Factitious hematemesis is the bleeding type of Munchausen’s syndrome together with dual diagnosis of school refusal is rarely reported in the literature. It is a condition in which the patient intentionally produces symptoms to assume a sick role and gain medical attention. Underdiagnosis of this disorder results in the unnecessary use of medical resources, i.e. unnecessary medical tests and evaluations.

case

We present this rare case of a patient with chronic factitious disorder who presented to the emergency with hematemesis. The 12 year old male patient grade 6 student presented with curious history of hematemesis just before the entrance of school and in the new school premises since 2 years resulting in school refusal and multiple doctor shopping. The patient underwent laboratory tests (such as the examination of sputum specimens, urinalysis, complete blood evaluations) and diagnostic studies (fiberoptic bronchoscopy with bronchoalveolar lavage, computerized tomography and radiography of the chest, bronchial arteriography, endocopic studies etc), because he continually presented with hematemesis, in order to spot and discover the nature of the bleeding. Since such examinations failed (a few of them-namely fiberoptic bronchoscopies--were even performed when he was coughing up blood) and psychiatric consultations revealed the presence of psychologically traumatic events in the patient’s history which could explain the psychopathic traits of her personality (in fact she was aggressive and unstable in interpersonal relations), a diagnosis of factitious hematemesis in Munchausen’s syndrome was made.

The typical characteristics that should prompt the physician to include Munchausen syndrome in the diagnosis include deliberately lying, repeatedly coming to the clinic/hospital with similar complaints in a short span of time, taking excessive drugs (especially insulin and warfarin) to induce side-effects, recurrent abdominal pain, scars on limbs, and rheumatologic and hematological disorders.

We recommend that physicians all across the globe should report more cases of Munchausen syndrome. More research is required in this arena to understand the cultural, social, and psychological aspects of Munchausen syndrome and to find out which treatment strategy can be most beneficial for such patients

Munchausen syndrome is a diagnostic dilemma that needs to be given adequate medical and social attention by encouraging further research and spreading awareness not only amongst the general population but also health care providers. With proper evaluation, diagnosis, and psychotherapy, the disease will not remain a diagnostic dilemma and would be easier to control and treat. This case report will contribute towards the awareness of physicians about Munchausen syndrome and the strategies to diagnose and treat it.

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Borderline personality disorder (BPD) is a real source of suffering for people affected and for those around them.

The aim of this study was to describe the socio-demographic and clinical characteristics of out patients with BPD consulting the psychiatry department of Hedi Chaker hospital in sfax tunisia during the period between January 2022 and October 2022.

It was a descriptive study. The population study consisted of patients diagnosed with BPD (DSM 5) consulting the psychiatry department of the hospital Hédi Chaker of Sfax tunisia during the period from January 2022 to October 2022.

Sociodemographic and clinical data were collected using a predefined form.

All statistical analyses were performed using the SPSS software package v 18.

Among 700 adult patients referred to the psychiatric unit of hedi chaker hospital in sfax from january 2022 to october 2022, 35 patients (5%) were identified as meeting the criteria for BPD.

The average age was about 35 years, 54.3% of the patients were men. They were married in 40% of cases.Only 31.4% of the patients had a regular job.

The presence of a family psychiatric illness was noted in 48.5% of cases and 20% had a childhood psychiatric follow-up .

The rates of sexual abuse, physical abuse, psychological abuse and neglect were 17.1%, 65.7% and 68.6% respectively.

In our sample,48.6% of the patients had attempted suicide and 60% of them had committed self-harm.

The most common means of attempted suicide was phlebotomy.No prior thoughts of suicide were mentioned, all suicide attempts were impulsive. Negative feelings and family conflicts motivated the suicide attempt (37.5% ,56.25%).

Comorbid psychiatric disorder was mentioned in 54.3% and The most frequent comorbid psychiatric disorders was depression (20%).

Pharmacotherapie was used in 88.6% of cases.

The results emphasize on the comorbidities with mainly depressive episodes and a high proportion of suicide attempts and self-harm. Moreover, this study confirms the impact of family conflicts and abuse in the development of this disorder

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Freelancing can be analyzed through psychological prism of escapism, through the desire not to be involved in the systems of inflexible social ties that are accepted in group (career, family, classical education, etc.)

Freelancers have a non-standard self-attitude and self-description, which indicates their “isolation” from the real social world by these people.

Quantitive (Spyrman’s criteria and corellations) and qualitive analisys ( semi-structured interviews). N = 300, residents of ussia and Austria.

The hypothesis was rejected that freelancers do not have career and personal orientations, in contrast to individuals who are not prone to this type of career choice. The absence of a connection between goal setting and downshifting was revealed based on the analysis of the author’s questionnaire for goal setting.

The hypothesis was empirically confirmed that freelancers have more pronounced indicators such as global self-attitude, self-esteem, self-sympathy, expected attitude from others, self-confidence, self-acceptance in the affective component of the self-concept, in contrast to people choosing the traditional career path.

Freelancers have a less pronounced indicator of self-accusation, in contrast to people committed to careerism.

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Philosophy and psychoanalysis have mutually influenced each other in many ways. Ancient Greek philosophers, Socrates and Plato were frequently cited by Freud in his works and the origins of certain psychoanalytic concepts can be found in their works. The philosophical works of Kant, Schopenhauer, Nietzsche, Heidegger, Husserl, Sartre and many others had a significant impact on the development of psychoanalytic ideas. The intersection of philosophy and literature was best depicted in Simone de Beauvoir’s concept of the metaphysical novel.

The goal of this presentation is to perform a comprehensive historical review of the relationship between psychoanalysis, philosophy and literature.

Different philosophical schools from ancient philosophy to classic German philosophy and philosophy of existentialism have been explored in their relationship with psychoanalysis and world literature. Among world literary classics, we selected only those who best represent the role of psychoanalysis in the modern literary critics and on the other hand the influence of philosophy on literature.

Early origins of the relationship between philosophy, psychoanalysis and literature can be found in the text of ancient philosophers and writers. The great Sophocles’ tragic drama Oedipus the King was the foundation for Freud’s concept of Oedipus complex. The Socratic dialogue, a technique best elaborated by his student Plato was the antecedent of modern psychotherapy. Later in history philosophical works of Kant, Schopenhauer, Nietzsche, Husserl, Heidegger, Sartre and many others had a significant impact on the development of psychoanalytic ideas. There is a number of other philosophical fictions in the world literature written by Sartre, Camus, Kafka, Proust and many others and some of these literary woks may have characteristics of psychological novel as well. Literary critics is an important field for the application of psychoanalysis. Psychoanalytic theory has been always in forefront of Shakespearean studies. Marcel Proust is a writer who gave a significant contribution to modern literary studies. He wrote about the interactive process between the reader and text and emotional impact of reading. Proust recognized the similar psychological processes that we can see in psychoanalytic setting.

This comprehensive historical review of the relationship between psychoanalysis, philosophy and literature demonstrates that all these disciplines have much in common, particularly in their intention to approach truth from different angles. Psychoanalysis is a science and applies scientific methodology in its theory and treatment. Certain branches of psychoanalysis like Jung’s analytic psychology are sometimes closer to philosophy and art than to science. Philosophy as a humanistic discipline has always been in between science and art.

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Nothing is taken more for granted than the feeling that we are in control of our own thoughts and actions. For those who experience thoughts insertion or delusion of control, known as first rank symptoms of schizophrenia, it becomes a luxury to rule their own thoughts. Kandinsky-Clerambault syndrome is characterized by pseudo-hallucinations, delusions of control, telepathy, thought broadcasting and thought insertion by an external force. The patient’s thoughts, emotions, perceptions or actions are under the control of a different agent, or sometimes he believes that the operator of control is inside his body.

Presentation of a clinical case of Kandinsky-Clerambault syndrome in a patient with treatment-resistant schizophrenia.

Case report

We present the case of a 38-year-old man, diagnosed with paranoid schizophrenia since 2014, who has followed several therapeutic plans, starting with Haloperidol followed by Risperidone, Paliperidone, Quetiapine, Clozapine. Since 2016 he had been under treatment with Xeplion injectable 150mg/month ambulatory, but the psychotic features never fully remitted. 10 days before admission he had last administration of Xeplion LAI. The patient reports the loss of control over his mental life and describes the triple automatism: ideo-verbal, sensory and motor. “There are some people in my body who control me, they move my limbs. I feel like my body is not mine.” He describes imperative and commentative auditory pseudo-hallucinations. The patient speaks intermittently in the 3rd person about himself, has circumstantial discourse, with elements of tangentiality, ideo-verbal and conceptual disorganization. He presents delusions of control, persecution and prejudice. The treatment received during admission – Riseridone 5ml/day, Amisulpride 600mg/day, Orfiril Long 1000mg/day.

After 14 days of hospitalization, the patient is discharged in an improved state, without mentioning spontaneously the delusional ideation. He affirms the intermittent presence of auditory pseudo-hallucinations, but with low intensity compared to the moment of admission. It is ironic how the loss of the self, along with the insertion of thoughts and auditory pseudo-hallucinations create a patient’s own reality, which at the same time is experienced as coming from the outside. From a phenomenological point of view, thought insertion is explained as an autoimmune disease. Thoughts are produced by our mind, but because we have lost the meaning of control and belonging to ourselves, those thoughts are attacked as foreign.

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Neuroscientific theories define the brain as a physical organ that provides the electrochemical basis for cognitive, sensory and motor functions; psychological theories define the mind as the hub of consciousness; and spiritual theories define the soul as our indivisible essence of being. We lack clarity on the mechanisms by which physiological processes in the brain give rise to mental phenomena in the mind, while the concept of the soul lacks scientific grounding. However, frameworks for understanding the brain, mind and soul have an impact on the aetiology, diagnosis, and treatment of mental illnesses, thereby shaping clinical practice.

To review the current literature explaining how psychiatrists can care for the brain, mind and soul of their patients.

Six electronic databases were searched for articles explaining how psychiatrists can care for the brain, mind and soul of their patients. Other relevant papers identified from the reference lists of included articles were also selected. A narrative literature review was undertaken due to the heterogeneity of the articles.

Twenty-six articles were included. These revealed that a psychiatrist’s approach to care is shaped by their understanding of the roles that the brain, mind and soul play in mental illness. A growing understanding of the brain’s physiological changes in mental illness has enabled the development of targeted electroconvulsive and pharmacological therapies for treatment and quantitative imaging for monitoring. Similarly, identifying and understanding cognitive-behavioural patterns associated with mental illness enables psychopathology to be directly addressed with focussed psychotherapy. Furthermore, helping patients to develop a spiritual connection with themselves, others or a higher power improves several protective factors, such as hopefulness, positive self-conceptions and social participation.

The weight a psychiatrist places on the physiological, psychological and spiritual components of mental illness inevitably influences their choice of treatments. It is important for psychiatrists to reflect on their own beliefs, and to empathise with the views of patients without imposing their own. Open dialogue with patients about their perspectives on each dimension facilitates engagement, empowerment and treatment adherence.

Distinguishing between pathophysiology of the brain, traumatic experiences of the mind, and unmet spiritual needs of the soul enables psychiatrists to accurately identify pathology and personalise care effectively. Further research into the relationships between each component would open additional avenues for understanding and caring for mental illness. As psychiatry strives to address its perceived overreliance on biological therapies, an appreciation for the distinct qualities of the brain, mind and soul has the potential to foster a more patient-centred and holistic approach to care.

None Declared

The endeavor of practitioners of psychiatry and psychoanalysis has been to break the disciplinary silos and to re-think what practice is all about. There was a person who pioneered this aim of intradisciplinary and interdisciplinary synthesis. His name was Girindrasekhar Bose. He was a psychiatrist, psychologist, and psychoanalyst who challenged the Freudian universalism of the Oedipus complex.

We have forgotten that the texts emanating from the land of India were profoundly psychological and can inform psychiatric/psychoanalytic practice. Bose’s exchange of letters with Sigmund Freud is known by many but read by only a few. He gave us a path to think about the psychiatric and psychoanalytic practice from India. The paper looks at his exchange of letters with Freud and his works on the Bhagavad Gita, Puranas, Yoga Sutras, and the Vedas, which he claimed, were immensely beneficial for psychiatric/psychoanalytic training and can help us to work through the way we perceive medical practice.

This research used primary sources like books and articles to re-think the works of Girindrasekhar Bose in terms of today’s medical practice.

Can we imagine writing in our native language and being critically acclaimed for our work internationally? His writings in Bengali suggest that he was more decolonized in the 1920s than the Indian scholars of today. Keeping in mind the existential ground of the patient, a decolonized understanding of symptoms can revolutionize medical care.

Our aim in today’s times is to inform our practice where we could possibly reach an intradisciplinary and interdisciplinary unity. A re-discovery of Bose’s work can help us in this earnest endeavor.

None Declared

Complex PTSD is a new trauma-related disorder in ICD 11 and it differs from PTSD by the trauma being repetitive or prolonged and some other symptoms, while selective anosmia is the inability to detect a particular odor.

Is there any relationship between severe trauma and selective anosmia as a novel feature?

INTERNATIONAL TRAUMA QUESTIONNAIRE (ITQ), Case report and non-systematic review through literature research in PubMed database, using the key-word “selective anosmia”

Two articles suggest that selective anosmia may present in animals when olfactory epithelium exposures to some chemical substances while the other two articles indicate that cortical nucleus in the amygdala has major olfactory connections and its degeneration is likely to contribute to the early selective anosmia common in Parkinson’s disease, but no one described this feature in psychiatric trauma.

May be this is the first time ever to describe selective anosmia during severe trauma suggesting a role of amygdala as in this case report, therefore Syria and other countries that had similar crisis need more studies to get accurate statistics, explore more rare features, and test the effectiveness of treatment options.

None Declared

Prevention of Post-traumatic stress disorder (PTSD) is a major public health interestand one of the concerns of any emergency physician.

The purpose of this study was to evaluate the efficacy and safety of a herbal supplement in preventing the occurrence of PTSD in high-risk patients.

: It is a randomized, double-blind, prospective, interventional study including patients exposed to a traumatic event meeting DSM-V Criterion A and having a Peri-traumatic Distress Inventory score and/or Peri-traumatic Dissociative Experience Questionnaire (PDEQ) and/or immediate stress score (L.Crocq score) higher than the thresholds between day 1 and day 3. A total of two hundred patients were included and they were randomly assigned into two groups: Aleozen group and placebo group. Patients included in the aleozen group received Aleozen® for 10 days while patients in the placebo group received a Placebo. A CAPS-5 assessment was performed for all patients at different moments. The main objective was to assess the efficacy of Aleozen® after day 90 of exposure to traumatic events according to PTSD. The secondary objectives were to evaluate the safety of Aleozen® at 10 and 30 days after its administration and to assess PTSD in the involved population after one year.

No statistical differences were noted between the two groups in terms of baseline characteristics, including age, sex, and ISS score. After day 90 of follow-up, and according to the CAPS-5 scale, 85 patients (42.5%) had PTSD. Concerning the primary endpoint, less PTSD was observed in the intervention group compared to the placebo group (38.8% versus 61.2%, respectively; p<0.001). No adverse events were noted during the study

The results of this study suggest the potential preventive effects of an herbal supplement on PTSD for traumatic patients in the emergency department. Further confirmatory studies are required

None Declared

Post-traumatic stress disorder is common and the risk of developing it after a trauma is high. Its global management is long and complex.

The general practitioner, as a primary care provider, has a fundamental role in detecting it. They may have to take care of these patients both physically and psychologically, and may find themselves at a loss when faced with repercussions such as Post-Traumatic Stress Disorder (PTSD).

In some countries, the role of the general practitioner is different. More involved and better trained, they are actors in the pre-hospital system in case of psychotrauma.

By means of a survey conducted among general practitioners in Morocco, we will first try to determine their place in the screening and management of psychotrauma, and then to evaluate their knowledge of EMDR therapy.

For this purpose, a questionnaire was developed and used as a basis for the study.

It included practical questions relating to the physicians’ activity, their practice in emergency consultations, their training, their management of physical and psychological trauma, and finally their knowledge of EMDR therapy,

Finally, we will attempt to propose concrete avenues for more effective, safer, and non-harmful management of psychotrauma in the basic health care system.

the general practitioner was the first professional to receive a patient who was a victim of a physical or psychological trauma (road accident, rape, physical or verbal aggression), but the degree of knowledge and training for this type of care was low among our doctors.

Training sessions should be scheduled for general practitioners in order to optimize the management and prevention of post-traumatic stress disorder.

None Declared

Contemporary for combatants with signs of adjustment disorders (AD) consists of “distorted” thoughts about the displacement of the value of one’s role, the loss of a certain significant position. This can be seen from the analysis of complaints about the feeling of anxiety, tension, asthenia, mood swings, lack of emotional regulation and the assessment of well-being criteria.

It is important to understand what is a preventer of maladjustment, and what is a predictor of the formation of psychological adaptation disturbances in combatants with a distinction based on the signs of AD and PTSD.

Based on the analysis of violations of the psycho-emotional sphere, peculiarities of perception of the social environment, understanding of one’s role in traumatic events, and personal adaptation potential, predictors and preventers of violation of psychological adaptation among combatants are determined.

The clinical investigation based on psychiatric examination with the narrative motivation interview,psychological examination by Mississippi Scale for Combat-Related Posttraumatic Stress Disorder.

The predictors of impaired psychological adaptation in combatants withAD: Low indicators of moral normativity, which structure thoughts and help in the interpretation and analysis of negative experienced events of a stressogenic level.Preventers of violation of psychological adaptation in combatants with AD:Communicative potential, which lies in the structure of personal adaptation potential. This indicator indicates the presence of a need in the social environment and opportunities for realization, that is, as a resource of the individual. The ability to receive from the social environment a sense of support, reinforcement of self-esteem, motivation for activity, determination of the goals of future projects. Predictors of impaired psychological adaptation in combatants with PTSD: Low communicative potential, which, under the significant influence of stressogenic factors, isolates from close social interaction and does not allow family members to influence the emotional state. Family support is diminished and perceived as a trigger for anger. Fixation on the intensity of emotional experiences, maintaining the tone of negative manifestations, as a form of receiving punishment. Keeping under control one’s values in the life system and an attempt to reorient oneself to the future.

Relying on preventers as the resource base of the personality of combatants and predictors as targets of psychocorrective intervention in the tasks of the medical and psychological rehabilitation program, algorithms for further psychocorrective intervention were determined.

None Declared

Race with cars is currently one of the most popular sports.

The aims of this study are establishing the profile of persons with posttraumatic stress disorder by using psychopathological dimensions – clinical scales (MMPI). Psychiatric measures (HAMD, HAMA, API) exploited to detect differences between acute and delayed type of PTSD on the level of depression, anxiety, and readiness for panic.

The research included 30 drivers: 20 have reacted with acute and 10 with delayed onset of PTSD. Diagnosis criteria were DSM-V.

The scores on subscales at MMPI personality profile for acute and delayed type of PTSD, are much higher D (T=80.15, t=3.10, p<0.05) and Hy (T=79.25, t=3.02, p<0.05), in relate to normal (T=70). There was high level of appearing the structural correlates D (t=4.22, p<0.01) and HS (t=3.43, p<0.01) in delayed PTSD in relate to acute.

There is a higher level of depression (HAMD: t=4.03, p<0.01) and of anxiety (HAMA: t=3.05, p<0.05). There is no statistical difference between acute and delayed PTSD, considering the panic. Whether running risk remains controversial.

Key words: PTSD, cars drivers, and psychological profile

None Declared

The treatment of psychological trauma is an integral part of the health care provided to military patients in Tunisia. For patients with PTSD several therapeutic options are proposed to patients as EMDR but there are various barriers to the use of EMDR . It seems that being patients consider the therapy which necessitate recognition and expression of emotional distress as a weakness. Added to that patients may be judged negatively by others and experiencing social rejection and isolation which limited the use of EMDR in a military setting.

The aim of this study is to study the contribution of the EMDR associated to pharmacological treatment in PTSD among military patients comparing to patients who received only medication .

The study was conducted since 2021 during ten months at the military hospital concerned two groups of patients with PTSD the first one composed of four military patients with PTSD who received 11 sessions of EMDR associated to medication and the second one four patients exposed to the same trauma under medication only. The evolution oftroubles were assessed using PCL-5 scale and medication compliance was assessed by psychometric scale MARS .Other data was gathered from medical files .

The first group of four military patients who were followed for PTSD since a year under pharmacological treatment presented sleep disorders with flaschbaks and nightmares , . The patients consulted for a depressive disorder and asocial isolation with feelings of insecurity about others. Psychiatrists proposed to associate 11 sessions of EMDR . At the end of sessions the evolution was interesting with regression of symptoms and remission comparing to the second group who presented relapses ten months later.

To improve symptoms of PTSD The use of EMDR is not systematic in a culture where emotional expression is restrictive in an environment that favors the intellect over the emotions. However EMDR can help the military patients with PTSD to link cognition to the emotions. PsychiatristS should propose this therapy as well as possible to patient with severe trauma to avoid relapse .

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Childbirth can be a very painful experience, especially vaginally. It can have many complications. The obstetrical complications of caesarean section are well studied but its psychological complications are little mentioned. Most women recover quickly after giving birth, but others seem to have more difficulty. Researchers have attempted to identify perinatal risk factors for the development of post-traumatic stress disorder in parturients and caesarean section seems to be one of the predictors.

The objective of our study is to detect post traumatic stress disorder in women after vaginal delivery.

This is a cross-sectional descriptive study conducted among women from the general population who have given birth vaginally. The information was collected using a questionnaire distributed on social networks. Symptom severity was quantified using the PTSD checklist for DSM-V (PCL-5).PCL-5 is a 20-item self-assessment that measures the 20 DSM-5 symptoms of PTSD. She rates each symptom from 0 (not at all) to 4 (extremely). The score varies from 0 to 80. A threshold of 33 allows screening for post-traumatic stress disorder.

61 women took part in this study, 81.5% of whom gave birth vaginally between the ages of 20 and 30.70.3% of the participants gave birth vaginally once, 44.4% twice and 7.3% of the women in our sample had a caesarean three times.Regarding the indication of the high way in our sample: the narrowing of the pelvis and fetal distress were in 22.2%. Exceeding term was in 18.5% of cases.In our sample, 59.3% of the women had planned their vaginal delivery and 40.7% had given birth urgently.Regarding the results of the PCL-5 scale (PTSD checklist for DSM-V), the score varies between 0 and 48 with a median score equal to 12. 3.7% of the participants had a score greater than 33.

Post-traumatic stress disorder can accompany childbirth, especially when it is high and in an emergency. Postpartum post traumatic stress disorder affects the mother-child relationship and can be complicated by depressive disorder. Medical monitoring of pregnancy, good medical and family support for the parturient and preparation for childbirth are necessary to better start the maternity experience.

None Declared

Nurses are at an increased risk for work-related stress resulting in post-traumatic stress disorder (PTSD). They are susceptible due to frequent exposure to traumatic situations providing care for patients.

The purpose of this systematic review is to comprehensively review the content and characteristics of intervention programs for reducing the post-traumatic stress of nurses or nursing students, providing a basis for developing a standardized protocol for programs to promote the integrated health of nurses and protect them from stress events in clinical environments.

This is a systematic review. Participants (P) targeted nurses or nursing students; Intervention (I) included intervention programs for reducing post-traumatic stress; Comparison (C) was control groups provided with usual or no interventions ; and Outcomes (O) referred to changes in physical or emotional reactions toward post-traumatic stress. Two researchers searched four databases including PubMed, CINAHL, PsycINFO, and EMBASE with keywords such as “nurse,” “post-trumatic stress disorder,” “program,” and “intervention”. A total of 7,523 studies were searched and 10 studies were included for final analysis (Image 1). The Risk of Bias2 (Image 2) and the Risk of Bias for Non-randomized Study I (Image 3) were used to evaluate the quality the included studies.

The number of studies is increasing, with four studies published before 2020, and six studies published since, of which three in 2022. Definitions of trauma situations to which nurses are exposed included diverse elements such as patient death, workplace violence, the COVID-19 pandemic, and complex trauma experiences due to working environments. Most studies have provided multiple intervention sessions, which is appropriate considering the characteristics of PTSD. Most studies examined the secondary effects on mental health such as anxiety, depression, and burnout caused by stress rather than evaluating stress itself. The quality of the study was generally highly biased. The risk of bias increased for the two randomized controlled trials in terms of measurement outcomes and outcome description. The other eight non-randomized studies all included a self-reporting questionnaire of participants, leading to a risk of bias in terms of measurement outcomes.

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Image 2:

Image 3:

Studies have been conducted to confirm the effectiveness of interventions given heightened concerns about PTSD in nurses. However, the concept of the trauma experienced by nurses was not integrally defined, and information on interventions was often limited. Efforts are required to improve the quality of research in terms of experimental study design.

None Declared

The Department of Cordoba is located in the north of Colombia and is a key territory for understanding the political violence that the country has experienced. Cordoba has suffered the armed conflict with various groups present in the area. In the category of victimizing acts, more than 30,000 victims of forced displacement have been reported and 4,621 for forced disappearance.

The objective of this study is to evaluate the prevalence of PTSD and associated factors in a population victim of violence in Cordoba, Colombia.

Design: cross-sectional, using quantitative data. Participants: victims of forced displacement in Cordoba (n=95), of whom 42.75% (n=45) were men and 57.25% (n=50) were women. The mean age of the participants was 40.7 (SD 14.1) Instruments: Clinician-Administered PTSD Scale (CAPS) (Blake et al., 1990) was administered to check clinical symptoms of the Disorder; to assess the causes of symptoms was administered The PTSD Checklist PCL-C is a short version of the PTSD Checklist – Civilian version (Weathers, 1993). Additionally, the BDI was administered to assess depression and STAI to measure anxiety. Data analysis: a Student’s t-test was used to assess the difference by gender and age groups. Descriptive statistics were also used to identify clinical characteristics of the sample.

In relation to the activation factor, it was found that the men in the sample presented significant differences compared to the women [Activation. F= (1.117) = .79; p = 0.00]. Meanwhile, PTSD was presented equally in both sexes and in all age groups with a prevalence of 26% of the sample. The most prevalent events assumed to cause the disorder were extreme human suffering and natural disaster. Depression levels were moderate in 33.3% of the population and state anxiety showed a level of 77.8% of the sample.

Our study finds that 26% of the population suffered from PTSD and in a significant percentage comorbidities were found with depression, anxiety, added to the vulnerability of those who have experienced these events, that is, revictimization, low access to social services, low schooling and poverty. It is important to consider the multifactorial nature of PTSD and its relationship with the presence of traumatic events (Bados, 2015; Kessler et al., 2014). In Colombia there is a challenge related to the intervention of this population, which constitutes future lines in our research.

None Declared

Post-traumatic stress disorder (PTSD) is characterized by intense, unpleasant, and dysfunctional reactions that appear after an overwhelming traumatic event. A life-threatening or serious injury event can cause lasting and intense suffering.

Hospitalization without consent, the use of isolation techniques, restraint or the obligation to take treatment are situations that can be perceived as traumatic.

Our goal is: The search for the existence of psycho-pathological links and vulnerabilities between the state of post-traumatic stress and physical restraint. Consideration of the traumatic event in the development of appropriate care strategies.

Our goal is:The search for the existence of psycho-pathological links and vulnerabilities between the state of post-traumatic stress and physical restraint.Consideration of the traumatic event in the development of appropriate care strategies.

To meet this objective, we carried out a descriptive study which identified 200 cases collected in the psychiatric emergency department of the Arrazi Hospital in Salé from 2017 to 2021. An exploitation sheet was drawn up and the study was carried out using Meta-chart and Visuel-chart software.

At the end of this work we found: The average age is 35 years +/- the sex ratio is equal to 1.42. 80% are single while 10% are divorced. Regarding professional activity, 70% are unemployed. 10% of patients have a level of education above the baccalaureate.

As for the history, 60% of the cases studied have a personal psycho-addictive history. 34.6% of the cases studied have a medical-surgical history.

The psychiatric pathologies that were found are: 10% suffer from depressive disorder, 80% have psychosis, 10% have attempted suicide.

During an acute episode, patients may be exposed to coercive treatments. Hospitalization without consent, the use of isolation techniques, restraint or the obligation to take treatment are all factors that can be perceived as traumatic. For example, patients recently exposed to a first psychotic episode confirmed the traumatic character of the psychotic episode itself, of the treatment or of both.

None Declared

On 11 October, 2020, a post-traumatic psychological rehabilitation (PPR) department was formed in the Armed Forces owing to the last Nagorno-Karabakh war on 27 September 2020. Initially, it was located in one of the military training centers, and a day after the end of the war, on November 10, it was moved to the “Mountain Armenia” rest house in Dilijan to ensure the continuous process of rehabilitation of wounded servicemen. In addition to the qualified professional help, the favorable climatic, high-quality social-living conditions were added, which, in terms of treatment, contributes more to the transformation of the psycho-traumatic memory of the combat situation and conditions.

The objective was to sort military personnel who suffered as a result of hostilities, psychological, post-stress, mental illnesses that have not yet been diagnosed, inpatient treatment, and psychological support.

The composition of patients treated in the PPR center by category.

Compulsory military service, officers and NCOs, contract servicemen, conscripted by mobilization.

All the patients admitted with acute stress reactions or PTSD also had the following conditions:

• - Mine debris (after processing),

• - Gunshot wound /after treatment/,

• - Closed Head Injury,

• - Witnessed the death of a comrade-in-arms or close brother or father or childhood friend,

• - Provided assistance to a wounded or mutilated corpse,

• - They were under siege, in captivity.

The following therapeutic methods were used in the Center.

Pharmacotherapy

• - Antidepressants, tranquilizers, herbal preparations, nootropics, atypical neuroleptics, symptomatic medication.

Group and individual psychotherapy and psychodiagnostics

• - CBT/REBT, EMDR, Biofeedback, Art Therapy, Music Therapy, Sport Activity etc.

From 11 October, 2020 to 24 December, 2021, more than 700 military personnel received inpatient treatment in the post-traumatic rehabilitation unit, the vast majority of whom were discharged from the unit with improvement to continue their service.

In the post-war period, the number of suicides and suicidal attempts has noticeably increased in society. None of the military personnel who received treatment through the specialized activities of the PPR Center and returned to further military service committed suicide or attempted suicide over the entire subsequent service.

“The Mountain Armenia” Psychological Rehabilitation Center was carried out its work by support of the Franco-Swiss international organization «Santé Arménie», which conducted international professional supervision for a year and financed the work of psychologists working part-time at the Center. We would like to express our deepest gratitude to the «Santé Arménie» which support was invaluable.

None Declared

Post-traumatic stress disorder (PTSD) is defined by an exaggerated fear responses (FA) which fails to extinguish over time and cannot be inhibited in safe contexts. Studies report that traumatic experiences (TE) affect hormonal systems mediated by the hypothalamic-pituitary-adrenal (HPA) axis and the oxytocinergic system. Oxytocin (OXT) is a neurohormone produced in the hypothalamus that has social functions like the promotion of prosocial and affiliative behaviors, increased self-confidence and positive social memories. In PTSD there is a diminished inhibitory top-down control over the FA, which is characterized by amygdala hyperactivity, ventromedial prefrontal cortex (vmPFC) hypoactivity and diminished structural and functional connectivity between both areas, which results in anxiety increase and dysregulated autonomic and endocrine FA. In parallel, TE decrease the synthesis and release of OXT, resulting in the dysfunction of the negative feedback mechanism on the HPA, leading to hypercortisolemia and maximizing the response to a stressful stimulus. Previous studies report that the administration of OXT can reduce cortisol levels as well as attenuating amygdala hyperactivity and normalizing the connectivity of this structure with frontal areas, diminishing the FA. Therefore, OXT has been investigated as a potential therapeutic agent administered intranasally early after trauma as a strategy to prevent PTDS on individuals having high risk.

The aim of this work is to review the potential of intranasal OXT administration as early preventive intervention for PTSD.

Systematic review of the literature published in Pubmed, using the terms “Oxytocin”, “Post-traumatic Stress Disorder”, “Stress”.

Studies found significant associations between TE and OXT and report that TE and PTSD are strongly associated with reductions in OXT. Literature report that the acute effects of OXT administrations in individuals with TE tend to be anxiolytic only in less severe forms, by modulating the HPA axis and the autonomic nervous system. Moreover, in recent TE, OXT seems to increase the re-experience of traumas and restore the function of different networks associated with fear control in PTSD patients. FMRI studies indicate that intranasal OXT attenuates amygdala hyperactivity and enhances amygdala´s connectivity with vmPFC, resulting in increased control over the FA. Finally, studies report that a single oxytocin administration increases neuronal fear processing but repeated administration reduces PTSD symptoms up to 6 months post trauma in patients with high acute symptoms.

Repeated administration of intranasal oxytocin early after trauma seems to diminish the acute symptoms in early stages of PTDS, being a potential pharmacological strategy to prevent PTDS in individuals at high risk by increasing the control of FA.

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Adult survivors of childhood sexual abuse (CSA) may experience psychological difficulties in adulthood. Such adverse experiences in the developmental years, sometimes for prolonged periods, could have an impact on their emotional, social and psychological resources. This impact is heightened in CSA adult survivors as the interpersonal nature of harm could reverberate throughout their adult relationships, with complex emotional responses to traumatic stressors. Despite the demonstrated effectiveness of trauma focused treatments in the West, culturally specific understanding of the needs and treatments for such survivors in South Asia is still in its infancy. This is important to address their meaning of presenting complaints in South Asia and offering them treatments suitable for them.

In this systematic review, we aimed to synthesize the findings of existing research on the impact of CSA on adult survivors in South Asia and the current approaches used to treat them.

We searched nine databases and ‘hand searched’ important peer-reviewed journals published in South Asian countries from inception until 3rd April 2022. Searches focused on adult survivors of CSA of South Asian origin residing in South Asia, different treatments offered and the efficacy and acceptability of these treatments.

We identified and screened 2608 records and included 56 articles in our full text screening. Out of those, we included 22 articles in the final review. Studies were from four out of the eight countries in South Asia; India, Sri Lanka, Nepal and Pakistan. Of note, only six of those studies focused exclusively on CSA whereas others included all forms of abuse and neglect. All except one article explored experiences of survivors. Only one article focused on their recovery process, within and/or outside of professional treatment with no published research on treatments for them in South Asia. Physical abuse and emotional abuse or neglect were more often reported in our included studies as compared to sexual abuse.

Our review suggests that even though the needs of adult CSA survivors in South Asia have been partly identified, there is very little research into the treatment of CSA adult survivors in this region. Perpetrators often come from their immediate or extended families, leading to their distrust of the familial and legal systems. Even when not diagnosed with a severe mental health condition, there are potentially serious implications for victims’ adult relationships and social functioning. There is a current lack of research and therefore, lack of evidence-based treatment for adult survivors of CSA in South Asia.

None Declared