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Insomnia and depression as risk factors for dementia. A scoping review
- I. Duran-Cristobal, A. Noguero-Alegre, A. M. Matas-Ochoa, S. Rubio-Corgo, F. J. Gomez-Beteta
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S80
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Introduction
One of the most important functions of sleep may be the promotion of brain development. The non-REM and REM sleep sequences show the succession of cerebral processing phenomena that underlie memory consolidation. The negative consequences of sleep loss on neural and behavioral plasticity has been examined. On the other hand, sleep disruption can be a crucial symptom to develop depression disorders. Recent literature suggests that maintenance insomnia may be a risk factor for dementia. It would be important to elucidate which factors may increase the risk of developing dementia and aggravating its progression.
ObjectivesThe aim of this scoping review is to point out the increased risk of developing dementia related to insomnia and depression.
MethodsRelevant literature was searched with PUBMED as electronic database. We used and combined the following MeSH terms: depression, insomnia, cognitive impairment and dementia. We chose sixteen recent studies from 2009 to 2021. Four of them were ruled out because the methodology and conclusions were not enough evident.
ResultsWe underlined an interesting research which was carried out with Chinese population in 2021. A total of 256 patients with insomnia disorder were diagnosed by neurologists, 45 of whom were diagnosed with amnesic mild cognitive impairment (aMCI) and 45 participants with intact cognition were chosen as controls matched for age and education. A case-control study was conducted to compare sleep structure between aMCI and control patients with insomnia disorder. An American prospective research in 2016 founded a statistically significant association with a higher MCI/dementia risk in women with either short (≤6 hours/night) or long (≥8 hours/night) sleep duration (vs.7 hours/night). The relationships between depression, cognitive function, serum brain-derived neurotrophic factor (BDNF) and volumetric MRI measurements in older adults were investigated. A total of 4352 individuals aged 65 years or older (mean age 72 years) participated in this Japanese study.
ConclusionsAccording to these researches, we emphasize the importance of detecting sleep disturbances as potential risk factors for MCI and dementia. All of them provide evidences that future studies should investigate dementia prevention among elderly individuals through the management of insomnia. At that point we have to consider personalized medicine and machine learning techniques for sleep and cognitive or mood symptoms.
Disclosure of InterestNone Declared
Chronic disease (CD) during transition from child to adult.Psychopathological consequences and coping strategies
- S. Rubio Corgo, M. Arrieta Pey, A. M. Matas Ochoa, M. I. Duran Cristobal, E. Perez Vicente, A. Delgado Campos, C. Diaz Gordillo, A. C. Castro Ibañez, A. Alvarez Astorga, P. Alcindor Huelva
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S745
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Introduction
CD is characterized by at least three features: its duration is prolonged, it does not resolve spontaneously and it is rarely completely cured. Approximately 10-15% of young people have CD. Adolescents with CD often have emotional and behavioral problems.
ObjectivesTo assess risk factors, derived psychiatric pathologies and coping strategies for a CD diagnosis in adolescence.
MethodsAn extensive literature review was carried out on the subject in question, extracting information mainly from scientific articles, manuals and books.
ResultsThe main risk factors are those related with the CD in question, physical sequelae, the need for long-term hospital admissions or the use of drugs whose side effects include affective or behavioral symptoms; those related to the personality traits of the affected child or adolescent. In addition, as far as the family is concerned, the presence of a low level of education, lack of support or communication, as well as the presence of psychiatric disorders or serious medical conditions in parents. Among the most frequent psychiatric disorders associated with CD are affective and anxiety disorders, adaptive disorders, somatoform disorders, eating disorders and behavioral disorders. Whatever the CD is, it generates high levels of stress and uncertainty in the patient and family, which must be dealt together from a flexible perspective, allowing child or adolescent to adapt to the changes, reorganize and facing them with adaptive patterns of behavior. For this, it will be essential to have adequate social and family support with relational style based on communication, trust and acceptance.
ConclusionsIn general, both adolescents with CD and their families have an adequate capacity to adapt to the repercussions and effects derived from the disease. Nevertheless, in case of possible emotional difficulties that may appear, a comprehensive and individualized approach to these adolescents and their families is necessary to provide them resources and coping strategies in different areas and contexts in which the disease debuts.The comprehensive therapeutic approach will consist of interventions at the individual and family level. Among the main objectives of these interventions are to achieve acceptance and adaptation to CD provinding adequate psychosocial support to enable them to cope with CD in the best possible way and to detect and address the emotional implications, even coexisting psychopathology.
Disclosure of InterestNone Declared
Metaverse and mental health, what about the future?
- A. M. Matas Ochoa, S. Rubio Corgo, I. Durán Cristóbal
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S555
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Introduction
The metaverse is a digital world created using different technologies like virtual reality (VR), augmented reality (AR), cryptocurrency and the internet.
Interest in the metaverse has grown in recent months in different fields and it could have potential application in the treatment of mental health disorders.
ObjectivesTo gain a better understanding of metaverse and to explore its possible applications on mental health.
MethodsReview of recent literature about the implications of the metaverse users in mental health.
ResultsMetaverse is a virtual universe where people can interact with other users, objects, and environments personifying an avatar. VR, AR and mixed reality (MR) have been used in the treatment and diagnosis of various mental health disorders for last years.
Attention deficit hyperactivity disorder, eating disorders, anxiety, phobias and post-traumatic stress disorder have been already benefited from VR. Also, there are results to treat persecutory delusions in psychosis. On the other hand, we know that to spend a significant amount of time playing 3D immersive games and using social media, could lead to insecurity, anxiety, depression and behavioural addiction.
The lack of evidence and these risks could be limitations to implement Metaverse for the therapeutic management of mental health.
Many companies have already started to develop virtual mental health clinics with mental health professionals serving patients in real time, some spaces have already offer group therapy sessions. Other immersive spaces have also been created for practising mindfulness, meditation, or yoga.
ConclusionsThe new technologys have changed the way that we socialise, work, and interact, even the way that we receive medical treatment. The metaverse could prove useful in the management of the mental health disorders that have already benefited from VR, but at the same time we could potentially lead to the worsening of others.
Disclosure of InterestNone Declared
Blood polyamine levels in drug-free schizophrenics
- C. Riaza Bermudo-Soriano, C. Vaquero-Lorenzo, M. Dîaz-Hernândez, M. Garda Dorado, P. Sânchez-Pâez, I. Durân Cristobal, R. Manzanero Estopinân, J. Gômez-Arnau, E. Baca-Garcîa, J. Pérez Piqueras, J. Sâiz Ruiz, A. Chinchilla Moreno
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- Journal:
- European Psychiatry / Volume 26 / Issue S2 / March 2011
- Published online by Cambridge University Press:
- 16 April 2020, p. 1492
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Background
Natural polyamines (putrescine, spermidine and spermine) are low molecular weight highly protonated aliphatic molecules that physiologically modulate NMDA, AMPA/kainate glutamatergic receptors and limbic dopaminergic neurotransmission. Previous studies had demonstrated that polyamine metabolism might be disrupted in schizophrenia, what could potentially be linked to glutamatergic dysfunction. In particular, polyamine levels in blood and fibroblast cultures from patients with schizophrenia had previously been found to be higher than in healthy controls. Indeed, a significant positive correlation between blood polyamine levels and severity of illness may exist.
MethodsIn order to test potential differences in blood polyamine levels between drug-free schizophrenia in-patients (n = 12), and healthy controls (n = 26, blood donors), spermidine (spd), spermine (spm), and spermidine/spermine index (spd/spm) were determined using HPLC after dansylation.
ResultsNo significant differences were found between groups (t = 0,974; df = 36; P = 0,337 for spd, t = l0, 52; df = 36; P = 0,959 for Spm, and, t = 0, 662; df = 36; P = 0,512 for spd/spm).
ConclusionsThough we couldn’t replicate previous findings suggesting disturbances in blood polyamine levels in schizophrenia, this issue may be a promising target. Future research should take into account possible factors such as sex, nutritional state, and stress.
Profitability of cranial CT scans in emergency services
- D.C. de la Vega, M. García Dorado, J. Andrada Meyer, I. Durán Cristóbal, Á. Arcenegui Calvo, A. Chinchilla Moreno
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- Journal:
- European Psychiatry / Volume 26 / Issue S2 / March 2011
- Published online by Cambridge University Press:
- 16 April 2020, p. 918
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Introduction
The request of diagnostic imagining techniques, such as CT, is sometimes necessary when working in the emergency service as a psychiatrist. Common circumstances that need CT are altered level of consciousness, absence of psychiatric history, sudden beginning of the symptoms or visual hallucinations.
ObjectivesTo study the profitability of the cranial CT for patients with psychiatric symptoms in the Emergency Service.
MethodsRetrospective review of the cranial CT was made to patients who presented psychiatric symptoms in the Emergency Service of our hospital from November 2009 to July 2010 using Hospital Ramon Cajal’s history software.
ResultsWe collected a total of 94 patients.-Sex: there were no important differences, 45,7% were women and 53,3% were men. -Age: < 18 years (3,2%), 18–30 years (12,8%), 31–40 (7,4%), 41–50 (26,6%), 51–60 (17%), 61–70 (14,9%), >71 (18,1%) Cause of consulting: The most frequent cause of consulting was “behavior disorder” (35,1%) and psychotic symptoms (14,9%). Other causes were altered level of consciousness and neurological symptoms.
Image findings: It stands out that up to a 63,8% of the patients had no significant radiological findings. The most frequent diagnosis (26,6%) was cortical-subcortical atrophy, followed by vascular cerebral illness in 9,6%.
Diagnosis: 20,2% were diagnosticated of psychotic disorder, 11,7% neurological disorder and 10,6% dementia.
Conclusions- Only in 6,4% of the cases the image results were indispensable to reach a correct diagnosis.
- Cranial CT requests should not be made routinely and guides should be followed more strictly.