bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge Attitudes and Sense of Self-Efficacy of Primary Education Teachers towards Students with Insulin-Dependent Diabetes Mellitus
Authors: Detsis D. , Vlachou E. , Adamakidou T. , Zartaloudi A. 
Published: August 2023

IntroductionThe positive attitude towards students with Diabetes Mellitus type 1(DM1) and the teacher’s knowledge seem to be important conditions both for the practical support of children with type 1 ED in primary education and for the self-efficacy of teachers in the school context. Self-efficacy involves the belief that a person has the ability to create change through personal actions.ObjectivesTo investigate the level of knowledge of Primary Education teachers about DM1, their attitudes towards students with insulin-dependent diabetes, as well as their levels of self-efficacy in the management of diabetes in the school environment.MethodsThis is a cross-sectional study, where the sample consisted of 150 teachers working in Public Primary Schools of Athens, the capital of Greece. The following questionnaires were used to collect the data: (a) socio-demographic characteristics questionnaire, (b) primary education teachers’ knowledge and attitudes questionnaire about insulin-dependent diabetes, and (c) the generalized self-efficacy scale.Results24.7% of participants were male and the mean age was 43.79 (±10.11). The average percentage of correct answers to the knowledge questionnaire was 86.00 (±9.01), also, the average score of perceptions about the role of the school nurse was 90.53 (±9.39), for the role of students with DM1 89.17 (±11.42), for the readiness of teachers/educational system to manage students with DM1 48.10 (±13.22), and of the self-efficacy was 30.71 (±13, 67). The questions with the lowest percentage of correct answers were: “What is the normal range of blood sugar values when we are fasting?” (62.70%) and “If you find a child with DM1 unconscious what should you do immediately?” (52.70%). The percentage of correct responses was found to have a positive statistically significant correlation with self-efficacy score (p=0.05), years of service (p=0.003), age (p=0.014), teachers who had at some point students with DM1 in their classroom versus those who did not (p=0.045).ConclusionsExperienced and qualified staff could effectively support students not only practically by assisting them with daily activities but also by creating an environment based on understanding and acceptance.Disclosure of InterestNone Declared
Appropriate Therapeutic Disclosures in Improving Client Engagement in Mental Health Management
Authors: Myers L. 
Published: August 2023

IntroductionAs psychiatrists, we are taught not to disclose and to present a blank canvas to the clientShould mental health professionals be reconsidering this stance if aiming to effectively manage their clients who live in a world that promotes vulnerability and lived experience as powerful therapeutic strategies?ObjectivesPromote mental health and remove the shame and stigma limiting client engagement by advocating for ‘real’ psychiatristsMethods-Discuss therapeutic disclosure and its history-The impact of social media and current trends in mental health promotion-Suggestions for improving client engagement through reclaiming the expert role in mental health promotion and the value of sharing lived experience within professional boundaries. ToResults-Clients improve communication and openness-Mental health engagement promoted and encouragedConclusionsClients respond favourably to psychiatrist vulnerability and authenticity with therapeutic disclosuresDisclosure of InterestNone Declared
Weight gain as a secondary effect of Olanzapine, and its interference in treatment adherence: a case report.
Authors: Setién Preciados P. , Arroyo Sánchez E. 
Published: August 2023

IntroductionOlanzapine is a second generation antipsychotic that is approved for the treatment of schizophrenia, bipolar disorder type 1 as monotherapy, or as an add-on to lithium or valproate (manic or mixed episodes), and it is also used off label for acute anxiety, insomnia… It is one of the most effective antipsychotics but concerns remain due to its significant metabolic adverse effects. Olanzapine has one of the highest rates of weight gain among all antipsychotic drugs, which challenges patient’s adherence to treatment.ObjectivesReview how much influence Olanzapine has on weight gain, its influence in treatment adherence and alternatives in clinical practice.MethodsPresentation of a patient’s case and review of existing literature, in regards to Olanzapine and its repercussions on weight gain and the old and new alternatives available right now.ResultsOlanzapine is an effective antipsychotic, however, it causes secondary effects that complicate treatment, especially weight gain. In the case presented, the patient does gain weight with Olanzapine and adherence is compromised. In these cases, professionals try to look for alternatives, either to try another drug or use adjunct treatment. In this patient, a change to lithium was made. In the last few years, adjunct treatment has gained traction, like for example: metformin and topiramate. The latest discovery in this matter are opioid antagonists: single dose oral tablet Olanzapine/samidorphan.ConclusionsEven though Olanzapine is one of the most effective antipsychotics and medications in mental health, its impact on patients’ weight hinders treatment continuity. The use of other already known medications and the appearance of new ones, that reduce weight gain probability, are the possible ways forward.Disclosure of InterestNone Declared
Quality Improvement Project - Initial survey of a new Mental Health of Intellectual
Disabilities Service established in Ireland in January 2022
Authors: Curtin A.-M. , Fitzgerald B. 
Published: August 2023

Introduction
A new mental health service specialising in intellectual disabilities in Ireland was
set up in January 2022. Its current compliment of staff includes is a Consultant
Psychiatrist, Trainee Psychiatrist, Social Worker and Administrator. The current National
Directive in Ireland is to prioritize Mental Health of Intellectual Disabilities
services.

Objectives
The aim of the project is to establish the current baseline level of diagnostics and
interventions within the new service. Our aim is to develop this service by implementing and
following the gold standard guidelines and determine what extra resources does the service
need.

Methods
The first fifty case notes of patients assessed by the new service were inspected. The
reviewer looked for evidence of the following clinical descriptions:Diagnosis of Intellectual
Disabilities and its severity; Mental Capacity; Psychiatric Diagnoses; Physical health
diagnoses; Medications and evidence of a Positive Behavioural Support Plan to manage complex
challenging behaviours.

Results
The fifty patient audit contained 38 (76%) men and 12 (24% women) . One patient had
Mild Intellectual Disabilities (ID), 39 (78%) had Moderate ID and 10 (20%) had Severe ID. All
patents were very vulnerable and had limited or lacking Mental Capacity. Common diagnoses of
the following were recorded in the following numbers and percentages; - Autism diagnosis 30 (
60% ); Epilepsy 19 (38%); & Down Syndrome 9 (18%). A Formal Psychiatric diagnosis was
identified in 26 (52%) of patients. Challenging Behaviour (severe and complex) was identified
for 41 ( 82%) of the patients. The full breakdown of psychiatric diagnoses was ‘Psychotic
illness’ – 9 (18%); Anxiety – 7(14%); Bipolar Affective Disorder 5 (10%): Depression – 4(8%);
Attention Deficit Hyperactivity Disorder (ADHD) 3 (6%); Obsessive Compulsive Disorder (OCD) –
2(4%); Dementia – 2(4%): Post Traumatic Stress Disorder (PTSD) – 1 (2%); &
Schizoaffective Disorder 1(2%). A Positive Behavioural Support plan (PBS) was available to
support 33 (66%) of patients.
42 (84%) of patients were prescribed antipsychotic medication. 12 (24%) were
prescribed more than one antipsychotic. 20 (40%) were prescribed an antipsychotic without a
formally documented diagnosis of a psychotic disorder. 12 (24%).

Conclusions
The results of this first survey highlight areas in which the service can be
improved. The service has requested funding for a Community Nurse and a Psychologist.
Psychological evaluations and Positive Behavioural Support plans are essential for people
with complex challenging behaviours. A Community Nurse should assist with Health Promotion
and help supervise patients requiring Depot Antipsychotic medication or Clozapine. We also
plan to set up a joint clinic with the Consultant Neurologist on a regular basis.

Disclosure of Interest
None Declared
Do we have an “anti-stigmotic”? – Addressing Mental-Illness Related Stigma as the main issue
Authors: Cabaços C. , Andrade J. , Pocinho F. , Carneiro M. , Santos G. , Loureiro D. , Macedo A. 
Published: August 2023

IntroductionFor people with mental illness, internalized stigma, also referred to as self-stigma, is characterized by a subjective perception of devaluation, marginalization, secrecy, shame, and withdrawal. It has many adverse effects on individual’s psychological well-being and clinical outcomes. The iatrogenic effects it has during psychotherapeutic treatment can significantly reduce utilization of mental health care services, reduce quality of life and increase avoidant coping. Overall, internalized stigma is considered a risk factor for poorer mental health prognosis. Although some interventions have recently been developed to specifically intervene on this target as part of psychological recovery goals over the course of treatment, most clinicians are not yet aware or empowered to correctly address this.ObjectivesDescription of a clinical case illustrating the relevance on addressing internalized mental illness related stigma during the recovery process.MethodsClinical case report and review of the literature on the subject.ResultsWe present the case of a 47-year-old female patient, C.S., single, graduated in social work (currently unemployed), who was admitted at the Psychiatry Day Hospital, where she was referred by her Psychiatry Assistant because of abulia, social withdrawal and isolation, depressed mood, thoughts of shame, guilt and self-devaluation and work incapacity. She had been admitted in the Psychiatry ward one year earlier for a first psychotic breakthrough, presenting persecutory and grandiose delusions and auditory hallucinations. After three weeks of inpatient treatment with antipsychotics, a full remission of the symptoms was achieved, without any posterior relapse. Before that first psychotic episode, the patient had been taking anti-depressive medication (escitalopram 20 mg id) for many years, prescribed by her General Practitioner, for mild to moderate depressive symptoms. After being discharged from the Psychiatry ward, C. kept following an outpatient treatment with anti-depressives and behavioural activation-based psychotherapy. She started to believe she was mentally ill and therefore weak, uncapable, and less deserving than her peers or her previous self. These self-stigmatizing ideas were enhanced by the lack of family support and the beliefs that were fostered by her mother, with whom she started to live after the hospitalization. These factors led to a dysfunctional internalization of an illness behaviour, jeopardizing the patient’s ability to reach full recovery.ConclusionsThis case reinforces the importance of targeting mental illness related stigma during the recovery process. Also, involving the family is of extreme importance to achieve support and address shared beliefs and the interchange between social and internalized stigma.Disclosure of InterestNone Declared
Evaluation of the effectiveness of psychosocial treatment of patients with schizophrenia at different stages of its rendering
Authors: Mitikhin V. , Tiumenkova G. ?. , Solokhina T. , Alieva L. 
Published: August 2023

IntroductionCurrently, there is an active introduction of modern types of psychosocial treatment (PST). At the same time, an important direction is the evaluation of the effectiveness of PST, the identification of factors affecting it, which determines the urgency of research in this area.ObjectivesTo evaluate the effectiveness of psychosocial treatment of patients with schizophrenia at different stages of psychiatric care; to build regression models to identify factors that influence the effectiveness of psychosocial treatment.MethodsClinical and psychopathological, statistical, as well as a battery of tests: PANSS, CGI; Drug Attitude Inventory (DAI, Hogan T.P. et al., 1983); Insight Scale for Psychosis (ISP, Birchwood M., 1994); «SF-36 Health Status Survey» (SF-36, Ware J.E. et al., 1993); URICA (McConnaughy E.A. et al., 1983); The Social Adjustment Scale-Self (SAS-SR, Weissman M, Bothwell S.,1976); PSP (Morosini P.L. et al., 2000) and a number of other scales. 90 patients with schizophrenia in the community, inpatient department of psychiatric hospital, day hospital participated in the basic PST program, which included psychoeducation, motivational training, social and cognitive skills training. At each stage, PST was received by 30 patients who did not differ significantly in age and other socio-demographic characteristics, but were characterized by different quality of remission, the duration of the PST program was 3 months. The assessment of the patients’ condition was carried out before and after the rehabilitation program.ResultsA significant improvement in the indicators on the PANSS scale was found in patients of all three groups, as evidenced by a reduction of more than 10 points in the total score of the scale. As a result of the PST program, patients of all three groups have improved to varying degrees their awareness of the disease understanding of the need for drug treatment, increased motivation, and have shown a tendency to improve a number of cognitive functions. The participants of the program demonstrated an increase in the level of activity and purposefulness of activity, as well as the ability to master new social skills and implement them. Correlation and regression analysis, during which more than 100 factors were studied, allowed us to identify the most significant factors that positively or negatively affected the effectiveness of PST: severity of the condition, duration of illness, age of onset of the disease, age of referral to the service, number of hospitalizations, type of remission, observation group, level of education, marital status, family support, family relationships, having friends, having income.ConclusionsThe effectiveness of the basic PST program has been shown. However, the work on evaluating the effectiveness of the PST should be continued, especially for the development of information criteria and a tool for its evaluation.Disclosure of InterestNone Declared
Parasuicidal behavior in early stages of psychosis
Authors: Serván Rendón-Luna B. , Montes Montero A. , Gómez Merino P. 
Published: August 2023

IntroductionPsychotic experiences (PE) are strongly associated with non-suicidal self-harm (NSA). NSA are present throughout life, but are more frequent during adolescence and young adulthood. Early psychotic episodes (PEP) are a particularly vulnerable group compared to later phases of psychosis psychosis.ObjectivesAnalyze risk factors for suicide attempts and NSA, in order to improve early detection and prevention of suicides in adolescents and young adults with PDMethodsReview in the literature of the different risk factors associated with parasuicidal behaviors in early psychosisResults•Presence of positive psychotic symptoms: auditory hallucinations, Delusional ideation.•Social isolation•Longer duration of untreated psychosis.•Comorbid symptoms: irritability, depression, anxiety, psychotic distress, insomnia.•Traumatic events in childhood•Difficulty in regulating emotional, impulsivity and sensitivity to reward.•Consumption of substances.•Psychosocial stress.ConclusionsWe consider essential the inclusion of early intervention programs aimed at the prevention of suicide and NSA, evaluating all risk factors for suicide and NSA among individuals with a PEP and high-risk mental states.Initial assessment and ongoing assessments of suicide risk and parasuicidal behaviors, positive psychotic symptoms, depression, and the other related risk factors mentioned are required. Integrating trauma management into PEP care is critical.Bibliography:1.- Honings S, et al. Psychotic experiences and risk of self-injurious behaviour in the general population: a systematic review and meta-analysis. Psychol Med. 2016;46(02):237–51. doi: 10.1017/S00332917150018412.- Honings S, et al. Psychotic experiences and incident suicidal ideation and behaviour: Disentangling the longitudinal associations from connected psychopathology. Psychiatry Res. 2016;245:267–75. doi: 10.1016/j.psychres.2016.08.0023.- Nishida A, et al. Risk for suicidal problems in poor-help-seeking adolescents with psychotic-like experiences: Findings from a cross-sectional survey of 16,131 adolescents. Schizphr Res. 2014;159(2–3):257–62. doi: 10.1016/j.schres.2014.09.030 39.Disclosure of InterestNone Declared
Anxiety and depression in natural caregivers of patients with schizophrenia
Authors: Znaidi F. , Ellouze S. , Ghachem R. 
Published: August 2023

IntroductionNatural caregivers of patients with schizophrenia constitute a main source of care as they have to shoulder a multitude of caregiving responsibilities and are then confronted with considerable difficulties while providing care. As a result, natural caregivers, often described as “the hidden patients” usually suffer from psychological consequences such as anxiety and depression.ObjectivesThis study aimed to asses anxiety and depression among natural caregivers of patients with schizophrenia and to identify risk factors for developing such disorders.MethodsWe conducted a cross-sectional, descriptive and analytical study, including 80 natural caregivers of patients with schizophrenia. We used the Hospital Anxiety and Depression Scale (HADS) to evaluate anxiety and depression.ResultsThe typical caregiver profile was consistent with a 55-year old married illiterate first degree relative (mostly parents or spouses) with a low socio-economic level.The mean anxiety score was 10.6± 5,1 and the mean depression score was 11.6± 6.2. Depression and anxiety were diagnosed in 66% of caregivers.Anxiety and depression scores were significantly higher among female illiterate unemployed caregivers, those with organic history and among parents and correlated with the caregiving duration.Anxiety scores were higher when patients in charge had poor therapeutic adherence and aggressive behavior and correlated with the age of caregivers and the number of other sick persons in charge.Caregivers reported higher levels of depression when patients in charge were not married, unemployed and had a history of suicide attempts.Anxiety score were significantly correlated with depression scores.ConclusionsCaregivers of patients with schizophrenia, although thought to be a privileged source of emotional and social support, are hardly taken into account following the deinstitutionalization movement.Disclosure of InterestNone Declared
Acute psychosis with compulsive behaviour caused by hypothyroidism: a case report
Authors: Ilgen Erdem I. , Alioglu Karayilan F. , Kalay Demirci B. 
Published: August 2023

IntroductionHypothyroidism is a common problem in clinical practice which can be seen with diverse psychiatric manifestations.ObjectivesHere we report a case of psychosis with compulsive behavior in a 46-year-old man who had no previous history of psychiatric disorder was brought to the emergency department by his family.MethodsDuring his evaluation, he described visual and auditory hallucinations. In addition, it was observed that dermatitis developed on her hands and around his mouth due to compulsive washing behavior. It was learned that he was diagnosed with hypothyroidism 2 months ago but he was not taking his medication. He was admitted inpatient clinic for 39 days and consulted to an endocrinologist. Inpatient treatment was initiated with haloperidol 10mg PO and levothyroxine. Given the persistence of irregular intake, it was decided to switch to haloperidol long-acting treatment.ResultsAfter only requiring both antipsychotic drugs and thyroxine replacement our patient showed progressive clinical recovery attaining full remission within 5 weeks.ConclusionsIt was clear that physicians should be aware of the possible different manifestations of endocrinologic disorders. All patients presenting with a first episode psychosis and compulsive behavior should be screened for thyroid dysfunctionDisclosure of InterestNone Declared
How sexuality is affected and managed in patients under antipsychotic drugs
Authors: Ribeirinho Soares F. , Mesquita B. , Fraga A. M. , Albuquerque M. , Facucho J. O. , Santos P. E. , Sousa D. E. , Moura N. , Cintra P. 
Published: August 2023

IntroductionSexual dysfunction (SD) is a prevalent side effect of antipsychotic drugs (AP), and it impairs patients’ quality of life. Because of the distress caused by it, it should be borne in mind when prescribed since it is responsible for treatment nonadherence or discontinuation. SD affects about 45- 80% of males and 30-80% of females that take it. In SD, all phases of the sexual response cycle may be compromised.ObjectivesThis non-systematic review of the literature aims to better understand the antipsychotic-induced SD and its management to better compliance of AP-treated patients without compromising their quality of life.MethodsA semi-structured review on PubMed linking SD as a side effect of AP drugs.ResultsAll AP drugs can cause SD. It seems related to their mechanism of activity at receptors D2, 5-HT2, α1, H1, and M, which are also involved in sexual function. They do it by diminishing arousal, decreasing libido by blocking motivation and reward system and orgasm indirectly, provoking erectile dysfunction by vasodilatation, and decreasing woman lubrification. Hyperprolactinemia is a significant cause of sexual dysfunctions. Haloperidol, Risperidone, and Amisulpride (prolactin elevating AP) are more likely to cause SD than Olanzapine, Clozapine, Quetiapine, and Aripiprazole (prolactin sparing AP). Although psychotic disorders (Schizophrenia and other psychotic disorders) can impact sexual functioning, according to evidence, there is no denying the role of AP in this issue. Aripiprazole, a D2 partial agonist, has been associated with lower rates of SD and seems to reduce the rates of SD in patients previously treated with other AP. Other AP with the same potential dopamine agonist activity, such as Cariprazine and Brexpiprazole, can probably have the same effect. The management of SD induced by AP drugs should include measuring serum prolactin and modifying risk factors like hypertension, smoking, hyperglycemia, and hypercholesterolemia. In that regard, waiting for spontaneous remission, reducing the dose of the AP prescribed, or switching to Aripiprazole are all viable strategies, if possible. Although the evidence supporting the addition of symptomatic therapies is weak, adding dopaminergic drugs (amantadine, bromocriptine, cabergoline) or drugs with specific effects on sexual functioning (such as phosphodiesterase inhibitors or yohimbine) may be helpful in selected cases.ConclusionsAlthough all AP drugs can cause sexual dysfunction, it is difficult to determine its true prevalence accurately. AP-induced sexual dysfunction can adversely affect compliance and is one of the factors that must be considered when selecting treatment. In summarizing, Aripiprazole has shown to be the AP with the most favorable profile concerning SD. Cariprazine and Brexpiprazole, being also D2 partial agonists, may cause less SD.Disclosure of InterestNone Declared