3 results
Outpatient management of REM sleep behavior disorder case in Brunner syndrome
- E. Cesari, I. Ochandiano, J. I. Mena, S. Salmeron, C. Gaig
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1101
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Introduction
Brunner syndrome is a recessive X-linked disorder characterized by impulsive aggressiveness and mild mental retardation associated with Monoamine Oxidase – A (MAOA) deficiency (Brunner et al. Science 1993; 262 578-580).
ObjectivesTo present a REM sleep behavior disorder (RBD) case in a patient with Brunner syndrome.
MethodsThe present study is a case report of a patient followed in our hospital’s outpatient care. We also searched for previous case reports of sleep disorders and other clinical features in Brunner syndrome using a pubmed query.
ResultsA 46-year-old Spanish male, diagnosed with Brunner syndrome due to the mutation c.1438A>G/iVS14-2 A>G, a loss-of-function mutation in the X-linked MAOA gene. He suffers from mild mental retardation and psychotic disturbances treated with SSRI and antipsychotic drugs. The patient was referred to our outpatient care to assess his sleep abnormal behaviors. He had been presenting with episodes of sleep-related vocalization and complex motor behaviors during sleep for the last 3 years, correlating with dream mentation. His relatives recounted episodes of talking, screaming, gesturing, kicking, falling out of bed and crying during sleep. Dream content referred by the patient was often related to persecutions, attacks and fights.
Polysomnography revealed vocalization and gesticulation during REM sleep compatible with the diagnosis of RBD. The addition of clonazepam to his treatment at doses of 1-3 mg per day achieved significant clinical response of the sleep disorder.
ConclusionsThe clinical presentation suggested the diagnosis of RBD case in a patient with Brunner syndrome. Although sleep disorders are not one of the most important or frequent clinical features in Brunner syndrome, they are described in the literature and can significantly affect the patient’s quality of life. To our knowledge, this is the first report about clinical management of RBD case in Brunner syndrome.
Disclosure of InterestNone Declared
Virtual Reality in the acute psychiatry ward: a pilot study
- J. I. Mena, B. Andrés, I. Hernandez, A. Bastidas, E. Cesari, I. Ochandiano, S. Salmerón, P. Barrio
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S901-S902
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Introduction
New technologies have been steadily impacting and redefining the health care landscape over the last decades, a process recently enhanced by the covid-19 pandemics . VR is an advanced media that can simulate highly realistic virtual environments, providing a high sense of immersion (the feeling of “being really there”). VR has expanded its healthcare application over the last years. Surprisingly, the acute psychiatry ward has been, so far, systematically left out of the VR application field. Psychiatric wards are complex environments. Patients are frequently admitted against their will and many wards have a locked doors policy, with subsequent feelings of seclusion experienced by patients. Therefore the question emerges: could VR help psychiatry inpatients have a better experience during their hospitalization?
ObjectivesThis is a pilot study where psychiatry inpatients are offered a single session with the Oculus Quest 2, where they are immersed in a computer generate scenario provided by a commercially available software (“Nature Treks”). The scenario is a nature-based immersive 360° walk. Patients are allowed to freely explore the scenario with no time restraints.
MethodsThe STAI (State-Trait Anxiety Inventory), and the PANAS (Positive and Negative Affect Schedule) questionnaires are completed by patients before and after the VR exposure. After exposure, patients are also asked to complete the SUS (System Usability Scale) questionnaire, the IQ-presence questionnaire and the SSQ (Simulator Sickness Questionnaire). Electrophysiological recordings are gathered with the Empatica E4.
ResultsUp to date, 4 patients have been recruited. The sessions have lasted around 10 minutes. Reductions in the STAI and the PANAS have been reported by 3 patients (with no statistical significance so far). Usability has been extremely high as reported by the SUS. Minimal adverse reactions to VR use have been reported in the SSQ, mainly dizziness and nausea.
ConclusionsVR has a high potential to ameliorate the conditions of psychiatry inpatients admitted to a close-doors ward. As with many technological novelties, implementation and sustainability will be key. The small evidence provided by this pilot study points out to an initial good acceptability and potential efficacy in some patient-related outcomes.
Disclosure of InterestNone Declared
SARS-CoV2 vaccination status among psychiatry inpatients: a retrospective cohort analysis
- H. Andreu, I. Ochandiano, L. Olivier, Ò. De Juan, L. Bueno, E. Cesari, J. I. Mena, S. Salmerón, P. Barrio
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S404
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Introduction
The coronavirus infectious disease 2019 (COVID-19) pandemic has had a deleterious impact in many areas. Given this, efforts have focused on developing effective vaccines and vaccination campaigns have been carried out prioritizing population at risk. This should include mental health patients since they are at higher risk of developing complications or ending up in a critical status. Since it may be sometimes difficult for these patients to access vaccination, hospitalization may be a window of opportunity to evaluate and offer vaccination.
ObjectivesThis study aims to retrospectively assess vaccination status and offer during admission of psychiatry inpatients at Hospital Clínic of Barcelona during a 6-month period, in order to determine if there are differences regarding vaccination rates compared to general population and between main diagnostic categories.
MethodsWe retrospectively evaluated all admitted patients to the acute psychiatry ward. The main collected variables included age, gender, main psychiatric diagnosis, presence of organic comorbidities, vaccination status at admission and vaccination offer during admission. We used descriptive statistics to extract most of the information. A binary logistic regression was also conducted to evaluate whether the main diagnosis, age and gender had some influence upon vaccination status at admission.
ResultsBetween January 1st and June 30th of 2022, 216 patients were admitted to the psychiatry ward. A total of 42% were female, with a mean age for the whole sample of 42.8 years (SD 14.7). More than half were current smokers (55%), and 46% of the patients had at least one significant organic comorbidity. The percentages of main diagnosis were as follows: addiction 21.3%; bipolar disorder 18.5%; schizophrenia 18.1%; non-specified psychosis 14.4%; depression 7.4%; cognitive impairment 0.9%; personality disorders 6.9%.
Vaccination status was available for 187 patients (86.6%). Of these, 78 patients were fully vaccinated, 68 had an incomplete vaccination status and 41 patients had not received any dose. No differences on the vaccination status were seen based on the psychiatric diagnosis. Among patients with incomplete or no vaccination, 19 patients (17.4%) were offered a vaccination dose. A total of 11 patients accepted and received it (57.9%). In the logistic regression model, the only significant variable predicting an increase in the likelihood of being fully vaccinated was age, with every year of age increasing the probability of full vaccination by 6%.
ConclusionsOur data suggest that routine screening of vaccination status during psychiatric admission and improved strategies for vaccination offer and acceptance should become a priority in psychiatric wards. Given the impact of the pandemics, and the likelihood of new waves or even new pandemics, more research on vaccination strategies among mental health patients is warranted.
Disclosure of InterestNone Declared