bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric disorders in professional drivers and fitness for work
Authors: Ayed W. , Bahri G. , Mersni M. , Brahim D. , Houissa L. , Youssef I. , Mechergui N. , Bani M. , Bensaid H. , Yaich I. , Bensaid C. , Bram N. , Ladhari N. 
Published: August 2024

IntroductionThe driver’s job is a safety job requiring a meticulous neuropsychological assessment, which can affect the decision on fitness to drive. Professional driving benefits from codified regulations concerning neuropsychological disorders.ObjectivesTo describe the socio-professional characteristics of drivers with psychiatric illnessesTo specify the impact of these pathologies on decisions on fitness for workMethodsRetrospective descriptive study of drivers with psychiatric disorders who consulted the occupational pathology and fitness for work department of the Charles Nicolle Hospital for fitness for work assessment during the period from January 2016 to January 2023.ResultsOut of 98 drivers who consulted our department for an aptitude assessment, nine (n=9) patients had a psychiatric disorder. The average age was 45±7 years. They were all men. They were bus (n=7), light car (n=1), and lorry (n=1) drivers. They belonged to the transport (n=7) and service (n=2) sectors. Length of service ranged from one year to 35 years. The pathologies presented by the patients were: anxiety-depressive disorder (n=7) , bipolar disorder (=1) and drug-addiction (n=1). They were being treated with antidepressants (n=7), anxiolytics (n=3), and thymoregulators (n=1). The medico-legal decision was to avoid professional driving (n=7) and to avoid professional driving at night (n=2).Conclusionspsychiatric illnesses can compromise fitness to work. The role of the occupational physician in the primary and secondary prevention of people at risk is important.Disclosure of InterestNone Declared
Attitude of tunisian psychiatry residents toward internet searches for patient informations
Authors: Ben Youssef Y. , Lagha M. , Boudriga S. , Methni M. , Ben Romdhane I. , Homri W. , Labbane R. 
Published: August 2024

IntroductionIn the age of digital information, the volume of personal information available online continues to grow. Examining patients’ online profiles has become common for various reasons especially in psychiatry, despite ethical concerns. Therefore, it is interesting to explore the attitudes of tunisian psychiatric residents in this regard.Objectives
This study aimed to identify the purposes that make psychiatry residents consult their patients’ profiles on social media and to evaluate the consequences of being friends with them or following them on the treatment course and on the doctor-patient relationship.MethodsThis was a cross-sectional descriptive study from August to September. A questionnaire on Google form was distributed to psychiatry Tunisian residents.The study evaluated the frequency and causes of patient profiles consultation on social networks, its role and impact in the doctor-patient relationshipResultsThe study population included 53 psychiatry residents with a mean age of 28 (+-5) years and a sex ratio of 0.127. Among the responders, 53 % were in their first or second year of residency. And the predominant workplace was El Razi Hospital : a university hospital.
For the frenquency of patient profiles consultation on social networks : 87% of treating psychiatrists declared consulting their patients’ profiles on social media at least once. The purposes of consulting patient’s profiles noted in our study were: looking for signs of pre-morbid functioning (n=32), looking for clinical features of the current episode (n=30). They do it also to verify the informations provided by the patient (n= 18) ,have an idea of their private lives (marital status ,employment, hobbies,..)(n=11) ,or locate a family member (n=5). It can be also out of curiosity (n=21). And this made the psychiatry residents empathetic towards the patient (n=10) .But, in 91% of cases, patient’s permission was not taken .Moreover, 4 of treating psychiatrists declared being friends with their patients or following their profiles on social media. Two of them regret it. The friend or follow request was an initiative from the patient, in all cases.ConclusionsThe attitudes of psychiatry residents regarding the consultation of patients’ profiles on social networks were not clear. However, as the boundaries of the digital doctor-patient relationship remain undefined, it is imperative to develop clear guidelines and educational resources.Disclosure of InterestNone Declared
Perceived stigma and associated factors among family caregivers of patients with severe mental disorders
Authors: Masmoudi R. , Abid W. , Ben salem E. , Ouali R. , Feki I. , Baati I. , Masmoudi J. 
Published: August 2024

IntroductionGiving care to someone who is experiencing mental distress is a difficult and challenging task that could be detrimental to the caregiver’s overall quality of life. Stigma associated with mental illness is one of the most important mental health issues faced by these caregivers.ObjectivesOur aims were to assess perceived stigma among family caregivers of patients with severe mental disorders and to identify its associated factors.Methods
We conducted a descriptive and analytical cross-sectional study among family caregivers of patients followed at the psychiatry outpatient clinic of the Hedi Chaker University Hospital in Sfax, during the period from February 2022 to July 2022.A structured interview questionnaire was designed to collect socio-demographic data of both patients and their caregivers. We used the Stigma Devaluation Scale (SDS) to assess stigma.ResultsA total of 90 family caregivers of severely mentally ill patients were included: 26 men and 64 women, with an average age of 50.68 ±11.67 years.Patients’ parents accounted for 40% of family caregivers. The majority of family caregivers (83.3%) had no more than secondary education. Married people represented 70% of cases.The median age of patients was 42 years. Schizophrenia was the diagnosis in 68.9% of cases. The mean duration of illness was 16.23 years.Daily assistance lasted from 4 to 8 hours in 30% of cases and more than 8 hours in 66.7% of cases.The mean score (SDS12) for family-focused stigma was 13.12 ± 2.34 with ranges from 8 to 18.Perceived stigma scores were significantly higher among caregivers caring for non-married patients (p=0.04), with an age <50 years (p=0.04), and with a higher level of education (p=0.02).Long duration of providing care (> 8 hours per day) (p=0.05) and insufficient information about the illness (p=0.02) were significantly associated with perceived stigma.ConclusionsThe clinicians managing patients with severe mental disorders must focus on stigma and psychological distress among the caregivers and plan intervention strategies to reduce stigma.Disclosure of InterestNone Declared
Exploring Child-Parent Relationship Therapy -CPRT- Impact on Externalised Behaviours of Foster Children Experienced Complex Trauma: A Case Study
Authors: Hatam S. , Moss S. , Cubillo C. , Parsafar S. , Berry D. 
Published: August 2024

IntroductionMany foster children experience traumatic events that result in a wide range of disruptive behaviours, such as temper tantrums, superficially charming, no sincere remorse, and so forth. These problematic behaviours are challenging to the implementation of holistic therapeutic interventions.ObjectivesThe purpose of the current study is to explore the effectiveness of employing Child-Parent Relationship Therapy (CPRT) on externalised behaviours of a traumatised child at home and in social interactions.MethodsThis study used a case study to explore the influence of CPRT on externalised behaviours of traumatised foster children. The case study focused on the externalised problematic behaviours of an Australian Aboriginal child fostered under long-term care at 18 months by a Caucasian family. The foster parent and the foster child received a 10-session structured CPRT across ten weeks. The child’s externalised behaviours were evaluated through the Child Behaviour Checklist (CBCL) form.Results
The findings describe the process of a 10-session structured CPRT with a foster child who exhibits externalised disruptive behaviours because of abandonment and complex trauma. The themes in the foster parent’s role and the play therapy approach relate to traumatic events and attachment issues. The results indicated a slight reduction in these behaviours. According to the follow-up interview, the child still showed aggressive behaviours in social interactions but not at home. Interviews with the foster parent indicated both the parent and child require additional support and further sessions of CPRT.Conclusions
This case study identified an improvement in externalised behaviours for foster children with experience of complex trauma and abandonment after a 10-session CPRT. Further research is required to explore the effectiveness of a longer-term session of CPRT alongside additional support services for foster parents.Disclosure of InterestNone Declared
A Machine Learning Model for Predicting Major Depressive Disorder Using Diffusion-Tensor Imaging Data
Authors: Lee J. H. , Lee D.-K. 
Published: August 2024

IntroductionMajor Depressive Disorder (MDD) stands as a prevalent psychiatric condition within the general population. Despite extensive research efforts, the identification of definitive diagnostic biomarkers for depressive disorders remains elusive. Currently, machine learning methods are gaining prominence in the diagnosis of medical illnesses.ObjectivesThis study aims to construct a machine learning-based prediction model for Major Depressive Disorder (MDD) by harnessing diffusion tensor imaging (DTI) data.MethodsThe DTI datasets comprising MDD (N=83) and Healthy Control (N=70) groups were procured from the cohort study of Anxiety and Depression conducted at the National Center for Mental Health in South Korea. A machine learning method using a decision tree algorithm was employed to select relevant brain regions and establish a robust diagnostic model. Features associated with white matter (WM) tracts were chosen through recursive feature elimination.Results
Demographic characteristics, including age, sex, and handedness, displayed no significant differences between the MDD and Healthy Control groups. However, the total score of the Beck Depression Inventory was notably higher in individuals with MDD compared to Healthy Controls. A diagnostic model was crafted using the decision tree algorithms to distinguish between the two groups. The model demonstrated the following classification performance metrics: accuracy (65.6% ± 8.5), sensitivity (66.6% ± 12.5), and specificity (64.7% ± 13.6). Furthermore, through recursive feature elimination, specific neuroanatomical features tied to brain structures such as the inferior cerebellar peduncle, posterior thalamic radiation, cingulum (hippocampus), uncinate fasciculus, and tapetum were identified.ConclusionsDespite of limited performance of classification, a machine learning-based approach could provide insights into the development of a diagnostic model for MDD using neuroimaging data. Furthermore, these features, derived from DTI-derived data, may have implications for understanding the neural underpinnings of major depressive disorder.Disclosure of InterestNone Declared
Use of low-dose Aripiprazole to lower the antipsychotic medication - induced hyperprolactinemia.
Authors: Argitis P. , Karampas A. , Peyioti M. , Koukouras T. , Demetriou M. , Karavia S. , Chaviaras Z. 
Published: August 2024

IntroductionHyperprolactinemia (HPL) is a condition associated with disturbing consequences. Antipsychotic medications are one of the main causes of nontumoral hyperprolactinemia. Prolactin release in the hypothalamic tuberoinfundibular tract is increased through dopaminergic inhibition, which occurs more frequently with high- potency typical antipsychotics (40%–90%). Less commonly than typical antipsychotics, atypical antipsychotics can also result in hyperprolactinemia. In the presence of symptoms, clinicians frequently struggle with the decision of whether to stop using the suspected offending agent, lower the dosage, switch to another medication, or even add a full or partial dopamine agonist to the patient&#39;s current treatment. The issue is exacerbated by the fact that finding a suitable agent for each patient is sometimes a challenging task.ObjectivesDue to the partial D2 receptor agonistic activity of aripiprazole, there is enough dopaminergic tone to continue the inhibition of prolactin release. Aripiprazole has been recommended in literature either as an adjunctive treatment in low doses or as a switch in therapy.MethodsIn the Psychiatric clinic of the General Hospital of Corfu, a low-dose (5mg/day) of aripiprazole is being used as adjunctive therapy in patients with antipsychotic-induced hyperprolactinemia. More specifically in total 42 subjects, 19 male and 22 female, with a mean prolactin level of 862ng/ml, were introduced to the prior therapy. We whereupon conducted prolactin measurements to evaluate the response at the first, the third, and the sixth month of treatment.ResultsOf the 42 subjects, 38 responded with an average reduction of prolactin to the level of 530ng/ml (mean reduction 38,5%).ConclusionsHaving noticed the beneficial effect of low-dose Aripiprazole in patients with antipsychotic-induced hyperprolactinemia, we consider it appropriate that the literature recommendations concerning this additional use of aripiprazole should not be overlooked in clinical practice.Disclosure of InterestNone Declared
Short-term olfactory deprivation reorganizes brain activity
Authors: Tukaiev S. , Zyma I. , Makarchuk M. 
Published: August 2024

IntroductionOlfactory loss (including short-term) initiates neural reorganization processes in the brain, but the central mechanisms of this largely remain unknown.ObjectivesWe aim to conduct a neurophysiological study of neocortical mechanisms for the effects of olfactory sensation on functional activity of human brain under temporary obstruction of nasal breathing.Methods
123 healthy volunteers (76 female and 47 male students aged 18 to 23 years)participated in this study.EEG was registered during the rest state (5 min), olfactory blockage (5 min), under odor stimulation with the lemon essential oil (5 min) and renewal of nasal breathing (5 min). We estimated the spectral power density and the levels of coherence of all the frequencies from 0.2 to 35 Hz.ResultsThe onset of orthonasal olfactory sensory blockage was accompanied by an increase in the power of processes of local synchronization of beta frequency in the caudal regions of the brain, with simultaneous enhancement of the coherence of the theta band in parietal-occipital zones and a certain enhancement of the interfrontal and intrahemispherical left-side and right-side interactions in the beta2-subband. Thus, the sudden cessation of olfactory detection led to activation of thalamo-cortical loops and top-down control systems (search for the olfactory signal): that is an active orienting process (triangle of increase in F4-T4-P4 connections) with emotional coloring (the caudal localization of the coherence changes in the theta band). The prolongation of the nasal blockage, despite the possibility of activation of the retronasal route of odor perception and odorized air, was accompanied by a definite inhibition of distant interactions in the posterior regions of the brain in the theta-band and a significant decrease in right-brain long-distant and parietooccipital beta2-subband functional connectivity. Restoration of nasal breathing and olfactory perception is accompanied by sufficiently powerful activation of interhemispheric long and short distance information interactions in the theta1,2 and beta1 frequency bands.ConclusionsOur data indicated that cessation and restoration of olfactory perception lead to an increase cognitive activity, the development of memory processes, the current sensory and cognitive-emotional control of behavioral reactions, focusing attention, assessment of the significant stimulus.Disclosure of InterestNone Declared
Alzheimer’s and Parkinson’s disease drugs side effects
Authors: Batistela J. , Ropero Pelaez F. J. , Hida G. , Taniguchi S. 
Published: August 2024

IntroductionAlzheimer’s and Parkinson’s disease are neurodegenerative disorders with life limiting conditions. The symptomatic pharmacological therapeutic strategies unfortunately are also related to undesirable side effects. Acetylcholinesterase inhibitors administered to Alzheimer’s disease patients increase cholinergic transmission in cortex and hippocampus.Antiparkinsonian drugs increase dopaminergic system activity, to compensate for dopaminergic neurons’ degeneration in corpus striatum, therefore supplying the imbalance of these neurotransmitters in these degenerative areas.But undesirable the increase of these neurotransmitters in other cerebral and peripheral areas brings us important side effectsObjectivesTo study Alzheimer’s cholinergic drugs and Parkinson’s dopaminergic drugs’ side effectsMethods
This retrospective study included 107 geriatric patients enrolled in a private long-term care institution. 79 patients with Alzheimer’s disease had mean age of 88.11 ± 5,78 years old, mean weight of 61.62 ± 13.10 kg. 28 patients with Parkinson’s disease had mean age of 84.93 ± 5.71 years old, weight mean 66.36 ± 2.83 kg.ResultsAlzheimer’s disease patients 41.77% (33) received. Acetylcholinesterase inhibitors (Donepezil, galantamine and rivastigmine) Psychomotor agitation and aggressive behavior 63.666% and nausea (15%) were observed in the patients treated with these drugs. The association of L-DOPA and DOPA decarboxylase inhibitors (benserazide) were administered to 53%(15) of the Parkinson’s disease patients in doses between 2.0-19.0 mg/kg/day. L-DOPA associated to catechol-O-methyltransferase inhibitor (entacapone) 3 mg/kg/day were given to 7.14% (2) patients. Bromocriptine 0.04 mg/kg/day was given to 3.57% (1) patients. Mental confusion and hallucination side effects were observed in 53.33% (8) patients treated with L-DOPA associated with the DOPA decarboxylase inhibitor (benserazide).ConclusionsThe increase of cholinergic activity due to the acetylcholinesterase inhibitors in the Nigro- striatal pathway could be related to psychomotor agitation in Alzheimer’s disease patients in a similar way to akathisia induced by neuroleptics. The increase of dopamine levels due to the administration of L-DOPA, in corpus striatum improved Parkinson’s disease symptoms although the increase of dopaminergic activity at mesocortical pathways may be related to confusion and hallucination observed in these patients. Adjustments in dosage of these drugs could provide improvement in these patients’ daily life conditions.Disclosure of InterestNone Declared
Practice recommendations to manage Alzheimer’s disease based on the targeted behavioral and psychological symptoms
Authors: Ouazzani Housni Touhami Y. , Layoussifi E. , Benjelloun R. 
Published: August 2024

IntroductionBehavioral and psychological symptoms (BPS) of Alzheimer’s disease, known as neuropsychiatric symptoms, involve a range of symptoms that include agitation, psychosis (hallucinations, delusions), affective symptoms (depression and anxiety), apathy, and sleep disturbances. These behavioral and psychological symptoms harm the patients’ daily lives and significantly burden their families. Managing BPS of Alzheimer’s disease requires a targeted approach focused on each symptom to achieve a better therapeutic response.ObjectivesProviding practice pharmacological recommendations targeted to each of the behavioral and psychological symptoms of Alzheimer’s disease.MethodsA literature review was conducted using Medline via PubMed, Embase, PsycINFO, and Cochrane databases until September 2023.ResultsThere is a consensus in the literature that non-pharmacological approaches should be recommended as the first-line treatment for most behavioral and psychological symptoms of Alzheimer’s.Second-generation antipsychotics (risperidone and olanzapine, with improved efficacy; aripiprazole and quetiapine, with better tolerance) are recommended for severe agitation states with a risk of self or hetero-aggression, as well as for persistent psychotic symptoms in Alzheimer’s disease. The benefit-risk balance of these agents must be assessed, with close monitoring of heart arrhythmias, metabolic risk, orthostatic hypotension, and extrapyramidal symptoms. The recommendations suggest tapering antipsychotics within the first three months of their prescription. Selective serotonin reuptake inhibitors (SSRIs) such as Escitalopram, Citalopram, and Sertraline can be considered a therapeutic option for persistent affective symptoms (depression and anxiety) with significant functional impairment or suicidal risk, severe apathy, or constant agitation. Minimum effective doses are recommended for Escitalopram and Citalopram due to the risk of QT interval prolongation. There is limited evidence regarding the effectiveness of benzodiazepines, mood stabilizers, cholinesterase inhibitors, and memantine for various behavioral and psychological symptoms; the benefit-risk ratio and therapeutic response do not support the prescription of these agents. Melatonin and Mirtazapine have limited benefits for sleep disturbances, while benzodiazepines, antihistamines, and antipsychotics should be avoided.ConclusionsThe pharmacological approach should target a thorough clinical assessment of the psychopathological dimensions of behavioral and psychological symptoms of Alzheimer’s disease. The prescription should be based on evaluating the benefit-risk balance and adherence to literature recommendations for patient safety.Disclosure of InterestNone Declared
Neuropsychiatric symptoms in frontotemporal dementia: a case report
Authors: Izquierdo De La Puente A. , del Sol Calderón P. , Fernandez Fernandez R. 
Published: August 2024

IntroductionWe present the case of a 70-year-old man who, after presenting atypical depressive symptoms, was diagnosed with incipient frontotemporal dementia.ObjectivesThrough the presentation of the case, a brief review is made of the affective prodromes of frontotemporal dementiaMethods
The patient, who had no personal history of interest, suddenly began to present depressive symptoms consisting of marked irritability, dysphoric mood, anxious semiology with a subjective feeling of anguish, maintenance insomnia and a feeling of lack of self-control, with a tendency towards verbal heteroaggressiveness. The patient reported all these symptoms with great suffering.After one year of treatment with venlafaxine 300g DMD and quetiapine 400g DMD, with one admission to the short-stay inpatient unit for self-harm threats, the patient had not experienced any improvement. In addition, during this year, the patient’s family began to observe small memory lapses that affected his daily functioning, making the patient progressively more dependent.ResultsIn view of this clinical picture, it was decided to request an MRI and a brain PET scan, where deficits in the frontal and temporal regions were observed, and a diagnosis of incipient frontotemporal dementia was made.ConclusionsFrontotemporal dementia is the third most common dementia in people over 65 years of age. About half of the patients debut with psychiatric symptoms, one of them being depressive symptoms. Treatment is focused on the use of psychotropic drugs with the aim of symptom management. Olanzapine or aripiprazole are effective for psychotic symptoms or acute agitation. For more subacute conditions, SSRIs or trazodone are recommended. The iACOs are not recommended, because they are ineffective and worsen neuropsychiatric symptoms.Disclosure of InterestNone Declared