Hyperhidrosis, the excessive and uncontrollable sweating, is a well-documented side effect of various medications. Among these, bupropion, a commonly prescribed antidepressant and smoking cessation aid, has been associated with the development of severe hyperhidrosis in a subset of patients. This clinical report aims to shed light on a compelling case of severe hyperhidrosis induced by bupropion use and the subsequent treatment strategies employed

The patient under discussion is a 42-year-old female with a history of recurrent major depressive disorder and a previous favorable response to selective serotonin reuptake inhibitors (SSRIs). Due to side effect concerns and a desire to quit smoking, she was transitioned to bupropion, a norepinephrine-dopamine reuptake inhibitor (NDRI), at a standard therapeutic dose of 150 mg daily.

Approximately four weeks after initiating bupropion therapy, the patient began experiencing debilitating symptoms of excessive sweating, particularly affecting her palms, soles, and axillae. The profuse sweating episodes occurred throughout the day and night, significantly impairing her quality of life, social interactions, and occupational functioning. No previous history of hyperhidrosis was reported, and physical examinations revealed no underlying medical conditions or dermatological issues.

To aknowledge the importance of recognizing and addressing medication-induced side effects within the realm of psychiatry and an early implementation of patient-centered treatment.

Clinical case report and a brief literature review.

The treatment of hyperhidrosis secondary to bupropion use presents a challenging clinical scenario that requires a delicate balance between managing the distressing side effect and ensuring the continued efficacy of psychiatric therapy. Given the rarity of severe hyperhidrosis as a side effect of bupropion, there is a limited body of evidence guiding treatment strategies. Gradual withdrawal in the dose of bupropion was initiated, with careful monitoring of depressive symptoms to prevent relapse, switching to Duloxetine 90mg daily, with adecuate efectiveness.In this particular case, the combination of medication adjustment and psychological support led to a significant reduction in hyperhidrosis symptoms. The patient reported improved social interactions, enhanced self-esteem, and restored occupational functioning. Importantly, her depressive symptoms remained well-managed, underscoring the success of the treatment strategy.

This clinical report highlights the importance of a patient-centered approach when addressing rare medication-induced side effects within the field of psychiatry. Bupropion withdrawal and regular follow-up showed effective in the treatment of the simptoms. Future research may provide additional insights and treatment options for cases like this, further enhancing patient care and outcomes.

None Declared

Psychiatric care is unique in its scope and complexity, as it involves the assessment and treatment of a wide variety of pathologies and, as these patients seek treatment, it is imperative to understand who accompanies them in clinical consultations and how the presence of these companions influences the treatment path. The dynamics between psychiatric patients and their companions in consultation, is extremely important as it can have significant implications for the effectiveness of treatment and the well-being of the patient.. Therefore, the presence of companions can take different forms, varying according to the diagnosis and needs of each person.

Thus, the authors intend, through carrying out a research study, to fill a critical gap in the understanding of presence of companions in psychiatric consultations, exploring the diversity of companions and their profiles in relation to patients psychiatric patients with specific diagnoses. Furthermore, they intend to understand how their presence impacts the process of adherence to the treatment.

To achieve this, they defined a two-year follow-up period, where they examined in detail the composition of companions in psychiatric consultations, including who they are, their relationship with the patient and how this relationship varies according to different psychiatric diagnoses.

The presence of companions in psychiatric consultations is expected to prove to be a significant facet in the field of mental health, providing valuable insights into the dynamics of consultations and the treatment of patients with different psychiatric diagnoses. In this study we highlight how the presence of companions varied in relation to psychiatric diagnoses and how this influenced the process therapeutic. One of the main results was the identification of the different types of companions who were present at the consultations psychiatric disorders, reflecting the diversity of available social support and highlighting the importance of understanding the available support networks. A notable variation in the presence of companions in relation to psychiatric diagnoses was also observed, emphasizing the variations monitoring needs according to the nature of psychiatric disorders, suggesting the need for management strategies personalized treatment. This study also highlighted the influence of the presence of companions on doctor-patient communication and on adherence to treatment, in which the presence of family members often facilitated communication, allowing for a better understanding comprehensive history of the patient.

In conclusion, this study contributes to a more holistic understanding of mental health care provision, highlighting the importance to consider not only the patient, but also the support context in which they are inserted

None Declared

Since December 2019, the coronavirus pandemic has led to the deaths of almost 4.37 million people worldwide and 21,905 people in Tunisia. Containment measures, stress due to fear of infection by the virus and death are likely to be traumatic events, particularly in adolescents, and may lead to the development of symptoms of post-traumatic stress disorder (PTSD).

To determine the prevalence of PTSD in a population of adolescents during the COVID-19 pandemic and to identify the factors associated with it.

This study was a cross-sectional among a representative sample of students enrolled in secondary schools, in the region of Hamma- Gabes. We used a pre-established information sheet comprising 27 questions exploring sociodemographic and family data and specific data relating to the COVID-19 pandemic. The Arabic version of The Child PTSD Symptom Scale (CPSS) was used to screen for PTSD symptoms.

326 adolescents were collected which the mean age was 16.6 years (14 to 18 years). The family environment was conflictual in 11.9% of cases. Among the adolescents, 5.5% had a history of somatic pathology. A history of psychiatric pathology was noted in 0.6%, dominated by depression. Personal infection by Covid-19 was noted in 4% of adolescents. A family member was affected in 27.3% of cases. Adolescents were exposed to the death of a close relative in 22.4% of cases. PTSD was diagnosed (according to the CPSS) in 37.4% of cases, with mild severity in 6.5%, moderate in 0.6%, moderately severe in 8%, severe in 5.2% and extremely severe in 17.2%. The analytical study showed that PTSD was correlated with a conflictual family environment (p=0.017), personal infection by COVID (P=0.003), infection of a close relative by COVID (P<0.001) and the death of a close relative by COVID (p<0.001).

According to our study, the frequency of post-traumatic stress disorder among adolescents during the COVID-19 pandemic was high, underlining the need to screen at-risk populations for populations for early intervention.

None Declared

The issue of screen time usage among children has become a contentious topic for parents in contemporary society. While electronic devices offer undeniable benefits, their inappropriate use can lead to substantial mental and physical health challenges for children. Parents are tasked with the responsibility of equipping themselves and their children with the knowledge and skills necessary for mindful electronic device use.

This study aims to assess the awareness levels of mothers regarding their children’s screen time usage and to promote mindful screen usage. It also aims to understand the reasons behind parents’ decisions to allow their children access to electronic devices.

An adapted short online screen-time questionnaire (Vizcaino et al 2019), was distributed through online Google forms, primarily to mothers residing in India. The questionnaire comprised of ten questions encompassing topics related to the child’s background, mothers’ awareness and patterns of screen-time usage.

213 mothers with children aged one year to 17 years responded. 157 mothers (73.7%) were in employment (104 were working in an office, 32 were working from home and 18 were freelancing). 121 mothers had >one child. Majority of the mothers (n=170, 79.81%), believed that children should have <one hour screen-time. However, they also admitted that majority of their children spent >one hour per day screen-time. The usage was more during weekends (>one hour=161, 75.58%) than weekdays (>one hour = 145, 68%)(p=0.021). Weekend screen-time was more in children whose mothers were employed (p=0.006). There is a significant increase in weekday (p=0.044) and weekend (p=0.006) screen-time usage as the child’s age increased. Children predominantly watched television, followed by mobile phones and tablets. Except for 29 children, the rest enjoyed interacting with other people (54 with everyone, 73 with only family members and 57 only for some time). The primary context in which children engaged with electronic devices was while they were being fed/ meals-time (n = 114,54%) or when the mothers were busy with household chores (n = 85,40%).

Despite maternal awareness about healthy screen-time, majority of the children were allowed to use higher screen-time. Efficient strategies should be imparted to parents to change the current practices of using digital-media as pacifier or distractor to mindful screen-time including usage for educational purposes.

H. Atturu Consultant of: Advisor to CognitiveBotics, AI based software., S. Gujju: None Declared

Hematological diseases represent a diverse disease group ranging from benign to life-threatening conditions, with hematological malignancies being a major cause of mortality in the population worldwide. Although most hematological diseases require ongoing medical care making these conditions even more difficult for patients to endure. Since these diseases can pose many challenges by causing symptoms and limitations in various aspects of daily life, health-related quality of life (HRQoL) is a crucial aspect of their healthcare. Different dimensions of health-related quality of life are influenced by several psychological factors, including illness perception, stigmatization, and optimism: a more positive illness perception, along with optimism and reduced stigmatization, can contribute to a better HRQoL among hematology patients.

Since hematological diseases often cause serious life changes, the current study aimed to explore the direct and indirect effects of illness perception on health-related quality of life among hematology patients in Hungary, including stigmatization and optimism as possible contributors.

In this cross-sectional study, 96 hematology patients (mean age = 56.45 years; SD = 15.55 years; 43.8% female) completed a self-administered survey including the following instruments: EORTC Quality of Life Scale, Brief Illness Perception Questionnaire, Stigma Scale for Chronic Illness, Revised Life Orientation Test.

By creating two pathway models, illness perception had significant indirect effects on physical functioning (β = -.205, p < .05) through role and cognitive functioning while emotional functioning had significant indirect effects on social functioning (β = .369, p < .01) through illness perception and stigmatization, both effects moderated by optimism. After controlling for other factors, both illness perception and emotional functioning directly influenced physical and social functioning, respectively.

Our study supports previous research on the direct and indirect effects of illness perception on HRQoL. Based on our data, more optimistic illness perceptions and greater emotional functioning improve hematology patients’ health-related quality of life by facilitating an unbiased understanding of the disease. Optimism serves as a potential moderating mechanism by positively altering indirect effects. Healthcare professionals need to optimize patients’ illness perception to improve physical and social functioning.

H. Kiss Grant / Research support from: This work was supported by the New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund, #ÚNKP-22-4-SZTE-301., V. Müller: None Declared, K. Dani: None Declared, B. Pikó: None Declared

Studies conducted up to date on the subject of deprivation of sleep (DS) primarily focused either on its impact on certain cognitive abilities or mood-enhancing effects in patients with depression. A notable body of evidence suggests that both might be related to alterations in neurotrophin synthesis induced by DS. However, the role of NTs as an interface between DS, mood, and cognitive functions is unclear.

The study aimed to investigate associations between cognitive abilities measured by Trail Making Test (TMT) and Stroop Color and Wort Test (ST), serum protein concentrations of brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), neurotrophin-3 (NT3), neurotrophin-4 (NT4) as well as the expression of their respective genes after a night of sleep deprivation.

Each participant (n=76) underwent a 24-hour DS under the control of actigraphy. Venous blood collection, TMT, and ST were carried out in the morning after DS. Mood was evaluated twice, after DS and in the preceding evening; based on the alleviation of depression symptoms participants were divided into respondents (RE; n=47) and non-respondents (NR; n=29). Serum protein concentration was determined using ELISA kits. Gene expression was evaluated by quantitative real-time polymerase chain reaction with gene-specific probes (reference gene: β-actin). Relative expression was calculated using the Livak formula. TMT is a neuropsychological instrument; Part 1 is thought to evaluate mostly attention, whereas Part 2 executive functions. ST is a 2-part test applied in the assessment of response inhibition and complex attention.

In RE, cognitive abilities were not associated with expression levels of any of the studied proteins or mRNA (all p>0.05). In NR, BDNF and GDNF mRNA expressions negatively correlated with TMT Part 1 (p=0.017, p=0.048, respectively); scores obtained in TMT Part 2 bore a similar relation to BDNF, GDNF, and NT4 mRNA (p=0.034, p=0.041, p=0.026, respectively). In this group, expression of all BDNF, GDNF, NT3, NT4 mRNA correlated negatively with both parts of ST (p<0.001, p=0.009, p=0.042, p=0.009 for Part 1; p<0.001, p=0.003, p=0.031, p=0.014 for Part 2, respectively).

Those results suggest that alterations in the synthesis of NTs might be an element of the molecular milieu characterizing different types of DS response. Negative correlations between test scores and NT mRNA expressions could imply that the reduction of the production of NT proforms might protect against the decline of cognitive functions in the aftermath of DS. Projects using a larger battery of tests as well as analyzing immature forms of NTs would be desirable in order to further investigate mechanisms underlying DS response.

None Declared

Emotional competencies, according to Bisquerra Alzina & Escoda (2007), refer to “knowledge, skills and attitudes necessary to understand, express and appropriately regulate emotional phenomena” (p. 22) in the management of emotions with oneself and with the other.

Measure the emotional competencies Empathy, Emotional Expression and Emotional Regulation in health professionals in healthcare centers.

Quantitative descriptive. The Inventory of Emotional Competencies for Adults (Mikulic, Crespi, Radusky, 2015) was applied to 30 participants (doctor, psychologist, nurse, dentist).

The grouped measurements show skills at a medium and high level.Table 1.

Measurement of empathy capacity, emotional regulation capacity and emotional expression capacity

The emotional reaction of congruence with the emotional state of the other, empathy, shows a medium level (Table 1), a result consistent with the study by Ruiz González (2019), in the Colombian population, where a medium level of empathy is observed in doctors.

In the strategy for management, support, increase and suppression of the current affective state to self-soothe and find a state of relaxation, it is at an average value between medium and high (table 1.)

In the ability to start and maintain conversations, express one’s own thoughts and feelings clearly, both in verbal and non-verbal communication, and demonstrate to others that they have been well understood, the level is mostly medium (table 1.)

The levels of emotional competencies evaluated are mostly in the middle in the assessment by dimensions, empathy registered a lower level in contrast to other dimensions.Taking into consideration professional practice, response to organic and mental human vulnerability, it is a field for promoting the well-being of the health professional.

None Declared

Numerous countries, notably within Europe, have sanctioned the practice of euthanasia. Extant legal frameworks meticulously define the extent, essence, and application of euthanasia, encompassing divergent characterizations, explications of entitlements, procedural modalities, and provisions for access. Nonetheless, the precise function of psychiatrists within these legislative contours remains conspicuously nebulous.

The present inquiry undertakes a comprehensive evaluative review of the euthanasia phenomenon vis-à-vis the intricate tapestry of European legislative paradigms, with an emphasis on elucidating the multifaceted involvement of psychiatry within this evolving landscape.

A nuanced narrative review is undertaken, encapsulating the contemporary state-of-affairs, fundamental conceptual architectures, the tenets of the Spanish Organic Law 03/2021, and the pharmaceutic armamentarium deployed in the orchestration of euthanasic practices. Additionally, the methodological blueprint employed within a prominent tertiary healthcare institution situated in Madrid is meticulously expounded.

To date, euthanasia has garnered legal imprimatur across diverse jurisdictions including, but not limited to, the Netherlands, Belgium, Colombia, Canada, Spain, and New Zealand. The ambit of assisted death and its application to the domain of mental infirmities is meticulously deconstructed. Within the overarching realm of foundational concepts, a rigorous delineation is rendered between euthanasia, medical succor in the throes of mortality, assisted self-termination, facilitated demise, provision of mortal release, judicious calibration of therapeutic enterprise, and the contours of palliative sedation. Distinction between the principal executor and the advisory consultant is rendered salient. The rubric of conscientious objection emerges as an inviolable entitlement of healthcare practitioners enmeshed in the provisionary matrix.

The enduring incumbency of the psychiatrist as a pivotal appraiser of cognitive and volitional faculties holds firm. The conspicuous influence of psychopathological constellations upon the contours of euthanasia eligibility precipitates cogent deliberation.

As the frontiers of euthanasia expand to encompass an augmented array of legal jurisdictions, this study underscores the increasingly intricate role inhabited by psychiatrists in the matrix of evaluative assessments. The proclivity of mental maladies to exert a substantial gravitational pull upon determinations of eligibility for euthanasia accentuates the exigency for refined explication of roles and responsibilities within this evolving sphere, a clarion call resonant not only within the precincts of psychiatry but reverberating across the broader firmament of medical praxis.

None Declared