bluuebunny/crossref_metadata_2025_split huggingface dataset:
Forced displacement and mental health problems in refugees residing in Quetta for decades
Authors: Sherzad S. , Khan H. A. , Sherzad T. 
Published: August 2023

IntroductionAs written by Warsan Shire, “no one leaves home until the home is the mouth of a shark”. UNHCR defines forced displacement as “displaced because of persecution, conflict, generalized violence or human rights violations"Objectivesto study the prevalence of common Mental health disorders among forcibly displaced people and comparing with the common mental health disorders among host community members.MethodsThe OPD of BIPBS in SPH and BMCH of Quetta attends 800+ patients per month the data of the OPD of both hospitals was collected for Jan-May 2022 and was analyzed to numerate both the host community and refugees. out of 4120 for 354 refugee patients identified using their POR card and for 3776 of host community using their CNIC, data was analyzed for the prevalence of mental health disorders among them.ResultsThis study states that Afghan Refugees presented to OPD services of BIPBS, 47% were diagnosed as MDD with/without psychosis, 19% with GAD, 5% diagnosed as BAD, 5% With schizophrenia, 4% as PTSD, 3% as migraine, 3% conversion disorder, 2% OCD, 1% somatoform disorder and 10% of them presented with other psychiatric disorders, while in host community 21% were diagnosed as MDD with/without psychosis, 24% as GAD, 12% as somatoform disorder, 10% as OCD, 8% as migraine, 7% as conversion disorder, 4% as BAD, 3% as Schizophrenia, 3% as MBD due to substance misuse and rest of 7% presented with other psychiatric disorders.ConclusionsThe conclusion of this study states that mental health disorders are more common among refugees than in other populations, the result of this study shows that there is a big difference in the prevalence of mental health disorders among displaced people and the rest of the population, some of the Mental health disorders are present in higher percentage among displaced people rather than among host community, while some other disorders are present in lower percentage among displaced people rather than among host community, this study also highlights that further studies are needed to determine, risk and protective factors within the host community.Disclosure of InterestNone Declared
A tale of excess: the curious case of the woman with 1447 emergency visits
Authors: Sagué Vilavella M. , Giménez Palomo A. , Àvila-Parcet A. , Fernández Plaza T. , Navarro Cortés L. , Oretega Hernández G. , Pons Cabrera M. , Tardón Senabre L. , Vázquez M. 
Published: August 2023

IntroductionFrequent attenders to emergency services are challenging and costly. We report the case of a woman in her mid-twenties who stands out for a total of 1447 emergency visits.ObjectivesOur primary objective was to describe the emergency visits of our patient. Secondary objectives were to assess her use of other healthcare services and to calculate her health expenditure.MethodsThis is a clinical case report. We reviewed the patient’s electronic medical records for sociodemographic and clinical data. We obtained detailed information of psychiatric ED visits (length, most frequent times and days) regarding the second most-visited hospital. We assessed the efficacy of hospitalizations in reducing ED visits with a paired samples t Test, comparing the number of visits 30 days pre- and post-hospitalization. We estimated the health expenditure using the regional public health system prices, including three direct costs: emergency visits, hospitalizations and ambulance transportation. We obtained written informed consent from the patient’s legal guardian.ResultsA 26-year-old woman from Barcelona (Catalonia, Spain), diagnosed with mild intellectual disability, made 1447 emergency visits between 2009 and 2021 (figure 1). 946 visits (65%) took place in psychiatric emergency departments (EDs), whilst 353 (24%) in non-psychiatric EDs and 148 (10%) in urgent primary care. She attended 24 hospitals (ranking number one the closest to the patient’s home, with 387 visits) and seven primary care centers, distributed across 17 cities in Catalonia. Most visits were self-referred, being the main presenting problems anxiety and instrumental suicidal behaviour. Saturday was her favorite day for hospital visits (24,1%), while she seeked care on Tuesdays much less often (4.5%). She made 73.5% of consultations between 1pm and 6pm, with a median length per visit of 2.8 hours (range 0.33-20.9 hours). Regarding other therapeutic approaches, she attended day hospitals, psychiatric rehabilitation programs and family therapy, among others (figure 2), for which she showed low adherence and scarce benefit. She had ten acute hospitalizations, interventions that did not reduce ED visits (t=-0.9835, p=0.36). Health expenditure reached 410.035€.Image:Image 2:ConclusionsThe most common definition of frequent attendance is a patient who has five or more visits per year. Many times, but not always, repeat visits are also inappropriate. The case we report is a grotesque example of both frequent and inappropriate attendance, which has been resistant to all kinds of interventions and has quality-of-care, financial and ethical implications. As of today, it is still a pending case. Maybe it is worth considering residential treatment?Disclosure of InterestNone Declared
A systematic review on the link between adverse childhood experiences (ACE) and later involvement in gang violence and extremist groups
Authors: Matei I.-C. 
Published: August 2023

IntroductionAdverse childhood experiences are common and have been linked to a number of physical illnesses, as well as socioeconomic problems. Moreover, it has been proven that ACEs can increase chances of people showing criminal behaviour. The question arises whether people with ACEs also have an increased chance of joining extremist groups or violent gangs.ObjectivesThe aim of this systematic review is to measure the ACE rates in violent extremists and gangs and to establish whether there is a pattern linking ACEs to violent extremist organizations and gangs.MethodsThe following databases were searched to retrieve relevant studies: the ProQuest Social Science database, Pubmed, Scopus. Eligible studies were articles of any study design that reported ACE rates in either extremists or gang members. Data was extracted and organized into a table and a quality assessment was performed using standardized tools (CASP and NHLBI). A narrative synthesis of the evidence was conducted. A meta-analysis could not be performed due to the heterogeneity of the studies.Results22 studies (eight on extremists and fourteen on gang members) were included. The studies varied in terms of research design, sample size, location and measured ACEs. Quality also varied across the studies. The prevalence rates were heterogenous and ranged from 0% to almost 100%.Physical abuse was the most addressed ACE (5 studies on extremists and 11 on gang members). Sexual abuse was the second most explored ACE (4 studies on extremists and 9 studies on gang members). Neglect and caregiver loss were also common ACEs, while the other ACEs were less represented in the two subpopulations. A comparison between the two subpopulations was difficult due to the differences in the studies.ConclusionsWhile overall ACE rates were high in the two groups and some ACEs were salient in the two subpopulations, quality of evidence varied across the studies. No solid ACE pattern across the studies could be found. Moreover, there were only two prospective studies on gang members and none on extremists, so a causal relationship between ACEs and involvement in violent gangs or extremist organizations could not be established. Future research should concentrate on studies of this design, as well as on improving the quality of the evidence.As ACEs are extremely common, researchers should also look beyond them when searching for causes of extremism or violent gang membership. Other negative events (bullying, racism) should also be explored.Disclosure of InterestNone Declared
Psychosomatic symptoms according to psychiatric diagnosis
Authors: Fernández Fernández R. , Fontecha Banegas L. , Suárez Pérez C. , Gómez Olmeda D. , Santos Carrasco I. D. L. M. 
Published: August 2023

IntroductionPsychosomatic symptoms are an important problem that is frequently presented in medical consultations. These symptoms are often associated with psychiatric disorders, especially depressive and anxiety disorders.ObjectivesTo study the association between anxiety disorders and psychosomatic symptoms in a sample of patients referred for pathology of functional origin.MethodsWe made a descriptive retrospective study through the use of electronic medical records. The symptom onset and diagnosis were obtained for all patients referred to outpatients for psychosomatic symptoms during a 1-year period. We performed χ² Tests to assess the association of the diagnosis with the occurrence of psychosomatic symptoms.ResultsThe only diagnosis that presented statistically significant association was anxiety disorder (χ² = 11.1; p<0.001).Anxiety disorderPsychosomatic symptomsNoSiTotalNoObserved3127319Expected30613.47319YesObserved11912131Expected1255.53131TotalObserved43119450Expected43119450ConclusionsOur study finds results that follow the line of other studies that show this association, such as Campo’s study which finds that functional somatic symptoms are consistently associated cross-sectionally with anxiety and depressive symptoms (Campo, 2012) or Imran’s study which finds that higher levels of somatization independently and significantly predicted higher anxiety (β=.37, p=.0001) (Imran et al., 2013). However, our results show no association with depressive disorders whereas frequent associations are found in the literature; for example, a recent meta-analysis found that neuroticism and depression had the strongest influence on the association of medically unexplained physical symptoms and frequent healthcare use (den Boeft et al., 2016). This lack of association is probably due to greater ease in identifying depressive disorders as the main pathology versus anxiety disorders.ReferencesCampo J. V. (2012). Annual research review: functional somatic symptoms and associated anxiety and depression--developmental psychopathology in pediatric practice. Journal of child psychology and psychiatry, and allied disciplines, 53(5), 575–592. den Boeft, M., Twisk, J. W., Terluin, B., Penninx, B. W., van Marwijk, H. W., Numans, M. E., van der Wouden, J. C., & van der Horst, H. E. (2016). The association between medically unexplained physical symptoms and health care use over two years and the influence of depressive and anxiety disorders and personality traits: a longitudinal study. BMC health services research, 16, 100Imran, N., Ani, C., Mahmood, Z., Hassan, K. A., & Bhatti, M. R. (2014). Anxiety and depression predicted by medically unexplained symptoms in Pakistani children: a case-control study. Journal of psychosomatic research, 76(2), 105–112.Disclosure of InterestNone Declared
Mental Health of University Students during the COVID-19 Pandemic – A Prospective Cross-National Study
Authors: Ochnik D. 
Published: August 2023

AbstractThis prospective study aimed to examine changes in mental health and differences due to educational status (ES) and country among young adults aged 20-40 from four countries during the COVID-19 pandemic in a three-month period.The total of 1714 participants (932 women): students (n = 321) and non-students (n = 519) aged 20-30, educated (n = 388), and non-educated (n = 486) adults aged 31-40 from Poland (n = 445), Slovenia (n = 430), Germany (n = 417), and Israel (n = 422) responded to online survey in February 2021 and May–June 2021. The used measurements were: Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire (PHQ-8).A repeated-measures two-way mixed-factor ANOVA was performed to examine changes over time, educational status (ES), and across countries for mental health indicators. The results showed stability over time in anxiety and depression while a small decrease in stress. Students scored significantly higher in stress, anxiety, and depression compared to non-/educated adults and in depression compared to non-studying peers. Participants from Poland and Germany scored higher in anxiety and depression than from Slovenia and Israel. Moreover, Polish participants reported the highest stress among all countries.The student population is more vulnerable to mental health issues than non-studying peers and adults with and without an academic degree, particularly in Poland and Germany.Disclosure of InterestNone Declared
The effect of psychological factors in pain intensity of patients with chronic pain conditions
Authors: Lyrakos G. N. , Ogah H. U. A. , Aslani E. , Spinaris V. 
Published: August 2023

IntroductionChronic pain can lead to depression, weariness, sleep problems, decreased physical and cognitive function, personality changes/shifts, and social interactions, all of which can lead to social marginalization and financial loss.ObjectivesThe aim of the present study was to investigate how psychological variables affects pain intensity.Methods193 patients diagnosed with chronic pain conditions, men 67 (34.8%) and women 126 (65.2%), participated in the study. This study used a quantitative between-subjects design to investigate the effect of psychological factors on pain intensity using the VAS scale. Analysis was performed with the use of SPSS23.ResultsThe analysis produces a coefficient of determination R2 = 0.448 – suggesting that a total 44.8% variability in pain intensity in the previous month can be explained by Age, Fear-avoidance belief about physical activity, Commitment to activity, fear avoidance beliefs about work and Pain catastrophizing magnification. A repeated measure analysis of variance shows that the regression model is statistically significant F (1, 187) = 30.381, p = 0.000. The predictors variables (Age, fear-avoidance belief about physical activity, commitment in activity, fear avoidance beliefs about work and pain catastrophizing magnification) are found to statistically significant t (187) = 9.627, p = 0.001, t (187) = 4.616, p = 0.001, t (187) = 2.982, p = 0.003, t (187) = -2.599, p = 0.010, t (187) = 2.253, p = 0.025 respectively.ConclusionsThe findings of this study are in agreement with previous literature and also provide insight into the major psychological factors correlates with pain intensityDisclosure of InterestNone Declared
Examination of the Effectiveness of a Universal Prevention Program to Enhance Understanding and Regulating Others’ Emotions for Children in Terms of Implicit and Explicit Affect
Authors: Uchida K. , Yamasaki K. 
Published: August 2023

IntroductionUchida & Yamasaki (2012, 2022) have developed a universal prevention program to enhance understanding and regulating others’ emotions for elementary and junior high school students. In recent years, affect and emotions are popular research topics in the domains of psychology and brain science. Most research has thus far focused on the effects of explicit affect on health and adjustment. However, an increasing number of studies have started to examine the effects of implicit affect on psychological outcomes. Although the program was developed for enhancing coping of explicit emotions for health and adjustment, the effectiveness needs to be examined also in terms of implicit affect.ObjectivesThe purpose of this study was to examine the effectiveness of this program in terms of implicit and explicit affect.MethodsParticipants were 6th-grade children in a public elementary school in Japan. The final sample was 61 children (32 boys and 29 girls). Participants completed a battery of two questionnaires just before (Time 1) and just after (Time 2) the intervention program. The questionnaires were the Implicit Positive and Negative Affect Test for Children (IPANAT-C) for assessing implicit positive and negative affect (IPA and INA) and the Japanese version of the Positive and Negative Affect Schedule for Children (PANAS-C) for measuring explicit positive and negative affect (EPA and ENA). The universal intervention program that was one of the programs we developed for children’s health and adjustment was implemented over four regular classes targeting all children in their homeroom classes.ResultsData were analyzed by 2 (pre-intervention and post-intervention periods) x 2 (boys and girls) analyses of variance (ANOVA) with the hoc tests using Holm corrections. First, regarding the EPA and IPA, there was a significant main effect of periods (Fs (1, 59) = 6.82 and 4.54, p < .05, respectively), revealing in the post hoc tests that they significantly increased at the post-intervention period. In contrast, regarding ENA and INA, there was no significant main effect of periods. Moreover, regarding EPA, there was a significant main effect of sex. No significant period x sex interactions were found in any affect.ConclusionsThese results revealed that the current program was effective in enhancing explicit and implicit positive affect. On the other hand, no significant effects were found in enhancing explicit and implicit negative affect. The necessity of future research that will examine the sustainability of the effectiveness of the program is discussed, along with several limitations.Disclosure of InterestNone Declared
Caring for Bierzo: A plan for improving motivation for health workers from Mental Health
Authors: Pelayo-Terán J. M. , Zapico-Merayo Y. , Vega-García S. , García-Llamas M. E. , Gutiérrez-Hervás Z. , Castro-Bayón A. 
Published: August 2023

IntroductionMotivation is an essential determinant of performance, particularly for those working in difficult conditions, such as the conditions facing many health workers. The relationship between motivation and performance is influenced by the health workers’ organizational environment and social context. Many intrinsic and extrinsic factors may influence the impulse to head for and maintain and effort to achieve the objectives of the organization these may include acknowledgements, status and incentives, but also auto efficacy perception, personal growth, welfare and physical and mental health.In the last years and particularly during COVID-19 pandemic health organizations have suffered a crisis of lack of motivation and high turnover rates in health professional, particularly among highly specialized professions.Objectivesto develop a quality program to promote mental health and motivation, detect risk of mental disorders and improve communication skills in the health workers of the Health Area of El Bierzo (GASBI).MethodsA committee with four members form the psychiatry and mental health service, two from the Quality and Security Unit and 1 from the Occupational Risk Prevention Service analyzed the GASBI with a SWOT-CAME matrix analysis. Actions to be implemented were ordered with a Hanlon method score according to a representative sample of the employees of GASBI.ResultsThe CAME matrix recommended an offensive strategy, given a number of strengths and the opportunities for an administration sensible to new paradigms. The program proposed included 6 main lines (evaluation, access to mental health consultation, prevention of suicide behavior, resilience group, communication and relation groups and a group of actions to improve motivation and prevent burnout called “10 actions to dream together”, displayed in figures 1 and 2. The Hanlon classified suicide behaviour as the highest priority (score: 16,25 points), mental disorders the second (score: 13.75), then fatigue (13 p), burnout and resilience (12p) and the less prioritary was motivation (7 points). The project was displayed in a canvas business model (figure 3)Image:Image 2:Image 3:ConclusionsMental health, fatigue, burnout and motivation of health workers is a complex problem that affect health organizations and quality of services. Mental Health service have an important role in the promotion of wellbeing and prevent burnout in the health system.Disclosure of InterestNone Declared
Implementing Individual Placement and Support (IPS) program of supported employment in Finland: Experiences on integrating the program in psychiatric care
Authors: Appelqvist-Schmidlechner K. , Sipilä N. 
Published: August 2023

IntroductionMental health problems increase the risk for long-term sick leaves, early transitions to disability pensions and unstable career paths. Individual Placement and Support (IPS) is an evidence-based program integrated into psychiatric care aiming to support individuals with serious mental illness in finding employment. One key element in the implementation of the program is that the program is adequately integrated into the psychiatric care. However, knowledge on implementation challenges as well as best practices experienced by the practitioners, especially from the perspective of professionals in psychiatric care, is limited.ObjectivesThe Finnish Individual Placement and Support Evaluation Study (2020-2023) aims at investigating the implementation, feasibility as well as perceived benefits and outcomes of IPS program. The present study focuses on experiences on implementation of the program in the psychiatric care.MethodsBoth quantitative and qualitative data from different stakeholders have been and will be collected. The data collection will be finished at the end of 2022. For the present study, data among professionals (psychiatric nurses and psychiatrists) in the psychiatric care has been and will be collected using questionnaires (n=58) and individual interviews (n=17). Among IPS employment specialist delivering the program, the data have been / will be collected using focus group interviews (6 focus groups, n=29) and workshops.ResultsThe preliminary findings of the study show that the key elements in successful implementation of the IPS program into the psychiatric care are sufficient information about the program among professionals in the psychiatric care, adequate flow of information between IPS employment specialists and psychiatric care (including regular meetings) and facilities promoting the co-operation (including physical space and common information system). Majority of professionals in psychiatric care reported that the client-related communication with the IPS employment specialist had been active (81%) and adequate (76%).ConclusionsSuccessful implementation and integration of the IPS program into psychiatric care requires seamless cooperation and communication between mental health professionals and IPS employment specialists, especially in cases when the IPS employment specialists do not have access to patient information due to confidentiality legislation.Disclosure of InterestNone Declared