bluuebunny/crossref_metadata_2025_split huggingface dataset:
physician assisted dying : A French Perspective - a new revolution?
Authors: Courtet P. 
Published: August 2024

AbstractThe debates on euthanasia and assisted suicide (EAS) are topical in Europe. The extension of EAS for psychiatric reasons, already legalized in some countries, raises ethical and clinical issues, given the proximity between suicidal patients and patients who request or have accessed EAS. How can ESA be reconciled with the promotion of suicide prevention, which kills nearly 10,000 people per year in France? We will raise here several key questions that deserve a clear answer before considering going further in the social debates: how to ensure the irreversibility of psychological suffering? how to ensure that patients requesting EAS have full decision-making capacity? how to judge therapeutic futility? It seems crucial to protect the most vulnerable patients by ensuring that psychiatry benefits from scientific progress and can offer new solutions to suffering patients.Thes issues will be discussed viewing the proposed law on EAS in France, which is supposed to come in February 2024…Disclosure of InterestNone Declared
The Romanian forensic pscychiatry system related to the admission of patients- aspects of the criminal law
Authors: Anghel C. E. , Băcilă C. , Tănase M. 
Published: August 2024

IntroductionIn the Romanian forensic psychiatric and legal system, the legislation allows people diagnosed with mental disorders and who have committed a crime, without discrimination, to come under the Criminal Code, thus applying the safety measure of medical hospitalization. Although it is a complex measure, which requires increased attention in its application, any omission on the part of the authorities could lead to the violation of various human rights. The role of this measure is to improve the mental state of perpetrators, who represent, both for them and for society, an important danger. Approaching from this perspective we can say that this legal framework defines and limits the circumstances in which this measure can be produced to prevent the violation of human rights..ObjectivesThe objective of this presentation was to carry out an analysis of the applying criteria for the safety measure of medical hospitalization, as well as the procedural aspects, in the national institutions where the perpetrators serve their sentences, called “psychiatric and security hospitals”MethodsIn this way, in our research we wanted to discover the most frequent pathologies blamed to be the cause of crimes and determined the application of these measures.ResultsAll the results were evaluated and integrated according to the objective of this study.ConclusionsIn parallel with this analysis, we wanted to identify the main aspects that make the activity difficult and also to be able to offer the possibility of creating some solutions to improve the forensic psychiatric and legal system.Disclosure of InterestNone Declared
Development and establishment of a patient advisory board for forensic psychiatric patients - Insights and experiences from the PART project
Authors: Drewelow E. , Daum M. , Ferra F. , Gerullis K. , Kilimann I. , Klein O. , Walde P. , Teipel S. , Völlm B. 
Published: August 2024

IntroductionParticipatory research (PF) actively involves people with lived experience (pwle), e.g. for a disease, in research. This improves the relevance, quality and impact of research and can help to raise third-party funds, increase recruitment numbers, select research methods. Pwle can support all stages of the research process, including dissemination. While PF is already standard in other countries, Germany is still lagging behind. Our participatory advisory board aims to create a sustainable structure to involve underrepresented patients.ObjectivesIn the PART advisory board, pwle and researchers should actively cooperate in projects in the field of forensic psychiatry. In preparation to establish the advisory board procedures, key documents and training material were developed. In addition experiences, opinions, ideas and concerns of stakeholders and pwle in relation to PF were collected.MethodsGuided interviews were conducted with stakeholders (clinical, research) and focus groups with in-patient pwle from forensic psychiatry. They were asked how they imagine the structure, tasks and goals of a participatory advisory board, what opportunities and obstacles they see. Anticipated framework conditions and support needs for the successful implementation were also asked. The interviews and focus groups were audio-recorded and transcribed. Data was analysed with MAXQDA using thematic analysis.ResultsIn total, 8 expert interviews and 2 focus groups with 15 pwle were conducted in the first half of the year 2023. The analysis so far shows great interest in PF, although the term is mostly unknown and experience seems to be limited. The respondents identified opportunities for participatory research, but also challenges that need to be overcome in terms of its implementation. Both groups emphasise the importance of PF, especially in the field of mental illness, and express ideas for its implementation.ConclusionsThe results will be incorporated into the structure of the advisory board, so that PF in the field of forensic psychiatry will be more successful and the exchange between researchers and pwle will be facilitated. Detailed results as well as impressions from the first meeting(s) of the advisory board will be presented at the EPA conference.Disclosure of InterestNone Declared
Fatal pulmonary embolism related to anti-psychotics: forensic implications. About four autopsy cases with review of the literature
Authors: Kacem M. , Bouali W. , Mahjoub Y. , Brahim S. , Zarrouk L. 
Published: August 2024

IntroductionThe association between the intake of antipsychotic drugs and the occurrence of thromboembolic complications is widely described in the literature. The occurrence of this complication may call into question the medical responsibility of the attending physician.ObjectivesThe objective of this work is to describe the physiopathological mechanisms involved in the occurrence of thromboembolic complications in a patient under antipsychotic treatment, whether or not associated with physical restraint and to discuss the forensic implications.MethodsOur study is retrospective on cases of fatal pulmonary embolism, discovered at autopsy, in connection with the taking of antipsychotics. The autopsies were carried out in the Department of Forensic Medicine of the Tahar Sfar University Hospital in Mahdia. The cases were collected over a period of 04 years. A review of the literature was carried out. We only selected articles published until February 2021 and dealing with cases of patients on antipsychotics, diagnosed with pulmonary embolism by performing a chest CT scan or during an autopsy.Results915 autopsy cases were performed during the study period. Twenty cases of pulmonary embolism, discovered at autopsy, were collected. Four cases were related to the taking of antipsychotics (incidence 0.004%), including two men and two women, aged between 25 and 52 years. They were all on antipsychotic treatment for at least 5 years, with the exception of one case who was put on 3 antipsychotics, 7 days before his death, with indication of physical restraint. After analysis of the memorial data, the external examination and the autopsy, the results of additional examinations, the death was attributed, in the 4 cases, to a massive fibrino-cruoric pulmonary embolism. A selection of 45 studies regarding thromboembolic complications associated with taking antipsychotics, was included in the final review.ConclusionsThe reported cases provided additional evidence on the involvement of antipsychotics in the occurrence of thromboembolic complications. Psychiatrists should be careful when prescribing these treatments. The establishment of therapeutic guidelines, taking into account the thromboembolic risk factors, becomes essential, in order to avoid the occurrence of a complication which could engage both the vital prognosis of patients and the responsibility of the physician.Disclosure of InterestNone Declared
Behavioral and neurocognitive phenotypes in Crigler-Najjar syndrome in Tunisia
Authors: Bouayed Abdelmoula N. , Zekri R. , Bouaziz F. , Bensalem K. , Feki M. , Etteyeb A. , Abdelmoula B. 
Published: August 2024

IntroductionCrigler-Najjar 1 (CN1) due to exon 3 mutations of the UGT1A1 gene is a not rare genetic disease in Tunisia with a founder effect. CN1 syndrome is very severe, and most of CN1 Tunisian patients die soon after birth, within a maximum of one year, due to kernicterus. Liver transplantation, which is the only available therapeutic method for CN1, remains unreachable.ObjectivesThe aim of this study was to report behavioral and neurocognitive phenotypes in CN1 patients who survived to school enrollment.Methods
We have selected all patients evaluated from 2004 to 2010, both clinically and molecularly, for a deficiency of bilirubin-UGT enzyme activity leading to a pathological elevation of unconjugated bilirubin with a suspicion of CN1 syndrome. Direct sequencing of targeted PCR amplification products was performed for molecular analysis of UGT1A1. Behavioral and mental features of patients were studied through our genetic counselling.Results
We identified 15 patients with the homozygous c.1070 A>G Tunisian mutation. Their age at diagnosis ranged from one week to 9 months for 13 patients. Six of them died within a month of molecular investigation. Only two boys were of school age, i.e. 6 and 9 years. The first had been hospitalized at 3 months year-old for a prolonged jaundice treated with phenobarbital and phototherapy. His psychomotor and neurological development was normal, with school attendance at the age of six. The second patient presented with an unexplored jaundice at the age of 3 days, which was later complicated by seizures and treated with phenobarbital. Despite neurological and motor sequelae associated to language impairments with slurred speech, he attended school at the age of six.ConclusionsThe neurological and behavioral profile of CN1 patients depends on familial and medical management. Quick diagnosis, close follow up and early liver transplantation can improve prognosis.Disclosure of InterestNone Declared
Multidisciplinary users oriented approach in the community mental health care
Authors: Racetovic G. , Grujic Timarac S. , Latinovic M. 
Published: August 2024

Introduction
For more than 25 years, Bosnia and Herzegovina (BH) has maintained and improved reform processes in the field of mental health (MH) care. In the last 13 years, the results of the reform are visible, and they focused on the quality of services oriented to people with mental disorders (PMD), as well as raising the quality of specific services to the general population. The developed network of community mental health centers (CMHC) as the leading concept of the reform (community psychiatry) enabled affordable, timely and adequate protection of mental health in whole country, while relying on other resources, primarily clinical and hospital capacities and centers for social work.ObjectivesReform orientation had several directions: broad promotion and prevention, protection of the rights of the people with mental health disorders, quality education and more specific qualifications and competencies of mental health professionals and public promotion as a part of destigmatization.MethodsOverview of the mental health reform in last two decades.Results
In last more than 25 years reforming processes were focused mainly to users of mental health services. Specific legislative was created and recently upgraded trough Mental Health Protection Law, as unique document focused to users, mental health professionals and services, and general population as well. Users organization were formed and have important role in creation of further directions in the reform. Main principles in daily care for users are community based with case management and intersectoral collaboration trough joint discharge planning. Also, special focus is given to media reporting about mental health as well as to children and adolescents, prenatal psychiatry and elderly.Conclusions
Republic of Srpska and Bosnia and Herzegovina made significant steps and visible changes in the quaity of mental health services focused to users needs. Further activities will be oriented to continuous destigmatization of the people with mental health disorders, psychiatry and mental health professionals and further implementation of results achieved in reforming processes in our county.Disclosure of InterestNone Declared
Implementation of a peer support intervention for family members of involuntarily hospitalised patients
Authors: Wells I. , Wintsch K. , Giacco D. 
Published: August 2024

IntroductionPeer support has been identified as successful in improving patient wellbeing and empowerment and there is evidence that peer support can also help their family members (FMs). A peer support programme for FMs, developed in Germany, significantly improved FMs’ quality of life. We have worked to adapt this support programme for delivery in England. We will report the results of this adaptation process and of the implementation of peer support for FMs.ObjectivesTo examine the feasibility of the peer support programme developed and assess whether it can be delivered using a “train-the-trainer” approach.MethodsThe peer support programme is being implemented in two stages. In stage one, FMs with experience of supporting an involuntarily hospitalised patient (family peer supporters (FPSs)) receive an online training programme consisting of four sessions. These sessions, provided by the research team and FMs with lived experience of caring for an involuntarily hospitalised patient, teach FPSs skills in communication, reflection, coping and trialogue (promotion of equal communication between FMs, professionals and patients). FPSs then use these skills to deliver support to FMs of patients who are currently involuntarily hospitalised. This support is delivered for up to three months. The impact of this programme is assessed through one-to-one interviews with FPSs and FMs. Questionnaires are also provided to FMs measuring their quality of life, caregiving burden and psychological wellbeing before and after receiving support from FPSs.In stage two, a modified version of the training programme (based on FPS feedback) is provided to a new group of FPSs. This training will be delivered by FPSs from stage one. After receiving the training programme, stage two FPSs will deliver support to other FMs as described for stage one. Assessment of the modified programme will mirror stage one.ResultsProvision of the stage one training programme is complete, and delivery of support is in progress with modifications being made for stage two. Eight FPSs and six out of a target of 12 FMs have been recruited for stage one. FPSs reported the training programme to be a positive experience, highlighting that it was engaging, easy to understand and gave them the confidence to support other FMs. Technical difficulties and an overload of information were cited as areas to improve for the next stage.ConclusionsFPSs described the peer support training programme as a positive experience overall. However, improvements need to be made for stage two which is in progress. A more comprehensive report of our findings, including the impact of this peer support programme and the feasibility of implementing it in England, will be provided as the programme progresses.Disclosure of InterestNone Declared
Understanding females with attention deficit and hyperactivity disorder
Authors: Kilic O. 
Published: August 2024

AbstractThe predominant association of attention deficit and hyperactivity disorder (ADHD) with males, often leads to underdiagnosis or misdiagnosis in females. Recent studies have highlighted marked differences between genders in the manifestation, symptoms, and outcomes of ADHD. Understanding these differences is essential for accurate identification, diagnosis, and tailored interventions for affected individuals, particularly females. TThe multifaceted nature of ADHD demands a nuanced examination of its impact on females, considering how societal expectations, hormonal influences, and a range of symptom presentations may contribute to the variation in the manifestation of this disorder across genders. This presentation aims to contribute to a more comprehensive understanding of ADHD, fostering improved recognition and tailored strategies to support both males and females who suffer from this condition.Disclosure of InterestNone Declared
Evaluation of a scalable psychosocial intervention for refugees in Greece
Authors: Papathanasiou C. , Kougioumtzi A. 
Published: August 2024

IntroductionThe world of the third millennium is witnessing the highest levels of displacement on record. To meet the specific needs of this vulnerable population, a task-shifting approach is developed, where individuals with refugee background and lived experience are trained and supervised my mental health professionals to provide emotional and practical support to members of their communities.ObjectivesThe evaluation of a scalable psychosocial intervention for refugees based on the task-shifting approach.MethodsThe intervention consisted of sessions of Problem Management Plus (PM+) and peer case management delivered by a team of community psychosocial workers (trained refugees). The sample consisted of 173 participants, Arabic- and Farsi-speakers male and female, recognized refugees, and asylum seekers. Anxiety, depression, and psychological distress were measured before and after the intervention using the Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire - 9 (PHQ-9), and Psychological Outcome Profiles (Psychlops) scales respectively. Repeated measures analysis of variance (ANOVA) was adopted to evaluate the difference in the degree of change across patients’ characteristics over the follow up period. Statistical significance was set at p<0.05 and analyses were conducted using SPSS statistical software (version 26.0).ResultsSignificant decreases were found in all post-test scales, indicating diminution of anxiety, depression symptoms, and psychological distress. Large effects sizes were found in all scales.ConclusionsThe findings support that task-shifting approach incorporating PM+ and case management is effective for the mental health of refugees. Peer support could be included in a stepped care model for refugee mental health and well-being in high-income countries. For future research a randomized controlled trial is proposed as a study protocol.Disclosure of InterestNone Declared
War and Migration – when Mental Health is left behind
Authors: Ramos A. L. , Salgado H. 
Published: August 2024

IntroductionWars and armed conflicts are known to have devastating consequences for both physical and mental health of all the people involved. Studies have shown that conflict situations cause more mortality and disability than any major disease and, among the consequences of war, the impact on mental health of the civilian population is one of the most significant.Forced migration, compelling people to become internally displaced or refugees who have fled to other countries, is responsible for additional physical and mental health problems. Regardless of the reasons for migration, the process itself can be a highly stressful life event, leading to a higher risk of psychiatric disorders. Refugees are particularly susceptible to mood and anxiety disorders, whose prevalence rates is almost twice as high as those found among non-refugee migrants.ObjectivesSince 2022, with the progression of the conflict between Russia and Ukraine, and the establishment of a real war scenario, many Ukrainians were forced to leave their homeland, to ensure their survival and security. In Europe, many countries took in Ukrainian refugees and Portugal was no exception.In the Psychiatry Inpatient Service of University Hospital Center of São João, there were admissions of Ukrainian refugees who already had a known mental disease - at that time decompensated - and also new cases, to date without follow-up by the specialty.MethodsIn this work, we will carry out a bibliographical review on the impact of war and migration on mental health and the potential of proper medical approach, based on articles indexed in Pubmed, in the last 10 years.Furthermore, we will present the cases of war refugees interned in our service between January 2022 and December 2023.ResultsWe will describe the psychopathological features and also the sociofamilial circumstances of these patients, as well as explain the intervention and longitudinal support developed in these cases.ConclusionsAs a conclusion, we point out the importance of approaching mental illness in light of the individual’s context, knowing that this context may contain the problem and also the solution. War and forced migration bring increased challenges to psychiatry and, in an increasingly globalized society, geographical, linguistic or cultural barriers cannot impose limits on our best and most appropriate medical treatment.Disclosure of InterestNone Declared
Sense of Agency and Its Disturbances: A Systematic Review Targeting the Intentional Binding Effect in Neuropsychiatric Disorders.
Authors: Di Luzio M. , Moccia L. , Conte E. , Modica M. , Ambrosecchia M. , Ardizzi M. , Lanzotti P. , Kotzalidis G. , Janiri D. , Di Nicola M. , Janiri L. , Sani G. , Gallese V. 
Published: August 2024

IntroductionThe sense of agency (SoA) indicates a person’s ability to feel her/his own motor acts as actually being her/his, and through them to exert control over the course of external events. Disruptions in SoA may profoundly affect the individual’s functioning, as observed in several neuropsychiatric disorders.ObjectivesThis is the first article to systematically review studies that investigated intentional binding (IB), a quantitative proxy for SoA measurement, in neurological and psychiatric patients.MethodsEligible were studies of IB involving patients with neurological and/or psychiatric disorders. The research adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).ResultsWe included 15 studies involving 692 individuals. Risk of bias was low throughout studies. Eligible studies dealt with data from 357 patients with neuropsychiatric disorders matched with 335 HCs. Of included patients, 95 were with schizophrenia (SCZ), 30 with a putative prodromal psychosis (PP), 21 with borderline personality disorder (BPD), 66 with Parkinson’s disease (PD), 38 with an autism spectrum disorder (ASD), 29 with functional movement disorders (FMDs), 25 with Gilles de la Tourette syndrome (GTS), 52 with anorexia nervosa (AN; 22 with active disorder and 30 after they had recovered), and 10 with Cortico-Basal syndrome (CBS).Temporal binding was calculated in eleven studies using variations of the experimental procedure introduced by Haggard et al. (Haggard et al. Nat Neurosci 2002;5 382-385)(Figure 1, A), while four studies utilized a different paradigm named interval estimation (IE)(Figure 1, B).Image:ConclusionsAbnormally increased action-outcome binding was found in schizophrenia and in patients with Parkinson’s disease taking dopaminergic medications or reporting impulsive-compulsive behaviours. A decreased IB effect was observed in Tourette’s disorder and functional movement disorders whereas increased action-outcome binding was found in patients with cortico-basal syndrome. The extent of IB deviation from healthy control values correlated with the severity of symptoms in several disorders. Inconsistent effects were found for autism spectrum disorders, anorexia nervosa, and borderline personality disorder. Findings pave the way for treatments specifically targeting SoA in neuropsychiatric disorders where IB is altered.Disclosure of InterestNone Declared