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Knowledge Discovery from Archaeological Materials
- Pedro A. López García, Denisse L. Argote, Manuel A. Torres-García, Michael C. Thrun
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- July 2024
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- 31 July 2024
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This volume highlights the employment within archaeology of classification methods developed in the field of chemometrics, artificial intelligence, and Bayesian statistics. These operate in both high- and low-dimensional environments and often have better results than traditional methods. The basic principles and main methods are introduced with recommendations when to use them.
P154: Mild Behavioral Impairment (MBI) in a sample of general population aged > 55: associations with degree of cognitive impairment.
- P Gracia-García, R López-Antón, C de la Cámara, J Santabárbara, E Lobo, A Lobo
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- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, p. 219
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Objective:
The present study aims to determine the prevalence estimates of MBI and specific MBI domains in a large sample of the general population, by degree of cognitive impairment (CI).
Method:A representative community sample of individuals aged 55+ (n=4803) (ZARADEMP Study) was studied. MBI, and specific MBI domains, were assessed according to ISTAART-AA MBI criteria, using the Geriatric Mental State (GMS). In accordance with these criteria, clinically significant anxiety, depression, and dementia were excluded. For the standardized degree of CI Perneczky et al. ́s criteria were applied: normal (MMSE 30), questionable (MMSE 26-29), mild CI (MMSE 21-25), moderate-severe CI (MMSE <21).
Results:The prevalence of MBI, and specifically the domain Decrease Motivation (DM), increased progressively and significantly by degree of CI, the differences being significant between all cognitive groups. After control by age and education, DM was 2- and 4.5-times more frequent in subjects with mild CI (10.6%) and moderate-severe CI (18.3%), respectively, than in cognitive normal (5.8%). Affective Dysregulation (AD) was 1.7-times more frequent in mild CI (26.4%) (vs 20.4% in normal). Impulsive Dyscontrol (ID) was 2- and 7.9-times more frequent in mild CI (8%) and moderate-severe CI (23.5%) than in cognitive normal (4.7%). And Abnormal Perception and Thoughts (APT) was 6-times more frequent in moderate-severe CI (10%) (vs 1.4% in cognitive normal).
Conclusion:Our results confirm an increase of MBI prevalence across the spectrum of CI. However, each specific domain of MBI shows a different pattern of association with CI. Our results support the relevance of studying MBI domains independently.
39 Perceived Workload and Language Order Effects on the Cordoba Naming Test in Spanish-English Bilinguals
- Krissy E. Smith, Isabel D. C. Munoz, Raymundo Cervantes, Andrea R. Preciado, Tara L. Victor, Natalia Garcia, Paula V. Bracho, Enrique Lopez, Alberto L. Fernandez, Yvette De Jesus, Daniel W. Lopez-Hernandez
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- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 451-452
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Objective:
The Cordoba Naming Test (CNT) is a 30-item confrontation naming task. The administration of the CNT can be administered in multiple languages. Hardy and Wright (2018) conditionally validated a measure of perceived mental workload called the National Aeronautic Space Administration Task Load Index (NASA-TLX). They found that workload ratings on the NASA-TLX increased with increased demands on a cognitive task. Researchers found interactions in a study examining language proficiency and language (i.e., in which the test was administered) on several tasks of the Golden Stroop Test. Their results revealed that unbalanced bilinguals’ best-spoken language showed significantly better results compared to balanced bilinguals’ where language use did not matter. To our knowledge, no study has examined the order effects of Spanish-English bilingual speakers’ CNT performance and perceived workloads when completed in Spanish first compared to English second and vice-versa. We predicted that persons that completed the CNT in English first would demonstrate better performances and report lower perceived workloads on the CNT compared to completing the CNT in Spanish second. In addition, we predicted that persons that completed the CNT in Spanish first would demonstrate worse performance and higher perceived workloads on the CNT compared to completing the CNT in English second.
Participants and Methods:The sample consisted of 62 Spanish-English healthy and neurologically bilingual speakers with a mean age of 19.94 (SD= 3.36). Thirty-seven participants completed the CNT in English first and then in Spanish (English-to-Spanish) and 25 participants completed the CNT in Spanish first and then in English (Spanish-to-English). The NASA-TLX was used to evaluate CNT perceived workloads. All the participants completed the NASA-TLX in English and Spanish after completing the CNT in the language given, respectfully. A series of paired-samples T-Tests were completed to evaluate groups CNT performance and perceived workload.
Results:We found that the English-to-Spanish group performed better on the CNT in English first than completing it in Spanish second, p = .000. We also found that the English-to-Spanish group reported better performance and less mentally demanding on the CNT when it was completed in English first compared to completing it in Spanish second, p’s < .05. Regarding the Spanish-to-English group, we found participants performed worse when they completed the CNT in Spanish first compared to completing the CNT in English second, p = .000. Finally, the Spanish-to-English group reported worse performance completing the CNT in Spanish first, more temporal demanding, and more frustrating compared to completing the CNT in English second, p’s < .05.
Conclusions:As expected, when participants completed the CNT in English, regardless of the order, they performed better and reported lower perceived workloads compared to completing the CNT in Spanish. Our data suggests that language order effect influenced participants CNT performance possibly due to not knowing specific items in Spanish compared to in English. Future studies using larger sample sizes should evaluate language order effects on the CNT in Spanish-English balanced bilingual speakers compared to unbalanced bilingual speakers.
Gender Differences in the abuse of new technologies, and other addiction problems of patients from primary care
- F. Méndez-López, M. Dominguez-García, B. Oliván-Blázquez, C. Bartolomé-Moreno, A. Aguilar-Latorre, R. Magallón-Botaya
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S327-S328
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Introduction
The use/abuse of Information and Communication Technologies (ICT) has become a topic of great interest in recent years. With advances in technology, today’s population spends a great deal of screen time (ST) making watching television (TV), using computers, smartphones, or playing video games a central component of their daily lives. These studies have analyzed the psychological impact of technological exposure or abuse, such as aggressive behaviors, anxiety, depression and other mental problems.
ObjectivesThe main objective of this study is to explore the differences between men and women and the abusive use of social networks, technologies, pathological gambling and other addiction problems in primary care.
MethodsThis study is an observational study conducted within the framework of primary care in the Spanish region of Aragon. The population of the study were participants of 35-74 years old, had been receiving care from the Aragon Health Service. Recruitment is shown at figure 1. Sociodemographic, quality of life, personal factors on health behaviour, social support, lifestyle patterns and chronic comorbid pathology variables were collected during the period 2021–2023. The project was approved by the Clinical Research Ethics Committee of Aragon Nº PI20/302. The comparisons by sex were carried out using a Student T-test or chi squared test to analyse differences.
ResultsThere are significant differences in the abuse of new technologies between men and women. 25.20% of men (CI 95% 18.26-33.25) compared to 13.41% of women (CI 95% 8.85-19.25) make abusive use of the Internet, with statistically significant differences. In the same way, men present greater abuse of video games (6.25% of men (CI 95% 3.0-11.45) compared to 3.05% of women (CI 95% 1.17-6.55).
Analysing the differences by sex in dependence if it is an urban or rural population. Significant differences in the abuse of new technologies between men and women are present in the urban population, while in the rural population these differences are not observed
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ConclusionsGender modifies the ways in which technologies are used, so that men have a more problematic use of video games and the Internet than women. On the other hand, in relation to emotional symptoms, it was observed that women presented more anxiety and less satisfaction with life than men. The evaluation of abuse of new technologies cts should be incorporated into health services to improve people’s ability their self-care, the level of knowledge of managing their disease and their physical, mental and social health.
Disclosure of InterestNone Declared
Is social media important in adolescents with eating disorders?
- B. Martínez-Núñez, D. S. Cohen, R. Encinas-Encinas, A. Paniagua-Velasco, D. A. Gómez-Guimaraes, C. García-López, B. Muchada-López, M. Faya-Barrios, M. Graell-Berna
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S522-S523
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Introduction
Eating disorders (ED) are complex entities of multicausal etiology that mainly affect adolescents and young women. For this reason, EDs frequently cause medical and psychological complications that can cause potentially irreversible developmental sequelae during adolescence.
96% of Spanish youth (15-29 years old) use daily Internet. In addition, 83% use Social Networks. Internet could be a good way to spread information through social media, websites, providing material and means to achieve the body culture purpose.
As we have seen in various papers, social media can influence and trigger the development of EDs.
ObjectivesThe objetives of the study are to analyse the preferred social network by adolescents diagnosed with eating disorders, as well as to measure characteristic and time-use of these networks.
MethodsWe decided to undergo a transversal study to analyse the use of social media. For that, we developed a survey to reflect the use of the main social networks (Instagram, Facebook, Snapchat, Twitter, YouTube and Reddit) in adolescents diagnosed with eating disorders in Spain, who are in outpatient treatment in a specialised ED unit.
ResultsThe total number of adolescents interviewed was 65; of these 96.9% were females and 3.1% males. The mean age was 14.8 years.
The preferred social network was Instagram (54%), followed by TikTok (34%) and YouTube (6%).
Most of the patients interviewed (68%) admitted checking Instagram daily, and 31% reflected spending between 1-3 hours/day. None of the adolescents reported using Facebook or Reddit.
The majority of adolescents (89%) admitted having ignored friend requests while 12% reflected the importance of having a high number of followers as a way of external validation, getting more ‘likes’ and getting to know more people.
ConclusionsThe obtained results reinforce the need of exploring and taking into account the use of Social Media in adolescents with ED and how it may influence their pathology. There is a need for further prospective research in this field.
Disclosure of InterestNone Declared
Intracranial hemorrhage in a patient with depressive anxiety disorder about a case
- M. Palomo Monge, M. V. Lopez Rodrigo, C. Garcia Montero, A. Osca Oliver, V. R. Fons, A. Duque Dominguez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S923
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Introduction
We present the case of a 69-year-old patient who went to the emergency department due to an episode of aggressiveness and behavioral alteration, presenting irritability and nervousness, of about 2 days of evolution according to her family member. Given that the patient had previously presented chronic behavioral disorders and had previously been followed up in psychiatric consultations, psychiatry was notified after an initial evaluation by the emergency physician.
ObjectivesSomatic personal history: NAMC. HTA. Not DM, not DL. Former smoker of 20 cigarettes/day. Recurrent intracranial hemorrhage secondary to amyloid angiopathy and suspected amyloid vasculitis. Last admission to the neurology service in June 2022, also presenting symptomatic epileptic seizures and secondary behavioral alterations. Mastocytosis. Post-traumatic vertebral fracture. Non-anticoagulated paroxysmal atrial fibrillation. Surgical: Left ear surgery. appendectomy. Hysterectomy + oophorectomy.
Personal psychiatric history: In follow-up since May 2021 referred from neurology for emotional lability, episodes of anger and fear. Diagnosed with anxiety-depressive disorder secondary to a medical illness.
Current psychiatric treatment: Oxcarbazepine 800mg 0-0-1, trazodone 100mg 0-0-1, aripiprazole 10mg 1-0-0.
MethodsCurrent illness: The patient goes to the emergency room brought by her husband. During the interview she minimizes her aggressive behaviors or even does not remember them. She is disoriented in time, with very striking memory failures. Her husband comments verbal aggressiveness if he contradicts her in something, sometimes even presenting physical aggressiveness with her relatives. They report that in the last psychiatric consultation a little over 1 month ago, aripiprazole was withdrawn due to an increased risk of cardiovascular events.
After the examination of the patient, she was referred back to the emergency department for a new assessment and to rule out the organicity of the current condition, given that the patient had cardiovascular risk factors, due to the suspicion of a new episode of intracranial hemorrhage.
Resultssychopathological examination: Vigil, conscious, disoriented in time, partially in space. Collaborative, calm during the interview. Coherent, structured speech, with obvious memory failures. Labile, irritable mood. Verbal and physical heteroaggressiveness at home, not during the interview. No structured or planned autolytic ideation at this time. Appetite and sleep preserved.
ConclusionsAn urgent head CT was requested, with the result of a small intraparenchymal bleeding in the left frontal location, and she was admitted to the neurology department, with a diagnosis at discharge of: small left frontal haematoma, suspected amyloid vasculitis, and secondary behavioral alteration (vascular dementia).
Disclosure of InterestNone Declared
The response to unfolded proteins in schizophrenia and bipolar disorder
- C. Cachán, I. M. Valle, Y. Potes, A. González Rubio, N. Menéndez Coto, D. López Fanjul, I. Vega Naredo, B. Caballero, P. Saiz, J. Bobes, P. García Portilla, A. Coto Montes
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S636-S637
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Introduction
Schizophrenia (SCH) and bipolar disorder (BD) are severe mental disordes, which have high incidence (Whiteford et al. Lancet 2013; 381 1575-86) and are the main causes of diasibility in young people (WHO 2022; https://www.who.int/news-room/fact-sheets/detail/mental-disorders).
Psycological stress appears in different mental disorders, and this is directly related to oxidative stress (Moller et al. Chem Biol Interact. 1996; 102 17-36)(Pupic-Bakrac et al. 2020; Psychiatr Danub. 32 412-9). Oxidative stress causes reticulum edoplasmic stress (ER stress) and this produces high levels of misfolded proteins. Defective proteins are degraded by the proteasome, but but when the density of misfolded proteins exceeds the capacity of the proteosome, the Unfolded and Misfolded Protein Response (UPR) is triggered through three main pathways: Inositol-requiring enzyme 1α (IRE1α); transcription factor 6 alpha (ATF6α) and protein kinase RNA-Like ER kinase (PERK), trying to recover normal protein synthesis capacity (Bermejo-Millo et al. 2018; Mol Neurobiol. 55 7973-86) (González-Blanco et al. 2022; J Cachexia Sarcopenia Muscle 13 919-31).
ObjectivesCharacterizing ER stress and UPR in SCH and BD.
MethodsWe studied ER stress and UPR in peripheral blood mononuclear cells (PBMC) from 50 patients with SCH and an equal number of patients with BD compared to their corresponding controls in order to achieve our objectives.
Western Blot assay were performed following classical procedure () and the results was normalized to Ponceau as loanding control (Nie et al. 2017; BiochemByophys Resp 12 10-13) (Sander et al. 2019; Anal Biochem 575 44-53). Proteasome activity was assessed using Proteasome Activity Assay Kit (ab107921, Abcam, Cambridge, UK).
ResultsER stress was evaluated with BiP/GRP78. Our results showed significantly increased expression in SCH (p<0,01) and BD (p<0,05), being more increased in SCH. Proteasome activity was increased in SCH and BD, being only statistically significant in SQZ (p<0,05). UPR study showed IRE1a cascade significantly activated in SCH (p<0,001) and only slight increased in BD showed without statistical differences. ATF6a pathway is measured by cleavage to active protein (50-kDa). Results showed higher expression in SCH than in BD and controls (p<0,001). In addition, PERK pathway showed higher statistical levels of p-eIF2a/eiF2a ratio in SCH than in BD and control respectively (p<0,05 and p<0,01).
ConclusionsOur results showed a greater alteration in SCH than in BD at the level of protein synthesis, which implies a greater toxicity at the cellular level and, therefore, a clear risk for the survival of cells in this pathology.
Disclosure of InterestNone Declared
Impact of COVID-19 pandemic on psychiatric emergency care in a general hospital
- J. M. Rodríguez Capilla, A. Rubio Carramiñana, S. Vega Castellote, S. López Fernández, I. Arilla Herrera, J. M. Almenara Galdeano, A. Mora Prat, M. Campillo Benito, J. Albero Garcia, A. Valderrey Ratia, A. Grau Peñas, C. Pastor Fernández, M. Moreno Monzó, J. Guitart Gil, J. Martínez Raga, C. Knecht
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S405-S406
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Introduction
The SARS-CoV-2 pandemic has produced an unprecedented clinical situation, causing a direct and indirect impact on the physical and mental health of the population. In Spain, between March 15 and June 21 of 2020, it was decreed a home confinement that caused the interruption of the daily life of millions of people. However, there are few studies that analyze the changes produced in psychiatric care in the Emergency Department (ED).
ObjectivesTo analyze the changes produced in psychiatric emergencies, subanalysing paediatric population, during the first year of the pandemic (COV1/Y-COV1) compared to the previous year (NOCOV/Y-NOCOV1). To analyze the clinical features of patients attended during the lockdown period of the pandemic (LOCK) and compare it to the period of the pandemic after the lockdown (NOLOCK).
MethodsThrough the registry of computerized medical records, patients who attended the psychiatric hospital emergency department between 03/01/2019 and 02/28/2021 were identified. We also identified all attendances from 15/03 to 21/06 in 2019 and in 2020 to obtain variables from the lockdown period.
ResultsDuring period of this study, 2694 psychiatric visits made in the ED (1744 patients - 54.3% women, and 69.5% were between 25 and 64 years-), 1537 in NOCOV and 1157 in COV1. Significant differences were found between COV1 and NOCOV in sociodemographic variables, such as employment status and number of offspring. At a clinical level, in COV1, we observed an increase in attendance due to heteroaggressive behaviors, mania, insomnia and problems due to substance use. An increase in the prescription and/or modification of treatment was observed (59.3% vs 54.3%). During COV1, in terms of discharge follow-up in the month following the ED visit, telematic assistance increased (11.4% vs. 5.3%). During the period of study, 282 ED attendances were performed, 153 in Y-NOCOV and 129 in Y-COV1. At a clinical level, during Y-COV1, a decrease in attendances related to substance use was found significant. The sub-analysis carried out for LOCK and NOLOCK yields similar data to those obtained in the COV1 vs. NOCOV1 comparison. During lockdown, the face-to-face follow-up in the month following the ED was significantly lower (39,5% vs 57,1%) regarding telematic follow-up (24,4% vs 5,8%) In this period, an increase of adolescents without previous mental health follow-up was observed (44% LOCK vs. 22% NOLOCK).
ConclusionsOur work supports the hypothesis that the COVID-19 pandemic caused a change in psychiatric care in the ED. It also shows how lockdown changed the attendance in psychiatric emergencies, and also in the later community care attendance. Changes are detected in emergency care for adolescents during the pandemic compared to the previous year. Strikingly, our study does not reflect a quantitative increase in the demand. It would be of interest to continue collecting data after the time of the present project.
Disclosure of InterestNone Declared
Delusional disorder during pregnancy. A case report.
- M. Palomo Monge, M. V. Lopez Rodrigo, C. Garcia Montero, M. F. Tascon Guerra, A. Osca Oliver, A. Duque Dominguez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1070-S1071
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Introduction
We present the case of a 34-year-old female patient, 35 weeks pregnant and previously diagnosed with delusional disorder.
ObjectivesSomatic personal history: NAMC. intrinsic asthma. Cutaneous psoriasis.
Personal psychiatric history: In psychiatric follow-up since childhood, due to eating problems. Subsequently by adaptive pictures, with anxiety and dysfunctional personality traits intermittently. She resumes contact again in February 2017 presenting frank delusional clinic. Father diagnosed with schizophrenia.
Personal data: 34-year-old woman, married, with a 6-year-old son.
MethodsCurrent illness: The patient presents active delusional symptoms of about 3 years of evolution, she reports that she knows that there are people in her neighborhood who want to harm her and have guns with which they are constantly shooting to kill her "I hear the shots every day, I have the windows covered with metal plates and I cannot go out with my son, nor to the park, nor to do the shopping”. When she began the delusional symptoms, she was prescribed treatment with olanzapine without response, later with paliperidone palmitate, without response, and then with oral aripiprazole and depot 400mg once a month, with partial response. Prior to the current pregnancy, treatment with clozapine was considered, which the patient accepted but did not tolerate and had to be withdrawn.
ResultsEvolution: The patient then remains in treatment with depot aripiprazole, with a partial response and less behavioral repercussion of the delusional content, but with a torpid evolution and tending to chronicity. During this course the patient accidentally becomes pregnant again. The doses of benzodiazepines that she was previously taking to control anxiety and sleep were lowered, maintaining treatment with depot aripiprazole, reducing the dose to 300mg monthly. The pregnancy has proceeded normally to date, with close controls by the gynecology service and monthly visits to psychiatry clinics.
ConclusionsClinical judgment: Persistent delusional disorder.
In this case, the need arises to maintain depot antipsychotic treatment in a patient with a severe mental disorder during pregnancy, given the serious consequences of delusional content on the patient’s functioning and thus be able to preserve stability at this level during pregnancy.
Disclosure of InterestNone Declared
Tobacco use in first-episode psychosis, a multinational EU-GEI study
- T. Sánchez-Gutiérrez, E. Rodríguez-Toscano, L. Roldán, L. Ferraro, M. Parellada, A. Calvo, G. López, M. Rapado-Castro, D. La Barbera, C. La Cascia, G. Tripoli, M. Di Forti, R. M. Murray, D. Quattrone, C. Morgan, J. van Os, P. García-Portilla, S. Al-Halabí, J. Bobes, L. de Haan, M. Bernardo, J. L. Santos, J. Sanjuán, M. Arrojo, A. Ferchiou, A. Szoke, B. P. Rutten, S. Stilo, G. D'Andrea, I. Tarricone, EU-GEI WP2 Group, C. M. Díaz-Caneja, C. Arango
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- Psychological Medicine / Volume 53 / Issue 15 / November 2023
- Published online by Cambridge University Press:
- 26 April 2023, pp. 7265-7276
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Background
Tobacco is a highly prevalent substance of abuse in patients with psychosis. Previous studies have reported an association between tobacco use and schizophrenia. The aim of this study was to analyze the relationship between tobacco use and first-episode psychosis (FEP), age at onset of psychosis, and specific diagnosis of psychosis.
MethodsThe sample consisted of 1105 FEP patients and 1355 controls from the European Network of National Schizophrenia Networks Studying Gene–Environment Interactions (EU-GEI) study. We assessed substance use with the Tobacco and Alcohol Questionnaire and performed a series of regression analyses using case-control status, age of onset of psychosis, and diagnosis as outcomes and tobacco use and frequency of tobacco use as predictors. Analyses were adjusted for sociodemographic characteristics, alcohol, and cannabis use.
ResultsAfter controlling for cannabis use, FEP patients were 2.6 times more likely to use tobacco [p ⩽ 0.001; adjusted odds ratio (AOR) 2.6; 95% confidence interval (CI) [2.1–3.2]] and 1.7 times more likely to smoke 20 or more cigarettes a day (p = 0.003; AOR 1.7; 95% CI [1.2–2.4]) than controls. Tobacco use was associated with an earlier age at psychosis onset (β = −2.3; p ⩽ 0.001; 95% CI [−3.7 to −0.9]) and was 1.3 times more frequent in FEP patients with a diagnosis of schizophrenia than in other diagnoses of psychosis (AOR 1.3; 95% CI [1.0–1.8]); however, these results were no longer significant after controlling for cannabis use.
ConclusionsTobacco and heavy-tobacco use are associated with increased odds of FEP. These findings further support the relevance of tobacco prevention in young populations.
Two of us live in this body
- M. Palomo Monge, M. Pérez Fominaya, M.V. López Rodrigo, A. Osca Oliver, M.F. Tascón Guerra, C. García Montero, V. Ros Font
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- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S870
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Introduction
The dissociative disorders are characterized by a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior.
ObjectivesWe present the case of a 22-year-old patient, who has been following up for just over a year. The patient refers that two people inhabit her body, talk to each other, exchange opinions and both have control over the body, one giving the turn to the other depending on the circumstances. To this is added delusional symptoms of grandeur and sensorial-perceptual symptoms. In turn, depressive symptoms have appeared that have led the patient to have several suicide attempts throughout the follow-up time.
MethodsDuring this time, the patient has required hospital admission on two occasions due to the autolytic ideation. Treatment with neuroleptics and antidepressants has been established that have helped control delusions and thoughts of death, but not the dissociative clinic.
ResultsDissociative Identity disorder 300.14 (F44.81)
ConclusionsThe different symptoms presented by the patient, as well as the social and occupational deterioration that he presents, make this an extremely complicated case, both in diagnosis and in treatment. Dissociative identity disorder has been very controversial, changing its diagnostic criteria over time. More studies are needed and perhaps future research can give us more clues about this disorder.
DisclosureNo significant relationships.
Folie à deux, about a case
- M. Palomo Monge, M.F. Tascón Guerra, M. Pérez Fominaya, M.V. López Rodrigo, A. Osca Oliver, C. García Montero, V. Ros Font
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- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S771
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Introduction
First described in France by Lasègue and Falret as the presence of the same psychiatric symptom in 2 individuals. It involves the transference of delusional ideas from a “primary” affected individual to one or more “secondaries,” in close association.
ObjectivesWe present the case of a patient, diagnosed with schizophrenia, who, after several years of evolution, and after a relapse, comes accompanied by his mother, who recently began to present the same delusional symptoms that the patient reported previously.
MethodsAfter several pharmacological adjustments, control of the patient’s symptoms is achieved and it is he himself who is able to identify the symptoms that his mother presents, allowing her to also attend and be treated.
ResultsInduced delusional disorder F.24
ConclusionsAmong the variants that the folie a deux encompasses (folie imposée, folie communiquée, folie simultenée, folie induite) in this case we are probably talking about a folie communiquée, given the resistance over time of the patient’s mother until the symptoms develop. It is important to know these syndromes to be able to make a clear diagnosis, and depending on the way of onset and evolution, to be able to distinguish between the different subtypes, in order to avoid future complications and guide the corresponding treatment.
DisclosureNo significant relationships.
Transcultural approach to psychotic episodes. About a case
- C. Martín Villarroel, L. Carpio García, L. Santolaya López, G. Belmonte García, M. Sánchez Revuelta, J. Matsuura, E.F. Benavides Rivero
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- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S636
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Introduction
Cultural differences influence understanding and therapeutic adherence of migrant patients, therefore it is very important to acquire cultural competence.
ObjectivesThe objective of this paper is to study, from the following case, the effect of cultural competence in approach to psychosis in migrant patients.
MethodsA bibliographic search was performed from different database (Pubmed, TripDatabase) about the influence of culture on psychosis and its resolution. A 25-year-old Moroccan man who came to Spain two years ago fleeing his country and suffered violence in different countries until he arrived. He lived on the street until they offered him a sheltered house with other Moroccans. He felt lack of acceptance and loss of his roots. In this context, he developed a first psychotic episode in which he described “the presence of a devil”.
ResultsHe distrusted antipsychotic treatment and believed “that devil” was still inside him, being convinced that he needed a Muslim healer to expel him. We followed up with the patient and a cultural mediator, better understanding his cultural reality, uprooting and traumas, and he could feel understood and trust us. During the process, he decided to go to the Muslim healer who performed a symbolic rite for which he felt he “expelled the devil”, while accepting antipsychotics. With all this, the psychotic symptoms and their acculturation process improved.
ConclusionsIt is very important that psychiatrists have cultural competence to understand the context of migrant patients, and to be able to provide them with the best treatment.
DisclosureNo significant relationships.
Unplanned Pregnancy in women with mental disorder
- A. Roca Lecumberri, E. Gelabert, A. Torres Giménez, E. Solé, S. Andrés-Perpiñá, E. Roda, C. Lopez, C. Naranjo, L. Garcia-Esteve
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- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, pp. S331-S332
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Introduction
Few studies have investigated the level of planning of pregnancy among women with mental disorder and associated risk factors.
ObjectivesThe purpose of this study was to determine the associated factors to UP and psychopathological consequences.
MethodsA cross sectional study was conducted at the Perinatal Mental Health Unit of the Hospital Clínic in Barcelona. The total sample comprised 675 consecutive pregnant women with diagnosis of mental disorder (DSM-IV criteria), seen between January 2006 and December 2018. Clinical, psychometric and socio-demographic variables were collected at the first visit. Pregnancy planning was assessed by a question “Was this pregnancy planned?” with three possible answers: 1) Yes, it was planned and has been well received; 2) No, it was not planned but it has been well received; and 3) No, it was an accident. Response 1 was coded as “planned pregnancy” and responses 2 and 3 as “Unplanned Pregnancy”.
Results38.4% of the sample had an UP. Younger age, lower levels of education, Latin-American population, multiparity, financials problems and poor relationship with the partner were associated with UP in women with mental disorder. The mean EPDS and STAI scores and the presence of self-harming thoughts were significantly higher in women with UP.
ConclusionsUP was associated with more depressive and anxious symptoms and more self-harming thoughts. It is necessary to promote reproductive health care for women with mental disorders and to take into account their reproductive life plan, especially in those with risk factors described.
DisclosureNo significant relationships.
Differences in physical activity in subjects with psychosis versus a control group
- A.L. Montejo, B. Buch, M.J. López, M.T. Arias, M.D. Corrales, E. Dominguez, C. Matos, B. Cortés, Y. Santana, I. Valrriberas, J. Matías, T. Prieto, M. Gómez-Marcos, L. García-Ortiz, J.M. Acosta
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S763
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Introduction
Psychiatric illnesses are related with a reduced life expectancy and an increase of mortality rates (around 60%) mainly associated with cardiovascular diseases [1]. The high prevalence of obesity, metabolic syndrome, diabetes mellitus and tobacco use among these patients undoubtelly predispose to the impairment in physical health and mortaility increase. Regular physical activity in the general population is associated with a decrease in cardiovascular risk but litle is know about iss influence in some chronic and severe mental disorders like schizophrenia [2].
ObjectivesTo quantify the physical activity performed by a sample of subjects with psychosis, borth males and female, compared to a control group.
MethodsA sample composed of 141 patients with schizoprenia was compared to 103 healthy subjects as a control group. The International Physical Activity Questionnaire - Short Form (IPAQ) scale was applied to all participants. The time (minutes) of physical activity performed in a week (METs) was collected by each participant [3].
ResultsThe differences in the total physical activity Mets for the patients with schizophrenia were highly significant (p = 0.001), showing a lower degree of physical activity compared to the control group. A higher and significant percentage of sedentary lifestyle among the psychiatric group (64.5%), compared to 35.5% in the control group was found.
ConclusionsThe group of pateints with Schizophrenia showed a significant higher sedentary lifestile including less physical activity. This finding could be highly related with a higher risk of cardiovascular disease and deterioration of the physical health.
DisclosureNo significant relationships.
Association between inflammation and neural plasticity biomarkers in olfactory neuroepithelium – derived cells and cognitive performance in patients with major depressive disorder
- A. Toll, M. Portella, P. Robledo, M. Barrera-Conde, R. De La Torre, J.M. Ginés, C. Diez-Aja, V. Soria, P. Lopez-Garcia, V. Pérez-Solà, P. Alvarez
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S552
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Introduction
Inflammation and neural plasticity play a significant role in major depressive disorder (MDD) pathogenesis and cognitive dysfunction. The olfactory neuroepithelium (ON), closely related to the central nervous system (CNS), allows a non-invasive, low-cost study of neuropsychiatric disorders. However, few studies have used ON cells to ascertain them as biomarkers for MDD.
ObjectivesDetermine the relationship between inflammatory/neural plasticity markers and cognitive functioning in MDD patients and healthy controls.
MethodsSample: 9 MDD patients and 7 healthy controls. Exclusion criteria: other Axis I mental disorders (patients) or any mental disorder (controls) and any inflammatory, autoimmune, or CNS diseases. Assessment: sociodemographic, clinical, and cognitive variables (CANTAB) were recorded. mRNA was isolated from ON cells and MAPK14, IL6, TNF-α, Mecp2, BDNF, GSK3, GRIA2, and FosB gene expression levels were quantified using quantitative polymerase chain reaction.
ResultsMDD patients showed decreased levels of BDNF (p=0.022), GSK3 (p=0.027), and working memory (p=0.024) compared with healthy controls. In healthy controls, planning was positively correlated with NRF2, BDNF, and MAPK14 gene expression. In MDD patients no correlation between cognitive parameters and inflammation/neural plasticity biomarkers was found.
ConclusionsThese results reveal that: (1) Plasticity biomarkers such as BDNF and GSK3 could be useful diagnostic tools for MDD (2) MDD is associated with working memory deficits; (3) no association could be determined between planning and NRF2, BDNF, and MAPK14 gene expression in MDD and (4) the ON is a promising model in the study of neuropsychiatric disorders.
DisclosureNo significant relationships.
Miss attending risk factors in gynecological prenatal care among pregnant women at risk for dual pathology
- I. Caro-Cañizares, R. Carmona Camacho, C. Vidal Mariño, N. Lopez Carpintero, E. Baca Garcia
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S320
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Introduction
Access to adequate healthcare is the best means we have for detecting and preventing complications during pregnancy and childbirth. Identifying and preventing factors that can interfere with this access become essential (Gulliford et al., 2002). Mother dual pathology during pregnancy is a condition with severe consequences (Cosp & Ontano, 2009). However there is scarce literature regarding barriers to obstetric care among women at risk for dual pathology.
ObjectivesThe main objective was to explore healthcare access barriers among pregnant women at risk for dual pathology.
MethodsFramed in a broader research (The WOMAP project) 2014 adult pregnant women less than 26 weeks of pregnancy were screened in five hospitals in Madrid (Spain) between 2016-2019. If the screening test (AC-Ok scale) identified the presence of dual pathology during the last month, women were included in the clinical trial and assessed with a more extensive battery (compound by PHQ-9; GAD-7; PCL-5; AUDIT; DAST; and Fagerström Test) and a semi-structured interview.
Results163 women at risk for dual pathology were assessed. Of them, 152 (93,2%) referred to having attended all scheduled appointments. Socioeconomic level (0.184, p=0.024), depression (-0.174, p=0.034), post-traumatic stress symptoms (-0.214, p=0.011) and alcohol reporting (-0.259, p=0.045) were significantly correlated with attendance level.
ConclusionsWomen with more severe symptoms of dual pathology are at higher risk for misatending obstetrical appointments. Social criticism, even subtle or unintentional, related to dual pathology during pregnancy could be restraining these women to attend properly. Thus, care providers should pay attention to women’s mental health and alcohol abuse to prevent miss-attention.
DisclosureNo significant relationships.
Factors associated to stigma in mental health workers of Castilla y Leon. The role of burnout and work motivation
- J.M. Pelayo-Terán, Y. Zapico-Merayo, M.E. Garcia Llamas, S. Vega-García, C. López-Zapico, M.R. Villa-Carcedo, Á. Álvaro-Prieto
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, pp. S689-S690
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Introduction
Stigma is one of the most important barriers to help-seeking, treating maintenance and recovery for people suffering mental disorders. These attitudes, when present in mental health workers, may have a negative effect on the quality of health care.
Objectivesto evaluate the levels of stigma in a representative sample of mental health workers and to explore potential modifiable factors associated to stigma attitudes.
MethodsAn online survey was conducted on the mental health workers of Castilla y León (Spain, 2409164 habs) while projecting the 2022 Mental Health Humanization plan in order to asses educational skills, burnout (Maschlach MBI), Professional Quiality of life (CVP-35) and Stigma attitudes (Mental Illness: Cinician’s Attitudes Scales, MICA4) together with sociodemographic and work position variables.
Results193 workers completed completed the survey. Stigma Attitude values of the sample were low (MICA4: 31.71; SD:7.3) and burnout were low or medium (medium Emotional Exhaustion: 19.22; SD8.89; low Depersonalization: 4.91; SD:3.61; Medium Personal Accomplishment: 34,17; 6.3). In the linear regression (R2=0.249; F:11,527; p<0,001), a lower Stigma was predicted by psychologist (Beta:0,207; p=0,003) or psychiatrist position (Beta:0,204; 0,005), Self-efficacy assessed by the item “I am qualified” in the CVP-35 (Beta:-10,144; p=0,023), and a higher stigma was predicted by nurse assistant position (Beta: -0.230; p=0.001), Depersonalization Burnout dimension (Beta:0,351; p<0,001) and years of service (Beta:0.148; p=0,023)
ConclusionsSome groups of mental workers are more vulnerable to develop stigma attitudes. These, may be increased by fatigue and burnout. Future interventions should determine if reducing burnout and increasing capacitation may be effective in stigma eradication
DisclosureNo significant relationships.
Levetirazetam: antiepileptic-induced psychosis
- C. Vilella Martín, P. García Vázquez, Y. Barrera García, P. Fernández Perea, A. Serrano García, M.Á. Alonso De La Torre López, R. Gómez Martínez, C. Franch Pato
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S732
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Introduction
Levetirazetam is an antiepileptic drug with psychiatric adverse reactions. It includes psychosis, paranoia or hallucinations. The frequency is less than 1%.
ObjectivesTo describe a case of Psychosis produced by Levetirazetam
MethodsRetrospective review of clinical records and complementary test, including psychiatry, electrophysiology and neurology. Diagnosis schales such as Salamanca Questionnaire were used as suport.
ResultsA 42-year-old woman diagnosed with tuberous sclerosis and undergoing treatment with levetirazetam acudes to the emergency department for behavioral disorders. She has presented an episode of aggression against a relative threatening him with a kitchen knife. The family reports that since the change in antiepilepticus 1 month ago, the patient has presented strange behaviors. Te Patient is conscious, uncooperative. Barely Approachable. Suspicious of her surroundings, with psychomotor restlessness, self-reference ideas and sparse speech. Auditory hallucinations seem to be present, as well as depressed and irritable mood. Psychic and somatic anxiety is found.
Levetirazetam is discontinued, being replaced by valproic acid. Risperidone is started at a 3 mg dose. Treatment is well tolerated, and clinical stability is achived. Cluster A personality traits are found. Complementary test Blood and Urine simples, Imaging tests (CT and MRI), electroencephalogram and Electrocardiogram show no alterations
ConclusionsLevetirazetam can cause psychiatric adverse effects. it is important to make a proper diagnosis before a first psychotic outbreak in later life. Drugs that can produce psychiatric side effects should be identified and patients should be inform.
DisclosureNo significant relationships.
Bipolar disorder and maternity
- M. Palomo Monge, M.V. López Rodrigo, C. García Montero, A. Osca Oliver, M.F. Tascón Guerra, M. Pérez Fominaya, V. Ros Font
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, pp. S858-S859
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Introduction
Bipolar disorder can be a severe psychiatric disorder. The combined prevalence of bipolar I, bipolar II, and unspecified bipolar disorders according to DSM-IV is 1.8%. Mean age at first affective episode has been estimated to 20 years among out-patients in the United States (2).
ObjectivesWe present the case of a 40-year-old patient, diagnosed with type I bipolar disorder. In her story, multiple admissions are recorded for both manic and depressive episodes. The patient showed a desire to be a mother and multiple therapeutic interventions were performed, de-escalation of stabilizers until she was withdrawn, which triggered generally manic episodes that required hospital admission.
MethodsGiven the controversy in the decision to maintain or not drug treatment during pregnancy and the lack of clear criteria, in this case it was decided to try to gradually withdraw the treatment, which triggered several serious relapses. It was then decided to maintain the treatment at lower doses than usual or complete withdrawal, which in all cases precipitated relapses. Finally the patient reconsidered her wishes and abandoned the possibility of pregnancy.
ResultsBipolar I Disorder
ConclusionsAlthough most studies have found similar lifetime prevalence rates of bipolar disorder between men and women, gender differences may be evident in the impact of reproductive life events on affected women. In addition to the controversy regarding the decision to maintain or not treatment during pregnancy, there is also the certainty that childbirth can be the specific trigger for a manic or hypomanic episode.
DisclosureNo significant relationships.