bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thyroid psychosis: when your hormones take over your mind: a case report
Authors: Razki K. , Najar C. , Ouali U. , Ben Aissa S. , Jomli R. 
Published: August 2024

IntroductionHyperthyroidism, characterized by excessive production of thyroid hormones, is a common endocrine disorder that affects various body systems. While most commonly recognized for its classic symptoms such as weight loss, tremors, and palpitations, it is important to acknowledge that hyperthyroidism can also lead to a rare but significant complication: psychosis. Psychosis in the context of hyperthyroidism refers to the presence of delusions, hallucinations, and disordered thinking, which can significantly impact an individual’s mental health and overall well-being.ObjectivesThis case report aims to describe a rare case of hyperthyroidism-related psychosis in a patient including the clinical presentation, diagnosis, and management. Additionally, we aim to increase awareness of and promote further research into this condition.MethodsWe present a comprehensive case report detailing the clinical course of a 29-year-old male patient with no previous medical or psychiatric history, who sought urgent psychiatric evaluation at the Razi Hospital La Manouba’s emergency department due to escalating symptoms of agitation and paranoia persisting for three days. The patient, identified as Mr. S.O., a Tunisian male, presented with severe agitation and paranoia necessitating the use of restraints upon admission to the psychiatric emergency department. The initial physical examination revealed no notable abnormalities, except for the presence of tachycardia, which was subsequently confirmed on an electrocardiogram, arousing suspicion of a primary psychiatric illness.ResultsWhile the standard blood workup yielded unremarkable findings, the endocrine workup revealed decreased levels of thyroid-stimulating hormone (TSH) and elevated free thyroxine (FT4). Further laboratory investigations demonstrated elevated anti-thyroid-stimulating hormone receptor antibodies, leading to the diagnosis of Graves’ disease. Collaborative consultation with an endocrinologist resulted in the initiation of a treatment regimen consisting of methimazole, propranolol, and risperidone. Notably, within three days of the initiated therapy, the patient exhibited significant improvement in terms of reduced agitation, coherent speech, and the development of self-reflection regarding the episode, ultimately leading to his discharge on the seventh day of hospitalization. This case report serves to highlight the complexity of psychiatric presentations associated with underlying endocrine disorders and underscores the importance of interdisciplinary collaboration in achieving optimal patient outcomes.ConclusionsWhile mental health factors play a significant role in the development of psychosis, it is essential to recognize that underlying medical conditions may also contribute to its onset or exacerbation.Disclosure of InterestNone Declared
A HORMONAL INFLUENCE? Polycystic ovary syndrome and borderline personality disorder
Authors: Jesus Magueta S. , Almeida M. , Osório E. , Guerra C. 
Published: August 2024

IntroductionBorderline Personality Disorder (BPD) is a chronic personality disorder characterized by emotional and interpersonal instability, difficulty in mentalization, impulsivity with functional impairment and increased rates of comorbid mental disorders. Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in premenopausal women, with important impact on quality of life and mental health. Studies have begun to explore the eventual relationship between these two pathologies.ObjectivesThe authors aim to describe the existing evidence exploring the relationship between BPD and PCOS as well as explore eventual common causal pathways and the forms which one might influence the other.MethodsThe authors describe a clinical case of a 31 year old female patient with history of borderline personality disorder and polycystic ovary syndrome presenting with hyperandrogenism and hirsutism as well as menstrual irregularities. As a compliment to the case, the authors conducted a brief non-structured literature review using articles published in the Medline/Pubmed, ScienceDirect and Google Scholar databases. The keywords used during the research, alone or in combination, included: Polycystic ovary syndrome and Borderline Personality Disorder. The studies consulted in this work included: cross-sectional studies, cohort studies, literature reviews and clinical case reports. Of these, those that were written in the English language and deemed most pertinent to the explored theme were chosen for review in this work.ResultsThe results demonstrate a paucity in the literature with only 10 articles having been published between 2009 and 2023 having dedicated studies and research to the relationship between the pathologies. One study reports that those with PCOS show relevant psychiatric disorders in comparison to controls, including personality disorders, such as is demonstrated in the described clinical case. Of the few case studies available, these found that BPD was associated with PCOS with the latter having most frequently been diagnosed previously to the personality disorder. Altered androgen metabolism has been described in both these pathologies, thus further strengthening the relationship between these.ConclusionsHormonal fluctuation has been classically associated with psychopathological symptoms, including unstable mood and impulsivity. The alterations demonstrated in PCOS might serve as an exacerbating factor in the genesis of the emotional instability and other symptoms present in BPD. The literature on this topic is still in an embryonic phase with a clear lacuna existing which merits attention and further study so as to fully comprehend the potential of these comorbid states. Clinicians should remain attentive to this comorbidity and the influence that PCOS might have on the psychopathology of BPD so as to better quality of life and global functioning which is impacted in both.Disclosure of InterestNone Declared
Dandy-Walker malformation and psychotic disorder. Review in accordance with a clinical case
Authors: Calle González A. , Batet Sánchez D. , Martínez Hernanz Á. , Roque González I. 
Published: August 2024

IntroductionA clinical case is presented of an 18-year-old woman diagnosed with Dandy-Walker malformation, who is admitted to an Acute Inpatient Psychiatry Unit due to atypical psychotic symptoms, pseudology and aggressive behaviour. After several medication trials, there is a partial response observed with low doses of clozapine, consolidating the improvement afterwards, being referred to an open-door community mental health center because of poor family and social network.ObjectivesReview clinical information about Dandy-Walker malformation and the development of psychiatric disorders, specifically psychotic symptoms, pointing out the peculiarities regarding clinical presentation and treatment management.MethodsSearch in the medical database PUBMED, MEDSCAPE and UPTODATE. Keywords: “Dandy-Walker Syndrome”,” Psychotic Disorders”.ResultsThe Dandy-Walker syndrome consists on a cystic dilatation of the fourth ventricle, an abnormally high tentorium and the agenesis of the cerebellar vermis. Cerebellar structures are involved in cognitive, emotional and behavioural processes. This syndrome is related to the development of psychotic and affective disorders, as well as obsessive-compulsive disorder. The clinical presentation is usually atypical, being characterised by an early onset, a family history of psychosis and a high prevalence of cognitive deficit and borderline intelligence. There are no specific drugs recommended for the treatment of these patients, which present a high rate of refractoriness to antipsychotic treatments, together with a greater sensitivity to its side effects. Depending on the clinical presentation it is advisable to focus on the most relevant symptoms to be treated and potential side effects in order to reduce polypharmacy.Image:Conclusions-The Dandy-Walker syndrome is related to a higher risk of psychiatric disorders-Clinical presentation is usually atypical and in early stages-There is a high rate of refractoriness and greater sensitivity to treatments-A specific pharmacological treatment is not recommended and it is recommended to avoid polypharmacyDisclosure of InterestNone Declared
Training curriculum psychiatry: an European perspective
Authors: Szulc A. 
Published: August 2024

AbstractTraining in psychiatry varies greatly from country to country in Europe - there are differences in the duration of training, the content of training, etc. Different perspectives on training will be presented, especially as far as common features are concerned. We will also present proposals and directions leading to a common European curriculum in psychiatry.Further work is needed in the direction of developing a European curriculum and organizing a European exam in psychiatry.Disclosure of InterestNone Declared
Psychiatryai.com: Real-Time AI Scoping Review (RAISR 4D) in Psychiatry and Mental Health with Live Real-World Evidence and CPD/CME for Psychiatrists
Authors: Naik P. , O’Leary D. 
Published: August 2024

IntroductionPsychiatryai.com was launched in 2021 and initial findings were published at EPA 2023. The portal is an advanced computing science project in Applied Data Science and Evidence-Based Healthcare for my MSc studies at the University of Oxford (Kellogg College). Artificial Intelligence (AI) and Data Science (DS) technology are utilised to analyse live Real-World Evidence (RWE) in Psychiatry and Mental Health from PubMed to provide CPD/CME online. A two-year review of the site and its performance will be presented to EPA 2024.ObjectivesTo develop and study an experimental real-time AI and DS platform in Global Mental Health and Psychiatry, to provide the latest RWE from PubMed for online education and training, and to report findings to EPA 2024 for peer review in Budapest. AI and misinformation are newly identified risks in healthcare (AI Safety Summit 2023). The site also aims to raise awareness about “Aiatrogenesis” to address this problem, with RWE and CPD/CME utilising AI and DS technology for the categorisation and meta-analysis of evidence, rather than the production of possibly misleading or false Generative AI evidence (Monteith et al. BJP 2023; 1-3).MethodsAs reported to EPA 2023 in Paris, a free open-code WordPress site was launched on the 22nd of November 2021 (Psychiatryai.com). The portal has been further developed and now features over 90k pages comprising 7GB of data with Cloudflare security and speed. Live evidence is collected into an open database and research articles are categorised into evidence nodes with AI. The results are presented in a real-time Evidence Matrix and Blueprint, creating 15-minute CPD/CME reflection modules. Data analytics from Psychiatryai.com with Google Analytics (G4A) along with platform insights from two years of development and research will be presented to EPA 2024. The site is conceptualised and designed to be viewed in an interactive VR headset.ResultsLive Citations380000+PubMed Articles Analysed with AI92142CPD/CME23002 hoursAlgorithms/Topics in Psychiatry291Open Data7 GBImage:Image 2:Image 3:ConclusionsPsychiatryai.com has successfully developed a novel AI and DS platform that incorporates the latest research in mental health and psychiatry, providing real-world evidence (RWE) for psychiatrists and healthcare professionals worldwide, along with CPD/CME online. This enhances hypothesis testing in research by presenting a related Evidence Matrix and Blueprint (from the last 365 days) for each evidence node on the site (RAISR 4D). These matrices provide a real-time visual table (8 x 8 / 64) of global research related to the evidence node in the preceding year. The site is VR-ready and has a special focus on AI and Psychiatry, Disaster and Traumatology Sciences, and Youth Mental Health. This project is dedicated to the memory of Dr Denis O’Leary and Dr Navin Venkatraman.Disclosure of InterestNone Declared
Comparison of Smartphone and internet addiction and Optical Coherence Tomography findings among University students
Authors: Atan Y. S. , Güzel Özdemir P. 
Published: August 2024

IntroductionInternet and smartphone use that reaches the level of addiction often leads to deterioration in the quality of life and functionality of individuals.ObjectivesIn our study, we aimed to investigate possible differences in retinal nerve fiber layer (RNFL) thickness and central macular thickness obtained by optical coherence tomography in internet and smartphone addiction.MethodsA total of 212 volunteer university students participated in our study. All participants were administered the Sociodemographic Information Form, Chen Internet Addiction Scale, Smartphone Addiction Scale-Short Form. Participants who completed the scales underwent routine eye examinations by experienced physicians in the ophthalmology outpatient clinic. Retinal nerve fiber layer (RNFL) thickness and central macular thickness were measured by optical coherence tomography (OCT).ResultsIn our study, internet addiction rate was 17% and smartphone addiction rate was 38.2%. RNFL thickness was found to be statistically significantly increased in the temporal superior and temporal inferior quadrants in those with internet addiction compared to healthy subjects (p<0.05). In smartphone addiction, RNFL thickness was found to be statistically significantly increased in the temporal inferior quadrant compared to healthy subjects (p<0.05). In the analyses comparing OCT measurements according to sex, it was found that nasal inferior (p<0.01) and global (p<0.05) quadrants in women and central macular thickness (p<0.01) in men were statistically significantly increased.The correlation analyses in our study revealed statistically significant positive correlations between internet addiction scale scores (p<0.01) and smartphone addiction scale scores (p<0.01), RNFL temporal superior quadrant thickness (p<0.01); smartphone addiction scale scores and RNFL temporal superior quadrant thickness (p<0.05).ConclusionsInternet and smartphone addiction are seen considerable rates among university students. In OCT measurements, RNFL thickness was found to be increased in various quadrants in patients with addiction. In addition, RNFL thickness was found to be increased in all quadrants in female gender and central macular thickness was found to be increased in male gender. Correlation analysis revealed that internet addiction scale scores, smartphone addiction scale scores, and RNFL temporal superior quadrant thickness were positively correlated. In addition, there was a positive correlation between smartphone addiction scale scores, and RNFL temporal superior quadrant thicknessDisclosure of InterestNone Declared
Experiences of commissioning mental health services for children and young people in England: qualitative study of commissioners’ perspectives
Authors: Trethewey S. P. , Allen K. A. , Matthews F. , Price A. , Newlove-Delgado T. 
Published: August 2024

IntroductionCommissioners play a central role in coordinating and planning CAMHS. However, there is little research on their experiences and approaches to understanding the needs of their populations. An improved understanding is likely to benefit the translation of research into practice, by ensuring research outputs meet the needs of key stakeholders and in optimising the sharing and use of data to improve services.ObjectivesTo better understand commissioners’ experiences of commissioning child and adolescent mental health services (CAMHS) and the challenges they face.MethodsBetween May to June 2023, we conducted twelve individual, semi-structured interviews with Integrated Care Board commissioners of CAMHS across England. We analysed data using framework analysis; a qualitative analysis method which involves systematically charting and organising data using a framework to generate themes.ResultsWe generated five core themes from the data: 1) ‘Reflections on role’ – how commissioners’ roles are informed by their background and ‘positioning’ within the system in which they work, 2) ‘Priorities and Tensions’ – the wider context in which commissioners work and how this may present challenges, 3) ‘Insights and evidence’– how commissioners develop an understanding of child mental health need and the different roles of quantitative and qualitative data, 4) ‘Children’s mental health in the limelight’ – commissioners’ perceptions of changes in child mental health in their populations, 5) ‘Responding to need’ – how commissioners are addressing the needs of their populations and the challenges they perceive.ConclusionsCAMHS commissioners are negotiating a complex and changing political, social and economic environment with differing priorities and pressures. Commissioners draw heavily on insights from providers and their role is shifting towards managing relationships and bringing the system together. A key challenge is balancing investment in prevention/early intervention versus specialist services needed by children with more severe and complex problems.Disclosure of InterestNone Declared
Cognitive activity of infants after severe brain damage (early habilitation/ rehabilitation)
Authors: Zakrepina A. , Martishevskaya D. , Sidneva Y. 
Published: August 2024

IntroductionOne of the forms of early comprehensive care for children after severe brain injuries is inpatient habilitation/ rehabilitation. Children receive help from a team of medical, psychological and pedagogical specialists. The process of special education consists mainly in the development of cognitive interest, because it is the basis of socialization.ObjectivesTo study cognitive activity in children who have suffered severe brain damage.Methodsobservation, pedagogical examination, psychiatric supervision.Materials36 children aged 1.2-1.8 years during hospital treatment.ResultsAccording to the results of the pedagogical survey, three groups of children were identified.Group 1 (11%): fixed gaze; emotional response to sound (smile); short-term eye tracking of an object; ability to touch an object and hold it for a short time; walking skill is formed.Group 2 (33%): short-term gaze fixation; reaction to sound by involuntary hand movements; lack of eye tracking of an adult’s face; lack of ability to touch or hold an object; walking skill is formed.Group 3 (56%): lack of fixed gaze; reaction to sound by shouting and increased motor activity; lack of ability to touch or hold an object; lack of walking skills.ConclusionsIndicative responses to an adult’s voice and face, eye tracking of an object, sensorimotor activity, and so on. these are indicators that show whether a child has cognitive activity. The rehabilitation team can rely on these indicators when choosing treatment and the content of the special educational process.Key words: early intervention, toddlers, organic damage of central nervous system, rehabilitation/ habilitationDisclosure of InterestNone Declared
Depression and Medierranean diet: analysis of the PREDIDEP randomised trial
Authors: Cabrera Suárez B. M. , Sánchez Villegas A. , Hernández Fleta J. L. , Molero Santos P. , Sosa J. T. R. 
Published: August 2024

IntroductionUnipolar depression is a growing global Public Health challenge. During last years, life factors such as diet, have been identified as a target for the development of adjunctive treatment that could reduce the rates of depression. The Mediterranean Diet (MD) is one of the most studied dietary factors that has been inversely associated with depression (Rahe et al. Eur J Nutr. 2014;53:997–1013). The PREDIDEP study is an ongoing secondary prevention trial aimed at assessing the effect of a MD enriched with extra virgin olive oil (EVOO) on depression recurrence (Sánchez-Villegas et al. BMC Psychiatry. 2019 Feb 11;19(1):63).ObjectivesThis study aims to assess the effectiveness of a remote Mediterranean diet–based nutritional intervention in the context of a trial of depression.MethodsThe PREDIDEP study is a 2-year multicenter, randomized, single-blinded trial designed to analyse the effect of the MD enriched with extra virgin olive oil (EVOO) on the prevention of depression recurrence. The inervention group received phone contacts with dietist and had access to web-based information, and the control group had usual care for depressed patients. The 14-item MD Adherence Screener (MEDAS) questionnaire and a semiquantitative food frequency questionnaire (FFQ) were collected by dietitians at baseline and at 1-year and 2-year of follow-up. We used mixed effects linear models to assess changes in nutritional variables according to the group of intervention. The trial was registered at ClinicalTrials.gov NCT03081065.ResultsWe observed that participants in the MD group increased their adherence to MD (between-group difference: 2.50; 95% CI 1.88-3.12; p<0.001) after one and two years (between-group difference: 2.57; 95% CI 1.93-3.22; p<0.001) of intervention compared with control group.
MEDAS questionnaire
Control, mean
(95% CI)
Intervention, mean
(95% CI)
Between group difference, mean (95% CI)P valueBaseline6.96 (6.54-7.39)7 (6.63-7.39)N/AN/A1 year7.2 (6.82-7.58)9.74 (9.3-10.18)N/AN/A1-year change0.23 (-0.19-0.65)2.74 (2.28-3.19)2.50 (1.88-3.12)<0.0012 years7.06 (6.66-7.46)9.68 (9.28-10.07)N/AN/A2-years change0.10 (-0.38-0.58)2.67 (2.24-3.1)2.57 (1.93-3.22)<0.001Calculated using mixed-effect models with center as random factor.P value between group intervention difference.N/A: not applicable.MEDAS: Mediterranean Diet Adherence ScreenerConclusionsWe found that this multifaceted remote nutritional intervention is a useful tool kit to maintain the quality of the diet according to the goals of the MD among patients at risk of depression.Disclosure of InterestNone Declared