bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benzodiazepines and risk of dementia – Is there a reason for alarm?
Authors: Andrade R. P. L. , Castro N. , Vaz R. , Martins J. , Abreu J. , Almeida E. , Santos I. , Cunha F. , Afonso H. 
Published: August 2024

IntroductionThe population ageing is a reality associated with an increase in prevalence of Dementia. The use of benzodiazepines is often postulated as a risk factor in these syndromes.Contrary to recommendations for its short-time use, long-term and chronic use are common, with an estimated 8,7% of elderly people in the US taking benzodiazepines.ObjectivesTo clarify the most recent evidence on the use of benzodiazepines and the risk of developing dementia.MethodsNon-systematic review of literature, using PubMed as database and filtering the results for meta-analysis.ResultsFour articles were included in this review.Zhong G et al. concluded that risk of dementia increased in consumers of benzodiazepines and it was associated with higher doses.In turn, AlDawasari A et al., when trying to clarify the use of different sedative-hypnotic drugs, found and increased risk with the consumption of benzodiazepines. After exclusion of articles with confounders and adjustment for protopathic bias, the risk was not maintained.Lucchetta RC et al. concluded that the risk exists but without inferring differences between doses or duration of action.Finally, Penninkilampi R e Eslick GD investigated this association, after controlling for the protopathic bias, concluding, contrary to AlDawasari et al., that the association benzodiazepines consumption and dementia do not result from this bias.ConclusionsWe cannot draw robust and concrete conclusions between benzodiazepines consumption and the pathogenesis of dementia because not only is the literature limited, but results are also heterogeneous.
However, these prescriptions must be carried out cautiously, especially in the elderly, due to the known adverse effects associated with them.Disclosure of InterestNone Declared
Differential diagnosis between frontotemporal dementia and bipolar disorder, review and case report
Authors: García Moreno M. , De Cos Milas A. , Beatobe Carreño L. , Del Sol Calderón P. , Izquierdo de la Puente A. 
Published: August 2024

IntroductionDementia can present with psychiatric symptoms even before the cognitive impairment, which makes difficult to establish an adequate diagnosis. There have described symptoms of this type in vascular dementia, frontotemporal dementia, Alzheimer disease and Lewy bodies dementia. Frontotemporal dementia has a prevalence of 9-20% and it`s the third in frequency among degenerative dementia. It appears before the age of 65 years old and is more common in men. Two variants have been described, linguistic and behavioral. The behavioral one has usually an initial psychiatric presentation, with behavioral disorders, disinhibition and personality changes. Therefore it`s important to make an adequate differential diagnosis with late onset bipolar disorder.ObjectivesTo review about frontotemporal dementia and its differential diagnosis with late onset bipolar disorder.MethodsWe carry out a literature review about frontotemporal dementia and its differential diagnosis with late onset bipolar disorder, accompanied by a clinical description of one patient with behavioral disturbance and language disorder.Results

A 59-year-old female was admitted to the short-term hospitalization unit from the emergency department due to behavior disorder. She had no relevant personal or familiar psychiatric history up to two years before when she received diagnosis of bipolar disorder. She presented behavioral disorganization, psychomotor restlessness, verbal aggressiveness, verbiage, insomnia and decreased intake. Psychopathological examination became difficult due to her language disorder since she presented an incoherent speech with paraphasias and loss of the common thread. Neurological study guided diagnosis to frontotemporal dementia even though they left the psychopharmacological treatment to our discretion. Olanzapine 5 mg twice a day was initiated, and behavioral improvement was observed. However, the patient maintained a significant functional impairment.ConclusionsPsychiatric presentation is frequent in dementia, even before cognitive failures which makes essential an exhaustive differential diagnosis. It`s important to consider the diagnosis of frontotemporal dementia in those patients who debut with behavioral disturbance in the 50s. Psychopharmacological treatment is only symptomatic so functional recovery should not be expected.Disclosure of InterestNone Declared
Navigating Neurocognitive Territory: Late-Onset Bipolar Disorder Insights
Authors: Cotovio D. V. , Agostinho F. , Resende M. R. , Lousada R. S. , Nogueira R. S. , Silva F. A. , Melo M. M. 
Published: August 2024

IntroductionAffective disorders are associated with cognitive deterioration, manifested by an increased risk of developing dementia. Late-onset bipolar disorder (BD) establishes a dynamic interaction between dementia and BD, considering its particular manifestations in old age.ObjectivesProvide a comprehensive overview of the clinical and epidemiological attributes specific to late-onset BD, elucidating its interplay with dementia.Methods
We conducted a literature search on PubMed in August 2023, using the following terms: late-onset bipolar disorder AND dementia. Only systematic reviews and meta-analysis were included with no year or language restrictions. Three articles were eligible for this review: two systematic reviews and one meta-analysis.ResultsLate-onset BD can be defined as a secondary condition and may result from an expression of lower vulnerability to BD, when compared to early-onset BD. On the other hand, late-onset BD may be conceptualized as a subtype of pseudodementia, or even considered a risk factor for dementia. In fact, this particular association with dementia supports the existence of a specific class of BD, i.e. BD type VI. Such diagnostic overlap might be explained by common factors that have been associated with both BD and dementia, such as cardiovascular risk factors, systemic inflammation, stress and levels of baseline cognitive reserve. Despite the commonalities, other aspects, such as family history and prior history of a mood disorder, may help to make the differential diagnosis between late-onset BD and dementia.ConclusionsThere is a diagnostic challenge between dementia and the neurocognitive decline associated with BD, particularly in the case of a late-onset BD. Although the available evidence is limited, current evidence demonstrates that BD can indeed be seen as a risk factor for dementia. Therefore, cognitive impairment in individuals with BD should not be overlooked.Disclosure of InterestNone Declared
Major depressive episode in the elderly. Use of maintenance ECT: a case report.
Authors: Izquierdo De La Puente A. , del Sol Calderón P. , Fernandez Fernandez R. , Garcia Moreno M. 
Published: August 2024

IntroductionWe present the case of an elderly patient with a severe depressive episode who, in order to maintain psychopathological stabilisation, receives ECT on an outpatient basis.ObjectivesThe objective is to briefly review the use of ECT as a maintenance treatment for severe depression in the elderly.MethodsPatient aged 76 years, multipathological, with a history of hypertension, DM and LBP. Femoral head fracture, myelodysplastic syndrome, severe osteoporosis with vertebral crushing, requiring rescue treatment with tramadol, and renal failure.She came for consultation, reporting depressive symptoms of months’ duration, together with delusions of ruin and nihilism. Despite antidepressant and stabilising treatment with duloxetine at daily doses of 120mg, extended-release quetiapine 600mg, lorazepam 2.5mg and mirtazapine 45mg, the patient began to show negative behaviour towards accepting food, clinophilic behaviour and abandonment, which led to her being admitted to the short-term hospitalisation unit.ResultsDue to the severity of the depressive symptomatology, it was decided to start ECT, administering a total of 12 sessions, which were effective, and outpatient follow-up was resumed. However, after a week, the patient again began to show marked apathy and abulia, as well as complete anorexia lasting more than 24 hours, which led to a new admission. It was then that it was decided to maintain the ECT treatment, on an outpatient basis, as maintenance treatment, together with pharmacological treatment.ConclusionsECT is indicated in severe depression, with or without psychotic symptoms, with malnutrition and organic pathology. According to studies, it has a beneficial response of more than 60%. However, the rate of receiving depressive symptomatology in a severe episode is high, despite ECT, so studies and clinical practice recommend maintenance ECT. It is usual to start with weekly sessions, and progressively space them out to maintain the minimum that guarantees stability.Disclosure of InterestNone Declared
Network Analysis of the Relationships Between Symptoms, Functioning, and Sleep/Fatigue in Colorectal Cancer Patients
Authors: Sim J. , Yu J. , Yun Y. 
Published: August 2024

IntroductionAmong the various patient experiences, cancer-related fatigue and sleep disturbances emerge as pivotal aspects that can substantially impact individuals’ quality of life. There exists a relative scarcity of research focusing on the intricate relationship between symptoms, functioning, fatigue, and sleep disturbances in colorectal cancer (CRC) patients.ObjectivesIn this context, the current research endeavors to apply advanced statistical methodologies to elucidate the complex relationships between symptoms, functioning, fatigue, and sleep disturbances. By exploring the intricate web of patient characteristics, clinical factors, psychosocial elements, this study aims to construct a holistic model that not only captures the nuances of colorectal cancer patients’ experiences but also uncovers potential avenues for intervention and support.MethodsIn our cross sectional study, we administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the Quality of Life Questionnaire Colorectal Cancer Module (QLQ-CR29) to 987patients who were surgically-treated for CRC from the tertiary hospital from 2013 through 2018. To confirm the relationship between symptoms of CRC patients, univariable logistic regression was used to examine the potential relationship between independent variables and the occurrence of fatigue and sleep disorders. Least Absolute Shrinkage and Selection Operator (Lasso) was used for variable selection. The selected variables were then applied to a multivariate logistic regression analysis to examine the most influential predictors of fatigue and sleep disturbance. Finally, gaussian graphical models (GGM) were used to identify potential interactions between characteristics, symptoms, functioning, with fatigue, and sleep disturbances in CRC. In this study, Directed Acyclic Graph (DAG) was used to identify causal dependancy and path of variables.Results
About 10.4% of study participants reported experiencing fatigue. Sleep problems were reported by 15.8% of the study participants. Multivariable logistic regression analysis using Lasso showed that sleep problem (odds ratio [OR]=2.34; 95% CI, 1.03-5.31), physical, role, and emotional functioning, pain, dyspnoea, and appetite loss were significant predictors of fatigue, while emotional functioning, dyspnoea, and appetite loss were significant predictors of sleep problem. The variables that were directly linked to fatigue were role functioning, emotional functioning, dyspnoea, appetite loss, body image and trouble with taste. The variables that were directly linked to sleep problem were emotional functioning and appetite loss.ConclusionsIn conclusion, there were complex relationships between symptoms, functioning, fatigue, and sleep disturbances. The symptom network of CRC patients showed different patterns toward fatigue and sleep.Disclosure of InterestNone Declared
Can Ecological Momentary assessments be used to investigate the person-environment interactions in people with psychosis?
Authors: Myin Germeys I. 
Published: August 2024

Abstract
Psychotic experiences show a dynamic pattern over time, often in interaction with the environment. In my talk, I will discuss how Ecological Momentary Assessment (EMA) or Experience Sampling Methodology can be used to assess psychotic symptoms in the flow of daily life. I will focus on the assessment of both positive and negative symptoms, where I will discuss both how we can measure such symptoms as well as what the dynamic patterns look like in everyday life. Furthermore, I will also focus on how ESM can be used to transfer psychological treatment to daily life using an app. I will discuss the INTERACT trial, a trial in people at the early stages of psychosis, where we investigated the effect of Acceptance And Commitment Therapy in Daily Life, compared to Treatment As Usual.Disclosure of InterestNone Declared
Personality disorders and addiction A study of 54 patients
Authors: Bensalah Y. , Tbatou L. , Sabir M. , Elomari F. 
Published: August 2024

IntroductionPersonality disorders are very often comorbid with addictions and are known to have a negative impact on the development of substance use disorder.ObjectivesEvaluate the prevalence of personality disorder in patients with problematic use of psychoactive substances followed at Ar Razi hospital Determine the relationship between different personality disorders and the clinical aspects of psychoactive substance useMethodsThis is a descriptive and analytical cross-sectional study carried out among 54 patients followed at Ar-Razi hospital Salé in Morocco for problematic use of psychoactive substances from June 1 to September 15, 2023 (Diagnosis assessed by DSM 5) Data collection was done using a questionnaire including clinical and socio-demographic characteristics and data on addiction to psychoactive and behavioral substances. The psychometric scale used to assess personality disorder: Personality Disorder Questionnaire (PDQ-4+)ResultsWe recruited 54 patients with age ranges from 18 to 45 years, with a male predominance. The average age at the start of psychoactive substance use was 15 years. Tobacco is the most used substance followed by cannabis Antisocial, histrionic and borderline personality disorders were the most common in our population. There was a statistically significant difference between specific personality disorder and the presence of severe psychoactive substance use disorderConclusionsThe frequency of personality disorders is high among subjects with problematic use of psychoactive substances. It is necessary to take care of them simultaneously (integrated care) in order to improve the prognosisDisclosure of InterestNone Declared
Virtual Insanity: Perspectives from a Political Digital Ethnographer of Young Adults Using Social Media for Mental Health
Authors: Bailie A. 
Published: August 2024

AbstractTo contribute to this debate I offer perspectives from my PhD research which critically examines the contemporary U.K politics of mental health and illness amongst young adults via social media. My work examines the way in which social media, like Instagram and Tiktok allows young adults to explore, express and share their selfhood and identity around ideas of mental health and illness through videos, posts and online interactions. Through this work I have engaged with digital services, psychologists and medical professionals on the subject of using technology for the treatment, engagement of and knowledge of mental health and illness. I have additionally engaged with some work on the role of the Metaverse for treating mental illness, and how this could work, but also the limitations of virtual spaces. Exploring debates in digital sociology adds evidence to these arguments and can support the understanding of the political ramifications of using technologies in the clinical space. Arguing that these new developments in language and social practices around mental health and illness via social media need to be further explored, acknowledged and addressed in social science and this can be supported by work in the field of psychiatry. Overall, my contribution to the debate will be to offer political and digital social perspectives on the use of technology and highlight some of the biases and drawbacks of utilising AI to treat mental health and illness.Disclosure of InterestNone Declared
Specifics of socialization of children with autism spectrum disorders
Authors: Akhmetzyanova A. , Artemyeva T. , Minullina A. 
Published: August 2024

IntroductionOne of the important tasks of modern education is the adaptation of children with autism spectrum disorders to the social space, which allows them to ensure their personal development and self-realization.ObjectivesStudy of the specifics of the socialization of children of preschool age with autism spectrum disorders.Methods
The study involved 27 preschool children with autism spectrum disorders attending an educational institution for children with disabilities; 6 were girls and 21 were boys; 20 children with intact speech and 7 children with speech disorders. The following methods were used: “Map of manifestations of activity by A.M. Shchetinina, N.A. Abramova; “Map of observations of the manifestations of communicative abilities in preschool children” A.M. Shchetinina, M.A. Nikiforova; “Emotional faces” N.Y. Semago.ResultsIt was found that children with autism spectrum disorders have the greatest severity of such activity indicators as “is in a good mood” (1.67), “shows stubbornness” (1.56) and “shows great mobility” (1.56). Among the manifestations of communicative abilities in preschool children, the most developed parameter is: “sincere in his statements, in the manifestation of his feelings” (2,07). At the same time, the lowest expression of communication skills (0.96) in children with autism spectrum disorders is observed in terms of: “has organizational skills”, “the child seeks to understand the other, his thoughts, feelings”; “observant, sees and realizes the characteristics of other children and adults”. The least pronounced indicator is observed in the indicator of initiative; children do not show initiative in communication, have difficulty understanding and supporting the initiative of another child in an interaction situation. Children have a low level of operational communicative actions and skills: children are not expressive in communication, do not master verbal means of communication and are not able to maintain contact with communication partners.ConclusionsThe results obtained in the study confirm the need to develop and implement psychological and pedagogical programs aimed at developing social skills in preschool children with autism spectrum disorders. This paper has been supported by the Kazan Federal University Strategic Academic Leadership Program.Disclosure of InterestNone Declared
Post-traumatic stress disorder after childbirth: A Tunisian study
Authors: Sghaier N. , Ben Soussia R. , Bouchahda H. , Belhadj I. , Ben Garouia H. , Khiari H. 
Published: August 2024

Introduction
Childbirth is a special time for every woman, bringing pregnancy to an end and marking the birth of a new baby. This transitional event presents countless physical and psychological changes. Post-traumatic stress disorder (PTSD), the result of particularly intense stress, is often linked to the perception of childbirth as a traumatic event, requiring optimized follow-up and screening.Objectives
The aim of this current study is to estimate the prevalence of post-partum post-traumatic stress disorder in a sample group of Tunisian women and to determine factors associated with childbirth-related post-traumatic stress disorder.Methods
This is a longitudinal prospective descriptive study conducted among women hospitalized for childbirth in the obstetrics and gynecology department and those who consulted the prenatal outpatient clinic at Taher Sfar Mahdia Hospital. The duration of the study is 7 months, from March 15, 2020 to September 15, 2020. Data collection was based on a pre-established questionnaire determining the various socio-demographic and clinical characteristics. Psychometric assessment was carried out using the Posttraumatic Stress Disorder Checklist Scale (PCL-S).Results
We enrolled 120 women with a mean age of 28.2± 5.3 years. Few women had a psychiatric history of depression (1.2%) or anxiety (3%), and 29% had a pathological obstetric history. Nevertheless, 12.5% of patients were hospitalized during pregnancy. Eighty-seven patients expressed anticipatory fear of childbirth, and 102 women had good marital and social support. Almost half of deliveries (48.3%) were vaginal, and almost a third (27.5%) were emergency caesarean sections. Level 3 pain was reported in 73.3% of cases. Psychometric assessment revealed a prevalence of PTSD of 5.8%, with PTSD symptomatology in 18.4% of women. PTSD was statistically associated with low level of education (p=0.02), postpartum complications (p=0.05) and gender of newborn (p=0.01).Conclusions

Postpartum PTSD is a major public health problem affecting the healthy development of the newborn, the overall mental and physical recovery and well-being of the mother.Our findings suggest several intervention points for healthcare practitioners, including careful prenatal screening of past trauma history, social support, pain management and expectations about the birth, within a multidisciplinary approach.Disclosure of InterestNone Declared
Challenges that early career psychiatrists can face on compulsory treatment
Authors: Chumakov E. 
Published: August 2024

AbstractThe delivery of mental health care worldwide often involves compulsory treatment, a practice encountered by early career psychiatrists from the outset of their training. Despite its prevalence, little research has explored the challenges faced by trainees and early career psychiatrists when compelled to administer treatment without patient’s consent. This presentation will synthesize research data and offer personal reflections on the author’s experiences.Challenges that early career psychiatrists can face regarding compulsory treatment can be categorized into personal, professional, and institutional. Personal challenges encompass the emotional stress associated with applying coercive measures, coping with negative emotions, and managing service users’ attitudes toward treatment without consent. There is also concern that compulsory treatment may elevate the risk of emotional burnout. Professional challenges involve the administrative burden associated with organizing compulsory treatment, often exacerbated by the formalization of the process as a bureaucratic procedure in many European countries. Additionally, dealing with legal processes, including interactions with lawyers and courts, can pose significant difficulties, even though it is clearly done to protect the rights of the persons receiving care. Institutional challenges encompass the overall policy of providing compulsory psychiatric care in the psychiatrist’s home country and the specific practices of coercive measures in a given treatment facility. Furthermore, the lack of dedicated time for ethics of coercion during training is a common issue.In the current landscape of mental health care, early career psychiatrists must undergo training to handle coercive measures. While these measures are sometimes unavoidable, ethical principles must guide their administration. Additionally, access to supervision/mentoring is crucial for early career professionals facing challenging cases.Disclosure of InterestNone Declared