bluuebunny/crossref_metadata_2025_split huggingface dataset:
Context of implementation of mental health fremekork in Blumenau, Brazil (evidence based)
Authors: Cigognini M. A. 
Published: August 2024

IntroductionPromoting high quality mental health (MS) services is an obligation of many social agents due to the impact of these diseases on the population. Making care increasingly evidence-based does not depend exclusively on technical training, but also on gradual and functional changes in the structure of an institution. Improving the quality of services in MH is a predominantly social intervention, in which it is necessary to group and interpret complex data. They represent real-time interventions in a real world by teams delivering health services.ObjectivesDescribe the context where the MH service (iNC) is inserted, its main characteristics and purposes.Methods
Mixed study identifying the location, socio-demographic data, characteristics and fundamentals of an organization providing services in MH that proposes to act based on evidence.Results

iNC is a private secondary care institution located in the city of Blumenau, Vale do Itajaí, state of Santa Catarina, Brazil (FIG 1). Vale do Itajaí is a mesoregion with approximately 1.5 million inhabitants composed of small regions: Blumenau, Itajaí Ituporanga and Rio do Sul. Most of the population is of German and Italian descent. Blumenau has 361,261 inhabitants, an average monthly income of 2.9 minimum wages, 97% of schooling between 6-14 years old and the number of deaths of 6.48 (1000 live births). iNC is located in the center of the city (3-story building) with a clinical staff idealized for 3 psychiatrists, 16 psychologists, 4 nutritionists, 1 nurse, 1 nursing technician and 1 physical educator in face-to-face and online, individual and in-person sessions group. Performs care for adult patients between 18-70 years. Its missions are: to promote MS care from an interdisciplinary perspective, to provide health interventions supported by the best individualized scientific evidence and to encourage teaching and research in the field of MH. Its guiding principles are: psychopathology and nosology (DSM-5 and CID-11), neuroscience and psychopharmacology, mood, anxiety, sleep, eating and obesity disorders (FIG 2), psychological treatments and psychoeducation, assessment instruments in MH and neuropsychology, evidence-based medicine, health promotion and disease prevention.ConclusionsIdentifying, measuring and quantifying a local assistance service in MH can help in its development and allow comparisons over time. The improvement of services depends on multiple factors and is necessary for their development, both for researchers, implementers, health professionals and patients.Disclosure of InterestNone Declared
Stress and its impact on healthcare professionals: A study on prevalence and coping strategies
Authors: Lafraxo M. A. , Guider H. , Boumaaize Z. , Darif H. , El Madhi Y. , Soulaymani A. , Hami H. 
Published: August 2024

IntroductionStress is a significant issue among healthcare professionals and impacts both their personal well-being and the quality of care they provide.ObjectivesThis study evaluated the prevalence of stress among healthcare professionals and investigated the possible effect of physical activity on perceived stress levels.Methods

In 2019, a cross-sectional observational study of 30 nurses was conducted at the Hassan II Oncology Center in Oujda. A self-administered survey was used to gather information regarding the participants’ sociodemographic and professional characteristics. The Perceived Stress Scale was employed to gauge stress levels, whereas the Ricci-Gagnon questionnaire was used to determine physical activity levels and engagement in sports.ResultsThe study findings indicate that the sample had moderate levels of stress measured by the Perceived Stress Scale (PSS) and struggled with managing stress in diverse situations. Physical activity was common among 87% of the participants, as indicated by the Ricci-Gagnon questionnaire. In addition, a statistically significant correlation was found between stress levels and family situation (p = 0.05). The Perceived Stress Scale and the Ricci-Gagnon questionnaire exhibited high internal consistency, with Cronbach’s alpha values of 0.79 and 0.64, respectively.ConclusionsThe study results have raised significant concerns regarding the effectiveness of different coping strategies in managing stress. In particular, the results indicate that engagement in physical activity and sports does not significantly affect stress levels. Thus, stress management training is recommended as the best strategy for stress prevention.Disclosure of InterestNone Declared
Different patterns of MRI structural alterations in schizophrenia spectrum disorders with delusions of influence vs persecution
Authors: Tomyshev A. S. , Dudina A. , Romanov D. , Ilina E. , Magomedagaev M. , Kostyuk G. , Andriushchenko A. , Smulevich A. , Lebedeva I. 
Published: August 2024

IntroductionThere is strong evidence that delusions are associated with cortical and subcortical structural alterations. However, whether these abnormalities differ in different types of delusions within schizophrenia spectrum disorders remains unclear.ObjectivesWe aimed at exploring structural neural patterns underlying influence/persecutory delusions across diagnostic categories within the schizophrenia-spectrum disorders.MethodsTwenty six right-handed patients with delusional disorder (n=7) and schizophrenia (n=19), presenting with delusions were divided in two clinical subgroups. The first one was presented with persecutory delusions (n=12, 20.2-55.4 years, mean age 36.0±11.6, 2 females) and the second with delusions of influence (n=14, 21.2-47.6 years, mean age 36.7±8.4, 2 females). The control group consist of 26 matched healthy controls (20.2-53.6 years, mean age 36.3±9.9, 4 females). All participants underwent structural MRI at 3T scanner. MRI images were processed via FreeSurfer 6.0 to quantify cortical thickness (CTh) and volumes for subcortical and brainstem (midbrain, pons, superior cerebellar peduncle and medulla) structures.ResultsCompared to healthy controls, patients with delusions of influence showed decreased gray matter thickness in 17 cortical regions (Figure, A), and decreased volumes of thalamus bilaterally (left: F(1,35)=9.0, p=0.005; Cohen’s d=−0.8; right: F(1,35)=8.0, p=0.008; Cohen’s d=−0.8), left hippocampus (F(1,35)=8.8, p=0.005; Cohen’s d=−0.8), midbrain (F(1,35)=11.0, p=0.002; Cohen’s d=−0.9) and pons (F(1,35)=8.2, p=0.007; Cohen’s d=−0.8). Conversely, patients with delusions of persecution showed decreased thickness only in 4 cortical regions of the right hemisphere (figure, B) and no alterations in subcortical volumes compared to healthy controls.No differences in cortical or subcortical measures between two clinical subgroups survived corrections for multiple comparisons. No correlations between structural alterations and total PANSS or BABS scores were found in either clinical groups.Figure. Clusters of decreased cortical thickness according to atlas of Desikan et al. (2006) in delusions of influence (A) and delusions of persecution (B) subgroups compared to healthy controls.Image:Conclusions
The findings suggest that patients with delusions of influence have more pronounced cortical, subcortical and brainstem structural deficit as compared to patients with delusions of persecution. However, the limited sample size and the lack of correlations with clinical scores do not allow to conclude definitely whether the revealed structural abnormalities underlies delusions of influence, which should be elucidated via further research.This study was supported by RFBR grant 21-515-12007Disclosure of InterestNone Declared
Body dysmorphia in a 23 year old patient with obsessive compulsive disorder: a case report
Authors: Setién Preciados P. , Arroyo Sánchez E. , Díaz Mayoral C. 
Published: August 2024

IntroductionBody dysmorphic disorder (BDD) was considered an anxiety disorder in the DSM-IV, but in the DSM-V was added to the obsessive-compulsive and related disorders category. BDD is a psychiatric disorder characterised by an excessive, persistent, and distressful preoccupation with a perceived defect in appearance. These perceived defects are slight and are unnoticed by others. People with BDD usually have poor insight and are preoccupied with a perceived physical defect which causes them to check on it repeatedly. This leads to an impairment in psychosocial functioning, depression, and an increase in suicide risk.ObjectivesReview how dismorphophobia (BDD) and obsessive compulsive syndrome intersect, the differences they present in symptomatology, prevalence and treatment.MethodsPresentation of a patient’s case and review of existing literature, in regards to body dysmorphic syndrome and its similarities and differences with respect to obsessive compulsive syndrome.ResultsThere are common features between both disorders, which are genetic overlap, physical past traumatic events, sex ratio, trait of perfectionism and body image disturbance.Studies have found the prevalence of BDD in patients with OCD in a large patient sample was 8.7% to 15% compared to 3% in non-OCD.The risk of comorbidity of OCD-BDD is three times higher in samples with a primary diagnosis of BDD compared to those with a primary diagnosis of OCD with 27.5% and 10.4%, respectively.BDD as well as OCD must be managed with pharmacological and psychotherapy treatment. A selective serotonin reuptake inhibitor is the recommended first-line medication for BDD, even if appearance beliefs are delusional in nature.
Serotonin reuptake inhibitor (SRI) doses and trial durations are similar to those used for OCD; higher doses and a longer treatment trial are recommended than those typically used for depression and most other disorders. Cognitive-behavioral therapy that is specifically tailored to BDD is the psychosocial treatment of choice. Simply treating BDD as if it were OCD is not recommended.ConclusionsThere are limitations included a restricted number of studies overall, an absence of studies comparing biological parameters, and the frequent inclusion of participants with comorbid body dysmorphic disorder and obsessive-compulsive disorder. The current nosological status of body dysmorphic disorder is somewhat tenuous and requires further investigation, with particular focus on dimensional, biological and aetiological elements.Disclosure of InterestNone Declared
Prevalence and Associations of geriatric depression in Sudur-Paschim Province of Nepal: A community-based cross-sectional study
Authors: Kunwar D. 
Published: August 2024

IntroductionThe elderly population is rapidly growing worldwide. Depression is an important public health concern among the elderly population in terms of its prevalence and the burdens of ill health in individual sufferers and families.A considerable number of studies focusing on the prevalence, associated factors, and treatment of depression have been conducted in Western Europe and North America. However, this kind of research is relatively limited in Nepal.Objectives- To find out and prevalence and its associated factors of depression among the elderly in sudur paschim province Nepal.MethodsThis community-based, cross-sectional, door-to-door survey was conducted in the two representative districts of Sudur-paschim Province, Nepal. Eligible participants were assessed for geriatric depression and quality of life. the sample size was calculated at 945.ResultsDepression was found in 43.9% of the participants.The association of different variables with WHOQOL-8 first question. Income was significantly associated with poor quality of life (p-value 0.04).Furthermore, we have evaluated the association of different variables across four domains of the WHOQOL-8 scale and found statistically significant differences across age, sex, residence, occupation, income, history of smoking, history of alcohol use, comorbidities, and depression.ConclusionsDepression is highly prevalent among the elderly in the Sudur-Paschim Province of Nepal. So policymakers should take this research outcome seriously and should keep the mental health of the elderly population a priority during the implementation of public health policies.Disclosure of InterestNone Declared
User involvement in psychiatric research: shifting from traditional research paradigms to collaborative partnerships
Authors: Cavaleri D. 
Published: August 2024

AbstractIn recent years, there has been a growing recognition of the importance of involving people with lived experience of mental health issues in psychiatric research. User involvement in research goes beyond being merely instrumental and is deeply intertwined with ethical and political considerations. Shifting from traditional research paradigms to collaborative partnerships with users is seen as a crucial step in ensuring that research is more relevant, meaningful, and respectful of the diverse perspectives within the mental health community. While there is a growing interest and responsibility regarding this matter, there is still a need to better understand the differences between participation, engagement, and user-led research alongside a respectful integration of user perspectives.In this presentation, the state-of-the-art regarding user involvement in psychiatric research will be reviewed and possible ways to practically implement such practice will be discussed.Disclosure of InterestNone Declared
Prevalence of Dementia, associated Co-morbidities, and Multidisciplinary Team Involvement in a Psychiatry of Old Age Service
Authors: Crowley S. , Dunne E. 
Published: August 2024

IntroductionDementia is a common diagnosis in service users seen by Psychiatry of Old Age (POA) Services. This clinical audit was conducted prior to the services engagement with a focus group, which aimed to explore the implementation of the “Appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia” (National Clinical Guideline No. 21) and identify additional resource requirements to be submitted for consideration by the HSE’s estimate process for 2023.ObjectivesIts aims were to evaluate:•The prevalence of service users with a dementia diagnosis among those seen by the POA Service, from January 2018-June 2022•The prevalence of co-morbid psychiatric diagnoses among those with a dementia diagnosis.•The resources needed to manage currently active cases with a diagnosis of dementia, by evaluating MDT member involvement.MethodsData is routinely collected on service users treated by the POA service for service evaluation, including service users’ diagnoses, and current MDT member involvement. All service users seen by the POA service between Jan 2018 – June 2022 were included. The total number of service users, and service users with dementia and mild Cognitive impairment were counted, in order to evaluate the prevalence of dementia. We then evaluated the proportion of those with dementia who had co-morbid psychiatric diagnoses. We then looked at currently active cases with dementia, and evaluated how many MDT members were involved in their ongoing care.Results392 service users were treated by the service from Jan 2018-June 2022. Of these 104 cases were still active with the service. 152 (39%) of these service users had a diagnosis of dementia. Of those with dementia, 45% (68, n=152) also had another psychiatric co-morbidity. Psychosis was the most common psychiatric co-morbidity, seen in 22% of those with dementia (33, n=152). 12% of active service users with a dementia diagnosis were only seen in outpatients clinics only, 60% were seeing one MDT member, 28% were seeing multiple MDT members (n=25).ConclusionsDementia was the most common diagnosis among service users seen by the POA service. 45% of service users with dementia being seen by the POA service also had another psychiatric co-morbidity. Such patients require significant MDT input.Disclosure of InterestNone Declared
Underrated and Underestimated – Deprivation in Dementia. A Case Report
Authors: Steininger S. C. , Frizi-Roser R. , Schneider S. , Hoang T.-V. , Zetzsche T. 
Published: August 2024

Introduction
Deprivation is widely known in children and adolescents and means a lack of social, emotional, or sensory stimuli, due to disabilities such as deafness, but also social isolation and reduced parental care. It may cause developmental disorders such as impaired language, motoric and social development. Little is known of the impact of social deprivation in demented patients.Stimulus shielding, which is a widespread option for psychiatric symptoms of dementia such as agitation, vocalization and aggressive behavior may – if frequently used- have similar effects on demented patients.ObjectivesWe report the case of a 71-year-old patient with dementia caused by PSP (Progressive Supranuclear Palsy), who was in inpatient treatment due to continuous undirected vocalizations. She presented with inability to walk, dysarthria, aphasia, and hearing difficulties beside major mnestic impairment. In a prior hospitalization and in her residency, she was frequently isolated from other patients due to loud screaming and vocalizations in terms of stimulus shielding by suspected overstimulation. In order to that, for four months, she developed progressive difficulties to speak, hear, understand, as well as gait disorders. In addition, the vocalizations increased.Methods
We rated the symptoms due to deprivation, triggered by lack of mobilization, social experiences, visual, tactile and acoustic stimuli following a vicious circle of anxiety, vocalizations and recurrent isolations. Therefore, a multimodal therapy assessment was implemented, including daily physical therapy, mobilization, basal stimulation, social reintegration and basal conversation training.Results
After a few days of high intensity treatment, speech reappeared in form of one- word sentences and proceeded to the ability to have short conversations. Mobility increased, starting from severe gait disorder, including the use of a wheelchair and emerged to the ability of walking up to 50 metres. Additionally, the undirected vocalizations improved and were reduced. In addition, hearing ability improved during the four-week treatment.Conclusions
This case highlights the impact of deprivation in demented patients. Especially it shows that these symptoms can be reversible under a high intensity multimodal and multi- professional treatment within a few weeks. Therefore, stimulus shielding, should be carefully evaluated in order to prevent deprivation – and thus deterioration of the symptoms – in demented patients.Disclosure of InterestNone Declared
Fibromyalgia: functional, autoimmune or both? Treatment options for drug-resistant fibromyalgia
Authors: Desport C. P. , Martins D. O. , Freitas J. R. , de Castro L. C. 
Published: August 2024

Introductionfibromyalgia is a modern disease, with growing investigation concerning its etiology and treatment. It has become a very prevalent diagnosis and total remission of symptoms is the exception which is dramatic considering the socio-occupational impact of this highly debilitating disease.Objectivesto review the updates in the pathophysiology and treatment of fibromyalgia, especially when it is refractory to treatment. The authors also intend to better understand where fibromyalgia belongs, is it in psychiatry as a functional disorder or in rheumatology as an auto-immune disease?Methodsbibliographical search in PubMed database, using the key-words “fibromyalgia” and “psychiatry”, limited to works published in the last 10 years.Resultsfrom our search resulted 158 articles, from reading of abstracts 30 were chosen for further reading.Conclusionsconcerning the etiology of this disease, on the one hand psychological factors cannot be neglected since there are several studies finding a positive correlation between stressors like history of physical abuse and fibromyalgia in adulthood, on the other hand investigation and meta-analysis have found that the immune-inflammatory response system might be altered with dysregulation of pro and anti-inflammatory cytokines and cell-mediated immunity. Regarding treatment, symptom relief is often unsatisfactory with classical treatment and so adjunct treatment such as electrical neuromodulation and aerobic exercise might, respectively, be effective in reducing pain and depressive symptoms, thereby improving quality of life, and in improving fatigue and in a lesser degree sleep.Disclosure of InterestNone Declared
Level of personality functioning among outpatients with predominant anxiety symptoms
Authors: Bogdanovska Toskic A. , Arsova Hadzi-Angjelkovska S. 
Published: August 2024

IntroductionDimensional diagnosis of personality disorders has as its main criterion the assessment of the level of functionality. And in patients with other diagnostic categories, there is a difference in the degree of functioning, as well as a difference in the course and prognosis of the disorder. The reason for such a different course may be the existence of a certain degree of personality dysfunctionality.ObjectivesThe aim of the study is to determine the prevalence of personality disorder in patients with neurotic disorder and predominantly anxiety symptomatology.MethodsA descriptive cross-sectional study was made to determine personality disorder in patients with neurotic disorder (F40-F48, excluding those where the disorder is related to stress F43) and predominantly anxiety symptomatology. The HAM-A scale was used to assess anxiety, and the LPFS-BF-2.0 was used to assess the level of personality functioning. The results were processed by descriptive statistical analysis.ResultsThe study included 25 individuals (N 25, 64% women), aged between 18 and 65 years (mean age 44.16, SD 13.20) with a diagnosed neurotic disorder. All subjects had elevated anxiety symptomatology, mean HAM-A score was 35.36 (SD 7.76). The assessment of the level of personality functioning with the LPFS-BF-2.0 gave the following results: 20% of people have a personality difficulty, 12% have a mild personality disorder, 32% have a moderate and 4% have a severe personality disorder.Conclusions
According to the obtained results, 68% of people with a neurotic disorder and a high degree of anxiety have a certain degree of personality dysfunction. The prevalence of personality disorder in individuals with neurotic disorder is high (48%). These results lead to the conclusion that people with pronounced anxiety often have a disruption in personality. In people with a high level of anxiety, an assessment should be made for the level of functioning of the person, as well as for the existence of a personality disorder, and the treatment should be adjusted according to the results obtained. In addition to the treatment of the emerging symptoms, the personality dysfunctions should also be treated.Disclosure of InterestNone Declared