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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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- 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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- 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
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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- 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
I don’t know where I’m going or where I come from. Self-disorders in schizophrenia.
- M. D. C. Vallecillo Adame, L. Rodríguez Andrés, C. de Andrés Lobo, T. Jimenez Aparicio, M. Queipo de Llano de la Viuda, G. Guerra Valera, A. A. Gonzaga Ramirez, M. Fernández Lozano, M. J. Mateos Sexmero, N. Navarro Barriga, B. Rodríguez Rodríguez, M. P. Pando Fernández, M. Calvo Valcárcel, P. Martínez Gimeno, M. A. Andreo Vidal, I. D. L. M. Santos Carrasco
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1069-S1070
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Introduction
In the early stages of schizophrenia the person experiences feelings of strangeness about themselves, difficulty in making sense of things and difficulty in interacting with their environment. Based on this, self-disorder assessment instruments have been developed and empirical studies have been conducted to assess people at risk of developing a schizophrenia spectrum disorder. These studies show that self-disorders are found in pre-psychotic stages and that their manifestation can predict the transition to schizophrenia spectrum disorders.
ObjectivesWe present the case of a patient with multiple diagnoses and mainly dissociative symptoms who, after years of evolution, was diagnosed with schizophrenia.
MethodsBibliographic review including the latest articles in Pubmed about self-disorders and schizophrenia.
ResultsWe present the clinical case of a 51-year-old woman with a long history of follow-up in mental health consultations and with multiple hospital admissions to the psychiatric unit, with several diagnoses including: dissociative disorder, histrionic personality disorder, adaptive disorder unspecified psychotic disorder and, finally, schizophrenia. The patient during the first hospital admissions showed a clinical picture of intense anxiety, disorientation and claiming to be a different person. The patient related these episodes to stressors she had experienced, and they improved markedly after a short period of hospital admission. Later, psychotic symptoms appeared in the form of auditory and visual hallucinations and delusional ideation, mainly of harm, so that after several years of follow-up and study in mental health consultations and in the psychiatric day hospital, she was diagnosed with schizophrenia and treatment with antipsychotics was introduced, with a marked clinical improvement being observed.
ConclusionsIt is important to take into account this type of symptoms (self-disorders), as they allow the identification of individuals in the early stages of the disorder and create the opportunity for early therapeutic interventions.
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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- 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
Late diagnosis of attention deficit hyperactivity disorder and cocaine abuse
- C. De Andrés Lobo, C. Vallecillo Adame, T. Jiménez Aparicio, M. Queipo de Llano de la Viuda, G. Guerra Valera, A. A. Gonzaga Ramírez, M. Fernández Lozano, N. Navarro Barriga, M. J. Mateos Sexmero, B. Rodríguez Rodríguez, M. Calvo Valcárcel, M. Andreo Vidal, M. P. Pando Fernández, P. Martínez Gimeno, I. D. L. M. Santos Carrasco, J. I. Gonçalves Cerejeira, A. Rodríguez Campos
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S335-S336
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Introduction
Adult ADHD diagnosis sometimes represents a challenge for the clinician, due to the comorbid psychiatric diseases that are often associated and which complicate de recognition of the primary symptoms of ADHD. The prevalence of ADHD in adult populations is 2’5% and it is a relevant cause of functional impairment.
ObjectivesPresentation of a clinical case of a male cocaine user diagnosed with adult ADHD.
MethodsLiterature review on adult ADHD and comorbid substance abuse.
ResultsA 43-year-old male who consulted in the Emergency Department due to auditory hallucinosis in the context of an increase in his daily cocaine use. There were not delusional symptoms associated and judgment of reality was preserved. Treatment with olanzapine was started and the patient was referred for consultation. In psychiatry consultations, he did not refer sensory-perceptual alterations anymore, nor appeared any signals to suspect so, and he was willing to abandon cocaine use after a few appointments. He expressed some work concerns, highlighting that in recent months, in the context of a greater workload, he had been given several traffic tickets for “distractions.” His wife explained that he had always been a inattentive person (he forgets important dates or appointments) and impulsive, sometimes interrupting conversations. In the Barkley Adult ADHD Rating Scale he scored 32 points.
He was diagnosed with adult ADHD and treatment with extended-release methylphenidate was started with good tolerance and evolution, with improvement in adaptation to his job and social environment. Since then, the patient has moderately reduced the consumption of drugs, although he continues to use cocaine very sporadically.
ConclusionsEarly detection of ADHD and its comorbidities has the potential to change the course of the disorder and the morbidity that will occur later in adults. Comorbidity in adult ADHD is rather the norm than the exception, and it renders diagnosis more difficult. The most frequent comorbidities are usually mood disorders, substance use disorders, and personality disorders. Treatment of adult ADHD consists mainly of pharmacotherapy supported by behavioral interventions. When ADHD coexists with another disorder, the one that most compromises functionality will be treated first and they can be treated simultaneously. The individual characteristics of each patient must be taken into account to choose the optimal treatment.
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
“The cat and the calcium”. A case of delirium secondary to hypercalcaemia.
- T. Jiménez Aparicio, C. Vallecillo Adame, C. de Andrés Lobo, G. Medina Ojeda, M. Queipo de Llano de la Viuda, A. A. Gonzaga Ramírez, G. Guerra Valera, M. Fernández Lozano, M. J. Mateos Sexmero, B. Rodríguez Rodríguez, N. Navarro Barriga, M. A. Andreo Vidal, M. Calvo Valcárcel, P. Martínez Gimeno, M. P. Pando Fernández, I. D. L. M. Santos Carrasco, J. I. Gonçalves Cerejeira
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S946-S947
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Introduction
Interconsultation with the psychiatry service is frequently requested from other specialties for the assessment and treatment of patients who present neuropsychiatric symptoms secondary to organic alterations. On the other hand (and in relation to this case), within the possible causes for the elevation of calcaemia figures, the most frequent are hyperparathyroidism and neoplasms, representing between these two entities 90% of cases (1).
Among the organic mental disorders, Delirium stands out, with an approximate prevalence between 1 and 2% (general population), which increases in hospitalized and elderly patients (2).
ObjectivesPresentation of a clinical case about a patient with delirium secondary to hypercalcemia, with hallucinations and behavioral disturbance.
MethodsBibliographic review including the latest articles in Pubmed about delirium (causes and treatment) and hypercalcaemia secondary to neoplasms.
ResultsWe present a 52-year-old male patient, who went to the emergency room accompanied by his wife, due to behavioral alteration. Two days before, he had been evaluated by Neurology, after a first epileptic crisis (with no previous history) that resolved spontaneously. At that time, it was decided not to start antiepileptic treatment.
The patient reported that he had left his house at midnight, looking for a cat. As he explained, this cat had appeared in his house and had left his entire bed full of insects. His wife denied that this had really happened, and when she told the patient to go to the emergency room, he had become very upset.
As background, the patient used to consume alcohol regularly, so the first hypothesis was that this was a withdrawal syndrome. However, although the consumption was daily, in recent months it was not very high, and at that time no other symptoms compatible with alcohol withdrawal were observed (tremor, tachycardia, sweating, hypertension…).
We requested a general blood test and a brain scan. The only relevant finding was hypercalcaemia 12.9mg/dL (which could also be the origin of the previous seizure). It was decided to start treatment with Diazepam and Tiapride in the emergency room, with serum perfusion, and keep under observation. After several hours, the patient felt better, the hallucinations disappeared, and calcium had dropped to 10.2mg/dL. A preferential consultation was scheduled, due to suspicion that the hypercalcaemia could be secondary to a tumor process.
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ConclusionsIt is important to rule out an organic alteration in those patients who present acute psychiatric symptoms. Hypercalcaemia is frequently associated with tumor processes (1) due to secretion of PTH-like peptide (4), so a complete study should be carried out in these cases.
Delirium has a prevalence between 1 and 2% in the general population (2).
Psychopharmacological treatment is used symptomatically, with antipsychotics (3). For the episode to fully resolve, the underlying cause must be treated.
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
Surface mass balance monitoring of the peripheral glaciers of the Antarctic Peninsula in the context of regional climate change
- Francisco Navarro, Cayetana Recio-Blitz, Ricardo Rodríguez-Cielos, Jaime Otero, Kaian Shahateet, Eva De Andrés, María I. Corcuera, Unai Letamendia, José M. Muñoz-Hermosilla
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- Annals of Glaciology / Volume 63 / Issue 87-89 / September 2022
- Published online by Cambridge University Press:
- 27 April 2023, pp. 101-106
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During the second half of the 20th century, the Antarctic Peninsula region has undergone a long and sustained warming period, followed by a shorter but also sustained cooling period, and then a very recent return to warming conditions. All of these have profoundly impacted the glaciers peripheral to the Antarctic Peninsula. This paper focuses on the analysis of the surface mass balance monitoring of such glaciers by the glaciological method, complemented by the analysis of mass-balance estimates by geodetic methods, as well as frontal ablation estimates. We aim to summarize the current knowledge and outline the main challenges faced by investigating the mass balance of such peripheral glaciers and their current contribution to sea-level rise.
My stomach is full
- M. Queipo De Llano De La Viuda, A. Gonzaga Ramírez, N. De Uribe Viloria, G. Guerra Valera, T. Jiménez Aparicio, C. Vallecillo Adame, C. De Andrés Lobo, I. Santos Carrasco, J. Gonçalves Cerejeira, N. Navarro Barriga, M.J. Mateos Sexmero, B. Rodríguez Rodríguez, M. Fernández Lozano
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- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S583
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Introduction
Anorexia nervosa is an eating behavior disorder that is often related to various personality factors. The relationship between obsessive compulsive disorder and eating Disorders has been highlighted.
ObjectivesTo present a clinical case of a patient with eating disorder and gastric bezoar, secondary to compulsive hair ingestion.
MethodsBibliographic review of articles published in relation to the comorbidity of these disorders, based on articles published in the last 5 years in Pubmed.
Results26-year-old female. Diagnosis of restrictive anorexia nervosa. She was admitted to the hospital on two occasions for nutritional disorders. In the last admission, she reported greater anxiety and significant weight loss. She reports that she has limited her food intake, but she does feel thin and is unable to eat for fear of gaining weight. Ruminative thoughts about her body image. During admission, the patient expressed a sensation of fullness, nausea and vomiting, later observing in abdominal X-ray and gastroscopy, the presence of a gastric trichobezoar, which was finally resolved conservatively.
ConclusionsTrichotillomania is observerd in 1 in 2000 people, trichophagia is even less frequent. According to DSM- V, these disorders are grouped within obsessive-compulsive spectrum disorders. A Trichobezoar is a conglomerate that can be found in the stomach or intestine, composed mainly of hair, previously ingested. Trichotillomania can be associated with anorexia nervosa, especially in patients with obsessive personality traits, which occurs frequently. The gastric slowing that patients with anorexia often present is a factor that favors the formation of the bezoar
DisclosureNo significant relationships.
Mindfulness-based interventions and employment: Descriptive analysis of the MER-ACT project
- T. Castellanos Villaverde, G. Navarro Oliver, I. Torrea Araiz, E. Vidal Bermejo, A. Hospital Moreno, I. Louzao Rojas, E. Fernández-Jiménez
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- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, pp. S696-S697
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Introduction
Evidence shows unemployment as a negative impact factor on a variety of health outcomes. Regarding mental health, unemployment is considered one of the most consolidated risk factors for morbidity. This relationship is considered bi-directional. Prevention and wellness promotion are essential guidelines for mental health providers.
ObjectivesTo describe the work status in a sample of patients with anxiety disorders after two types of group mindfulness-based interventions in the MER-ACT project.
MethodsA descriptive analysis was conducted on work status before and 6 months after two types of mindfulness-based interventions. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. The employment change was calculated (percentage of change from unemployed or temporary incapacity to employed).
ResultsThe work status of participants of the sample (n = 40), before and 6 months after interventions, were employed: 55% vs. 60%; temporary incapacity: 12.5% vs. 12.5%; unemployed: 25% vs. 20% and others: 7.5% vs. 7.5%. In the same period, the unemployment rate in the Spanish general population was from 13.8% to 14.5%. After 6 months the percentage of change on work status was 25% (15% improved their employment situation).
ConclusionsPreliminary results show worse work status of participants compared to the Spanish general population. It is recommendable to include well-established risk factor measurements to establish the effectiveness of interventions in mental health. More research is required to determine the impact of interventions on the employment status.
DisclosureNo significant relationships.
Something inside my head
- T. Jiménez Aparicio, G. Medina Ojeda, C. De Andrés Lobo, C. Vallecillo Adame, J. Gonçalves Cerejeira, I. Santos Carrasco, G. Guerra Valera, A. Gonzaga Ramírez, M. Queipo De Llano De La Viuda, N. Navarro Barriga, M. Fernández Lozano, B. Rodríguez Rodríguez, M.J. Mateos Sexmero, N. De Uribe Viloria
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S740
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Introduction
Electroconvulsive therapy (ECT) is a medical treatment for those patients with high suicide risk or refractory psychiatric disorders. It is currently a safe technique, and its effectiveness has been widely demonstrated.
ObjectivesPresentation of a clinical case about a patient with drug-resistant delusional disorder and high suicide risk, who eventually received ECT treatment.
MethodsBibliographic review including the latest articles in Pubmed about ECT procedure, effects and use.
ResultsWe present a 45-year-old man, who visited different doctors several times by reporting he had the feeling of “having a brain tumor or a vascular disorder”, so he requested imaging tests (computed tomography and magnetic resonance). These tests were absolutely normal, but he kept thinking something was wrong, and eventually attempted suicide by hanging (his family founded him before it was too late). The patient was admitted to hospital, and started psychopharmacological treatment, with minimal response. He desperately insisted that he had “something inside his head”. At this point, it was proposed to start ECT, and the patient accepted. After 6 bilateral ECT sessions, he was visibly more relaxed and less worried, and he no longer presented autolytic ideation. He was still a little bit suspicious about the feeling of having a neurological disease. Currently, the patient runs a follow-up consultation.
ConclusionsElectroconvulsive therapy is a safe and effective technique for those patients with high suicide risk. It may be useful to perform imaging tests in certain cases, for detecting intracranial pressure, acute hemorrhage, tumors… A follow-up of these patients must be performed
DisclosureNo significant relationships.
Mutism. What to expect?
- I. Santos Carrasco, J. Gonçalves Cerejeira, M. Fernández Lozano, A. Gonzaga Ramírez, M. Queipo De Llano De La Viuda, G. Guerra Valera, C. Vallecillo Adame, C. De Andrés Lobo, T. Jiménez Aparicio, B. Rodríguez Rodríguez, N. Navarro Barriga, M.J. Mateos Sexmero, E. Pérez, L. Gallardo Borge
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S588
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Introduction
Mutism is the inability or unwillingness to speak, resulting in an absence or marked paucity of verbal output. Mutism is a common manifestation of psychiatric, neurological, and drug-related illnesses. Psychiatric disorders associated with mutism include schizophrenia, affective disorders, conversion reactions, dissociative states, and dementias. Neurological disorders causing mutism affect the basal ganglia, frontal lobes, or the limbic system.
ObjectivesOutline the importance of setting a differential diagnosis of mutism in the Emergency Room.
MethodsReview of scientific literature based on a relevant clinical case.
ResultsMale, 58 years old. He has lived in a residence for 3 months due to voluntary refusal to ingest. Diagnosed with paranoid personality disorder. He is refered to the Emergency Service due to sudden mutism. During this day, he has been stable and suitable with a good functionality. For 3 hours he is mutist, oppositional attitude and stiff limbs, refusing to obey simple orders. Hyperalert and hyperproxia. Not staring. After ruling out organic pathology: normal blood tests, negative urine toxins and cranial CT without alterations, he was admitted to Psychiatry for observation and, finally, he was diagnosed with Psychotic Disorder NOS.
ConclusionsMutism most often occurs in association with other disturbances in behavior, thought processes, affect, or level of consciousness. The most common disorder of behavior occurring with mutism is catatonia. The differential diagnosis of mutism is complex. In some cases the diagnosis will be clarified only by careful observation and after a neurological evaluation. Published studies show neurological disorders presenting with mutism can be misdiagnosed as psychiatric.
DisclosureNo significant relationships.
Descriptive analysis of adherence to mindfulness-based group therapies: online versus face-to-face interventions
- G. Navarro Oliver, T. Castellanos Villaverde, I. Torrea Araiz, E. Vidal Bermejo, A. Hospital Moreno, I. Louzao Rojas, E. Fernández-Jiménez
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, pp. S323-S324
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Introduction
The use of technological supports in psychotherapeutic interventions has been widespread in recent years. Since the COVID-19 pandemic, the increase has been greater. The feasibility of online group interventions has been proved in previous studies. Research comparing dropout rates in group interventions with clinical population that include mindfulness training is infrequent.
ObjectivesTo compare the difference in dropout rates between online and face-to-face mindfulness-based group interventions.
MethodsThis study was carried out in a Mental Health Unit in Colmenar Viejo (Madrid, Spain). One hundred thirty-five adult patients with anxiety disorders were included in group interventions (74 face-to-face; 61 online). The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. A descriptive analysis of dropout rates (participants attending 3 or fewer sessions out of the total number of participants starting the intervention) was performed.
ResultsOf the 135 patients included, 8 did not participate in the interventions (5 face-to-face; 3 online), which represents a 5.93% rejection rate; 6.76% for the face-to-face intervention and 4.92% for the online intervention. Of the remaining sample (127 participants), a total dropout rate of 12.6% was obtained, with 8.69% in the face-to-face intervention versus 17.24% online.
ConclusionsA higher dropout rate was obtained in online interventions compared to face-to-face, with an increase of almost double. Research on specific factors that may interfere with treatment adherence to online group interventions is needed.
DisclosureNo significant relationships.
Personality disorders and Juvenil Myoclonic Epilepsy
- I. Santos Carrasco, J. Gonçalves Cerejeira, M. Queipo De Llano De La Viuda, A. Gonzaga Ramírez, G. Guerra Valera, T. Jiménez Aparicio, C. De Andrés Lobo, C. Vallecillo Adame, M. Fernández Lozano, B. Rodríguez Rodríguez, N. Navarro Barriga, M.J. Mateos Sexmero, L. Gallardo Borge
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S668
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Introduction
There is a high comorbidity between psychiatric disorders and juvenile myoclonic epilepsy (JME), observed in up to 58% of these patients; specifically, mood disorders, anxiety and personality disorders (PD). In some patients with PD there are nonspecific alterations in the EEG, which nevertheless sometimes involve pathology. The presence of personality disorders along with JME has been repeatedly described. Previous studies have emphasized the difficulties in treating patients with JME, which have been attributed to some specific psychiatric, psychological and psychosocial characteristics.
ObjectivesDescribing distinctive personality traits in JME
MethodsReview of scientific literature based on a relevant clinical case.
Results19-year-old woman, single. Psychiatric history since she was 12 due to anxiety-depressive symptoms, after being diagnosed with JME. 4 admissions in Psychiatry, with a variety of diagnoses: eating disorder, attention deficit hyperactivity disorder and borderline personality disorder. The evolution of both disorders has been parallel, presenting epileptic seizures due to irregular therapeutic adherence together with pseudo-seizures, which made difficult their differential diagnosis. In addition, he has had frequent visits to the emergency room for suicide attempts and impulsive behaviors.
ConclusionsIn 1957, for the first time, distinctive personality traits were described in patients with JME: lack of control and perseverance, emotional instability, variable self-concept and reactive mood, which have been confirmed in subsequent studies. It is believed as epilepsy progresses, patients tend to develop symptoms of depression, anxiety, social problems, and attention deficit. Therefore, these patients have difficulty in following medical recommendations, especially precautions regarding precipitating factors for seizures.
DisclosureNo significant relationships.
Traumatic brain injury, antisocial personality disorder and alcohol
- C. De Andrés Lobo, T. Jiménez Aparicio, C. Vallecillo Adame, M. Queipo De Llano De La Viuda, A. Gonzaga Ramírez, G. Guerra Valera, I. Santos Carrasco, J. Gonçalves Cerejeira, M. Fernández Lozano, B. Rodríguez Rodríguez, N. Navarro Barriga, M.J. Mateos Sexmero, N. De Uribe Viloria, G. Medina Ojeda
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S667
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Introduction
Traumatic brain injury (TBI) can cause changes in the personality and behaviors. History of TBI has been associated with violent behavior and substance abuse.
ObjectivesPresentation of a clinical case of a patient with antisocial personality traits who suffered a TBI and abuses alcohol.
MethodsWe conducted a bibliographic review by searching for articles published the last 5 years in Pubmed
ResultsWe present the case of a 48-year-old male patient with a history of myoclonic epilepsy, who suffered a TBI in a car crash. During his stay at ICU antisocial and borderline personality traits were found. When he came to consultations, he presented signs of alcohol intoxication (verbiage with hasty and dysarthric speech, and psychomotor incoordination). He acknowledges daily alcohol intake, although he minimizes it. During the interview he is irritable, prone to anger when contradicted and boasts of episodes of heteroaggressiveness and violence that he has carried out in the past. He reports morning sickness and tremors, but does not accept that they may be due to alcohol withdrawal. There is no motivation for change.
ConclusionsIt has been determined that history of TBI is more frequent in individuals with antisocial personality. TBI has been linked to violent behaviors, poor inhibitory control, engaging in illegal acts and higher rates of substance abuse. However, the causal relationship between antisocial behavior and TBI has yet to be clarified, as the available evidence does not show which comes first. More research is needed in the future that takes into account the temporal sequence of events.
DisclosureNo significant relationships.
Migration and psychosis: the link between them
- C. De Andrés Lobo, T. Jiménez Aparicio, C. Vallecillo Adame, A. Gonzaga Ramírez, G. Guerra Valera, I. Santos Carrasco, J. Gonçalves Cerejeira, M. Fernández Lozano, B. Rodríguez Rodríguez, N. Navarro Barriga, M.J. Mateos Sexmero, N. De Uribe Viloria
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S217
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Introduction
Migrations are a source of stress for patients, which can have repercussions on their Mental Health. We present the case of a native Senegalese patient who presented a first psychotic episode.
ObjectivesPresentation of a clinical case of an immigrant patient with a psychotic disorder.
MethodsBibliographic review on migration and psychosis by searching for articles in Pubmed.
ResultsWe present the case of a patient of 20 years, a native of Senegal, who has been living in Spain for 3 months in a shelter home. He has no family or relations in Spain, and only speaks Wolof, presenting serious difficulties in communication with healthcare workers. He came to Hospital with his social worker because strange behaviors had been observed. He presented delusional ideation of self-referential and mystical-religious content, related to “the prophet” and “the need to fulfill a mission”. He also presented auditory hallucinations that he identified as of divine origin, and ordered him to perform behaviors such as picking hairs from the ground and various rituals. He acknowledges cannabis and alcohol use in the previous days. Paliperidone treatment was started. Throughout the admission, he begins to show concern for the state of his relatives in Senegal and the need to send them money.
ConclusionsMultiple studies indicate that migrants are at higher risk of psychosis, specially those from countries where the majority of population was black, according to some series. The challenge lies in understanding the mechanisms underlying this increased incidence, taking into account psychosocial factors such as social isolation and trauma.
DisclosureNo significant relationships.