitries and their involvement in shared pathological endophenotypes. One such endophenotype is unbalanced approach avoidance conflict (AAC), a highly recurrent trait of psychopathology. A translationally validated rodent model of AAC is the elevated plus maze (EPM) test, recently shown to be pharmacologically controlled in human and rodents via homologous neural substrates. Thanks to this test, we identified the involvement of the epigenetic enzyme LSD1 as a molecular restrainer of anxiety. We identified LSD1 aberrant regulation within the hippocampus of suicidal victims, suggesting its broad functional involvement in maladaptive behaviors. Interestingly, thanks to the parallel employment of rodent models, we evaluated a stress-related LSD1 homeostatic regulation that transiently limits memory formation-instrumental gene expression in the hippocampus upon trauma. Our work shed new light on epigenetic processes devoted to trauma resiliency through a negative regulation of anxiety plasticity.

Disclosure

No significant relationships.
BAD NEWS FOR HYPOCHONDRIACS: Covid-19 Associated Aggravation of Somatic Symptom Disorder with Psychotic Depression
Authors: Jesus S. , Costa A. , Simões G. , Garrido P.
Published: September 2022

Introduction

The Covid-19 pandemic has brought with it far-reaching consequences that affect the mental health of a significant population. Those suffering from somatic symptom disorder (SSD) present a significant focus on physical symptoms, with excessive thoughts and behaviours, to an extent that results in major distress and dysfunction. Aggravation of SSD could be associated with various stressors, including the current pandemic, and culminate in an increased severity of the base presentation.

Objectives

The authors present the case of an elderly man with previous diagnosis of SSD which began to aggravate and evolve into a depressive psychotic state, precipitated by the beginning of the Covid-19 pandemic.

Methods

The authors conducted a non-systematized literature review with focus on those articles most pertinent to the topic in question as well as presenting a clinical case as compliment.

Results

With the pandemic overwhelming the globe, the literature has demonstrated a significant correlation with aggravation of mental health and psychiatric cases. The patient in question was previously followed in consultation for SSD. With the pandemic acting as precipitating stressor, the patient demonstrated a significant aggravation in his base presentation with the development of psychotic depression. He was subsequently hospitalized with implementation of psychotherapeutic and psychopharmacological methods, with remission of the psychotic state, with poor response of the SSD.

Conclusions

External stressors are an important influence on psychiatric disorders. Whenever potential life stressors, especially those that exert influence on a global scale, the psychiatrist should be attentive to the possibility of significant aggravation of a stabilized clinical picture and offer support.

Disclosure

No significant relationships.
Features of the Psychoemotional status of Patients with Type 2 Diabetes Mellitus
Authors: Chernus N. , Kamynina L. , Gorenkov R. , Sivkov A. , Savina T. , Serdakova A. , Sivkov S. , Zolotovickaja A.
Published: September 2022

Introduction

The study of the personal characteristics of patients with SD2 continues to be an urgent problem.

Objectives

Study the features of the psychoemotional status of patients with type 2 diabetes mellitus

Methods

The study included 62 patients with T2DM (HbA1c 7,3±1,3%) and visceral obesity (Grade 2) were included mean age 56.1 ± 2.4; BMI: 34.8 ± 2.3.. Research methods: the Beck test, the Hamilton scale, the Spielberger-Hanin questionnaire

Results

Clinical signs of anxiety-depressive disorders were detected in (47) 75.8% of patients. - 1 group, 15 patients - 2 comparison group (without affective disorders). Beck’s test: 23.5 + 0.5 against 10.6 ± 0.3 and Hamilton’s shock 22.4 ± 0.4 against 7.9 + 0.2 revealed a reliable difference between groups (p < 0,001). In both groups of patients on the Spielberger-Hanin scale, moderate reactive anxiety was identified: 44.9 ± 0.7 versus 36.7 ± 0.5 point, which is significantly higher (p < 0,001) in patients of the 1 group. The level of personal anxiety 56.0 ± 0.5 versus 37.5 ± 0.4 points, which also revealed a reliable difference between groups (p < 0,001).

Conclusions

The findings suggest a high incidence of anxiety-depressive disorders in patients of patients with T2DM and visceral obesity, which should be considered in pathogenetic therapy for these patients.

Disclosure

No significant relationships.
Conversion disorder in an 18-year-old boy: a case report
Authors: Vilella Martín C. , García Vázquez P. , Fernández Perea P. , Barrera García Y. , Serrano García A. , De Santiago Sastre J. , Gómez Martínez R. , Franch Pato C.
Published: September 2022

Introduction

Conversion is the transformation of a conflict (unconscious) into a somatic symptom or a “non-verbal way of expressing psychological discomfort”, through somatizations. The disorder suggests a neurological or medical disease, associated psychological factors appear and is not produced intentionally.

Objectives

To describe a case of conversion disorder.

Methods

Retrospective review of clinical records and complementary test, including psychiatry, electrophysiology and neurology.

Results

An 18-year-old boy came to the emergency room for paralysis. He has anesthesia of lower limbs. He shows indifference towards this symthoms.He denies any stressful situation. On examination, no psychotic or affective symptoms were observed. Belle indifference. Blood tests and a cranial CT scan were performed without alterations, so the patient was admitted for study. The electromyogram, lumbar puncture and cranial magnetic resonance show negative results. Suggestion is carried out, proving effective and recovering gait and sensitivity. These episodes are repeated up to 4 times until finally, during an interview with the family, episodes of bullying come to light. We work in therapy with a diagnosis of conversion disorder.

Conclusions

The most frequent symptoms in conversion disorder are mutism, paralysis, anesthesia, blindness and seizures. It is usually monosymptomatic for each patient. Diferencial diagnosis with neurological pathology should be made.

Disclosure

No significant relationships.
Pregabalin for the treatment of generalized anxiety disorder
Authors: Khallouk A. , Rhaouti A. , Boukdir A. , Stati S. , Nafiaa H. , Ouanass A.
Published: September 2022

Introduction

Pregabalin is a treatement with a complexe mechanism of action. It’s an antiepileptic drug used as adjunctive treatment of partial epilepsy, it is also taken in the treatment of neuropathic pain, and generalized anxiety disorder, in addition to epilepsy. Some of the advantages of pregabalin include. pharmacokinetics, safety, and tolerability. Clinical trials have demonstrated the efficacy of pregabalin comparable to benzodiazepines, without risk of abuse.

Objectives

to assess the efficacy of pregabalin in patients with generalized anxiety disorder in the Ar-Razi university psychiatric hospital in Salé in Morocco

Methods

To assess the place of pregabalin in the treatement of anxiety disorders through patients hospitalized in the Ar-Razi university psychiatric hospital in Salé in Morocco The evaluation instruments are: For anxiety the Hamilton Anxiety Scale and For therapeutic efficacy CGI-therapeutic index

Results

based on the results of our study on the patients who have improved after an optimal duration of treatment, in conjunction with psychological monitoring, we retain that pregabalin can significantly improve the quality of life of anxious patients and also guarantee them a better prognosis

Conclusions

Pregabalin was significantly more efficacious for the treatment of psychic and somatic symptoms of generalized anxiety disorder and was well tolerated by most study patients.

Disclosure

No significant relationships.
Clinical Correlates of Cardiac Conduction in Bipolar Disorder
Authors: Prieto M. , Carocca A. , Fullerton C. , Hidalgo A. , Diaz J. , San Martin P. , Godoy M. , Nuño M. , De Leon A. , Rodriguez J. , Sanchez R. , Batiz F. , Castillo A. , Cuellar-Barboza A. , Biernacka J. , Frye M.
Published: September 2022

Introduction

Patients with bipolar disorder (BD) have an increased risk for cardiovascular morbimortality. Clinical risk factors, specifically for arrhythmias and sudden cardiac death remain understudied.

Objectives

This study was conducted to assess differences in cardiac conduction among BD patients.

Methods

We included patients with BD in a cross-sectional design, confirmed by structured interview, age 18 through 80. Clinical characteristics were obtained using a structured questionnaire or medical records review. ECG intervals duration and morphology were manually assessed by cardiologists and compared among clinical subgroups using Chi-square, Mann-Whitney, and Kruskall-Wallis tests. Exploratory multivariable linear and logistic regression models were fitted to adjust for potential confounders.

Results

We included 117 patients (60.7% women, 76.9% bipolar I, 50% history of psychosis, 22.6% suicide attempts). We found a significantly longer QTc interval in BD patients with hypertension (difference: 9.5 ms, p=0.006), obesity (difference: 25 ms, p=0.001), and metabolic syndrome (difference: 13 ms, p=0.007). Hypertension remained a significant predictor of longer QTc after adjusting for age, gender, and antipsychotic use (estimate 17.718, p=0.018). We observed a significantly shorter PR interval in women (difference: 6 ms, p=0.029), early age of onset (difference 6 ms, p=0.025), non-users of lithium (difference 4 ms, p=0.002), and early trauma (difference 4 ms, p=0.038). Finally, we identified significant correlations between symptom severity, blood glucose and PR interval (r=0.298, p=0.001; r=0.278, p=0.003; respectively).

Conclusions

Patients with BD and hypertension may have an increased risk for QTc prolongation. Careful cardiovascular monitoring may be warranted.

Disclosure

No significant relationships.
Social Isolation and its Brain Correlations: From Symptomatology to Neuroimaging Findings
Authors: Bellani M.
Published: September 2022

According to the social brain hypothesis, the human brain includes a network designed for the processing of social information. This network includes several brain regions that elaborate social cues, interactions and contexts, i.e. prefrontal paracingulate and parietal cortices, amygdala, temporal lobes and the posterior superior temporal sulcus. We will explore neuroimaging studies that investigated social isolation in healthy subjects.

Disclosure

No significant relationships.
Evaluation of the relationship between lithium treatment response and suicide attempt in bipolar disorder
Authors: Altınbaş K.
Published: September 2022

Introduction

Suicide risk is 20-30 fold higher in bipolar disorder(BD) than general population. A positive family history of suicide, early-onset bipolar disorder, rapid cycling, and drug/alcohol addiction have been identified as risk factors for non-fatal suicidal behavior. Lithium is the only mood stabilizer known to have a suicide-reducing effect in patients with BD. Less than half of the bipolar patients respond lithium well. Even though mechanism of action on suicide behavior is not clearly known, it is thought that lithium significantly reduces “impulsive-aggressive” behavior via serotonergic system which might also be related with treatment response in BD.

Objectives

The aim of this study is to evaluate the relationship between lithium response and history of suicide.

Methods

Those who scored 7 points or more from the Alda total score were considered good responders. Patients were divided into those who responded well to lithium treatment and those who did not. History of suicide attemptbetween these two groups was compared.

Results

65.3% of the patients were female (n:49). The mean age of the patients was 36.82±13.35 years. 25 patients responded well to lithium treatment. Among the good responders, 32% of the patients and 25% of the non-responders had a history of suicide attempts. This difference was not statistically significant. (p=0.46 x²=0.13)

Conclusions

The insufficient number of data in the study was considered as a limitation of this study. In addition, there is a need for more studies as there are many factors that cause suicide attempts.

Disclosure

No significant relationships.
Role of MAOI drugs as triggers of manic episodes in bipolar disorders: A case report and a narrative review
Authors: Olivier Mayorga L. , Ilzarbe L. , Andreu Gracia H. , Bueno Sanya L. , De Juan Viladegut O. , Barrio P.
Published: September 2022

Introduction

Use of Monoamine Oxidase Inhibitors (MAOIs) has experimented an important reduction in recent years, being replaced by other antidepressant drugs (ADs) associated with a better safety profile. Its use has been restricted to instructed professionals treating resistant and atypical depression. Thus, treatment-emergent affective switch (TEAS) induced by MAOIs is a rare event nowadays.

Objectives

To describe a manic episode associated to a one-year-long treatment with phenelzine, a MAOI agent.

Methods

We present the case of a 47-year-old man hospitalized in our acute psychiatric unit after presenting compatible clinical symptoms with a manic episode. He showed severe irritability, decreased need for sleep, pressured speech, increased energy and goal-directed activities. The patient had started phenelzine a year ago for the treatment of major depressive episode resistant to previous pharmacological essayed treatments. No previous history of TEAS was reported, although he had already taken other ADs and mood-stabilizer treatments in the past.

Results

Several studies reported the effectiveness of MAOIs for the treatment of monopolar depressive episodes resistant to other ADs, especially when atypical symptoms were observed. Data on the use of MAOIs for the treatment of drug-resistant bipolar depressive episodes is scarce. Few studies have described a good response without showing and increased risk of TEAS.

Conclusions

As MAOIs have fallen out of favour with modern psychiatry, there is scarce evidence on the prevalence of TEAS in patients undergoing treatment with these drugs. Further research is needed in order to accurately define these complex relationships.

Disclosure

No significant relationships.
A review: Circadian Rhythm Dysfunction and Bipolar Disorder
Authors: Ribeiro M. , Lourenço A. , Lemos M. , Bastos J. , Pereira J.M.
Published: September 2022

Introduction

Circadian rhythm (CR) dysfunction is a prominent feature in bipolar disorder (BD) and sleep disturbances are characteristic, although not essential to the diagnosis.

Objectives

To review the literature regarding the CR dysfunction and its impact on the onset and clinical course of BD.

Methods

We conducted a MEDLINE search using bipolar disorder, circadian rhythm and sleep as keywords, selecting studies written in English.

Results

CR dysfunction is a trait marker of BD. It’s known that during depressive episodes insomnia is present, with difficulty falling asleep/ maintaining sleep and early awakening. Regarding mania, decreased need for sleep is a critical marker. During the euthymic period significant alterations in sleep pattern have been described. It’s also known that changes in the sleep pattern occur prior to those in mood patterns, indicating that sleep dysregulation may trigger the onset of mood episodes or relapses. Therefore, CR disruption may be associated with the pathophysiology of BD and some factors have already been identified: irregularity of the sleep-wake rhythm, eveningness chronotype, abnormality of melatonin secretion, vulnerability of clock genes and the irregularity of social zeitgeber.

Conclusions

Disturbances of sleep are pervasive, and an essential feature of BD, worse during mood episodes, but still present during euthymic periods. It remains to determine whether circadian rhythm dysfunction is a trait marker or mood state dependent. Further studies are warranted to clarify this association.

Disclosure

No significant relationships.
Bipolar Disorder - New era of Treatments: High dose Levothyroxine, rTMS and genetics
Authors: Zamar A. , Koutsomitros T. , Lulsegged A.
Published: September 2022

Introduction

Rapid cycling Bipolar disorder and mixed affective states are treatment resistant conditions. Standard treatments are ineffective. Homozygous polymorphism of DIO2 gene is associated 3.75-fold risk of bipolar disorder.

Objectives

High Dose Levothyroxine combined with repetitive transcranial magnetic stimulation (rTMS) in Rapid cycling Bipolar disorder: Is it thyroid disease?

Methods

20 RCBPD with ICD-10criteria for bipolar disorder. All were severely symptomatic. TFTs and ECGs were monitored weekly with cardiology and endocrinology backup. Genetic testing was undertaken for DiO1/DiO2 status.

Results

17 were female, average age 32.4 yrs. 19/20 had Single nucleotide polymorphisms (SNP) of either DIO1, DIO2 or both. All but two patients were treated with rTMS to induce cerebral neuroplasticity. Average pre-treatment fT4 was 17.0 pmol/L , and fT3 4.5 pmol/L Average post-treatment, fT4 was 59.7 pmol/L and fT3 5.3 pmol/L. Average fT4:fT3 ratio pre-treatment was 4:1, and post-treatment was 5:1. HDL range was 200-800 mcg daily for remission. Average dose 472 mcg daily. Discontinuation rate was 0%. All patients had ECG and cardiac review One patient required a dose reduction because of minimal side effects 12 patients needed one mood stabiliser All were in remission for a minimum of 6 months.

Conclusions

We speculate that BPD may be a form of cerebral hypothyroidism and that HDL helps to overcome the deficit while robust inactivating deiodinases in the periphery protect from systemic thyrotoxicosis. This is evidenced by findings of normal clinical examination and elevated rT3. rTMS exercises its well established neuroplastic effect, helping to achieve and maintain remission as an adjunct to HDL.

Disclosure

The London Psychiatry Centre (TLPC) has pending patents for the combined protocol of rTMS and/or Thyroid hormones depending on the territory: - Pending US Patent application: (and/or) US20200384279 - Pending European patent appl
Use of intravenous valproate in acute manic: about a clinical case
Authors: Suárez Gómez M. , Suárez Gómez A. , Rodrigues P. , Sánchez Rus S.S. , Matos-Pires A.
Published: September 2022

Introduction

Acute mania can have behavioral effects such as agitation, being a frequent cause of presentation in the emergency department. Pharmacological treatments include mood stabilizers and atypical antipsychotics. Valproate is an effective drug. However, the intravenous formulation is relegated to other pathologies, such as epilepsy.

Objectives

The objective was to review the use of intravenous valproate in acute mania in the literature and present its use through a clinical case.

Methods

A clinical case using intravenous valproate to treat an episode of acute mania is described and the scientific literature of the last 5 years is reviewed.

Results

A 43-year-old patient attended the emergency department with a diagnosis of bipolar disorder type I in manic episode with agitation, rejection of oral medication, brought in by the police due to risk of aggression against family members, who reported that the patient had stopped taking her usual medication with valproate 500 mg / 24h and quetiapine 200 mg / 24h threemonths ago. Due to the possibility of having intravenous valproate, it was decided to administer 300 mg intravenously, as well as haloperidol 5 mg intravenously, and hospitalization was decided. The patient had a favorable evolution, with no side effects to the medication, and oral treatment was started after 8 hours, with a good response. In the literature there are few studies in this regard, although the most of them approved the use of valproate as a loading dose in acute mania.

Conclusions

Intravenous valproate is an effective, safe, and tolerated treatment in acute mania. More studies are needed to collect precise information.

Disclosure

No significant relationships.
The use of pramipexole in drug-induced parkinsonism: A case study on a patient with bipolar depression
Authors: Bueno Sanya L. , Bermejo Pastor A. , Andreu Gracia H. , De Juan Viladegut O. , Olivier Mayorga L. , Pacchiarotti I.
Published: September 2022

Introduction

Pramipexole is a dopaminergic agonist used in the treatment of Parkinson’s disease and restless leg syndrome. Although there is a lack of pharmacological options to treat drug-induced parkinsonism, not many studies have been made on the use of pramipexole in its management. There is also evidence on pramipexole effectiveness on major depressive episodes, particularly for bipolar and treatment-resistant depression.

Objectives

To describe a case of drug-induced parkinsonism treated with pramipexole in a complex patient with bipolar disorder type I and obsessive-compulsive disorder, long-term treated with antipsychotics and valproate.

Methods

We present the case of a 51-year-old woman admitted in our psychiatric inpatient unit mainly to treat a bipolar depression. She also presented a parkinsonian syndrome, and a neurological study was conducted. As a negative DaTSCAN concluded its cause to be pharmacological, we decided to stop lurasidone and initiated pramipexole.

Results

Guidelines suggest that drug-induced parkinsonism should be managed by discontinuing causative drugs or switching to another agent. However, we decided to use pramipexole with the aim of not only treating the parkinsonian syndrome but helping manage the depressive episode. We observed a remission of the depressive symptoms and an improvement in the parkinsonian symptoms.

Conclusions

Although the best way to treat drug-induced parkinsonism is to avoid its causative agents, in clinical practice it is not always possible as some patients have resistant and complex psychiatric syndromes. We suggest considering pramipexole in its management, especially when dealing with a patient with a comorbid unipolar or bipolar depression. Further research is necessary to clarify its utility.

Disclosure

No significant relationships.
Uric acid levels among Tunisian patients with bipolar disorder during different phases of illness
Authors: Falfel D. , Hamdi G. , Ben Ammar H. , Ridha R.
Published: September 2022

Introduction

Bipolar disorder is a recurrent chronic disorder characterised by fluctuation of mood state. Recent studies focused on the involvement of adenosine and the purinergic system in the pathophysiology of bipolar disorder.

Objectives

We aimed to investigate the difference in (SUA) levels between different phases of relapse and remission period.

Methods

For this aim a prospective study was conducted during six months at Razi psychiatric Hospital in Tunisia with patients diagnosed with BD The socio-demographic, clinical data were gathered from patient and a psychometric assessment using YMRS and Beck scale was employed. Uric acid level was studied during relapse and remission period.

Results

Among 30 consentent patients included in the study : 65.7% were women, The age of the participants varied between 22 and 65 years old. Uric acid level at the relapse varied between 328 and 499 mmol/L and level of controlled value at the remission period which is eight weeks under treatment varied between 137 and 307 mmol/L. Patients under antipsychotic treatment were 55.9% the other were under lithium or mood stabilizer. There is no significant difference between patients with bipolar disorder type I or II neither for the molecule chosen for treatment (p<0.05).

Conclusions

Bipolar disorder is a chronic psychiatric disease which needs to be regulary controlled. Uric acid levels were higher in manic or depressive phases as compared with euthymia phase. Uric acid could be used as a trait marker in bipolar disorder and help psychiatrist to monitor patients and to adjust treatment in order to avoid relapsing.

Disclosure

No significant relationships.
Do people with bipolar disorder have a lack of empathy?
Authors: Mhiri E. , Ben Thabet J. , Feki R. , Gassara I. , Smaoui N. , Zouari L. , Omri S. , Maalej M. , Charfi N. , Maalej M.
Published: September 2022

Introduction

Impairments of empathy have been observed in patients with various psychiatric Disorders. Yet, little research on empathy concerning mood disorders exists.

Objectives

To compare empathy levels in euthymic bipolar patients (BP) and healthy controls (HC).

Methods

A cross-sectional and comparative study of 78 patients followed for bipolar disorder, during euthymia, at the psychiatric outpatient clinic at CHU Hédi Chaker in Sfax, and 78 age-gender matched HC. We used a socio-demographic and clinical data sheet and the Questionnaire of Cognitive And Affective Empathy (QCAE) to assess empathy with its two dimensions : “Affective empathy” and “Cognitive empathy”.

Results

The average age was 36.27 years, the sex ratio was 5.5. Bipolar I disorder was diagnosed in 88.5% of patients. The mean age of onset was 27.73 years, and the mean duration of illness was 8.4 years. Total scores of empathy as well as scores of cognitive and affective empathy were higher in HC than in BP. *Total QCAE BP vs HC : 72.49 vs 80.53 *Cognitive empathy BP vs HC : 43.21 vs 94.24 *Affective empathy BP vs HC : 29.36 vs 30.44 A significant difference in QCAE score and cognitive empathy score between BP and HC was found (p<10-3).

Conclusions

In our study, euthymic BP have been less empathetic than HC. Research on the subject are small and few. Thus, more studies are needed to confirm our results on the effect of mood disorders on empathy.

Disclosure

No significant relationships.
The Power of Technology Addressing Anxiety for a Better Mental Health
Authors: Minier J.-C.
Published: September 2022

As the manager of a business incubator, I’m involved in the European project IT4Anxiety. It focuses on the creation and implementation of innovative solutions designed to reduce the anxiety of patients experiencing neurological disorders or PTSD. The IT4Anxiety project is a collaboration between mental health professionals, users and start-ups, but also universities, research centres and higher education establishments. There is growing evidence that technological solutions can expand and complement conventional medical protocols. Such “blended therapies” are central to the approach being developed through several work packages. In the framework of the IT4Anxiety project, I carry out actions to develop interactions between startups and mental health professionals.In this context, my speech will focus on 3 specific points: - Feedback on the process of testing and validation of innovative tools in hospitals, care homes… We developped a framework for testing and validating tools with patients and start-ups in order to guarantee the effective implementation of these innovative solutions, especially from an ethical point of view. Going before the ethics committee is often a new experience for start-up managers who have to answer complex questions - Feedback on co-creation processes, in particular through the organisation of hackathons bringing together start-ups, users and health professionals.The objective of the hackathons is to bring together stakeholders in the co-creation of innovative solutions and their integration thereafter into the mental health care sector - Examples of innovative tools in mental health developed by startups which have joined the IT4Anxiety project. These tools complement conventional medical protocols

Disclosure

No significant relationships.
Recognition of emotional and expressive movements (gestures) and self-esteem of adolescents with affective disorders
Authors: Zvereva M. , Avdyukhina S.
Published: September 2022

Introduction

Successful adolescence depends on ability to correctly understand emotionally expressive gestures, especially symbolic (same meaning for everyone) and expressive (individual understanding). Presence of an internal mismatch in adolescent’s self-esteem between what he shows in society and what he really feels can lead to difficulties in forming an adequate adult self-esteem.

Objectives

Adolescents with affective disorders (F31) -12, normal adolescents - 32. Ages 12-17.

Methods

Recognition of emotionally expressive movements: postures&gestures (gestures-test), direct self-esteem by Dembo-Rubinstein test and indirect self-esteem by color attitude test by Etkind.

Results

The Mann-Whitney test showed significant differences between samples in terms of self-esteem gap - “mind” (U=270,000, p<0.37), “character” (U=279,000, p<0.20), “happiness” (U=288,000, p<0.01 ), gestures-test “symbolic” (U=301,000, p<0.003), “expressive” (U=292,000, p<0.007), “emotions” (U=109,000, p<0.028). Cluster analysis divided each of groups into two distinct clusters. Normal: Cluster1 small self-esteem gap, good gesture recognition, negative pole of emotions prevails. Cluster2 small self-esteem gap, worse gesture recognition, pole of emotions is closer to positive. Affective: Cluster1 large self-esteem gap in “mind”, good gesture recognition. Cluster2 large self-esteem gap in “character”, good gesture recognition and bright negative pole of emotions.

Conclusions

Gestures recognition in normal group is significantly higher than in affective disorder group. Normal adolescents clusters are distinguished by change in gaps throughout self-esteem and pole of emotional recognition. Affective disorder clusters differ by significant gap in one of self-esteem parameters, as well as in the degree of emotional recognition. Those with the largest “character” gap are more likely to attribute negative emotions to gestures than those with larger “mind” gap.

Disclosure

No significant relationships.
Psychological problems in tunisian children during the covid-19 pandemic
Authors: Guermazi A. , Guermazi F. , Zouari A. , Hentati S. , Baati I. , Masmoudi J.
Published: September 2022

Introduction

The Covid-19 outbreak and the subsequent lockdown have profoundly impacted families’ daily life. Children may be among the most exposed to the psychosocial consequences of the pandemic.

Objectives

To assess the psychological well-being of children during the COVID-19 pandemic.

Methods

This was a descriptive study shared on social media during the period from 8 to 20 April 2021, targeting mothers of children aged 2 to 18 years. The first part included socio-demographic data of mothers and children. Then, to assess the behavior and coping skills of children and adolescents, we administered the Strengths and Difficulties Questionnaire (SDQ).

Results

Our study included 65 middle-aged moms = 35.28 years. Among mothers, 1.5% reported having at least one child with a psychiatric, medical or genetic illness. The average age of the children was 8.54 years, the sex ratio was 1.03 and they were in primary school in 52.3%. Moms had talked to their child about COVID in 93.8%, using scientific data in 69.4% of cases. The total average SDQ score was 10.82; and overall mental health was at risk in 15.4% of the children. They had risky emotional symptoms in 9.2%, risky aggressive behaviors in 12.3%, risky hyperactivity-inattention symptoms in 16.9%, relationship behaviors with at-risk pairs in 24.6%, and risky prosocial behavior in 9.2% of cases.

Conclusions

Researchers and government officials should be more concerned about the mental health of children who are often neglected as a result of the pandemic due to their comparatively lower mortality than older adults.

Disclosure

No significant relationships.
Impact of Cyberbullying on Adolescent Mental Health in the midst of pandemic – Hidden Crisis
Authors: Deol Y. , Lashai M.
Published: September 2022

Introduction

Cyberbullying has become more prevalent with the increased use of social media among younger population. It is more harmful than traditional bullying as it can happen at any time, has a much wider audience, and can invade personal space. YouTube, Instagram and Snapchat are the most popular online platforms among teens. The victims of cyberbullying can present with social anxiety (41%), depression (37%), suicidal thoughts (26%) among many others (self-harm, substance use, etc). In the past year, these numbers have significantly risen due to switch to virtual learning due to the pandemic, hence the risk of exposure to cyberbullying has risen.

Objectives

To study the impact of cyberbullying on Adolescent Mental health

Methods

A review of articles (2016-2021), was done using PubMed and Google scholar focusing on impact of cyberbullying in children and young adults.

Results

John et al group showed that both victims [OR- 2.10 (95% CI 1.73-2.55)] and perpetrators [ OR 1.21 (95% CI 1.02-1.44)] have increased risk of exhibiting suicidal behaviors. Kwan I et al group showed a negative association between cyberbullying and mental health. One study suggested that during the pandemic there has been increased online perpetrators due to increased amount of fear and anger which has projected in the form online aggression.

Conclusions

There is an increase in prevalence of cyberbullying with young population spending more time on internet and social media. Psychoeducation of parents and mental health experts is needed to recognize early warning signs in order to take steps for early intervention.

Disclosure

No significant relationships.
Psychotic episode with onset in childhood and adolescence – Factors which may influence the outcome
Authors: Stoica C.-E. , Iotu A. , Nicolau I. , Nistor C. , Grigore I. , Rad F.
Published: September 2022

Introduction

A psychotic episode might stem from various psychiatric disorders, such as Major Depressive Disorder, Mania, Autism Spectrum Disorder, it might lead to Schizophrenia, or it might be a single event.

Objectives

The study aimed to assess the main comorbidities encountered in the onset of psychotic episodes in children and adolescents, who were hospitalized in a pediatric psychiatry department for at least one night. Furthermore, another objective was to establish whether a family history of mental illness or a poor socio-economic status have bigger impact on the evolution of these patients.

Methods

To analyze the objectives, it was used an observational study, based on patients with the onset of a psychotic episode and associated diagnosis according to ICD-10, evaluated in Child and Adolescent Psychiatric Department of “Prof. Dr. Al. Obregia” Hospital, between 2015-2019. Patients with psychotic episodes with onset related to Major Depressive Disorder and Mania or a personal history of Schizophrenia were excluded.

Results

The most frequent associated comorbidity was Autism Spectrum Disorder. In terms of long-term evolution, patients with comorbidities have poorer outcomes, more relapses and hospitalizations. Family history of mental illness, low socio-economic status, the age of onset were found to be prognostic factors and have an important impact on the outcome.

Conclusions

This study compared patients with psychotic episodes with and without comorbid conditions associated, considering the length of hospitalization period, the evolution and the number of relapses. The presence and the type of comorbidities are important factors of evolution and prognostic for these patients.

Disclosure

No significant relationships.
Russian Adaptation of Questionnaire of Mental Health Treatment Stigma among Adolescents: Preliminary Results
Authors: Khromov A.
Published: September 2022

Introduction

There is a lack of instruments evaluating self-stigma among adolescents with mental health issues in the Russian language for today. The questionnaire developed by Tally Moses (Moses, 2009) is convenient to fill that lack.

Objectives

The study aims to compare the main parameters of the original questionnaire to that of the version translated in Russian.

Methods

The original questionnaire was translated into Russian and administered to 40 adolescents (21 males, aged 12 to 17) with mental disorders except for severe cognitive deficits or pervasive developmental disorders. Means and Cronbach’s alpha for each of the four scales were assessed and compared to the author’s questionnaire values.

Results

Reliability analysis revealed similar Cronbach’s alpha for 3 of 4 scales (table 1) except the Secrecy scale (1 of 6 questions showed low consistency; its exclusion increased α from 0.63 to 0.74).ScalesCronbach’s αM (SD)Original versionTranslated versionOriginal versionTranslated versiont-testSocietal Devaluation.76.762.3 (0.40)2.3 (0.42).501Personal Rejection.78.700.48 (0.39)0.33 (0.29).002Self-Stigma.81.762.0 (0.74)2.2 (0.68).122Secrecy scale.84.632.5 (0.50)2.5 (0.55).594

The means for each scale were compared with original data using a one-sample t-test. Only the Personal Rejection scale was significantly low on average than the original data.

Conclusions

Preliminary results showed that Russian adolescent patients perceived the translated questionnaire much the same way as American ones. Thus, our findings provide optimistical perspectives of further adaptation of the questionnaire.

Disclosure

No significant relationships.