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A spark of genius and a flash of madness: Nikola Tesla and his struggles with mental illness
- S. Jesus Magueta, A. L. Costa, G. Simões, A. I. Gomes, C. Madaíl Grego, P. Garrido
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S320
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Introduction
An example of the unification of the contrast between artistic creativity and discipline of science, Nikola Tesla engineer and physicist, was also a prolific inventor that contributed to the transformation of modern society. Having resurfaced in the mainstream culture as a mythical figure, he appears to be enjoying a renaissance of posthumous recognition and praise. Throughaccounts available directly from his autobiography and descriptions offered by those who worked with him, the existence of the inventor´s eccentricities appear to reveal the existence of mental health disorder.
ObjectivesThe authors explore Tesla and the psychopathology that accompanied him throughout his periods of brilliance and as well as hardship.
MethodsThe authors conducted a brief non-structured narrative literature review. The keywords used during the research, alone or in combination, included: Nikola Tesla, psychopathology and mental illness. The works consulted included: news articles, autobiographies and biographies. Of these, those that were written in the English language and deemed most pertinent to the explored theme were chosen for review in this work.
ResultsThe popular image of the mad scientist, which describes a brilliant but solitary and eccentric individual focused on their work is one that could be applied to Tesla. Documents reveal that he suffered a nervous breakdown, as well as having symptoms that point to a probably presence of obsessive-compulsive disorder, of which included counting and cleanliness rituals, exacerbated by chronic insomnia.
ConclusionsThere appears to be anecdotal evidence pointing to an eventual relationship between creative genius and mental pathology. Although not formally evidenced through the scientific literature, exploring the life and accomplishments of Tesla serve as a significant example of a spark of genius perhaps ignited by mental illness. Tesla demonstrated suffering associated with his symptoms especially when considering the end of his life. At the time, adequate mental health interventions and treatments were not widely available, with his diagnosis probably being considered the quirks of genius and not the symptoms of disease.
Disclosure of InterestNone Declared
Understanding the Occurrence of Psychiatric Disorders in Epilepsy in Brazil: An Epidemiological Investigation
- L. Bardini Goulart, A. Roloff Krüger, G. Moreno Xavier, G. Fiorio Grando, J. Michelon, L. F. Alves Nascimento, J. Adames, A. T. Konzen, G. Pereira Bernd, C. Fontes Augusto, H. Wolmeister, I. Fachinetto Thoen, Y. de França, P. H. Filipin Von Muhlen, F. J. Carvalho da Costa, V. Kayser, P. H. Paesi Dutra, R. Rahal de Albuquerque, T. Garcia Furtado, G. Macelaro, A. C. Castelo, H. Vieira Rodrigues, E. Rockenbach Fidélis, D. Crusius, E. Guidugli, M. F. Valentim de Paula, Y. Marques Loureiro, E. Paiva Borsa, L. de Paula e Souza, G. Ferreira Cruz
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S98
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Introduction
Epilepsy is one of the most common serious brain illness, with symptoms influenced by multiple risk factors and a strong genetic predisposition, rather than having a single expression and cause¹. Neuropsychiatric symptoms in epilepsy can encompass manifestations such as mood alterations, anxiety, sleep disturbances, psychosis, and behavioral disorders. While the motor and sensory manifestations of epileptic seizures are widely recognized, neuropsychiatric symptoms accompanying epilepsy are often underestimated. Therefore, it is essential to understand the most prevalent epidemiological profile of these patients to improve the diagnosis and management of these symptoms.
ObjectivesOur goal was to evaluate the neuropsychiatric behavior of epilepsy patients in Brazilian over the past 3 years through hospitalization data in order to outline an epidemiological and behavioral profile.
MethodsA cross-sectional, descriptive, retrospective, and quantitative study was conducted on hospitalizations of individuals simultaneously diagnosed with epilepsy, schizotypal and delusional disorders, and mood disorders in all five regions of Brazil (South, Southeast, Midwest, North, and Northeast) between February 2020 and December 2022. Data from January 2020 were not available. The data used were collected through the Department of Health Informatics of the Brazilian Unified Health System (DATASUS) in the “Hospital Information System of SUS” section, gathering information regarding the nature of care, age range, gender, and ethnicity of the patients.
ResultsThe analysis covers the years 2020 to 2022, totaling 503,045 hospitalizations. In 2022, the highest number of cases occurred (≈ 37.55%), followed by 2021 (≈ 33.62%) and 2020 (≈ 28.81%). Urgent hospitalizations represented ≈ 90.85% of the total. The most affected age group was 30 to 39 years old (≈ 18.30%). Men were more affected than women (≈ 52.03% and ≈ 47.96%, respectively), and Caucasians accounted for ≈ 36.07% of the hospitalizations. The average length of stay was 19.1 days, and the mortality rate was 1.4%.
ConclusionsThus, there is a gradual and annual increase in the number of hospitalizations during the observed period. While there is a minimal disparity between the affected genders, it is evident that the profile of male, caucasian, and adult patients is the most prevalent. Moreover, the predominantly urgent nature of hospitalizations points to an alarming scenario regarding this issue. From the analysis of the data obtained in the study, there is a clear need for interventions capable of reducing the prevalence of hospitalizations for neuropsychiatric symptoms in epilepsy patients in Brazil.
Disclosure of InterestNone Declared
Mental and Behavioral Disorders Associated with the Use of Psychoactive Substances and Alcohol: An Epidemiological Analysis in Southern Brazil
- L. Bardini, A. Roloff Krüger, G. Moreno Xavier, G. Fiorio Grando, J. Michelon, L. F. Alves Nascimento, J. Adames, A. T. Konzen, G. Pereira Bernd, C. Fontes Augusto, H. Wolmeister, I. Fachinetto Thoen, Y. de França, P. H. Filipin Von Muhlen, F. J. Carvalho da Costa, V. Kayser, P. H. Paesi Dutra, R. Rahal de Albuquerque, T. Garcia Furtado, G. Macelaro, A. C. Castelo, H. Vieira Rodrigues, E. Rockenbach Fidélis, D. Crusius, E. Guidugli, M. F. Valentim de Paula, Y. Marques Loureiro, E. Paiva Borsa, L. de Paula e Souza, G. Ferreira Cruz
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S831
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Introduction
Neuropsychiatric disorders are the leading cause of disability worldwide, as seen in cases such as depression, anxiety, bipolar mood disorder and schizophrenia, which can be developed or exacerbated by the use of psychoactive substances. Most mental disorders have an early onset, often leading to early and/or permanent disability, increasing the need and cost of healthcare. Therefore, it is necessary to improve the identification of the epidemiological profile of these cases in the South of Brazil in order to enhance the diagnosis and reduce the costs associated with managing these disorders.
ObjectivesThe present study aimed to analyze statistical data regarding hospitalizations related to mental disorders caused by the use of psychoactive substances and alcohol in the southern region of Brazil, highlighting the pathological scenario and identifying the most prevalent profiles of these disorders in this region.
MethodsA cross-sectional, descriptive, retrospective, and quantitative study was conducted on hospitalizations of individuals diagnosed with mental and behavioral disorders due to the use of psychoactive substances and alcohol in the states of the Southern region of Brazil (Paraná, Santa Catarina, and Rio Grande do Sul) between February 2020 and December 2022. Data of January 2020 were not available. The data used were collected through the Department of Health Informatics of the Brazilian Unified Health System (DATASUS) in the “Hospital Information System of SUS” section, gathering information regarding the nature of the care, age range, gender, and ethnicity of the patients.
ResultsThe study covers the years 2020 to 2022, indicating a total of 81,608 hospitalizations, with the year 2022 having the highest number of cases (≈ 37.13%), followed by 2021 (≈ 33.30%) and 2020 (≈ 29.55%). The states with the highest number of hospitalizations were Rio Grande do Sul (≈ 54.90%), Paraná (≈ 29.29%), and Santa Catarina (≈ 15.79%). Urgent hospitalizations accounted for ≈ 87.29% of the total. The most affected age group was 30 to 39 years old (≈ 25.61%). Men were more affected than women (≈ 81.70% and ≈ 18.28%, respectively). Caucasians accounted for ≈ 64.29% of the hospitalizations. The average length of stay was 20.8 days, and the mortality rate was 0.32%.
ConclusionsThere is a clear increase in the number of hospitalizations related to mental disorders caused by the use of psychoactive substances in the period from 2020 to 2022 in the southern region of Brazil, with the highest number of cases in the state of Rio Grande do Sul. The most affected population consisted of Caucasian men aged 30 to 39 years old. Furthermore, these results may be related to the increasing trend of psychoactive substance use among the Brazilian population and also the COVID-19 pandemic, which led to a period of underreporting due to social isolation.
Disclosure of InterestNone Declared
Hormones and Psychosis: The Role of Estrogen in Schizophrenia
- S. Jesus Magueta, A. L. Costa, G. Simões, A. I. Gomes, C. Madaíl Grego, P. Garrido
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S175-S176
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Introduction
Schizophrenia is a complex psychiatric disorder in which biological sex differences, have been extensively documented and researched. What is less well described, is what motivates these differences. Of the various proposed and explored reasons, estrogen appears to be one that has maintained some interest and promise. An increase in symptoms of schizophrenia has been observed to correspond with decreasing levels of estrogen in menopausal women, this, allied to the later symptom onset, culminated in the interest in this hormone and its role in psychotic illness.
ObjectivesThe authors aim to briefly explore the current evidence on the association between estrogen and schizophrenia. Its relevance in symptom onset, protective status and eventual therapeutic applications will also be discussed.
MethodsThe authors conducted a brief non-structured narrative literature review using articles published in the Medline/Pubmed, ScienceDirect and Google Scholar databases. The keywords used during the research, alone or in combination, included: sex hormones, estrogen, schizophrenia and psychiatry.The studies consulted in this work included: cross-sectional studies, cohort studies, literature reviews and clinical case reports.
ResultsThe literature exploring the relationship between the sex hormone, estrogen, and schizophrenia is extensive. Various studies confirm that during periods of estrogen withdrawal, women appear more susceptible to psychotic episodes. Results also demonstred that those with low estrogen, respond poorly to anti-psychotic drugs, whereas estrogen increased the efficiency of antipsychotics. In regards to symptoms, estrogen has been demonstrated to reduce the positive and cognitive symptoms of schizophrenia in the short term, thus being proposed as an eventual complementary treatment in those suffering from the disorder. It is known that estrogen regulates important pathophysiological pathways in schizophrenia, including dopamine activity, mitochondrial function, and the stress system.One of the explanations for this beneficial effect has been proposed to be action on cerebral blood flow and glucoce metabilism, as well as sensitizing postsynaptic dopamine receptors, thus serving as a protective agent against schizophrenia.
ConclusionsThe research appears to be pointing in the direction that estrogen appears to have an effect on psychosis in women, serving as a protective factor in these conditions as well as playing a significant part of the pathophysiology in schizophrenia. This influence on the pathophysiology, promises clinical pertinence, not only in a possible application so to attenuate positive and cognitive symptoms but also as a method to influence antipsychotic efficacy. Continued study in regards to the effects of sex hormones on the psychotic disorders is merited so as to further expand the tools in the mental health professional’s repertoire in the treatment of these serious mental illnesses.
Disclosure of InterestNone Declared
SCHIZOPHRENIC DREAMS: A Brief Description of Sleep Disturbances in Schizophrenia
- S. Jesus Magueta, A. L. Costa, G. Simões, A. I. Gomes, C. Madaíl Grego, P. Garrido
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S774
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Introduction
Shakespeare wrote that “We are such stuff as dreams are made on; and our little life is rounded with a sleep.” Sleep is a fundamental part of our being, so much so, humans tend to spend one third of their lives in this immobile and vulnerable state. Disorders of sleep have been the target of much scientific curiosity and investigation, with inumerous articles, reports and books dedicated to the theme. The bidirectional relationship between psychiatric disorders and those of sleep is also well described. Schizophrenia is a heterogenous psychiatric disorder which is often associated with sleep disturbances of various kinds.
ObjectivesThe authors aim to briefly explore the relationship between schizophrenia and sleep disturbances. Potential underlying mechanisms and risk factors, as well as therapeutic interventions will be addressed.
MethodsThe authors conducted a brief non-structured narrative literature review using articles published in the Medline/Pubmed, ScienceDirect and Google Scholar databases. The keywords used during the research, alone or in combination, included: sleep disturbance, sleep disorder and schizophrenia.The studies consulted in this work included: cross-sectional studies, cohort studies, literature reviews and clinical case reports. Works that were included, were written in the English language and deemed as pertinent to the explored theme.
ResultsAlthough sleep disturbances do not make up part of the criteria formal diagnosis of schizophrenia, they are present in approximately 80% of those with the condition and have been identified as a common symptom in prodromic clinical pictures. The problems in sleep are as heterogenous as the presentations in schizophrenia, ranging from insomnia, restless legs syndrome, obstructuve sleep apnea, circadian rhythm disfunctions to hypersomnia. Sleep has been identified as fundamental for the reparation and restoration of various bodily systems, it is no surprise that sleep irregularities, especially in schizophrenia, can significantly reduce quality of life and promote deterioration. Some studies have stated the role that D2 receptors have in the classic symptoms of schizophrenia as well as on sleep disturbances. Second-generations antipsychotics have not only demonstrated much promise on psychotic symptoms, but they appear to aid in sleep regulation and quality.
ConclusionsSleep is fundamental for mental health. Various sleep disturbances have been identified in those suffering with schizophrenia. Slepe disturbances have been associated with worse outcomes, more florid clinical pictures and significant deterioration. Thus, bettering sleep quality in these patients, would permit better health outcomes which are fundamental in those who live with schizophrenia.
Disclosure of InterestNone Declared
Epidemiological analysis of hospitalizations for Schizophrenia, Schizotypal Disorders and Delirium in Rio Grande do Sul over the last 5 years
- L. Bardini, A. Roloff Krüger, G. Moreno Xavier, G. Fiorio Grando, J. Michelon, L. F. Alves Nascimento, J. Adames, A. T. Konzen, G. Pereira Bernd, C. Fontes Augusto, H. Wolmeister, I. Fachinetto Thoen, Y. de França, P. H. Filipin Von Muhlen, F. J. Carvalho da Costa, V. Kayser, P. H. Paesi Dutra, R. Rahal de Albuquerque, T. Garcia Furtado, G. Macelaro, A. C. Castelo, H. Vieira Rodrigues, E. Rockenbach Fidélis, D. Crusius, E. Guidugli, M. F. Valentim de Paula, Y. Marques Loureiro, E. Paiva Borsa, L. de Paula e Souza, G. Ferreira Cruz
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S390-S391
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Introduction
In recent years, mental health has gained prominence in public health, prompting thorough investigations into psychiatric condition trends. This study conducts a comprehensive epidemiological analysis of hospitalizations for Schizophrenia, Schizotypal, and Delirium Disorders in Rio Grande do Sul (RS) over the past five years. By revealing these patterns, it enhances our understanding of regional mental health dynamics and offers insights for intervention strategies, resource planning, and improved mental healthcare. The ultimate goal is to advance more effective and accessible mental healthcare in RS and beyond.
ObjectivesThis study aims to analyze the prevalence and epidemiological profile of hospitalizations due to psychiatric disorders to assist in the diagnosis and outcome of affected patients.
MethodsA cross-sectional, descriptive, retrospective, and quantitative study was conducted regarding hospitalizations for Schizophrenia, Schizotypal Disorders, and Delirium in the state of RS between January 2018 and November 2022. Data were collected from the Department of Informatics of the Brazilian Unified Health System (DATASUS) in the “Hospital Information System of SUS” section, focusing on the nature of care, age group, gender, and ethnicity of the patients. The information was aggregated over the five-year period based on the four mentioned descriptors and subsequently analyzed to establish a profile of hospitalizations during that period.
ResultsThe analysis spans from 2018 to 2022, encompassing a total of 28,345 hospitalizations. In 2019, there was the highest number of cases (22.21%), followed by 2018 (21.08%). Urgent care admissions constituted 85.34% of the total. The age group most affected was 35 to 39 years (11.8%). Men were more affected than women (60.18%), and the majority of hospitalizations were among the Caucasian ethnicity (75.12%). The average length of stay was 23.7 days, and the mortality rate stood at 0.26%.
ConclusionsThe increasing trend in hospitalizations, peaking in 2019, highlights the need for preventive measures. Urgent admissions (85.34%) underscore the demand for accessible mental health resources. Men in the 35 to 39 age group are disproportionately affected, suggesting specific risk factors. The predominance of Caucasian ethnicity emphasizes the need for culturally sensitive care. A longer average length of stay (23.7 days) underscores treatment complexity, while a low mortality rate (0.26%) signals effective medical care. In essence, these findings inform tailored mental health policies to enhance service quality and prioritize patient-centered approaches.
Disclosure of InterestNone Declared
An ethical dilemma: the role of the psychiatrist in physician assisted suicide and/or euthanasia
- S. Jesus Magueta, A. L. Costa, G. Simões, A. I. Gomes, C. Madaíl Grego, P. Garrido
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S575-S576
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Introduction
Questions regarding death have generated debates and art since the dawn of civilization. These themes permeate through various areas of study, including religion, philosophy, ethics, medicine and humanities. Various countries have been revising their laws regarding the end of life, especially on the right to aid and choice in the end in the context of medical and phychological suffering. Physician-Assisted Suicide (PAS) and euthanasia are methods by which people, mostly terminal patients, seek to end their lives with the help of medical professionals. PAS and euthanasia have been the target of heated debates in politics and in medicine, with the question of ethics centering most of these.
ObjectivesThe authors aim to explore PAS and euthanasia in the context of the ethical debate. Based on the pillars of ethics, based on the principal of do no harm and beneficence, the authors explore the role of the Psychiatrist, if any, in these end of life issues.
MethodsThe authors performed a brief narrative review of the available literature, with recourse to various databases such as PubMed and Scopus. The search terms utilized in isolation or combination included: physician assisted suicide, euthanasia, psychiatry, mental illness and ethical issues. Taking into consideration the widespread discussion of these themes in the public forum, news articles were included based on their merit and relevance to the explored topic.
ResultsThe ethical debate appears to rest between the pillars of first, do no harm, the principles of beneficence and nonmaleficence and aut. Here, the conflict between the first and last appear, where the killing of any patient, whether directly or indirectly is clearly contrary to the principle of primum non nocere. However, the prolonging of suffering in a terminal patient, appears to contradict the principles of nonmaleficence. The Psychiatrist is called to evaluate competence to choose, which is allied to autonomy. Other sources explore the role of the Psychiatrist in permitting a suicide to occur, when the profession is dedicated to the prevention of suicide. From the literature, the psychiatric evaluation is rarely regularly carried out, usually being solicited in cases where mental illness which might compromise the capacity to choose is suspected.
ConclusionsIn ethical debates, clear cut answers are rarely every developed, with the nuance and greyscale of difficult topics usually dividing those that ferverantly champion each cause. Psychiatric evaluation is usually invoked when patient autonomy, especially in terms of capacity, is called into question. Questions remain as to whether the presence of the psychiatrist should be a regular one in these procedures or if it should be carried out in a selective manner. There is little consensus in regards to this role, which merits further conversation in the various forums of medical and ethical communication.
Disclosure of InterestNone Declared
Spatially evolving cascades in wall turbulence with and without interface
- A. Cimarelli, G. Boga, A. Pavan, P. Costa, E. Stalio
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- Journal of Fluid Mechanics / Volume 987 / 25 May 2024
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- 13 May 2024, A4
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Direct numerical simulations of channel flow and temporal boundary layer at a Reynolds number $Re_{\tau } = 1500$ are used to assess the scale-by-scale mechanisms of wall turbulence. From the peak of turbulence production embedded at the small scales of the near-wall region, spatially ascending reverse cascades are generated that move through self-similar eddies growing in size with the wall distance. These fluxes are followed by spatially ascending forward cascades through detached eddies thus reaching sufficiently small scales where eventually scale energy is dissipated. This phenomenology is shared by both boundary layer and channel flow and is recognized as a robust physical feature characterizing wall turbulence in general. Specific features related to the flow configuration are indeed identified in the outer region. In particular, the central region of channels is characterized by a generalized Richardson energy cascade where large scales are in equilibrium with small scales at different wall distances through a combined forward cascade and spatial flux. On the contrary, the interface region of boundary layers is characterized by an almost two-dimensional physics where spatially ascending reverse cascades sustain long and wide interface structures with a forward cascade that survives only in the wall-normal scales. The overall scenario consists in a variety of scale motions that while protruding from the turbulent core towards the external region, squeeze at the interface thus sustaining vertical shear in a thin layer. The observed multidimensional physics sheds light on the complex interactions between outer entrainment and near-wall self-sustaining mechanisms with possible repercussions for theories.
Influence of Nonstoichiometry and the Presence of Maghemite on the Mössbauer Spectrum of Magnetite
- G. M. da Costa, E. de Grave, P. M. A. De Bakker, R. E. Vandenberghe
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- Clays and Clay Minerals / Volume 43 / Issue 6 / December 1995
- Published online by Cambridge University Press:
- 28 February 2024, pp. 656-668
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Several samples of large- and small-particle magnetite (Fe3O4), as well as its thermal decomposition products formed at different temperatures and atmospheres, have been studied extensively by Mössbauer spectroscopy (MS), both with and without an applied field of 6T. Synthetic mixtures of magnetite and poorly- or well-crystallized maghemite have also been studied. Large-particle magnetite (MCD > 200 nm), when heated in air for 12 hours at T < 400°C, transforms to a mixture of well-crystallized hematite and magnetite, the latter one remaining stoichiometric, according to the relative area-ratios obtained from MS. Thermal treatment at 1300°C in a controlled O2 partial pressure, produced a mixture of stoichiometric and nonstoichiometric magnetite, but the latter component seems to be composed of particles with different degrees of nonstoichiometry. The Mössbauer spectra of the decomposition products at T < 200°C in air of small-particle magnetite (MCD ~ 80 nm) could be successfully interpreted as a mixture of magnetite and maghemite, rather than nonstoichiometric magnetite. This suggestion is further supported by the experiments with the synthetic mixtures. It is clearly demonstrated that is not possible, even by applying a strong external field, to separate the contribution of the A-site of magnetite from that of maghemite.
The Center Shift in Mössbauer Spectra of Maghemite and Aluminum Maghemites
- G. M. Da Costa, E. De Grave, L. H. Bowen, R. E. Vandenberghe, P. M. A. De Bakker
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- Clays and Clay Minerals / Volume 42 / Issue 5 / October 1994
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- 28 February 2024, pp. 628-633
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Synthetic, relatively well-crystallized aluminum-substituted maghemite samples, γ-(Aly·Fe1−y)2O3, with y = 0, 0.032, 0.058, 0.084, 0.106 and 0.151 have been studied by X-ray diffraction and zero-field Mössbauer spectroscopy in the range 8 K to 475 K, and also with an external field of 60 kOe at 4.2 K and 275 K. It was found that there are two different converging models for fitting the zero-field spectra of the maghemites with a superposition of two Lorentzian-shaped sextets, both resulting in inconsistent values for the hyperfine fields (Hhf) and/or the center shifts (δ) of the tetrahedral (A) and octahedral (B) ferric ions. From the applied-field measurements it is concluded that there is a constant difference of 0.12 ± 0.01 mm/s between δB and δA, regardless of the Al content. For the Al-free sample the center shifts are found as: δA = 0.370 mm/s and δB = 0.491 mm/s at 4.2 K and δA = 0.233 mm/s and δB = 0.357 mm/s at 275 K (relative to metallic iron), with an estimated error of 0.005 mm/s. Both δA and δB are observed to decrease with increasing Al concentration. The effective hyperfine fields for the non-substituted maghemite sample are: Heff,A = 575 kOe and Heff,B = 471 kOe at 4.2 K and Heff,A = 562 kOe and Heff,B = 449 kOe at 275 K, with an error of 1 kOe. The B-site hyperfine field remains approximately constant with Al substitution, while for the A site a slight decrease with increasing Al content was observed.
Variable-Temperature Mössbauer Spectroscopy of Nano-Sized Maghemite and Al-Substituted Maghemites
- G. M. Da Costa, E. De Grave, L. H. Bowen, P. M. A. De Barker, R. E. Vandenberghe
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- Clays and Clay Minerals / Volume 43 / Issue 5 / October 1995
- Published online by Cambridge University Press:
- 28 February 2024, pp. 562-568
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Synthetic aluminum-substituted maghemite samples, γ-(Fe1-xAlx)2O3, have been prepared by thermal decomposition of Al-lepidocrocite (γ-Fe1-xAlxOOH), with × = 0, 0.04, 0.06, 0.14 and 0.18. The particles are needle-shaped and the mean crystallite diameter along the [311] crystallographic direction was found to be between 2.0 and 5.0 nm. Mössbauer spectra were collected at 6 K and from 80 K up to 475 K at steps of 25 K. In a wide range of temperatures the spectra of the non-substituted sample consist of a superposition of a broad sextet and a superparamagnetic doublet, whereas for the Al-maghemites this range is much smaller. From the temperature variation of the fractional doublet area two different parameters were defined: the temperature corresponding to a 50/50 doublet-sextet spectrum (T1/2), and the temperature below which the doublet ceases to exist (T0). These two parameters (T1/2 and T0) decrease from 390 K and 92 K (Al-free sample), to 118 K and 64 K (4 mole % Al) and to 100 K and 48 K (18 mole % Al), respectively. The average hyperfine fields at 6 K undergo a steep drop in going from the Al-free sample (Hhf = 506 kOe) to the sample with 4 mole % Al (Hhf = 498 kOe), but for higher substitutions the effect is much smaller. The A- and B-site quadrupole splittings, obtained from the data between 220 K and 475 K, were found as: ΔEQ,A = 0.86 ± 0.04 mm/s and ΔEQ,B = 0.65 ± 0.04 mm/s for the 4 mole % Al sample. The characteristic Mössbauer temperature, determined from the temperature dependence of the average isomer shift, was found to be in the range of 500–600 K.
Water use efficiency and yield responses of Cenchrus purpureus genotypes under irrigation
- R. E. P. Ribeiro, A. C. L. Mello, M. V. Cunha, M. V. F. Santos, S. B. M. Costa, J. J. Coelho, R. O. Carvalho, V. J. Silva
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- The Journal of Agricultural Science / Volume 161 / Issue 4 / August 2023
- Published online by Cambridge University Press:
- 07 September 2023, pp. 572-580
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In tropical regions, water stress is one of the main causes of the reduction in forage productivity, and irrigation strategies can mitigate the problem, especially for highly productive species. The objective of this study was to evaluate the effects of irrigation, genotype and plant size on productive responses and water use efficiency (WUE) of elephant grass (Cenchrus purpureus [Schumach.] Morrone), in the rainy and dry season. The experimental design was randomized in blocks, arranged in split plots, the main plots were established based on the use of irrigation and the subplots were the tall-sized genotypes (IRI 381 and Elephant B) and dwarfs (Taiwan A-146 2.37 and Mott). The genotypes were evaluated for two years and harvested every 60 days. Water use efficiency, total forage accumulation per year and harvest, forage accumulation rate and forage density were evaluated. There was a significant difference between the genotypes in terms of total forage accumulated (P < 0.05). The most productive genotype was IRI 381, which showed the greatest total forage accumulation (42 168 kg of DM/ha in two years) in the irrigated plots. During the rainy seasons, IRI 381 stood out in terms of forage accumulated (24 667 kg of DM/ha). Irrigation favoured increases in forage accumulation around 60%, in both years of evaluation. Irrigation and plant size influenced the productivity and WUE of elephant grass harvested in 60-day intervals. Tall genotypes and Taiwan A-146 2.37 (dwarf size) stood out in most of the productive traits analysed, while Mott was highlighted by its forage density.
Night-time/daytime Protein S100B serum levels in paranoid schizophrenic patients
- E. Diaz-Mesa, A. Morera-Fumero, L. Torres-Tejera, A. Crisostomo-Siverio, P. Abreu-Gonzalez, R. Zuñiga-Costa, S. Yelmo-Cruz, R. Cejas-Mendez, C. Rodriguez-Jimenez, L. Fernandez-Lopez, M. Henry-Benitez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S445-S446
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Introduction
S100B is a calcium-binding astrocyte-specific cytokine, that is considered a biomarker of neurodegeneration; which may be involved in the imbalance of the inflammatory response observed in several brain disorders, including major depression and schizophrenia. Two meta-analyses have reported higher serum levels of S100B in patients with schizophrenia respect to healthy controls.
Different studies have described circadian and seasonal variations of biological variables, such as melatonin or cortisol. It has been reported that there is not circadian rhythm of S100B blood levels in healthy subjects. However, it is not known whether there are circadian oscillations in S100B blood concentrations in patients with schizophrenia.
ObjectivesThe aim of this study is to describe S100B serum levels in patients with schizophrenia and to analyse whether they follow a circadian rhythm.
MethodsOur sample consists in 47 patients in acute phase and stabilized status. Blood samples were collected at 12:00 and 00:00 hours by venipuncture. Serum levels of Protein S100B were measured three times: at admission, discharge and three months after discharge. Protein S100B was measured by means of ELISA (Enzyme-linked immunosorbent assay) techniques.
Results12:00 24:00 P ADMISSION 132,95±199,27 85,85±121,44 0,004 DISCHARGE 73,65±71,744 75,80±123,628 0,070 CONTROL 43,49±34,60 40,14±23,08 0,47 P global P Admission Vs. Discharge P Admission Vs. Control P Discharge Vs. Control 0,97 There is a significance difference between 12:00 and 24:00 at admission for the Protein S100B.However, these difference did not occur at discharge and at three months after discharge.It can be interpreted as there is a circadian rhythm of Protein S100B when the patient has got a psychotic outbreak and disappears at discharge and when is psychopathologically stable.
ConclusionsWith respect to our results we can hypothesize that schizophrenic patients in acute relapse present circadian S100B rhythm that is not present when the patients are clinically stable.Furthermore, the decrease of serum protein S100B levels at discharge is indicative of a reduction of the cerebral inflammation, thus it can be a biomarker of cerebral inflammation and this reduction can be the effect of the treatment. Finally, its circadianity could be a guide of this process and clinical improvement.
Disclosure of InterestNone Declared
The Fall of Icarus: Post-psychotic depression - Apropros a clinical case
- S. Jesus, A. R. Costa, G. Simões, M. Almeida, A. Tarelho, P. Garrido
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S843-S844
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Introduction
Depressive symptoms occur in different phases of psychosis, including prodromal, acute and post-psychotic. Post-psychotic depression (PPD) is a phenomenon that presents as a diagnostic and therapeutic challenge. Having been ascribed various descriptions in the past, PPD has been used in a broad manner to describe depressive symptoms that appear in patients with history of psychosis. PPD unveils itself as a separate nosological entity, differing from the adverse effects typically associated with antipsychotics, the negative symptoms of psychosis, and other psychiatric disorders that present with both psychotic and depressive symptoms (e.g. bipolar disorder, schizoaffective disorder, or psychotic depression).
ObjectivesThe authors present a case of a 64 year-old man hospitalized due to inaugural psychosis with persecutory and grandiose delusions as well as auditory hallucinatory activity, who began to develop a depressive clinical picture whilst under treatment. A brief discussion on post-psychotic depression, from its clinical presentation to its treatment and implications in prognosis is also presented.
MethodsA brief non-systematized literature review using the Pubmed platform as well as presentation of a clinical case.
ResultsDepressive complaints are a common complication of psychotic episodes, with the literature estimating that approximately a quarter of psychotic patients present with PPD. Although typically described in association with schizophrenia, recent literature describes PPD occurring alongside other psychotic presentations, including first-episode psychosis. A division between affect and psychosis has been attempted in terms of psychiatric classification, however, the blurred lines between the two continue to contribute to difficulties in differential diagnosis. This becomes a challenge when distinguishing between extrapyramidal symptoms associated with antipsychotics, negative symptoms (i.e apathy, abulia and alogia) and psychiatric disorders with affective-psychotic overlap. Having only recently been considered a distinct clinical entity in psychiatric classification systems, research on its etiology, course, treatment and prognosis are scarce. In regards to the previously described patient, a depressive disorder whilst in treatment for psychosis was identified, and through early recognition of the symptoms treatment with an antidepressant was initiated with favourable response.
ConclusionsPPD is a relatively common phenomenon which is gaining more attention in recent literature. As classifications have begun to consider PPD as a distinct clinical entity, as well as unifying defining criteria, further studies can be developed so as to clarify aspects which remain to be defined. The clinician should be aware of this entity as well as the potentially confounding symptom presentations, so as to provide adequate early treatment thus contributing to improved patient outcomes.
Disclosure of InterestNone Declared
Off-label use of atypical antipsychotics- Where are we?
- R. P. Vaz, J. Martins, A. L. Costa, J. Brás, R. Sousa, E. Almeida, J. Abreu, N. Castro, R. Andrade, N. Gil
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S305
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Introduction
Nowadays, In the exercise of psychiatric clinical activity, the prescription of atypical antipsychotics is a widespread practice.
However, despite the approval in the treatment of psychoses and bipolar affective disorder, where its effectiveness is clearly demonstrated, these drugs are off-label prescribed in most of the clinical situations.
ObjectivesThis work aims to clarify which atypical antipsychotics are most frequent prescribed and the clinical conditions where their off-label prescription is more common.
MethodsBibliographic research in the Pubmed® database using the terms “atypical antipsychotics and off-label use”
ResultsAccording to the scientific literature consulted, the off-label prescription of atypical antipsychotics may represent about 70% of the total prescription of these psychotropic drugs.
Risperidone, olanzapine, quetiapine and aripiprazole are the most off-label prescribed among the atypical antipsychotics.
The psychiatric conditions where atypical antipsychotics are most often off-label prescribed are addictive disorders, anxiety disorders, post-traumatic stress disorder, personality disorders, eating disorders, insomnia and dementia, where therapeutic benefits are demonstrated when carefully selected.
ConclusionsThe off-label prescription can be interpreted from two points of view. On the one hand, it can guide innovation in clinical practice and improve symptoms in patients who do not respond to standard treatments. On the other hand, it may be associated with negative consequences due to the lack of data on safety and efficacy in these situations.
Despite widespread prescribing of atypical antipsychotics, there is no evidence-based recommendation beyond psychoses and bipolar affective disorder.
Thus, when prescribed, we must proceed with careful monitoring and consider the risks and benefits in relation to off-label prescription.
Disclosure of InterestNone Declared
Healthy mental higher education students’: Presentation of a project
- A. Torres, J. Costa, P. Carvalho, M. Loureiro
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S985-S986
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Introduction
The prevalence of mental disorders in Higher Education Students (HES) is high and has shown a worrying growth. However, only a small percentage of HES in need of psychological support request it, due to the stigma related to mental illness, requesting informal help from friends and family. Training and increasing Mental Health Literacy (MHL) have been stated as appropriate strategies to reduce stigma and increase the demand for professional psychological support. However, with the increase in the demand for help, the difficulty of providing an adequate response from psychological support of HE services also increases. Therefore, procedures that develop socio-emotional skills in the HES and strategies that enhance the responsiveness of these services are necessary.
ObjectivesTaking in consideration the literature review in this field, we develop a project to improve the mental health of HES. The project objectives’: a) the reduction of stigma related to mental disorders through the promotion of MHL in the academic community; b) the promotion of mental health and socio-emotional skills of HES; c) increasing detection and active search for professional mental health support, and d) the implementation of psychological intervention based on a stepped care model that provides an adequate response to most of the students’ mental health needs, according to individual needs.
MethodsThe project proposes to perform the following methods: a) training in mental health open to the academic community, which will aim to train volunteers to be Gatekeepers, in order to promote awareness, detection and referral of students in need of professional psychological support; b) implementation of a Student Observatory, with tracking of psychopathological symptoms, supported on the Web; c) implementation of a psychological intervention program based on a stepped care model, which will include the following progressive phases by severity: 1) digital self-help manual; 2) web-based self-help groups; 3) psychological intervention groups supported by the Web; 4) face-to-face intervention groups and 5) individual psychological intervention.
Students will be assessed before and after each step of care, with the following psychological instruments: Mental Health Inventory (MHI); Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7).
ResultsThe implementation of the presented methods expect to achieve improvements on HES’ mental health, namely improvement of MHI, reduction of PHQ-9 and GAD-7 after each step of the psychological care.
ConclusionsThe project presented encloses evidence-based interventions, with inspiration on psychoeducation and cognitive behavioral approaches, and it is expected to contribute to the improvement of mental health of HES. The results will be collected and disseminated. We encourage other researcher and clinicians to perform studies about the mental health of HES.
Disclosure of InterestNone Declared
Psychopathology without Borders: Transcultural psychiatry and implications in clinical presentation and practice
- S. Jesus, A. R. Costa, G. Simões, A. I. Gomes, A. Tarelho, P. Garrido
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S823
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Introduction
Existing as an emerging topic in the field and undergoing constant evolution, Transcultural Psychiatry addresses how social and cultural factors influence mental illness. During the second half of the twentieth century, phenomena such as globalization, massive migrations and immigration, occurring in ever increasing frequency, continue to bring this topic to the forefront of discussion as challenges in the treatment of patients from varying cultural backgrounds emerge. Viewed from the biopsychosocial perspective, culture delineates a framework for the evaluation of various expressions of emotion and behaviour as well as defining the limits of what counts as disorder. As border restrictions are lifted, cases which present with these particularities are bound to increase, necessitating an increased attention to the influence that cultural and social factors play in the psychopathological clinical pictures which may present to the practitioner.
ObjectivesThe authors aim to briefly explore the concept of transcultural psychiatry and its importance in clinical presentation and practice with recourse to various clinical cases of international patients hospitalized in a Portuguese Psychiatry ward during a two-year period.
MethodsA brief non-systematized literature review was performed based on works most pertinent to the topic discussed. As compliment to the topic, a discussion of various clinical cases of hospitalized international patients is presented.
ResultsCulture has been demonstrated to contribute to psychopathological presentations in a variety of forms, solidifying the old adage that ‘no man is an island’ and giving reason to the biopsychosocial approach applied in clinical practice. The impact of sociocultural factors is such that the DSM-5-TR includes in its classification culture-specific syndromes. The cases discussed demonstrate the various nuances necessary not only in exploring psychopathology, but also in implementing appropriate standards of care.
ConclusionsTranscultural psychiatry rises as a relatively recent topic as well as raising important philosophical, theoretical and technical challenges for mental health practitioners. Although existing as a subspecialty, each mental health practitioner should strive to be transcultural, taking into consideration the influence that these factors exert on mental illness. The patient should be evaluated with consideration to their cultural background, as well as not neglecting how the culture of the practitioner may influence the interpretation of psychopathological presentation.
Disclosure of InterestNone Declared
The Green-Eyed Monster: A Brief Exploration of the Jealousy Spectrum
- S. Jesus, A. R. Costa, M. Almeida, P. Garrido
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1002
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Introduction
A feeling as ancient as humankind, having been documented in the Bible, represented by mythological figures and appearing as a recurrent theme in art and literature, jealousy is a complex emotion that is non-discriminatory and often associated with negative feelings ranging from insecurity, suspicion, rage, fear to humiliation. Commonly associated with romantic relationships, it typically arises when one perceives a threat, either real or imagined, from a third party in regards to possession or perceived security. Jealousy, like other aspects of the human experience, varies in its expression and intensity, ranging from an adaptive response to a potentially dangerous psychopathological symptom.
ObjectivesThe authors aim to describe jealousy and discuss the spectrum on which it appears, ranging from an adaptive response to a psychopathological manifestation.
MethodsA brief non-structured literature review was carried out with recourse to various databases such as Pubmed as well as complimentary literary sources when deemed pertinent.
ResultsDescribed as a defensive reaction that is expressed as a cognitive, emotional and behavioural response to a perceived threat, jealousy has been discussed in various arenas of thought ranging from evolutionary psychology to philosophy to psychiatry to representation in the arts. It is a difficult term to define as it is a feeling expressed through diverse emotions and behaviours originating from various contexts as well as varying in its intensity. The literature demonstrates that jealousy can exist as an adaptive response, with evolutionary explanations, to a psychopathological expression either as obsessive jealousy or morbid jealousy, also known as Othello’s Syndrome. Each carries its own particularities in terms of expression, clinical significance and intervention. The more often described delusional jealousy, is characterized by the presence of strong, false beliefs that the partner is unfaithful, whereas obsessive jealousy, less commonly described, presents with unpleasant, ego-dystonic and irrational jealous ruminations that the partner could be unfaithful. These thoughts are often accompanied by compulsive verification of the partners’ behaviour. Treatment interventions in these cases are varied and present implications in prognosis.
ConclusionsJealousy is a complex emotional state and has been described as part of the universal human experience, with research indicating its existence across various cultures. The expression of this emotional experience as well as its potential manifestation types should be taken into consideration by the mental health practitioner when carrying out an evaluation, as treatment interventions and prognosis may vary depending on the presentation.
Disclosure of InterestNone Declared
Suicide among physicians: what do we know about it?
- R. P. Vaz, J. Martins, A. L. Costa, J. Brás, R. Sousa, E. Almeida, J. Abreu, N. Castro, R. Andrade, N. Gil
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1115-S1116
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Introduction
The prevalence of mental illness has increased worldwide over the past few years. At the same time, and even in the sense, there is also an increase in suicide rates with special incidence in certain risk groups, among which health professionals stand out.
In this particular group, physicians seem to represent a class particularly vulnerable by the stress and demand associated with it, but also by access and knowledge about potentially lethal means.
For this very part, they have a higher risk of suicide than the general population.
ObjectivesThis paper aims to better understand the phenomenon of suicide among physicians and identify which medical specialties are most vulnerable.
MethodsBibliographic research in the Pubmed® database using the terms “suicide and physicians”.
ResultsThe data obtained from the scientific literature consulted indicate that physicians have a higher risk of suicide than the general population, with greater emphasis on females who have higher rates compared to males.
Work factors that translate into higher levels of demand and stress combined with easy access and knowledge about the use of potentially lethal means seem to contribute very significantly to this phenomenon. Perfectionist personality traits with a high sense of responsibility and duty are also important characteristics that place these professionals in a position of greater vulnerability.
With regard to the different medical specialties, anesthesiology, psychiatry and general and family medicine are the ones with higher suicide rates among the medical class.
ConclusionsThe risk of suicide, although admittedly high in the medical class, is not homogeneous among different countries, being naturally influenced by the satisfaction/gratification obtained in the performance of their profession. In this sense, countries such as Switzerland and Canada show higher levels of professional satisfaction. In the opposite direction, dissatisfaction in the exercise of clinical activity is associated with higher levels of fatigue and burnout.
Medical women, due to the need to combine the responsibility of family tasks with professional responsibility, are at greater risk.
In this sense, it is necessary to develop strategies that are more appropriate for the prevention and early identification of suicide risk situations that can be experienced not only by improving working conditions but also by better addressing professionals suffering from mental disorders.
Disclosure of InterestNone Declared
Suicidality among inpatients - Right under our noses
- A. S. Morais, F. Martins, V. Henriques, P. Casimiro, N. Descalço, R. Diniz Gomes, N. Cunha e Costa, S. Cruz
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1106-S1107
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Introduction
An inpatient suicide is a tragic event that, despite not very prevalent, should not be overlooked. It occurs in 250 in 100 000 psychiatric hospital admissions (which represents a suicide risk fifteen times greater than general population) and in 1.7-1.9 in 100 000 in general hospitals (4-5 times greater risk). Together they constitute 5-6% of all suicides.
ObjectivesThe purpose of the authors is to explore the epidemiology, the risk factors and the prevention of suicide in inpatient setting.
MethodsA brief non-systematized review is presented, using the literature available on PubMed and Google Scholar.
ResultsThe risk was higher at admission (first week) and immediately after discharge (first 24 hours, up to two weeks).
It was found to be correlated to pour staffing, an increased number of patients with severe mental illnesses and accessibility to lethal means. Many risk factors were identified, some of them specific to context. Risk Factors at admission in a psychiatric hospital – personal or familiar suicide history, schizophrenia or mood disorder, alcohol use, involuntary admission, living alone, absence from the service without permission. Later till discharge - personal suicide history (or attempts after admission), relational conflicts, unemployment, living alone, lack of discharge planning and lack of contact in the immediate post-discharge period. In General Hospitals – chronicity and severity of somatic disease, poor coping strategies, psychiatric comorbidities and lack of liaison psychiatry.
Strategies to prevent inpatient suicide should take in environmental modification (specific to environment and specific to patient – as planned levels of supervision), optimisation of the care of the patients at suicidal risk, staff education and involvement of families in care. There are few studies on the efficacy of pharmacotherapy on reducing suicidal ideation in inpatients (just for clozapine and ketamine); some psychotherapies show promising results. The post-suicide approach cannot be neglected, whether in supporting the family, the team involved and even other patients.
ConclusionsThe assumption of the predictive and preventive value of the risk assessment has been under scrutiny. Depressed mood and a prior history of self-harm are well-established independent risk factors for inpatient suicide; however they lose their predictive value due to their high prevalence. Up to 70% of inpatients who committed suicide didn’t express suicidal ideation on the previous interviews. Most effective measures to prevent suicide are environmental modifications and staff education approaches, giving appropriate responses to each patient’s circumstances.
There is a paucity of literature on suicide in this setting. It should become a priority in national programs of Suicide Prevention.
Disclosure of InterestNone Declared