17 results
Adherence to psychiatric medications and diagnosis
- C. González Navarro, A. Bilbao Idarraga, I. Alonso Salas, L. Morado San segundo, A. López Fariña, U. López Puentes, B. Samsó Martínez, R. F. Lopez Brokate, T. Ruiz de Azua Aspizua, E. M. Garnica de Cos, U. Ortega Pozas
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S240-S241
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Introduction
Patients with mental disorders frequently become non-adherent during their long term prescribed treatment. This situation frequently triggers clinical worsening and hospital admission. Therefore, non-adherence may result in poorer long term clinical outcomes and has economic implications for health-care providers (Carlos De las Cuevas et al. Neuropsychopharmacol Hung 2021; 23(4):347-362).
Objectives- To describe the adherence to oral and long acting injectable treatment in the sample of patients that were admitted to the short stay hospital unit during the period of study.
- To describe the adherence to treatment amongst psychiatric diagnosis in the sample of study.
MethodsIt was a retrospective observational study with a duration of three months. Data was collected from all patients admitted to the short stay hospital unit during the period of study and there were no specific exclusion criteria. Descriptive statistics were performed. To assess the adherence to pharmachological treatment the patient report, the family report and the pharmacy dispensation according to the existent informatic prescription platform was considered. Regarding the long acting injectable treatment the formulary of administration in the clinical history was checked.
ResultsDuring the period of study 172 patients were admitted to the short stay hospital unit. Of those, 146 patients had a previous pharmacologic prescription. Data of treatment was not possible to obtain in 7 patients. In the sample of study, 83.5% were on oral and 16.5% on long acting injectable treatment. The general adherence to treatment in the sample was 61.87%. In the oral treatment group the adherence was 58.4% and in the long acting injectable treatment group was 65.2%.
Amongst the different psychiatric diagnoses the outcomes of adherence to treatment were: 60.4% in schizophrenia and related psychosis, 62.5% in bipolar disorder, 78.6% in depression, 58.3% in personality disorders and 62% in addictive disorders.
ConclusionsIn our descriptive study adherence to treatment was higher in the long acting injectable treatment group, agreeing with the existent scientific literature.
The results of adherence for schizophrenia and bipolar disorder are similar to the ones found in scientific literature but differ from the ones for depression, being higher in our sample (Judit Lazary et al. Neuropsychopharmacol Hung 2021;23(4): 347-362). Moreover, in scientific literature it is found a similar prevalence of adherence across diagnosis (for schizophrenia, bipolar disorder and depression) whereas in our sample patients with depression showed a different and higher adherence to treatment (Judit Lazary et al. Neuropsychopharmacol Hung 2021;23(4): 347-362). In our sample, patients with personality disorders had the lowest adherence to treatment.
Disclosure of InterestNone Declared
Efficacy of maintenance electroconvulsive therapy in recurrent depression: a case series
- G. Guerra Valera, Ó. Martín Santiago, M. Esperesate Pajares, Q. D. L. de la Viuda, A. A. Gonzaga Ramírez, C. Vallecillo Adame, C. de Andrés Lobo, T. Jiménez Aparicio, N. Navarro Barriga, B. Rodríguez Rodríguez, M. Fernández Lozano, M. J. Mateos Sexmero, A. Aparicio Parras, M. Calvo Valcárcel, M. A. Andreo Vidal, P. Martínez Gimeno, M. P. Pando Fernández, M. D. L. Á. Guillén Soto
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S832
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Introduction
Maintenance electroconvulsive therapy (mECT) is an option in the treatment of affective disorders which progress is not satisfactory. It is certainly neglected and underused during the clinical practice.
ObjectivesTo evaluate the efficacy of mECT in reducing recurrence and relapse in recurrent depression within a sample of three patients.
MethodsWe followed up these patients among two years since they received the first set of electroconvulsive sessions. We applied the Beck Depression Inventory (BDI) in the succesives consultations for evaluating the progress.
ResultsThe three patients were diagnosed with Recurrent Depressive Disorder (RDD). One of them is a 60 year old man that received initially a cycle of 12 sessions; since then he received 10 maintenance sessions. Other one is a 70 year old woman that received initially a cycle of 10 sessions; since then she received 6 maintenance sessions. The last one is a 55 year old woman that received initially a cycle of 14 sessions; since then she received 20 maintenance sessions.
All of them showed a significant reduction in depressive symptoms evaluated through BDI and clinical examination. In the first case, we found a reduction in the BDI from the first consultation to the last that goes from 60 to 12 points; in the second case, from 58 to 8 points; and in the last case, from 55 to 10 points. The main sections that improved were emotional, physical and delusional.
As side-effects of the treatment, we found anterograde amnesia, lack of concentration and loss of focus at all of them.
ConclusionsWe find mECT as a very useful treatment for resistant cases of affective disorders like RDD.
It should be considered as a real therapeutic option when the first option drugs have been proved without success.
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
UNTIL IT BURSTS OR ALL OF US BURST. A SCHIZOTYPICAL CASE.
- B. Rodríguez Rodríguez, N. Navarro Barriga, M. Fernández Lozano, M. J. Mateos Sexmero, M. A. Andreo Vidal, M. Calvo Valcárcel, P. Martínez Gimeno, M. P. Pando Fernández, A. Aparicio Parras, M. D. L. Á. Guillén Soto, T. Jiménez Aparicio, M. D. C. Vallecillo Adame, C. de Andrés Lobo, A. A. Gonzaga Ramírez, G. Guerra Valera, M. Queipo de Llano de la Viuda, M. Esperesate Pajares
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S967
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Introduction
Schizotypal disorder is conceptualized as a stable personality pathology (Cluster A) and as a latent manifestation of schizophrenia. It can be understood as an attenuated form of psychosis or high-risk mental state, which may precede the onset of schizophrenia or represent a more stable form of psychopathology that doesn’t necessarily progress to psychosis.
ObjectivesTo exemplify the continuum of psychosis
MethodsReview of scientific literature based on a relevant clinical case.
Results39-year-old male living with his parents. He started studying philosophy. He is a regular cannabis user and has an aunt with schizophrenia. He’s admitted to psychiatry for behavioral disturbance in public. He refers to having been hearing a beeping noise in his street for months, what he interprets as a possible way of being watched due to his past ideology. Without specifying who and why, he sometimes shouts “until it bursts” to stop the noise and he thinks that his neighbours alerted the police about his behavior. During the interview he alludes to Milgram’s experiment, saying that throughout history there have been crimes against humanity and those who pointed them out were labeled “crazy”. His father refers that he has always been “strange” and with certain extravagant revolutionary ideas and thoughts. He doesn’t maintain social relationships and dedicates himself to reading and writing.
ConclusionsIt’s important to understand psychosis as a continuum to advance the understanding of etiology, pathophysiology and resilience of psychotic disorders and to develop strategies for prevention and early intervention
Disclosure of InterestNone Declared
Delirious episode secondary to rotigotine: the psychotic patch
- M. A. Andreo Vidal, M. Calvo Valcárcel, P. Martínez Gimeno, P. Pando Fernández, B. Rodríguez Rodríguez, N. Navarro Barriga, M. Fernández Lozano, M. J. Mateos Sexmero, T. Jiménez Aparicio, M. D. C. Valdecillo Adame, C. de Andrés Lobo, G. Guerra Valera, M. Queipo de Llano de la Viuda, A. A. Gonzaga Ramirez, M. D. L. Á. Guillén Soto, A. Aparicio Parras, M. Esperesate Pajares
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S626
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Introduction
There is a fine line separating psychiatry and neurology. Most movement disorders can have psychiatric symptoms, not only those caused by the disease itself, but also those induced by the drugs used to treat them.
ObjectivesPresentation of a clinical case about a patient diagnosed with Parkinson’s disease presenting a several-month-long delirious episode due to dopaminergic drugs.
MethodsLiterature review on drug-induced psychosis episodes in Parkinson’s disease.
ResultsA 57-year-old patient with diagnosis of Parkinson’s disease for six years, who went to the emergency room accompanied by his wife due to delirious ideation. He was being treated with levodopa, carbidopa and rasagiline for years, and rotigotine patches whose dosage was being increased over the last few months.
His wife reported celotypical clinical manifestations and multiple interpretations of different circumstances occurring around her. He chased her on the street, had downloaded an app to look for a second cell phone because he believed she was cheating on him, and was obsessed with sex. He had no psychiatric background. It was decided to prescribe quetiapine.
The following day, he returned because he refused to take the medication since he thought he was going to be put to sleep or poisoned. It was decided to admit him to Psychiatry.
During the stay, rasagiline and rotigotine were suspended. Olanzapine and clozapine were introduced, with behavioral improvement and distancing from the psychotic symptoms which motivated the admission. The patient was also motorically stable. Although levodopa is best known for causing psychotic episodes, the symptons were attributed to rotigotine patches for temporally overlapping the dose increase.
ConclusionsPsychiatric symptoms are the third most frequent group of complications in Parkinson’s disease after gastrointestinal complications and abnormal movements. All medication used to control motor disorders can lead to psychosis, not only dopaminergics, but also selegiline, amantadine and anticholinergics.
Excessive stimulation of mesocortical and mesolimbic dopaminergic pathways can lead to psychosis, which is the most common psychiatric problem related to dopaminergic treatment.
In the face of a psychotic episode, antiparkinsonian drugs which are not strictly necessary for motor control should be withdrawn. If this is not sufficient, levodopa dose should be reduced, considering the side effects that may occur. When the adjustment of antiparkinsonian treatment is not effective, neuroleptics, especially quetiapine or clozapine, should be administered. In a recent study, pimavanserin, a serotonin 5-HT2 antagonist, was associated with approximately 35% lower mortality than atypical antipsychotic use during the first 180 days of treatment in community-dwelling patients.
Medication should always be tailor-made to suit each patient and we usually have to resort to lowering or withdrawing the dopaminergic medication.
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
“Keeping an eye on amylase”. Side effects of antidepressants
- T. Jiménez Aparicio, G. Medina Ojeda, A. Rodríguez Campos, L. Rodríguez Andrés, C. Vallecillo Adame, C. De Andrés Lobo, M. Queipo de Llano de la Viuda, G. Guerra Valera, A. A. Gonzaga Ramírez, M. J. Mateos Sexmero, M. Fernández Lozano, B. Rodríguez Rodríguez, N. Navarro Barriga, M. P. Pando Fernández, P. Martínez Gimeno, M. Calvo Valcárcel, M. A. Andreo Vidal
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S831
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Introduction
Both in consultations with the general practitioner and with the psychiatrist, antidepressants are one of the most used drugs (1). These have multiple indications, and there are different groups according to their mechanism of action. In relation to this case, we are going to talk about Venlafaxine, a dual-type antidepressant, that is, it inhibits the reuptake of serotonin and norepinephrine. One of the most common side effects is digestive discomfort, which usually resolves after a few weeks (2). However, we should not ignore these symptoms, since they can hide something more serious.
ObjectivesPresentation of a clinical case on a patient who presented an increase in pancreatic amylase after starting treatment with Venlafaxine.
MethodsBibliographic review including the latest articles in Pubmed on side effects of antidepressant treatment, and more specifically at the gastrointestinal level (in this case we will talk about pancreatitis).
ResultsWe present the case of a 49-year-old woman, who was hospitalized 2 years ago, due to a first depressive episode. During this admission, psychopharmacological treatment was started for the first time, on that occasion with a selective serotonin reuptake inhibitor (SSRI), treatment of first choice (3). The patient had no side effects at that time, but the response was very modest, so it was decided to replace that antidepressant with Venlafaxine (with dual action), up to 150mg. The depressive symptoms improved markedly, however the patient began to feel digestive discomfort (which at first did not seem to be of great importance). A general analysis was performed, in which an increase in lipase (978 U/L) and amylase (528 U/L) was detected. An echoendoscopy, an abdominal scan, and a magnetic resonance cholangiography were performed; Pancreatitis secondary to drugs was suspected (a severe condition). Luckily, no significant lesions were found in the tests, and the levels of amylase and lipase decreased when Venlafaxine treatment was withdrawn (without reaching the normal range). The patient was discharged and continued to attend consultations. In the last control, amylase had dropped to 225 U/L. His abdominal pain disappeared. Treatment with Vortioxetine (a multimodal antidepressant) was started, however the amylase levels continue to be monitored, and the patient continues to see the gastroenterologist.
ConclusionsGastrointestinal side effects are very common when taking antidepressant treatment, and in most cases they do not usually represent a serious problem.
However, it is described in the scientific literature that in some cases, acute pancreatitis secondary to some drugs, including Venlafaxine, can occur (4). In order to detect it, it is necessary to perform a blood test and sometimes also other complementary tests.
For its treatment, the fundamental thing is to withdraw the causing drug, trying to find other alternatives, and carry out a control to monitor possible complications
Disclosure of InterestNone Declared
Drug Use Among Medical Students: Gender Differences and Variations On Drug Use Across Seven Academic Courses (2008/09-2014/15)
- C. Roncero, L. Rodriguez-Cintas, L. Grau-López, A. Egido, C. Barral, J. Pérez-Pazos, J. Navarro, N. Martínez-Luna, E. Ros-Cucurull, N. Tarifa, C. Daigre, M. Casas
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- Journal:
- European Psychiatry / Volume 30 / Issue S1 / March 2015
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction
Drug use among medical students is partially unknown. However, consumption among medical students may have a similar role if compared with the rest of population.
ObjectivesTo study drugs use among medical students comparing gender and evolution on drugs use.
AimsStudents enrolled in the fifth year of the medical studies at the Universidad Autónoma de Barcelona, from the course 2008-2009 to 2014-2015, were offered the chance to participate voluntarily in the study.
MethodsThe students agreed to participate anonymously in a survey filled in during the beginning days of the psychiatry classes. They were asked about their drug consumption, including legal drugs (alcohol and tobacco) and illegal drugs. During the seven study years, 469 questionnaires were collected (74.1% of women) and mean age was 22.77 (20-35) yearsold.
ResultsThe students reported consuming alcohol (66.7%; 65.5% women, 70.4% men), tobacco (18.6%; 18.1% women, 20% men) and illegal drugs (15.1%; 12.4% women, 22.8% men). The female students consumed fewer illegal drugs than the men (p 0.008) as showed above. Comparing 2008/2009 and 2014/2015 courses, the consumption was: alcohol 75.5% and 65.7%, tobacco 24.5% and 13.2% and illegal drugs 22.4% and 14.7%.
ConclusionsDrug consumption is an important problem among medicalstudents who will becomeprescribing doctors in a few months after the survey. There is a decreased tendency to use illegal drugs. Due to the gender differences on illegal drug use a special focus must be placed on the male group.
Carbon Nanotubes Synthesis from Four Different Organic Precursors by CVD
- F. G. Granados-Martínez, J. J. Contreras-Navarrete, D. L. García-Ruiz, C. J. Gutiérrez-García, A. Durán-Navarro, E. E. Gama-Ortega, N. Flores-Ramírez, E. Huipe-Nava, L. García-González, M. de L. Mondragón-Sánchez, L. Domratcheva-Lvova
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- Journal:
- MRS Online Proceedings Library Archive / Volume 1817 / 2016
- Published online by Cambridge University Press:
- 14 April 2016, imrc2015abs070-abs308
- Print publication:
- 2016
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Carbon nanotubes (CNTs) were synthesized by Chemical Vapor Deposition (CVD) from diethyl ether, butanol, hexane and ethyl acetate. A quartz tube with a stainless steel tube catalyst core with 0.019 m diameter and 0.6 m large formed the reactor. To avoid combustion, argon was used as the carrier gas. Time process ranged 30 to 60 min. The range of CNTs synthesis temperature was 680-850 °C for different precursors. Scanning Electron Microscopy micrographs have demonstrated tangled CNTs growth in all samples, thus presenting difficult length measurement. The CNTs diameters from diethyl ether are 45-200 nm, butanol diameter range from 55-230 nm, hexane diameter range is 50-130 nm and ethyl acetate range from 100 to 300 nm. Carbon content for all samples was higher than 93 %, CNTs from butanol showed carbon concentration up to 99%. FTIR, Raman and X-Ray Spectroscopies spectra for all samples demonstrated the characteristics signals present in carbon nanotubes. This research proposes a simple, effective and innovative method to synthesize CNTs by CVD on iron stainless steel catalyst in combination with diethyl ether, ethyl acetate, butanol and hexane as precursors by applying the principles of green chemistry, sustainability and its ease to be scaled.
Consumption of added fats and oils in the European Prospective Investigation into Cancer and Nutrition (EPIC) centres across 10 European countries as assessed by 24-hour dietary recalls
- J Linseisen, E Bergström, L Gafá, CA González, A Thiébaut, A Trichopoulou, R Tumino, C Navarro Sánchez, C Martínez Garcia, I Mattisson, S Nilsson, A Welch, EA Spencer, K Overvad, A Tjønneland, F Clavel-Chapelon, E Kesse, AB Miller, M Schulz, K Botsi, A Naska, S Sieri, C Sacerdote, MC Ocké, PHM Peeters, G Skeie, D Engeset, UR Charrondière, N Slimani
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- Journal:
- Public Health Nutrition / Volume 5 / Issue 6b / December 2002
- Published online by Cambridge University Press:
- 02 January 2007, pp. 1227-1242
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Objective:
To evaluate the consumption of added fats and oils across the European centres and countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC).
Design and setting:24-Hour dietary recalls were collected by means of standardised computer-guided interviews in 27 redefined EPIC centres across 10 European countries.
Subjects:From an initial number of 36 900 subjects, single dietary recalls from 22 924 women and 13 031 men in the age range of 35–74 years were included.
Results:Mean daily intake of added fats and oils varied between 16.2 g (Varese, Italy) and 41.1 g (Malmö, Sweden) in women and between 24.7 g (Ragusa, Italy) and 66.0 g (Potsdam, Germany) in men. Total mean lipid intake by consumption of added fats and oils, including those used for sauce preparation, ranged between 18.3 (Norway) and 37.2 g day−1 (Greece) in women and 28.4 (Heidelberg, Germany) and 51.2 g day−1 (Greece) in men. The Mediterranean EPIC centres with high olive oil consumption combined with low animal fat intake contrasted with the central and northern European centres where fewer vegetable oils, more animal fats and a high proportion of margarine were consumed. The consumption of added fats and oils of animal origin was highest in the German EPIC centres, followed by the French. The contribution of added fats and oils to total energy intake ranged from 8% in Norway to 22% in Greece.
Conclusions:The results demonstrate a high variation in dietary intake of added fats and oils in EPIC, providing a good opportunity to elucidate the role of dietary fats in cancer aetiology.
A focal adhesion-like process underlies induction of long-term potentiation in the Schaffer collateral-CA1 region of the hippocampus
- RICHARD G. LEBARON, RUBEN V. HERNANDEZ, MARY M. NAVARRO, LISA R. CURRY, JAMES E. ORFILA, JOE L. MARTINEZ, JR
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- Journal:
- Neuron Glia Biology / Volume 1 / Issue 4 / November 2004
- Published online by Cambridge University Press:
- 07 September 2005, pp. 385-393
- Print publication:
- November 2004
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In the series of experiments reported here we provide evidence that a focal adhesion-like process underlies the induction of long-term potentiation (LTP) in the Schaffer Collateral-CA1 projection in the hippocampus. Here we show that an integrin-binding peptide (RGD) impairs induction of Schaffer Collateral-CA1 LTP in hippocampal slice preparations in vitro. The heparin-binding peptide that binds heparan sulfate proteoglycan (HSPG) and blocks the formation of focal adhesions also impairs induction of LTP. Either the integrin-binding peptide or heparin-binding peptide reduces LTP partially. However, when the two peptides were administered simultaneously, there was no LTP 1 hour after induction. This indicates that these two molecules might function together and that a focal adhesion-like process might be involved in the induction of LTP. Additionally, we report that the RGD effect on LTP is time dependent and occurs only in the first few minutes following LTP induction, that the binding of the RGD peptide in CA1 stratum radiatum increases after LTP induction and that this increased binding depends on Ca2+. Using electron microscopy we show that integrins are present in synapses.
Síndrome de Charles Bonnet y enfermedad de Parkinson
- A. G. Alcántara, L. Valenciano, A. Díaz-Ortuño, M. L. Martínez-Navarro, D. Barcía
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- Journal:
- European Psychiatry (Ed.Española) / Volume 6 / Issue 3 / April 1999
- Published online by Cambridge University Press:
- 12 May 2020, pp. 182-194
- Print publication:
- April 1999
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Presentamos dos casos de síndrome de Charles Bonnet en comorbilidad con enfermedad de Parkinson. Los pacientes desarrollaron alucinosis visual antes de comenzar el tratamiento antiparkinsoniano. Analizamos brevemente los posibles mecanismos fisiopatológicos que implican a la agudeza visual baja y la enfermedad de Parkinson con la alucinosis visual.