bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental Health Impacts of Wildfire, Flooding and COVID-19: on educators: A Comparative Study
Authors: Agyapong B. , Eboreime E. , Shalaby R. , Pazderka H. , Obuobi-Donkor G. , Adu M. , Mao W. , Oluwasina F. , Owusu E. , Greenshaw A. , Agyapong V. 
Published: August 2023

IntroductionFort McMurray, a city in northern Alberta, Canada, has experienced multiple traumas in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Eighteen months after the wildfire, major depressive disorder (MDD), generalized anxiety disorder (GAD), and Post Traumatic Stress Disorder (PTSD) symptoms were elevated among school board employees in the city.ObjectivesThis study aimed to compare employees of the school board and other employees of Fort McMurray in respect to the impact the 2016 wildfires, the 2019 COVID pandemic, and the 2020 floods had on their mental health.MethodsA quantitative cross-sectional survey was conducted in Fort McMurray from 24 April to 2 June 2021. Online questionnaires were administered through REDCap and were designed to capture socio-demographic characteristics, clinical as well as wildfire, COVID-19, and flooding-related variables. Mental health outcome variables were captured using self-reported standardized assessment scales. Data were analysed with descriptive statistics, Chi-square/Fisher’s Exact tests, and binary regression analysis.ResultsOf the 249 residents who accessed the online survey, 186 completed the survey, giving a response rate of 74.7%. Of these respondents, 93.5% (174) indicated their employment status and were included in the Chi-square analysis. Most of the respondents were female (86.2%, (150)), above 40 years (53.4%, (93)), and were in a relationship (71.3%, (124)). The prevalence values for MDD, GAD and PTSD among respondents were 42.4%, 41.0, and 36.8%, respectively. There was a statistically significant difference between employees of the school board and other employees with respect to likely PTSD prevalence (28% vs. 45%, respectively, p < 0.05), although with other factors controlled for, in a binary logistic regression model, employer type did not significantly predict likely PTSD.ConclusionsThe study has established that likely PTSD symptoms were significantly higher in other employees compared to those of school board employees. Greater exposure to the traumatic events and a greater perceived lack of support from other employers might have contributed to the significantly higher prevalence of PTSD in other employeesDisclosure of InterestNone Declared
Associations between occupational stress and working conditions in a shoe and leather company
Authors: Rmadi N. , Sellami I. , Jmal Hmmami K. , Masmoudi M. L. , Hajjaji M. 
Published: August 2023

IntroductionOccupational stress (OS) is one of the major health hazards of the modern workplace. Poor working conditions are major occupational stressors and have a great impact on employees’ well-being.ObjectivesThis study aimed to assess the associations between OS and working conditions.MethodsWe conducted an exhaustive cross-sectional study among workers in a shoe and leather company. We used the Job Demand Control model of Karasek to measure occupational stress. Workers were asked about their perception of working conditions such as the noise, heat generated by certain tools and machines, fabric smells and uncomfortable workspaces. Data were analysed using SPSS software.ResultsThe study involved 310 workers (58 men and 252 women) with an average age of 34.2 ± 10.3 years. Workers reported different concerns about working conditions. The noise was the major complaint reported by 73.7% of workers. Workspaces were uncomfortable according to 48.7% of workers. Job strain and isostrain situations were found in 56.5% and 44.5% respectively. Unpleasant smell from leather products was associated with job strain (p= 0.004, OR = 1.9, 95%; CI [1.2-3.1]) and isostrain (p= 0.043, OR = 1.6, 95%; CI [1.03-2.6]) situations. Heat generated by certain tools and machines was associated to isostrain situation (p= 0.009, OR = 2.7, 95%; CI [1.2-5.9]). Perceiving workspaces as uncomfortable was associated with isostrain situation (p= 0.004, OR = 1.9; 95%; CI [1.2-3.09]).ConclusionsWorking conditions have an important impact on workers’ mental health. Thus, improving job conditions is a key way to improve workers’ health and well-being.Disclosure of InterestNone Declared
Dissociative Identity Disorder: a case of three Selfs
Authors: Bravo J. , Canelas da Silva I. , Buta F. 
Published: August 2023

IntroductionThe DSM-5 defines dissociation as “disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior”. The disorders in this group include depersonalization/derealization disorder, dissociative amnesia, and dissociative identity disorder, the last being a controversial entity.Dissociative disorders are associated with elevated levels of disability, impaired quality of life, high economic cost, and a significantly increased risk of suicide attempts.ObjectivesIn this work we present the case of a 21-year-old man that was assisted in the Emergency Room with dissociative symptoms. We intend to do a non-systematic review on the subject of dissociation symptoms, the psychiatric disorders in which they are present, identified risk factors, how to access the psychopathology features and the recommended treatment to best address them.MethodsFor a comprehensive approach of this subject we proceeded to a non-systematic review in PubMed using the following keywords “dissociation”, “dissociative identity disorder” and “dissociative disorders”.ResultsIn this work we present the case of a 21-year-old man assisted in the Emergency Room describing dissociative symptoms that were suggestive of Dissociative identity disorder. He referred out-of-body experiences and a sense that he was not controlling his actions while self-injuring himself and being aggressive towards his family. He described “three Selfs”: the “Normal Self”, the “Suicidal Self” and the “Bad Self”.Symptoms of dissociation are present in a variety of mental disorders namely depression, anxiety disorders, posttraumatic stress disorder, borderline personality disorder and eating disorders.Dissociative disorders appear to be linked to trauma, interpersonal stress, and strongly associated with a history of chronic child abuse. An association with alexithymia, depression and suicidality were also found. Some studies found structural and functional abnormalities, particularly a reduction in grey matter volume in limbic system structures, a dysregulation of prefrontal–limbic circuitry and dysfunction of the hypothalamic–pituitary-adrenal axis.Psychotherapy appears to be the cornerstone of treatment for dissociative disorders, namely Cognitive-Behavior therapy and Eye-movement desensitization and reprocessing.ConclusionsSymptoms of dissociation are not only present in dissociative disorders, but they may be present in almost all mental disorders. The evaluation of possible dissociative symptoms should be a part of every psychopathological assessment. There is a need for further studies to better understand this diagnostic entity and improve the therapeutic intervention.Disclosure of InterestNone Declared
Intranasal Esketamine administration in catatonia: a case report.
Authors: Romay J. , Sevilla C. , Hernandez P. , Lastra I. , Isidro G. , Cayon L. , Cortez G. , Anabitarte O. , Ijalba P. , Gomez Revuelta M. 
Published: August 2023

IntroductionCatatonia is a complex psychomotor syndrome that often goes unrecognized and, consequently, untreated. Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications. Benzodiazepines and electroconvulsive therapy (ECT) are the most widely studied treatment methods. However, no uniform treatment method has yet been brought forward and no previous attempts to treat catatonia on a patient suffering concomitant major depressive disorder (MDD) with NMDA receptor antagonists have been documented so far.ObjectivesTo describe the unknown and novel management of catatonia and MDD with intranasal esketamine, a NMDA receptor antagonist.MethodsA 55-year-old woman with a diagnosis of long-standing recurrent major depressive disorder who was admitted to the psychiatric inpatient unit of UniversityHospital Marqués de Valdecilla (Santander, Spain) suffering a complex catatonic, mutative state framed on a severe MDD. Different ineffective therapeutic interventions were deployed during the course of her illness. After failing to improve under conventional pharmacological treatment and ECT, and given the complexity of peripheral venous access on this patient (which disabled the option for iv ketamine use), we decided to initiate compassionate treatment with intranasal esketamine.ResultsIntranasal esketamine was effective in the resolution of patient’s complex catatonic state. Clinical response from catatonia was observed after 6 intranasal esketamine administrations (2-week follow-up), reaching full catatonia and MDD remission after 12 sessions in absence of significant adverse eventsConclusionsEsketamine showed promising effectiveness for the treatment of catatonia in the context of MDD, although further research on this topic is needed.Disclosure of InterestNone Declared
Ethics in mental health research
Authors: Pinto da Costa M. 
Published: August 2023

AbstractThe boundaries between innovative clinical practices and research-related experimentation can be difficult to distinguish. Whilst mental health research has increased remarkably over recent decades, ethics is required to maintain and improve the standards of mental health research. Ethics and science can be seen as opposing forces with different aims championed by different people. However, ethics should not be a barrier to scientific advancement, but rather as the way that mental health research can be conducted with broader societal support, with the expectation of bringing wider benefit to people with mental illness. Scientific advancements may also lead to novel ethical problems and raise questions in relation to oversight responsibilities. Mental health research faces several unique ethical challenges. This presentation will provide an overview of the ethical issues linked with mental health research.Disclosure of InterestNone Declared
AIDS dementia complex and neuropsychiatric symptoms : a case report
Authors: Fernández Fernández R. , del Sol Calderón P. , Izquierdo de la Puente Á. , Rodríguez Rodríguez A. 
Published: August 2023

IntroductionHIV infection presents complications that may include neuropsychiatric symptoms and whose management is important to avoid misdiagnosis and mistreatment.ObjectivesThis case aims to highlight the importance of assessing HIV comorbidity in patients with psychiatric onset pathology.MethodsCase report and literature review.ResultsWe present the case of a patient diagnosed with HIV in 1985, who after 20 years of disease with irregular adherence begins to present delusional ideation of harm and self-referential, control experiences, thought diffusion phenomena, and possible auditory hallucinations, with poor evolution despite the establishment of numerous antipsychotic treatments, which evolves over the years towards a confabulatory character and with progressive neuropsychological deterioration. After numerous admissions, and despite several treatments, the patient developed over time memory failures, bradypsychia, gait disturbances, and difficulties in self-care, which further aggravated his condition by hindering therapeutic adherence, which ended with the patient’s chronic institutionalization. Diagnosis was AIDS dementia complex.ConclusionsHIV hardly replicates in the central nervous system but generates antigenemia which, in turn, generates an inflammatory infiltrate that can cause diffuse involvement, predominantly subcortical and limbic system. Usually, the dementia-AIDS picture is insidious and develops in patients with poor control of the primary disease. It is recommended to optimize antiretroviral therapy and neuroprotective agents, as well as symptomatic treatment by psychiatry.Disclosure of InterestNone Declared
BORDERLINE PERSONALITY DISORDER: ATTITUDES OF PSYCHIATRY AND FAMILY MEDICINE
RESIDENTS
Authors: Olfa B. , Sana O. , Syrine A. , Rim F. , Najeh S. , Imen G. , Nada C. , Jihen B. T. , Lobna Z. , Manel M. B. , Mohamed M. 
Published: August 2023

Introduction
Patients with Borderline Personality Disorder (BPD) require a significant amount of
time and effort on the part of general practitioners and psychiatrists, resulting in longer
visits and complex medical records, with a poor resolution of both physical and mental
symptoms.
These patients are likely to express feelings of anger and violence, compared to other
patients which makes it difficult to deal with them.

Objectives
To determine attitudes toward patients with BPD among psychiatry and family medicine
residents in Tunisia. To understand in addition the challenges that these professionals
encounter in their everyday practice

Methods
An online anonymous questionnaires was distributed through social networks to
psychiatry residents and family medicine resident.
The attitudes of health professionals towards people with BPD was used to assess
clinicians’ attitudes towards people with BPD.

Results
Thirty three clinicians were in the study. A high proportion of respondents (81.8%)
were females .The age of the participants ranged from 25 to 34 years, with an average age of
28 years and 3 months (SD = 2.23).In our study 34% reported that they often see patients with
borderline personality .The half of the participants (51.5%) reported a feeling being on
guard when meeting borderlines while 36.4% were empathetic and neutral. The feeling of anger
and frustration was reported with 12.1 % of the participants.
The most frequent cause of these feelings was the difficulty of taking care of
patients with BPD.
The majority of the participants (51.5%) reported avoiding working with them. However,
only 39.4% reported asking a colleague to replace them in their follow-up.
The results of Attitudes of health professionals towards people with BPD Scale
indicate that clinicians generally present a positive attitude towards patient BPD with a
mean score 94.94(SD=18.60)

Conclusions
Working with patients with BPD can be challenging. Professionals’ attitude can create
obstacles to effective communication and successful treatment.
Therefore, all clinicians should receive more specific training to be able to deal
with this condition.

Disclosure of Interest
None Declared
Challenges in the Borderline Personality Disorder diagnostic in clinical practice in community: results of a pilot study
Authors: Chumakov E. , Charnaia D. , Petrova N. 
Published: August 2023

IntroductionBorderline personality disorder (BPD) has a significant presence in outpatient psychiatric practice worldwide, but data on the clinical features of patients with BPD in Russia are limited. Clinicians experience a number of difficulties in diagnosing BPD, which is also due to the high comorbidity of BPD with other mental disorders (affective, anxiety, other personality and addictive disorders).ObjectivesThe aim of this pilot study was to investigate clinical characteristics of mental health care for patients с BPD in real clinical practice in community in Saint-Petersburg, Russia.MethodsFifty patients (72% female; n=36; mean age 22.4±4.3) who were treated in an outpatient community care were included in the study. Diagnosis was made according to the ICD-10 criteria (F60.31), as it does in clinical practice in Russia. Research methods included a clinical-catamnestic method.ResultsThe age of onset of BPD symptoms was 14.9±2.7. It was found that 50% of patients had previously received inpatient (20%, n=10) and outpatient (30%, n=15) psychiatric care unrelated to the current mental condition, that is, not due to the BPD. 16% of patients (n=8) referred for the first time for psychiatric care in adolescence. The vast majority of patients (86%; n=43) were not diagnosed with BPD when they first consulted a psychiatrist. Prior to the diagnosis of BPD, patients were diagnosed with mental disorders due to organic brain injury (4%), affective disorders (44%), schizophrenia spectrum disorders (12%), anxiety disorders (20%) and other personality disorders (6%). On average, it took 7.5±4.0 years from the date of first psychiatric assessment before the diagnosis of BPD was confirmed. At the time of inclusion in the study, patients were diagnosed with the following comorbid mental health conditions: affective disorders (12%), anxiety disorders (6%), eating disorders (4%), and addictive disorders (2%).ConclusionsThe hypodiagnosis of BPD in the early stages of the disorder has been identified, making it challenging to obtain high quality mental health care in a timely manner. The frequent comorbidity between BPD and other mental disorders has been confirmed. The study demonstrates the relevance of introducing programs (including education) to improve the diagnosis and study of comorbidity of BPD in real clinical practice. The pilot study results provide the basis for a project to investigate approaches to differential diagnosis and evaluation of treatment strategies for patients with BPD.Disclosure of InterestNone Declared
Mechanisms of the formation of psychological disadaptation in combatants with a distinction based on the signs of adjustment disorders and PTSD
Authors: Mykhaylov B. , Mishiev V. , Grinevich E. , Omeljanovich V. , Kudinova O. 
Published: August 2023

IntroductionContemporary for combatants with signs of adjustment disorders (AD) consists of “distorted” thoughts about the displacement of the value of one’s role, the loss of a certain significant position. This can be seen from the analysis of complaints about the feeling of anxiety, tension, asthenia, mood swings, lack of emotional regulation and the assessment of well-being criteria.It is important to understand what is a preventer of maladjustment, and what is a predictor of the formation of psychological adaptation disturbances in combatants with a distinction based on the signs of AD and PTSD.ObjectivesBased on the analysis of violations of the psycho-emotional sphere, peculiarities of perception of the social environment, understanding of one’s role in traumatic events, and personal adaptation potential, predictors and preventers of violation of psychological adaptation among combatants are determined.MethodsThe clinical investigation based on psychiatric examination with the narrative motivation interview,psychological examination by Mississippi Scale for Combat-Related Posttraumatic Stress Disorder.ResultsThe predictors of impaired psychological adaptation in combatants withAD: Low indicators of moral normativity, which structure thoughts and help in the interpretation and analysis of negative experienced events of a stressogenic level.Preventers of violation of psychological adaptation in combatants with AD:Communicative potential, which lies in the structure of personal adaptation potential. This indicator indicates the presence of a need in the social environment and opportunities for realization, that is, as a resource of the individual. The ability to receive from the social environment a sense of support, reinforcement of self-esteem, motivation for activity, determination of the goals of future projects. Predictors of impaired psychological adaptation in combatants with PTSD: Low communicative potential, which, under the significant influence of stressogenic factors, isolates from close social interaction and does not allow family members to influence the emotional state. Family support is diminished and perceived as a trigger for anger. Fixation on the intensity of emotional experiences, maintaining the tone of negative manifestations, as a form of receiving punishment. Keeping under control one’s values in the life system and an attempt to reorient oneself to the future.ConclusionsRelying on preventers as the resource base of the personality of combatants and predictors as targets of psychocorrective intervention in the tasks of the medical and psychological rehabilitation program, algorithms for further psychocorrective intervention were determined.Disclosure of InterestNone Declared
Caesarean section and post traumatic stress disorder
Authors: Chebli H. , Chtibi M. , Azraf F. , Laboudi F. , Ouanass A. 
Published: August 2023

IntroductionChildbirth can be a very painful experience, especially vaginally. It can have many complications. The obstetrical complications of caesarean section are well studied but its psychological complications are little mentioned. Most women recover quickly after giving birth, but others seem to have more difficulty. Researchers have attempted to identify perinatal risk factors for the development of post-traumatic stress disorder in parturients and caesarean section seems to be one of the predictors.ObjectivesThe objective of our study is to detect post traumatic stress disorder in women after vaginal delivery.MethodsThis is a cross-sectional descriptive study conducted among women from the general population who have given birth vaginally. The information was collected using a questionnaire distributed on social networks. Symptom severity was quantified using the PTSD checklist for DSM-V (PCL-5).PCL-5 is a 20-item self-assessment that measures the 20 DSM-5 symptoms of PTSD. She rates each symptom from 0 (not at all) to 4 (extremely). The score varies from 0 to 80. A threshold of 33 allows screening for post-traumatic stress disorder.Results61 women took part in this study, 81.5% of whom gave birth vaginally between the ages of 20 and 30.70.3% of the participants gave birth vaginally once, 44.4% twice and 7.3% of the women in our sample had a caesarean three times.Regarding the indication of the high way in our sample: the narrowing of the pelvis and fetal distress were in 22.2%. Exceeding term was in 18.5% of cases.In our sample, 59.3% of the women had planned their vaginal delivery and 40.7% had given birth urgently.Regarding the results of the PCL-5 scale (PTSD checklist for DSM-V), the score varies between 0 and 48 with a median score equal to 12. 3.7% of the participants had a score greater than 33.ConclusionsPost-traumatic stress disorder can accompany childbirth, especially when it is high and in an emergency. Postpartum post traumatic stress disorder affects the mother-child relationship and can be complicated by depressive disorder. Medical monitoring of pregnancy, good medical and family support for the parturient and preparation for childbirth are necessary to better start the maternity experience.Disclosure of InterestNone Declared