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Comparison of IgG3 responses to carbohydrates following mouse infection or immunization with six species of Trichinella
- M.A. Dea-Ayuela, A.R. Martinez-Fernandez, F. Bolas-Fernandez
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- Journal of Helminthology / Volume 74 / Issue 3 / September 2000
- Published online by Cambridge University Press:
- 12 April 2024, pp. 215-223
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The IgG3 antibody responses to carbohydrate epitopes were compared in BALB/c mice infected or immunized with six species of Trichinella: T. spiralis (T1), T. nativa (T2), T. britovi (T3), T6, T. nelsoni (T7), and T8. The dynamics of IgG3 responses and antigen recognition following infection or immunization were measured by ELISA and Western blot respectively, using glycosylated and deglycosylated larval crude extracts (LCE) prepared from homologous isolates. A high degree of protein glycosylation was found in all species and with similar profiles. Deglycosylation was completely achieved only in LCE from T1 and T6 isolates. The dynamics of IgG3 responses following infection or immunization significantly differed whereas the antigen recognition profiles appeared similar. Variations in the levels and antigen recognition patterns of IgG3 among the different species were apparent. The highest IgG3 levels were recorded in infections by the T8 isolate and the lowest in infections by the T6 isolate, whereas for immunization the highest IgG3 response was induced by T7 and the lowest by T8. Following antigen deglycosylation, the IgG3 responses were significantly reduced or abrogated and the recognition patterns markedly modified or suppressed in the different species of Trichinella.
Biological variation in Trichinella species and genotypes
- F. Bolas-Fernández
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- Journal of Helminthology / Volume 77 / Issue 2 / June 2003
- Published online by Cambridge University Press:
- 12 April 2024, pp. 111-118
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At present, the genus Trichinella comprises seven species of which five have encapsulated muscle larvae (T. spiralis, T. nativa, T. britovi, T. nelsoni and T. murrelli) and two do not (T. pseudospiralis and T. papuae) plus three genotypes of non-specific status (T6, T8 and T9). The diagnostic characteristics of these species are based on biological, biochemical and genetic criteria. Of biological significance is variation observed among species and isolates in parameters such as infectivity and immunogenicity. Infectivity of Trichinella species or isolates is determined, among other considerations, by the immune status of the host in response to species- or isolate-specific antigens. Common and particular antigens determine the extent of protective responses against homologous or heterologous challenge. The kinetics of isotype, cytokine and inflammatory responses against T. spiralis infections are isolate-dependent. Trichinella spiralis and T. pseudospiralis induce different dose-dependent T-cell polarizations in the early host response, with T. spiralis initially preferentially promoting Th1-type responses before switching to Th2 and T. pseudospiralis driving Th2-type responses from the outset.
Inequality on the frontline: A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic
- Diana Czepiel, Clare McCormack, Andréa T.C. da Silva, Dominika Seblova, Maria F. Moro, Alexandra Restrepo-Henao, Adriana M. Martínez, Oyeyemi Afolabi, Lubna Alnasser, Rubén Alvarado, Hiroki Asaoka, Olatunde Ayinde, Arin Balalian, Dinarte Ballester, Josleen A.l. Barathie, Armando Basagoitia, Djordje Basic, María S. Burrone, Mauro G. Carta, Sol Durand-Arias, Mehmet Eskin, Eduardo Fernández-Jiménez, Marcela I. F. Frey, Oye Gureje, Anna Isahakyan, Rodrigo Jaldo, Elie G. Karam, Dorra Khattech, Jutta Lindert, Gonzalo Martínez-Alés, Franco Mascayano, Roberto Mediavilla, Javier A. Narvaez Gonzalez, Aimee Nasser-Karam, Daisuke Nishi, Olusegun Olaopa, Uta Ouali, Victor Puac-Polanco, Dorian E. Ramírez, Jorge Ramírez, Eliut Rivera-Segarra, Bart P.F. Rutten, Julian Santaella-Tenorio, Jaime C. Sapag, Jana Šeblová, María T. S. Soto, Maria Tavares-Cavalcanti, Linda Valeri, Marit Sijbrandij, Ezra S. Susser, Hans W. Hoek, Els van der Ven
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- Journal:
- Cambridge Prisms: Global Mental Health / Volume 11 / 2024
- Published online by Cambridge University Press:
- 04 March 2024, e34
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Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women’s well-being and ensure healthcare system preparedness during future public health crises.
Formation of Nontronite from Oxidative Dissolution of Pyrite Disseminated in Precambrian Felsic Metavolcanics of the Southern Iberian Massif (Spain)
- J. C. Fernández-Caliani, E. Crespo, M. Rodas, J. F. Barrenechea, F. J. Luque
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- Clays and Clay Minerals / Volume 52 / Issue 1 / February 2004
- Published online by Cambridge University Press:
- 01 January 2024, pp. 106-114
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This paper describes a rare occurrence of nontronite associated with sulfide-bearing felsic metavolcanics, providing evidence of colloidal deposition in open spaces as result of a low-temperature water-rock interaction. Microbotryoidal masses of green nontronite with impurities of kaolinite, illite, barite, amorphous silica and iron oxyhydroxides are found as vein and cavity fillings in deeply kaolinized rhyolites and rhyolitic tuffs of Precambrian age, at Oliva de Merida in SW Spain. Clay mineral characterization has been carried out by X-ray diffraction, infrared spectroscopy, thermal analysis, analytical electron microscopy and stable isotope (oxygen and hydrogen) analysis. Nontronite was formed under low-temperature alteration conditions, from a continuous sequence of reactions and aqueous solution compositions, involving two basic processes that acted in concert: oxidative dissolution of pyrite and hydrolysis of K-feldspar. After acidity neutralization, dissolved silica released by incongruent dissolution of K-feldspar reacted with ferric sulfate derived from pyrite oxidation to form nontronite under oxidizing conditions, in the presence of relatively warm meteoric water.
5 Cognitive Rehabilitation Using Teleneuropsychology. A Cohort Study in South America
- Carlos Martinez Canyazo, Rodrigo S Fernandez, Maria B Helou, Micaela Arruabarrena, Nicolas Corvalan, Agostina Carello, Paula Harris, Monica Feldman, Ismael Luis Calandri, Maria E Martin, Ricardo F Allegri, Lucia Crivelli
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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, p. 209
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Objective:
The COVID-19 pandemic has affected the continuity of cognitive rehabilitation (CR) worldwide. However, the use of teleneuropsychology (TNP) to provide CR has contributed significantly to the continuity of treatment. The objective of this study was to measure the effects of CR via the TNP on cognition, neuropsychiatric symptoms, and memory strategies in a cohort of patients with Mild Cognitive Impairment (MCI).
Participants and Methods:A sample of 60 patients (60% female; age: 72.4±6.96) with MCI according to Petersen criteria was randomly divided into two groups: 30 cases (treatment group) and 30 controls (waiting list group). Subjects were matched for age, sex, and MMSE or MoCA.
The treatment group received ten weekly CR sessions of 45 minutes weekly. Pre-treatment (week 0) and post-treatment (week 10) measures were assessed for both groups. Different Linear Mixed Models were estimated to test treatment effect (CR vs. Controls) on each outcome of interest over Time (Pre/Post), controlling for Diagnosis, Age, Sex, and MMSE/MoCA performance.
Results:A significant Group (Control/Treatment) x Time (pre/post) interaction revealed that the treatment group at 10 weeks had better scores in cognitive variables: memory (RAVLT learning trials p=0.030; RAVLT delayed recall p=0.029), phonological fluency(p=0.001), activities of daily living (FAQ p=0.001), satisfaction with memory performance (MMQ Satisfaction p=0.004) and use of memory strategies (MMQ Strategy p=0.00), and a significant reduction of affective symptomatology: depression (GDS p=0.00), neuropsychiatric symptoms (NPIQ p=0.045), Forgetfulness (EDO-10 p=0.00), Stress (DAS Stress p=0.00).
Conclusions:This is the first study to test CR using teleNP in South America. Our results suggest that CR through teleNP is an effective intervention to improve performance on cognitive variables and reduce neuropsychiatric symptomatology compared to patients with MCI. These results have great significance in the context of the COVID-19 pandemic in South America, where teleNP is proving to be a valuable tool.
Ten new insights in climate science 2023
- Mercedes Bustamante, Joyashree Roy, Daniel Ospina, Ploy Achakulwisut, Anubha Aggarwal, Ana Bastos, Wendy Broadgate, Josep G. Canadell, Edward R. Carr, Deliang Chen, Helen A. Cleugh, Kristie L. Ebi, Clea Edwards, Carol Farbotko, Marcos Fernández-Martínez, Thomas L. Frölicher, Sabine Fuss, Oliver Geden, Nicolas Gruber, Luke J. Harrington, Judith Hauck, Zeke Hausfather, Sophie Hebden, Aniek Hebinck, Saleemul Huq, Matthias Huss, M. Laurice P. Jamero, Sirkku Juhola, Nilushi Kumarasinghe, Shuaib Lwasa, Bishawjit Mallick, Maria Martin, Steven McGreevy, Paula Mirazo, Aditi Mukherji, Greg Muttitt, Gregory F. Nemet, David Obura, Chukwumerije Okereke, Tom Oliver, Ben Orlove, Nadia S. Ouedraogo, Prabir K. Patra, Mark Pelling, Laura M. Pereira, Åsa Persson, Julia Pongratz, Anjal Prakash, Anja Rammig, Colin Raymond, Aaron Redman, Cristobal Reveco, Johan Rockström, Regina Rodrigues, David R. Rounce, E. Lisa F. Schipper, Peter Schlosser, Odirilwe Selomane, Gregor Semieniuk, Yunne-Jai Shin, Tasneem A. Siddiqui, Vartika Singh, Giles B. Sioen, Youba Sokona, Detlef Stammer, Norman J. Steinert, Sunhee Suk, Rowan Sutton, Lisa Thalheimer, Vikki Thompson, Gregory Trencher, Kees van der Geest, Saskia E. Werners, Thea Wübbelmann, Nico Wunderling, Jiabo Yin, Kirsten Zickfeld, Jakob Zscheischler
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- Journal:
- Global Sustainability / Volume 7 / 2024
- Published online by Cambridge University Press:
- 01 December 2023, e19
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Non-technical summary
We identify a set of essential recent advances in climate change research with high policy relevance, across natural and social sciences: (1) looming inevitability and implications of overshooting the 1.5°C warming limit, (2) urgent need for a rapid and managed fossil fuel phase-out, (3) challenges for scaling carbon dioxide removal, (4) uncertainties regarding the future contribution of natural carbon sinks, (5) intertwinedness of the crises of biodiversity loss and climate change, (6) compound events, (7) mountain glacier loss, (8) human immobility in the face of climate risks, (9) adaptation justice, and (10) just transitions in food systems.
Technical summaryThe Intergovernmental Panel on Climate Change Assessment Reports provides the scientific foundation for international climate negotiations and constitutes an unmatched resource for researchers. However, the assessment cycles take multiple years. As a contribution to cross- and interdisciplinary understanding of climate change across diverse research communities, we have streamlined an annual process to identify and synthesize significant research advances. We collected input from experts on various fields using an online questionnaire and prioritized a set of 10 key research insights with high policy relevance. This year, we focus on: (1) the looming overshoot of the 1.5°C warming limit, (2) the urgency of fossil fuel phase-out, (3) challenges to scale-up carbon dioxide removal, (4) uncertainties regarding future natural carbon sinks, (5) the need for joint governance of biodiversity loss and climate change, (6) advances in understanding compound events, (7) accelerated mountain glacier loss, (8) human immobility amidst climate risks, (9) adaptation justice, and (10) just transitions in food systems. We present a succinct account of these insights, reflect on their policy implications, and offer an integrated set of policy-relevant messages. This science synthesis and science communication effort is also the basis for a policy report contributing to elevate climate science every year in time for the United Nations Climate Change Conference.
Social media summaryWe highlight recent and policy-relevant advances in climate change research – with input from more than 200 experts.
Using rational surfaces to improve pellet fuelling in stellarators
- N. Panadero, K. J. McCarthy, B. Pégourié, R. Carrasco, I. García-Cortés, R. García, J. Hernández-Sánchez, F. Köchl, J. Martínez-Fernández, R. Sakamoto, the TJ-II team
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- Journal:
- Journal of Plasma Physics / Volume 89 / Issue 6 / December 2023
- Published online by Cambridge University Press:
- 16 November 2023, 955890601
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Pellet injection is currently the primary candidate for achieving efficient plasma fuelling, one of the key issues for steady-state operation in large fusion devices. In this paper, pellet injection experiments are performed for several magnetic configurations of the TJ-II stellarator. The aim of this study is to increase the understanding of the role played by rational surfaces in plasmoid drift and deposition profiles in stellarators. The analysis of experimentally observed plasmoid drifts is supported by simulations of such cases made with the HPI2 code. Plasmoid drift is found to be significantly reduced, as in tokamaks, in the vicinity of rational surfaces. This is attributed to the fact that plasmoid external charge reconnection lengths are shorter near rational surfaces, resulting in a more effective damping of the plasmoid drift. Although the effect of plasmoid external currents on the drift is expected to be negligible in stellarators, compared with those caused by plasmoid internal currents, the effect observed in TJ-II is clearly measurable. In addition, simulations show that enhanced drift reductions near rational surfaces lead to significantly different deposition profiles for the magnetic configurations included in this study. This implies that it should be possible to select the magnetic configurations to obtain more efficient pellet fuelling.
Mapping high-altitude peatlands to inform a landscape conservation strategy in the Andes of northern Peru
- Giulia F Curatola Fernández, Sandro Makowski Giannoni, Ellen Delgado Florián, Piero Rengifo, Jesús Rascón, Elder Chichipe Vela, Carolina Butrich, Rolando Salas López, Manuel Oliva-Cruz, Christel Scheske
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- Journal:
- Environmental Conservation / Volume 50 / Issue 4 / December 2023
- Published online by Cambridge University Press:
- 12 October 2023, pp. 212-219
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The wetlands of the jalca ecoregion in the Andes of northern Peru form peat and play a major role in the hydrological ecosystem services of the ecoregion. Although peat is globally valued for carbon sequestration and storage, peatlands have not yet been mapped in the jalca. In this region, the Gocta waterfall, one of the 20 highest waterfalls in the world, depends on the jalca’s wetlands ecosystem. The local population depends on tourism to the waterfall and is concerned about preserving its drainage area. To inform conservation planning, in this study we delimited the drainage area of the Gocta waterfall and identified land tenure by applying Geographic Information System (GIS), remote sensing and participatory mapping techniques. Then, by classifying optical, radar and digital elevation models data, we mapped peatland in the jalca of the Gocta drainage area with an overall accuracy of 97.1%. Our results will inform conservation strategy in this complex area of communal, private and informal land tenure systems. At a regional level, this appears to be the first attempt at mapping peatlands using remote sensing imagery in the jalca ecoregion, and it represents a milestone for future efforts to map and conserve peatlands in other tropical mountain areas of the world.
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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- Journal:
- 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
Time discrimination in psychosis: findings from a neuroimaging study
- J. Goena, C. Vidal, S. Solís, M. Fernandez Seara, F. Ortuño, S. Garcés, M. Fernández
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S130-S131
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Introduction
Previous functional neuroimaging studies have demonstrated a brain network responsible of time discrimination (TD) processes, which may play a significant mediating role in other cognitive processes, such as change detection and cognitive control. The study of TD and its dysfunction in psychosis has become a matter of growing interest. We hypothesize that the impairment of the TD network is involved both in the mechanisms of psychosis and in the cognitive deficit presented by patients.
Objectives1. To delimit the brain regions involved in TD.
2. To examine the dysfunction in TD brain network in patients diagnosed with psychosis.
3. To sudy the integrity of brain white matter pathways in psychosis.
4. To verify whether the neuroimaging findings and TD test performance predict the neurocognitive profile of the patients.
MethodsParticipants included 20 patients with psychosis (PSY group) and 13 healthy controls (HC group). PSY group participants met remission criteria for 6 months prior to the study. Participants were interviewed for sociodemographic information and clinical assessments. They underwent a detailed cognitive assesment using the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB). Neuroimaging study was performed on a 3 Tesla MRI scanner. We designed an experimental task including a test tool to assess TD and Oddbal detection (OD) paradigms with a cognitive control component. The task was conducted under functional magentic resonance imaging (fMRI). We used the general linear model analysis of the individual data of the fMRI images and the random effects model for group inference. Group differences in DTI were tested using tract-based spatial statistics (TBSS).
ResultsWe find statistically significant differences (fMRI) in the activity related to TD (in HC), with greater activity in frontal cortical regions, the insular cortex and the cerebellum. In the PSY group, differences in the functionality and activation pattern of brain networks responsible for TD are observed, although voxel clustering does not reach the cluster significance limit when compared to HC. Compared to the HC, the PSY group has a significant deficit of fractional anisotropy (DTI) in the whole brain and in 21 specific brain regions. The PSY group has significantly lower scores in six of the seven cognitive domains than the control group, as well as in the overall composite. We correlated FA values in the groups of interest with MCCB scores.
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ConclusionsWe have defined the TD network, its relationship with other brain networks and cognitive processes of more complexity. The inclusion of participants with stable psychosis allowed us to analyze de TD disfunction in the PSY group. We compared the integrity of TD related brain pathways and correlated the findings with various clinical characteristics and the cognitive impairment present in psychotic patients.
Disclosure of InterestNone Declared
Screening and early therapeutic intervention of bonding disorders at first six months of life: An alternative to prevent disorganised attachment and severe mental disorder
- G. Hernández-Santillán, M. Alcamí-Pertejo, B. Palacios-Hernández, G. Lahera-Forteza, A. Fernández-Sánchez, M. F. Bravo-Ortiz
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S101
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Introduction
Disorganized attachment has been described as an important risk factor for developing serious mental disorders in childhood, adolescence and adulthood, such as borderline personality disorder, psychoses, afective disorders, and a higher suicide risk, for instance. Bonding disorders (BD) in parents are related to insecure and disorganized attachment in children. BD can be early diagnosed at 4 to 6 weeks after birth.
ObjectivesDetermine if there is a significant difference between the results of the prevalence of affective disorders, disorganized attachment, and suicidal risk five years after the birth of the offspring of parents with and without attachment disorders detected in the first year postpartum during the covid-19 pandemic.
MethodsDescribe a pilot project of an analytical prospective study following a cohort of parents from the cohort SAMPECO/PEMHSCO (Perinatal Mental Health in Spain during the Covid-19 pandemic). The cohort is planned to be divided into two groups: with bonding disorders an without bonding disorders, which was established using the Postpartum Bonding Questionnaire (Brockington, 2006). Follow the offspring of both groups for 5 years and compare the results of disorganized attachment, affective disorders and suicide risk.
ResultsThe cohort SAMPECO/PEMHSCO was recruited between March 2021 and June 2022. There was measured postpartum depression in mothers and fathers using the EPDS and bonding disorders in parents using the PBQ validated to the Spaniard population. More than 1500 families were involved at the beginning and around 450 families finished the follow-up six months after birth. Around 500 families were lost because of non-right contact information.
ConclusionsThe covid-19 pandemic has seriously affected the mental health of the general population. Consequently, there is a higher demand for mental health assistance by public and private sanity sectors. Currently, the youth population is suffering very much from the consequences of isolation and other social factors, and many families who had babies in this period haven’t had enough support to breed and look after both their babies and themselves. Some papers suggest that the prevalence of perinatal mental disorders in parents has increased since the covid-19 pandemic because of several factors. Paradoxically, despite the high preventive potential of early intervention in the perinatal period, there are not yet exist well-equipped perinatal mental health units to solve this problem. It is urgent to boost the development of Perinatal Mental Health Services to prevent a major worsening of the situation and to prevent the increasing rate of severe mental disorders in children, adolescents and adults.
Disclosure of InterestNone Declared
Moria or Mania? Manic symptoms as the clinical manifestation of glioblastoma recurrence: a case report
- F. Mayor Sanabria, M. E. Expósito Durán, M. Fernández Fariña, C. E. Regueiro Martín-Albo, M. Paz Otero, I. Alberdi Páramo, B. Rodado León
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S520
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Introduction
Up to 50% of patients with brain tumors experience psychiatric symptoms, and rates up to 80% have been reported in malignant neoplasms such as glioblastoma multiforme (GBM). Still, clinical presentation as mania-like syndromes is a rare phenomenon, mainly occurring when frontal structures are compromised.
We present the case of a 42-year-old woman who was admitted to our hospital due to manic symptoms coinciding with a recurrence of a bifrontal GBM, for which she underwent surgery 5 months prior.
Objectives1) To describe the clinical particularities of this case, focusing on the differential diagnosis.
2) To review the association between manic symptoms and frontal dysfunction caused by brain tumors, with special interest on GBM.
MethodsA review of the patient’s clinical history and complementary tests performed was carried out. Likewise, we reviewed the available literature in relation to manic symptoms related to brain tumors.
ResultsThe patient’s GBM recurrence presented with late onset symptoms of mania, including euphoric mood, increased spending, ideas of grandiosity and hyper-religiosity. She had no previous psychiatric history but, interestingly, she had an extensive affective burden in her family, with 4 consummated suicides. However, she also presented other clinical signs, such as disorientation, perseveration, mild memory impairment and stereotyped motor behaviors, that pointed to relevant frontal lobe dysfunction, suggesting Moria as a possible contribution for the symptoms described.
Manic symptoms in the context of brain tumors appear in 7-15% of patients with psychiatric symptoms, usually associated with right frontal dysfunction (75% of cases). Bifrontal affectation, such as this patient, is only described in 6% of cases. Although fast growing, malignant tumors have been associated with higher rates of psychiatric symptoms, no correlation has been described between these and brain tumor histology.
Conclusions- The presence of atypical manic symptoms, such as those presented in this case, should raise clinical concern for secondary mania.
- Moria shares similarities with mania, including mood elevation, tendency to hilarity or hyper-sexuality, that may hinder diagnosis of patients with frontal dysfunction.
- This case outlines the difficulties in making a differential diagnosis in patient with both manic and neurological signs, and highlights the implication of frontal structures in the development of manic symptoms.
Disclosure of InterestNone Declared
Outcome Measurement and Evaluation as a Routine practice in alcohol and other drug services in Belgium (OMER-BE)
- C. Migchels, A. Zerrouk, F. Matthys, W. van den Brink, K. Fernandez, J. Antoine, W. Vanderplasschen, C. L. Crunelle
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S141-S142
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Introduction
There is a variety of specialized outpatient and residential Alcohol and Other Drugs (AOD) services, but research on outcomes of these services is limited. Given the chronic, relapsing nature of AOD problems, there is a need for longitudinal research on outcomes after treatment in various AOD services.
Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) are hardly used in the AOD field but provide excellent tools and a framework to monitor progress and outcomes in these services based on experiences of service users.
ObjectivesThe objectives of the OMER-BE study are to:
1. Assess and compare patient characteristics at baseline in various treatment modalities
2. Test and prepare the routine measurement of PROMs and PREMs in AOD services using a self-report tool
3. Assess patient-reported experiences qualitatively in various treatment modalities for AOD patients
The overall goal is to continuously assess and improve AOD services.
MethodsWe have set up a naturalistic, longitudinal cohort study for which we will engage and follow up 250 AOD users as they present themselves in selected AOD services in four different treatment modalities (outpatient non-pharmacological treatment, outpatient substitution treatment, residential psychiatric treatment and therapeutic communities for addictions).
Sociodemographic and clinical factors and PROMs will be assessed at baseline. PROMs and PREMs will be assessed at 45-, 90- and 180-days follow-up. The questionnaires that will be used during the baseline and follow-up assessments are based on the ICHOM Standard Set for Addictions (ICHOM SSA, 2020), a set of brief validated questionnaires to measure and monitor treatment outcomes routinely in AOD services.
Following the 6-month follow-up we will perform a qualitative study in a subset of N=20 participants (5 per treatment modality). These participants will be invited to take part in an in-depth interview with one of the researchers, where the following topics will be discussed: treatment history, recovery experiences, helping and hindering factors in recovery, and experiences with different treatment modalities.
Results47 participants have been recruited in the OMER-BE study up until October 2022. 38 (81%) of the participants were born male, 9 (19%) were born female. The average age of participants is 33, with ages ranging from 19 to 47 years old.
Preliminary findings will be presented at the congress.
Further recruitment of study participants up to a total of 250 will be undertaken until the end of 2023.
ConclusionsThe OMER-BE study aims to assess and improve AOD services by using a self-report tool, measuring PROMs and PREMs.
Disclosure of InterestNone Declared
Cultural factors in depressive experience and its severity: A case report
- C. Regueiro Martín-Albo, F. Mayor Sanabria, E. Expósito Durán, M. Fernández Fariña, M. Navas Tejedor
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S816
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Introduction
For a very long time, anthropologists and psychiatrists have studied how the symptomatology of mental diseases varies among cultures. Different social environments approach depression in different ways, and cultural practices and meanings influence how it develops. Culture also affects how symptoms are felt and described, how treatments are chosen, how patients and doctors interact, how likely it is that certain events, like suicide, will occur, and how professionals behave. As a result, all of these circumstances must be taken into consideration when approaching the diagnosis and management of depressive disorders. To illustrate the above, we present the case of a 31-year-old man, originally from Nigeria, who was admitted to the hospital after a suicide attempt by precipitation onto the subway tracks.
Objectives(1) To describe the clinical particularities of this case, focusing on the diagnostic difficulties we faced derived from intercultural contrasts (2) To review cross-cultural differences in the symptomatology and its implication on severity of depressive disorders.
MethodsA review of the patient’s clinical history and complementary tests performed was carried out. Likewise, a bibliographic review of the available scientific literature was also performed in relation to transcultural depressive experiences and its severity.
ResultsThere is little evidence in favor of a direct link between sociocultural factors and severe depression, but we reviewed the arguments that look significant for further research. Depressive illnesses are found in all societies and their symptomatic expression varies culturally, particularly in terms of somatization and delusional ideas. Similarly, the social and individual representations of the disease depend on the culture, and some conceptual models can increase the effects of stigmatization. These cross-cultural variations could influence the care-seeking process and therefore modulate the evolution of the disease in the sense of greater severity.
ConclusionsAll societies experience depressive disorders, which exhibit symptoms that vary culturally, especially in terms of somatization and delusional beliefs.
The care-seeking process is affected by cross-cultural differences, and as a result, the disease’s progression may also be modulated in terms of increased severity.
When we ignore cultural factors in understanding, assessing, and treating depression, we are contributing to misdiagnosis and errors in patient management.
Disclosure of InterestNone Declared
Treatment adherence of a case managed program for patients with severe schizophrenia compared to standard care in mental health units.
- S. Díaz-Fernández, J. J. Fernández-Miranda, F. López-Muñoz
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1088-S1089
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Introduction
Although some studies have reported that case management (CM), when is compared with standard care, reduces the loss of contact with health services, the debate continues about its superiority over other treatment models.
ObjectivesTo assess treatment adherence and reasons for treatment discontinuation, and the impact of the type of APs administration on it, for a group of patients with schizophrenia treated in a CMP or receiving standard treatment in mental health units (MHUs).
MethodsAn observational, longitudinal study (ten-year follow-up) was conducted on 688 patients with severe schizophrenia (CGI-S ≥ 5). All the causes of the end of treatment were recorded, together with the AP medication prescribed and kind of regimes.
Results43.6% of the patients had discontinued treatment in MHUs and only 12.1% on the CMP (p < 0.0001). 27.6% of patients in MHUs were on long-acting injectables (LAIs), and 57.6 on the CMP (p < 0.001). Treatment discontinuation was closely linked to be on OAPs medication in both cases (p < 0.001).
Table 1. Treatment discontinuation, hospital admissions and suicide attempts [N(%)] N= 688 MHU (N=344) CMP (N= 344) P value Treatment discontinuation 290 (84.3) 42 (12.2) <0.00001 OAP LAI OAP LAI Treatment discontinuation 180(52.3) 90(26.2)a 34(9.9) 8(2.3)b Hospital admissions 260 (75.6) 80 (23.5) <0.001 OAP LAI OAP LAI Hospital admissions 180 (52.3) 80 (23.5)a 65 (18.9) 15 (4.4)b Suicide attempts 134 (38.9) 26 (7.7) <0.0001 OAP LAI OAP LAI Suicide attempts 160(46.5) 74(21.5)a 18(5.2) 8(2.3)b a: p<0.01 b: p<0.001 N: number of patients %: percentage of patients
MHU: mental health unit CMP: case managed programme
AP: antipsychotic FGA, SGA: first, second generation antipsychotic
OAP: oral antipsychotic LAI: long-acting injectable antipsychotic
ConclusionsOur findings show how specific strategies as programs with an integrated treatment and case-managed approach, increase adherence. Moreover, treating with LAI APs clearly contributes to the achievement of these results. The widespread implementation of comprehensive community programs with case management, and the use of LAI-APs, should be an effective choice for people with schizophrenia and clinical severity and impairment, and at high risk of treatment discontinuation.
Disclosure of InterestNone Declared
Visual hallucinosis and Linezolid use: A case report.
- M. Fernández Fariña, C. E. Regueiro Martín-Albo, M. E. Expósito Durán, F. Mayor Sanabria, Í. Alberdi Páramo
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1012
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Introduction
We present the case of a 78-year-old man with multiple somatic pathologies and associated depressive symptoms, under treatment with Citalopram 10mg, who was admitted due to cholangitis secondary to biliary prosthetic obstruction.
Empirical antibiotic treatment with Meropenem and Linezolid was started, along with an increase in the dose of Citalopram to 20mg due to mood worsening. The patient begins with symptoms consisting of complex and polymorphic visual hallucinosis, without any affective or behavioral repercussions. He does not present another semiology of the psychotic sphere.
ObjectivesTo highlight the importance of knowing the different interactions and adverse effects of drugs for good clinical management.
MethodsWe collected the complete medical history of our patient and we carried out a review of the interactions and adverse effects described with the antibiotic drug Linezolid.
ResultsAs the onset of hallucinations was temporarily correlated with the use of medications, drug-induced hallucinations were suspected, resolving completely after 2 days after withdrawal of Linezolid treatment.
Linezolid is a nonselective inhibitor of MAO A and B, preventing the destruction of monoamine neurotransmitters like serotonin, dopamine, or norepinephrine. It has dopaminergic properties that may enhance the central nervous system effects of anticholinergics and co-prescription with serotonergic drugs increases the risk of serotonin syndrome.
ConclusionsThis case highlights the importance of taking into account drug interactions and adverse effects to reduce the risk of drug induced symptoms and optimize their management.
The increase in resistance to antibiotic treatment allows us to anticipate that the use of Linezolid will increase in the coming years, and it is important to know its mechanism of action given the interactions with psychotropic drugs that we use in our usual clinical practice
Disclosure of InterestNone Declared
Relationship between Signals Regulating Energy Homeostasis and Neuropsychological and Clinical Features in Gambling Disorder: A Case-Control Study
- F. Fernandez-Aranda, I. Baenas, M. Etxandi, B. Mora-Maltas, R. Granero, S. Tovar, C. Diéguez, M. N. Potenza, S. Jiménez-Murcia
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S328
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Introduction
The neurobiology of gambling disorder (GD) is not yet fully understood. Although dysfunctional signalling involved in energy homeostasis has been studied in substance use disorders, it should be examined in detail in GD.
ObjectivesTo compare different endocrine and neuropsychological factors between individuals with GD and healthy controls (HC), and to explore endocrine interactions with neuropsychological and clinical variables.
MethodsA case-control design was performed in 297 individuals with GD and 41 HC, assessed through a semi-structured clinical interview and a psychometric battery, adding 38 HC in the evaluation of endocrine and anthropometric variables.
ResultsIndividuals with GD presented higher fasting plasma ghrelin (p<.001) and lower LEAP2 and adiponectin concentrations (p<.001) than HC adjusting for body mass index (BMI). The GD group reported higher cognitive impairment regarding cognitive flexibility and decision-making strategies, a worse psychological state, higher impulsivity levels, and a more dysfunctional personality profile. Despite failing to find significant associations between endocrine factors and either neuropsychological or clinical aspects in GD, some impaired cognitive dimensions and lower LEAP2 concentrations significantly predicted GD presence.
ConclusionsThis study suggests distinctive neuropsychological and endocrine dysfunctions may operate in individuals with GD, predicting GD presence. Further exploration of endophenotypic vulnerability pathways in GD appear warranted, especially with respect to etiological and therapeutic potentials.
Disclosure of InterestF. Fernandez-Aranda Consultant of: Novo Nordisk , Employee of: editorial honoraria as EIC from Wiley, I. Baenas: None Declared, M. Etxandi : None Declared, B. Mora-Maltas: None Declared, R. Granero : None Declared, S. Tovar : None Declared, C. Diéguez: None Declared, M. Potenza Grant / Research support from: Mohegan Sun Casino and Connecticut Council on Problem Gambling, Consultant of: Opiant Pharmaceuticals, Idorsia Pharmaceuticals, Baria-Tek, AXA, Game Day Data and the Addiction Policy Forum; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse control disorders or other health topics; and has consulted for law offices and gambling entities on issues related to impulse control or addictive disorders, Employee of: patent application in Yale University and Novartis, S. Jiménez-Murcia: None Declared.
Cyclothymia, bipolar disorder and multiple sclerosis: A case report
- M. D. P. Paz Otero, E. Lozano Bori, J. Sánchez Rodríguez, S. Puyal González, M. Fernández Fariña, F. Mayor Sanabria, A. Francos Ajona
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S703-S704
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Introduction
We present the case of a 49-year-old woman who was diagnosed with multiple sclerosis at the age of 19 and suffers from an affective disorder that has been evolving for years. This condition, for which she has been followed by psychiatry and psychology for more than ten years, consists of alternating periods of hypomania lasting weeks and phases in which frank depressive symptomatology predominates, with no phases of euthymia in between and with a predominance of severe deterioration of her functionality at both poles.
Objectives(1) We will review the term cyclothymia and explore the concept of “cyclothymic temperament” advocated by some authors, in order to be able to understand the dimension of the present case and reformulate its approach.
(2) The relationship between multiple sclerosis and bipolar spectrum disorders will be covered, reviewing the current knowledge in this regard and relating it to the patient’s symptomatology.
MethodsA review of the patient’s clinical history will be carried out, taking into account her life history, the complementary tests performed as well as the multiple therapeutic approaches tried over the last few years.
Likewise, a bibliographic review of the available scientific literature will be carried out in relation to the diagnosis of cyclothymia or bipolar disorder type II, the controversial term “cyclothymic temperament”, and the relationship that these diagnoses have with the diagnosis of Multiple Sclerosis.
Results(1) Our patient could fit into what many authors define as a cyclothymic temperament, fulfilling, in certain episodes, the criteria that the manuals propose for bipolar disorder type II.
(2) 2.1 The prevalence of bipolar affective disorder in MS is approximately twice as high as in the general population (rates of 0.3-2.4%). 2.2 Patients with MS have higher scores in cyclothymic and hyperthymic temperament than the control group. 2.3 Certain drugs generally used in BD also seem to have a beneficial effect on MS.
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ConclusionsThe reformulation of the concept of cyclothymia would allow us to recognize in our patient a basic temperament of long evolution that would be the substrate on which different factors have subsequently influenced, such as antidepressant drugs or multiple sclerosis. In addition, it is necessary to know the association between BD and MS, in order to be able to offer an adequate treatment, contemplating some pharmacological options such as Lithium or some Atypical Antipsychotics, given the beneficial effect both for the affective disorder and for the neurological process.
Disclosure of InterestNone Declared
An empirical staging model for schizophrenia using machine learning
- M.-C. Clara, F. Sánchez-Lasheras, A. García-Fernández, L. González-Blanco, P. A. Sáiz, J. Bobes, M. P. García-Portilla
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S626-S627
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Introduction
One of the great challenges still to be achieved in schizophrenia is the development of a staging model that reflects the progression of the disorder. The previous models suggested have been developed from a theoretical point of view and do not include objective variables such as biomarkers, physical comorbidities, or self-reported subjective variables (Martinez-Cao et al. Transl Psychiatry 2022; 12(1) 1-11).
ObjectivesDevelop a multidimensional staging model for schizophrenia based on empirical data.
MethodsNaturalistic, cross-sectional study. Sample: 212 stable patients with Schizophrenia (F20). Assessments: ad hoc questionnaire (demographic and clinical information); psychopathology: PANSS, CDS, OSQ, CGI-S; functioning: PSP; cognition: MATRICS; laboratory tests: C-Reactive Protein (CRP), IL-1RA, IL-6, Platelets/Lymphocytes (PLR), Neutrophils/Lymphocytes (NLR), and Monocytes/Lymphocytes (MLR) ratios. Statistical analysis: Variables selection was performed with an ad hoc algorithm developed for this research. The referred algorithm makes use of genetic algorithms (GA) to select those variables that show the best performance for the patients classification according to their global CGI-S. The objective function of the GA maximizes the individuals correct classification of a support vector machines (SVM) model that employs as input variables those given by the GA (Díez-Díaz et al. Mathematics 2021; 9(6) 654). Models performance was assessed with the help of 3-fold cross-validation and these process was repeated 10,000 times for each one of the models assessed.
ResultsMean age(SD): 39.5(13.54); men: 63.5%; secondary education: 59.50%. Most patients in our sample had never been married (74.10%), and more than a third received disability benefits due to schizophrenia (37.70%). The mean length of the disease was 11.98(12.02) years. The best SVM model included the following variables: 1)Clinical: number of hospitalizations, positive, negative, depressive symptoms and general psychopathology; 2)Cognition: speed of processing, visual learning and social cognition; 3)Functioning: PSP total score; 4)Biomarkers: PLR, NLR and MLR. This model was executed again 100,000 times applying again 3-fold cross-validation. In 95% of the algorithm executions more than a 53.52% of the patients were classfied in the right CGI-S category. On average the right classification was of 61.93%. About specificity and sensitivity the average values obtained were of 0.85 and 0.64 respectively.
ConclusionsOur staging model is a robust method that appropriately distributes patients according to the severity of the disorder. Highlights the importance of clinical, functional and cognitive factors to classify patients. Finally, the inflammatory parameters PLR, NLR and MLR have also emerged as potential biomarkers for staging schizophrenia.
Disclosure of InterestNone Declared
POVERTY, TRUST, AND SOCIAL DISTANCE: A SELF-REINFORCING “POVERTY TRAP”?
- Almudena Fernández, Luis F. López-Calva, Santiago Rodríguez
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- Social Philosophy and Policy / Volume 40 / Issue 1 / Summer 2023
- Published online by Cambridge University Press:
- 05 February 2024, pp. 129-149
- Print publication:
- Summer 2023
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We consider the concept of poverty from the asset-accumulation approach and propose an integrated framework, building upon existing theories, to describe how the interconnected factors of trust (or lack thereof) and social distance can reinforce poverty traps. Social distance is influenced by choice, while trust is the symptom that defines the strength of social ties on a group. We look at how an absence of trust influences how households make decisions about the use and accumulation of assets in ways that could perpetuate poverty. Weak trust also affects how groups interact with each other in a society, creating “trust clusters” within homogeneous groups and antagonism across groups, which in turn affects aspirations and leads to an erosion of the basis of a social contract. For more effective and sustainable poverty reduction, we need to understand these linkages and address them systematically.