bluuebunny/crossref_metadata_2025 huggingface dataset:
Pandemic COVID 19 and healthcare professionals: Mental health impact and depression
Authors: Ben Soussia R. , Melki R. , Aoun M. H. , Bouali W. , Zarrouk L.
Published: August 2023

Introduction

The SARS-COV2 pandemic represents a problematic and disruption of global health. Repeated exposure to stressful situations leads to increased psychological distress.

Objectives

To determine the psychoaffective impact of the Covid-19 pandemic on the mental health of health professionals in Tunisia, assess the intensity of depressive symptoms professionals and determine factors associated with the development of these symptoms.

Methods

This was a multicenter, cross-sectional, descriptive and analytical study conducted among health professionals, from May 2nd, 2020 to June 30th, 2020 in Tunisia. The health professionals included were physicians, nurses, dentists, and pharmacists. Using an electronic form << Google Form >>, a questionnaire was drawn up with 32 items. Assessment of depressive symptoms was performed using the PHQ-9 psychometric scale.

Statistical analysis was performed using SPSS 21.0 statistical software. Regarding the analytical study, a professional with a PHQ-9 scale score between 10 and 27 was considered as having moderate to severe depressive symptoms while a score between 15-27 was in favor of severe depressive symptoms.

Results

Caregivers were predominantly female 69.5% with a mean age of 30.74 years. Anxiety-depressive psychiatric history was found in 11.8% of the subjects. The majority of the professionals were doctors (77.8%) and 9.4% of the participants were nurses. The majority of participants worked in university hospitals (84.2%). One third of the participants, (34.3%) worked in departments with Covid-19 patients with respective rates of 57% for nurses and 36% for physicians. Dentists and pharmacists did not work in Covid-19 circuits.

The mean score on the PHQ-9 scale was equal to 8.62 ± 5.35. Depressive symptoms were noted in 37.4% of the professionals, with moderate to severe intensity in 35.5% of cases. Participants with a psychiatric history of depression or anxiety disorder had significantly higher depressive symptom scores (p<0.001) with 6 times higher the risk of developing moderate to severe depressive symptoms (p<0.0001, OR 6.25, CI [2.35-16.61] and almost 3 times higher the risk of experiencing severe depressive symptoms (p=0.05, OR=2.93, CI [1.09-7.88]). The nursing profession had high odds ratios for the occurrence of moderate to severe depressive symptoms (p=0.002, OR=4.41, CI [1.58-12.28]) and severe depressive symptoms (p=0.02, OR=3.82, CI [1.28-11.39]). A significant relationship was established, between the development of depressive symptoms of moderate to severe intensity with the history of depressive disorder or anxiety disorder (p=0.001) and the nursing profession (p=0.01).

Conclusions

The optimization of prevention, the creation of specific treatment, the promotion of health education and specific hygiene rules would participate in improving the mental health of health professionals.

Disclosure of Interest

None Declared
First episode psychosis Post-COVID 19 infection : case report
Authors: Dhakouani S. , Kammoun R. , Hamrouni N. , Karoui M. , Ellouze F.
Published: August 2023

Introduction

During the course of COVID-19 pandemic, the respiratory system is the most commonly affected while many neuropsychiatric manifestations of the disease have been observed.

Objectives

Emphasize the importance of detecting psychiatric symptoms in patients infected with Covid 19.

Methods

Presentation of case report

Results

A 44-year-old woman with no personal history of chronic diseases and with no psychiatric family history. About her experience with covid 19, her mother died as a result of covid 19 infection and our patient had been hospitalized for 17 days for pulmonary infection covid 19, during her hospitalization in COVID 19 unit she presented insomnia and anxiety without behavioural disorders. She had a good evolution of the respiratory symptoms and she was discharged under corticotherapy and anticoagulants.

She was admitted in our department after 45 days of her covid 19 infection for acute behavioural disorders.

On physical examination: she was hemodynamically stable and well oriented. Neurological examination was with no abnormalities. Cerebral CT scan was normal and lumbar puncture was indicated and the analysis of the CSF did not reveal any anomalies. At the psychiatric interview she was extremely agitated, anxious and hallucinated, she had disorganised speech with derailment and neologisms, she was disinhibited and her mood was exalted. She presented also a delusion of grandeur and delusion of persecution.

Conclusions

In individuals presenting with COVID-19 infection, consideration should be made for psychiatric manifestations because COVID-19 diagnosis predispose vulnerable patients to psychosis.

Disclosure of Interest

None Declared
Socio-professional stigmatization among healthcare workers with COVID-19
Authors: Fendri M. N. , Brahim D. , Mechergui N. , Youssef I. , Ernez S. , Ben Said H. , Ladhari N.
Published: August 2023

Introduction

The COVID-19 pandemic had deeply altered the social and professional lives of people with SARS-COV2. The anxiety of being contaminated by the virus during the first waves had created avoidance behaviors and established a climate of rejection towards healthcare workers (HW) with COVID.

Objectives

The aim of this study was to assess stigmatization among healthcare workers with COVID-19

Methods

This is a retrospective cross-sectional study carried out on HWs in a university hospital in Tunis who were affected by COVID-19 and who consulted the occupational medicine department. The study was conducted between March 2021 and June 2021. Data collection was based on pre-established forms. The questionnaire assessing stigmatization was inspired by the questionnaire assessing stigma in AIDS patients

Results

The study included 100 health personnel. The sex ratio (M/W) = 0.29. The average age was 39.22 ± 9.3 with extremes ranging from 24 to 58 years. The average professional seniority was 11.39±9.4. Nurses were the most represented professional category (26%). The psychiatric history was: Depressive disorder (14%) and anxiety disorder (10%). Eighty HW were infected with SARS-COV2 for the first time. Contamination was intra-hospital in 50% of cases. Eighteen HW had been rejected. Verbal abuse towards HW with COVID was noted in 8% and physical abuse in 11%. Twenty-six HW had lost their friends and 36 of them no longer had as much social activity as before. In the workplace, rejection was noted in 21% cases, 10 health personnel reported a discriminatory orientation for the care of patients with COVID and 19 HW felt useless at work.

Conclusions

Socio-professional stigmatization should help us to understand the vulnerability and psychological impact of this health crisis on health workers. Control and prevention strategies need to be established.

Disclosure of Interest

None Declared
Neuropsychiatric consequences of Covid 19- CASE REPORT
Authors: Gugleta U. V. , Tošić-Golubović S. , Žikić O. , Slavković V. , Petkovic M.
Published: August 2023

Introduction

SARS-CoV-2 is a virus with a multisystem effect, and it can cause numerous neuropsychiatric disorders, both in the acute phase of infection and in the period after the disease has passed. According to Nalbandian et al. (2021), post-acute COVID-19 syndrome is a condition of persistent symptoms and/or delayed long-term complications caused by SARS-CoV-2 infection lasting longer than four weeks after the onset of symptoms.

Objectives

To indicate the possible role of the SARS-COV 2 virus in the development of long-term neuropsychiatric and cognitive consequences of COVID-19.

Methods

We undertook a search of the available medical literature in the period after 2020 with the keywords COVID 19 and neuropsychiatric complications

Results: Case report: Female patient, 40 years old, unemployed, married, mother of two children. She was admitted for the first hospital treatment at the Psychiatry Clinic of the UCC of Niš due to psychological disturbances in the form of experiencing her own body changes and changes in the environment, moodiness, anxiety, the conviction that she is suffering from incurable diseases, the experience of being centered and existentially threatened, insomnia. In 2020, one month after the recovery from COVID-19, she was treated at the Neurology Clinic of the UCC of Niš for a crisis of consciousness, diagnosis at discharge: encephalitis, encephalopathy. At the end of the treatment, cognitive-mnestic deficits remain. In April 2021, after reinfection with the SARS-COV2 virus, a depressive-interpretive syndrome developed, which is the reason for the current hospitalization. Depersonalization and derealization phenomena, time disorientation, hypochondrial delusions, ideas of self-accusation, cenesthetic hallucinations, impaired volitional-instinctual dynamism and deficits in cognitive-mnestic functioning are observed during hospitalization. NMR of the endocranium with contrast shows changes in the form of encephalomalacia, porencephaly, which indicates a condition after a cerebrovascular insult. She was treated with low doses of haloperidol (2 mg pd), antidementia and vasoactive therapy, which led to a reduction of psychotic symptoms as well as an initial improvement in cognitive-mnestic functioning.

Conclusions

This case report confirms the neurotoxicity of the SARS-CoV-2 virus and it is in accordance with the available literature. The neuropsychiatric and cognitive complications that accompany COVID-19 are different and have a significant impact on the health of people who recovered from COVID-19. It is necessary for the health system to recognize this problem in time and provide organized neuropsychiatric and cognitive monitoring to patients suffering from COVID-19.

Disclosure of Interest

None Declared
A CASE OF MULTIPLE SCLEROSİS PRESENTING AS DEPRESSION IN A YOUNG PERSON
Authors: Sertler I.
Published: August 2023

Introduction

Multiple sclerosis(MS)is a chronic immune-mediated, inflammatory disease of the central nervous system. Depression is one of the most common psychiatric conditions associated with MS. Lifetime prevalence of major depression has been estimated to be around 50%.

Objectives

Although the prevalence of depression in MS patients has been shown by many studies, there has not been a case in the literature demonstrating the onset of MS disease with depressive symptoms. In this article, a case of multiple sclerosis (undiagnosed before) presenting as depression in a young woman is presented and discussed.

Methods

An eighteen years-old female patient visited the emergency room of Erenkoy Mental and Neurological Diseases Hospital with complaints of unhappiness,malaise,anhedonia,introversion,sleepiness,lack of appetite and nausea. She was admitted to another hospital one and a half years ago with similar complaints and duloxetine 30 mg/day treatment was started. The patient, who did not benefit from this treatment, stopped using the drug by herself and did not consult a doctor again. Her complaints regressed over time without treatment.Her current symptoms started four days prior to her visit. She had no other medically diagnosed condition. No pathology was detected in the emergency blood test parameters of the patient.Her brain tomography was normal. The patient, who had periventricular ovoid hyperintense lesions on cranial MRI, was diagnosed with multiple sclerosis and was admitted to the neurology unit of our hospital. The lumbar puncture was performed during the hospitalization, oligoclonal band positivity was detected. The IgG index was found to be increased at CSF (cerebrospinal fluid). She underwent pulse steroid therapy for seven days. The patient was discharged since her symptoms regressed after treatment.

Results

Here we present a case of MS presenting as depression in a young woman. Depression is a very common, and very important comorbidity in multiple sclerosis. The etiology of depression in MS is likely to be multifactorial, and to include biological, psychological, and social determinants. Although the relationship between depression and MS has been clearly demonstrated in all of these studies, there is no case of MS presenting as depression in the literature.

Conclusions

We know that depression may occur as a prodromal symptom in some organic diseases that affect brain such as dementia and Parkinson. In this case, we wanted to emphasize that organic etiological research is necessary for patients who present with psychiatric complaints for the first time, and that psychiatric complaints may be a symptom of organic diseases that may affect the brain.

Disclosure of Interest

None Declared
Therapeutic education program in adults with unipolar depression
Authors: Halouani N. , Regaieg N. , Turki M. , Ellouze S. , Aloulou J.
Published: August 2023

Introduction

Depression is one of the most common chronic illnesses. It requires long-term multidisciplinary care, combining pharmacological and non-pharmacological treatments. Hence the need for an educational approach to improve the quality of life of these patients.

Objectives

Our objective is to create a personalized educational program for patients followed for depression allowing them to acquire the necessary skills to become autonomous in the management of their pathologies on a daily basis.

Methods

The therapeutic education program is aimed at patients followed for depression and their families. Our team is multidisciplinary made up of a psychiatrist, a nurse and a dietitian. The educational tools are rich and varied, including computerized resources, written information, brochures and educational games.

Results

The first step is the educational diagnosis which allows to identify the personalized needs of the patient. The caregiver-educator sets with the patient the objectives to be achieved throughout the course, thus defining the educational contract. Then the patient and his entourage can follow a personalized therapeutic patient education program. We offer a program consisting of 7 sessions at the rate of one session per one to two months (2 individual sessions and 5 group workshops). At the end of the program, evaluation and self-evaluation grids are completed.

Conclusions

Therapeutic patient education provides knowledge through which patients with depression develop personal and interpersonal coping skills. This program will allow them to give an acceptable place to their disease so that they can evolve well with it.

Disclosure of Interest

None Declared
The Influence of Probiotic Supplementation on Depression, Anxiety, and Stress Level, as well as Inflammation, Anthropometric and Metabolic Parameters in Patients with Depressive Disorders - preliminary results of an RCT
Authors: Gawlik-Kotelnicka O. , Skowrońska A. , Margulska A. , Strzelecki D.
Published: August 2023

Introduction

There is a huge need to search for new treatment options for depression but as well as its comorbidities. Particularly, depression and metabolic abnormalities often coexist, while a pathophysiological overlap, including microbiota changes, may play a role. Thus, the trials of microbiota interventions (e.g., probiotics) may establish a safe and easy-to-use treatment option as an adjunctive therapy in patients only partially responsive to pharmacological treatment.

Objectives

The paper presents preliminary results of an RCT on the effect of probiotic supplementation on depression, anxiety and stress level, anthropometric, metabolic, and inflammatory parameters in adult patients with depressive disorders.

Methods

The trial was a two-arm, parallel-group, prospective, randomized, double-blind, controlled design that included 43 participants and lasted 60 days. The probiotic preparation contained Lactobacillus helveticus Rosell®-52 and Bifidobacterium longum Rosell®-175 in the amount of 3 × 109 colony forming units (CFU). We assessed depression level with Montgomery-Asberg Depression Rating Scale (MADRS), depressiveness, anxiety and stress level with 21-item version of Depression, Anxiety and Stress Scale (DASS-21), quality of life, blood pressure, body mass index and waist circumference, complete blood count, serum levels of C-reactive protein, high-density lipoprotein cholesterol, triglycerides, fasting glucose, selected secondary markers of inflammation and metabolic risk, as well as noninvasive biomarkers of liver fibrosis (APRI and FIB-4).

Results

There were no differences in sociodemographic traits and psychometric questionnaires scores, as well as in anthropometric and basic laboratory findings between placebo and probiotic group at the start of the intervention period. Interestingly, there was a statistically significant improvement in MADRS score in both, placebo (p=0,010) and probiotic group (p=0,037) after intervention (see figure). The same finding was observed in total DASS-21 score as well as anxiety subscale of DASS-21. However, there were no differences in anthropometric, inflammation or metabolic laboratory parameters at the end of the study regardless of intervention.

Image:

Conclusions

Whilst probiotics may benefit some individuals who do not fully respond to antidepressant medications, our study did not show the superiority of probiotics over placebo in managing depressive and anxiety symptoms. However, the target clinical sample, as well as the intervention period and dosage of preparation for this intervention is not fully recognized. Moreover, larger clinical sample may be needed to detect differences between placebo and probiotics.

Disclosure of Interest

None Declared
Catatonia in depressive disorder, more usual than it is supposed to be
Authors: Carrillo Molina R. J. , Vilchez Español F. , Caparros del Moral I.
Published: August 2023

Introduction

Catatonia is a psychomotor syndrome characterized by various motor, affective and behavioral symptoms. It can occur as a cause of various underlying organic and psychiatric disorders. In Psychiatric nosology is used to specify a subtype of the disorder underlying.Unlike what was assumed in the past, today it is accepted that catatonia is more frequent in affective disorders than in schizophrenia. But despite this, diagnosis and treatment are still late in affective cases on many occasions.

Objectives

-A case of catatonia is presented to review the diagnostic difficulties that can sometimes entail.-Review treatment algorithm.

Methods

We present the case of a 62-year-old woman, initially diagnosed of major depressive symptoms with psychotic symptoms, showing no response to different treatments, evolving to catatonia, which is diagnosed after screening for neurological and medical diseases.

Results

The patient had an adequate evolution after the withdrawal of antipsychotics and the application of ECT (Electroconvulsive therapy).

Conclusions

- It is important to carry out an adequate screening, because many times the symptoms are caused by medical or neurological diseases.

-Catatonia has a good prognosis with an early treatment, but it may increase the risk of mortality after 5 days from the onset of symptoms.

-It is important to avoid the use of antipsychotics or other dopamine blockers. The use of benzodiazepines and ECT is indicated.

Disclosure of Interest

None Declared
PREVALENCE AND DETERMINANTS OF EATING DISORDER RISK AMONG TUNISIAN UNIVERSITY STUDENTS
Authors: Turki M. , Jemil F. , Mhiri H. E. , Samet A. , Bennaceur F. , Halouani N. , Ellouze S. , Aloulou J.
Published: August 2023

Introduction

The transition to college life can be a stressful period for young adults, and coping strategies can involve changes in eating behaviors.

Objectives

The aim of this study was to assess the prevalence and correlates of eating disorder risk among Tunisian university students.

Methods

We conducted a cross-sectional descriptive and analytical study among 144 university students in Tunisia. Data were collected using an online questionnaire spread throughout social media (Facebook), using the Google Forms® platform.

Attitudes, feelings and behaviors related to eating were measured using “Eating Attitudes Test” (EAT-26) in order to assess the eating disorder risk.

Results

The mean age of our population was 23.38±3.27 years. More females (73.6%) than males (26.4%) participated in the study. Among them, 10.4% were followed for chronic somatic disease while 11.1% suffered from mental illness. Tobacco, alcohol and cannabis use was noted respectively in 12.5%, 3.5% and 3.5% of cases.

The mean score EAT-26 was 20.45. According to this scale, 32,6% of participants were at high risk of eating disorders.

EAT-26 scores were higher in females (21.23) than males (16.95%), without a significant relationship.

Users of psychoactive substances were more likely to present higher EAT-26 scores (p=0.012), especially the use of alcohol (p=0.005) and weed (p=0.024).

EAT-26 scores were significantly higher among students with a prior history of depression.

Conclusions

Our study highlighted a high prevalence of eating disorder risk in university students. Implementation of public health policies are required, and psychological intervention and health awareness programs would effectively prevent the eating disorder risk.

Disclosure of Interest

None Declared
Psychotic symptoms in eating disorders: a case report
Authors: Arroyo Sánchez E. , Setién Preciados P. , Sanz- Giancola A.
Published: August 2023

Introduction

Psychotic symptoms and eating disorders can occur in the same person, sometimes at the same time. This comorbidity is not well studied despite the difficulties of management at both clinical and pharmacological levels that it may entail. We present the case of a 35-year.old female patient with anorexia nervosa with years of evolution, currently admitted to a center specializing in Eating Disorders, who comes to the emergency department with psychotic symptoms.

Objectives

To know the prevalence of comorbidity of psychotic symptoms in people with eating disorders, as well as possible risk factors, severity and management of them.

Methods

Presentation of a case and review of the available literature on the presence of symptoms of the psychotic sphere in persons diagnosed with eating disorders.

Results

The literature reflects data of a prevalence of 10-15% of patients with eating disorders presenting psychotic symptoms. The presence of psychotic symptoms is not directly related to a greater severity of the eating disorder. Some genetic associations have been found, as well as alterations at the physiological, cognitive and brain structure level that coincide in both pathologies. In some cases, an improvement in eating behavior has been observed when the psychotic symptomatology is resolved. In the case of patients with bulimia nervosa, a higher number of psychotic symptomatology has been observed, such as paranoid ideations, which some studies relate to a greater emotional capacity and histrionic expressiveness of this patient profile.

Conclusions

The comorbidity of psychotic symptoms and eating disorders is relatively frequent and makes us face challenges in the diagnosis, as well as in the management of these patients. This comorbidity is especially important in patients with bulimia nervosa. Future research is necessary to know a more exact management of these pathologies.

Disclosure of Interest

None Declared
Evaluation of therapeutic compliance in psychiatry
Authors: Abrebak H. , Chamsi F. Z. , Essafi A. , Radi S. , Taqui A. , El Ammouri A.
Published: August 2023

Introduction

Therapeutic non-adherence is a problem frequently encountered in patients suffering from psychotic disorders. It has consequences on the quality of life and on the prognosis of the evolution of the disease. It is essential to understand the causes in order to best support the patient towards adherence to care.

Objectives

The objective of the study is to evaluate the therapeutic observance of patients hospitalized in the women’s department of the psychiatric hospital and to collect the reasons for therapeutic non-observance, as well as to identify the desired themes for the implementation group therapeutic education workshops.

Methods

It is a monocentric and prospective study, carried out in the women’s department through individual interviews on day 7 +/- 2 of the admission of patients to the psychiatric hospital of Tangier. The inclusion criteria are:

-

the patient’s consent,

-

the autonomous taking of a treatment before admission,

-

sufficient communication skills

The psychometric tool used during this study is the MARS scale (Medication Adherence Report Scale) which allows the patient to assess his compliance, by answering 10 questions, assigning himself a score between 0 and 10 with a good compliance from 8/10. The discussion following the questionnaire makes it possible to identify the reason(s) for non-compliance and the themes to be addressed to improve compliance.

Results

Our first initial results were calculated from 60 patients admitted to hospital. Among them, 35 met the criteria for inclusion in the study. The interview takes place within an average of 8.0 ± 2.3 days. The average age is 40 ± 15 years. Patients present with schizophrenia in 80% of cases, bipolarity (8%) or borderline personality disorder (3%). Nine percent of patients have no diagnosis. Patients take an average of 2.5 drugs [1; 5] before hospitalization. The average MARS score is 5.6 ± 2.6. The reasons for non-adherence identified by patients are:

-

The presence of side effects,

-

Lack of means

-

Feeling of healing

-

The weariness of a long treatment

-

Inefficiency,

-

fear of interactions in case of toxic consumption

-

five patients declared observing and did not identify any reason for non-compliance

Conclusions

Our study has made it possible to better understand the difficulties and support needs of patients to improve their adherence to care. As a follow-up to this work, a multidisciplinary discussion will allow the setting up of group therapeutic education workshops around the identified themes.

Disclosure of Interest

None Declared
International collaboration and networking in academic medicine through social media
Authors: Pereira-Sanchez V.
Published: August 2023

Dr. Pereira-Sanchez will draw upon his experience of use of various major social media platforms for professional networking and collaboration in international psychiatry and global mental health. These platforms offer opportunities to connect with colleagues worldwide individually and in groups and open avenues for peer support, research and advocacy. Specific examples the speaker will bring from his own experience include the World Network of Psychiatric Trainees and the Global Mental Health Think Tank, both of which gather hundreds of colleagues across continents.

Disclosure of Interest

None Declared
Beliefs about self-care by pregnant women belonging to a population group in Monteria, Córdoba, Colombia.
Authors: Ruiz Gonzalez E. P. , Velez Carvajal J. D. , Guzmán Bejarano D. A. , Malluk Marenco A. L. , Agudelo Jiménez J.
Published: August 2023

Introduction

Scientific disciplines recognize that pregnancy not only refers to the biological dimension. It also constitutes a social category, since sociocultural matrices have implications on what is conceived as the state of gestation (Noguera & Rodríguez, 2008). In this sense, cultures develop protocols to guide the actions of pregnant women and their loved ones regarding self-care during pregnancy in order to contribute to the well-being of mother and child (Carmona, Hurtado and Marín 2007). In this context, the belief category becomes relevant as a form of understanding the ways in which we appropriate reality and intervene it (Peirce, 1903).

Objectives

To analyze the beliefs that a group of pregnant women belonging to a population group from Montería (Córdoba, Colombia) have about taking care of themselves.

Methods

Approach: qualitative. The sample was defined by saturation, for a total of 15 pregnant women affiliated to the Mocarí Hospital in the city of Montería, Córdoba. Instrument: semi-structured open interview; content analysis technique through AtlasTi. Emerging categories: a) care during pregnancy; b) relationships with others.

Results

Main belief: Pregnant women need to take care of themselves physically and psychologically, for which it is necessary to have parents, siblings and partner’s support. Care is based on healthy nutrition, physical activity and mental health prevention. It is assumed that self-care is important for the well-being of mother and child. The importance of the family support networks’ participation is also recognized.

Image:

Conclusions

According to the approaches stated/developed by Peirce (1903), beliefs have implications on the way we behave and intervene in reality. Mental habits function as a link between belief and concrete action. For this research, the beliefs that arise from the sociocultural matrices of the pregnant women are evidenced in their concrete actions.

Disclosure of Interest

None Declared
MULTIDISCIPLINARY COLLABORATION AS A IMPROVEMENT IN PROVIDING QUALITY USER-ORIENTED SERVICES
Authors: Racetovic G. , Latinovic M. , Grujic-Timarac S.
Published: August 2023

Introduction

As one of main aim of broad mental health (MH) reform in Bosnia and Herzegovina (BH), quality of services and continuous improvement are priorities. In last decade network of community services-community mental health centers (CMHC) covered all the parts of the country and is connected with secondary and tertiary medical institutions as well as with broad network of centers for social welfare and growing number of user organizations.

Objectives

As a novel practice that will be involved in standards of quality for all MH services is joint planning of hospital discharge people with mental illnesses, supported by legislative and connected with other positive results of mental health reform in BH

Methods

Review of implementation of results of MH reform in BH with focus on joint planning hospital discharge.

Results

In BH in last decade has been established broad spectrum of services that improved quality of care through multidisciplinary collaboration between sectors. Important role has given to users’ organization. Quality standards are defined trough certification and accreditation. New services were developed or renewed and implemented (such as case management, occupational therapy). Entities’ policies and strategies involved new services and improved MH legislative following the course of more involvement of patients as well as their families, representatives or persons of their trust in decision making and planning of multidisciplinary treatments in the CMHCs. Joint Planning of discharge from the hospital fund as important step in further improvement of quality of care for people with MH disorders, especially for those with severe mental illnesses.

Conclusions

Last decade in BH gave important results in the better quality of MH care. Further plans will be focused on implementation of new MH user-oriented services.

Disclosure of Interest

None Declared
Brief intervervention for a metabolic syndrome in psychiatric outpatients with severe/persistent mental illness: A prospective study
Authors: Escarti M. , Alonso C. , Fernandez L. , Ribera O. , Beato A. , Cozar R. , Selva G.
Published: August 2023

Introduction

Metabolic syndrome and other cardiovascular risk factors are highly prevalent in people with mental severe illness (Sun & Jang, 2020).Metabolic disorders in people with schizophrenia increase their risk of developing cardiovascular disease, consequently reducing their life expectancy by approximately 10 to 25 years (Heald et al., 2017)In part these cardio-metabolic risk factors are attributable to unhealthy lifestyle, including poor diet and sedentary behaviour.Lifestyle interventions (diet, increased physical activity) are the first-line treatments to decrease that risk.

Objectives

Our objective is to carry out a prospective study on the application of a program of healthy habits in outpatients unit

Methods

Patients with mental severe illness were recruited at a mental health center in the Hospital Clinic of Valencia. Inclusion criteria: age from 18 to 65 years and diagnosis of severe/persistent mental illness Exclusion criteria: acute illness, were not understanding Spanish, not be able to read and understand questionnaries. We included following data: sociodemographic data and aspects of the health behaviors, anthropometric measurements and analytical with hemogram and biochemistry pre and post-intervention. All subjects gave informed consent for participation in the study.

Results

We included 12 patients, but only 9 completed the full program. Average baseline data suggests that participants were at increased health risk when entering the program.At the end of the program, differences were observed: a reduction in glucose profile, a reduction of an average of 3.33 kg from the initial weight and a reduction of 10 points in blood pressure.

Conclusions

This real world pilot trial evaluate of a health promotion intervention targeting physical activity and healthy eating in mental health care using a specific programme.

Disclosure of Interest

None Declared
Mental health evaluation in senior year medical students
Authors: Ghrab M. A. , Sellami I. , Haddar A. , Hajjaji M. , Jmal Hammami K. , Masmoudi M. L.
Published: August 2023

Introduction

Medical studies are known for being difficult and hard. They require a lot of dedication and hard work from students. This takes a toll on their mental health over the years.

Objectives

Detect signs of anxiety, depression, and stress levels in 5th-year medical students.

Methods

This study was cross-sectional through a self-administered pre-established questionnaire for medical students during September and October 2022. We used the General Anxiety Disorder-7 (GAD-7) questionnaire, the Patient Health Questionnaire-9 (PHQ-9) and the Perceived Stress Scale-10 (PSS-10). The satisfaction level with the choice of the medical field as a career was assessed on a scale ranging from 1 to 10.

Results

Our population consisted of 54 5th-year medical students. The average age was 22.94±0.78 and 64.8% were female. All our population were singles. Active smokers represented 9.3% and alcohol consumption was reported by 9.3% of the participants. More than half of the population (51.9%) had a regular leisure activity. Most of the students had no medical history (72.2%) or psychiatric history (94.4%). The mean satisfaction level from choosing the medical field was 7.43±1.84. The mean GAD-7 and PHQ-9 scores were respectively 3.50±3.80 and 4.70±4.42. The PSS-10 score had a mean of 14.07±5.29. Five students (7.4%) presented self-harm thoughts. Students who were less satisfied with their choice of the medical field as a career had significantly higher scores of PHQ-9 (p<0.001), GAD-7 (p=0.004) and PSS-10 (p=.042).

Conclusions

Medical studies are the first step for these young doctors in their professional careers, which presents further psychological stressors. More attention towards the mental health of this population is needed to properly prepare them for their future.

Disclosure of Interest

None Declared
Tobacco and mental health- Deciphering the vulnerability to nicotine in patients with schizophrenia as a function of their dopamine neurotransmission genes: a clinical and preclinical study
Authors: Mallet J. , Gorgievski V. , Ramoz N. , Tzavara E. , Dubertret C.
Published: August 2023

Introduction

Schizophrenia (SZ) is a severe and frequent mental disorder that has multifactorial origins (genetic but also environmental vulnerability, gene environment interactions). Our team has shown that in France smoking is common among these patients and often begins before the onset of symptoms. This calls into question the hypothesis of self-medication of psychotic symptoms and cognitive disorders by tobacco consumption, and raises the question of specific interactions between nicotine consumption and the genes of the dopaminergic and cholinergic nicotinic systems, in particular with regard to adolescence, period of neurodevelopmental vulnerability.

Objectives

to study (i) the interactions between the DA system and exogenous nicotine in a pre-clinical mouse model (transgenic for DAT) (ii) the impact of smoking on the psychotic and clinical phenotype in a national cohort of SZ patients (iii) interactions between tobacco consumption and several genetic polymorphisms of the dopaminergic and nicotinic system in SZ population. Hypothesis: Disruption of the balance between DA and nicotine systems by nicotine consumption in adolescence may be a key neurobiological mechanism for the emergence of SZ disorders.

Methods

The characterization of the model is behavioral (anxiety, memory, social interactions, locomotion, motor coordination) but also biochemical. For the clinical approach, we exploit the clinical / cognitive / genetic data of a national cohort (Fondamental foundation) and another smaller and local cohort.

Results

We demonstrate, for the clinical study, that some clinical and cognitive characteristics are associated with tobacco use in schizophrenia patients, with more cognitive distubrances in smokers, against the self medication hypothesis. Genes envionment interactions also demonstrate associations with genes involved in dopaminergic system. Regarding the preclinical study, we show a gene environment interaction, as heterozygote mice for the DAT gene exposed to Nicotine durig a critical neurodevelopmental window ( adolescence) show a loss of familiarity in the social memory test and a loss of cognitive flexibility at the set shifting test, similar to what is found in schizophrenia.

Conclusions

TBetter characterization of patients with schizophrenia is necessary to better understand the physiopathology of this disease and explore new personalized preventive and therapeutical targets. We show that tobacco is associated with cognitive disturbances in schizophrenia patients, against selfmedication hypothesis; and in our animal model, that nicotine exposition during the adolescence combined to a moderate cortical and limbic hyperdopaminergia, is associated with persistent cognitive and social deficits, in favor of a gene environment interaction.

Disclosure of Interest

None Declared
Cyst of Septum Pellucidum in mental disorders: Schizophrenia and Mental Retardation: Two case reports
Authors: Belak M.
Published: August 2023

Introduction

A septum pellucidum cyst is defined as a fluid collection between the lateral ventricles whose walls have a lateral curvature and are separated by 10 mm or more . Most of these cysts are benign and their clinical significance should be considered as a neurodevelopmental anomaly that may contribute to neuropsychiatric abnormalities . It is often of incidental finding, of little clinical significance. However, an association between this developmental anomaly and a mental disorder, such as schizophrenia and/or intellectual disability, has been reported

Objectives

The objective of this study is to discuss the relationship between the septum pellucidum cyst and mental disorders, especially schizophrenia and intellectual disability.

Methods

We report in this study two clinical cases, diagnosed with schizophrenia comorbid with intellectual disability and in whom brain imaging has objectified a cyst of the septum pellucidum

Results

multiple cases reports of patients with Schizophrenia and/or mental retardation revealed, on brain imaging, significant abnormalities in midline brain regions such as Septum Pellucidum. It is suggested that CSP, particularly if large, should be considered a developmental anomaly that may contribute to neuropsychiatric abnormalities.

Conclusions

Whether the CSP may serve as a risk factor for psychosis or is only a reflection of neuroanatomical changes in individuals with chronic psychotic disorders remains ambiguous. More studies and case reports will be needed to establish the veritable association of CSP and neuropsychiatric disorders in the future, and perhaps to acknowledge the CSP as an early marker and predictor of psychosis.

Disclosure of Interest

None Declared
Assessment of psychosocial risks in Electricity and Gaz Company
Authors: Hrairi A. , Kammoun N. , Rmadi N. , Masmoudi R. , Jmal Hammami K. , Masmoudi M. L. , Masmoudi J. , Hajjaji M.
Published: August 2023

Introduction

Risk evaluation is a global process covering different aspects of employee’s workandfamily life. Nowadays, psychosocial risks are as important as physical and chemical risks, and their identification isdeterminant in each workplace.

Objectives

Our study aimed to assess psychosocial risks among Electricity and Gas Company’s employees and to identify factors related to these risks.

Methods

A cross sectional study was conducted among male workers in a Tunisian electricity and gas Company. The KRASEK scale was used to assess psychosocial risks. The Statistical analysis was performed with SPSS version 23.

Results

Among male workers in the company, 83 employees participated in this study. The mean age of our population was 41.28 years± 12.12 years. Manuel labour was identified in 67.5% of cases. High psychological demands were reported by 63.9% of the employees. The assessment of decision latitude dimension identified low autonomy at work in 54.2% of cases. The mean social support scale was 23.73± 4.18. Job strain was identified among 32.5% of participants. Among employees in job strain, twenty-one subjects (77.8%) were affected in the technical division and 21.7% were in “iso strain”. Job strain and iso strain were associated with sedentary workers aged less than 45 years, p values were 0.006 (OR= 5.474; IC 95% [1.477-20.290]) and 0.010 (OR= 4.917; IC 95% [1.353-17.872]) respectively. However, Iso strain was negatively associated with being married (p=0.038) (0.0327 IC 95% [0.111-0.964]).

Conclusions

This study highlighted the importance of psychosocial risks in this company. The identification of these risks in the workplace may further help preventers to recommend proper interventions to offer employees a supportive work environment and to enhance their personal and professional well-being.

Disclosure of Interest

None Declared
ANXIETY AND DEPRESSION IN TUNISIAN PATIENTS WITH PARKINSON’S DISEASE
Authors: Kolsi S. , Fakhfakh E. , Messedi N. , Chaari I. , Charfeddine F. , Aribi L. , Farhat N. , Mhiri C. , Aloulou J.
Published: August 2023

Introduction

Anxiodepressive disorders in Parkinson’s disease (PD) are quite frequent and considered as non-motor signs of the disease. Few studies have studied the link between these entities.

Objectives

The objective of this study is to determinate the prevalence of anxiety and depression in patients with PD, and factors associated with them

Methods

A descriptive and analytical cross-sectional study collected from patients followed at the neurology consultation of Habib Bourguiba’s university Hospital in Sfax, Tunisia. We used:

-

a sociodemographic, clinical and therapeutic data sheet

-

Hospital Anxiety and Depression Scale(HADS): to study anxiety and depression. A score ≥10 means a certain anxiety or depression

Results

We have involved 47 patients. The average age was 61.47 years with a sex ratio (M/W)=1,47. Amantadine was received by 12.77% of patients, anticholinergics by 14.9% of patients and 87.24% of patients were treated with Levodopa.

HADS: the average scale of Depression was8.62 ± 4.54 and the median scaleanxiety was 7 [1-18]. Depression and anxiety were presentin 38.29% and 27.68% of cases, respectively. Depression was significantly correlated with Amantadine intake (P=0.036) and Levodopa dose (P=0.016). Anxiety was significantly associated with anticholinergic intake(P=0.011).Both depression and anxiety were notstatistically correlated to the presence ofmotor complications of dopa therapy (P= 0.44 and 0.7 respectively)

Conclusions

The therapeutic management of patients with PD influences the occurrence of anxiety and depression, which proves the importance of early detection of these disordersto ensure better support

Disclosure of Interest

None Declared
Narcissistic Perfectionism does not lead to an increased perception of Academic Efficacy
Authors: Brito M. J. , Seco C. , Pereira A. T. , Macedo A.
Published: August 2023

Introduction

The relationship between narcissism and burnout has been explored in the literature with somewhat inconsistent findings. Though most studies have found a positive correlation between Narcissism and Burnout, some have failed to establish a significant link between the two, while others have even reported a protective role of narcissism against burnout.

In our previous work regarding the link between perfectionism and student burnout, we found that when using the Big Three model of Perfectionism, Narcissistic Perfectionism had only a weak connection to burnout, requiring full mediation by low-self compassion.

We hypothesized that this might be due to an exaggerated sense of Academic Efficacy in Narcissistic Perfectionists, which would compensate for some of the emotional exhaustion and depersonalization brought upon by their efforts to gain the admiration of others.

Objectives

To investigate the link between Narcissistic Perfectionism and Academic Efficacy, and its impact on burnout levels.

Methods

A sample of 1080 students from healthcare-related courses (80,7% females; mean age=21.13±3.023; range: 17-41) filled in an online questionnaire including, among others, the Portuguese Version of BIG3-SF and MBI-SS. Correlational analysis was performed.

Results

Contrary to our initial theory, Narcissistic Perfectionism did not significantly correlate with Academic Efficacy (r=0.011, p=0.728), although it had significant correlations with the other burnout dimensions and total burnout score.

Conclusions

This work disproved our initial hypothesis, suggesting that narcissistic perfectionism may be associated with other nefarious dimensions that cancel out the effects of grandiosity and inflated self-esteem on the perception of academic efficacy. This negative finding could possibly be further explored by using a psychometric instrument that differentiates between maladaptive and adaptive facets of narcissism.

Disclosure of Interest

None Declared