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Mechanism of Acid Activation of Magnesic Palygorskite
- F. Gonzalez, C. Pesquera, I. Benito, S. Mendioroz, J. A. Pajares
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- Journal:
- Clays and Clay Minerals / Volume 37 / Issue 3 / June 1989
- Published online by Cambridge University Press:
- 02 April 2024, pp. 258-262
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This paper compares the texture of palygorskite after acid leaching with that of the product after extraction silica is removed. These effects were evaluated on the basis of nitrogen adsorption-desorption and mercury penetration porosimetry. Acid leaching at reflux temperature with 2 N HCl resulted in an increase in surface area from 138 to 399 m2/g, due to a partial (~50%) dissolution of the octahedral sheet and the creation of microporosity. This microporosity disappeared if the silica generated by the leaching was removed. The surface area also decreased from 399 to 214 m2/g, and the pore volume decreased from 0.538 to 0.507 cm3/g. The microporosity must therefore have been due to texture development in the generated silica.
Inequality on the frontline: A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic
- Diana Czepiel, Clare McCormack, Andréa T.C. da Silva, Dominika Seblova, Maria F. Moro, Alexandra Restrepo-Henao, Adriana M. Martínez, Oyeyemi Afolabi, Lubna Alnasser, Rubén Alvarado, Hiroki Asaoka, Olatunde Ayinde, Arin Balalian, Dinarte Ballester, Josleen A.l. Barathie, Armando Basagoitia, Djordje Basic, María S. Burrone, Mauro G. Carta, Sol Durand-Arias, Mehmet Eskin, Eduardo Fernández-Jiménez, Marcela I. F. Frey, Oye Gureje, Anna Isahakyan, Rodrigo Jaldo, Elie G. Karam, Dorra Khattech, Jutta Lindert, Gonzalo Martínez-Alés, Franco Mascayano, Roberto Mediavilla, Javier A. Narvaez Gonzalez, Aimee Nasser-Karam, Daisuke Nishi, Olusegun Olaopa, Uta Ouali, Victor Puac-Polanco, Dorian E. Ramírez, Jorge Ramírez, Eliut Rivera-Segarra, Bart P.F. Rutten, Julian Santaella-Tenorio, Jaime C. Sapag, Jana Šeblová, María T. S. Soto, Maria Tavares-Cavalcanti, Linda Valeri, Marit Sijbrandij, Ezra S. Susser, Hans W. Hoek, Els van der Ven
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- Journal:
- Cambridge Prisms: Global Mental Health / Volume 11 / 2024
- Published online by Cambridge University Press:
- 04 March 2024, e34
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Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women’s well-being and ensure healthcare system preparedness during future public health crises.
P110: Development and validation of the Relationship Quality Scales in Caregiving (RQSC): preliminary results.
- L. Mérida, I. Cabrera, L. Gallego-Alberto, I. García-Batalloso, V. Da Silva, A. Losada- Baltar, M. Márquez-González
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 128-129
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Objective:
Caring for a person with dementia is a chronic stress situation. The quality of the relationship between the family caregiver and the persona with dementia (PWD) is a relevant variable to understanding caregivers ́ well-being. However, there are no specific scales that measure this variable in this context. This study aims to analyze the preliminary psychometric properties of the Relationship Quality Scales in Caregiving” (RQSC) ” which measures caregivers ́ perception of different aspects of the relationship in the dyad before the onset of dementia and the present moment.
Methods:The sample was composed of 55 family caregivers of people with dementia. The Relationship Quality Scales in Caregiving (RQSC) include two subscales assessing the quality of the relationship, respectively, before the dementia onset (Past Relationship; PR) and in the present moment (Current Relationship; CR), and it also provides an index of the perception of change (Change score) in the relationship quality, namely: Actual Quality minus Past Quality. Internal consistency and factor validity (through exploratory factor analysis and parallel analysis) were explored. Construct validity of the instrument was also explored, analyzing its correlation with caregivers’ reactivity to behavioral and psychological symptoms of dementia (BPSD), caregivers’ ambivalent feelings towards the care recipient, and caregivers’ depressive symptoms.
Results:The results from the EFA and parallel analyses suggest that both RQSC subscales have a unidimensional structure. Both the PR subscale and the CR subscale show good to excellent reliability and validity indexes. Significant negative correlations between both PR and CR subscales and reactivity to BPSD, ambivalent feelings, and depression have been found
Conclusion:The instrument seems to show good psychometric properties that recommend its use. The results support the relevance of caregivers ́ perception of their relationship with the PWD for understanding caregivers’ wellbeing. However, these are preliminary results that should be replicated in future studies using a bigger sample and additional psychometric data.
Phase-Transition Process in the Hydrothermal Zeolitization of Volcanic Ash into LTA and FAU Structures
- Jorge D. Monzón, Maximiliano R. Gonzalez, Mercedes Muñoz, Andrea M. Pereyra, Elena I. Basaldella
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- Clays and Clay Minerals / Volume 69 / Issue 6 / December 2021
- Published online by Cambridge University Press:
- 01 January 2024, pp. 735-745
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Minerals such as quartz, present widely in various volcanic ashes, remain unaltered throughout the low-temperature hydrothermal process currently used in industry to obtain zeolites, causing an incomplete hydrothermal transformation of the starting solid. This study presents a novel and cost-effective procedure which improves the reactivity of ash toward the generation of zeolite by increasing the availability of silica and alumina components. This method leads to a final product with a large zeolite content. The transformation consisted of an ash-activation step followed by hydrothermal zeolitization. The influence of the structural, chemical, and morphological characteristics of the volcanic ash as well as the effect of the activation procedure on the ash reactivity were studied. A collected sample (VA) and an amorphous fraction obtained after VA sieving (VA40, retained on #40 mesh) were used for zeolite production. These solids were alkaline-treated separately, aged, and reacted under controlled conditions of temperature at autogenous pressure. Throughout the process, the solid phases were characterized by X-ray diffraction, energy dispersive X-ray microanalysis, scanning electron microscopy, Fourier-transform infrared spectroscopy, and N2adsorption-desorption porosimetry measurements. After activation and alkaline aging, the presence of quartz and plagioclase minerals in the natural ash seemed to improve the growth of NaAlSiO4 polymorphs, which in turn were transformed easily to zeolite structures. Even under adequate pretreatment and suitable synthesis conditions, the coarse non-crystalline fraction led to low conversion, while the highest conversions to zeolites A and X were obtained from the natural ash. The outcomes of the present study could be used to improve the conversion levels of other non-conventional aluminosiliceous minerals into zeolites.
“Helping us by helping you”: Pro bono consulting and graduate student training
- Manuel F. Gonzalez, Lauren Offermann, Nicole A. Alonso, Jennifer D. Bragger, Valerie I. Sessa, Mele Kramer
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- Industrial and Organizational Psychology / Volume 16 / Issue 4 / December 2023
- Published online by Cambridge University Press:
- 22 November 2023, pp. 468-472
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Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study
- Ana Portillo-Van Diest, Gemma Vilagut, Itxaso Alayo, Montse Ferrer, Franco Amigo, Benedikt L. Amann, Andrés Aragón-Peña, Enric Aragonès, Ángel Asúnsolo Del Barco, Mireia Campos, Isabel Del Cura-González, Meritxell Espuga, Ana González-Pinto, Josep M. Haro, Amparo Larrauri, Nieves López-Fresneña, Alma Martínez de Salázar, Juan D. Molina, Rafael M. Ortí-Lucas, Mara Parellada, José M. Pelayo-Terán, Aurora Pérez-Zapata, José I. Pijoan, Nieves Plana, Teresa Puig, Cristina Rius, Carmen Rodríguez-Blázquez, Ferran Sanz, Consol Serra, Iratxe Urreta-Barallobre, Ronald C. Kessler, Ronny Bruffaerts, Eduard Vieta, Víctor Pérez-Solá, Jordi Alonso, Philippe Mortier, MINDCOVID Working Group
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 32 / 2023
- Published online by Cambridge University Press:
- 09 August 2023, e50
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Aim
To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress.
MethodsThis is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP).
ResultsThirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4–95.6%) and work-related stressful experiences (PARP range 76.8–86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety.
ConclusionsTSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.
Use of tianeptine sulfate over-the-counter, literature review, and case report
- A. J. Palma Conesa, M. I. Rico Rangel, I. González Milla, A. Aranzadi
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S137-S138
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Introduction
Tianeptine is prescribed as an antidepresant in Europe. The prescription drug is produced as tianeptine sodium. However, it can also be found on the Internet as tianeptine sulfate sold as a nootropric. Misuse of tianeptine sodium has been documented, but there’s little scientific evidence of tianeptine sulfate use.
ObjectivesReview the use of tianeptine sulfate without prescription.
Present a clinical report of tianeptine sulfate use.
MethodsPubMed review of tienptine use without prescription.
Clinical report of a patient using tianeptine sulfate adquiered on the Internet.
ResultsSystematic review on PubMed using the search term “tianeptine abuse” conducted on 01/10/2022. A total of 71 articles were found from wich 33 mentioned the use of tianeptine use without prescription. A total of 23 case reports of tianeptine use without prescription were found. None of them made the difference between tiaenptine sodium or tianeptine sulfate. Only one article mentioned the use of tianeptine sulfate from an Internet search on Internet fora (Smith et al. Am J Drug Alcohol Abuse 2021 47(4), 455–466).
The case report of a 23 years old patient is presented. Diagnoses: ADHD (F98.8); Psychotic episodes four (F23) and two (F16.150) years ago; Major depressive disorder (F32.2). Use of psychedelics, cannabis, psychoestimulants and opioids meeting substance use disorder (SUD) criteria. The patient brought proof of the tianeptine sulfate bought on the Internet (image 1) for self-treatment of his depressive symptoms. Tianeptine sodium is prescribed. The patient then restarts opioid use with fear of a new opioid use disorder episode and an oxicodone prescription is maintained. The patient then interrupts the antipsychotic medication and suffers a psychotic relapse. After this psychotic episode a LAI treatment with paliperidone is started. Currently, the patient is recovered and maintains psychopathological stability and abstinence from other substances. Blod test result unaltered. Current treatment: lisdexamphetamine 70mg /day, tianeptina sodium 12.5mg/day; oxicodone 40mg/12h and paliperidone 150mg /28d.
Image:
ConclusionsTianeptine sulfate is believed to present some diferences versus tianeptine sodium: it is sold only through the Internet without prescrption, the daily dose is 25mg per day versus 12.5mg every 8 hours and it might be more potent and long lasting. Those differences were confirmed by the patient after the prescription of tianeptine sodium.
Self-medication with psychoactive substances is one of the theories for substance use and might lead to a substance use disorder. This case shows how the prescription of a drug similar to the one used without presription might favour the therapeutical alliance and reduce the risk associated to the use of non-regulated substances.
Further research is needed to better understand the use of tianeptine sulfate.
Disclosure of InterestNone Declared
Analysis of the predictive potential of good clinical response of plasma levels of clozapine in patients with resistant schizophrenia in an area of southern Spain
- L. I. Muñoz-Manchado, F. González-Saiz, J. I. Pérez-Revuelta, N. Laherrán-Cantera, R. J. Pardo-Velasco
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S446
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Introduction
Resistant schizophrenia is a schizophrenia subtype characterized by a non-ability to respond to an appropriate antipsychotic treatment in dosage and duration by the patients. These patients show a lower prognostic and symptomatology. The unique drug which has shown efficacy for resistant schizophrenia treatment is clozapine, which is effective in suicide and aggressive behaviour prevention too. Whereas clozapine has numerous and serious adverse effects such as agranulocytosis risk. Because of this, and for guaranteeing an accurate diagnosis of resistant schizophrenia, distinguishing this from pseudo-resistance due to a poor tracing of schizophrenia, clozapine’s plasmatic levels monitoring is recommended in Spain by many clinical practise-guidelines.
ObjectivesThis studio has the objective of determining if altered clozapine’s plasmatic levels have predictive potential of therapeutical response and answering what clinical and sociodemographic variables are associated to these anormal plasmatic levels.
MethodsIn this work, a cross-sectional observational study was carried out in which clinical and sociodemographic data obtained by the Mental Health Unit of the Jerez de la Frontera University Hospital were collected within the research project entitled: "Role of social cognition as a factor psychosocial functioning of the schizophrenic patient” (ECOFUN), of all the participating patients (in total the sample was 141 patients, of which 40 are in treatment with clozapine).
ResultsThe sample of patients has a mean age of 44 years and medium-high educational levels. The vast majority are men and do not currently consume substances of abuse, and when this consumption occurs, tobacco and alcohol are the most consumed substances. Their total scores on the PANSS and Markova Barrios scales are generally very disparate, but with average values of 55 and 16. It has been obtained as results that there is no significant statistical correlation between the plasma levels of clozapine and the values of the PANSS scale and its subscales in the patients. On the other hand, patients treated with clozapine would present clinical and sociodemographic characteristics practically identical to those of patients treated with other antipsychotics, especially their values on the PANSS scale. In addition, plasma levels of clozapine are correlated, although not significantly, with an improvement in the positive symptomatology of schizophrenia.
ConclusionsAs a conclusion, unusually higher values of clozapine are correlated significantly with lower values in positive symptomatology in schizophrenia, but plasmatic levels are not correlated significantly with values of PANSS scale.
Disclosure of InterestNone Declared
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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- 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
PSYCHOTIC DISORDER DUE TO PSYCHOSOCIAL STRESS EPISODE. REVIEW OF A CASE.
- A. Gonzalez-Mota, I. M. Peso-Navarro, C. Garcia-Cerdan, C. Munaiz-Cosio, M. Ligero-Argudo, C. Martin-Gomez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1040-S1041
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Introduction
Psychotic disorder is defined as a loss of contact with reality. Those who suffer from it perceive an altered reality, assuming it to be true.This feeling of unreality generates nervousness, anguish, hypervigilance and even social and emotional isolation.
We present the case of a 18-year-old woman who attended the Emergency Department accompanied by the director of her college due to behavioral alterations. The patient reports that since she has moved to Salamanca to study,she has the feeling that her father has hired spies, one of them being her classmate, being able to hear sounds and voices, which she defines as motivating her to go on with her life. She reports that she is in a lower mood in this context and that there have been some days when she has not been able to attend class.
ObjectivesThe objectives are to study the severity of the psychotic disorder in a young patient subjected to an episode of stress and to observe the reaction of the patient when it has been properly treated.
MethodsWe carry out a review of the clinical history of a 18-year-old female patient with psychotic disorder, admitted to the Psychiatric Brief Hospitalization Unit (PBHU) in Salamanca.
ResultsThe patient was treated with Risperidone 2mg/24h. After a few days in the PBHU, total disappearance of the psychotic symptoms was observed and the patient is completely self-critical. Once she was discharged, it was decided that she should return home with her parents for several months and continue treatment with Aripiprazole and Sertraline.
ConclusionsOccasionaly, there are ethical dilemmas about beginning to treat young patients with psychotic ideas derived from external situations. Optimal treatment including drugs, psychotherapy and family support are essential. According to the scientific literature,a greater involvement in diagnosis,treatment and follow-up is recommended in patients with psychotic symptomatology derived from stress.
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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- 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
Gastric bezoar in a patient hospitalized in an eating disorder unit. Case report
- J. Torres Cortés, I. Esteban Avendaño, J. B. González del Valle, R. González Lucas, J. J. Padín Calo, J. P. Morillo González
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S850-S851
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Introduction
It is well known that eating disorders are related to comorbidity. At least, half of these patients have other mental disorders and, in addition to it, the presence of physical comorbidity (cardiovascular, kidney, nervous system, digestive tract, metabolic or endocrine disorders) comes with a decline in life expectancy.
ObjectivesDescription of a patient with a diagnosis of anorexia nervosa (AN) who developed a gastric bezoar during hospitalization.
MethodsCase treated in a specific Eating Disorder Unit in a Third-Level Hospital.
Results26 years old woman with a diagnosis of AN hospitalized in General Psychiatric Unit with BMI of 11,78 kg/m2. Nasogastric tube was necessary and, after 1 month with a progressive weight recovery (BMI 13,84 kg/m2), the patient was transferred to the Eating Disorder Unit in order to follow specific psychological therapy. No incidence related to physical exploration or clinical analyses happened during this month apart from pancytopenia due to malnutrition.
However, 8 days after, patient developed nausea and had 3 vomit episodes, constant abdominal pain at hipogastrium (moderate intensity), dizziness, instability and constipation. The patient refused possibility of pregnancy. The physical exam showed bowel sounds augmented but no mass or peritoneal irritation appeared. Blood test results were normal. Abdominal X-Ray showed gastric dilatation with small bowel faeces sign, which suggested diagnosis of gastric bezoar.
The treatment was the dissolution of the bezoar by Coca-Cola, solving the symptoms completely.
The patient refused having eaten hair or any other kind of object or indigestible material but admitted to be following a strict vegan diet. Finally, after an endoscopy was done, the patient was diagnosed of phytobezoar.
ConclusionsBased on literature, bezoars are rare in AN, being phytobezoars the most common between the types of bezoars. Nevertheless, there are some risk factors, such as delayed gastric emptying, dehydration or, in the case of phytobezoar, ingestion of food containing high amount of cellulose, hemi-cellulose, lignin, and tannins (celery, pumpkin, grape skins, prunes, raisins and, in particular, persimmons). Some of the symptoms caused by phytobezoar can be similar to those of the AN (abdominal pain, intestinal obstruction, poor appetite, vomiting, malnutrition, weight loss). Therefore, gastric bezoar could be an underdiagnosed or even undiagnosed disease in this group of patients. Taking this into account could reduce time until diagnosis and treatment, decreasing the risks associated.
Disclosure of InterestNone Declared
Brief psychotic episode in an adult without medical antecedents after suffering the indirect consequences of the Russian-Ukrainian war
- R. G. Troyano, M. Fariña Francia, E. Marimon Muñoz, I. Fernandez Marquez, E. Miranda Ruiz, M. Arroyo Ucar, J. Ramirez Gonzalez, S. Ferreiro Gonzalez, C. Hidalgo, A. Quispe
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S911
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Introduction
Almost nine months after the start of the war between Russia and Ukraine, millions of people have been affected physically, economically and mainly mentally. Those who have stayed in their homeland, and the ones that have chosen to emigrate to a safer place.
ObjectivesThe objective of this article is to assess the importance of social stressors in the onset of a brief psychotic episode, even in the absence of substance abuse or previous illnesses.
MethodsThe case of a 45-year-old woman is described, known by the Pediatric Emergency Service, for being the tutor of a patient who suffered from anxiety attacks, having emigrated without her parents from Ukraine together with her 5 brothers. The psychotic episode begins when our patient gets notified that she must abandon the custody of the girl, because she will have to go to Turkey with her legal guardians. The family explains the behavioral changes that the patient made and how the clinical picture worsened.
ResultsShe was admitted at the Hospital’s Psychiatry Service and antipsychotics treatment started. After 5 days, the episode had completely been solved.
ConclusionsIn conclusion, we highlight the importance of social problems in the development of a psychiatric pathology and the necessary elements to prevent it: family support network, fast and efficient care services and availability of hospital and pharmaceutical resources.
Disclosure of InterestNone Declared
Acute psychosis following corticosteroid administration for COVID-19 and Respiratory Syncytial Virus infection: A case study
- E. Miranda Ruiz, E. Marimon Muñoz, J. Ramirez Gonzalez, M. Fariña, R. G. Troyano, M. I. Arroyo Ucar, S. Ferreiro, I. Fernandez Marquez, C. Hidalgo, A. Quispe, L. Delgado
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S790
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Introduction
Steroids are a necessary treatment for hypoxic respiratory failure; however there are many side effects that should be taken into account. A 44- year-old-woman with asthma and no past psychiatric history was admitted due to COVID-19 pneumonia and Respiratory syncytial virus (RSV) infection, presenting hypoxic respiratory failure. After two days of intravenous methylprednisolone administration, the patient presented acute psychosis and agitation.
It has been previously described that steroid use can cause effects such as mania, anxiety, agitation, delirium and psychosis amongst other. However they are a necessary treatment in respiratory illnesses and are sometimes unavoidable.
ObjectivesThe aim was to examine the appropriate medical response to steroid induced psychosis in patients with acute hypoxic failure.
MethodsA bibliographical review was done in PubMed database searching recent cases of steroid induced psychosis using the words (“Steroid”, “Psychosis” and “COVID-19”).
ResultsAccording to literature, it has been shown that partial or complete reduction of steroid use and/or use of psychotropic has been successfully used to treat steroid induced psychosis. Following the research it was decided to reduce intravenous methylprednisolone dose from 20mg/ 8h to 20mg/12h and start oral haloperidol 5mg/8h the first 24h and reducing the dose progressively as the patient recovered. After the first 24 hours the patient presented adequate response to steroids as well as partial response to antipsychotic treatment; presenting no further agitation, absence of hallucinations and partial persistence of the persecutory delusion. A couple of days later there was complete remission of the psychotic symptoms and the patient was on the way to recovery from COVID-19 and RSV.
ConclusionsThere is evidence that suggests that medications such as steroids used to treat COVID-19 and other respiratory illnesses can lead to psychotic episodes. It is very important to pay attention to possible side effects when treating with steroids and evaluate the patient history as well as suggest having a follow up visit after the hospital discharge.
Disclosure of InterestNone Declared
Acute mutism in a young female. A case report of a 20-year-old female who presents a 3-month mutism
- A. Gonzalez-Mota, A. Gonzalez-Gil, C. Martin-Gomez, J. A. Benito-Sanchez, I. M. Peso-Navarro, L. Fernandez-Alonso
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S177-S178
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Introduction
A 20-year-old female presents with a progressive 3-month mutism, hyporexia (20kg weight loss), abulia, anhedonia, apathy, social isolation,seeking company of her parents even at night, bradypsychia, sialorrhea, psychomotor slowdown and hypomimia. She is hospitalized in the Psychiatric Brief Hospitalization Unit (PBHU).Her parents relate the beginning of this symptomatology to a breakup and gender violence,which the patient confirms during the interview by eye/cephalic movements and single words jotted down.
ObjectivesThe objective of this study is to describe the evolution of the patient during her hospitalization in the PBHU of Salamanca and to look into the available bibliography about mutism related to stress and sialorrhea.
MethodsWe carried out a follow-up of the hospitalization of the patient and a structured search in PubMed with the keywords “mutism”,“sialorrhea” and “stress” in the last 10 years in English,Spanish and French.
ResultsFew or no articles where found.Therefore, the articles about mutism and stress were analyzed, which focused mostly in selective mutism. Regarding fear,the response to cope with the threat(fight, flight, freeze) is mediated by the autonomic system. The “Polyvagal Theory” speaks about the vagus nerve participating in emotion regulation (social communication and mobilization). Dissociation, in this context,has adaptive and defensive purposes and its threshold can be reduced by repeated stress situations.Long-term alteration of the autonomic nervous system has been described in selective mutism.This malfunction can be related to an elevated production of saliva due to the activation of the parasympathetic in the salivary glands, causing sialorrhea in our patient.
The patient began treatment with sertraline 100mg and risperidone 2mg with the aim of its antidepressive and major tranquilizer effects, she also began individual and family psychotherapy, we assured her sleep and intakes and she began to progressively recover her speech and mobility,identifying a possible trigger for the symptomatology: a physical beating of gender violence after her breakup.
ConclusionsDissociation and “freeze” response can be a maladaptative mechanism to fear.The malfunction of the autonomic nervous system can explain the disconnection,poor gaze,low facial and body expression and inability to speak.
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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- Journal:
- 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
Joint treatment of an acute manic episode and a multiple sclerosis debut: A case study
- M. Fariña Francia, E. Marimon Muñoz, E. Miranda Ruiz, I. Fernandez Marquez, R. G. Troyano, J. Ramirez Gonzalez, S. Ferreiro Gonzalez, C. Hidalgo Vazquez, A. Quispe Sulca, M. I. Arroyo Ucar
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S570-S571
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Introduction
Multiple Sclerosis (MS) is an autoimmune inflammatory disease that affects 1 in 1000 people. Given the association of MS to many affective disorders and specifically with Bipolar Disorder (BD), it is possible that a manic episode and an acute episode of MS may appear together. In these cases, it is difficult to decide whether it is necessary to start a corticosteroid regimen as treatment for the acute episode of MS, since it may worsen manic symptoms.
ObjectivesThe aim is to carry out a review of the existing information in relation to the comorbidity prevalence of MS and TB as well as the joint treatment of both illnesses, and to expose the details of a clinical case, regarding the treatment that was used in the acute psychiatry unit.
MethodsFirst, a search was done in PubMed database reviewing recent cases of steroid induced psychosis using the words (Multiple Sclerosis) AND (Bipolar Disorder). Subsequently, we describe the case of a 41-year-old patient who was admitted to the acute care unit from the emergency department presenting manic symptoms (megalomania, sensation of increased capacities and ideas of mystical content) associated to episodes of muscle weakness and gait disturbances. A screening Magnetic Resonance was performed in which lesions with inflammatory-demyelinating characteristics were detected, and was therefore catalogued as MS debut.
ResultsAfter carrying out a bibliographical review, we can conclude that studies recommend the inclusion of MS within the differential diagnosis of a first manic episode (1), performing neurological examinations, complete anamnesis and imaging tests, given that there is a high prevalence ratio of the comorbidity (2.95%) (2). It has been described that the use of lithium has a calming and neuroprotective agent that may be useful (3).
ConclusionsWe consider it of interest to describe the therapeutic approach to the case. After the introduction of Aripiprazole and Lithium, a short regimen of methylprednisolone in high doses was administered to treat the MS episode. When the treatment started, the patient presented a progressive improvement of the manic episode and motor symptoms. We observed that corticosteroid therapy did not worsen the manic symptoms or the patient’s evolution in this case. We intend to contribute by providing information on the joint management of these pathologies and we consider that it is necessary to continue studying this matter to be able to manage these cases in the most appropriate way.
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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- Journal:
- 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
Psychiatric comorbidity profiles among suicidal attempters: A cohort study
- Y. Sanchez-Carro, M. Diaz-Marsa, V. Fernandez-Rodrigues, W. Ayad-Ahmed, A. Pemau, I. Perez-Diaz, A. Galvez-Merlin, P. de la Higuera-Gonzalez, V. Perez-Sola, P. Saiz, I. Grande, A. Cebria, J. Andreo-Jover, P. Lopez-Peña, M. Ruiz-Veguilla, A. de la Torre-Luque
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S318-S319
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Introduction
More than 700,000 people die by suicide in 2019 globally (World Health Organitation 2021). Mental health problems constitute a risk factor for suicidal behavior and death by suicide (Hoertel et al. Mol Psychiatry 2015; 20 718–726). Different mental disorders have been related to different forms of suicidal ideation and behavior (Conejero et al. Curr Psychiatry Rep 2018; 20, 33) (Quevedo et al. Compr Psychiatry 2020; 102 152194). However, little is known on comorbidity profiles among suicide attempters.
ObjectivesThe aim of our work was to identify the psychiatric comorbidity profiles of individuals who were admitted a hospital emergency department due to a suicide attempt. Moreover, it intended to know their clinical characteristics according to comorbidity profile.
MethodsA sample of 683 attempters (71.30% female; M age= 40.85, SD= 15.48) from the SURVIVE study was used. Patients were assessed within the 15 days after emergency department admission. Sociodemographic (i.e., sex, age, marital status and employment status) and clinical data were collected. The International Neuropsychiatric Interview (MINI) was used to assess DSM-V Axis 1 mental health diagnoses and the Columbia Suicide Rating Scale (C-SSRS) to assess suicidal ideation and behavior. The Acquired Capacity for Suicide-Fear of Death Scale (ACSS-FAD), the Patient Health Questionnaire (PHQ-9) to assess the frequency of depressive symptoms during the past 2 weeks, and the General Anxiety Disorder-7 (GAD-7) scale to assess symptoms of worry and anxiety were also conducted. For the identification of comorbidity profiles, latent class analysis framework was followed considering diagnosis to each individual disorder as clustering variables. On the other hand, binary logistic regression was used to study the relationship between comorbidity profile membership and clinical factors.
ResultsTwo classes were found (Class I= mild symptomatology class, mainly featured by emotional disorder endorsement; and Class II= high comorbidity class, featured by a wide amount of endorsed diagnoses) (see figure 1). Individuals from the High comorbidity class were more likely to be female (OR= 0.98, p<.05), younger in age (OR= 0.52, p< .01), with more depressive symptoms (OR=1.09, p<.001) and have greater impulsivity (OR= 1.01, p<.05).
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ConclusionsWe found two profiles of people with suicidal behavior based on the presence of mental disorders. Each of the suicidal subtypes had different associated risk factors. They also had a different profile of suicidal behavior.
Disclosure of InterestNone Declared
The therapeutic potential of psilocybin in depression resistant to psychotropic drugs
- J. Ramírez González, I. Fernández Márquez, S. Ferreiro González, E. M. Ruíz
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S834
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Introduction
The use of hallucinogens has accompanied the human being throughout history. In the 1970s, studies focused on the therapeutic potential of hallucinogens were blocked due to their misuse in the young population. At present, psilocybin is re-emerging as the center of attention due to its possible therapeutic potential in different psychiatric pathologies such as depression, anxiety or substance use.
ObjectivesThe main objective of this work has been to review recent studies on the therapeutic potential of psilocybin in drug-resistant depressive disorder.
MethodsFor the search for articles, the search strategy “psilocybin AND depression” was established in PUBMED. Regarding the inclusion criteria, it was established that they were recent articles, in Spanish or English and that the full text was freely accessible. On the other hand, those articles whose studies did not focus on humans and resistant depressive disorder were excluded. A total of 19 articles were obtained to review.
ResultsFocusing on Drug-Resistant Depressive Disorder, multiple studies have agreed that the administration of one or two microdoses (10-25mg) of psilocybin accompanied by psychotherapy improves the clinical picture for at least 6 months. These results make us feel optimistic in the search for new treatments in the field of mental health.
ConclusionsPsilocybin microdoses associated with psychotherapy improves depressive symptoms in a patient resistant to common antidepressants.
The psilocybin response in terms of improvement of the depressive symptoms persists after 6 months of evolution.
One or, in some two cases, two microdoses of psilocybin (10-25mg) are enough to obtain statistically significant results in the improvement of the depressive symptoms.
Disclosure of InterestNone Declared