3297820 results
Designing youth mental health services to improve access: A qualitative study and framework analysis of youths’ perspectives in Singapore
- J. A. Vaingankar, M. Subramaniam, E. Samari, S. Chang, C. Tang, Y. P. Lee, S. A. Chong, S. Verma
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S113
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Introduction
Although there is an increasing interest in making mental health services (MHS) accessible to youths, there is limited ground-up involvement of youths while designing MHS in Asian settings.
ObjectivesThis qualitative study sought to understand what youths considered as important elements of youth centric MHS and how these could be designed to improve access by youths in Singapore.
MethodsWe conducted seven focus group discussions, and four semi-structured interviews with 50 multiracial youths aged 15-35 years in Singapore - a high-income Southeast Asian country. Purposive sampling allowed adequate representation of age, gender, and race (mainly Chinese, Malay, and Indian) groups. Participants reflected on the features of an ideal MHS for youths and how these could improve youths’ attitude and access to services. Participants also shared their preferences and additional opinions for culturally tailored and age appropriate MHS. Framework analysis using the ‘Conceptual Framework of Access to Healthcare’ (Levesque et al. Int J Equity Health 2013, 12:18) was used to code transcripts and identify the key themes (Ritchie & Spencer. In Analyzing qualitative data, 1994).
ResultsThe average age of the participants was 24 years. About one third of the participants had accessed MHS in the past. Three key themes were identified – making facilities ‘approachable’, ‘available and appropriate’ and ‘affordable’. (i) Making facilities approachable related to having non-stigmatizing, non-threatening and welcoming aesthetics, organizational culture, and personnel. The participants also recommended a range of professional services, digital tools, and online features to enhance the approachability of MHS designed for youths. (ii) Flexible operating hours, easy appointment management, accessible location, and easy availability to youths with unique needs (e.g., employed youths) or socio-cultural backgrounds were necessary for making facilities available and accessible to youths. (iii) While sharing challenges of family involvement in the help-seeking process, most of the participants, particularly those in the lower ages, talked about tailoring MHS to the ability of youths to pay for the services. Preferences such as having cheaper services for teenagers and initial contacts, offering more non-medical but trained professionals, and considering shorter in-person counselling sessions, followed by free online options were brought up by the participants.
ConclusionsThe study provided insights into multiple aspects of MHS and how these could be designed to cater to the needs of youths in Singapore from their perspective. MHS that incorporate non-stigmatizing, flexible, non-threatening and affordable design approaches could improve help-seeking and early interventions in youths.
Disclosure of InterestNone Declared
Exploring the legacy of Ibn Imrân’s Treatise on melancholia in contemporary psychiatry
- S. Boudriga, M. Lagha, M. Methni, Y. Ben youssef, I. Ben romdhane, W. Homri, R. Labbane
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S523
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Introduction
Melancholia is a concept deeply intertwined with the history of mood disorders in psychiatry. Isháq Ibn Imrân, a prominent Arab-Muslim physician of the 12th century, contributed significantly to the understanding of melancholia in his era, its. His treatise is the oldest surviving work entirely dedicated to melancholia, making it a pivotal milestone in the history of psychiatry. It is noteworthy that Ibn Imrân’s work has often been overlooked in Western psychiatry. This oversight highlights the enduring relevance of his insights within the context of modern psychiatry.
ObjectivesThe objective of this study is to assess the clinical and therapeutic aspects delineated by Ibn Imrân in his treatise on melancholia for their contemporary accuracy and relevance within the field of modern psychiatry.
MethodsThe review method for the Isháq Ibn Imrân treatise involves a detailed analysis of the original Arabic text and its French translation by Adel Omrani and Radhi Jazi from the Tunisian Academy of Sciences, Letters, and Arts Beit el Hekma. This includes studying the content, structure, and historical context, as well as comparing the Arabic and French versions for accuracy.
ResultsThe treatise is divided into two parts to clinical examination and treatment. While some of the terminology may differ from contemporary classifications, the core observations resonate with modern psychiatric knowledge. The clinical form is described as sadness, loss of pleasure, social withdrawal, dark thoughts, and loss of interest, along with somatic manifestations: sleep disturbances such as onset insomnia or hypersomnia, as well as weight loss. Additionally, perceptual disturbances, including elementary visual hallucinations (black silhouettes), are mentioned. Regarding etiologies, perinatal factors are mentioned in the treatise (“mood of the uterus”), along with six postnatal acquired causes that must be balanced in an individual: movement and rest, sleep and wakefulness, food and drink, depletion and retention, ambient air and location and psychological torment. A seasonal pattern is described, with an association between melancholia and autumn. Several clinical forms are described, with the most prominent being catatonia compared to epilepsy, in its two agitated and inhibited forms. The second part of his treatise is dedicated to treatment, focusing on individualized approaches such as talk therapy, music therapy, and dietary interventions. Ibn Imrân also describes mental strategies to correct false beliefs. For the pharmacological treatment, specific herbs has been used via oral, nasal, or intra-rectal.
ConclusionsIn conclusion, Isháq Ibn Imrân’s treatise on melancholia represents a timeless cornerstone in the history of psychiatry. This historical treasure serves as a reminder of the enduring quest to understand and alleviate the complexities of mental health.
Disclosure of InterestNone Declared
Synchronization of accelerated intermittent Theta-Burst-Stimulation (aiTBS) with VNS in difficult-to-treat depression (DTD)
- E. Kavakbasi, S. B. Klass, B. T. Baune
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S704
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Introduction
Patients with difficult-to-treat depression (DTD) need multimodal treatment with combination of psychotherapy, pharmacotherapy and neuromodulation. In severe cases, combination of neuromodulatory techniques may be considered to achieve symptom relief.
ObjectivesTo describe a novel treatment approach, which combines VNS in synchronization with accelerated intermittent Theta-Burst-Stimulation (aiTBS) over three weeks in two cases with difficult-to-treat depression.
MethodsIn this presentation we describe two cases of DTD, which have been implanted with VNS and did not respond to aiTBS previously. Patients then were offered a synchronized treatment regimen, where each stimulus train of aiTBS was synchronized with ON-time of VNS. To start each train simultaneously with VNS ON-time, we set treatment cycle of each aiTBS and VNS to 19 sec. Patients received 2400-3000 TBS pulses daily for 3 weeks over left dorsolateral prefrontal cortex (DLPFC) at 100% of resting motor threshold.
ResultsIn the first patient the MADRS score decreased from 37 to 26 (-30%) and in the other patient there was a decrease of MADRS score from 20 to 9 (-55%), which corresponded to remission after 3 weeks of treatment. The synchronized treatment procedure was well-tolerated in both cases. As both patients experienced significant improvement, we planned maintenance treatment in both cases.
ConclusionsSynchronization of aiTBS with VNS is a novel treatment approach in patients with DTD, which can lead to improvement even if patients previously did not respond to aiTBS without synchronization with VNS.
Disclosure of InterestNone Declared
Enhancing Physical Health in Patients with Severe Mental Disorder: Addressing Physical Multimorbidity
- I. Š. Filipčić, I. Filipčić
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S492
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Introduction
Over the last two decades, a growing volume of research has discovered a correlation between severe mental disorders (SMD) and early mortality. This is attributed to the elevated incidence of chronic physical illnesses s and multimorbidity, resulting in a reduction of life expectancy by 10-20 years. Individuals with SMD exhibit lower rates of prevention, diagnosis, and treatment for medical comorbidities when contrasted with the general population (GP).
ObjectivesThe objective is to assess the prevalence of CPM and its impact on psychiatric treatment outcomes in individuals with SMD, and to propose preventive interventions to enhance physical health.
MethodsThis nested cross-sectional study enrolled 343 SSD patients and 620 GEP.
ResultsIndividuals diagnosed with SMD encounter CPM earlier in life compared to the GP. Notably, individuals under 35 years old within the schizophrenia spectrum disorder have almost three times higher odds for experiencing CPM compared to their GP counterparts, a difference that is both clinically and theoretically significant. This disparity is especially pronounced among younger women, with the gap widening the younger the patient is in comparison to peers in the general population. CPM has been identified as a factor affecting the outcomes of psychiatric treatment.
ConclusionsThe treatment approach for SMD should be tailored to accommodate the diverse physical multimorbidity patterns of patients. It’s imperative for future research to delve into how CPM impacts the outcomes of SMD treatments. There’s a pressing need for detailed treatment guidelines addressing CPM in patients with SMD.
Disclosure of InterestNone Declared
Deep brain stimulation and psychosis as side effect: A case study
- M. Selakovic, C. Panetsou, T. Karkatsoulis, D. Tsaklakidou
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S213-S214
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Introduction
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a therapeutic method used for decades in neurological diseases such as Parkinson’s disease (PD), Huntington’s disease (HD) or dystonia. HD is a rare, inherited, neurodegenerative condition that causes progressive motor deficits, psychiatric symptoms, and cognitive impairment.
ObjectivesMoreover, after DBS as a psychiatric side effect has been marked and the etiology of that side effect is not well- understood.
MethodsA case study of a 51 years old male is presented, who developed involuntary movements, for the first time at the age of 17, being diagnosed with Chorea Huntington, was treated with medication without improvement of the symptoms, such as rigidity and bradykinesia. After ten years, based on guidelines, he was treated with DBS, the outcome of which showed complete improvement of neurological symptomatology. Nevertheless, he started to present delusional ideas of reference with his siblings, sleep disturbance, dysphoria and agitation.
ResultsObviously, DBS improved neurological symptomatology permanently. The medical history of our patient has shown the recurrence of psychiatric symptoms as a few mandatory psychiatric hospitalizations and his condition has improved with olanzapine 20 mg/ daily and L.A.I. of paliperidone (once /monthly).
ConclusionsBy far, DBS, as a treatment modality, has great potential to modify disease outcomes and potentially cure the devastating genetic neurodegenerative disorder such as chorea. The cases with psychiatric side effects of DBS have been described so rarely, that it’s difficult to formulate conclusions that can be applied to the whole population of patients treated with DBS. In our opinion, in some cases it is possible to effectively treat the psychotic symptoms without resignation from the benefits of DBS.
Disclosure of InterestNone Declared
Deafness and depression in the workplace: is there an association?
- W. Ayed, D. Brahim, I. Yaich, C. Bensaid, L. Houissa, N. Mechergui, H. Bensaid, M. Mersni, G. Bahri, I. Youssef, M. Bani, N. Bram, N. Ladhari
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S541
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Introduction
Chronic exposure to damaging noise can lead to hearing loss . People suffering from hearing problems find it increasingly difficult to communicate and become withdrawn. This lack of contact can lead to the onset of anxiodepressive disorders .
ObjectivesTo study the epidemiological and clinical particularities of hearing loss in patients with psychoaffective disorders.
To study the impact of this association on the medical aptitude for work.
MethodsRetrospective descriptive study of depressive patients with hearing loss who consulted the Occupational Medicine Department at Charles Nicolle Hospital over a six-year period from January 2016 to November 2022.
ResultsOut of 150 patients with hearing loss who consulted our service, 10 patients had an axio-dépressive disorder . Seven were men and three were women. The mean age was 43 ± 5 years and the mean job seniority was 11 years [3-20]. they belonged to the telecommunications (n=6), industry (n=2), printing(n=1), and transport sectors (n=1) . The job positions were : teleconsultant (n=6), operator machine (n=3) and driver (n=1) the symptoms presented by the patients were hearing loss (n=4), otalgia (n=1) , diziness (n=1), tinnitus(n=1) . The average time to onset of symptoms was 13±8 years [1-35] . The hearing deficits presented by the patients were: sensorineural hearing loss (n=7), mixed hearing loss (n=1) and conductive hearing loss (n=2). The mean of Hearing loss were 34±9 dB in the right ear and 34±6 dB in the left ear . A declaration of the deafness as an occupational disease was indicated in two of the cases. the univariate statistical study showed that anxiety-depressive disorders were associated with tinnitus (p=0,036,OR=4,2[0,99-17,659]) and the position of teleconsultant (p=0,009,OR=5,622[1,338-23,627] . Eviction from exposition to noise was indicated in seven cases
ConclusionsAccording to our study, hearing loss in patients with anxio-depressice disordes is associated with tinnitus and teleconsultant job position . Early screening early screening of people at risk is recommended.
Disclosure of InterestNone Declared
Diagnostic Challenges in Affective Disorders: Delirious Mania - A Case Report and Literature Review.
- P. Herrero Ortega, A. Oliva Lozano, J. Garde González, M. A. Morillas Romerosa
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S438
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Introduction
Affective disorders exhibit diverse clinical manifestations, and one distinctive subtype is delirious mania. Despite its exclusion from formal diagnostic manuals, delirious mania frequently emerges in everyday clinical practice. Recognizing it within the realm of differential diagnosis is crucial. Delirious mania is characterized by acute onset of excitement, grandiosity, emotional lability, delusions, and insomnia typical of mania, combined with disorientation and altered consciousness characteristic of delirium. Some authors consider delirious mania as a variant of classic bipolar disorder, while others associate it with catatonia. Additionally, some link it to underlying medical or neuropsychiatric causes.
ObjectivesTo describe the clinical case of a patient with delirious mania and emphasize the importance of recognizing this as a potencial diagnosis in patients with abrupt alterations in mental state.
MethodsClinical case report and literature review.
ResultsA 61-year-old female patient with a history of a unique depressive episode over 20 years ago, treated with Carbamazepine up to 750 mg, is admitted to the Emergency Room with acute symptoms consistent in global disorientation, agressive behavior, mutism, bradyphrenic and repetitive incoherent speech, along with visual hallucinations, all of which had developed over a few days. The gradual withdrawal of Tegretol over an 8-month period preceded her admission to the ER.
Relevant medical tests, including cranial CT, EEG, blood tests, and urine analysis, were conducted during her ER stay, all of which yielded normal results. Neurological evaluation ruled out acute neurological pathology, leading to her subsequent admission to the Psychiatry department. Throughout her admission, the patient exhibited irritability and expressed derogatory comments filled with offensive language. She gradually became more expansive, with her thought content becoming megalomaniac in a delirious range. Her speech was incoherent, verbose and had loose associations.
Treatment was reintroduced with Carbamazepine up to 600 mg/day and Olanzapine up to 20 mg/day, resulting in a rapid and comprehensive improvement of her symptoms, ultimately leading to the complete resolution of her condition.
ConclusionsThis case highlights the concept of delirious mania, characterized by alterations in attention, orientation, memory, confusion, behavioral and thought fluctuations, and psychomotor disturbances which can manifest abruptly, as observed in this patient. This clinical case underscores the significance of considering delirious mania in the differential diagnosis of patients with abrupt alterations in mental state, particularly those of advanced age with a history of affective episodes. A global understanding of this condition is essential for its timely recognition and appropriate management.
Disclosure of InterestNone Declared
Uncovering the Connection: PTSD and Road Accidents
- S. Bellafqih, Y. El Fatmaoui, S. Belbachir, A. Ouanas
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S665
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Introduction
Post-Traumatic Stress Disorder (PTSD) is a psychiatric disorder that can occur after a traumatic event. It results in mental suffering and physical complications that profoundly alter personal, social, and professional life.
One can develop PTSD after experiencing a frightening event, for example: rape, the death of a loved one, war veterans, or following a car accident. In Morocco, traffic accidents cause, on average, nearly 3,500 deaths and 12,000 serious injuries per year.
ObjectivesOur main purpose is to evaluate the incidence of post-traumatic stress disorder in patients who are victims of traffic accidents and to identify key risk factors in the general population.
MethodsThis is a descriptive cross-sectional study through a questionnaire shared on social networks including a socio-demographic description, a clinical description, and the “Peri-traumatic Distress Inventory (PDI)” Scale to evaluate the risk of developing PTSD.
ResultsThis study is based on 48 participants with 82.8% of females and 17.2% of men. The average age was 27.6. Most of the participants lived in urban areas (93%), a majority had higher education (93.1%), and 41.4% of the candidates had a physical impact of the accident.
According to PDI scale, 65% showed PTSD and the average score was 20.3. A score of 15 and above indicates significant distress.
ConclusionsOur results confirm the presence of PTSD in victims of accidents. We propose a clinical reflection on the possible improvement of the care of people suffering from PTSD following a public road accident.
Disclosure of InterestNone Declared
A Study on Irritable Bowel Syndrome (IBS) in Mental Health Professionals and the Psychosocial Factors Affecting This
- J. Hong
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S492
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Introduction
he present study investigates irritable bowel syndrome in mental health professionals and the characteristics of psychosocial factors that affect this.
ObjectivesMethodsThe present study selected an irritable bowel syndrome group among 291 mental health professionals based on the Rome III criteria, and investigated demographic variables. The Hospital Anxiety Depression Scale (HADS), Psychosocial Well-being Index (PWI), and Korean Occupational Stress Scale (KOSS) were used to evaluate psychosocial factors. An independent t-test and chi-square test were used to determine differences between the groups, and a logistic regression analysis was used to determine the odds ratio (OR) of IBS based on occupational stress. SPSS 21.0 (IBM Statistical Package for the Social Sciences 21.0) was utilized for all statistics.
ResultsDifferences in demographic variables based on IBS group were not statistically significant. Depressive symptoms (t = -4.767, p<0.001) and anxiety (t = -4.068, p<0.001) were higher in the IBS group, and psychosocial well-being was lower (t = 2.288, p<0.05). The OR of IBS based on depressive symptoms was 5.737 (95% CI = 2.24–14.69). There were significant differences in occupational stress based on IBS within the subordinate domains of physical environment (t = -3.160, p<0.01), job demand (t = -3.273, p<0.01), interpersonal conflict (t = -2.295, p<0.05), job security (t = -3.005, p<0.01), and lack of reward (t = -2.046, p<0.05). The OR of IBS based on the subordinate domains of occupational stress was 3.708 (95% CI = 1.20-11.41) in physical environment, and 3.759 (95% CI = 1.33-10.56) in job demand.
ConclusionsThe results of the present study verify that psychosocial factors in mental health professionals have a close correlation with IBS. Accordingly, improvements in both IBS symptoms and quality of life should occur through proactive intervention in these variables.
Disclosure of InterestNone Declared
“Where are we headed?” To better understand the career paths and barriers psychiatrists, psychologists, and psychotherapists face in Hungary. An outline of a quantitative and qualitative study
- I. Bitter, B. Péley, M. Bérdi, B. Henrietta, K. Farkas, E. Gergics, P. Nagy, K. Pál, B. Ungvári, P. Szabó, I. Tiringer, M. Fülöp, G. Szőnyi
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S797-S798
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Introduction
Becoming a psychiatrist, clinical psychologist or psychotherapist involves a complex set of skills that require extensive training. Clinical practice development and professional and personal identity formation are closely intertwined and continue throughout one’s career. Individual and environmental factors influence dropout. The beginning stages of training are incredibly challenging for trainees and can be a time of vulnerability as they face early professional hurdles. We propose that certain educational factors, such as inadequate practical training and insufficient emotional support during professional dilemmas, play a crucial role in manifesting burnout or other symptoms, potentially leading to stagnation in one’s career.
ObjectivesThe main objective of our study is to identify causes of disruption and/or discontinuation of the training/residency programs in psychiatry, clinical psychology, and psychotherapy. Our study also aims to highlight the causes of chronic exhaustion among trainees in mental health professions.
MethodsThe research team has developed a comprehensive questionnaire including two validated psychometric scales, the Effort-Reward Imbalance Questionnaire (ERI, Siegrist et al. Soc Sci Med 2004; 58 1483-99, Salavecz et al. J Men Psychosom 2006; 7 231–246) and the Mental Health Test (MHT, Vargha et al. J Men Psychosom 2020; 21 281–322). A quantitative analysis (Braun et al. Qual. Res. Psychol. 2006; 3 77–101) will be performed on the responses, following which interviews will be conducted with previous volunteers who participated in the study. The interviews will be evaluated through content analysis. Our survey is prepared with the involvement of all significant training centers in Hungary. The study was approved by the United Ethical Review Committee for Research in Psychology (EPKEB, approval numbers: 2021-109, 2023-101).
ResultsThe participants’ main characteristics and the questionnaires’ results will be summarized with standard statistical methods, while the interviews will be analyzed with the help of qualitative methods.
ConclusionsBased on the results of the described study, we aim to investigate the educational system’s impact on the career development and commitment of psychiatrists, psychologists, and psychotherapists in Hungary. Additionally, the research will yield valuable perspectives on how these factors affect the mental well-being of these professionals. Ultimately, the results could help address areas of concern and improve mental health professionals’ training.
* Presenting author
** The two authors contributed equally.
Disclosure of InterestNone Declared
Natural soundscapes, urban design and psychological well-being
- E. Abdelmoula, B. Abdelmoula, N. Bouayed Abdelmoula
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S680
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Introduction
While the acoustic environment in the cities correlates with various health-related problems, health benefits of natural sounds are proven. These positive effects of the sounds of nature should probably be taken seriously in urban design and urban renewal projects.
ObjectivesThe aim of this study was to review the paradigm of natural soundscapes in the cities, psychological effects of natural soundscapes and the potential urban recommendations for such architecture design.
MethodsWe conducted a comprehensive review of the scientific literature using Web databases with the following keywords: natural soundscapes, natural sound, urban design, and mental health.
ResultsOur research found that improving the urban environment soundscape for the well-being of city dwellers has become one of the most pressing challenges of modern times. In a growing number of published studies, positive psychological effects of natural soundscapes are explored using various methods such as questionnaires, biofeedback sensors coupled with virtual reality experiences in laboratories, and quantification of the prevalence of restorative acoustic environments in parks. In a recent study (2023), Jian Kang from the United Kingdome, reported that “by taking psycho-acoustical, neural and physiological, and contextual factors into account, the European Research Council Soundscape Indices project will adequately reflect levels of human comfort, to integrate side-by-side with (and eventually replace) decibel-based metrics into existing (international) regulations”. The same paper highlighted how the transition from fighting noise pollution to creating soundscapes is key.
ConclusionsArchitects should develop mandatory guidelines regarding the spatial planning focusing on managing natural soundscapes in cities. Various sites such as green urban public spaces that offers exposure to natural sounds should be an integral part of the urban environment. These areas must be with a high abundance of natural sound (geophony and bio phony) and a low anthropogenic sound to enhance human physical and psychological health.
Disclosure of InterestNone Declared
The impact of clinical context on the recognition of facial expressions
- C. De Sousa, S. Morgado, J. Ferreira, S. Tukaiev, R. Fonseca
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S114
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Introduction
Several authors have demonstrated the relevance of the therapist sensitivity to the affective expression of his client (Merten & Schwab, 2005; 150-158), as well as to his own emotional experience (Haynal-Raymond et al., 2005;142-148) in order to build a more effective therapeutic relationship, and results. An important source of information to decode the emotional expression hints is the face, and its expression (Ekman & Friesen, 1975; Russel & Fernández-Dolls, 1997;275-294). Despite common sense saying that context is relevant to understand the meaning of the emotional facial expression, the literature review shows inconsistent results.
ObjectivesThe main goal of this study was to evaluate the impact of clinical context over the perception of the emotional facial expression.
MethodsThis study followed a within-subjects design, and its sample consisted of 60 clinical psychologists. 21 combinations of prototypical expression images with mixed emotional signals, and clinical information texts were presented to the participants. Then their judgement on the type of emotion displayed was requested. The presentation of the text-image pairs was randomized between three conditions: consistent, and non-consistent, and neutral.
ResultsThe results suggest that emotions are more easily recognized in the presence of a concordant context than a non-concordant or neutral one, and that the greater the similarity between the facial expression of the image presented and the face prototypically associated with the context, the greater the influence of the context.
However, In the recognition of mixed emotional signs, there was greater recognition of signs of anger in the facial expression, as a non-dominant emotion, when in the presence of the neutral story than of the story that agreed with the dominant emotion (sadness). There was also greater recognition of sadness, as a non-dominant emotion, in the presence of a story in agreement with fear than in the presence of a neutral story. There was also a statistically significant increase in the attribution of anger to images in which it is not present and whose dominant emotion is fear, when associated with a context of aggression vs. a neutral context.
It was also found that there was a significant decrease in the attribution of fear to the sadness-anger image (25%-75%) in the presence of the aggression context compared to the neutral and panic contexts.There was also a statistically significant decrease in the attribution of sadness to an image of fear in the neutral context compared to the other contexts (panic and aggression).
ConclusionsIn conclusion, our study have shown an impact of context over overvaluation or the undervaluation of the emotional facial expression as well as either with prototypical expressions or the mixed emotional signals when referring to sadness, fear, and anger. Thus, mental health clinicians should consider the influence of these contexts.
Disclosure of InterestNone Declared
Catatonic stupor in 32 years old man diagnosed with schizotypal disorder
- I. Ljutica, Z. B. Otasevic, D. Otasevic
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S733
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Introduction
Stupor is a state of numbness of almost all personality functions, accompanied by stiffness, lethargy and abulia (lethargy). A person in a state of stupor is recognized by the fact that he is constantly silent, does not respond to stimuli at all, refuses food, has a motionless body posture, a face immobile like a mask, a gloomy and absent look. We can call a person who is in a stupor only by calling loudly, shaking hard and similar charms. Catatonic stupor is a state of complete loss of spontaneous and active movement, the patient stands stiffly for hours, sits, does not take food, does not speak but registers everything that is happening around him because his consciousness is not clouded.
ObjectivesHere, we report on the case of a 32 year-old man. He was brought in the Emergency Center by his mother with the eyes shut and unresponsive to all sorts of verbal and gestural attempts to elicit any kind of response, with extreme complete body rigidity. He was sweating.
Over several weaks, he developed gradually social withdrowal, motoric stereotypies, loss of apetite, body stiffness. Three days before he was admited to the hospital he stopped eating, drinking water, he was developed body rigidity.
MethodsCase report
ResultsHe was admitted to a Psychiatric Clinic and first days he was treated with 7,5 mg of lorazepam daily, kariprazin tbl. a 3mg in the morning and olanzapine 10 mg in the evening. Over several days symptoms has diminished.
ConclusionsThe patient was reacted very well on the therapy and after several days syptoms diminished. After a month he was released from the hospital. He is in good remission for over a year. He comes regularly for outpatient check-ups
Disclosure of InterestNone Declared
How to have an acute gastroenteritis and an Anxiety Disorder at the same time: Cannabinoid hyperemesis syndrome (CHS) Case Series
- P. A. Hernández Liebo, J. Romay González, C. Sevilla Díez, O. S. Anabitarte Bautista, L. Cayón de la Hoz, G. E. Cortez Astudillo, M. Polo Gay, R. Obeso Menéndez, M. Hoyuelos Cob, M. Gómez Revuelta
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S565-S566
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Introduction
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.
ObjectivesThe objective is to study this phenomenom in our hospital and to alert of its existence in order to avoid a suspected misdiagnosis and overdiagnosis.
MethodsWe 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.
ResultsThe 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.
ConclusionsCHS 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.
Disclosure of InterestNone Declared
Rates of delirium referrals to the Neuropsychiatry Service in a tertiary referral centre hospital
- S. M. Gunawardena, S. Riaz, K. Murphy
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S94-S95
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Introduction
Beaumont Hospital is the National Neurosurgical Centre in Ireland. Due to the high numbers of referrals from Neurology and Neurosurgery, The Department of Psychiatry established a specialist Neuropsychiatry inpatient Liaison service and a weekly Neuropsychiatry outpatient clinic. Many of the referrals that the service receive involve the management of delirium. Delirium is a common medical complication, particularly in neurosurgical settings. Delirium causes significant symptom burden which can lead to distress to all involved and impacts quality of life.
ObjectivesThe aim was to improve the rates of referrals for delirium presentations and referral rates overall from Neurology and Neurosurgery. The neuropsychiatry service have implemented a delirium protocol for all medical and surgical teams in Beaumont Hospital. This protocol can be accessed through the Beaumont hospital phone app, or on site on each ward. For this reason, delirium can be managed by medical teams in the first instance. If this is not successful, neuropsychiatry can be contacted for further advice or review of patients with more complicated presentations.
MethodsThe neuropsychiatry service receives referrals through the Patient Information Profile Explorer system which is accessed through the Beaumont Hospital online portal. In the event of an urgent referral, neurology or neurosurgery teams can contact the neuropsychiatry service directly by phone. Referrals are logged on the team referral log book, and details of the referral are recorded along with diagnosis and management. Data was collected retrospectively from the PIPE and log book to measure the rates and reasons for referrals over a one year period. Rates and details of referrals were initially recorded between July-December 2022. An educational intervention was provided where psychoeducation was provided to junior hospital doctors during protected teaching times and further education was provided over the phone when referrals were discussed between team members. Rates and details of referrals were then recorded between January-July 2023.
ResultsThere was a reduction in referrals when comparing the two six month periods. There were 115 neuropsychiatry referrals from July to December 2022 and 78 referrals from January to July 2023. Rates of delirium referrals also reduced from 31% to 25% after psychoeducation was provided to junior doctors.
ConclusionsThis audit highlights the importance of communication and education for medical and surgical trainees in the management of delirium. There is a high rate of turnover of junior doctors throughout the year in Beaumont Hospital. For this reason, it is imperative that continued education is provided to allow them to follow the delirium protocol independently before seeking tertiary service assistance. Ultimately, early and rapid intervention of delirium can have a positive impact on patient care and prognosis
Disclosure of InterestNone Declared
Role of Omega 3 Fatty Acid as an Adjunct Treatment to Depression in Different Age Groups of the Patient Population - A Current Literature Review
- S. Poudel, A. Dhawan, V. Vijayakumar, S. Flores, A. Abozaid, K. Parajuli, R. Aggarwal, A. Sadana, H. Kumar, J. Choudhari, N. Panta, S. S. Ahmed
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S544
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Introduction
Depression is a widespread problem that affects individuals of all ages. This study looks at the use of omega-3 polyunsaturated fatty acids (PUFAs) as an additional therapy for depression in people of different ages. Depression has an impact on everyone, from youth to the elderly, causing therapeutic concerns such as treatment resistance and recurrence. Omega-3 PUFAs, which may be found in fish and flaxseed, are important because of their impact on neurochemistry, inflammation, and neuroprotection. While pharmacotherapy, including antidepressants, has proven beneficial for many, the likelihood of remission and recurrence remains substantial. In recent years, there has been a growing interest in the potential role of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in mitigating depressive symptoms. The primary constituents of n-3 PUFAs are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Understanding the potential of omega-3 PUFAs across the lifespan can help address the multifaceted challenges posed by depression and improve mental health outcomes for diverse age groups.
ObjectivesThis review aims to assess the role of omega-3 fatty acids in depression treatment across different age groups: children and adolescents, adults (18–60), and the elderly (60+). It investigates the effectiveness and potential differences in omega-3 supplementation among these age cohorts.
MethodsA comprehensive literature search was conducted from 2003 to 2023 using PubMed, Google Scholar, and EMBASE, using specific keywords. Studies with inadequate age group information or Omega-3 intervention were excluded.
ResultsIn children and adolescents, several studies indicate a positive association between omega-3 supplementation and improved depressive symptoms. In adults, results are mixed, with some studies showing benefits while others do not. In the elderly, omega-3 PUFAs appear to have a more consistent positive effect on depression. In contrast, a consistent positive association was observed in the geriatric population, suggesting that Omega-3 PUFAs may hold particular promise in the treatment of depression among older adults. However, variations in methodology, dosage, and study populations contribute to these mixed findings.
ConclusionsOmega-3 PUFAs show promise as an adjunct therapy for depression across different age groups. Further research with standardized methodologies and larger sample sizes is needed to clarify their role and establish optimal dosage guidelines. Omega-3 PUFAs should be considered as a potential complement to conventional depression treatments, emphasizing the need for personalized approaches in depression management.
Disclosure of InterestNone Declared
Interplay of Environmental Factors, Genetic Susceptibility, and Sleep Disturbances predict Bipolar Disorder’s Relapses: preliminary results from a pilot study
- M. Bort, G. Fico, V. Oliva, M. de Prisco, L. Bracco, C. Possidente, M. Y. Rivas, V. Ruiz, L. Montejo, E. Vieta, A. Murru
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S251
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Introduction
Predicting acute affective episodes in individuals with Bipolar Disorder (BD) remains a clinical challenge. Specific environmental stressors, including air pollution, noise, and temperature variations might worsen affective symptoms or sleep in the general population, but their role in BD relapses is often overlooked. Indeed, they might exacerbate BD by perturbing circadian rhythms – fundamental aspects of BD.
ObjectivesWe thereby present the protocol of this pilot study and future preliminary data. We aim to longitudinally assess sleep alterations, mood fluctuations, and environmental exposure to several factors (air pollutants, climate, noise, artificial light-at-night, green space access) in patients with BD and to check the association of these variables with BD relapses.
MethodsIn this pilot study, we will recruit 40 patients with BD in a 6-month prospective study. Patients were assessed during baseline, at 3 and 6 months. Data recollected will consist of a subjective (questionnaires) and objective (through meteorological stations) evaluation of physical environmental factors around the home residence; clinical assessment of mood and circadian rhythms, and continuous tracking of sleep-wake patterns, energy, and movement using actigraphy.
ResultsExpected results will show that exposure to a worse environment (higher pollution, noise, light exposure, climate) will be associated with worse BD outcomes (i.e., relapse, mood symptoms, sleep alterations).
ConclusionsWe will be sharing preliminary data from our ongoing study, offering insights into early patterns and findings that shed light on our objectives.
Disclosure of InterestNone Declared
Crisis resolution teams: are we doing things well?
- J. J. Martínez Jambrina, L. P. Gómez, A. M. G. Alvarez, C. P. Miranda, S. P. Alvarez, N. A. Alvargonzalez, I. F. Arias
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S609-S610
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Introduction
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.
ObjectivesDefining 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. Escala de Intensidad de Crisis (CIS): se utiliza para medir la gravedad de la crisis y la necesidad de intervención inmediata.
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. 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.
Methods- 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.
ResultsConclusions- 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.
Disclosure of InterestNone Declared
The Right Numeraire or the Just Weights? How to Make BCA Rational and Fair
- Marc Fleurbaey, James K. Hammitt
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- Journal:
- Journal of Benefit-Cost Analysis , First View
- Published online by Cambridge University Press:
- 27 August 2024, pp. 1-20
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Unweighted benefit–cost analysis (BCA) based on aggregate willingness to pay might be, at long last, falling into disrepute, as it is widely recognized that it exhibits a bias toward the wealthy, and as alternatives are appearing more and more practicable. However, the choice of alternatives is often framed in terms of choosing an alternative metric to willingness to pay in money, such as willingness to pay in healthy life years, or a measure of subjective well-being. It is argued in this paper that (i) a simple summation of individuals’ willingness to pay in any numeraire (e.g., money, healthy life years) is bound to generate non-transitivity issues in a similar way as money-based BCA, and (ii) a metric such as subjective well-being involves distributional value judgments that are too specific to reflect the relevant spectrum in the public debate. The “orthodox” weighted BCA method, which links BCA to an underlying social welfare function, offers more flexibility and guarantees transitive choices. Fortunately, in some relevant cases, these various methods may provide similar results, and the main options currently proposed all give greater weight to the worse off in the population than does unweighted BCA.
Effects of the COVID-19 Pandemic on Anger and Life Satisfaction among Children Aged 10-12 years old in Preveza
- D. Georgaki, C. Kalogirou, A. Potamianou, M. Bakola, P. Gourzis, G. Charalambous, E. Jelastopulu
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S516-S517
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Introduction
Children, who are particularly vulnerable in emergency situations, need tailored mental health strategies.
ObjectivesWe investigated the impact of the COVID-19 pandemic on anger and life satisfaction in children.
MethodsSeptember 2021, we conducted a cross-sectional study in Preveza, Greece, interviewing 91 students aged 10-12 years from four elementary schools. The survey included socio-demographic questions, the Anger Expression Scale for Children (AESC), and the Satisfaction with Life Scale (SWLS). AESC scores range from 6 to 30 indicating anger severity, while SWLS scores between 5-9 signify extreme dissatisfaction and 31-35 extreme satisfaction.
ResultsSignificant correlations were found between the number of siblings (p 0.004), duration of electronic play (p 0.005), and duration of sleep (p 0.014) with life satisfaction. Children without siblings, with limited play consumption, and early bedtimes had lower life satisfaction. The presence of a television in their room (p 0.027) and daily use of television and social media (p 0.007) correlated with anger management and behavior. Social media/TV use was associated with better anger management.
ConclusionsDespite the pandemic lasting almost two years, children’s anger levels in Preveza remained stable, possibly due to outdoor activities and online interactions. These findings provide insights for policy makers, healthcare professionals, and parents seeking to improve anger management of children.
Disclosure of InterestNone Declared