Acute mutism in a young female. A case report of a 20-year-old female who presents a 3-month mutism

Introduction A 20-year-old female presents with a progressive 3-month mutism, hyporexia (20kg weight loss), abulia, anhedonia, apathy, social isolation,seeking company of her parents even at night, bradypsychia, sialorrhea, psychomotor slowdown and hypomimia. She is hospitalized in the Psychiatric Brief Hospitalization Unit (PBHU).Her parents relate the beginning of this symptomatology to a breakup and gender violence,which the patient confirms during the interview by eye/cephalic movements and single words jotted down. Objectives The objective of this study is to describe the evolution of the patient during her hospitalization in the PBHU of Salamanca and to look into the available bibliography about mutism related to stress and sialorrhea. Methods We carried out a follow-up of the hospitalization of the patient and a structured search in PubMed with the keywords “mutism”,“sialorrhea” and “stress” in the last 10 years in English,Spanish and French. Results Few or no articles where found.Therefore, the articles about mutism and stress were analyzed, which focused mostly in selective mutism. Regarding fear,the response to cope with the threat(fight, flight, freeze) is mediated by the autonomic system. The “Polyvagal Theory” speaks about the vagus nerve participating in emotion regulation (social communication and mobilization). Dissociation, in this context,has adaptive and defensive purposes and its threshold can be reduced by repeated stress situations.Long-term alteration of the autonomic nervous system has been described in selective mutism.This malfunction can be related to an elevated production of saliva due to the activation of the parasympathetic in the salivary glands, causing sialorrhea in our patient. The patient began treatment with sertraline 100mg and risperidone 2mg with the aim of its antidepressive and major tranquilizer effects, she also began individual and family psychotherapy, we assured her sleep and intakes and she began to progressively recover her speech and mobility,identifying a possible trigger for the symptomatology: a physical beating of gender violence after her breakup. Conclusions Dissociation and “freeze” response can be a maladaptative mechanism to fear.The malfunction of the autonomic nervous system can explain the disconnection,poor gaze,low facial and body expression and inability to speak. Disclosure of Interest None Declared


Introduction:
The innermost relationship of the borderline concept and psychosis has been historically intertwined and can be traced back to the 20th century, but remarkably, to date, they have not been the focus of many empirical studies.Likewise, the contributions of empirical research on the DSM-5 dimensional approach to this topic are also uncommon.Objectives: In this study the framework of psychosis superspectrum were put closely in relation to both DSM-5 psychoticism/ detachment domains, personality traits and psychopathological symptoms features in borderline personality disorder (PD).Methods: A cross-sectional study of a borderline PD sample of 58 participants (M age =39.76 years, SD=11.37;M schooling =9 years), mainly male (58.5%).Self-reported assessment: PID-5; BSI; NEO-FFI.A multiple linear regression was computed.Results: In borderline PD, the PID-5 disinhibition (β=.51),BSI psychoticism (β=.43),BSI depression (β=-.24) and NEO neuroticism (β=.29) predicted psychosis superspectrum, explaining 94% of the variance.Also, stands out as a complement that, the BSI psychoticism was predicted by PID-5 detachment and PID-5 psychoticism, explaining 82% of the variance.Conclusions: Evidence appears to be emerging for the underlying psychosis superspectrum trough borderline PD.There is a closer dialogue between the state-of-art view of a dimensional pathological personality-symptoms and the borderline pathology.

Disclosure of Interest: None Declared
Post-Traumatic Stress Disorder 01 EPP0088 Acute mutism in a young female.A case report of a 20-year-old female who presents a 3-month mutism Introduction: A 20-year-old female presents with a progressive 3-month mutism, hyporexia (20kg weight loss), abulia, anhedonia, apathy, social isolation,seeking company of her parents even at night, bradypsychia, sialorrhea, psychomotor slowdown and hypomimia.She is hospitalized in the Psychiatric Brief Hospitalization Unit (PBHU).Her parents relate the beginning of this symptomatology to a breakup and gender violence,which the patient confirms during the interview by eye/cephalic movements and single words jotted down.Objectives: The objective of this study is to describe the evolution of the patient during her hospitalization in the PBHU of Salamanca and to look into the available bibliography about mutism related to stress and sialorrhea.Methods: We carried out a follow-up of the hospitalization of the patient and a structured search in PubMed with the keywords "mutism","sialorrhea" and "stress" in the last 10 years in English,Spanish and French.Results: Few or no articles where found.Therefore, the articles about mutism and stress were analyzed, which focused mostly in selective mutism.Regarding fear,the response to cope with the threat(fight, flight, freeze) is mediated by the autonomic system.The "Polyvagal Theory" speaks about the vagus nerve participating in emotion regulation (social communication and mobilization).Dissociation, in this context,has adaptive and defensive purposes and its threshold can be reduced by repeated stress situations.Longterm alteration of the autonomic nervous system has been described in selective mutism.This malfunction can be related to an elevated production of saliva due to the activation of the parasympathetic in the salivary glands, causing sialorrhea in our patient.The patient began treatment with sertraline 100mg and risperidone 2mg with the aim of its antidepressive and major tranquilizer effects, she also began individual and family psychotherapy, we assured her sleep and intakes and she began to progressively recover her speech and mobility,identifying a possible trigger for the symptomatology: a physical beating of gender violence after her breakup.
Introduction: Prospective memory is a memory for actions to be performed in the future, such as composing an abstract for Congress.Various studies (see, for instance, Khan, A, 2020) showed that deficits in prospective memory are part of depressive cognitive deficits.This study is devoted to the prospective memory characteristics of migrants -students from Afghanistan who study at American University in Central Asia Objectives: The study's objective was to test the hypothesis of the existing connections between PTSD and prospective memory.Methods: One hundred and fifty students submitted informed consent for participation in the study, which the local IRB approved.Twenty-five had been diagnosed with PTSD; others also experienced traumatic stress but did not present the complete clinical picture of PTSD.The research was quantitative; a variety of self-questioners were used, including the one Dr developed by Azzizudin Khan in 2021 (Khan and others, 2021) to measure traumatic stress level, depression, anxiety, and subjective perception of the prospective memory.ANOVA and family of regression statistics helped to establish connections between several variables.One hundred and fifty students submitted informed consent for participation in the study, which the local IRB approved.Twentyfive had been diagnosed with PTSD; others also experienced traumatic stress but did not present the complete clinical picture of PTSD.The research was quantitative; a variety of self-questioners were used, including the one Dr developed by Azzizudin Khan in 2021 (Khan and others, 2021) to measure traumatic stress level, depression, anxiety, and subjective perception of the prospective memory.ANOVA and family of regression statistics helped to establish connections between several variables.Results: The study's preliminary results, which are still in progress, showed that the perceived level of traumatization predicts the perceived failure in prospective memory.However, there are also a lot of statistical outcomes which need to be analyzed.Among those are, for instance, the connection between depression and prospective memory and the connection between prospective memory and anxiety.Conclusions: Prospective memory deficiency is a part of a traumatic cognitive deficit.More research is needed to investigate cognitive distortion in PTSD.

EPP0091
Emotional stabilization interventions for people exposed to chronic traumatic events, in humanitarian settings

E. Dozio
Introduction: In contexts of chronic crisis, such as wars, the population is affected by prolonged traumatic exposure.In this type of context, it is sometimes difficult to provide psychological support to work through the trauma because the environment is neither stable nor reassuring.It is about finding care devices that despite the complexity of the situation, manage to bring relief and improve the ability to manage negative emotions and stress.Objectives: The objective of the intervention was to relieve people in distress, to help them contain their reactions to moments of anxiety so that they are more available and calm in their daily lives.Since the intervention could not provide long-term treatment for the potential traumatic stress, due to the abuses still in progress, it aimed to prevent the appearance and installation of the symptoms.Methods: A group protocol based on emotional stabilization exercises was offered to children and adults from communities affected by the fighting in the civil war in the Central African Republic in 2021.In addition to giving elements of psychoeducation, participants could practice exercises aimed at stabilizing emotions and managing stress.People could benefit from this psychosocial support with daily frequency for four consecutive days.At the beginning and at the end of the care device, psychometric scales were administered in order to be able to measure the improvement in well-being (WHO5) the reduction in symptoms of anxiety and depression (HAD) as well as traumatic symptoms in adults (PCL -5) and children (CPTS-RI).Results: Between February and April 2021, 1,200 adults and 400 children were able to participate in the emotional stabilization device.90% of the participants showed an improvement in wellbeing and a reduction in stress and axiety reactions.The participants particularly appreciated the exercises for the ease with which they could be reproduced in daily life and transmitted to other members of the family and the community.Despite the fact that exposure to stress remained significant and daily, they expressed the feeling of having regained some control, at least over their own emotions and reactions.Conclusions: In situations of chronic stress, where psychic traumatic symptoms cannot be treated sustainably, this emotional stabilization protocol can be an effective option to regulate the emotional states of exposed people and give them tools to cope with anxiety.Two important points to emphasize are also the fact that this device can reach a large part of the population without a lot of means and that it can be provided by non-professionals in mental health, if properly trained and constantly supervised by experts.