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Characterization and drug release of benzalkonium chloride-loaded organo-palygorskite or organo-montmorillonite
- Héctor A. Lobato-Aguilar, Wilberth A. Herrera-Kao, Santiago Duarte-Aranda, Fernando J. Aguilar-Pérez, Andrés I. Oliva-Arias, Víctor Rejón-Moo, José M. Baas-López, Jorge A. Uribe-Calderón, José M. Cervantes-Uc
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- Clay Minerals / Volume 58 / Issue 2 / June 2023
- Published online by Cambridge University Press:
- 21 July 2023, pp. 102-112
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This study examined the incorporation of benzalkonium chloride into palygorskite and montmorillonite, assessing their potential as drug carriers. The aim was to evaluate the use of both clay minerals as viable options for antibacterial drug delivery. Various amounts (0.5, 1.0 and 2.0 times the cation-exchange capacity) of benzalkonium chloride were incorporated into both clay minerals, and the resulting materials were characterized using Fourier-transform infrared spectroscopy, thermogravimetric analysis, X-ray diffraction and elemental analysis using both CHNS-O elemental analysis and energy-dispersive X-ray spectroscopy. The Fourier-transform infrared spectroscopy and elemental analysis results indicate that benzalkonium chloride was incorporated successfully into the clay minerals. The X-ray diffraction traces of organo-montmorillonite indicate that the d-value increased as benzalkonium chloride content increased, confirming the intercalation of benzalkonium chloride within the montmorillonite interlayer space. By contrast, this behaviour was not observed for palygorskite. For the benzalkonium chloride-release studies, an initial burst release was found within the first 5 h, followed by a sustained release of benzalkonium chloride during the remaining testing time (24 h). Drug-release profiles were similar for modified palygorskite or montmorillonite during the testing time (24 h). Both clay minerals modified with benzalkonium chloride are promising materials for use as antibacterial fillers for several applications, including in the dental care industry.
Group psychotherapy for patients with first-episode psychosis: Effect on the clinical status and use of resources
- P. Herrero Ortega, A. Oliva Lozano, J. Garde González, C. Bayón-Pérez, R. Mediavilla, M. P. Vidal-Villegas, B. Rodríguez-Vega, S. Cebolla, E. Román, E. V. Pérez Pérez, M. F. Bravo-Ortiz, O. B. O. AGES-Mind Group
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S635-S636
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Introduction
Psychotic disorders carry several economical, psychological and social consequences, both at individual and community levels. Early intervention programs after first-episode psychosis which combine pharmacological and psychosocial strategies are aimed at reducing symptoms, lowering costs in the use of health and non-health care resources and improving overall functioning. AGES-Mind study is based on manualized psychotherapeutic interventions for people with first-psychosis episodes.
ObjectivesThe aim of the study was to evaluate the effect of a group psychotherapeutic intervention on the clinical status and use of clinical resources in a sample of patients with first-episode psychosis at 12 and 24 months after the beginning of the intervention. This cohort will be compared to patients with first-psychosis episodes without group psychotherapeutic intervention.
MethodsLongitudinal, observational, retrospective study on a cohort of N=46 patients with first-episode psychosis within the last 5 years. Two groups of 23 patients each were formed. The participants of one of those groups received group psychotherapy in the context of the AGES-Mind study and the other group received treatment as usual without group intervention. Non-exposed patients were matched by age, gender and time elapsed since first-episode psychosis with those exposed to the intervention. Sociodemographic data, clinical status and use of clinical resources outcome variables were assessed.
ResultsNo significant differences were found in clinical status and use of resources between participants and non-participants in the psychotherapeutic group intervention after 12 and 24 months.
ConclusionsAfter controlling for potentially confounding variables as sociodemographic, age and time since first-episode, participating in a group psychotherapeutic program does not seem to improve clinical variables or use of resources. Further studies with larger samples would be necessary to explore other variables, such as symptoms, satisfaction with the intervention or social functioning.
Disclosure of InterestNone Declared
AGESMind clinical trial: SocialMIND® results at 16 weeks
- M. P. Vidal-Villegas, A. Abad Pérez, P. Herrero Ortega, A. Oliva Lozano, J. Garde González, J. Andreo-Jover, A. Muñoz-Sanjosé, R. Mediavilla, B. Rodríguez-Vega, G. Lahera, Á. Palao-Tarrero, C. Bayón-Pérez, M. F. Bravo-Ortiz
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S480-S481
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Introduction
Early intervention on a first psychotic episode is fundamental for a more favorable prognosis, and it usually combines pharmacological treatment, which mainly affects positive psychotic symptoms, with interventions that can improve the rest of the symptoms and associated problems such as deterioration in social functioning (Harvey & Penn, 2010; Fusar-Poli, McGorry & Kane, 2017). While Mindfulness is gaining more and more prominence in the field of psychotherapy (Chan et al., 2019; Cillesen et al., 2019), social cognition and social functioning are being researched as key targets on which to intervene after a first psychotic episode (Green, Horan & Lee, 2015).
SocialMIND® is a mindfulness-based social cognition training tailor-made to improve social functioning in people who have suffered a first psychotic episode within the last five years. It is currently being compared with a group Psychoeducational Multicomponent Intervention (PMI) in a Randomized Controlled Trial (RCT) (Mediavilla et al., 2019). Both group psychotherapies include 17 sessions delivered over a 9 month period: 8 weekly sessions, 4 biweekly sessions and 5 monthly sessions.
The results of SocialMIND® at 8 weeks showed improvements in social cognition and social functioning, specifically on affective social cognition and self-care (Mediavilla et al., 2021).
ObjectivesTo evaluate the efficacy of SocialMIND® in improving social functioning, measured by the Personal and Social Functioning (PSP) scale 16 weeks after starting the intervention, in people who have suffered a first psychotic episode in the last 5 years.
MethodsRandomized, controlled pilot trial (use of a psychoeducational multicomponent intervention or PMI as active comparator) of two parallel groups (SocialMIND® and PMI) with a 1:1 ratio using a blind evaluator.
ResultsNo statistically significant differences were found in the social functioning variable between the two treatment arms. Intragroup differences are observed in other secondary variables studied (social cognition) 16 weeks after starting the interventions.
ConclusionsSocialMIND® has not been shown to be more effective than a PMI in improving social functioning at 16 weeks after starting the intervention in people who have suffered a first psychotic episode in the five years prior to being included in the study.
Disclosure of InterestNone Declared
Meta-analysis of the variability in the individual response to pharmacological treatments for mania in bipolar disorder
- G. Anmella, M. De Prisco, V. Oliva, M. Sanabra, L. Fortea, M. Ortuño, G. Fico, A. Murru, E. Vieta, D. Hidalgo-Mazzei, A. Solanes, J. Radua
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S84
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Introduction
Many studies have investigated whether there exist predictors of good response to antimanic drugs in bipolar disorder (BD). However, these factors predict response or only indicate benign illness course.
ObjectivesTo shed some light on the topic, we tested whether the response to antimanic drugs showed any variability beyond that expected by the effects of illness course and placebo.
MethodsWe included all double-blind, placebo-controlled RCTs of oral pharmacotherapies targeting adult patients with acute bipolar mania from 1991 to 2020. The primary outcome was the variance of the improvement in manic symptoms in treated individuals compared to placebo. The effect size was the log variability ratio (logVR). We performed a random-effects meta-analysis, including assessments of heterogeneity, sensitivity/cumulative/subgroup analyses, and meta-regression.
Results42 RCTs (46 comparisons) from a total of 8,438 BD patients with acute mania (53.7% male, mean age=39.3; 5,563 treatment/2,875 control groups) were included in the analysis. Individuals in active treatment groups did not show variability in the response beyond that observed in individuals under placebo (VR=1; 95% C.I.=0.97,1.03; p-value=0.97). No heterogeneity was detected between the studies (I2=0%; tau2=0%; Q=29.21; df=45; p-value=0.97). Results were similar in the leave-one-out/cumulative/subgroup analyses. Meta-regression did not show influences by age, sample size, sex, severity of manic symptoms at baseline, or clinical features (rapid cycling, mixed or psychotic features).
ConclusionsThis meta-analysis shows no evidence of differences in the individual response to treatments. These findings suggest that the average treatment effect is a reasonable assumption for the individual BD patient with acute mania. The presented article adds evidence to the equivalent results in schizophrenia-spectrum disorders, clinical high-risk state for psychosis, and major depressive disorder, not supporting classification in responders vs. non-responders. However, these findings should be balanced with results from other fields supporting such classification.
Disclosure of InterestNone Declared
Is emotion dysregulation correlated to depressive and manic symptoms of bipolar disorder? Results from a systematic review and network meta-analysis
- V. Oliva, M. De Prisco, G. Fico, A. Murru, M. Fornaro, A. Serretti, J. Radua, E. Vieta
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S275-S276
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Introduction
Emotion dysregulation (ED) is a multidimensional construct involving the lack of awareness, understanding and acceptance of emotions, a reduced access to adaptive and appropriate strategies to modulate the intensity or duration of emotional responses, and the inability to control behaviors in accordance with desired goals when experiencing negative emotions. ED is outlined in the general population and several psychiatric disorders, including bipolar disorder (BD), and influences its clinical course and management, quality of life, and daily social functioning.
ObjectivesThe objective of this systematic review was to examine the correlations between maladaptive (i.e., positive and negative rumination, negative focus, risk taking behaviors, suppression, and dampening) and adaptive (i.e., cognitive reframing, adaptive coping, and acceptance) strategies of emotion regulation (ER) and depressive and manic symptoms of BD.
MethodsWe searched the literature from inception to April 12, 2022, and included studies focusing on ER/ED assessed with a validated scale. We conducted multiple pairwise meta-analyses for correlations between ED dimension (or overall ED) and the measures of depressive and manic symptoms of BD, and separate Bayesian network meta-analyses to examine which aspects of emotion regulation were most closely associated with depressive and manic symptoms of BD. The Pearson’s r coefficients were adjusted using sample-size weights and Fisher’s r-to-z transformed was conducted.
ResultsA total of 13,826 records was identified and, after duplicate removal and title/abstract evaluation, 442 were explored at the full text. Sixteen studies were finally included. Results from pairwise meta-analyses are shown in Figure 1, results from network meta-analyses in Figure 2 and 3. Both depressive and manic BD symptomatology were found to be related to maladaptive ER strategies, with the only difference of positive rumination, associated only to manic symptoms. Negative rumination and risk-taking behaviors were the strategies more correlated to both manic and depressive symptoms, as confirmed by both pairwise metanalyses and network metanalyses. On the other hand, depressive symptomatology appeared more correlated with decreased adaptive strategies than manic symptomatology.
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ConclusionsED has a significant correlation with BD symptomatology, therefore it should be explicitly considered during clinical assessment, diagnosis, and intervention on BD, and specific treatments should be implemented. More studies, and with longitudinal design, are needed to better explore these associations and their causal direction. In addition, future studies should mainly focus on the complex interactions between cognitive, social, and cultural aspects, and biological correlates to improve knowledge on a topic that is still poorly investigated.
Disclosure of InterestV. Oliva: None Declared, M. De Prisco: None Declared, G. Fico Grant / Research support from: “La Caixa” Foundation (ID 100010434 - fellowship code LCF/BQ/DR21/11880019), Consultant of: Angelini, Janssen-Cilag and Lundbeck, A. Murru Grant / Research support from: Spanish Ministry of Science and Innovation (PI19/00672) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER), Consultant of: Angelini, Idorsia, Lundbeck, Pfizer, Takeda, M. Fornaro: None Declared, A. Serretti Consultant of: Abbott, Abbvie, Angelini, AstraZeneca, Clinical Data, Boehringer, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Innovapharma, Italfarmaco, Janssen, Lundbeck, Naurex, Pfizer, Polifarma, Sanofi, Servier, and Taliaz, J. Radua Grant / Research support from: Spanish Ministry of Science and Innovation (PI19/00394, CPII19/00009) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER) and the Instituto de Salud Carlos III, E. Vieta Grant / Research support from: Spanish Ministry of Science and Innovation (PI18/00805, PI21/00787) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. Thanks the support of the European Union Horizon 2020 research and innovation program (EU.3.1.1. Understanding health, wellbeing and disease: Grant No 754907 and EU.3.1.3. Treating and managing disease: Grant No 945151), Consultant of: AB-Biotics, AbbVie, Angelini, Biogen, Boehringer-Ingelheim, Celon Pharma, Dainippon Sumitomo Pharma, Ethypharm, Ferrer, Gedeon Richter, GH Research, Glaxo-Smith Kline, Janssen, Lundbeck, Medincell, Novartis, Orion Corporation, Organon, Otsuka, Rovi, Sage, Sanofi-Aventis, Sunovion, Takeda, and Viatris
Does bipolar disorder differ from other mental illnesses in terms of emotion dysregulation? A systematic review and meta-analysis
- M. De Prisco, V. Oliva, G. Fico, J. Radua, I. Grande, N. Roberto, G. Anmella, D. Hidalgo-Mazzei, M. Fornaro, A. de Bartolomeis, A. Serretti, E. Vieta, A. Murru
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S571-S572
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Introduction
Emotion regulation (ER) is the ability to assess, monitor, or modify emotional reactions to achieve a goal (Gross. Psychological inquiry 2015; 26 1-26). When ER strategies are rigidly or maladaptively applied, emotional dysregulation (ED) can occur (Thompson. Development and psychopathology 2019; 31 805-815). ED is common in people diagnosed with bipolar disorder (BD), but it can also be described in other clinical populations given its transdiagnostic nature. Numerous aspects of ED have been described in BD (De Prisco et al. Neuroscience & Biobehavioral Reviews 2022; 104914), but it is unclear whether these manifest similarly in other conditions such as major depressive disorder (MDD) or borderline personality disorder (BPD), or whether they are specific to BD.
ObjectivesThe objective of this systematic review and meta-analysis is to examine the literature comparing BD with other psychiatric disorders in terms of ED, focusing on those studies using validated clinical tools.
MethodsA systematic search from inception to April 28th, 2022, was conducted exploring the PubMed/MEDLINE,EMBASE, Scopus, and PsycINFO databases. Those studies providing quantitative data on ED in people diagnosed with BD and compared with clinical groups were eligible for inclusion. No restriction about age, sample size, or language were applied. Random effect meta-analyses were conducted, and effect sizes were calculated as standardized mean differences (SMD).
ResultsA total of 3,239 records was identified and, after duplicate removal and title/abstract evaluation, 112 were explored at the full text. Twenty-nine studies were finally included, and it was possible to perform a meta-analysis with twenty-two (145 comparisons) of them. Only studies comparing BD with MDD, and BPD provided sufficient data to perform a meta-analysis. People with BD did not differ from people with MDD in most of the comparisons considered. However, BD patients presented higher positive rumination (two comparisons: SMD=0.46; CI=0.27, 0.64; p=8.5e-07; I2=0%; and SMD=0.34; CI=0.15, 0.52; p=2.7e-04; I2=0%) and risk-taking behaviors (SMD=0.48; CI=0.27, 0.69; p=8.11e-06; I2=0%). In contrast, people with BPD displayed an overall higher degree of ED (SMD=-1.22; CI=-1.94, -0.5; p=9.1e-04; I2= 90.7) and used fewer adaptive ER strategies. Additionally, higher levels of self-blaming (SMD=-0.80; CI=-1.11, -0.50; p=2.68e-07; I2=0) and impulsive behavior (SMD=-0.76; CI=-0.89, -0.63; p=5.4e-29; I2=0) were observed.
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ConclusionsED is a trans-diagnostic construct that spans a continuum of different psychiatric disorders. Outlining the specific clinical features of one disorder versus another may help future research to increase our knowledge of these issues and develop new treatment strategies to reduce the clinical burden of these patients.
Disclosure of InterestM. De Prisco: None Declared, V. Oliva: None Declared, G. Fico Grant / Research support from: “La Caixa” Foundation (ID 100010434 - fellowship code LCF/BQ/DR21/11880019), Consultant of: Angelini, Janssen-Cilag and Lundbeck, J. Radua Grant / Research support from: Spanish Ministry of Science and Innovation (PI19/00394, CPII19/00009) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER) and the Instituto de Salud Carlos III, I. Grande Grant / Research support from: Spanish Ministry of Science and Innovation (MCIN) (PI19/00954) integrated into the Plan Nacional de I+D+I and cofinanced by the ISCIII-Subdirección General de Evaluación y el Fondos Europeos de la Unión Europea (FEDER, FSE, Next Generation EU/Plan de Recuperación Transformación y Resiliencia_PRTR ); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); and the the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017 SGR 1365), CERCA Programme / Generalitat de Catalunya as well as the Fundació Clínic per la Recerca Biomèdica (Pons Bartran 2022-FRCB_PB1_2022), Consultant of: ADAMED, Angelini, Casen Recordati, Ferrer, Janssen Cilag, and Lundbeck, Lundbeck-Otsuka, Luye, SEI Healthcare, N. Roberto: None Declared, G. Anmella Grant / Research support from: Rio Hortega 2021 grant (CM21/00017) from the Spanish Ministry of Health financed by the Instituto de Salud Carlos III (ISCIII) and co-financed by the Fondo Social Europeo Plus (FSE+), Consultant of: Janssen-Cilag, Lundbeck, Lundbeck/Otsuka, and Angelini, D. Hidalgo-Mazzei Grant / Research support from: Juan Rodés JR18/00021 granted by the Instituto de Salud Carlos III (ISCIII), M. Fornaro: None Declared, A. de Bartolomeis Consultant of: Janssen, Lundbeck, and Otsuka and lecture fees for educational meeting from Chiesi, Lundbeck, Roche, Sunovion, Vitria, Recordati, Angelini and Takeda; he has served on advisory boards for Eli Lilly, Jansen, Lundbeck, Otsuka, Roche, and Takeda, Chiesi, Recordati, Angelini, Vitria, A. Serretti Consultant of: Abbott, Abbvie, Angelini, AstraZeneca, Clinical Data, Boehringer, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Innovapharma, Italfarmaco, Janssen, Lundbeck, Naurex, Pfizer, Polifarma, Sanofi, Servier, and Taliaz, E. Vieta Grant / Research support from: Spanish Ministry of Science and Innovation (PI18/00805, PI21/00787) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. Thanks the support of the European Union Horizon 2020 research and innovation program (EU.3.1.1. Understanding health, wellbeing and disease: Grant No 754907 and EU.3.1.3. Treating and managing disease: Grant No 945151), Consultant of: AB-Biotics, AbbVie, Angelini, Biogen, Boehringer-Ingelheim, Celon Pharma, Dainippon Sumitomo Pharma, Ethypharm, Ferrer, Gedeon Richter, GH Research, Glaxo-Smith Kline, Janssen, Lundbeck, Medincell, Novartis, Orion Corporation, Organon, Otsuka, Rovi, Sage, Sanofi-Aventis, Sunovion, Takeda, and Viatris, A. Murru Grant / Research support from: Spanish Ministry of Science and Innovation (PI19/00672) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER), Consultant of: Angelini, Idorsia, Lundbeck, Pfizer, Takeda
Superior mesenteric artery syndrome: when vomiting are not voluntary
- M. A. Morillas Romerosa, A. Oliva Lozano, P. Herrero Ortega, J. Garde Gonzalez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S851
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Introduction
Superior mesenteric artery syndrome is a gastro-vascular disorder in which the third and final portion of the duodenum is compressed between the abdominal aorta and the overlying superior mesenteric artery. This rare, potentially life-threatening syndrome is typically caused by an angle of 6°–25° between the abdominal aorta and the superior mesenteric artery, in comparison to the normal range of 38°–56°, due to a lack of retroperitoneal and visceral fat (mesenteric fat). In addition, the aortomesenteric distance is 2–8 millimeters, as opposed to the typical 10–20. However, a narrow superior mesenteric artery angle alone is not enough to make a diagnosis with no symptoms.
Symptoms are fullness and epigastric tightness after meals, nausea and vomiting (often bilious) and pain in the middle of the abdomen that improves with the prone or knees flexed to the chest. The diagnosis is supported by imaging tests (esophagogastroduodenal transit or CT) showing dilation and stasis proximal to AMS in the third duodenal portion.
Relief from vomiting with feeding through a enteral probe placed beyond the obstruction to the proximal jejunum supports diagnosis.
Precipitating factors should be corrected first, whenever possible. Acute symptoms can be resolved with gastric decompression and intravenous fluids. Therefore, surgical correction should only be done in well-studied patients with chronic recurrent episodes of AMS syndrome. The most recommended surgical technique is a laparoscopic proximal duodenojejunostomy
ObjectivesTo describe a case of superior mesenteric artery syndrome and review in literature the organic complications and associated psychopathology of this disorder
MethodsClinical case report and brief review of literatura
Results17-year-old woman with a diagnosis of anorexia nervosa. Admitted for behavioral disorder, repeated self-harm and low mood. Presents a BMI of 16.6. Irregular rules. Progressive diet is started to which nutritional supplements are added with good initial tolerance. It presents a loss of 2kg and begins with nausea, vomiting and postprandial epigastralgia. Oral panendoscopy and abdominal ultrasound are performed showing possible mesenteric aortic clamp so naso-jejunal probe and exclusive enteral feeding is prescribed. She received enteral jejunal nutrition progressively with feedback syndrome prophylaxis that included parenteral vitamin B1. After a few days, oral supplementation began. He remained hemodynamically stable, with no signs of heart failure. It gained 3kg of weight up to 43.2kg, starting before discharge from the hospital successfully oral tolerance.
ConclusionsSuperior mesenteric artery syndrome is a serious complication in anorexia nervosa with a low incidence and an estimated mortality of 33%. A multidisplinar approach that addresses both the medical and psychological needs of these patients throughout their hospital stay is necessary.
Disclosure of InterestNone Declared
“Social functioning and use of rehabilitation resources in a group of people who experienced a first episode of psychosis and participated in a psychotherapeutic group program versus a control group”
- A. Oliva Lozano, J. Garde Gonzalez, P. Herrero Ortega, A. Muñoz-Sanjosé, Á. Palao-Tarrero, M. P. Vidal-Villegas, R. Mediavilla, P. Tarín Garrón, J. M. Pastor-Haro, Á. De Diego Gómez-Cornejo, M. F. Bravo-Ortiz, O. B. O. A.-M. Group
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S185
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Introduction
Psychotic disorders have a huge impact on social functioning, which is the ability to stablish and maintain social activities such as interpersonal relationships and self-care activities of daily living. Research data support that the early intervention in people who have experienced a first episode of psychosis (FEP) -based on a multidisciplinary treatment including both psychopharmacological and psychosocial treatments-, has a relevant role in a favorable evolution. AGES-Mind study is based on manualized psychotherapeutic interventions for people with first-psychosis episodes.
ObjectivesTo describe the use of rehabilitation resources and social functioning in a group of people with FEP who were included in a psychotherapeutic group program versus a control group, at 12 and 24 months since the beginning of the intervention.
MethodsLongitudinal, analytical, observational, retrospective study on a cohort of 46 patients with first-episode psychosis within the last 5 years. 23 patients received group psychotherapy in the context of the AGES-Mind study and they were compared with 23 control patients who did not receive a group intervention (treatment as usual). Controls were matched by age, gender and time elapsed since the first episode of psychosis with those exposed to the intervention. Sociodemographic data, social functioning (self-care, social activities, social relationships, and behavior) and use of rehabilitation resources outcome variables were assessed.
ResultsSignificant differences were found regarding participation in social activities in the intervention group versus control group at 24 months. No significant differences were found in other dimensions of social functioning or in the use of rehabilitation resources.
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ConclusionsFurther studies with larger sample sizes are needed in order to determine if the participation in group therapy leads to an improvement in social functioning and use of rehabilitation resources for people who have experienced a first episode of psychosis.
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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- 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
Sociodemographic and clinical characteristics of the population with a first psychotic episode attended in the mental health services of area 5 of Madrid (Spain)
- J. Garde González, P. Herrero Ortega, A. Oliva Lozano, I. I. Louzao Rojas, M. P. Vidal-Villegas, A. Muñoz-Sanjosé, M. P. Sánchez-Castro, G. Lahera, S. Sánchez Quílez, M. F. Bravo-Ortiz, O. B. O. A.-M. Group
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S443
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Introduction
Risk of functional impairment and progression to chronic illness in people with a first episode of psychosis (FEP) has motivated early intervention programs, showing promising results. Defining the characteristics of people with FEP at local level enables the clinicians to adjust interventional models to the reality of the population. The area 5 of Madrid (Spain) is referred to La Paz University Hospital and it serves a catchment area of roughly 527,000 people.
ObjectivesWe aim to identify sociodemographic and clinical characteristics of patients in the area 5 of Madrid (Spain) who meet the criteria of FEP.
MethodsA descriptive retrospective study including 179 people (age range 18-40 years) who were attended in mental health services of La Paz University Hospital (area 5 of Madrid, Spain), between January 2019 and May 2020, having suffered a psychotic episode in the last five years.
ResultsThe average age of people with FEP was 29.32 years, with a higher proportion of men (62%). The mean duration of untreated psychosis (DUP) was 3.64 months and 47% of patients consume cannabis. We found disparities in DUP among the different districts in the area and we also observed differences depending on the district for inclusion in rehabilitation programs or psychotherapy. The following averages were obtained for the aggregate sample: 1.01 hospitalization/year, 1.42 emergency room visits/year, 1.81 years of illness and a mean dosage equivalent to olanzapine 6.75 mg/day. The incidence of psychosis in our area has been 7.01 cases per 100000 inhabitants/year.
ConclusionsThe incidence of psychosis has been as expected according to data recorded at previous studies in Spain. The results obtained in our sample have included a lower DUP and a higher use of cannabis than those described in the literature. We have also found differences when observing the inclusion of patients in different treatments (psychotherapy, rehabilitation), which may be related to the differences in the DUP by districts. Further exploration in this field is needed to draw causal conclusions.
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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- Journal:
- 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
Glacial–interglacial cycles in the south-central and southeastern Pyrenees since ~180 ka (NE Spain–Andorra–S France)
- Valenti Turu, Jose Luís Peña-Monné, Pedro P. Cunha, Guy Jalut, Jan-Pieter Buylaert, Andrew S. Murray, David Bridgland, Mads Faurschou-Knudsen, Marc Oliva, Rosa M. Carrasco, Xavier Ros, Laia Turu-Font, Josep Ventura Roca
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- Journal:
- Quaternary Research / Volume 113 / May 2023
- Published online by Cambridge University Press:
- 26 January 2023, pp. 1-28
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This study uses luminescence and 14C accelerator mass spectrometry procedures to date relevant glaciofluvial and glacial deposits from the south-central and southeastern Pyrenees (Andorra–France–Spain). We distinguish two types of end-moraine complexes: (1) those in which at least a far-flung moraine exists beyond a frequently nested end-moraine complex (the most common) and (2) those in which a close-nested end moraine encompasses at least two glacial cycles. Both types formed within six distinctive glacial intervals: (1) A penultimate glacial cycle during Marine Oxygen Isotope Stage (MIS) 6 and older glaciofluvial terraces occurred beyond the range of the luminescence dating method. (2) An early glacial advance in MIS 5d (~97 −15/+19 ka) was followed by glacial retreat during MIS 5c (< 91 ± 9 ka). (3) The last maximum ice extent (LMIE) was in early MIS 4 (~74 ± 4.5 ka). (4) Unexpectedly, glaciers thinned during the second half of MIS 3 (~39 −6/+11 ka). (5) During the MIS 3–2 transition, glaciers subsequently fluctuated behind the LMIE limits. (6) The global last glacial maximum (LGM) started as early as ~26.6 ± 0.365 ka b2k, and the corresponding end moraines were built behind the LMIE limits or merged with it, forming close-nested moraines.
A pilot add-on Randomized-Controlled Trial evaluating the effect of binaural beats on study performance, mind-wandering, and core symptoms of adult ADHD patients
- F. Malandrone, M. Spadotto, M. Boero, I.F. Bracco, F. Oliva
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S274
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Introduction
ADHD is a neurodevelopmental disorder that frequently persists throughout adulthood. Binaural Beats (BB) are auditory perceptions occurring when two soundwaves of slightly different frequency are carried separately to the ears; they might modulate brain activity and performance.
ObjectivesTo evaluate BB efficacy on studing performance, mind-wandering, and core symptoms of a sample of adult ADHD outpatients
MethodsIn this randomized-controlled trial we recruited a sample of University students in pharmacological treatment for adult ADHD. A track with 15 Hz BB (415 Hz to right and 400 Hz to the left ear) was delivered to the intervention group; whereas, a placebo track consisting of two identical frequencies (400 Hz) was administered to control group. The RCT consisted of a baseline assessment (T0) and two fortnightly follow-ups (T1-T2). Each time, the patient filled the ADHD-RS-5 (ADHD Rating Scale-5) and the MEWS (Mind Excessively Wandering Scale) and executed an online version of SART (Sustained Attention to Response Task). The effect of self-administered acoustic stimulation during individual studying sessions was estimated by a subjective studying performance (SSP) evaluation questionnaire.
ResultsA significant improvement of SSP from baseline assessment (T1) to the last observation (T3) was detected in BB group only (mean differences= 2.7, p<.001). A significant between-group contrast for SSP was also found at T3. No other significant changes were detected for ADHD-RS, MEWS and SART at p<.05 level.
ConclusionsBB seem to improve subjective studying performance and ADHD symptoms severity. These preliminary findings must be confirmed in larger sample.
DisclosureNo significant relationships.
Streptococcal infections, autoimmunity, and innate immune system in adult ADHD: A preliminary study
- G. Di Girolamo, S. Peracchia, M. Boero, I.F. Bracco, F. Oliva
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S335
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Introduction
High rate of streptococcus-like infections and related titers has been found in adult ADHD patients. No studies have expressively investigated innate immune system in ADHD patients.
ObjectivesTo evaluate the relationship between streptococcal infections, autoimmunity and innate immune system in adult ADHD patients.
MethodsThe study sample consisted of adult DSM-5 ADHD outpatients referring to the adult ADHD center of “San Luigi Gonzaga” University Hospital and non-clinical adult controls recruited among general population (screened using Adult ADHD Self-Report Scale - ASRS-v.1). All titers were determined in patients’ plasma by specific microwell ELISA kits, whereas genetic polymorphisms were determined by PCR methodology. We compared anti-streptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and anti-basal ganglia antibodies (ABGA) titers of patients with those of controls. Data about history of previous streptococcus/ streptococcus-like infections were collected by ad-hoc form. Furthermore, to investigate the susceptibility to Gram+-borne infections of adult ADHD patients, due to innate immune system impairment, we also evaluated the polymorphism of Toll-like receptors 2, 4, and 9.
ResultsAlthough ADHD patients did not show higher rate of both previous infections (52.7% vs. 66.7%, p=.678) and ASO titers (18.2% vs. 0.0%, p=.577), they had really higher levels of anti-DNase B (85.5% vs. 16.7%, p=.001) and ABGA titers (78.2% vs. 33.3%, p=.036). Genetic analysis did not underline differences in polymorphism compared to general population (GENOME browser).
ConclusionsThe high association between previous streptococcal infections, basal ganglia autoimmunity among ADHD patients was confirmed. TLR polymorphism does not seem to be involved in this type of vulnerability.
DisclosureNo significant relationships.
Pregnant Women and Opioid Use Disorder: Examining the Legal Landscape for Controlling Women’s Reproductive Health
- Lynn M. Madden, Jenn Oliva, Anthony Eller, Elizabeth DiDomizio, Mat Roosa, Lisa Blanchard, Natalie Kil, Frederick L. Altice, Kimberly Johnson
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- Journal:
- American Journal of Law & Medicine / Volume 48 / Issue 2-3 / July 2022
- Published online by Cambridge University Press:
- 30 January 2023, pp. 209-222
- Print publication:
- July 2022
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Women with opioid use disorder (“OUD”) are more likely than other women to experience sexual assault, unintentional pregnancy, transactional sex and coercion regarding reproductive health care choices than women without OUD. Laws described as family friendly may be punitive rather than helpful to women and rarely apply to men. Laws regarding reproductive health and OUD are unevenly enforced and therefore biased against poor, minority women. As part of a larger study oriented toward strengthening systems of care related to the intersection of HIV and OUD, we conducted an analysis of state laws related to pregnant and postpartum women with OUD. Data on disparities in child removals and pregnant women’s use of evidence-based treatment for OUD by income and race were captured for the five states with the most restrictive laws in both categories. Laws that were purportedly designed to improve reproductive health outcomes for women with OUD and/or their children often have the opposite of the expressed intended outcome. There is a relationship between restrictive reproductive choice and coercive OUD treatment policy for women. Restrictive state regulations for pregnant women with OUD persist despite negative outcomes for maternal and child health. Altering coercive and/or criminalizing regulation and redefining ‘family friendly’ may improve outcomes for individuals and families.
The potential role of imaging techniques in avoiding neck dissection during salvage surgery after head and neck carcinoma treated with bioradiotherapy
- A Rovira, J Tornero, M Taberna, M Oliva, R Montal, J Nogues, A Mari, J M Viñals, A Lozano, M Maños, R Mesia
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- Journal:
- The Journal of Laryngology & Otology / Volume 135 / Issue 11 / November 2021
- Published online by Cambridge University Press:
- 06 September 2021, pp. 970-975
- Print publication:
- November 2021
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Objective
This study aimed to evaluate the effectiveness of computed tomography and positron emission tomography-computed tomography prior to salvage surgery after head and neck carcinoma treated with bioradiotherapy and to look at the role of neck dissection in this setting.
MethodThis study was a retrospective chart review of a series of consecutive patients with locally advanced head and neck squamous cell carcinoma treated with bioradiotherapy. Radiological and pathological stages were compared to evaluate the accuracy of computed tomography and positron emission tomography-computed tomography in detecting occult neck metastasis in the context of recurrence of primary tumour. In order to assess the impact of neck dissection on survival, Kaplan–Meier survival curves after salvage surgery with and without neck dissection were derived.
ResultsA total of 268 patients were identified, of which 22 underwent salvage surgery. The negative predictive value of computed tomography and positron emission tomography-computed tomography was excellent. Neck dissection did not represent an improvement on overall, disease specific and regional recurrence free survival (p = 0.67, p = 0.91 and p = 0.62, respectively) amongst clinically and radiologically negative necks.
ConclusionConservative treatment of the neck should be considered when dealing with patients with primary site recurrence or persistent disease after bioradiotherapy without evidence of neck disease.
Personality traits and disorders among adult adhd patients: Do they vary between males and females?
- I.F. Bracco, M. Boero, C. Mangiapane, F. Oliva
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S181
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Introduction
Patients with Attention Deficit/Hyperactivity Disorder (ADHD) have shown an increased risk of developing a DSM Cluster B (i.e., Borderline, OR=13.16; Antisocial, OR=3.03; Narcissistic, OR=8.69) and DSM Avoidant Personality Disorder (PD; OR=9.77; Miller et al., 2008). Although different comorbidities affect males and females with ADHD (Kooij et al., 2013), gender differences in personality traits and disorders have not yet been investigated.
ObjectivesTo describe gender differences in personality traits and disorders among a sample of adult outpatients with ADHD.
MethodsA consecutive sample of DSM-5 ADHD outpatients was recruited at the Adult ADHD Center of the “San Luigi” University Hospital (Orbassano (TO), Italy) between Jan 2017 and Jan 2018. Patients’ personality was assessed by Millon Clinical Multiaxial Inventory (MCMI-III; Zennaro et al, 2008).
ResultsThe study sample consisted of 82 males and 31 females. Sixty percent of men vs. 77% of women had a personality disorder (
ConclusionsWomen with ADHD showed a higher frequency of personality disorders and higher rate of Masochistic PD than men. Moreover, the two most important clusters detected in women included severe personality components (i.e., Borderline and Paranoid) when compared with men. Further studies on larger samples should be conducted to confirm more severe personality profiles in women than in men.
DisclosureNo significant relationships.
P-73 - Anxiety, Depression and Quality of Life Among Patients Accessing Alcohol Detoxification
- R.L. Picci, P. Vizzuso, M. Zuffranieri, A. Jaretti Sodano, P.M. Furlan, F. Oliva
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- Journal:
- European Psychiatry / Volume 27 / Issue S1 / 2012
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction
Anxiety and depression are showed as more frequent in alcoholics in both epidemiological surveys and clinical samples. Affective and mood disorder in alcohol-dependent patients may have a negative impact on Quality of Life (QoL) and than on relapse.
ObjectivesTo evaluate the course of alcohol use, anxiety, depression and QoL during alcohol detoxification.
Methods126 patients entering alcohol detoxification were evaluated at the beginning, at the end and 6 month later of treatment for frequency of alcohol intake, quality of life, anxiety and depression using Alcohol Use Disorders Identification Test (AUDIT), World Health Organization Quality of Life - Brief Version (WHOQOL-BREF), State Trait Anxiety Inventor (STAI-Y) and Beck Depression Inventory (BDI).
ResultsAt the admission 78% (n = 98) and 94% (n = 118) of the sample presented an anxiety score above the threshold on states and traits scale respectively, 92% (n = 116) showed depression ranged from mild to severe and QoL score was lower than normative levels in all domains. At the discharge, depression and state anxiety significantly decreased to normative level (p = < 0.0001), otherwise half part of the sample showed trait anxiety score above threshold. After 6 month, state anxiety was also decreased, whereas trait anxiety and depression levels increased again. QoL was significantly improved at follow-up except for psychological domain.
ConclusionsThe negative effect of anxiety, depression and alcohol abuse on quality of life was confirmed. Follow-up results suggest that trait anxiety should maintain low levels in psychological domain of WHOQoL in alcoholdependent patients.
Low frequency of request for liaison psychiatry: A difficulty in the early detection of mental disorders by medical assistants?
- M. Aguiar Machado, J. Gonçalves Oliveira, E. Oliveira Cunha, E. Vieira de Melo, E. Oliva-Costa
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- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S487
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Introduction
The liaison psychiatry (LP) is a feature used by the psychiatrist in order to improve the management of patients with mental suffering and/or mental disorder admitted to general hospital.
ObjectivesTo characterize the epidemiological profile of hospitalized patients at the university hospital of the federal university of Sergipe (HU-UFS) submitted to LP.
Methodsretrospective and observational study, through analysis of medical records of patients admitted in the wards of clinical medicine and surgery from the HU-UFS, in the period from January to December 2015, submitted to LP. The information collected fed a specific questionnaire developed by the authors, intended for research of socio-demographic data and clinical profile.
Resultsthe frequency of request for IP was of 3.5%, with the majority of applications was performed by clinical medicine (71.2%), while the surgical clinic was responsible for 28.8%. The main reason for the request of LP was the presence of depressive symptoms (49.1%). There was a predominance of females (52.5%) and the mean age was 45.9 ± 14.6 years.
ConclusionsThe frequency of request for LP was very low, suggesting a difficulty in the early detection of mental disorders by physicians. This finding points to an underreporting of cases, since the prevalence of depressive symptoms in hospitalized patients is over 50% in this institution.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Prevalence of depressive symptoms among inpatients at the university hospital of Sergipe, Brazil
- J. Oliveira, M. Machado, E. Cunha, K.M. Mansilla, E. Vieira Melo, E. Oliva-costa
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- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, pp. s499-s500
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Introduction
Depressive Symptoms (DS) generate a public and economic health problem, with decreasing productivity, labour market withdrawal and increased demand for health services. Studies show that in hospitalized patients, DS rates are higher than in the general population, in medical practice, however, they are under diagnosed or under-treated. Consultation Liaison Psychiatry (LP) can prevent aggravation of the psychic symptoms by early identification of them and by integration of psychiatry with the other medical specialties.
ObjectivesTo estimate the prevalence of DS and associated factors in inpatients and the frequency of consultation LP.
MethodsA cross-sectional study was carried out in March 2016, with 87 patients hospitalized in the clinical and surgical wards at the University Hospital (Sergipe/BR), through two instruments: (1) Structured Questionnaire prepared by the authors, (2) Beck Depression Inventory (BDI). Data analysis through descriptive and analytical statistics with final step of logistic regression.
ResultsThe prevalence of DS were 54%, of which 24% correspond to moderate and severe symptoms, and only 3.4% of the patients had a LP. In Logistic Regression, the only factor associated with DS was the reason for hospitalization. Clinical causes (87.2%) were 9.24 times more likely to develop DS than surgical causes.
ConclusionsResults suggest a high prevalence of inpatients with some psychic symptom. Physicians did not detect these symptoms and, therefore, LP request was low. These data reinforce the importance of LP for early identification of DS that should be stimulated during medical training.
Disclosure of interestThe authors have not supplied their declaration of competing interest.