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Mindfullness-Based Interventions for Anxiety and Depression
- B. L. B. Mesquita, F. Ribeirinho Soares, M. Fraga, M. Albuquerque, J. Facucho, P. Espada, S. Paulino, P. Cintra
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S948
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Introduction
Mindfulness refers to a process that leads to a mental state characterized by non-judgmental awareness of the present moment experience, including one´s sensations, thoughts, bodily states, consciousness, and the environment, while encouraging openness, curiosity, and acceptance.
ObjectivesThe purpose of this paper is to review the ways in which cognitive and behavioural treatments for depression and anxiety have been advanced by the application of mindfulness practices.
MethodsBrief non-systematic literature on the topic.
ResultsMindfulness has spread rapidly in Western psychology research and practice, in large because of the success of standardized mindfulness-based interventions, consequently research on mindfulness based interventions (MBIs) has increased exponentially in the past decade. The most common include Mindfullness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), which incorporate the essence of Eastern mindfulness practices into the Western cognitive-behavioral practice. MBIs have showed efficacy in reducing the severity of anxiety and depressive symptoms in a broad range of treatment seeking individuals. MBIs have also been showed to perform with not so different results to cognitive-behavioral therapy (CBT).
ConclusionsMBIs have been showed to be important co-adjuvants to pharmacological treatment and psychotherapy of depression and anxiety. To prove this point without doubts and create adequate guidelines that include these forms of treatment more research needs to be done on the matter.
Disclosure of InterestNone Declared
How sexuality is affected and managed in patients under antipsychotic drugs
- F. Ribeirinho Soares, B. Mesquita, A. M. Fraga, M. Albuquerque, J. O. Facucho, P. E. Santos, D. E. Sousa, N. Moura, P. Cintra
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1057
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Introduction
Sexual dysfunction (SD) is a prevalent side effect of antipsychotic drugs (AP), and it impairs patients’ quality of life. Because of the distress caused by it, it should be borne in mind when prescribed since it is responsible for treatment nonadherence or discontinuation. SD affects about 45- 80% of males and 30-80% of females that take it. In SD, all phases of the sexual response cycle may be compromised.
ObjectivesThis non-systematic review of the literature aims to better understand the antipsychotic-induced SD and its management to better compliance of AP-treated patients without compromising their quality of life.
MethodsA semi-structured review on PubMed linking SD as a side effect of AP drugs.
ResultsAll AP drugs can cause SD. It seems related to their mechanism of activity at receptors D2, 5-HT2, α1, H1, and M, which are also involved in sexual function. They do it by diminishing arousal, decreasing libido by blocking motivation and reward system and orgasm indirectly, provoking erectile dysfunction by vasodilatation, and decreasing woman lubrification. Hyperprolactinemia is a significant cause of sexual dysfunctions. Haloperidol, Risperidone, and Amisulpride (prolactin elevating AP) are more likely to cause SD than Olanzapine, Clozapine, Quetiapine, and Aripiprazole (prolactin sparing AP). Although psychotic disorders (Schizophrenia and other psychotic disorders) can impact sexual functioning, according to evidence, there is no denying the role of AP in this issue. Aripiprazole, a D2 partial agonist, has been associated with lower rates of SD and seems to reduce the rates of SD in patients previously treated with other AP. Other AP with the same potential dopamine agonist activity, such as Cariprazine and Brexpiprazole, can probably have the same effect. The management of SD induced by AP drugs should include measuring serum prolactin and modifying risk factors like hypertension, smoking, hyperglycemia, and hypercholesterolemia. In that regard, waiting for spontaneous remission, reducing the dose of the AP prescribed, or switching to Aripiprazole are all viable strategies, if possible. Although the evidence supporting the addition of symptomatic therapies is weak, adding dopaminergic drugs (amantadine, bromocriptine, cabergoline) or drugs with specific effects on sexual functioning (such as phosphodiesterase inhibitors or yohimbine) may be helpful in selected cases.
ConclusionsAlthough all AP drugs can cause sexual dysfunction, it is difficult to determine its true prevalence accurately. AP-induced sexual dysfunction can adversely affect compliance and is one of the factors that must be considered when selecting treatment. In summarizing, Aripiprazole has shown to be the AP with the most favorable profile concerning SD. Cariprazine and Brexpiprazole, being also D2 partial agonists, may cause less SD.
Disclosure of InterestNone Declared
First episode psychosis: the depressive symptoms and suicidal behaviour that follow
- B. L. B. Mesquita, F. Ribeirinho Soares, M. Fraga, M. Albuquerque, J. Facucho, P. Espada, S. Paulino, P. Cintra
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1048
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Depressive symptoms and suicidal behaviour are common among patients that suffered a first-episode psychosis. Depressive symptoms could occur in different phases of psychosis, including in post-psychotic period. Depression is a well-known risk factor for suicidal behaviour in psychosis with data showing that occurrence of depression in psychosis have a significant correlation with suicide risk.
ObjectivesThe purpose of this paper is todo a brief review on the relation of causality that existes between first episode psychosis and depressive symptoms as well as suicidal ideation.
MethodsBrief non-systematic literature review on the topic.
ResultsFirst episode psychosis is not uncommonly followed by depressive symptoms and suicidal thoughts. The rate of suicide attempt in psychotic patients range from 10 to 50%. Individuals with first episode psychosis have a greater risk of suicidal behavior compared with normal population and chronic disorders. In several studies, factors identified as being associated with depressive symptoms after first episode psychosis were anomalies of psychosocial development, poor premorbid childhood adjustment, greater level of continuing positive symptoms and longer duration of untreated psychosis. Suicidal behavior was associated with sexual abuse, previous suicide attempt, comorbid polysubstance use, lower baseline functioning, longer time in treatment, recent negative events, older patients, longer duration of untreated positive and negative psychotic symptoms, family history of severe mental disorder, depressive symptoms and cannabis use. Data also indicate that treatment and early intervention programs reduce depressive symptoms and suicidal behavior after first episode psychosis.
ConclusionsThere is convincing evidence that depressive symptoms and suicidal behaviour have high rates after first episode psychosis. The research for treatment of depressive symptoms and/or suicidal behaviour after first-episode psychosis is very limited, therefore this paper aims to bring to light the importance of more studies on the matter.
Disclosure of InterestNone Declared