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Evaluation of a peer-led research best practices training for community health workers and promotoras
- Susan L. Murphy, Alexandra E. Harper, Gina M. Jay, Vanessa I. Trujillo, Kristen Weeks-Norton, Elias Samuels, Jonathan P. Troost, Brenda Eakin, Gretchen Piatt, Catherine Striley, Analay Perez, Shannen McIntosh, Daphne C. Watkins, Sergio Aguilar-Gaxiola, Linda Cottler
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- Journal:
- Journal of Clinical and Translational Science / Volume 8 / Issue 1 / 2024
- Published online by Cambridge University Press:
- 16 September 2024, e117
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Introduction:
Community health workers and promotoras (CHW/Ps) increasingly support research conducted in communities but receive variable or no training. We developed a culturally and linguistically tailored research best practices course for CHW/Ps that can be taken independently or in facilitated groups. The purpose of this study was to evaluate the facilitated training.
Methods:CHW/Ps were recruited from communities and partners affiliated with study sites in Michigan, Florida, and California. They participated in virtual or in-person training facilitated by a peer in English or Spanish and then completed a survey about their abilities (i.e., knowledge and skills for participating in research-related work) and perceptions of the training. Linear regression analyses were used to examine differences in training experience across several factors.
Results:A total of 394 CHW/Ps, mean age 41.6 ± 13.8 years, completed the training and survey (n = 275 English; 119 Spanish). Most CHW/Ps were female (80%), and 50% identified as Hispanic, Latino, or Spanish. Over 95% of CHW/Ps rated their abilities as improved after training; 98% agreed the course was relevant to their work and felt the training was useful. Small differences were observed between training sites.
Discussion:Most CHW/Ps rated the training positively and noted improved knowledge and skills for engaging in research-related work. Despite slight site differences, the training was well received, and CHW/Ps appreciated having a facilitator with experience working in community-based settings. This course offers a standard and scalable approach to training the CHW/P workforce. Future studies can examine its uptake and effect on research quality.
Self-perceived health of patients hospitalized due to non-psychiatric conditions: associations with psychiatric comorbidities and substance use
- M. Pons-Cabrera, E. Caballería-Lamora, L. Navarro-Cortés, M. Balcells-Oliveró, L. Pintor-Pérez, H. López-Pelayo
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S494
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Introduction
Self-perceived health (SPH) is an epidemiologically used variable, recognized as a subjective yet predictive indicator of mortality (Bopp et al. Plos One 2012; 7:e30795) SPH, among other subjective indicators, such as quality of life, contributes to understanding an individual’s overall experience and well-being. While health information, including medical diagnoses given by physicians, forms a substantial part of an individual’s subjective health (Falconer & Quesnel-Vallée, 2017; 190 227-236) the World Health Organization (WHO, 2014) defines health not only by the absence of somatic diseases but also encompasses components of social and mental well-being.
ObjectivesThis study aims to explore factors associated with a poorer level of self-perceived health in inpatients due to non-psychiatric conditions with a focus on mental health and substance use-related factors.
MethodsWe recruited 800 patients during their hospital stay for various pathologies in cardiology, pneumology, internal medicine, and gastroenterology units. Self-reported sociodemographic variables and well-being-related variables, such as SPH, were collected during admission. The MINI Neuropsychiatric Interview was administered to screen for psychiatric conditions, the ASSIST scale assessed the risk related to the use of various substances. Data on the frequency and quantity of substance use, in the three months prior to admission, were also recorded by timeline follow-back. Information on the severity of somatic comorbidity was gathered using the Charlson Comorbidity Index. Non-parametric tests compared SPH in different groups, and variables showing significant differences were included in a multivariate linear regression analysis. This study obtained approval from the ethics committee.
ResultsSignificant and clinically relevant differences were found in the SPH of patients with anxiety disorders, depressive disorders, and bipolar disorders. These patients reported lower SPH than those without these comorbidities. Patients scoring medium or high risk on the ASSIST scale for tobacco, alcohol, and cannabis also demonstrated lower SPH compared to those with low-risk scores. In the multivariate analysis, accounting for confounding factors, including comorbidity severity, patients with depressive disorders maintained statistically significant lower levels of SPH (ß = -13.391, p < 0.001), as did those with bipolar disorders (ß = -6.096, p = 0.019).
ConclusionsPatients with anxiety, depressive, or bipolar disorders, as well as those with higher-risk use of tobacco, alcohol, and cannabis, exhibited lower SPH. After adjusting for other relevant factors, such as diagnosed somatic pathology, patients with affective disorders continued to score lower in SPH levels. Proper attention and management of psychiatric comorbidities and substance use are crucial in medical hospital settings.
Disclosure of InterestM. Pons-Cabrera Employee of: This work has been funded by Contractes Clínic de Recerca “Emili Letang - Josep Font” 2021 granted by Hospital Clínic of Barcelona, E. Caballería-Lamora: None Declared, L. Navarro-Cortés: None Declared, M. Balcells-Oliveró: None Declared, L. Pintor-Pérez: None Declared, H. López-Pelayo: None Declared
Bipolar Disorder due to Cushing’s Disease, with manic characteristics. Regarding a clinical case.
- M. D. C. Blasco Fresco, S. Ciria Villar, L. T. Durán Sandoval, A. Perez Poza, E. De La Fuente Ruiz
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S250
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Introduction
The increase in cortisol can be exogenous or endogenous. As etiologies of endogenous increase we find: Cushing’s disease, 68% of cases, generally due to an ACTH-producing pituitary tumor; Adrenal Cushing syndrome (17%); Ectopic Cushing syndrome (15%) due to lung tumor most frequently. It is relevant since among its symptoms one of the most notable are the psychiatric alterations it produces, among them mood disorders, depression being the most common, as well as psychotic symptoms, delirium and anxiety disorder.
ObjectivesTo carry out a correct differential diagnosis of the pathologies that could present with symptoms of a manic episode.
MethodsClinical case description of a 52-year-old woman, who presented with manic symptoms in 2020, requiring hospitalization. Upon discharge from the acute care unit, she consulted with the endocrinologist due to weight gain, revealing an increase in abdominal diameter, hyperpigmentation, a moon-like face, and a hump. Free cortisol was measured in 24-hour urine, with a high result, followed by brain MRI, and pituitary microadenoma was confirmed.
ResultsThe patient underwent surgical resection of the microadenoma, which was partially effective, so she maintained high cortisol levels, even despite oral retreatment. In 2023 she had a new manic episode, with a cortisol value of approximately 300 nmol/day.
ConclusionsThe importance lies in the correct diagnosis to provide appropriate treatment and avoid the chronicity of the disease and the patient psychiatrization. In this case and as in many other diseases, which present with psychiatric symptoms, it is important to differentiate whether it is a primary psychiatric disorder or are component symptoms of another disease that, upon receiving treatment, would resolve the psychiatric symptoms.
Disclosure of InterestNone Declared
Differences in clinical variables of cervical cancer in women with schizophrenia
- F. Casanovas, F. Dinamarca, S. Oller, A. Trabsa, L. Martínez-Sadurní, R. Rodríguez-Seoane, N. Zabaleta, L. M. Martin, V. Perez-Sola, A. I. Ruiz
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S318
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Introduction
Schizophrenia is associated with a reduced life expectancy, not only because of suicide, but also medical causes such as cancer. Standardized mortality for cancer is higher in patients with schizophrenia, specially for lung, breast and colorectal locations (Ni et al, 2019). Other less frequent tumor locations have not been deeply studied.
Thir mortality gap could be related to a delayed diagnosis due to several reasons, such as lower inclusion in screening programs (Solmi et al, 2019). Since cervical cancer has a very efficient screening technique, women with schizophrenia and cervical cancer could have a worse prognosis because of a delayed diagnosis. However, there is a lack of research in this tumor location.
ObjectivesTo analyze clinical differences in women with cervical cancer with and without a diagnosis of schizophrenia.
MethodsWe carried out a retrospective cohort analysis with adult patients from the cancer registry of Hospital del Mar diagnosed between 1997 and 2021. The information was crossed with the Minimum Basic Data Set (MBDS) to identify those cancer patients with a diagnosis of schizophrenia using International Classification of Diseases (ICD) 9 codes 295*. The sociodemographic variables were age and sex. The clinical oncological variables included tumor location, place of first conultation, stage, first treatment intention, vital status and place of decease. We used t-student for continuous data and Chi-squared test for categorical variables. We performed a post-hoc analysis using Bonferroni correction for multiple comparisons to identify specifically which categories were significantly different between groups.
ResultsWe identified 13 women with schizophrenia and cervical cancer, and 1354 women with cervical cancer without schizophrenia. The proportion of this location was higher in the schizophrenia group (8% of all cancers vs. 4.4%; p=0.03). The proportion of diagnoses through screening programm was significantly lower (7.7% vs 14.6%; p=0.04). There was a trend of fewer diagnoses in situ in patients with schizophrenia (30.8% vs 55.6%) and less radical intention as first treatment option (15.4% vs 3.5%) but without statistical significance in both cases. There was a higher proportion of deceased patients in the group with schizophrenia (46.2% vs 15% p=0.002), and also a higher proportion of deaths outside hospital facilities (30.8% vs 6.6%; p=0.003).
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ConclusionsWomen with schizophrenia receive less diagnoses of cervical cancer through screening programs and more in emergency facilities, which could lead to more advanced stages and fewer indication of radical treatments. This ultimately leads to a higher proportion of deaths, and more frequently outside of hospital facilities.
Our data supports the idea that the increased mortality for cancer is related to a delayed diagnosis. Women with schizophrenia need special care to ensure their inclusion in early detection programs for cancer.
Disclosure of InterestNone Declared
Patient satisfaction with 6-month paliperidone palmitate versus other long-acting injectable antipsychotics
- A. Pérez-Balaguer, I. García del Castillo, B. Gómez-Esteban, M. Vicente-Burguillo, H. Vizcaíno-Herrezuelo, S. Castelao-Almodóvar, A. Arce de la Riva, F. Neira-Serrano
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S726
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Introduction
Long-acting injectable antipsychotics (LAIs) offer advantages for schizophrenic patients compared to oral antipsychotics: less frequent dosing, lower relapse rates, better adherence, and lower healthcare costs. LAIs include paliperidone, aripiprazole, olanzapine, risperidone, and zuclopenthixol. Paliperidone palmitate is the only antipsychotic with two formulations with an administration interval longer than one month (3-monthly and 6-monthly), which could be better for the patient and help ensure treatment continuity, especially in cases of limited access to the health care system.
ObjectivesTo assess the satisfaction of patients under treatment with 6-month paliperidone palmitate compared to other long-acting injectable antipsychotics with a higher frequency of administration.
MethodsWe analyzed the satisfaction level of a sample of patients receiving treatment with LAIs at the Mental Health Center of El Escorial. All patients had a diagnosis of schizophrenia or other psychotic disorders (according to DSM-5). Patients who met the inclusion criteria completed the Treatment Satisfaction Questionnaire for Medication (TSQM), a generic questionnaire of treatment satisfaction that measures four dimensions: side effects, treatment efficacy, comfort of use, and overall satisfaction. Other clinical and socio-demographic variables were collected, as well as the type of injectable, dose, and frequency of administration.
ResultsData from approximately 30 patients will be analyzed and discussed later.
ConclusionsLess frequent administration of LAIs may result in greater patient satisfaction and be just as beneficial clinically. Treatment satisfaction is positively associated with an improvement in psychotic symptoms and seems to be related to better adherence.
Disclosure of InterestNone Declared
Emotional intelligence in teachers of educational institutions in the department of Magdalena
- K. L. Perez Correa, J. Viloria Escobar, L. P. Pedraza Àlvarez, M. Egea Lavalle
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S822
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Introduction
Psychosocial and mental health-related variables are crucial determinants of individuals’ lives in society and their roles within organizations, especially in educational institutions that are characterized by social complexities. In this regard, this research aims to determine the levels of emotional intelligence among teachers in educational institutions in the Department of Magdalena.
ObjectivesDetermine the levels of emotional intelligence among teachers in educational institutions in the Department of Magdalena
MethodsMethodologically, it is situated within the empirical-analytical paradigm with a quantitative approach, using the descriptive method. A convenience sample of 179 teachers was used, and the TMMS-24 questionnaire was administered.
ResultsThe results revealed that 37.7% of the teachers completely agree, and 30.9% strongly agree with the statement that they pay a lot of attention to their feelings. On the other hand, only 12.2% somewhat agree, and 1.2% strongly disagree with the statement that they normally worry about what they feel.
Additionally, 33.9% agree with the statement that they usually take time to think about their emotions, while 25.6% somewhat agree, and only 1.2% strongly disagree with the statement that it is worth paying attention to their emotions and mood. Furthermore, 6.4% agree, and 5.2% strongly agree with the statement that they let their feelings affect their thoughts.
As for thinking about their mood constantly, 16.7% strongly disagree, and 39.1% somewhat agree. Moreover, 6.9% strongly disagree, and 21.4% somewhat agree with the statement that they pay a lot of attention to what they feel.
Only 1.1% strongly disagree with being able to frequently define their feelings. and only 1.7% strongly disagree, and 10.2% somewhat agree with the expression “I often become aware of my feelings in different situations.” 34.1% strongly agree, and 26.6% completely agree with the statement “I can always tell how I feel.” Finally, 5.1% strongly disagree, and 19.4% somewhat agree with the statement “Sometimes I can tell what my emotions are.”
ConclusionsIn conclusion, the study emphasizes in the importance of teachers’ emotional intelligence and its potential impact on their performance and students’ learning outcomes. It also highlights the need for intervention strategies to strengthen this psychosocial variable in educational institutions in the Department of Magdalena.
Disclosure of InterestNone Declared
Relationship Between Quality of Life and Academic Performance in a Sample of Colombian University Students
- M. Paredes Bermúdez, M. Bayona Velásquez, M. Lora Monsalve, J. Viloria Escobar, K. L. Perez Correa
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S599-S600
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Introduction
Quality of life encompasses a multidimensional component that includes aspects of lifestyle, health, housing, personal satisfactions, which can affect the academic performance of students in their university studies.
ObjectivesTo determine the relationship between the quality of life and academic performance of students at the National Institute of Professional Technical Training “Humberto Velásquez García” in Ciénaga, Colombia.
MethodsCross-sectional observational study involving a sample of 344 undergraduate students who completed the WHOQOL-BREF questionnaire, a sociodemographic form, and were asked about their academic performance in the last semester. Data were analyzed using RStudio, where categorical variables were interpreted through relative and absolute frequencies, and quantitative variables through medians. Bivariate analysis was conducted using non-parametric tests such as Mann-Whitney U and Kruskal-Wallis for group comparisons, and Kendall for correlations.
ResultsAcademic performance had a median of 4.00, and the quality of life had a median of 47.57. The Mann-Whitney U test showed p=0.03 for gender-based performance comparison. Kruskal-Wallis comparison by age group regarding performance showed p=0.003. The correlation between academic performance and quality of life showed tau=0.120 and p=0.004.
ConclusionsThe median academic performance is above the approval point, but the quality of life is below average levels (on a scale of 1 to 100). There are significant differences in median performance among gender and age groups, as well as a very low, positive, and statistically significant correlation between academic performance and levels of quality of life.
Disclosure of InterestNone Declared
“Ekbom syndrome: delirium engraved on the skin”
- C. Perez Aparicio, L. Rodriguez Rodriguez, M. J. Gordillo Montaño
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S759-S760
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Introduction
Ekbom syndrome also known as Morgellons syndrome or delirium of parasitosis is a psychiatric condition where the patient has the absolute conviction of being infested in spite of medical evidence. Patients may even mutilate themselves or apply toxic substances in order to get rid of these hypothetical organisms. Sometimes they bring samples of these hypothetical parasites to the office to prove their existence, which is known as the “matchbox sign”, a pathognomonic finding.
ObjectivesThe aim of this clinical case is to make visible the impact that this psychiatric condition can have on the patient’s quality of life
MethodsWe present the case of a 40-year-old woman from Peru who was admitted to the otorhinolaryngology unit for injuries compatible with necrosis of the right pinna. When the patient was examined, scars were found on the lower limbs and back. The patient justifies the scratching lesions with the presence of pathogenic organisms, with no trace of them by the physician.
ResultsThe patient was evaluated by psychiatry service during her admission in otorhinolaryngology, being diagnosed with Ekbom’s delirium and starting treatment with 3 mL of Aripiprazole. Subsequently she was referred to the mental health unit where she left the follow-up until today.
ConclusionsDifferent effective treatments have been described, among them pimozide, atypical antipsychotics and some SSRIs. However, the complexity of treatment arises when dealing with the irreducible idea that the patient has of being infested, refusing in most cases to receive psychiatric treatment. This can degenerate into major organic and psychological problems that turn the patient’s life into a real hell, which often end up losing much of their daily functionality. The fact of empathizing with the patient and trying to elaborate a plan adjusted to the reality and needs of the moment, can help us to establish a good therapeutic bond that facilitates an early start of treatment and greater therapeutic adherence, enabling a significant improvement in their quality of life.
Disclosure of InterestNone Declared
The winners project: neuropsycological changes after a video game-based training program in pediatric cancer survivors. a case report
- C. Gonzalez-Perez, E. Moran, N. Malpica, J. Alvarez-Linera, H. Melero, M. Alonso, M. Esteban, A. Perez-Martinez, E. Fernández-Jiménez
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S649
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Introduction
Children who have undergone an oncological process and have received treatment with chemotherapy or radiotherapy on the central nervous system may have significant neurocognitive sequelae. Some video games have shown neurocognitive benefits in people with impairments in different areas, such as attention or memory.
ObjectivesThis work aims to demonstrate the benefit of a video game-based training program to improve the neurocognitive profile in a child survivor of cancer.
MethodsThe patient is a 9-year-old female who was diagnosed with acute lymphoblastic leukemia at the age of 4 years. She received routine treatment of this disease by chemotherapy, including high-dose chemotherapy (with blood-brain barrier crossing) and intrathecal chemotherapy. She is currently 3 years after the end of treatment.
The Continuous Performance Test 3 (CPT-3) (sustained attention/vigilance) was administered before and after a multifaceted training program consisting of playing 3 video games for 12 weeks, as follows: a brain-training game (4 days per week, 7-12 minutes per day), a skill-training game (2 days per week, 10 minutes per day) and an exergaming game (2 days per week, 10 minutes per day).
ResultsPrior to intervention, the patient had 3 atypical z-scores on the CPT-3 (z scores: mean = 0, S.D. = 1), with a pattern compatible with ADHD (omissions z = 1.2; hit reaction time z = 3.4; hit reaction time block change z = 1.2). After intervention, she had only an atypical z-score (hit reaction time z = 3.6), with a pattern compatible with slowing, without ADHD.
ConclusionsThe neuropsychological evaluation of this patient showed an improvement in his attentional pattern on the CPT-3 after the video game-based training.
Disclosure of InterestNone Declared
Impulsivity: A Dimensional Perspective in PD and ED. Comparison of Results in a Case-Control Study.
- M. Pérez-Lombardo, Í. Alberdi-Páramo, W. Ayad-Ahmed, J. L. Carrasco-Perera, M. Díaz-Marsá
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S471
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Introduction
Personality Disorders (PD) - specifically Borderline Personality Disorder (BPD), and certain Eating Disorders (ED) share common clinical features. One of these features is impulsivity, studied individually in each diagnostic group, and scarcely used to encompass specific profiles of these patients.
Understanding the common clinical variables of this patient population would facilitate therapeutic efforts and enable greater precision regarding the prognosis of these patients.
ObjectivesThis study aims to study impulsivity in a group collectively formed by BPD and ED, compared to a control group, in contrast to the individualized study approach typically conducted in the literature.
MethodsA cross-sectional descriptive study is conducted to assess impulsivity as a common diagnostic variable in a group of PD and ED in comparison with a healthy control group. The sample was collected between 2016 and 2019 at the Hospital Clínico San Carlos, totaling 108 subjects.
ResultsA statistically significant difference is observed (p<0.005 in all scales) in total impulsivity, cognitive impulsivity, motor impulsivity, and unplanned impulsivity in the cases group comprising patients diagnosed with PD and ED, compared to the control group from the general population.
ConclusionsImpulsivity is closely related to the concept of borderline personality disorder. This analysis also includes eating disorders, with the difference from the control group still statistically significant.
The presence of common clinical variables in these groups (PD and ED) may have clinical and therapeutic implications that differ from those pursued thus far. This allows moving away from the categorical model and understanding these disorders from a more enriching and advanced dimensional perspective.”
Disclosure of InterestNone Declared
The study protocol of the winners project: a randomized and controlled trial using a videogame-based training program in pediatric cancer survivors
- C. Gonzalez-Perez, E. Moran, N. Malpica, J. Alvarez-Linera, H. Melero, M. Alonso, M. Esteban, E. Fernández-Jiménez, A. Perez-Martinez
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S648-S649
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Introduction
Childhood cancer survivors have neurocognitive sequelae that in most survivor follow-up programs are underdiagnosed and for which there is usually no treatment plan.
Video games have demonstrated various psychological and neurocognitive benefits in different subpopulations, such as patients with organic neurological deficits or children with ADHD. However, few studies have been carried out using video games-based interventions in the paediatric oncology population.
ObjectivesThe aim of this work is to present the WINNERS study protocol, the objectives of which are to diagnose the neurological and cognitive sequelae in child cancer survivors, and to demonstrate the benefit in these areas of a training program based on video games.
MethodsA randomized controlled and unblinded trial is presented. Fifty-six patients aged 8 to 17 years stratified into two age groups (8-12 and 13-17) who had received any of the following treatments 1 to 6 years before the enrolment will be selected: high-dose chemotherapy with blood-brain barrier crossing, intrathecal or intraventricular chemotherapy, CNS radiotherapy or hematopoietic stem cell transplantation.
A neuropsychological evaluation will be performed consisting of a battery of neuropsychological tests to assess parameters such as attention, memory, visuospatial ability or speed of response, as well as a neuroimaging evaluation by structural and functional magnetic resonance imaging. The evaluation will be repeated 3 months and 6 months after the enrolment. Patients will be randomized to a treatment group or to a recycled waiting group. Intervention will consist on a 12-week training at home using 3 video games: a brain training game, an exergaming game and a skill training game.
ResultsAccording to the hypotheses of this study, it is expected that the proposed program of videogame-based interventions will improve neurocognitive and other wellbeing parameters in the intervention group.
ConclusionsThis study aims to improve the quality of care for patients who have survived a cancer disease by detecting sequelae that have so far been poorly attended, and by proposing a gamification-based intervention program that is effective and attractive for this population.
Disclosure of InterestNone Declared
Suicidality and social cognition: the association between hypomentalizing and suicide lethality
- J. Andreo-Jover, K. March, E. Fernández-Jiménez, J. Fernandez Fernandez, A. Garcia Fernandez, M. P. Lopez Peña, M. Ruiz Veguilla, B. Crespo Facorro, N. Garrido Torres, A. Cebria, I. Grande, N. Roberto, W. Ayad-Ahmed, A. Pemau Gurumeta, A. Garcia Ramos, M. Diaz-Marsa, M. F. Bravo-Ortiz, A. Palao-Tarrero, V. Perez-Sola
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S183
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Introduction
Suicide attempts (SA) leading to highly lethal consequences have been associated with heightened suicide planning (Barker et al., 2022), along with deficits in social cognition (Levi-Belz et al., 2022). Hypomentalizing, characterized by excessive uncertainty regarding mental states, may contribute to heightened social withdrawal and an increased risk of SA (Nestor & Sutherland, 2022). Although certain studies have identified a connection between hypomentalizing profiles and self-harm (Badoud et al., 2015), research into the lethality of SA remains limited.
ObjectivesThis study aimed to explore the association between hypomentalizing and SA lethality.
MethodsOur study encompassed a cohort of 1,371 patients who committed a SA. We conducted assessments of mentalizing using the RFQ-8 instrument, and evaluations of suicidal ideation and behavior employing the CSRSS questionnaire. Demographic and clinical characteristics were compared using the T-student and Chi-square tests. To investigate the relationship between hypomentalizing and the SA lethality, we employed logistic regression models.
ResultsDescriptive date are presented in Table 1. Our results show that hypomentalizing do not predict a higher SA lethality. Additionally, hypomentalizing increased the risk of SA planning (p≤0.001, B=-0.182), and SA planning predicted a higher SA lethality (see Table 2).
Table 1. Means Comparison for low and high lethality (N=1371)
Low lethality N=539 High lethality N=832 p value Effect size Age, mean (SD) 38.65 (15.65) 41.91 (15.37) ≤0.001 -0.209a Female sex, N (%) 392 (72.7) 571 (68.6) 0.116 0.044b Educational years, mean (SD) 12.45 (2.99) 12.43 (3.41) 0.890 0.0076a Employed, N (%) 220 (41.2) 332 (40) 0.692 0.012b Suicide Ideation, N (%) 475 (88.1) 742 (89.2) 0.541 0.016b Suicide Planning, N (%) 159 (39.2) 400 (58.1) ≤0.001 0.183b Number of attempts, mean (SD) 3.28 (5.48) 3.63 (5.74) 0.269 -0.169a RFQ, mean (SD) 4.68 (1.27) 4.56 (1.32) 0.087 0.095a Table 2. Logistic regression analyses for high SA lethality (N=1371).
Univariate analysis Multivariate analysis OR p value OR p value Age 1.014 (1.007-1.021) ≤0.001 1.014 (1.005-1.022) 0.001 Female sex 0.820 (0.646-1.042) 0.105 Educational years 0.998 (0.965-1.031) 0.890 Employed 0.952 (0.763-1.187) 0.660 Suicide ideation 1.111 (0.790-1.562) 0.545 Suicide planning 2.150 (1.674-2.761) ≤0.001 2.183 (1.697-2.808) ≤0.001 Number SA 1.012 (0.990-1.034) 0.277 RFQ 0.929 (0.854-1.011) 0.088 ConclusionsWhile the association between hypomentalizing and high SA lethality was not significant, a discernible trend toward such relationship can be noted. Further studies examining the moderating effects of planning in the association between hypomentalizing and SA lethality are required.
Disclosure of InterestNone Declared
Hydroxychloroquine in systemic lupus erythematosus and psychosis. A case report
- M. Martínez Grimal, A. M. Morales Rivero, P. Rivero Rodríguez, E. E. Morales Castellano, N. Molina Pérez
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S748-S749
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Introduction
Hydroxychloroquine, an antimalarial drug, is an important therapeutic tool in the management of rheumatic diseases such as Systemic Lupus Erythematosus (SLE) due to its anti-inflammatory action. SLE is a chronic autoimmune inflammatory disease that affects the connective tissue of multiple organs. Neuropsychiatric disturbances in SLE are common; however, lupus psychosis is rare, occurring in 2 to 11% of patients. The literature has described the emergence of neuropsychiatric symptoms as an adverse effect of hydroxychloroquine use, with some patients experiencing clinical depression, anxiety, suicidal ideation, and psychotic symptoms.
ObjectivesThe aim of this work is to review the available evidence regarding neuropsychiatric symptoms secondary to the use of hydroxychloroquine.
MethodsThe case of a 50-year-old woman diagnosed with SLE, with no other relevant medical history, has been evaluated. She was brought to the emergency department due to paranoid and persecutory ideas, as well as self-referentiality, coinciding with the introduction of hydroxychloroquine in her treatment. She was admitted to the University Hospital of Gran Canaria Doctor Negrín with a diagnostic orientation of a first psychotic episode.
ResultsThe presence of neuropsychiatric symptoms in patients diagnosed with SLE is so common that they constitute a diagnostic criterion for the disease. On the other hand, the medications used for therapeutic management of this disease can lead to the emergence of new neuropsychiatric symptoms or exacerbate preexisting neuropsychiatric clinical manifestations.
ConclusionsThe study of this case highlights the challenges in establishing a differential diagnosis between primary SLE symptoms that require an increase in hydroxychloroquine and those caused by its own treatment. It underscores the need for further studies to explore the risk of psychiatric symptoms associated with the use of hydroxychloroquine, as well as its impact on the course of underlying mental disorders.
Disclosure of InterestNone Declared
Deaths of patients diagnosed with psychotic disorder due to SARS Cov-2 in Avilés, Spain
- M. A. Reyes Cortina, L. Pérez Gómez, L. Iglesias Fernández, R. Fernandez García, J. J. Martínez Jambrina
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S505
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Introduction
Psychotic patients are a vulnerable population from a social and health point of view. The SARS Cov-2 pandemic affected millions of people around the world, however, its effects on psychotic patients in Avilés Spain, have not been analized.
ObjectivesThe objective of this study was to determine and compare the mortality of patients with psychosis due to SARS Cov-2 in Avilés, Spain with others regions and countries in the European Union. Determine the influence of social condition and antipsychotic treatment on the condition of these patients.
MethodsThis is a descriptive, observational study, in which patients diagnosed with psychosis in the period 2020-2021 who contracted SARS Cov-2 infection in Avilés, Spain, were studied to determine those who died from this cause. The influence of social status and antipsychotic medication, as well as sociodemographic factors (age, sex, marital status) were analyzed and compared with other regions and countries of the European Union.
ResultsDespite the high mortality rate in patients with psychosis, during the years of the pandemic SARS Cov-2 played an important role given the vulnerability of these patients.
ConclusionsThe negative effects and deaths during the COVID-19 pandemic were at the time a major problem for public health worldwide. This study concluded that the morbidity and mortality of psychotic patients who contracted COVID-19 was lower than the rest of the population.
Disclosure of InterestNone Declared
Transcranial Magnetic Stimulation and its Efficacy in Alleviating Depressive Symptoms in Patients with Suicidal Ideation
- A. Moleon, M. Martín-Bejarano, P. Alvarez de Toledo, I. Perez, J. Narbona, M. García-Ferriol, R. Perea, J. M. Oropesa, J. Torres
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S181
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Introduction
Suicide is a global public health issue. According to the latest available data from the National Institute of Statistics, 4,003 people died by suicide in 2021, reaching a new historical high. Approximately 90% of suicide victims suffer from one or more severe psychiatric disorders, and there is a documented 20-fold higher risk of suicide in individuals with affective disorders compared to healthy subjects (Abdelnaim et al., 2020). Repetitive transcranial magnetic stimulation (rTMS) has been established as an effective alternative or complementary treatment option for patients with depressive disorders, but little is known about its effects on suicide risk.
ObjectivesTo assess the efficacy of rTMS in reducing depressive symptoms in patients with suicidal ideation and behaviors.
MethodsPopulation and Methods: A retrospective analysis was conducted on a sample of 28 psychiatric patients (23 females; mean age 49.36 ± 16.23) with suicidal ideation identified by item 3 (suicidality) of the Hamilton Depression Rating Scale (HDRS), who were treated with rTMS. All patients received a minimum of 30 sessions, consisting of the application of a high-frequency (>10Hz) or intermittent theta burst stimulation (TBS) over the left dorsolateral prefrontal cortex (DLPFC) at an intensity of 120% of the resting motor threshold (RMT), and repeated low-frequency pulses (1Hz) or continuous TBS over the right DLPFC with an intensity of 110% of the RMT.
ResultsResults: The results show a statistically significant improvement in depressive symptoms following rTMS intervention (p < 0.001). Furthermore, remission was observed in 46% of the sample (HDRS < 8).
ConclusionsDiscussion: In line with recent studies (Abdelnaim et al., 2020; Hines et al., 2022) and systematic reviews (Cui et al., 2022; Bozzay et al., 2020) on suicidal ideation in the context of psychiatric disorders, the findings of this study demonstrated that rTMS achieved satisfactory results in reducing depressive symptoms and suicidal ideation.
Conclusions: This clinical study indicates preliminary promise for the prevention of suicidal acts and underscores the need for more detailed and specific research on rTMS in the field of suicide.
Keywords: rTMS, neuromodulation, depression, suicide.
Disclosure of InterestNone Declared
Grading of Recommendations of psychological interventions in the rehabilitation of patients with schizophrenia
- R. Vazquez-Noguerol Mendez, S. Garcia Pineiro, P. G. S. Perez, M. Puime Miguez, C. Cinos Galan, M. J. Veiga Candan, M. Suarez Baldomir, M. Soriano Garcia
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S741
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Introduction
As part of the intervention, patients with severe schizophrenia who are cared for in psychiatric rehabilitation units need psychological treatments. However, there is great variability within the psychotherapy alternatives that are proposed for rehabilitation in schizophrenia, and it is necessary to know which are the most efficient interventions in order to prioritize their inclusion in intervention programs.
ObjectivesTo know the level of evidence of the existing psychotherapy alternatives for the rehabilitation treatment in schizophrenia through the systematic review of recently published studies.
MethodsConsecutive systematic searches in the scientific literature were used in a sensitive and specific way, aimed at identifying the existence of documents in databases and clinical practice guidelines based on evidence of psychological treatment in schizophrenia. Psychosocial and social approaches and family members interventions were excluded, and the search was limited to the last 5 years. The PICO format has been used, and a subsequent critical reading using the AGREE II tool, considering the inclusion criteria of presenting a score >60% in 4 domains.
ResultsThe following interventions have been found to be therapeutically effective: Level 1B (Early intervention in Psychosis; Patient and Family psychoeducational intervention; Basic ando social skills training; Social cognition and Metakognition training; Cognitive Remediation; Cognitive Behavioral Individual Therapy; Assertive Community treatment; Supported employment). Level 2B (Family Problem Solving Therapy, Dynamic Psychotherapy; Cognitive Behavioral Group Therapy); Level 2C (Horticultural, Art, Music, Animals Therapies).
ConclusionsSeveral psychotherapy alternatives are proposed for rehabilitation in schizophrenia, with known level of evidenca in order to prioritize their inclusion in intervention programs.
Disclosure of InterestNone Declared
The deaths of invisible people. A literature review
- M. I. Santana Ortiz, N. Molina Pérez, J. Pereira López
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S787
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Introduction
Suicide is a serious public health problem. Each year it is estimated that it causes almost one million deaths worldwide, much more than those caused by war or homicide. These deaths are also devastating, affecting not only the person who commits them, but also his or her environment (family, friends, professionals involved, etc.) and society as a whole. The risk and protective factors for suicide are well known in the literature, which gives rise to the estimation of possible high-risk groups according to their characteristics, especially when risk factors are added, protective factors are reduced, and unfavorable life circumstances are present. Among these groups with greater vulnerability to suicidal behavior are homeless people with severe mental disorders, who are unfortunately little visible in society and in the investigation.
ObjectivesThe aim of this paper is to review the current state of the question of suicide in homeless people with severe mental disorders.
MethodsReview of the international scientific literature on the issue published in the last twenty years.
ResultsThe few studies available conclude the higher prevalence of suicidal behavior in homeless people with severe mental disorders compared to the general population, which has not been translated into the development of specific care and prevention plans and programs.
ConclusionsIt is considered essential to expand investigation in this field, which will be very useful to lay the foundations for the development of guidelines, plans and specific programs, and to know the evidence about them.
Disclosure of InterestNone Declared
Sodium Oxybate-Induced secondary mania with psychotic symptoms: a case report and literature review
- C. Cárdenes Moreno, S. Yelmo-Cruz, I. Pérez Sagaseta de Ilurdoz, J. J. Tascón-Cervera, G. P. González-Rodríguez, M. Gallego-Restrepo
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S693
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Introduction
Sodium oxybate, an effective treatment for narcolepsy-associated daytime sleepiness and cataplexy, has been extensively. Despite its therapeutic benefits, sodium oxybate is not without its risks, and adverse psychiatric effects have been documented. This case report highlights a rare manifestation of sodium oxybate-related secondary mania with psychotic symptoms in a patient with narcolepsy, emphasizing the importance of recognizing and managing such adverse events. Additionally, we provide a brief review of similar cases reported in the literature.
ObjectivesThis report aims to describe the presentation, evaluation, and management of sodium oxybate-induced secondary mania with psychotic symptoms in a patient with narcolepsy. We also discuss the potential mechanisms underlying this adverse reaction and its clinical implications. Furthermore, we summarize findings from previous studies that have reported cases of secondary mania associated with sodium oxybate use.
MethodsWe present the case of Mr. X, a 48-year-old male diagnosed with “Narcolepsy with cataplexy,” who had been receiving sodium oxybate treatment for 11 years. He was admitted to the hospital following a mild head injury and the emergence of a manic episode with psychotic features. Comprehensive clinical evaluation, including medical history, toxicology screening, and neuroimaging, was conducted.
ResultsUpon evaluation, Mr. X exhibited hyperactivity, restlessnes, grandiose delusions, paranoid delusions related to hospital staff, and decreased need for sleep. Notably, he had been consuming sodium oxybate excessively. Sodium oxybate was discontinued, and low-dose olanzapine was initiated. Within 24 hours, his manic and psychotic symptoms resolved. He admitted to overusing his medication, and his family reported a recent increase in his activity level. A review of the literature revealed similar cases of sodium oxybate-induced secondary mania with psychotic symptoms.
ConclusionsThis case underscores the importance of vigilance for psychiatric side effects of sodium oxybate, particularly in patients with a history of substance abuse or potential overuse. Secondary mania associated with medications is a rare but significant clinical entity. Prompt recognition and intervention are crucial for patient safety and well-being. Further research is needed to elucidate the mechanisms underlying such reactions and to establish guidelines for their prevention and management.
Disclosure of InterestNone Declared
Gender diversity and autism spectrum disorder in child and youth population
- P. R. Rodríguez, M. M. Grimal, E. E. M. Castellano, F. A. R. Batista, N. M. Pérez
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S465
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Introduction
Interest in the co-occurrence of gender dysphoria and autism spectrum disorder has gained prominence in recent years. Gender dysphoria refers to the distress experienced when there is an incongruence between gender identity and sex assigned at birth. On the other hand, autism spectrum disorder is characterized by difficulties in communication and social interaction, as well as restrictive and repetitive patterns of behavior.
ObjectivesThe aim of this paper is to review the current available literature in order to expand our knowledge about gender identity and dysphoria in the population with autism spectrum disorder.
MethodsA qualitative review was conducted over the last 20 years, using the Medline database through PubMed. Combinations of MeSH terms related to gender identity and people with autism spectrum disorder were used, selecting those studies in English, French or Spanish that met the objectives of the review, excluding references in other languages. The scientific evidence obtained was analyzed and synthesized.
ResultsThe development of gender identity of people with autism spectrum disorder can be a complex process. Comparing the general population with the population with autism spectrum disorder, a higher prevalence of gender dysphoria has been evidenced in the population with autism spectrum disorder, and within this group when segmented by gender, greater in women than in men.
ConclusionsThis review highlights the importance of increasing knowledge about sexuality and gender dysphoria in people with autism spectrum disorder in order to facilitate the development, understanding and acceptance of their gender identity and sexual orientation of these people.
Disclosure of InterestNone Declared
Spiritual awakening. Substance abuse, dual pathology
- M. J. Gordillo Montaño, L. Rodriguez Rodriguez, C. Pérez Aparicio, S. V. Boned Torres
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S488
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Introduction
Kambó is considered an “ancestral medicine” by the indigenous tribes of the western region of the Amazon.
ObjectivesThrough this clinical case, the aim is to present the particularities of the symptoms and management of patients with consumption of not so common substances, such as Kambo or salvia divinorum, as well as the evolution that will occur in a patient with a previous diagnosis of a Depressive Episode.
MethodsWe present the case of a 23-year-old male, Gestalt therapy student. History of tobacco, THC, and recent use of salvia divinorum and Kambo. He began follow-up by psychiatry in a private setting three years ago due to a severe depressive episode, having required treatment with antidepressants, antipsychotics and benzodiazepines, and having been triggered by a serious assault. The episode is resolved and follow-up is discontinued. Family history of depressive syndrome and suicide.
He resumed contact through the Emergency Department, requiring hospital admission due to symptoms compatible with a manic episode with psychotic symptoms. It begins with behavioral alterations and global insomnia that are related to the consumption of some substance, initially unknown to them, making the skin lesions they presented suspect the consumption of kambo.
ResultsWe assess the risk of consuming these substances, which are sometimes used as alternative therapies, and especially in this type of patient, who is more vulnerable and perhaps seeks a way out of the problems they present.
ConclusionsIn our case, it triggered a manic episode with psychotic symptoms, which consisted of delusional ideation of mystical content accompanied by auditory hallucinations. The episode took about a month to subside, despite treatment. Subsequently, there have been more episodes with similar characteristics, and they have not been associated with the consumption of kambó, but have been linked to the consumption of “natural medicinal substances.”
Disclosure of InterestNone Declared