bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deliberate self-poisoning in children and adolescents
Authors: Hmimou S. , Boukhorb S. , Irnat S. , Hadrya F. , Rhalem N. , Bellimam M. A. , Soulaymani A. , Mokhtari A. , Soulaymani-Bencheikh R. , Hami H. 
Published: August 2024

IntroductionSuicide is a significant global public health issue that has a severe impact on children and adolescents.ObjectivesThis study examined the epidemiological features of self-poisoning events among these groups in Morocco.MethodsIn this retrospective study, data on intentional poisoning cases among children under 15 years of age and adolescents aged 15-19 years were analyzed. The Moroccan Poison Control Center has reported these cases over a period of 34 years.Results
During the study period, 7,111 deliberate self-poisoning cases were documented among children and adolescents, representing 30% of all reported self-poisoning cases (out of a total of 23,711 cases with known ages). The vast majority of the cases (80.8%) involved females, indicating a significant female-to-male ratio of 4.2. The patients had a mean age of 16.05 ± 2.10 years. Notably, drugs were the predominant method of self-poisoning, comprising 51.7% of the cases, followed by pesticides at 31.3%. The symptoms of poisoning manifested with significant variation, contingent on the type of toxin involved, the amount ingested, and the time passed before medical care was administered. Of the 4,711 cases with known outcomes, 144 (3.06%) were fatal. Nonetheless, the outcomes were favorable for the remaining cases, with or without lasting sequelae.ConclusionsThe ongoing prevalence of suicide and suicide attempts among children and adolescents is a prominent issue in public health. Our research emphasizes the crucial necessity to address suicide, as it remains one of the primary causes of mortality in young individuals.Disclosure of InterestNone Declared
Enhancing Psychiatry Resident Bonding and Education using an Escape Room Challenge Activity
Authors: Lee G. , Russell G. , Farhan H. , Lin J. , Spring L. 
Published: August 2024

Introduction
An “escape room” is a game requiring teamwork and problem-solving during which a series of puzzles are solved to escape a locked room. Various escape room activities have been designed for healthcare professionals, including internal medicine residents and nursing students (Anderson et al. Simulation & Gaming 2021; 52(1) 7-17; Rodríguez-Ferrer et al. BMC Med Educ 2022; 22:901; Khanna et al. Cureus 2021; 13 (9) e18314). Escape rooms provide an opportunity for social activity, an important component of resident wellness (Mari et al. BMC Med Educ 2019; 19(1):437). This abstract describes an escape room challenge designed and implemented at our psychiatry residency program quarterly wellness afternoon event, which is an afternoon session dedicated to resident wellness.ObjectivesThe objective of this project was to design and implement an escape room challenge containing multiple game mechanics, including hidden roles, information asymmetry, acting, logical deduction, and spying. This activity was conducted to enhance bonding among residents while reinforcing knowledge in psychiatry.Methods
We designed and implemented an escape room for 22 residents. Residents were divided into four teams each tasked with completing a sequence of puzzles to open the final lockbox. Two novel mechanics were added to the activity. Each team had a “clue holder” with clues to help solve all the puzzles. This team member had to conceal their identity because, if any of the other teams identified this person, the original winning team would have to give up the prize to the team that guessed the identity of this person. One member of each team was assigned a “spy” role whose mission was to make it hard for the clue holder to reveal all the clues. An anonymous post-activity survey was completed using Google Forms.Results
The script was set in a fictional, abandoned psychiatric emergency room. The first task was a visual puzzle of a historic figure in psychiatry. The second activity involved residents guessing the psychotropic medication being acted out by another resident in the style of charades. The third activity required residents to apply developmental milestones to decode a combination lock. The fourth puzzle involved residents solving riddles by using information gathered from resident profiles on the residency program website.Eleven (50%) residents completed the post-game survey. All residents answered true or very true that they enjoyed the game and that participation helped them better connect with their peers. Eight (73%) residents answered true or very true that they learned something from the activity.ConclusionsAn adapted escape room challenge is a novel wellness activity that enhance resident collegiality, teamwork, and bonding. All residents who completed the post-activity survey indicated that they enjoyed the activity and felt more connected to their peers afterwards.Disclosure of InterestNone Declared
A Case of Severe Polyhydramnios During Pregnancy Associated with Long-Term Use of Lithium
Authors: Stoppa A. , Roda E. , Hernández A. S. , Roca A. 
Published: August 2024

IntroductionThe perinatal period poses heightened vulnerability to bipolar affective episodes. Lithium serves as first line in the management of bipolar disorder, demonstrating efficacy in stabilizing mood episodes and preventing relapses. Therefore, it also a recommended treatment during the pregnancy period. However, its use presents potential risks for both the mother and the developing fetus. Given the prevalence of bipolar disorder in reproductive-age women, it is crucial to investigate the risks associated with lithium use during pregnancy, along with its subsequent obstetric and neonatal complications.ObjectivesThis report outlines a case of severe polyhydramnios in a 42-year-old primigravida patient, under long-term lithium and antipsychotic treatment. Additionally, a systematic search for similar case reports was conducted to provide an overview of the existing literature.Methods
The patient’s medical history and perinatal medical care are documented in this case report. A systematic literature search on MEDLINE (PubMed) was conducted using Boolean operators.ResultsThe patient was diagnosed with bipolar disorder type I and had a history of lithium treatment for over 20 years, supplemented later with antipsychotics. During her pregnancy, she experienced a polyuria-polydipsia syndrome and a severe polyhydramnios. She also suffered renal impairment. Together, it is indicative of a nephrogenic diabetes insipidus (NDI), likely induced by prolonged lithium treatment. As the pregnancy progressed, she experienced premature rupture of membranes at 34 weeks and 5 days. The newborn needed medical support and was admitted to the neonatal unit, without further complications.Systematic research showed three published case reports describing nephrogenic diabetes insipidus (NDI) and polyhydramnios associated to lithium treatment.ConclusionsChronic administration of lithium may contribute to the development of resistance to antidiuretic hormone (ADH), leading to polyuria-polydipsia syndrome and potentially severe obstetric complications. The co-administration of lithium and antipsychotics may exacerbate these effects. Further research is needed to elucidate their combined clinical impacts.Disclosure of InterestNone Declared
Conjugal violence in Tunisia: the characteristics of marriage
Authors: Jbir R. , Aribi L. , Chaari I. , Samet A. , Ben jemaa R. , Messedi N. , Aloulou J. 
Published: August 2024

IntroductionViolence is a global phenomenon, destroying the fabric of society and threatening the lives, health and prosperity of all. In recent years, there has been an upsurge in domestic violence in Tunsia. Unfortunately, few studies have focused on the relationship within these couples.ObjectivesTo describe the characteristics of marriage between Tunisian couples where domestic violence prevails.MethodsOur study was descriptive and analytical cross-sectional, carried out with women victims of domestic violence examined in the context of psychiatric expertise.An anonymous survey was asked to these ladies concerning the socio-demographic characteristics of the wife and spouse and the characteristics of the marriage.ResultsOur population was made up of 122 couples. The average age of ladies was 35.66 years (from18 to 64 years). As for the spouses, their average age was 41.68, with extremes of 22 and 70.92,6% of couples had at least one child.Professionally, (6.6%) of the husbands were inactive and 51.6% (n= 63) of couples had an average socio-economic level.43.4% (n=53) lived in rented houses, 41% (n=50) owned their own homes, 14.8% (n=18) lived in a room with their in-laws and 0.8% (n=1) were homeless.
The average duration of marriage in our study was 11.16 ± 9.12 years and extremes of 1 and 40 years.Judicial records were found in 28.7% of assailants (n=35).The majority of women surveyed, 92.6% (n=113), were victims of three types of violence at once (verbal, psychological and physical). Sixty-two women (50.8%) were victims of four types of violence simultaneously (verbal, psychological, physical and sexual).Various causes of violence were reported, dominated mainly by claims for money, sexual problems, drunkenness and infidelity, with prevalence rates of 38.5%, 23.8%, 22.1% and 21.3% respectively.The majority of women, 66.4% (n=81), had been assaulted by their spouses during the first year of marriage. Forty-seven ladies (38.5%) were subjected to violence on a daily basis.According to the survey, 86.9% of women have been assaulted at least once before, and 38.7% of them have reported previous assaults to the police.The first person contacted after the violence was the mother, with a percentage of 48.4% (n=59).53.3% of ladies were assaulted during pregnancy, 43% of whom suffered obstetrical complications of varying severity.ConclusionsAccording to our results, there is no typical profile of a couple where conjugal violence can reign.Neither the length of the marriage nor pregnancy prevented the woman from being a victim of domestic violence.Disclosure of InterestNone Declared
Domestic violence in Tunisia: which forms of physical violence?
Authors: Jbir R. , Aribi L. , Chaari I. , Guermazi F. , Samet A. , Bouattour N. , Messedi N. , Aloulou J. 
Published: August 2024

IntroductionDomestic violence is a universal phenomenon that destroys the fabric of society and threatens the lives, health and prosperity of all.It can take different forms, including physical abuse. This is one of the most serious form of violence, as it can range from a simple shove to homicide.ObjectivesTo determine the prevalence and describe the various forms of physical violence perpetrated by husbands against their wives.MethodsWe contacted women who consulted at the psychiatric emergency of ‘Hedi Chaker hospital’,Sfax examined in the context of medical expertise on the period between May 2021 until January 2022.A questionnaire regarding the violence was asked to responders. It included a section for collecting socio-demographic and clinical data on the woman, and a section for assessing the various forms of domestic violence.Results122 women were surveyed. The average age of victims was 35.66 years with extremes of 18 and 64 years. 78.7% (n=96) of ladies were of urban origin. The majority of them (44,3%) had secondary level education.The half of the population (51.6%) had an average socio-economic level and 43.4% (n=53) lived in rented houses.All the women of our population were married: it was the first marriage in (89.3%) and the majority (86.1%) had children.Almost all women (95.1%; n=116) were victims of physical violence.Different types of physical violence were reported with decreasing prevalence: slap (65,6%), punch (58,2%), strangle (46,7%), kicking (38,1%), stabbing threat (28,7%), kidnapping (4,9%), and gun threat (3,3%).Should be noted that some women experience different forms of violence simultaneously.ConclusionsOur study showed a high prevalence of physical violence with different shapes.These figures must be taken into account by the authorities given the gravity of physical and psychological consequences of this form of violence.Disclosure of InterestNone Declared
Women with borderline personality disorder and pathophilia: understanding causes of pandemic diffusion of transmissible diseases through samos syndrome
Authors: Lazzari C. G. , Rabottini M. 
Published: August 2024

IntroductionWhen faced with perilous transmittable infections, individuals defend themselves or welcome them, such as the Samos Syndrome, a pathophilia (people attracted by illnesses). As borderline personality disorder (BPD), found in Samos Syndrome, becomes more common, so will people who reject primary protection from transmittable diseases and health behaviour as their choices. Pandemics would sinisterly draw pathophilies and persons with borderline personality disorder who migh surf pandemics risk as a parasuicidal behaviour.ObjectivesTo investigate why pandemics (HIV, COVID-19) cannot be stopped. We have conducted a long-term assessment of HIV-discordant couples where a female partner, HIV-negative, voluntarily chooses to decline any prevention during stable and consensual relationships with HIV+ve partners. We also explored sociodemographic data that could explain health behaviours and condom use in HIV serodiscordant couples at risk of pandemic diffusion, those where one of the partners, usually male, already has a transmissible disease.MethodsWe used a mix of naturalistic and ethnographic approaches to understand the dynamics of Samos Syndrome. We also utilised a questionnaire to extract salient points in the sexual prevention of HIV infection. We assessed 475 HIV-serodiscordant couples.Results
Pathophilia is defined as an excessive, abnormal desire to be sick, also known as nosophilia, from the Greek word ‘pathos’ indicating illness and ‘philia’, meaning attraction. Women diagnosed with BPD can become high diffusers during pandemics of transmissible diseases as suffering from pathophila, a form of parasuicidal behaviour. In the couples assessed, when the HIV-negative woman comes from a socially disadvantaged family, the couple uses condoms in 87% of cases (p<0.001); when she comes from a middle-high class, the couple uses condoms in 59% (p<0.001) of sexual relationships. Suppose the HIV-negative female partner has conflicting relationships with their parents. In that case, condom use is only in 40% (p<0.001) of cases, compared to 83% (p<0.001) of instances where she has a good relationship with parents. If the female partner with BPD has a higher level of education than the HIV+ve partner the frequency of use if 90% (p<0.001) of cases compared to 60% (p<0.001) of instances where she has the same level of education as the male partner.ConclusionsThe current study confirms that female persons diagnosed with BPD are at high risk of becoming high diffusers during transmissible diseases and pandemics. Parasuicidal behaviours and self-harm in BPD could increase the risk of entering into relationships with persons who are already infected by sexually communicable diseases or are at risk of diffusing viral infections (HIV and COVID-19).Disclosure of InterestNone Declared
Prospective mortality in patients with non-fatal deliberate self-harm: a national cohort study
Authors: Qin P. 
Published: August 2024

IntroductionDeliberate self-harm (DSH) is a strong indicator of psychological distress and constitutes a significant risk factor for subsequent mortalities.ObjectivesIn this study we want to gain insights into cause-specific mortalities in self-harming patients and to disentangle important factors differentiating the risks so that to inform follow-up care and mortality prevention.MethodsRetrospective data from nationwide registries were interlinked to follow all patients presenting to specialist healthcare with non-fatal DSH from January 2008 through December 2018. Data on cause of death, personal socioeconomic status, clinical features of DSH and other medical covariates were retrieved. The Fine and Gray competing risks model was used to identify significant factors impacting subsequent mortality risk by specific causes of death in the cohort.ResultsThe cohort of 43153 DSH patients comprised 24286 females and 18867 males, with 45.3% being 10-34 years old, 38.1% being 35-64 years old and 16.6% above 65 years old at index DSH episode. Of these patients, 7041 died during the follow-up period, including 2290 within the first 1-year, corresponding to a mortality rate of 31.9 per 1000 person-years in the follow-up period and 54.9 per 1000 person-years in the first year. Common causes of death included suicide (n=911), other external causes (n=1020), cancer (n=896), cardiovascular diseases (n=1523), respiratory disease (n=787) and mental and substance misuse disorders (n=463), but the causes of death varied greatly by age groups and other factors. The risk of dying by suicide was highly associated with middle-age, male gender, tertiary education, psychiatric history, and DSH by injury, clear intent of self-harm, comorbid affective or personality disorder, referral to psychiatric treatmen, as well as DSH repetition during the period of follow-up. Significant risk factors for death by other external causes included male gender, old or middle age, single marital status, lowest quartile income, history of psychiatric treatment, and DSH by injury and comorbid substance misuse. For death by natural causes, the relative risk was highest among the elderly and the middle-aged, with other significant risk factors including male gender, single marital status, low education, lowest quartile income, and comorbid substance misuse. Attendance in psychiatric treatment after DSH appeared to be beneficial reducing the risk for mortality by suicide, other external causes and natural causes as well.ConclusionsPatients with DSH represent a high-risk group for suicide, other external and natural cause mortalities. Mental healthcare is essential in follow-up care and personalized care should take into account patients´ socio-demographic background and clinical features of self-harm.Disclosure of InterestNone Declared
Co-design of a digital violence prevention and management tool for psychiatric inpatient care: focus on supporting integration into electronic health record system
Authors: Lantta T. , Rautiainen T. , Anttila M. , Anttila J. , Ameel M. 
Published: August 2024

IntroductionViolence in psychiatric inpatient settings is a global challenge. Several methods have been developed and tested to help staff prevent the occurrence of violence on the wards. One novel and effective method is eDASA+APP, originating from Australian forensic psychiatric settings (Maguire et al. Int J Ment Health Nurs 2019; 281186-1197, Griffith et al. Psychiatr Serv 2021; 72 885-890). This electronic method contains an instrument (DASA) to assess the risk for imminent violence and includes evidence-based violence risk management methods for risk levels. It is important to ensure that this electronic intervention is integrated into daily clinical practice. This can be done in co-design between all that are involved e.g., staff and experts by experience, and by encouraging them to achieve a common goal and gain benefits by working together.ObjectivesThis prevention gives an overview of how the Finnish version of eDASA+APP was co-designed with healthcare staff and experts by experience, focusing on integration into the electronic patient health record system. The presentation is part of a larger research project testing eDASA+APP in Finnish psychiatric inpatient care.MethodsCo-design workshops focusing on three major themes: 1) identifying current practices and how eDASA+APP would fit in those, 2) producing a linguistically and culturally appropriate version of eDASA+APP, and 3) preferred use of eDASA+APP in an electronic patient health record system. Notes were kept during the workshops by researchers. Qualitative material were analysed with deductive content analysis. Results from the third theme are shared in this presentation.ResultsStaff and experts by experience described that integration of eDASA+APP in electronic patient health record system is supported if it 1) brings clear and fast information to the staff about the violence risk of a patient, 2) is a visible measure that is concretely in sight in electronic patient health record system, 3) provides information about which violence prevention and management interventions have worked with a patient, 4) involves patient preferences, and 5) consist of joint decisions that have been agreed multi-professionally.ConclusionsIntegration of eDASA+APP in the electronic patient health record system has the potential to succeed if it is realized in cooperation with staff and experts by experience, is technically easy to use, and the users have an understanding of its benefits to everyone involved.Disclosure of InterestNone Declared
Understanding Attitudes and Perceptions Towards Blood Donation in Greece: An Analysis Aligned with the Health Belief Model
Authors: Theodoratou M. , Papandrea D. , Papathanasiou I. V. , Andriopoulou P. , Dafogianni C. , Farmakopoulou I. 
Published: August 2024

IntroductionThis study explores attitudes toward blood donation in Greece, where maintaining an adequate supply is challenging. Using the Health Belief Model, we examine factors like perceived severity, vulnerability, and self-efficacy.ObjectivesThe main aims of this study are to assess public perceptions and barriers concerning blood shortage in Greece, and to identify motivators and self-efficacy levels for regular blood donation.MethodsA cross-sectional study was conducted using a self-administered questionnaire distributed to a sample of Greek adults. The questionnaire was designed based on the constructs of the Health Belief Model and included questions related to perceived severity, vulnerability, self-efficacy, and barriers and facilitators to blood donation. Descriptive statistics were used to analyse the responses, calculating means and standard deviations (SDs) for each variable.ResultsPerceived Severity and VulnerabilityParticipants in our study show a heightened awareness of the severity of blood shortages, especially in summer months and during increased surgical interventions. They also acknowledge Greece’s dependency on more than just voluntary donations to meet blood supply needs. These findings align with the Health Belief Model’s constructs of perceived severity and vulnerability, suggesting avenues for promoting donation.Perceived Benefits and BarriersA significant 74% of participants believe they can regularly donate blood and plan to do so in the next six months. However, fear of needles, health concerns, and fears of transmissible diseases act as barriers. According to the Health Belief Model, targeting these barriers could facilitate blood donation.Self-EfficacyA high percentage (74%, SD=5) of participants displayed strong self-efficacy, suggesting they are likely to engage in blood donation if encouraged. This aligns with the Health Belief Model’s emphasis on self-efficacy as a motivator for health actions.Cues to ActionParticipants identified informational campaigns, digital reminders, and social encouragement as cues to action, with a disfavor for financial incentives. These cues could serve as triggers for blood donation, consistent with the Health Belief Model.ConclusionsBy aligning these findings with the Health Belief Model, it becomes evident that there are strong perceptions of severity and vulnerability, but also considerable barriers to overcome. The high self-efficacy among participants and the cues to action identified could serve as bases for targeted interventions to improve blood donation rates.Disclosure of InterestNone Declared