367 results
Helminth parasites of the Eurasian otter Lutra lutra in southwest Europe
- J. Torres, C. Feliu, J. Fernández-Morán, J. Ruíz-Olmo, R. Rosoux, M. Santos-Reis, J. Miquel, R. Fons
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- Journal:
- Journal of Helminthology / Volume 78 / Issue 4 / December 2004
- Published online by Cambridge University Press:
- 12 April 2024, pp. 353-359
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The helminth fauna in 109 Eurasian otters (Lutra lutra L.) from France, Portugal and Spain was analysed, together with 56 faecal samples collected in Portugal and 23 fresh stools from otters included in a reintroduction programme. Seven helminth species were found in L. lutra in southwest Europe: Phagicola sp. (Trematoda), Aonchotheca putorii, Eucoleus schvalovoj, Strongyloides lutrae, Anisakis (third stage larvae) and Dirofilaria immitis (Nematoda), and Gigantorhynchus sp. (Acanthocephala). Eucoleus schvalovoj was the dominant species throughout southwest Europe. Strongyloides lutrae was significantly more prevalent in the Iberian Peninsula than in France. Apart from these two dominant nematodes and A. putorii, the other helminth species were incidental parasites of L. lutra in southwest Europe. The helminth fauna of L. lutra in southwest Europe is, in general, poorer than that reported in eastern Europe and in all other aquatic mustelids in southwest Europe. Phagicola specimens are reported for the first time in a non-marine wild carnivore in Europe. The prevalences of E. schvalovoj and S. lutrae obtained by necropsy were higher than those observed by coprological analysis using a formalin-ether concentration method (Ritchie). Nevertheless, the culture of fresh faeces appears to be the best method to study infection of L. lutra by Strongyloides.
Nutritional composition of ultra-processed plant-based foods in the out-of-home environment: a multi-country survey with plant-based burgers
- R. E. Vellinga, H. L. Rippin, B. G. Gonzales, E. H. M. Temme, C. Farrand, A. Halloran, B. Clough, K. Wickramasinghe, M. Santos, T. Fontes, M. J. Pires, A. C. Nascimento, S. Santiago, H. E. Burt, M. K. Brown, K. H. Jenner, R. Alessandrini, A. M. Marczak, R. Flore, Y. Sun, C. Motta
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- Journal:
- British Journal of Nutrition / Volume 131 / Issue 10 / 28 May 2024
- Published online by Cambridge University Press:
- 15 January 2024, pp. 1691-1698
- Print publication:
- 28 May 2024
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Ultra-processed plant-based foods, such as plant-based burgers, have gained in popularity. Particularly in the out-of-home (OOH) environment, evidence regarding their nutritional profile and environmental sustainability is still evolving. Plant-based burgers available at selected OOH sites were randomly sampled in Amsterdam, Copenhagen, Lisbon and London. Plant-based burgers (patty, bread and condiment) (n 41) were lab analysed for their energy, macronutrients, amino acids and minerals content per 100 g and serving and were compared with reference values. For the plant-based burgers, the median values per 100 g were 234 kcal, 20·8 g carbohydrates, 3·5 g dietary fibre and 12·0 g fat, including 0·08 g TFS and 2·2 g SFA. Protein content was 8·9 g/100 g, with low protein quality according to amino acid composition. Median Na content was 389 mg/100 g, equivalent to 1 g salt. Compared with references, the median serving provided 31% of energy intake based on a 2000 kcal per day and contributed to carbohydrates (17–28%), dietary fibre (42%), protein (40%), total fat (48%), SFA (26%) and Na (54%). One serving provided 15–23% of the reference values for Ca, K and Mg, while higher contributions were found for Zn, Mn, P and Fe (30–67%). The ultra-processed plant-based burgers provide protein, dietary fibre and essential minerals and contain relatively high levels of energy, Na and total fats. The amino acid composition indicated low protein quality. The multifaceted nutritional profile of plant-based burgers highlights the need for manufacturers to implement improvements to better support healthy dietary habits, including reducing energy, Na and total fats.
Yield and nutritive value of Stylosanthes spp. genotypes subjected to different harvest frequencies and seasons of the year
- W. P. S. Diniz, M. V. F. Santos, M. V. Cunha, M. A. Lira Junior, D. E. Simões Neto, O. F. Oliveira, G. G. Leal, A. C. L. Mello, L. S. Santos
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- The Journal of Agricultural Science / Volume 161 / Issue 6 / December 2023
- Published online by Cambridge University Press:
- 09 January 2024, pp. 808-816
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Productive and nutritional traits of forage species in various regions worldwide depend on different management strategies. This study aimed to evaluate the effects of harvest frequency (56, 77 and 98 days) and season of the year (rainy and dry) on the nutritional value and fractionation of carbohydrates and proteins of Stylosanthes genotypes (S. seabrana, S. scabra, S. mucronata and Stylosanthes spp. cv. Campo Grande). The experiment was conducted using a randomized complete block design with a split-plot arrangement and four repetitions. Contents of neutral detergent fibre (NDF), acid detergent fibre (ADF), in vitro digestible dry matter (IVDDM), condensed tannins and total phenolic compounds were influenced by the interaction of harvest frequency and season of the year. The 98-day harvest frequency resulted in lower IVDDM (579 g/kg) due to the high NDF and ADF concentrations during the rainy season. S. seabrana and S. scabra showed a higher proportion of A + B1 and B2 carbohydrate fractions, while the C fraction in the rainy season was greater in the Campo Grande, resembling S. seabrana. S. scabra displayed 15% of the crude protein in fraction A. The bromatological traits of Stylosanthes spp. did not decline sharply owing to plant age advancement, indicating these genotypes are suitable for forage production systems in tropical or semiarid regions.
Proton and helium ions acceleration in near-critical density gas targets by short-pulse Ti:Sa PW-class laser
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- J.L. Henares, P. Puyuelo-Valdes, C. Salgado-López, J.I. Apiñaniz, P. Bradford, F. Consoli, D. de Luis, M. Ehret, F. Hannachi, R. Hernández-Martín, A. Huber, L. Lancia, M. Mackeviciute, A. Maitrallain, J.-R. Marquès, J.A. Pérez-Hernández, C. Santos, J.J. Santos, V. Stankevic, M. Tarisien, V. Tomkus, L. Volpe, G. Gatti
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- Journal:
- Journal of Plasma Physics / Volume 89 / Issue 6 / December 2023
- Published online by Cambridge University Press:
- 28 December 2023, 965890601
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The ability to quickly refresh gas-jet targets without cycling the vacuum chamber makes them a promising candidate for laser-accelerated ion experiments at high repetition rate. Here we present results from the first high repetition rate ion acceleration experiment on the VEGA-3 PW-class laser at CLPU. A near-critical density gas-jet target was produced by forcing a 1000 bar H$_2$ and He gas mix through bespoke supersonic shock nozzles. Proton energies up to 2 MeV were measured in the laser forward direction and 2.2 MeV transversally. He$^{2+}$ ions up to 5.8 MeV were also measured in the transverse direction. To help maintain a consistent gas density profile over many shots, nozzles were designed to produce a high-density shock at distances larger than 1 mm from the nozzle exit. We outline a procedure for optimizing the laser–gas interaction by translating the nozzle along the laser axis and using different nozzle materials. Several tens of laser interactions were performed with the same nozzle which demonstrates the potential usefulness of gas-jet targets as high repetition rate particle source.
Natural parasitism of the coffee leaf miner: climate factors, insecticide, and landscape affecting parasitoid diversity and their ecosystem services in coffee agroecosystems
- Mateus P. dos Santos, Benício de M. S. Neto, Ana C. P. Cardoso, Iuri dos Santos, Beatriz S. Coelho, Suzany A. Leite, Daniell R. R. Fernandes, Geraldo A. Carvalho, Maria A. Castellani
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- Journal:
- Bulletin of Entomological Research / Volume 113 / Issue 6 / December 2023
- Published online by Cambridge University Press:
- 24 November 2023, pp. 814-828
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Climate factors, pesticides, and landscape in coffee agroecosystems directly affect the populations of the coffee leaf miner and its parasitoids. This study aimed to investigate the effects of climate factors, insecticide use, and landscape on natural parasitism, parasitoid diversity, and infestation of L. coffeella in coffee plantations in the Planalto region, Bahia, Brazil. Mined leaves were collected monthly in six coffee plantations with varying edge density, vegetation cover, landscape diversity in scales of 500 to 3000 m of radius, insecticide use, and climate factors. Closterocerus coffeellae, and Proacrias coffeae (Eulophidae) predominated in the pest's natural parasitism. Our record is the first for the occurrence of Stiropius reticulatus, Neochrysocharis sp. 1, Neochrysocharis sp. 2, and Zagrammosoma sp. in Bahia. Higher temperature and larger forest cover increased the coffee leaf miner infestation. Higher rainfall values, insecticide use, and landscape diversity decreased the pest infestations. Natural parasitism and species diversity are favoured by increase in temperature, forest cover, and edge density, while increase in rainfall, insecticide use, and landscape diversity lead them to decrease.The natural parasitism and diversity of parasitoid species of the coffee leaf miner have been enhancing in the areas with greater forest cover and edge density associated with low use of insecticides. The areas composed of different lands with annual croplands surrounding the coffee plantations showed less natural parasitism and parasitoid species diversity. The ecosystem services provided by C. coffeellae and P. coffeae in coffee crops areas require conservation and these species are potential bioproducts for applied biological control programmes.
Water use efficiency and yield responses of Cenchrus purpureus genotypes under irrigation
- R. E. P. Ribeiro, A. C. L. Mello, M. V. Cunha, M. V. F. Santos, S. B. M. Costa, J. J. Coelho, R. O. Carvalho, V. J. Silva
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- Journal:
- The Journal of Agricultural Science / Volume 161 / Issue 4 / August 2023
- Published online by Cambridge University Press:
- 07 September 2023, pp. 572-580
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In tropical regions, water stress is one of the main causes of the reduction in forage productivity, and irrigation strategies can mitigate the problem, especially for highly productive species. The objective of this study was to evaluate the effects of irrigation, genotype and plant size on productive responses and water use efficiency (WUE) of elephant grass (Cenchrus purpureus [Schumach.] Morrone), in the rainy and dry season. The experimental design was randomized in blocks, arranged in split plots, the main plots were established based on the use of irrigation and the subplots were the tall-sized genotypes (IRI 381 and Elephant B) and dwarfs (Taiwan A-146 2.37 and Mott). The genotypes were evaluated for two years and harvested every 60 days. Water use efficiency, total forage accumulation per year and harvest, forage accumulation rate and forage density were evaluated. There was a significant difference between the genotypes in terms of total forage accumulated (P < 0.05). The most productive genotype was IRI 381, which showed the greatest total forage accumulation (42 168 kg of DM/ha in two years) in the irrigated plots. During the rainy seasons, IRI 381 stood out in terms of forage accumulated (24 667 kg of DM/ha). Irrigation favoured increases in forage accumulation around 60%, in both years of evaluation. Irrigation and plant size influenced the productivity and WUE of elephant grass harvested in 60-day intervals. Tall genotypes and Taiwan A-146 2.37 (dwarf size) stood out in most of the productive traits analysed, while Mott was highlighted by its forage density.
Establishing Disorder-Specific and Transdiagnostic Neural Features of Psychiatric Disorders Through Large-Scale Functional Magnetic Resonance Imaging Meta-Analyses
- C. H. Miller, E. Pritchard, S. Saravia, M. Duran, S. L. Santos, J. P. Hamilton, D. W. Hedges, I. H. Gotlib, M. D. Sacchet
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S547-S548
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Introduction
Meta-analyses of functional magnetic resonance imaging (fMRI) studies have been used to elucidate the most reliable neural features associated with various psychiatric disorders. However, it has not been well-established whether each of these neural features is linked to a specific disorder or is transdiagnostic across multiple disorders and disorder categories, including mood, anxiety, and anxiety-related disorders.
ObjectivesThis project aims to advance our understanding of the disorder-specific and transdiagnostic neural features associated with mood, anxiety, and anxiety-related disorders as well as to refine the methodology used to compare multiple disorders.
MethodsWe conducted an exhaustive PubMed literature search followed by double-screening, double-extraction, and cross-checking to identify all whole-brain, case-control fMRI activation studies of mood, anxiety, and anxiety-related disorders in order to construct a large-scale meta-analytic database of primary studies of these disorders. We then employed multilevel kernel density analysis (MKDA) with Monte-Carlo simulations to correct for multiple comparisons as well as ensemble thresholding to reduce cluster size bias to analyze primary fMRI studies of mood, anxiety, and anxiety-related disorders followed by application of triple subtraction techniques and a second-order analysis to elucidate the disorder-specificity of the previously identified neural features.
ResultsWe found that participants diagnosed with mood, anxiety, and anxiety-related disorders exhibited statistically significant (p < .05 – 0.0001; FWE-corrected) differences in neural activation relative to healthy controls throughout the cerebral cortex, limbic system, and basal ganglia. In addition, each of these psychiatric disorders exhibited a particular profile of neural features that ranged from disorder-specific, to category-specific, to transdiagnostic.
ConclusionsThese findings indicate that psychiatric disorders exhibit a complex profile of neural features that vary in their disorder-specificity and can be detected with large-scale fMRI meta-analytic techniques. This approach has potential to fundamentally transform neuroimaging investigations of clinical disorders by providing a novel procedure for establishing disorder-specificity of observed results, which can be then used to advance our understanding of individual disorders as well as broader nosological issues related to diagnosis and classification of psychiatric disorders.
Disclosure of InterestNone Declared
Do we have an “anti-stigmotic”? – Addressing Mental-Illness Related Stigma as the main issue
- C. Cabaços, J. Andrade, F. Pocinho, M. Carneiro, G. Santos, D. Loureiro, A. Macedo
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1031
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Introduction
For people with mental illness, internalized stigma, also referred to as self-stigma, is characterized by a subjective perception of devaluation, marginalization, secrecy, shame, and withdrawal. It has many adverse effects on individual’s psychological well-being and clinical outcomes. The iatrogenic effects it has during psychotherapeutic treatment can significantly reduce utilization of mental health care services, reduce quality of life and increase avoidant coping. Overall, internalized stigma is considered a risk factor for poorer mental health prognosis. Although some interventions have recently been developed to specifically intervene on this target as part of psychological recovery goals over the course of treatment, most clinicians are not yet aware or empowered to correctly address this.
ObjectivesDescription of a clinical case illustrating the relevance on addressing internalized mental illness related stigma during the recovery process.
MethodsClinical case report and review of the literature on the subject.
ResultsWe present the case of a 47-year-old female patient, C.S., single, graduated in social work (currently unemployed), who was admitted at the Psychiatry Day Hospital, where she was referred by her Psychiatry Assistant because of abulia, social withdrawal and isolation, depressed mood, thoughts of shame, guilt and self-devaluation and work incapacity. She had been admitted in the Psychiatry ward one year earlier for a first psychotic breakthrough, presenting persecutory and grandiose delusions and auditory hallucinations. After three weeks of inpatient treatment with antipsychotics, a full remission of the symptoms was achieved, without any posterior relapse. Before that first psychotic episode, the patient had been taking anti-depressive medication (escitalopram 20 mg id) for many years, prescribed by her General Practitioner, for mild to moderate depressive symptoms. After being discharged from the Psychiatry ward, C. kept following an outpatient treatment with anti-depressives and behavioural activation-based psychotherapy. She started to believe she was mentally ill and therefore weak, uncapable, and less deserving than her peers or her previous self. These self-stigmatizing ideas were enhanced by the lack of family support and the beliefs that were fostered by her mother, with whom she started to live after the hospitalization. These factors led to a dysfunctional internalization of an illness behaviour, jeopardizing the patient’s ability to reach full recovery.
ConclusionsThis case reinforces the importance of targeting mental illness related stigma during the recovery process. Also, involving the family is of extreme importance to achieve support and address shared beliefs and the interchange between social and internalized stigma.
Disclosure of InterestNone Declared
Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies
- S. K. Kahlon, Z. Ali, E. Pritchard, S. Saravia, C. Baten, A. M. Klassen, J. H. Shepherd, G. Zamora, J. Jordan, M. Duran, S. L. Santos, D. W. Hedges, J. P. Hamilton, M. D. Sacchet, C. H. Miller
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S452
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Introduction
Generalized anxiety disorder (GAD) is a highly prevalent mental illness that is associated with clinically significant distress, functional impairment, and poor emotional regulation. Primary functional magnetic resonance imaging (fMRI) studies of GAD report neural abnormalities in comparison to healthy controls. However, many of these findings in the primary literature are inconsistent, and it is unclear whether they are specific to GAD or shared transdiagnostically across related disorders.
ObjectivesThis meta-analysis seeks to establish the most reliable neural abnormalities observed in individuals with GAD, as reported in the primary fMRI activation literature.
MethodsWe conducted an exhaustive literature search in PubMed to identify primary studies that met our pre-specified inclusion criteria and then extracted relevant data from primary, whole-brain fMRI activation studies of GAD that reported coordinates in Talairach or MNI space. We then used multilevel kernel density analysis (MKDA) with ensemble thresholding to examine the differences between adults with GAD and healthy controls in order to identify brain regions that reached statistical significance across primary studies.
ResultsPatients with GAD showed statistically significant (α=0.05–0.0001; family-wise-error-rate corrected) neural activation in various regions of the cerebral cortex and basal ganglia across a variety of experimental tasks.
ConclusionsThese results inform our understanding of the neural basis of GAD and are interpreted using a frontolimbic model of anxiety as well as specific clinical symptoms of this disorder and its relation to other mood and anxiety disorders. These results also suggest possible novel targets for emerging neurostimulation therapies (e.g., transcranial magnetic stimulation) and may be used to advance our understanding of the effects of current pharmaceutical treatments and ways to improve treatment selection and symptom-targeting for patients diagnosed with GAD.
Disclosure of InterestNone Declared
SUICIDE AND COVID-19: A TEMPORAL-SPATIAL ANALYSIS IN THE STATE OF PARANÁ AND THE 15th HEALTH REGIONAL FROM 2010 TO 2020
- K. Silva, C. Bettoni, R. Santos, N. Schoeler, M. Porcu
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S781
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Introduction
Suicide occurs throughout all the life course, but in 2019 it was the fourth leading cause of death among 15-29 years old worldwide.
In Brazil, between 2010 and 2019, 112,230 deaths from suicide were recorded, with a 43% increase in the annual number of deaths from the beginning to the end of that period in all age groups. (SAÚDE, 2021).
ObjectivesTo accomplish a space-time analysis of the rate of suicide deaths in the state of Paraná and in its 15th Health Regional, from 2010 to 2020, in the population aged 20 to 69 years, contrasting the pre-pandemic periods (2010 to 2019) and during the COVID-19 pandemic (2020).
MethodsThis is an ecological, observational, cross-sectional, retrospective study, using spatial and temporal analysis tools, based on secondary data obtained from the Department of Informatics of the Unified Health System (DATASUS), in the period 2010 and 2020, referring to the 5568 Brazilian cities, with emphasis on the 399 of the state of Paraná and the 30 cities of its 15th Health Regional (HR).
Exploratory Spatial Data Analysis (AEDE) techniques were used through GeoDA (version 1.20.0.8) and QGis (version 3.22.4) software to determine the existence of Spatial Autocorrelation (Moran’s Global Index or Moran I) and to calculation and visualization of the Local Spatial Association Indicator (LISA).
Global (Moran I) and local (LISA) spatial autocorrelation coefficients were considered significant when p < 0.05 at a 95% confidence level.
The Space Time Cube is a simultaneous spatial and temporal analysis methodology of ArcGIS Pro Software (ESRI, 2011) that evaluates the behavior of a value in space over a defined time interval.
ResultsThe arithmetic mean of the age at death by suicide, from 2010 to 2020, was 41.1 years, with a standard deviation of 13.3 years and a median of 40 years. Most deaths in the pre-pandemic period occurred among men aged 20 to 29, followed by women aged 30 to 39 years and men aged 40 to 49 years.
Regarding the most common causes and modes of suicide in the State, there was no significant difference between the periods from 2010 to 2019, pre-pandemic reference, and 2020 (pandemic) in a global perspective. The three main causes of death were: 1) Hanging, strangulation or suffocation (ICD-10 X70, T71) were the majority and accounted for more than half of all causes; 2) Self-harm by gunshot (ICD- 10 X74 and X72); 3) Self-poisoning by pesticides and drugs, respectively (ICD-10 X68 and X61).
ConclusionsThis study showed an increase in suicide deaths in the state of Paraná, when analyzing the periods before and during the COVID-19 pandemic. The most affected population was men, aged 20 to 29 years.
Disclosure of InterestNone Declared
DOCTOR, I’M PREGNANT. Psychopharmacological treatment of depression in pregnant women. A clinical case of a pregnant woman and major depressive disorder
- M. Queipo De Llano De La Viuda, G. Guerra Valera, C. Vallecillo Adame, C. De Andrés Lobo, T. Jiménez Aparicio, M. Fernández Lozano, I. D. L. M. Santos Carrasco, N. De Uribe Viloria
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1011
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Introduction
Depression during pregnancy can appear with a prevalence of up to 11% of pregnant women. Psychotherapeutic treatment in these cases is considered the first option, but treatment with antidepressants is sometimes required in these cases.
ObjectivesTo present a clinical case of a pregnant patient diagnosed with depression.
MethodsLiterature review of the psychopharmacological treatment of depression during pregnancy and possible complications.
ResultsA 25y Year old woman, 22 weeks pregnant, who lives with her partner. She has no background in mental health. Paternal aunt diagnosed with type I Bipolar Disorder. She goes to the Mental Health Center for evaluation, due to anxiety and depressive symptoms of 4 weeks of evolution, she refers sadness and apathy, continuous crying, somatic anxiety and obsessive ruminations in relation to childbirth and inability to care for your child. Suicidal ideation as a resolution of her discomfort. She presents with global insomnia and a significant loss of appetite, with a weight loss of 3 kg. Treatment with sertraline 50 mg/day was started, with good tolerance and clinical response
ConclusionsThe psychopharmacological treatment of antenatal depression is a challenge for the psychiatric professional. In all cases, an adequate balance must be made between the risks and complications for the fetus and the psychopathological stability of the pregnant woman. Among the main risks of untreated depression are: preterm delivery and low birth weight, an increased risk of suicide and alterations in the development during the baby’s infancy. The most used antidepressants are the SSRIs, with sertraline being a good option. Paroxetine has been associated with cardiac defects in the newborn. There are studies with tricyclics and duals but no specific teratogenic pattern has been seen. They are associated with an increased risk of spontaneous abortion. Exposure during the third trimester may be associated with obstetric complications.
Disclosure of InterestNone Declared
Major Depressive Disorder Across Development and Course of Illness: A Functional Neuroimaging Meta-Analysis
- C. Baten, A. M. Klassen, J. H. Shepherd, G. Zamora, E. Pritchard, S. Saravia, Z. Ali, J. Jordan, S. K. Kahlon, G. Maly, M. Duran, S. Santos, A. F. Nimarko, D. W. Hedges, P. Hamilton, I. H. Gotlib, M. D. Sacchet, C. H. Miller
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S345-S346
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Introduction
Functional magnetic resonance imaging (fMRI) has been used to identify the neural activity of both youth and adults diagnosed with major depressive disorder (MDD) in comparison to healthy age-matched controls. Previously reported abnormalities in depressed youth appear to mostly align with those found in depressed adults; however, some of the reported aberrant brain activity in youth has not been consistent with what is observed in adults, and to our knowledge there has not yet been a formal, quantitative comparison of these two groups. In addition, it is not known whether these observed differences between youth and adults with depression are attributable to developmental age or length-of-illness.
ObjectivesThe aim of this study is to elucidate the similarities and differences in patterns of abnormal neural activity between adults and youth diagnosed with MDD and to then determine whether these observed differences are due to either developmental age or length-of-illness.
MethodsWe used multilevel kernel density analysis (MKDA) with ensemble thresholding and triple subtraction to separately determine neural abnormalities throughout the whole brain in primary studies of depressed youth and depressed adults and then directly compare the observed abnormalities between each of those age groups. We then conducted further comparisons between multiple subgroups to control for age and length-of-illness and thereby determine the source of the observed differences between youth and adults with depression.
ResultsAdults and youth diagnosed with MDD demonstrated reliable, differential patterns of abnormal activation in various brain regions throughout the cerebral cortex that are statistically significant (p < .05; FWE-corrected). In addition, several of these brain regions that exhibited differential patterns of neural activation between the two age groups can be reliably attributed to either developmental age or length-of-illness.
ConclusionsThese findings indicate that there are common and disparate patterns of brain activity between youth and adults with MDD, several of which can be reliably attributed to developmental age or length-of-illness. These results expand our understanding of the neural basis of depression across development and course of illness and may be used to inform the development of new, age-specific clinical treatments as well as prevention strategies for this disorder.
Disclosure of InterestNone Declared
Anorexia Nervosa and Autism Spectrum Disorder: what links them?
- C. M. Santos, A. Quintão, D. Jeremias, M. Fraga
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S523
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Introduction
According to the literature, about 35% of patients with Anorexia Nervosa (AN) also have a diagnosis of Autism Spectrum Disorder (ASD), and this comorbidity occurs more frequently in males.
ObjectivesWith this work, the authors intend to address the characteristics present in this comorbidity and what is the impact of this comorbidity in the diagnosis, approach and prognosis of AN.
MethodsNon-systematic research of the literature through the PubMed database with the terms “autism spectrum disorder” and “anorexia nervosa”. Only surveys conducted in the last 10 years were considered for inclusion.
ResultsAlthough AN and ASD may seem to be quite distinct conditions, the studies found suggest the existence of four characteristics that overlap the two diagnoses: deficits in theory of mind, inability to switch between courses of action fluently, inability to see the whole pictures to the detriment of detail and alexithymia. Studies also point to greater resistance to treatment in AN when an ASD is present in comorbidity.
ConclusionsScientific evidence suggests that autistic characteristics in people with AN are not a consequence of being underweight, but rather stable characteristics present before and after the onset of AN. The studies thus conclude that comorbidity between the two disorders exists and is frequent enough to warrant greater attention to the diagnosis of ASD in people with AN. However, there are still no specific guidelines for the treatment of AN in people with ASD, which leads to a worse response to treatment, evolution and prognosis of AN in people with ASD.
Disclosure of InterestNone Declared
LATE ONSET PSYCHOSIS AND VERY LATE ONSET PSYCHOSIS: WHAT ARE THE POSSIBLE ETHIOLOGIES?
- A. C. Ramos, S. C. Martins, T. M. Afonso, N. B. Santos, P. Gonçalves, T. Maia
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1039
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Introduction
Psychotic symptoms have long been known to show up earlier in life, typically during adolescence and early adulthood. Late Onset Psychosis (LOP), in which symptoms start between 40 and 60 years of age, and Very Late Onset Psychosis (VLOP), in which onset of symptoms happens after 60 years of age, although classically rare, have had a growing prevalence in the last decades.
ObjectivesTo access the definition and main etiologies of LOP and VLOP, based on the current literature.
MethodsNon-systematic review of literature using the terms “late onset psychosis” and “very late onset psychosis”. Case report of a patient who was admitted and treated in our inward patient field.
Results51-year-old female patient. She is divorced (two previous marriages) and has two daughters (26 and 16, respectively). She was brought by police officers because of behavior problems at the shelter where she was living. She was evicted from the house she was living in because of delay in paying the rent. On observation, she verbalizes persecutory and prejudicial delusions and auditory hallucinations on the 2nd and 3rd person (commenting voices) with at least 5 years of duration. She was hospitalized for almost 3 months, with slow but progressive clinical improvement on haloperidol 7,5mg/day. At the date of discharge, she did not spontaneously verbalize her symptoms, although she did not recognize them as delusional. Recent studies have shown that the prevalence of Schizophrenia in the typical age range is 75-80%, which means that an important proportion of diagnosis is made after that age span. Primary causes of LOP and VLOP are schizophrenia (of late onset), schizophrenia-like very late onset psychosis, delusion disorder, unipolar depression with psychotic symptoms and bipolar disorder. Secondary causes should also be considered, such as delirium, dementia (Alzheimer’s, Lewi bodies and vascular), and substances abuse; even more rare, other conditions should be considered, as cerebrovascular accident, encephalitis, epilepsy, and multiple sclerosis.
ConclusionsLOP and VLOP have been a growing diagnosis in the past decades. In the assessment of these patients, we must consider the importance of secondary etiologies besides the primary psychiatric ones. Primary psychosis is a diagnosis of exclusion, and the clinician must rule out secondary causes. Recent data point out these symptoms as markers for an increased risk of dementia in these patients. Further research involving individuals with LOP and VLOPs is required to increase the evidence base for treatment and improve outcomes of care.
Disclosure of InterestNone Declared
The link between Pos-Traumatic Stress Disorder and Childbirth
- A. M. Fraga, A. Quintão, B. Mesquita, C. Melo Santos, F. Soares, J. Correia, M. Albuquerque, S. Neves, A. Moutinho, P. Cintra
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1124
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Introduction
Childbirth can be experienced as distressing or even traumatic for some women and her partners, which could cause psychological distress, intense fear or helplessness and increases the risk of anxiety, depression and even post-traumatic stress disorder (PTSD). The reported prevalence of post-traumatic stress disorder after childbirth ranges from 1.5% to 6%.
ObjectivesThe current study aimed to elaborate a narrative literature review to identify predictors associated development of PTSD in women and the partners.
MethodsPubMed database searched using the terms “post-traumatic stress disorder” and “childbirth” and “trauma”. Only research conducted in the past 20 years was considered for inclusion.
ResultsSeveral variables were associated with risk to development PTSD after childbirth, including negative experiences and severe fear of childbirth, subjetive distress, previous abortion, psychological difficulties in pregnancy, previous psychiatric problems, history of PTSD and trauma. Futhermore, obstretic and birth-related factors such as pregnancy complications, type of birth could also contribute to PTSD in women and her partners. Additionally, diferent environmental factors like poor interaction between provider and mother, low social support during labour and birth are associated with development of PTSD.
ConclusionsClinicians should be aware that many women and her parterns have a risk to development PTSD following childbirth. We need to research risk factors in routine clinical practice and carefully monitored the patients with high risk.
Disclosure of InterestNone Declared
Major Depressive Disorder in Youth: A Meta-Analysis of Functional Magnetic Resonance Imaging Studies
- G. Zamora, C. Baten, A. M. Klassen, J. H. Shepherd, E. Pritchard, S. Saravia, Z. Ali, J. Jordan, S. K. Kahlon, G. Maly, M. Duran, S. L. Santos, A. F. Nimarko, D. W. Hedges, J. P. Hamilton, I. H. Gotlib, M. D. Sacchet, C. H. Miller
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S219-S220
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Introduction
Major depressive disorder (MDD) is a highly prevalent mental illness that frequently originates in early development and is pervasive during adolescence. Despite its high prevalence and early age of onset, our understanding of the potentially unique neural basis of MDD in this age group is still not well understood, and the existing primary literature on the topic includes many new and divergent results. This limited understanding of MDD in youth presents a critical need to further investigate its neural basis in youth and presents an opportunity to also improve clinical treatments that target its neural abnormalities.
ObjectivesThe present study aims to advance our understanding of the neural basis of MDD in youth by identifying abnormal functional activation in various brain regions compared with healthy controls.
MethodsWe conducted a meta-analysis of functional magnetic resonance imaging (fMRI) studies of MDD by using a well-established method, multilevel kernel density analysis (MKDA) with ensemble thresholding, to quantitatively combine all existing whole-brain fMRI studies of MDD in youth compared with healthy controls. This method involves a voxel-wise, whole-brain approach, that compares neural activation of patients with MDD to age-matched healthy controls across variations of task-based conditions, which we subcategorize into affective processing, executive functioning, positive valence, negative valence, and symptom provocation tasks.
ResultsYouth with MDD exhibited statistically significant (p<0.05; FWE-corrected) hyperactivation and hypoactivation in multiple brain regions compared with age-matched healthy controls. These results include significant effects that are stable across various tasks as well as some that appear to depend on task conditions.
ConclusionsThis study strengthens our understanding of the neural basis of MDD in youth and may also be used to help identify possible similarities and differences between youth and adults with depression. It may also help inform the development of new treatment interventions and tools for predicting unique treatment responses in youth with depression.
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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- Journal:
- 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
Conversive and Factitious disorders: Differential diagnosis based on a case report
- M. Fernández Lozano, I. Santos Carrasco, C. Vallecillo Adame, M. Queipo de Llano de la Viuda, T. Jimenez Aparicio, C. De Andrés Lobo
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S687
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Introduction
Conversive disorder is characterised by the presence of one or more involuntary neurological symptoms that are not due to a clear medical pathology. On the other hand, consciously simulated illnesses fall into two diagnostic categories: factitious disorders and malingering, which are differentiated by both the motivation for the behaviour and the awareness of that motivation. Factitious disorder behaviours are motivated by an unconscious need to assume the sick role, whereas malingering behaviours are consciously driven to achieve external secondary gains.
ObjectivesStudy of the differences between conversion disorder and factitious disorder and their repercussions from a case of difficult diagnosis.
MethodsBibliographic review of scientific literature based on a relevant clinical case.
ResultsWe present the case of a 14-year-old male patient. Adoptive parents. Studying in high school. Social difficulties since childhood. He comes to the emergency department on several occasions referring stereotyped movements and motor tics in the four extremities with left cervical lateralization. Increase of these symptoms in the last month, so it was decided to admit him to the pediatric hospital. After observation and study of the patient’s movements with normal complementary tests he should return home. The following day he returned to the emergency department after an episode of dizziness, mutism and emotional block. It was decided to admit him to Psychiatry for behavioral observation and differential diagnosis.
ConclusionsIn the assessment of patients it is essential to make an appropriate diagnosis taking into account the patient’s symptomatology and the patient’s background and life context. Conversion disorder is the unintentional production of neurological symptom, whereas malingering and factitious disorder represent the voluntary production of symptoms with internal or external incentives. They have a close history and this has been frequently confounded. Practitioners are often confronted to medically unexplained symptoms; they represent almost 30% of neurologist’s consultation. The first challenge is to detect them, and recent studies have confirmed the importance of “positive” clinical bedside signs based on incoherence and discordance. Multidisciplinary therapy is recommended with behavioral cognitive therapy, antidepressant to treat frequent comorbid anxiety or depression, and physiotherapy. Factitious disorder and malingering should be clearly delineated from conversion disorder. Factitious disorder should be considered as a mental illness and more research on its physiopathology and treatment is needed, when malingering is a non-medical condition encountered in medico-legal cases.
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
Psychosomatic symptoms according to psychiatric diagnosis
- R. Fernández Fernández, L. Fontecha Banegas, C. Suárez Pérez, D. Gómez Olmeda, 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, p. S299
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Introduction
Psychosomatic symptoms are an important problem that is frequently presented in medical consultations. These symptoms are often associated with psychiatric disorders, especially depressive and anxiety disorders.
ObjectivesTo study the association between anxiety disorders and psychosomatic symptoms in a sample of patients referred for pathology of functional origin.
MethodsWe made a descriptive retrospective study through the use of electronic medical records. The symptom onset and diagnosis were obtained for all patients referred to outpatients for psychosomatic symptoms during a 1-year period. We performed χ² Tests to assess the association of the diagnosis with the occurrence of psychosomatic symptoms.
ResultsThe only diagnosis that presented statistically significant association was anxiety disorder (χ² = 11.1; p<0.001).
Anxiety disorder Psychosomatic symptoms No Si Total No Observed 312 7 319 Expected 306 13.47 319 Yes Observed 119 12 131 Expected 125 5.53 131 Total Observed 431 19 450 Expected 431 19 450 ConclusionsOur study finds results that follow the line of other studies that show this association, such as Campo’s study which finds that functional somatic symptoms are consistently associated cross-sectionally with anxiety and depressive symptoms (Campo, 2012) or Imran’s study which finds that higher levels of somatization independently and significantly predicted higher anxiety (β=.37, p=.0001) (Imran et al., 2013). However, our results show no association with depressive disorders whereas frequent associations are found in the literature; for example, a recent meta-analysis found that neuroticism and depression had the strongest influence on the association of medically unexplained physical symptoms and frequent healthcare use (den Boeft et al., 2016). This lack of association is probably due to greater ease in identifying depressive disorders as the main pathology versus anxiety disorders.
ReferencesCampo J. V. (2012). Annual research review: functional somatic symptoms and associated anxiety and depression--developmental psychopathology in pediatric practice. Journal of child psychology and psychiatry, and allied disciplines, 53(5), 575–592. den Boeft, M., Twisk, J. W., Terluin, B., Penninx, B. W., van Marwijk, H. W., Numans, M. E., van der Wouden, J. C., & van der Horst, H. E. (2016). The association between medically unexplained physical symptoms and health care use over two years and the influence of depressive and anxiety disorders and personality traits: a longitudinal study. BMC health services research, 16, 100
Imran, N., Ani, C., Mahmood, Z., Hassan, K. A., & Bhatti, M. R. (2014). Anxiety and depression predicted by medically unexplained symptoms in Pakistani children: a case-control study. Journal of psychosomatic research, 76(2), 105–112.
Disclosure of InterestNone Declared