bluuebunny/crossref_metadata_2025_split huggingface dataset:
Avoidant Restrictive Food Intake Disorder in a 28 year old man: a case report
Authors: Setién Preciados P. , Arroyo Sánchez E. , Díaz Mayoral C. 
Published: August 2024

IntroductionAvoidant Restrictive Food Intake Disorder is a disorder included among the eating disorders criteria group. Prevalence and incidence rates of ARFID in the general population remain largely unknown. Despite ongoing variability in the interpretation of diagnostic criteria in clinical practice, good progress has been made regarding recognition and assessment of ARFID. Different approaches to treatment are currently being explored, with reported outcomes for ARFID vary, consistent with the heterogeneity of the disorder. At present, there is insufficient evidence to determine the likely course and prognosis.ObjectivesReview what avoidant restrictive food intake disorder consists of, the challenges it presents, as well as its prognosis and potential treatments.MethodsPresentation of a patient’s case and review of existing literature, in regards to ARFID.Results
The patient in question is not clear he can be diagnosed of avoidant restrictive food intake disorder given his OCD symptoms, which are intertwined. That said, he does not have body dysmorphophobia and does check for all the ARFID criteria. Their prognosis is not good, having failed several psychological and pharmacological treatments.
In literature, there is not much evidence around the disease because of its novelty, being recently included in the DSM 5 as a new class of eating disorders (EDs), not finding high quality studies (meta analysis, systematic review). ARFID is characterised by a lack of interest in eating or avoiding specific types of foods because of their sensory characteristics. This avoidance results in decreased nutritional intake, eventually causing nutritional deficiencies. In severe cases, ARFID can lead to dependence on oral nutritional suplemments, which interferes with psychosocial functioning. The prevalence of ARFID can be as high as 3% in the general population, and it is often associated with gastrointestinal symptom. Given the high prevalence of ARFID, a rapid and systematic nutrition survey should be conducted during every consultation. Its treatment should also be adapted depending on the severity of the nutritional problem and may involve hospitalisation with multidisciplinary care (paediatrician, nutritional therapist, dietitian, psychologists, and speech therapists).
In regards to potential treatments, there is no evidence-based psychological treatment suitable for all forms of ARFID at this time. Several groups are currently evaluating the efficacy of new psychological treatments for ARFID, particularly, family-based and cognitive-behavioural approaches, but results have not yet been published.ConclusionsFuture directions for research could be usefully informed by closer collaboration with other fields, including feeding disorders, emotion processing and regulation, neurodevelopment, and appetite.Disclosure of InterestNone Declared
Body image as a mediator in the relationship between psychotic experiences and later disordered eating: A 12-month longitudinal study in high school adolescents
Authors: Houissa L. , Hallit S. , Cheour M. , Loch A. A. , Fekih-Romdhane F. 
Published: August 2024

IntroductionPsychotic experiences (PE) and disordered eating (DE) are frequently observed among the general population, especially in childhood and adolescence. However, the relationship between the two groups of disorders is still unclear.ObjectivesTo explore the hypothesis that the pathways from PEs to DE are mediated by body-image disturbances in a sample of adolescentsMethodsWe conducted a 12-month longitudinal study on high school students from four different high schools from the Ariana governorate, from April 2022 to April 2023.Participants were evaluated at baseline then every 6 months with a target length of follow-up of 1 year.The questionnaire containedQuestions about socio demographic variablesThe Eating Attitude Test (EAT-26)The Multidimensionnal Body Self-Relations Questionnaire Appearance Scale (MBSRQ-AS)The Community Assesment of Psychic Experiences (CAPE-42)Results1) Sample characteristicsSample was constituted of 510 individuals. Of those, 312 (61.2%) were females. Mean age was of 16.05 (SD=1.01) years.The majority of the students resided in urban areas, accounting for 97.8% of the total.When it comes to family income, 4.1% of the students’ families had an income of less than 1000 Tunisian Dinars (TD), 25.9% had an income between 1000 and 2000 TD, 32.2% had an income ranging from 2000 to 3000 TD, and the remaining 37.8% had a family income of over 3000 TD.The EAT-26, MBSRQ-AS and CAPE-42 scores are shown in table 1.
Table 1.The longitudinal evolution of study variables
Baseline
T 6 months
T 12 months
pPartial Eta Squared η2Disordered eating (EAT-26)11.9 ± 9.411.9 ± 9.712.6 ± 10.2.080.006Self-classified weight (Body image)6.0 ± 1.75.9 ± 1.66.0 ± 1.6.946.001Body areas satisfaction30.9 ± 6.431.8 ± 6.431.4 ± 6.8.025.010Overweight preoccupation9.3 ± 3.69.2 ± 3.79.2 ± 3.7.545.001Appearance Orientation41.0 ± 5.441.6 ± 5.441.6 ± 5.5.007.014CAPE positive dimension (total)39.6 ± 8.739.1 ± 9.139.7 ± 9.5.756.001Body Mass index21.6 ± 3.421.5 ± 3.221.7 ± 3.2.034.0092) Findings of the mediating analysisDisordered Eating scores had no significant effect in subjects across time. However, the effect of the interaction between baseline Overweight Preoccupation with Disordered Eating across time was statistically significant (p=0.036). Overweight Preoccupation (Z=85.095, p<0.001), Body Area Satisfaction (Z=25.053, p<0.001), and CAPE positive dimension (Z=59.931, p<0.001) scores had significant main effects between subjects. (figure 1 and figure 2)Image:Image 2:ConclusionsFindings showed that body image disturbances mediated the prospective association between PEs and DE. Adolescents with increased PEs were more likely to experience body image disturbances and, in turn, DE symptoms. These findings offer promising new avenues for prevention and early intervention.Disclosure of InterestNone Declared
Serotonin Syndrome Following Low-Dose Sertraline: A Case Report
Authors: Chan C. Y. 
Published: August 2024

IntroductionSerotonin syndrome is a potentially life-threatening condition that is precipitated by the use of serotonergic medications, Selective Serotonin Reuptake Inhibitors (SSRIs) and Monoamine Oxidase Inhibitors (MAOIs). It usually occurs when high doses of serotonergic drugs are prescribed. It is a medical emergency that requires prompt recognition, cessation of offending drugs and supportive therapy.ObjectivesWe present a case of serotonin syndrome that occurred in a patient who was prescribed a low dose of sertraline, and aim to highlight the importance of early detection of this severe condition.MethodsDetails of the case were described. Information was gathered based on medical records.Results
Patient M was a 29-year-old Malay male with a history of major depressive disorder, who was previously trialed on fluvoxamine 100mg every night but subsequently switched to and maintained on sertraline 75mg every night in 2020. He then defaulted follow up appointments. In 2023, he presented to the emergency services for a suicide attempt and was diagnosed with major depressive disorder with psychotic features. He was restarted on sertraline 50mg every night and risperidone 0.5mg every night was newly started. Two days later, sertraline was increased to 100mg every night. Two days following this increase, he was noted to have altered mental state, fever of 39.3-degree celcius, tachycardia of 120 beats per minute, ocular clonus and generalized hyperreflexia. Sertraline and risperidone were immediately stopped. Blood tests including creatine kinase, lumbar puncture and magnetic resonance imaging (MRI) of the brain did not show any abnormalities. After stopping of the medications, the patient’s symptoms resolved within 24 hours. Based on clinical symptoms and a normal creatine kinase level, neuroleptic malignant syndrome (NMS) was ruled out. Subsequently, he was restarted on risperidone 0.5mg and mirtazapine 7.5mg every night. He developed symptoms of serotonin syndrome with a low dose of sertraline. Symptoms resolved after the discontinuation of the SSRI.Conclusions
In this case, differential diagnoses of serotonin syndrome were also considered, such as NMS, encephalitis, meningitis and thyroid storm. NMS was less likely due to the rapid onset of onset and resolution of symptoms. Encephalitis and meningitis were unlikely in view of normal MRI brain and lumbar puncture findings.There have been case reports of serotonin syndrome developing with lower doses of an SSRI in the pediatric population. There is, however, a lack of literature describing serotonin syndrome with low doses of SSRI in the adult population. To avoid a missed diagnosis, clinicians should monitor closely for SSRI toxicity, including serotonin syndrome, even when low doses of serotonergic drugs are used.Disclosure of InterestNone Declared
Triage mistakes in the Psychiatry Emergency Room: do we really know how to rule out organicity?
Authors: Andreu H. , Giménez-Palomo A. , Bueno L. , Cesari E. , De Juan O. , Mena J. I. , Ochandiano I. , Olivier L. , Salmerón S. , Sagué-Vilavella M. 
Published: August 2024

IntroductionIn Spain and other European countries, patients coming to the emergency room (ER) are usually classified as “organic” or “psychiatric” on arrival, but this may be complicated when psychiatric history is present as the focus can be misplaced (Leeman. IJPM 1975;6(4):544-40; Alam et al. Psychiatr. Clin. North Am. 2017;40(3):425–33).Objectives
To describe three cases seen in the psychiatric emergency room (PER) in which triage errors occurred and to review whether it is widespread for psychiatric patients with organic pathology or in need of medical care to be wrongly triaged.Methods
We retrospectively reviewed three cases seen in the PER of Hospital Clínic in July 2023 in which triage errors happened. Triage error was considered when patients triaged directly to the PER presented symptoms that either needed medical treatment or required medical clearance before being considered purely psychiatric.ResultsCase 1: A 27-year-old woman with history of depressive syndrome was triaged for a speech disturbance that had occurred fifteen minutes after intercourse. After being evaluated, she was referred to neurology where she was diagnosed with an acute ischaemic stroke in left middle cerebral artery territory, requiring thrombectomy and posterior admission to neurology.Case 2: A 50-year-old man with history of alcohol use disorder was brought to the PER after saying that “he was seeing people doing magic” at home. When evaluated, significant distal tremor, tachycardia and hypertension were observed, being compatible with withdrawal symptoms, so he was transferred to the ER. There he was monitored and treated, finally requiring admission to internal medicine due to persistent symptoms.Case 3: A 26-year-old man with history of substance use disorder was triaged for loss of consciousness and “spasms”. After evaluation, he was transferred to the ER, where organic screening was carried out, being oriented as a probable tonic-clonic seizure and discharged with outpatient follow-up.ConclusionsThe cases presented are instances in which somatic diseases in patients pre-labelled with psychiatric histories were wrongly assumed to be recurrences of their psychiatric disorders. In all cases, they needed to be re-examined by the corresponding medical specialty and required diagnostic tests, in two cases hospital admission was needed. Emergency physicians and emergency psychiatrists often disagree on how to medically clear patients (Alam et al. Psychiatr. Clin. North Am. 2017;40(3):425–33; Janiak et al. JEM. 2012;43(5):866–70), some authors have even proposed protocols for doing this in a more systematic way (Shah et al. JEM. 2012;43(5):871–5). To avoid a delay in diagnosis and treatment and the consequences that may result from it, establishing guidelines for proper triage of patients with psychiatric history should be considered.Disclosure of InterestNone Declared
Parents’ Assessment of Their Children’s Use of Technology
Authors: Tepetaş M. , Ünsal A. , Tepetaş Cengiz G. S. 
Published: August 2024

IntroductionThe use of technology in many areas of daily life is widespread among both children and adults. Excessive and inappropriate use of technological aids causes significant problems in physical, psychomotor, psychological and social stages of development, especially in childhood. One of the reasons for some problems that arise in adulthood, such as communication problems, anxiety disorders, obesity, musculoskeletal disorders and tendency to violence is the excessive and inappropriate use of technology in childhood. For this reason, it is of great importance to complete the developmental stages in childhood in a healthy way.ObjectivesThe aim of this study was to qualitatively assess the technology use habits of 48-72 month old preschool children and their parents.MethodsThe study is a qualitative research conducted among the parents of children in Eskişehir and Bolu between March and June 2023. A semi-structured form was used for the personal interviews with the 25 parents who constituted the study group. The interviews were recorded. The audio recordings were then transcribed and a thematic content analysis was conducted. The main themes of the interviews concerned the habits of parents’ and children’s in the use of technology at home, the content used on technological devices and how it is controlled, and the arrangements for technology use at home.ResultsIn the interviews, parents reported that when they needed to use technological devices, they most often chose a time and place when the children were not present or asleep. When children spent more time at home, this was the most common reason for increased technology use, while the most common reason for decreased use was that children spent more time outside the home. Most parents limited the amount of time their children’s daily technology using time. It was found that children generally complied with these restrictions, and when they did not, they often expressed themselves with reactions such as sulking/angry/crying.ConclusionsThis study emphasizes that the most important factor determining children’s attitudes towards technology use is their parents’ attitudes towards technology use In order for children to develop a positive attitude towards technology use, it can be beneficial for parents to regulate and control their children’s technology use as well as their own.Disclosure of InterestNone Declared
The Sense of Resilience of health care professionals in Latvia measured by Antonovsky’s Sense of Coherence Scale
Authors: Janovskis D. , Eglītis R. 
Published: August 2024

IntroductionIn this research work the sense of resilience was studied, which is an essential factor in reducing the stress of health care workers, it also helps to maintain the sustainability of the work of medical specialists and prevents the burnout syndrome. Aaron Antonovsky’s Sense of Coherence scale was used in this study, which helps to determine how health care professionals are able to preserve their mental and physical health.ObjectivesThis study is aimed to determine the differences in components of Antonovsky’s Sense of Coherence scale for various health care specialists and to describe the factor structure of Coherence scale for health care specialists in Latvia, that forms the sense of resilience for health care specialists.Methods
The questionnaire used in the study is Antonovsky’s Sense of Coherence scale’s (Antonovsky, 1987) Latvian version, that was translated into Latvian and adapted in the research work of A. Veylande, N. Bahmačova (2000). 202 respondents who are representatives of medical professions took part in this study. The obtained data were entered into the MS Excel computer program and were statistically processed using the SPSS 22 computer program.Results
Looking at the obtained results of this study, it can be stated that Medical Doctors- Specialists have statistically significantly higher Comprehensibility scores than Medical Orderlies (p = 0.01, r = 0.24), while Medical Doctors- Specialists and Medical Doctors- Residents have statistically significantly higher Manageability scores than Medical Orderlies (p= 0.04, r=0.21). Based on the analysis of the results, it has been determined that Doctors-Specialists (p=0.00, r=0.32) and Doctors-Residents (p=0.00, r=0.34) have statistically significantly higher Meaningfulness indicators than Medical Orderlies, as well as Doctors-Specialists (p=0.00, r=0.29) and Doctors-Residents (p=0.00, r=0.31) have statistically significantly higher Meaningfulness scores than Medical Nurses.ConclusionsHigher scores of the three components of Antonovsky’s scale for Medical Doctors-Specialists and Medical Doctors-Residents compared to Medical Orderlies and Medical Nurses could be explained by a lower overall time that Doctors spend in the department with patients. Higher education helps to overcome stress at work and to become aware of possible strategies for improving the joy of life, ways to reduce stress at work and to relax from work.Disclosure of InterestNone Declared
Euthanasia and assisted suicide in people with mental disorders: a case report
Authors: Martin De Argila Lorente M. , Franco Lovaco B. , González Guembe M. , Fresnillo Palomera M. , Díaz Mayoral C. 
Published: August 2024

IntroductionUntil 2020, only Belgium, Luxembourg, Switzerland, and the Netherlands legalized euthanasia and assisted suicide in Europe. Spain joined this list in March 2021 with the Euthanasia Regulation Law. However, the practice of euthanasia and assisted suicide in individuals with severe mental disorders is complex due to potential cognitive and decision-making challenges. Psychiatrists play a vital role in evaluating such requests.Objectiveshe case of a patient with recurrent depressive disorder requesting euthanasia is presented, followed by a theoretical review of the subject.MethodsA case is presented with a bibliographic review.Results
An 89-year-old man with a history of one prior brief psychiatric hospitalization for depression three years ago was admitted after attempting suicide with an overdose of medication. He reports depressive symptoms of several years of evolution. Medical tests came back normal, but he had a urinary catheter due to voiding issues. He was initially on a medication regimen of amitriptyline, clomethiazole, and fluvoxamine. Despite his depressive state, he maintained his cognitive and decision-making abilities. Medication adjustments were made, including discontinuing amitriptyline and switching fluvoxamine to amitriptyline. His depressive symptoms worsened after three days, leading to the addition of trazodone to his treatment. He also developed urinary symptoms and was diagnosed with a urinary tract infection and metastatic prostate cancer during urological evaluation. Emotionally, he became more apathetic, anergic, and anhedonic, frequently expressing a desire for euthanasia, even with medication changes. Hyponatremia led to the discontinuation of duloxetine and the introduction of venlafaxine. To address anxiety and sleep problems, clomethiazole was replaced with mirtazapine. Upon learning of his cancer diagnosis, his mood deteriorated further, along with increased anxiety and continued mentions of euthanasia. Lorazepam was introduced, and he was informed of his right to request euthanasia after discussing therapeutic options with urology. Following this consultation, the patient became calmer, stopped expressing thoughts of death, and began making short-term plans, including the possibility of receiving palliative care at home upon discharge.Conclusions
Euthanasia and assisted suicide in severe mental disorders are complex due to ethical and medical challenges. Patients must understand their condition, prognosis, and have decision-making capacity. Assessing their suffering is crucial. Coexisting mental and organic issues complicate the request’s origin. In SMD, determining irreversibility is tricky, as these are often chronic, non-terminal conditions. Exhausting treatment options is essential before considering euthanasia, despite patient treatment refusal. Limited research underscores the need for more studies.Disclosure of InterestNone Declared
The interplay of aggression and psychopathy in a correctional treatment setting
Authors: Voulgaris A. , Briken P. , Stück E. 
Published: August 2024

IntroductionAggression is a relevant risk factor for criminal behavior. Psychopathy is known to correlate with a higher risk for violent offenses and research suggests that successful therapy of psychopathy is complicated.ObjectivesOur goal was to explore the overlap between psychopathy and aggression and the specific influence of psychopathic traits on change in aggression during correctional therapy.Methods
A pre-post-study rating psychopathy and aggression in men imprisoned for sexual and non-sexual violent offenses aged between 20 and 67 (M=37.6, SD 11.6) was conducted. The participants filled out standardized pre- and post-treatment ratings after admission and after an average of 16 months (n=144 for pre-rating, n=89 for post-rating). Psychopathy was measured via the PCL-R and aggression with the BDHI (Buss-Durkee Hostility Inventory).
We calculated two-tailed Pearson correlations for BDHI Pre-, Post-, and Change Scores and the PCL-R. Further, the BDHI pre-post-differences were compared using independent t-Tests, effect sizes were calculated using Cohen’s d (small, medium, and large effect sizes are d = .20, .50, and .80). Also, unpaired t-tests were carried out to compare between participants with lower and higher PCL-R sum scores (median split, mdn= 16.8, M=16.8, SD=7.0).ResultsPsychopathy facets 3 and 4 (lifestyle, antisocial) and the sum score correlate significantly with the pre-, and post-BDHI total score and the subscale direct hostility but not with indirect hostility. Regarding BDHI change scores, only the interpersonal facet of PCL-R correlated significantly with direct hostility and the total BDHI score. In the whole population, a significant reduction of the BDHI was only found in the subscale indirect hostility (p=.015, cohens d= .26). In the subgroup of individuals with lower PCL-R (<16.8) showed a reduction of indirect hostility (p<.001, cohens d= .50) and the total BDHI score (p=.003, cohens d=.42). Interestingly, in the group with higher PCL-R scores no significant reduction of self-assessed hostility via BDHI was observable during therapy.ConclusionsWe identified a significant correlation between psychopathy and aggression, especially regarding facets three, four, and the sum score. Only the interpersonal facet correlated with the change in aggression during treatment in prison. In the group with higher psychopathic traits, no change in aggression was achievable during therapy. Thus, in the aspect of aggression and hostility, our data suggest that higher psychopathic traits may be viewed as a complicating factor for successful therapy.Disclosure of InterestNone Declared