The psychosocial and mental health-oriented variables of people are determinants for their life in society and their roles within organizations, especially educational institutions that are endowed with social complexities.

The objective of this research was to understand the meaning of work for teachers in educational institutions in the department in order to recognize elements such as the level of importance that work holds for them and the factors that either promote or hinder that centrality.

This is a descriptive study with a quantitative methodology, and the sample selection was done for convenience, taking into account ethical aspects such as the handling of confidentiality for both the individuals who participated in this study and the educational institutions involved.

Regarding the meaning attributed to work by teachers, the results indicate that 29.6% of teachers declare themselves neutral when it comes to the statement that “the most important things in people’s lives are related to work”. 26.8% of teachers are neutral regarding the statement that “the primary function of work is to generate income”, and 17.9% somewhat agree. 20.7% disagree to some extent. 15.6% disagree with the statement that “people’s primary goals in life should be oriented toward work”. 25.1% of teachers are neutral, and 17.9% somewhat agree with the statement that “the main function of work is to enable interesting contacts with other people”. Only 11.7% strongly agree with the statement that “work is, in general, one of the most important things in people’s lives.

It is concluded that there is a need to implement strategies that contribute to the strengthening of the teaching profession and contribute to improving educational quality

None Declared

Cannabinoid hyperemesis syndrome (CHS) is an underrecognized condition characterized by acute episodes of intractable nausea and vomiting, colic abdominal pain and restlessness related to chronic cannabis use. Antiemetics commonly fail to alleviate the severe nausea and vomiting. A very particular finding is the symptomatic relief with hot water. Antipsychotics (such as haloperidol), benzodiazepines and/or capsaicin cream appear to be the most efficacious in the treatment of this unique disorder. Precisely, it has been studied that transient relief of symptoms with topic capsaicin or hot water share the same pathophysiology. Nevertheless, abstinence from cannabis remains the most effective way of mitigating morbidity associated with CHS.

The objective is to study this phenomenom in our hospital and to alert of its existence in order to avoid a suspected misdiagnosis and overdiagnosis.

We report a case series of seven patients who attended the Emergency Room (ER) of a third level hospital located in Cantabria (Spain) where a psychiatric evaluation was demanded.

The reasons for consultation were agitation and/or compulsive vomit provocation and showers. They were all women, with a median age of 29 years (range 21 to 38), who all smoked cannabis and in probable high doses (seven to up to twenty joints per day, information was missing in three of the patients) and probable long duration of consumption (more than nine years up to twenty-three, information was missing in three of the patients).

One of the most striking findings is the time to diagnosis, being the median of years of more than eight (range from two to twenty-one). In all of the cases there is a hyperfrequentation to the ER for this reason (not counting other emergency centres we have in Cantabria which we don´t have access to), being the average of almost twenty-two times (thirteen up to thirty times), not diagnosing it until last visits. Another interesting fact is that Psychiatric evaluation is done approximately in a third of the visits, being the department that makes all of the diagnosis except in one case. In all of the cases there are a lot of diagnostic orientation doubts from different medical departments, being the two most common psychiatric misdiagnosis: Other Specified Anxiety Disorder and Other Specified Feeding or Eating Disorder. Two of the patients were hospitalized in an acute psychiatric unit for this reason, one of them nine times and the other patient, twice.

CHS has a very particular presentation which makes its recognition very simple. From our experience, it is an unknown entity for most of the doctors, something that needs to change in order to make a correct therapeutic management. Larger studies need to be done to make this findings more solid and for further information.

None Declared

Crisis resolution teams (CRTs) are a crucial component of mental health care, providing timely support to individuals experiencing acute mental health crises. This abstract delves into the concept of crisis and seeks to identify the patients who stand to benefit from these specialized services.

Defining crisis within the context of CRTs can be complex. It encompasses not only immediate emergencies but also broader mental health distress.

Research suggests that suitable candidates for CRT interventions are those facing acute mental health crises : This includes individuals experiencing suicidal ideation, severe agitation, or severe emotional distress.

La “Escala de Evaluación de Resolución de Crisis” (Crisis Resolution Team Assessment Tool, CRTAT) de Sonia Johnson es una herramienta diseñada para para medir la efectividad de los CRT y la duración de la intervención en crisis. Establece un límite de seis semanas como el período máximo durante el cual se debe ofrecer la atención en crisis.

Existen otras escalas de evaluación para medir la eficacia de la resolución de crisis:

1. 1. Escala de Intensidad de Crisis (CIS): se utiliza para medir la gravedad de la crisis y la necesidad de intervención inmediata.

2. 2. Escala de Evaluación de Crisis de Brage Hansen (BCES): se enfoca en la evaluación de crisis suicidas y evalúa la intensidad de la ideación suicida y la urgencia de la intervención.

3. 3. Escala de Evaluación de Crisis de Eriksson (ECAS): Diseñada para evaluar la intensidad de la crisis en pacientes psiquiátricos, la ECAS se centra en la agitación, la ansiedad y la angustia emocional.

- Studies have explored the effectiveness of CRTs and the perspectives of service users. Understanding how patients perceive crisis and CRT services is crucial for tailoring interventions effectively.

- CRTs play a vital role in mental health care, offering timely support to individuals experiencing crises. While defining crisis is complex, suitable candidates often include those in acute distress requiring immediate intervention. Understanding the perspectives of service users and the diverse nature of crisis experiences informs effective crisis resolution strategies.

None Declared

“Cluster suicides,” also known as “suicide clusters,” refer to a phenomenon in which a series of suicides occur within a specific community, group, or geographic area within a relatively short period of time. These suicides often appear to be interconnected, either through imitation or contagion, and may involve individuals who have some form of social or emotional connection to each other.

• - Understanding the definition and characteristics of cluster suicides.

• - Analyzing common risk factors and triggers in cluster suicide cases.

• - Evaluating prevention and support strategies for affected individuals and communities.

We conduct an analysis of this concept based on a sample of suicides that occurred in a Spanish region over an 8-year period (2015-2022).

We will Analyzethe following aspects:

• - Definition and characteristics of cluster suicides.

• - Risk factors contributing to the occurrence of cluster suicides.

• - Examples of real cases or case studies illustrating this phenomenon.

• - The role of imitation and contagion in cluster suicides.

• - Prevention and support strategies, including education on warning signs and access to mental health services.

• - The impact of media coverage and how it can amplify the contagion effect.

• - Measures to reduce access to lethal means of suicide.

We will discuss about the results found:

• - Definition and characteristics of cluster suicides.

• - Risk factors contributing to the occurrence of cluster suicides.

• - Examples of real cases or case studies illustrating this phenomenon.

• - The role of imitation and contagion in cluster suicides.

• - Prevention and support strategies, including education on warning signs and access to mental health services.

• - The impact of media coverage and how it can amplify the contagion effect.

• - Measures to reduce access to lethal means of suicide.

The main conclusions of our presentation are :

• - The importance of recognizing cluster suicides as a real and concerning phenomenon.

• - The need to address specific risk factors and triggers in affected communities.

• - The effectiveness of prevention and support strategies in reducing cluster suicide cases.

• - The importance of promoting media responsibility in suicide coverage.

BIBLIOGRAPHY

1. 1. Cluster Suicides: A Critical Review and Theoretical Framework” (2019) - Este estudio proporciona una revisión crítica de la literatura sobre cluster suicides y presenta un marco teórico para comprender mejor este fenómeno

2. 2. “Clusters of Suicides and Suicide Attempts: Identification, Prediction, and Prevention” (2016) - Aunque este estudio no se centra exclusivamente en España, ofrece información sobre la identificación y prevención de clusters de suicidio que puede ser relevante.

3. 3. “Epidemiology of Suicide in Spain, 1981–2008” (2012) - Proporciona una visión general de la epidemiología del suicidio en España, lo que podría ayudar a contextualizar los estudios específicos sobre clusters.

None Declared

N-Methyl-D-aspartate (NMDA) receptors are involved in learning and memory. It is known that ventral hippocampus is a crucial structure involved in emotional memory formation mainly for fear and anxiety situations. The aim of this research is to identify the effect of the stimulation of ventral hipocampal NMDA receptors on the reextinction of an aversive emotional memory task. NMDA (0.2 ug/μl; 0.2 μl) or saline (0.9 %; 0.2 μl) was bilateral and locally administered in the ventral hippocampus of male Wistar rats, before the re-instatement trial.

The experimental group consisted of 10 animals and the control group by 9 subjects. The results suggest that the activation of ventral hipocampal NMDA receptors induces an increase in the time needed to re-extinguish the conditioned fear, suggesting a possible potentiating effect on re-installation.

To evaluate the effect of NMDA at the intrahippocampal level, on the reinstatement and re extinction of a conditioned fear response in male Wistar rats.

This study is experimental, where two groups of adult male Wistar rats were used. The bilateral cannulas was implanted, the animals were injected intraperitoneally with a mixture of ketamine (Rotexmédica) and xylacin (Bayer; 75 mg/Kg and 5 mg/Kg), respectively, then the animals were placed in a stereotaxic apparatus (Narishige) and injected with veterinary antibiotic.The (21G) caliber cannulas were bilaterally implanted in HPv at the following coordinates: AP = -5.2 mm relative to Bregma; ML = ± 5 mm in relation to the midline and DV = 5.1 mm in relation to the skull and according to the atlas (Paxinos & Watson, 1985).

It was observed that in the first phase of extinction there were no statistically significant differences between the two groups, experimental and control, as in the second phase of extinction. The results obtained for the re-extinction phase 1 and 2 showed that there were significant statistical differences between the groups. This difference was only evident in the first three minutes in the two phases of re-extinction.

Image 2:

Image 3:

Statistically significant differences were observed between the two groups, in the phases of re-extinction, seeing a longer time of the freezing response in the experimental group, as an effect of the application of NMDA in the ventral hippocampus (HPv), which suggests that this substance has a memory-enhancing effect, and therefore contributes to increasing the permanence of the fear response. It should be noted that this difference was only evident in the first three minutes in the two re-extinction phases. These results may be related to other studies where it has been shown that LTP is dependent on the N-methyl-D-aspartate receptor in the CA1 region in vivo (Zhong, Cherry, Bies, Florence, & Gerges, 2009)

None Declared

Obsessive-compulsive disorder (OCD) is a mental disorder in which patients who suffer from it have repetitive and undesirable thoughts, feelings, ideas, sensations (obsessions) and behaviors that drive them to do something over and over again (compulsions).

Often the person tries to get rid of the obsessive thoughts through compulsions, but this only provides short-term relief. Not carrying out the obsessive rituals can cause enormous anxiety and suffering.

To describe a 23-year-old male patient, who suffers from anxiety and mood symptoms, reacts to ego-dystonic obsessive ideas and sexual content, of months of evolution, and who manages to calm down through compulsive masturbation or watching sexual videos on the internet. All this clinic negatively interferes with their quality of life, asking the patient for medical help to calm these ideas.

We carried out a review in Pubmed with the terms Antiandrogens and TOC, in order to make a better description of the clinical case.

After several treatment attempts (Sertraline, Paroxetine, Clomipramine, Clomipramine + SSRI), reaching maximum doses according to clinical guidelines, and with poor therapeutic response, it was decided to discuss the case with the endocrinology department of our hospital, deciding to start treatment with antiandrogens, in order to alleviate the persistent intrusive ideas of a sexual nature. The administration of antiandrogens in men can cause a decrease or increase in the development or involution of secondary sexual characteristics in men, reducing the activity or function of accessory sexual organs, and hyposexuality, with decreased sexual desire or libido.

After several weeks, there was improvement in the obsessive symptoms with a decrease in compulsive rituals. However, after the 3rd mo, some symptoms reappeared, but not with the same severity and intensity as before treatment. In addition, we cannot ignore the adverse effects that have occurred, such as involution of secondary sexual characteristics. However, and taking into account the negative repercussion that this clinic had on the patient’s quality of life, the benefit obtained exceeded the risk, having noted clear improvement with this therapy, and maintaining evolutionary controls by both psychiatry and endocrinology.

Patients suffering from obsessive-compulsive disorder can be effectively treated with anti-androgenic pharmacological agents with various modes of action. The most effective group of such agents is the long-acting analogues of the gonadotropin-releasing hormone. The objective of this review is to elucidate the possibility of using such powerful anti-androgenic agents in the treatment of obsessive-compulsive disorder.

None Declared

Catatonia is a complex psychomotor syndrome that often goes unrecognized and, consequently, untreated. Prompt and correct identification of catatonia allows for highly effective treatment and prevention of possible complications. Benzodiazepines and electroconvulsive therapy (ECT) are the most widely studied treatment methods. However, no uniform treatment method has yet been brought forward and no previous attempts to treat catatonia on a patient suffering concomitant major depressive disorder (MDD) with NMDA receptor antagonists have been documented so far.

To describe the unknown and novel management of catatonia and MDD with intranasal esketamine, a NMDA receptor antagonist.

A 55-year-old woman with a diagnosis of long-standing recurrent major depressive disorder who was admitted to the psychiatric inpatient unit of UniversityHospital Marqués de Valdecilla (Santander, Spain) suffering a complex catatonic, mutative state framed on a severe MDD. Different ineffective therapeutic interventions were deployed during the course of her illness. After failing to improve under conventional pharmacological treatment and ECT, and given the complexity of peripheral venous access on this patient (which disabled the option for iv ketamine use), we decided to initiate compassionate treatment with intranasal esketamine.

Intranasal esketamine was effective in the resolution of patient’s complex catatonic state. Clinical response from catatonia was observed after 6 intranasal esketamine administrations (2-week follow-up), reaching full catatonia and MDD remission after 12 sessions in absence of significant adverse events

Esketamine showed promising effectiveness for the treatment of catatonia in the context of MDD, although further research on this topic is needed.

None Declared

Since Kraepelin and Bleuler, schizotypy was understood as a mild expression of psychosis, a latent form with the same trajectory but different severity. They pointed characteristics such as being eccentric, unreasonable, supersticious or hipersensitive, interpersonal aversiveness (often related to suspiciousness and expectation of rejection), ambivalence, anhedonia,… and psychosis-like features that don’t usually lead to help-seeking.

To do a case review

We report a case of a 17 years old boy with a childhood trauma history who started psychiatric consultations a year and a half ago because his “usual” (as his mother referred) strange behaviour got worse, which was perceived by his

ENT specialist. During the appointments, the patient showed suspiciousness, odd speech, inappropriate affect, tendency to social withdrawal, obsessive ruminations with sexual content and occasional perceptual experiences (such as depersonalization, derealization and auditory hallucinations).

Psychosis and schizotypy are linked historically and phenomenologically, which is evidenced by their placement in non-affective psychosis in the ICD-10 and DSM-5, and it is known that the direct observation (by clinicians or family members) during the childhood and adolescence are key for a correct diagnosis. In fact, this construct reflects a phenotypic expression of vulnerability to schizophrenia, and during childhood or adolescence it may be understood as an early mental risk state.

In contrast to models of psychosis that mainly rely on positive features and assume a progression of them, the positive traits of schizotypy seem to be beneficial and related to a “benign or happy schizotypy” according to the articles we reviewed.

No significant relationships.

It’s well known the challenge of differential diagnosis between Obssesive compulsive disorder and autism since their symptoms (intrusive, recurrent thoughts and repetitive behaviours) often overlap.

We report a case of a 14 years old boy diagnosed of ASD who was hospitalized for the first time due to difficult management of repetitive behaviours that made him incapable of doing basic activities without help. To interrupt them led to anxiety, aggressive responses and to insistence on sameness behaviours. Only with this information and with the literature research we made, anyone could tell the problem was probably an ASD symptom. However, during his evolution it was difficult to know whether this behaviour was due to ASD or OCD: after adjusting the medication, and when he started trusting his therapists, he told us about a theory he believed so he could explain the uncomfortable ideas that crossed his mind more than often, so he used those behaviours as an anxiety-reduction technique. This new situation was the fuel to make the present review.

To report a case.

The results are included in the “conclusions” section.

Although there is an ongoing debate concerning the nature of the symptoms in ASD versus those observed in OCD, there are commonly used criteria to differentiate them according to the articles we reviewed:

No significant relationships.

UPD is a regional referral hospital psychiatric care unit, endowed with multidisciplinary equipment. It provides care to people with light/moderate/severe intellectual incapacity coexisting with mental disease and/or severe behavioral disorders. It offers attention to patients who need a protected therapeutical environment for correcting behavior disorders. It was opened in September 2008.

Description of:therapeutic goals, inclusion/exclusion criteria, admission protocol and psychotherapeutic/pharmacological interventions.

Analysis of inpatients's sociodemographic/clinical characteristics and preliminary assessment of therapy goals.

Retrospective study(13-month) of patients admitted to UPD of Leon Hospital from its inception to date. Data are collected from medical histories.

47 referrals have been received,5 of them have been rejected not to fulfill criteria. We’ve 16 patients on waiting list.32 incomes have been realized and 22 discharges have occurred.

19 of the incomes correspond to Mild,6 to Moderate,6 to Severe and 1 to Profound mental Retardation.

Regarding co-morbidity:22 patients presented serious behavioral disorder. From this group, 2 met criteria for autistic disorder, 5 had schizophrenia or unspecific psychotic disorders, 5 presented Personality Disorder and one ADHD.

10 patients did’nt present any important behavioral disturbance. From this group 2 were diagnosed with OCD,3 presented problems due to Alcohol and Substance-related Disorders,3 had Psychotic Disorders, one met criteria for Impulse Control Disorder and one presented Mood Disorder.

Before admission, 12 patients resided in specific handicappeds center, 5 intermittently at selected centers and in family, and 15 lived with family.

Psychotherapeutic intervention and treatment were useful in most cases. It was particularly helpful in treatment of behavioral disturbances. Now we must determine effectiveness in maintenance of improvement when they return to their community.

It is interesting to note somatic comorbidity of psychiatric patients that attend an outpatient Mental Health Unit (MHU). In medical literature there are few studies that reflect which diseases make these patients go to an Emergency Room (ER).

To determine the percentage of patients presenting to an ER in the year prior to psychiatric consultation in a MHU, noting which is the most common assitance and the differences regarding sex, age and marital status.

Retrospective and descriptive study of ER assistances at the Hospital Clínico de Santiago in the previous year of patients attending our MHU. Time period: from February 1st 2010 to August 31th 2010. Once collected the data, these are analyzed using the Excel 2008 Statistical Package for Mac.

From 577 patients studied (68.3% women), 224 had gone at least once to the ER in the last year (72.3% women): 19.6% consulted for psychiatric conditions and 80.4% for somatic causes. Among the predominant somatic complaints we found musculoskeletal causes (24.4%), cardiovascular (8.8%), respiratory (9.4%) and gynecological (2.7%). 3% of them were hospitalized in medical or surgical services and 3% in psychiatric units. There was not statistically significant differences regarding their age. Married and divorced patients went to the ER more than bachelors or widowers.

Profile of the studied patient: “Woman, 53 years old, married, user of an outpatient MHU and that has consulted at least once in the last year to an ER due to musculoeskeletal cause.”

Previous studies suggest a relationship between decreased serum cholesterollevels and impulsive/aggressive behaviors [1]; howeverwe found just one study in the literature based in eating disorder [2].

To investigate the potentialrelationship between lipid profile (cholesterol, HDL, LDL, triglycerides) andmeasures of impulsivity, aggression or suicidal behavior in a sample of nevertreated patient whit Eating disorder and healthy controls.

The first episode of eatingdisorders group consisted of 199 (age range 14-60) subjects included in DETECTAprogram of Cantabria, Spain, from 2011 to 2013. Other group of 199healthy controls were initially recruited from the community and matched by ageand gender. Socio-demographic information was collected for each subject. Clinicalcharacteristics were ascertained either from clinical charts or by directquestioning the study participants. Lifetime diagnosis of impulse control wasassessed with questionnaires developed ad hoc. Impulsivity was evaluated using self-administered questionnaires, EatingDisorder Inventory and Cloninger's Temperament and Character Inventory.

Differences found betweensubgroups did not differ from those shown in the literature, with higher levelsof impulsivity in the group of Bulimia. However in the partial correlation we did not find a relationship betweencholesterol levels and Impulsivity. We neither found this relationshipbetween suicide attempts, pathological gambling, compulsive buying disorder, self-harm or kleptomania.

Although the biological mechanism between plasma hypocholesterolemia andimpulsive behavior has not been fully elucidated this relationship has beenestablished in others pathologies [3], howeverin eating disorders so far, this theory has not been proved.

The utility of Mobile Crisis Unit (MCU) and its target population has been a controversial issue and many scientific articles have been writen about it (1,2).

The aim of this study is to identify the demographic and clinical features of patients diagnosed with psychotic disorder who have been hospitalized and have not required hospitalization in psychiatric unit through a Mobile Crisis Unit (MCU).

We collected retrospectively demographic and clinical variables. These include psychiatric rating scales of severity: Clinical Global Impression Scale (CGI) and Psychiatric Disease Severity (GEP); of functionality as Global Assessment of Functioning Scale (GAF); the aggressive behaviour and violence scale (AVAT) and psychopathology with the Positive and Negative Syndrome Scale (PANSS) of a total of 136 patients between June 2007 and July 2010.

There have been found stadisticaly significative differences between patients who have been hospitalized versus patients who have not in the items of treatment adherence and security staff intervention (Table 1). There is a positive correlation between patients who required hospitalization and the clinical scales CGI, GEP, GAF, AVAT, SUMD, PANSS-P and PANSS-G (Table 2).

We can conclude that patients cared for by the Mobile Crisis Unit (MCU) that require of psychiatric hospitalization have poor adherence to previous treatment. A high frequency of cases require intervention of security staff for having a higher risk of aggressiveness at the moment of hospitalization. The presence of greater psychopathology and functionality severity in patients hospitalized through the Mobile Crisis Unit (MCU) is also considered.