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Impact of COVID-19 on the degree of compliance with hand hygiene: a repeated Cross-sectional study
- M Guerrero-Soler, P Gras-Valentí, IL Gómez-Sotero, G Platas-Abenza, R Silva-Afonso, CM Benito-Miralles, M Fuster-Pérez, L Cartagena-Llopis, M Sánchez-Valero, J Sánchez-Payá, P Chico-Sánchez
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- Epidemiology & Infection / Accepted manuscript
- Published online by Cambridge University Press:
- 01 April 2024, pp. 1-21
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Feed intake, microbial adherence and fibrolytic activity in residues of forage samples incubated in the rumen of sheep fed grass forages and/or a total mixed ration
- A. Pérez-Ruchel, J. L. Repetto, C. Cajarville, M. P. Mezzomo, G. V. Kozloski
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- The Journal of Agricultural Science / Volume 161 / Issue 6 / December 2023
- Published online by Cambridge University Press:
- 15 February 2024, pp. 871-876
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Three male sheep were fed, throughout three experimental periods, with either only forage, only total mixed ration (TMR) or a mixed diet (TMR + forage). The rich-fibre ingredients of each diet were incubated daily in situ for three days and the ruminal pH was measured every 2 h during the last day of each experimental period. Rumen pH decreased at increased proportion of TMR in diet (P < 0.05). The dry matter (DM) degradability of the grass forage was higher (P < 0.05) in animals receiving only forage than in those receiving the mixed diet whereas the DM degradability of the corn silage was higher (P < 0.05) in animals receiving the mixed diet than in those receiving only TMR. The level of microbial adherence in residues of grass forage was higher (P < 0.05) in animals fed with only forage than in those fed with the mixed diet and, the level of microbial adherence in residue of corn silage was higher (P < 0.05) in animals receiving the mixed diet than in those receiving TMR. The carboxymethylcellulase activity in residues of grass forage was higher (P < 0.05) in sheep fed the mixed diet whereas not significant effect of diet type was observed for this variable in residues of corn silage. In conclusion, increased inclusion of TMR in sheep diet showed a negative impact on microbial adherence and forage degradability in situ, an effect mediated by changes in rumen pH which was not compensated by increased fibrolytic activity.
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.
Scaphanocephalus spp. (Trematoda: Opisthorchiidae) in intermediate and definitive hosts of the Yucatán Peninsula, Mexico, with a re-description of Scaphanocephalus expansus
- M. T. González-García, M. García-Varela, A. López-Jiménez, M. P. Ortega-Olivares, G. Pérez-Ponce de León, L. Andrade-Gómez
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- Journal:
- Journal of Helminthology / Volume 97 / 2023
- Published online by Cambridge University Press:
- 14 December 2023, e98
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Scaphanocephalus is a small trematode genus belonging to the family Opistorchiidae. The genus currently contains only three species associated with marine fish as intermediate hosts and fish-eating birds as definitive hosts. Here, specimens of Scaphanocephalus were collected from the Osprey, Pandion haliaetus, and the White mullet, Mugil curema in the Yucatán Peninsula, Mexico. We report for the first-time DNA sequences of adult specimens of Scaphanocephalus, particularly S. expansus, as well as a sequence of a different species sampled as metacercaria. Morphological comparisons of Scaphanocephalus expansus confirmed the identity of the adult specimens, with minor morphological variations; Scanning electron photomicrographs were included, and the species was re-described. Phylogenetic analysis based on 28S rDNA sequences showed that Scaphanocephalus is monophyletic within Opisthorchiidae and consists of three independent lineages. Sequences of adults are identical to those of S. expansus. Instead, the sequence of the metacercaria sampled from the mesentery of Mugil curema nested with specimens reported as Scaphanocephalus sp. from a labrid fish in the Mediterranean Sea, herein named it as Scaphanocephalus sp. 2.
The evolving role of data & safety monitoring boards for real-world clinical trials
- Bryan J. Bunning, Haley Hedlin, Jonathan H. Chen, Jody D. Ciolino, Johannes Opsahl Ferstad, Emily Fox, Ariadna Garcia, Alan Go, Ramesh Johari, Justin Lee, David M. Maahs, Kenneth W. Mahaffey, Krista Opsahl-Ong, Marco Perez, Kaylin Rochford, David Scheinker, Heidi Spratt, Mintu P. Turakhia, Manisha Desai
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- Journal:
- Journal of Clinical and Translational Science / Volume 7 / Issue 1 / 2023
- Published online by Cambridge University Press:
- 02 August 2023, e179
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Introduction:
Clinical trials provide the “gold standard” evidence for advancing the practice of medicine, even as they evolve to integrate real-world data sources. Modern clinical trials are increasingly incorporating real-world data sources – data not intended for research and often collected in free-living contexts. We refer to trials that incorporate real-world data sources as real-world trials. Such trials may have the potential to enhance the generalizability of findings, facilitate pragmatic study designs, and evaluate real-world effectiveness. However, key differences in the design, conduct, and implementation of real-world vs traditional trials have ramifications in data management that can threaten their desired rigor.
Methods:Three examples of real-world trials that leverage different types of data sources – wearables, medical devices, and electronic health records are described. Key insights applicable to all three trials in their relationship to Data and Safety Monitoring Boards (DSMBs) are derived.
Results:Insight and recommendations are given on four topic areas: A. Charge of the DSMB; B. Composition of the DSMB; C. Pre-launch Activities; and D. Post-launch Activities. We recommend stronger and additional focus on data integrity.
Conclusions:Clinical trials can benefit from incorporating real-world data sources, potentially increasing the generalizability of findings and overall trial scale and efficiency. The data, however, present a level of informatic complexity that relies heavily on a robust data science infrastructure. The nature of monitoring the data and safety must evolve to adapt to new trial scenarios to protect the rigor of clinical trials.
Assessment of executive functions through a virtual reality task in euthymic patients with bipolar disorder and influence in psychosocial functioning
- J. Andreu Martínez, D. Beltrán Cristancho, P. Navalón, P. Sierra San Miguel, A. García Blanco, A. Chicchi Glioli, S. Cervera Torres, M. Alcañiz Raya, Y. Cañada Pérez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S700
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Introduction
Previous research has shown that neurocognitive deficits, especially deficits in executive functions, may persist during euthymia in in patients with bipolar disorder (BD) and that those are associated with an impairment of psychosocial functioning. The assessment of executive functions (EFs) is normally carried out using laboratory tests. Novel methodologies such as virtual reality (VR) allow the creation of immersive environments, to evaluate executive performance with greater potential for ecological validity than evaluations with standard tasks.
ObjectivesThe objectives of this project are to evaluate executive performance in euthymic patients with BD with a novel virtual reality task compared to standard computerized tasks, and to find predictors of functioning associated with cognitive performance.
MethodsThis is a cross sectional study in which 46 euthymic patients with BD treated at La Fe University and Polytechnic Hospital were assessed with a battery of standard computerized tasks (ST) (TMT/Stroop,/Go-No-Go/TOL/DOT) and with the Cooking Task virtual reality task. The Cooking Task presents 4 tasks of increasing difficulty in which you must cook food in a specific time. It records total time to complete the task, whether food is cooled or burned, the simultaneous use of two fires, the proper use of seasonings and the time to set the table.
Functioning was assessed with the Functioning Assessment Short Test (FAST) that evaluates the overall functioning of patients with a mental illness in 6 subscales.
Correlation analyses between cognitive performance variables and clinical variables were done. Multiple linear regression was performed with the FAST score as a dependent variable and cognitive performance variables and relevant clinical variables to executive functioning (months of euthymia, age, and number of total episodes) were included as independent variables.
ResultsA worse psychosocial functioning was significantly associated with a worse performance in standard tasks (TMTA, TMTB, STROOP, and TOL) and cooking task (total time spent on task 2, burning time and total time spent on task 3, and total time spent on task 4). In the regression analysis, the correct simultaneous use of the two fires was the best predictor of a better psychosocial functioning in BD patient. This implies the preserved ability of planning and performing dual tasks.
ConclusionsOur findings suggest that euthymic patients with BD present deficits in executive functions related with a worse psychosocial functioning. Among the tasks, the cooking task may have a greater sensitivity than standards task to predict real functioning. This in an opportunity to design virtual applications for diagnostic and therapeutic purposes.
Disclosure of InterestNone Declared
Group psychotherapy for patients with first-episode psychosis: Effect on the clinical status and use of resources
- P. Herrero Ortega, A. Oliva Lozano, J. Garde González, C. Bayón-Pérez, R. Mediavilla, M. P. Vidal-Villegas, B. Rodríguez-Vega, S. Cebolla, E. Román, E. V. Pérez Pérez, M. F. Bravo-Ortiz, O. B. O. AGES-Mind Group
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S635-S636
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Introduction
Psychotic disorders carry several economical, psychological and social consequences, both at individual and community levels. Early intervention programs after first-episode psychosis which combine pharmacological and psychosocial strategies are aimed at reducing symptoms, lowering costs in the use of health and non-health care resources and improving overall functioning. AGES-Mind study is based on manualized psychotherapeutic interventions for people with first-psychosis episodes.
ObjectivesThe aim of the study was to evaluate the effect of a group psychotherapeutic intervention on the clinical status and use of clinical resources in a sample of patients with first-episode psychosis at 12 and 24 months after the beginning of the intervention. This cohort will be compared to patients with first-psychosis episodes without group psychotherapeutic intervention.
MethodsLongitudinal, observational, retrospective study on a cohort of N=46 patients with first-episode psychosis within the last 5 years. Two groups of 23 patients each were formed. The participants of one of those groups received group psychotherapy in the context of the AGES-Mind study and the other group received treatment as usual without group intervention. Non-exposed patients were matched by age, gender and time elapsed since first-episode psychosis with those exposed to the intervention. Sociodemographic data, clinical status and use of clinical resources outcome variables were assessed.
ResultsNo significant differences were found in clinical status and use of resources between participants and non-participants in the psychotherapeutic group intervention after 12 and 24 months.
ConclusionsAfter controlling for potentially confounding variables as sociodemographic, age and time since first-episode, participating in a group psychotherapeutic program does not seem to improve clinical variables or use of resources. Further studies with larger samples would be necessary to explore other variables, such as symptoms, satisfaction with the intervention or social functioning.
Disclosure of InterestNone Declared
Continuous Theta-Burst Stimulation in a 9-year-old girl with a history of neurotoxicity after Acute Lymphoblastic Leukemia B
- A. Moleon, M. Martín-Bejarano, T. Javier, I. Pérez, T. Rosa, M. Garcia-Ferriol, P. Rocío, J. M. Oropesa, N. Javier
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S144-S145
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Introduction
Transcranial Magnetic Stimulation is a non invasive brain stimulation technique used for several neuropsychiatric conditions. The treatment of Acute Lymphoblastic Leukaemia (ALL) involves many cytotoxic drugs that inhibit the rapid growth of cancer cells, but also damage healthy cells, resulting in a wide range of adverse effects (Śliwa-Tytko et al., 2022). Studies have shown that approximately 10-30% of paediatric ALL patients suffer from psychiatric disorders. Therefore, new therapeutic tools are needed, and repetitive transcranial magnetic stimulation (rTMS) has demonstrated tolerability, effectiveness and safety in children (Allen et al., 2017).
ObjectivesWe discuss the first case of a 9-year-old girl diagnosed with acute lymphoblastic leukaemia B in who underwent Continuous Theta-Burst Stimulation
MethodsCase Presentation. In this study, we describe a case of a 9-year-old girl diagnosed with acute lymphoblastic leukaemia B in November 2016 who completed treatment in July 2019. Since April 2018 she presented symptoms of intracranial hypertension and encephalopathy with behavioural alterations, attention deficit secondary to toxicity. Psychotic outbreaks after toxicity from different treatments was also present. Since starting pericyazine (July 2022) there has been a slight improvement, but her symptoms continue to have a severe impact in her daily functioning. Baseline developmental profile assessed with the Battelle Inventory was significantly below the expected level in all developmental areas except for gross motor skills. Treatment. The TMS intervention consisted of the application on right DLPFC (F4), inhibitory cTBS protocol (5Hz bursts and 3 pulses of 50 Hz each). The protocol consisted in delivering 2 sessions per day for 15 days (separated by 55 minutes), 4 minutes per session (3600 pulses/session), 30 sessions in total. An intensity of 100% of resting motor threshold (C4). TMS was performed with the Magventure Magpro X100 MagOption equipment, Cool DB-80 double cone coil. The Child Behaviour Checklist (CBCL) for parents was used to assess intervention effects.
ResultsCBCL results reflect improvements in both internalising and externalising total scores after treatment. Specifically, the patient presents clinically significant decreases in several dimensions such as anxious/depressed symptoms, somatic complaints, and social problems. No adverse effects have been reported since the beginning of the intervention.
ConclusionsInternalising and externalising behaviours severity were reduced after 30 TMS sessions. In accordance with the latest systematic reviews on the safety of TMS in the paediatric patient (Zewdie et al, 2020) we propose the development of paediatric guidelines to offer this technique to patients with a history of intolerability or poor drug response.
Disclosure of InterestNone Declared
AGESMind clinical trial: SocialMIND® results at 16 weeks
- M. P. Vidal-Villegas, A. Abad Pérez, P. Herrero Ortega, A. Oliva Lozano, J. Garde González, J. Andreo-Jover, A. Muñoz-Sanjosé, R. Mediavilla, B. Rodríguez-Vega, G. Lahera, Á. Palao-Tarrero, C. Bayón-Pérez, M. F. Bravo-Ortiz
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S480-S481
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Introduction
Early intervention on a first psychotic episode is fundamental for a more favorable prognosis, and it usually combines pharmacological treatment, which mainly affects positive psychotic symptoms, with interventions that can improve the rest of the symptoms and associated problems such as deterioration in social functioning (Harvey & Penn, 2010; Fusar-Poli, McGorry & Kane, 2017). While Mindfulness is gaining more and more prominence in the field of psychotherapy (Chan et al., 2019; Cillesen et al., 2019), social cognition and social functioning are being researched as key targets on which to intervene after a first psychotic episode (Green, Horan & Lee, 2015).
SocialMIND® is a mindfulness-based social cognition training tailor-made to improve social functioning in people who have suffered a first psychotic episode within the last five years. It is currently being compared with a group Psychoeducational Multicomponent Intervention (PMI) in a Randomized Controlled Trial (RCT) (Mediavilla et al., 2019). Both group psychotherapies include 17 sessions delivered over a 9 month period: 8 weekly sessions, 4 biweekly sessions and 5 monthly sessions.
The results of SocialMIND® at 8 weeks showed improvements in social cognition and social functioning, specifically on affective social cognition and self-care (Mediavilla et al., 2021).
ObjectivesTo evaluate the efficacy of SocialMIND® in improving social functioning, measured by the Personal and Social Functioning (PSP) scale 16 weeks after starting the intervention, in people who have suffered a first psychotic episode in the last 5 years.
MethodsRandomized, controlled pilot trial (use of a psychoeducational multicomponent intervention or PMI as active comparator) of two parallel groups (SocialMIND® and PMI) with a 1:1 ratio using a blind evaluator.
ResultsNo statistically significant differences were found in the social functioning variable between the two treatment arms. Intragroup differences are observed in other secondary variables studied (social cognition) 16 weeks after starting the interventions.
ConclusionsSocialMIND® has not been shown to be more effective than a PMI in improving social functioning at 16 weeks after starting the intervention in people who have suffered a first psychotic episode in the five years prior to being included in the study.
Disclosure of InterestNone Declared
Risk factors contributing to the possibility of conducting intensive home treatment and to the risk of hospitalization of 1045 home treated patients with Schizophrenia
- A. Sabaté, R. Talisa, D. Córcoles, J. León, A. Malagon, A. M. González, M. Bellsolà, P. Samos, F. Casanovas, M. A. Jerónimo, L. M. Martin, V. Pérez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S184
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Introduction
Home Treatment (HT) teams are among the better-studied options to reduce admission at the hospital, having been described as an alternative to hospitalization in patients with schizophrenia. There may be certain risk factors which has already been described such as living alone (Dean and Gadd, BMJ, 1990; 301, 1021–1023; Schnyder et al., Acta Psychiatr. Scand. 1999; 99, 179–187), lack of awareness of the illness, uncooperativeness (Cotton et al., BMC Psychiatry, 2007; 7, 52) and fewer visits carried out (Morgan et al., Aust. New Zeal. J. Psychiatry,2006; 40, 683–690) which together can negatively influence the possibility of conducting intensive home follow-up and, therefore, increase the likelihood of hospitalization.
ObjectivesTo describe de relative contribution of several risk factors to patient hospitalization related to the possibility of conducting intensive home follow-up of patients diagnosed with Schizophrenia following home treatment. Second, to determine de risk of hospitalization related to the possibility of conducting intensive home follow-up according to the presence of one or more risk factors of patients diagnosed with Schizophrenia following home treatment.
MethodsAll patients with schizophrenia who were visited by a home treatment team in Barcelona between January 2017 and December 2021 were included in the study. To assess whether there was an increased risk of hospitalization associated with factors such as living alone, uncooperativeness (PANSS G8 item >= 4) and ≤1 home visit, two bivariate logistic regression analyses were conducted. We studied these factors as independent variables to assess the relative contribution to the risk of hospitalization, and we studied if the presence of 1, 2, 3 or 4 of these risk factors as independent variables worsened the risk of hospitalization.
ResultsUncooperativeness shows the highest contribution to the risk of hospitalization, followed by ≤ 1 home visit, lack of insight and living alone, all results reaching significance (p=0.000).
There is an increase in the risk of hospitalization depending of the presence of 1,2,3 or 4 of these risk factors (1 risk factor (Odds Ratio = 1.21), 2 risk factors (Odds Ratio = 5.28), 3 risk factors (Odds ratio = 13.53), 4 risk factors (Odds ratio = 29.18).
ConclusionsThere are a number of factors directly related to the possibility of conducting intensive follow-up that appear relevant in the case of psychotic patients in acute crisis treated at home. This set of variables are the lack of awareness of the illness, lack of collaboration, living alone and the number of visits that have been made, all with statistically significant differences in our study. These factors together also greatly increase the risk of hospitalization, becoming almost 30 times more likely when these 4 factors are present.
Disclosure of InterestNone Declared
Antiandrogenic treatment of obsessive compulsive neurosis: A case review
- L. Huerga García, I. Careno Baez, G. Oropeza Hernández, A. Marcos Rodrigo, C. Delgado Torres, G. Garriga Rocío, P. Gómez Pérez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S927
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Introduction
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.
ObjectivesTo 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.
MethodsWe carried out a review in Pubmed with the terms Antiandrogens and TOC, in order to make a better description of the clinical case.
ResultsAfter 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.
ConclusionsPatients 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.
Disclosure of InterestNone Declared
Understanding socio-labor inclusion among young adults with autism spectrum and mental disorders: preliminary findings
- M. S. Burrone, M. J. González, M. T. Solís-Soto, P. Valenzuela, L. Rojas, L. Colantonio, C. Cortés, C. Pérez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S436-S437
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Introduction
Previous studies suggest that adults with mental disorders (MD) or Autism Spectrum Disorder (ASD) are more likely to be unemployed than those without MD. However, it is unclear whether working adults with MD or ASD perceive the same effort-reward balance as their counterparts without MD or ASD.
ObjectivesTo analyze labor conditions and to identify factors associated with effort-reward imbalance among young adults with ASD, MD and those from the general population (GP).
MethodsA qualitative and quantitative study design is being conducted to analyze the rates of employment among young adults with ASD, and to identify factors associated with employment rates (Fondecyt ID11201028.). As part of this study, we conducted a quantitative analysis in young adults 16 to 30 years of age in two regions of Chile between August and October, 2022. Young adults with MD and ASD were compared with adults of similar age recruited from the GP. We applied a questionnaire to collect data on participant’s sociodemographic information, autonomy level and employment status. We applied the short Spanish version of the effort–reward imbalance (ERI) and overcommitment (OC) questionnaire, which has been widely used in Latin American countries.
Chi-square test was used and the Kruskal Wallis H Test was applied to compare among groups. The statistical significance was set at P<0.05.
ResultsOverall, 422 participants were included in the analysis (mean age 22±3.2, 64.2% women, 65.2% students, and 4.4% unemployed). Of the total respondents, 22% of young adults from GP, 17.8% with MD, and 4.8% with ASD were working at the moment of the survey. Regarding autonomy level, a higher proportion of participants with ASD needed support (36.4%), compared with 9.7% and 0.8% of young adults with MD and GP, respectively. Of the population who reported working (n=125), about 56.0% have a permanent job, and 44% a seasonal or occasional job. The median value for the effort–reward ratio was 0.96 (range 0.4–1.8), with no significant differences between the groups. Of those participants working, 44.3% showed an ERI ratio higher than 1, which was higher in participants with ASD (60%). ERI-esteem was significantly different (P=0.01) among ASD (7.0; range 5-8), MD (6.0; range 2-8) and PG (6.0; range 2-8). In the OC questionnaire, young adults with ASD were more likely to think about work (P=0.01) and having trouble sleeping at night due to work issues (P=0.03) than GP and MD groups.
ConclusionsThe ASD group showed higher overcommitment and a considerable proportion of subjects at risk of effort-reward imbalance at work, were more likely to think about work at home, and had trouble sleeping thinking about work. Our preliminary results highlight the importance of considering the working conditions of young adults diagnosed with ASD and the need to provide them with enough support to promote labor inclusion.
Disclosure of InterestNone Declared
fMRI neurofeedback leads to long-term symptomatic reduction in treatment-resistant patients with obsessive-compulsive disorder
- S. Ferreira, M. Machado-Sousa, R. Vieira, R. Magalhaes, A. Coelho, M. Picó-Pérez, P. Morgado
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S229-S230
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Introduction
Obsessive‐compulsive disorder (OCD) is a severe condition with a profound impact on the health, social and professional functioning of the patients. More than one third of the patients do not achieve remission of the symptoms after first‐line treatment with cognitive‐behavioral therapy and selective serotonin reuptake inhibitor medication. Neurofeedback is a promising technique that allows the non‐invasive self‐regulation of neural activity associated with symptomatic manifestation. Previous literature reported preliminary evidence of positive effects of functional magnetic resonance imaging (fMRI) neurofeedback on OCD symptoms. However, these studies have small samples and/or were not controlled. Additionally, these studies did not involve treatment‐resistant patients.
ObjectivesWe aim at developing a fMRI neurofeedback task to treatment-resistant OCD patients and to explore the underlying brain changes.
MethodsWe implemented a sham‐controlled double‐blinded fMRI neurofeedback protocol to target hyperactivity in orbitofrontal regions in treatment‐resistant OCD patients with contamination/cleaning symptoms. The protocol had two sessions of neurofeedback (72 min of total training). The patients included were under treatment‐as‐usual.
ResultsOur preliminary results with the experimental group (n = 10 patients) demonstrated decreased OCD and stress symptoms three months after the neurofeedback sessions. Moreover, immediately after the neurofeedback sessions, we observed reduced functional connectivity between orbitofrontal and temporoparietal regions, and increased brain activity in dorsolateral prefrontal and premotor areas during symptomatic provocation. The brain functional changes might be associated with a better control over obsessions.
ConclusionsfMRI neurofeedback led to long-term symptomatic reduction in treatment-resistant patients with OCD. Our results need further validation with the sham‐control group but highlight the efficacy of fMRI neurofeedback for refractory OCD and the necessity of prolonged neurofeedback protocols.
Disclosure of InterestNone Declared
Psychiatric comorbidity profiles among suicidal attempters: A cohort study
- Y. Sanchez-Carro, M. Diaz-Marsa, V. Fernandez-Rodrigues, W. Ayad-Ahmed, A. Pemau, I. Perez-Diaz, A. Galvez-Merlin, P. de la Higuera-Gonzalez, V. Perez-Sola, P. Saiz, I. Grande, A. Cebria, J. Andreo-Jover, P. Lopez-Peña, M. Ruiz-Veguilla, A. de la Torre-Luque
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S318-S319
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Introduction
More than 700,000 people die by suicide in 2019 globally (World Health Organitation 2021). Mental health problems constitute a risk factor for suicidal behavior and death by suicide (Hoertel et al. Mol Psychiatry 2015; 20 718–726). Different mental disorders have been related to different forms of suicidal ideation and behavior (Conejero et al. Curr Psychiatry Rep 2018; 20, 33) (Quevedo et al. Compr Psychiatry 2020; 102 152194). However, little is known on comorbidity profiles among suicide attempters.
ObjectivesThe aim of our work was to identify the psychiatric comorbidity profiles of individuals who were admitted a hospital emergency department due to a suicide attempt. Moreover, it intended to know their clinical characteristics according to comorbidity profile.
MethodsA sample of 683 attempters (71.30% female; M age= 40.85, SD= 15.48) from the SURVIVE study was used. Patients were assessed within the 15 days after emergency department admission. Sociodemographic (i.e., sex, age, marital status and employment status) and clinical data were collected. The International Neuropsychiatric Interview (MINI) was used to assess DSM-V Axis 1 mental health diagnoses and the Columbia Suicide Rating Scale (C-SSRS) to assess suicidal ideation and behavior. The Acquired Capacity for Suicide-Fear of Death Scale (ACSS-FAD), the Patient Health Questionnaire (PHQ-9) to assess the frequency of depressive symptoms during the past 2 weeks, and the General Anxiety Disorder-7 (GAD-7) scale to assess symptoms of worry and anxiety were also conducted. For the identification of comorbidity profiles, latent class analysis framework was followed considering diagnosis to each individual disorder as clustering variables. On the other hand, binary logistic regression was used to study the relationship between comorbidity profile membership and clinical factors.
ResultsTwo classes were found (Class I= mild symptomatology class, mainly featured by emotional disorder endorsement; and Class II= high comorbidity class, featured by a wide amount of endorsed diagnoses) (see figure 1). Individuals from the High comorbidity class were more likely to be female (OR= 0.98, p<.05), younger in age (OR= 0.52, p< .01), with more depressive symptoms (OR=1.09, p<.001) and have greater impulsivity (OR= 1.01, p<.05).
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ConclusionsWe found two profiles of people with suicidal behavior based on the presence of mental disorders. Each of the suicidal subtypes had different associated risk factors. They also had a different profile of suicidal behavior.
Disclosure of InterestNone Declared
Chronic disease (CD) during transition from child to adult.Psychopathological consequences and coping strategies
- S. Rubio Corgo, M. Arrieta Pey, A. M. Matas Ochoa, M. I. Duran Cristobal, E. Perez Vicente, A. Delgado Campos, C. Diaz Gordillo, A. C. Castro Ibañez, A. Alvarez Astorga, P. Alcindor Huelva
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S745
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Introduction
CD is characterized by at least three features: its duration is prolonged, it does not resolve spontaneously and it is rarely completely cured. Approximately 10-15% of young people have CD. Adolescents with CD often have emotional and behavioral problems.
ObjectivesTo assess risk factors, derived psychiatric pathologies and coping strategies for a CD diagnosis in adolescence.
MethodsAn extensive literature review was carried out on the subject in question, extracting information mainly from scientific articles, manuals and books.
ResultsThe main risk factors are those related with the CD in question, physical sequelae, the need for long-term hospital admissions or the use of drugs whose side effects include affective or behavioral symptoms; those related to the personality traits of the affected child or adolescent. In addition, as far as the family is concerned, the presence of a low level of education, lack of support or communication, as well as the presence of psychiatric disorders or serious medical conditions in parents. Among the most frequent psychiatric disorders associated with CD are affective and anxiety disorders, adaptive disorders, somatoform disorders, eating disorders and behavioral disorders. Whatever the CD is, it generates high levels of stress and uncertainty in the patient and family, which must be dealt together from a flexible perspective, allowing child or adolescent to adapt to the changes, reorganize and facing them with adaptive patterns of behavior. For this, it will be essential to have adequate social and family support with relational style based on communication, trust and acceptance.
ConclusionsIn general, both adolescents with CD and their families have an adequate capacity to adapt to the repercussions and effects derived from the disease. Nevertheless, in case of possible emotional difficulties that may appear, a comprehensive and individualized approach to these adolescents and their families is necessary to provide them resources and coping strategies in different areas and contexts in which the disease debuts.The comprehensive therapeutic approach will consist of interventions at the individual and family level. Among the main objectives of these interventions are to achieve acceptance and adaptation to CD provinding adequate psychosocial support to enable them to cope with CD in the best possible way and to detect and address the emotional implications, even coexisting psychopathology.
Disclosure of InterestNone Declared
How do emotion regulation strategies influence the way personality affects obsessive-compulsive symptoms?
- M. B. Couto, I. Araújo, M. Picó-Pérez, P. Morgado
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S228-S229
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Introduction
Obsessive-Compulsive Disorder (OCD) is a chronic disabling condition, with considerable lifetime prevalence. There are interindividual differences regarding personality dimensions and how they affect obsessive- compulsive (OC) symptomatology. Furthermore, there is a connection between OC symptoms and the use of maladaptive emotion regulation strategies (expressive suppression) instead of using more cognitive reappraisal.
ObjectivesExplore the relationship between personality, emotion regulation strategies and OC symptoms by testing a path analytic model in a sample of healthy participants and in a sample of OCD patients.
MethodsTwo samples of participants were utilized. Sample 1 consists of 787 healthy participants from the general Portuguese population. Sample 2 is composed of 33 OCD patients and 32 Healthy Controls (HC). Participants completed different scales: Emotion Regulation Questionnaire (ERQ), Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) and Obsessive-Compulsive Inventory-Revised (OCI-R), through online surveys (sample 1) or a clinical interview (sample 2). These questionnaires were then analyzed with a path-analytic approach.
ResultsIn sample 2, we found significant differences between OCD patients and HC in every OCI-R subscale, except Hoarding and Neutralizing. In the NEO-FFI, OCD patients scored higher on Neuroticism and lower on Extraversion. No significant differences were found regarding the ERQ. Relatively to sample 1: path analysis results showed that 13,4% of the variance of OC symptoms was explained by the best-fitting model. Only Neuroticism and Extraversion were directly associated with higher OCI-R Total scores, whereas Agreeableness predicted less OC symptoms. The use of Expressive Suppression was associated with more OC symptomology, but no significant connection was found with Cognitive Reappraisal. Regarding sample 2, no model was found, showing no modifying effect of emotion regulation strategies on OC Symptoms.
ConclusionsThere is a deep-rooted interconnection between personality and emotion regulation regarding OC symptomatology in a sample of healthy participants but no effect of emotion regulation was seen regarding OCD patients.
To sum up, promising results were obtained and it could be an important field for the OCD in terms of diagnostic, severity and treatment.
Disclosure of InterestNone Declared
Positive and Negative Syndrome Scale (PANSS) predictors of hospitalization during home treatment on 1045 patients with schizophrenia in acute crisis
- R. Talisa, A. Sabaté, D. Córcoles, J. Leon, A. Malagón, A. M. González, M. Bellsolà, P. Samos, M. Á. Jerónimo, L. M. Martín, V. Pérez
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S640-S641
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Introduction
Several factors related to the risk of requiring psychiatric hospitalization have been described in patients diagnosed with schizophrenia treated with methods other than home treatment. With regard to the symptoms, high global illness severity and positive symptoms of schizophrenia have been most frequently related to the risk of hospitalization in patients with schizophrenia. However, there are no studies describing which clinical factors increase the likelihood of being hospitalized while undergoing home follow-up.
ObjectivesTo determine which of the clinical factors assessed in the PANSS predict the risk of hospitalization in patients diagnosed with schizophrenia following a home treatment program.
MethodsAll patients with schizophrenia who were visited by a home treatment team in Barcelona between January 2017 and December 2021 were included in the study. A comparative, bivariate analysis of each item of the PANSS and of the global results of each category was conducted on those who were hospitalized and those who were not hospitalized. Finally, a logistic regression of each category of the PANSS was done on both groups, controlling for other socio-demographic and clinical factors.
ResultsA total of 1045 patients with schizophrenia were evaluated in this study. PANSS positive symptom subscale (PANSS-S), PANSS General Psychopathology, PANSS Excited Component and PANSS Global Score scored higher in patients who were finally hospitalized in a conventional acute treatment unit. Regarding the PANSS negative symptom subscale, no significant differences were found between the two groups.
In patients who required hospitalization, the scores of all the PANSS positive symptom subscale (PANSS-P) items and all items on the PANSS excited component (excitement, tension, hostility, uncooperativeness and poor impulse control) were significantly higher. Some items regarding general psychopathology (Somatic concern, anxiety, guilt feelings, tension, and mannerisms) were also significantly higher in the hospitalization group. Only 3 items—blunted affect, guilt feelings and motor retardation—scored significantly higher in patients who did not require hospitalization. In the logistic regression, only the global score of the PANSS-P reached statistical significance (P = 0.001).
ConclusionsPositive symptoms scored in the PANSS seem to be the most predictive factors of hospitalization regarding clinical symptoms in patients with Schizophrenia following home treatment. Other items regarding exciting symptoms and general psychopathology also showed as relevant regarding the risk of conventional hospitalization in those patients.
Disclosure of InterestNone Declared
Losing psychiatric or psychological follow-up during the first COVID-19 confinement in Portugal: outcomes in mental health
- M. Gomes, P. Silva Moreira, S. Ferreira, B. Couto, M. Machado-Sousa, C. Raposo-Lima, N. Sousa, M. Picó-Pérez, P. Morgado
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S593
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Introduction
The COVID-19 outbreak imposed several periods of lockdown to stop the pandemic, with a determinant impact on access to mental health services. In Portugal, the first State of Emergency was declared on the 18th of March 2020, with the obligation of mandatory confinement and circulation restriction. Restrictive measures were alleviated on the 2nd of May 2020.
ObjectivesWe aimed to investigate the impact of the first confinement on the maintenance or loss of psychiatric and psychological follow-up. Also, we aimed to explore the outcomes in the mental health of losing psychiatric or psychological consultations.
MethodsWe conducted an online survey among the Portuguese population to evaluate demographic, clinical and mental health variables (STAI, DASS-21, PHQ, OCI-R, Quality of Life [QoL] and PSS). Individuals were invited to answer the survey at two timepoints: third week of March 2020 and third week of May 2020. Concerning the first timepoint, we used independent t-tests to compare the mental health variables in the individuals who loss and who did not lose consultations. Then, we evaluated the impact of losing consultations across time in those individuals who continued responding in the second timepoint, through a Linear Fixed Model. All the analyses were performed using JASP software.
ResultsFrom the total sample (n=2040), 334 individuals (84.4% female gender) had psychiatric and/or psychological consultations previously to the confinement. In March 2020, the individuals who maintained the consultations (35.0%) showed best mental health indicators in the QoL Self Evaluation (p=0.002), QoL Satisfaction (p=0.037), STAI State (p<0.001), DASS-21 (p=0.001), PHQ (p<0.001), OCI-R (p=0.002) and PSS (p<0.001). Among the matched individuals who answered the survey in May 2020 (n=93), we found that the group who maintained follow-up (n=24) did not improve significantly more than the other group (n=69) for any of the mental health variables in study.
ConclusionsThe results indicate that stopping psychiatric and psychological follow-up represented worse mental health outcomes at the beginning of the first confinement. However, anxiety feelings improved at the end of the first confinement, which happened independently of psychiatric/ psychological follow-up.
Disclosure of InterestNone Declared
Psychosomatics and mentalization
- A. M. Delgado Campos, P. Alcindor Huelva, A. Alvarez Astorga, S. Rubio Corgo, E. Pérez Vicente, M. Arrieta Pey, C. Diaz Gordillo, P. Del Sol Calderón, A. C. Martín Martín
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1024
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Introduction
We have investigated the relationship between the Psychosomatic Classification method (Marty) and the Rorschach Test, with respect to the diagnosis of psychosomatic disorders, within the framework of the degree of mentalization measured by both.
ObjectivesA) To verify statistical coincidence with respect to the degree of mentalization (risk of generating psychosomatic disorders in a subject) between the Rorschach Test and the diagnostic technique Psychosomatic Classification, by P. Marty. B) To test the hypothesis: Patients diagnosed with infertility, whose degree of mentalization is good, will have a greater probability of achieving a successful pregnancy throught Assisted Reproduction Techniques.
MethodsTwo evaluation tools were used: a) Psychosomatic Classification based on the criteria established by this diagnostic method; b) The Rorschach test (based on the evaluation of 29 indicators, selected according to their greater relevance in the generation of somatic symptoms).
A sample of 120 patients (women) diagnosed infertility at the Assisted Reproduction Unit (U.R.A.) at Hospital Universitario 12 de Octubre in Madrid was recruited. The method of ‘statistical correlation of coincidence’ between the results of the two diagnostic instruments used was used. Once both tests had been assessed by the “inter-judge” method and the quantitative values of the selected items had been weighted, the KAPPA statistical method was applied to establish the “correlation of coincidence” between the results of the two assessment instruments.
ResultsConsidering that the KAPPA method takes values between “0" and ”1" and that between 0.6 and 0.8 the agreement or coincidence is considered good, and above 0.8 very good, the result applied to the hypothesis is 0’76 (’good’).
ConclusionsA) Using the Rorschach Test and P. Marty’s Psychosomatic Classification in a complementary manner, these two instruments together provide high reliability, with respect to the degree of mentalization (a subject’s risk of suffering psychosomatic disorders). B) The degree of mentalization has a significant impact on the success or failure in the application of Assisted Reproduction Techniques in infertile women.
Disclosure of InterestNone Declared
Female infertility, Alexithymia and Stress
- A. M. Delgado Campos, P. Alcindor Huelva, A. Alvarez Astorga, S. Rubio Corgo, E. Pérez Vicente, M. Arrieta Pey, C. Diaz Gordillo, P. del Sol Calderón, A. C. Martín Martín
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S648
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Introduction
In this research the Paris School (I.P.S.O.), by P. Marty, is chosen as the theoretical and clinical basis of Psychosomatics. We work with the degree of mentalization (good, bad and uncertain) -obtained through Marty’s Psychosomatic Classification-, as a previous diagnosis and prognosis of 120 infertile women undergoing treatment at the Assisted Reproduction Unit (ARU) at Hospital Universitario 12 de Octubre in Madrid.
Objectivesa) To analyse the statistical coincidence between female infertility, stress and alexithymia syndrome. b) To verify the differences between psychosomatic disorders and other somatoform symptoms and syndromes (conversive and hypochondriac). c) To test the following hypothesis: subjects whose degree of mentalization is deficient, present high degree of alexithymia and stress.
Methods120 infertile women undergoing treatment with Assisted Reproduction Techniques were examined by means of psychodiagnostic tests.
Diagnostic tools: P. Mary’s Psychosomatic Classification (P.C.) (semi-structured interview), as a means of diagnosing the degree of mentalization; T.A.S. (Toronto Alexithymia Scale); Battery of stress measurement questionnaires (H.A.D., PANAS. IRE, MCMQ).
The correlation of coincidence between the results of C.P. and the different Alexithymia and Stress questionnaires with the independent variable (success or failure of pregnancy in the selected subjects) has been studied, applying Spearman’s Correlation Coefficient.
ResultsWith respect to what was obtained in the Psychosomatic Classification:
- T.A.S. questionnaire yields a coefficient of [-0.48]. Therefore, there is a negative correlation between the degree of mentalization and the presence of alexithymia; in other words, as the degree of mentalization increases, the degree of alexithymia decreases and vice versa;
- There is positive correlation [0.39] between the results of Mentalization (Psychosomatic Classification) and the degree of stress; therefore, the existence of stress does not prevent better mentalization.
ConclusionsThe present research concludes: a) that people at risk for psychosomatic disorders have high scores on “alexithymia”; b) that patients at high risk for psychosomatic disorders do not necessarily suffer from “stress” situations; c) that there are many indicators in behavior and psychological functioning that differentiate psychosomatic disorders from conversive and hypochondriac disorders - both in their etiology and their development; d) there is a statistical correlation between female infertility and alexithymia; e) there is no statistical correlation between female infertility and stress.
Disclosure of InterestNone Declared