6 results
Neuroimaging in Internet gaming disorder comorbid with Attention-deficit disorder
- B. Wildenberg, R. Pires, D. Pereira, I. Faria, N. Madeira
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S912
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Introduction
Internet gaming disorder (IGD) refers to a pattern of persistent gambling behaviour or recurring gambling, on the Internet, with impaired control, increased priority, and continuation or escalation of gambling despite the occurrence of negative consequences. Currently, online gambling - more frequent among men - represents a very important, constantly growing economic activity. Since the COVID-19 pandemic and the need to conduct classes online, there has been an increase in the rate of IGD in children and youth (7-25 years old). Comorbidities, namely attention deficit hyperactivity disorder (ADHD), have been associated with a higher prevalence of IGD. They share core traits, such as impulsiveness, seeking immediate reward, deficient motivation, and hostility, which may translate into neuroimaging similarities.
ObjectivesNon-systematic review of the literature about neuroimaging of IGD comorbid with ADHD.
MethodsA search was conducted on PubMed and other databases, using the MeSH terms “Internet Addiction Disorder”, “Attention Deficit Disorder with Hyperactivity” and {“MRI” OR “fMRI” OR “functional connectivity” OR “neuroimaging OR neural alteration OR neuronal alteration OR neural change"}.
ResultsIGD and ADHD have shared and disorder specific patterns of structural and functional abnormalities, particularly in reward function. For instance, IGD has been associated with lower putamen grey matter volume (GMV), while ADHD patients have lower GMV in the orbitofrontal cortex. Disorder-specific fMRI activation has been observed in the precuneus in IGD; in ADHD, there is special activation in the fusiform gyrus. Finally, shared structural and functional alterations between IGD and ADHD seem to converge in the prefrontal-striatum circuit, especially the anterior cingulate cortex.
ConclusionsADHD has been suggested as the most significant predictor of IGD in cross-sectional and prospective studies, however there is no study that clarifies their relationship. It is unclear whether IGD causes ADHD symptoms or whether a problem with gambling is a prodromal sign of the development of full ADHD. Studies revealing common neurobiological foundations between these disorders are pivotal to understand their basic mechanisms, while alerting to the necessity to screen for both pathologies when one is present. They may also point to an overlapping target (the reward circuit) for behavioural and pharmacological treatment.
Disclosure of InterestNone Declared
Alcohol related dementia and Brain Imaging
- I. Faria, J. Galiano, B. Wildenberg, T. Silva, C. Silva
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S516
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Introduction
Alcohol is considered a social evil worldwide owing to its vast array of associated problems and complications, which may manifest in medical, legal or social domains. Excessive and prolonged alcohol use may lead to permanent structural and functional damage to the brain. The evidence from neuroimaging, neuropathological reports and autopsy evaluations suggest some degree of brain pathology in individuals diagnosed with an alcohol related disorder.
ObjectivesThe aim of this study is to characterize the structural imaging findings on computed tomography (CT) and magnetic resonance (MR) imaging of our sample and provide an overview of the literature on the subject.
MethodsRetrospective observational study with inpatients of Coimbra Hospital and University Centre (CHUC), who had alcohol use disorder diagnosis associated with dementia or cognition deficit. Patients were admitted from 2017 to 2021 and submitted to neuroimaging: CT and MR. Data was collected in May 2021 at informatic system.
ResultsAmong 38 participants, the median age was 64 years; 86,8% were male. 35 realize CT, 34 with alterations: 23 with microvascular lesions, 17 with cortical atrophy, 8 with white matter hypodensities and 7 with subcortical atrophy. From all patients, only 14 realize MR, 13 with alterations, the most common vascular leukoencephalopathy and cortical atrophy.
ConclusionsOur results support the hypothesis of neuroimaging changes resulting from alcohol consumption. The severity of alcohol dependence also correlates with neuropathophysiological and neuroimaging changes. Volume shrinkage, altered glucose metabolism and perfusion along with evidence of markedly decreased neuron density are commonly reported. The evidence of neuro-circuit disturbances is seen in form of significant loss of white matter (most prominent in the prefrontal cortex, cerebellum and corpus callosum) on functional imaging. Greater cognitive impairment has been associated with multiple and repeated withdrawal due to greater neuronal damage, and can limit the psychotherapeutic intervention, the adherence to pharmacological therapy and abstinence maintenance. The sheer presence of alcohol use disorder should encourage a neuroimaging evaluation.
Disclosure of InterestNone Declared
Perinatal depressive symptoms in Portuguese new fathers and mothers during COVID-19 pandemic
- D. Pereira, A. Macedo, C. Cabaços, B. Wildenberg, N. Madeira, A. T. Pereira
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S784-S785
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Introduction
Postpartum depression, refers to depressive symptoms within a 12-month period after the birth of an infant in a new father or mother. It’s have been a growing mental health concern, as it is one of the leading causes of poor familial and infant health outcomes. Despite the growing attention being given to fathers’ depression, including in Portugal, prevalence data and its possible correlates are still scarce compared to depression in mothers, especially during the COVID-19 pandemic.
ObjectivesTo explore and compare levels of depressive symptomatology and to analyze potential correlates for postpartum depression in Portuguese new mothers and fathers during the COVID-19 pandemic.
Methods153 men and 187 women (mean age: 36.61± 4.99 vs. 32.98 ±5.00 years, respectively) were recruited in the perinatal period (7.29±3.22 vs 8.58± 0.97 months post-partum) and answered to an online survey that included questions related to sociodemographic and psychosocial variables and validated questionnaires: Perinatal Depression Screening Scale (PDSS), Perseverative Thinking Questionnaire (for Repetitive Negative Thinking/RNT) and Dysfunctional Beliefs Towards Motherhood/Fatherhood Scale (DBTM/F). Statistical analysis was performed using IBM Statistical Package for the Social Sciences (SPSS Version 26 for Mac).
ResultsNew-mothers had significantly higher levels of depressive symptoms than new-fathers (41.89±16.94 VS. 33.95±14.99, p<.001). Based on the PDSS’ cutoff point the prevalence of clinically relevant depressive symptoms in male and female progenitors was 21.6% and 39.6%, respectively (p<.001).
DBTF were significantly higher compared to DBTM (p<.05). Male and female progenitors did not differ regarding levels of RNT.
DBT-M/F (r».40) and RNT (r>.55) significantly and positively correlated with PDSS scores.
In both genders, DBT-M/F and RNT significantly (p<.01) predicted PDSS scores explaining 33.8% (Beta: DBT=.136, p=.050; RNT=.538, p<.01) of its variance in fathers and 50.4% in mothers (Beta: DBT=.218, p=.001; RNT=.565, p<.01).
ConclusionsDuring the COVID-19 pandemic, Portuguese recent mothers had higher levels of depressive symptoms when compared to recent fathers. However, in both new mothers and fathers, depressive symptoms’ prevalence and severity were higher than the figures found in samples of new parents outside of the pandemic period and of samples from the general population. Addressing DBT-M/F, as well as RNT, in recent parents, could be relevant in preventing/improving their depressive symptoms.
Disclosure of InterestNone Declared
Epileptic Seizures or not, that is the question: a case report
- B. Wildenberg, D. Pereira, I. Carvalho, N. Madeira
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, pp. S395-S396
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Introduction
Psychogenic nonepileptic seizures (PNES) consist of paroxysmal changes in responsiveness, movements, or behaviour that superficially resemble epileptic seizures.
ObjectivesPresentation of a clinical case of a PNES in a patient with a diagnose of secondary epilepsy, illustrating the relevance of an adequate evaluation, differential diagnosis, and intervention.
MethodsDescription of the clinical case, with brief literature review and discussion. A search was conducted on PubMed and other databases, using the MeSH terms “nonepileptic seizure”, and “epileptic seizure”.
ResultsWe report the case of a 45-year-old female patient, brought to the emergency department because of tonic axial and limb nonsynchronous movements, closed eyes, long duration, with immediate awareness, no desaturation, tongue bite, facial flushing, dyspnoea or sphincter incontinency. She was medicated with clonazepam 1 mg and levetiracetam 1000 mg ev. TC-CE had no acute alteration. Bloodwork had no other major alteration except valproic acid below therapeutic levels (her usual medication, along with other antiepileptic drugs, antidepressant and antipsychotic). The antecedents of the patient: mild intellectual disability and an accidental traumatic brain injury in infancy, with secondary epilepsy. She was transferred to Psychiatry department. No electroencephalogram (EEG) was realized, because she had a recent one confirming PNES, and many other emergency observations with the diagnosis of PNES.
ConclusionsThis clinical case showcases the diagnostic difficulties that clinicians face when there is an overlap in symptoms, emphasizing the need to combine patient history, witness reports, clinician observations, and ictal and interictal EEG to help distinguish these different clinical identities.
DisclosureNo significant relationships.
The Portuguese adapted version of the fear of covid-19 scale for the postpartum period
- D. Pereira, A.T. Pereira, B. Wildenberg, A. Gaspar, C. Cabacos, N. Madeira, A. Macedo
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S236
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Introduction
The Portuguese version of the Fear of COVID-19 Scale (FCV-19S; Cabaços et al. 2021), composed of seven items, presented good validity and reliability to be used in general population. To be used within perinatal context, specifically in the postpartum period, we have added an item related to the baby (item 8 – “I’m afraid my baby will be infected with coronavirus-19”).
ObjectivesTo analyze the psychometric properties of Portuguese adapted version of the Fear of COVID-19 Scale for the postpartum period (FCV-19SP), namely construct validity, internal consistency, and convergent validity.
Methods207 women (mean age= 33.51 ± 5.23 years) recruited in the postpartum period (9,06 ± 8,52 months after delivery) fill in a set of self-reported validated questionnaires: Perinatal Depression Screening Scale (PDSS), Perinatal Anxiety Screening Scale (PASS) and Coronavirus-19 Fear Scale for the postpartum period (FCV-19SP).
ResultsCFA revealed that the unifactorial model composed of eight items presented good fit indexes (X2/df=1.508; CFI=.991; GFI=.974; TLI=.983; p[RMSEA≤.01] = .049), better than those of the seven items version (X2/df=3.963; CFI=.957; GFI=.909; TLI=.905; p[RMSEA≤.01] =.219). Cronbach alpha for the FCV-19SPP was α=.880. The total score significantly (p<.01) and moderately correlated with PDSS (r=.262) and PASS (r=.371).
ConclusionsThe FCV-19SP is a valid and reliable questionnaire to assess fear of COVID-19 in women in the postpartum period.
DisclosureNo significant relationships.
Action Control Deficits in Patients With Essential Tremor
- Shelby Hughes, Daniel O. Claassen, Wery P.M. van den Wildenberg, Fenna T. Phibbs, Elise B. Bradley, Scott A. Wylie, Nelleke C. van Wouwe
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- Journal:
- Journal of the International Neuropsychological Society / Volume 25 / Issue 2 / February 2019
- Published online by Cambridge University Press:
- 03 December 2018, pp. 156-164
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Objectives: Essential tremor (ET) is a movement disorder characterized by action tremor which impacts motor execution. Given the disrupted cerebellar-thalamo-cortical networks in ET, we hypothesized that ET could interfere with the control mechanisms involved in regulating motor performance. The ability to inhibit or stop actions is critical for navigating many daily life situations such as driving or social interactions. The current study investigated the speed of action initiation and two forms of action control, response stopping and proactive slowing in ET. Methods: Thirty-three ET patients and 25 healthy controls (HCs) completed a choice reaction task and a stop-signal task, and measures of going speed, proactive slowing and stop latencies were assessed. Results: Going speed was significantly slower in ET patients (649 ms) compared to HCs (526 ms; F(1,56) = 42.37; p <.001; η2 = .43), whereas proactive slowing did not differ between groups. ET patients exhibited slower stop signal reaction times (320 ms) compared to HCs (258 ms, F(1,56) = 15.3; p <.00; η2 = .22) and more severe motor symptoms of ET were associated with longer stopping latencies in a subset of patients (Spearman rho = .48; p <.05). Conclusions: In line with previous studies, ET patients showed slower action initiation. Additionally, inhibitory control was impaired whereas proactive slowing remained intact relative to HCs. More severe motor symptoms of ET were associated with slower stopping speed, and may reflect more progressive changes to the cerebellar-thalamo-cortical network. Future imaging studies should specify which structural and functional changes in ET can explain changes in inhibitory action control. (JINS, 2019, 25, 156–164)