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P.104 Prognostic value of NIRS regional oxygen saturation based cerebrovascular reactivity in TBI: a Canadian high resolution traumatic brain injury (CAHR-TBI) cohort study
- A Gomez, L Froese, D Griesdale, EP Thelin, R Raj, L van Iperenburg, J Tas, M Aries, KY Stein, C Gallagher, F Bernard, AH Kramer, FA Zeiler
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- Canadian Journal of Neurological Sciences / Volume 51 / Issue s1 / June 2024
- Published online by Cambridge University Press:
- 24 May 2024, p. S44
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Background: Near-infrared spectroscopy regional cerebral oxygen saturation (rSO2) has gained interest as a raw parameter and as a basis for measuring cerebrovascular reactivity (CVR). This study aimed to identify threshold values of rSO2 and rSO2 based CVR at which outcomes worsened following traumatic brain injury (TBI). Methods: A retrospective multi-institutional cohort study was performed. The cerebral oxygen indices, COx (using rSO2 and cerebral perfusion pressure) as well as COx_a (using rSO2 and arterial blood pressure) were calculated for each patient. 2x2 tables were created grouping patients by alive/dead and favorable/unfavorable outcomes at various thresholds of COx and COx_a as well as rSO2 itself. Chi-square values were calculated to identify the most discriminative significant threshold. Results: In the cohort of 129 patients rSO2 did not have any statistically significant threshold value. For COx and COx_a, an optimal threshold value of 0.2 was identified for both survival and favorable outcomes with values above this associated with worse outcomes. Conclusions: In this study, raw rSO2was found to contain no significant prognostic information. However, rSO2 based indices of CVR, were found to have a uniform threshold of 0.2, above which clinical outcomes worsened. This study lays the groundwork to transition to less invasive means of continuously measuring CVR.
393 Harnessing the potential of transcriptional adaptation as a mechanism for rare Amyotrophic lateral sclerosis
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- Adriana Morales Gomez, Nathan Staff, Stephen C. Ekker
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- Journal:
- Journal of Clinical and Translational Science / Volume 8 / Issue s1 / April 2024
- Published online by Cambridge University Press:
- 03 April 2024, p. 117
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OBJECTIVES/GOALS: Transcriptional adaptation is a phenomenon in which a mutation in one gene leads to the genetic compensation of another homogenous gene. Understanding the mechanism of transcriptional adaptation may contribute to an explanation for variation in clinical manifestations of rare Amyotrophic lateral sclerosis patient phenotypes. METHODS/STUDY POPULATION: The presence of a premature termination codon triggers transcriptional activation. Therefore, we utilized CRISPR-Cas9 tool to generate a premature termination codon in CHCHD10 gene in multiple types of cells, including induced pluripotent stem cells derived from patient samples with known CHCHD10 mutations causative for Amyotrophic lateral sclerosis. CRISPR-Cas9 tool was delivered via ribonucleoprotein electroporation and transfect cell’s DNA was sequenced to validate gene editing. To confirm transcriptional adaption, changes in levels of protein and gene expression will be measured via immunoblot and quantification of CHCHD10 and CHCHCD2 from whole cells lysates of the edited cells. RESULTS/ANTICIPATED RESULTS: We anticipate that CHCHD2 transcriptional adaptation can functionally compensate for the locus loss of function of CHCHD10. This mechanism of transcriptional adaptation may contribute to an explanation for variation in clinical manifestations of patient phenotypes. DISCUSSION/SIGNIFICANCE: Our approach would advance discovery science towards by exploring transcriptional adaptation mechanism in humans, which can lead to novel therapies for rare Amyotrophic lateral sclerosis, such as CHCHD10.
Unlocking archaeological data online via the PEPAdb (Prehistoric Europe's Personal Adornment Database) initiative for Open Science
- Galo Romero-García, Daniel Sánchez-Gómez, José Á. Garrido-Cordero, José M. Martínez-Blanes, Ana C. Sousa, Carlos P. Odriozola
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PEPAdb (Prehistoric Europe's Personal Adornment Database) is a long-term, open-ended project that aims to improve access to archaeological data online. Its website (https://pepadb.us.es) publishes and analyses datasets about prehistoric personal adornment, drawing on the results of various research projects and bibliographic references.
25 Exploring Phonemic and Semantic Fluency Ability Across Multiple Generations
- Krithika Sivaramakrishnan, Dorthy Schmidt, Krissy E Smith, Brittany Heuchert, Adriana C Cuello, Natalia L Acosta, Miriam Gomez, Isabel D Munoz, Yvette D Jesus, Daniel W Lopez-Hernandez
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 438-439
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Objective:
Verbal fluency tasks evaluate executive functioning by requiring a person to provide words within a certain time period that start with a certain letter (phonemic fluency) or category (semantic fluency). Research shows that age impacts test takers’ phonemic and semantic verbal fluency performance. In fact, it has been suggested that phonemic verbal fluency peaks around age 30 to 39 and begins to decline at older ages. In contrast to phonemic fluency, research suggests that semantic fluency increases steadily between test takers until age 12 and begins declining around age 20. A generation is a cohort of people born within a certain period who share age and experiences. Studies show that Generation X individuals (persons born between 1965-1980) outperform Generation Y (persons born between 19811995) and Generation Z individuals (persons born between 1965-1980) on the Cordoba Naming Test. To our knowledge, no study has investigated verbal fluency performance across generational groups. We predicted that Generation X individuals would outperform individuals from Generation Y and Z on both verbal fluency measures.
Participants and Methods:The sample of the present study consisted of 107 participants with a mean age of 27.39 (SD = 9.16). Participants were divided into three groups: Generation X (n = 19), Generation Y (n = 52), and Generation Z (n = 36). The phonemic verbal fluency task consisted of three trials and the semantic verbal fluency task consisted of one trial, one minute each. A series of ANCOVAs with Bonferroni post-hoc tests were used to evaluate verbal fluency performance between generational groups. All participants passed performance validity testing.
Results:We found significant differences between our generational groups on both verbal fluency tasks. Post-hoc tests revealed that the Generation Y group outperformed both Generation X and Z groups on both verbal fluency tasks, p’s <.05, np2 =.11 -.16. No significant differences were found on either verbal fluency task between the Generation X and Z groups.
Conclusions:Contrary to our hypothesis, Generation Y individuals possessed better phonemic and semantic fluency than both Generation X and Z individuals. Meanwhile, Generation X individuals did not significantly differ on any of the verbal fluency tasks compared to Generation Z individuals. Speaking multiple languages has been shown to impact verbal fluency performance. In our sample, the Generation X and Z groups consisted primarily of bilingual speakers compared to the Generation Y group. Examining generational differences is essential to understand the unique characteristics and impact of the times in which various individuals have grown up. Future research, for instance, should evaluate the influence of bilingualism across generational groups on verbal fluency performance.
30 Analyzing Spanish Speakers Cordoba Naming Test Performance
- Raymundo Cervantes, Isabel D.C. Munoz, Estefania J. Aguirre, Natalia Lozano Acosta, Mariam Gomez, Adriana C. Cuello, Krissy E. Smith, Diana I. Palacios Mata, Krithika Sivaramakrishnan, Yvette De Jesus, Santiago I. Espinoza, Diana M. R. Maqueda, David J. Hardy, Tara L. Victor, Alberto L. Fernandez, Daniel W. Lopez-Hernandez
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 443-444
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Objective:
A 30-item confrontation naming test was developed in Argentina for Spanish speakers, The Cordoba Naming Test (CNT). The Boston Naming Test is an established confrontation naming task in the United States. Researchers have used the Boston Naming Test to identify individuals with different clinical pathologies (e.g., Alzheimer’s disease). The current literature on how Spanish speakers across various countries perform on confrontational naming tasks is limited. To our knowledge, one study investigated CNT performance across three Spanish-speaking countries (i.e., Argentina, Mexico, and Guatemala). Investigators found that the Guatemalan group underperformed on the CNT compared to the Argentine and Mexican groups. The purpose of this study was to extend the current literature and investigate CNT performance across five Spanish-speaking countries (i.e., Argentina, Mexico, Guatemala, Colombia, United States). We predicted that the Argentine group would outperform the other Spanish-speaking countries.
Participants and Methods:The present study sample consisted of 502 neurologically and psychologically healthy participants with a mean age of 29.06 (SD = 13.41) with 14.75 years of education completed (SD = 3.01). Participants were divided into five different groups based on their country of birth and current country residency (i.e., United States, Mexico, Guatemala, Argentina, & Colombia). All participants consented to voluntary participation and completed the CNT and a comprehensive background questionnaire in Spanish. The CNT consisted of 30 black and white line drawings, ranging from easy to hard in difficulty. An ANCOVA, controlling for gender, education, and age, was used to evaluate CNT performance between the five Spanish-speaking country groups. Meanwhile, a Bonferroni post-hoc test was utilized to evaluate the significant differences between Spanish-speaking groups. We used a threshold of p < .05 for statistical significance.
Results:Results revealed significant group differences between the five Spanish speaking groups on the CNT, p = .000, np2 = .48. Bonferroni post-hoc test revealed that the United States group significantly underperformed on the CNT compared to all the Spanish-speaking groups. Next, we found the Guatemalan group underperformed on the CNT compared to the Argentinian, Mexican, and Colombian groups. Additionally, we found the Argentinian group outperformed the Mexican, Guatemalan, and United States groups on the CNT. No significant differences were found between the Argentinian group and Colombian group or the Mexican group and Colombian group on the CNT.
Conclusions:As predicted, the Argentinian group outperformed all the Spanish-speaking groups on the CNT except the Colombian group. Additionally, we found that the United States group underperformed on the CNT compared to all the Spanish-speaking groups. A possible explanation is that Spanish is not the official language in the United States compared to the rest of the Spanish-speaking groups. Meanwhile, a possible reason why the Argentinian and Colombian groups demonstrated better CNT performances might have been that it was less culturally sensitive than the United States, Mexican, and Guatemalan groups. Further analysis is needed with bigger sample sizes across other Spanish-speaking countries (e.g., Costa Rica, Chile) to evaluate what variables, if any, are influencing CNT performance.
68 Bilinguals' Perceived Workloads on The Boston Naming Test
- Krithika Sivaramakrishnan, Yvette D Jesus, Dorthy Schmidt, Brittany Heuchert, Krissy E Smith, Adriana C Cancino, Natalia Lozano, Miriam Gomez, Isabel D Munoz, Daniel W Lopez-Hernandez
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 272-273
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Objective:
The Boston Naming Test (BNT) is a 60-item confrontation naming task requiring participants to name a series of pictures. Prior research has shown that bilingual children have smaller vocabularies than monolinguals and that this effect continues into adulthood. Numerous studies have confirmed that bilingual adults name fewer pictures correctly than monolinguals on the BNT. Research also shows that self-reported workload correlates with neuropsychological test performance and that estimates of workload provide additional information regarding cognitive outcomes. Hardy and Wright (2018) conditionally validated a measure of perceived mental workload called the NASA Task Load Index (NASA-TLX; Hart & Staveland 1988) with healthy adults on a neuropsychological test (i.e., the Tower of Hanoi). Research also shows that bilinguals report higher perceived workloads on cognitive tasks compared to monolinguals. Although this work has recently extended to other tests, to our knowledge, the workload profile of the BNT remains relatively unexplored. We evaluated BNT performance and perceived workload via the NASA-TLX in monolinguals and bilinguals. We predicted that monolinguals would outperform bilinguals on the BNT, but that bilinguals would report higher workloads.
Participants and Methods:The study sample consisted of 84 healthy participants (36 monolinguals, 48 bilinguals) with a mean age of 28.94 (SD = 10.76). Participants completed the standard 60-item BNT in English. The NASA-TLX scale was utilized to evaluate perceived workload across six subscales. The NASA-TLX was also completed in English after the completion of the BNT. ANOVAs were used to test BNT performance and perceived workload ratings between our language groups.
Results:We found that monolinguals performed better on the BNT compared to bilinguals, p =.001, np2 = 24. However, bilinguals reported exerting more effort when completing the BNT compared to monolinguals, p =.002, np2 = .11. Additionally. bilinguals also experienced more frustration when completing the BNT compared to monolinguals, p =.034, np2 = .05.
Conclusions:As expected, results revealed that monolinguals outperformed bilingual participants on the BNT. However, bilinguals exerted more effort on the BNT and reported the BNT to be more frustrating. A possible reason for bilinguals underperforming and reporting higher perceived workloads on the BNT may be because correct responses were only accepted in English. This may have caused bilingual speakers to exert increased effort to complete the task in a non-native language. In turn, this increased effort likely increased cognitive load and led to higher frustration levels. Further research is needed to confirm our findings and support the idea that bilingualism leads to perceiving greater effort and frustration, and to determine whether there are subgroup differences in BNT performances among bilingual individuals (e.g., English learned as a first language compared to English learned as a second language).
Do attention-deficit/hyperactivity symptoms influence treatment outcome in gambling disorder?
- C. Vintró-Alcaraz, G. Mestre-Bach, R. Granero, M. Gómez-Peña, L. Moragas, F. Fernández-Aranda, M. N. Potenza, S. Jiménez-Murcia
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S58-S59
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Introduction
Numerous studies point to the comorbidity between gambling disorder (GD) and attention deficit hyperactivity disorder (ADHD). However, there is a lack of research exploring how ADHD symptoms might influence psychological treatment outcomes for GD.
ObjectivesTherefore, we aimed to explore differences between patients with GD with and without ADHD symptoms regarding psychopathology, personality, sociodemographic and especially treatment outcome measures.
MethodsThis longitudinal study included n=170 patients with GD receiving 16 sessions of cognitive behavioral therapy (CBT) in a specialized unit of a public hospital. Multiple self-reported instruments were used to assess GD severity, personality, ADHD and other symptoms and sociodemographic measures prior to treatment.
ResultsA clinical profile characterized by greater GD severity, higher psychopathology and impulsivity, and less adaptive personality features was observed in patients with self-reported ADHD symptoms compared to those without. No significant differences in treatment response (measured by dropout and relapse rates) were reported between the two groups. However, patients with ADHD symptoms described more severe relapses (more money gambled) and GD patients who relapsed scored higher on measures of ADHD, particularly inattention.
ConclusionsIndividuals with GD and ADHD may experience more severe relapses following treatment, suggesting a need for more vigilant follow-up and interventions for patients with this comorbidity.
Disclosure of InterestC. Vintró-Alcaraz: None Declared, G. Mestre-Bach: None Declared, R. Granero: None Declared, M. Gómez-Peña: None Declared, L. Moragas: None Declared, F. Fernández-Aranda Consultant of: Novo Nordisk and editorial honoraria as EIC from Wiley, M. Potenza Consultant of: Opiant Pharmaceuticals, Idorsia Pharmaceuticals, AXA, Game Day Data, Baria-Tek and the Addiction Policy Forum; has been involved in a patent application with Yale University and Novartis; has received research support (to Yale) from Mohegan Sun Casino and Connecticut Council on Problem Gambling; and has consulted for and/or advised gambling and legal entities on issues related to impulse-control/addictive disorders, S. Jiménez-Murcia: None Declared
TRANVIA: A program for continuum mental health assistance in transition period
- L. Pérez Gómez, A. González Álvarez, M. A. Reyes Cortina, E. Lanza Quintana, N. Álvarez Alvargonzález, C. Rodríguez Turiel, E. Lago Machado, J. J. Martínez Jambrina
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S728
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Introduction
Transition between adolescence and adulthood represents the most important challenge for personal development and involves several transformations: physical, psychological and social. It is a complex age bracket, concurring the transition from youth psychiatric units to adult ones, with an increased risk for the appearance of mental disorders and risky behaviours. TRANVIA program, developed in Avilés, provides psychiatric assistance to patients between 15 and 25 years old, diagnosed with a severe psychiatric disorder or with an increased risk of having one.
ObjectivesOur objectives are: ensuring clinical continuity assistance, promoting communication among professionals and the empowerment of our patients to improve their functionality and quality of life.
MethodsDescriptive study including patients involved in TRANVIA program from November 2019 to November 2021.
ResultsDuring this two-years period there have been 44 referrals to the program, 11 of them were rejected for failure to comply with diagnostic criteria. In November 2021 there were 33 patients included in the TRANVIA program with an average age of 17 years old (range: 15-22). 70% of them were men and 30% women. All of them had psychiatric assistance from different sources: youth mental health units, neuropediatrics… About 75% of the patients were diagnosed with autistic spectrum disorder and approximately three-quarters of the sample needed pharmacological treatment. Risperidone was the most prescribed drug. We have also developed other assistance alternatives as home-based care, relaxation sessions, social worker interventions and coordination with schools.
ConclusionsTRANVIA program has allowed us to provide continual attention to vulnerable patients that shift from youth psychiatric units to adult ones. Patients that meet inclusion criteria were enrolled independently the type of assistance they have previously received. Accessibility and flexibility were our priority. During the described period there was only one dropout, three patients required psychiatric hospitalization and two others visited the emergency department. There have been no cases of completed suicide.
Disclosure of InterestNone Declared
PSYCHOTIC DISORDER DUE TO PSYCHOSOCIAL STRESS EPISODE. REVIEW OF A CASE.
- A. Gonzalez-Mota, I. M. Peso-Navarro, C. Garcia-Cerdan, C. Munaiz-Cosio, M. Ligero-Argudo, C. Martin-Gomez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1040-S1041
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Introduction
Psychotic disorder is defined as a loss of contact with reality. Those who suffer from it perceive an altered reality, assuming it to be true.This feeling of unreality generates nervousness, anguish, hypervigilance and even social and emotional isolation.
We present the case of a 18-year-old woman who attended the Emergency Department accompanied by the director of her college due to behavioral alterations. The patient reports that since she has moved to Salamanca to study,she has the feeling that her father has hired spies, one of them being her classmate, being able to hear sounds and voices, which she defines as motivating her to go on with her life. She reports that she is in a lower mood in this context and that there have been some days when she has not been able to attend class.
ObjectivesThe objectives are to study the severity of the psychotic disorder in a young patient subjected to an episode of stress and to observe the reaction of the patient when it has been properly treated.
MethodsWe carry out a review of the clinical history of a 18-year-old female patient with psychotic disorder, admitted to the Psychiatric Brief Hospitalization Unit (PBHU) in Salamanca.
ResultsThe patient was treated with Risperidone 2mg/24h. After a few days in the PBHU, total disappearance of the psychotic symptoms was observed and the patient is completely self-critical. Once she was discharged, it was decided that she should return home with her parents for several months and continue treatment with Aripiprazole and Sertraline.
ConclusionsOccasionaly, there are ethical dilemmas about beginning to treat young patients with psychotic ideas derived from external situations. Optimal treatment including drugs, psychotherapy and family support are essential. According to the scientific literature,a greater involvement in diagnosis,treatment and follow-up is recommended in patients with psychotic symptomatology derived from stress.
Disclosure of InterestNone Declared
Is social media important in adolescents with eating disorders?
- B. Martínez-Núñez, D. S. Cohen, R. Encinas-Encinas, A. Paniagua-Velasco, D. A. Gómez-Guimaraes, C. García-López, B. Muchada-López, M. Faya-Barrios, M. Graell-Berna
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S522-S523
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Introduction
Eating disorders (ED) are complex entities of multicausal etiology that mainly affect adolescents and young women. For this reason, EDs frequently cause medical and psychological complications that can cause potentially irreversible developmental sequelae during adolescence.
96% of Spanish youth (15-29 years old) use daily Internet. In addition, 83% use Social Networks. Internet could be a good way to spread information through social media, websites, providing material and means to achieve the body culture purpose.
As we have seen in various papers, social media can influence and trigger the development of EDs.
ObjectivesThe objetives of the study are to analyse the preferred social network by adolescents diagnosed with eating disorders, as well as to measure characteristic and time-use of these networks.
MethodsWe decided to undergo a transversal study to analyse the use of social media. For that, we developed a survey to reflect the use of the main social networks (Instagram, Facebook, Snapchat, Twitter, YouTube and Reddit) in adolescents diagnosed with eating disorders in Spain, who are in outpatient treatment in a specialised ED unit.
ResultsThe total number of adolescents interviewed was 65; of these 96.9% were females and 3.1% males. The mean age was 14.8 years.
The preferred social network was Instagram (54%), followed by TikTok (34%) and YouTube (6%).
Most of the patients interviewed (68%) admitted checking Instagram daily, and 31% reflected spending between 1-3 hours/day. None of the adolescents reported using Facebook or Reddit.
The majority of adolescents (89%) admitted having ignored friend requests while 12% reflected the importance of having a high number of followers as a way of external validation, getting more ‘likes’ and getting to know more people.
ConclusionsThe obtained results reinforce the need of exploring and taking into account the use of Social Media in adolescents with ED and how it may influence their pathology. There is a need for further prospective research in this field.
Disclosure of InterestNone Declared
Acute mutism in a young female. A case report of a 20-year-old female who presents a 3-month mutism
- A. Gonzalez-Mota, A. Gonzalez-Gil, C. Martin-Gomez, J. A. Benito-Sanchez, I. M. Peso-Navarro, L. Fernandez-Alonso
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S177-S178
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Introduction
A 20-year-old female presents with a progressive 3-month mutism, hyporexia (20kg weight loss), abulia, anhedonia, apathy, social isolation,seeking company of her parents even at night, bradypsychia, sialorrhea, psychomotor slowdown and hypomimia. She is hospitalized in the Psychiatric Brief Hospitalization Unit (PBHU).Her parents relate the beginning of this symptomatology to a breakup and gender violence,which the patient confirms during the interview by eye/cephalic movements and single words jotted down.
ObjectivesThe objective of this study is to describe the evolution of the patient during her hospitalization in the PBHU of Salamanca and to look into the available bibliography about mutism related to stress and sialorrhea.
MethodsWe carried out a follow-up of the hospitalization of the patient and a structured search in PubMed with the keywords “mutism”,“sialorrhea” and “stress” in the last 10 years in English,Spanish and French.
ResultsFew or no articles where found.Therefore, the articles about mutism and stress were analyzed, which focused mostly in selective mutism. Regarding fear,the response to cope with the threat(fight, flight, freeze) is mediated by the autonomic system. The “Polyvagal Theory” speaks about the vagus nerve participating in emotion regulation (social communication and mobilization). Dissociation, in this context,has adaptive and defensive purposes and its threshold can be reduced by repeated stress situations.Long-term alteration of the autonomic nervous system has been described in selective mutism.This malfunction can be related to an elevated production of saliva due to the activation of the parasympathetic in the salivary glands, causing sialorrhea in our patient.
The patient began treatment with sertraline 100mg and risperidone 2mg with the aim of its antidepressive and major tranquilizer effects, she also began individual and family psychotherapy, we assured her sleep and intakes and she began to progressively recover her speech and mobility,identifying a possible trigger for the symptomatology: a physical beating of gender violence after her breakup.
ConclusionsDissociation and “freeze” response can be a maladaptative mechanism to fear.The malfunction of the autonomic nervous system can explain the disconnection,poor gaze,low facial and body expression and inability to speak.
Disclosure of InterestNone Declared
Antiandrogenic treatment of obsessive compulsive neurosis: A case review
- L. Huerga García, I. Careno Baez, G. Oropeza Hernández, A. Marcos Rodrigo, C. Delgado Torres, G. Garriga Rocío, P. Gómez Pérez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S927
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Introduction
Obsessive-compulsive disorder (OCD) is a mental disorder in which patients who suffer from it have repetitive and undesirable thoughts, feelings, ideas, sensations (obsessions) and behaviors that drive them to do something over and over again (compulsions).
Often the person tries to get rid of the obsessive thoughts through compulsions, but this only provides short-term relief. Not carrying out the obsessive rituals can cause enormous anxiety and suffering.
ObjectivesTo describe a 23-year-old male patient, who suffers from anxiety and mood symptoms, reacts to ego-dystonic obsessive ideas and sexual content, of months of evolution, and who manages to calm down through compulsive masturbation or watching sexual videos on the internet. All this clinic negatively interferes with their quality of life, asking the patient for medical help to calm these ideas.
MethodsWe carried out a review in Pubmed with the terms Antiandrogens and TOC, in order to make a better description of the clinical case.
ResultsAfter several treatment attempts (Sertraline, Paroxetine, Clomipramine, Clomipramine + SSRI), reaching maximum doses according to clinical guidelines, and with poor therapeutic response, it was decided to discuss the case with the endocrinology department of our hospital, deciding to start treatment with antiandrogens, in order to alleviate the persistent intrusive ideas of a sexual nature. The administration of antiandrogens in men can cause a decrease or increase in the development or involution of secondary sexual characteristics in men, reducing the activity or function of accessory sexual organs, and hyposexuality, with decreased sexual desire or libido.
After several weeks, there was improvement in the obsessive symptoms with a decrease in compulsive rituals. However, after the 3rd mo, some symptoms reappeared, but not with the same severity and intensity as before treatment. In addition, we cannot ignore the adverse effects that have occurred, such as involution of secondary sexual characteristics. However, and taking into account the negative repercussion that this clinic had on the patient’s quality of life, the benefit obtained exceeded the risk, having noted clear improvement with this therapy, and maintaining evolutionary controls by both psychiatry and endocrinology.
ConclusionsPatients suffering from obsessive-compulsive disorder can be effectively treated with anti-androgenic pharmacological agents with various modes of action. The most effective group of such agents is the long-acting analogues of the gonadotropin-releasing hormone. The objective of this review is to elucidate the possibility of using such powerful anti-androgenic agents in the treatment of obsessive-compulsive disorder.
Disclosure of InterestNone Declared
Intranasal Esketamine administration in catatonia: a case report.
- J. Romay, C. Sevilla, P. Hernandez, I. Lastra, G. Isidro, L. Cayon, G. Cortez, O. Anabitarte, P. Ijalba, M. Gomez Revuelta
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S956
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Introduction
Catatonia is a complex psychomotor syndrome that often goes unrecognized and, consequently, untreated. Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications. Benzodiazepines and electroconvulsive therapy (ECT) are the most widely studied treatment methods. However, no uniform treatment method has yet been brought forward and no previous attempts to treat catatonia on a patient suffering concomitant major depressive disorder (MDD) with NMDA receptor antagonists have been documented so far.
ObjectivesTo describe the unknown and novel management of catatonia and MDD with intranasal esketamine, a NMDA receptor antagonist.
MethodsA 55-year-old woman with a diagnosis of long-standing recurrent major depressive disorder who was admitted to the psychiatric inpatient unit of UniversityHospital Marqués de Valdecilla (Santander, Spain) suffering a complex catatonic, mutative state framed on a severe MDD. Different ineffective therapeutic interventions were deployed during the course of her illness. After failing to improve under conventional pharmacological treatment and ECT, and given the complexity of peripheral venous access on this patient (which disabled the option for iv ketamine use), we decided to initiate compassionate treatment with intranasal esketamine.
ResultsIntranasal esketamine was effective in the resolution of patient’s complex catatonic state. Clinical response from catatonia was observed after 6 intranasal esketamine administrations (2-week follow-up), reaching full catatonia and MDD remission after 12 sessions in absence of significant adverse events
ConclusionsEsketamine showed promising effectiveness for the treatment of catatonia in the context of MDD, although further research on this topic is needed.
Disclosure of InterestNone Declared
Obsessive-Compulsive Personality Disorder and Death by Suicide
- J. Overholser, S. Gomez, C. McGovern, C. Silva, C. Stockmeier
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S222-S223
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Introduction
The risk of suicide may be elevated in the presence of personality pathology. Adults with Obsessive Compulsive Personality Disorder (OCPD) may be vulnerable to depression and suicidal thoughts.
ObjectivesTo identify factors associated with suicide in cases of OCPD.
MethodsPsychological autopsy procedures were used to gather detailed information about adults who died by suicide and natural causes. A total of 75 deceased adults were evaluated using psychological autopsy procedures. Family members were interviewed about a recently deceased adult, using structured diagnostic interviews (SCID and SIDP-IV). Diagnostic summaries, coroner’s reports and police records were reviewed by a psychiatrist, a psychologist, a social worker, and a neuroscientist until agreement was reached about final diagnosis. The final sample included 40 adults who met criteria for OCPD (18 had died by suicide; 20 had died by natural causes). An additional 40 cases were examined in which evidence of PD was absent (19 had died by suicide; 18 had died by natural causes).
ResultsThe diagnosis of a Major Depressive Disorder was significantly more common in suicide completers with OCPD compared to suicide completers without OCPD (X2 = 6.74, p < .01) or cases of natural death with OCPD (X2 = 12.70, p < .001). Suicide completers with OCPD displayed many symptoms of depression, more often than suicide completers without OCPD or cases of natural death with OCPD (see Table 1). As compared to the cases of natural death, both groups of suicide completers were more likely to have previously attempted suicide prior to their final act (X2 = 8.52, p < .05).
Table 1. Comparison of four groups using psychological autopsy procedures to identify the presence of diagnostic criteria for a Major Depressive Episode at the time of death. OCPD Suicide OCPD Natural Death No PD Suicide No PD Natural Death X2 Sad mood 82.4% 36.8% 78.9% 50.0% 11.38 ** Sleep disturbance 82.4% 38.9% 73.7% 46.7% 9.53 * Feelings of worthlessness 60.0% 38.9% 84.2% 17.6% 17.49 *** Reduced concentration 58.8% 27.8% 57.9% 14.3% 9.89 * Recurrent suicidal ideation 88.2% 26.3% 78.9% 0.0% 35.57 *** Loss of pleasure 82.4% 38.9% 73.7% 40.0% 10.80 ** Psychomotor changes 50.0% 33.3% 61.1% 26.7% 5.04 Reduced energy 64.7% 44.4% 63.2% 33.3% 4.12 Change of appetite 70.6% 26.3% 42.1% 31.3% 8.37 * Note:
* = p < .05;
** = p < .01;
*** = p < .001
ConclusionsAdults with OCPD appear vulnerable to a Major Depressive episode, and the combination of MDD with OCPD creates a significant risk for death by suicide. It is important to appreciate the influence of personality disorder or depression and suicide risk.
Disclosure of InterestNone Declared
Case report: Improvement of chronic mania after Steven-Johnson syndrome
- C. Pardo González, A. Tellez Gomez, C. Sanjuán Ortiz, J. Ribes Cuenca, D. M. Beltrán Cristancho, G. Ribes Jordán
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S694-S695
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Introduction
Stevens-Johnson Syndrome is a rare life-threatening condition characterized by severe mucocutaneous epidermal necrolysis and detachment of the epidermis. The condition centers around a delayed-type hypersensitivity reaction with a complex etiology stemming from a variety of causes.
ObjectivesTo present the case of a patient with a diagnosis of intellectual disability, bipolar disorder and epilepsy who, 14 days after starting treatment with Cariprazine, presented with pseudovesicular skin lesions suggestive of Steven-Johnson syndrome.
MethodsA non-systematic literature review on PubMed database on Steven-Johnson syndrome and other autoimmune processes in patients with bipolar disorder, and the impact on the affective symptoms of the former, was conducted. The clinical case report was prepared through the review of clinical records of the patient.
ResultsThe authors present the case of a 50-year-old woman, undergoing psychiatric follow-up for more than 30 years with a diagnosis of bipolar disorder. She has a moderate intellectual disability and generalized epilepsy diagnosed at the age of 13. Since the age of 20, the patient has presented clinical manifestations compatible with bipolar disorder.
On a dermatological level, the patient had medical records of hypersensitivity reaction to amoxicillin-clavulanic acid, intolerance to carbamazepine; and toxicoderma and hepatitis after treatment with Lamotrigine, compatible with DRESS syndrome.
At the time of the study, psychopharmacological treatment consisted in valproic acid, lithium and cariprazine (the latter being introduced 14 days earlier). Pseudovesicular and papular skin lesions were observed, with a dianiform appearance and central necrosis.
Prior to the debut of the dermatological condition, the patient showed a decompensation of her bipolar disorder, with escalating irritability, soliloquies, verbosity and hostility towards her parents, with episodes of psychomotor agitation.
After the appearance of the skin lesions, a striking clinical change was observed, with an almost complete remission of affective symptoms, temporally coincident with DRESS syndrome and cariprazine withdrawal.
ConclusionsIn recent years, research on autoimmune diseases and their relationship with mental disorders, such as bipolar disorder, schizophrenia and depression, has become increasingly abundant. The conclusions point to the fact that both disorders could be interrelated even at an etiopathogenic level. In this case report, we discuss a patient with a diagnosis of bipolar disorder with an important component of autoimmune response to different drugs, which seems to have influenced the clinical course of the mental illness.
Disclosure of InterestNone Declared
Extrapyramidal syndrome in psychotic depression: a case report.
- C. Álvarez, A. M. Gómez Martín
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1049-S1050
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Introduction
Psychotic depression is a subtype of major depression, with worst prognosis but underdiagnosed and undertreated. We introduce the case of a 75-year-old patient who is attended in the hospital presenting sorrow and behavioral disturbances. He also had delusions of ruin and surveillance through his phone, adding amnesia, dizziness, constipation, tremor and bradykinesia. He had suffered a limited depressive episode regarding his wife’s death.
ObjectivesTo highlight the importance of a correct differential diagnosis in psychotic depression to prescribe an adequate treatment that provides a better outcome for the patient.
MethodsA narrative search of the available literature on the subject through the presentation of a case.
ResultsThe presumptive diagnosis is Parkinson vs psychotic depression. After some weeks of treatment with venlafaxine and olanzapine, the absence of improvement and fluctuating symptoms orientates towards Parkinson. This is later excluded due to a normal DATSCAN. Therefore, the diagnosis of psychotic depression is made, explaining parkinsonism as secondary to psychotropics. Olanzapine and venlafaxine are retired, introducing clozapine because of its lower incidence of extrapyramidal symptoms. After two weeks, the symptoms disappear, recovering the patient his basal functionality.
ConclusionsDepression with psychotic symptoms can take several weeks to respond to treatment, requiring a proper organic screening. In our case, the slow response to treatment made the organic etiology as one of the main differential diagnoses, specifically Parkinson disease. It ruled out because of the absence of findings in the DATSCAN and the resolution of the extrapyramidal symptoms with the change of treatment.
Disclosure of InterestNone Declared
How do men differ from women? Case-Control study on clinic and personality characteristics of eating disorders
- F. Ruiz Guerrero, J. Gonzalez Gómez, C. Cobo Gutierrez, L. Castro Fuentes, C. Hernández Jimenez, J. Romay González, A. Gómez del Barrio
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S849-S850
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Introduction
A review of the literature shows how female sex is a crucial factor in the development of ED, being the proportion of women and men 10 to 1 regardless of the location of the sample (Duncan, Ziobrowski & Nicol, 2017) and different clinical subtypes (AN, BN) (Swanson et al., 2011). However, male population has always been less studied, some works find that only 1% of the articles published in AN is aimed at the study of males (Galusca, 2012).
Nowadays it is accepted that the etiopathogenesis of these disorders is multifactorial and in addition to female gender other risk factors have been identified, such as neurobiological alterations, psychological predictors, personality traits, low self-esteem, extreme perfectionism or thinness values focused on body and figure. On the other hand, certain impulsive behaviours such as self-harm, substance use, physical activity or diets are factors that may be confused as predisposing or as symptoms of the pathology itself (Connan et al., 2003, Treasure, Stein and Maguire, 2015).
Recently, Kinasz, Accurso, Kass and Le Grange (2016) have compared the clinical characteristics that differentiate men (59) from women (560) in a sample of children and adolescents between 6 and 18 years-old, finding that males presented an earlier start of the ED and not appreciating differences in the duration of the disease, income, episodes of purgue and psychiatric comorbidity of anxiety, behaviour disorders or impulsivity.
ObjectivesThe aim of this study was to evaluate gender differences in clinical characteristics, levels of depression, previous obsessiveness and personality dimensions in eating disorders (ED) compared with controls.
MethodsA total of 80 participants was divided into 4 groups, 20 men and 20 women with ED and 20 men and 20 women without ED (healthy control), matched by age and socioeconomic status. The design of the study was case-control, and data was collected through clinical interview and a battery of cuestionaires.
ResultsMen with ED only differ in vigorous physical activity (measured by IPAQ) from controls and women with pathology. Regarding personality traits, men and women with ED do not differ among them, although they do differ in novelty search and harm avoidance respect to their controls.
ConclusionsBehaviors such as physical activity in males frame a slightly different way of reducing their discomfort, however, clinical implication indicates that the treatment may be similar according to gender.
Disclosure of InterestNone Declared
Depressive episode as initial symptoms of Perry syndrome
- A. Téllez Gómez, C. Pardo González, A. Sabater Ferragut, J. Ribes Cuenca
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S825
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Introduction
Perry syndrome is a rare neurological disorder, characterized by atypical parkinsonian symptoms, sleep disturbances, central hypoventilation, weight loss, and psychiatric symptoms, especially apathy or depression. This syndrome is due to a TDP-43 proteinopathy as a result of a mutation in the DCTN-1 gene.
ObjectivesTo present the case of a patient with a mutation in the DCTN1 gene, related to Perry syndrome, who debuted with several depressive episodes, with apathy and weight loss.
MethodsA non-systematic literature review was conducted on PubMed database on depressive episodes related to Perry´s syndrome. The clinical case report was prepared through the review of the clinical record of the patient.
ResultsThe authors present the case of a 49-year-old man, who contacted psychiatry for the first time 10 years earlier due to depressive symptoms, suffering multiple episodes. These episodes consisted of hypothymic mood, apathy, anhedonia and marked irritability, together with suicidal ideation, leading to several drug overdoses. He also presented disruptive behaviors, such as abusive drinking and aggressiveness. These episodes responded to antidepressants at medium doses, although maintaining several relapses. Given this, it was decided to introduce valproic acid as a mood stabilizer, with good tolerance.
In parallel, the patient’s mother, who had also suffered from depressive episodes, began with dementia symptoms, after which it was decided to request a genetic study. In this context, a mutation, similar in both patients, was observed in the DCTN1 gene, related to Perry syndrome.
In the case of the patient presented, no other associated alterations were found, neither in the neurological examination or in the rest of the tests performed (polysomnography without notable alterations, functional imaging tests without pathological findings).
ConclusionsNeurological diseases as Perry syndrome can show depressive symptoms and other behavioral changes at the beginning, developing the rest of the symptoms (parkinsonism, weight loss or central hypoventilation) several years after the onset of the symptoms. It must be taken into account in patients with a family history of mutations or atypical depressive symptoms. It should also be assessed in terms of genetic counseling.
Disclosure of InterestNone Declared
Psychosomatic symptoms according to psychiatric diagnosis
- R. Fernández Fernández, L. Fontecha Banegas, C. Suárez Pérez, D. Gómez Olmeda, I. D. L. M. Santos Carrasco
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S299
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Introduction
Psychosomatic symptoms are an important problem that is frequently presented in medical consultations. These symptoms are often associated with psychiatric disorders, especially depressive and anxiety disorders.
ObjectivesTo study the association between anxiety disorders and psychosomatic symptoms in a sample of patients referred for pathology of functional origin.
MethodsWe made a descriptive retrospective study through the use of electronic medical records. The symptom onset and diagnosis were obtained for all patients referred to outpatients for psychosomatic symptoms during a 1-year period. We performed χ² Tests to assess the association of the diagnosis with the occurrence of psychosomatic symptoms.
ResultsThe only diagnosis that presented statistically significant association was anxiety disorder (χ² = 11.1; p<0.001).
Anxiety disorder Psychosomatic symptoms No Si Total No Observed 312 7 319 Expected 306 13.47 319 Yes Observed 119 12 131 Expected 125 5.53 131 Total Observed 431 19 450 Expected 431 19 450 ConclusionsOur study finds results that follow the line of other studies that show this association, such as Campo’s study which finds that functional somatic symptoms are consistently associated cross-sectionally with anxiety and depressive symptoms (Campo, 2012) or Imran’s study which finds that higher levels of somatization independently and significantly predicted higher anxiety (β=.37, p=.0001) (Imran et al., 2013). However, our results show no association with depressive disorders whereas frequent associations are found in the literature; for example, a recent meta-analysis found that neuroticism and depression had the strongest influence on the association of medically unexplained physical symptoms and frequent healthcare use (den Boeft et al., 2016). This lack of association is probably due to greater ease in identifying depressive disorders as the main pathology versus anxiety disorders.
ReferencesCampo J. V. (2012). Annual research review: functional somatic symptoms and associated anxiety and depression--developmental psychopathology in pediatric practice. Journal of child psychology and psychiatry, and allied disciplines, 53(5), 575–592. den Boeft, M., Twisk, J. W., Terluin, B., Penninx, B. W., van Marwijk, H. W., Numans, M. E., van der Wouden, J. C., & van der Horst, H. E. (2016). The association between medically unexplained physical symptoms and health care use over two years and the influence of depressive and anxiety disorders and personality traits: a longitudinal study. BMC health services research, 16, 100
Imran, N., Ani, C., Mahmood, Z., Hassan, K. A., & Bhatti, M. R. (2014). Anxiety and depression predicted by medically unexplained symptoms in Pakistani children: a case-control study. Journal of psychosomatic research, 76(2), 105–112.
Disclosure of InterestNone Declared
Scipion3: A workflow engine for cryo-electron microscopy image processing and structural biology
- Pablo Conesa, Yunior C. Fonseca, Jorge Jiménez de la Morena, Grigory Sharov, Jose Miguel de la Rosa-Trevín, Ana Cuervo, Alberto García Mena, Borja Rodríguez de Francisco, Daniel del Hoyo, David Herreros, Daniel Marchan, David Strelak, Estrella Fernández-Giménez, Erney Ramírez-Aportela, Federico Pedro de Isidro-Gómez, Irene Sánchez, James Krieger, José Luis Vilas, Laura del Cano, Marcos Gragera, Mikel Iceta, Marta Martínez, Patricia Losana, Roberto Melero, Roberto Marabini, José María Carazo, Carlos Oscar Sánchez Sorzano
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- Journal:
- Biological Imaging / Volume 3 / 2023
- Published online by Cambridge University Press:
- 29 June 2023, e13
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Image-processing pipelines require the design of complex workflows combining many different steps that bring the raw acquired data to a final result with biological meaning. In the image-processing domain of cryo-electron microscopy single-particle analysis (cryo-EM SPA), hundreds of steps must be performed to obtain the three-dimensional structure of a biological macromolecule by integrating data spread over thousands of micrographs containing millions of copies of allegedly the same macromolecule. The execution of such complicated workflows demands a specific tool to keep track of all these steps performed. Additionally, due to the extremely low signal-to-noise ratio (SNR), the estimation of any image parameter is heavily affected by noise resulting in a significant fraction of incorrect estimates. Although low SNR and processing millions of images by hundreds of sequential steps requiring substantial computational resources are specific to cryo-EM, these characteristics may be shared by other biological imaging domains. Here, we present Scipion, a Python generic open-source workflow engine specifically adapted for image processing. Its main characteristics are: (a) interoperability, (b) smart object model, (c) gluing operations, (d) comparison operations, (e) wide set of domain-specific operations, (f) execution in streaming, (g) smooth integration in high-performance computing environments, (h) execution with and without graphical capabilities, (i) flexible visualization, (j) user authentication and private access to private data, (k) scripting capabilities, (l) high performance, (m) traceability, (n) reproducibility, (o) self-reporting, (p) reusability, (q) extensibility, (r) software updates, and (s) non-restrictive software licensing.