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Quantification and Characterization of Maghemite in Soils Derived from Volcanic Rocks in Southern Brazil
- Antonio Carlos S. da Costa, Jerry M. Bigham, Fred E. Rhoton, Samuel J. Traina
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- Clays and Clay Minerals / Volume 47 / Issue 4 / August 1999
- Published online by Cambridge University Press:
- 28 February 2024, pp. 466-473
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Many soils developed from volcanic rocks in southern Brazil exhibit spontaneous magnetization caused by the presence of fine-grained maghemite (γ-Fe2O3), but few attempts were made to quantify or characterize this important soil component. To that end, clays were separated from freely drained soils derived from acid (≥63% SiO2), intermediate (54–62% SiO2), and basic (≤53% SiO2) igneous rocks produced by the Paraná flood volcanism. The sample set included soils with a wide range of pedogenic development on different landscape positions. The Fe oxide mineralogy of these samples was examined by using a combination of selective dissolution, magnetic susceptibility, and X-ray diffraction (XRD) techniques. Hematite and maghemite were the primary Fe oxides in mature soils (Oxisols, Ultisols, and Alfisols) developed from basic rocks; whereas goethite was dominant in all other soils, especially those formed from acid-intermediate rocks. The association of maghemite with basic rock materials suggests that it was primarily formed by oxidation of lithogenic magnetite. A strong, positive correlation (R2 = 0.89) was obtained between mass specific magnetic susceptibility (χ) of the clay fractions and maghemite contents estimated by XRD. Either method could be used for quantitative analyses, but χ was more sensitive than XRD at low maghemite concentrations (<2 wt. %). The clay-sized maghem-ites were superparamagnetic with an estimated value for the mass specific magnetic susceptibility (χlf) value of 91,000 × 10−8 m3 kg−1 and frequency dependent variations of 10–15%. The maghemites also had low unit cell constants, which, if attributed entirely to replacement of Fe by Al, would correlate with Al substitutions in the range of 5–16 mole %. Selective dissolution of the soil maghemites was achieved by treatment of Fe oxide concentrates with 1.8 M H2SO4 at 75°C for 2 h.
Iron Oxides in a Soil Developed from Basalt
- A. T. Goulart, J. D. Fabris, M. F. de Jesus Filho, J. M. D. Coey, G. M. da Costa, E. de Grave
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- Clays and Clay Minerals / Volume 46 / Issue 4 / August 1998
- Published online by Cambridge University Press:
- 28 February 2024, pp. 369-378
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A dusky red Oxisol forming on a tholeiitic basalt is found to contain varying proportion of aluminous hematite (Hm) and titanoaluminous maghemite (Mh) in the different size fractions. Maghemite is the main iron oxide in the sand and silt fractions whereas Hm is dominant in the clay fraction, together with gibbsite (Gb), kaolinite (Ka), rutile (Rt) (and probably anatase, An) and Mh. Maghemite is also the major oxide mineral in the magnetic separates of soil fractions (sand, about 65% of the relative Mössbauer spectral area; silt, 60%). Hematite (sand, 30%; silt, 15%) and ilmenite (Im) (sand, 5%; silt, 16%) are also significantly present in the magnetic extract. Accessory minerals are Rt and An. No magnetite (Mt) was detected in any soil fraction. Sand- and silt-size Mh have similar nature (a 0= 0.8319 ± 0.0005 nm; about 8 mol% of Al substitution; saturation magnetization of 49 J T−1 kg−1), and certainly a common origin. Lattice parameters of clay-Mh are more difficult to deduce, as magnetic separation was ineffective in removing nonmagnetic phases. Al content in Hm varies from 14 mol% (clay and silt) to 20 mol% (sand). The proposed cation distribution on the spinel sites of the sand-size Mh is:
(◻ = vacancy, [ ] = tetrahedral sites and { } = octahedral sites), with a corresponding molar mass of 208.8 g mol−1. The predicted magnetization based on this formula is σ ≅ 68 J T−1 kg−1, assuming collinear spin arrangement. The large discrepancy with the experimentally determined magnetization is discussed.
Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)
- Konstantinos N. Fountoulakis, Grigorios N. Karakatsoulis, Seri Abraham, Kristina Adorjan, Helal Uddin Ahmed, Renato D. Alarcón, Kiyomi Arai, Sani Salihu Auwal, Michael Berk, Sarah Bjedov, Julio Bobes, Teresa Bobes-Bascaran, Julie Bourgin-Duchesnay, Cristina Ana Bredicean, Laurynas Bukelskis, Akaki Burkadze, Indira Indiana Cabrera Abud, Ruby Castilla-Puentes, Marcelo Cetkovich, Hector Colon-Rivera, Ricardo Corral, Carla Cortez-Vergara, Piirika Crepin, Domenico De Berardis, Sergio Zamora Delgado, David De Lucena, Avinash De Sousa, Ramona Di Stefano, Seetal Dodd, Livia Priyanka Elek, Anna Elissa, Berta Erdelyi-Hamza, Gamze Erzin, Martin J. Etchevers, Peter Falkai, Adriana Farcas, Ilya Fedotov, Viktoriia Filatova, Nikolaos K. Fountoulakis, Iryna Frankova, Francesco Franza, Pedro Frias, Tatiana Galako, Cristian J. Garay, Leticia Garcia-Álvarez, Maria Paz García-Portilla, Xenia Gonda, Tomasz M. Gondek, Daniela Morera González, Hilary Gould, Paolo Grandinetti, Arturo Grau, Violeta Groudeva, Michal Hagin, Takayuki Harada, Tasdik M. Hasan, Nurul Azreen Hashim, Jan Hilbig, Sahadat Hossain, Rossitza Iakimova, Mona Ibrahim, Felicia Iftene, Yulia Ignatenko, Matias Irarrazaval, Zaliha Ismail, Jamila Ismayilova, Asaf Jakobs, Miro Jakovljević, Nenad Jakšić, Afzal Javed, Helin Yilmaz Kafali, Sagar Karia, Olga Kazakova, Doaa Khalifa, Olena Khaustova, Steve Koh, Svetlana Kopishinskaia, Korneliia Kosenko, Sotirios A. Koupidis, Illes Kovacs, Barbara Kulig, Alisha Lalljee, Justine Liewig, Abdul Majid, Evgeniia Malashonkova, Khamelia Malik, Najma Iqbal Malik, Gulay Mammadzada, Bilvesh Mandalia, Donatella Marazziti, Darko Marčinko, Stephanie Martinez, Eimantas Matiekus, Gabriela Mejia, Roha Saeed Memon, Xarah Elenne Meza Martínez, Dalia Mickevičiūtė, Roumen Milev, Muftau Mohammed, Alejandro Molina-López, Petr Morozov, Nuru Suleiman Muhammad, Filip Mustač, Mika S. Naor, Amira Nassieb, Alvydas Navickas, Tarek Okasha, Milena Pandova, Anca-Livia Panfil, Liliya Panteleeva, Ion Papava, Mikaella E. Patsali, Alexey Pavlichenko, Bojana Pejuskovic, Mariana Pinto Da Costa, Mikhail Popkov, Dina Popovic, Nor Jannah Nasution Raduan, Francisca Vargas Ramírez, Elmars Rancans, Salmi Razali, Federico Rebok, Anna Rewekant, Elena Ninoska Reyes Flores, María Teresa Rivera-Encinas, Pilar Saiz, Manuel Sánchez de Carmona, David Saucedo Martínez, Jo Anne Saw, Görkem Saygili, Patricia Schneidereit, Bhumika Shah, Tomohiro Shirasaka, Ketevan Silagadze, Satti Sitanggang, Oleg Skugarevsky, Anna Spikina, Sridevi Sira Mahalingappa, Maria Stoyanova, Anna Szczegielniak, Simona Claudia Tamasan, Giuseppe Tavormina, Maurilio Giuseppe Maria Tavormina, Pavlos N. Theodorakis, Mauricio Tohen, Eva Maria Tsapakis, Dina Tukhvatullina, Irfan Ullah, Ratnaraj Vaidya, Johann M. Vega-Dienstmaier, Jelena Vrublevska, Olivera Vukovic, Olga Vysotska, Natalia Widiasih, Anna Yashikhina, Panagiotis E. Prezerakos, Daria Smirnova
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- Journal:
- CNS Spectrums / Volume 29 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 25 January 2024, pp. 126-149
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Background
The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.
MethodsThe sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.
ResultsAbout 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.
ConclusionsThe finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
Machine Learning for Smart and Energy-Efficient Buildings
- Hari Prasanna Das, Yu-Wen Lin, Utkarsha Agwan, Lucas Spangher, Alex Devonport, Yu Yang, Ján Drgoňa, Adrian Chong, Stefano Schiavon, Costas J. Spanos
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- Environmental Data Science / Volume 3 / 2024
- Published online by Cambridge University Press:
- 04 January 2024, e1
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Energy consumption in buildings, both residential and commercial, accounts for approximately 40% of all energy usage in the United States, and similar numbers are being reported from countries around the world. This significant amount of energy is used to maintain a comfortable, secure, and productive environment for the occupants. So, it is crucial that energy consumption in buildings must be optimized, all the while maintaining satisfactory levels of occupant comfort, health, and safety. Machine learning (ML) has been proven to be an invaluable tool in deriving important insights from data and optimizing various systems. In this work, we review some of the most promising ways in which ML has been leveraged to make buildings smart and energy-efficient. For the convenience of readers, we provide a brief introduction to the relevant ML paradigms and the components and functioning of each smart building system we cover. Finally, we discuss the challenges faced while implementing machine learning algorithms in smart buildings and provide future avenues for research in this field.
Difficulties during delivery, brain ventricle enlargement and cognitive impairment in first episode psychosis
- Ana Costas-Carrera, Norma Verdolini, Clemente Garcia-Rizo, Gisela Mezquida, Joost Janssen, Isabel Valli, Iluminada Corripio, Ana M. Sanchez-Torres, Miquel Bioque, Antonio Lobo, Ana Gonzalez-Pinto, Marta Rapado-Castro, Eduard Vieta, Helena De la Serna, Anna Mane, Alexandra Roldan, Nicolas Crossley, Rafael Penades, Manuel J. Cuesta, Mara Parellada, Miquel Bernardo, PEPs group
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- Journal:
- Psychological Medicine / Volume 54 / Issue 7 / May 2024
- Published online by Cambridge University Press:
- 28 November 2023, pp. 1339-1349
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Background
Patients with a first episode of psychosis (FEP) display clinical, cognitive, and structural brain abnormalities at illness onset. Ventricular enlargement has been identified in schizophrenia since the initial development of neuroimaging techniques. Obstetric abnormalities have been associated with an increased risk of developing psychosis but also with cognitive impairment and brain structure abnormalities. Difficulties during delivery are associated with a higher risk of birth asphyxia leading to brain structural abnormalities, such as ventriculomegaly, which has been related to cognitive disturbances.
MethodsWe examined differences in ventricular size between 142 FEP patients and 123 healthy control participants using magnetic resonance imaging. Obstetric complications were evaluated using the Lewis–Murray scale. We examined the impact of obstetric difficulties during delivery on ventricle size as well as the possible relationship between ventricle size and cognitive impairment in both groups.
ResultsFEP patients displayed significantly larger third ventricle size compared with healthy controls. Third ventricle enlargement was associated with diagnosis (higher volume in patients), with difficulties during delivery (higher volume in subjects with difficulties), and was highest in patients with difficulties during delivery. Verbal memory was significantly associated with third ventricle to brain ratio.
ConclusionsOur results suggest that difficulties during delivery might be significant contributors to the ventricular enlargement historically described in schizophrenia. Thus, obstetric complications may contribute to the development of psychosis through changes in brain architecture.
Water use efficiency and yield responses of Cenchrus purpureus genotypes under irrigation
- R. E. P. Ribeiro, A. C. L. Mello, M. V. Cunha, M. V. F. Santos, S. B. M. Costa, J. J. Coelho, R. O. Carvalho, V. J. Silva
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- The Journal of Agricultural Science / Volume 161 / Issue 4 / August 2023
- Published online by Cambridge University Press:
- 07 September 2023, pp. 572-580
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In tropical regions, water stress is one of the main causes of the reduction in forage productivity, and irrigation strategies can mitigate the problem, especially for highly productive species. The objective of this study was to evaluate the effects of irrigation, genotype and plant size on productive responses and water use efficiency (WUE) of elephant grass (Cenchrus purpureus [Schumach.] Morrone), in the rainy and dry season. The experimental design was randomized in blocks, arranged in split plots, the main plots were established based on the use of irrigation and the subplots were the tall-sized genotypes (IRI 381 and Elephant B) and dwarfs (Taiwan A-146 2.37 and Mott). The genotypes were evaluated for two years and harvested every 60 days. Water use efficiency, total forage accumulation per year and harvest, forage accumulation rate and forage density were evaluated. There was a significant difference between the genotypes in terms of total forage accumulated (P < 0.05). The most productive genotype was IRI 381, which showed the greatest total forage accumulation (42 168 kg of DM/ha in two years) in the irrigated plots. During the rainy seasons, IRI 381 stood out in terms of forage accumulated (24 667 kg of DM/ha). Irrigation favoured increases in forage accumulation around 60%, in both years of evaluation. Irrigation and plant size influenced the productivity and WUE of elephant grass harvested in 60-day intervals. Tall genotypes and Taiwan A-146 2.37 (dwarf size) stood out in most of the productive traits analysed, while Mott was highlighted by its forage density.
Psychosocial differences in perceived older workers’ work (un)adaptability, effectiveness and workplace age discrimination
- S. von Humboldt, I. Miguel, J. Valentim, A. Costa, G. Low, I. Leal
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S237
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Introduction
The aging population in the developed world has implied increasing age diversity in the workforce of organizations. Consequently, mutual perceptions about one’s co-workers and age discrimination is becoming increasingly important.
ObjectivesThis study aims to explore how perceptions about older workers’ work (un)adaptability, work effectiveness and workplace age discrimination vary according to participants’ psychosocial factors, such as age group, gender, education level and work sector.
MethodsThis study included a sample of 453 workers in Portugal, diverse in terms of age, gender, education level and work sector. Four different instruments were used: (a) a sociodemographic questionnaire; (b) an older workers’ Work Adaptability scale; (c) an older workers’ Work Effectiveness Scale and; (d) the Workplace Age Discrimination Scale (WADS).
ResultsMiddle-aged and older participants perceive older workers as more adaptable than younger participants. The oldest group of participants perceives older workers to be more work-effective and experience the highest levels of age discrimination in the workplace, when compared to the other age groups. Also, participants with lower levels of education tend to perceive higher levels of workplace age discrimination, when compared to participants with high school and higher education.
ConclusionsGenerational perceptions in the workplace are perceived by workers differently, hence organizations should implement age management strategies to address age discrimination, particularly due to the increasing proportion of older workers.
Disclosure of InterestNone Declared
Off-label use of atypical antipsychotics- Where are we?
- R. P. Vaz, J. Martins, A. L. Costa, J. Brás, R. Sousa, E. Almeida, J. Abreu, N. Castro, R. Andrade, N. Gil
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S305
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Introduction
Nowadays, In the exercise of psychiatric clinical activity, the prescription of atypical antipsychotics is a widespread practice.
However, despite the approval in the treatment of psychoses and bipolar affective disorder, where its effectiveness is clearly demonstrated, these drugs are off-label prescribed in most of the clinical situations.
ObjectivesThis work aims to clarify which atypical antipsychotics are most frequent prescribed and the clinical conditions where their off-label prescription is more common.
MethodsBibliographic research in the Pubmed® database using the terms “atypical antipsychotics and off-label use”
ResultsAccording to the scientific literature consulted, the off-label prescription of atypical antipsychotics may represent about 70% of the total prescription of these psychotropic drugs.
Risperidone, olanzapine, quetiapine and aripiprazole are the most off-label prescribed among the atypical antipsychotics.
The psychiatric conditions where atypical antipsychotics are most often off-label prescribed are addictive disorders, anxiety disorders, post-traumatic stress disorder, personality disorders, eating disorders, insomnia and dementia, where therapeutic benefits are demonstrated when carefully selected.
ConclusionsThe off-label prescription can be interpreted from two points of view. On the one hand, it can guide innovation in clinical practice and improve symptoms in patients who do not respond to standard treatments. On the other hand, it may be associated with negative consequences due to the lack of data on safety and efficacy in these situations.
Despite widespread prescribing of atypical antipsychotics, there is no evidence-based recommendation beyond psychoses and bipolar affective disorder.
Thus, when prescribed, we must proceed with careful monitoring and consider the risks and benefits in relation to off-label prescription.
Disclosure of InterestNone Declared
Healthy mental higher education students’: Presentation of a project
- A. Torres, J. Costa, P. Carvalho, M. Loureiro
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S985-S986
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Introduction
The prevalence of mental disorders in Higher Education Students (HES) is high and has shown a worrying growth. However, only a small percentage of HES in need of psychological support request it, due to the stigma related to mental illness, requesting informal help from friends and family. Training and increasing Mental Health Literacy (MHL) have been stated as appropriate strategies to reduce stigma and increase the demand for professional psychological support. However, with the increase in the demand for help, the difficulty of providing an adequate response from psychological support of HE services also increases. Therefore, procedures that develop socio-emotional skills in the HES and strategies that enhance the responsiveness of these services are necessary.
ObjectivesTaking in consideration the literature review in this field, we develop a project to improve the mental health of HES. The project objectives’: a) the reduction of stigma related to mental disorders through the promotion of MHL in the academic community; b) the promotion of mental health and socio-emotional skills of HES; c) increasing detection and active search for professional mental health support, and d) the implementation of psychological intervention based on a stepped care model that provides an adequate response to most of the students’ mental health needs, according to individual needs.
MethodsThe project proposes to perform the following methods: a) training in mental health open to the academic community, which will aim to train volunteers to be Gatekeepers, in order to promote awareness, detection and referral of students in need of professional psychological support; b) implementation of a Student Observatory, with tracking of psychopathological symptoms, supported on the Web; c) implementation of a psychological intervention program based on a stepped care model, which will include the following progressive phases by severity: 1) digital self-help manual; 2) web-based self-help groups; 3) psychological intervention groups supported by the Web; 4) face-to-face intervention groups and 5) individual psychological intervention.
Students will be assessed before and after each step of care, with the following psychological instruments: Mental Health Inventory (MHI); Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7).
ResultsThe implementation of the presented methods expect to achieve improvements on HES’ mental health, namely improvement of MHI, reduction of PHQ-9 and GAD-7 after each step of the psychological care.
ConclusionsThe project presented encloses evidence-based interventions, with inspiration on psychoeducation and cognitive behavioral approaches, and it is expected to contribute to the improvement of mental health of HES. The results will be collected and disseminated. We encourage other researcher and clinicians to perform studies about the mental health of HES.
Disclosure of InterestNone Declared
Knocking on the Doors of Perception: the role of psilocybin in substance use disorder treatment
- R. Sousa, L. Costa, J. Brás, R. Vaz, J. Martins, J. Abreu, E. Almeida, N. Castro, R. Andrade, N. Cunha
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S270
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Introduction
Substance use disorders(SUDs) are a major health concern and current treatment interventions have proven only limited success. Despite increasing effectiveness, still about 50–60% relapse within 6–12 months after treatment [Cornelius et al., Addict Behav. 2003;28 381-386]. SUDs are defined as chronic disorders of brain reward system, motivation, and memory processes that have gone awry. Medication reducing craving and substance use is mainly available for alcohol dependence and to a lesser extent for other substances.
Hallucinogens may represent a group of agents with potential anti-craving properties subsequently reducing substance use in SUD patients. For instance, lysergic acid diethylamide(LSD) and psilocybin have previously been shown to effectively alleviate symptoms of alcohol and nicotine dependence.
ObjectivesNew treatments preferably focusing on reducing craving and subsequent substance use are therefore urgently needed. The hallucinogen psilocybin may provide a new treatment option for SUD patients, given the beneficial results observed in recent studies
MethodsSystematic revision of literature.
ResultsIn the 1950s, a group of drugs with potential to alter consciousness were discovered (hallucinogens). Several studies suggested their anti-SUD potential, improving self-acceptance and interpersonal relationships, reducing craving and alcohol use. As a result of its recreational popularity during the 1960s, they were banned in 1967, greatly hampering scientific research in this field. Recently, psilocybin, an hallucinogenic substance in psilocybin-containing mushrooms has gained popularity in neuropsychological research, showing to increase trait openness, cognitive and behavioral flexibility, and ratings of positive attitude, mood, social effects, and behavior and even reported persistent positive changes in attitude and behavior. These findings might suggest a valuable compound for the treatment of psychiatric conditions with several additional studies providing supportive evidence for the therapeutic potential of psilocybin for SUD treatment and relapse prevention.
ConclusionsWith the reported limited amount of side effects and potential beneficial effects of psilocybin in SUD, there are valid reasons to further investigate the therapeutic efficacy and safety of psilocybin as a potential SUD treatment. On the one hand, psilocybin may exert its anti-addictive properties by beneficial effects on negative emotional states and stress. On the other hand, psilocybin may improve cognitive inflexibility and compulsivity. Research on the efficacy of psilocybin on SUD is still limited to a handful of published studies to date. As a result, many important questions related to the use of psilocybin as a complement to current treatment of SUD and its working mechanisms remain unanswered. Before psilocybin can be implemented as a treatment option for SUD, more extensive research is needed.
Disclosure of InterestNone Declared
Suicide among physicians: what do we know about it?
- R. P. Vaz, J. Martins, A. L. Costa, J. Brás, R. Sousa, E. Almeida, J. Abreu, N. Castro, R. Andrade, N. Gil
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1115-S1116
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Introduction
The prevalence of mental illness has increased worldwide over the past few years. At the same time, and even in the sense, there is also an increase in suicide rates with special incidence in certain risk groups, among which health professionals stand out.
In this particular group, physicians seem to represent a class particularly vulnerable by the stress and demand associated with it, but also by access and knowledge about potentially lethal means.
For this very part, they have a higher risk of suicide than the general population.
ObjectivesThis paper aims to better understand the phenomenon of suicide among physicians and identify which medical specialties are most vulnerable.
MethodsBibliographic research in the Pubmed® database using the terms “suicide and physicians”.
ResultsThe data obtained from the scientific literature consulted indicate that physicians have a higher risk of suicide than the general population, with greater emphasis on females who have higher rates compared to males.
Work factors that translate into higher levels of demand and stress combined with easy access and knowledge about the use of potentially lethal means seem to contribute very significantly to this phenomenon. Perfectionist personality traits with a high sense of responsibility and duty are also important characteristics that place these professionals in a position of greater vulnerability.
With regard to the different medical specialties, anesthesiology, psychiatry and general and family medicine are the ones with higher suicide rates among the medical class.
ConclusionsThe risk of suicide, although admittedly high in the medical class, is not homogeneous among different countries, being naturally influenced by the satisfaction/gratification obtained in the performance of their profession. In this sense, countries such as Switzerland and Canada show higher levels of professional satisfaction. In the opposite direction, dissatisfaction in the exercise of clinical activity is associated with higher levels of fatigue and burnout.
Medical women, due to the need to combine the responsibility of family tasks with professional responsibility, are at greater risk.
In this sense, it is necessary to develop strategies that are more appropriate for the prevention and early identification of suicide risk situations that can be experienced not only by improving working conditions but also by better addressing professionals suffering from mental disorders.
Disclosure of InterestNone Declared
DELUSION OF PREGNANCY IN PATIENT WITH MAJOR NEUROCOGNITIVE DISORDER: A CASE REPORT
- M. O. Pires, S. Mouta, I. Fonseca Vaz, B. Jesus, J. Nunes, A. Pissarra da Costa
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S939-S940
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Introduction
Delusion of pregnancy (DP) is a heterogeneous symptom that can emerge from different neuropsychiatric syndromes, including schizophrenia, bipolar disorders, but also major neurocognitive disorder (MND). According to the Diagnostic and Statistical Manuel of Mental Disorders-5 (DSM-5), DP is an unspecified type of delusional disorder present in the spectrum of schizophrenia and other psychotic disorders This type of delusion, which can affect both sexes, may have numerous determinants to its genesis and may last decades to resolve.
ObjectivesWe aim to present a case and review of DP and its association with dementia/MND, hyperprolactinemia and galactorrhea.
MethodsNon-systematic literature review and case report, based on the search for titles and/or abstracts of articles that address both DP and dementia, and DP and hyperprolactinemia/galactorrhea, including articles published between 2010 and 2022 in English.
ResultsA 71-year-old female patient was admitted to the Psychiatric unit due to a change in usual behavior in the past 6 months: insomnia, anterograde amnesia, delusions of ruin and persecutory and, for the past month, the belief of being pregnant with twins, supported by the galactorrhea she presented after starting Risperidone prescribed by her Family Doctor weeks prior. Shortly after admission, the patient also revealed hearing her fetuses’ voices. DP vanished briefly after admission due to the combination between the change of Risperidone to Aripiprazole (a prolactin-sparing antipsychotic) and psychotherapy to help deconstruct the patient’s cognitive misinterpretations. She was furthermore diagnosed with Alzheimer’s disease and Memantine was started.
ConclusionsThis patient, according to Bera et al. (Bera et.al. Indian J Psychol Med 2015;37:131-7) is part of the 28.6% of patients more than 50 years of age who present DP, 6.0% that report having twins and 8.3% that report hearing voices of their fetuses. No data was found correlating DP and MND directly. Hyperprolactinemia and its consequent galactorrhea represent one of the many explanations behind DP, especially in suggestible demented patients that easily misinterpret somatic sensations, in which delusional thoughts are frequent and contribute to the morbidity.
Disclosure of InterestNone Declared
Psychosis in Parkinson’s Disease: a Case Report of Diagnosis and Management
- R. P. L. Andrade, N. P. Gil, A. L. Costa, J. Brás, N. Castro, R. Sousa, R. P. Vaz, J. Martins, E. Almeida, J. Abreu, H. Afonso
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1085
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Introduction
Psychosis is a frequent complication in patients diagnosed with Parkinson’s Disease (PD). Characterized mainly by visual hallucinations and paranoid delusions, it occurs most frequently, but not exclusively, as an adverse effect of antiparkinson medications. Nevertheless, cognitive impairment and dementia, as a frequent feature of PD, needs to be considered for differential diagnosis.
ObjectivesOur main objective is to report a case of PD Psychosis, its diagnosis and management and complement it with a non-systematic review of literature.
MethodsPatient file consultation and an additional research, based on the key words “Psychosis” and “Parkinson’s Disease”, using Pubmed as database.
ResultsA 53-year-old female, diagnosed with Juvenile Parkinson’s Disease since age 45 and, as expected, polimedicated with antiparkinson medication. Without any relevant psychiatric background, she was admitted to the emergency department for disorganized behaviour, with 2 weeks of evolution. There, it was also possible to determine the presence of auditive hallucinations and persecutory delusions, associated with marked anguish.
After exclusion of any underlying cause for this symptomatology, inpatient treatment was proposed and accepted by the patient. In collaboration with the Neurology Department, a gradual reduction and optimization of antiparkinson drugs was conducted, associated with introduction of low doses of antipsychotic drugs, in this case Olanzapine. With this medication adjustments, clinical improvement was accomplished, with eventual fading and cessation of psychotic symptoms. Additionally, an irregularly intake of antiparkinson drugs was considered the most probably cause of this clinical decompensation.
ConclusionsAs present in literature, due to the chronicity and complexity of PD, stopping all antiparkinson drugs is not an option, even when psychotic symptoms, that could be a consequence of these drugs, are present. Therefore, a rigorous evaluation and management are mandatory, including the exclusion of other underlying causes and a careful therapeutic adjustment, with gradual reduction of antiparkinson drugs, addressing an eventual temporal relationship between the beginning of a specific drug and the onset of symptoms, and verification of therapeutic compliance, including an involuntary overdose. In cases of refractory symptoms, and after a risk-benefit assessment, pharmacologic treatment directed at these symptoms, low doses of anti-psychotics, may be necessary.
Disclosure of InterestNone Declared
A Challenging Sexsomnia Seen as a Deceptive Case of Depression
- J. Brás, M. Meira e Cruz, C. Teixeira, R. Andrade, A. P. Costa
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1103
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Introduction
Sleep related sexual behaviors or sexsomnias are unconscious behavioral activities that occur during sleep (e.g. parasomnias). Behaviors could range from sexual vocalizations, orgasms, sexualized movements, masturbation, or full sexual intercourse with a subsequent amnesia. Early epidemiological studies showed a prevalence of 7.1%, with a male predominance. While intended as a rare condition, leads to important physical and psychological consequences for both the patient and their bed partner. For our knowledge this is the first case of sexsomnia reported in Portugal.
ObjectivesTo report the clinical and psychosocial impact of a Sexsomnia case in a young woman which was misdiagnosed with depression.
MethodsPatient´s clinical files consultation and literature review using Pubmedâ and the keywords: sexsomnia.
ResultsA 18-year-old female referred to a psychiatric consultation to be assessed and treated from a diagnostic of depressive disorder. This was a young woman with a previous history of sleepwalking during childhood, with no recurrent episodes since adolescence. A familiar positive history for sleepwalking was confirmed (mother). She reported the beginning of her sleep related sexual behavior six months before the consultation, conflicting with the moment in which she started pharmacological therapy for Chron Disease, diagnosed at that time.
After she slept with her boyfriend, she was told by him about the recurrence of masturbatory activity during sleep. These episodes were told to occur as often as 1 to 2 times a night, shortly after falling asleep, with posterior amnesia for the event.
As for medical or psychiatric history, only Chron’s disease is highlighted, being under control with azathioprine. Likewise, he took 1mg of melatonin/night.
Pittsburgh Sleep Quality Index at presentation was 7/21 and the STOP-Bang questionnaire revealed a low risk of Obstructive Sleep Apnea.
A Type I Polysomnographic study was performed revealing decreased sleep efficiency and fragmented sleep presenting an alternating cyclic pattern. The existence of significant respiratory events during sleep, as well as periodic movements, was excluded.
Cognitive behavioral therapy by means of highlighting the need of improvement on sleep hygiene measures was prescribed and the dose of melatonin was increased up to 3mg. Despite the good clinical response, the patient discontinued the melatonin treatment mainly due to familiar and personal reasons and failed to comply with the prescribed hygienic measures, with a further worsening of the clinical condition.
ConclusionsThis particularly challenging case representing the emerging medicolegal issues and psychosocial aspects related with the still poorly understood sleep disorders like sexomnia, shows up how much awareness is required from psychiatric team members to better assist and refer patients, promoting both an assertive diagnostic and an effective management.
Disclosure of InterestNone Declared
European Journal of Psychiatric Trainees - a new scientific peer-reviewed Journal in Psychiatry
- F. Santos Martins, M. J. Santos, L. Afonso Fernandes, D. Cavaleri, M. Pinto da Costa, N. Žaja, K. Markin, L. Tomašić, H. Ryland, J. D King, L. E Stirland, A. Seker
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1118-S1119
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Introduction
Psychiatry training programs vary in the degree to which they offer trainees with an opportunity to get involved in research. Exposure to research during the training period is critical, as this is usually when trainees start their own scientific research projects and gain their first experiences in academic publishing.
ObjectivesWe present the European Journal of Psychiatric Trainees (EJPT) (ejpt.scholasticahq.com), the official journal of the European Federation of Psychiatric Trainees (EFPT), including its scope, mission and vision and practical considerations.
MethodsReflecting on the foundation and operation of the European Journal of Psychiatric Trainees.
ResultsThe European Journal of Psychiatric Trainees is an Open Access, double blind peer-reviewed journal which aims to publish original and innovative research as well as clinical, theory, perspective and policy articles, and reviews in the field of psychiatric training, psychiatry and mental health. Its mission is to encourage research on psychiatric training and inspire scientific engagement by psychiatric trainees. Work conducted by psychiatric trainees and studies of training in psychiatry are prioritized. The journal is open to submissions, and while articles from psychiatric trainees are prioritized, submissions within scope from others are also encouraged. The article processing fee is very low and waivable. It is planned to publish two issues yearly.
The first article was published in July 2022, titled “Fluoxetine misuse by snorting in a teenager: a case report” and it received 218 views as of 17 October 2022, which confirms the journal’s potential for visibility.
ConclusionsThe European Journal of Psychiatric Trainees is a non-profit initiative designed to offer psychiatric trainees a platform to publish and gain experience in publishing. Thanks to its robust double blind peer reviewing system, it has the potential to contribute to scientific excellence.
Disclosure of InterestNone Declared
Sleep Quality in Medical Students of a Portuguese University: a cross-sectional Study
- R. Gonzaga, J. Brás, A. P. Costa, C. Peixoto, J. Fialho
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S266
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Introduction
Sleep is a complex physiological process present in all living beings, performing essential functions for various biological functions. The prevalence of sleep disorders has increased exponentially, as well as studies relating to sleep patterns of the general population.
University students are especially vulnerable to a decrease in sleep quality, particularly medical students. Even so, the literature on sleep quality in medical students is scarce, especially when referring to Portugal, where studies are almost non-existent.
ObjectivesTo evaluate sleep quality in medical students and to analyze the differences in sleep quality according to age, sex, cohabitation and physical activity. It is also intended to compare the sleep quality of medical students throughout the various phases of the medical course.
MethodsThis is a cross-sectional study involving medical students at the University of Beira Interior, Covilhã, Portugal. All medical students were invited to complete the Pittsburgh Sleep Quality Index (PSQI), which has been validated for the portuguese population. First, the scores obtained in each of the components of the PSQI and the global PSQI score were analyzed for the global population. Lastly, the global PSQI score was correlated with each of the sociodemographic variables to verify the existence of a statistically significant relationship.
Results296 students completed the instrument. Of these, 62.2% classify their sleep quality as good; 42.4% scored 2 in the sleep latency component; 50% reported sleeping 6 to 7 hours; 73.9% stated an adequate sleep efficiency; 85.5% mentioned few or no sleep disturbances; 83,8% said they never used sleep medication; and 60.8% had low or no sleepiness or daytime dysfunction.
As for the overall PSQI score, 72.6% of the students had a score greater than 5, indicating a poor quality of sleep. 74.7% of female respondents have a low quality of sleep, as well as 67.7% of male respondents. Likewise, 91.3% of students who live alone have poor sleep quality, as well as 76.8% of those living with family members and 69.8% of those living with colleagues.
Regarding the course year, 82.4% of the first-year students report a poor quality of sleep, as well as 77.5% of the second-year students, 72.1% of the third-year students, 77.8% of the fourth-year, 65.8% of the fifth-year students and 71.4% of the sixth-year students.
ConclusionsMedical students seem to be more likely to have poor sleep quality, especially when compared to other university students. Thus, further studies are needed to prove this susceptibility as well as therapeutic interventions aimed at improving sleep parameters.
Disclosure of InterestNone Declared
Postpartum Delirium: A Psychosis Born in the 18th Century
- J. R. Martins, R. Vaz, A. L. Costa, J. Brás, R. Sousa, J. Abreu, E. Almeida, R. Andrade, N. Castro, T. Casanova
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1128
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Introduction
Pregnancy and childbirth are moments of great vulnerability in a woman’s life, which can predispose her to the development of psychopathology, ranging from transient depressive symptoms (“baby blues”) to psychotic symptoms. Postpartum delirium is the psychiatric syndrome that some authors refer to as puerperal psychosis par excellence. It was first described in the 18th century and were thought to be associated with painful delivery, then became rare after the introduction of effective analgesia.
ObjectivesThe objective of this work is to contribute to a better understanding of this condition, through a literature review.
MethodsBibliographic research using Pubmed® and the keywords: postpartum delirium.
ResultsClinical presentation of postpartum delirium includes: constantly varying degrees of consciousness; perplexity; hallucinations or pseudo-hallucinations of one or more organs of sense; delusions or delusive-type thoughts; great motoric unrest and considerable motoric and verbal abandon; and acute aggressive discharges can also occur. It is thought to be due to organic complications, such as infectious disease, abnormal loss of blood, thrombosis, neurological disease, obstetric disease, vitamin deficiencies, hormonal changes. An article from 1975 mentions how difficult was to treat postpartum delirium despite the development of psychopharmaceutical therapy. The patients remained psychotic for long periods and had many relapses. They mention a comparative study that found that the symptomatic treatment of this syndrome with a combination of perfenazine and lithium carbonate produced relatively favorable results. For that reason, at that time, it was the medication of choice. Nowadays the psychopharmacological treatment of puerperal psychosis, in general, still consists of the combination of lithium and an antipsychotic, such as haloperidol, and possibly a benzodiazepine, such as lorazepam.
ConclusionsPostpartum delirium is rarely mentioned in the literature and just a few cases have been described. It is considered a rare postpartum psychotic condition but would perhaps be less rare if its existence were recognized. On this note, it is important for clinical practice to research on the psychoses of pregnancy and not just the most common.
Disclosure of InterestNone Declared
Physical and psychoeducation combined group intervention: a quasi-experimental study with Portuguese cancer survivors
- A. Torres, A. Ribeiro, C. Matos, J. Costa, A. F. Oliveira, I. M. Santos, S. R. Costa
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S69-S70
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Introduction
Cancer is a major public health problem worldwide and the risk of death from cancer has decreased continuously since 1991, therefore, This translates into an increasing number of cancer survivors (CS) worldwide.
During the survivorship seasons, CS face several short-term, long-term, persistent, and late-emerging health and psychosocial problems, including cancer-related pain, fatigue, menopausal symptoms, anxiety, depression, distress associated with the risk of cancer recurrence, chronic uncertainty, social disruption, alterations of sleep, sexual and cognitive dysfunctions.
Since 2002 that some researchers and clinicians argued that it is important to de-velop and implement rehabilitation programs for cancer patients that integrate both psychosocial and physical rehabilitation.
ObjectivesWith the scarcity of studies on the effectiveness of combined interventions in this population, despite the strong recommendation to perform and study it, and aiming to contribute to a greater knowledge on the theme, the present work aims to build, implement, and evaluate a combined intervention program, which integrates psychoeducational intervention with physical exercise to cancer survivors and relatives, through the following indicators: psychopathological symptoms (anxiety and depression), self-concept, coping strategies, personal growth and QoL.
MethodsA non-probabilistic convenience sample of 70 cancer survivors was assigned to: control (without intervention: n=32), combined intervention (n=21) and psychoedu-cation intervention (n=17) groups. Both intervention groups were 9 consecutive weeks duration. The combined intervention group benefited from 2 weekly exercise sessions additionally. It was administered before and after intervention the following questionnaires: demographic; Hospital Anxiety and Depression Scale (HADS); Clinical Self-concept Inventory (ICAC); Cancer Coping Questionnaire (CCQ); sub-scale of Personal Growth of the Psychological Well-being Scale (EBEP) and the World Health Organization Quality of Life Questionnaire (WHOQOL-Bref).
ResultsIt was observed a statistically significant reduction of anxiety and depression symptoms from the beginning to the end of the intervention, as well as a significative improvement of overall and all do-mains of self-concept and personal growth. It was not observed a significative difference on quality of life.
ConclusionsThe findings of this study contribute to support of the beneficial effect of combined intervention on psychological functioning of cancer survivors. Positive effects of the psychological program were observed but not into the same extent as in the combined intervention.
Disclosure of InterestNone Declared
The Prevalence of Traumatic Brain Injury and ADHD in Secure Settings
- David Kelsey, Alex J. Berry, Filipa Alves-Costa, Matthew Loughran, Salma Ameir, Richard Taylor
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, pp. S8-S9
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Aims
Traumatic brain injury (TBI) is highly prevalent in prison populations, with an estimated prevalence of 51%-82% according to a 2018 review. TBI has been linked to higher rates of interpersonal violence, recidivism, suicide, higher drop-out rates in rehabilitation programmes, and lower age of first conviction. Attention deficit hyperactivity disorder (ADHD) has been shown to be associated with an increased risk of interpersonal violence, and previous TBI. Little is known about prevalence of TBI or ADHD amongst inpatients in secure psychiatric settings in the UK. We aimed to estimate the prevalence of TBI and ADHD in inpatients admitted to a psychiatric intensive care unit (PICU) and to low and medium secure units across three London mental health NHS trusts.
Methods60 male participants were identified through prospective purposive sampling. Three questionnaires were administered: the Brain Injury screening Index (BISI); Adult ADHD Self-Report Scale v1.1 (ASRS); and the Brief-Barkley Adult ADHD Rating scale (B-BAARS). We also reviewed medical records of participants, age, psychiatric diagnoses, level of education, and convictions for violent and/or non-violent offences, number of admissions, and length of current admission. Ethical approval was granted by the local research ethics committee
Results67.8% of participants screened positive for a history of head injury, and 68.3% and 32.2% screened positive on the ASRS and B-BAARS respectively. 38.33% recorded greater than one head injury on the BISI. The most commonly recorded psychiatric diagnoses were schizophrenia (43.33%), schizoaffective disorder (23.33%), Bipolar Affective Disorder (11.67%), and Unspecified Non-Organic Psychosis (10.00%). Screening positive on ASRS was associated with screening positive for previous head injuries BISI (p = 0.01, ꭕ2). No other statistical associations were identified.
ConclusionA relatively high proportion of participants screened positive for head injury and ADHD in this population. A history of head injury was associated with positive screening on the ASRS, which is consistent with previously reported associations between these conditions in other populations. A similar relationship was not seen with the B-BAARS however, and it is notable that fewer participants in the sample screened positive on the B-BAARS than using the ASRS. Few (n = 5) patients were able to provide detailed descriptions of head injuries using the BISI, suggesting that the BISI may not be suitable in this specific population as a screening tool.
A new specialist group for Brazilian fungi
- Elisandro Ricardo Drechsler-Santos, Francisco J. Simões Calaça, Kelmer Martins-Cunha, Diogo H. Costa-Rezende, Jadson D.P. Bezerra, Larissa Trierveiler-Pereira, Nelson Menolli, Jr., Luciana Canêz, Tiara S. Cabral, Cátia Canteiro, Gregory M. Mueller
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