bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of the occupational therapist in treatment of patients with prescription medicine dependence
Authors: Iskendri D. , Šťastná L.
Published: August 2024

Introduction

The abuse of prescription drugs (especially sedatives, hypnotics and opioid analgesics) is a serious and increasingly common phenomenon occurring across addiction clinics. Medications are prescribed for the treatment of chronic pain, sleep difficulties or as mood stabilisers in response to the rush of time and demands of performance. The onset of addiction is often protracted and subtle, but has a major impact on the quality of life and the health, economic or social status of the user. Patients may experience, among other things, cognitive impairment, fatigue, sleep disturbances, irritability, loss of motivation, headaches or impaired coordination of movements. This study is focused on cognitive impairment due to prescription drug dependence and how this impairment affects patients in everyday life.

Objectives

This poster aims to introduce the audience to the possibilities of occupational therapy intervention in the context of addiction medicine.

Methods

Data will be taken using standardized tests and questionnaires dealing with cognitive function. It will be conducted upon the patient’s admission to addiction treatment and again after six months of cognitive rehabilitation following the initial survey. Data are collected at the General University Hospital in Prague, Department of Addictology, Prague, Czech Republic.

Results

Data are being collected.

Conclusions

The case study manifests multidisciplinary approach in care of patients addicted of prescription medicine. The aim is a comprehensive view of all aspects of the patient’s life affected by prescription drug abuse with cognitive impairment.

Grant affiliation: This paper was made possible by the institutional support programme Cooperatio, research area Health Sciences and Grant No. 260632 within the Specific Academic Research.

Disclosure of Interest

None Declared
Different facets of addiction from a systemic perspective: a case report
Authors: Osiak A. , Altunoez U. , Anthoff M. , Rietig G. , Bald M. , Akbas S. , Graef-Calliess I. T.
Published: August 2024

Introduction

Many individuals who suffer from one or multiple substance use disorders often also struggle with another co-morbid psychiatric condition, primarily anxiety disorders. As substance dependency develops, the loss of self-control becomes a pivotal issue, leading to challenges in self-esteem and self-respect. These challenges subsequently give rise to problems in interpersonal communication and close relationships. In addition to the biological model of substance use problems and highly manualized approaches, it is crucial to have a systemic understanding of the patient’s situation and appropriate treatment settings. This understanding allows for the proper consideration of individual differences and requirements, ultimately enabling better treatment and prevention strategies.

Objectives

Our aim is to present a comprehensive case that shows various facets of addiction and introduce a systemic therapy concept of an integrative/systemic day clinic from Germany.

Methods

Through a detailed case presentation, we will introduce a systemic-psychotherapeutic day-clinic concept from a psychiatric training hospital in Wunstorf, Germany.

Results

Case: In the case of a 48-year-old female patient initially diagnosed with recurrent depressive disorder, it was later revealed that she also deals with alcohol addiction and its interconnectedness with sex addiction. Shame and a lack of self-esteem in relationships played a central role in her journey. She does not perceive herself to be loved but to be harmed, which led to many violent sexual acts that increased her feelings of shame. Systemic therapeutic approaches like family constellations were applied, helping her to experience her child-ego states. This profound insight propelled her willingness to change. She began prioritizing self-care, learning to like, accept, and eventually love herself. Aromatherapy aided in calming and maintaining focus. The patient learned to redefine her emotions, aligning them with reality, thereby enabling the adaptive fulfillment of her needs.

Conclusions

Our interdisciplinary team at the day clinic employs therapeutic approaches like dynamic, cognitive-behavioral, and systemic therapy to thoroughly understand the patients and their conditions. This case underscores the significance of an individually tailored treatment drawing from diverse therapeutic concepts, especially in patients with addiction. The combination of different therapeutic approaches facilitates a profound engagement with the patient, potentially resulting in more intensive therapeutic work and a higher rate of success which should be evaluated in future studies.

Disclosure of Interest

None Declared
Addiction to budda blues : About 2 clinical cases
Authors: Belabbes I.
Published: August 2024

Introduction

Buddha Blue, or PTC for “Pète Ton Crâne”, is a synthetic drug particularly popular with young people. It is sold as a liquid to be inhaled in electronic cigarettes.

Objectives

To discuss the clinical manifestations and psychopathology associated with PTC.

Methods

We shed light on PTC addiction through clinical vignettes of patients who were hospitalized in pediatrics at the Gonesse hospital.

Results

We received two male patients with manifestations of PTC intoxication or withdrawal. One of the patients presented with an acute delirious flush requiring long-term treatment, while the second presented with somatic manifestations of pain and vomiting, as well as psychiatric manifestations such as hallucinations, without meeting the criteria for a psychiatric disorder. Both cases required addictological follow-up and child psychiatric therapy.

Conclusions

PTC addiction can lead to life-threatening complications, hence the importance of prevention and screening in order to institute early and effective treatment.

Disclosure of Interest

None Declared
Alcohol and tobacco dependence among medical practitioners
Authors: Belkahla A. , Brahim D. , Yaich I. , Ben Said C. , Ghenim A. , Mersni M. , Ben Said H. , Mechergui N. , Youssef I. , Bahri G. , Bram N. , Ladhari N.
Published: August 2024

Introduction

Excessive use of tobacco, alcohol and other illicit drugs has a negative impact on the physical and mental health and work capacity of users. Physicians are no exception to these dreadful practices.

Objectives

To assess tobacco and alcohol use among medical staff and the factors associated with these uses.

Methods

Descriptive cross-sectional study of physicians practicing in different Tunisian hospitals. The levels of tobacco and alcohol dependence were assessed by the Fangeström and AUDIT tests. Anxiety and depression disorders were screened by the hospital anxiety and depression scale (HAD)

Results

A total of 45 physicians participated in our study. The average professional seniority was 3.36 ± 3.5 years. The mean age was 32.11 ± 6.08 years with a sex ratio (M/F) of 0.32. The participants were medical residents in 64% of the cases. The frequency of smoking was estimated at 24%. The level of smoking dependence was high in 9% of cases. Men were more addicted to nicotine than women (p=0.014). Alcohol consumption was 18%, made up of 62% of women; with a strong dependence rate in 25% of users. Definite anxiety disorders were found in 7% of cases and definite depressive disorders were present in 13% of cases. No correlation between medical specialty, grade, anxiety disorders and level of dependence was observed.

Conclusions

Doctors seem to be particularly affected by addictive behaviours and psycho-emotional disorders which could sustain these practices. Awareness-raising sessions and special monitoring must be introduced to combat these scourges.

Disclosure of Interest

None Declared
Prevalence and determinants of internet addiction among children with depression: A study in a school setting in Tunisia
Authors: Mayssa K. , Imen H. , Ali K. , Jaweher B. , Donia B. T. , Hela A. , Khaoula K. , Yousr M.
Published: August 2024

Introduction

Child depression is a public health problem. Its association with internet addiction (IA) could increase the frequency of complications and have a significant impact on the child’s psychological well-being, schooling, family and social life.

Objectives

To study the clinical profile and associated factors of IA in a population of primary school children with depressive disorders.

Methods

This was a descriptive and analytical cross-sectional study of 182 children with depression attending four primary schools in the government of Sfax. The study took place from 1 March 2022 to 30 June 2022. In the present study, we administered the following psychometric scales: Internet Addiction Test (IAT), Revised Children’s Anxiety and Depression Scale (RCADS- 47), Birleson Depression Scale Questionnaire and the Rosenberg Self-Esteem Scale.

Results

The mean age of the children studied was 9.9 ±1.17 years and the sex ratio was 0.8. Mean score of Internet Addiction Test was 40 ±4,46. In addition, Internet addiction was identified in 73.6% of students with depression (N=143). Following a univariate analysis, internet addiction among depressed Childrens was positively correlated to individual factors such as the absence of leisure activity, the number of hours per day spent on the internet (1.63 VS 3.25, P < 0.001) and interest in accessing Tiktok (p=0.002). Internet addiction in depressed children also depended on family factors. Internet addiction was more common among childrens with a medium to high family socio-economic level (P < 0.001) in cases where parent-child communication was deemed unsatisfactory (P = 0.002) and in cases of verbal violence (P < 0.001). We were also able to establish a significant link between internet addiction among depressed pupils and significant symptoms of anxiety (P=0.019) and low self-esteem (P<0.001). Multivariate analysis using binary logistic regression revealed that medium to high socio-economic level, unsatisfactory parent-child communication, absence of leisure activities and significant symptoms of social phobia were independent predictors of Internet addiction in children with depression.

Conclusions

Our study highlighted the high frequency of IA in children with depression and demonstrated the implication of certain variables such as medium to high socio-economic status, disruption of the family environment, anxiety and low self-esteem. The identification of these different factors would make it possible to identify a group at risk of IA. This raises the case for introducing prevention and awareness-raising campaigns on IA among depressed children, targeting these groups and targeting health professionals and parents.

Disclosure of Interest

None Declared
Addiction and pregnancy: case report on gender perspective.
Authors: Bueno Sanya L. , De Juan Viladegut O. , Olivier Mayorga L. , Andreu Gracia H. , Barrio Giménez P.
Published: August 2024

Introduction

In recent years, interest has grown in understanding the particularities of addiction in women. One of these singularities, with an important impact on public health, is pregnancy. Substance use during pregnancy has increased in recent decades. Given that addiction is mainly a chronic disease of the brain circuits of reward, motivation and memory, an event such as pregnancy does not exempt people who suffer from substance use disorder (SUD) from the difficulties of achieving abstinence. Moreover, as addiction often involves cycles of relapse and remission, pregnant women can also suffer a relapse even if they previously had achieved abstinence. On the other hand, given that addiction is a disease with a significant social component, we can find patients in precarious economic and social situations who suffer unwanted and therefore unplanned pregnancies.

Objectives

To describe the case of a pregnant woman with SUD for multiple drugs who is admitted to the inpatient ward of the Hospital Clínic of Barcelona for detoxification. Also to reflect, taking in to account gender perspective, on the particularities of substance use in women on childbearing age.

Methods

We present the case of a 25-year-old woman, six weeks pregnant and homeless, who was admitted to the inpatient ward for presumed psychotic symptoms. Even if the patient had a history of intravenous heroin, cocaine, and methamphetamine use, during the admission she only admitted current alcohol consumption (3 UBE/day). During admission, the patient decided to undergo a legal voluntary abortion. Regarding this case, we did a literature review on the consequences of different substances use to pregnancy (to both the fetus and the mother’s health). Likewise, we reflected on interventions that could be carried out in community mental health facilities to detect cases like the one exposed and provide help.

Results

Poor obstetric outcomes are six times higher in patients who use substances. Newborns can have withdrawal syndrome, spontaneous abortion, pre-term birth, fetal malformations and fetal growth restriction. More than 50% of women of reproductive age use drugs, mainly alcohol. Routine screening and education of women of reproductive age is the best way to reduce substance use during pregnancy.

Conclusions

We consider it essential for a better management of these patients to remember that the evidence suggests that the decisions that addicts make are mainly driven by a pathology, not by a moral failure. However, pregnancy can be a moment of greater motivation to stop using drugs, given that it is a high risk situation for the mother and the fetus.

Disclosure of Interest

None Declared
Liquor for breakfast, fighting against alcohol consumption
Authors: Navarro Barriga N. , Marqués Cabezas P. , Arribas Simón M. B. , Rodríguez Rodríguez B. , Alario Ruiz C. , Guerra Valera G. , Aparicio Parras A. , Mateos Sexmero M. J. , Fernández Lozano M. , Martínez Gimeno P. , Andreo Vidal M. A. , Calvo Valcárcel M. , Pando Fernández M. P. , Guillén Soto M. D. L. A. , Jimenez Aparicio T. , Vallecillo Adame M. D. C. , De Andrés Lobo C.
Published: August 2024

Introduction

The harmful consumption of alcohol is known for how tortuous its management can be in mental health, encouraging introspection of it as a serious problem is perhaps the main key to starting to battle against its damaging influence on the development of a functional and full life.

Objectives

To describe a clinical case showing an unpredictible complication in an alcohol detoxification process.

Methods

54-year-old man, native of Cádiz, widowed for half a decade, without children. He resides with his parents in the family home. Currently unemployed for approximately a year. He has previously worked in the IT sector. As a notable somatic history, we found long-established arterial hypertension and a total hip replacement. He has been under irregular follow-up with a mental health team for anxiety-depressive symptoms in the context of grief. He goes to the emergency service brought by his family to begin the detoxification process in the hospital setting. He acknowledges ethanol consumption since he was widowed, which began when he awakes; quantities that ranged between one or up to three bottles of distilled liquor per day, generally consumption is in the home environment. A little less than a year ago, he began to isolate himself in his room and abandon his self-care, eating increasingly insufficient food intake, refusing to receive professional care to quit the habit, mainly because he did not recognize it as disruptive.

The patient was admitted to hospital with symptoms suggestive of withdrawal, making it extremely difficult to control blood pressure levels. On the third day of admission to the acute care unit, fever peaks, blood pressure levels well below normal parameters, and compromised level of consciousness began to be evident.

Results

Blood tests were performed that, together with the clinical picture, suggested imminent septic shock, so critical care was contacted for transfer and stabilization. A germ of probable urinary etiology sensitive to a broad spectrum of antibiotics was isolated in blood cultures, and the medication of the detoxification process was progressively optimized. Once clinical stability was achieved at all levels, an inpatient cessation resource was managed, which the patient accepted and considered suitable for his complete recovery.

Conclusions

A holistic approach to the alcoholic patient is important, since serious problems of an organic nature often arise. This is why a multidisciplinary intervention is necessary, as well as a holistic approach to care, involving both classic pharmacology and assiduous long-term psychotherapeutic intervention.

Disclosure of Interest

None Declared
Correlations between Clinic Preferences and Alcohol Use Disorder: an Alcohol Cohort Study in Northern Taiwan in 2022
Authors: Su W.-Y. , Wang S.-C. , Yeh S.-Y.
Published: August 2024

Introduction

Chronic alcoholism can result in severe liver conditions such as fatty liver disease and cirrhosis, potentially leading to life-threatening complications and premature death.

Objectives

This study investigated the age-sex distribution of patients with alcohol addiction and aimed to identify differences in clinic department preferences based on their principal and additional diagnoses in Taiwan, in 2022.

Methods

We conducted a comprehensive analysis of the diagnostic patterns of 334 patients with alcohol addiction from the Taoyuan General Hospital, Ministry of Health and Welfare.

Results

Figure 1 depicts patient demographics, highlighting 297 male and 37 female patients with alcohol-related disorders. Males aged 41-60 years were particularly dominant, as shown in Figure 2. Principal diagnoses, including alcoholic liver disease and acute pancreatitis, are detailed in Table 1. Additional diagnoses, such as chronic pancreatitis and esophageal varices, are presented in Table 2. For departmental preferences, Table 3 reveals the Gastrointestinal (GI) department as the top choice, followed by Kidney, Neurological, and Cardiovascular/Chest.Table 1.

Top 5 Principal Diagnoses of Alcohol Addiction Patients.

ICD-10-CMPrinciple diagnosisTimesRankK70Alcoholic liver disease431K85Acute pancreatitis272F10Alcohol related disorders183A41Other sepsis144K86Other chronic pancreatits115Table 2.

Top 5 Additional Diagnoses of Alcohol Addiction Patients.

ICD-10-CMAdditional diagnosisTimesRankF10Alcohol related disorders401K86Other chronic pancreatits182I85Esophageal varices163K70Other sepsis16E87Other disorders of fluid, electrolyte and acid-base balance154R65Symptoms and signs specifically associated with systemic inflammation and infection105Table 3.

Top 5 Departments for Alcoholism Patient Presentation.

DepartmentTimesRankGastrointestinal1621Kidney392Neurological253Cardiovascular Chest154

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Image 2:

Conclusions

The study revealed that patients with alcohol addiction often delay seeking psychiatric help instead of presenting for medical care only after liver or gastrointestinal complications occur. This underscores the crucial need for better health education regarding the relationship between alcohol addiction and liver disease. Prompt recognition and early intervention for substance addiction can significantly reduce these risks and improve patient outcomes.

Disclosure of Interest

None Declared
Exploring the Impact of 2023 Wildfires on Generalized Anxiety Disorder Symptoms among Residents in Alberta and Nova Scotia
Authors: Obuobi-Donkor G. , Shalaby R. , Agyapong B. , Dias R. D. L. , Agyapong V. I. O.
Published: August 2024

Introduction

Raging wildfires are rising in diverse areas, leading to significant environmental and psychological repercussions that are drawing growing concern.

Objectives

This study seeks to assess the prevalence of likely Generalized Anxiety Disorder (GAD) and investigate the factors contributing to its occurrence amidst the wildfires in Alberta and Nova Scotia.

Methods

Data were collected online through a cross-sectional survey from May 14 to June 23, 2023. Alberta and Nova Scotia participants self-subscribe to the program by texting ‘HopeAB’ or ‘HopeNS’ to a designated short code, respectively. The GAD-7 validated scale assessed likely GAD symptoms among the participants.

Results

There were 298 respondents in this study, with a majority residing in Alberta/Nova Scotia areas affected by recent wildfires (62.3%). Among the respondents, 41.9% were likely to experience Generalized Anxiety Disorder (GAD) symptoms. Those living in regions recently impacted by wildfires in Alberta/Nova Scotia were found to be twice as likely to have GAD symptoms, with an odds ratio of 2.4 and a confidence interval of 95% ranging from 1.3 to 4.3.

Conclusions

The study’s findings highlight a relationship between living in areas affected by wildfires and the likelihood of experiencing generalized anxiety disorder (GAD). Exploring potential predictors through additional research could aid in developing strategies to alleviate the mental health impact of natural disasters.

Disclosure of Interest

None Declared
Treatment of Misophonia with Cognitive Behaviour Therapy: A Case Report
Authors: Avanoğlu K. B. , Kılıç C.
Published: August 2024

Introduction

Misophonia is a condition characterized by extreme emotional reactions, such as irritation or anger, triggered by specific sounds. Despite its prevalence, there is a lack of evidence-based treatment methods for misophonia.

Objectives

This case report aims to explore the effectiveness of combining psychoeducation with Cognitive Behavioral Therapy (CBT) in the treatment of a misophonic patient. The focus is on reducing the patient’s emotional distress and improving their quality of life.

Methods

The patient is a 28-year-old woman employed as a salesperson in a busy city. Mouth smacking, gum chewing and clock ticking are the sounds that bother her the most. She has never used any medications or attempted any methods to alleviate her misophonia. Neither she, nor her family has a history of a psychiatric disorder.

The therapeutic intervention spanned eight sessions, each lasting around half an hour. The first two sessions, a patient history was taken and Mısophonia Interview Scale (MIS) was conducted. MIS comprised the Misophonia Checklist (MCL), which involved reading fifty misophonic sounds to the patient one by one. She then rated her discomfort in response to each sound on a four-point Likert-type scale. From the MCL responses, a total severity score (Misophonia Total Score - MTS), was calculated.

The treatment commenced with a psychoeducational component focused on enhancing the patient’s comprehension of misophonia. This phase aimed to elucidate the neurobiological underpinnings of the condition, common triggers, and the emotional reactions associated with it.

Then, CBT was employed to identify and challenge the patient’s negative automatic thoughts (NATs) linked to her misophonia. Three sessions primarily concentrated on identifying and managing NATs associated with her misophonia. These sessions equipped the patient with the skills to recognize and confront NATs through structured discussions and practical assignments.

The last three sessions centered on exposure therapy, with the goal of reducing emotional and physiological responses to triggers. Homework assignments during this phase encouraged the patient to independently practice exposure exercises.

Results

The initial MTS was 54, indicating significant distress. After the interventions, the final MTS decreased to 35 and the impact of misophonic symptoms on her life decreased from severe to moderate.

Conclusions

Misophonia is a challenging disorder to treat due to its limited evidence-based interventions. This case report demonstrates that a combination of psychoeducation and CBT methods may hold promise in managing misophonic symptoms. However, it is essential to acknowledge the need for further research in this area, as misophonia’s treatment strategies require more robust empirical support. This case highlights the potential benefits of psychoeducation and CBT, emphasizing the need to explore and develop effective treatments for this debilitating condition.

Disclosure of Interest

None Declared
Using Virtual Reality Assisted Therapy to Reduce Cognitive Test Anxiety and Dysfunctional Metacognitions
Authors: Obuća F. , Ünal-Aydın P. , Aydın O.
Published: August 2024

Introduction

Cognitive test anxiety and dysfunctional metacognitions can significantly impact an individual’s performance and overall mental health. However, the effectiveness of various treatment strategies, including Virtual Reality (VR) therapy, is yet to be fully explored.

Objectives

This study aimed to examine the effectiveness of VR therapy in reducing cognitive test anxiety and dysfunctional metacognitions in adults.

Methods

A total of 64 participants were enrolled in the study, with 40 in the treatment group and 24 in the control group. Data were collected using the Metacognition Questionnaire-30, Cognitive Test Anxiety Scale, and a sociodemographic questionnaire. Paired samples t-tests were used to compare pretest and posttest scores, while independent samples t-tests were used to compare the means between the groups.

Results

The findings suggest that the treatment group experienced a significant reduction in cognitive test anxiety and negative metacognition scores following VR therapy. No significant changes were observed in the control group, and there were no significant differences in pretest scores between the treatment and control groups.

Conclusions

The study indicates that VR therapy may be an effective treatment strategy for reducing cognitive test anxiety and dysfunctional metacognitions. Further research is recommended to validate these findings and explore the potential of VR therapy in treating other psychological disorders.

Disclosure of Interest

None Declared
Sex differences in addiction: gonadal hormones and substance use effects in women
Authors: Fonseca F.
Published: August 2024

Substance use disorders (SUD) affect differentially women and men. Although the prevalence has been reported higher in men, those women with addictive disorders present a more vulnerable profile and are less likely to enter treatment than men. The aim of this presentation is to present an overview of how gonadal hormones may influence in response to substances, clinical differences in the addictive disorders and implications in treatment response.Ovarian steroid hormones (estrogen, progesterone), the metabolites of progesterone, and negative allosteric modulators of the gamma-aminobutyric acid A (GABA-A) receptor, such as dehydroepiandrostenedione (DHEA) may influence the behavioral effects of drugs.

Disclosure of Interest

None Declared
Treatment Resistant Early-Onset Schizophrenia: A Tale of Two Siblings
Authors: Yerlikaya Oral E.
Published: August 2024

Introduction

Early-Onset Schizophrenia (EOS) is a rare and severe form of schizophrenia that begins in childhood and it is often associated with genetic risk factors, poorer prognosis, and increased treatment resistance compared to adult-onset schizophrenia (Hatzimanolis et al. Eur Psychiatry 2020;63(1):e44). This case report presents two siblings diagnosed with EOS and treated at the same inpatient clinic in different years.

Objectives

The aim is offering a perspective on the clinical characteristics, genetic and enviromental implications, and treatment challenges of two siblings with EOS and seeking to enhance understanding of EOS’s complexity, particularly in the context of treatment resistance.

Methods

A comprehensive retrospective review of the siblings’ all medical records was conducted, focusing on their psychiatric history, symptoms, treatment trials, and responses of treatment. Both cases’ current clinical situations were evaluated cross-sectionally.

Results

Older sibling: 19 year-old male, was diagnosed with EOS following the onset of symptoms as social withdrawal, negativism and suspiciousness at the age of 14. He referred to the inpatient clinic with the cause of drug intake refusal. Risperidone treatment started but there was no significant response. Risperidone to olanzapine switch made and clinical remission observed. After his discharge, 4 more hospitalisations in 5 years needed due to low socioeconomic status, parental neglect and him having no insight and stopped taking his medications repeatedly. Several depot form antipsychotic injections started to prevent recurrent hospitalisation. Despite that he needed several hospitalisations to adult psychiatry inpatient clinics.Younger sibling: 14 year-old female, were diagnosed with EOS following the symptoms as auditory hallucinations, suspiciousness, disorganised speech and behaviours at the age of 13. She referred to the same inpatient clinic with suicidal risk after 2 years of his brother’s last hospital stay. She responded good to olanzapine treatment like her brother’s, during her first stay. After 2 weeks of her discharge, her psychotic symptoms started again with no specific reason. Second hospitalisation needed due to her homicidal and suicidal risk. Clozapine and aripipirazole treatment started and she discharged in partial remission. She is being followed in outpatient clinic, with low functioning.

Conclusions

Despite trials of multiple antipsychotic medications and adjunctive treatments, both siblings demonstrated significant treatment resistance. These sibling cases underscore the complexity and challenges in managing EOS, particularly when it presents with treatment resistance. The shared familial environment and potential genetic factors demand further investigation to elucidate the pathogenesis of EOS and optimize therapeutic approaches.

Disclosure of Interest

None Declared
ADHD: Development of a printable poster for parents, teachers and healthcare professionals
Authors: Belabbes I.
Published: August 2024

Introduction

ADHD is a very frequent reason for consultation in child psychiatry. It affects 2.5% of children and 5% of adults. Diagnosis is clinical. Treatment is based on medication combined with psychosocial interventions.

Objectives

Develop an ADHD guide for caregivers.

Methods

We carried out a literature review covering the last 5 years using the google scholar and pubmed search engines, including the key words ADHD, in order to produce a printable guide for caregivers working with children, in particular school teachers and healthcare personnel.

Results

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting 5% of school-age children.

It is characterized by abnormally high levels of developmental inattention, hyperactivity and impulsivity, leading to impaired personal, social, academic or occupational functioning. Because of its pervasiveness, ADHD can interfere negatively with general well-being, as well as with social life, academic performance and the development of social skills, which can lead to low self-esteem.

ADHD has multiple etiologies. It is thought to be due to a complex interaction between genes and environment. In fact, genetic vulnerability predisposes to the disorder which, under the influence of an unfavorable environment, expresses itself in clinical symptoms represented by 2 dimensions: inattention, hyperactivity and impulsivity.

Diagnosis is essentially clinical, and treatment is based on medication combined with psychosocial interventions.

Conclusions

ADHD is one of the most frequently encountered disorders in general practice, pediatrics and child psychiatry. Early recognition of the disorder enables appropriate management, while limiting the impact of the disease on the functioning of the young person and his or her family.

Disclosure of Interest

None Declared
Association Between Maternal Diabetes and ChildhoodNeurodevelopmental Disorders
Authors: Shah K. , Thomas C.
Published: August 2024

Introduction

The prevalence of metabolic disorders is rising, diabetes prevalence doubled during 1990-2017. In 2020, 7.8% of US pregnancies were complicated by Gestational Diabetes Mellitus (GDM). Our aim is to assess the impact this increase has on childhood developmental disorders and understand the link between maternal metabolic disorders and neurodevelopmental disorders in children with focus on Autism Spectrum Disorder (ASD) and ADHD.

Objectives

Our aim is to assess the impact this increase has on childhood developmental disorders and understand the link between maternal metabolic disorders and neurodevelopmental disorders in children with focus on Autism Spectrum Disorder (ASD) and ADHD.

Methods

A literature search was conducted using medical subject heading (MeSH) terms in PubMed, database from Jan 1 2014 to Feb 15, 2023. Only large-scale (n>20,000) were reviewed. A total of 3 articles were included in our final qualitative synthesis review.

Results

An increased rate of ASD and ADHD are observed in children of mothers with insulin resistance, demonstrated by Type 2 Diabetes (T2DM) and GDM (Kuan-Ru Chen, et al.). T2DM had the strongest association with ASA and ADHD when looking at other neurodevelopmental disorders (Chen, et al.). GDM severity correlates to increased risk of ADHD (Xiang, et al.). Maternal obesity as a risk factor for ASA and ADHD has confidence intervals in the same ranges as immune dysregulatory disorders including Asthma and Autoimmune disorders (Woolfenden, et al.).

Conclusions

Pathomechanism of neurodevelopmental disorders involves maternal oxidative stress and inflammation. Maternal T2DM and obesity are pro-inflammatory states that can be targeted as modifiable risk factors of ASD and ADHD in children. Preconception metabolic optimization and tight glycemic control in pregnancy are two ways clinicians can start to address the rates of rising ASD and ADHD.

Disclosure of Interest

None Declared
Early language intervention and IQ of children with non-syndromic orofacial clefts
Authors: Sándor-Bajusz K. A. , Molnár E. , Dergez T. , Hadzsiev K. , Vástyán A. , Csábi G.
Published: August 2024

Introduction

Children with non-syndromic orofacial clefts are at higher risk for developmental difficulties. Speech and language as commonly affected developmental domains in these children.

Objectives

The aim of the current study was to explore the effects of early interventions for speech and language on later cognitive outcomes in this patient population.

Methods

A combined retrospective/prospective-comparative study was carried out at the Department of Pediatrics of the University of Pécs in Hungary. The participants were children between 6 and 16 years of age. The study consisted of a self-designed demographic questionnaire and an IQ test (WISC-IV).

Results

A total of 41 children with non-syndromic orofacial clefts and 44 age-matched controls participated in the study. Children of the cleft group were examined by pedagogical professional services and required special education plans significantly more often than controls (p<0.001 and p=0.02, respectively). Participants of the cleft group who received early speech and language therapy score higher on the Verbal Comprehension Index (p=.005). Full-Scale IQ score was also higher for cleft participants who received therapy, however not significant but borderline (p=0.08).

Conclusions

Early language and speech interventions for children with non-syndromic orofacial clefts may have a positive effect on verbal skills and overall cognitive development. Future longitudinal studies examining baseline cognitive functioning of infants are needed to provide more conclusive evidence on the effects of interventional programs on speech and language development in cleft patients.

Disclosure of Interest

None Declared
Vortioxetine as an effective drug in the treatment of depression in adolescents with long QT index. A case report
Authors: Del Sol Calderon P. , Izquierdo de la Puente A. , Fernández R. , García Moreno M.
Published: August 2024

Introduction

This is a 13-year-old female patient admitted to the psychiatric unit active suicidal ideation.

Objectives

the objective is to show through a clinical case how vortioxetine can be safe in adolescents.

Methods

Case report and literature review

Results

She has a history of daily consumption of at least 2 units of cannabis per day. She presents high emotional distress secondary to academic failure, consuming the substance as a coping strategy. Due to prohibition and control by her parents, the patient stopped taking the substance, presenting severe depressive symptoms, self-injury and suicide ideation. For this reason she is admitted to the inpatient psychiatric unit. The electrocardiogram performed on admission shows a corrected QT index of 524. Exploring physical symptoms, she recognized episodes of syncope and palpitations. Coordination was made with cardiology, who performed an echocardiogram with normal results and began follow-up with them without prescribing medication. It was agreed not to use drugs that could prolong the QT index. Evaluating the clinical situation, it was decided to start treatment with Vortioxetine up to 10 mg. With this treatment there was no worsening of the electrocardiogram and the patient’s mood improved, anxiety and ideas of death were remitted

Conclusions

This work aims to show how vortioxetine has been effective and safe at the cardiological level in the case of moderate-severe depression in an adolescent with prolonged QT index

Disclosure of Interest

None Declared
Exploring the Impact of Wildfires on Children’s Psychological Well-being: A Comprehensive Review of Recent Literature
Authors: Adu M. K. , Agyapong B. , Agyapong V. I. O.
Published: August 2024

Introduction

Wildfire disasters have become increasingly rampant. There is a critical need for all to fully understand the mechanism and impact of these disasters on humans, with a special emphasis on the mental health effects they pose on the affected individuals and communities. This article specifically presents a scoping review of the psychological reactions of children and adolescents post-wildfire disaster.

Objectives

This review aims to synthesize currently available literature regarding the impact of wildfire on mental health, specifically the psychological reactions of children to wildfires.

Methods

We identified 8 research articles using 6 databases for this review. Data extraction was performed using a qualitative descriptive approach.

Results

The results identified post-traumatic stress disorder (PTSD), anxiety, depression, stress, alcohol/substance misuse, hopelessness, low resilience, reduced quality of life, and self-esteem as the psychological conditions manifesting in children and adolescents post-wildfire disaster. PTSD was the most evaluated psychological reaction in the participants (7 out of eight studies).

Conclusions

This review highlights that deleterious mental health effects, such as PTSD, depression, anxiety, and suicidality, can persist in children for years post-wildfire disaster. Factors such as gender, direct exposure to the wildfire, re-traumatization, and resilience informed or ameliorated the severity of the impact of wildfire on children and adolescents. Our findings further emphasize the need for multi-year funding and programs to support children and adolescents’ mental health, including children with disabilities in the communities that have experienced wildfire disasters.

Disclosure of Interest

None Declared
The relation between autism and psychosis: overlapping and differing features
Authors: Ruas Resende M. B. , Agostinho F. , Nogueira R. , Silva F. A. , Lousada R. , Cotovio D.
Published: August 2024

Introduction

Autism spectrum disorders (ASD) and schizophrenia (SCZ) have a strong historic connection. At the beginning of the 20th century when referring to schizophrenic patients Eugen Bleuler used the term autism to describe the apparent withdrawal from the outside world. Other authors also emphasized the association between this two entities. In fact, only in DSM-III were these disorders placed in different diagnostic categories. Today, even though this nosological vision still prevails, a growing number of studies have shown significant overlaps between the two disorders. Patients with the diagnosis of ASD often experience psychotic symptoms and similarly schizophrenic patients have a high prevalence of autistic traits.

Objectives

To clarify the distinction between ASD and psychotic disorders, namely to help the clinical and phenomenological distinction between patients with a primary psychotic disorder versus patients with the diagnosis of an autism spectrum disorder that might also experience psychotic symptoms.

Methods

Research on UpToDate using the terms “Autism Spectrum Disorders”; “Schizophrenia” and “psychosis”.

Results

Delusional beliefs and paranoid ideation are common findings in autistic individuals in the same way that they constitute one of the main features of schizophrenia spectrum disorders. However, in ASD individuals one must be vigilant of its distinction with “childish fantasies”. Both disorders (ASD and SCZ spectrum disorders) share Theory of Mind (ToM) impairments that contribute to the development of paranoia.

Sensory anomalies are common in ASD and might be confused with hallucinations. However, anomalous perceptual experiences can and do often happen in ASD and are clinically overlapping with hallucinatory phenomena. In the case of a neurodevelopment disorder, however, they could probably be better understood as a part of it more than the signal of a co-ocurring psychotic disorder. Attenuated psychotic symptoms pose an even more complex subject because of the overlap between autistic symptoms and subclinical psychotic symptoms. Another area that poses diagnostic difficulties has to do with the distinction between negative symptoms seen in schizophrenia and autistic symptoms. Lack of emotional reciprocity in ASD can be confused with “blunted” affect in schizophrenia.

Other overlapping features between these two entities can be identified.

Conclusions

The diagnostic boundaries between ASD and SCZ are not always clear. Their overlapping characteristics and potential co-occurrence might pose important diagnostic challenges in clinical practice. The clinical course of both diseases frequently represents a key element for the differential diagnosis between autism and psychosis. The profound knowledge of these two entities is of extreme importance contributing to the implementation of more targeted and effective management strategies.

Disclosure of Interest

None Declared
Preadolescent and Adolescent Victims of Cyber Victimization in Tunisia
Authors: Touiti A. , Askri W. , Halayem S. , Bouden A.
Published: August 2024

Introduction

Nowadays children and adolescents are exposed to cyber victimization.This modern form of aggressive behavior has a negative impact on the psychological of victims,self esteem, and social interaction

Objectives

To investigate the relation between cybervictimization and depression in tunisian preadolescents and adolescents

Methods

The Arabic validated version of the “cyberbullying assessment instrument” was distributed through social media groups of preadolescent and adolescents in Tunisia.The participants were also invited to answer items about social and demographic characteristics.The participation was voluntary,without confidential data.

Results

Fifty four preadolescent and adolescent aged between 9 and 16 years old have participated. The average age was 12.4 years old. 64% of participants were girls.More than 80% of children have their own smartphone and a personal count on social media.Among those respondents,12 (22.2%) reported being cyberbullied at least once in the year.the children most likely to be bullied were girl aged between 9 and 12 years old with a poor socioeconomic level.low self esteem, depressive symptoms, anxiety symptoms are associated with cyber victimization.

Conclusions

The level of cyber victimization among preadolescents and adolescents is underestimated. Psychiatric disorder associated to this phenomena have to be considered in order to develop strategies and intervention to reduce the cyberbullying among vulnerable population.

Disclosure of Interest

None Declared
Melatonin and self harm behavior in youth, beyond the sleep impact
Authors: Kouki N. , Maamri A. , kouki N. , Ghrissi F. , Hajri A. , zalila H.
Published: August 2024

Introduction

Sleep disorders in youth are associated to psychiatric disorders and may lead to significant negative effects on cognitive skills, emotional regulation and behavior such as self harm.

Objectives

The aim of our study is to highlight the melatonin effects on reducing self harm behaviors in the youth.

Methods

Our work is a literature review based on the PubMed interface and adapted for 2 databases: Science Direct and Google Scholar using the following combination ( self harm [MeSH terms]) AND ( melatonin [MeSH terms]) AND ( youth [MeSH terms]) .

Results

We initially reviewed 6 articles published between 2012 and 2022. We retained 3 articles which corresponded to the aim of our study.

Self harm behaviors were mainly described in youth during adolescenthood. In fact, self injurious release may be considered as way to release emotional tension and physical discomfort.

Melatonin prescribed in youth for the treatment of sleep disorders not only improved sleep ,but also mood disorders and impulsivity. Melatonin restores indirectly serotonin levels through a continuous bidirectional connexion . Therefore it is efficient on psychiatric comorbidites, especially anxiety and depression which are associated with intentional self-harm.

Conclusions

Melatonin is the most prescribed drug for sleep disturbances in children and adolescents, its impact covers a large spectrum of disturbances including the self harm behaviors.

Disclosure of Interest

None Declared
Substance use, anxiety and depression among Tunisian college students
Authors: Bergaoui E. , Bouallagui A. , Moalla M. , Zrelli M. , Amri G. , Ghachem R.
Published: August 2024

Introduction

Substance use and mental health symptoms are frequent among college students worldwide.

Objectives

This study examined the prevalence of substance use, anxiety and depression among college students and their associated factors.

Methods

A total of 115 college students aged between 19 and 30 years from different universities completed a self-reported online survey during March 2023. The questionnaire included items on demographic information, substance use and the Hospital Anxiety and Depression scale.

Results

Women represented 70% of our population. The average age was 25,1±3,5 years.

Twenty-nine (25,2%) were smokers, thirty-three students (28,7%) consumed alcohol and nine students (7,8%) used cannabis. Five students used ecstasy. Four students used LSD. Three students used cocaine.

Average HADS anxiety score was 7,96±4,26. Twenty-one students (18,3%) had mild anxiety symptoms. Thirty-three students (28,7%) had moderate to severe anxiety symptoms.

Average HADS depression score was 8,59±4. Thirty-one students (27%) had mild depressive symptoms. Forty-one (35,7%) had moderate to severe symptoms of depression.

Smoking was unrelated to gender, age, field of studies, economic or social status, family or personal history. It was related to drinking and doing other activities or hanging out with friends (p<0,001). Drinking alcohol was related to the field and year of study, age, hanging out with friends and other substance use (p<0,001). Using cannabis was related to psychiatric family history (p<0,05). Using one substance was related to using other substances (p<0,05). Anxiety was related to gender (p<0,001). Depression levels were related to socio-economic statuts (p=0,041). Poly-use was more frequent among older students (p=0,003) and medical students (p=0,031). Substance use was unrelated to anxiety and depression levels.

Conclusions

Tunisian universisties should consider detecting students with substance and mental health problems and offer them support and treatment if needed.

Disclosure of Interest

None Declared