2 results
Delirium and dementia retrospective cohort study
- O. Martin-Santiago, C. Alario-Ruiz, G. Guerra-Valera
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S399
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Introduction
Delirium is common and is associated with many adverse short-term consequences as increased hospital costs, health care complications, and increased mortality. Long-term cognition consequences on delirium have not been well synthesized and quantified.
ObjectivesOur study aims to determine the relationship between an episode of delirium and subsequent dementia and death over five years.
MethodsPostoperative delirium, previous psychiatric disorders, mental health service use, and death data collected from a cohort of inpatients diagnosed with delirium that requires psychiatric attendance in a general hospital were analyzed. Between 2009 and 2011, we started a follow-up of 91 patients aged 65 years or older at baseline for 60 months.
ResultsFive patients (5.4%) were diagnosed with dementia previously. During the first year, 35 patients without previous dementia (40.6%) died. More than half of the one-year survivors (27; 52.9%) were diagnosed with dementia at the follow-up. Differences in age (79,5 vs 80.3; Z=-0.07; p=0.93), survival time (54.8 vs 48.8;Z=1.30;p=0.19), postoperative delirium rates (74%vs66.6%; χ2=0.33, DF=1, p=0.56) and mental disorder antecedents were not found. Patients with dementia after delirium were more likely to be attentive in mental health services (48.1vs16.6%; χ2=5.666, DF=1, p=0.017).
ConclusionsIn our study, delirium is an important risk marker for dementia and death and is significantly associated with the long-term cognitive decline in surgical and non-surgical patients. Subsequent follow-up in mental health service could help detect dementia after episodes of delirium and lead to fewer potentially harmful interventions such as hospitalization or antipsychotic medication. An important question to determine is whether delirium is simply a risk marker for dementia or whether the delirium could cause neuronal damage leading to dementia.
Disclosure of InterestNone Declared
Chronic psychosis associated with new hallucinogenic drug 25I-NBOMe
- O. Martin-Santiago, G. Guerra-Valera, C. Alario-Ruiz, N. Navarro-Barriga
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S634
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- Article
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Introduction
The presence of perceptual disturbances and psychotic symptoms associated with substance abuse are widely known. While the abuse of substances is becoming more widespread, there is a general perception that their use entails fewer risks. 25I-NBOMe is a recently introduced hallucinogenic drug producing visual hallucinations and euphoria. Although people consume it like LSD, its chemical structure is different to LSD. 25I-NBOMe is related to other phenylethylamine derivatives (amphetamines and mescaline).
ObjectivesPresent a clinical case of psychosis triggered after the consumption of new emerging drugs and highlight that the extension of their consumption in the general population, especially in the most vulnerable, can trigger prolonged psychotic symptoms.
MethodsWe present a clinical case report of a subject who developed perceptual disturbances and paranoid symptoms. These lasted for months.
ResultsWe describe the case of a 30-year-old man who required psychiatric admission after a single NBOMe intake five months earlier. He began with self-referential experiences and delusional ideas of prejudice, persecution and control in social networks. For months, intrusive images appeared in the form of flashbacks. He remains isolated, hardly sleeps and is easily irritated. He previously worked and had a well social network. Since adolescence, he had occasionally used alcohol, cannabis and cocaine. An uncle was diagnosed with schizophrenia. Treatment with long-term injectable aripiprazole started, reducing the symptoms and managing to recover work activity in a year.
Conclusions25I-NBOMe has its main activity as 5HT2 receptor agonism, which is associated with increased dopaminergic activity in the brain. Hallucinations, delusions, anxiety symptoms and depersonalization appear during acute consumption. However, some patients have developed a persistent hallucinatory chronic syndrome after consumption. As its use is expanding, it probably could increase the number of patients with induced chronic psychoses, especially those with greater susceptibility. One of the possible causes would be its analogous structure to other derivatives of phenylethylamine, which increase the risk of psychosis, and another would be the erroneous perception of being a less dangerous drug.
Disclosure of InterestNone Declared