bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized comparative study of 1-Hz transcranial magnetic stimulation (TMS), continuous theta-burst stimulation (cTBS) and sham-TMS for treatment-refractory auditory hallucinations (AH) in schizophrenia
Authors: Potapov I. , Maslenikov N. , Tsukarzi E. , Mosolov S. 
Published: September 2022

IntroductionInsufficient efficacy of conventional treatment of auditory hallucinations (AH) in schizophrenia supports rising interest to brain stimulation techniques including transcranial magnetic stimulation (TMS). Left temporo-parietal cortex (TP3) is involved in emergence of AH, thus neuromodulation of this area might be reasonable.ObjectivesComparison of efficacy and tolerability of 2 protocols of TMS (1 Hz and cTBS) over TP3 and sham-TMS for treatment resistant AH in schizophrenia.Methods76 schizophrenia (ICD-10 - F20) patients with prominent AH (PANSS P3 ≥ 4, AHRS ≥ 15), who had failed to respond to previous antipsychotic treatment, were randomized into 3 groups: 1) 1 Hz TMS (30 patients); 2) cTBS (25 patients); 3) Sham-TMS (21 patients). Sessions were performed 5 days a week for 3 weeks. Antipsychotic medication was continued throughout the study. Patients were assessed weekly with PANSS, AHRS, CDSS, CGI-S by blinded raters. The criterion of efficacy was 30% AHRS score reduction after 3 weeks of treatment.ResultsThe number of responders were 13 (43,3%) in 1 Hz TMS group, 14 (56%) – in cTBS group, 4 (19,1%) in sham-TMS group. There was no statistically significant difference in efficacy between 1 Hz TMS and cTBS, but each of the active protocols was more effective than sham-TMS. Treatment was generally well tolerated in all groups, nobody was discontinued the study due to adverse events.ConclusionsBoth protocols of TMS (1 Hz and cTBS) over TP3 are safe and effective in the treatment of schizophrenic patients with pharmacotherapy resistant AH. Further studies are needed.DisclosureNo significant relationships.
Local field potentials in the BNST in patients with OCD: acute effects of DBS after symptom provocation
Authors: Bervoets C. , Heylen H. , Nuttin B. , Mc Laughlin M. 
Published: September 2022

IntroductionObsessive-compulsive disorder (OCD) is a disabling psychiatric disorder that affects 2-3% of the population. Pharmacological or cognitive behavioral therapy can reduce symptoms. Deep brain stimulation is emerging for treatment-resistant patients.ObjectivesWe measured neuronal activity in two patients with treatment-resistant OCD, who had DBS electrodes implanted bilaterally in the BNST. Local field potentials were recorded directly from the BNST during and without symptom provocation and without electrical stimulation.MethodsIn two patients with a diagnosis of treatment resistant OCD (TR-OCD) local field potentials (LFP) were recorded as part of their clinical follow up post-implantation. In both patients, the diagnosis of TR-OCD was confirmed by a neuropsychiatric examination and a multidisciplinary committee comprising both experienced psychiatrists and neurosurgeons from different medical centers in Belgium. We used BrainSense recording technology in the Percept PC to record the LFPs. The LFP recordings in the first patient were acquired on the 15th day after DBS surgery. In the second patient, the interval between implantation and recording was 18 days. Symptom provocation was performed using the MOCCS image set, developed by Mataix-Cols.ResultsAt rest, relative power peaks in the BNST were highest in the theta (4-8 Hz) frequency band for both patients. In both patients switching DBS ON during provocation images appears to cause the LFP signal to closely resemble that recorded during neutral images.ConclusionsThe main finding of this pilot study is that switching stimulation ON in the BNST during provocation images causes the LFP signal to more closely resemble the LFP recorded during neutral images.DisclosureNo significant relationships.
Medical Student Perspectives on the Future of Psychiatry: The View from Turkey
Authors: Kahraman U. , Kilic O. 
Published: September 2022

Psychiatry is still considerably ‘young’ compared to other positive sciences. Thus, it holds a huge potential for improvement of the current diagnostic and classification systems and modes of treatment particularly. For instance, the Research Domain Criteria Project will certainly generate novel research questions that will shed a light upon mechanisms, and processes for the expression of psychiatric phenomenology and develop psychiatric treatments. The new era of Digital Psychiatry/Telepsychiatry and real-time mobile monitoring are other approaches that have a lot to offer to advance the field of psychiatry. Despite these developments, the stigma around psychiatry is still a big obstacle to tackle with. Addressing and reducing stigma during medical education should benefit from training and experience co-facilitated by people living with mental illness ideally starting from the early years in medical school. Besides clinic rotations, student clubs, student scientific congresses, and clinical research that facilitate contact with the patients may be potential platforms to attract medical students’ attention to the work of psychiatry. The speaker will touch upon some examples and implementations from the medical schools in Turkey.DisclosureNo significant relationships.
Psychiatrist and Peritoneal Dialysis
Authors: Klarić D. , Klarić V. , Klarić M. 
Published: September 2022

IntroductionPeritoneal dialysis (PD) is an equal method of treating patients with end stage renal disease ( ESRD). The patients are left to themselves in the new situation. The psychiatrist recognizes their needs and through group therapy enables them to heal quality intrapsychic conflicts.ObjectivesThe study analized data on the intensity of depression, anxiety of an individual patient respectively, but also of his family member (caregiver) too. The control questionnaires are foreseen for both groups one year after group therapy participation. The assumption is that symptoms of depression and anxiety will be less expressed with group support by the psychiatrist.MethodsTwo questionnaires were used: Hamilton’s rating scale for depression and Hamilton’s anxiety rating scale and identical questionnaires for member of the family caring for the patients. 13 patients who accepted group therapy were examined in our institution. They were of different gender and age, mean age 53±13.46 mini-max 25-72 years.ResultsAverage months of dialysis duration 29.15±21.84 min-max 6-84 Dialysis was performed without an assistant but with some help n 13( 100%) from the patient. They describe ailments from anxiety (30.77%) and depression ( 38.46% ) which they did not have premorbidly, and feel rejected on the emotional sphere, although not on the part of organic medicine.ConclusionsEmphasis is placed on the emotional state and needs of the patient with severe physical ailments, in other words, demanding treatment methods, as well as the importance of emotional support from family members without whom these patients would have a poorer quality of life.DisclosureNo significant relationships.
Pro Perspective
Authors: Gorwood P. , Di Lodovico L. 
Published: September 2022

Four sets of arguments are supporting the idea that compulsory admissions should be possible in anorexia nervosa, as much as it is other in psychiatric disorders. Indeed, if nobody challenges the use of compulsory treatments for patients with acutte schizophrenia or a manic episodes, it is because the usual rational for compulsory admission relies on (1) the severity of the disorder (a need), (2) the capacity of hospitalisation to really improve patients and prognosis (a utility), associated to the fact that (3) the disorder alters the capacity to spontaneously ask for care (a rational), and (4) the possible danger of the present medical conditions for others (a protection). We will explain that these four points are clearly being equivalent for anorexia nervosa compared to other psychiatric disorders, with some subtilities that modify their expression, but not the spirit of these rationals. We will then propose that a much easier way to understand the paicity of use of this hospitalisation modalities is related to the strange position of anorexia nervosa, a metabo-psychiatric disorder, namely a complex disorder at the interface of somatic and psychiatric disorder. We will conclude in promoting a step-by-step procedure to reuce the risk of abuse, and facilitate the paradoxical “acceptance” of a “forced” hospitalisation.DisclosureNo significant relationships.
Experiential Family Intervention for Children and Youth
Authors: Guillemet I. , Jackson B. 
Published: September 2022

IntroductionReviews suggest that family interventions including family therapy are effective for a range of disorders in youth. Family sculpting is used in different clinical settings to help young patients, their parents and siblings when words are not enough.ObjectivesParticipants will be able to understand the clinical relevance of family sculpting: shifting from discussions about family problems to physical representations of family dynamics and how to apply in their practice.MethodsThere will be a brief overview of the general principle of family sculpting followed by clinical vignettes of patients combined with videos of the intervention. These examples will guide the discussion on how relevant in our clinical work this therapeutic practice may be. This variation on sculpting incorporates theater warmup exercises and therapists joining the family experience.ResultsFamily sculpting captures an immediate picture of the family dynamics that is a therapeutic turning point for families and gives voice to the children. The clinical cases and videos will guide clinicians on how to integrate into their own practice.ConclusionsThis presentation will make possible integrating family sculpting into your own practice, providing an engaging alternative modality for complex cases.DisclosureNo significant relationships.
The connection between diabetes and depression. Is coaching the best therapeutic path?
Authors: Farmakopoulou I. , Theodoratou M. 
Published: September 2022

IntroductionAs it is well known, diabetes and depression are highly prevalent conditions and affect significantly overall health (Egede & Ellis,2010). This presentation aims to describe the impact of a chronic disease (diabetes) on mental health and its comorbidity with depression. Additionally, it presents the psychotherapeutic process and beneficial effects of coaching on an adolescent patient.ObjectivesThe current study tries to present the comorbidity and interaction between diabetes and depression. It explores the therapeutic path followed, so that the patient could cope effectively with the comorbidity of these diseases and break the vicious circle of sadness that he had been into.MethodsA case study of an adolescent with diabetes is presented. It depicts how the sudden appearance and diagnosis of diabetes led to depressive impasse and cancellation of his dream to become a pilot. The role of coaching is described.ResultsThrough monthly coaching the young adolescent discovered his hidden talents and thus he was able to redirect his professional goals and to design a pathway that would lead to the fulfillment of his new life plans. Working closely together with his therapist, step by step, his depressive symptoms were diminished and anti-depressive medication was reduced gradually. Consequently, his diabetes was well regulated, and his overall health was radically improved.ConclusionsPsychotherapeutic coaching is proved to be appropriate for patients with comorbidity in order to cope effectively with their chronic disease and discover new meaning in their own lives. Last, but not least, self-management skills and diabetes education are required in addition to psychological interventions.DisclosureNo significant relationships.
Incomplete Medical Charts: Impacts And Possible Solutions
Authors: Chowdhury M. , Peteru S. , Askandaryan A. , Banik D. , Hiana J. 
Published: September 2022

IntroductionProper documentation and relevant updating of patients’ health status has become a cumbersome task with the inception of electronic medical records.Inpatient, ED, and ambulatory patient evaluation generate billions of records each year.It brings about a burden on the workload of the providers regarding registering and completing patients’ records.Incomplete medical records set up complications in patient management and subsequent administrative operations.Specifically, denials for reimbursement because of incomplete medical records emerge as a critical concern.Effective measures, consisting of both technical and administrative enforcements are required to reduce number of open charts.ObjectivesTo understand the reasons,consequences and solutions for Incomplete/Delinquent medical records.MethodsWe searched Google scholar and Pubmed database using keywords “Incomplete medical records”, “Imapacts” and “Solutions”.Articles popped up.We selected 4 based on internal and external validity.ResultsIncomplete/Delinquent medical records are nowadays imposing a critical challenge upon financial, administrative and legal affairs in practicing Medicine.Our review shows that CMS recovery audit with hospital denials went high from 7-10% in recent years because of open/incomplete medical records.Provider’s documentation time increases as well with implementation of EHR.Appropriate measures could be taken to resolve this issue, broadly we can try two ways- training and administrative courses.ConclusionsPhysicians,residents and all respective providers should get training on a regular basis regarding EMR/EHR to complete medical records duly and effectively.The other way is administrative surveillance.If providers fail repeatedly to comply with HIM standard and complete delinquent medical records, warnings, suspensions or other regulatory actions can be executed strictly to keep them on track.DisclosureNo significant relationships.
Improving Awareness of Safe Sleeping Practices for Babies on a Mother and Baby Psychiatric Unit
Authors: Puttaroo I. , Sheppard K. , Lewin J. , Sriranjan S. 
Published: September 2022

IntroductionSIDS is the sudden, unexpected and unexplained death of a baby. Safe sleeping practices can help to reduce a baby’s risk of SIDS. At the Coombe Wood Mother & Baby Unit (MBU), it was found that many patients were opting to co-sleep with their babies which contradicts safe sleeping guidelines.ObjectivesTo improve patient awareness of the condition SIDS and to implement an interactive training session improving awareness of safe sleeping practices for babies. To improve patients’ confidence in implementing safe sleeping practices for their babies; thus reducing the risk of SIDS occurring.MethodsThe Lullaby Trust™ is a charity that raises awareness of SIDS and provides expert advice on safe sleep for babies. An interactive training session for patients was organised by incorporating published materials from The Lullaby Trust™, facilitated by medical and occupational therapy staff on the MBU. The participants filled out a pre-training and post-training questionnaire to test the effectiveness and quality of the training session.ResultsThe participants’ average level of confidence in knowing and applying safe sleeping practices for their babies doubled following the training session (from 2.3→4.8 and 2.6→5 respectively, with 5 meaning “Very Confident.”) The average level of knowledge of SIDS also increased from 1.6→4.4 (with 5 meaning “A Lot” of Knowledge.)ConclusionsWe were surprised at the low level of knowledge and confidence the patients had regarding safe sleeping practices for their babies. This project shows how interactive, ward-based training can be an effective way to engage and stimulate patients into improving the safety of their baby care.DisclosureNo significant relationships.
Development of a web-based platform for the semi-structured record of the psychiatric interview during clinical practice: an opportunity to impact research and improve health care
Authors: Vasquez D. , Velez C. 
Published: September 2022

IntroductionManaging healthcare data is a major challenge for today’s medicine. The use of artificial intelligence and big data tools has allowed solving questions related to this topic. However, the wide heterogeneity in the psychiatric consultation record makes the retrospective analysis of these data limited due to a lack of information or differences between specialists.ObjectivesWe aim to develop a platform that allows the structured record of medical care data (based on dementia) while maintaining flexibility and format for its usefulness during clinical practice in psychiatry.MethodsWe developed a web-based platform for the structured and semi-structured record of psychiatric evaluation. The instrument is diagnosed-oriented (for our version we used dementia). We used Core outcome sets and expert opinion to identify the relevant outcomes for the attention.ResultsA web-based platform is presented for the care of people with suspected dementia at different levels of care designed with the potential to record information of interest in research but also of clinical utility for closer follow-up.ConclusionsThis strategy allows developing the proposal towards other pathologies of interest. Also, with the integration of recommendation algorithms, a monitoring and recommendation system could be achieved to promote knowledge of psychiatric illness from routine practice. This proposal intends to have an impact by increasing the quality of care, reducing care times, and providing better approaches from primary care systems.DisclosureNo significant relationships.
Protocol for the safety of brodalumab regarding psychiatric comorbidities in patients with psoriasis
Authors: Pikou O. , Argitis P. , Karampas A. , Karavia S. , Chaviaras Z. 
Published: September 2022

IntroductionBrodalumab, an anti-IL17RA monoclonal antibody, is a treatment option for plaque psoriasis related to increased risk of suicidal ideation and behavior, including completed suicide.However, in the literature no causal relationship is reported, and the reported incidence of patients receiving brodalumab that committed suicide did not differ from the expected suicide incidence of the general population.ObjectivesOur objective is to answer the followings:1) What is the probability of developing emotional disorders during treatment with brodalumab.2) What is the recurrence rate of previously diagnosed emotional disorders in brodalumab responders (Kaplan-Meier curve). 3) What is the relationship between suicide and/or suicidal ideation in patients receiving treatment with brodalumab.MethodsThe study will enroll patients with moderate to severe psoriasis (aged 18-70) that attend the outpatient dermatology, and who already receive or are eligible to receive treatment with brodalumab. Patients who are willing to participate in the study will be provided with the self-completing questionnaires PHQ-9, GAD-7, RASS, HRQoL. During follow-up, if a patient presents with a PHQ> 9, will be referred for an HDRS evaluation in which if score> 17 in at least 2 scores or an increase in the RASS scale is detected, will be referred for psychiatric intervention.ResultsAssessments will take place a) before treatment , b) 2 weeks after initiation of treatment with brodalumab , c) every month for the first 3 months, and e) on a quarterly basis up to 52 weeks.ConclusionsThis study will focus on creating a protocol for the safe use of brodalumab in psoriasis patients with concomitant psychological/psychiatric comorbidities.DisclosureNo significant relationships.
An alternative to jail by assertive community treatment and housing for people with severe psychiatric disorders and insecure accommodation: a potential win-win outcome of reduced recidivism and reduced public expenditure
Authors: Loubiere S. , Tinland A. , Bosetti T. , Auquier P. 
Published: September 2022

IntroductionPeople with severe psychiatric disorders (SPD) who experience housing vulnerability have to negotiate discontinuous mental health care pathways including poor access to common rights services and an increased risk of incarceration. To reduce morbidity and improve social integration of these people, Médecins du Monde (NGO), in association with the Ministry of Justice and APHM, is piloting the experimentation of an alternative to prison through assertive community treatment (ACT) and independent housing for people with SPS without housing who are referred to the court for immediate appearance.ObjectivesThe main objective is to evaluate the effectiveness of the innovative program (AILSI) compared to usual services by assessing the duration of re-incarceration at 18 months of follow up.MethodsThe AILSI project has been certified as a Social Impact Bond, in which private investors support the program, with the guarantee that the French government will reimburse the investments if social impact outcomes are met. To measure the effectiveness and efficiency of the program, a randomized controlled study was designed: 100 patients will be included in the AILSI group (intervention) and 120 in the TAU group (usual services). Four social impact outcomes are identified: inclusion rate, signed leases rate, total length of re-incarceration and total resource use. It is a mixed quali-quanti research, which integrates a matching to administrative health and judicial databases.ResultsInclusions are ongoing.ConclusionsThe AILSI program and the research methods used are described herein. In addition, detailed information on the limitations and strengths of the SIB system are also discussed.DisclosureNo significant relationships.
Association between lymphocytes, hippocampus volume and depressive symptoms in drug – naïve First Episode Psychosis
Authors: Toll A. , Bergé D. , El-Abidi K. , Legido T. , Pérez-Solà V. , Mané A. 
Published: September 2022

IntroductionThe role of the white blood cells, which form the peripheral immune system and are crucial in inflammatory processes, has been laid aside in the context of brain structural changes in schizophrenia.ObjectivesDetermine how blood cells are associated with some brain structures volumes in first episode psychosis (FEP) and their relationship with clinical variables at baseline and 1 year follow – up.MethodsFifty drug-naïve FEP treated between April 2013 and July 2017 at the ETEP Program at Hospital del Mar were included. Inclusion criteria were: 1) age 18-35 years; 2) fulfillment of DSM-IV-TR criteria for brief psychotic disorder, schizophreniform disorder, schizophrenia or unspecified psychosis; 3) no previous history of severe neurological medical conditions or severe traumatic brain injury; 4) presumed IQ level > 80, and 5) no substance abuse or dependence disorders except for cannabis and/or nicotine use. All patients underwent an assessment at baseline and at one-year follow-up, including sociodemographic and clinical variables (substance use, DUP, PANSS, GAF and CDSS). Fasting blood samples were obtained before administering any medication at baseline. Structural T1 MRI was performed at baseline and brain volumes were quantified though FreeSurfer software. SPSS program was used for statistical analyzes.ResultsLymphocytes have a positive correlation with right and left hippocampus at baseline. Moreover, lymphocytes have a negative correlation with depressive symptoms at baseline and 1 year follow – up.ConclusionsLymphocytes may have a protective effect in some brain structures in FEP patients at baseline, especially those implicated in depressive symptoms.DisclosureNo significant relationships.