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Bipolar disorder type II - will the new classification help in setting an adequate diagnosis
- S. Vuk Pisk, E. Ivezic, L. Senjug Mance, K. Matic, D. Svetinovic, V. Grosic, I. Filipcic
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S709-S710
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Introduction
Bipolar affective disorder type II is often misunderstood, neglected and rarely receives the attention it deserves and often remains undiagnosed. Despite its neglect and insufficient diagnosis, it is an important diagnostic entity because it causes significant suffering and functional impairment, a chronic course of the disease and a high suicide rate. Cognitive impairments and multiple comorbidities that significantly affect the course and outcome of the disease are common.
ObjectivesThe purpose of this research was to determine the extent of the deficiency in diagnosing bipolar affective disorder type II in daily clinical work.
MethodsA total of 82 adult psychiatric inpatients diagnosed with affective disorders (depressive disorders and bipolar affective disorders) and borderline disorders participated in this study. They completed HCL-32, MDQ and PHQ-9 questionairres. The average age of the sample is 43.9 years. A total of 76.8% were women in the sample.
Results72.8% of respondents achieved a score above 14 on the HCL-32 questionnaire and thus met the criteria for possible hypomania. All three criteria for mania on the MDQ questionnaire were satisfied by 27.5% of respondents. 68% of respondents have moderate or severe symptoms of depression according to PHQ-9.
ConclusionsThe results confirmed our assumption about the lack of recognition and diagnosis of bipolar affective disorder type II. Only 5 respondents (6.1%) were diagnosed with BAP II upon arrival. After the research, 73% of them met the criteria for diagnosing BAP II. As a correctly established diagnosis affects the selection of adequate therapy, we have tried to emphasize the importance of correct recognition of BAP II.
Disclosure of InterestNone Declared
“Lactose free” depression- Antidepressant with and without lactose registered in Croatia
- D. Svetinović, I. Barun, S. Vuk Pisk, I. Filipčić, V. Grošić
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S828-S829
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Introduction
Depression is a common illness worldwide, with an estimated 3.8% of the population affected, including 5.0% among adults and 5.7% among adults older than 60 years. Lactose intolerance affects 70% of the world population. With both conditions being common there are a lot of people having both lactose intolerance and depression. People with lactose intolerance are unable to fully digest lactose. As a result, they have diarrhea, bloating and gas after eating or drinking dairy products. Lactose is one of the most used excipients in drug formulations and is ofteny overlooked when prescribed.
ObjectivesTo quantify and identify the amount of lactose in medications used for the treatment of depression and to identify ‘lactose-free’ medication registered in Croatia.
MethodsMedications used for the treatment of depression were identified from the Agency for medicinal products and medical products of Croatia (HALMED). Their formulation including excipients was obtained from the Agency.
ResultsWide range of antidepressants contains lactose. We have quantified the lactose amount using information on medicinal products with marketing authorisation granted by HALMED.
Antidepressant Brand name and dosage Lactose per tablet (mg) Sertraline Sonalia ® 50 mg 19.80mg Paroxetine Paroksetin PharmaS® 10mg Escitalopram Escital ® 10mg 117.8mg Elicea ® 5mg 51.3mg Citalopram Citalon ® 20mg 23mg Mirtazapine Calixta ® 15mg 44.4mg Mirzaten ® 30mg 120.56mg Mirzaten Q tab ® 15mg 35.63mg ConclusionsWith this research, we have pointed out a high proportion of the most commonly prescribed antidepressants that contain lactose. Considering the high proportion of the general population with lactose intolerance, we have pointed out the importance of knowing the data that antidepressants do not contain lactose in order to choose an adequate therapy for our patients, while not causing them discomfort that will further reduce the effectiveness of the therapy, as well as increase the percentage of those who due to the side effects of the drug, they stop taking the therapy. This research will help clinicians in their daily work to choose the most optimal therapy for their patients. With this study, we will give doctors a list of medications for depression treatment without lactose. With this study, we will give doctors a list of medications for depression treatment without lactose.
Disclosure of InterestNone Declared
Hidden face of pandemic – Case study of an art therapy process during the pandemic of the virus COVID-19
- I. Barun, D. Svetinović, S. Vuk Pisk, V. Grošić, I. Filipčić
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S371-S372
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Introduction
Pandemic caused by the virus COVID-19 had a significant impact on mental health of the population, not only by increasing the levels of stress and anxiety, but by affecting the most vulnerable ones, aggravating the symptoms of mental illnesses in people suffering from one of the mental health conditions [1], including the people suffering from schizophrenia. Pandemic made the increased need of that particular patient population for various psychotherapeutic and sociotherapeutic interventions even more evident. Art therapy is a form of psychotherapy that in itself integrates expressive characteristics of art with explorative characteristic of psychotherapy using the visual language of arts as the main media of communication and expression. Art therapy has been used from its beginnings with people suffering from one of the psychotic disorders [2] and it is enlisted today in NICE guidelines as one of the psychological therapies of schizophrenia [3].
ObjectivesTo understand and to activate the potential of artistic expression in patients suffering from psychotic disorders during the pandemic of virus COVID-19.
MethodsDuring the period of lockdown in pandemic of virus COVID-19, a young male patient suffering from schizophrenia was admitted to the Acute ward of the University psychiatric hospital Sveti Ivan in Zagreb. As the patient was keen on visually expressing himself, five individual psychodynamically oriented art therapy sessions were carried out on a weekly basis with professionally trained art therapist during the period of patient’s hospitalization. The patient was offered various art materials allowing him to visually express himself in a free manner and the artistic artefact created during the process served as a catalyst for later therapeutic work.
ResultsDuring the therapeutic process, single image was being gradually made and developed session by session. As new layers of color and form were added to the painting, each session revealed new layers of meaning and symbolism to both patient and therapist. First sessions pertained to the anxiety caused by the experience of pandemic, but as the process moved forward, deeper subject matters were brought to the surface, such as the nature of the therapeutic relationship, patient’s splitting, hidden aggressive potentials and, in the end, the nature of father-son relationship connecting the image of coronavirus causing fear and discomfort with the image of the oppressive father.
ConclusionsCircumstances caused by the pandemic of virus COVID-19 aggravated the patient’s symptoms and his internal conflicts. The art therapeutic process, with its possibility of projections and its multilayered interpretations, enabled the patient to express the true conflict and disturbing content hiding underneath the anxiety related to the pandemic of coronavirus which the patient was primarily complaining about.
Disclosure of InterestNone Declared