9 results
Charles-bonnet Syndrome: Hallucinations are in the Eye of the Beholder
- N. De Uribe-viloria, E. Mayor Toranzo, S. Cepedello Perez, I. Sevillano Benito, M. De Lorenzo Calzon, M. Gomez Garcia, G. Medina Ojeda, F. De Uribe Ladron De Cegama
-
- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S631
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Charles-Bonnet Syndrome (CBS) is a clinical entity characterized for visual hallucinations in patients with severe vision impairment and preserved cognitive state. Its pathogeny is still unknown, limiting management options. For diagnosis neurological and psychiatric disorders must be discarded. Treatment is based in three pillars: explaining to the patient the origin and nature of the symptoms, treating the visual deficit when possible, and pharmacotherapy with anti-psychotics.
Objectives and aimsTo outline the main characteristics and etiopathogenic theories of the CBS, so as to improve diagnosis and treatment.
MethodsBasing on a case followed in mental health consults, we made a systematic review of the articles published in Medline (PubMed) in the last 5 years, with the following keywords, Charles-Bonnet Syndrome, hallucinations, deafferentation, visual impairment.
ResultsWe found that all our case and the reported ones had in common the nature and characteristics of the hallucinations, the presence of a trigger, usually a new medicament, and the functional MRI patrons of activity; those patrons located the loss of input prior to the association cortex, which appeared hyper-excitable in functional MRI.
ConclusionsAlthough the aetiology and pathogeny of CBS is still unclear, present data suggests that the key mechanism may be a dysregulation in the homeostatic adaptation of the neural pathway when it is left without external input, traducing a hyper-function of a physiological process, probably mediated by acetylcholine, as opposed with other neuropsychiatric pathologies, in which the cortex is the primary affected area.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Application of Cognitive-behavioral Therapy in a Case of Obsessive-compulsive Disorder
- L. Rodríguez Andrés, A. Rodriguez Campos, I. Sevillano Benito, H. De la Red Gallego, C. Noval Canga, P. Marques Cabezas, F. Uribe Ladron de Cegama
-
- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S644
-
- Article
-
- You have access Access
- Export citation
-
We present the case report of a 46-year-old woman who experienced obsessive-compulsive symptoms for over twenty years, with multiple relapses, severe depressive symptoms and many hospitalizations in the psychiatric Inpatient Unit. Treatment with different SSRIs, tricyclic antidepressants, atypical antipsychotics and even electroconvulsive therapy were administered with poor results.
After her last hospitalization a Cognitive-Behavioral Therapy, including exposure and response prevention and cognitive therapy, is initiated combined with medication, improving depressive symptoms, the ritual behaviors and levels of anxiety.
Modern treatments for Obsessive-Compulsive Disorder (OCD) have radically changed how the disorder is viewed. While in the past OCD was regarded as chronic and untreatable, a diagnosis of OCD may now be regarded with hope. Cognitive and behavior therapy and antidepressant medications are currently used to treat the disorder. They can be used to control the symptoms and enable people with OCD to restore normal function in their lives.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Increased libido as a buproion-SR side effect: Clinical description of a case
- L. Gallardo Borge, C. Noval Canga, L. Rodíguez Andrés, I. Sevillano Benito, M. Hernández García, A. Álvarez Astorga, R. Hernández Antón, S. Gómez Sánchez, G. Isidro García, P. Marqués Cabezas
-
- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S545
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Bupropion is a dual antidepressant, a norepinephrine and dopamine reuptake inhibitor. Its main use is in affective disorders as major depression. Antidepressants have been commonly associated with sexual side effects in the libido, sexual arousal, orgasm and erectile function. Bupropion has negative influence in sexual function, even it could increase the libido. Due to this, it could be a good option in patients with active sexual life and affective disorder.
Clinical reportA 58-year-old female with a long history of depression disorder for 5 years. History of lots of side effects with different treatments, sexual dysfunction with serotonin-antidepressants. Treated with bupropion SR 150 mg/day and alprazolam, she suffered a relapse. The bupropion was increased to 300 mg/day. Three days later she appeared in the consultation room, presented a sense of pre-orgasmic of 72 hours of evolution, high increased libido, tiredness, muscle tension and insomnia. This sense did not improve after the sexual act. It had never happened previously. The side effect improved when the bupropion was reduced to 150 mg/day and disappeared with its withdrawal.
ConclusionsThe case made a relationship between the increased of bupropion's dose and the appearance of unusual sexual side effects (increased of libido and pre-orgasmic sense). Not only bupropion is one of the antidepressants that do not cause sexual dysfunction, if not it was reported in some trials that could be a treatment against this dysfunction due to its prosexual effects. The mechanism is unknown but could be related with norepinephrine or dopamine transmission.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
I am trapped in a wrong body
- R. Hernandez Anton, C. Noval Canga, E. Rybak Koite, H. De La Red Gallego, L. Gallardo Borge, A. Alonso Sanchez, I. Sevillano Benito, M.J. Garcia Cantalapiedra, P. Marques Cabezas, F. Uribe Ladron De Cegama, J.A. Espina Barrio, G. Isidro Garcia
-
- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S590
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Gender dysphoria is incoherence between the sex a person feels or expresses and the biological.
ObjectiveRevise the inclusion criteria for hormone therapy and sex reassignment surgery in gender dysphoria. Expose the multidisciplinary approach. Make differential diagnosis with other psychological disorders.
MethodologyA 45 years old male patient (biological female), who was sent from Endocrinology Unit for a psychiatric evaluation before restart a hormonal treatment. Since his childhood, he has presented dissatisfaction with his sexual characteristics; he has had fantasies and dreams, in which he belonged to the other sex. He has always chosen male activities and male stereotypes companies. He has presented preference for cross-dressing from 9 years. Always felt the sexual attraction for women. He first consulted for this reason in 1995.
ResultsIt reported favorably to start hormone treatment after completing the eligibility criteria: > 18 years old; knowledge of the effects of hormones; and more 3 months documented real-life experience. The hormone therapy caused the growth of microprolactinoma, which was treated with dopamine agonists until it disappeared and the cessation of galactorrhea. Testosterone treatment is restarted. Laboratory tests are done every 3 months during the first year and then, every 6 months.
ConclusionsIs the gender disphoria a pathology? The EU recommends a reclassification as no pathological disorders in ICD-11. The treatment of gender dysphoria is necessary, and there is no reason to postpone it. The main difficulty is the differential diagnosis; there may be comorbidity with others mental disorders which are not exclusive (psychotic disorder, OCD, personality disorders and other disorders of gender identity).
Disclosure of interestThe authors have not supplied their declaration of competing interest.
A new psychiatric society is born: Spanish Society of Psychiatry Residents (SERP)
- C. Llanes Álvarez, A. San Román Uría, N. Núñez Morales, I. Sevillano Benito, P. Hervías Higueras, N. Gómez-Coronado Suárez de Venegas, S. Puerta Rodríguez, J. Valdés Valdazo, V. Prieto Lorenzo, V. Pimenta, M. Pinto da Costa
-
- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S168
-
- Article
-
- You have access Access
- Export citation
-
Introduction
The European Federation of Psychiatric Trainees (EFPT) is an independent Federation of Psychiatric Trainees and represents the consensus of psychiatric trainee's organizations across European countries and advocates for what training should look like, regardless of the country. Spain was one of the last countries to be part of the Association. Finally, and after months of hard work and networking, on September 2015 the Spanish Society of Psychiatry Trainees(SERP), was founded and Spain became a observer member of the EFPT.
ObjectivesOne of the main goals of the SERP, is creating a program of clerkships, in both directions, from other trainees to come to Spain, and for Spanish Trainees to go abroad.
MethodsOur idea in this poster is to explain a first look of which Hospitals/Units would be appropriate to make a rotation, and to explain the first steps in order to create a database with information about the nightshifts, possible accommodation and other aspects related to the organization. We want to use this poster to present to Europe our new Association.
ResultsOn September 25 at the National Congress of Psychiatry in Santiago de Compostela, a Group of Spanish trainees founded the SERP, organized the first Board and signed the Founding Amendments.
ConclusionsAfter two previous failed attempts, finally on 25th September 201; the Spanish Society of Psychiatry Residents (SERP) was founded, an important part of the activity of this company is promoting exchanges between residents of member countries in Spain.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Immunity and eating disorders. Clinical description of a case
- M.D.H. Gallego, A. Álvarez Astorga, A. Alonso Sánchez, R. Hernández Antón, E. Mayor Toranzo, I. Sevillano Benito, M.S. Hernández García, M.S. Geijo Uribe, F. De Uribe Ladrón de Cegama
-
- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, pp. S552-S553
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Recently, there is an increasing interest in the link between anorexia nervosa and autoimmune diseases. Studies show significant association between anorexia nervosa, diabetes mellitus, autoimmune thyroid disease and Crohn's disease [1]. The findings of significantly elevated autoantibodies (anti α-MSH, anti ACTH) and cytokines (IL-1, IL-6, IFN-γ, TNF-α) support this relationship.
ObjectivesTo illustrate with a clinical case the connection between eating disorders and Crohn's disease.
MethodsFourteen years-old boy with moderate depression syndrome after his grandfather's decease. Since overweight diagnosis by his pediatrician, he begins to restrict food intake with an important weight loss (19 kg in 9 months) and over exercising. Blood test reveals microcytic and hypochromic anaemia, rest of the examination shows no other disorder. Psychometric assessment EDI-3 suggests Anorexia Nervosa restricting type.
ResultsTwo months after clinical stabilization, he is hospitalized due to abdominal pain. Exploration including blood test, serology, coproculture, sonography and colonoscopy reveals severe Crohn's disease.
ConclusionsThis case is about a patient diagnosed of moderate depressive syndrome, who develops anorexia nervosa and Crohn's disease during his follow up. It exemplifies the link between stress, immunity and eating disorders. Recent findings suggest that immune diseases are involved in onset and maintenance of eating disorders. More studies are required in order to inference its consequences in evaluation, prognostic, treatment and identification of subgroups of patients.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
The psychotic patient at the General Hospital
- J.Á. Monforte Porto, A. San Román Uría, C. Llanes Álvarez, G. Humada Álvarez, I. Sevillano Benito, S. Cepedello Pérez, R. Hernández Antón, S. Gómez Sánchez
-
- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, pp. S151-S152
-
- Article
-
- You have access Access
- Export citation
-
Background
Patients with schizophrenia have a higher prevalence of physical illness and a higher mortality from natural causes than the general population, which is a reason why they can be hospitalized for medical and surgical pathologies.
AimsTo determine the demand, the reason for consultation and the sociodemographic characteristics of the psychotic patient admitted at the general hospital.
MethodsSociodemographic variables (age, sex, marital status, education, place of residence, residential housing, with who they live, work status) and health care (service of origin, type of request and its relevance, complaints, days of delay between the request and assistance, number of visits, average length of stay).
Study designProspective epidemiological study of 80 psychotic patients (F.2 ICD-10), from the total of 906 consults solicited from 1 January 2012 until 31 December 2014. Bioethical considerations: compliance with these principles justice, non-maleficence, autonomy and beneficence.
ResultsThe average age is 58.34 years old, 60% were male, 73.8% single, 81.3% with primary education, 52.5% living in urban areas; and the 88.8% of cases were pensioners. The Departments that generate a greater demand are Internal Medicine (53.8%), Orthopaedic Surgery (10%), Pneumology (8.8%) and ICU (8.8%). The most frequent reasons for consultation are assessment/treatment setting (77.5%), abnormal behavior (30%), disorientation (18.8%) and psychotic symptoms (18.8%).
ConclusionsThe typical profile of psychotic patients hospitalized for medical-surgical diseases is a male, middle-aged, single, with primary education and pensioner; from whom it's sued consultation for adjusting of treatment, and secondly for abnormal behavior.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Belle De Jour: A Case of Hysteria
- C. Noval Canga, S. Gómez Sánchez, S. Cepedello Pérez, R. Hernández Antón, I. Sevillano Benito, L. Rodriguez Andrés, L. Gallardo Borge, G. Medina Ojeda, H. De la Red Gallego, A. Portilla Fernánadez
-
- Journal:
- European Psychiatry / Volume 33 / Issue S1 / March 2016
- Published online by Cambridge University Press:
- 23 March 2020, p. S506
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Histrionic Personality Disorder is one of the most common personality disorders diagnosed in Psychiatry. This disorder has been known to be present in more than 40% of patients. There is also a high tendency for those diagnosed with this disorder to be female.
ObjectivesThe case is to show all the difficulties caused by this pathology, differencial diagnosis with other personality disorders, groups of characteristics from different clusters and also, complications produced in daily routine.
MethodsThe purpose is to study a clinical case of a 27-year-old woman, with a degree in journalism, who began with a depressive episode after a failed relationship. After being diagnosed of infertility, she debuted with dissociative episodes and somatization symptoms. After that, she suffered several depressive episodes. At the moment, all the clinical symptoms support the diagnosis of histrionic personality disorder.
ResultsHistrionic Personality Disorder can be found in the cluster B group of personality disorders. They often present in an overly dramatic, erratic or emotional manner. They may fulfil their need for attention through speech and behaviour that draws one's focus of attention toward themselves, and also demanding and manipulative in interpersonal relationships. There are high comorbidity rates in those who suffer from HPD with other diagnoses.
ConclusionsHistrionic Personality Disorder appears to be one of the least threatening diagnosis among personality disorders as those affected are high functioning and do not seek relief for the disorder itself. There is also very little research on HPD which makes treatment options limitless.
Disclosure of interestThe authors have not supplied their declaration of competing interest.
Health intervention in gender violence
- R. Hernandez Anton, C. Noval Canga, N. De Uribe Viloria, I. Sevillano Benito, J.A. Espina Barrio, P. Marques Cabezas, L. Gallardo Borges, A.I. Segura Rodriguez, M. Gomez Garcia, F. Uribe Ladron De Cegama
-
- Journal:
- European Psychiatry / Volume 41 / Issue S1 / April 2017
- Published online by Cambridge University Press:
- 23 March 2020, p. S572
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Male and female social roles were built on a historical inequality. Gender violence is a public health problem of the first order. We consider it important to conduct a study to improve diagnosis and interventions. From the Theory of Roles Moreno, each role has a complementary role that maintains the link. In gender violence predominates control, domination, submission and asymmetry of functions as dysfunctional elements of a relationship, which should be symmetrical.
MethodologyWe reviewed 48 stories of women who come for abuse mental health team from 2013 to 2016. We analyzed the following aspects: socio-demographic data (age, nationality, marital status, education, jobs, dependent children); reason for consultation and number of queries; violence; roles, because of maintenance and interventions.
ResultsEighty percent Spanish. It occurs at all levels of education; 60% have children; 70% were derived from primary care for others reasons; almost 90% suffered psychological violence, 25% physical and economic, sexual only 3 women, 52.08% of women adopt a submissive role, passive-aggressive 20.83% and 25% ambivalent; maintenance of the violence is reinforced by the psychological dependence that occurs in all women (one in 45.83%).
ConclusionsRoles analysis is an effective method in the diagnosis of abuse and designing appropriate intervention. Psychotherapy, benefits of a psychopharmacological treatment that lessens the suffering and lets face their difficulties. It is important to ask about abuse at any level of care, because it contributes more to cover a hidden reality. The Psychological and economic dependence. They establish and maintain the mistreatment.
Disclosure of interestThe authors have not supplied their declaration of competing interest.