bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient safety in community-based mental healthcare: A systematic scoping review
Authors: Averill P. , Vincent C. , Reen G. , Sevdalis N. , Henderson C. 
Published: September 2022

IntroductionThere is limited existing research about patient safety issues in mental healthcare. A lack of evidence is particularly pronounced in relation to safety in community-based mental health services, where the majority of care is provided. To date, reviews of mental health patient safety literature have focused primarily on inpatient care settings.ObjectivesThis systematic scoping review will aim to identify and synthesise literature about the types of patient safety problems in adult community-based mental health settings, the causes of these problems, and evaluated safety interventions in this care context.MethodsA systematic search was conducted on 19th June 2020 and refreshed on 23rd October 2021, across five databases: Medline, Embase, PsycINFO, Health Management Information Consortium, and Cumulative Index to Nursing and Allied Health Literature. The search strategy focused on three key elements: ‘mental health’, ‘patient safety’ and ‘community-based mental health services’. Retrieved articles were screened at title, abstract and subject heading level, followed by full-text screen of longlisted articles.ResultsIn this presentation, the findings of this systematic scoping review will be described, based on synthesised literature about safety incidents, broader care delivery problems, their causes, and evaluated patient safety interventions to address these issues.ConclusionsThis study will offer learning opportunities about the safety problems, contributory factors, and safety interventions in adult community-based mental health services, as described in the evidence base. Review findings will also help to ascertain gaps in existing research, which should be addressed in future studies.Disclosure

NS is the director of London Safety and Training Solutions Ltd, which offers training in patient safety, implementation solutions and human factors to healthcare organisations and the pharmaceutical industry. The other authors have no competing interests.
Application of a decision support system for providing better mental health care: the case of the Basque Country (Spain)
Authors: Almeda N. , García-Alonso C. , Salvador-Carulla L. 
Published: September 2022

IntroductionDecision Support Systems (DSS) are appropriate tools for guiding policymaking processes in Mental Health (MH) management, especially where a balanced and integrated care provision is required.ObjectivesTo assess the performance of a MH ecosystem for identifying benchmark and target-for-improvement catchment areas according to the Balanced Care model.Methods

The MH provision, distinguishing inpatient, day and outpatient main types of care, has been assessed in the Mental Health Network of Gipuzkoa (Basque Country, Spain) using a DSS, integrating Data Envelopment Analysis, Monte-Carlo Simulation and Artificial Intelligence. 13 catchment areas, defined by a reference MH centre, are the units (universe) for the analysis. The indicators for MH ecosystem performance were: relative technical efficiency, stability and entropy, for identifying both benchmarking and target-for-improvement areas. The analysis of the differences between the two groups can be used to design organizational interventions.ResultsThe Mental Health Network of Gipuzkoa showed high global efficiency scores, but it can be considered statistically unstable (small changes in variable values can have relevant impacts on its performance). For a global performance improvement, it is recommended to reduce admissions and readmissions in inpatient care, increase workforce capacity and utilization of day care services and, finally, increase the availability of outpatient care services.ConclusionsThis research offers a guide for evidence-informed policy-making to improve MH care provision in the main types of care and provide aftercare. The characteristics of the area to be improved are critical to design interventions and assess their potential impact on the MH ecosystem.DisclosureNo significant relationships.
Mental Health and economic effects: correlation between unemployment and psychoactive drugs
Authors: Ramos J. 
Published: September 2022

Introduction

Mental Health is an invisible part of public health, and a determinant of it by affecting the human, social and economic capital of countries. Is one of the main causes of disability worldwide and, when left untreated, they can lead to increased costs and premature mortality. In 2019 they represented 22% of the disability burden in DALY in the European Union. Regarding the effects of economic recessions studies suggest that they have detrimental effects on mental health. And can became a reality in the current pandemic scenario.Objectives
To reflect on the studies carried out that debate the effects of previous economic crises on mental health, particularly the 2008-2013 crisis. It aims to list not only the possible intervention strategies in the area as well as the barriers to their implementation.Methods

Classic review of the topic through the international literature and the state of the art on available platforms. Establish a proxy between the unemployment rate and the number of packages (antidepressants and anxiolytics consumed) in homologous periods as a representative capacity of the impact of the crisis on mental health.ResultsThe number of packages of antidepressants and anxiolytics behave differently. the antidepressants have greater consumption when unemployment decreases.ConclusionsSeveral studies describe that the increase in the unemployment rate, indebtedness and social exclusion are empirically proven as consequences of the economic crises and predisposing factors for mental pathology. However, this does not translate into a proxy for the consumption of antidepressant packages with the increase in the unemployment rate. It may be due to the non-prioritization of mental health.DisclosureNo significant relationships.
Scalable psychological interventions for Syrian refugees: Preliminary results of a randomized controlled trial on the peer-refugee delivered Problem Management Plus (PM+) intervention in the Netherlands
Authors: De Graaff A. , Sijbrandij M. , Cuijpers P. 
Published: September 2022

Introduction
In the past decade, millions of Syrians have sought refuge in neighboring countries and Europe. Refugees are at increased risk for the development of common mental disorders (CMD), such as depression and posttraumatic stress disorder (PTSD), but only a small percentage access mental health services. Problem Management Plus (PM+) is a brief, scalable intervention targeting symptoms of CMDs that can be delivered by non-specialist helpers in communities affected by adversity, such as refugees.ObjectivesThe aim of this randomized controlled trial (RCT) is to evaluate the effectiveness of PM+ among Syrian refugees in the Netherlands.MethodsAdult Syrian refugees and other Arabic-speaking refugees of 18 years and older with self-reported psychological distress (K10 >15) and functional impairment (WHODAS 2.0 >16) are included. Participants are randomized into PM+ or care as usual. Follow-up assessments are conducted at one-week, three-month and twelve-month follow-ups. Clinical outcomes are symptoms of depression/anxiety (HSCL-25), PTSD (PCL-5), and functional impairment (WHODAS 2.0).ResultsBy November 2021 [recruitment ends by December 2021], 214 participants were screened for eligibility and 184 participants were included. Participants are M=36.5yrs old (range 18-69yrs), and 73 participants are female (39.7%). We will present preliminary results for the effects of PM+ on depression, anxiety, PTSD, and functional impairment at one-week follow-up, as well as barriers and facilitators for implementing PM+ in a European country.ConclusionsAfter positive evaluation of peer-refugee delivered PM+, the Arabic manual and training materials will be made available through WHO to encourage scaling-up.DisclosureNo significant relationships.
Bipolar disorder and grey matter heterotopia : a case report
Authors: Bergaoui E. , Zrelli M. , Staali N. , Moalla M. , Lansari R. , Melki W. 
Published: September 2022

IntroductionThe grey matter heterotopias are a relatively common group of conditions characterized by interruption of normal neuronal migration from near the ventricle to the cortex. Subependymal grey matter heterotopia, also known as periventricular heterotopia, is the most common form.ObjectivesTo search a link between bipolar disorder and grey matter heterotopiaMethodsA case report of a woman with grey matter heterotopia who is diagnosed as bipolarResults

A 34 year old woman was admitted at Razi psychiatric hospital 3 months after childbirth. She was agitated, logorrheic with multiple projects and insomniac. The diagnosis was a manic episod with a marked score of 28/44 at The Bech-Rafaelsen Mania Scale (MAS). The patient was treated with 4 mg of risperidone and 1000 mg of sodium valproate with partial remission after two weeks. One month after her discharge, she had depressive mood, asthenia, anhedonia and insomnia. She had a score of 19 at Hamilton Depression Rating Scale (HDRS). She was switched from risperidone to olanzapine 15mg/j with partial remission after two weeks. In front of persistent symptoms with labile mood, she took lithium 1000 mg/j. She was complaining of a headache and a fluctuating heaviness of the right upper limb. At brain imaging, she had periventricular nodular heterotopia. The patient was adressed to neurology department.ConclusionsGrey matter heterotopia can cause a variety of neuropsychiatrc symptoms which can lead to diagnosis difficulties. Therefore, in front of atypical symptoms or drug-resistance, patients should be referred for brain imaging.DisclosureNo significant relationships.
A narrative approach to trichotillomania
Authors: Gonçalves Cerejeira J. , Santos Carrasco I. , Gonzaga Ramírez A. , Queipo De Llano De La Viuda M. , Guerra Valera G. , De Andrés Lobo C. , Jiménez Aparicio T. 
Published: September 2022

IntroductionTrichotillomania is an obsessive-compulsive spectrum disorder characterized by recurrent and uncontrolled hair pulling. This behavior causes significant anxiety as well as low self-esteem in people who suffer from this disorder. There is still no therapy of proven efficacy in the treatment of trichotillomania. Psychotropic drugs and cognitive behavioral psychotherapy have been tried in the management of this disease, but the relapse rate is high. Narrative therapy is an innovative type of postmodern psychotherapy and in our literary search we have not found data related to its use in the treatment of trichotillomania.ObjectivesTo present a novel therapeutic approach to a highly resistant disorder, trichotillomania.MethodsCase report and literature review.ResultsWe present a case of a 39-year-old woman diagnosed with trichoticolomania twenty years earlier. She tried several types of psychotherapies for manage her hair-pulling problem, all related with relapse only a few days after finishing the sessions. We have carried out a total of 5 narrative therapy sessions spread over 3 months. No relapses have been observed during the subsequent 9-month follow-up period.ConclusionsBased on our experience, we believe that Narrative Therapy is a good and still unexplored alternative for people diagnosed with trichotillomania.DisclosureNo significant relationships.
Herpes Simplex-1 and Toxoplasma gondii in Obsessive-Compulsive Disorder: clinical and brain imaging correlates
Authors: Maia A. , De Souza Queiroz J. , Barahona-Correa B. , Oliveira J. , Oliveira-Maia A.J. 
Published: September 2022

IntroductionObsessive-compulsive disorder (OCD) is a chronic, prevalent, and highly impairing psychiatric illness. While its aetiology remains unknown, several infectious agents have been associated to obsessive-compulsive symptoms, including herpes simplex virus 1 (HSV-1) and Toxoplasma gondii.ObjectivesTo evaluate the serostatus for HSV-1 and Toxoplasma gondii in sample of patients with OCD, as well as its clinical and brain imaging correlates.Methods

Twenty-six patients with OCD and 30 healthy controls recruited in Lisbon were assessed for sociodemographic and clinical characteristics using the Yale-Brown Obsessive-Compulsive Scale-II (YBOCS-II) and the Beck Depression Inventory-II (BDI-II). Seropositivity for HSV-1 and Toxoplasma gondii was assessed in serum using ELISA, and volumes of cortical and subcortical structures were assessed using T1-weighted magnetic resonance imaging.ResultsYBOCS-II and BDI-II scores were significantly higher in patients, while age, sex, smoking status, and seropositivity for HSV-1 and Toxoplasma gondii were similar between the two groups. Among OCD patients, those seropositive for HSV-1 had significantly lower volumes of total white-matter, total grey-matter, left and right putamen, while for HSV-1 seropositive healthy controls, only the last two were significantly smaller. In multiple regression analyses to control for age, associations between HSV-1 and brain volumes were conserved, while the effect of age was not significant. No significant differences were found in brain volumes of patients with OCD according to seropositivity for Toxoplasma gondii.ConclusionsOur preliminary results suggest that in patients with OCD, seropositivity to HSV-1 is associated with smaller volumes of total white- and grey-matter in the brain.DisclosureNo significant relationships.
Assessment of obsessive and compulsive symptoms in patients with schizophrenia
Authors: Ajmi S. , Ellouze S. , Abdelkefi M. , Turki M. , Halouani N. , Aloulou J. 
Published: September 2022

IntroductionObsessive-Compulsive Symptoms (OCS) are common in patients with schizophrenia, with a prevalence of 3.5% to 25%.ObjectivesThe aim of our study was to assess the frequency of OCS in patients with schizophrenia, and to study the clinical and evolutionary characteristics of schizophrenia and OCS comorbidity.MethodsWe conducted a cross-sectional, descriptive, and analytical study. Thirty schizophrenic patients were recruited in the department of psychiatry B of Hedi Chaker university hospital of Sfax. We used the Yale-Brown Obsession-Compulsion Scale (Y-BOCS) to assess obsessive and compulsive symptoms, at the end of hospitalization, after clinical remission of schizophrenic symptoms.ResultsThe mean age of patients was 41.2, that of disease onset was 27.3. Most of patients were male (86.7%) and unemployed (81.3%). A personal history of suicide attempts was found in 16.6% of patients. The average number of hospitalizations was 8.83. OCS were noted in 36% of patients with a Y-BOCS mean score of 5.5. Patients with OCS had significantly more frequent alcohol use (p = 0,008), a higher number (p = 0.03) and longer duration of hospitalizations (P = 0,034) and are more frequently treated with atypical antipsychotics (p = 0.001).ConclusionsOur results show that patients with schizophrenia frequently present OCS. This comorbidity has a negative impact on the evolution and the prognosis of the disease, as well as the functioning of patients. Therefore, it should be investigated in order to ensure better care and promote the socio-professional reintegration of these patients.DisclosureNo significant relationships.
OCD symptom dimensions and treatment: a new dimension?
Authors: Soares Da Costa I. , Moreira R. 
Published: September 2022

IntroductionBackground: Obsessive-compulsive disorder (OCD) is a condition that includes distressing obsessions and repetitive compulsions. Usually presents with a wide range of symptons normally grouped into different clusters or dimensions. clinical impression and some empirical data suggest that certain groups of symptoms or clusters are more responsive to treatment than others, thus it can help clinicians to better guide initial treatment choices and management of individual patientsObjectivesObjetictive: to describe the symptom dimensions in a clinical database that includes patients accompannied in an obssessive conpulsive disorder consultation in a tertiary hospital in Portugal and to point out some differences in treatment outcomes.MethodsWe searched Pubmed and Cochrane Library database for english language articles.ResultsTo date it appears that pharmacotherapy and CBT are an effective treatment for the various OCD dimensions, although not all dimensions have been adequately studied or respond well to treatment. Knowing a specific symptom profile may have implications in treatment components that clinicians should be aware of.ConclusionsMore research will be needed to determine the best tailor treatments to each patient’s profile and Modifications to treatment may be needed. Clinical implications and directions for future research are discussed.DisclosureNo significant relationships.
Obsessive-Compulsive Disorder and suicide: what do we know up until now?
Authors: Salvadori G. , Osaku L. , Porcu M. 
Published: September 2022

Introduction

Obsessive-Compulsive Disorder (OCD) was recently (in 2015) associated with suicidal risk, regardless of depression or other mental disorders, but it is a disorder with great heterogeneity, and the subtypes involved in this risk have not yet been clarified.ObjectivesTo verify which patterns of OCD symptoms are more associated with suicidal risk, other possible risk factors and better treatment options evidenced in the literature.MethodsLiterature review with predefined search criteria and keywords in electronic databases (Pubmed, Virtual Health Library and Cochrane) between 2015 and 2020. Identification, analysis, calculation and synthesis of the results were carried out in a descriptive and qualitative manner.ResultsTwenty five articles were included. Obsessions of unacceptable thoughts pattern, perfectionism traits and alexithymia are important predictors of suicidal risk. Compulsions were not associated with suicide. Depression is the comorbidity with the greatest impact on suicidal ideation. Better socioeconomic status, education, and female gender are protective factors for mortality. The method chosen for attempts is preferably non-violent (drug intoxication). Treatments derived from cognitive behavioral therapy are currently being investigated further, and in addition to the evidence for the use of selective serotonin reuptake inhibitors, antipsychotics have been used as an adjuvant.ConclusionsUnacceptable thoughts play an important role in suicide resulting from OCD, and the absence of compulsive behavior may be correlated to suicide risk. Treatment directed at cognitions seems relevant. Further studies are needed to clarify the appropriate approach in this subtype of the disease.DisclosureNo significant relationships.
When depression envelops frontotemporal dementia: The differential diagnostic frame through a case report
Authors: Altunoz U. , Menstell J. , Ziegenbein M. 
Published: September 2022

IntroductionFrontotemporal dementia (FTD) is common in presenile population. The overlapping symptoms with other psychiatric disorders can lead to wrong/late diagnosis which cause delays/difficulties regarding case-management. Especially, long-standing and/or late-onset depression can descriptively envelop bvFTD (behavioral-variant) and leads to unnecessary treatments and increased distress. It’s important to implement a descriptive diagnostic algorithm which will help clinicians to distinguish the phenomenology of these disorders.ObjectivesThis presentation aims to call attention of the clinicians/researchers to an elaborated effort concerning differential diagnosis of two common disorders with overlapping features through a case-study of a 59-year-old male patient.MethodsOne case from an inpatient unit of a psychiatric clinic in Lower Saxony, Germany will be reported.Results

Case: The patient was referred to our acute-psychiatric-ward from the day-clinic-unit because of treatment-resistant, severe and long-lasting depressive symptoms. He was depressed, desperate, hopeless, listless and had suicidal thoughts. During the first days of treatment, symptoms like apathy, bad hygiene, weird eating-behavior, urinary incontinence, lack of empathy, language disorders and other behavioral symptoms were evident. Brain-MRI yielded frontotemporal lobar atrophy. Trail-Making-Test and Frontal-Assessment-Battery showed pronounced impairment of executive functions. Mini mental state examination and DemTect yielded light to moderate memory dysfunction. Diagnostic Criteria for Probable bvFTD (International-Consensus-Criteria) were fulfilled.ConclusionsThe diagnosis of bvFTD enabled a rapid assignment of a legal representative and relieved the long-lasting discomfort of the patient and his family that was caused by multiple unsuccessful treatment trials against depression. The differential diagnostic frame between bvFTD and depression will be discussed in view of the current literature.DisclosureNo significant relationships.
Electronic smart-hub based intervention during COVID-19 in a rural Psychiatry of Old Age service in North-West Ireland
Authors: Patel S. , Gannon A. , Cryan M. , Dolan C. , Mcdonald C. , Houghton C. , Mccarthy G. 
Published: September 2022

IntroductionThe COVID-19 pandemic caused significant disruptions in services and necessitated innovation to continue care provision to the vulnerable population of older adults with psychiatric needs.ObjectivesThe objective of this study was to examine the experiences of staff and patients using a hands-free electronic smart-hub (eSMART hub) intervention to keep patients connected with psychiatry of old age following COVID-19 restrictions.MethodsA risk stratification register was created of all patients known to the Psychiatry of Old Age service in the North-West of Ireland to identify those at highest risk of relapse. These patients were offered a smart-hub with remote communication and personal assistant technology to be installed into their homes. Smart-hubs were also installed in the team base to facilitate direct device to device communication. Semi-structured qualitative interviews were conducted with 10 staff members and 15 patients at 6-12 months following the installation of the smart-hubs.ResultsThe smart-hubs were utilized by the POA team to offer remote interventions over video including clinician reviews, regular contact with key workers and day-hospital based therapeutic interventions such as anxiety management groups and OT led physical exercises. Patients also used the personal assistant aspect of the hub to attend to personal hobbies such as accessing music and radio. Positive feedback related to companionship during isolation and connectivity to services. Negative feedback was mainly related to technology, particularly internet access and narrow scope of communication abilities.ConclusionsElectronic smart-hub devices may offer an acceptable avenue for remote intervention and communication for isolated high-risk older persons.DisclosureThe smart hub devices used in this study were donated by Amazon. However, the company was not involved in any other aspect of the study and the researchers have no significant financial interest, consultancy or other relationship with products, manufactur