bluuebunny/crossref_metadata_2025 huggingface dataset:
A sound mind in a sound body? The role of cooperation between medical specialists and patients with comorbid mental and somatic disorders
Authors: Adamczewska K. , Bień M. , Dudzic K. , Krysta K. , Krzystanek M.
Published: February 2022

Introduction

Treatment of accompanying somatic disorders in patients with schizophrenia is a crucial issue, as those people die about 25 years earlier, compared with the general population. Moreover, premature death in this group of patients is more often caused by comorbidities than by suicide. It is worth emphasizing that cardiovascular disease itself in people with schizophrenia accounts for as much as 23% of causes of death, followed by suicides and drug toxicity. The paper presents a description of a 65-year-old patient diagnosed with schizophrenia, alcohol addiction, metabolic syndrome, and cardiac arrhythmia.

Objectives

To determine the impact of cooperation between medical specialists and a psychiatric patient on the treatment effect.

Methods

A case of a patient treated in a day ward is described. A literature search was made in the PubMed database.

Results

A patient after exacerbations of mental illness, often preceded by a return to alcohol use, tends to discontinue both psychiatric drugs and those prescribed for somatic diseases. Due to the diagnosed atrial fibrillation, sudden discontinuation of cardiac medications significantly increases the risk of life-threatening somatic complications, including stroke.

Conclusions

Diagnostic and therapeutic management in the treatment of psychiatric and somatic diseases with concurrent addiction to psychoactive substances requires interdisciplinary cooperation of medical specialists with the patient to achieve a successful outcome. Summarizing, in treatment, we must always look at the patient as a whole. Aside from caring for the mental state, the physical condition along with the possibility of cooperation on the part of the patient remains essential.

Disclosure

No significant relationships.
Paraphrenia in modern times? Revisiting an elder concept
Authors: Jesus M.
Published: February 2022

Introduction

The concept of paraphrenia was first introduced by Kraeplin and has since been a controversial issue. However, a group of patients still represent a diagnostic problem and many remind us of the initial description of Paraphrenia: “The uncertain group between paranoia and dementia preacox”.

Objectives

Revisit paraphrenia and to transpose it to modern times.

Methods

Clinical report and literature review.

Results

“M”., a 68 yo women with no psychiatric history was admitted in with depressive humor, anhedonia, asthenia and structured delusional ideas of guilt and persecution and auditory hallucinations. Antidepressant therapy improved the mood, but with worsening of the psychotic symptoms. With further exploration it was was clear that the mood disorder was secondary to the psychotic symptoms that arose in insidiously. The family described her as very reserved and suspicious and notice that she abandoned many of her daily tasks. MMSE was 26 points and the laboratory results and the Cranial Computed Tomography were normal. There was little response to antipsychotics and the patient is undergoing electroconvulsive therapy with positive results.

Conclusions

Initially thought to be a depressive episode, the psychotic symptoms were the primary manifestation. Although the insidious installation, structured delusional ideas and the preservation of the affects pointed to a delusional disorder, the presence of auditory hallucinations and gradual loss of functionality are characteristic of schizophrenia. Some authors rejected the classic definition of Paraphrenia, but accepted that schizophrenia in the elderly could assume a paraphrenic form. In this case, the clinical picture and evolution are close to the classical description of the disorder.

Disclosure

No significant relationships.
Negative symptoms of schizophrenia in patients with acute and transient psychotic disorders
Authors: Aleshkina G. , Pugacheva M. , Bardenshteyn L.
Published: February 2022

Introduction

The ICD-10 acute and transient psychotic disorders (ATPD, F23) without symptoms of schizophrenia are considered predominantly reactive psychotic disorders or affective pathology. However, negative symptoms of schizophrenia may be revealed in some of these cases after the psychotic reduction.

Objectives

To investigate the association between the developmental characteristics of psychosis and the negative symptoms detection after the psychotic reduction of ATPD without symptoms of schizophrenia.

Methods

68 adult inpatients with ATPD without symptoms of schizophrenia (F23.0) were examined. Negative symptoms were assessed with the PANSS negative symptom subscale (PANSS-NSS). The sample was divided into two groups: with PANSS-NSS score>14 (n=12) and with PANSS-NSS score≤14 (n=56), respectively. Clinical-psychopathological, psychometric and statistical methods were applied.

Results

The results of the study are presented in Table 1.Table 1. The ATPD developmental featuresFeaturesThe 1st group (n=12)The 2nd group (n=56)Pearson’s contingency coefficient (C)Males7 (58,3%)37 (66,1%)0.062Females5 (41,7%)19 (33,9%)0.062Mean age of psychotic onset, years (М±m)24,9±10,530,8±10,2-Family history of schizophrenia*4 (33,3%)1 (1,8%)0.418Poor premorbid social adaptation*5 (41,7%)00.520Prodromal functional decline*9 (75,0%)4 (7,1%)0.550Prodromal non-psychotic symptoms9 (75,0%)30 (53,6%)0.163Associated acute stress4 (33,3%)27 (48,2%)0.113

*p<0,001

Conclusions

The probability of negative symptoms detection in ATPD without symptoms of schizophrenia is relatively strongly associated with the family history of schizophrenia, poor premorbid social adaptation and functional decline prior to the psychotic onset.

Disclosure

No significant relationships.
Introducing a psychiatric genetic cohort of schizophrenia patients and controls from Vietnam
Authors: Braun A. , Nguyen T.V. , Ripke S. , Nguyen P.V. , Kraft J. , Nguyen H.T. , Le T.C. , Panagiotaropoulou G. , Hahne I.M. , Böge K. , Hahn E. , Ta T.M.T.
Published: February 2022

Introduction

Genome-wide association studies (GWAS) have successfully revealed genetic risk variants for schizophrenia (SCZ). However, the vast majority of GWAS largely comprise European samples. As a result, the derived polygenic risk scores (PRS) show decreased predictive power when applied to non-European populations.

Objectives

A long-term scientific cooperation between the Charité Universitätsmedizin Berlin and the Hanoi Medical University aims to address this limitation by recruiting a large genetic cohort of comprehensively phenotyped schizophrenia patients and controls in Vietnam.

Methods

A pilot study was conducted at the Department of Psychiatry of the Medical University Hanoi in 2017. Data collection encompassed i) genome-wide SNP genotyping of 200 schizophrenia patients and 200 control subjects ii) structured interviews to assess symptom severity (PANSS), iii) clinical parameters (e.g. duration of illness, medication) and demography.

Results

SCZ-PRS of the pilot sample (N=400) were generated using different training data sets: i) European, ii) East-Asian and iii) mixed GWAS summary statistics from the Psychiatric Genomics Consortium’s latest discovery sample. Most variance explained was observed using a mixed discovery sample (R2liability=0.053, p=3.11*10-8, Pd <0.5), followed by PRS based on the East-Asian summary statistics (R2liability=0.0503, p=6.78*10-8, Pd <1) and the European sample (R2liability=0.0363, p = 4.26*10-6, Pd <0.01).

Conclusions

With this pilot project we established an efficient recruitment, genotyping and data analysis pipeline. Our results corroborate previous findings indicating that transferability of PRS across populations depends on the ancestral composition of the initial discovery dataset. We therefore aim to expand data collection efforts in the future in order to improve risk prediction across diverse populations.

Disclosure

No significant relationships.
Being psychotic is not necessarily being ill: Psychotic continuum and the relevance of lacanian psychoanalytic approach
Authors: Mitropoulos G.
Published: February 2022

Introduction

The notion of subclinical psychosis is as old as Eugen Bleuler’s work on schizophrenia. It is also consistent with psychodynamic theories (see PDM-2) on the organization of personality on different levels including, among others, a psychotic level of personality organization. Research on the continuum of psychosis has offered substantial support to the view that psychotic phenotypes are significantly more prevalent than clinical psychosis.

Objectives

This may imply that being “psychotic” is not necessarily being ill. This assumption raises important theoretical and clinical questions: what causes psychosis to manifest itself clinically and, conversely, what possibly prevents it from doing so?

Methods

At the same time, it potentially frees psychiatry from certain diagnostic and therapeutic impasses. It allows for a shift of emphasis from misguiding classifications and often frustrating “evidence-based” therapeutic attempts to a more personalized approach.

Results

Diagnosis may thus rely on psychoanalytical “markers” or “indicators” regarding the subject (e.g. deficits in the symbolic register, dysregulated rapport with one’s body, problematic inscription in social relations etc.) at least as much as on symptomic phenomenology. Therapy may also take advantage of and deploy the unique coping strategies employed by the psychotic individual.

Conclusions

The diagnostic and therapeutic insights offered by Lacanian psychoanalysis create the possibility of a fruitful theoretical, diagnostic and therapeutic approach for clinical and subclinical psychotic conditions; indicate that psychoanalysis is indispensable for clinical psychiatry; and signal the possibility of a time-honored alternative to the in-vogue neurocognitive paradigm of “personalized” psychiatry.

Disclosure

No significant relationships.
Psychosis developed on a travel to china – a case report
Authors: Certo A. , Mendes E.
Published: February 2022

Introduction

Psychosis it is a serious medical condition that could happen to anyone while travelling, even without a prior history of mental illness. Some psychotic episodes during travel likely are brief psychotic disorders. This is a poorly understood subject that seems to have an increasing incidence.

Objectives

This work aims to present a clinical case of a patient who developed psychotic symptoms on her visit to China, and to provide a brief update review of this subject.

Methods

We describe a case based on patient’s history and clinical data. We also searched and reviewed cases on “travel” AND “psychosis” and “tourist” AND “psychosis” using PubMed® database.

Results

We report the case of a 41-year-old woman without psychiatric antecedents or substance use who developed psychotic symptoms during a travel to China. Symptoms resolved completely soon after returning to Portugal and admission to the psychiatric emergency service where an antipsychotic treatment was initiated. Psychosis in tourists typically occur in destinations with strong symbolic or mystical connotations and in individuals who travel alone for several days. The most common symptoms are hallucinations, delusions, ideas of reference and agitation. Most patients improved and returned to previous functioning.

Conclusions

To improve the knowledge of travel-related psychosis it is important to identify the cases and the associated biological and clinical factors, later on it may be possible to identify the predictive factors of these psychosis. Further research are necessary to establish a possible association between brief psychotic episode and travel to China, as reports for tourists to Jerusalem and to Florence.

Disclosure

No significant relationships.
Mindfulness-based group therapy for inpatients with schizophrenia spectrum disorders – feasibility, acceptability, and preliminary outcomes of a rater-blinded randomized controlled trial
Authors: Böge K. , Hahne I.M. , Bergmann N. , Zierhut M. , Ta T.M.T. , Wingenfeld K. , Bajbouj M. , Hahn E.
Published: February 2022

Introduction

The therapeutic effectiveness of mindfulness-based interventions (MBIs) has been shown for various mental disorders. However, for schizophrenia spectrum disorders (SSD), only a few trials have been conducted, mostly in outpatient settings.

Objectives

This study aimed to investigate feasibility, acceptability, and preliminary effectiveness of a four-week mindfulness-based group therapy (MBGT) for in-patients with SSD.

Methods

A pre-registered randomized controlled trial (RCT) was conducted at the in-patient ward for SSD. All measures were employed at baseline, post-intervention (4-weeks), and follow-up (12-weeks). The primary outcome was ‘mindfulness’. Secondary outcomes were rater-blinded positive- and negative symptoms, depression, social functioning, as well as self-rated mindfulness, depression, anxiety, psychological flexibility, quality of life, and medication regime.

Results

N=40 participants were randomized into either four-week treatment-as-usual (TAU; n=19) or MBGT+TAU (n = 21). Protocol adherence was 95.2%, and the retention rate to treatments was 95%. ANCOVA analysis revealed significant improvements in the MBGT+TAU compared to TAU for the primary outcome and negative symptoms. Exploratory analyses showed medium-to-large intervention effects on secondary outcomes mindfulness, positive, negative, and depressive symptoms, psychological flexibility, quality of life, and social functioning for MBGT+TAU and small-to-moderate changes on positive symptoms and social functioning for TAU. No serious adverse effects were reported.

Conclusions

This study supports the feasibility and acceptability of MBGT for in-patients with SSD, including high protocol adherence and retention rates. A proof of concept of the MBIs and corresponding improvements on various clinical and process parameters warrant a fully powered RCT to determine effectiveness, cost-efficiency, and longitudinal outcomes of MBGT for SSD.

Disclosure

No significant relationships.
Insomnia associated with neutrophil/lymphocyte ratio in female patients with schizophrenia
Authors: Paniagua G. , González-Blanco L. , Santo F. Dal , Martínez-Cao C. , Moya-Lacasa C. , Valtueña-García M. , Gil E. Martín , García-Alvarez L. , Saiz P.A. , García-Portilla M.P. , Bobes J.
Published: February 2022

Introduction

Worse sleep quality and increased inflammatory markers in women with schizophrenia (Sch) have been reported (Lee et al. 2019). However, the physiological mechanisms underlying the interplay between sleep and the inflammatory pathways are not yet well understood (Fang et al. 2016).

Objectives

Analyze the relationship between Neutrophil/Lymphocyte (NLR), Monocyte/Lymphocyte (MLR) and Platelet/Lymphocyte (PLR) ratios, and insomnia in Sch stratified by sex.

Methods

Final sample included 176 Sch patients (ICD-10 criteria) [mean age: 38.9±13.39; males: 111(63.1%)]. Assessment: PANSS, Calgary Depression Scale (CDSS), and Oviedo Sleep Questionnaire (OSQ) to identify a comorbid diagnosis of insomnia based on ICD-10. Fasting counting blood cell were performed to calculate ratios. Statistics: U Mann-Whitney, logistic regression.

Results

Insomnia as comorbid diagnosis was present in 22 Sch (12.5%) with no differences between sex [14 males (12.6%), 8 females (12.3%)], neither in their age. Female patients with insomnia showed increased NLR [2.44±0.69 vs. 1.88±0.80, U=122.00 (p=0.034)]. However, no differences in PLR and MLR were found, neither in any ratio in males. Regression models using insomnia as dependent variable and covariates (age, PANSS-positive, PANSS-negative, CDSS) were estimated. Females: presence of insomnia was associated with NLR [OR=3.564 (p=0.032)], PANSS-positive [OR=1.263 (p=0.013)] and CDSS [OR=1.198 (p=0.092)]. Males: only PANSS-positive [OR=1.123 (p=0.027)] and CDSS scores [OR=1.220 (p=0.005)] were associated with insomnia.

Conclusions

NLR represent an inflammatory marker of insomnia in Sch but only in female patients. Improving sleep quality in these patients could help to decrease their inflammatory response.

Disclosure

No significant relationships.
Investigating the influence of thought interference and somatic passivity on outcomes in patients with psychosis
Authors: Magrangeas T. , Kolliakou A. , Sanyal J. , Patel R. , Stewart R.
Published: February 2022

Introduction

Of the many studies describing psychotic symptoms in schizophrenia, few have investigated their direct influence on prognosis.

Objectives

We aimed to apply natural language-processing (NLP) algorithms in routine healthcare records to identify reported somatic passivity and thought interference symptoms (thought broadcasting, insertion and withdrawal), and determine associations with prognosis by an analysis of routine outcomes.

Methods

Four algorithms were thus developed on de-identified mental healthcare data from a large south London provider and were applied to ascertain recorded symptoms over the three months following first presentation to that service in a cohort of patients with a primary schizophreniform disorder (ICD-10 F20-F29) diagnosis. The primary binary dependent variable for logistic regression analyses was any negative outcome (Mental Health Act section, >2 antipsychotics prescribed, >22 days spent in crisis care) over the subsequent 2 years, adjusted for age, gender, ethnic group, neighbourhood deprivation, diagnostic group, and recorded paranoia, persecutory delusions or auditory hallucinations.

Results

In 9,323 patients, final models indicated significant associations of this composite outcome with baseline somatic passivity (prevalence 4.9%; adjusted odds ratio 1.61, 95% CI 1.37-1.88), thought insertion (10.7%; 1.24, 1.15-1.55) and thought withdrawal (4.9%; 1.36, 1.10-1.69), but not independently with thought broadcast (10.3%; 1.05, 0.91-1.22).

Conclusions

Symptoms traditionally central to the diagnosis of schizophrenia, but under-represented in current diagnostic frameworks, were thus identified as important predictors of short- to medium-term prognosis.

Disclosure

No conflict of interest - past support from Janssen; GSK; Takeda; Induction Healthcare; Holmusk; the NIHR; SLaM NHS Trust; the MRC; KCL; the NIHR ARC; KCH NHS Trust; the Academy of Medical Sciences; The Wellcome Trust; BHF; Arthritis Research UK; the Roya
Decision making and implicit suicidality in schizophrenia spectrum disorders
Authors: Vorontsova O. , Medvedeva T. , Enikolopov S. , Boyko O. , Rupchev G.
Published: February 2022

Introduction

Research shows that mental illnesses increase suicidal risk. Studies have found that suicidal risk is associated with impaired decision-making.

Objectives

To analyze decision making based on emotional learning in implicit suicidality.

Methods

56 male patients with schizophrenia spectrum disorder (F20) and denied presence of suicidal ideation were involved into the study (mean age 23±2.7),. Methods: Iowa gambling task (IGT) - integral indicators were used: the prevalence of “good” choices over “bad” ones, total score; and an indicator reflecting the ignorance of consequences of one’s choice - the subject remains on a “bad deck” after a loss. The Rorschach test (Rorschach Comprehensive system) was administered: Suicide Constellation «S-CON» and its components were used.

Results

According to the analysis, prevalence of “good” choices (IGT) negatively correlates with «S-CON» (Spearman’s correlation -0.328*, hereinafter significance level: ~ - p<0.1; * - p<0.05). A decrease in the total IGT score is associated with the following cognitive indicators: disregard for social conventions, non-conformism («P») (Spearman’s, 0.337*); a tendency to react defensively to a problem situation, blocking activity in terms of making decisions («R») (0.308*). Ignoring the consequences of one’s choice (IGT) correlates with such emotional factors as emotional incontinence, superficiality of emotions, emotional lability («FC:CF+C») (-.0382*), ambivalence of emotions («Blcol-shd») (statistical tendency, 0.277~), expressed dissatisfaction with the existing situation, internal tension and dysphoria («S») (0.291~).

Conclusions

The relationship of implicit suicidality with decision-making was found to be similar to the relationship of pronounced suicidality with decision-making. Suicidality is associated with impaired ability to make decisions based on emotional learning.

Disclosure

No significant relationships.
Yoga-based group therapy for in-patients with schizophrenia spectrum disorders – a qualitative approach
Authors: Schulze T. , Hahn E. , Hahne I.M. , Bergmann N. , Zierhut M. , Ta T.M.T. , Pijnenborg M. , Böge K.
Published: February 2022

Introduction

Yoga may pose a promising complementary therapy in the multimodal treatment of schizophrenia spectrum disorders (SSD). However, to date, no studies have qualitatively examined the patients’ experience of practising Yoga.

Objectives

This qualitative study aimed to assess the mechanisms and processes of Yoga-based group therapy (YBGT) for in-patients with SSD by exploring their subjective experiences.

Methods

Twenty-five semi-structured interviews were conducted with in-patients with SSD after they participated in a YBGT session. Interviews were transcribed, coded by two independent researchers, and analysed using an inductive thematic approach. The research team collaboratively discussed emerging categories to reduce redundancy and form meaningful themes and subthemes.

Results

The analysis revealed seven main themes. YBGT was perceived as feasible and focusing on individual adaptation, captured by the theme ‘inclusivity’. Nevertheless, participants encountered ‘challenges’; thus, physical limitations need to be considered. While practising together, participants experienced ‘interconnectedness’ and developed a ‘mindful stance’ as they accepted their limitations and adapted exercises with self-compassion. Following the flow of asanas required physical persistence, which ultimately led many participants to experience ‘confidence’ and ‘relaxation’. YBGT affected ‘symptom representation’ as heightened awareness led participants to notice impeding as well as improved symptoms.

Conclusions

YBGT seemed to have various promising effects on in-patients with SSD. Future research should examine to what extent these effects can be sustained and how the mindful approach during YBGT can be transferred to areas outside the Yoga class. Furthermore, a randomised-controlled trial could investigate the effectiveness of a manualised YBGT.

Disclosure

No significant relationships.
Starting a career as a psychiatrist
Authors: Sartorius N.
Published: February 2022

Abstract Body

There are several sets of skills first set of skills which psychiatrists should acquire before or as early as possible after starting their career. THe first of those are communication skills – including those of listening, speaking clearly and convincingly, negotiating and writing scientific and other types of documents. A second set of skills are those that will enable psychiatrists to understand and use legal documents and materials. The third set of skills that is likely to be useful are skills necessary to function as a physician. These sets of skills combined with the knowledge of the subject of psychiatry should help in building a career in any of the areas open to psychiatrists.. Yet, more important than any of the skills or bits of knowledge that a candidate psychiatrist should have to build a career and be happy with it are the motivation to do psychiatry and the acceptance of a style of work marked by empathy, willing acceptance of ethical principles of medicine and if at all possible infectious optimism. The above array of skills, knowledge style of work are not easily developed and those educating future psychiatrists should be careful in their selection of trainees and resourceful in the provision of training that will create psychiatrists who can advance the health of their patients as well as their discipline and will have a chance to live a rewarding life.

Disclosure

No significant relationships.
Schizophrenia likely related to be with cadasil: A case report
Authors: Göy D. , Şahmelikoğlu Onur Ö. , Yesilkaya U.
Published: February 2022

Introduction

CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is an inherited disease caused by mutations in the Notch3 gene in chromosome 19.The clinical features are primarily neurological, which include recurrent transient ischaemic attacks, strokes, and migraines.However, psychiatric manifestations such as severe depression, psychosis, changes in behavior and personality have also been reported in CADASIL. Symptoms and disease onset vary widely, with signs typically appearing in the mid-30s.Some individuals may not show signs of the disease until later in life.

Objectives

In this case report, we present a possible case of CADASIL, a 67-year old female patient diagnosed with schizophrenia fifteen years ago to discuss the co-occurrence of these conditions in the light of the literature.

Methods

Hospitalization records of the patient viewed.

Results

Our patient suffered from sleep disturbances, hearing religious voices and in psychiatric examination resistant to treatment psychotic symptoms such as blunted affect, mystic, persecutory delusions, auditory hallucinations were present.Cranial magnetic resonance imaging scan was performed and revealed leukoencephalopathy, high-signal intensity lesions in the periventricular white matter consistent with a diagnosis of CADASIL.Atypical antipsychotics found to be effective in treating psychotic symptoms in our case.

Conclusions

Persistent psychotic symptoms despite adequate antipsychotic treatment in patients diagnosed with schizophrenia, also with pathological findings in MRI an organic cause such as CADASIL must be considered. Further studies are needed to better understand the exact impacts of cerebral tissue lesions and psychiatric symptoms in CADASIL patients.

Disclosure

No significant relationships.
Electroconvulsive therapy in a patient with resistant paranoid schizophrenia treated with clozapine
Authors: Castelao-Almodóvar S. , Pérez-Balaguer A. , Ponte T. , Peña B. Estevez , Fuentes Y.D. Corres , Gil-Benito E. , Del Río E.M. Suárez , Gayubo-Moreo L. , Sanz-Aranguez B.
Published: February 2022

Introduction

One of the usual indications for Electroconvulsive Therapy (ECT) is Paranoid Schizophrenia (PS), being performed usually in cases resistant to antipsychotics.

Objectives

To present a clinical case of a patient with antipsychotic-resistant PS, including Clozapine, who received ECT.

Methods

We present the case of a 47-year-old patient with an 8-years diagnosis of PS. He presented visual, auditory, and kinesthetic hallucinations, delusions, and thought insertion and diffusion phenomena that impeded concentration. He had received treatment with different antipsychotics (including Clozapine), without achieving remission of symptoms. He also presented significant adverse effects such as hypersalivation and extrapyramidal symptoms. Due to the poor response and the adverse effects that limited the dose increase, it was decided to start ECT.

Results

The patient received a total of 9 sessions, presenting a significant reduction in symptoms since the 5th session (disappearance of the sensory-perceptual alterations and thought disturbances). As side effects, the patient presented amnesia of the moments prior to applying the therapy, which subsequently resolved. The patient continued to present concentration difficulties, although after ECT he denied the presence of thought insertion or diffusion phenomena to which he previously attributed the cause of these difficulties.

Conclusions

Although less responsive than in other indications, ECT combined with antipsychotic drugs has been proven to be more effective than monotherapy (regardless of whether it’s Clozapine or another). This lower response could be due to the use of ECT in the most resistant cases, since it has been demostrated that in more acute cases a faster improvement occurs when the two treatments are combined.

Disclosure

No significant relationships.
Acute polymorphic psychosis: An interesting case report
Authors: Mari V. , Georgiadi A. , Maris A. , Gkolia I.
Published: February 2022

Introduction

Acute Polymorphic Psychotic Disorder is a psychotic disorder with an acute onset, presenting thought and perception disorders variable into hours. Often, an emotional fluctuation is present and it may have a sudden onset and a rapid remission.

Objectives

The review’s objective is to manifest acute polymorhic psychotic disorders and possible effective medical interventions.

Methods

The current case concerns a 52-year old mother of 4 children with the manifestation of acute polymorphic psychotic disorder with a background of a stressful factor. The patient was involuntarily hospitalized in the Psychiatric Hospital of Thessaloniki from 04/01/ 2019 -21/ 01/2019 due to disorganization and acute confusing condition within the last 9 days. Delusional ideas of religious content were first observed, which alternated with ideas of greatness and then persecution, association and self-denial. She also presented auditory hallucinations while there was a fluctuation of emotion from excessive euphoria to depression. The patient had no previous hospitalization in a psychiatric clinic, however, 7 months ago she experienced another acute psychotic epeisode, while at the age of 17 and under the influence of intense stress, she described mood disorders.

Results

The current symptoms subsided after one week from the day of admission. During her hospitalization, a brain CT was performed without presence of pathological findings. Initially, her medication included i.m. haloperidol 15mg / ml daily, followed by a change to per os paliperidone 9mg daily.

Conclusions

Her mental status was improved, with no disturbances of consciousness noted and she was discharged on paliperidone as home medication.

Disclosure

No significant relationships.
Investigation of early signs of peripheral artery disease in patients with schizophrenia using toe-brachial index
Authors: Jørgensen L. , Hostrup C. Tranekær , Jensen S. Eggert , Nielsen R. Ernst
Published: February 2022

Introduction

Patients with schizophrenia have a reduced life expectancy compared to the general population, and cardiovascular diseases contribute to this. Peripheral arterial disease (PAD) is associated with excess all-cause mortality and specifically with cardiovascular morbidity and mortality. The risk factors for PAD, such as diabetes, smoking, hypertension, dyslipidaemia and obesity, are more common among patients with schizophrenia which could contribute to a possibly higher prevalence of PAD among patients with schizophrenia.

Objectives

To investigate PAD utilizing toe brachial index (TBI) in a population of patients diagnosed with schizophrenia with the purpose of establishing prevalence rates amongst newly diagnosed as well as more chronic patients.

Methods

A cross-sectional study of patients with schizophrenia (ICD10-diagnosis F20 or F25) with a study population of 57 patients diagnosed with schizophrenia within the last 2 years, psychiatric healthy controls matched by age, sex and smoking status and 142 patients with a schizophrenia diagnosis more than 10 years ago. The primary outcome is TBI in patients with schizophrenia stratified to the two subpopulations. The TBI will be calculated from the arm and toe systolic pressures. The toe pressures were measured using photoplethysmography (SysToe®, Atys Medical).

Results

No results are available yet. The cohort will be described by age, sex, smoking status, body fat percentage and physical comorbidities. The TBI of the two subpopulations will be compared with psychiatrically healthy controls using paired t-tests if data is normally distributed. If transformation is unsuitable, Wilcoxon test will be carried out instead.

Conclusions

No results are available yet. Results will be presented at the EPA’s congress 2021.

Disclosure

No significant relationships.
Homosexuallity in the eastern soceity
Authors: Mahasneh V.
Published: February 2022

Introduction

Everybody Knows the murmurs about homosexuallity that make harm to those humans especially in the Eastern Society.

Objectives

We (as Mental Health Professionals) should struggle against Stigma of Homosexuality as well as psychoeducate others about their human rights.

Methods

As a psychiatrist as well as EMDR Clinician Practitioner, i interviewed and still interview many clients who are homosexual. The first sessions, they are afraid to talk about their situation because of the Stigma as well as i am a Muslim, and their bad expeirence when they went to some psychiatrists who tortured them verbally. Withregard many of them tell me (i pray, fast, etc.), but their families and religious leaders say to them (you are not faithful) as judgement for them. Even me, i was attacked by some others (for example : Religious Leaders …) because i say homosexuality is normal.

Results

Homosexualls till now are tortured (Verbally, Physically and Sexually) in general, and especially in the Eastern Sosciety.

Conclusions

We should work more and more to psychoeducate others about homosexuallity especially the religious leadrers that those are humans and we should respect their human rights. And this Stigma should be DELETED from the MIND.

Disclosure

No significant relationships.
Unravelling a couple in conflict: Undiagnosed obstructive sleep apnea
Authors: Ganhao I.
Published: February 2022

Introduction

Obstructive sleep apnea impacts quality of sleep and leads to sleep deprivation with consequences on level of general functioning and interpersonal relationships besides the known contribution to cardio and cerebrovascular disorders and sexual dysfunction. Most adults sleep with a partner and sleep disorders may also disrupt the partner´s sleep, yet surprisingly obstructive sleep apnea, even when such is the case, goes frequently undiagnosed.

Objectives

To reflect on a clinical case that presents apparently as just another couple in conflict but in fact when unravelled leads to a diagnosis of obstructive sleep apnea that may have significant contribution to the conflict.

Methods

Unravelling what was at the core of a couple in conflict.

Results

A heterosexual couple in their late thities present in serious conflict with each other. Both are depressed and anxious, sleeping badly, with intimacy issues and having trouble dealing with work obligations and household chores. After continued squabbling, some self-reflection but mostly other blaming, a thread released by the female partner leads to sleep evaluation of the male partner with a resulting diagnosis of obstructive sleep apnea and subsequent treatment. And the couple relationship got better…

Conclusions

Obstructive sleep apnea is frequent in the general population and more often than not undiagnosed but may be even more frequent in patients seeking mental health services. A sleep history is an important part of evaluation of patients who present with anxiety, depressive, sexual function and/or cognitive complaints and relationship issues. Interviewing intimate partners may provide essential clues to the possibility of existing sleep disorders.

Disclosure

No significant relationships.
Oneiroid catatonia due to the usage of spice: The case study
Authors: Pityk O. , Pushko A. , Striltsiv N. , Lutska O. , Karbovskyi N.
Published: February 2022

Introduction

Designer drugs, as a term, first came about in the 1980s. Most of these “designer drugs” have synthetic cannabinoids and other psychoactive formulas difficulty to detect.

Objectives

A 28 year man was referred to the hospital.

Methods

CT brain and EEG were also normal.

Results

Among 7 days before attending the hospital the patient had a strange behaviour. He was staying like in changed reality. The day before admission he got irritable in the evening was reporting that he could hear animal’s imperative voices “we together with squirrel, dolphin visited giraffe, that someone told to jump from the window”. That symptoms were temporary after that he was shocked when realized that he was in a room. The patient has the history of marihuana use in the past 5 years, periodically. There is no evidence data about the usage of other narcotic substances. On examination he was alert, sitting on a same place looking at one point, sometimes trying to find something or suddenly standing and trying to go somewhere. He has a change of catatonic stupor and excitement. The psychomotor activity was changeable. While observing the patient during few days several times he disrobed all his clothes, staying or laying on a bed or suddenly freezing in one pose.

Conclusions

Taking into account clinical symptoms, the patient developed, the conclusion was made about connection of patients’ oneiroid catatonia with the usage of “Spice” or “Designer drug”. Thus, designer drugs may sound like a safer alternative, but often can lead to serious mental disturbances.

Disclosure

No significant relationships.
Emotional disorder dynamics for patients depending on psychoactive substances at the stages of psychosocial rehabilitation
Authors: Mykhaylov B. , Kudinova O.
Published: February 2022

Introduction

Objective laws of emotional disorder formation, their frequency along with clinic and psychopathological structure have been poorly studied until now.3 groups of patients have been observed: 200 people with alcohol addiction, 180 people with opioid addiction, and 90 people with psychostimulant addiction.

Objectives

All these have influenced our research which goal is to study patients’ emotional state at the stages of psychosocial rehabilitation.

Methods

Signs of psychological and physical addiction, specific personality disorders and decrease in social functioning level have been found for all of the observed patients. Psychodiagnostic research (performed according to Hamilton, Spielberger and Hanin, Buss-Durkee methods) has shown significant increase of depression and anxiety parameters, as well as aggression level for all the patients.

Results

Psychosocial rehabilitation system has been formed and created according to the results of the research. It is built based on a stepwise multimodal principle, including social deprivation, individual and group psychotherapy, craft therapy with an outcome to self-organizing psychotherapeutic groups.

Conclusions

Emotional sphere state normalization occurred during the process of participation in the system. According to catamnesis data of 1 to 2 years, the developed system efficiency is: 72.00 % for patients with alcohol addiction, 64.00 % for patients with opioid addiction, 51.00 % for patients with psychostimulant addiction.

Disclosure

No significant relationships.
CON perspective
Authors: Falkai P.
Published: February 2022

Abstract Body

Psychiatry is facing major challenges during times of a pandemic as illustrated by the current COVID-19 pandemic. The challenges involve its actual and perceived role within the medical system, in particular how psychiatric hospitals can maintain their core mission of attending to the mentally ill while at the same time providing relief to general medicine. Although psychiatric disorders are the top leading causes of global burden of disease, we can witness mental health care being de-emphasized in the wake of the massive onslaught of the pandemic: psychiatric wards are being downsized, clinics closed, psychiatric support systems discontinued etc. in order to make room for emergency care. While nobody can deny the need to act decisively and swiftly and ramp up intensive care readiness, we believe that there is no need to do this at the expense of psychiatric care. Using the pandemic COVID-19 contingency plan developed at the Department of Psychiatry and Psychotherapy of the University Hospital of LMU Munich as a case in point, we demonstrate how a psychiatric hospital can share in the acute care of a health care system facing an acute and highly infectious pandemic like COVID-19 and at the same time provide for the mentally ill, with or without a COVID-19 infection, and develop mid and long-term plans for coping with the aftermath of the pandemic.

Disclosure

No significant relationships.
Modulated in vitro lymphocytes in the treatment of alcoholism: Experimental study
Authors: Markova E. , Savkin I.
Published: February 2022

Introduction

Immune cells are dysfunctional during long-term ethanol consumption and may contribute to the progression from healthy to problem drinking. Lymphocytes from mice with chronic ethanol exposure characterized by impaired functional activity, manifested in the combination of increased spontaneous proliferation against the background of low sensitivity to T- cell mitogens.

Objectives

We first demonstrated that original compound meta-chloro-benzhydryl-urea (m-ch-BHU) in vitro restored long-term alcoholized mice lymphocytes activity through GABA(A) receptors. We also revealed the possibility of animal’s behavioral regulation by the transplantation of immune cells with definite functional characteristics, also modulated by psychoactive drugs. Based on the previous results we investigated effects of m-ch-BHU modulated lymphocytes transplantation in recipients with experimental alcoholism.

Methods

Male (CBAxC57Bl/6)F1 mice with 6-month 10% ethanol exposure were undergoing the transplantation of syngeneic long-term alcoholized mice lymphocytes, pretreated in vitro with m-ch-BHU. Recipient’s ethanol consumption, nervous and immune systems functional activities were estimated.

Results

It was shown that transplantation of lymphocytes with in vitro m-ch-BHU modulated functional activity caused in syngeneic recipients with chronic alcohol exposure essential ethanol consumption decrease and stimulation of motor and exploratory activities in the “open field” against the background of cytokines modulation in brain. The significant stimulation of humoral immune response, estimated by the relative number of antibody-forming spleen cells, and stimulation of DTH reaction were also detected in recipients after lymphocytes transplantation.

Conclusions

Results demonstrated that transplantation of m-ch-BHU modulated lymphocytes caused positive psychoneuroimmunomodulating effect in animals with chronic alcohol exposure, so, it may be considered as a promising method in the treatment of alcoholism

Disclosure

No significant relationships.
Original compound with anticonvulsant activity in the treatment of alcoholism
Authors: Markova E. , Savkin I. , Knyazheva M. , Shushpanova T.
Published: February 2022

Introduction

Original compound ortho-fluorobenzonal, a barbiturate derivative, is shown to reveal strong anticonvulsant activity by means increasing GABA-mediation. Disturbance of GABA(A) -receptors functions play an essential role in both alcoholism and epilepsy pathogenesis.

Objectives

Taking into account the presence of GABA(A)-receptors on the lymphocytes surface and involvement of immune system in alcoholism pathogenesis, we investigated ortho-fluorobenzonal effects on the immune and nervous systems functional activities in mice with chronic alcohol exposure to find new perspective pharmacological substances in the treatment of alcoholism.

Methods

(CBAxC57Bl/6) F1 male mice with 6-month 10% ethanol exposure were undergoing intragastric administration of original compound ortho-fluorobenzonal for 10 days. Animal’s alcohol consumption, behavior and immune parameters were estimated.

Results

It was found that ethanol daily consumption decreased sharply starting from 2 days of ortho-fluorobenzonal administration and led to the cessation of ethanol consumption by the 4 day in mice with chronic alcohol exposure. Pronounced changes in motor and exploratory activities in “open field” test was registered in long-term alcoholized mice after 10-
day course ortho-fluorobenzonal administration. The above behavioral changes were recorded against the brain cytokines synthesis modulation. We have shown also the modulation by ortho-fluorobenzonal of immune system functional activity, in particular, significant cellular and humoral immune response stimulation, estimated by the relative number of antibody forming cells and reaction of delayed-type hypersensitivity respectively.

Conclusions

Original compound ortho-fluorobenzonal has a positive neuroimmunomodulation effect that manifests itself in the correction of iimmune and behavior disorders caused by the chronic ethanol exposure, therefore, this compound is promising in the therapy of alcoholism

Disclosure

No significant relationships.
Six-month contingency management effects on smoking cessation in individuals with substance use disorders
Authors: Aonso-Diego G. , Krotter A. , García-Pérez Á. , Secades-Villa R.
Published: February 2022

Introduction

Persons with substance use disorders (SUD) smoke at strikingly high rates and tobacco use cessation rates are notably low in this population. Contingency Management (CM) is effective to promote substance abstinence, including tobacco, in a large range of populations. CM is scarcely implemented in clinical settings mainly due to barriers at the therapist and organizational levels.

Objectives

The study sought to examine the additive effectiveness of CM on Cognitive-Behavioral Therapy (CBT) over long-term smoking abstinence in persons undergoing SUD treatment.

Methods

A total of 54 smokers (75.9% males, Mage=46.19, SD=9.21) were randomly assigned to CBT (n=30) or to CBT+CM (n=24). Interventions consisted of eight weeks of group-based therapy. Participants were instructed to gradually reduce their nicotine intake by 20% weekly. The CM arm was voucher-based, and the primary outcome was biochemically verified tobacco abstinence (CO≤4ppm, and urine cotinine≤80ng/ml).

Results

A total of 42/54 (77.78%) participants completed the treatment (73.33% in CBT and 83.33% in CBT+CM; p=.380). At the end of treatment, participants in CBT+CM showed higher 24-hour smoking abstinence (50% vs. 20%, p=.032); however, both treatment conditions show equal abstinence rates in the remaining follow-ups (CBT1month= 13.33% vs. CBT+CM1month= 25%; CBT2months= 10% vs. CBT+CM2months= 16.66%; CBT3months= 10% vs. CBT+CM3months= 16.66%; CBT6months= 10% vs. CBT+CM6months= 8.33%; all p-values ≥ .244).

Conclusions

CM facilitates early abstinence outcomes in smokers with SUD more than CBT only does. However, no additive effects of CM were observed at long-term, suggesting the convenience to intensify CM schedules or using technology platforms for incentives delivery.

Disclosure

No significant relationships.
Electronic cigarettes use among teenagers in Tunisia
Authors: Maalej R. , Zgueb Y. , Aissa A. , Ouali U. , Nacef F.
Published: February 2022

Introduction

Electronic cigarettes (e-cigarettes) are battery-powered devices developed with the goal of mimicking the action of smoking. Their use has increased over the past years.

Objectives

The aim of this study was to evaluate the prevalence of the use of e-cigarettes among teenagers in high school and to examine the predictor factors.

Methods

A survey was conducted with a sample of 234 students in Mohamed Ali high school in Sfax, a town in the south of Tunisia, in February 2020. We estimated e-cigarette prevalence among adolescents and the predictor factors of vaping.

Results

Among high school students aged 15 to 20, 58,8% have ever used e-cigarette, 38,3% had done so within the previous 30 days and 20,5 % were regular users of vapes. The mean age of e-cigarette users was 16,59 +/- 0,908 years old, 83,3% of e-cigarettes users were males. Male gender, high socio-economic level, practicing leisure activities, smoking cigarettes and drinking alcohol were associated with regular use of e-cigarettes. Overall, 51, 6% of never smoking students reported ever use of e-cigarettes. The main reason for initiating e-cigarettes use was curiosity (65%).

Conclusions

Our findings showed the significant use of e-cigarettes among high school students thus it would be interesting to provide adolescents with information about the use of e-cigarettes and other tobacco products.

Disclosure

No significant relationships.