bluuebunny/crossref_metadata_2025 huggingface dataset:
Postnatal hospitalization and self-esteem in mothers
Authors: Chiha K. , Khemakhem K. , Regaieg C. , Ben Touhemi D. , Ayadi H. , Hmida N. , Gargouri A. , Moalla Y.
Published: August 2023

Introduction

Hospitalization in neonatology constitutes a narcissistic wound for the mother. This mother-baby separation disturbs the maternal identity and generates a strong feeling of failure and guilt.

Objectives

To assess self-esteem in mothers of babies hospitalised during the postnatal period in the neonatal unit and to identify risk factors associated with the persistence of low self-esteem 3 months after discharge.

Methods

This was a longitudinal, descriptive and analytical study conducted between April and September 2021. The sample consisted of mothers of babies hospitalized in the neonatology department of Sfax-Tunisia for a period ranging from 5 to 15 days. Socio-demographic data were collected using a pre-established form. Self-esteem was assessed during the baby’s hospitalisation and 3 months after discharge, using the Rosenberg self-esteem scale, with 10 items, validated in Arabic.

Results

The sample consisted of 86 mothers with a mean age of 32.17 years.

Low to very low self-esteem was found in mothers in 81.20% of cases when their babies were hospitalised and in 68.40% of cases 3 months after discharge.

Some factors were significantly related to the persistence of low self-esteem in mothers after 3 months of their babies’ hospitalisation, such as a low educational level of the mother (p=0.017), an unattended pregnancy (p=0.034), the occurrence of a post-partum complication (p=0.043) and the absence of the first smile in the baby at the age of 3 months (p=0.008).

Conclusions

This study shows a high prevalence of low self-esteem in mothers following hospitalization of their babies in the postnatal period. The concomitance with several socio-clinical factors contributes to the persistence of this low level of self-esteem in these mothers.

Appropriate early and multidisciplinary care helps to rebuild strong self-esteem in the young mother so that she can overcome her psychological difficulties and build a solid foundation for the mother-baby bond.

Disclosure of Interest

None Declared
Clinician-Administered PTSD Scale for DSM-5,child and adolescent version: Clinical characteristics of paediatric population
Authors: Kouki N. , Bourgou S. , Rezgui H. , Naffet A. , Hamdoun M. , Belhadj A.
Published: August 2023

Introduction

Posttraumatic stress disorder in the paediatric population has clinical features. The Clinician-Administered PTSD Scale for DSM-5,child and adolescent version (CAPS-CA-5) is the gold standard in positive diagnosis

Objectives

The objectives of our work was to study the clinical characteristics of the paediatric population with the diagnosis of PTSD.

Methods

This is a descriptive cross-sectional study conducted in the child psychiatry department of Mongi Slim Hospital and the forensic medicine department of Charles-Nicolle Hospital, among children older than seven years who were exposed to a potentially traumatic event at least one month before. We made clinical assessment for PTSD using CAPS-CA-5 which is currently being validated in Tunisian dialect. Then We investigated the clinical characteristics of PTSD according to age, gender, history, and event specifics.

Results

We conducted our study with 150 patients . The diagnosis of PTSD according to DSM 5 criteria was retained in 56.2% of patients (N=80).

The average age was 12.4 years with extremes ranging from 7 to 17 years. We noted a female predominance at 58.8% (n=47)

Male gender was significantly associated with persistent avoidance (p=0.03). Sexual assault was significantly associated with the severity of flashback symptoms (p<10-3) and reckless and self-destructive behaviors (p<10-3) and with the frequency of dissociative symptoms (p<10-3).

We also noted in our work that dissociative symptoms were significantly more frequent in victims with no personal psychiatric history with a p value of 0.021.

In our population, we found a predominance of hypervigilance and a greater severity of exaggerated startle reactions in the absence of a family psychiatric history with a p value of 0.048 and 0.008 respectively.

We noted a significant predominance of exaggerated startle reactions in relation to the absence of exposure to previous traumatic events with a p equal to 0.043

Conclusions

The specificities identified in relation to the child should be taken into consideration during further evaluations and further analysis in the general population.

Disclosure of Interest

None Declared
A machine learning approach on whole blood immunomarkers to identify an inflammation associated psychosis onset subgroups
Authors: Delvecchio G.
Published: August 2023

Psychosis onset is a transdiagnostic event that leads to a range of psychiatric disorders, which are currently diagnosed through clinical observation. Since several years, the role of immune system in the pathophysiology of psychosis has been well-recognized, showing differences from the onset to chronic phases. In this lecture, I will show the results of our recent study that tested the hypothesis of the existence of subgroups of first-episode psychosis (FEP) patients identified by distinct peripheral immunomarkers’ profiles, possibly underpinning a subgroup-specific immunopathogenesis. More in detail, I will show the results obtained by the unsupervised machine learning model that we applied to the set of 12 peripheral blood immune gene transcripts, which we recently demonstrated to classify with high accuracy a cohort of FEP patients and HC. Also, I will report the results obtained by performing post-hoc univariate analyses using selective clinical, cognitive, and brain structural phenotypes of FEP patients and HC belonging to each subgroup identified by the computational model. I will extensively discuss two key clusters identified and validated by our model: 1) a FEP cluster characterized by the high expression of inflammatory and immune-activating genes; 2) a cluster consisting of an equal number of FEP and HC subjects, which did not show a relative over or under expression of any immune marker (balanced subgroup). Therefore, in this lecture I will emphasize that our study has been the first to demonstrate the existence of a psychosis onset subgroup identified by a peculiar multivariate pattern of immunomarkers, independently of clinical features or categorical diagnosis. This is paramount as if validated in independent samples, our clustering model could enable the sample selection in clinical trials aiming to test the efficacy of novel immunomodulant or anti-inflammatory therapies tailored to the specific inflammatory subgroup of psychotic patients.

Disclosure of Interest

None Declared
Prevalence and factors associated with non-suicidal self-Injury and suicidality in children and adolescent attending Emergency department in Oman
Authors: Alamri R.
Published: August 2023

Introduction

Non-suicidal self-Injury (NSSI) and suicidality are common reasons for emergency presentations in child and adolescent psychiatry (1). NSSI is defined as intentional destruction of one’s body tissue without suicidal intent and has a prevalence rate in adolescents of approximately 30–40% in clinical samples (2). Suicide prevalence is around 24–33% (3).

There are many factors leading to suicidal or self-harming behavior. A prior history of self-injurious behavior is one of the strongest predictors of future suicidal behavior, both cross-sectionally and longitudinally (6) . Additionally, longitudinal studies have found that a previous suicide attempt increases the risk of a future suicide attempt threefold.

Suicide and NSSI have a significant impact on families and communities. Hence, considerable required clinical attention is warranted to develop preventive strategies.

Objectives

The aim of this study is to investigate the prevalence of non-suicidal self-Injury (NSSI) and suicidality among children and adolescents presenting in emergency department of the tertiary psychiatric services and to study their demographic and clinical characteristics.

Methods

This is a retrospective cross-sectional analytical study included all children and adolescent patients attended the emergency department at Sultan Qaboos University Hospital between June 2021 to March 2016. The data was collected using the hospital´s electronic database to retrieve the medical records of children and adolescents who visited the emergency department. Patients who were 18 years of the age or younger were included in the study. The included patients must had been evaluated by psychiatrist during their presentations in the emergency department.

Results

During the 63 months of observation, 114 patients attended the emergency department and required psychiatric evaluation, 44.7%(n=51) of patients presented with NSSI and/or SA. The mean age was 15.7. 80.4%(n=41) were females while 19.6%(n=10) were males. 37.3% had a primary diagnosis of major depressive disorder (MDD) and 21.5% had comorbid medical illness. 44% of suicidal attempts were with drug overdose, mostly paracetamol overdose, while the most used method for NSSI was cutting the body with a razor, 57%.19 patients had a primary diagnosis of major depressive disorder, 17 patients had no clear diagnosis at presentation.22% of the patients had other medical comorbidities, 5 patients with epilepsy. 51% of the patients had positive family history of mental illness.

Conclusions

Considering that NSSI and suicidality were found to be the main reasons for presenting to a child and adolescent emergency psychiatric service, it seems crucial for physicians at PEDs to provide proper crisis intervention and referral to mental health services when appropriate. Early identification of risk factors is highly recommended.

Disclosure of Interest

None Declared
Chronic disease (CD) during transition from child to adult.Psychopathological consequences and coping strategies
Authors: Rubio Corgo S. , Arrieta Pey M. , Matas Ochoa A. M. , Duran Cristobal M. I. , Perez Vicente E. , Delgado Campos A. , Diaz Gordillo C. , Castro Ibañez A. C. , Alvarez Astorga A. , Alcindor Huelva P.
Published: August 2023

Introduction

CD is characterized by at least three features: its duration is prolonged, it does not resolve spontaneously and it is rarely completely cured. Approximately 10-15% of young people have CD. Adolescents with CD often have emotional and behavioral problems.

Objectives

To assess risk factors, derived psychiatric pathologies and coping strategies for a CD diagnosis in adolescence.

Methods

An extensive literature review was carried out on the subject in question, extracting information mainly from scientific articles, manuals and books.

Results

The main risk factors are those related with the CD in question, physical sequelae, the need for long-term hospital admissions or the use of drugs whose side effects include affective or behavioral symptoms; those related to the personality traits of the affected child or adolescent. In addition, as far as the family is concerned, the presence of a low level of education, lack of support or communication, as well as the presence of psychiatric disorders or serious medical conditions in parents. Among the most frequent psychiatric disorders associated with CD are affective and anxiety disorders, adaptive disorders, somatoform disorders, eating disorders and behavioral disorders. Whatever the CD is, it generates high levels of stress and uncertainty in the patient and family, which must be dealt together from a flexible perspective, allowing child or adolescent to adapt to the changes, reorganize and facing them with adaptive patterns of behavior. For this, it will be essential to have adequate social and family support with relational style based on communication, trust and acceptance.

Conclusions

In general, both adolescents with CD and their families have an adequate capacity to adapt to the repercussions and effects derived from the disease. Nevertheless, in case of possible emotional difficulties that may appear, a comprehensive and individualized approach to these adolescents and their families is necessary to provide them resources and coping strategies in different areas and contexts in which the disease debuts.The comprehensive therapeutic approach will consist of interventions at the individual and family level. Among the main objectives of these interventions are to achieve acceptance and adaptation to CD provinding adequate psychosocial support to enable them to cope with CD in the best possible way and to detect and address the emotional implications, even coexisting psychopathology.

Disclosure of Interest

None Declared
The distribution of IQ index scores in the psychometric profile of children with High Intellectual Potential (HIP): Is the heterogeneity specific to HIP?
Authors: Hamdioui S. , Vaivre-Douret L.
Published: August 2023

Introduction

The majority of studies on the HIP IQ attest a heterogeneity of the IQ profile as specific to HIP. However, the samples are recruited in clinical consultations. Thus, it is important to investigate new samples from schools.

Objectives

We aimed to analyze the index scores of the IQ profile of children without disorders or specific school assistance.

Methods

The WISC-V was conducted and analyzed in 80 healthy children (50 HIP vs. 30 non-HIP), aged 7-to-13 years-old (mean 10y; SD 1.8). All children were recruited in private and public schools in Paris.

Results

All IQ index scores were significantly higher in the HIP vs. non-HIP. In both groups, the Verbal Comprehension Index was the highest index while the Processing Speed Index was the lowest. There are significantly (p=0.02) more heterogeneous IQ profiles in HIP (64%) vs. non-HIP (47%), with a significantly larger gap between the highest and lowest index (respectively: median = 29.5 vs. 21.5). There was a significant-positive correlation between IQ level in general and the heterogeneity of the profile (r = 0.42; p<0.001).

Conclusions

The HIP children show better verbal, visual-spatial, fluid reasoning, working memory, and processing speed index scores. However, the distribution of IQ index scores was similar in both groups. Thus, the heterogeneity of the IQ profile is not specific to HIP children, but rather related to IQ score level. This highlights the importance of considering the IQ as a continuum rather than as a categorical distribution. Moreover, it points to the interest to better understand the IQ profile by completing it with multidimensional assessments.

Disclosure of Interest

None Declared
Reciprocal relationships between self-esteem, coping styles and anxiety symptoms among adolescents: Between-person and within-person effects
Authors: Li W. , Lu C.
Published: August 2023

Introduction

Previous researches have not distinguished between-person effects from within-person effects when exploring the relationship between self-esteem, coping styles, and anxiety symptoms among adolescents.

Objectives

To address this gap, this study investigated reciprocal associations among self-esteem, coping styles, and anxiety symptoms in a three-wave longitudinal panel survey, using an analytical strategy that disaggregates within-person and between-person variance.

Methods

The data was drawn from the Longitudinal Study of Adolescents’ Mental and Behavioral Well-being Research study conducted in 10 public schools in the Guangdong province of China. All participants had a baseline visit (N = 1957, age 13.6, grades 7 and 10) and follow-up interviews at one-year intervals for 3 years. A random intercept cross-lagged panel model combined with mediation analysis was performed.

Results

At the within-person level, following results were observed. (1) Low self-esteem and anxiety symptoms bidirectionally predicted each other. (2) Low self-esteem and negative coping style bidirectionally predicted each other. (3) Anxiety symptoms predicted subsequent negative coping style but not vice versa. At the between-person level, we obtained the following main results. (1) Significant predictive effects on the random intercept were found among all three study constructs. (2) There were sex differences regarding the association between self-esteem and anxiety symptoms and the correlation strength of females was greater than that of males. (3) Self-esteem mediated the reciprocal relations between coping styles and anxiety symptoms.

Conclusions

These results could be an important advance by elucidating the reciprocal relationships among self-esteem, coping styles, and anxiety symptoms at the within-person level, suggesting that interventions targeted at promoting self-esteem and cultivating positive coping style may help reduce adolescent anxiety.

Disclosure of Interest

None Declared
Smoking treatments for patients with mental illness: case presentation and a brief literature review
Authors: Garcia Sanchez F. , Gutierrez Rodriguez M. , Moreno Menguiano C. , Corral Alonso M. A. , Vazquez Vazquez J. J. , Bañon Gonzalez S. M. , Voces Domingo V. , Casado de la Hera J. A.
Published: August 2023

Introduction

Smoking prevalence in patients with mental illness ranges between two to 4 times higher than general population. This higher prevalence has a multifactorial origin, and some of the possible causes are still unknown.

They have a higher prevalence of tobacco-associated diseases and higher mortality.

Additionally, these patients have greater difficulty in treating and quitting smoking.

A relationship has been found between severity of mental illness and smoking. Risk of suicide seems to be higher in patients with higher tobacco consumption. Schizophrenia is the mental illness that has been most closely related to smoking, with a prevalence close to 90%.

Objectives

The aim of this work is reviewing the current bibliography referring to smoking treatments for patients with mental illness

Methods

A literature search using electronic manuscripts available in PubMed database published during the last ten years and further description and discussion of a single-patient clinical case

Results

The treatment of tobacco dependence in patients with mental illnesses is sometimes waited until there is psychiatric stability, which can take a long time in those cases with more severe mental disorders, which can have negative physical and psychiatric consequences.

The combined treatment of cognitive behavioral therapy and pharmacological treatment is the most effective approach. Nicotine replacement therapy can be useful, while combined use of antidepressants or anxiolytics is also recommended.

Bupropion has shown efficacy. In patients with schizophrenia it does not seem to worsen positive symptomatology, but improving the negative one. It should not be used in patients with bipolar disorder or bulimia.

Varenicline has shown efficacy in the general population, but limitations were established in patients with mental illness, although it is the drug that has shown greater efficacy. However, is not currently available in our country.

Cytisine is a drug with limited number of studies in the psychiatric population but it may be a reasonable treatment alternative.

Conclusions

The prevalence of tobacco use in patients with mental illness is higher than the general population, especially in paranoid schizophrenia. The consequences on physical health and the evolution of psychiatric illness are very relevant. Based on above, a multidisciplinary and coordinated management involving psychiatrists and other specialists in the treatment of these patients should be desirable.

Disclosure of Interest

None Declared
The prevalence of psychiatric comorbidities in epileptic patients
Authors: Berrada H. , Chebli H. , Hajjami K. , Belbachir S. , Ouanass A.
Published: August 2023

Introduction

Habituellement, nous voyons dans la consultation psychiatrique des patients épileptiques pour des plaintes psychologiques. Souvent pour un trouble anxieux ou dépressif. Dans d’autres cas, nous prenons en charge des patients psychiatriques atteints d’épilepsie.

Objectives

L’objectif de notre travail est d’étudier la prévalence de la comorbidité psychiatrique dans une population de patients épileptiques.

Methods

Nous avons mené une étude transversale auprès de la consultation de l’hopital ar-razi de salé, à l’aide d’un questionnaire et d’échelles d’évaluation préétablies : le MINI (mini entretien neuropsychiatrique international), l’inventaire de la dépression de Beck, et Échelle d’anxiété de Hamilton.

Results

55 patients ont répondu aux critères d’inclusion. L’âge moyen de nos patients est de 25,9 ans. Le sex-ratio F/H est de 1,6. Plus de la moitié de nos patients sont célibataires (78%). Seuls 21 % des patients ont une activité professionnelle régulière. La prévalence des troubles psychiatriques dans notre étude est de 66,6%. L’anxiété est retrouvée dans 68,2 % des cas, alors que la dépression est évaluée à 58,9 % des cas dont 23,7 % ont une dépression sévère qu’il faut traiter, avec une prédominance du sexe féminin (66,8 %).

Conclusions

Dans notre étude, l’ anxiété et la dépression sont les troubles psychiatriques les plus rapportés en cas d’épilepsie. Ils doivent être systématiquement recherchés pour tout épileptique et traités pour améliorer la qualité de vie des patients.

Disclosure of Interest

None Declared
A TRANSDISCIPLINARY APPROACH TO THE TREATMENT OF DRY EYE DISEASE IN PATIENTS WITH PSYCHIATRIC DISORDERS
Authors: Bakija I. , Bogadi M. , Tripković M. , Kaštelan S.
Published: August 2023

Introduction

Dry eye disease (DED) is a multifactorial disease of the tear film and ocular surface representing one of the most common problems in ophthalmological practice and significant public health problem. Characteristic symptoms of DED include gritty, sandy foreign body sensation as well as visual disturbances that have a negative impact on the patient’s daily activities and also affecting patient’s quality of life (QOL).

Objectives

The objective of this research is to point out the importance of transdisciplinary approach to treatment of dry eye disease in patients with psychiatric disorders.

Methods

We reviewed all current available literature in Pubmed dealing with the topic of connection of dry eye disease and psychiatric disorders.

Results

In recent years, the relationship between DED and psychiatric disorders has been gaining attention. A number of epidemiological studies have reported a possible association between dry eye and psychiatric disorders showing that the subjective symptoms of dry eye can be affected not only by changes of the tear film and ocular surface but also psychological factors such as anxiety, depression, schizophrenia, post-traumatic stress disorder (PTSP) and subjective happiness. Apart from psychiatric disorders, psychiatric medications are also considered as risk factors for DED due to their influence on the tear film status. The incidence of ocular side effects increases rapidly with the use of polypharmacy, a very common form of treatment used in psychiatry.

Mental health disorders may be one of considerable contributing factors for dry eye symptoms and undiagnosed mental health conditions can be an influencing element for unexplained levels of DED symptoms. Depression, anxiety, stress, hypochondriasis, neuroticism, sleep and mood disorders may be associated with the exacerbation of symptoms to degrees that are not consistent with the objective signs related to tear dysfunction as well as changes in the anterior surface of the eye.

There is often inconsistency between signs and symptoms of DED, where symptoms often are more related to non-ocular conditions including psychiatric disorders than to tear film parameters. Consequently, in many cases DED may be considered as a psychiatric as well as ophthalmological problem. Psychiatrists and ophthalmologists need to be aware of the potential influence of psychiatric disorders and medications on tear film stability.

Conclusions

A detailed medical history, thorough ophthalmological examination and referral to a psychologist or psychiatrist may be essential in the treatment of those patients. In treatment of psychiatric patients, an integrative and transdisciplinary approach will result in better functioning and higher QOL.

Disclosure of Interest

None Declared
An auditory Charles Bonnet Syndrome managed with psychological intervention: A case report
Authors: Karoui M. , Mediouni A. , Nefzi H. , Ellouze F.
Published: August 2023

Introduction

Charles Bonnet Syndrome (CBS) is an age-related disorder characterized by complex visual hallucinations in older persons with vision loss and underlying ocular pathology. The management of these symptoms is imprecise and combines psychological measures with psychotropic drugs.

Objectives

to discuss the non-pharmacological management of Bonnet syndrome through a case report.

Methods

We report a case of atypical CBS in a 76-year-old male patient presenting with visual and auditory hallucinations that were improved by reassurance.

Results

The past medical history was significant for diabetic retinopathy, difficulty hearing due to bilateral sensorineural hearing loss. He recognized these visions as unreal and felt distressed by them. No cognitive impairment was observed on several neuropsychological tests. He was reassured of the false nature of the visual experiences after explanations that he had no mental illness and that the problem could disappear. He was taught how to keep the images away by closing his eyes for sometimes and repeated blinking. After six weeks of psychological intervention, the visual experiences had disappeared without using any drug

Conclusions

In the management of CBS drug treatments remain partially satisfactory. Nonpharmacological interventions focus on the reduction of the visual pathway deprivation. This therapeutic alternative seems to provide positive benefits.

Disclosure of Interest

None Declared
Associations between polysubstance use and psychiatric comorbidities
Authors: Fernández Fernández R. , del Sol Calderón P. , Izquierdo de la Puente Á. , Vizcaíno da Silva M.
Published: August 2023

Introduction

Polydrug use studies mention demographic and socioeconomic factors that may influence this problem. One of them is the existence of psychiatric comorbidity; Rentrop’s study (Rentrop et al., 2014) finds in a sample of 50 patients that all patients had at least one axis I disorder, 90% at least one axis II disorder, which may compromise the outcome of detoxification and dehabituation treatments (Rentrop et al., 2014). Another study found that 44.9% of patients admitted to a psychiatric unit are polydrug users (Karam et al., 2002).

Objectives

To study the possible association of polydrug use with psychiatric comorbidity in patients admitted to a general hospital and presenting drug use.

Methods

We made a descriptive retrospective study through the use of electronic medical records. The drug use history was obtained for all patients admitted to the inpatient service of a general hospital during a 3-year period.

Results

More cases of poly-consumption together with psychiatric comorbidity are found than expected in the χ² Test, with significant results (χ² = 27.2; p<0.001). The mean age of the patient with poly-consumption and psychiatric comorbidity is 34.9 years.Psychiatric comorbidityPolydrug useNoYesTotalNoObserved2960296Expected28411.64296YesObserved21721238Expected2299.36238TotalObserved5132153451321534

Conclusions

Psychiatric comorbidity in patients with polydrug use may be overlooked (Kruckow et al. 2016). Identifying patients with dual diagnosis is important given that these patients suffer decreased treatment compliance and life expectancy compared with single-diagnosis patients (Kruckow et al., 2016).

References

Rentrop, M., Zilker, T., Lederle, A., Birkhofer, A., & Hörz, S. (2014). Psychiatric comorbidity and personality structure in patients with polyvalent addiction. Psychopathology, 47(2), 133–140. https://doi.org/10.1159/000351784

Kruckow, L., Linnet, K., & Banner, J. (2016). Psychiatric disorders are overlooked in patients with drug abuse. Danish medical journal, 63(3), A5207.

Disclosure of Interest

None Declared
About a case: affective psychosis and hyperthyroidism
Authors: Peñalver J. , Llimona A. , Mayans J. , Vargas L. N. , Campillo M. T. , Muro C. , Oller S.
Published: August 2023

Introduction

Hyperthyroidism due to Graves-Basedow disease is a common cause of neuropsychiatric manifestations, such as anxiety, psychomotor restlessness, mood disturbances, insomnia and psychosis. Hashimoto’s encephalopathy rarely occurs in so-called autoimmune thyroiditis, which can present with hyperthyroidism and neuropsychiatric symptoms similar to Graves’ disease. We add that the mystical-religious beliefs, present in all human cultures, and decisive in the case at hand, make us propose an evolutionary origin of them.

Objectives

Clinical case description

Methods

A clinical case based on medical reports is described

Results

We present the case of a 72-year-old woman, a member of the Seventh-day Adventist Church, well adapted to the Community. Known history of elevated antithyroid antibodies since 2019, brought to the emergency room involuntarily due to a mystical-religious delusional condition associated with behavioral disturbance. On examination, cachectic appearance, distal tremor, emotional exaltation and megalomanic speech were highlighted. Laboratory tests revealed primary hyperthyroidism with elevated antibodies. During admission, the differential diagnosis between Graves-Basedow disease and Hashimoto’s encephalopathy was considered. Thyroid scintigraphy oriented the diagnosis to Graves-Basedow disease, not requiring lumbar puncture or corticosteroid treatment. Treatment was based on high-dose antithyroid and antipsychotic drugs, with clinical and analytical remission at 3 weeks. The patient was referred to a Social Health Center for functional recovery. The family refers to a similar episode in 2014, of less intensity and self-limited, which is proposed to be a hashitoxicosis.

Conclusions

Differential diagnosis between Graves-Basedow and Hashimoto disease is essential as they differ in treatment and prognosis. The continuity that the delusion presents with the previous beliefs of the patient, differing mainly in the affective-behavioral implication, makes us consider a predisposition to psychosis in our patient. Religiosity can be adaptive in certain environments, since mystical beliefs have existed throughout the history of the human species and seem to be part of our nature.

Disclosure of Interest

None Declared
EEG CORRELATES OF SOMATIC DISORDERS IN DEPRESSIVE PATIENTS WHO SURVIVED AND HAVE NOT BEEN ILL WITH COVID-19
Authors: Iznak A. F. , Iznak E. V. , Damyanovich E. V.
Published: August 2023

Introduction

Coronavirus infection is accompanied by the development of a wide range of neuropsychiatric and somatic complications.

Objectives

The aim of the study is to assess the severity of somatic disorders and to identify their EEG correlates in depressive patients who had and did not have COVID-19.

Methods

The study involved 30 female depressive patients (F31.3-4, F21.3-4 + F34.0, according to ICD-10), aged 16-25 years, who previously had a mild or asymptomatic coronavirus infection (group "COVID”), and 40 depressive patients matched in gender, age and syndrome structure to patients of the “COVID” group, but who did not have COVID-19 (“non-COVID” group). The pre-treatment severity of depressive symptoms was assessed by the total sum, and by sums of clusters: depression (items 1, 2, 3, 7, 8), anxiety (items 9, 10, 11), sleep disorders (items 4, 5 , 6) and somatic disorders (items 12, 13, 14) of HDRS-17 scale. All patients underwent pre-treatment multichannel (16 leads) recordings of the background EEG followed by analysis of the absolute EEG spectral power (SP) in 8 narrow frequency sub-bands. Statistical analysis of the data was carried out using the methods of descriptive statistics and correlation analysis of the IBM SPSS Statistics, v.22 software package.

Results

The values of the total sums of scores of individual clusters (depression, anxiety, sleep disorders) of the HDRS-17 scale in the “COVID” and “non-COVID” groups did not differ statistically. The exception was a significantly higher (p>0.01) number of complaints of somatic disorders (weakness, heaviness and pain in the muscles, a feeling of loss of energy, loss of strength, decreased libido) in patients who had COVID compared to those who did not (2.4±1.0 and 1.4±1.1 points, respectively). In the “non-COVID” group, the HDRS-17 somatic disorder cluster scores positively correlated with SP values of beta2 EEG (20–30 Hz) in leads F3, F8, and P3. which reflects the increased activation of brain stem structures, characteristic for depressive conditions. In the “COVID” group, these scores correlated with the SP values of alpha3 (11-13 Hz, in leads F4, F8, C4 and T4) and beta2 (20-30 Hz, in C4) not positively, but negatively. Thus, the severity of somatic complaints in patients of this group is associated not with greater, but with less activation of the brain (in particular, of the right hemisphere), which, presumably, may be associated with the “exhaustion” of the central mechanisms of regulation of autonomic functions after suffering COVID disease.

Conclusions

COVID (in a mild or asymptomatic form) did not show a significant effect on the overall severity of depression of the studied group of patients who recovered from COVID, with the exception of a significantly greater severity of their somatic complaints compared to the group of patients who had not been ill with COVID. The study supported by the RSF grant No. 21-18-00129.

Disclosure of Interest

None Declared
Affective state of people suffering from long covid and associated factors. Cross-sectional descriptive study
Authors: Oliván-Blázquez B. , Samper-Pardo M. , León-Herrera S. , Aguilar-Latorre A. , López-Mendez F. , Magallón-Botaya R.
Published: August 2023

Introduction

The “Post-COVID Syndrome” affects approximately 10% of people who have been infected with Covid-19. These people have a physical and mental impact.

Objectives

The objective of this study is to analyze factors related to poorer mental health in these patients from primary health care.

Methods

Cross-sectional study. The study population was post-COVID-19 patients aged 18 years or older and treated by Primary Health Care (PHC). The main variable was Affective state through the Hospital Anxiety and Depression Scale (HADS) questionnaire. The rest of the variables were: Socio-demographic variables, number of residual symptoms, cognitive using the Montreal Cognitive Assessment (MoCA), physical functioning variable will be measured by Sit to Stand Test and Sleep quality through the Insomnia Severity Index (ISI). A bivariate analysis and also a lineal multivariate model were developed. Ethics approval was granted by the Clinical Research Ethics Committee of Aragón (PI21/139 and PI21/454).

Results

A total of 100 individuals participated, of whom, 80 were women and 20 were men. The median scores in HADS was 16 and the interquartile range was 12. Multilevel analysis shows that better physical functioning (sit to stand test) and worse sleep quality (Insomnia severity index) are predictors of worse affective state. The models explain 36.5% of the HADS variance.

Conclusions

It is relevant to take account these variables in the treatment of the affective state of patients with long covid.

Disclosure of Interest

None Declared
Evolution of the affective state of a cohort of people suffering from long covid and associated factors
Authors: Oliván-Blázquez B. , León-Herrera S. , Samper-Pardo M. , Méndez-López F. , Aguilar-Latorre A. , Martinez-Perrochan M.
Published: August 2023

Introduction

Long COVID patients have experienced a decline in their quality of life caused, in part but not wholly, by its negative emotional impact. Some of the most prevalent mental symptoms presented by Long COVID patients are anxiety, depression and sleep disorders.

Objectives

The objective of this study is to increase understanding of the affective state of people diagnosed with Long COVID, the evolution and associated factors.

Methods

Longitudinal study of three months of duration. The study population was 100 post-COVID-19 patients aged 18 years or older (80 women and 20 men). The main variable was the affective state through the Hospital Anxiety and Depression Scale (HADS) questionnaire. The rest of the collected variables were: Socio-demographic variables, number of residual symptoms, cognitive functioning using the Montreal Cognitive Assessment (MoCA), physical functioning variable measured by Sit to Stand Test and Sleep quality through the Insomnia Severity Index (ISI). A statistical analysis comparing baseline and 3months follow up measures were performed, using a Student T for related samples statistical. A lineal regression analysing associated factors to a reduction in HADS score was also performed. Ethics approval was granted by the Clinical Research Ethics Committee of Aragón (PI21/139 and PI21/454).

Results

At baseline the score in anxiety, depression and total score were 9,10 (SD: 4,67), 8,25 (SD: 4,51) and 17,35 (SD: 8,43) respectively, and 74% of the participants were considered cases. At three months, there is a slightly decrease but not significative in the score of HADS, both in anxiety, depression and total score (pvalue 0,465; 0,236; and 0,216 respectively). 64,4% of the participants had a positive diagnosis of depression/anxiety. About the rest of the variables there were also a slight decrease but without being significant There was not a predictive model that explained the decrease in the HADS score.

Conclusions

The evolution of the people suffering long covid is very slow along the time, and also the affective state.

Disclosure of Interest

None Declared
Assessing the surge capacity of hospitals in Ugandan health care systems in managing the COVID-19 pandemic
Authors: Jephthah D. , Ddumba I.
Published: August 2023

Introduction

The increasing cases of COVID-19 poses a threat on the over strained health care systems, especially in developing countries. Health care systems might need a surge to accommodate the ever increasing number of COVID1-19 cases. Hence, we assessed the Ugandan healthcare systems’ capacity to accommodate the surge in the increased caseloads, which might need admission and critical care due to COVID-19.

Objectives

Understanding the health systems capacity to accomadate the surge in increase caseload of COVID-19

Methods

We assumed that 2% of the Uganda population get symptomatic infections by COVID-19 based on modelled estimates of Uganda and ascertained the healthcare systems surge capacity for COVID-19 under three transmission curves scenarios; 6, 12 and 18 months. We estimated four measures for hospital surge capacity; ICU bed surge capacity, ICU bed tipping point, hospital bed capacity and hospital bed tipping point. Estimates were made for national level and 132 district local government.

Results

The capacity of Ugandan health care system to accommodate the increasing numbers of cases due to COVID-19 is hindered by the lack of oxygen. Only 9 in 20 (46%) of hospital beds had oxygen supply. The hospital bed surge capacity varied across districts. Under the 12 months transmission scenario, the proportion of hospital with available beds, that would accommodate COVID-19 cases varied from 4% in Karomoja district, to 84% in Kampala district. The Ugandan healthcare systems faces a critical gap in ICU beds and ventilator capacity. Only 48 out of 132 districts had at least 1 ICU unit. An additional 2,247 bed and 2,756 ventilators (12 months transmission curve) will be needed to accommodate the caseloads due to COVID-19.

Conclusions

The capacity for Ugandan healthcare systems to manage to manage the COVID-19 caseloads is minimal. There need to address the sub-national variations in bed surge capacity, ICU units and ventilators within the Ugandan healthcare system.

Disclosure of Interest

None Declared
Subjective memory disorders and psychological distress in post COVID 19
Authors: Halouani N. , Gdoura D. , Bouattour O. , Chamseddine A. , Moussa N. , Ellouze S. , Aloulou J.
Published: August 2023

Introduction

In addition to psychological distress in patients with COVID 19, neurological and neurocognitive manifestations, such as memory impairment, are increasingly reported. Screening for cognitive impairment is therefore crucial.

Objectives

Identify cognitive impairment inpost COVID19.

Methods

This is a descriptive and analytical cross-sectional study that took place during the period from 1 st March 15 th May 2021 with 154 patients who were hospitalized at the COVID19 unit at Hedi Chaker Hospital Sfax. The psychometric evaluation, done by telephone, was performed using the "Hospital Anxiety and Depression Scale" for the screening of anxiety-depressive disorders, the "Impact of Event Scale-Revised" for the screening of post-traumatic stress disorder, the Insomnia Severity Index for the evaluation of sleep, the "The Prospective and Retrospective Memory Questionnaire" scale and the Mac Nair questionnaire for the evaluation of subjective memory.

Results

The mean age was 66.62 ± 13.34 years. Male patients represented 60.4% of the population. The prevalence of anxiety, depression and post-traumatic stress disorder was 24.7%, 11% and 13.6% respectively. For the assessment of subjective memory, the mean total score of the PRMQ was 27.72 ± 7.71, with that of prospective and retrospective memory 15.41 ± 4.44 and 12.16 ± 3.73 respectively. According to the Mac Nair scale, 18.8% of patients had memory impairment (Mac Nair score >15). Anxious patients showed more memory impairment. Depressed patients had the most impaired scores for total memory (p= 0.03) and retrospective memory (p= 0.022). Patients with post-traumatic stress disorder had more memory impairment (p=0.021).

Conclusions

Psychological distress is multifactorial in its etiology. The medium and long term management of COVID+ patients must therefore be multidisciplinary.

Disclosure of Interest

None Declared
Vaccination against SARSCoV-19 among psychiatric patients at the central Greek hospital
Authors: Anagnostaki M. E. , Anagnostaki I. , Papaspiropouloou G.-E.
Published: August 2023

Introduction

Vaccination against SARSCov-19 all over Europe reached over 80% of adult population confronting the pandemic burden on National Health Systems. On the contrary large parts of population remained unvaccinated. These groups are mainly individuals with poor socioeconomic status and psychiatric patients

Objectives

to determine the ratio of fully vaccinated patients among the hospitalized and outpatient of Psychiatric Hospital of Attika. The reason of vaccination avoidance recorded by the clinician

Methods

The study has done retrospectively and included 2583 psychiatric patients who are hospitalized or are visiting the Outpatient clinic. A concise questionnaire was formed to record the main reason of avoidance (Denial/Medical Issues/ Loss of follow up/ other)

Results

520 out of 2583 (21%) remained not fully vaccinated throughout the pandemic and denial by the patient was the main reason (55%). The reasons recorded at the patient’s file by the physician are shown at table 1.
Table 1

main reasons of vaccine avoidance.

Denial55%Medical contraindications15%Loss of follow up26%other4%

Conclusions

Psychiatric patients belong to a high probability group for vaccine avoidance. In our study the frequency of unvaccinated psychiatric patients found greater than healthy population and the main reason is patient decision not to consent. Loss of information, distrust, inadequate social help are causes of poor decision making and consequent low quality health services

Disclosure of Interest

None Declared
Spatial typologies in psychiatric facilities
Authors: Kirch J.
Published: August 2023

A psychiatric facility represents a temporary home for its patients. Multiple studies have provided ample evidence that the built environment has the potential to support patients in their recovery process, in part by offering a homely surrounding. If their environment also succeeds in creating a therapeutic milieu in which the patients’ needs for protection, security, privacy, and orientation are met, the contribution of these surroundings can be even more significant. For example, clear, comprehensible building structures help patients to find their way around the new environment and further provide a feeling of security. To fulfill this goal, planners should pay special attention to the access zones and semi-public spaces in these types of buildings, as psychiatric patients often spend a lot of time there. Corridors should provide high spatial quality with daylight areas and places to sit down.

Based on an analysis of more than 30 psychiatric facilities in Germany, three spatial typologies were identified within which the factors listed above have been explored.

Firstly, the “Pavilion type”: square or slightly rectangular pavilion structures, generally with courtyards enclosed on four sides and multiple additions. This typology is found very often, especially on new build sites. The Pavilion type allows a useful combination of room functions and good lighting of all spaces. Secondly, the “L- or T-shaped type”: Linked L- or T-shaped, often appearing as comb-like buildings. These structures are particularly successful in integrating with the surrounding landscape. Thirdly, the “Block type”: Closed, block-like single-floor and two-floor typologies of different lengths. However, these building structures are increasingly rare as they often appear out of human scale and result in long, monotonous corridors.

In building design it is crucial to consider the triad of “architecture/interior design/ and landscape design” and to emphasize the specifics of the site. Each of these typologies offer different opportunities to achieve this goal; yet, only when a unique atmosphere is created – one in which everyone feels accepted and is seen as an individual – can patients, staff and visitors feel the comfort and support of a successful homely environment.

Disclosure of Interest

None Declared
Patience and its relationship to Stress Tolerance in the medical system in Bethlehem Governorate during the Corona pandemic
Authors: Al-Arja N. S.
Published: August 2023

Introduction

The COVID-19 pandemic has set unprecedented demand on the medical system globally. Palestine was one of the Arab countries affected

Objectives

The present study aims to identify the relationship between patience and Stress Tolerance in the medical system in Bethlehem Governorate during the Corona pandemic, as well as to identify the impact of several demographic variables on it.

Methods

Descriptive method were used. Appropriate statistical analyses were conducted using (SPSS). A random sample of 160 workers of the medical staff completed the Patience Scale and Coping Processes Scale questionnaire.

Results

: showed there is a significant positive effect for patience on stress tolerance and there were statistically significant differences in the level of patience in favor of males and single workers. It was also found that there is no difference in the specific duties of a health care worker and no variance of statistical evidence was found in the level of patience due to work with Covid patients but there were differences in stress tolerance in favor of those who do not work with Covid patients.

There is a significance in the level of stress tolerance in favor of the National Center in regard to bearing pressure.

There was a negative correlation with statistical significance between stress tolerance and age. The nature of stress changes with age, from episodic to chronic, which in turn affects appraisal and coping processes

Conclusions

This study, which was conducted on a sample of Palestinian medical workers in the Bethlehem area, showed that at the beginning of the pandemic, the medical system in Palestine was not ready to handle Covid 19, and had no precautions to prevent the disease. In spite of that, the doctors and nurses who were undergoing psychological pressure were able to stand at the front line and face the outbreak of the Corona virus.

Disclosure of Interest

None Declared