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Treatment Interruptions and Mortality among Puerto Rican Women with Gynecologic Cancers in Puerto Rico after Hurricanes Irma and María: A Retrospective Cohort Study
- Fabiola A. Rivera-Gastón, Sharee Umpierre-Catinchi, Jeslie M. Ramos-Cartagena, Karen J. Ortiz-Ortiz, Carlos R. Torres-Cintrón, Sandra I. García-Camacho, William A. Calo, Guillermo Tortolero-Luna, Liz M. Martínez Ocasio, Ana P. Ortiz
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- Disaster Medicine and Public Health Preparedness / Accepted manuscript
- Published online by Cambridge University Press:
- 21 May 2024, pp. 1-12
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Objective:
Cancer patients are among the most vulnerable populations during and after a disaster. We evaluated the impact of treatment interruption on the survival of women with gynecologic cancer in Puerto Rico following hurricanes Irma and María.
Methods:Retrospective cohort study among a clinic-based sample of women diagnosed between January 2016-September 2017 (n=112). Women were followed up from their diagnosis until December 2019, to assess vital status. Kaplan-Meier survival curves and Cox proportional hazards models were performed.
Results:Mean age was 56 (±12.3) years; corpus uteri (58.9%) was the most common gynecologic cancer. Predominant treatments were surgery (91.1%) and chemotherapy (44.6%). Overall, 75.9% were receiving treatment before the hurricanes, 16.1% experienced treatment interruptions and 8.9% died during the follow-up period. Factors associated with treatment interruption in bivariate analysis included younger age (≤55 years), having regional/distant disease, and receiving >1 cancer treatment (p<0.05). Crude analysis revealed an increased risk of death among women with treatment interruption (HR: 3.88, 95% CI=1.09-13.77), persisting after adjusting for age and cancer stage (HR: 2.49, 95% CI= 0.69-9.01).
Conclusions:Findings underscore the detrimental impact of treatment interruption on cancer survival in the aftermath of hurricanes, emphasizing the need for emergency response plans for this vulnerable population.
Comparison of body composition assessment tools in infancy
- J. Lyons-Reid, J.G.B. Derraik, B.B. Albert, T. Kenealy, W.S. Cutfield, L.C. Ward, M-T. Tint, S-Y. Chan, C.R. Monnard, J.M. Ramos Nieves, K.M. Godfrey
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- Proceedings of the Nutrition Society / Volume 83 / Issue OCE1 / April 2024
- Published online by Cambridge University Press:
- 07 May 2024, E90
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The prevalence of childhood obesity is increasing globally(1). While BMI is commonly used to define obesity, it is unable to differentiate between fat and muscle mass, leading to calls to measure body composition specifically(2). While several tools are available to assess body composition in infancy, it is unclear if they are directly comparable. Among a subset of healthy infants born to mothers participating in a randomised controlled trial of a preconception and antenatal nutritional supplement(3), measurements were made at ages 6 weeks (n = 58) and 6 months (n = 70) using air displacement plethysmography (ADP), whole-body dual-energy X-ray absorptiometry (DXA), and bioelectrical impedance spectroscopy (BIS). Estimates of percentage fat mass (%FM) were compared using Cohen’s kappa statistic (κ) and Bland-Altman analysis (4,5). There was none to weak agreement when comparing tertiles of %FM (κ = 0.15–0.59). When comparing absolute values, the bias (i.e., mean difference) was smallest when comparing BIS to ADP at 6 weeks (+1.7%). A similar bias was observed at 6 months when comparing DXA to ADP (+1.8%). However, when comparing BIA to DXA at both ages, biases were much larger (+7.6% and +4.7% at 6 weeks and 6 months, respectively). Furthermore, there was wide interindividual variance (limits of agreement [LOA] i.e., ± 1.96 SD) for each comparison. At 6 weeks, LOA ranged from ± 4.8 to ± 6.5% for BIA vs. DXA and BIA vs. ADP, respectively. At 6 months, LOA were even wider, ranging from ± 7.3 to ± 8.1% (DXA vs. ADP and BIA vs. DXA, respectively). Proportional biases were apparent when comparing BIS to the other tools at both ages, with BIS generally overestimating %FM more among infants with low adiposity. In addition to differences according to tool type, within-tool factors impacted body composition estimation. For ADP measurements, the choice of FFM density reference (Fomon vs. Butte) had minimal impact; however, choice of DXA software version (GE Lunar enCORE basic vs. enhanced) and BIS analysis approach (empirical equation vs. mixture theory prediction) led to very different estimates of body composition. In conclusion, when comparing body composition assessment tools in infancy, there was limited agreement between three commonly used tools. Therefore, researchers and clinicians must be cautious when conducting longitudinal analyses or when comparing findings across studies, as estimates are not comparable across tools.
Naturally-Occurring Silicates as Carriers for Copper Catalysts used in Methanol Conversion
- M. R. Sun Kou, S. Mendioroz, J. L. G. Fierro, I. Rodriguez-Ramos, J. M. Palacios, A. Guerrero-Ruiz, A. M. De Andres
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- Clays and Clay Minerals / Volume 40 / Issue 2 / April 1992
- Published online by Cambridge University Press:
- 28 February 2024, pp. 167-174
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Bentonite- and sepiolite-supported copper catalysts have been prepared either by adsorption of Cu(II) from aqueous solutions of copper nitrate at pH ~4.5 or by adsorption of a [Cu(NH3)4]2+ complex from an ammonia solution of CuSO4 at pH ~9.5. The structure and composition of the calcined preparations have been studied by X-ray diffraction, chemical analysis, and energy dispersive X-rays. Textural characteristics have derived from the analysis of the adsorption-desorption isotherms of N2. All catalysts have been tested for the dehydrogenation of methanol to methyl formate. For this reaction, bentonite-based catalysts were found to have very little activity, which indicates that copper located in the inter-lamellar spaces is inaccessible to methanol molecules. On the contrary, copper-sepiolite catalysts showed a very high specific activity even for those catalysts with a very low copper content. The chemical state of copper in the catalysts on-stream has been revealed by X-ray photoelectron spectroscopy and X-ray-induced Auger techniques. In most of the catalysts Cu+ is the dominant copper species.
On the Structural Stability of Montmorillonite Submitted to Heavy γ-Irradiation
- Alicia Negron, Sergio Ramos, Alexander L. Blumenfeld, Graciela Pacheco, Jose J. Fripiat
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- Clays and Clay Minerals / Volume 50 / Issue 1 / February 2002
- Published online by Cambridge University Press:
- 01 January 2024, pp. 35-37
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The effect of heavy doses (up to 200 Mrad) of γ-radiation on the short-range structural organization in montmorillonite was studied using infrared (IR) spectroscopy and solid-state high-resolution 27Al and 29Si nuclear magnetic resonance (NMR). No change attributable to irradiation was observed. A small variation in the water content was noted but it is not systematic. The results show that the montmorillonite structure can accumulate high doses of radiation without damage and therefore this clay is a suitable material for use in the safe disposal of radioactive waste.
The role of primary health care in long-term care facilities during the COVID-19 pandemic in 30 European countries: a retrospective descriptive study (Eurodata study)
- Marina Guisado-Clavero, Sara Ares-Blanco, Alice Serafini, Lourdes Ramos Del Rio, Ileana Gefaell Larrondo, Louise Fitzgerald, Shlomo Vinker, Gijs van Pottebergh, Kirsi Valtonen, Bert Vaes, Canan Tuz Yilmaz, Péter Torzsa, Paula Tilli, Theresa Sentker, Bohumil Seifert, Natalija Saurek-Aleksandrovska, Martin Sattler, Goranka Petricek, Ferdinando Petrazzuoli, Davorina Petek, Ábel Perjés, Naldy Parodi López, Ana Luisa Neves, Liubovė Murauskienė, Heidrun Lingner, Katarzyna Nessler, Bruno Heleno, Anna Krztoń-Królewiecka, Milena Kostić, Büsra Çimen Korkmaz, Snežana Knežević, Aleksandar Kirkovski, Vasilis Trifon Karathanos, Marijana Jandrić-Kočić, Shushman Ivanna, Оксана Ільков, Kathryn Hoffmann, Miroslav Hanževački, Mila Gómez-Johansson, Dragan Gjorgjievski, Philippe-Richard J. Domeyer, Maryher Delphin Peña, Asja Ćosić Divjak, Iliana-Carmen Busneag, Elena Brutskaya-Stempkovskaya, Sabine Bayen, Maria Bakola, Limor Adler, Radost Assenova, María Pilar Astier-Peña, Raquel Gómez Bravo
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- Journal:
- Primary Health Care Research & Development / Volume 24 / 2023
- Published online by Cambridge University Press:
- 24 October 2023, e60
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Background and aim:
Primary health care (PHC) supported long-term care facilities (LTCFs) in attending COVID-19 patients. The aim of this study is to describe the role of PHC in LTCFs in Europe during the early phase of the pandemic.
Methods:Retrospective descriptive study from 30 European countries using data from September 2020 collected with an ad hoc semi-structured questionnaire. Related variables are SARS-CoV-2 testing, contact tracing, follow-up, additional testing, and patient care.
Results:Twenty-six out of the 30 European countries had PHC involvement in LTCFs during the COVID-19 pandemic. PHC participated in initial medical care in 22 countries, while, in 15, PHC was responsible for SARS-CoV-2 test along with other institutions. Supervision of individuals in isolation was carried out mostly by LTCF staff, but physical examination or symptom’s follow-up was performed mainly by PHC.
Conclusion:PHC has participated in COVID-19 pandemic assistance in LTCFs in coordination with LTCF staff, public health officers, and hospitals.
Coronavirus disease 2019 is associated with long-term depressive symptoms in Spanish older adults with overweight/obesity and metabolic syndrome
- Sangeetha Shyam, Carlos Gómez-Martínez, Indira Paz-Graniel, José J. Gaforio, Miguel Ángel Martínez-González, Dolores Corella, Montserrat Fitó, J. Alfredo Martínez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque, Dora Romaguera, José López-Miranda, Ramon Estruch, Francisco J. Tinahones, José Manuel Santos-Lozano, J. Luís Serra-Majem, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín Sánchez, Xavier Pintó, María Ortiz Ramos, Josep Vidal, Maria Mar Alcarria, Lidia Daimiel, Emilio Ros, Fernando Fernandez-Aranda, Stephanie K. Nishi, Oscar García Regata, Estefania Toledo, Jose V. Sorli, Olga Castañer, Antonio Garcia-Rios, Rafael Valls-Enguix, Napoleon Perez-Farinos, M. Angeles Zulet, Elena Rayó-Gago, Rosa Casas, Mario Rivera-Izquierdo, Lucas Tojal-Sierra, Miguel Damas-Fuentes, Pilar Buil-Cosiales, Rebeca Fernández-Carrion, Albert Goday, Patricia J. Peña-Orihuela, Laura Compañ-Gabucio, Javier Diez-Espino, Susanna Tello, Ana González-Pinto, Víctor de la O, Miguel Delgado-Rodríguez, Nancy Babio, Jordi Salas-Salvadó
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- Psychological Medicine / Volume 54 / Issue 3 / February 2024
- Published online by Cambridge University Press:
- 05 September 2023, pp. 620-630
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Background
The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.
MethodsParticipants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.
ResultsCOVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).
ConclusionsCOVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.
Association between adverse childhood experiences and the number of suicide attempts in lifetime
- J. Andreo-Jover, E. Fernandez-Jimenez, J. Curto-Ramos, N. Angarita-Osorio, N. Roberto, A. De la Torre-Luque, A. Cebria, M. Diaz-Marsa, M. Ruiz-Veguillla, J. B. Bobes Garcia, M. Fe Bravo Ortiz, V. Perez Solá
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S561-S562
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Introduction
Adverse childhood experiences (ACEs), defined as abuse, neglect, or a dysfunctional household in childhood, have been associated with suicidality (Fjeldsted et al., 2020). Every type of ACE has a direct impact on suicide ideation, self-harm and/or suicide attempt (Angelakis et al., 2019).
ObjectivesWe aim to quantify the association between types of ACEs (including emotional, physical, sexual abuse, and emotional and physical neglect) and the number of suicide attempts in lifetime.
MethodsWe included 748 patients who attempted suicide at least once. They were asked to complete the Columbia-Suicide Severity Rating Scale (CSSRS), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Logistic regression models were run to assess the association between each ACE type and the number of suicide attempts.
ResultsPoisson univariate regression analyses show a linear trend in the relationship between having a higher number of suicide attempts and having suffered every ACE type in childhood (p<0.05). Our results show a lower percentage of previous suicide attempts among participants without ACEs, and an increasing tendency among patients with various types of ACEs. The rate of ACEs types is significantly higher in the group with previous suicide attempts than in the first-attempt group (p=0.000).
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ConclusionsThis study contributes to clarify the role of childhood trauma in the number of suicide attempts in lifetime. This has important implications for reducing suicide rates, and preventing future re-attempts. Further studies analysing every construct of childhood trauma may contribute to the detection of suicidal behaviour.
FundingsThis work was supported by the Instituto de Salud Carlos III (grant number: PI19/00941 SURVIVE) and co-funded by the European Union (grant numbers: COV20/00988, PI17/00768), the European Union’s Horizon 2020 research and innovation programme Societal Challenges (grant number: 101016127), and the Fundación Española de Psiquiatría y Salud Mental
AcknowledgementsSURVIVE project (PI19/00941)
KeywordsSuicide attempt, Adverse Childhood Experiences
ReferencesAngelakis, I., Gillespie, E. L., & Panagioti, M. (2019). Childhood maltreatment and adult suicidality: A comprehensive systematic review with meta-analysis. Psychological Medicine, 49(7), 1057-1078. https://doi.org/10.1017/S0033291718003823
Fjeldsted, R., Teasdale, T. W., & Bach, B. (2020). Childhood trauma, stressful life events, and suicidality in Danish psychiatric outpatients. Nordic Journal of Psychiatry, 74(4), 280-286. https://doi.org/10.1080/08039488.2019.1702096
Disclosure of InterestNone Declared
Chemsex behaviours, sexual response and sexual health
- J. Curto Ramos, I. Azqueta, M. T. Heredia, R. Molina Prado, I. De Ema López
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S644
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Introduction
The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.
ObjectivesThe objective of this study was to understand the impact of chemsex on sexual health and sexual response by the participantes of a sexual health program for chemsex users in two Substance Use Disorder Clinics in Madrid.
MethodsQualitative research approach. We analyze an anonymous survey with chemsex users with open answer questions about the impact of chemsex practice on sexual response and sexual health. Data analysis was based on thematic analysis of content.
ResultsSeveral differences were identifed between chemsex and sober sex. In sober sex it can take longer to feel aroused, sexual desire is more context-dependent and more easyly controled. They connect easily with other people needs when they had sober sex. They described difficulties with consent with some sexual practices when they were on drugs. Shame and guilt was associated with chemsex. They describe more arousal, more independent of the erotic context, longer sexual intercourse and delayed ejaculation when they had sex under the influence of drugs.
ConclusionsChemsex is a phenomenon that needs a multidisciplinary approach and mental and sexual health must be taken into account including sexological perspective. Interventions that provide sexual counselling and sexual therapy for chemsex users must be developped.
Disclosure of InterestNone Declared
Substance Use Disorders and other Mental Health Disorders associated with sexualized intravenous sbustance use (slamsex)
- J. Curto Ramos, P. Barrio, L. Ibarguchi, A. García, J. Garde, A. Oliva, H. Dolengevich Segal
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S380
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Introduction
The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health.
ObjectivesThe objective of this study was to compare the psychopathological characteristics between users whith sexualized intravenous substance use (slamsex) versus those who did not slamsex attended by the non-govenrmental organization Apoyo Positivo in the program “Sex, Drugs and You”.
MethodsA cross-sectional descriptive analysis of a sample of users attended by the non-govenrmental organization Apoyo Positivo in the program “Sex, Drugs and You” was performed.
Results230 participants were included. Slam was associated with higher risk of having and anxiety or depressive disorder, suicidal ideation, induced psychosis and suicidal behavior, the differences were statistically significant (p<0.05) in all cases.
ConclusionsSlamsex is usually reported in our sample. Substance use disorders in slam users are usually associated with other mental disorders. This challenge requires adapt the therapeutical interventions of the professionals who work with patients with chemsex practices, specially with those who practice slamsex.
Disclosure of InterestNone Declared
“Unspecified organic personality and behavioral disorder due to brain damage from HHV-6 encephalitis in child. case report and literature review”
- A. Oliva Lozano, M. A. Morillas Romerosa, P. Herrero Ortega, J. Garde Gonzalez, B. Orgaz Álvarez, J. Curto Ramos, M. Alcamí Pertejo
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S143-S144
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Introduction
We present a case of a 15 year-old boy diagnosed with Unspecified Personality and Beheavioral Disorder Due to Brain Damage from a Human Herpes Virus-6 Encephalitis.
ObjectivesTo describe a case of an Unspecified Organic Personality and Behavioral Disorder secondary to brain damage from Human Herpes Virus-6 (HHV-6) Encephalitis in an 11 year-old childand to review recent literature, in order to improve clinical practice.
MethodsClinical case report and brief review of literature. A bibliographic research was made in the database PubMed, using the terms “Viral Encephalitis” AND “Neuropsychiatric symptoms”; “Viral Encephalitis” AND “Behavioral Disorder”; “Long-Term Neurological Morbidity” AND “Viral Encephalitis”.
Results15 year-old boy diagnosed with Unspecified Personality and Beheavioral Disorder Due to Brain Damage from a Human Herpes Virus-6 Encephalitis, secondary to immunosupression in the context of haematopoietic progenitor transplantation (HPT) at 11 years old. MRI showed supratentorial ventriculomegaly, atrophic changes in encephalon and right hippocampus with subcortical retraction secondary to previous encephalitis. Clinically, main changes appeared in behavior, presenting a serious frontal syndrome with high disinhibition, what implied severe social and academic difficulties. During the outpatient follow-up, the behavioural disorder is being pharmacologically treated with Risperidone 1,5mg per day with a partially favorable evolution. The patient presented intolerance to olanzapine, with an episode of low level of conciuosness after taking it.
Bibliographic research results indicate that the gold standard treatment for behavioral disturbances are antipsychotics. Risperdidone is proven save for treatment in children. Results point out also the importance of an early multidisciplinar intervention, involving family training, rehabilitation resources and curricular adaptations.
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ConclusionsViral encephalitis may have serious neuropsychiatric consequences, especially during childhood while the brain development is not finished. When the neurological damage affects the frontal lobes of the brain, behavioural and personality disturbances are expected and an early multidisciplinar intervention should be considered. Antypsichotics are the gold standard pharmacological treatment for behavioural disturbances. During the scholar period, special curricular adaptations should be done in order to reduce study-related stress.
Disclosure of InterestNone Declared
Rapid improvements in MADRS with zuranolone in major depressive disorder and postpartum depression: results from the LANDSCAPE/NEST clinical development programmes
- A. H. Clayton, K. M. Deligiannidis, J. A. Ramos-Quiroga, R. Lasser, A. J. Sankoh, B. Leclair, M. Kotecha, J. Doherty
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S93-S94
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Introduction
Rapid-acting therapies remain an unmet need in the treatment of major depressive disorder (MDD) and postpartum depression (PPD). Zuranolone (ZRN) is being evaluated as a once-daily, oral, 14-day treatment for adult patients with MDD and PPD.
ObjectivesTo evaluate the efficacy (assessed by Montgomery–Åsberg Depression Rating Scale [MADRS]) and safety of ZRN versus placebo across clinical studies with MDD and PPD.
MethodsIn 5 completed Phase 2/3 placebo-controlled randomised studies of once-daily ZRN 30 or 50 mg in adults with MDD or PPD, improvement in depressive symptoms was assessed at Day 15 (end of 14-day treatment) by change from baseline in MADRS total score and the percentage of patients achieving MADRS response (≥ 50% improvement from baseline in total score) and remission (total score ≤ 10). Safety was assessed throughout.
ResultsPatients in the ZRN arm achieved improvements in depressive symptoms, as assessed by MADRS. Improvements in MADRS total score at Day 15 were observed in all 5 studies and were nominally significant (p < 0.05) versus placebo in 4 studies (Fig. 1). Percentage of patients achieving response and/or remission in the ZRN arm was numerically greater than placebo in all MDD studies and significantly greater than placebo in the PPD studies (Fig. 2 and 3). ZRN was generally well tolerated with consistent safety and tolerability profiles across studies. The most common treatment-emergent adverse events (≥5 % in ZRN treatment arm) were headache, somnolence, dizziness, nausea, sedation, diarrhea, upper respiratory tract infection, fatigue, and COVID-19.
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ConclusionsIn the 5 completed clinical studies, rapid improvement in depressive symptoms assessed by MADRS was observed across studies of adults with MDD and PPD who received a 14-day treatment of once-daily ZRN. In all studies, ZRN was generally well tolerated. These data support further development of ZRN as a potential oral, rapid-acting treatment for patients with MDD or PPD.
FundingThe MDD-201B, MOUNTAIN, and ROBIN studies were sponsored by Sage Therapeutics, Inc.; the WATERFALL and SKYLARK studies were sponsored by Sage Therapeutics, Inc. and Biogen Inc. Medical writing and editorial support were provided by MediTech Media, Ltd, and funded by Sage Therapeutics, Inc. and Biogen Inc.
Disclosure of InterestA. Clayton Shareolder of: Royalties from Ballantine Books/Random House, the Changes in Sexual Functioning Questionnaire, and Guilford Publications; and restricted stock in Euthymics, Mediflix LLC, and S1 Biopharma., Grant / Research support from: Daré Bioscience, Janssen, Otsuka, Praxis Precision Medicines, Relmada Therapeutics, Inc., and Sage Therapeutics, Inc, Consultant of: AbbVie, Inc., Brii Biosciences, Inc., Fabre-Kramer, Janssen Research & Development, LLC, Mind Cure Health, Ovoca Bio plc, Praxis Precision Medicines, PureTech Health, Reunion Neuroscience (formerly Field Trip Health) S1 Biopharma, Sage Therapeutics, Inc., Takeda/Lundbeck, Vella Bioscience, Inc., and WCG MedAvante-ProPhase, K. Deligiannidis Shareolder of: Royalties from an NIH employee invention outside of the submitted work. , Grant / Research support from: Received grants from from NIH and Vorso Corporation. Grants awarded to Zucker Hillside Hospital/Feinstein Institutes for Medical Research during the conduct of the brexanolone injection and zuranolone clinical trials (Sage Therapeutics), Consultant of: Sage Therapeutics, Inc., Brii Biosciences, Inc., and GH Research Ireland Limited, J. A. Ramos-Quiroga Grant / Research support from: The Department of Mental Health chaired by him received unrestricted educational and research support from the following companies in the last 3 years: Janssen-Cilag, Shire, Oryzon, Roche, Psious, and Rubió. Dr Ramos-QuirogaReceived travel awards (air tickets + hotel) for taking part in psychiatric meetings from Janssen-Cilag, Rubió, Shire, Takeda, Shionogi, Bial, and Medice., Consultant of: Was on the speaker’s bureau and/or acted as consultant for Janssen-Cilag, Novartis, Shire, Takeda, Bial, Shionogi, Sincrolab, Novartis, BMS, Medice, Technofarma, Rubió and Raffo in the last 3 years., Speakers bureau of: Was on the speaker’s bureau and/or acted as consultant for Janssen-Cilag, Novartis, Shire, Takeda, Bial, Shionogi, Sincrolab, Novartis, BMS, Medice, Technofarma, Rubió and Raffo in the last 3 years., R. Lasser Shareolder of: May hold stock and/or stock options of Sage Therapeutics, Inc. , Employee of: Employee of Sage Therapeutics, Inc., A. Sankoh Shareolder of: May hold stock and/or stock options of Sage Therapeutics, Inc., Employee of: Employee of Sage Therapeutics, Inc. , B. Leclair Shareolder of: May hold stock of Biogen Inc., Employee of: Employee of Biogen Inc., M. Kotecha Shareolder of: May hold stock of Biogen Inc., Employee of: Employee of Biogen Inc., J. Doherty Shareolder of: May hold stock and/or stock options of Sage Therapeutics, Inc., Employee of: Employee of Sage Therapeutics, Inc.
Virtual self-conversation to support people living with obesity when starting their change process towards a healthier lifestyle: Preliminary results of a longitudinal study
- P. Lusilla, D. Anastasiadou, P. Herrero, J. Vazquez, B. Spanlang, M. Slater, J. A. Ramos, G. Parramon, A. Ciudin, M. Comas
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S110
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Introduction
People living with obesity (PLWO) often experience ambivalence when starting their change process towards a healthier lifestyle. Psychological treatments for obesity should resolve this ambivalence and help PLWO to explore their own reasons for change in line with their needs and values, as well as promote self-efficacy. Following the Motivational Interviewing (MI) principles, the SOCRATES project proposes a “virtual self-conversation” to help PLWO to address some of the psychological aspects associated with obesity, such as the lack of awareness about their condition, the impact of the internalization of weight stigma, and the lack of self-efficacy.
ObjectivesWith the current longitudinal study, we aim to explore how the participants’ process of lifestyle change, and how their eating habits and dysfunctional eating patterns change before and after the virtual intervention.
MethodsForty-eight patients with obesity from the Vall d’Hebron University Hospital (Mean age = 19.7 years) were assigned to 3 groups. The Experimental Group 1 (EG1) (N = 21), after completing an intensive training on MI, received a virtual intervention using the “motivational self-conversation” technique. The Experimental Group 2 (EG2) (N = 17) underwent a virtual intervention with a pre-registered psychoeducational dialogue, and the Control Group (CG) (N = 10) followed treatment-as-usual. All participants completed self-reported questionnaires on their motivation to change lifestyle [(Readiness Rulers (RR), Processes of Change questionnaire in weight management (P-W)], eating habits (Habits questionnaire) and dysfunctional eating patterns (Three Factor Eating Questionnaire-18) at baseline (T0), post-intervention (T1), and 4 weeks follow-up (T2). Repeated measures ANOVA was performed for all the questionnaires.
ResultsStatistically significant results were shown regarding motivation to change through the RR and the “evaluation of the consequences of their weight” subscale of P-W across time for the EG1 (p < .05). These results suggest that participants’ motivation to eat healthier and do more exercise, as well as self-awareness about the negative consequences of their condition increased after the virtual intervention.
ConclusionsThe present study showed that this novel virtual intervention might be an effective tool in helping PLWO resolve their ambivalence to change lifestyle and acquire self-awareness about their condition. However, the intervention did not lead to significant changes in other psychological variables, such as lifestyle habits or dysfunctional eating patterns; domains that may be less sensitive to changes over the time, and which may take place once motivation is well-established.
Disclosure of InterestNone Declared
Changes in the characteristics of Suicide Attempts during COVID-19 pandemic
- J. Curto Ramos, N. Kishanchandani Chandiramani, M. Torrijos, J. Andreo-Jover, B. Orgaz-Alvarez, M. Velasco, D. García Martínez, G. Juárez, S. Cebolla, P. Aguirre, B. Rodríguez Vega
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S405
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Introduction
Different studies indicate high prevalence’s of suicidal behaviour, anxiety, depression, insomnia, and PTSD associated with the COVID-19 pandemic. There is currently not enough scientific evidence available to analyze the impact that the COVID-19 pandemic has had on the rate of suicide attempts and their characteristics.
ObjectivesTo analyze and compare the characteristics of suicidal behavior (in terms of method, severity, medical damage produced and need for hospitalization) of patients attended during the COVID-19 pandemic compared to previous years.
MethodsA retrospective study was performed based on a standardized data collection of patients attending the University Hospital La Paz between April 2018 and November 2021. 581 patients who attempted suicide at least once were included in this study. We compared the severity using the Beck Suicide Intent Scale. Chi-square ant Student’s t were used to compare clinical characteristics such as medical damage, method of suicide attempt and indication for admission after the attempt, between suicide attempts during the COVID-19 pandemic and previous years.
ResultsOur results suggest that during the COVID-19 pandemic suicide attempts caused more medical damage (p<0.001), had higher severity (p<0.000), and required more admission in Intensive Care Units, General Internal Medicine and Psychiatry compared with pre-Covid years (p<0.000).
ConclusionsThis is the first study in Spain analysing the changes in characteristics of suicide attempts during the COVID-19 pandemic. This has important implications for reducing suicide rates, preventing future attempts, and enabling us to design specific treatments of Suicidal Behaviour.
Disclosure of InterestNone Declared
Sexual motivations for engaging in chemsex behaviours
- J. Curto Ramos, M. T. Heredia Soriano, I. Azqueta, I. De Ema Lopez, R. Molina Prado
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S662-S663
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Introduction
The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.Objectives: The objective of this study was to understand the sexual motivations for chemsex practice o a group participantes of a sexual health program for chemsex users in two Drug Substace Use Disorder Clinics in Madrid.
MethodsQualitative research approach. We analyze an anonymous survey with chemsex users with open answer questions about the motivations for chemsex practice. Data analysis was based on thematic analysis of content.
ResultsDifferent qualitative studies have examined the motivations for engaging in chemsex. The participants identified two main raisons: pleasure and losing inhibitions. We analyed the inhibitions described by participants: difficulties with arousal, ejaculation, social interaction in sexual context, difficulties in situations that require intimacy, sexual practices that make them feel guilt/shame (for example BDSM) problems with “erotic” self-esteem: rejection of non-normative bodies or towards non- normative gender expression perceived as undesirable.
ConclusionsUnderstanding the sexual motivations for engaging in chemsex seems necessary to develop and multidisciplinary approach. Mental health proffesionals should consider sexual counselling and sexual therapy for chemsex users in their treatment.
Disclosure of InterestNone Declared
Non-schizophrenic psychotic disorders: Cycloid psychosis. Case report and literature review
- P. Herrero Ortega, J. Garde González, M. A. Morillas Romerosa, A. Oliva Lozano, J. Curto Ramos
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S636
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Introduction
Cycloid psychosis is a clinical entity with defining traits which emerged from the Wernicke-Kleist-Leonhard school of psychiatry and has a long history in Europe. Leonhard distinguished three clinical forms: anxiety-happiness, confusion and motility psychosis. It is a condition with high clinical heterogeneity and favorable prognosis.
ObjectivesTo describe a case of cycloid psychosis and review in literature the heterogeneity of this phenomena and its clinical management.
MethodsClinical case report and brief review of literature.
Results57-year old male with previous diagnosis of paranoid schizophrenia and severe congenital hearing loss. Preserved autonomy and adequate real-life and interpersonal functioning. Along the past few years the patient has presented episodes of a significant clinical global worsening in context of mainly somatic symptoms (intestinal obstruction and volvulus) and minor stressful life events. On this occasion he appears in the emergency room with a new episode of abdominal pain and is admitted to Internal Medicine with presumptive diagnosis of intestinal volvulus. The patient gathered heterogeneous symptoms including disorientation, confusion, generalized tremor, gait disorder, profuse sweating, regressive and oppositional behaviors (refusal to eat or drink liquids) and sudden behavioral oscillations (from agitation to prostration). From the psychic point of view he showed thought blocking, mutism, significant anxiety, fear of death, delusional prejudice ideas and sensoperceptive disturbance which seemed otherwise related to previous sensorial problems. We introduced treatment with Olanzapine 30 mg and after 4 weeks, the patient suddenly showed a significant clinical improvement until the complete remission of the symptoms and restitution of his previous state. In coordination with his regular psychiatrist was proposed the controversial diagnosis of cycloid psychosis. Cycloid psychosis gather a few clinical features which differentiate it from other entities: acute onset, polymorphic symptomatology, global disturbance of psychic life, remitting and recurrent course and favorable prognosis. Regarding its clinical management no controlled studies have been conducted to this date of the treatment of this phenomena. According to literature ECT seems to be an effective treatment as well as low-doses of atypical antipsychotics. Some authors propose pharmacological maintenance treatment with mood stabilizers.
ConclusionsThe diagnosis of cycloid psychosis can be useful as well as necessary to describe certain patients with similar clinical features, recurrent course and favorable prognosis. Future studies on pharmacological approach would be useful to ensure the appropriate clinical management of these patients.
Disclosure of InterestNone Declared
Cerebellar dysfunction and autism spectrum disorders – what do we know?
- C. Pinheiro Ramos, M. Alves, J. Marta, R. Ribeiro, A. Gamito
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S239
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Introduction
Autism spectrum disorders (ASD) are complex neurodevelopmental conditions characterized by impairments in social cognition and repetitive behaviors with onset in early infancy. Deficits in emotion recognition, social perception, and communication have been identified as core symptoms of ASD.
Comorbid disorders are frequent, namely psychiatric illness, epilepsy, sleep disruption, and hyperactivity.
Immune profile changes during early life may contribute to pathogenesis of ASD. Other risk factors include advanced parental age, fetal environment, fertility treatments, medications, and nutritional and toxic factors.
Several brain regions are involved in the pathophysiology of ASD but the cerebellum is the structure most consistently found altered. An increased risk of ASD is associated with cerebellar damage.
ObjectivesTo highlight the importance of understanding the key processes of cerebellar development and how altered cerebellar function leads to social and cognitive impairments, and consequently ASD.
MethodsNon-systematic review of the literature using Pubmed database. Papers were selected according to their relevance.
ResultsFrom imaging studies, we can understand that cerebellum is not just about motor function. Different tasks like adding working memory, emotional and social processing, and language seem to be part of core functions of the cerebellar circuit.
Adults with lesions in the cerebellum can develop cerebellar cognitive affective syndrome (CCAS), with core symptoms of impaired executive function, difficulties in spatial cognition, blunted affect, or inappropriate behavior. Some children who have tumor resection surgery for medulloblastomas also exhibit symptoms of CCAS, and some experience posterior fossa syndrome (PFS).
The linguistic, cognitive, and behavioral deficits in CCAS and PFS may contribute to explaining how cerebellar alterations are related to ASD, which is a neurodevelopmental disorder characterized by an earlier onset and broader spectrum of these symptoms.
ConclusionsThe literature has suggested an important role for cerebellar dysfunction in etiology of ASD, under certain premises: (a) cerebellar expansion temporarily coincides with onset of ASD; (b) cerebellum is prone to lesions during this period; (3) cerebellar lesions contribute to dysfunctional social and language abilities.
Disturbances in cerebellar development lead to alterations in higher cognitive functions, due to changes in Purkinje cells. These dysfunctional neurons, once integrated into a brain circuit that controls complex tasks, lead to these functions becoming aberrant.
It is therefore fair to say that cerebellum is important for development of the so-called “cognitive and social brain” since it is itself part of this network. So, the cerebellum certainly plays a relevant role in pathophysiology of ASD.
Disclosure of InterestNone Declared
Clinical characteristics of chemsex users attended in a ngo in madrid
- J. Curto Ramos, L. Ibarguchi, P. Barrio, A. García, M. A. Morillas Romerosa, P. Herrero, H. Dolengevich Segal
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S644
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Introduction
The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health.
ObjectivesThe objective of this study was to describe the sociodemographic and medical characteristics, psychoactive substances use of a sample of users with sexualized drug use (chemsex) attended by the non-govenrmental organization Apoyo Positivo in the program “Sex, Drugs and You”.
MethodsA cross-sectional descriptive analysis of a sample of users attended by the non-govenrmental organization Apoyo Positivo in the program “Sex, Drugs and You” was performed.
Results230 participants were included. Most common drugs used during sexual intercourse were: mephedrone, cocaine, poppers, GHB and methamphetamine. The frequencies of substances consumed during sex were: mephedrone (95%), methamphetamine (80%), GHB (92.2%), ketamine (52%), poppers (alkyl nitrites) (95%), cocaine (89 .7%), speed (amphetamine sulfate) (49.6%) and drugs for erectile dysfunction (86%). 61.3% reported having practiced slamsex intravenous substance use at some time in their life, being a habitual practice at the time of collecting information for 50.7%. The most frequent genitally transmitted infections were: syphilis, chlamydia and gonorrhea. Users reported having been diagnosed with the following genitally transmitted infections: hepatitis B virus (7.4%), hepatitis A virus (18.6%), syphilis (69.6%), human papillomavirus (16 %), herpes (9.4%), chlamydia (43%), gonorrhea (60.5%) and candidiasis (9.7%).
ConclusionsSlamsex and STIs are usually reported in our sample. Interventions for chemsex users must include a colaborative model which includes professionals from different areas, including internists and emergency physicians, psychiatrists, psychologists, nurses, social workers and sexologists.
Disclosure of InterestNone Declared
P.026 Frontal cognitive-behavioural deficits in patients with anti-leucine-rich glioma-inactivated protein 1 antibody encephalitis
- S Lee, SA Climans, GS Day, J Hébert, S Lapointe, RC Ramos, C Steriade, RA Wennberg, A Muccilli, DF Tang-Wai
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 50 / Issue s2 / June 2023
- Published online by Cambridge University Press:
- 05 June 2023, p. S64
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Background: Cognitive impairment is a common manifestation of anti-LGI1 encephalitis and is typically defined as prominent memory deficits. We frequently encounter frontal cognitive-behavioural deficits when evaluating these patients, but this has yet to be well described in the literature. Methods: Patients with anti-LGI1 encephalitis were retrospectively identified from three tertiary centres in Toronto, Ontario between 2013 and 2022. Their medical records were evaluated and frontal features were categorized based on diagnostic criteria for behavioural variant frontotemporal dementia (bvFTD). Results: Nineteen patients were identified (median age 60 years [range 18–84]; 10 [52.6%] male). Eighteen (94.7%) had frontal cognitive-behavioural symptoms. Two developed these symptoms during treatment with steroids and were excluded from further analysis. The remaining 16 presented with behavioural disinhibition (n=13), apathy or inertia (n=6), perseverative, stereotyped or compulsive/ritualistic behaviours (n=6), hyperorality and dietary changes (n=4), a neuropsychological profile with predominant deficits in executive tasks (n=4), and loss of sympathy or empathy (n=4). Nine (47.3%) met diagnostic criteria for possible bvFTD. Anterograde memory impairment was common (n=14). Of the 16 patients with frontal features, 6 had faciobrachial dystonic seizures. Conclusions: Patients with anti-LGI1 encephalitis exhibit frontal cognitive-behavioural symptoms in addition to memory impairment. Clinicians should consider anti-LGI1 encephalitis in the differential diagnosis of bvFTD.
BIG LITTLE THIEFS - Kleptomania Treatment
- S. Mouta, J. Correia, I. Fonseca Vaz, S. Freitas Ramos, B. Jesus, S. Fontes
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- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S878
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Introduction
Kleptomania is characterized by recurrent failure to resist the impulse to steal items of little value despite the ego-dystonic impulse and awareness of the wrongfulness of the act. Its prevalence is considered to be 0.6–0.8% in the general population and it is mostly comorbid with other psychiatric disorders. Kleptomania is a disabling disorder since patients suffer from emotional distress and impaired functioning.
ObjectivesAlthough there is no cure, treatment may help prevent Kleptomania worsening and its negative consequences. We propose a review of the therapeutic approach to this disease.
MethodsNon-systematic literature review.
ResultsNo effective treatment is available for Kleptomania. Better efficacy can be achieved by combining psychotherapy with pharmacotherapy. Different treatment interventions can be selected based on clinical similarities to other disorders, co-occurring conditions or behavioral core features. Patients with significant mood symptoms may benefit from mood stabilizers or antidepressants. For patients with shoplift cravings and/or family history of substance use disorders, Naltrexone may reduce symptoms. Stimulants may be useful for Kleptomania bassociated with Attention Deficit Hyperactivity Disorder impulsivity. Benzodiazepines are effective in tension relief when used as adjuvants, at the beginning of treatment. Electroconvulsive therapy should be reserved for patients with treatment-resistant symptoms and comorbid depression. Cognitive-behavioral therapy has replaced Psychoanalytic and Psychodynamic psychotherapies.
ConclusionsTreatment helps decrease disruption to the person’s life, preventing the intense shame, legal, social, family, and occupational repercussions of Kleptomania. Although pharmaceutical and psychosocial interventions are available, we still lack specific treatments for Kleptomania.
DisclosureNo significant relationships.
Mental Health and economic effects: correlation between unemployment and psychoactive drugs
- J. Ramos
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S632
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Introduction
Mental Health is an invisible part of public health, and a determinant of it by affecting the human, social and economic capital of countries. Is one of the main causes of disability worldwide and, when left untreated, they can lead to increased costs and premature mortality. In 2019 they represented 22% of the disability burden in DALY in the European Union. Regarding the effects of economic recessions studies suggest that they have detrimental effects on mental health. And can became a reality in the current pandemic scenario.
ObjectivesTo reflect on the studies carried out that debate the effects of previous economic crises on mental health, particularly the 2008-2013 crisis. It aims to list not only the possible intervention strategies in the area as well as the barriers to their implementation.
MethodsClassic review of the topic through the international literature and the state of the art on available platforms. Establish a proxy between the unemployment rate and the number of packages (antidepressants and anxiolytics consumed) in homologous periods as a representative capacity of the impact of the crisis on mental health.
ResultsThe number of packages of antidepressants and anxiolytics behave differently. the antidepressants have greater consumption when unemployment decreases.
ConclusionsSeveral studies describe that the increase in the unemployment rate, indebtedness and social exclusion are empirically proven as consequences of the economic crises and predisposing factors for mental pathology. However, this does not translate into a proxy for the consumption of antidepressant packages with the increase in the unemployment rate. It may be due to the non-prioritization of mental health.
DisclosureNo significant relationships.