bluuebunny/crossref_metadata_2025_split huggingface dataset:
Providing psychiatric diagnosis and intervention in patients with chronic medical illness in the community: A novel collaboration between the Psychiatry team and the community team in a Singapore restructured hospital
Authors: Lee W. S. , Lim G. S. , Goh H. Y. , Chan Y. S. 
Published: August 2024

IntroductionHome nursing and medical services have an established role in delivering chronic medical care to populations which face difficulty accessing physical clinics. Those with chronic medical conditions and reduced mobility face a higher likelihood of suffering from psychiatric co-morbidity. However, till date there has been limited research done on home-based psychiatric care in this population.Since 2021, the Psychiatry department of Tan Tock Seng Hospital (TTSH) has been collaborating with TTSH Community Health Team (CHT) to manage potential psychiatric issues in community patients.These patients would be discussed in a weekly multidisciplinary setting. If indicated, home visit by both teams for home-based assessment and treatment would be arranged, allowing for detection and treatment of psychiatric illness.ObjectivesTo demonstrate that the collaboration between the psychiatry team and CHT leads to diagnosis and treatment of psychiatric illness in a population that might otherwise have been unable to access psychiatric services.Methods
We performed a retrospective study on all referrals from the CHT to the psychiatry team, within the 2-year period of August 2021 to August 2023. We collected demographic information, psychiatric history prior to referral, reason for referral, outcome of multidisciplinary discussion, and outcome of the home visits (including diagnoses made, and medications initiated).ResultsA total of 92 patients were referred by the CHT to the psychiatry team. Most were elderly with multiple medical co-morbidities; of note, a history of stroke was present in 24 of the referred patients.Common reasons for referral include suspected mental illness, risk assessment, and management of behavioural issues.
28 of the referred patients did not have a prior psychiatric history at the point of referral. Among these, home visits involving the psychiatric team were done for 16 patients. 11 (68%) of these home visits led to diagnosis of a new psychiatric illness. 9 of these patients were initiated on psychotropic medications in the home setting.ConclusionsA significant proportion of patients (68% of home visits without prior psychiatric diagnosis) were newly diagnosed with psychiatric illness, allowing early psychiatric intervention to be delivered. This was achieved in a population with a high prevalence of multiple medical comorbidity and barriers to clinic-based psychiatric evaluation and treatment.We propose future comparative studies into how the collaboration between the psychiatric team and community health team can improve the quality of life and caregiver experience of patients with chronic medical problems, as well as how the service had improved the confidence of the community health team in identifying and managing patients with possible psychiatric issues.Disclosure of InterestNone Declared
Socio-emotionalcompetencies in teachers of educational institutions in the department of cordoba, acomparative study between men and women
Authors: Ruiz Gonzalez E. P. , Muñoz Argel M. N. , Romero Otalvaro A. M. , Gracia Castañeda M. G. 
Published: August 2024

IntroductionAccording to Bisquerra Alzina (2003),competencies are defined as a set of knowledge, capabilities, skills and attitudes, necessary to understand, express and regulate emotional phenomena appropriately and which are fundamental in the teaching profesion since they are closely related to students´performance and mental health.Objectivescompare socio-emotional skills in two groups of participants: female and maleMethodsA non-experimental,cross-sectional design was proposed for this study. The scope of this research is descriptive, in the sense,that it seeks to establish measures in regard to specific variables. Sample (100 female and 100 male).ResultsResults revealed that the evaluated teachers show average level of socio-emotional competencies, (Table 1).The highest scores were encountered in relation to the optimism competence. It suggests that teachers have the ability to obtain favorable balances from adverse situations presented in their daily lives.
Table 1:Distribution of socio-emotional competency levels in the professionals evaluatedLOW %MEDIUM %HIGHT %EMOTIONAL AWARENESS19801SELF EFFICACY32662EMOTIONAL REGULATION17812EMOTIONAL EXPRESSION6859PROSOCIALITY6859ASSERTIVENESS68212OPTIMISM02179EMOTIONAL AUTONOMY25714EMPATHY8857Findings showed that there exists a statiscally significative difference (P=0,000) in the empathy and self-efficacy dimensions. Women obtained higher scores in these two abilities in regard to men. (Table 2). No differences were observed in the rest of the competences evaluated.
Table 2:Differences according to men and womenFEMALEMALESELF EFFICACY1,781,61EMPATHY2,021,96ConclusionsAlthough teachers´s socio-emotional competences were classified in medium levels, it is necessary to implement an intervention design that allows to streghten those dimensions since they could improve not only the relationships with their students but also teachers´ mental health.Disclosure of InterestNone Declared
Analysis of the reasons for consultation in psychiatric emergency triage
Authors: Cruz S. , Ferre S. R. , Español F. V. 
Published: August 2024

IntroductionThe chain of care in psychiatric emergencies should be reviewed to improve assistance.ObjectivesOur objective was to determine the reality behind the reasons for consultation assigned in triage as “Psychiatry Assessment” and “Psychiatric Patient”, examining diagnoses to the discharge of said patientsMethodsTo this end, reasons for triage consultation and patient diagnoses are retrospectively collected who were evaluated by the main author in the emergency room of Hospital de Jaén between June 23, 2019 and May 31, 2020. They were selected following these criteria; inclusion: patients with psychiatry consultation, evaluated by the first signatory of the text and with reasons for consultation in triage: “Psychiatric patient” or “Assessment by Psychiatry”. As exclusion criteria: high due to escape. Among the 224 patients evaluated, we found 35 who met criteriaResultsOf the total reasons of consultation collected at beginning, 16.6% corresponds to “Assessment by Psychiatry” (13.9%) and “Patient psychiatric” (2.7%), this being group the second reason for most frequent consultation after of “Anxiety” with 33%. Relating these reasons for consultation with the discharge diagnoses made in these patients, we found that the percentage of patients in each diagnosis would be: Regarding the action plan followed after the evaluation and diagnosis of these patients, it is reported that 45% of them required admission, 37% were referred to Mental Health Unit, 9% to family doctor and 6% to the Drug Addiction Center. - 11.4% of pharmacological intakes; 8.6% of psychotic episodes, symptoms anxiety, treatment renewal and mood disorders personality; respectively; 5.7% of autolytic attempts, autolytic ideation, schizoaffective disorder, bipolar disorder, heteroaggressiveness and depression; respectively; 2.9% of adverse effects to drugs among others diagnosticsConclusions
It is appreciated that the reasons for consultation triated as “Psychiatric patient” or “Psychiatry assessment” does not provide real information about the clinical characteristics of the patient to be evaluated in the emergency room, having a wide range of diagnoses encompassed in these terms. This fact does not allow discern the fundamental reason why the patient goes to the emergency room, nor receive assistance adequate to the problem it presents, nor a correct regulation of waiting and logistical planning. We believe it is advisable to review the use of these terms in the practice of the psychiatric emergencies training all professionals involved in the triage chain and we value the need to count on all emergency services with a standardized triage method for the psychiatric emergencies.Disclosure of InterestNone Declared
Responses to serious adverse incidents in mental health care settings: a qualitative study of a complex patient safety system
Authors: Anderson N. , Nathan R. 
Published: August 2024

IntroductionIndividual patient safety processes (such as reporting, investigating, learning and improving patient outcomes) activated following serious adverse incidents (e.g. patient suicide) are not distinct or standalone. Rather, they are embedded within a complex system of multiple interdependent processes enacted by individuals who are subject to an array of implicit and explicit influences (Nathan et al. BJPsych Advances 2022; 1-11). Although some specific elements of the response to adverse incidents have been examined, no previous empirical research has set out to study the complex interacting system within which these elements are situated.ObjectivesThis study’s aim was to characterise a complex patient safety system and to identify types of processes across that system that have an impact on the goal of improving patient safety.Methods
Recorded 1:1 semi-structured interviews were undertaken with staff in a range of patient safety roles across a mental health care system to elicit accounts of the system response to serious adverse incidents. These interviews were transcribed, and the transcriptions were subject to thematic analysis using the Framework Method for qualitative research in health care settings (Gale et al. BMC Med. Res. Methodol. 2013; 13.1; 1-8).This preliminary study relates to the analysis of 8 interviews.ResultsThe following six main types of influences on the effectiveness of patient safety system responses to adverse incidents were identified:1.Differing functions/expectations of investigations into serious incidents (due to differing demands of different parties, such as the health provider, the family, the coroner, etc);2.Differing methodologies used to investigate serious adverse incidents (although system-based generally preferred, there was a noted risk that this approach may fail to identify occasional examples of poor practice);3.Relationship between incident investigation processes and patient safety processes (with a particular potential for the latter to dominate the system at the expense of the former);4.System complexity (multiple interacting processes/processors at multiple levels within the health provider and wider health system);5.Operationalising recommendations from investigations (with the potential for adverse unintended patient safety consequences)6.Influence of national directivesConclusionsAs well as paying attention to individual components of the safety system (e.g. investigation methodology and organisational culture), the development of an effective patient safety system is dependent on an understanding of the complex interacting processes across the system. This study sheds empirical light on key influences that act across a mental health provider system. Both researchers of patient safety and providers intending to improve their approach to patient safety should take account of such systemic influences on effectiveness.Disclosure of InterestNone Declared
Suicide risk, hopelessness, interpersonal needs, and mental health in a sample of migrant psychiatric patients: a case-control study
Authors: Polidori L. , Berardelli I. , Sarubbi S. , Sarli G. , Corti C. , Erbuto D. , Pompili M. , Cifrodelli M. 
Published: August 2024

IntroductionSuicide is a multifactorial phenomenon characterized by many biological, psychological, and social-cultural factors. The study of this phenomenon in migrants is complex, with no theoretical framework that can describe the available heterogeneous data. Although Italy has the fourth largest migrant population of EU, only few studies have assessed suicidal risk in migrants.ObjectivesThe aim of his study is to assess suicide risk factors (hopelessness; interpersonal needs; traumatic experiences) in a sample of migrant patients, and to evaluate the possible application of the Interpersonal Theory of Suicide (ITS). Moreover, suicidal ideation and attempts were compared between migrants and natives. Lastly, a wider psychometric assessment has been conducted (depressive and anxiety symptoms; autistic traits).MethodsIn this case-control study, we included 50 migrants vs. 50 natives. Data were collected during the same period by gender, age, and diagnosis. We collected sociodemographic and clinical characteristics. We administered the following tests: Columbia Suicide Severity Rating Scale, Interpersonal Needs Questionnaire, Beck Hopelessness Scale, Beck Depression Inventory-II, Hamilton Anxiety Scale, Childhood Trauma Questionnaire, and Adult Autism Subthreshold Spectrum.ResultsThere were no differences in sociodemographic characteristics, except for ethnicity. Otherwise, there were significative differences between diagnosis (p:0.013), with native reporting more Mood Disorders, and migrants reporting more Anxiety, Obsessive-Compulsive, Trauma-Related, Eating, and Substance Use Disorders. Migrants were more prone to be on treatment with Mood Stabilizers (p:0.000). There were significative differences for interpersonal needs, trauma, anxiety, and autistic traits. Migrants show more perceived burdensomeness (p:0.05), more physical neglect (p:0.004), physical abuse (p:0.002), and sexual abuse (p:0.016), more anxiety symptoms (p:0.046), and more empathy alterations (p:0.014). No differences were found for suicidal ideation and attempts, hopelessness, and depressive symptoms.ConclusionsDespite there were no differences in suicide risk, migrants showed higher rates of perceived burdensomeness (PB) and childhood traumatic experiences (CTE). Both PB and CTE represent cardinal constructs of the ITS. No differences were found for hopelessness and depressive symptoms. Migrants showed higher rates of anxiety symptoms and empathy alterations. Even if suicide rates between migrants and natives were similar, accurate assessment of suicidal risk in migrants is crucial in improving suicide prevention strategies. Suicide risk evaluation in migrants should consider the application of ITS. For an appropriate clinical evaluation of the migrant patients, anxiety dimensions and autistic traits should be investigated.Disclosure of InterestNone Declared
Principles of ADHD diagnosis in adults The diagnosis of ADHD in adults poses unique challenges due to the subtlety of symptoms and the presence of comorbidities
Authors: Todzia A. 
Published: August 2024

AbstractAttention-Deficit/Hyperactivity Disorder (ADHD) is commonly associated with childhood, yet its prevalence and impact extend into adulthood. The diagnosis of ADHD in adults poses unique challenges due to the subtlety of symptoms and the presence of comorbidities.The workshop aims to provide early career psychiatrists with a comprehensive understanding of the unique challenges associated with adult ADHD, emphasizing evidence-based approaches to diagnosis and effective management.The management of adult ADHD involves a multimodal approach encompassing psychoeducation, pharmacotherapy, and psychosocial interventions. The integration of cognitive-behavioral therapy (CBT) and coaching strategies proves beneficial in addressing executive function deficits and enhancing adaptive skills.Pharmacological interventions are a key component in the management of ADHD. These interventions aim to alleviate symptoms, improve cognitive functioning, and enhance overall functioning. The two main classes of medications commonly used for ADHD treatment are stimulants and non-stimulants.Disclosure of InterestNone Declared
Correlations of altered functional connectivity in resting-state fMRI and symptom severity in tic disorders
Authors: Meeh J. B. , Orth L. , Leiding D. , Habel U. , Neuner I. , Sarkheil P. 
Published: August 2024

IntroductionVocal and motor tics are characteristic for Tic disorders (TD) and Tourette’s syndrome (APA 2022) . Because of the pathophysiology of the disorders not being fully understood and the presence of the externally measurable symptoms; great attention has been paid to the cortico-striatal regions of patients with TD . In addition to the alterations in motor symptoms patients can experience a premonitory urge (PU) which can be felt before a tic (Reese et al. Behav. Ther. 2014; 45 177–186) . Previous studies found an impact of these urges on sensory perception, attention and social cognition as well as an involvement of the brain regions insula, anterior cingulate cortex (ACC) and the temporoparietal junction (TPJ) (Seeley J. Neurosci. 2019; 39 9878–9882, Kucyi et al. J. Neurophysiol. 2012; 108 3382–3392, Uddin et al. Brain Topogr. 2019; 32 926–942) . These findings lead to the idea of altered functional connectivity of the salience network (SN) in patients with TD.ObjectivesThis study aims to investigate the connectivity changes of the SN in patients with TD. We examined functional resting-state scans of patients with TD and searched for possible correlations between the tic and PU severity and the connectivity of the SN.Methods
21 Patients (mean age: 30.9 years ± 10.0 [range = 19–57], 6 females) diagnosed with TD, and 20 healthy controls (mean age: 29.7 years ± 8.9 [range = 18–50], 5 females) underwent a resting-state fMRI scan. Functional and anatomical images were conducted on a 3T Siemens Prisma fit MRI scanner. PU and tic severity were measured by the Premonitory Urges for Tics Scale (PUTS) and the Yale Global Tic Severity Scale (YGTSS). The connectivity analysis of the resting-state scans was done using the CONN toolbox v21.a. After pre-processing and de-noising steps, a whole-brain seed-based connectivity analysis was carried out with the seeds being the major cortical nods of the SN. For the correlation analysis a linear regression of the YGTSS score/PUTS score and the brain connectivity of the seed regions was conducted.ResultsThe PUTS score was 25.3±5.4 (range 10-33) and the YGTSS total tic score was 23.1±7.9 (range 10-38) for the patients. The connectivity analysis revealed a significant difference in connectivity between the groups for the ACC, the right insula and the TPJ. A negative correlation between the YGTSS scores and the connectivity of the left insula and the right superior frontal gyrus (SFG) was shown in the correlation analysis. No significant correlation was found for the PUTS scores in the investigated seed regions.ConclusionsThe right SFG mediates motor urgency and inhibitory control. Since we found a negative correlation between the insula and the right SFG regarding to higher YGTSS scores of the patients, our results might shed some light on the pathophysiology regarding lower inhibitory control in patients which experience higher tic severity.Disclosure of InterestNone Declared
Neuropsychiatric manifestations inaugurating Biermer’s disease
Authors: Bader S. , Msadek N. , Ellini S. , Damak R. , Cheour M. 
Published: August 2024

IntroductionVitamin B12 deficiency gives rise to a wide spectrum of hematological, gastrointestinal, psychiatric, and neurological disorders. Notable among the neuropsychiatric symptoms are mood disturbances, cognitive decline, and psychotic manifestations.ObjectivesWe present a case of a woman with neuropsychiatric symptoms linked to vitamin B12 deficiency to highlight certain organic aetiologies with psychiatric symptoms in the foreground.MethodsWe discussed through a clinical case and a literature review, the relationship between neuropsychiatric symptoms and vitamine B12 deficiency in the context of biermer’s disease.Results
We presented a patient aged 51-years-old without neurological or psychiatric history, she was hospitalised in a psychiatry department for behavioral disturbances, hetero-aggression, and incoherent speech. The psychiatric examination revealed distant contact, inappropriate affects, disorganized speech with persecutory delusions, memory problems, and poor insight. Neurological et physical examinations were normal, and cerebral magnetic resonance imaging (MRI) showed no abnormalities. First, haloperidol 25mg was prescribed, however, there was only partial improvement. Complete blood counts revealed macrocytic anemia (Hemoglobin: 8 g/dL, mean corpuscular volume: 106 fL). Her serum B12 assay was 48.19 pmol/L.Given these results we proceed to a Fundic biopsy, performed by fibroscopy, that revealed fundic atrophy and intestinal metaplasia compatible with Biermer’s disease. Vitamin B12 replacement therapy began with hydroxocobalamin at 1000 μg/day intramuscularly for 15 days, followed by 1000 μg every 15 days for one month. Subsequently, there was a remarkable improvement in psychotic symptoms and cognitive function. Follow-up assessments demonstrated a return to baseline functioning.ConclusionsThis case, coupled with prior studies, emphasizes the importance of considering vitamin B12 deficiency in the differential diagnosis of neuropsychiatric symptoms. Therefore, prompt diagnosis and treatment of vitamin B12 deficiency are imperative in preventing potential irreversible neurological damage.Disclosure of InterestNone Declared
Exploring the Potential of Cannabinoids in the Treatment of Tourette’s Syndrome
Authors: Cunha F. , Santos I. , Castro N. , Andrade R. , Almeida E. , Abreu J. , Martins J. , Vaz R. , Borges S. 
Published: August 2024

Introduction
Tourette’s syndrome (TS) is a disorder characterized by repetitive, involuntary movements, and vocalizations known as tics. While there are existing treatment options, there is a growing need for novel pharmacological approaches to manage the symptoms of TS effectively. This study delves into the emerging field of using cannabinoids as a potential treatment for Tourette’s syndrome.Objectives
The primary objectives of this review are to examine the current evidence base for the use of cannabinoids in the treatment of Tourette’s syndrome, to assess the biological rationale supporting the use of cannabinoids in managing tic severity, to provide insights into the results of existing clinical trials involving cannabinoids and Tourette’s syndrome, and to draw conclusions regarding the potential efficacy and safety of cannabinoid-based treatments for TS.MethodsNarrative review of the available scientific literature.ResultsThere is a strong biological rationale for how cannabinoids could impact tic severity. The endocannabinoid system plays a crucial role in regulating various physiological processes, including motor control and neurotransmitter release. Activation of cannabinoid receptors in the brain may modulate these processes, potentially reducing tics. While limited, two small randomized, placebo-controlled trials of THC have been conducted in TS patients. These trials suggested potential benefits of cannabis-derived agents in reducing tic frequency and severity. Self-report and examiner rating scales demonstrated significant improvements in tic symptoms. The trials indicated that THC treatment did not result in significant adverse effects in TS patients.ConclusionsThe exploration of cannabinoids as a treatment option for Tourette’s syndrome is promising but requires further investigation. The biological mechanisms through which cannabinoids may affect tic severity in TS are sound, suggesting their potential as a therapeutic option. Existing trials with THC have shown encouraging results, demonstrating a reduction in tics without significant adverse effects. However, the limited number of trials warrants caution in drawing definitive conclusions. Despite the promising findings, the overall efficacy and safety of cannabinoid-based treatments remain largely unknown. Further trials are essential to address dosing, active ingredients, optimal administration, and potential long-term effects. Clinical use should be approached with caution. While early evidence is encouraging, additional rigorous studies are needed to establish the safety and efficacy of cannabinoid-based treatments for this disorder.Disclosure of InterestNone Declared