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Schizophrenia is often associated with impaired functioning abilities due to its disabling symptoms.
Objectives
to determine the clinical factors that impact the functioning in stabilized patients withschizophrenia and schizoaffective disorder.
Methods
We conducted a cross-sectional, descriptive and analytical study. It was carried out on an outpatient population with schizophrenia or schizoaffective disorder diagnosis. We used the Functional Assessment Staging Scale (FAST) to measure the functional capacity, the PANSS to assess psychosis symptom severity and the Calgary scale to screen for comorbid depression.
Results
Seventy-five patients were included with 61 males (81.3%).The mean age was 39.81 ± 9.96 years. The mean sore of the Fast scale was 33 ± 14.95. 90% of our patients scored higher than 11 on the FAST scale revealing a functioning deficiency. 18.7% scored higher than 6 on the Calgary scale revealing a comorbid depression .No significant correlations were found between the FAST score and the age of patient, the gender,the age of onset of psychosis, the duration of untreated psychosis and the number of life-time episodes. Scores of PANSS were significantly higher among patients with a functioning deficiency (p<0.00).No significant correlation was found between the FAST score and the Calgary score.
Conclusions
Our study suggests that the severity of residual positive and negative symptoms affects negatively the functioning of patients with schizophrenia or schizoaffective disorder. Thus, targeting those symptoms in the treatment may have significant functional benefits.
Autonomic arousal is believed to be an underlying reinforcer for problematic gambling behavior. Theories suggests that near-misses (outcomes falling just short of a true win) are structural characteristics affecting emotion and motivation while increasing gambling persistence.
Objectives
Psychophysiological responses to different outcomes in gambling were investigated in a community-based sample of young adults. Furthermore, sex differences in responses to different gambling outcomes were investigated.
Methods
Young adults (n=270) performed a simplified virtual slot machine producing wins, two types of near-misses (before/after payline) and full-misses, with simultaneous measurements of heart rate (HR) and skin conductance responses (SCR). Self-reports of perceived chance of winning, pleasure and motivation to play were given by the participants on each trial.
Results
Near-misses were associated with the largest HR acceleration compared to wins and full-misses, and larger HR deceleration and SCRs compared to full-misses. Differential autonomic and subjective reports were observed for near-misses subtypes, suggesting that near-misses are processed differently depending on their position before or after payline. Females showed larger SCR responses and increased motivation following wins compared to males.
Conclusions
Slot machine gambling outcomes elicit differential physiological and subjective responses in young adults. Specifically, near-misses produce larger autonomic responses compared to regular full-misses. However, near-misses are complex, multifaceted events producing various emotional responses depending on their characterization. Males and females respond differently to wins, highlighting the importance of considering sex differences in experimental research on autonomic responses in gambling.
Sexual minorities have been coming out more than ever before. However, Tunisian laws and society are still not supportive of LGBT (lesbian, gay, bisexual and transgender) rights. To this day, Tunisian doctors are requisitioned to carry out anal tests as part of expert testimonies in cases of conviction for homosexuality.
Objectives
Assess Tunisian physicians’ attitudes and knowledge towards LGBT patients.
Methods
We conducted a cross-sectional study in October 2021, among 445 Tunisian physicians and medical students. Data were collected via an anonymous self-administered online questionnaire including sociodemographic data and the LGBT Development of Clinical Skills Scale (LGBT-DOCSS).
Results
The overall LGBT-DOCSS score was quite good (4.47 ±0.85). The attitudes of Tunisian doctors were better than their knowledge (p=0.01; t=2.6), which was better than their clinical preparedness (p<10-3; t=25) in treating LGBT patients. Doctors who self-identify as sexual minorities and those who interacted with LGBT people in their daily lives, were less stigmatising, more able to treat them and had better knowledge of their needs. Those who had had sexology training (5%) had better LGBT-DOCSS score (p=0.013), better knowledge (p=0.045) and preparedness (p<10-3) in treating LGBT patients but did not appear to be less stigmatising than the rest of the group (p=0.9). Religiosity was associated with a more stigmatising attitude (p<10-3), but had no impact on knowledge or preparedness.
Conclusions
This study points to gaps, identified by doctors themselves when faced with an LGBT patient. A more inclusive health system requires better matching of health services to the needs of the whole population without discrimination.
Trans-cranial magnetic stimulation (TMS) as a non-invasive method of altering brain activity (1) has widened the array of therapeutic options available for various psychiatric disorders.
Objectives
Trans-cranial Magnetic stimulation (TMS) as a non-invasive method of altering brain activity has widened the array of therapeutic options available for various psychiatric disorders. •A large number of studies have shown therapeutic benefits in a wide range of patient population with majority of studies in adults. •TMS is used increasingly for the treatment of child and adolescent depression. •Yet, the scarcity of studies and lack of published guidelines for this population is notable. •As TMS use is expanding in this population, an overview of the use of TMS in children and adolescents with depression may provide much needed and timely perspective on this neuropsychiatric intervention.
Methods
We searched all published studies using PubMed database, on TMS use in depressive disorders in children and adolescents. A total of 13 studies were found to have reported use of TMS in depression in children and adolescents.
Results
We found various case series, open label studies as well as sham controlled blind studies indicating that TMS has been effective in treating depression in children and adolescents. No significant side effects were found in our review.
Conclusions
Studies have shown that TMS is an effective treatment option for depressive disorders in children and adolescents. Initial studies look promising but implications in large pediatric population may be different and there is a need for more double blind, controlled trials with larger sample size.
Surrey and Borders NHS Foundation Trust’s AVATr (Augmented Virtual-reality Avatar in Training) is a unique ground-breaking Virtual Patient simulation system, which uses the Xenodu platform to train learners in essential clinical and complex communication skills. Over 30 patient scenarios have been developed after identifying learner-specific development needs, including exploration of overt psychosis, assessment of capacity, sharing bad news, and neglect in care home residents.
During the session, the trainee is projected on to a large screen, using a camera and video special effects, which results in a life-like interaction with the Virtual Patient. Trainees can view themselves interacting with the Virtual Patient in real-time, from a unique ’out-of-body’ perspective, immersed in a customdesigned interactive virtual environment. This is different to a first-person perspective used in virtual or augmented-reality systems in several clinical specialties. During the COVID-19 pandemic, we evolved the AVATr model to remote or hybrid sessions, where simulations were digitally enhanced, and have been run through Microsoft Teams. The simulation facilitator is connected to a multi-user video call, enabling the Virtual Patient to be projected as an attendee using Microsoft Teams.
Objectives
To evaluate the feedback from Doctors in training taking part on the education sessions.
Methods
We collected qualitiative and quanttaive infromation from participants after the teaching session.
Results
We received strongly positive reults in all parameters measured. the presenters will show a detailed breakdoen in the session.
Conclusions
The digitalised delivery of the virtual patient simulation, has been pivotal in limiting interruptions to communication skills training in mental health.
Disclosure
The NHS trust has co produced the simulation platform with a private software firm Xenadu Virtual Environments
Social cognition refers to a complex set of mental abilities that support the construction of adequate social competence and adaptation. Impairments in social cognition can be found in several psychiatric disorders, particularly in psychoses. Polygenic Risk Scores (PRSs) represent single metrics of molecular genetic risk and are a predictor of the genetic susceptibility to diseases, although they explain only a small part of the risk.
Objectives
To explore the association between PRS for psychiatric disorders and social cognition.
Methods
We conducted a systematic search in PubMed and Scopus according to the PRISMA guidelines up to August 2021. We included papers evaluating PRS and social cognition with psychometric scales. Articles concerning single-nucleotide polymorphisms and biological measures of social cognition (e.g., neuroimaging, peripheral biomarkers) were excluded.
Results
We initially retrieved 150 articles. After removing duplicates, we screened 133 titles and abstracts and preliminary selected 19 papers. Participants recruited in the papers of interest were either people with schizophrenia, ASD or ADHD, their family members or healthy subjects. Articles evaluated the association between different psychometrical measures of social cognition and PRS for schizophrenia, Autism Spectrum Disorder and ADHD.
Conclusions
Literature regarding the association between PRS for psychiatric disorders and social cognition is heterogeneous in terms of populations, genetic risk evaluation, and outcome tools. Given the critical role played by social cognition in the onset and progression of mental disorders and its association with real-world functioning, future research should try to disentangle the complex genetic basis of this domain.
Parkinson’s disease (PD) is a progressive neurological disorder that associates multiple psychiatric symptoms and disorders, like depression, neurocognitive impairment, sleeping disorders, etc. Insomnia is frequently detected in this population, with a prevalence of over 50% according to several studies.
Objectives
To present a case series dedicated to the treatment of insomnia in patients diagnosed with PD, who did not meet diagnostic criteria for any other psychiatric disorder.
Methods
A number of three patients (2 male, one female, mean age 65.2 years) diagnosed with PD, were evaluated for insomnia. They were all initiated on quetiapine XR 50 mg QD, and up-titrated according to the individual response. All these patients were undergoing treatment for their neurological disease, which remained stable for the next 3 months. A structured clinical evaluation was performed monthly, and safety measurements were also performed. All patients self-evaluated their insomnia severity on a 10-point visual analogic scale (VAS).
Results
After 3 months, patients reported a favorable evolution of their insomnia- VAS score improved significantly to baseline (from 7.3 to 3.3), without significant adverse events (metabolic parameters and QTc values did not change significantly during the treatment period). Daytime sleepiness was not reported as being significant by any of these patients. The mean dose of quetiapine XR used was 75 mg QD (50-150 mg QD), and the mean duration of the needed treatment for insomnia was 8.3 weeks (4-11 weeks).
Conclusions
Quetiapine XR could be useful in patients with PD-related insomnia, and the mean dose is usually below 100 mg QD.
Both theoretical conceptualizations (M.&E. Laufers, E. Furman, J. Maltsberger, etc. ) and empirical studies (I. Orbach) suggest an important role body image plays in the dynamics of adolescent suicidal attempts.
Objectives
To study the relationships between body image vulnerability and attachment attitudes concerning early care and current relationships.
Methods
Participants were 100 adolescents with suicidal behavior (46 with suicidal ideation only, 54 with suicide attempts) compared to 100 controls (12-17 years). Body attitudes were assessed with Body Investment Scale (BIS), perceived early care was assessed by Parental Bonding Inventory (PBI), current attachments experiences were assessed with Attachment Style Questionnaire (ASQ).
Results
Adolescents with suicidal manifestations scored significantly lower on BIS Body Care (p<.001) , but higher on Comfort with Touch scales (p=.05). They did not differ significantly on Body Image and Body Protection scales. With regard to perceived early care, suicidal adolescents did score lower on all Care and Control PBI scales, in both paternal and maternal forms. For current attachments suicidal adolescents scored lower on Confidence (p<.001) and higher on Approval Need (p<0.05) ASQ scales. Correlation analysis suggests, for both groups, stronger relationships of body attitude dimensions to current relationships than to perceived parental care, the former being more marked in clinical group, with Body Image scale being related to all ASQ scales ranging from r=-.32 to r=-.63.
Conclusions
In current study only weaker tendency to care for body in suicidal adolescents was noted. However, in suicidal group the relationship between body image vulnerability and negative experiences of current attachments was stronger.
Therapies focused on exposure like prolonged exposure (PE) or Eye Movement Desensitization and Reprocessing (EMDR) dominate the treatment of posttraumatic stress disorder (PTSD). There are many patients with PTSD who are not fully responding with exposure-therapies. or don’t want exposure therapies at all. Many patients don’t like to be confronted with elements of their traumatic experience. IPT has proven to be highly efficient in e.g. depression and bulimia and is promising as a treatment for PTSD while NOT using exposure. IPT aims to repair the damage trauma does to interpersonal trust and social functioning.
Objectives
Learn more about IPT. Learn more about the way IPT is used in the treatment for patients with PTSD (adaptations).
Methods
Literature review focused on IPT for PTSD.
Results
Among the consequences of PTSD are affective numbing, interpersonal hypervigilance, and social withdrawal (1). Numbness, an avoidance particularly of negative affect, makes it hard to read one’s interpersonal environment. Thus in adapting IPT for PTSD, we devote the early part of treatment to affective reattunement: helping patients to identify their emotions and to recognize them as helpful social signals. Once patients can read their feelings, they can put them to use to handle relationships better, deciding whom they can trust and whom they can’t. IPT for PTSD tends to focus on role transitions, which are usually inherent having been traumatized (2).
Conclusions
In the past there has been several kinds of research that show that group IPT and individual IPT reduce PTSD and depression in traumatized patients with PTSD.
Prevention of disorders has become a central element of psychiatric research and clinic. Currently, Ultra High Risk (UHR) criteria are internationally recognized for psychiatric risk assessment. Self Disorders (SD) aroused particular interest because they were found to be specific to schizophrenic spectrum disorders and a marker of vulnerability for psychotic onset.
Objectives
To evaluate the correlation between psychotic risk and depressive symptoms in at-risk adolescent population.
Methods
We collected data from 80 patients, aged 14-18, with sufficient skills in the Italian language and an IQ ≥70, excluding patients with disorders related to direct effects of a general medical condition or substance. Psychodiagnostic evaluation included K-SADS-PL, SIPS/SOPS, EASE (for the assessment of SDs) and the CDSS (for the assessment of Depression).
Results
35 subjects have UHR criteria, while 45 do not have a psychotic risk syndrome or psychotic features. Between the two groups there is a significant difference in the total SCORE of EASE, in domains 1, 2 and 5. In addition, a positive correlation between SDs and depressive symptoms emerged, in particular with pathological guilt and with reference ideas of guilt.
Conclusions
The results confirm the validity of SDs for early detection of psychosis. Depressive features appear to be associated with the presence of abnormalities of experience. This results suggest a close care and monitoring of depressive symptoms in adolescence, because they can mask disorders of different nature, particularly pathological guilt and guilty ideas of reference that are depressive “cognitive” symptoms more correlate with psychotic risk.
41 years-old man diagnosed of schizophrenia and peripheral spondyloarthropathy HLA-B27 (-) in treatment with methotrexate. Psychiatric background: First psychotic episode at 18, with no further medical monitoring. In 2018 he underwent a new episode consisting in auditory hallucinations, delusional ideas and clinophilia of months of evolution. He was sent to a Psychiatric Rehabilitation Unit and prescribed aripiprazole 20mg. The routine blood analysis revealed triglycerides level of 414mg/dL, with previous normal levels (123 mg/dL), without no other cause to justify it.
Objectives
To study the relationship between aripiprazole treatment and acute hypertriglyceridemia.
Methods
A clinical case is presented and available bibliography about the relation between aripiprazole and acute hypertriglyceridemia is reviewed.
Results
Hypertriglyceridemia was confirmed in the second analysis, so we concluded it was due to the start of aripiprazole, after rejecting other potential causes. Aripiprazole was replaced by cariprazine 3mg because of its similar profile. The analysis was repeated after a month and the normalization of the triglyceridemia (159mg/dL) was verified, while cholesterol levels remain stable. Moreover, the patient experienced an improvement in akathisia and sedation.
Conclusions
Although metabolic impact is not expected with aripiprazole, after reviewing the bibliography we have found a clinical trial and a case series that described this adverse effect. Our case highlights the importance of closely monitoring of patients in whom an antipsychotic treatment is started due to the high mortality and morbidity related to cardiovascular diseases.
Some projects have described post-disaster psychosocial services and planning across Europe. However, little is known about the real psychosocial disaster responses such as low-intensity initiatives after a terrorist attack
Objectives
This study aims (1) to describe psychological support (PS) in the immediate (<48 hours), post-immediate (48 hours – 1 week) periods and more than one week after a terrorist attack among terror-exposed people, and (2) to identify factors associated with a lack of short-term PS among those who suffered from mental health disorders.
Methods
This study used data from a longitudinal survey of 189 civilians exposed to the January 2015 terrorist attacks conducted 6 months after the attacks. Factors associated with lack of PS after the attacks was identified using a Robust Poisson regression in three separate models (for the 3 periods).
Results
Among participants who suffered from PTSD (n=34), depression (n=74), or anxiety (n=59) 6-9 months after the terrorist attacks, respectively, 9%, 18% and 12% did not received psychological support. The lack of immediate PS was associated with geographical distance, type of exposure, and support in daily life. The lack of post-immediate PS was associated with geographical distance, peri-traumatic reactions and past psychological follow-up. The lack of PS after one week was associated with geographical distance and social isolation.
Conclusions
Characteristics of exposition and social support seem to play an important role in lack of PS after a terrorist attack and highlights the need to use strategies to reach out to people regardless of the type of exposure.
Hyperprolactinemia is a frequent medical condition in daily clinical practice. In most laboratories, normal prolactin (PRL) concentrations are less than 25ng / ml in women and less than 20ng / ml in men. The causes of hyperprolactinemia can be physiological or secondary, among which a differential diagnosis must be made.
Objectives
The causes of hyperprolactinemia are reviewed on the basis of a clinical case.
Methods
Bibliographic review and presentation of a clinical case.
Results
The case of a 17-year-old patient is presented, who comes to the Emergency Department due to a picture of agitation at home. Her relatives comment that two months ago, they began to notice her strange, very active and without the need to sleep. During the examination, the patient presents with verbiage, flight of ideas, and megalomanic thoughts. A manic episode was diagnosed and the patient was admitted to the psychiatric hospital. She was prescribed risperidone up to 4mg / day, carrying out prolactin determination after a few days. The baseline prolactin determination was 140 ng / ml and 130 ng/ml at twenty minutes. Due to the very high levels, the question arises as to whether the cause of hyperprolactinemia is due to treatment or hypothalamic damage. The MRI: “slight asymmetry in the pituitary gland, being discreetly more globular the adenohypophyseal LD, which could be in relation to underlying microadenoma”. As there were no previous data, the decision was made to withdraw risperidone with the introduction of aripiprazole and imaging tests periodically.
Conclusions
Differential diagnosis of the cause of hyperprolactinemia is important.
Cognitive impairments have a considerable impact on the functioning of patients, their socialization and level of disability. Cognitive deficits significantly deteriorate the quality of patients’ life. Currently, the possibilities of pharmacological correction of cognitive disorders in patients with epilepsy are limited.
Objectives
Study of non-pharmacological program of cognitive disorder correction in patients with epilepsy and the assessment of its efficiency.
Methods
We have studied the features of clinical and psychopathological manifestations in patients suffering from epilepsy. The study included 146 patients with epilepsy (85 men and 61 women) who were receiving inpatient care. The following psychodiagnostic techniques were used: MOCA test, Mini Mult test, Münsterberg test, depression and Hamilton anxiety scale, quality of life scale. 63 patients received cognitive training online, of which 30 patients also used psychoeducation methods.
Results
According to the MoCA findings, patients with epilepsy showed cognitive decline, the average score was 20.72, whereas healthy persons’ average score was 27.36. The Quality of Life Scale: the average rate among all examined persons was 69.45 out of 100, 78.60 were the results of healthy persons. In patients with PG1, who used cognitive training and psychoeducation the results of the MoCA test showed an improvement in cognitive functions (1.4, p <0.001) and increased subjective assessment of quality of life (2.77, p <0.05).
Conclusions
The study of the use of cognitive training and psychoeducation in patients with epilepsy for cognitive functions, quality of life resulted in a positive outcome. Cognitive online training is an encouraging area in the rehabilitation of patients with cognitive decline.
Cancer is the second major cause of death among people with psychotic disorders. With the same incidence, mortality in these patients remains higher than in the general population. As stigma has been identified as a risk factor for excess mortality, we focused on oncologists’ beliefs and attitudes towards people with psychotic disorders.
Objectives
The aim of this study was to uncover physicians’ representations about the impact of psychosis on oncological care.
Methods
In this qualitative study, individual semi-structured interviews were conducted with 20 physicians working in oncology in the University Hospital of Brest (France). Transcribed interviews were thematically analyzed. This study meets the COREQ criteria.
Results
Psychosis is described as a broad-spectrum condition whose severity ranges from the “mild” patient with imperceptible abnormality to the “severe” patient with cognitive and affective deficits. Oncologists identified behavioral and emotional symptoms which may modify the patient-physician relationship with difficulties to interact. Some of them consider that these patients are not interested in their health and will not get involved in oncological care. While the psychotic disorder is not considered as a limiting factor per se, oncologists felt concerned about being stigmatizing. They mentioned different aspects (like anticipation of non-compliance or inability to get help) that lead to changes in conventional treatment regimens and may result in a loss of opportunity.
Conclusions
Oncologists’ beliefs may lead to stigmatizing attitudes towards people with psychotic disorders who may not be given the best possible chances. Thus, these specific elements should be the basis for collaboration between psychiatrists and oncologists.
Anxiety disorders are leading contributors to the global disease burden, highly prevalent across the lifespan, and associated with substantially increased morbidity and early mortality.
Objectives
The aim of this study was to examine age-related changes across a wide range of physiological measures in middle-aged and older adults with a lifetime history of anxiety disorders compared to healthy controls.
Methods
The UK Biobank study recruited >500,000 adults, aged 37-73, between 2006-2010. We used generalised additive models to estimate non-linear associations between age and hand-grip strength, cardiovascular function, body composition, lung function and heel bone mineral density in cases vs. controls.
Results
The main dataset included 332,078 adults (mean age = 56.37 years; 52.65% females). In both sexes, individuals with anxiety disorders had lower hand-grip strength and blood pressure than healthy controls, while their pulse rate and body composition measures were higher. Case-control differences were larger when considering individuals with chronic and/or severe anxiety disorders, and differences in body composition were modulated by depression comorbidity status. Differences in age-related physiological changes between female anxiety disorder cases and healthy controls were most evident for blood pressure, pulse rate and body composition, while in males for hand-grip strength, blood pressure and body composition. Most differences in physiological measures between cases and controls tended to decrease with age increase.
Conclusions
Individuals with a lifetime history of anxiety disorders differed from healthy controls across multiple physiological measures, with some evidence of case-control differences by age. The differences observed varied by chronicity/severity and depression comorbidity.
Disclosure
JM receives studentship funding from the Biotechnology and Biological Sciences Research Council (BBSRC) and Eli Lilly and Company Limited. CML is a member of the Scientific Advisory Board of Myriad Neuroscience. CF and THH declare no relevant conflict of
Clozapine is commonly associated with adverse hematological outcomes. However, incidence of blood dyscrasias in the north African population is scarce.
Objectives
The aim of this study was to assess the incidence of hematological side effects in a Tunisian sample of clozapine treated patients.
Methods
We conducted a retrospective longitudinal chart review of 64 patients on clozapine enrolled in our clozapine consultation between January 1, 2000 and September 2020.
Results
Our sample consisted of 15 women (23.5%) and 49 men (76.5%), mean age was 41.34 ±9.32 years. Patients were diagnosed with schizophrenia in 70.3% of the cases, 7 (10.9%) had a bipolar disorder and 12 (18.8%) had a schizoaffective disorder.We found blood dyscrasias in 21 patients (32.8%). Hematological abnormalities were as follow: 2 cases of agranulocytosis, 8 cases of neutropenia, 13 cases of thrombocytopenia, 5 cases of leukocytosis, 5 cases of eosinophilia and 3 cases of anemia. The incidence rate of hematological side effects was 0.1 case/year- person. The mean clozapine dose at the time of onset of the hematological side effect was 309.52 mg/day(range 25-600 mg/day).The median duration of clozapine treatment prior to developing hematological side effects was 119.71±126.52 days.Clozapine discontinuation was decided in 11 cases due to hematological side effects and reintroduced in 9 cases after normalization of blood count.
Conclusions
This study emphasis on the importance of a regular long-term monitoring of blood count to ensure early detection of hematological side effects.
Vulnerable groups like patients suffering from alcohol use disorders (AUD) are expected to be particularly affected by the negative consequences of the COVID-19 pandemic. In a prior study (N=127), we found that psychosocial COVID-19 factors and living alone elevated the probability for relapse during the initial stage of the pandemic, whereas long-term effects on mental health have yet to be investigated.
Objectives
Here we aimed to investigate the risk of PTSD, as well as levels and developments in depression, anxiety and stress symptomatology as a consequence of the COVID-19 pandemic among patients with AUD.
Methods
Data was collected from a clinical sample of patients with AUD (N=136) in late 2020 and early 2021. PTSD symptoms due to the pandemic were assessed using an adapted version of the impact of event scale (IES-R). Levels in clinical symptoms were collected on the depression, anxiety and stress scale (DASS-21), and changes since the onset of the pandemic were assessed additionally.
Results
The high-risk PTSD-group showed higher levels of depression, anxiety and stress, and reported more severe deteriorations in these symptoms, when compared to the low-risk group. A binary logistic regression model revealed psychological and social aspects of the pandemic to increase the probability for PTSD, whereas sociodemographic and other COVID-19 related factors showed no significant effects.
Conclusions
About 30% of patients with AUD indicated an elevated risk of PTSD due to the pandemic, as well as deteriorations in levels of depression, anxiety and stress. These concerning findings should be especially considered in current and future treatment settings.
Hysterical disorders were considered separately in the context of the dynamics of the course of either endogenous affective diseases or schizophrenia, without attention to the conjugation and interaction of issues of hysterical symptoms and affective or psychotic syndromes.
Objectives
To test the psychopathological structure and provide a typology of the conjugation of hysterical symptoms with other psychopathological syndromes.
Methods
120 patients (82 women and 38 men) with schizophrenic and affective disorders with associated hysterical symptoms were examined by a clinical psychopathological method.
Results
Three variants of conjugation were identified. In the group of hysterical disorders associated with affective diseases (37,1%) the structure and dynamics of hysterical symptoms directly influenced the developing affective phase: the low intensity of hysterical symptoms contributed to the development of an apatho-adynamic type of depression, and bright and spontaneous hysterical manifestations formed an anxious-hypochondriac type of depression. Hysterical disorders formed in the structure of the psychotic state (41,4%) influenced the nature, structure, dynamics and content of delusional, hallucinatory and paranoid disorders. “Caste” hysterical symptoms (21,4%) revealed a lack of connection with affective and psychotic states. Hysterical symptoms were characterized by persistence, stability, invariability of manifestations, long-term psychotherapeutic and psychopharmacological resistance.
Conclusions
Clinical and psychopathological analysis of endogenous mental diseases of the affective and schizophrenic spectrum, occurring with hysterical symptoms, showed that the parameter of the conjugation of hysterical symptoms with other psychopathological syndromes is prognostically significant.
The COVID19 outbreak was declared a public health emergency by The Word Health Organisation (WHO) on January 2020. By spring 2020, more than half of the world’s population had experienced a lockdown with strict pandemic prevention such as physical distancing measures. The COVID-19 pandemic have negatively affected many people’s mental health especially the ones who are at risk such as patients with cancer.
Objectives
This study aimed to screen mental health problems among patients with cancer during the fisrt wave of COVID 19.
Methods
To assess the impact of COVID-19 outbreak on mental health of patients with cancer, a Survey was conducted at the department of medical oncology in Nabeul (Tunisia) between March and May 2020. The patients were asked to answer a socio-demographic questionnaire. The COVID-19 infection-related mental Heath problems were measured using the Hospital Anxiety and Depression Scale (HADS). Medical conditions and clinical characteristics were extracted from patients healthcare records.
Results
The median age was 53 years (range, 34-70) with sex ratio 0.35. The majority of the patients had a social support (85%) and lived in urban areas (60%). Only 19 % of them had college degree. Almost quarter of patients had medical conditions. The most common cancer in our cohort was breast cancer (54%) followed by colorectal cancer (20%). Sixty four per cent of them were on adjuvant chemotherapy. Among the 80 person surveyed, 20% had depression and 39 % anxiety.
Conclusions
Further investigations are required to screen mental health status for all cancer patients in order to help them coping.