bluuebunny/crossref_metadata_2025 huggingface dataset:
The deaths of invisible people. A literature review
Authors: Santana Ortiz M. I. , Molina Pérez N. , Pereira López J.
Published: August 2024

Introduction

Suicide is a serious public health problem. Each year it is estimated that it causes almost one million deaths worldwide, much more than those caused by war or homicide. These deaths are also devastating, affecting not only the person who commits them, but also his or her environment (family, friends, professionals involved, etc.) and society as a whole. The risk and protective factors for suicide are well known in the literature, which gives rise to the estimation of possible high-risk groups according to their characteristics, especially when risk factors are added, protective factors are reduced, and unfavorable life circumstances are present. Among these groups with greater vulnerability to suicidal behavior are homeless people with severe mental disorders, who are unfortunately little visible in society and in the investigation.

Objectives

The aim of this paper is to review the current state of the question of suicide in homeless people with severe mental disorders.

Methods

Review of the international scientific literature on the issue published in the last twenty years.

Results

The few studies available conclude the higher prevalence of suicidal behavior in homeless people with severe mental disorders compared to the general population, which has not been translated into the development of specific care and prevention plans and programs.

Conclusions

It is considered essential to expand investigation in this field, which will be very useful to lay the foundations for the development of guidelines, plans and specific programs, and to know the evidence about them.

Disclosure of Interest

None Declared
Physical activity reduces cardiovascular risk and mortality in people with severe mental illness: a cohort study using accelerometry
Authors: Liang Y. Y. , Du J. , Zhou Y.
Published: August 2024

Introduction

Cardiovascular disease (CVD) is a leading cause of excess mortality in people with severe mental illness (SMI). Physical activity (PA) is widely acknowledged with multiple health benefits, but associations of PA with incident CVD, all-cause and CVD mortality in people with SMI remain unclear.

Objectives

To determine dose-response and intensity-specific associations of PA with incident CVD, all-cause and CVD mortality in people with SMI.

Methods

This prospective cohort study was conducted on 6313 SMI participants with accelerometry data from UK Biobank (mean age 61.05 years) from February 2013 to November 2021 (median 7-year follow-up). Moderate-to-vigorous PA (MVPA) was categorized by meeting the guideline level or not, while total PA and light-intensity PA (LPA) were grouped by tertiles. Incident CVD, all-cause and CVD mortality ascertained by hospital and death registries were main outcomes.

Results

PA was inversely associated with the risk for incident CVD (Poverall < 0.05 for total PA and MVPA, Pnonlinearity > 0.05 for all PA), all-cause mortality (Poverall < 0.05 for all PA, Pnonlinearity < 0.05 for total PA and LPA), and CVD mortality (Poverall < 0.001 for total PA and LPA, Pnonlinearity < 0.05 for all PA). Performing guideline-recommended volume of MVPA was associated with a reduced risk of 19% for incident CVD (95% CI, 0.67-0.98), 42% for all-cause mortality (95% CI, 0.43-0.79), and 50% for CVD mortality (95% CI, 0.31-0.82). A combination of recommended MVPA and a moderate volume of LPA was associated with the lowest risk, mitigating 21% risk for incident CVD, 59% for all-cause mortality, and 78% for CVD mortality.

Conclusions

Primary engagement of guideline-recommended MVPA, supplemented with moderate amount of LPA, was associated with lower risks for incident CVD, all-cause and CVD mortality among people with SMI.

Acknowledgements

This research has been conducted using the UK Biobank Resource under Application Number 58082.

Funding Support

This work was supported by the National Natural Science Foundation of China (grant number 32100880), Guangzhou Municipal Key Discipline in Medicine (2021-2023), Guangzhou High-level Clinical Key Specialty, and Guangzhou Research-oriented Hospital. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclosure of Interest

None Declared
Training on Addressing Patients’ Values (including Spirituality and Worldview) in Decision Making
Authors: Peh A. L. H. , Teo D. C. L. , Ong E. K. , Tan M. S. Q.
Published: August 2024

Introduction

Patients’ values are relevant in patient-centred care (PCC) as awareness and recognition of these can lead to better decision making and improved outcomes. Training in decision making is sorely lacking, especially in the area of spirituality and worldview.

Objectives

Our poster describes a training workshop to provide such medical education to healthcare professionals. The half-day training covers: importance of addressing patients’ values in decision making; using decisional aids; role of spirituality and worldview of the patient.

Methods

Clinicians of the hospital, including doctors, nurses and allied healthcare professionals were invited to attend the training. The evaluations by the participants for the workshops conducted in 2021-2023 were collated and presented.

Results

Four workshops in 2021 to 2023 were conducted, with a total of 43 participants. We achieved overall ratings of above average and excellent in more than 80% of responses; content relevance and usefulness to work, presentation and facilitation were similarly rated. Most participants would recommend it to colleagues.

Conclusions

The “Addressing Patients’ Values in Decision Making” workshop for clinicians will allow the hospital to promulgate a culture of quality care through patient engagement.

Disclosure of Interest

None Declared
Psychiatry Trainees’ Perspectives on Psychotherapy Training in Residencies Worldwide
Authors: Salgado R. M. , von Doellinger O.
Published: August 2024

Introduction

Incorporating psychotherapy into the curricula of psychiatry residency programs has been proven difficult, even in countries where psychotherapy training is a requirement for psychiatry residents to become psychiatrists. There is a risk that future psychiatrists lacking psychotherapy skills will be restricted in managing the wide scope of disorders and personalities they will face in clinical practice. It is important to assess what psychiatry trainees around the globe have to say about psychotherapy training as part of their residency curricula.

Objectives

The primary purpose of the article was to assess psychiatry trainees’ perspectives on psychotherapy training in residency programs worldwide.

Methods

The authors performed a narrative review, resulting 19 original research studies, published between 2001 and 2021, evaluating psychiatry residents’ perspectives by the application of a questionnaire.

Results

Nineteen articles were included in this review. Most of the studies were developed across European countries (47.4%) and in the USA (36.8%). Psychiatry residents are interested in and value psychotherapy training, and some consider it should be an obligatory competency for psychiatrists, as it already occurs in some countries worldwide. Even though, most psychiatry trainees feel dissatisfaction with the existing training in residency curricula, pointing out concerns related to the quality of resources such as courses of psychotherapy and supervision of cases, time within the residency period, and financial constraints. In terms of personal psychotherapy, we found contrasting views of its importance in psychotherapy training for psychiatry residents. A crucial finding was that psychiatry residents tend to lose interest in psychotherapy during the years of the residency, and dissatisfaction with the quality of the psychotherapy curricula, lack of support, and low self-perceived competence in psychotherapy by trainees were factors associated with reduced interest in psychotherapy training.

Conclusions

At a time when psychotherapy is increasingly becoming acknowledged to play a central role in the treatment of most psychiatric disorders, current training is failing to provide these competencies to psychiatry trainees. Serious reflection must be given to both the extent of the guidelines and the practical opportunities for psychotherapy training so future psychiatrists can be qualified to provide an accurate biopsychosocial model of psychiatric care. The authors postulate that maintaining residents’ interest in psychotherapy requires improvements in the residency curricula and departmental leadership must support trainees’ goals of becoming comprehensively trained psychiatrists.

Disclosure of Interest

None Declared
Dominant depressive, anxious and cyclothymic affective temperaments lower the chance of infertility treatment success
Authors: Szabó G. , Szigeti F J. , Sipos M. , Varbiro S. , Gonda X.
Published: August 2024

Introduction

Affective temperaments can play a significant role in the development, progression and outcome of various somatic diseases, as well as in the effectiveness of their treatment. Although infertility is influenced by both physical and psychological factors, the relationship between affective temperaments and infertility treatment success remains unexplored.

Objectives

The aim of this retrospective cohort study was to assess how dominant affective temperaments influence the outcome of infertility treatments.

Methods

Data was collected from a cohort of infertile women who underwent infertility treatment at an Assisted Reproduction Center in Budapest, Hungary. The study recorded treatment success defined as clinical pregnancy, detailed medical history, demographic parameters, and administered the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). TEMPS-A scores then were classified into nondominant and dominant temperaments for each scale, based on their score being above or below the mean+2 standard deviation for the given temperament. The predictive value of dominant temperaments on assisted reproduction outcomes were analyzed by multivariate logistic regression models, using age, BMI and previous miscarriage as covariates.

Results

In the cohort of 578 women who underwent infertility treatment, besides age, BMI, and previous miscarriage, dominant depressive, anxious and cyclothymic temperament decreased the odds of achieving clinical pregnancy by 85% (p=0.01), 64% (p=0.03), and 60% (p=0.050), respectively).

Conclusions

The findings of this study suggest that dominant affective temperaments have a significant impact on the outcomes of infertility treatments. As a clinical consequence, creening for affective temperaments, Identifying dominant affective temperaments, stratifying high-risk patient groups, and offering personalized treatment options may enhance the likelihood of successful pregnancy and live birth for women undergoing in vitro fertilization treatment.

Disclosure of Interest

None Declared
The impact of maternal psychopathology on psychomotor development trajectories in infants born after a threatened preterm labour from 6 to 30 months of age
Authors: Andreu J. , Buesa J. , Gómez N. , Ghosn F. , Moreno A. , Campos L. , Almansa B. , Zapata C. , Lizarán M. , García-Blanco A.
Published: August 2024

Introduction

Threatened preterm labor (TPL) represents an adverse prenatal event that can impact maternal mental health in the long term. Additionally, this prenatal event can disrupt fetal neurodevelopment, primarily during the third trimester of pregnancy when neuronal connections in the fetus are established. Indeed, infants born following TPL exhibit delayed communication and socio-individual skills at 6 months of age, regardless of prematurity. Furthermore, maternal mental health during the postpartum period can also influence the offspring’s psychomotor development.

Objectives

The aim of this study is to examine the impact of maternal psychopathology on psychomotor development trajectories in infants born after a TPL from 6 to 30 months of age.

Methods

This prospective cohort study recruited 117 mother–child pairs who suffered from a TPL. Psychomotor assessment was performed at 6 and 30 months of age using the communication and socio-individual subscales of Ages & Stages Questionnaires for psychomotor development. A regression model was carried out, including gestational age at birth, maternal anxiety trait, maternal history of psychological traumas, prenatal and postnatal maternal depression, anxiety, and cortisol as well as parenting stress as predictors.

Results

Increased communication delays were associated with higher maternal anxiety levels (p < 0.001), elevated maternal depression scores (p= .0003), and increased cortisol levels (p = .004) during postpartum. Similarly, elevated cortisol levels after 6 months postpartum were predictive of increased Personal-Social delays (p = .0018).

Conclusions

Maternal postpartum psychopathology was the main determinant of the course of psychomotor developmental disturbances. Therefore, infants born after TPL, whose mothers display postpartum psychopathology, should be identified and considered for psychological treatment to improve psychomotor delays in infants.

Disclosure of Interest

None Declared
Sex perspective on mandatory admission in acute psychotic patients
Authors: Delgado-Marí M. , Fernández-Ribas À. , Toll Privat A. , Giralt-López M. , Jiménez-Fernández B. , Motta-Rojas N. V. , Cuevas-Esteban J.
Published: August 2024

Introduction

Psychotic disorders are strongly linked to a higher risk of mandatory hospitalization, often affecting men more, though some studies report the opposite. Recent investigations also show a higher rate of involuntary admissions in younger individuals. Knowledge in this area is still limited despite extensive research.

Objectives

Analyze whether there is an association between sex and age with involuntary admissions of individuals with psychotic disorders.

Methods

Retrospectively, 254 people with psychotic disorders admitted between 2018-2023 to the adult psychiatric inpatient unit at Hospital Universitari Germans Trias i Pujol were selected, collecting their nature of admission, sex, age, and discharge diagnosis. Comparisons between voluntary and involuntary admissions, with respect to sex and age variables, were conducted using independent sample t-tests, Mann-Whitney U tests, Fisher’s exact test, and chi-square tests. A logistic regression model was used to identify variables significantly associated with mandatory admission.

Results

In both the male and female groups, there were no statistically significant differences in terms of the mean age at admission (p = 0.162) or the nature of admission (p = 0.586) (
Table 1). When analyzing the voluntary nature of admission based on age and sex, statistically significant differences were only found in the female group (p = 0.01), resulting in a 9.18 year age difference among those admitted voluntarily (
Table 2). The model that best predicted the probability of involuntary admission in individuals with psychotic disorders included the sex variable (OR = 4.88) and the interaction between sex and age (OR = 0.97) (
Table 3).
Table 1:

Differences between sex regarding voluntariness of patients with psychotic disorders.

MaleFemalep valueN (%)122 (48%)132 (52%)Age, m (SD)38.39 (16.64)44.15 (18.44)0.162Admissions, N (%)Voluntary38 (31.1%)37 (28.0%)0.586Involuntary84 (68.9%)95 (72.0%)
Table 2:

Analysis of voluntariness by sex and age.

Age, m (SD)VoluntaryInvoluntaryp valueMale37.45 (16.38)38.81 (16.84)0.677Female50.76 (18.19)41.58 (17.98)0.01*Total44.01 (18.44)40.28 (17.46)0.127
Table 3:

Predictors of involuntariness in psychotic patients: Logistic regression model (ENTER METHOD).

Predictor
-2log likelihood
Nagelkerke R2
x2 (df*)
OR* (95% CI*)p value301.220.0390.03 (1)Age1.01 (0.98; 1.03)0.674Sex4.88 (1.15; 20.72)0.032*Age x Sex Interaction0.97 (0.94; 0.99)0.046*

Conclusions

Young women with psychotic disorders face a higher risk of involuntary admissions, emphasizing the need for gender-specific strategies to improve care of these patients.

Disclosure of Interest

None Declared
Adjustment disorder among undergraduate students at Prince Mohammad Bin Fahd University, Al Khobar, Saudi Arabia
Authors: Aamir S.
Published: August 2024

Introduction

Adjustment disorder is characterized by an emotional or behavioral response to a stressful event or change in life. This condition can impact a student’s academic performance, social life, and overall well-being. Adjustment disorder with the stressor is a psychological response to identifiable stressors that result in the development of emotional or behavioral symptoms. These symptoms cause significant impairment in various areas of functioning, such as social, occupational, or academic performance.

Students with adjustment disorder may experience a range of symptoms, including feelings of sadness, anxiety, hopelessness, and a lack of concentration. They may also have trouble sleeping, feel overwhelmed, and struggle to cope with daily responsibilities. These symptoms can be triggered by various factors such as academic pressure, relationships, family issues, or cultural adjustments.

Objectives

This study aims to determine the prevalence of adjustment disorder among undergraduate students and investigate the potential risk factors of stress that can lead to adjustment difficulties.

Recognize the signs of adjustment disorder, how to access support, and how to create a supportive environment, therefore, students can effectively manage this condition and thrive in their academic and personal lives.

To prioritize mental health and provide the necessary resources for students to navigate the challenges of adjustment disorder effectively.

Methods

Adjustment Disorder‑New Model 20 (ADNM‑20) was used to assess prevalence of adjustment disorder among undergraduate students. It is a diagnostic tool used to assess adjustment disorder in individuals experiencing significant life stressors. The ADNM 20 is specifically designed to capture the nuanced manifestations of adjustment disorder with the stressor, enabling clinicians to make accurate assessments and develop targeted treatment plans.

Results

Adjustment disorder is a real and impactful challenge and a common mental health condition among undergraduate students at Prince Mohammad Bin Fahd University, Al Khobar, Saudi Arabia.

Conclusions

Adjustment disorder can significantly affect a student’s academic performance. The inability to focus, persistent feelings of distress, and a lack of motivation can lead to a decline in grades and overall achievement. By recognizing the signs, accessing support, and creating a supportive environment, students can effectively manage this condition and thrive in their academic and personal lives. It’s crucial to prioritize mental health and provide the necessary resources for students to navigate the challenges of adjustment disorder effectively.

Disclosure of Interest

None Declared
Myasthenia Gravis presenting as a Dissociative Disorder: a case report of a differential diagnosis
Authors: Laizāne A. P. , Blekte A. , Bērziņa A.
Published: August 2024

Introduction

Conversion disorder is characterised by symptoms that can impact sensory or motor function. The average incidence of conversion disorder is between 4 -12 per 100,000 per year. Conversion disorder has a wide variety of somatic and neurological differential diagnoses.

Objectives

A 22-year-old woman was admitted to the hospital due to COVID-19 pneumonia. During the hospitalisation period, she developed progressive weakness, due to which she couldn’t move, eat or take care of herself. In terms of history, she is healthy, married and gave birth to her first child almost 9 months ago. Two days postpartum, the patient experienced an inability to connect with the child and provide care, as well as a decline in her mood. The husband reports episodes in which the patient had difficulties holding the child while being able to perform house chores, which required more physical strength. Two years prior to hospitalization, during stressful situations she experienced similar episodes and difficulty swallowing. While hospitalized, extensive testing was done, including an acetylcholine receptor antibody test, which was negative at first. Because of of the initially negative testing results a psychiatrist was called. On the first visit, the patient remained in a supine position and reported a lack of strength in both arms and legs, occasionally experiencing difficulty raising her head, however managed to stand up from the bed, walk independently for 5–6 meters, turn around, and, as soon as she reached the bed, descend into it. The staff reported her inability to walk earlier in the day. On the second visit, she notes that she feels tired but now can feed and take care of herself; however, some weakness persists in the proximal muscle groups. In between visits she received treatment with corticosteroids because of the COVID infection. After repeating the acetylcholine receptor antibody test, there was a positive result, and a diagnosis was established.

Methods

This case report demonstrates how a somatic disorder can mimic a psychiatric one because of the overlapping symptoms and initial negative test results. While receiving symptomatic therapy with glucocorticoids due to the COVID infection, the patient’s condition improved; she began to eat and walk on her own.

Results

From the psychiatric aspect, it was associated with separation from the child— a relieving of the stress factor, due to which dissociative symptoms decreased.

Conclusions

Before considering a diagnosis of a dissociative disorder, a patient should be examined by other specialists according to their symptoms. A thorough neurologic and physical examination, as well as diagnostic tests, should be performed to exclude a physical pathology. Myasthenia gravis has a comorbidity with a number of psychiatric conditions and can also be very similar to a dissociative disorder, especially due to stress aggravating the symptoms of myasthenia gravis.

Disclosure of Interest

None Declared
Risk-taking propensity and emotional intelligence: an emotional version of the balloon analogue risk task (BART)
Authors: Megías-Robles A. , Sánchez-López M. , Gómez-Leal R. , Fernández-Berrocal P.
Published: August 2024

Introduction

It is well known that emotions guide decision-making processes in risk contexts. Several studies in the literature have showed the influence of emotions on risk-taking using the Balloon Analogue Risk Task (BART).

Objectives

The aim this research was to investigate the influence of emotional intelligence (EI) levels on the impact of emotions in risk-taking propensity assessed by the BART.

Methods

To this end, we developed a variant of the BART in wich each balloon displayed a face with an emotional expression: happiness, fear, or neutral. EI was assessed from the performance-based ability model by the MSCEIT. The sample consisted of 120 participants (Mage = 21.52; 80% women).

Results

A repeated measures ANOVA revealed a higher tendency to take risks when happy faces were presented, compared to the fear and neutral conditions. Moreover, participants with higher levels of EI showed a lower tendency to take risks across all emotional conditions. This relationship was particularly strong in the fear faces.

Conclusions

Our findings support the effect of incidental emotions on risk-taking and suggest the role of EI as a protective factor for risk engagement.

Disclosure of Interest

None Declared
The future of psychiatry and psychotherapy - An Early Career psychiatrist’s view
Authors: Kraxner F. H.
Published: August 2024

Introduction

Psychiatry is one of the most fast developing and agile discipline within human medicine. But more work is necessary to complete these advances.

Objectives

I address the following questions:

How does the future of psychiatry look in the eyes of early career psychiatrists?

What strengths, weaknesses opportunities and threats will come?

And what can we learn from different mental health systems and reagions?

Methods

Oral or written statements to the raised questions followed optimally by a discussion

Results

In low- and middle-income countries, a vast majority of people with mental disorders do not receive adequate treatment. Even in high income countries, roughly a third of people with severe forms of mental illness are not receiving the appropriate therapy. Laws concerning mental health are outdated in different countries. The protection of the human rights of the mentally ill is still incomplete and imperfect. The emphasis on economic gain and the digitalization of medicine in recent years has not helped. And new technical advancements such as artifical intelligence are becoming more important.

Conclusions

More discussion needs to be done on the identity and understanding of the psychiatric profession.

Disclosure of Interest

None Declared
Medical fitness for work in physicians with psychiatric disorders
Authors: Chemingui S. , Brahim D. , Youssfi I. , Mersni M. , Methni M. , Ben Said H. , Mechergui N. , Yaich I. , Ben Said C. , Bram N. , Ladhari N.
Published: August 2024

Introduction

Being a doctor is a profession with special medical requirements. Therefore, the assessment of medical fitness for work among physicians remains a complex decision, particularly for those with psychiatric disorders.

Objectives

To assess the fitness for work decisions among physicians with psychiatric disorders.

Methods

Descriptive and retrospective study including physicians with psychiatric disorders referred to the occupational department of the Charles Nicolle Hospital in Tunis for a medical fitness for work from January 1, 2018 to August 30, 2023.

Results

The study included 28 patients with a female predominance (sex ratio M/F at 0.3) and a mean age of 44.1 ± 12 years. Participants were general practitioners (N=12), junior doctors (N=10), specialists (N=5) and one dentist. They worked in the public health sector in 93% of cases, and had a mean professional seniority of 12.4 ± 9.3 years. A psychiatric history was found in 20 patients. Current psychiatric disorders recorded were: depression (N=15), bipolar disorder (N=7), anxiety-depressive disorder (N=4), personality disorders (N=1) and addiction (N=1). Concerning the fitness for work, six patients were fit for work and 11 were temporarily unfit. Job adjustments were proposed for 11 physicians, mainly night shift exemption.

Conclusions

Physicians are exposed to several occupational hazards and require strict medical qualifications. The impact of psychiatric disorders on medical fitness for work is considerable, and could be avoided by appropriate prevention by occupational health practionnairers, starting from professional orientation.

Disclosure of Interest

None Declared
Knowledge, attitudes, and beliefs about psychotropic medication among patients with mental disorders
Authors: Abdelkefi M. , Feki R. , Gassara I. , Omri S. , Smaoui N. , Charfi N. , Zouari L. , Ben thabet J. , Maalej bouali M. , Maalej M.
Published: August 2024

Introduction

Non-adherence to treatment is a major concern for mental health professionals. Knowledge of prescribed medications can influence patients’ willingness to adhere to them.

Objectives

The aim of this study was to assess the knowledge of patients with mental disorders about their prescribed medication and to evaluate their attitudes and beliefs toward treatment.

Methods

Our quantitative descriptive study involved 52 patients hospitalized in the psychiatric “C” department of the Hedi Chaker University Hospital in Sax between the 23rd and 30 October 2023. Excluded were aggressive patients, those who were unable to communicate, and those who refused to participate. Thirty-nine patients were included. For each patient, we collected sociodemographic, clinical, and disease progression data, as well as information, beliefs, and attitudes concerning the prescribed treatment.

Results

The mean age of our patients was 35.49 ± 10.24 years, with an exclusively male sample. Most patients had no occupation (69.2%). Only 10.3% were married. Over half of the patients had achieved primary school (61.5%) and lived in rural areas (64.1%). The mean duration of the mental disorder was 10.69 ± 9.07 years. Patients were hospitalized 3.62 times on average. The most frequent diagnoses were schizophrenia (35.9%) and bipolar disorder (33.3%). More than half of the patients (61.5%) knew the color and shape of the prescribed medication, and 48.2% knew the name and dose.

The source of treatment information was mainly doctors (33.3%) and family members (15.4%). Adherence to treatment was poor in 69.2% of cases. The majority of patients denied stopping treatment and 12.8% reported that they stopped treatment because of financial difficulties. Twenty-four patients confirmed that taking the treatment made people see them differently and that they preferred not to reveal they were taking it. Two-thirds of patients reported that the treatment relaxed them (71.8%) but could be stopped when they felt better (69.2%).

Conclusions

It is essential for mental health professionals to develop and implement effective intervention strategies that maximize therapeutic impact and reduce the risk of relapse.

Disclosure of Interest

None Declared
Prevalence and Risk Factors of Burnout Among Medical Residents in Tunisia: A Cross-Sectional Study
Authors: Haouari W. , Omri S. , Labyadh A. , Gassara I. , Feki R. , Charfi N. , Ben Thabet J. , Maalej M. B. , Smaoui N. , Zouari L. , Maalej M.
Published: August 2024

Introduction

The burnout syndrome is a blend of physical exhaustion and emotional fatigue that impairs an individual’s performance at work. In Tunisia, factors like working hours, the frequency of monthly shifts, and the physical and emotional abuse that physicians face from patients have collectively led to a significant incidence of burnout among medical professionals.

Objectives

To evaluate the prevalence of burnout syndrome among medical residents working in healthcare facilities in Tunisia and to pinpoint the contributing factors.

Methods

This study is a descriptive cross-sectional survey conducted among medical residents completing their training in various healthcare facilities in Tunisia. The study employed an online self-administered questionnaire and assessed burnout across three dimensions: personal burnout, professional burnout, and relational burnout, using the Copenhagen Burnout Inventory (CBI).

Results

A total of 50 physicians took part in the survey. Among them, 72% were female, 80% were single, and the average age at the time of the study was 27.72 years. Concerning their professional status, 84% worked in university hospitals, 16% specialized in surgery, 40% specialized in medicine, and 44% were family physicians. The majority were students from the Faculty of Medicine in Sfax (56%), with 30% in Monastir, 8% in Tunis, and 6% in Sousse. Regarding their work hours, more than 40 hours per week were reported by 32% of participants. According to the CBI scale, 12% of participants had scores indicating severe personal burnout, while 20% had scores indicating moderate personal burnout. Additionally,16% reported severe professional burnout, and 12% had scores suggesting severe relational burnout. In contrast, only 8% had scores indicating moderate relational burnout. The sociodemographic and professional factors that were studied, such as weekly working hours, monthly shifts, specialty, and workplace, did not show a significant correlation with the presence of burnout syndrome.

Conclusions

Burnout syndrome among medical resident physicians not only impacts their physical and mental well-being but also reduces their effectiveness and motivation at work. It is essential to introduce stress management strategies within hospitals to foster a healthier work-life balance.

Disclosure of Interest

None Declared
Women’s Attitude Toward Fertility And Childbearing in Saudi Arabia
Authors: Aloraini A. A. , Alamri R. A. , Alassaf D. S. , Alenzi E. , Alateeq D. A. , Almutlaq N. I. , jahhaf R. H. , Almajhad A. A. , Aloglla S. S.
Published: August 2024

Introduction

The decline in fertility is one of the major problems worldwide that could affect family structure. Many studies have been conducted to assess attitudes toward fertility and childbearing around the world, but there’s a lack of research about that in Saudi Arabia (SA). The study aims to assess women’s attitudes toward fertility and childbearing in SA and to investigate its association with sociodemographic, medical, and psychological factors.

Objectives

Aim of the Study: The purpose of the study is to assess women’s attitudes toward fertility and childbearing in Saudi Arabia and to investigate its association with sociodemographic, medical and psychological variables.

Specific Objectives:

1.

To assess women’s attitudes toward fertility and childbearing in Saudi Arabia.

2.

To investigate association between attitudes toward childbearing with sociodemographic characteristics in Saudi Arabia.

3.

To investigate association between attitudes toward childbearing with medical and psychiatric history in Saudi Arabia.

4.

To investigate association between attitudes toward childbearing with the childbearing preferences in Saudi Arabia.

Methods

This cross-sectional study of a convenient sample of 2172 women in SA in Dec 2022 and Jan 2023. Data were collected through a survey link that contains:1)Sociodemographic data, 2) medical and psychiatric history, 3) childbearing preference and 4) the Arabic version of the Attitudes toward Fertility and Childbearing Scale (AFCS). Data were analyzed by SPSS 25 ;We described the variables in means ± SD or percentage as appropriate. Student’s t-test and ANOVA were performed to analyze differences between the components and background characteristics.

Results

Individuals in the age group of 18-25 years (25.54± 9.08, p<0.001), unmarried (25.23 ± 8.87, p<0.001), and diagnosed with a psychiatric disorder (24.76 ±9.51, p<0.002) scored lower in importance of future of childbearing. In terms of hindrance at present and childbearing preparation, individuals in the age group of 18-25 years (25.66 ± 8.66, p<0.001) (18.53 ± 5.08, p<0.001) respectively, unmarried (25.71± 8.58, p<0.001) (18.46 ± 5.08, p<0.001) respectively, and students (25.92 ± 8.82, p<0.001) (18.55 ± 5.15, p=0.001) respectively were more likely to score high. Participants who had not made a decision about having children (9.36±3.32, p<0.001) scored lower in the female identity domain.

Conclusions

In conclusion, the findings of this study indicate that the younger age group (18-25 years) and those with psychiatric illnesses scored lower in the importance for future of childbearing compared to women of older age group (36-49 years ) and those without psychiatric illnesses. On the other hand, college students showed more concerns related to childbearing hindrance and preparation.

Disclosure of Interest

None Declared
Emotional burnout in psychiatrists during the war: experience of Ukraine
Authors: Maruta N. O. , Mishiev V. D. , Levin T. I. , Prib H. A. , Markov A. R.
Published: August 2024

Introduction

Psychiatrists being one of the significant groups associated with one of the highest risks of emotional burnout (EB). The risks of EB increase significantly in the conditions of war, which places increased demands on their physical, mental and psychological resources, and determines the relevance and necessity of studying the predictors, clinical phenomenology, psychological and psychopathological mechanisms of EB, and necessitates the development of innovative approaches to its corrections.

Objectives

The study the features of EB among psychiatrists in war period.

Methods

The examination included the usage of clinical-psychopathological, psychodiagnostic and psychometric research methods.

Results

The study sample consisted of 120 psychiatrists who worked in Kyiv in the period from February 24, 2022, during 2022. 69.2 of psychiatrists working in Kyiv during the war have manifestations of EB of varying intensity and clinical variability. All of them have signs of professional maladaptation (PM), deterioration of well-being, somatovegetative and dyssomnia disorders, deformation of social ties and decrease in motivation to work. In 47.5%, the formation of symptoms of tension, resistance and exhaustion are observed, 21.7% have clinically complited and formed all manifestations of EB and PM.

The leading diagnostic and prognostic marker of EB is PM, the manifestations of which are the first consequence of the imbalance of the processes of performing professional duties and internal resources, which will ensure their optimal implementation.

A mathematical model of the development and forecast of PM, as a leading descriptor of EB, was developed, which considers the state of socio-demographic characteristics (age, work experience, and the total quality of life indicator), affective indicators (objective and subjective manifestations of depression and anxiety) and psychosocial features (social-psychological adaptation). The use of this model makes it possible to determine 4 risk groups for the development of PM (low, moderate, high, very high), based on which personalized approaches to the diagnosis, therapy and prevention of EB among psychiatrists during the war have been developed.

Conclusions

The implementation and further evaluation of these approaches proved their effectiveness in eliminating the manifestations of EB and PM, normalizing the mental state with the levelling of psychopathological symptoms, improving the socio-psychological adaptation and quality of life of psychiatrists.

Disclosure of Interest

None Declared
Assessment of anorexia nervosa according to the DSM-5 alternative personality model using the SCID-5-AMPD diagnostic interview system
Authors: Bognár J. , Pólya D. B. , Purebl G. , Réthelyi J. , Bai-Nagy K. , Hamvas S. , Biliczki J.
Published: August 2024

Introduction

Anorexia nervosa (AN) is a chronic disease that significantly impairs the quality of life, with a low (less than 50%) remission rate, the incidence of which is increasing and it appears at younger and younger ages.

Objectives

Our aim is to facilitate effective and targeted therapy for anorexia nervosa by identifying personality traits and endophenotypes that aid diagnosis and identification of psychotherapeutic targets.

Methods

AN patients aged 18-45 years (N=14 female patients in the current study) completed online questionnaires on personality traits (PID-5), eating disorder (EDI-1), emotion regulation style, mentalization (MZQ), dissociation (DIS-Q), current emotional and mood state (SCL-90, PHQ-9), and past traumatic events (CTQ) after MINI and SCID-5-AMPD interview. Results were compared with a matched healthy control sample.

Results

Apart from AN, the most common comorbidity was depressive episode, and anxiety disorders were also present. In the SCID-5-AMPD interview, high scores were obtained for several domains describing personality dysfunction in the AN group. Among self-report questionnaires, we observed significant differences in scores on the SCL-90-R, and no difference in CTQ in the AN patients compared to healthy controls.

Conclusions

Based on the results of our study, the AN group showed more severe personality trauma, especially in the functional domains of identity and intimacy, and more psychological distress. The above may help to identify personalised psychotherapeutic treatment targets in AN patients, which may significantly improve effectiveness and reduce the time spent in therapy.

Disclosure of Interest

None Declared
The Prevalence of Attention Deficit Hyperactivity Disorder in Children and Adolescents: An Umbrella Review of Global Evidence
Authors: Ayano G. , Tsegay L. , Gizachew Y. , Demelash S. , Alati R.
Published: August 2024

Introduction

From recent epidemiological studies to emerging epidemiological evidence, it becomes evident that numerous primary studies have investigated the prevalence of ADHD in children and adolescents. Additionally, several systematic reviews and meta-analyses have explored this subject. The objective of this umbrella review is to offer a robust synthesis of evidence derived from these systematic reviews and meta-analyses

Objectives

To conduct a comprehensive umbrella review that synthesizes emerging epidemiological evidence regarding the prevalence of ADHD in children and adolescents, drawing insights from numerous primary studies as well as systematic reviews and meta-analyses.

Methods

We conducted a systematic search across multiple databases, including PubMed, Web of Science, PsychINFO, and Scopus, to identify relevant studies. The study was preregistered with PROSPERO (registration number: CRD42023389704). To assess the quality of these studies, we utilized the Measurement Tool to Assess Systematic Reviews (AMSTAR). We employed an inverse variance-weighted random-effects meta-analysis to combine prevalence estimates from the included studies.

Results

The final analysis incorporated thirteen meta-analytic systematic reviews, encompassing 588 primary studies and a total of 3,277,590 participants. A random-effects meta-analysis of these studies revealed that the global prevalence of ADHD in children and adolescents stood at 8.0% (95% CI: 6.0%–10%). Notably, the prevalence estimate was twice as high in boys (10%) compared to girls (5%). Among the three subtypes of ADHD, the inattentive type (ADHD-I) emerged as the most prevalent, followed by the hyperactive type (ADHD-HI) and the combined type (ADHD-C).

Conclusions

The comprehensive umbrella review findings emphasize the high prevalence of ADHD in children and adolescents, with a notable gender disparity, wherein boys are twice as likely to be affected compared to girls. These results underscore the urgency of prioritizing prevention, early identification, and treatment strategies for ADHD in children and adolescents.

Disclosure of Interest

None Declared
Working mechanisms of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy: a dynamic network approach
Authors: Van Eeden W. A.
Published: August 2024

Introduction

Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) seem be similarly effective for the treatment of major depressive disorder (MDD). However, much remains unknown about the differences in underlying psychological mechanisms of change. Assessing dynamic change of depressive symptoms and treatment-specific psychological constructs over time may yield important insights.

Objectives

The current study will be the first to compare dynamic symptom networks in randomized groups of two psychotherapies by using dynamic time-warp (DTW) analyses.

Methods

We reanalyzed data from a randomized controlled trail of 82 patients suffering from MDD. Three depressive symptom subscales (mood, sleep, appetite/weight) and three treatment-related constructs (dysfunctional attitudes, decentering, and experiential avoidance) were collected at 7 time-points before, during, after treatment, and at up to 12 months follow-up. The DTW-analysis modeled the temporal dynamics of depressive symptoms and treatment-related constructs within each individual after which the findings were aggregated on the group-level. Undirected and directed networks were constructed, of which the latter yielded in- and out-strength for each node, that were compared between treatment arms.

Results

Networks based on symptom and construct dynamics markedly differed between treatment arms. Within the CBT-arm a decrease of experiential avoidance was related to a decrease in dysfunctional attitudes (d = 0.059, p = 0.008). Within the ACT-arm a decrease of mood symptoms was related to a decrease of experiential avoidance (d = 0.051, p = 0.04) and an increase of decentering was related to a decrease in sleep symptoms (d = 0.038, p = 0.02) and appetite/weight symptoms (d = 0.049, p = 0.03).

Conclusions

DTW offers a promising alternative approach to study and compare working mechanisms of different treatment interventions. Comparing CBT and ACT revealed a decrease in experiential avoidance within CBT and an increase in the ability to decenter within ACT. However, within both treatments a change in other constructs, suggesting that a first alleviation of mood symptoms is important to activate underlying psychological change.

Disclosure of Interest

None Declared
Evaluation of The Relationship of Circular RNA With Suicide Behavior In Patients Diagnosed With Schizophrenia and Other Psychotic Disorder
Authors: Aydin M. , Unal S. O. , Ozdemir E. M.
Published: August 2024

Introduction

Schizophrenia is a major mental disorder with a high risk of suicide, which is one of the leading causes of early death in schizophrenia patients. It is known that suicidal behavior is 20-50 times higher in schizophrenia patients compared to the general population. Clinical features makes it difficult to determine the risk of suicide in this patient group. Since genetic studies on suicides of patients with schizophrenia are limited, this area was deemed worthy of research.

Objectives

CircRNAs can potentially serve as minimally invasive biomarkers because they can freely cross the blood-brain barrier. It is aimed to define the effect of circRNA molecules on suicidal behavior in patients diagnosed with schizophrenia and other schizophrenia spectrum psychotic disorders, and to increase protective and preventive approaches by predicting possible consequences of suicidal behavior.

Methods

104 patients followed up with the diagnosis of schizophrenia and and other schizophrenia spectrum psychotic disorders were included in the study. RNA was isolated from the blood taken into a hemogram tube, and three cirRNA molecules were identified using a number of RNA sequencing techniques. In addition, sociodemographic characteristics of the participants, clinical features of the disease, suicidal behavior history, current treatment status were questioned in detail. Simultaneously, the current clinical status was evaluated with clinical evaluation scales as Positive and Negative Syndrome Scale (PANSS), Calgary depression scale for schizophrenia (CDSS), Suicide Probability Scale (SPS), Beck Suicidal Intend Scale (BSIS).

Results

Three circRNA molecules were identified, chr3_196488683, chr5_69175537 and hsa_circ_0084021. No significant difference was found between these molecules and past suicide attempts. It was found that chr5_69175537 was negatively associated with the age of onset of psychotic disorder negative symptoms, and hsa_circ_0084021 was negatively associated with the age of onset of both negative and positive symptoms. When the relationship between the clinical assessment scales and suicidal behavior was evaluated, the PANSS general symptoms subscale score was significantly higher in the group with suicidal behavior (p<0.05). CDSS mean scores and BSIS scores were also found to be significantly higher in the group with previous suicide attempts (p<0.01).

Conclusions

Although our findings do not allow definitive conclusions due to the complex interaction between epidemiological and clinical factors and limited literature, it has shown that schizophrenia contains many risks that increase suicidal behavior. To predict suicide, circRNA molecules need to be supported by prospective studies with large sample groups and comparison with control groups.

Disclosure of Interest

None Declared