bluuebunny/crossref_metadata_2025_split huggingface dataset:
HCV screening, investigation and management in persons with SUD admitted to Mount Carmel Hospital, Malta
Authors: Apap Bologna M. A. , Sant K. , Camilleri A. , Grech G. 
Published: August 2024

IntroductionIndividuals who suffer from substance use disorder (SUD) are at increased risk of Hepatitis C (HCV). Mount Carmel Hospital (MCH) is the only public service in-patient mental health care facility on the island of Malta. Individuals with SUD are referred to MCH for support with comorbid mental health conditions.ObjectivesTo assess whether current practice meets the UK Clinical Guidelines on Drug Misuse and Dependence (2017) recommendations- yearly screening for HCV, further testing and referral to infectious disease specialists for those who screen positive for HCV. To compare current practice at MCH, Malta with other countries in the European Union and United Kingdom.MethodsRetrospective analysis of HCV screening, investigation and referral practices as recorded on iSoft Clinical Manager records for SUD-related admissions to MCH under the care of addiction specialists in 2022 (n=120). Admissions data were provided by the data protection office, with permission from the Chairman of the Department of Psychiatry, and de-identified at source to safeguard patient confidentiality.Results60% (n=72) of the SUD inpatient population underwent screening for HCV according to guideline recommendations. 37% (n=44) of this cohort has received a positive HCV antibody result. 32 persons had HCV RNA load records, 34% (n=11) of whom had a detectable viral load. 50% (n=17) of those who screened positive for HCV were offered an appointment with an infectious disease specialist within the year, 7 attended. The table below compares HCV status between our group and published data for the UK, Austria and Greece. Despite heterogeneity in study designs and populations (we describe an inpatient cohort with diagnosed SUD, not all of whom inject drugs) comparable proportions have undergone HCV screening in the preceding twelve months and similar proportions have chronic HCV infection.% Tested in past year for HCV% HCV antibody positive% HCV RNA detectable% HCV clearedMalta (MCH 2022)60373466England, Wales, N. Ireland
(UAMS 2021)43572674Scotland (NESI 2020)58558119Austria (EMCDDA 2019)59854456Greece (EMCDDA 2019)/615446ConclusionsMost SUD inpatients at MCH undergo HCV screening according to guideline recommendations but current practice falls short of ideal coverage and follow-up care. Current screening practices and chronic HCV infection rates at MCH are comparable to other countries in the EU and UK.Disclosure of InterestNone Declared
Assessment of self-esteem among Tunisian cannabis users
Authors: Kacem M. , Bouali W. , Henia M. , Brahim S. , Zarrouk L. 
Published: August 2024

IntroductionSelf-esteem plays a role in the adaptive functioning of the human being. It could be a protective factor regarding multiple risks particularly substance use.ObjectivesThe aim of this study is to assess self-esteem among a group of young Tunisian users of cannabis.Methods
The total study sample was composed of 137 participants, who took part of a transversal descriptive study during two months (January and February 2020). These partakers were comprehensively recruited among Emergency patients of Mahdia Hospital. Thereupon, the main criteria for the selection of these patients was their consumption of cannabis, regardless of their primary health care seeking reason or purpose. The research was carried out upon their declaration of cannabis consumption and their compliance to be part of such a study. Thus, Data were collected on a pre-determined data sheet that included various information (age, sex, lifestyle, personal and family psychiatric history, age at which they started their cannabis consumption and the rate of cannabis use …). Accordingly, Self-esteem was assessed using the Rosenberg Self-Esteem Scale (RSES). Consequently, the interview took place after the subject’s verbal and informed consent and the assurance of anonymity and confidentiality of the interview content.Results
In our study population, the cannabis consumers were young adults aged between 18 and 35 years old, with a male predominance of 71%. Among those users, 65.9% were single and 29.7% dropped out of school or experienced academic failure. On a socio-economic level, we concluded to a rate of 5.8% (lower class), 60.9% (middle class) and 33.3% (upper class). Besides, 40.8% were employed. In total, 23.2% had a psychiatric history. Furthermore, the use of other substances was also prominent and frequent as follows: alcohol 72.5%, tobacco 74.6%, ecstasy 41.3% and 25.4% cocaine. The use of cannabis was considered as a means of indulgence and pleasure for 66.7%, as an anxiolytic for 26.8% and as a sedative for 23.9%. Self-esteem, among those cannabis users, was very low in 20% of cases, low in 38% of cases, medium in 15% of cases and high in 25% of cases. Consequently, more than half of the study population remains below the medium average according to RSES.ConclusionsThese results lead us to question the relation between cannabis and self-esteem. The question that is evolved about the use of cannabis is the following: Is it used as a remedy or is it the cause of self-esteem deficiency?Disclosure of InterestNone Declared
Updating Code of Ethics of the Psychiatric Association of Turkey: process and content
Authors: Vahip S. 
Published: August 2024

AbstractScience, Ethics, Solidarity… These three words are mottos of Psychiatric Association of Türkiye (PAT), since its foundation in 1995. In accordance, PAT has Code of Ethics for more than 20 years. There are many developments and changes both in practicing psychiatry and in the community in the last couple of decades. As a result, many new ethical questions, dilemmas and approaches arise for psychiatry. PAT had decided to update the Code of Ethics about two years ago and the updating process is almost on the edge of finalization.In this presentation, main points of the updated and newly written principles will be summarized with special references to recent developments in the world and updated or newly written international Code of Ethics such as, EPA, WPA, and several national associations’ documents.One of the most important outcome and benefit of such an updating process is modelling the project on a participatory base, having wide feedback and inputs from experts (as many as possible, enriched by diverse interests of related disciplines) and reaching as many colleagues as possible from different working conditions. A six step project with this perspective was prepared and implemented, and will be summarized in the presentation for international exchange of experiences.Disclosure of InterestNone Declared
Revolutionizing Addiction Medicine: The Role of Artificial Intelligence
Authors: Poudel S. , Choudhari J. , Panta N. , Kumar H. , Leszkowitz D. , Ahmed S. S. 
Published: August 2024

Introduction
Addiction medicine is becoming more of an issue as addiction-related problems continue to plague people all over the globe, resulting in serious health consequences. Addiction has become increasingly prevalent in recent years, as have addiction-related disorders. For efficient care and improved patient outcomes, this growing pandemic requires early and precise identification. In the field of addiction medicine, artificial intelligence (AI) looks to be a feasible tool. This systematic review examines the current state of research on the use of AI in addiction medicine, including a variety of AI techniques, their efficiency compared to conventional diagnostic methods, and their potential influence on addiction therapy. While AI has great potential for transforming addiction treatment, further research is needed to assess its use fully.ObjectivesThe objective of this review is to assess the current state of research on the use of artificial intelligence in addiction medicine, focusing on its diagnostic efficacy and potential for revolutionizing addiction therapy.MethodsTo evaluate the effectiveness of AI in addiction medicine, we conducted an extensive search of the PubMed database. Our search encompassed articles published in the English language from January 2013 to March 2023. Inclusion criteria encompassed studies reporting the utilization of AI for addiction diagnosis in human patients.Results
The initial PubMed search produced 100 papers, of which 15 were included after meticulous analysis and screening. These studies assessed diverse types of data, including patient records and behavioral patterns, employing various AI techniques, such as machine learning and deep learning. The findings indicate that AI can accurately and swiftly identify addiction-related issues, boasting high sensitivity and specificity rates. Additionally, AI demonstrates potential in identifying specific addiction subtypes and forecasting patient outcomes. Nevertheless, these studies also underscore certain limitations of AI, such as the requirement for extensive data and susceptibility to overfitting.ConclusionsArtificial intelligence holds the potential to revolutionize addiction medicine by enabling faster and more precise diagnostics, pinpointing specific addiction subtypes, and predicting patient outcomes. However, further research is imperative to validate AI’s efficacy across diverse patient populations and address challenges related to data accessibility, communication, and integration into clinical practice.Disclosure of InterestNone Declared
Cortisol Levels Chorelated with Exposure to Alcohol Related Visual Stimuli in Patients with Alcohol Use Disorder
Authors: Mihai A. , Valeriu M. 
Published: August 2024

IntroductionThe mechanism of craving is not yet fully understood. It implies numerous factors contributing to the decisions an individual has to ponder when faced with a stimulus that has resemblance with the previous experiences related to it. Neural pathways implying the reward mechanism play a significant role in the interpretation of visual, auditory, olfactive stimuli, polarizing the perception towards positive or negative experiences with that substance of abuse.Objectives
In this study we focus on the cravings related to alcohol use, in a sample of patients admitted in hospital due to alcohol use disorder pathologies, providing the fact that Romania has the 2nd highest prevalence of heavy episodic drinking at least once a month (35% of adults, in a statistic published by Eurostat in 2019).Methods

We included 30 patients with alcohol use disorder. The PACS (Penn Alcohol Craving Scale) was used to assess the severity of craving in the week prior to the hospital admission.Before visualising any alcohol related cues using VRET, patients will have a half hour of group therapy to lower levels of anxiety. Cortisol and blood sugar will be measured after this half hour to set a baseline . Afterwards, using VRET, subjects will be asked to watch a number of visual stimuli that will include cues to alcohol consumption and different types of beverages. Half hour after visualising cues of alcohol, the craving will be assessed by measuring blood sugar and salivary cortisol levels once again. Completing these measurement, patients will be asked to complete the PACS scale one more time to corelate the patients craving with the biological findings. Blood sugar levels will be measured with a blood glucose meter with test strips. Cortisol levels will be measured using salivary levels of cortisol. We choose measuring the salivary levels of cortisol, due to the fact that using this method, the biological active, free cortisol. Measurements of the serum cortisol indicate the total quantity, but not the biologically effective cortisol.ResultsVisual stimuli of alcohol, with the help of VRET modifies the autonomous glucocorticoid secretion, and provide objective information complimentary to the each individual’s craving assessmentConclusionsThere are a great number of strong ties between alcoholic craving in patients and endogenous shifts in cortisol secretion. We aimed towards a better understanding on craving in patients hospitalised for AUD. Other directions for future research are to find out if it possible to consider craving a form of stress or if we could limit craving, by limiting stress.Disclosure of InterestNone Declared
Non-Adaptive Defense Mechanisms and Their Relationship to Psychosomatic Disorders among a Sample of University Students
Authors: Almajali D. M. M. M. , Abdelrasheed N. S. G. 
Published: August 2024

Introduction
In the university stage, the student is exposed to many psychological changes, pressures, and conflicts, which makes him resort to many non-consensual psychological defense mechanisms such as (repression, justification, projection, relapse, denial, delusional illness, reverse transference, daydreaming), which causes an imbalance in the personality and its psychological functions. This may lead to cognitive and mental distortions and physiological imbalances, and the appearance of symptoms that cause psychosomatic disorders that are not due to organic physiological imbalances or bacterial diseases, but rather as a result of imbalances in the psychological functions of the ego ,Which increases the symptoms of headache, vomiting, poor digestion, irritable bowel syndrome, shortness of breath, rapid heartbeat, hormonal imbalance, facial redness, and others.Objectives1.Identifying the degree of use of non-consensual psychological defense mechanisms among university students, and the differences in this according to the variable (gender and degree of academic achievement)
1.
Revealing the correlation between the degree of use of non-consensual psychological defense mechanisms and the emergence of disturbed psychosomatic symptoms in the functions of (the respiratory system, the digestive system, the cardiac system, the muscular system, sleep disorders, and bodily disorders).MethodsThe correlational analysis approach was used to study the relationship between the variables of the study. The sample consisted of 300 male and female university students. A scale for psychological defense mechanisms was constructed, and a scale for psychosomatic disorders prepared by Diop (2011) was adopted, and its psychometric properties were verified.Results
The responses in the degrees of non-consensual psychological defense mechanisms were varied, with a high degree in (justification, projection, repression, and delusional illness) and a moderate degree in (relapse, daydreaming, denial, and reverse transference). Differences appeared between males and females in favor of males, while differences in academic grades were in favor of the lowest grade. The results also showed a statistically significant correlation between psychological defense mechanisms and the appearance of psychosomatic symptoms, as it was high in disorders (respiratory system, cardiac system, muscular system, sleep disorders), and moderate in (emotional disorders and somatic disorders).ConclusionsThere is a positive correlation between the degrees of use of non-consensual psychological defense mechanisms and the emergence of psychosomatic disorders, in the functions of several bodily systems and behavioral and emotional disorders.Disclosure of InterestNone Declared
Cannabis Use and Its Interaction with Anxiety Disorders
Authors: Varino F. , Duarte T. , Silva F. S. , Froes P. , Fernandes A. M. , Baronet P. 
Published: August 2024

Introduction
Cannabis use has been reported to cause a myriad of acute adverse reactions, including those linked to anxiety disorders, such as panic attacks and derealization. Notably, in the emergency department, anxiety makes up a significant proportion of the complaints related to cannabinoid consumption. Several reports show these symptoms can persist after the cessation of cannabis consumption. Consequently, some questions have arisen regarding the role of cannabinoids as precipitators for anxiety disorders in vulnerable individuals. Alternatively, it has been hypothesized that patients with anxiety disorders are more prone to using cannabis.Objectives
We aim to understand whether there is an established relationship between anxiety disorders and cannabis use. Moreover, we intend to identify what are the factors which make an individual more likely to experience anxiety following cannabis consumption.MethodsA search was conducted in the PubMed database using the MeSH terms “cannabis”, “panic disorder”, “anxiety”, “panic” and “generalized anxiety disorder”. Articles published in the last ten years were considered. Publications were selected after careful reading of their abstract. A non-systematic review of the selected articles was performed.ResultsEight articles were included in this review. While a majority of these publications did not find a significant association between cannabis use and anxiety disorders, a small subset of analyzed articles found that cannabis use may increase anxiety severity in general, devoid of specific diagnostic association. Individuals who presented to the emergency department with anxiety complaints after cannabis use were likely to be young and to have ingested edible cannabis. History of psychiatric disease, especially substance use disorder, was common in this population.Conclusions
Most available data suggest cannabis use is not clearly linked to anxiety disorders. However, information around this topic is scarce and heterogenous. Further research is needed focusing on the natural evolution of acute anxiety after cannabis use. Factors such as young age, presence of psychiatric comorbidities and consumption of edible cannabis appear to contribute to a significantly increased risk of experiencing acute anxiety after cannabis use.Disclosure of InterestNone Declared
Liaison Psychiatry model intervention in Switzerland
Authors: Georgescu D. 
Published: August 2024

AbstractConsultation and liaison psychiatry (C-L psychiatry) in Switzerland can look back on a long tradition. It began in French-speaking Switzerland back in the 1960s and gradually spread throughout the country. Currently, C-L services are present throughout the country, although they differ greatly in terms of their services and dimensions. University hospitals and larger cantonal hospitals have extensive and differentiated services, while smaller hospitals in peripheral regions only offer basic services. There are also major differences in the financing models, which are decisive for the range of services offered. The question of funding, which has not yet been resolved satisfactorily despite various models and strategies, including at national level, is highly relevant for the further development and even the continued existence of C-L services. The introduction of the subspecialization in C-L psychiatry in 2010 and the lively training and CPD activities are of great importance for quality of the delivered services.Disclosure of InterestNone Declared
The Dilemma of Lithium Discontinuation in Bipolar Disorder During Pregnancy Planning: A Case Report and Literature Review
Authors: Orgaz Álvarez B. , Jiménez Sola E. , Velasco Santos M. , Ibáñez Mendoza P. , de Vicente Blanco Á. , Cebolla Lorenzo S. 
Published: August 2024

IntroductionLithium is considered the gold standard mood stabiliser for bipolar disorder, yet its use during pregnancy remains controversial, demanding careful consideration of potential risks and benefits. Classically, it has been associated with an increased risk in congenital heart defects, however, recent studies point towards a much lower absolute risk than was previously believed. Furthermore, discontinuation of lithium before or during pregnancy poses a high risk of destabilisation and lithium has been shown to reduce the risk of relapse both in pregnancy and in the postpartum period. Hence, treatment planning is of the upmost importance in this patient group and individual risk stratification should be undertaken for patients to make informed decisions about their treatment.ObjectivesTo describe the case of a patient with bipolar disorder who discontinued lithium treatment while attempting to conceive and subsequently presented with a manic episode and to expand the scientific knowledge on this topic.MethodsCase report and brief literature review.Results
A 41-year-old patient with a diagnosis of bipolar disorder, previously on lithium 900mg/day, was admitted to the emergency department with symptoms suggestive of a manic episode. One month prior, the patient had discontinued treatment with lithium due to her desire to pursue pregnancy and interrupt treatment while trying to conceive. The patient had a history of postpartum psychosis followed by various depressive and manic episodes with psychotic symptoms, leading to a bipolar disorder diagnosis and commencing treatment with lithium. Her consultant psychiatrist had informed her of the individualised risks of interrupting treatment with lithium and had advised to continue treatment alongside frequent follow-up due to the high-risk of relapse. Despite her consultant’s recommendation, she decided to interrupt treatment and hence a personalised lithium tapering regime and advice to continue treatment with quetiapine 200mg/day was given.
During the ED stay, treatment with olanzapine was introduced which helped to stabilise her symptoms. Lithium levels were subtherapeutic (lithium serum level 0.11 mmol/L). Inpatient psychiatric admission was avoided due to rapid symptom improvement, strong social support in the community and her preference for ambulatory care. Lithium was gradually reintroduced and antipsychotic treatment was adjusted at follow up appointments, which ultimately led to the resolution of symptoms and stabilisation.ConclusionsThis case highlights the significance of considering continuing lithium treatment in bipolar disorder during pregnancy planning. Decisions about medication in pregnancy are multifaceted, making appropriate risk stratification imperative in order to inform individualised care plans to minimise the risk of relapse in these patients.Disclosure of InterestNone Declared