6 results
Werther effect in the juvenile population. About a series of cases
- M. Valverde Barea, A. Alvarado Dafonte, L. Soldado Rodriguez, A. España Osuna
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1112-S1113
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Introduction
Suicide is currently one of the biggest public health problems, it is the third cause of death in the age group between 15 and 29 years (16.36% of young people who died in 2013). The ‘Werther effect’ refers to the mimetic behavior of the suicidal act, thus making reference to the controversial novel “The Sorrows of Young Werther” by Goethe, in 1774. The population most susceptible to this influence is the most vulnerable and ambivalent, such as they can be adolescents and young people, people with personality disorders and drug use. Durkheim considered that imitation was not due to the contagion effect of making suicides public, but to the social conditions of some places, which were what caused people to commit suicide.
ObjectivesThe objective of the case is to expose the vulnerability to the imitation of suicidal behaviors of young people suffering from personality disorder and drug use.
MethodsWe present the case of 4 young people between 18 and 21 years old (3 women and 1 man) from the same group of friends who, after the death by suicide of a 20-year-old boy, in the following 2 months, carried out suicidal behavior by taking medication they found at home and consumption of different drugs.
ResultsThe two 21-year-old patients planned for the first month of the anniversary of the friend’s death, the intake of drugs and medication and leave a farewell note explaining the reasons. The patients required hospitalization in an acute mental health unit, one patient developed myocarditis secondary to toxins, during hospitalization they undergo psychotherapeutic treatment and are evaluated, leading to the diagnosis of Borderline Personality Disorder and Multiple Drug Use Disorder. The 20-year-old patient took medication on the anniversary month but did not require hospitalization. He underwent outpatient follow-up at a day hospital. During the therapeutic process, he was diagnosed with schizoid personality disorder. The 18-year-old patient required hospitalization for structured self-injurious ideation with a risk of acting out at 2 months, psychotherapeutic treatment was started and she was diagnosed with borderline personality disorder and harmful drug use. The 4 young people continue outpatient follow-up by both the community mental health unit and the addiction treatment center.
ConclusionsWe observe in the series of cases exposed, the vulnerability of young people suffering from personality disorders and drug use to suicidal behavior, so risk factors for their prevention must be identified and continue working on adequate information of suicidal acts, whether completed or not, to avoid imitation phenomena. In all cases, suicide should not be seen as a desirable alternative and strategies to cope with difficulties and emotional management should be offered and promoted, especially in this young population that is still developing and is more vulnerable.
Disclosure of InterestNone Declared
Evaluation of self-stigma in patients with mental illness from hospitalization in the Mental Health Acute Unit
- M. Valverde Barea, A. España Osuna, M. O. Solis Correa
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S437
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Introduction
Stigma is a complex process and a universal phenomenon that is part of all social groups and that is maintained by its functions related to the establishment of one’s own identity and the facilitation of socialization processes. The stigma of the patient is important to evaluate since it is a subjective experience that can have negative correlations in relation to self-esteem, empowerment and recovery orientation of the patient with mental illness. Hospitalization in mental health takes place at times of mental illness decompensation and is an intervention closely related to the stigma towards mental illness.
ObjectivesThe objective of the study is to evaluate the stigma perceived by patients with mental illness hospitalized in an acute mental health unit.
MethodsObservational study with 53 patients hospitalized in an acute mental health unit.
Variables collected: Sociodemographic variables (age, sex), clinical diagnosis and stigma is evaluated with the Illness Self-stigma Scale (ISMI).
ResultsSample of 53 patients, 55% women and 44% men, the most frequent diagnoses among those admitted are psychosis spectrum 26.42%, depressive disorders 24.53%, personality disorders 22.64% and bipolar disorders 11.33%. The average age is 41.96 years, between 18 and 72 years. The self-stigma according to the scale (ISMI) we obtain as a total score the patient with the highest stigma scores 100 points and the one with the least scores 44 points. Regarding diagnoses, depressive disorders score 33-72 points, while psychotic disorders score 36-85 points. The highest scores in self-stigma in our study are in personality disorders 49-100 and borderline personality disorder stands out (100 points). In the 5 subscales such as alienation, self-stigma, perceived discrimination, social isolation and resistance to stigma. Higher scores in alienation stand out in all patients.
ConclusionsPatients with personality disorders, especially borderline personality disorder, followed by psychotic disorders, present greater perceived self-stigma in our study than the rest of the patients; it is a very important factor that can affect the evolution of the clinical picture. This factor is important to establish the therapeutic plan and the different interventions, it would be recommended to assess the stigma together with the measures to reduce symptoms.
Disclosure of InterestNone Declared
“When the virus decompensated the neurosis.” About a case
- M. Valverde Barea, A. España Osuna, P. Vargas Melero, M. Solis
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S524
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Introduction
The COVID-19 pandemic and social and mobility restriction measures have had a negative impact on the mental health of the population.
ObjectivesThe objective is to demonstrate the impact of the pandemic on mental disorders.
Methods64-year-old man who is taken to the emergency room after a suicide attempt, by hanging with a belt out of concern and measuring the contagion of the COVID-19 virus in the context of long-standing delirious ideas of contamination and hypochondriacal neurosis. Adaptive disorder in relation to previous divorce. Psychopathologically, the patient is anxious and restless, conscious, inattentive and poorly oriented in space and time. Accelerated language with monothematic discourse about the possibility of contagion that has caused isolation behavior to the point of shredding organic waste and throwing it down the toilet so as not to have to go out to throw it out for fear of contagion. Faced with a neighbor’s wake-up call due to a blocked pipe, he suffers a crisis of guilt and anxiety and attempts to commit suicide. COVID-19 PCR=negative. Beck’s Depression Inventory 24=moderate depression. IPDE accentuated obsessive and avoidant personality traits.
ResultsDiagnosis: Moderate depressive episode with psychotic symptoms. Hypochondriacal disorder. Ananchastic personality disorder. Treatment: Paliperidone 3mg/24h. Sertraline 100mg/24h
ConclusionsIn obsessive personalities and hypochondriacal neuroses, the COVID-19 pandemic has posed an increased risk of decompensation for affective disorders and even suicide attempts. Isolation, lack of treatment and prior monitoring, as well as the difficulty of identifying vital stressors, must be taken into account if an early intervention is to be carried out.
DisclosureNo significant relationships.
Dyskinesias in childhood, differential diagnosis and treatment. About a case
- M. Valverde Barea, C. Mata Castro, P. Vargas Melero, A. España Osuna
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S439
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Introduction
Dyskinesias are motor disorders that occur as a side effect to treatment with typical and less frequently with atypical antipsychotic drugs. They are more frequents in child population. Treatment usually consists of decrease the dose of drug or replace it with a better profile tolerability antipsychotic. Clozapine is an antipsychotic drug indicated as second-generation treatment of motor disorders that appear as side effects to treatment with neuroleptics.
ObjectivesDemonstrate the efficacy and tolerability of clozapine in the treatment of dyskinesias in childhood.
MethodsThe patient 12 year-old boy, has episodes of psychomotor agitation once a month. This will alternate with quiet moments in which dyskinetic movements are observed in upper limbs, without being able to detect any type triggering environmental factor. Personal history: hydrocele, diagnosed at 8 years becomes neurodevelopmental disorder considered. Neurosurgery tracking for Subarachnoid cyst. Psychopathological examination: Child presents psychomotor restlessness, disruptive behavior, impairments in communication, movement disorder, stereotypies and dyskinetic movements in shoulder and neck.
ResultsIn the patient suffering from an autistic disorder, stereotypies and other motor symptoms were observed, the predominant and most relevant being dyskinetic movements in the shoulder and neck, which appeared one month after starting treatment with risperidone and worsening psychomotor skills. Treatment of dyskinesia with clozapine improved the motor symptoms presented by the patient.
ConclusionsClozapine should be the treatment of choice in the event of dyskinesias as a secondary effect to other antipsychotic treatments, proving effective in controlling them as well as well tolerated in both adults and children.
DisclosureNo significant relationships.
Psychiatric symptoms and COVID-19, the importance of differential diagnosis. about two cases
- M. ValverDe Barea, M.O. Solis, L. Soldado Rodriguez, A. España Osuna
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S270
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Introduction
The COVID-19 pandemic presents symptomatic heterogeneity, so the differential diagnosis is even more relevant and more in patients with mental disorders. COVID-19 is a new disease that is under study and affects people over 65 with the greatest severity worldwide. The most frequent psychiatric symptoms are behavioral disturbances and confusional syndrome among those affected.
ObjectivesThe objective is to demonstrate the importance of differential diagnosis in patients with psychiatric symptoms and covid-19.
MethodsPatients aged 71 and 77, admitted to psychiatry. They present drowsiness that alternates with episodes of psychomotor agitation in which they verbalize fear of the coronavirus. Personal history: bipolar disorder and schizoaffective disorder. Psychopathological exploration: Spatial-temporal disorientation, uncooperative, fluctuating state of consciousness, verborrheic, salty and incoherent speech at times. Dysphoric mood. Psychomotor restlessness predominantly at night, verbal heteroaggressiveness. Negative to ingestion due to odynophagia. Sensory-perceptual alterations and nihilistic delusions “the virus has killed me, I’m already dead.” Upon admission, they present a cough and fever and are treated with azithromycin and dexamethasone for suspected COVID-19. Complementary tests: chest X-ray bilateral pleural effusion. Cranial CT: Diffuse cortical and subcortical brain parenchyma retraction pattern. PCR positive coronavirus.
ResultsAfter overcoming the infection and with psychopharmacological treatment the confusional syndrome remitted.
ConclusionsConfusional syndrome can present with different psychiatric symptoms, so the differential diagnosis is very important and even more so in patients older than 65 years who present somatic pathologies or acute infections. The differential diagnosis of confusional syndrome is key to adequate treatment and favor the prognosis.
Parkinson's disease and psychosis: Report of a case
- M. Valverde Barea, A. España Osuna, F. Cartas Moreno
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- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, pp. s843-s844
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Introduction
Jealous delusional ideation appears in 7-14% of cases of Parkinson's disease. Treatment with dopaminomimetics drugs is a significant risk factor for psychosis. However, the most likely etiology of psychosis in these patients is a loss of central cholinergic function associated with age since described psychosis even before the introduction of the L-Dopamine. Cognitive impairment and sleep disorders are predictors of development of psychosis.
ObjectivePresent a clinical case of psychosis in Parkinson's disease and its treatment.
MethodReason for consultation. Patient diagnosed with Parkinson's disease with behavioral disorder and delusional.
Current illnessThe patient after antiparkinsonian medication has increased suspicion, self-referentiality, delusional jealousy ideation to her husband, delusional interpretations regarding somatic symptoms, insomnia and behavioral disorders with aggression.
Family backgroundMother with Alzheimer's.
Personal historyNo contact with mental health.
Psychopathological examinationConscious, repetitive language, dysphoric mood with delusions of prejudice and jealousy.
Mixed insomnia.
DiagnosisPsychosis in Parkinson's disease.
TreatmentQuetiapine 300 mg/day. Carbidopa 25 mg/L-dopa 100 mg: 1-0-1. On subsequent visits quetiapine was suspended and replaced by clozapine 200 mg/day.
ResultsThe treatment of psychosis was effective with the use of quetiapine and subsequently clozapine with good tolerance and effectiveness. He also said lower antiparkinsonian medication.
ConclusionsPsychotic symptoms are the most common psychiatric clinic in Parkinson's disease. Often not enough antiparkinsonian dopaminomimetics reduced to control psychotic symptoms and use of antipsychotics is required. The use of antipsychotics in Parkinson's disease should be careful for the likely increase in motor clinical and increased mortality. The most useful, are especially quetiapine and clozapine atypical antipsychotics.
Disclosure of interestThe authors have not supplied their declaration of competing interest.