6 results
Perception of the covid-19 vaccination by the medical profession
- H. Abrebak, F. Z. chamsi, A. Essafi, S. Radi, A. Taqui, A. El ammouri
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S792-S793
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Introduction
By the end of October 2022, COVID-19 had infected more than 629 million people, with more than 6,5 million deaths worldwide.
During the pandemic, there have not been any specific antiviral drugs to effectively treat COVID-19, but non-specific drugs have been used and may improve the prognosis of high-risk patients with the disease. A vaccine is then considered the effective choice to stop this pandemic. The vaccine campaign against COVID-19 has been launched in Morocco since February 2021. This campaign has sparked great controversy over its effectiveness and safety in Morocco, as well as abroad, especially after the launch of the 3rd booster dose of the vaccine.
ObjectivesWe sought to assess individual perceptions among the medical profession regarding vaccination against COVID-19 in Morocco and to determine preferences among this particular population in order to facilitate vaccination coverage.
MethodsIt is a descriptive and analytical cross-sectional study on doctors of different medical specialties and general medicine students in Morocco. Data collection was done through an anonymous self-administered questionnaire completed online. The measuring instruments used were a questionnaire containing 29 questions. In addition to socio-demographic questions (age, sex, household composition and employment), the rest of the questionnaire aims to examine Moroccan doctors’ perceptions on COVID-19 vaccination, attitudes, beliefs and knowledge about the vaccine. Some survey items were adapted from other similar surveys, while others were created by the research team of the psychiatry laboratory of the CHU of Tangier. The data is grouped and then analyzed by statistical software (SPSS v26).
ResultsThere were 162 respondents with an average age of 26.52% with 66.7% of participants being female. 96% of doctors were vaccinated, 87.3% of them with 2 doses. 74% were vaccinated by Sinopharm, 23.5% by Astra Zeneca, 9.4% by Pfizer and 0.7% by Janssen. 68% had post-vaccination side effects. For unvaccinated doctors, 43% say they are not convinced of its usefulness, 28.5% find that there is not enough experience on its effectiveness and 14.3% report that they have a disease that contraindicates the vaccine.
For vaccinated doctors, 80% declare that they were vaccinated out of conviction and 20% out of obligation. 60% of our sample are against the obligation of the vaccination pass in public places, on the other hand 67% find that vaccination can stop the spread of the virus and 60% are ready to receive an annual vaccination if necessary.
ConclusionsPhysicians’ acceptance of the COVID-19 vaccine is important, as they are often a trusted source of vaccine information. Their vaccination can then positively influence the population, hence the need to integrate them into future awareness and prevention programs.
Disclosure of InterestNone Declared
The antidepressant properties of ketamine (literature review)
- F. Z. Chamsi, H. Abrebak, A. Z. essafi, S. Z. radi, A. el ammouri
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S830-S831
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Introduction
Major depression is a common condition. Despite significant advances in psychopharmacology since the 1950s, the onset of action and drug resistance remain therapeutic challenges for traditional antidepressant agents, such as serotonin reuptake blockers. The recent discovery of the rapid antidepressant effect of ketamine, receptor antagonist, has revolutionized research in this field.
Objectivesdemonstration of the antidepressant properties of ketamine
MethodsFor this purpose, major search engines such as Pubmed, medline, Science Direct, and journals specializing in sociology were contacted, with the introduction of keywords (ketamine-Esketamine-resistant depression) and the selection of literature reviews but also articles deemed relevant for this review.
ResultsThe initial demonstration of ketamine’s antidepressant effects was gradual, rather unusually in a treatment-resistant patient population. First administered in single doses in studies, ketamine showed a rapid and robust antidepressant effect, but not sustained over time. However, studies of repeated doses, spread over a period of a few weeks, then revealed that it was possible to prolong and even improve the clinical response. It is important to mention that the use of ketamine to treat depression still remains.
In 2000, the first randomized-controlled, double-blind clinical study used a crossover design, in which each participant received two infusions over 40 minutes, alternating between one week and one infusion of ketamine (0. 5 mg/kg) and a placebo infusion. A statistically significant antidepressant effect of ketamine compared to placebo was observed as early as 240 minutes after treatment and reached a maximum after 3 days; of the 8 patients treated with ketamine, 7 had an improvement in their symptoms of at least 30% and 4 of at least 50%
In 2006, Zarate et al. carried out the first replication study of the results obtained by the group from Yale University . In this study, 71% and 29% of the 17 patients who received ketamine achieved a response and remission, respectively ,the significant effect of ketamine was revealed after 110 minutes of treatment and until the end of the 7-day post-infusion follow-up.However, one week later, only 35% of patients had reached the clinical response threshold.
In 2010, Diazgranados et al. published the first study of ketamine treatment for bipolar depression. While the first two studies required patients to take no other psychotropic drugs, patients in this study had to show unresponsiveness to a therapeutic dose of lithium or valproic acid, two agents used in the treatment of bipolar disorder. Again here, 71% of patients who received ketamine achieved a clinical response
ConclusionsFinally, note that the discovery of the antidepressant action of ketamine has opened the door to the search for other molecules targeting the glutamatergic system, which will possibly provide an even greater
Disclosure of InterestNone Declared
Suicide in cancer patients: incidence and risk factors (literature review)
- H. Abrebak, F. Z. Chamsi, A. Essafi, A. Taqui, S. Radi, A. El Ammouri
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S69
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Introduction
Suicide is considered an important public health problem in contemporary society. Over 800,000 deaths by suicide are estimated each year and the mortality rate is 11.4 per 100,000 people.
In people with cancer, depression is a high-prevalence disorder that affects patients’ ability to cope with illness, decreases treatment acceptance, prolongs hospitalization, reduces quality of life, and increases the risk of suicide. In turn, the diagnosis of cancer is a serious stressor, with many physical and psychological consequences, and is thought to be a risk factor for suicide.
ObjectivesThis study aimed to perform a literature review on the incidence and risk factors of suicide in cancer patients
Methodsthe search for articles was carried out in the electronic scientific databases PubMed, ScienceDirect and Scopus. Variables studied included suicide rate, type of cancer, demographic characteristics, and signs and symptoms associated with suicide using the descriptors “suicide” and “cancer”.
Results42 articles were selected. As in the general population, the risk of suicide was higher in men with cancer than in women with cancer. Cancer patients aged 65 or older have a higher suicide rate than those under 65. Prostate, lung, pancreatic, bladder and colorectal cancers are the types most at risk for suicide. The first year after diagnosis carries a higher risk of completed suicide. Multiple risk assessment tools have been developed and are effective in identifying patients with depression or hopelessness, factors associated with a higher risk of suicide. However, there are no tools that can sensitively and specifically predict suicide.
ConclusionsThe incidence of suicide in a person diagnosed with cancer is approximately double the incidence of suicide in the general population. Early detection of depression in particular cancer populations, such as older male patients, can help identify those most at risk for suicide.
Disclosure of InterestNone Declared
Management of comorbid schizophrenia with prolactinome (about a case)
- F. Z. Chamsi, H. Aberbak, S. Radi, A. El Ammouri
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1056
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Introduction
Prolactin adenoma, called “prolactinoma” is a benign neoplasm, it is the most common secreting pituitary tumor, and represents up to 40% of all pituitary adenomas. More than 90% are small intrasellar tumors which rarely increase in size.
Objectivesthe problem of management lies in how to stabilize the patient on a psychiatric level without increasing the level of prolactin.
MethodsWe report the case of a young woman who presented a comorbid schizophrenia with a prolactinoma. We will try through this clinical vignette to study the different pillars of management of such pathologies.
At the same time, we did a literature review. The main search engines used were Pubmed, medline, and Science Direct. The keywords Prolatinoma schizophrenia olanzapine
ResultsThis is Mrs. N. Q., 39 years old She is single, an engineer but currently without a profession, from an average socio-economic level of a teacher father and a housewife mother. She is the 3rd of his siblings of 6 . She is currently hospitalized at Ar-razi Tanger hospital for treatment of decompensation of her chronic psychotic disorder. The patient would have been born following a premature delivery of 34 weeks. For her antecedent, she was followed for asthma since her childhood. Her mother and her maternal grandfather would have been psychotic. The history of the disease dates back to 2017. The patient suffered from headaches resistant to any treatment. The patient would have consulted a neurologist. Magnetic resonance brain imaging would have been requested, which objectified at the left latero-pituitary level a lesional process of 7 mm discretely intense in T2, hypo-intense in T1 and not enhanced by Gd reflecting a pituitary micro adenoma. The patient was put on Cabergoline (Dostinex®). So the psychiatric symptomatology dates back to the end of 2019, by behavioral problems, social withdrawal, she will have stopped all professional activity. At the same time, she will have stopped all medication (Cabergoline). In 2020, the patient would have been hospitalized for the first time at the Ar-razi Tangier psychiatric hospital. The diagnosis of schizophrenia was retained according to the DSM 5 criteria. After a stay of 5 weeks, the patient would be stabilized on olanzapine 20mg/d. Currently, and following non-compliance with treatment (because of adverse effects such as amenorrhea and galactorrhea), the patient has returned, suffering from a relapse, justifying her second hospitalization. During his stay, a check-up would have been requested to show hyperprolactinemia 3 times normal. We therefore switched to Aripiprazole.
ConclusionsWe have proposed an approach to the management of patients with comorbid schizophrenia and prolactinoma, an approach that balances the benefits and risks of managing the psychiatric stability of the patient on antipsychotics with the management of prolactinoma and symptoms. of hyperprolactinemia.
Disclosure of InterestNone Declared
EMDR as a treatment option for conditions other than PTSD
- H. Abrebak, F. Z. Chamsi, A. Essafi, A. Taqui, S. Radi, A. El ammouri
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S115
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Introduction
Eye movement desensitization and reprocessing (EMDR) is a psychotherapeutic approach that has been shown to be effective in the treatment of post-traumatic stress disorder (PTSD). The technique is known to facilitate the reprocessing of maladaptive memories thought to be at the heart of this pathology.
Strong evidence shows that traumatic events can contribute to the onset of serious mental disorders and can worsen their prognosis.
Therefore, research on EMDR therapy has increased beyond PTSD and several studies have analyzed the effect of this therapy in other mental health conditions such as psychosis, bipolar disorder, depression, anxiety disorders, substance use disorders and chronic pain.
ObjectivesThe objective of this systematic review is to summarize the most important results of available studies conducted in this area.
MethodsWe performed a systematic literature search among PubMed, ScienceDirect and Scopus. Studies included work published up to 2021
The search was performed automatically by title in each database and included the keywords “EMDR”, “Eye Movement Desensitization and Reprocessing” excluding those focusing on trauma and PTSD
ResultsStudies are still sparse in these comorbid conditions, but available evidence suggests that EMDR therapy improves trauma-associated symptoms and has a minor effect on primary disorders by achieving partial symptomatic improvement. A positive effect has been reported in many pathological situations, including addictions, somatoform disorders, sexual dysfunctions, eating disorders, adult personality disorders, mood disorders, severe stress reaction, anxiety disorders, pain, neurodegenerative disorders, mental disorders of childhood and adolescence and sleep.
ConclusionsDespite a generally positive view of EMDR as an alternative treatment option, more methodologically rigorous studies are needed.
Disclosure of InterestNone Declared
Evaluation of therapeutic compliance in psychiatry
- H. Abrebak, F. Z. Chamsi, A. Essafi, S. Radi, A. Taqui, A. El Ammouri
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S870
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Introduction
Therapeutic non-adherence is a problem frequently encountered in patients suffering from psychotic disorders. It has consequences on the quality of life and on the prognosis of the evolution of the disease. It is essential to understand the causes in order to best support the patient towards adherence to care.
ObjectivesThe objective of the study is to evaluate the therapeutic observance of patients hospitalized in the women’s department of the psychiatric hospital and to collect the reasons for therapeutic non-observance, as well as to identify the desired themes for the implementation group therapeutic education workshops.
MethodsIt is a monocentric and prospective study, carried out in the women’s department through individual interviews on day 7 +/- 2 of the admission of patients to the psychiatric hospital of Tangier. The inclusion criteria are:
- the patient’s consent,
- the autonomous taking of a treatment before admission,
- sufficient communication skills
The psychometric tool used during this study is the MARS scale (Medication Adherence Report Scale) which allows the patient to assess his compliance, by answering 10 questions, assigning himself a score between 0 and 10 with a good compliance from 8/10. The discussion following the questionnaire makes it possible to identify the reason(s) for non-compliance and the themes to be addressed to improve compliance.
ResultsOur first initial results were calculated from 60 patients admitted to hospital. Among them, 35 met the criteria for inclusion in the study. The interview takes place within an average of 8.0 ± 2.3 days. The average age is 40 ± 15 years. Patients present with schizophrenia in 80% of cases, bipolarity (8%) or borderline personality disorder (3%). Nine percent of patients have no diagnosis. Patients take an average of 2.5 drugs [1; 5] before hospitalization. The average MARS score is 5.6 ± 2.6. The reasons for non-adherence identified by patients are:
- The presence of side effects,
- Lack of means
- Feeling of healing
- The weariness of a long treatment
- Inefficiency,
- fear of interactions in case of toxic consumption
- five patients declared observing and did not identify any reason for non-compliance
ConclusionsOur study has made it possible to better understand the difficulties and support needs of patients to improve their adherence to care. As a follow-up to this work, a multidisciplinary discussion will allow the setting up of group therapeutic education workshops around the identified themes.
Disclosure of InterestNone Declared