bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between life quality and emotional status among patients living with HIV
during the second wave of the COVID-19 pandemic in Russia
Authors: Titova V. V. , Rozhdestvenskiy V. I. , Gorkovaya I. A. , Ivanov D. O. , Aleksandrovich Y. S.
Published: August 2023

Introduction

Different areas of life quality are associated with emotional status. In pandemic
conditions, the index of life quality may contribute to emotional stability. However,
HIV-infected patients are at risk for affective disorders and are often characterized by a
low life rate.

Objectives

The study aimed to examine the relationship between life quality and emotional status
among HIV-infected patients during the second wave of the pandemic.

Methods

Data were collected between February and July 2021 using a Google form we developed.
Fifty-nine HIV-positive patients participated in the study. We used the WHOQOL-BREF to
examine the quality of life and the DASS-21 to determine depression, anxiety, and stress
levels. Both questionnaires were adapted for use in Russia.

Results

We found that 64 % of the respondents had no symptoms of depression, 61 % of the
patients reported no anxiety, and 71 % had no detectable stress. We found that physical and
psychological well-being was associated with depression (rxy = -0.318, p
< 0.05) and anxiety (rxy = -0.308, p < 0.05), microsocial support
was associated with depression (rxy = -0.430, p < 0.01) and anxiety
(rxy = -0.330, p < 0.05), social well-being with depression
(rxy = -0.375, p < 0.01), anxiety (rxy =
-0.448, p < 0.01) and stress (rxy = -0.362, p < 0.01).

Conclusions

During the second pandemic wave, the social well-being was most strongly associated
with emotional well-being among patients living with HIV. This indicates that different types
of social support are essential for this group of patients. Therefore, state authorities
should pay special attention to the social welfare of this group of patients.

Disclosure of Interest

None Declared
Second Generation Long-Acting Injectable Antipsychotics in Africa: About a Case
Authors: Galvañ J. , Nguepy-Keubo F. R.
Published: August 2023

Introduction

Schizophrenia affects people worldwide. In Europe, the advantages of second-generation and long-acting injectable antipsychotics (SG-LAIs) are known and used, supported by scientific evidence. However, somewhere there is limited evidence on this topic.

Objectives

Highlight the improvements in antipsychotic treatment and raise awareness of the scar between Europe and Africa, showing the results of the evidence with a case of cooperation with Cameroon.

Methods

About a case of a 42-year-old Cameroonian woman with 25 years of schizophrenia, treated with first-generation antipsychotic polypharmacy (APP) oral and depot, with several psychotic relapses, disorganized behaviors, motor and cognitive impairment and isolation (telemedicine consultation received through a NGO platform).

A search on PubMed was performed, selecting two systematic reviews including “antipsychotic” AND “Africa”, one systematic review for SGAs and four reviews for LAIs.

Results

Seven articles were reviewed, finding that APP use is highly prevalent in Africa with a lack of research on this, SGAs show an improved safety and tolerability profile and LAIs are among the most effective treatments in psychiatry improving adherence and overall patient outcomes.

In our case, we recommend progressively adjusting treatment to SG-LAI monotherapy, visiting the patient six months later in Cameroon, observing sustained stability of positive symptoms with an improvement of negative symptoms and good adherence and tolerability to treatment without extrapyramidal effects.

Conclusions

Our case is an example of the evidence that supports the improvement that SG-LAIs represent in psychiatric treatment and how international cooperation can help bridge the gap between Africa and Europe. Nevertheless, more research is needed to build bridges.

Disclosure of Interest

None Declared
Environmental manipulation and stimulation of atypical children trough art therapy
Authors: Hosu L.-M.
Published: August 2023

Introduction

The accumulated experience, both with typical and atypical children, led to the desire for an easier integration into the collective.Detecting and encouraging the skills of the atypical child, with the help of combined arts techniques and environmental stimulation, supports their’s integration into the comunity.

Objectives

Beneficiaries-Centered Art therapy, with the aim of identifying and developing outstanding skills, trough environmental manipulation and combined arts techniques

Methods

The environmental manipulation method is used in the art therapy session trough artistic installations and colorful fabrics. Trough chromatics and textures are generated different contexts and atmospheres sense, through which the atypical child comes to accept and discover that environment. Through the manipulation of artistic installations, gross motor skills are also required, having to produce large movements with the whole body, in order to shape the elements in the environment.

Costume making as a transitional phase in the adaptation of the beneficiary to the previously created environment independently or together with the art therapist, consists in harmonizing the beneficiary with the environment. These stages are achieved through mixed techniques of artistic work, painting, decorating, modeling, collage, weaving and binding techniques.

Results

By practicing these methods during the art therapy sessions, the beneficiaries increased their self-esteem through the achievements they had and discovered and improved their outstanding skills: fine and gross motor skills, color sense, visual thinking, hand-eye coordination; improved and developed both verbal and non-verbal communication between beneficiary - art therapist and beneficiary - beneficiary, in the case of group sessions

Image:

Image 2:

Image 3:

Conclusions

The role of the artist/Art-therapist can be to identify and encourage the creative potential of the beneficiaries by making both individual and team artworks; to support social integration through art and to value the outstanding skills of the beneficiaries.

Disclosure of Interest

None Declared
Craig Driver & Ross Warren (architects) will present examples of an innovative waymaking (wayfinding) concept from a current development in Norwich, UK
Authors: Warren R. D.
Published: August 2023

A new interpretation of the normalised “Wayfinding” design task offers the opportunity to become an important element of the larger clinical and architectural project for a new “core” expansion of a large regional psychiatric hospital in the South-East of the UK. We call this new approach Waymaking, as it goes beyond signage, leveraging our deep-set knowledge and understanding of the entire project at all scales.

Waymaking at the Rivers Centre for Mental Health (Rivers) begins with the exploration of movement narratives into and around its larger site. It turns a classic design task into a design opportunity on all scales, starting with an urban design and planning perspective, through to the architectural and landscape design decisions outside of the building and into the specific on-ward atmospheres in a manner integrated with the detail interior design decisions of colour, built-in-furniture and others.

Rivers has been carefully composed out of existing structures as well as smaller new-build and extension buildings. These are all set within a large, sloping site of noteworthy natural beauty. As such, Rivers can well be understood as a hillside village or campus of health - rather than as a traditional “hospital.” As a health village, Rivers provides spatial sequencing as the landscape design directly introduces a series of smaller, more human scale spaces built and natural all of which together aid in orientation and identity across the site. This will help support the daily use of the buildings by all stakeholders.

This strategy has been “baked-in“ to the architectural design as well, strategically distributed retreat/recovery spaces allow for space for de-escalation or relaxation. These can be found in the form of regular niches in the hallways and “porch” entrance spaces, usually with built-in benches and bespoke lighting elements. In addition to creating orientation affordances, these also provide opportunities for neurodivergent persons (ie. ASD, learning disabilities, etc.) to better understand and master independent movement around the Centre.

Disclosure of Interest

None Declared
Migration, perceived discrimination and the development of psychosis
Authors: Barata V. , Bastos J. , Cativo C. , Gonçalves P.
Published: August 2023

Introduction

Migration is a rapidly growing phenomenon in European countries and its association with psychotic disorders is a public health concern. Psychosis is more prevalent among migrants, which suggests that adverse social experiences play an important role in its pathogenesis. Throughout the migration process, migrants are exposed to several social disadvantages, including in the post-immigration context, where perceived discrimination appears to be an important stressor. In fact, the highest incidence rates of psychosis occur in the most discriminated populations, namely migrants with darker skin complexion, particularly when living in low-ethnic-density neighborhoods, where both discrimination and social isolation are more prominent.

Objectives

To conduct an updated review about the association between migration, perceived discrimination and psychosis, aiming to better understand the mechanisms involved.

Methods

Narrative literature review using the keywords “migration”; “psychosis”; “discrimination”; “racism” on PubMed database, in conjunction with presentation of a clinical case concerning a patient from Guinea-Bissau, admitted to our hospital in the context of first-episode psychosis (FEP), with onset months after completing the Mediterranean migration route to Europe.

Results

Literature suggests that experiences of racism and social exclusion contribute to feelings of imminent danger, fear and general anxiety, which may develop into paranoid ideas of ubiquitous persecution. Furthermore, intense social defeat experiences, common in migrants, are associated with more distressing forms of delusional content, with delusions of psychological persecution being more common. However, there is also evidence that migrants with FEP have better occupational and social functioning profiles compared to natives, suggesting that, in these patients, there is a higher burden of social-environmental risk factors, with the onset of psychosis occurring only when this burden overcomes a higher threshold. Our patient fits this description. After completing his migratory route and while living in an Italian refugee camp, he described suffering experiences of severe discrimination. Real or not, these experiences escalated to become delusional ideas of persecution involving European governments, thought to seek for his humiliation. Despite the presence of psychotic symptoms, this patient was able to maintain a reasonable level of functioning during years, up to his psychiatric admission.

Conclusions

Given the notorious effect of perceived discrimination and racism on the increased risk of psychosis in immigrants, it is urgent to adopt policies that promote the social protection of these vulnerable groups, namely through enhancing their integration in the host countries.

Disclosure of Interest

None Declared
Depressive episode as initial symptoms of Perry syndrome
Authors: Téllez Gómez A. , Pardo González C. , Sabater Ferragut A. , Ribes Cuenca J.
Published: August 2023

Introduction

Perry syndrome is a rare neurological disorder, characterized by atypical parkinsonian symptoms, sleep disturbances, central hypoventilation, weight loss, and psychiatric symptoms, especially apathy or depression. This syndrome is due to a TDP-43 proteinopathy as a result of a mutation in the DCTN-1 gene.

Objectives

To present the case of a patient with a mutation in the DCTN1 gene, related to Perry syndrome, who debuted with several depressive episodes, with apathy and weight loss.

Methods

A non-systematic literature review was conducted on PubMed database on depressive episodes related to Perry´s syndrome. The clinical case report was prepared through the review of the clinical record of the patient.

Results

The authors present the case of a 49-year-old man, who contacted psychiatry for the first time 10 years earlier due to depressive symptoms, suffering multiple episodes. These episodes consisted of hypothymic mood, apathy, anhedonia and marked irritability, together with suicidal ideation, leading to several drug overdoses. He also presented disruptive behaviors, such as abusive drinking and aggressiveness. These episodes responded to antidepressants at medium doses, although maintaining several relapses. Given this, it was decided to introduce valproic acid as a mood stabilizer, with good tolerance.

In parallel, the patient’s mother, who had also suffered from depressive episodes, began with dementia symptoms, after which it was decided to request a genetic study. In this context, a mutation, similar in both patients, was observed in the DCTN1 gene, related to Perry syndrome.

In the case of the patient presented, no other associated alterations were found, neither in the neurological examination or in the rest of the tests performed (polysomnography without notable alterations, functional imaging tests without pathological findings).

Conclusions

Neurological diseases as Perry syndrome can show depressive symptoms and other behavioral changes at the beginning, developing the rest of the symptoms (parkinsonism, weight loss or central hypoventilation) several years after the onset of the symptoms. It must be taken into account in patients with a family history of mutations or atypical depressive symptoms. It should also be assessed in terms of genetic counseling.

Disclosure of Interest

None Declared
Barriers to deprescribing anti-depressants in a primary care setting; an observational study - Are SSRI drugs of dependence and should these be re classified as schedule 3 drugs
Authors: Patel A. , Rasheed R.
Published: August 2023

Introduction

There has been an exponential rise in SSRI prescribing, between 2021 and 2022 there was a 5% increase. The majority of SSRI prescription initiation takes place in primary care. This is a national trend and mirrored internationally.

Objectives

The study was undertaken to understand barriers to deprescribing both prescribing clinicians and patients and the potential of dependence caused by continued prescribing of SSRI and SNRI. We wanted to understand deprescribing challenges and both clinical anxiety and difficulty experienced and see if there is a correlation with the Drug use screening tool (DUST) tool.

Methods

Those patients who were stable on SSRI were offered lowering of dose and deprescribing as part of routine medication reviews. During medication reviews patients were asked about willingness to embark on a deprescribing schedule. Patients were screened during medication reviews on the DUST to see if this can be used to predict difficulty with deprescribing. We designed a deprescribing difficult questionnaire to assess the difficulty experienced by clinicians during a deprescribing consultation. We were able to study the is a correlation with DUST scores and Clinician experience of difficulty and challenge in deprescribing of the SSRI and SNRI.

Results

Current alcohol drinkers and smokers were less likely to deprescribe from their antidepressants. Clinicals should do a risk assessment using the DUST screening tool checking for risk of dependence. There is an R value of 0.1586 (P-value is 0.018848) between the correlation of patients increased length time and increased DUST score causing an increased risk of dependence. The average R-score across the three practices between patient’s length of time being on medications and their DUST score is R= 0.18705 (P value of 0.01)

Conclusions

Inability to access IAPT therapies, shortened length of CBT sessions and lack of post IAPT support caused poor patient experience and contributed to reluctance to re-engage with IAPT services. Both cascade and incremental prescribing following lower doses without documentation of the limitations of medication results in unrealistic expectations generated from the prescribing. There is positive correlation between length of SSRI and SNRI prescribed, DUST scores, and Clinical challenge scores with patients’ unwillingness to be deprescribed. Patients should have a DUST score review prior to having been put onto any antidepressant as there is a potential link between increased DUST score and lower chances of willingness to deprescribe. Clinicians need to counsel patient of risk of dependence. The likelihood is these are drugs of dependence and clinicians should counsel patients of these risks and given review dates and offered deprescribing.

Disclosure of Interest

None Declared
Measurement-based care vs. standard care for major depressive disorder in Pakistan: protocol for a randomized control trial
Authors: Husain I. , Umer M. , Nigah Z. , Kiran T. , Bukhsh A. , Ansari M. , Bhatia M. R. , Husain O. , Naqvi H. , Qadir A. , Saqib M. , Rajput A. H. , Zeb M. A. , Khan S. A. , Siddiqui K. M. S. , Sherzad S. , Mulsant B. , Chaudhry N. , Chaudhry I. , Husain N.
Published: August 2023

Introduction

Low and middle-income countries (LMICs) hold the majority of disease burden attributed to major depressive disorder (MDD). Despite this, there remains a substantial gap for access to evidence-based treatments for MDD in LMICs like Pakistan. Measurement-based care (MBC) incorporates systematic administration of validated outcome measures to guide treatment decision making and is considered a low-cost approach to optimise better clinical outcomes for individuals with MDD but there is a paucity of evidence on the efficacy of MBC in LMICs.

Objectives

This protocol highlights a randomized trial which will include Pakistani outpatients with moderate to severe major depression.

Methods

Participants will be randomised to either MBC (guided by schedule), or standard treatment (guided by clinicians’ judgement), and will be prescribed with paroxetine (10–60mg/day) or mirtazapine (7.5–45mg/day) for 24 weeks. Outcomes will be evaluated by raters blind to study protocol and treatment.

Results

National Bioethics Committee (NBC) of Pakistan has given full ethics approval. The trial is being conducted and reported as per recommendation of the CONSORT statement for RCTs.

Conclusions

With increasing evidence from high-income settings supporting the effectiveness of MBC for MDD, it is now necessary to explore its feasibility, utility. and efficacy in low-resource settings. The results of the proposed trial could inform the development of a low-cost and scalable approach to efficiently optimise outcomes for individuals with MDD in Pakistan.

Disclosure of Interest

None Declared
Comparative Effectiveness of Daily Supportive Text Messages Versus Email Messages for Patients with Depression. Randomized Hybrid Type II Effectiveness-Implementation Trial
Authors: Adu M. K. , Shalaby R. , Eboreime E. , Agyapong V.
Published: August 2023

Introduction: Background

Major depressive disorder (MDD) is a global health problem accounting for about 40.5% of disability-adjusted life years caused by mental and substance use disorders. Barriers to accessing healthcare services have been reported, highlighting the need for innovative, accessible, and cost-effective psychological interventions. Several clinical trials have proven the effectiveness of supportive SMS text messaging in ameliorating depressive symptoms, however, this approach can only be accessible to individuals having cell phones.

Objectives

This paper aims to evaluate the effectiveness, feasibility, and user satisfaction of daily supportive email messaging as a non-inferior intervention compared to daily supportive text messaging as an add-on treatment for patients with depression.

Methods

This trial will be carried out using a hybrid type II implementation-effectiveness design. In addition to the usual care, patients with depression will be randomized to receive either supportive text messages or supportive email messages. The messages in both groups will have the same content and will be provided daily for 6 months. The implementation evaluation will be guided by the Consolidated Framework for Implementation Research and the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Descriptive and inferential statistics will be employed in the analysis of the quantitative outcome measures, while thematic analysis will be used for Qualitative data.

Results

The results are expected to be available 18 months after the start of recruitment. The results will highlight the feasibility, acceptability, and effectiveness of using automated emails as a strategy for delivering supportive messages to patients with depression as non-inferior to text messaging.

Conclusions

The outcome of this trial will have a translational impact on routine patient care and access to mental health, as well as potentially support mental health policy decision-making for health care resource allocation.

Disclosure of Interest

None Declared
A Review of the Metabolism and Relevance to Form and Formulation of Ketamine
Authors: Chue P. , Andreiev A. , Chue J. , Chue J. , Tate M.
Published: August 2023

Introduction

Ketamine is a phenylcyclohexylamine derivative comprising a racemic mixture of S- and R-ketamine that possesses anesthetic, analgesic, anti-inflammatory, and antidepressant activity. Oral (including extended release [PO]), intravenous (IV) sublingual (SL), transmucosal (TM), intranasal (IN), intramuscular (IM), rectal (PR), and subcutaneous (SC) formulations have been developed since its commercialization in 1970.

Objectives

To review and understand the impact of different forms and formulations on the pharmacokinetics of ketamine.

Methods

The extant literature on ketamine metabolism and formulations was reviewed and discussed.

Results

IV (racemic) ketamine (KET) has been shown to improve depressed mood within 4 hours with maximal effect at 24 hours. KET is a chiral molecule with two optimal isomers, R- and S-KET. KET is stereoselectively metabolized by CYP2B6 and CYP3A4 initially via nitrogen demethylation to active metabolite, norketamine (NK); there is no interconversion between R- and S-KET. NK is further metabolized to hydroxynorketamine (HNK) by CYP3A4 and CYP3A5; and dehydronorketamine (DHNK) by CYP2B6. Additional metabolic pathways exist including a direct enantioselective hydroxylation of KET to 6-hydroxyketamine (HK). Bioavailablity is greatest (100%) with the IV racemic KET formulation, but as low as 8% for oral S-KET due to extensive first-pass metabolism; the KET: NK ratio is a measure of first pass metabolism. NK plasma levels are higher with oral S-KET than KET as a result of local intestinal metabolism effects. Additionally, greater plasma concentrations are noted with IV bolus doses of S-KET vs. racemic KET or R-KET. S-KET possesses a longer elimination half-life than racemic KET due to inhibition by R-KET. KET is primarily renally eliminated and twice as fast in children vs. adults.

Conclusions

Complex interactions are reported between ketamine form (racemic/enantiomer), formulation, dose, and route of administration that impact on clinical variables and thus, outcome.

Disclosure of Interest

None Declared
Suicidal ideation in older people, a public health matter
Authors: Cohen R. B. , Pereira I. M. , Garrido M. M. , Ferreira B. V. , Sousa M. C.
Published: August 2023

Introduction

Suicide in older people is a critical public and mental health issue which requires attention, given that the ageing population is increasing.

Multiple factors, including biological, psychological, and social stressors increase suicidal susceptibility. Unfortunately, elderly are more susceptible to these, such as psychiatric disturbances, physical comorbidities, prior suicide-related behaviours, lack of social support, grief, and increased difficulty in problem-solving

Objectives

In order to review the risk and protective factors, assessment and prevention of suicide in older adults.

Methods

Bibliographic research through PubMed and Web of Science.

Results

Older people can be subdivided into three age groups (from “young old” at 65 years old to “oldest old” after 85 years of age), with suicide being more prevalent in the oldest-old, and overall in men above 75 years old.

Previous psychiatric background, suicidal attempts, substance abuse, poor physical health or disability, family psychiatric history, low social support or isolation, and finantial stress most frequently predispose to suicidal ideation, suicide attempts or death by suicide in this community.

Besides this, ageing relates to a tendency to cognitive impairment, which affects coping mechanisms, leading to deficits in reasoning and decision-making under stressful circumstances during depressive episodes. This can mediate suicidal ideation and associates to greater lethality methods. Geriatric suicidal attempters have been shown to have greater degrees of cortical and subcortical cerebral areas, including the frontal, parietal and temporal regions, as well as significant loss of volume in the dorsomedial prefrontal cortex, insula, midbrain, cerebellum, lentiform nucleus and putamen. Abnormalities in these regions can impair executive and cognitive function, attention, problem solving and ultimately be responsible for suicidal behaviour.

On the other hand, there are suicide protective elements such as physical and cognitive fitness, quality of life and life satisfaction, marital status, religiousness and social support. A prompt identification of modifiable risk factors and strengthening the protective ones by health professionals can reduce this prospect.

Conclusions

Suicidal ideation in older people is a multifactorial public health concern given the very high frequency of completed suicides in this population. Therefore, it is urgent to review and further research to build more effective suicide prevention strategies.

Disclosure of Interest

None Declared
Self-esteem is associated with loss of autonomy and depression in the elderly
Authors: Bouali W. , Kacem M. , Haouari W. , Zarrouk L.
Published: August 2023

Introduction

Self-esteem is an important aspect of adaptive processes at all ages of life and particularly in older adults: it is linked to the quality of adaptation, well-being, life satisfaction and health.

Objectives

study the links between self-esteem, autonomy and depression in the elderly

Methods

This is a descriptive and analytical study carried out over four months in the offices of three doctors. The population of the study were the consultants whose age was over 65 years the study was made using a pre-established sheet with certain socio-demographic characteristics, the pathological antecedents of subjects. We assessed self-esteem using the Rosenberg scale, autonomy using the activities of daily living scale (KATZ index), and depression using the mini GDS. The analysis of the results was carried out using SPSS 17 software.

Results

Our sample is made up of 54 consultants. The average age was 68 years old. The sex ratio was equal to 0.875. Negative self-esteem, loss of autonomy, depression were observed respectively in 40%, 56.7%, 36.7% of cases. We found an association between negative self-esteem and loss of autonomy (p=0.01) on the one hand, and depression (p<0.0001) on the other.

Conclusions

Our work showed an association between loss of autonomy, depression and negative self-esteem. Depression and negative self-esteem could be a consequence of the loss of autonomy or contributing factors?

Disclosure of Interest

None Declared
Gastric bezoar in a patient hospitalized in an eating disorder unit. Case report
Authors: Torres Cortés J. , Esteban Avendaño I. , González del Valle J. B. , González Lucas R. , Padín Calo J. J. , Morillo González J. P.
Published: August 2023

Introduction

It is well known that eating disorders are related to comorbidity. At least, half of these patients have other mental disorders and, in addition to it, the presence of physical comorbidity (cardiovascular, kidney, nervous system, digestive tract, metabolic or endocrine disorders) comes with a decline in life expectancy.

Objectives

Description of a patient with a diagnosis of anorexia nervosa (AN) who developed a gastric bezoar during hospitalization.

Methods

Case treated in a specific Eating Disorder Unit in a Third-Level Hospital.

Results

26 years old woman with a diagnosis of AN hospitalized in General Psychiatric Unit with BMI of 11,78 kg/m2. Nasogastric tube was necessary and, after 1 month with a progressive weight recovery (BMI 13,84 kg/m2), the patient was transferred to the Eating Disorder Unit in order to follow specific psychological therapy. No incidence related to physical exploration or clinical analyses happened during this month apart from pancytopenia due to malnutrition.

However, 8 days after, patient developed nausea and had 3 vomit episodes, constant abdominal pain at hipogastrium (moderate intensity), dizziness, instability and constipation. The patient refused possibility of pregnancy. The physical exam showed bowel sounds augmented but no mass or peritoneal irritation appeared. Blood test results were normal. Abdominal X-Ray showed gastric dilatation with small bowel faeces sign, which suggested diagnosis of gastric bezoar.

The treatment was the dissolution of the bezoar by Coca-Cola, solving the symptoms completely.

The patient refused having eaten hair or any other kind of object or indigestible material but admitted to be following a strict vegan diet. Finally, after an endoscopy was done, the patient was diagnosed of phytobezoar.

Conclusions

Based on literature, bezoars are rare in AN, being phytobezoars the most common between the types of bezoars. Nevertheless, there are some risk factors, such as delayed gastric emptying, dehydration or, in the case of phytobezoar, ingestion of food containing high amount of cellulose, hemi-cellulose, lignin, and tannins (celery, pumpkin, grape skins, prunes, raisins and, in particular, persimmons). Some of the symptoms caused by phytobezoar can be similar to those of the AN (abdominal pain, intestinal obstruction, poor appetite, vomiting, malnutrition, weight loss). Therefore, gastric bezoar could be an underdiagnosed or even undiagnosed disease in this group of patients. Taking this into account could reduce time until diagnosis and treatment, decreasing the risks associated.

Disclosure of Interest

None Declared
TELEPSICHOLOGYY AND OTHER CUTTING-EDGE TECHNOLOGIES IN COVID-19 PANDEMIC: BRIDGING THE DISTANCE IN MENTAL HEALTH ASSISTANCE
Authors: Lancia I. S. , Festa G. M. , Mancini M.
Published: August 2023

Introduction

Background: At the end of 2019, a novel coronavirus (COVID-19) was identified in China. The high potential of human-to-human transmission led to subsequent COVID-19 global pandemic. Public health strategies, including reduced social contact and lockdown have been adopted in many countries. Nonetheless, social distancing and isolation could also represent risk factors for mental disorders, resulting in loneliness, reduced social support and under-detection of mental health needs. Along with this, social distancing determines a relevant obstacle for direct access to psychiatric care services. The pandemic generates the urgent need for integrating technology into innovative models of mental healthcare.

Objectives

In this paper, we discuss the potential role of Telepsichologyy (TP) and other cutting-edge technologies in the management of mental health assistance.

Methods

We narratively review the literature to examine the advantages and risks related to the extensive application of these new therapeutic settings, along with the possible limitations and ethical concerns.

Results

Telemental health services may be particularly flexible and appropriate for the support of patients, family members and healthcare providers during this COVID-19 pandemic. The integration of TP with other technological innovations (eg, mobile apps, virtual reality, big data and artificial intelligence (AI)) opens up interesting future perspectives for the improvement of mental health assistance.

Conclusions

Telepsichologyy is a promising and growing way to deliver mental health services; but it is still underused. The COVID-19 pandemic may serve as an opportunity to introduce and promote, among numerous mental health professionals, the knowledge of the possibilities offered by the digital era.

Disclosure of Interest

None Declared
TELEPSYCHOLOGY WITH ITS INNOVATIONS IN PSYCHOTHERAPY AND PSYCHODIAGNOSTICS
Authors: Lancia I. S. , Festa G. M. , Sisinna M. L. , Ciarrocchi M.
Published: August 2023

Introduction

The types of Electronic-Based Therapy & Intervention are spreading rapidly, especially after the onset of COVID, and several authors are dealing specifically with digital psychology and psychiatry, implementing new techniques and methodologies (Festa, Martinotti, 2022).The latest technological innovations related to metaverse and holography are emerging as new digital mediums and a reflection on their potential in the psychological field is urgent. Telepsychology, which currently uses text, audio and video-based communication as a medium, will see the way to relate to the patient with the “new digital presence” amplified at 360 degrees. This will of course revolutionize some aspects of classic psychological intervention: “physical proximity” will have a completely different meaning. New technologies through the digital medium have the power to cancel space, thus allowing the intervention to be separated from the sharing of the same physical environment. The first great epochal upheaval produced by new technologies in the field of the psychological profession is precisely this: psychological intervention no longer necessarily coincides with the sharing of the same physical space, space and intervention becoming independent.

Objectives

We will soon and increasingly refer to associations, national and international professional associations and institutions that deal with the subject, such as the American Psychological Association, the International Society for Mental Health Online, the Online Therapy Institute, to have guidelines on best practice with respect to psychological performance online. This will be accompanied by specific training courses for clinicians who decide to work using technological tools and courses related to telepsychology and the development of a professional online identity.

Methods

Holographic technology will revolutionize our “internal and external world”, and it is the task of psychological science to cultivate questions and provide answers both on the impact that this technology will have on the life of the average man and on the possibilities of use for our profession. The distance of the real world from the digital one is getting smaller with each passing day.

Results

Our habits, our way of working, having fun have changed in different ways and in a very short time. Our physical, cognitive and sensory boundaries have expanded and our way of life has “evolved”.

Conclusions

We find ourselves passing through and going through a phase, which began in the 1980s, which is not without shadows and settles into mass cultural aspects. The contradictions, abnormal uses and abuses of technology, but which accompany every innovative transformation and which we should gradually manage wisely, are also typical of this phase. We will see what the future holds!

Disclosure of Interest

None Declared
Social cohesion and artistic resources, Two Clinical cases.
Authors: Simone N.
Published: August 2023

Introduction

Two emblematic clinical cases will be addressed in this poster. The purpose of the poster is to relate the aspect of how the artistic resources of psychiatric patients are useful to improve social cohesion.

Objectives

Correlate psychotherapy work on superior defenses to social cohesion and clinical improvement.

Methods

Psychopharmacotherapy. Psychoanalytically oriented psychotherapy. Psychiatric rehabilitation.

Social jutice idex (Schraad-Tishler, 2015) and BES (Istat 2015) as sources of social cohesion indicators.

Results

In the first case we have a man with ciclotimic personality disorder and substace abuse with psicotic episodes. Previously, the patient underwent repeated hospitalizations . Once the therapeutic relationship was hooked up and introduced in addition to pharmacological treatment, a psychotherapy also aimed at activating personal resources, the patient began to take an interest in the activity of a street artist. Over time and with the improvement of this activity, aspects of social cohesion have been highlighted in the social context. Social relations both linked to work and affective activity, as well as friends; improvement of the economic situation both through the economic return of this activity and through associative loans linked to this activity; an improvement of social inclusion and non-discrimination in the cities where the artistic activities were carried out; the use of fixed environmental spaces where the activity can be carried out. These aspects have favored a recovery that has reached the complete economic independence of the patient, the establishment of a family unit of their own, the progressive remission of the toxicophilic relapses and therefore the psychotic imbalances they induce.

In a second case, we have a 30-year-old patient with a severe depressive disorder, with narcissistic, paranoid and obsessive personality traits, graduated from the Academy of Fine Arts and with an artistic production both before and after the illness. In addition pharmacological therapy, the patient began psychotherapeutic interventions on the enhancement of superior defenses such as sublimation through artistic activity. So she began to rededicate herself to the artistic activity , she however progressively improved the recovery aspects for a long period of time up to living, working and emotional autonomy. During this path the aspects of social cohesion were also decisive, such an economic autonomy linked to the work activity of an employee in an art gallery, a progressive social inclusion, the conquest of spaces where you can exhibit your works and an increase in trust both towards the family and towards health workers and towards friends and work relationships.

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Conclusions

In this Clinical cases and others not reported exist correlation between psychotherapy work on superior defenses to social cohesion and clinical improvement.

Disclosure of Interest

None Declared
The weight of caring for your elderly – a cross-sectional analysis of non-professional caregivers for people living with dementia in Romania.
Authors: Zaharia S. , Alexandrescu T. , Ionescu T.-C. , Tudose C.
Published: August 2023

Introduction

While a growing corpus of literature regarding the stress suffered by caretakers for people living with dementia (PLWD) already exists, very little data is available regarding this subject among Romanian caretakers.

Objectives

This cross-sectional study aims to compensate for this by assessing a small (N=72) sample of caretakers through the use of self-reporting questionnaires for subjective feelings of stress and burden.

Methods

Responders filled and online survey containing miscellaneous socio-demographic questions and the Kingston Caregiver Stress Scale (KCSS) along with the Caregiver Health Assessment Self Questionnaire (CHASQ). Results were collected and analysed in SPSS for subsequent correlations.

Results

The majority (77%) of caretakers are women and 86% of responders are offering their care at home, emphasizing pervasive gender roles and lack of availability or accessibility of social services for the PLWD in Romanian society. Three thirds of caregivers were children of PLDW. More than half of responders (51%) had KCSS scores that suggested severe stress while less than 9% related only mild stress. Most responders (52%) related social aspects of their lives as most affected by their caregiver status.

Conclusions

While in line with most other findings and limited in scope and means by its methodology, this study offers a quick snapshot on the subjective levels of stress affecting caretakers of Romanian PLWD and can lead towards further points of inquiry on the matter in the Romanian population.

Disclosure of Interest

None Declared
Profile of persons placed under guardianship in the psychiatric department of Monastir
Authors: Amamou B. , Betbout I. , Ben Mbarek M. , Ben Haouala A. , Zaafrane F. , Gaha L.
Published: August 2023

Introduction

The legally incapacitated major is any person who, having acquired the legal majority, should therefore enjoy his rights, and face his social duties, but because of an alteration of his physical or mental faculties, is not able to provide alone for the safeguarding of his interests, nor to face alone his social obligations; there is, therefore, a need for protection which is the placing under guardianship.

Objectives

To describe the clinical and sociodemographic profile of the subjects put under guardianship in the psychiatric services of Monastir.

Methods

This is a retrospective descriptive study that focused on 71 files of subjects examined in the context of psychiatric expertise of guardianship in the psychiatric department Fattouma Bourguiba of Monastir during the period from 10-02-2016 to 08-06-2022.

Results

In total, we included 71 files of the subjects who were examined in the framework of the expert assessments of guardianship. The average age was 53 years. The predominance of males was noted with a sex ratio M/F = 1.5. Most of the patients were of urban origin; more than half (54.9%) were single with an average socioeconomic level for most of the patients (81.7%); 53.5% were illiterate and only 11.3% had a higher education level.

Among the somatic antecedents in our population, 40.9% had neurological pathologies: stroke 8.5%, epilepsy 7%, and dementia 9.9%. The psychiatric history (71.8%) was marked by intellectual disability (47.9%) followed by schizophrenia (28.2%).

Neuropsychiatric comorbidity was noted in 25.4%. The diagnoses retained at the time of the expertise were: intellectual disability (47%), followed by psychosis and dementia with similar percentages of 21%. The duration of the evolution of the symptoms in our population varied between 1 year and 60 years with an average of 22.56 years.

The request for guardianship was made by the siblings in 40.8% of cases, followed by the ascendants in 21.1%.

All the assessments took place at the hospital on a pre-arranged appointment and were formulated in French language.

Conclusions

The knowledge of the specificities of the different Tunisian laws governing guardianship is essential and the meticulous drafting of expert reports requires adapted training, which should be included in the basic training modules for psychiatrists.

Disclosure of Interest

None Declared
Barriers and facilitators to help-seeking for mental health problems in prison: A qualitative interview study with incarcerated males in Northern Norway.
Authors: Solbakken L. , Wynn R.
Published: August 2023

Introduction

The prevalence of mental disorders is considerably higher among incarcerated individuals than in the general population, but this burden is not matched by a proportional use of mental health services. Studies have found that incarcerated males are reluctant to seek help for mental health problems. Gaining knowledge of factors that influence incarcerated individuals to access or avoid professional help for mental health problems is important for tailoring interventions to address the mental health needs of this population. Promoting mental health service utilization among people in prison has the potential to reduce prison suicide rates and increase institutional functioning, thereby providing safer conditions for peers and staff, promoting rehabilitation, and reducing recidivism upon release.

Objectives

This study explores personal, interpersonal, and systemic aspects that motivate incarcerated individuals to approach or avoid seeking help for mental health problems. While prior studies have primarily focused on barriers to help-seeking, this study also sheds light on facilitators for seeking professional help for people in prison.

Methods

Individual in-depth interviews were conducted with sixteen incarcerated males from three prisons in Northern Norway. The data analysis was inspired by Grounded Theory.

Results

The majority of participants shared positive personal perspectives related to professional help-seeking, whereas the barriers were predominantly perceived to be of an interpersonal and systemic nature. Aspects that encouraged help-seeking were: regarding mental health treatment as necessary for successful rehabilitation, sufficient knowledge of when and how to contact mental health services, support from peers, having a higher ranking in the prison hierarchy, health services that are out-reaching, and prior positive experiences with professional help. The barriers to professional help-seeking were: lack of information about when and how to access mental health services, challenges with the self-referral system, perceived unavailability of services, confidentiality issues, and a prison climate that favoured a tough appearance.

Conclusions

The participants appeared to be more positive to seeking professional help for mental health problems than reported in previous studies with incarcerated individuals. Interpersonal and systemic aspects were emphasized by the participants as barriers to accessing mental health services; some participants even perceived these services to be unavailable to them. The results are relevant for designing interventions to promote help-seeking for mental health problems among people in prison.

Disclosure of Interest

None Declared