bluuebunny/crossref_metadata_2025 huggingface dataset:
Suicidal attempts and non-suicidal self-injury during gender affirming hormone therapy (GAHT) – a case report
Authors: Puzio D. , Palka-Szafraniec K. , Makowska I.
Published: September 2022

Introduction

Transsexual adolescents frequently present psychiatric comorbidities and psychopathology among which self-injurious behaviours are prominent (Modrego Pardo et al., 2021). GAHT seems to decrease the rate of mental health problems especially in terms of anxiety, depression and hostility (Heylens et al., 2014). However the impact of exogenous cross-sex hormones on non-suicidal and suicidal self-injurious behaviours is not thoroughly understood (Claes et al., 2015).

Objectives

We present the case of a transsexual boy who was first diagnosed with depression and benign self-injurious behaviours and subsequently - transsexualism.

Methods

He was prescribed a treatment with testosterone depot injections in fortnight intervals. The initiation of testosterone injections co-occurred with the switching of antidepressant drug. Self-injurious behaviours, substance abuse and suicidal attempts were observed regularly after GAHT onset – 10-14 days after a testosterone injection. The lethality and intensity of self-harm was greater than that observed before GAHT. After admission to the psychiatry unit pharmacotherapy was adjusted accordingly to presented symptoms. Remission of self-injurious behaviours followed.

Results

The incidence of self-injury 10-14 days after the injection of depot testosterone overlaps the peak of serum testosterone levels in treated patients (O’Connor et al., 2004). Moreover, a relative serotonin deficiency in a depressed patient may be insufficient to counteract testosterone believed to be driving aggressive tendencies (Batrinos, 2012).

Conclusions

Since psychiatric comorbidity and psychopharmacotherapy in transsexual young population is the rule rather than the exception, careful monitoring and therapy adjustment is crucial for maintaining safety and obtaining best results (Kaltiala et al., 2020).

Disclosure

No significant relationships.
Stress during the COVID-19 pandemic - impact on neuroplasticity
Authors: Bondar A.C. , Buciuc A.-G.
Published: September 2022

Introduction

The world’s population has been exposed to traumatic events and high levels of stress due to the ongoing COVID-19 outbreak. Stress is known currently as a universal experience, but the concept was first defined in 1936 by Hans Selye. It has been shown that stress is associated with impairments in neuroplasticity (e.g. neuronal atrophy and synaptic loss in the hippocampus, prefrontal cortex) and has a crucial role in almost all mental disorders.

Objectives

In this paper we aim to highlight the recent theoretical and experimental advances in neuroscience regarding stress induced neuroplasticity.

Methods

We analyzed scientific literature written in English and published between 2019-2021. We used the electronic portal PubMed-NCBI.

Results

In the last few years, molecular and cellular studies on animal models of stress related and stress-induced psychopathologies revealed alterations in gene expression, micro ARNs expression, as well as in intracellular signaling pathways that mediate the stress induced adaptations. These findings have led to new theories regarding depression and anxiety in the molecular neurobiology field. It has been shown that stress reduces BDNF expression inducing neuronal atrophy in various brain areas. Contrastingly, other studies have demonstrated that chronic antidepressant treatment increases BDNF expression. Furthermore, a crucial role has been assigned to miRNAs in the development of chronic stress-induced depression-like behavior and neuroplasticity.

Conclusions

We hope that this paper will increase interest in the field of stress induced cellular and molecular changes. More research needs to be pursued in order to achieve a deeper understanding of the pathophysiology of stress-induced mental disorders.

Disclosure

No significant relationships.
Effectivines of drugs for insomnia treatment
Authors: Jupe T. , Zenelaj B.
Published: September 2022

Introduction

Up to 10% of the US adult population will experience chronic insomnia, with women and elderly individuals at particularly high risk. Cognitive behavioral therapy is the core treatment for insomnia. When cognitive behavioral therapy is not enough, medications can help patients overcome the barriers and learned behaviors that prevent a good night’s sleep.

Objectives

Through this research we aimed to investigate the effectiveness and safety of new drugs in the treatment of insomnia.

Methods

We try to do a Bibliographic Review in PubMed using keywords like “insomnia” “new hypnotic drugs” and “effectiveness”

Results

Patients receiving trazodone perceived better sleep quality than those receiving the placebo with a non-significantly moderate heterogeneity. As to secondary efficacy outcomes, we only found a significant reduction for trazodone in the number of awakenings compared to the placebo. Trazodone was effective in sleep maintenance by decreasing the number of early awakenings and it could significantly improve perceived sleep quality, although there were no significant improvements in sleep efficiency or other objective measures. Importantly, lemborexant improves latency to sleep onset and sleep maintenance and is able to help people who experience early morning awakenings. Safety data reveal that lemborexant has minimal residual effects on morning alertness or next day function.

Conclusions

Unfortunately, treatment of insomnia is not always that simple. The disorder’s complex underlying pathophysiology warrants consideration of different nonpharmacologic and pharmacologic treatment options. Indeed, recent insights gained from research into the pathophysiology of insomnia have facilitated development of newer treatment approaches with more efficacious outcomes.

Disclosure

No significant relationships.
Features of addictive beliefs with different types of addictions
Authors: Pustovaya A. , Yan Y. , Gutkevich E.
Published: September 2022

Introduction

Today, a number of researchers consider the problem of addictive behavior as one of the most global problems for Kazakhstan and Russia. Some scientists consider CBT to be the most effective way to work with addictions. In our country there are no scientific works devoted to the study of addictive beliefs, so we decided to conduct such a study.

Objectives

The Objective of the study was to identify the characteristic addictive beliefs of drug addicts with different type of addiction: opioids and synthetic cathinones (designer drugs called “salts”, “bath salts”).

Methods

Questionnaire of addictive beliefs by A, Beck, questionnaire of beliefs about cravings by A. Beck and F. Wright, clinical interview. Descriptive statistics and chi-square test were used for data processing.

Results

People with opioid addiction are more likely to believe that their lives will become more depressive if they stop using drugs (p= 0.0347); that drug use is the only way to cope with pain in their life (p= 0.0347) and that they cannot cope with anxiety without drugs (p=0.009). Respondents who use synthetic psychostimulants endorse to believe that addiction is not a problrm for them (p= 0.0358).

Conclusions

Having categorized these beliefs in accordance with A. Beck’s classification, we came to the conclusion that “relief-oriented beliefs” are more typical for people who use opiates. The motive for use is often the desire to alleviate a negative emotional or physical state. For people using psychostimulants “salt”, “anticipatory beliefs” are more characteristic - the desire to experience euphoria and pleasant experiences.

Disclosure

No significant relationships.
Alcohol abuse in trans and sexual minority women
Authors: Gouveia P.A.
Published: September 2022

Introduction

Sexual orientation is known to have some influence in alcohol consumption patterns and outcomes. Sexual minority women (SMW) are more likely to develop binge drinking and alcohol use disorder than heterossexual women. Because women tend to be more secretive with their drinking and hesitant to get help, and alcohol is particularly harmful to the female body, SMW pose particular challenges.

Objectives

Review the latest research on alcoholism in SMW, focusing on various specificities of this population.

Methods

Literature review in the PubMed database, using the MESH terms “alcohol use disorder”, “women”, “female”, “trans woman”, “adult”. Free full text, publication in the last 5 years, English or Portuguese and article typology filters were applied. Following primary hits, secondary references were checked and a total of 10 articles were included. Results were grouped in epidemiological, etiological, therapeutical and prognostic specificities.

Results

Data indicate that lesbian and bisexual women, compared to heterosexuals, are twice as likely to engage in binge drinking. AUD prevalence and patterns of alcohol use are especially higher among younger SMW. The influence of sexual orientation on alcohol use and related outcomes seems to be greater among women than men. Regarding etiology, internalized stigma, minority stress, victimization experiences, social norms and policies are the main culprits Even though SMW are more likely to report and ask hor help, many do not receive adequate treatment. SMW show an incresed risk of developing other complications, such as physical injuries, sexual assault, liver or cardiac disease.

Conclusions

Sexual minority women are particularly vulnerable to alcohol-related harms. Interventions especially directed to SMW need to be developed.

Disclosure

No significant relationships.
The effect of contamination disgust on Covid-19-related anxiety
Authors: Santarelli G. , Innocenti M. , Faggi V. , Galassi F. , Castellini G. , Ricca V.
Published: September 2022

Introduction

It is proven that high levels of disgust contribute to implementing protective behaviors. Investigators also discovered that the emotion of disgust plays a central role in determining anxiety related to the contraction of COVID-19. Few data are available about the role of the contamination disgust, a specific disgust domain, in this relationship.

Objectives

The effect of contamination disgust on COVID-19-related anxiety was investigated.

Methods

295 healthy subjects were enrolled through an online survey. They completed Disgust Scale-Revised (DS-R) and were asked to estimate their levels of Covid-19-related anxiety in 12 proposed situations. A total score was then calculated. An ANOVA model having Covid-19-related anxiety total score as dependent variable, and DS-R contamination disgust, age, and sex as predictors was estimated.

Results

The overall model was significant (F(3,291)=6.402, p<0.001) and explained 6.2% of total Covid-19 anxiety variance (R2=0.062). The effect of DS-R contamination disgust on Covid-19-related anxiety was positive, significant (B=0.974, t(291)=3.227, p=0.001) and explained 3.5% of Covid-19-related anxiety variance (partial η2=0.035). A significant effect of sex was detected
(F(1,291)=4.919, p=0.027), with females having higher Covid-19-related anxiety than males, while no effect was detected for age (B=-0.024, t(291)=-0.884, p=0.377).

Conclusions

The presented data provide preliminary evidence for an effect of contamination disgust on Covid-19-related anxiety.

Disclosure

No significant relationships.
The impact of psychiatric disorders of parents on the severity of substance use disorder in their offspring
Authors: El-Makawi S. , Abou El Magd S. , Nagy N.
Published: September 2022

Introduction

There is a lack of evidence in the literature about the impact of offspring addiction and their parents’ mental health. Objective is to explore psychiatric disorders in parents of patients with substance dependence and their effect on the severity of their addiction.

Objectives

To evaluate psychiatric disorders in parents of patients with substance dependence and their effect on the severity of their addiction.

Methods

This is a cross sectional study contained group (A) 150 patients diagnosed with substance dependence according to DSM-IV. Patients were recruited form Psychiatry and Addiction Hospital of Cairo University. Group (B) included one or both parents of the patients group. The Addiction Severity Index (ASI) was used for the patients.

Results

In the patients group, mean age was 24.89 (±4.52). 96% of them were males 4% were females. In the parent group, mean age was 51.59 (±5.48). 84% of them were mothers 16 % were females. Patients group was associated with moderate degree of education (46.7%), 73.3% were single and 64% were unemployed. Anxiety disorders (80%) and depressive disorders (69.3%) were the most prevalent among parents group. ASI score was statistically significant in predicting the incidence of parents psychotic and schizoid disorders (100% sensitivity, 86.3% specificity, AUC=0.887, P value <0.0001).Besides we found a significant correlation between patients ASI scores and parents psychiatric disorder.

Conclusions

This result emphasizes the relation between patient substance use disorder and psychiatric disorder of their parents. Patients ASI score may be a possible measure for parents mental disorder. Further research is needed to validate our findings.

Disclosure

No significant relationships.
A Network Analysis Study Investigating Posttraumatic Stress Disorder and Dissociation Comorbidity in a UK Armed Forces Veteran Sample
Authors: Armour C. , Mcglinchey E.
Published: September 2022

Introduction

An established body of literature has identified that PTSD and dissociation are comorbid. Furthermore, the DSM introduced a dissociative subtype of PTSD into their most recent update; DSM-5.

Objectives

The current study aimed to examine symptom-level associations between PTSD and dissociation using network analysis among UK Armed Forces veterans resident in Northern Ireland (NI) to identify if there are certain symptoms that may act as bridges between the two constructs.

Methods

A large scale cross sectional survey was conducted examining the physical and mental wellbeing of UK Armed Forces Veterans living in NI. The total eligible sample size was 619 (89.8% male), with a mean age of 55.38 years (SD = 10.41). Two networks were estimated, (1) a network consisting of 20 DSM-5 PTSD items and (2) a network consisting of 20 PTSD items and four dissociative items. Expected influence bridge centrality was calculated to examine symptoms with the most/strongest cross-domain associations (i.e. between PTSD and dissociation). The presence of meaningful clustering among symptoms was also explored.

Results

The PTSD symptoms ‘concentration problems’, ‘flashbacks’ and ‘negative emotional state’ had the highest relative bridge expected influence centrality. Of the four dissociative items, ‘gaps in awareness’ had the highest relative bridge expected influence centrality, followed by ‘cognitive-behavioural re-experiencing’. A community structure of five clusters was detected. Four clusters reflected each subscale of the PCL-5 PTSD items and the final cluster reflected the dissociation items.

Conclusions

This study extends our understanding of PTSD and disociation comorbidity by investigating symptom level relationships; potentially informing future treatments and interventions.

Disclosure

No significant relationships.
Behavior of addicted patients during the COVID-19 pandemic
Authors: Bencharfa Z. , Amara Y. , Tbatou L. , El Omari F.
Published: September 2022

Introduction

The COVID-19 pandemic led governments to take a number of restrictive measures, which had an impact on the consumption of psychoactive substances among the world population.

Objectives

The present study, carried out by the Addictology Center of Ar-razi Hospital in Salé, aimed to evaluate the behavior of addicted patients followed in ambulatory care, during the Covid-19 pandemic.

Methods

We conducted a cross-sectional study with 128 patients, through a questionnaire assessing sociodemographic factors, psychiatric history, type and quantity of substances used during the pandemic, and withdrawal attempts.

Results

The primary substance used was tobacco, followed by Cannabis, alcohol, hypnotics, and then Cocaine.

63% of patients reported an increase in their consumption during the pandemic, 64% started new substances, mainly Cannabis, followed by organic solvents.

The monthly amount spent by our patients varied from 300 to 40,000 dhs/month, the source of this amount was legal in 92.2% of the cases, 43.8% had already been incarcerated or taken into custody as a result of this consumption.

78% of our patients had already tried to wean themselves off the drug, but only 39% were able to succeed.

Conclusions

The pandemic had a profound effect on the incidence of substance use.

Confining the population has indeed reduced the transmission of the virus, but it is far from harmless for the mind.

Disclosure

No significant relationships.
Efficiency of the original flavonoids composition based on Curcumin in chronic alcohol intoxication
Authors: Markova E. , Goldina I. , Savkin I. , Knyazheva M. , Smyk A.
Published: September 2022

Introduction

Multiple tissue and organ damage induced by ethanol toxic effects requires prescription of a wide range of drugs that have a positive symptomatic effect, while simultaneously increasing the toxic load on the body, which necessitates the search for new approaches to the therapy of alcoholism, possibly with the use of parapharmaceuticals.

Objectives

The anti-inflammatory, antioxidant and neuroprotective properties of curcuminoids, as well as their ability to influence the epigenetic mechanisms of gene expression regulation, can provide a positive therapeutic effect in alcoholism by influencing the pathogenetic mechanisms of this pathology, which determines the relevance and prospects of studying their effects during chronic ethanol intoxication.

Methods

(CBAxC57Bl/6) F1 male mice with 6-month 10% ethanol exposure were undergoing administration of original composition of flavonoids based on Curcumin for 40 days. Animal’s alcohol consumption, behavior and immune parameters were estimated.

Results

As a result of flavonoids original composition administration, correction of the changes in the nervous system functional activity, caused by the chronic toxic effect of ethanol has been achieved (decrease in alcoholic motivation, exploratory behavior stimulation, modulation of the cytokines level in brain, indicating a neuroinflammation decrease). We also registered the immune system functional activity modulation (stimulation of immune response and lymphocytes proliferative activity) in mice with alcohol dependence.

Conclusions

The original composition of flavonoids against the background of long-term alcohol consumption has a positive psychoneuroimmunomodulatory effect, which serves as an experimental substantiation of the prospects of using the composition as an adjuvant in the treatment of chronic alcoholism.

Disclosure

No significant relationships.
prevalence of addictions among students at the High School of The Health Sciences and Techniques of Sousse
Authors: Betbout I. , Amemou B. , Ben Haouala A. , Sghaier A. , Sahli M. , Zaafrane F. , Mhalla A. , Gaha L.
Published: September 2022

Introduction

Addiction isfrequent in youngsubjects, particularly in students, who are in contact with psychoactive substances such as drugs, tobacco, alcohol, and cannabis

Objectives

The objectives of our study were to investigate the prevalence of addictions among ESSTSS students and to determine the factors associated with addictions.

Methods

A descriptive correlational cross-sectional study was conducted at ESSTSS among 122 students for 2 months (March and April 2021). The data was collectedusing a questionnaire administered to the students.

Results

There were 102 women and 20 men with an averageage of 20.96 years. theprevalence of drug use was 56.6% according to DAST-10, with addiction notedin 5.7% of cases. The prevalence of tobacco use was 35.3% according to the Fagerstörm test, with 23.3% of the students being highlyaddicted to tobacco. The prevalence of alcohol use was 29.5%, 35% for men, and 28.43% for womenaccording to the AUDIT, alcoholdependence was notedin 14.3% of men and 6.9% of women. The prevalence of cannabis use was 16.4% according to the CAST test, a high risk of dependence was observedin 20% of cases. The analytical study showedthat the factors associated with addiction were age, gender, year of study, and specialty

Conclusions

The prevalence of substance use among health science students is significant and since the use of these substances has a detrimental effect on health itisbetter to understand the associated factors and this obliges us to establish appropriate preventive interventions

Disclosure

No significant relationships.
“Walking with myself by my side” - non-medical use of Ketamine
Authors: Vaz R. , Martins J. , Costa A. , Brás J. , Sousa R. , Almeida E. , Abreu J. , Teixeira D. , Marques A. , Gil N. , Carriço P.
Published: September 2022

Introduction

Ketamine, synthesized in 1962 as phencyclidine derivate, is denominated a “dissociative anesthetic” because of its side-effects, such as dissociative episodes and psychotic-like symptoms, which have limited its applicability on clinical practice. Otherwise, in the last decades the non-medical use of ketamine has been growing and today is one of the most popular illicit substances consumed between adolescents and young adults.

Objectives

Increasing the knowledge and understanding of the factors related to crescent use of ketamine and the experiences and consequences associated to its consumption.

Methods

Clinical interview with patients diagnosed with ketamine use disorder and bibliographic research in Pubmed database using the terms “Ketamine use” and “Ketamine addiction”.

Results

Pat et al. (2002) describes a clinical case of a young male, diagnosed with substance use disorders, specifically alcohol and cocaine use disorders, that started a treatment with ketamine. After the treatment, pleasant depersonalization experiences contributed to the development of patient’s ketamine dependence. Other patient’s reports confirm the association of ketamine use with psychedelic effects and dissociative episodes and pointed these effects as main reason for its consumption.

Conclusions

The adverse effects that limited the medical use of ketamine are the same that promote its utilization with recreational purposes by adolescents and young adults in parties and nightclubs. About the ketamine dependence, the literature is scarce and doesn´t clearly identify a physical withdrawal syndrome, pointing only to a serious psychological dependence. Thus, with the crescent non-medical use of ketamine, it’s urgent to develop an intervention plan directed to this problem.

Disclosure

No significant relationships.
Tobacco dependence and schizophrenia: Tunisian cross-sectional study of 50 cases
Authors: Jabeur M. , Gassab L. , Anes I. , Ben Haouala A. , Zaafrane F. , Gaha L.
Published: September 2022

Introduction

Tobacco-use is currently one of the major public health problems and is more common among patients with schizophrenia.

Objectives

We aimed in this study to estimate the prevalence of smoking in a population of patients with schizophrenia, to assess tobacco dependence and to identify its correlated factors.

Methods

This is a descriptive and analytical cross-sectional study carried out on 50 outpatients at the Department of Psychiatry (Tunisia) over a period of two months. For the data collection, we used: a general questionnaire on sociodemographic characteristics and tobacco consumption and the Fagerström test for nicotine dependence.

Results

All the patients were male with a mean age of 32.7±7.02 years and 84% of them were tobacco consumers. More than half of the sample were single (68%) and had a primary school level (52%). A professional irregularity and low socio-economic level were found successively in 84% and 78% of cases. Half of the patients (52%) were diagnosed with paranoid schizophrenia and 46% of them were treated by atypical antipsychotics. Cigarette dependence was strong or very strong in 82% according to the Fagerstrom test. A positive correlation was found between strong tobacco dependence on the one hand and low socio-economic level, professional irregularity, smoking in a first-degree relative and treatment with a typical neuroleptic on the other hand.

Conclusions

Our study and data from the literature show that subjects with schizophrenia constitute a population of highly dependent smokers. A smoking cessation assistance program for this vulnerable population is a priority to improve their quality of life.

Disclosure

No significant relationships.
Psychiatric comorbidity among patients attending an addiction treatment center in Morocco
Authors: Jelti A. , Kennab F. , N’Sabi F. , Oneib B. , Elghazouani F.
Published: September 2022

Introduction

The comorbidity between psychiatric disorders and substance use disorders is more and more common in daily clinical practice. However, only few studies have adressed this subject in north african patients.

Objectives

The main objective of our study was the estimation of the prevalence and patterns of psychiatric co-morbidities in substance users seeking care.

Methods

Our work consisted of a cross-sectional study of a sample of patients attending outpatient substance use treatment at the addiction center in Oujda, Morocco. A hetero-questionnaire was used to collect sociodemographic data and patient history, DSM-IV criteria to assess substance abuse and dependence, and the Mini-International Neuropsychiatric Interview [MINI] to assess psychiatric comorbidities.

Results

Our study involved 100 patients, with a male predominance (89% of users). The main substances used in the last 12 months were tobacco (78%), followed by cannabis (74%), alcohol (50%), and benzodiazepines (44%). Psychiatric comorbidity was identified in 71% of the users, 51% of whom had a depressive disorder, 35% an anxiety disorder and 10% a gambling disorder. The dependence on the substance that initially motivated the consultation was higher in patients with psychiatric comorbidity (p=0.033). The post-traumatic stress disorder was significantly associated with the presence of alcohol dependence (p=0.028). The presence of benzodiazepine dependence (p=0.025) and abuse of cocaine (p=0.028) and Ecstasy (p=0.000) were significantly associated with suicide risk.

Conclusions

Our study found a high prevalence of psychiatric comorbidities among substance users seeking treatment, this should prompt clinicians to pay particular attention to this issue in order to adapt and improve their management.

Disclosure

No significant relationships.
Predictive factors for treatment failure in reducing alcoholic consumption by case management in alcoholics living in permanent rental apartments
Authors: Kim S.-G. , Huh S. , Kim Y.S.
Published: September 2022

Introduction

Based on the results showing that there are more alcoholics in the low-income bracket, case management (CM) for such cases was initiated in 2011. As a result, the treatment failure rate was identified between 43-44% based on the WHO criteria.

Objectives

We investigated the predictive factors for the treatment failure to maximize successful CM treatment.

Methods

Thirty-nine subjects from Sasang-gu and Saha-gu treated by four social workers using CM were included in this study. Failure was defined when the level of risk was maintained or increased as per the WHO criteria. The clinical characteristics of the subjects including their age and gender were collected.

Results

Typically, 17 (43.6%) subjects demonstrated treatment failure by the CM (TF). Compared with the subjects who were treated successfully (n=22; TS), TF maintained abstinence in shorter periods in terms of the longest abstinent period compared with TS while CM (28.24±.99 vs. 76.82±.27, p=.025). The higher population in TF did not make an effort to quit drinking compared with TS while CM (41.2% vs.13.6%, p=.051). Also, more TF stayed with their family members compared with TS (58.8% vs. 31.8%, p=.092).

Conclusions

The results showed that shorter abstinence periods and the absence of efforts initiated to quit drinking while CM, and living with family members were the predictive factors for failure in treating alcoholics by the CM. It is presumed that influencing patients to quit drinking and encouraging them to abstain for longer periods are crucial to attaining successful treatment.

Disclosure

No significant relationships.
Development of posttraumatic stress disorder symptoms after intensive care - how to prevent it?
Authors: Teixeira T. , Quarenta J. , Martins S. , Almeida A. , Ribeiro B.
Published: September 2022

Introduction

Over the last decade, there has been identified that critical illness survivors have high rates of psychiatric disorders such as posttraumatic stress disorder (PTSD). The experience of admission to intensive care units (ICU) and illusory memories may cause short and long-term psychological disorders.

Objectives

To evaluate psychiatric disorders, such as PTSD, after ICU discharge, and determine the prevalence, risk factors, and prevention strategies for PTSD in these patients.

Methods

Non-systematic review through research in PubMed. Addicionally, a case report will be exposed, after the patient was diagnosed with SARS‑CoV‑2 and stayed in ICU for more than 30 days.

Results

The development of PTSD has been related to the number of adverse memories patients recall from their ICU experience. Some studies have shown that approximately 47% of patients remember real facts and 34% have illusory memories relative to their stays in the ICU. There were identified some risk factor associated to the increased risk of post-ICU PTSD, such as early post-ICU memories or psychotic experiences, pre-ICU psychopathology, benzodiazepine sedation during ICU and substantial acute stress symptoms occurring < 1 month after exposure to a traumatic stressor.

Conclusions

High levels of anxiety and the development by patients of PTSD are being recognized as significant problems occurring after a stay in an ICU. The results of this study highlight the need to recognise the risk factors and to establish a early follow-up after ICU stay. This way is possible to identify patients who are at risk of developing acute PTSD-related symptoms, and early intervention can be institued.

Disclosure

No significant relationships.
Suicide attempts in patients with acute and transient psychotic disorders in in-patient centers in Latvia 2014-2019
Authors: Germanenko I. , Vrubleska J. , Rancans E.
Published: September 2022

Introduction

Acute and transient psychotic disorders (ATPDs) are a group of diagnoses with acute onset and polymorphic psychotic symptoms, divided into 6 subtypes, which may or may not associate with acute stress. Suicide is a serious public health problem, having long-lasting effects on social well-being and economics. The prevalence of suicide attempts (SA) in Latvia remains unknown, several studies are currently in progress.

Objectives

To determine the prevalence of SA among patients with ATPDs and features of this subgroup of patients.

Methods

Retrospective study based on socio-demographic data and additional diagnoses of all patients with ATPDs provided by the National Center of Statistics of Diseases.

Results

There were 1779 patients with ATDPs in 2014-2019, 44 people were admitted with a SA (24 men, 54.5%). There was a significant difference between sexes in the mean age – 39.64±14.66 for women, 31.94±11.88 for men (p<.001), as well as in case of associated acute stress – 37.61±12.95 with and 35.33±13.15 without it (p=.01). There were no differences in age or ATPDs subtypes between patients with SA and without one. Men with SA abused alcohol in everyday life more than women and men without SA (20%,p<.001), women with SA had acculturational difficulties more often than men and women without SA (45%,p<.001). Intentional self-harm by sharp objects was more common among men (p<.001), intentional self-poisoning among women (p<.001).

Conclusions

The prevalence of SA among patients with ATPDs was 2.47%. Factors, which were more commonly observed in patients with SA were alcohol consumption and acculturational difficulties. Types of self-harming differ between sexes.

Disclosure

No significant relationships.
Possible utility of neutrophil/lymphocyte ratio as a predictor of suicidal risk in mood disorders
Authors: Flamini W. , Torrigiani S. , Mucci F. , Ivaldi T. , Marazziti D. , Dell’Osso L.
Published: September 2022

Introduction

Correlations between neutrophil/lymphocyte, platelet/lymphocyte, and monocyte/lymphocyte ratios (NLR, PLR, and MLR, respectively) and psychopathological and clinical variables in the context of mood disorders are increasingly emerging in international scientific literature, being the former one of the most studied. The estimation of suicidal risk associated to affective disorders could benefit from such rapidly and easily available biomarker of inflammation, if significant in this regard.

Objectives

The present review would like to focus on any existing correlations between NLR and suicidal risk in patients with mood disorders.

Methods

We sourced articles on the topic found in major scientific literature databases, combining the keywords “neutrophil/lymphocyte ratio”, “NLR”, “mood disorders”, “major depressive disorder”, “bipolar disorder” and “suicide risk”.

Results

There are congruent findings of significantly higher NLR values in depressed patients attempting suicide than in depressed patients with no suicidal behaviors or healthy controls. In addition, violent means appear typical in this subgroup of depressed suicidal patients, suggesting that patients with higher levels of NLR are at risk of attempting suicide and to be successful in self-harming. Similar results have been found in patients with bipolar disorder, showing a positive correlation between NRL and suicide risk, evaluated by the Suicide Behaviors Questionnaire-Revised (SBQ-R). Moreover, in patients with a positive family history for suicide attempts, NRL was found to be a significant positive predictor of suicide risk.

Conclusions

These findings, although limited, support the notion that NLR might be a useful marker for suicide vulnerability in both BD and MDD patients.

Disclosure

No significant relationships.
Ingestion of Alcohol-Based Hand Sanitizer: A case report
Authors: Gutierrez Higueras T. , Calera Cortés F. , Hernández Gajate B. , Servin López E.D. , Sainz De La Cuesta Alonso S. , Vicent Forés S.
Published: September 2022

Introduction

Alcohol-based hand sanitizers containing ethanol or isopropanol are being used in order to prevent person-to-person transmission during the COVID-19. Early signs and symptoms of this ingestion include nausea, vomiting, headache, abdominal pain, blurred vision, loss of coordination, and decreased level of consciousness. After hand sanitizer ingestion we have to suspect about methanol poisoning, monitoring the start of anion-gap metabolic acidosis, seizures, and blindness is essential. Treatment includes supportive care, acidosis correction, and the administration of an alcohol dehydrogenase inhibitor. In servere cases hemodialysis may be required.

Objectives

To present a case of an 29-year-old woman who was taken to the emergency department after voluntary ingestion of alcohol-based hand sanitizer in a suicide attempt. To describe the most common side effects of hand sanitizer ingestion and the literature review.

Methods

Clinical case presentation and literature review of similar cases.

Results

A 29-year-old woman, with diagnosis of borderline personality disorder and previous suicide attempts was taken to the emergency department after 3 hours of voluntary ingestion of an unknown quantity of alcohol-based hand sanitizer. Initial laboratory findings showed laboratory a blood methanol concentration of 66 mg/dL, with an anion gap of 30 mEq/L, arterial blood pH of 7.2, serum bicarbonate concentration of 12 mEq/L. Patient complained of abdominal pain and nervoussness.

Conclusions

Most common signs and symptoms of alcohol-based hand sanitizer ingestion include nausea, vomiting, headache, abdominal pain, blurred vision, loss of coordination, and decreased level of consciousness. Treatment includes supportive care, acidosis correction, the administration of an alcohol dehydrogenase inhibitor and sometimes may be required.

Disclosure

No significant relationships.
The association between melatonin and suicide: a nationwide cohort study
Authors: Høier N. , Madsen T. , Spira A. , Hawton K. , Jennum P. , Nordentoft M. , Erlangsen A.
Published: September 2022

Introduction

Melatonin is often prescribed to patients experiencing sleep disturbances, which has been linked to elevated risks of suicide. However, it remains to be assessed whether melatonin is associated with suicide and suicide attempts.

Objectives

We aimed to investigate whether individuals in treatment with melatonin had higher rates of suicide and suicide attempt when compared to individuals not in treatment.

Methods

Using longitudinal data on all persons aged 10+ years living in Denmark between 2007-2016 were obtained. Data from the National Prescription Register was used to identify periods of being in treatment with melatonin based on number of tablets and daily defined dose. Suicide and suicide attempt were identified in hospital and cause of death registries.

Results

Among 5,798,923 included individuals, 10,577 (0.18%) were in treatment with melatonin (mean treatment length 50 days). Out of 5,952 individuals who died by suicide, 22 (0.37%) were in melatonin treatment, while 134 (0.53%) out of 25,136 had a first suicide attempt. After adjustment for sex and age-group, people in treatment with melatonin were found to have a higher rate of suicide (IRR: 4.2; 95% CI, 2.7-6.4) and suicide attempt (IRR: 6.7-fold (95% CI, 5.7-7.9) when compared to those not in treatment.

Conclusions

Treatment with melatonin was associated with higher rates of suicide and suicide attempt. The association might be explained through mediators, such as psychiatric comorbidity and sleep disorders. Our findings indicate that attention towards these issues might be warranted.

Disclosure

No significant relationships.
Perspectives of trainees and examiners on communication skills assessment during online postgraduate psychiatry examination in Ireland
Authors: Usman M. , Mccarthy G.
Published: September 2022

Introduction

Covid-19 pandemic caused a pivot to online clinical education and assessment across the globe.

Objectives

To explore the views of psychiatric trainees and examiners on assessment of communication skills during online high stakes postgraduate examination.

Methods

This study was designed as interpretive descriptive qualitative research. All candidates and examiners of the online Irish Basic Specialist Training exam in September and November 2020 were included. The respondents were interviewed by Zoom which were transcribed verbatim. Data was coded using NVivo20 pro and Braun and Clarke thematic analysis was used to draw various themes and subthemes.

Results

A total of seven candidates and seven examiners from different training deaneries and specialties were interviewed with average duration of 29m 45s and 24m 20s respectively. The participants were largely satisfied with the online examination but did not consider it equal to face-to-face for picking nonverbal cues. The candidates were very conscious of eye contact while examiners placed more emphasis on overall professional behavior and patient engagement. All candidates preferred to continue online format post pandemic for practical reasons e.g., avoiding travel and overnight stay, while all examiners preferred to go back to in-person Objective Structured Clinical Examination due to some limitations in assessing physical and cognitive examination. However, continuation of online Clinical Formulation and Management Examination was agreed by both groups.

Conclusions

The results of the study have shown different insights of two important stakeholders in a professional postgraduate psychiatry examination which can be useful to improve same exam and design similar assessments in other settings.

Disclosure

No significant relationships.
Joint Forces for Child and Adolescent Psychiatry Training: 1st ESCAP/UEMS-CAP/EFPT Training Day for CAP Trainees
Authors: Seker A. , Kotsis K. , Deschamps P.
Published: September 2022

Introduction

As the Covid-19 pandemic brought about travel and social restrictions, many activities including specialty training events for medical specialty trainees moved online. The European Federation of Psychiatric Trainees, European Society for Child and Adolescent Psychiatry and hild and Adolescent Psychiatry (CAP) Section of UEMS joined forces to turn challenges into an opportunity for CAP trainees and jointly organized the 1st ESCAP/UEMS-CAP/EFPT Training Day.

Objectives

The main aim was to offer CAP trainees throughout Europe high quality and up to date training content free of charge, making use of the different strengths of the organizing associations.

Methods

Content of the Training Day was prepared according to feedback and demand from CAP trainees, collected through a questionnaire prior to the event. This event took place online and ran 9 webinars/workshops as well as a plenary case session where trainees presented real life cases made more challenging with the pandemic and representatives from 3 organizing associations discussed the cases from different perspectives. Remaining webinars/workshops covered a wide range of themes including but not limited to research, leadership, administrative and management skills as well as scientific topics such as eating disorders, medically unexplained symptoms, psychosis.

Results

Almost 200 CAP trainees from 31 countries participated in the event and received certificates of completion. The outcome of the event is being evaluated via quantitative and qualitative methods and similar events will be planned accordingly.

Conclusions

1st ESCAP/UEMS-CAP/EFPT Training Day for CAP trainees was a success for reaching many trainees from across Europe and experimenting with different formats which will inspire future initiatives.

Disclosure

No significant relationships.
Taking back control of the Data. Developing an all in one System to monitor training post quality and provide trainer feedback
Authors: Mudunkotuwe J. , Schmidt M. , Khan A. , Sahlsberg T.
Published: September 2022

Introduction

We will present experience developing a system for monitoring training placements in psychiatry and community paediatrics, and how this was expanded to provide an automated anonymised MSF for trainers for annual appraisal and will identify trainers in need of additional support and other post/training programme issues. The session will be of interest to educators and medical education leads with practical tips and lessons learnt over the last 8 years since the system was first developed.

Objectives

The system was also used to identify trainers in need of additional support and other post/training programme issues.

Methods

We used an electronic system to gain the infromation as stated in the introduction.

Results

Over the last 8 years we have collected data using this system. the results for our trust will be displayed annoymously but the system is the ficus of this presenation.

Conclusions

The advantages of the system are that it runs throughout the year (so covers each post and placement), has high trainee response rates, has no selection bias (compared with some other MSF systems) and the results are embedded within local quality systems and individual consultant appraisals. The data that the system collects can help provide robust evidence when investigating concerns that might only arise periodically (for example through the annual GMC trainee survey in the UK). We believe that this system will be applicable for doctors providing training in other countries and empowers the improvement of psychiatric training for the profession.

Disclosure

No significant relationships.
Women’s access to mental health care in Tunisia
Authors: Bergaoui E. , Zrelli M. , Staali N. , Moalla M. , Lansari R. , Larnaout A. , Melki W.
Published: September 2022

Introduction

Tunisia is viewed as an advanced country in terms of women’s rights in the Arab world. However, women are more exposed than men to many specific risk factors which greatly contribute to threaten their mental health.

Objectives

The main objective of this study was to find out the sociodemographic and clinical profiles of women admitted in Razi psychiatric hospital and their access to mental health services.

Methods

A cross sectional and descriptive survey was conducted between March and April 2021 in the department of psychiatry D of Razi Hospital including 40 female inpatients.

Results

The majority of patients had low (37.1%) to moderate (61.9%) socio economic status, with primary education (40%), secondary education (20%) and higher education (28.6%). The majority was unemployed (68.8%). A significant difference was observed between adherence to treatment and family support (p=0.04). It was mainly the father or the husband who was taking care of the patient in 50% of cases. The first psychiatric consultation was 2.68 years after having symptoms. Hospitalization was about 4.94 years later. Twenty five percent of them have seen a tradipractioner before consulting. About 46.87% of patients had conflicts with a member of her family and 15.62% of them were victims of either domestic or family violence. The main diagnoses were mood disorders (31.4%) and schizophrenia (42.9%) Time between symptoms onset and hospitalisation was significantly associated with socioeconomic status (p=0.047) and cultural beliefs (p=0.026).

Conclusions

The protection of women’s mental health is not only a medical challenge but also a cultural and political one.

Disclosure

No significant relationships.
Women’s Perception and Attitude Towards Using Antidepressants During Pregnancy: A cross sectional study
Authors: Alshahrani S.
Published: September 2022

Introduction

Depression during pregnancy leads to deterioration of the mothers’ and the fetus’ health.

Objectives

To explore women’s perception and attitude towards using antidepressants during pregnancy and identify the factors that influence decision making regarding antidepressants use.

Methods

A cross-sectional survey of 991 subjects using convenient sampling. All study subjects (PNU affiliates; staff and students) were invited to fill out an electronic questionnaire, KAAUH staff and PNU female associates who were less than 18 years old were excluded. Answers were reported using 5-
point Likert scale. The responses were summed up to give a total score for each respondent. The cutoff point is 75%. Respondents who scored above or equal 75% of the total score was considered as positive perception or favorable attitude.

Results

The majority of women had negative perception and favorable attitude towards using antidepressants during pregnancy reaching 64%. While, women with positive perception and favorable attitude represented about 20% of the study subjects. The main factors influencing decision making were, education specialty (health, none-health) and subject history of diagnosis with any psychological disorder. Social stigma, religious believes and fear of addiction were reported by surveyors to be the reason influencing their perception and attitude about antidepressants use (P value <0.005).

Conclusions

This study reveals that although Saudi women reflect a negative perception towards using antidepressants during pregnancy, yet they have a favorable attitude once depression during pregnancy becomes an issue.

Disclosure

No significant relationships.