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Cannabis use in different mental disorders: a descriptive study in a psychiatric hospital
- B. Samso, A. López Fariña, C. González Navarro, L. Morado San Segundo, A. Bilbao Idarraga, U. López Puentes, R. F. Lopez Brokate, T. Ruiz de Azua Aspizua, U. Ortega Pozas, C. Arán Cisneros, E. Garnica de Cos, I. Alonso Salas
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S334-S335
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Introduction
In the last decade, the prevalence of THC use is increasing among adolescents and adults. There is also strong evidence to suggest that cannabis use is associated with psychiatric comorbidities. The strongest evidence is found between cannabis use and psychotic disorder. However, the literature shows that those who have used cannabis in the past or for a large part of their lives are at higher risk of mood disorders, anxiety, personality disorder or other drug use than those who do not use cannabis in a harmful way.
ObjectivesTo provide an overview of the association between cannabis use and the different mental pathologies presented by the patients admitted during the study period. To describe the prevalence of THC use in the study according to the mental pathology presented by the patient.
MethodsA retrospective observational descriptive study was developed for 3 months, of all patients admitted to the acute unit of the psychiatric hospital. No exclusion criteria were included.
ResultsDuring the period of study 172 patients were admitted to the hospital, classified according to the main diagnosis we have: 49 patients suffer from schizophrenia, 26 bipolar affective disorder, 20 with depressive disorder, 20 with personality disorder, 19 with substance use disorder, 18 with other unspecified disorders and 20 patients with no known previous diagnosis. The prevalence of THC use in the study sample according to diagnosis, would be schizophrenia 16%, Bipolar affective disorder 19%, Depressive disorder 5%, Personality disorder 45%, Substance use disorder 21%, Unspecified disorders 11% and patients with no known previous diagnosis 10%.
ConclusionsThe results obtained in the study in terms of THC use are in agreement with those obtained in the literature. In our study, we observed that cannabis use is associated with psychotic disorders as well as with mood, personality and substance abuse disorders. Given that the frequency of use has increased and there is a strong association with different comorbid psychiatric diagnoses, guidance on modifications in medication strategies might be necessary.
Disclosure of InterestNone Declared
Adherence to psychiatric medications and diagnosis
- C. González Navarro, A. Bilbao Idarraga, I. Alonso Salas, L. Morado San segundo, A. López Fariña, U. López Puentes, B. Samsó Martínez, R. F. Lopez Brokate, T. Ruiz de Azua Aspizua, E. M. Garnica de Cos, U. Ortega Pozas
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S240-S241
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Introduction
Patients with mental disorders frequently become non-adherent during their long term prescribed treatment. This situation frequently triggers clinical worsening and hospital admission. Therefore, non-adherence may result in poorer long term clinical outcomes and has economic implications for health-care providers (Carlos De las Cuevas et al. Neuropsychopharmacol Hung 2021; 23(4):347-362).
Objectives- To describe the adherence to oral and long acting injectable treatment in the sample of patients that were admitted to the short stay hospital unit during the period of study.
- To describe the adherence to treatment amongst psychiatric diagnosis in the sample of study.
MethodsIt was a retrospective observational study with a duration of three months. Data was collected from all patients admitted to the short stay hospital unit during the period of study and there were no specific exclusion criteria. Descriptive statistics were performed. To assess the adherence to pharmachological treatment the patient report, the family report and the pharmacy dispensation according to the existent informatic prescription platform was considered. Regarding the long acting injectable treatment the formulary of administration in the clinical history was checked.
ResultsDuring the period of study 172 patients were admitted to the short stay hospital unit. Of those, 146 patients had a previous pharmacologic prescription. Data of treatment was not possible to obtain in 7 patients. In the sample of study, 83.5% were on oral and 16.5% on long acting injectable treatment. The general adherence to treatment in the sample was 61.87%. In the oral treatment group the adherence was 58.4% and in the long acting injectable treatment group was 65.2%.
Amongst the different psychiatric diagnoses the outcomes of adherence to treatment were: 60.4% in schizophrenia and related psychosis, 62.5% in bipolar disorder, 78.6% in depression, 58.3% in personality disorders and 62% in addictive disorders.
ConclusionsIn our descriptive study adherence to treatment was higher in the long acting injectable treatment group, agreeing with the existent scientific literature.
The results of adherence for schizophrenia and bipolar disorder are similar to the ones found in scientific literature but differ from the ones for depression, being higher in our sample (Judit Lazary et al. Neuropsychopharmacol Hung 2021;23(4): 347-362). Moreover, in scientific literature it is found a similar prevalence of adherence across diagnosis (for schizophrenia, bipolar disorder and depression) whereas in our sample patients with depression showed a different and higher adherence to treatment (Judit Lazary et al. Neuropsychopharmacol Hung 2021;23(4): 347-362). In our sample, patients with personality disorders had the lowest adherence to treatment.
Disclosure of InterestNone Declared
Alcohol consumption and cardiovascular risk: a descriptive study in a psychiatric short stay unit
- C. González Navarro, I. Alonso Salas, L. Morado San segundo, A. López Fariña, A. Bilbao Idarraga, U. López Puentes, B. Samsó Martínez, R. F. Lopez Brokate, T. Ruiz de Azua Aspizua, E. M. Garnica de Cos, U. Ortega Pozas
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S754
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Introduction
Patients with mental disorders have a decreased life expectancy, being the main reason the cardiovascular disease. An important proportion of patients present a comorbid drug consumption. Amongst drugs, alcohol is the most frequent, and it is associated with a higher cardiovascular risk. The metabolic syndrome is one of the most employed tools to assess cardiovascular risk.
Objectives- To describe the demographic characteristics of the patients with an active alcohol consumption that were admitted to the hospital during the period of study.
- To describe the prevalence of metabolic syndrome in the sample, according to the Adult Treatment Panel III (ATP-III) criteria.
MethodsRetrospective observational study of three months duration. Data was collected from all patients admitted to the hospital during the period of study, with no specific exclusion criteria. Descriptive statistics were performed.
ResultsDuring the period of study 172 patients were admitted to the hospital (56.4% women and 43.6% men). A 44.8% presented alcohol consumption (25% sporadically, 6.4% weekly and 13.4% daily). Amongst women, 1% presented daily and 1% weekly consumption. Amongst men, 21.3% presented daily and 5.3% weekly consumption.
The prevalence of metabolic syndrome in the study sample was 29.11%. In the alcohol consumption group, the prevalence was 24.7% and differed according to the pattern of consumption: 43.5% in the daily consumption group, 27.3% in the weekly and 14% in the sporadically consumption group.
ConclusionsOn the one hand, in the sample of study a higher percentage of men present an active alcohol consumption, compared to women. It is remarkable the high percentage of daily alcohol consumption amongst men in our sample.
On the other hand, the prevalence of metabolic syndrome in our sample is similar to the one found in scientific literature regarding patients with mental disorders. It is noteworthy in our sample the increased prevalence of metabolic syndrome found in patients with a daily alcohol consumption, and a decreased prevalence in those with a sporadic pattern.
Disclosure of InterestNone Declared
Tobacco and hypertension: a descriptive study in a psychiatric short care unit
- I. Alonso Salas, A. Lopez Fariña, C. Gonzalez Navarro, A. Bilbao Idarraga, L. Morado San Segundo, U. Lopez Puentes, R. Lopez Brokate, T. Ruiz de Azua Aspizua, E. M. Garnica de Cos, U. Ortega Pozas, B. Samsó Martinez
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S954-S955
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Introduction
Patients affected by mental disorders are known to have a decreased life expectancy.
One of the main reasons are cardiovascular diseases. It is known that tobacco and hypertension are risk factors to develop them. WHO estimates that hypertension is diagnosed and treated in less than half of adults with hypertension, and even less in patients with severe mental illness.
ObjectivesTo describe the demographic characteristics of patients with tobacco comsumption and hypertension admitted to a short-term hospitalization unit.
MethodsA three-month retrospective observational study. Data were collected by interviewing incoming patients and performing a blood pressure measurement, with no exclusion criteria.
ResultsOf 172 patients admitted, 100 were smokers of whom 49 were men and 51 were women. Among the smokers, a total of 18 patients were diagnosed with hypertension and 79 were not diagnosed. Within the group of patients not diagnosed with hypertension, elevated blood pressure was recorded in 5 of them. A total of 67 patients were non-smokers, 23 of whom were male and 44 female. Among the non-smokers, 19 were diagnosed with hypertension and 48 were not, despite which elevated blood pressure levels were recorded in 4 of them. No data were collected from 5 patients.
ConclusionsThe prevalence of smokers in our sample was 58%. The prevalence of patients diagnosed with hypertension was 21,51% which is coherent with the existent literature. We did not find a higher percentage of hypertensive patients among the smokers admitted. There were patients who suffered from hypertension and were not diagnosed or treated previously.
Disclosure of InterestNone Declared
Thyroid disorders in psychiatric patients: a descriptive study in a psychiatric hospital
- U. López, L. Morado San Segundo, C. González Navarro, I. Alonso Salas, A. López Fariña, A. Bilbao Idarraga, B. Samsó Martínez, R. F. López Brokate, E. M. Garnica de Cos, T. Ruiz de Azua Aspizua, U. Ortega Pozas
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S471
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Introduction
Thyroid disorders can present with psychiatric symptons similar to depression, and, at the same time, certain treatments, like litio, can cause changes in thyroid function. Given, therefore, the importance for the treatment and care of patients, the study of thyroid function is one of the parametres that should be requested in patients with psychiatric pathology.
ObjectivesTo study the frequency of thyroid disorders in patients who where admitted to a psychiatric short stay unit.
MethodsRetrospective descriptive observational study is carried out in the acute stay unit of a psychiatric hospital. As a sample, all patients admitted to the unit over a period of three months. During admission, their sociodemographic data, the treatment they receive and their diagnosis are recorded. Secondly, blood test are performed whith differents parameters, including TSH values.
ResultsIn the total sample of 172 patients, 8 of them have TSH abnormalities. 7 of them, all women, present hypothyroidism values.
A single male patient presented values of hyperthryroidism.
ConclusionsAccording to the present study, 4,6% of the patients present alterations at the TSH at admission, although except in one case, the values were not markedly altered.
The thyroid study at admission allows detecting cases of altered TSH that are amenable to treatment and monitoring.
Disclosure of InterestNone Declared
Under-diagnosis of alcohol abuse: a descriptive study in a psychiatric hospital
- A. Lopez Fariña, U. López Puentes, I. Alonso Salas, C. Gonzalez Navarro, A. Bilbao Idarraga, L. Morado Sansegundo, U. Ortega Pozas, C. Aran Cisneros, B. Samso Martinez, R. F. Lopez Brokate, T. Ruiz de Azua Aspizua, E. M. Garnica De Cos
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S333
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Introduction
Incidence of alcohol abuse in our country is high, although it is still under-diagnosed and under-treated. The WHO estimates that a total of 3.3 million deaths worldwide per year are related to alcohol consumption.
ObjectivesThe main objective is to describe the pattern of alcohol consumption in a sample of patients who are admitted to our psychiatric hospital for different reasons, relating with previous diagnoses.
MethodsA retrospective observational descriptive study was carried out in the acute care unit of the psychiatric hospital, after approval of the corresponding protocol by the ethics committee. All patients admitted to this unit during a three-month period were taken as a sample. During admission, sociodemographic data, drug use, treatment type and time and previous diagnoses were collected.
ResultsOut of 172 patients, 81 reported being abstemious, 45 declared occasional consumption, 11 weekly and 22 daily consumption. There is no data about 13 patients. Among those who reported daily alcohol consumption, 59% had a previous diagnosis of Substance Use Disorder (SUD), 23% a previous diagnosis of Schizophrenia, 13.5% of Bipolar Disorder and finally 4.5% of Depressive Disorder. All the patients with a previous diagnosis of SUD reported consumption of more than 10 SDUs/day, the group with Schizophrenia stated less than 5 SDUs/day, of the group with T. Bipolar between 7-10 SDUs/day and with T. Depressive 5 SDUs/day.
ConclusionsThe results obtained are consistent with the literature in relation to the under-diagnosis of alcohol use disorder, taking into account that 40% of patients in the sample with daily alcohol consumption previously had not such a diagnosis and it was not recorded in their medical history. For this reason, and for the sake of being able to treat them, it is essential to question all patients about alcohol consumption, whatever the reason for their admission.
Disclosure of InterestNone Declared
Neuropsychiatric phenotypes of anti-NMDAR encephalitis: a prospective study
- M. Espinola-Nadurille, M. Restrepo-Martínez, L. Bayliss, E. Flores-Montes, V. Rivas-Alonso, S. Vargas-Cañas, L. Hernández, I. Martínez-Juarez, A. Gonzalez-Aguilar, R. Solis-Vivanco, G. L. Fricchione, J. Flores-Rivera, J. Ramirez-Bermudez
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- Psychological Medicine / Volume 53 / Issue 9 / July 2023
- Published online by Cambridge University Press:
- 10 May 2022, pp. 4266-4274
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Background
Patients with anti-N-methyl-d-aspartate (NMDA) receptor encephalitis (ANMDARE) show a wide range of behavioral abnormalities and are often mistaken for primary psychiatric presentations. We aimed to determine the behavioral hallmarks of ANMDARE with the use of systematic neuropsychiatric and cognitive assessments.
MethodsA prospective study was conducted, with 160 patients admitted to the National Institute of Neurology and Neurosurgery of Mexico, who fulfilled criteria for possible autoimmune encephalitis and/or red flags along a time window of seven years. Cerebrospinal fluid (CSF) antibodies against the NR1 subunit of the NMDAR were processed with rat brain immunohistochemistry and cell-based assays with NMDA expressing cells. Systematic cognitive, neuropsychiatric, and functional assessments were conducted before knowing NMDAR antibodies results. A multivariate analysis was used to compare patients with and without definite ANMDARE according to antibodies in CSF.
ResultsAfter obtaining the CSF antibodies results in 160 consecutive cases, 100 patients were positive and classified as having definite ANMDARE. The most frequent neuropsychiatric patterns were psychosis (81%), delirium (75%), catatonia (69%), anxiety-depression (65%), and mania (27%). Cognition was significantly impaired. A total of 34% of the patients had a predominantly neuropsychiatric presentation without seizures. After multivariate analysis, the clinical hallmarks of ANMDARE consisted of a catatonia–delirium comorbidity, tonic-clonic seizures, and orolingual dyskinesia.
ConclusionsOur study supports the notion of a neurobehavioral phenotype of ANMDARE characterized by a fluctuating course with psychotic and affective symptoms, catatonic signs, and global cognitive dysfunction, often accompanied by seizures and dyskinesia. The catatonia–delirium comorbidity could be a distinctive neurobehavioral phenotype of ANMDARE.
Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey
- J. Alonso, G. Vilagut, I. Alayo, M. Ferrer, F. Amigo, A. Aragón-Peña, E. Aragonès, M. Campos, I. del Cura-González, I. Urreta, M. Espuga, A. González Pinto, J. M. Haro, N. López Fresneña, A. Martínez de Salázar, J. D. Molina, R. M. Ortí Lucas, M. Parellada, J. M. Pelayo-Terán, A. Pérez Zapata, J. I. Pijoan, N. Plana, M. T. Puig, C. Rius, C. Rodriguez-Blazquez, F. Sanz, C. Serra, R. C. Kessler, R. Bruffaerts, E. Vieta, V. Pérez-Solá, P. Mortier, MINDCOVID Working group
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 31 / 2022
- Published online by Cambridge University Press:
- 29 April 2022, e28
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Aims
Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors.
Methods8996 healthcare workers evaluated on 5 May–7 September 2020 (baseline) were invited to a second web-based survey (October–December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview.
Results4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar.
ConclusionsOur study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565
Pending challenges to e-mental health in the COVID-19 era: Acceptability of a smartphone-based ecological momentary assessment application among patients with schizophrenia spectrum disorders
- J.-D. Lopez-Morinigo, B.-E. Maria Luisa, A. Porras-Segovia, A. Sánchez-Escribano Martínez, P.-J. Escobedo-Aedo, V. González Ruiz-Ruano, L. Mata-Iturralde, L. Muñoz-Lorenzo, S. Sánchez-Alonso, A. Artés-Rodríguez, E. Baca-Garcia
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S343
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Introduction
Concerns have been raised about ecological momentary assessment (EMA) acceptability among patients with schizophrenia spectrum disorders (SSD), which is of major relevance during the e-Mental health-focused COVID-19 pandemic.
ObjectivesTo investigate i) the levels of adherence to a passive smartphone-based EMA tool, the Evidence-Based Behavior (eB2), among SSD patients; and ii) putative predictors of this.
MethodsSample: SSD (F20-29-ICD10) outpatients, age 18-64, without financial incentives, recruited over 17/06/2019-11/03/2020 at the Hospital Universitario Fundación Jiménez Díaz (Madrid, Spain). Those who accepted the eB2 installation -users- and those who did not -non-users- were compared in sociodemographic, clinical, premorbid adjustment, neurocognitive, psychopathological, insight and metacognitive variables by a multivariable binary logistic regression model.
ResultsSample (N=77): n=41 males; age: 47.69±9.76 years, n=24 users (31.2%). n=14 users (70%) had the eB2 installed at follow-up (median=14.50 weeks).
Multivariable binary logistic regression model on ‘user’ as outcome β SE Wald p OR 95% CI Age -0.075 0.038 3.910 0.048 0.928 0.861-0.999 Education level -0.967 1.289 0.563 0.453 0.380 0.030-4.755 Early adolescence premorbid adjustment -0.285 0.110 6.695 0.010 0.752 0.606-0.933 Trail Making Test A -0.030 0.025 1.488 0.222 0.970 0.924-1.018 Trail Making Test B -0.005 0.010 0.278 0.598 0.995 0.976-1.014 Cognitive Insight 0.062 0.061 1.043 0.307 1.064 0.944-1.200 X2=25.296,df=6,p<0.001. Nagelkerke-R2=44.7%. Correctly classified: 76.9%, users:54.5%, non-users:88.4%.
ConclusionsAcceptability of a smartphone-based EMA application among SSD patients was low. Age (young) and good premorbid adjustment predicted acceptability. e-Mental Health methods need to be tailored for patients with SSD. Otherwise, these highly vulnerable individuals may be neglected by e-health-based services in the post-COVID-19 years ahead.
Thirty-day suicidal thoughts and behaviours in the Spanish adult general population during the first wave of the Spain COVID-19 pandemic
- P. Mortier, G. Vilagut, M. Ferrer, I. Alayo, R. Bruffaerts, P. Cristóbal-Narváez, I. del Cura-González, J. Domènech-Abella, M. Felez-Nobrega, B. Olaya, J. I. Pijoan, E. Vieta, V. Pérez-Solà, R. C. Kessler, J. M. Haro, J. Alonso, MINDCOVID Working group
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 30 / 2021
- Published online by Cambridge University Press:
- 17 February 2021, e19
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Aims
To investigate the prevalence of suicidal thoughts and behaviours (STB; i.e. suicidal ideation, plans or attempts) in the Spanish adult general population during the first wave of the Spain coronavirus disease 2019 (COVID-19) pandemic (March−July, 2020), and to investigate the individual- and population-level impact of relevant distal and proximal STB risk factor domains.
MethodsCross-sectional study design using data from the baseline assessment of an observational cohort study (MIND/COVID project). A nationally representative sample of 3500 non-institutionalised Spanish adults (51.5% female; mean age = 49.6 [s.d. = 17.0]) was taken using dual-frame random digit dialing, stratified for age, sex and geographical area. Professional interviewers carried out computer-assisted telephone interviews (1–30 June 2020). Thirty-day STB was assessed using modified items from the Columbia Suicide Severity Rating Scale. Distal (i.e. pre-pandemic) risk factors included sociodemographic variables, number of physical health conditions and pre-pandemic lifetime mental disorders; proximal (i.e. pandemic) risk factors included current mental disorders and a range of adverse events-experiences related to the pandemic. Logistic regression was used to investigate individual-level associations (odds ratios [OR]) and population-level associations (population attributable risk proportions [PARP]) between risk factors and 30-day STB. All data were weighted using post-stratification survey weights.
ResultsEstimated prevalence of 30-day STB was 4.5% (1.8% active suicidal ideation; n = 5 [0.1%] suicide attempts). STB was 9.7% among the 34.3% of respondents with pre-pandemic lifetime mental disorders, and 1.8% among the 65.7% without any pre-pandemic lifetime mental disorder. Factors significantly associated with STB were pre-pandemic lifetime mental disorders (total PARP = 49.1%) and current mental disorders (total PARP = 58.4%), i.e. major depressive disorder (OR = 6.0; PARP = 39.2%), generalised anxiety disorder (OR = 5.6; PARP = 36.3%), post-traumatic stress disorder (OR = 4.6; PARP = 26.6%), panic attacks (OR = 6.7; PARP = 36.6%) and alcohol/substance use disorder (OR = 3.3; PARP = 5.9%). Pandemic-related adverse events-experiences associated with STB were lack of social support, interpersonal stress, stress about personal health and about the health of loved ones (PARPs 32.7–42.6%%), and having loved ones infected with COVID-19 (OR = 1.7; PARP = 18.8%). Up to 74.1% of STB is potentially attributable to the joint effects of mental disorders and adverse events−experiences related to the pandemic.
ConclusionsSTB at the end of the first wave of the Spain COVID-19 pandemic was high, and large proportions of STB are potentially attributable to mental disorders and adverse events−experiences related to the pandemic, including health-related stress, lack of social support and interpersonal stress. There is an urgent need to allocate resources to increase access to adequate mental healthcare, even in times of healthcare system overload.
Study registration numberNCT04556565
PW01-35 - A Prospective Study of Mixed Bipolar Patients: Ten Years of Follow Up
- A. Ugarte, J. García, S. Ruiz de Azúa, I. González, M. Sáenz, M. Gutierrez, C. Valcarcel, E. Zuhaitz, I. de la Rosa, R. Alonso, A. González-Pinto
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- European Psychiatry / Volume 25 / Issue S1 / 2010
- Published online by Cambridge University Press:
- 17 April 2020, 25-E1437
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Introduction
Mixed Bipolar patients are those who have co-existing depressive symptoms during mania. These patients are supposed to have a worse evolution.
ObjectiveThe objective of this study was to compare the long-term outcomes of patients who had at least one mixed episode with those who experienced only pure manic episodes.
Methods169 outpatients diagnosed of Bipolar I disorder and treated at least during two years were included. 120 patients (71%) complited the follow-up over 10 years. Baseline demographic and clinical variables were included.
ResultsThe patients with mixed episodes (37%) had a significantly younger mean age at onset comparing with those with manic episodes (25.3 years vs. 30.8 years; p=0.025) they also had more previous mood- incongruent psychotic symptoms χ2= 6.77, p=0.034), more number of hospitalizations (OR= 1.36, 95% CI = 1.14; -1.63; p< 0.001), and more number of episodes (OR= 1.21, 95% CI = 1.10-1.31; p< 0.001). There were no significant differences relating to depressive episodes, alcohol use, drug abuse, suicidal behaviour and suicide attempts.
DiscussionAge at onset differed significantly between the mixed episode and pure mania groups, with mixed episode patients having a younger age of onset. This is interesting as one of the major results of the study we have found that age at onset mediates some of the factors classically related to outcome in mixed episodes like alcohol abuse and suicide attempts. However, independently of age at onset, these patients represent a especially severe type of bipolar disorder.
Psychopathology and global functioning in schizophrenic patients on depot antypsychotics and long-acting injectable risperidone: A six month comparative study
- A. Intxausti, A.L. Morera, C.C. González-Hernández, D. Alonso-Diaz, N. González-Brito, D. Hernández-García, M. Henry, A. Orozco, E. Díaz-Mesa, E. de Diego-Herrero
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- Journal:
- European Psychiatry / Volume 22 / Issue S1 / March 2007
- Published online by Cambridge University Press:
- 16 April 2020, p. S116
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Introduction:
The introduction of the first atypical antipsychotic with a long acting formulation has open new therapeutic options for the treatment of schizophrenic patients. Our objective consists of comparing psychopathology levels and global functioning in patients with paranoid schizophrenia treated in monotherapy either with long-acting injectable risperidone (LAIR) or conventional depot antipsychotics (DA).
Methods:Patients attending at the community mental health center during the six-month recruitment period were eligible to enter the study. Scores achieved in positive and negative subscales of PANNS and EEAG scale of (Global Activity Evaluating Scale) were evaluated at baseline and 6 months later. Six patients treated with RLAI and six patients treated with DA were recruited. Data were analyzed both with the real sample (N=6 per group) and extrapoling the same results to a bigger sample size (N=24 per group).
Results:Mean increase in scores for both PANNS positive and negative subscales were lower in patients treated with RLAI that in those treated with DA (positive subscale: 0.018±0.06 vs. 0.048±0.03, RLAI and DA, respectively, p=0.387; negative subscale: 0.232±0.076 vs. 0.3095±0.123, RLAI and DA, respectively, p=0.579). EEAG scores were higher for patients treated with RLAI than those treated with DA (1.250±0.56 vs. 0.333±0.225, p=0.144). When these results are extrapolated to a sample of 24 patients per group, differences in EEAG reach statistical significance (p=0.034).
Conclusions:After 6 months of treatment, patients treated with RLAI tend to show a greater improvement in their global activity than those treated with DA.
EPA-0610 – Without Fear of Change
- M. Gordillo Montaòo, S. Fuentes Marquez, R. Alonso Diaz, M. Ramirez Dominguez, C. Gonzalez Macìas, E. Guillen Guillen
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- European Psychiatry / Volume 29 / Issue S1 / 2014
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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In this exhibition we aim to describe a clinical case and the different consequences that may present additional problems with eating disorders, focusing with emphasis on development and clinical picture. This disorder usually occurs in non-obese adolescents accused, showing symptoms significantly related to interpersonal functioning of these adolescents, who tend to be isolated or seek company of younger guys. They are characteristic of obsessive-compulsive disorders related or unrelated to the food. Dietary restriction involves biological and physical changes, highlighting the alteration of hypothalamic and endocrine system, leading to signs and symptoms such as amenorrhea, cold intolerance, hypotension … Neurochemical changes have also been attributed to malnutrition.
The present case is a 31 year old woman. Initiates contact with Mental Health at age 15 by anorexia nervosa. Patient requests for worsening nutritional status, family relationships, and alcohol consumption, being the turning point and main motivation, the birth of his daughter. 8 months ago gave birth, being an unexpected delivery at home. Unaware that pregnancy, justifying as secondary amenorrhea eating disorder and abdominal inflammation malnutrition. Daughter born seven months income requires low weight and withdrawal symptoms during pregnancy as continuous with anxiolytic and antidepressant treatment.
It has a favorable, always maintaining therapeutic commitment announced at the beginning of tratamiento. Currently still in out patient reviews with Psychiatry, Clinical Psychology, Nursing and Nutrition.
2179 – Psychedelic Drugs In Psychotherapy. a Revival?
- V.M. Barrau-Alonso, J. Sendra-Lopez, N. Benítez-Álvarez, E. Vera-Barrios, A. Hernández-Dorta, G. Díaz-Marrero, I. González, P. Quandt, R. Gracia-Marco
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- Journal:
- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E1342
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Introduction
Psychedelic drugs were used extensively in psychotherapy in the 1950s to lower psychological defences and facilitate emotional insight. Thousands of research participants were administered hallucinogens in the context of basic clinical research or therapeutic clinical research, resulting in hundreds of publications. Results across studies were ultimately inconclusive due to such variations in methods and a lack of modern controls and experimental rigour. The growing controversy and sensationalism resulted in increasing restrictions on access to hallucinogens throughout the 1960s (ultimately resulting in the placement of the most popular hallucinogens into Schedule I of the 1970 Controlled Substances Act in the United States).
AimsRenewed human administration research began in the 1990s. Recent clinical studies have administered hallucinogens to evaluate their safety and efficacy in the treatment of psychiatric disorders: specifically, anxiety related to advanced-stage cancer (Grob, 2005), obsessive-compulsive disorder (Moreno, et al., 2006), heroin dependence (Krupitsky, et al., 2007), personal meaning and spiritual significance (Griffiths, et al., 2008), and a meta-analysis of randomized controlled trials of LSD for alcoholism (Krebs,et al., 2012).
ResultsPsychedelic-assisted psychotherapy utilizes the acute psychological effects of psychedelic drugs to enhance the normal mechanisms of psychotherapy. The effects of psychedelic psychotherapy are often very pronounced within several days or weeks after a treatment session, but then these effects quickly decline. This phenomenon was termed a “psychedelic afterglow”.
ConclusionsFhurther research, blinded, randomized, placebo-controlled, methodology should explore the efficacy of hallucinogens.
1852 – Psychosis In Parkinson's Disease. a Case Report
- G. Diaz Marrero, M.N. Suarez Benitez, E. Vera-Barrios, A. Hernandez-Dorta, I. Gonzalez, P. Quant-Herrera, V.M. Barrau Alonso, S. Yelmo
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- Journal:
- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E1103
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Introduction
Parkinson's disease (PD) is classified primarily as a movement disorder. Psychiatric complications, however, are common during the progression of the disease. Psychosis is rare in untreated patients with PD, but the prevalence rises to 40% during dopaminergic treatment.
ObjectivesWe report the clinical course of a ropinirole induced psychosis in a 57-year-old female with PD.
Aims/methodsThe patient was treated with different antiparkinsonians (rasagiline, ropinirole and levodopa), and after a dosage increase of ropinirole, psychotic symptoms appeared (auditory hallucinations and paranoid delusion). Antipsychotic treatment started with quetiapine and a gradual dose reduction of antiparkisonians. Nevertheless, psychotic symptoms required a hospital admission.
Rasagiline was suspended at admission, the dose of ropinirole was decreased until withdrawal, and the dose of levodopa was reduced. The dose of quetiapine was increased to control psychotic symptoms.
ResultsThe pathogenesis of psychosis in PD is poorly understood. It has been related with the presence of dementia and concomitant treatment with dopaminergic agonists (DA). According to the literature, pergolide is associated with a significantly increased risk for the development of psychosis, followed by ropinirole, pramipexole and cabergoline, whereas levodopa has the lowest associated risk. Treatment includes, in the first place, suspending anticholinergics and selegiline, and then, amantadine, DA, and entacapone. Finally, levodopa may also be reduced. These patients frequently require antipsychotic treatment that may worsen extrapyramidal symptoms.
ConclusionsPsychosis should be considered in PD, especially in patients treated with DA. Treatment begins with reducing antiparkinsonians and then adding antipsychotics. Clozapine and quetiapine are a good choice.
EPA-0508 - Suicide Risk in Group Therapy
- S. Fuentes Márquez, C. González Macías, R. Alonso Díaz, M.C. Ramírez Domínguez, M.J. Gordillo Montaño, M.A. Anguita Martínez, E. Guillén Guillén
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- Journal:
- European Psychiatry / Volume 29 / Issue S1 / 2014
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction:
Suicidal behavior is a serious public health problem, being one of the leading causes of death in our country. Therefore, the identification of factors that increase or decrease the level of suicidal risk is of great importance for the close link with the conduct. There are several risk factors, including family and contextual, among which are the loss of significant others, including those that have been produced by suicide.
Objectives:In this paper, we analyze these factors in a group of patients performing a Group Therapy.
Aims:Several studies point to the existence of a moderate correlation between the BDI item 9 (‘suicidal impulse’) with a higher score on the SSI. Another goal is to check whether this relationship is between the members of our group.
Methods:To this end, two scales were administered prior to the start of Therapy: Beck Depression Inventory, a self-report scale, and the Scale of Suicide Ideation Beck (hetero).
Results:Our study confirms the existence of a moderate correlation between BDI item 9 (‘suicidal impulse’) and SSI. Therefore, item 9 of the BDI predicts a moderate way the result of the SSI that is related to suicidality. Similarly there is a significant correlation between total BDI SSI. We conclude that the intensity of the symptoms of depression is related to suicidality.
Conclusions:Consider necessary after evaluation and detection of these high-risk individuals, conducting therapeutic work aimed at the prevention of suicidal behavior within the individual treatment plan for these patients.
EPA-0609 – This Time was Serious
- M. Gordillo Montaòo, M. Ramirez Dominguez, S. Fuentes Marquez, C. Gonzalez Macias, R. Alonso Diaz, E. Guillen Guillen, A. Rodriguez Martinez
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- European Psychiatry / Volume 29 / Issue S1 / 2014
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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The potential suicide is a person with intense suffering and is always a serious patient, for whom by their despair, future expectations do not exceed a painful present.
Expose more carefully try this idea by describing a case of a patient with highly lethal suicide attempts, severe, recurrent (repeated blows with a hammer to the skull, incised wound in the abdomen after a knife stab, multiple cuts with a knife upper and lower limbs …). Besides these aspects, point out the risk factors found in this patient and further foster suicide problem. Borderline personality disorder and depressive disorder, in which we highlight a high difficulty in solving problems and hopelessness, the harmful use of cocaine and alcohol, and demographic factors such as age, gender and part of socially minority group. The profile of temperament and personality point out a tendency to novelty seeking and harm avoidance, coupled with aggressive and impulsive behavior, without a clear definition of objectives and targets, and low capacity for cooperation which is observed by manipulative attitude posing in repeated hospital admissions.
Therefore, we emphasize that suicide is a complex entity and their pricing strategies, risk detection and prevention, are hampered by the lack of a definition and classification operative. That said, and considering that you have to work in a comprehensive manner, we considered what we should prioritize in the treatment of this patient to prevent another attempted suicide, is the psychiatric disorder, substance use, social status risk that found, or suicidal symptoms itself?
1391 – Manic Episode For Consumption Of Energy Drinks
- A. Hernandez Dorta, P. Quandt Herrera, G. Diaz Marrero, N. Suárez Benitez, E. Vera Barrios, V. Barrau Alonso, I. Gonzalez Gonazalez
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- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E721
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Introduction and objectives
Description of a manic episode with psychotic symptoms in a patient by consumption of energy drinks.
Aims and methodsLiterature review of the relationship between energy drink consumption and the possibility of suffering a manic episode and description of a clinical case.
CaseThis case report describes a patient with no history of psychiatric interest suffers a manic episode with psychotic symptoms after consuming high amounts of energy drinks.
Results and conclusionsTo my knowledge, this is one of the few cases that describe a manic episode in relation to the consumption of energy drinks, given this possibility, clinicians should consider asking about the consumption of energy drinks to young people without previous psychiatric history presenting a manic episode.
Results of a smoking cessation program in primary care
- H. de la Red Gallego, Y. González Silva, T. Montero Carretero, Á. Delgado de Paz, M.F. Sánchez Añorga, E. Cañibano Maroto, G. Isidro García, A. Álvarez Astorga, A. Alonso Sánchez, M. Martín Fernández, A. Álvarez Hodel, I. Pérez González, S. Nieto Sánchez, S. Calvo Sardón, I. González Gurdiel, R. Hernández Antón, S. Gómez Sánchez, C. Noval Canga, M.S. Hernández García, L. Rodríguez Andrés
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- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, pp. S297-S298
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Introduction
Smoking is an addictive and chronic disease. Twenty-four percent of the Spanish population in 2012 smoked daily.
Aims and objectivesTo evaluate a smoking cessation program in a Primary Care Center.
MethodsObservational, prospective study. We describe an individualized smoking cessation in Plaza del Ejército Health Center (Valladolid). Inclusion criteria: active smoker, ≥ 18 years old and belonging to the Health Center. Exclusion: severe mental illness. Included patients from November 2013 until January2014. Ended in July 2014. Four Medical residents participated, we present the results of one of them. During the first consultation motivational interviewing was conducted, physical examination and treatment was prescribed (cognitive behavioral therapy or drug treatment: varenicline). In subsequent consultations interview and follow-up. Variables: age, gender, pack-years, nicotine dependence (Fagerstrom) and Prochaska and DiClemente phase, weight, treatment used, dropout rate and final withdrawal of snuff.
ResultsEleven patients, mean age 48.18 (13.61), 7 (63.6) women. Comorbidity: 6 (54.5) anxious-depressive pathology, 1 (9.1) dysthymia, 2 (18.2) endocrine pathology and 1 (9.1) respiratory disease. Four (36.4) showed high dependency and 2 (18.2) extreme. Media packages 20.50/year (19,20). Seven (63.6) were in action phase of Prochaska and DiClemente and 2 (18.2) in preparation. Visits range: 1-11. The average was 4.55 (3.64). Three (27.27) patients attended only the first visit. Four (36.4) achieved complete abstinence, 3 (27.27) met maintenance phase. One (9.1) reduced consumption in half. Patients gained average 0.5 kg (2.47).
ConclusionsThe results are similar to those reported in other series. Modest dropout rate. No pharmacological treatment was used due to high coexistence of comorbidities, the only patient who used varenicline suffered insomnia. Average age and media packages were superior to other series.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Profile lipid and obesity in patients with Tms to treatment with antipsychotis
- A. Gonzále. Suaréz, L. Lago García, A. Alonso Huerta, S. Ocio León, M. Gómez Simon, M.J. Hernández González, O. Walid Muquebil Ali Al Shaban Rodriguez, M.P. Estebanez Suarez, I. Barreda Salas, J. Lopéz Fernandez, D. Frias Ortiz, E. Torio Ojea
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- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, pp. S684-S685
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Introduction
Psychiatric patients tend to have severe metabolic alterations of multifactorial causes, lifestyle, diet, drug use and psychopharmacological treatment, especially antipsychotic drugs which act as risk factors for cardiovascular disease, strokes, infections and complications of diseases basal negatively influencing its evolution and prognosis.
ObjectivesRating the profile lipid and the prevalence of obesity in patients registered as disorder mental severe in treatment with antipsychotics.
Aims/methodsA descriptive study was performed taking as variables to take into account levels of cholesterol, triglycerides, weight and size.
ResultsOf the 28 patients included in the study 7 refused to perform the corresponding measurements. Of the 21 remaining, 3 showed values higher than 150 mg/dl triglycerides and cholesterol figures higher than 200 mg/dl. Other 3 patients presented hypercholesterolemia without alteration of triglycerides and 2 hypertriglyceridemia without elevation of the cholesterol. Concerning the IMC, found that 7 patients presented overweight (BMI > 25 and < 30) and 5 patients obesity (BMI > 30). Of the 8 patients with lipid disorders, 2 had prescribed treatment with risperidone (oral or injectable) more quetiapine, 2 oral risperidone as monotherapy, risperidone1 more amisulpride, 1 quetiapine more aripiprazole, quetiapine 1 in monotherapyand 1 injection invega more oxcarbamacepina.
ConclusionsWe found lipid alterations in a 38.1% of patients and a BMI greater than 25 in a 57.14% of 21 patients who agreed to the study. The most prescribed antipsychoticamong these patients were risperidone (5 patients) followed closely by quetiapine (4 patients).
Disclosure of interestThe authors have not supplied their declaration of competing interest.