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COVID-19 has changed entire lives. Lockdowns all over the world have resulted in social isolation and whole populations started to live a new social norm.
Objectives
In this presentation I will discuss the role social media has played in social interactions during lockdown. Mainly if social media use has replaced social face to face interactions. This both in terms of quantity and emotional quality of interactions. I will be using a study we conducted in Malta in this regard.
Methods
It seems that social media use has increased during lockdown. To analyse this in Malta we studied a dataset comprising more than 50,000 comments and more than 150,000 interactions that has been extracted from Facebook covering a time span of four months. These months were the first wave of COVID- 19 cases in Malta. We conducted a quantitative and qualitative data analysis to establish the social polarity of the content.
Results
I will discuss how social media has in part replaced the social face to face interactions during COVID- 19 pandemic initial months, and use the results of the study we conducted in Malta as an example.
Conclusions
It would be useful to analyse further the use of social media in the new social norm caused by COVID- 19. Most importantly how it could be used to decrease social isolation effectively and increase psychological wellbeing.
This is a quasi-experimental and pioneering study in Portugal.
Objectives
(1) to provide assessment materials for symptoms of internalized homophobia, depression, and anxiety targeted at LGBT people; (2) offer support materials for psychotherapeutic work-oriented in the areas of internalized homonegativity, depression, and anxiety; and (3) offer monitoring measures throughout the program to demonstrate changes. It consists of three phases (pre-program evaluation, therapeutic activities and post-program evaluation).
Methods
38 LGBT + individuals participated, average age was 34.15 years, 30 self-identified as male. Measures used for the pre and post-intervention assessment were the sociodemographic questionnaire, the LGBT identity questionnaire, the Rosenberg self-esteem scale, and the BSI-18. Participants were invited to join the program online, through a platform created for this purpose, where ethical aspects were clarified, namely: confidentiality and commitment to adherence. Therapeutic tasks were sent by email or WhatsApp depending on the preference of each participant.
Results
Relevant differences in internalized homophobia, depressive, and anxious symptoms between the pre and post-intervention moments were observed, indicating that the program is effective in changing these symptoms.
Conclusions
The importance of validating this type of program allows reaching “hidden” populations by offering online support that minimizes the effects of sexual stigma on LGBT + populations.
The prevalence of borderline personality disorder (BPD) is significant, ranging from 0.5% to 5.9% in the general population. This personality disorder is associated with high rates of suicide attempt and for suicide attempt recurrence.
Objectives
Review recent studies of predictors of suicide attempt and for suicide attempt recurrence in patients with borderline personality disorder.
Methods
This is a literature review via Medline and Sciences Direct. The database was searched using the combination of the keywords “borderline” with “suicide”, “borderline personality disorder” with “suicide”, “borderline personality disorder” with “suicide attempts” “borderline personality disorder” with “suicide recurrence”.
Results
Recently it has been shown that BPD has a greater correlation with suicidal behavior than that of characterized depressive disorders. Several studies have shown that suicidal behavior in patients with BPD was associated with the coexistence of antisocial personality disorder, depression, hostility, impulsivity, a high number of suicide attempts and a first suicide attempt at a young age. Recently it has been established that the predictors of suicidal recidivism are the high number of suicide attempts, the female sex and single life status.
Conclusions
Special attention should be paid to predictive factors for suicide attempt and for suicide attempt recurrence in the clinical evaluation of patients with borderline personality disorder, especially in suicidal crisis.
Schizophrenia is associated with lower life expectancy due to cardiovascular disease. Metabolic syndrome (MetS) occupies an important place among the main problems. Indicators of hormones regulating metabolism may be appealing candidates as biomarkers of metabolic side-effects. Certain role belongs to genetic factors that might be the basis of sensitivity to development of MetS.
Objectives
The aim is to study polymorphisms of leptin gene (LEP) and serum leptin concentration in schizophrenia patients with metabolic syndrome.
Methods
After obtaining informed consent, patients with schizophrenia (ICD-10: F20) were included: 91 patients for biochemical research and 463 patients for genotyping. Patients were divided into two groups: 46 (119) with MetS; 45 (344) without it. Concentration of leptin was measured on an analyzer MAGPIX (Luminex, USA). Determination of 4 polymorphisms (rs2167270, rs3828942, rs10954173, rs4731426) of LEP was performed by PCR. Differences were considered significant at p<0.05.
Results
The leptin concentration is significantly (p<0.001) higher in MetS (13511.5 [7392.5; 28278.75] pg/ml) compared to patients without MetS (6662 [2131.5; 11380] pg/ml). Significant differences were found in the distribution of rs3828942 (GG:GA:AA): 25.9%:44%:30.2% in MetS and 31.2%:52.6%:16.2% without MetS (χ2=10.545, p=0.005). The genotype AA and the allele A have a predisposing effect on the development of MetS (OR1=2.247, C.I:1.248-4.046; OR2=1.475, C.I:1.093-1.991, χ2=6.49, p=0.01).
Conclusions
A number of features are observed in patients with MetS, which impair the functioning of patients. These investigations should aim to optimize the approach to assess the risk of MetS. The study was supported by grants from the RSF 19-75-10012 (genetic research) and 18-15-00011 (determination of leptin concentration)
Disclosure
The study was supported by grants from the Russian Science Foundation №19-75-10012 (genetic research) and №18-15-00011 (determination of leptin concentration)
In the late XIXth century Kraepelin described a new nosologic division for the psycothic disorders – Paranoia and Dementia Praecox. He emphasized that dementia praecox is a central nervous system disease, involving permanent lesions on cerebral cortex. Besides biological deterioration, it appears as the result of psychic degenerative process. From the mid-20th century onward, antipsychotic drugs had been robustly generalized, and in parallel to the current classifications, residual symptoms in schizophrenia tend to be rare but still prevail in our patients.
Objectives
The aim of our work is to report a clinical case of residual schizophrenia in parallel with the classic classification of Dementia Praecox and also do an overview of this disorder and its historical perspective.
Methods
We conducted clinical interviews with the patient and family members, reviewed clinical records and conducted a query in the MEDLINE database using the terms " Dementia Praecox ", “Psychosis”, “Paranoia”, “Kraepelin”, “History”.
Results
We present the clinical case of a 74-year-old man with onset of psychotic symptoms on his twenties and diagnosed with Schizophrenia. In the past years, after acute psychotic episodes it was increasingly difficult to return to prior levels of functioning. Currently, he was brought to psychiatric emergency ward presenting bizarre behavior, stereotyped movements and speech disturbances, which reveal disorganized thinking and inability to express his emotions.
Conclusions
Although these syndromes are nowadays relatively rare, it is important to keep them in mind, in order to understand the natural progression of psychotic diseases, improve their rehabilitative treatment and prognosis.
Major depressive disorder (MDD) is complex and multifactorial, posing a major challenge of tailoring the optimal medication for each patient. Current practice for MDD treatment mainly relies on trial-and-error, with estimated 42%-53% response rates for antidepressant use.
Objectives
We sought to generate an accurate predictor of response to a panel of antidepressants and optimize treatment selection using a data-driven approach analyzing combinations of clinical and demographic factors.
Methods
We analyzed the response patterns of patients to five antidepressant medications in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study and the Pharmacogenomic Research Network Antidepressant Medication Pharmacogenomic Study (PGRN-AMPS), and employed state-of-the-art machine learning (ML) tools to generate a predictive algorithm. To validate our results and confirm the algorithm’s external generalizability outside of its training groups, we assessed its capacity to predict individualized antidepressant responses on a separate validation and test sets consisting of 1,021 patients overall from both studies.
Results
The algorithm’s ML prediction models achieved an average accuracy of 0.6416 (64.16%, SD 4.4) across the analyzed medications, and a cumulative accuracy of 0.6012 (60.12%), AUC of 0.601, sensitivity of 0.6034 (60.34%) and specificity of 0.599 (59.9%).
Conclusions
These findings support applying ML to accumulating data derived from large studies to achieve a much-needed improvement in the treatment of depression. By an immediate analysis of large amount of combinatorial data at the point of care, such prediction models may support doctors’ prescription decisions, potentially allowing them to tailor the right antidepressant medication sooner.
Disclosure
Dekel Taliaz is the founder and CEO of Taliaz and reports stock ownership in Taliaz. Amit Spinrad and Sne Darki-Morag serve as data scientists in Taliaz.
15q11.2-q13.3 region is prone to genomic rearrangements leading to both deletions and duplications. A wide spectrum of neuropsychiatric conditions, such as developmental delay/intellectual disability (DD/ID), autism, attention-deficit hyperactivity disorder, schizophrenia, epilepsy was reported in association with genomic imbalances of this region.
Objectives
In this paper we report on 9 children carrying 15q11.2-q13.3 duplications.
Methods
Seven boys and two girls, aged 15 months to 15 years, were included in the study. Genomic investigations were carried out by array-based comparative genomic hybridization (Agilent Technologies). In all patients the psychomotor development, dysmorphic features, neuroimaging and EEG anomalies were assessed. Psychologic and psychiatric evaluation was performed with specific tests.
Results
The size of the duplications ranged from 9.65 Mb to 0.38 Mb. All patients presented speech delay. Autistic behavior and muscular hypotonia were detected in 8 out of 9 patients, DD/ID in 6. Two children presented epileptic seizures, in addition 4 other children had EEG anomalies. Facial dysmorphic features were observed in 5 patients. Neuroimaging studies showed anomalies in 4 children. The smallest region of overlap in our patient group harbors CHRNA7 gene, a candidate for the behavioral abnormalities.
Conclusions
15q duplications encompassing CHRNA7 gene were associated with different neuropsychiatric features in our patients. Our results further support the association of 15q duplications with neuropsychiatric phenotypes, with clinical heterogeneity and variable severity, which is yet to be explained. Acknowledgment: The research leading to these results has received funding from the EEA RO NO Grant 2014-2021, the project contract No 6/2019.
Early Career Psychiatrists (ECPs) are routinely at the front line of clinical practice worldwide, including the use of compulsory measures in psychiatry. However, ECPs practice in this aspect is understudied.
Objectives
The aims of the study were (i) to clarify whether ECPs experience any difficulties in the process of compulsory psychiatric care; and (ii) to find out how ECPs consider compulsory measures in psychiatry.
Methods
An online anonymous survey of ECPs around the world was conducted in July-August 2019. The final sample had 142 psychiatrists (53% female; mean age 32.3±3.1) from 43 countries. Results. 96% of the Early Career Psychiatrists who responded to this survey agree with the continued use of the current legal framework for compulsory psychiatric treatment in their country, either with or without amendments. More than half of the respondents (57%) reported difficulties in providing compulsory psychiatric care due to either challenging interactions with the courts, documentation issues or moral concerns. Over half of the participants (53%) were keen to reform the legal procedures for compulsory psychiatric care in their countries.
Conclusions
The study has shown that there is an agreement among ECPs around the world that legal compulsory psychiatric care procedures are relevant and useful in clinical practice under certain circumstances. As stakeholders, ECPs could be encouraged and involved in adding their own experience and opinions to the debate on the employment of coercion in psychiatry as an ethical and legal issue.
Body attitudes may serve as both vulnerability and protective factors for various forms of emotional and behavioral disorders, including suicidal and self-harm behaviors in adolescent and youth populations. Body Investment Scale (BIS, Orbach & Mikulincer, 1998) is an instrument specially designed to account for body attitudes in suicide assessment.
Objectives
The study was aimed to provide a preliminary evidence for using the BIS translation in the assessment of suicide risk factors in Russian-speaking student population in Azerbaijan.
Methods
The common recommendations for test translation were used. The factor structure, inter-item consistency of scales, and retest reliability were assessed. The participants were 100 students (18-23 years, 40 females, 60 males), 50 of them completed the retest.
Results
The exploratory factor analysis with fixed number of factors reveals a homologous structure to the original BIS scales, explaining 48.2% of variance (in comparison to 55% of original measure). Inter-item reliability coefficients were lower: .989 for Body attitude, .696 for comfort with touch, .65 for Care and .61 for Protection scales. Pearson’s r for retest reliability (in a month) were above 0.9. Three items that could be excluded for enhancing the consistency of scales address physical contact and self-harm issues and might be culturally inappropriate.
Conclusions
BIS is a promising instrument due to its grounded factor structure, but refinement of some items of the Russian translation is desired, as well as further study of applicability for adolescent population. BIS could fill the gap in scarcity of instruments for suicide assessment for Russian speaking population.
The original Profile of Mood States (McNair et al. 1971) is composed of 65 items to measure six affect dimensions. There is a Portuguese shorter version (POMS-27) for the perinatal period (Bos et al. 2013), which reduced the number of items (adjectives) down to 27. Although briefer, it still covers relevant mood states with good psychometric properties, being considered a good alternative to use during this demanding and busy period.
Objectives
To test if PoMS-27, composed of four dimensions (Depression, Anxiety, Vigour, Fatigue) and one second-order factor (Negative Affect, composed by the former two) is valid and reliable to be used with pregnant women from Brazil.
Methods
After confirming the items semantic equivalence and slightly adapt two adjectives from European to Brazilian Portuguese, 350 pregnant women (Mean age: 30.01±5.452; Mean gestation weeks=25.17±6.55), with uncomplicated pregnancies, completed the PoMS-27 and the Brazilian recently validated versions of Perinatal Depression Screening Scale and Perinatal Anxiety Screening Scale (PDSS; PASS; Barros et al. 2021). SPSS and AMOS software were used.
Results
After deleting two items (20 and 22) and some errors were correlated, CFA indicated that the PoMS-25 four-dimensional model presented an acceptable fit (χ2=3.163; RMSEA=.079, CFI=.868, TLI=.849). The Cronbach alphas of the dimensions were: Depression (.82), Anxiety (.86), Negative Affect (.89), Fatigue (.80) and Vigor (.50).
Conclusions
Within this psychometric study we found useful, valid and reliable measure of negative and positive affect for Brazilian pregnant women. From now on we will denominate it Profile of Mood States-25Br
The presence of psychological impact on relatives of patients admitted for Covid-19 has been described. The effectiveness of psychological first aid in critical situations has also been described. The first psychological aid describes a human response supporting another person who is suffering. This intervention is indicated for those affected by a traumatic event.
Objectives
To present a theoretical review about psychological first aid and to describe data about it on relatives of patients admitted for Covid-19.
Methods
Literature review about psychological first aid and data description of telephone intervention carried out by mental health professionals on family members of patients admitted for Covid-19.
Results
From an initial pool of 77 Covid-19 patients, 50 were selected as telephone contact with relatives was possible. Mean age was 68.9 years, 13 were female and 37 male. 90% were admitted in internal medicine department and 10% in intensive care unit. First telephone intervention in all cases was to introduce the psychiatrist in charge of the follow-up and provide contact number of psychiatry department. In 13 relatives` support, emotional ventilation and active listening was provided and 2 of them also received therapeutic guidelines. Further phone contact was required in 12 relatives. In follow-up phone calls, all relatives received therapeutic guidelines and 3 was referred to our outpatient clinic.
Conclusions
Family members of patients admitted for covid-19 may present emotional symptoms, many of them normal reactions in context of a crisis situation. A large percentage do not require a structured psychotherapeutic intervention but can benefit from a first psychological help.
Neurocognitive dysfunction is associated with important socio-professional consequences and diminished quality of life. In the Neurocognitive Remediation Clinic of the Centre Hospitalier Universitaire Brugmann (Brussels, Belgium), patients suffering from neurocognitive dysfunctions related to common mental disorders (e.g. psychotic, mood, adjustment disorders) are considered for Neurocognitive Remediation Therapy (NCRT), combining personalized computerized cognitive training and strategy training, with group sessions of physical rehabilitation and cognitive behavior therapy.
Objectives
This cross-sectional study aims to assess the efficacy of a 12 week (1day/week) NCRT program organized within the day clinic.
Methods
Patients who completed the NCRT between March 2018 and June 2019 were eligible to participate. Efficacy was assessed using the cognitive failure questionnaire (CFQ) and a 17-item questionnaire assessing daily functioning. Current scores on the CFQ were compared to the scores before and after NCRT. Additionally NCF was retrospectively assessed through the neuropsychological test results before and after NCRT.
Results
Of the eligible 38 patients, 27 consented to participate (18 women/9 men); median age was 52 years, range (29-61); median time since stop NCRT was 7 months, range (4-17). Twenty patients (80%) reported improvement in daily function. Subjective neurocognitive function improved significantly immediately after NCRT (t=2.681, df=23, p=0.013) and remained stable at time of assessment (t=2.775, df=24, p=0.011). After NCRT at least 1 neuropsychological subtest normalized in 25 patients (96.15%). Divided attention, long-term visual memory and planning improved in respectively 80%, 75% and 75% of the patients.
Conclusions
Our innovative integrative program improves neuropsychological performances and sustainably ameliorate subjective neurocognitive and daily function.
Stigma, including beliefs about mental illness, can operate in different cultures in different ways, making Western theoretical bases considered “universal” on the stigmatization of theories not applicable to non-Western cultures; hence the need for international studies on this subject.
Objectives
This work aimed to assess knowledge of mental illness, available treatments and recovery in a non-clinical sample of Tunisian university students.
Methods
In a cross-sectional descriptive study from October 1 to November 30, 2019, we evaluated 714 students from 3 Tunisian public universities using the Mental Health Knowledge Schedule scale (MAKS).
Results
We found that 34.2% of students did not agree that drugs can be an effective treatment for people with mental health issues, while 76.4% agreed on the effectiveness of psychotherapy. In addition, 34.3% did not consider drug addiction as a mental illness and 21.9% did not consider depression as a mental illness. We objectified a significant correlation of the MAKS score with gender (p=0.019), living environment (p=0.001), high academic level of father (p=0.000) and mother (p=0.027) and presence of personal psychiatric history (p=0.013).
Conclusions
Awareness and information campaigns aimed at developing the general public’s knowledge of the scientific, medical and psychosocial causes of mental illness and the means of management should be established.
During COVID 19 epidemic it has been interesting to observe the gradual transformation of the daily routine into death, sorrow and pain. The moment of transition from life to death was really changed by distressing for survivors who had to face with unexpected ways to live their mourning.
Objectives
The paper would like to analyze the mounring ritual during COVID 19 epidemic.
Methods
During COVID 19 tragedy victims and survivors have been first associated by the infection and then dramatically separated by its effects. It has been necessary to re-relaborate new procedures of separation from deceased, as far for laws prohibitions it was no longer possible to use the traditional ones.
Results
So a leaving “ritual” re-emerged very similar to the “crying ritual” of the Southern Italy folkloric culture. The traditional wailers have been substitued by the windows flash mobs trying to replace the forced absence of “pietas”, with a moment of positive sharing of physical distance between life and death, using sounds, songs, tools that always, in farming culture help to exorcise and take away death.
Conclusions
The relevant starting powerlessness to face the fast disease diffusion, its intrinsic seriousness, inspired surprising capabilities of immediate reaction and active mobilization in response to the attack suffered by Koerper and Leib (in Heidegger sense) which actualized in the research of a new “separation” dimension. In the end, as psychiatrists, we have to notice how this collectivization practice is actually a big distress container and wonder where and how this distress will finally arrive
Adaptive thinking demands a balance between manifestations of intrapsychic activity and reliance on requirements of the outer reality. Features of responses to Rorschach’s III card could provide information about subject’s ability to preserve the dialectical tension between the two poles of external and internal realities during solving tasks related to interpersonal relationships.
Objectives
To compare reality-fantasy relations during Rorschach’s III card responding in patients with schizophrenia, neurocognitive impairment and normal subjects.
Methods
Participants were 12 young adult inpatients with schizophrenia, 14 students without mental disorders and 12 inpatients with neurodegenerative diseases of old age. Reality-Fantasy Scale (RFS) was applied to assess responses to Rorschach’s III card. RFS scale ranges from –5 (reality collapse into fantasy) to 5 (fantasy collapse into reality) (Tibon-Czopp et al., 2015).
Results
Patients with schizophrenia (M= –3,38, SD= 1,9) demonstrated tendency to fantasy domination (and reality collapse) if compared with the students (M= –1,47, SD= 2,0, p<0,05). Patients with neurodegenerative diseases (M= 0,75, SD= 2,1), conversely, had difficulties to apply fantasy during solving Rorschach task (p<0,01).
Conclusions
Express Rorschach testing using III card could be useful to provide screening data of thinking tendencies related to situations of social interaction. Also it provides a mental pabulum regarding role of cognitive impairment in schizophrenia in relation to significance of affective dependence of their thinking process.
Conflict of interest
The reported study was funded by RFBR, project number 20-013-00772
The evidence that supports an association between domestic violence and abuse (DVA) perpetration and mental disorders is increasing. Since 2011, authorities in England and Wales have been required to conduct Domestic Homicide Reviews (DHRs) into deaths caused by violence, abuse or neglect of individuals aged 16 or over, by a family member or a current or ex-partner.
Objectives
The aim of the study is to describe the characteristics of perpetrators of domestic homicide in a sample of DHR reports in which the perpetrator was known to mental health services in the 12 months before the offence. This sample will undergo qualitative framework analysis as part of another study conducted by the authors.
Methods
The researchers compiled a list of DHRs available online and randomly sampled 168 reports; in 20 of those reports, the perpetrators were under the care of mental health services in the 12 months prior to the offence. We have applied descriptive statistics to report on the sample characteristics.
Results
The common mental illnesses diagnosed amongst perpetrators were depression (20%), anxiety (15%) and schizophrenia (15%). 25% of the perpetrators didn’t have a psychiatric diagnosis and 70% had a history of self-harm and suicidal ideation. Substance use was prevalent (60%). Half of the homicides involved children.
Conclusions
This report describes the demographic and mental health characteristics of a sample of perpetrators of domestic homicides. Further research is needed into the patterns of mental health service use by DVA perpetrators in order to improve identification and risk management.
The 2019 coronavirus disease (COVID-19) is a global health crisis that originated in China. As an adjacent city to the origin of COVID-19, Hong Kong has been facing different public health challenges raised by the epidemic.
Objectives
This paper examined the prevalence of common physical symptoms, psychological symptoms, somatic symptoms, and health anxiety among the Hong Kong youth population.
Methods
HKYES is an on-going territory-wide epidemiological study collecting youth mental health data with randomly stratified sampling. Participants aged 15-24 years were to complete a physical symptom checklist, Depression, Anxiety and Stress Scale (DASS-21), Insomnia Severity Index (ISI), Patient Health Questionnaire-15 (PHQ-15), and Short Health Anxiety Inventory (SHAI).
Results
A total of 594 participants have completed the survey since April 2020. The three most common physical symptoms were headache (n=106, 17.8%), fever (n=94, 15.8%) and fatigue (n=78, 13.1%). The mean scores of DASS depression, anxiety and stress subscales were 7.98 (SD 8.14), 5.81 (SD 6.32), and 8.83 (SD 7.93) respectively. Among all, 135 (22.8%) participants reported moderate to severe levels of depressive symptoms, 133 (22.4%) reported moderate to severe levels of anxiety symptoms, and 71 (12%) reported moderate to severe levels of stress. There were 40 (6.7%) and 60 (10.1%) participants showing significant levels of insomnia and somatic symptoms, while around one-third of the participants reported a high level of health anxiety.
Conclusions
Youth is at risk of severe psychological impact during the coronavirus. Monitoring the mental health trajectory for youth should become routine practice during times of crisis.
Discovered in December 2019, COVID has affected the entire planet, through direct exposure to its virus; SARS-COV-2, or indirectly through the media, Indeed, on January 20, 2020, the World Health Organization declared COVID-19 to be “a public health emergency of international concern.” Along with other public health crises and other collective trauma (terrorism, H1N1 epidemic or SARS-COV), exposure to publicized information on this virus generates psychiatric disorders, in particular anxiety and absence of well-being. Objective: To link exposure to information about this pandemic through social media and anxiety and lack of well-being.
Objectives
Explore the relationship between anxiety, well-being and exposure to social medias
Methods
Use of a questionnaire consisting of three sections, individual status and conditions, the French versions of the GAD-7 scale for anxiety (Generalized anxiety scale of 7items) and the WHO-5 (five well-being index). This questionnaire is dedicated to the general population who have not been in direct contact with the virus, but through the media.
Results
We were able to collect 209 participants, they were essentially females with a mean age of 28yo, 17,7% had psychiatric history of anxiety and depression, the median use of social medias was 5.7 hours per day. And they were essentially getting their information about the pandemic from Instagram, Facebook, the Moroccan ministry of health’s website and electronic newspapers. 31,1% of our participants had anxiety which was above a Chinese study, and had a poor well-being.
Conclusions
The use of social media to get information about the pandemic had an impact on well-being and anxiety.
Antipsychotics are frequently used for managing psychiatric and behavioral symptoms of dementia. However, it’s an off-label resource which remains controversial due to significant safety concerns in the elderly population, namely increasing cardiovascular adverse effects.
Objectives
To access antipsychotic safety and potential risks when used in dementia.
Methods
A non-systematic review was carefully conducted on PubMed using the following keywords: “dementia”, “antipsychotics” and “safety.” We selected clinical trials, meta-analysis, randomized controlled trials published in the last 10 years.
Results
A total of 43 articles was obtained, of which 22 were excluded because they didn’t meet our inclusion criteria. Regarding atypical antipsychotics, one study found an incidence of severe events in 23,7% of patients and a OR=2.5 for cerebrovascular side effects. Quetiapine was suspended midway given it had a higher incidence of adverse effects compared to others. There weren’t any significant statistic differences concerning serious events between classes of antipsychotics(p<0,01). No study was found comparing typical and atypical antipsychotics safety in dementia.
Conclusions
Overall, we can conclude that antipsychotics pose a risk of serious adverse effects when used in elderly patients, namely cerebrovascular events. Among atypical antipsychotics, quetiapine, used frequently for controlling neuropsychiatric symptoms in these patients appears a higher risk for severe adverse events compared with other drugs. Their use should be restricted after there aren’t any other options available. New protocols could be developed to control these symptoms, for example, environmental measures before resorting to antipsychotics.
Children in Autism Spectrum Disorder (ASD) have a qualitative deficit in social interaction. The DIR/Floortime (Stanley Greenspan and Serena Wieder) is based on the Child’s Functional Development, Individual Differences and Relationships (D for development, I for individuality or individual differences and R for relationship), aiming at building the foundations for social, emotional and intellectual skills of children.
Objectives
To determine the results of 18 months DIR/Floortime™ parent training for an additional benefit in encouraging children with ASD climbing the developmental “ladder”.
Methods
The participants are 15 children with ASD aged between 2 and 6 years-old. The follow-up occurs in two private DIR Floortime Model service centers in Brazil. Protocols: Functional Emotional Assessment Scale – FEAS and Functional Emotional Developmental Questionnaire – FEDQ. The participants were followed-up one on one every four months.
Results
At the first month of assessment the children showed lack of self regulation, social interaction and engagement with their parents in a symbolic, sensory and motor play setting. At the following evaluations, they showed increase of social interaction and engagement in the same play setting. Besides the high affect of the parents during the play time promoted a two way purpose communication and behavioral organization.
Conclusions
Children showed a good development of functional and emotional capacities during the study period, demonstrating the effectiveness of the DIR/Floortime model in the intervention.