bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychological meanings reported by patients with Graves’ Disease in hyperthyroidism but without ophthalmopathy about their quotidian life: A qualitative study conducted in a Brazilian university specialized outpatient service
Authors: Valladão L. S. , Silva F. S. , Casagrande C. F. , Guerra L. M. , Zantut-Wittmann D. E. , Turato E. R. 
Published: August 2024

IntroductionTo handle well clinical treatments, it is crucial to know the expectations of patients who seek help. We need to ask ourselves: how do patients interpret subjectively their diagnosis, treatments, and self-care? Medical Psychology brings us theories for this understanding. Grave’s Disease is an autoimmune disorder, a form of hyperthyroidism with a goitre, affecting also the eyes and the skin, as well as emotional manifestations. Weight loss, sometimes psychologically welcome, although due to a disease, can mean a psychoanalytic secondary gain. So, the medicine that leads to clinical improvement can be taken with ambivalence and bad adherence to treatment. It is important to differentiate between disease, a scientific entity explained by the clinical professional, and illness as a patient’s subjective perception of an un-health.ObjectivesTo understand psychodynamically the fantasies, desires, and views related to Graves’ Disease as reported by patients in hyperthyroidism but without ophthalmopathy interviewed at an endocrinology-specialized outpatient clinic. (in the EPA-2023, it was presented the qualitative results of a sample in hyperthyroidism, with ophthalmopathy, studied at the same service).MethodsClinical-Qualitative Method designed by Turato. Data collected through Semi-Directed Interviews with Open-ended Questions in-Depth; and Field Notes, transcript fully. Treated by the Seven Steps of Clinical-Qualitative Content Analysis of Faria-Schützer, using psychodynamic concepts from Balintian Medical Psychology. Although we have extracted categories that permit us interesting discussions, we intend to close the sample (through the information saturation criterion by Fontanella) when we obtain other categories. The interviewer, a male psychologist, is the first author. The findings are validated by peer-reviewers of the Lab of Clinical Qualitative Research of the State University of Campinas.ResultsThree categories were chosen for this presentation: 1) “An atomic bomb in my life”: How drastic changes of a hormonal disease re-symbolize the patient’s life; 2) “I didn’t think the thyroid did that much”: the disease seen as a metaphor in a psychological blaming language to own disease and to himself as a sick person. 3) “I have so much medicine!”: a mode of referring to treatment that would justify an undisciplined use of medications.ConclusionsOur findings can help clinical professionals to have a better understanding of some psychological meanings which have sense in the patients’ conscience, often not verbalized clearly in the conversation, and so to handle better the patients and relatives. In this way, it can reduce the patient’s resistance to recommended treatment, as well as encourage the clinical team to construct empathy with them.Disclosure of InterestNone Declared
Contagion beyond the virus: A case obsessive-compulsive disorder centered on Covid-19
Authors: Pires A. S. , Pires M. , Nunes J. , Vaz I. F. , Mouta S. , Jesus B. , Cruz e Sousa D. , Figueiredo D. 
Published: August 2024

IntroductionThe Covid-19 pandemic has generated an unprecedented impact on multiple levels (health, occupational, economic, and social) which affected the general population and has been an enormous stress factor for individuals with obsessive-compulsive disorder (OCD), particularly for those with contamination symptoms. Many patients, as well as healthy individuals, experienced new obsessive-compulsive-like symptoms centered on COVID-19 during the pandemic. However, data on this population are still scarce.ObjectivesTo present a case exemplifying the association between the Covid-19 pandemic and the onset of OCD.MethodsCase presentation and non-systematic review of existing literature on Pubmed using the keywords: Covid-19, OCD, pandemic, depression.ResultsWe report a case of a 30-year-old female who presented to the emergency department due to depressive mood and suicidal ideation associated with exacerbation of OCD symptoms, namely intense fear of being infected with Covid-19. These symptoms led to avoidance of touching objects, surfaces or even herself in addition to frequent and long rituals of hand-washing and showers. She was asymptomatic prior to being infected with Covid-19, when she started developing obsessive ideas of contamination. She sought psychiatric support and was medicated with fluoxetine, olanzapine and clonazepam. Due to insufficient symptom control, she was admitted to the psychiatry ward, where treatment was initiated with aripiprazol and fluvoxamine. After dose titration, gradual remission of OCD symptomatology and depressive mood was observed.ConclusionsThe present case illustrates the correlation between Covid-19 and the onset of OCD symptomatology. Existing studies demonstrate that the pandemic worsened the landscape of symptoms of OCD, both in diagnosed patients as well as in previously healthy individuals. However literature is still limited thus, multinational and cross-cultural, longitudinal studies are warranted to gain further insights on this topic.Disclosure of InterestNone Declared
Insomnia and pain in COVID-19 survivors: a cohort Tunisian study
Authors: Mariem T. , Nadia B. , Houda B. A. , Islem M. , Najla H. , Sameh M. , Samy K. , Sahar E. , Jihen A. 
Published: August 2024

IntroductionThe SARS-COV-2 infection emerging in 2019 caused over 600 million infected people worldwide leading to an explosion of multiple physical and mental health problems. In this study we brought the light to the persistent troubles in sleep and pain among the survivors of the pandemic.ObjectivesWe aimed to assess the prevalence of insomnia and the severity of pain among covid-19 survivors, and to seek an association between the two disorders.MethodsWe conducted a prospective cohort study including 121 Tunisian COVID-19 inpatients who had been discharged alive from hospital. Each enrolled patient was asked about the period before the hospital stay, and the 6-9 month-period after hospital discharge, using the visual analog scale (VAS) to assess pain, insomnia severity index (ISI) to evaluate insomnia severity and the mMRC (modified British Medical Research Council) to estimate dyspnea.ResultsThe median age of participants was 59 years. Among them, 51.2% were females.Our findings showed a significant increase in VAS score after COVID infection (1 [IQR (1-2] vs 3[1-6]; p<0.001) as well as with the ISI score (1 [IQR (1-1)] vs 5 [IQR (1-9)]; p<0.0001). The prevalence of insomnia and pain in long haulers was 30.56% and 26.4% respectively.We found a significant correlation between insomnia and pain (p<0.0001, r=0.398). We also found a significant association between dyspnea and insomnia (p<0.0001) and between dyspnea and pain (p=0.001). The age of the patients was correlated with insomnia (p=0.028) and with dyspnea (p=0.007) but not with pain. Female gender was associated with developing insomnia (p<0.0001) and with pain (p=0.001) but not with dyspnea.ConclusionsScreening for persistent symptoms after the pandemic is important to help the survivors getting a better recovery in the long term.Disclosure of InterestNone Declared
Screening the dysfunctional grief and its associated factors due to a death from covid-19 in Tunisia
Authors: Askri F. , Dhemaid M. , Mahfoudh K. , Jedda S. , Ouali U. , Aissa A. 
Published: August 2024

IntroductionIn Tunisia, the 2019 corona virus pandemic was a challenging health situation, with more than 28 000 confirmed deaths in May 2022. The pandemic was responsible for people losing their beloved ones in a sudden and brutal ways. Even though the numbers of bereaved people had been escalating, little attention was paid toward their mental health. Grief is a normal response to losing someone close. However, recent studies have shown that the covid-19 grief is more severe than other causes of grief. It not only causes a negative impact on the bereaved life aspects but also creates severe consequences in the society. Screening a possible dysfunctional grief is a major need to prevent serious outcomes.ObjectivesTo identify the prevalence of covid-19 dysfunctional grief and find out the possible associated risk factors to it.MethodsA cross sectional online survey designed using Google Forms and distributed on social media platforms (Facebook, Instagram, WhatsApp) was conducted from 16 February 2022 to 05 May 2022. The participants provided information related to socio-demographic data. Covid-19 grief scale was assessed using the pandemic grief scale, which was translated into Arabic but not validated.ResultsA sample of 106 participants were recruited to this study .The sample was composed of Approximately 72% female and 28 % males, most of them were aged between 26 and 35 years old (37.7% ) . Overall, individuals who lost a loved one more than 06 months period were more frequent (81%). 91.7 % of the sample scored above the cut score of 7 on the PGS.Covid-19 grief was higher among those who sought psychological help (p = 0.02). In this sample, there was no associated risk factors between different socio-demographic characteristics and dysfunctional grief, as well as no correlation were found between period of time since the loss and dysfunctional grief ( rho = 0.186, p = 0.56) .ConclusionsAlthough our study did not find a significant high prevalence of dysfunctional grief giving the small number of participants. More studies and screening must be conducted to identify those at risk of developing dysfunctional grief to prevent the serious individual and general outcomes.Disclosure of InterestNone Declared
Enduring the unseen burden: a qualitative analysis on long-term emotional impact of COVID-19 on long-term care workers
Authors: Gonzalez-Spinoglio L. , Monistrol-Mula A. , Vindrola-Padros C. , Aguilar-Ortiz S. , Carreras B. , Haro J. M. , Felez-Nobrega M. 
Published: August 2024

IntroductionLong-term care facilities, such as nursing homes and other assisted living facilities, have been hit particularly hard by the COVID-19. The overall pandemic created an enormous pressure on long-term care workers (LTCWs), making them particularly vulnerable to mental disorders. However, most of the existing evidence regarding the well-being of care professionals has predominantly focused on frontline healthcare workers.ObjectivesThis study aimed to identify long-term psychological needs of LTCWs derived from the COVID-19 pandemic, as part of a project that is developing an intervention to reduce psychological distress in this population group.MethodsWe performed a qualitative study with a rapid research approach. Participants were recruited from long-term care facilities located in Catalonia, Spain. Between April and September 2022, we conducted semi-structured interviews inquiring about the most psychologically challenging stages of the pandemic, perceived emotions during those stages, main determinants of those emotions, and their emotional state at the time of the interview. We used a qualitative content analysis method with an inductive-deductive approach.ResultsThirty LTCWs participated in the study. Mean age was 44 (SD=11,4), 87% were females and one third were from foreign nationalities. The period of the pandemic with highest mental health burden was the outbreak, with almost every worker having experienced some form of emotional distress. Emotional distress persisted over time in more than half of participants, with fatigue and nervousness being the main emotions expressed at the time of the interview. High workload, feeling that pandemic times are not over and poor working conditions that have remained since then, have been the most frequently expressed determinants of such emotions.ConclusionsLong after the pandemic outbreak, emotional distress is still relevant. The persistent burden of psychological distress points to a need for institutions to take action to improve working conditions and promote employees’ wellbeing.Disclosure of InterestNone Declared
Quality of sleep among trainee doctors at the Charles Nicolle Hospital after vaccination against COVID19
Authors: Athimni Z. , Bahri G. , Mersni M. , Youssef I. , Brahim D. , Ben Said H. , Mechergui N. , Ladhari N. , Imene K. 
Published: August 2024

IntroductionSleep quality depends on several factors such as smoking, physical activity, diet, and certain pathologies, namely obstructive sleep apnoea syndrome. Indeed, following their vaccination against COVID19, several medical trainees complained about a deterioration of their sleep quality.ObjectivesTo evaluate the quality of sleep of medical trainees who work at Charles Nicolle Hospital and who were vaccinated against SARS-COV2.MethodsWe conducted a descriptive cross-sectional study among medical trainees at Charles Nicolle Hospital who were vaccinated against COVID-19 during the period from March 2020 to August 2022. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Trainees were contacted during the period August 2022 to September 2022.ResultsSixty-nine medical trainees, vaccinated against Covid19 joined our study. Forty-nine of them had a significant sleep disturbance: Pittsburgh Sleep Quality Index (PSQI) greater than five. The average age was 29.39±3.04 years with a female majority (73.5%). No psychiatric history was found. The most affected category of trainees were residents (71.4%). Forty-three of them were inoculated with the messenger RNA vaccine and 4 with inactivated vaccine. Twenty-one patients vaccinated with the messenger RNA vaccine received two doses, seventeen received three doses and only one received a single dose. Sleep latency was high in 20,4% of cases. A sleep duration of less than five hours per night was found in 18,4% of the cases. Six participants reported using a sleep aid three to four times a week.ConclusionsOur study revealed a significant sleep disturbance in medical trainees at Charles Nicolle Hospital. This could be due to the SARS-COV2 vaccination but can also be explained by the night shifts and the stress to which they are exposed, especially during this pandemic period.Disclosure of InterestNone Declared
The psychosocial well-being of an individual is a driver for illegal immigration: a clinical case study
Authors: Bouguerra I. , Touiti A. , Hajri A. , Maamri A. , Zalila H. 
Published: August 2024

IntroductionThe European Border and Coast Guard Agency (Frontex) detected 330,000 irregular border crossings last year.Tunisian nationals are among the top three nationalities reported.While there are many reasons for illegal immigration,the social driver is one of the most important to study.ObjectivesTo highlight the role of the social environment in promoting illegal immigration and its impact on the psychosocial well-being of individuals in Tunisia through a clinical case study.Methodswe reported the clinical case of a 32 years old tunisian patient who was diagnosed with severe major depressive disorder and post traumatic stress disorder after an illigale immigration to Europe.ResultsA 32-year-old Tunisian man from Tataouine,a region in southern Tunisia,was the subject of this case study.He was the youngest of four siblings,had a secondary education,and worked as a shepherd.His socio-economic status was moderate,unstable and seasonal.He had already attempted to immigrate to Italy twice illegally,by sea,but had been deported both times.The patient sought consultation for depressive symptoms.In January 2023,he made a third attempt to immigrate to Europe,this time by plane.He traveled with two of his cousins,aged 18 and 20,and paid 22,000 Tunisian dinars for the trip.Both cousins died during the journey,one from hypothermia and the other from police pursuit.The patient was deported again and was diagnosed with post-traumatic stress disorder (PTSD) and a major depressive episode.Hamilton Depression scalePTSD checklist scaleRosemberg self esteem scale22 severe depression66 sup 44Poor self esteem 21Tataouine is konwn as “little Paris” a region in the south-east which,according to the National Institute of Statistics,had 71 emigrants/1000 inhabitants or 7.1% of the population.Where the society promotes youth immigration through societal values.ConclusionsThe social environment in Tataouine,which has a high rate of emigration,promotes the idea that immigration is a way to achieve social status and economic security. This can lead to young people feeling pressured to immigrate, even if they are not prepared for the risks involved.Disclosure of InterestNone Declared
“They say I’m crazy, but I’ve lived through hell.”
Authors: Molina Pérez N. , Pereira López J. , Santana Ortiz M. I. , Rivero Rodríguez P. , Del Rosario A. R. N. , Grimal M. M. , Acosta Pérez V. 
Published: August 2024

IntroductionMigration has been present in the evolution of human beings throughout history. Economic inequalities give rise to a permanent flow of people trying to improve their lives. In addition, there are people who are forced to seek asylum or refuge due to wars or political violence. Therefore, the migratory flow, gives rise to a clinical scenario in which, the arrival of immigrant people demands an adaptation of the psychiatric paradigm.ObjectivesThe objective of this paper is to review the international scientific literature published on the impact of the migration process on mental health.MethodsWe propose a review of the international scientific literature published in recent years on psychiatry and migration.We present the case of a 27-year-old male, diagnosed with paranoid schizophrenia, who arrived in the Canary Islands after a 2-year migration process from his country of origin (Senegal).ResultsThe limits between normality and pathology of certain types of behavior vary from one culture to another.In the case of a patient with a mental disorder who has undergone a migration process, an approach based on the cultural formulation of the case should be made, taking into account the process of adaptation to the culture of the host country, as well as the impact of the culture of origin on the patient’s interpretation of his or her psychopathology.ConclusionsCulture can influence the acceptance or rejection of a diagnosis and treatment, affecting the course of the disease and recovery.Therefore, understanding the cultural context in which the disease is experienced is essential for a good diagnostic evaluation and effective clinical management.Disclosure of InterestN. Molina Pérez: None Declared, J. Pereira López: None Declared, M. I. Santana Ortiz: None Declared, P. Rivero Rodríguez: None Declared, A. R. Del Rosario Grant / Research support from: Jansen Pharmaceuticals, Inc., Consultant of: Jansen Pharmaceuticals, Inc.; Lundbeck, Inc., Employee of: Universidad de Las Palmas de Gran Canaria, Speakers bureau of: Jansen Pharmaceuticals, Inc.; Lundbeck, Inc.; Otsuka Pharmaceutical Co.; Pfizer Inc.; Esteve Pharmaceuticals, S.A.; AstraZeneca Pharmaceuticals LP.; Angelini Pharma S.L.U.; Laboratorios Farmacéuticos ROVI SA., M. Grimal: None Declared, V. Acosta Pérez: None Declared
Modifying Conventional Psychiatric Practice to Serve Indigenous People
Authors: Mehl-Madrona L. , Mainguy B. 
Published: August 2024

IntroductionPsychiatry has historically underserved Indigenous people. Earlier, cross-cultural psychiatry assumed that psychiatric disorders were universal and varied little across cultures. We must acknowledge their different views of mind and mental health.ObjectivesIn our auto-ethnographic approach, we introduce or re-introduce participants to cultural beliefs, values, and methods for treating addictions, including narrative methods (storytelling), which receive greater acceptance by indigenous and marginalized peoples. Indigenous philosophy states that we see the world using the stories we have absorbed or constructed to explain our perceptions. Using substances is a story that is connected to poverty and adverse childhood events.MethodsWe create new stories to develop a sense of agency, that one’s actions can make a difference in one’s life. We present our experiences and findings from providing psychiatric and addiction services in rural and remote Indigenous settings in Canada (Saskatchewan and Northern Ontario) and in Maine (USA). We present data on a modified approach to psychiatric evaluations and services that emphasizes Indigenous values and begins with a life story interview that determines positive aspects of the client’s history and problem areas and engages the client in therapy from the beginning of the evaluation.ResultsWe will demonstrate how this process changes the process of the psychiatric interview, engages Indigenous clients, and results in better outcomes. We discuss how psychotherapy must change to engage Indigenous clients and to be effective with addictions. She will present data on this area. We present the lessons learned and the results of using this approach with a tribal population in Maine. Some key concepts include (1) reframing the person’s self-story about being addicted within a threat-power-meaning network, (2) working with stories about the spirit of the addiction and the consequences of ingesting spirit-laden substances without knowing their songs and protocols, (3) constructing future-self-narratives that explore right relationships and meaningful conduct, (4) constructing stories about the intergenerational transmission of addictions and exploring the question of “whom will be the recipient of your addiction?” We understood that the client sets their goals and defines what recovery means for them, which is the heart of a harm reduction approach.ConclusionsIndigenous cultures across the world are different but share some similarities including a highly relational approach to defining the self, a collectivist mindset in which the needs of the group can supersede the needs of the individual, a reliance upon stories for transmission of knowledge and culture, and a commitment to a biopsychosocial and spiritual approach, which is often symbolized by the metaphor of the Four Cardinal Directions.Disclosure of InterestNone Declared