The interface between dermatology and psychiatry is complex and of clinical importance. Skin disorders in psychiatric inpatients are common, serious and under diagnosed.

The aim of our study was to assess the prevalence and profile of several skin diseases observed in psychiatric inpatients.

We conducted a cross-sectional study in the period from october,13 2023 to october,20 2023, among psychiatric male inpatients, hospitalized in psychiatry B department of the Hedi Chaker University Hospital (Sfax, Tunisia). We collected sociodemographic and clinical data using a pre-established form.

Over a period of a week, 35 patients were included in our study. The mean age of patients was 39,97 years. Among them, 80% were single and 14,3% were married. Addictive behaviors were reported in 74,3% of cases. The level of hygiene was good in 74,3% of patients. The three most common psychiatric diagnoses were schizophrenia (31,4%), followed by bipolar disorder (28,6%) and schizoaffective disorder (25,7%). We recorded 13 cases of skin diseases (37,2% of patients). Dermatological lesions were dominated by traumatic origin in 14,3% of cases. They were of infectious origin in 11,4% of cases, immunoallergic in 8,6% and parasitic in 2.9%.

The prevalence of skin diseases is high in psychiatric inpatients, for whom proper skin care is necessary to improve their quality of life.

None Declared

Osteoporosis (OP) prevalence is on the rise as a result of an ageing population and lifestyle factors such as inactivity. Previous research has reported OP in individuals with depressive symptoms. Furthermore, OP has been shown to be a risk factor for anxiety.

In this study, we aimed to describe anxiety and depression symptoms among osteoporotic women in a university hospital in Tunisia.

A cross-sectional study was conducted between January and June 2023 in a university hospital in Tunisia. Women with postmenopausal OP in the rheumatology department were interviewed. A hospital anxiety and depressive scale was used to describe anxiety and depression symptoms among patients. It consists of seven items for depression (HADS-D) and seven items for anxiety (HADS-A). For each component a score ≤ 7 indicated the absence of symptomatology.

Seventy-two women diagnosed with post-menopausal OP participated in the study. The mean age was 72.5 (±1.08). The median duration of menopause was 23 years (IIQ= [10.5-28.5]). All patients were receiving bisphosphonates. Fifty-eight women (80.5%) were identified with depressive symptoms. The median depression score was 17.5 (IIQ= [9-19]). Physical activity was significantly and inversely associated with the presence of depressive symptoms (r= -6.36; p=10-3). Those who were overweight or even obese had significantly more depressive symptoms than those who were not overweight (94%, 57%, p= 0.001).

The median score of anxiety was 16 (IIQ= [9-17]). Sixty-three patients (87.5%) were identified with anxiety symptoms. Physical activity was significantly and inversely associated with the presence of anxiety symptoms (r= -4.89; p=10-3). Women who had bone fractures were significantly more anxious than those without a history of bone fractures (100%, 63%, p<10-3). Patients who were overweight were significantly more anxious than those with normal weight (96%, 57%, p<10-3).

Physical activity and obesity were associated with depression and anxiety among osteoporotic patients. These data are consistent with previous findings That’s why, promoting physical activity and weight loss is essential to preventing mental disorders among osteoporotic women.

None Declared

Ankylosing spondylitis (AS) is the second most common rheumatic disease after rheumatoid arthritis. The significant functional impact of this chronic disease can affect patients’ mental health.

The aim of this study was to determine the prevalence of anxiety in subjects with AS in Southern-Tunisia and to identify its associated factors.

It was a retrospective study conducted in 2021 over a period of 5 years on patients with AS consulting the rheumatology department at the Hedi Chaker University Hospital in SFAX, Southern-Tunisia. The “Anxiety and Depression scale” was used to screen for anxiety. A score ≥11 defined confirmed anxiety symptoms.

Of the 62 patients, 35 were male (56.5%), giving a male to female ratio of 1.3. Twenty-seven patients (43.5%) were aged between 35 and 50 years. The level of education was primary in 19 cases (30.6%) and university in 15 cases (24.2%). A family history of chronic disease was present in 32 cases (51.6%). Severe fatigue was noted among 27 patients (43.5%). Quality of life was poor in 39 patients (62.9%). The mean anxiety score was 11.35±4.6. Thirty-four subjects (54.8%) had confirmed anxiety symptoms and 19 (30.5%) had borderline symptoms. Confirmed anxiety was significantly associated with the educational level (p=0.03) (illiterate: 87.5%, primary: 68.4%, secondary: 35% and university: 46.7%). Similarly, having a family history of chronic disease (OR=3.3; p=0.02), suffering from severe fatigue (OR=36, p<0.01), having associated depression (HAD score≥11) (OR=19.5; p<0.001) and having poor quality of life [Ankylosing spondylitis quality of life questionnaire (Asqol) Score ≥13] (OR=15.8; p<0.001) were statistically associated with higher prevalence of confirmed anxiety symptoms.

It was found that patients treated for AS frequently suffer from psychological co-morbidities, particularly anxiety, which can lead to a further deterioration in their quality of life and even their withdrawal from active life. Thus, anxiety should not be ignored when treating these patients.

None Declared

The prevalence of psychosis in patients with epilepsy is estimated approximately 7.8%. However, postictal psychosis appears to be much less common, with a prevalence of 2% in epilepsy. Postictal psychosis is defined as psychotic episodes starting within less than one week after an epileptic seizure.

Our aim was to study the clinical characteristics and the therapeutic options through a case report and a review of the literature.

Case report and unsystematic literature review were obtained by searching the Pubmed.gov database. Thirty-six articles were identified through searches of this database and thirty-five articles were included in the selection of in-text articles integral

A 32-year-old men patient, without a personal or family history of psychiatric illness, was admitted to a psychiatric unit for a psychotic episode which has started three days before, mystical delusions, irritability, disorganized behavior, and aggressiveness, that had emerged shortly after a cluster of generalized tonic-clonic GTC seizures. Additionally, divided attention and memory deficits were noticed during psychiatric hospitalization.

Past medical history was relevant for epilepsy since he was 20 years olds. He did not regularly attend follow-up neurology appointments and had poor adherence to antiepileptic treatment. Last tomography images, a day before the hospitalization in psychiatry, had documented hypodense lesions in the periventricular white matter and subcortical semi-oval center distributed bilaterally and symmetrically suggestive of leukopathy. During the hospitalization, biochemical screening, renal and thyroid function were normal, serologies for B and C hepatitis were negative.

Psychotic symptoms subsided in the first 36 hours after admission upon treatment with Risperidone 4 mg/day, carbamazepine 600 mg/day, and 15O mg phenobarbital.

From our research, we can deduce that although these syndromes are widely recognized, standard diagnostic manuals fail to acknowledge them, resulting in a noticeable lack of attention in the literature. Therefore, it is crucial for physicians to carefully examine patients with known risk factors for the symptoms of postictal psychosis.

None Declared

While postictal mania is a well-recognized clinical condition, it has received less research attention compared to other postictal manifestations.

Drawing upon an analysis of a case report that underscores the clinical and therapeutic challenges associated with comorbid epilepsy and mania, a literature review was carried out to investigate the connection between these two disorders.

We illustrate a case of comorbidity between mania and epilepsy and provide a concise review of the literature summarizing the key characteristics of this association.

This case pertains to Mr. M, a 44-year-old male with a history of frontal epilepsy characterized by secondary partial generalization, which was partially controlled with sodium valproate. He was admitted to our service due to acute agitation following a loss of consciousness lasting a few minutes.

Upon admission, the patient exhibited symptoms of mental confusion. A neurological examination did not uncover any abnormalities. Brain computed tomography revealed mild frontal atrophy. Video electroencephalography conducted during the interictal period and outside the episodes of confusion did not reveal any abnormalities. The patient was restarted on sodium valproate (20 mg/kg/day) and clonazepam (2 mg/day). Following a lucid interval of ten days, the patient started to manifest psychiatric symptoms, which included irritability, hostility towards his spouse, increased talkativeness, thought pressure, and an unusual sense of familiarity, raising suspicion of post-ictal mania.

Based on this clinical case and the existing scientific literature, post-ictal mania occupies a distinct position among the mental disorders observed in the post-ictal period. Therefore, clinicians must be aware of these conditions to facilitate accurate diagnosis and appropriate management.

None Declared

G6PD is essential for the production of NADPH, which is a cofactor for many enzymes involved in antioxidant defense and neurotransmitter synthesis. A deficiency in this enzyme could lead to increased oxidative stress, impaired neurotransmitter and immune function. The latter have been implicated in the pathophysiology of schizophrenia.

The present case is presented to underscore the infrequent and uncharacteristic manifestation of this condition, in the context of clinical symptoms and the trajectory of evolution of schizophrenia when associated with G6PD Deficiency. Moreover, it sheds light on the challenges clinicians encounter in the management of such cases.

A case report of a patient who was admitted to the Psychiatry Department (“Ibn Omrane”) of Razi Hospital”.

Mr. M.T is a 26 year-old unmarried man. He comes from a non-consanguineous marriage and has an educational level of a bachelor’s degree plus three additional years of study. He has a significant family medical history. His maternal uncle is under treatment for a chronic psychotic disorder. He has a personal history of G6PD deficiency and no specific habits to note. At the age of 24, he insidiously developed anxiety with incoherent statements of persecution accompanied by behavioral manifestations leading to mistrust and social isolation. He discontinued his studies for a year and began verbalizing suicidal thoughts accompanied by self-harm behaviors.

The family sought help from a psychiatrist who prescribed 5 mg of olanzapine, which was covertly administered to the patient.

At the age of 28, after a suicide attempt, he was involuntarily admitted to Razi Hospital. The clinical presentation was dominated by disorganization, with a partial response to treatment.

More research is needed to confirm the association between G6PD deficiency and schizophrenia and to determine the underlying mechanisms. Larger studies with well-defined populations and methodologies are needed. It is also important to study the interaction between G6PD deficiency and other genetic and environmental factors that contribute to schizophrenia.

None Declared

Kambó is considered an “ancestral medicine” by the indigenous tribes of the western region of the Amazon.

Through this clinical case, the aim is to present the particularities of the symptoms and management of patients with consumption of not so common substances, such as Kambo or salvia divinorum, as well as the evolution that will occur in a patient with a previous diagnosis of a Depressive Episode.

We present the case of a 23-year-old male, Gestalt therapy student. History of tobacco, THC, and recent use of salvia divinorum and Kambo. He began follow-up by psychiatry in a private setting three years ago due to a severe depressive episode, having required treatment with antidepressants, antipsychotics and benzodiazepines, and having been triggered by a serious assault. The episode is resolved and follow-up is discontinued. Family history of depressive syndrome and suicide.

He resumed contact through the Emergency Department, requiring hospital admission due to symptoms compatible with a manic episode with psychotic symptoms. It begins with behavioral alterations and global insomnia that are related to the consumption of some substance, initially unknown to them, making the skin lesions they presented suspect the consumption of kambo.

We assess the risk of consuming these substances, which are sometimes used as alternative therapies, and especially in this type of patient, who is more vulnerable and perhaps seeks a way out of the problems they present.

In our case, it triggered a manic episode with psychotic symptoms, which consisted of delusional ideation of mystical content accompanied by auditory hallucinations. The episode took about a month to subside, despite treatment. Subsequently, there have been more episodes with similar characteristics, and they have not been associated with the consumption of kambó, but have been linked to the consumption of “natural medicinal substances.”

None Declared

Several neurologic conditions can produce or mimic psychotic symptoms. It is important to make an exhaustive differential diagnosis between a psychiatric manifestation of an underlying neurological condition and a primary psychiatric one. We explore through the present clinical case of a young woman admitted to neurology the relationship between intracranial hypertension and a case of atypical psychosis that resolved itself with the treatment of the intracranial hypertension, without the need for antipsychotic medication.

To explore through the presented clinical case and the concerning literature the concept and management of psychotic-like symptoms in patients with intracranial hypertension.

We present a clinical case and a review of the existing literature concerning atypical psychosis or psychosis-like symptoms in cases of intracranial hypertension.

We report the case of a 24 year old woman with no relevant medical history hospitalised in the neurology unit due to suspected encephalitis. Native to New Zealand, she is brought from the airport due to behavioural alterations. During the last few days before admission she had presented with incoherent speech, derailment, religious and persecutory delusions, and erotomania towards her cousin. She described feelings of strangeness with her surroundings and of time moving at a different speed than usual, either faster or slower. She also had a headache and visual alterations, as well as memory errors concerning recent events, clouding of consciousness and inattention.

No fever or other relevant physical symptoms. A lumbar puncture is done, which shows an opening pressure of 37mmHg but no other anomalies. Body CT scan shows no relevant findings. Empirical treatment with dexamethasone is initiated for suspected encephalitis, progressively reducing the dosage until suspension in the following days. During her stay at the hospital she is assessed by ophthalmology, which finds no abnormalities in the eye fundus examination, and psychiatry. A second evacuating lumbar punture is done to reduce intracraneal hypertension. No antipsychotic treatment is initiated: the symptomatology remitted with the lowering of intracranial pressure. At time of discharge, the patient remained asymptomatic without treatment and was able to return home to continue outpatient neurologic study of the etiology of the intracranial hypertension.

Finally, we conduct a review ot the existing literature concerning psychotic and psychosis-like symptoms in patients with intracranial hypertension, to explore the diagnostic and management options of this rare finding.

Our findings point to the existing relationship between intracranial hypertension and psychosis-like symptoms. Further studies on pathogenic mechanisms and therapeutic management are required.

None Declared

Liver cirrhosis, a chronic liver disease, can be closely linked to chronic alcohol abuse, posing a significant medical challenge. Hepatic encephalopathy (HE), a neuropsychiatric condition resulting from liver dysfunction, commonly occurs in cirrhotic patients due to the accumulation of neurotoxic substances like ammonia and manganese in the body. Managing cirrhosis and alcohol addiction is crucial to enhancing the quality of life for these patients, as HE can manifest in various ways and with varying degrees of severity.

To emphasize the importance of recognizing and treating hepatic encephalopathy as a potential complication of liver cirrhosis and sedatives during alcohol withdrawal.

We compiled clinical data, medical history, neuroimaging tests, and therapeutic interventions applied.

A 55-year-old man with a complex medical history, including Child-Pugh B liver cirrhosis, portal hypertension, hypertension, diabetes mellitus, and chronic alcohol abuse with numerous prior hospitalizations for acute pancreatitis and severe head trauma related to alcohol consumption, presented to the emergency department with symptoms of alcohol withdrawal and suicidal thoughts, leading to lorazepam administration and a recommendation for admission to a specialized Therapeutic Community. After 72 hours, he developed hepatic encephalopathy with symptoms such as confusion, sleep disturbance, sweet-smelling breath, abnormal hand movements, conjunctival icterus, and urinary difficulties.

An EEG revealed a globally attenuated and disorganized bioelectrical activity with triphasic waves. The magnetic resonance imaging showed signs of hepato-cerebral degeneration, including T1-weighted hyperintensity in the lentiform and mesencephalic nuclei due to manganese deposition. Treatment was adjusted to reduce sedative use, and therapy with Rifaximin and Lactulose was initiated to control blood ammonia levels. After a week, the patient exhibited significant neurological improvement, underscoring the importance of appropriate management in patients with hepatic encephalopathy related to liver cirrhosis and chronic alcohol abuse.

This case underscores the complexity of HE in patients with liver cirrhosis and alcohol dependence. HE can present in various ways, from subtle symptoms to severe episodes of confusion and coma. Findings on EEG, such as triphasic waves, are characteristic of HE and reflect brain dysfunction. Furthermore, manganese accumulation in the brain, as evidenced by magnetic resonance imaging, may contribute to neurological symptoms in cirrhotic patients. In this context, the early recognition and multidisciplinary treatment are emphasized to improve the quality of life and prevent the progression of this neuropsychiatric complication. EEG and magnetic resonance imaging findings play an essential role in the evaluation of these patients.

None Declared

The Acute Organic Change of Character (AOCC) is an organic mental disorder subtype in which perception, thought, mood and personality impairment predominate. It consists in a change in the individual’s general behaviour or attitude, which is shown to be closely associated with or caused by an underlying organic process, and which is rapidly resolved when the organic noxious agent is eliminated (Pintor et al. Journal of Psychiatry and Psychiatric Disorders 4 (2020): 354-358).

To describe the importance of taking AOCC diagnosis into consideration and the role of liaison psychiatrists in AOCC management by presenting two AOCC cases admitted to the Hospital Clinic of Barcelona.

We retrospectively reviewed two AOCC cases in patients followed by our hospital’s liaison psychiatry unit during the summer of 2023. We also searched for previous case reports of AOCC using a PubMed query.

Case 1: A 50-year-old male who suffered a polytrauma with diffuse axonal injury (DAI). His relatives and the referring medical team observed a change in his behaviour consisting in irritability, suspicion, hostility and impatience. No cognitive impairment nor fluctuation in the described symptoms were observed. At the time of discharge character changes were still present due to DAI slow and unpredictable clinical course. Symptomatic treatment with risperidone 6mg/day and quetiapine 100mg/day was administered achieving a satisfactory clinical response.

Case 2: A 47-year-old woman with type 2 diabetes who suffered an infectious cellulitis that spread causing sepsis. The patient began to appear disruptive with verbose and tangential speech during her admission. No cognitive impairment nor fluctuation in the described symptoms were observed. Symptomatic treatment with risperidone 10mg/day and olanzapine 5mg/day was administered achieving a satisfactory clinical response. At the time of discharge character changes described before were almost resolved.

The clinical presentation of both cases suggested organic mental disorders in which a change in general behaviour predominates. Liaison psychiatrists play a key role in AOCC management by recognizing the clinical pattern, helping if needed with psychopharmacological treatment and ensuring a good understanding of the disorder both by the referring medical team and the patient’s relatives. To our knowledge, it would be of great importance to achieve a better understanding of this clinical condition which to date we consider to be underdiagnosed.

None Declared

The spectrum of neuropsychiatric adverse effects of corticosteroids ranges from unspecific symptoms to structured psychotic or affective episodes. We present the case of a 30-year-old woman admitted to our hospital due to behavioral alterations, coinciding with the initiation of treatment with corticosteroid boluses as part of a chemotherapy regimen for gastric adenocarcinoma. She had a previous diagnose of Addison’s disease, undergoing treatment with supplemental corticosteroids.

1. 1) To describe the clinical particularities of this case, focusing on the psychopathological aspects and their correlation with the corticoid treatment.

2. 2) To review the available literature regarding the clinical characteristics and management of corticosteroid-induced psychosis, with special interest in patients with adrenal insufficiency that require long term steroid supplementation.

A review of the patient’s clinical history and complementary tests were carried out. Likewise, we reviewed the available literature in relation to the clinical presentation of corticosteroid-induced psychosis and its pharmacological management.

The patient was admitted to our hospital due to acute behavioural alterations, which temporally coincided with the 4th cycle of FOLFOX chemotherapy and corticosteroid boluses. She presented with incoherent speech, with non sequitur answers and glossolalia, as well as dysphoric affect and purposeless behavior. She presented a favorable clinical course after the initiation of treatment with antipsychotics and temporary suspension of corticosteroid treatment.

Manic symptoms are the most common presentation of “corticosteroid-induced psychosis”, with the key characteristic being the temporal association with the corticosteroids administration. Although the discontinuation of steroids generally results in a sudden decrease in symptoms, additional treatment with antipsychotics such as haloperidol or olanzapine might be required for a symptomatic control. In patients with adrenal insufficiency, long-term treatment with lithium or anti-seizure treatments are effective strategies in relapse prevention when a higer steroid dose is required.

• - Corticosteroid-induced psychosis is a well described clinical phenomenon, that usually presents with manic symptoms rather than psychotic experiences.

• - Progressive discontinuation of corticosteroid treatment usually results in complete cessation of symptoms, but additional psychopharmacological treatment might be required, especially in patients with adrenal insufficiency undergoing long-term corticosteroid treatment.

• - This case outlines the psychopathological richness in the presentation of corticosteroid-induced psychosis, and illustrates the challenges in the pharmacological management in patients with adrenal insufficiency.

None Declared

Isotretinoin is an effective treatment for acne vulgaris; however, many patients experience anxiety while deciding to get it. Isotretinoin, indeed, has significant adverse effects. On the other hand, effective treatment of acne vulgaris may reduce dermatological and psychiatric complications.

The present study aims to develop and validate the Isotretionin Hesitancy Scale to measure the patients’ drawbacks to the treatment.

The specialists, including dermatologists and mental health professionals, determined an item pool of 30 items. Before the data collection, all items were checked by the researchers in terms of clarity and acceptability. Thus, the eight items were removed from the questionnaire due to having similar meanings, measuring the facts about treatments that are not the study’s objective, and containing unclear statements. The final version of the questionnaire, which consists of 22 items, was applied to the participants.

One hundred patients with acne vulgaris were recruited. Among the participants, 72% were women, and the mean age was 22.72. Most patients’ acne severity was group 2 (40%) and group 3 (36%). Three items were removed because of having low item-total score correlations. Five items were removed in factor analysis because of low factor loading or cross-loading. Exploratory factor analysis results of the scale are presented in Table 1.Table 1.

Exploratory Factor Analysis Results of the Scale

The Cronbach alpha score of the final form of the scale was found to be .81, the internal consistency of the first factor (hesitancy related to reversible adverse effects) was calculated as .79, the second factor (hesitancy related to irreversible adverse effects) was calculated as .78, and the final factor (isotretinoin-related anxiety) was found to be .72.

The Isotretionin Hesitancy Scale is valid and reliable among patients with acne vulgaris.

None Declared

Patients undergoing bariatric surgery often present with impulsive behavior and symptoms of anxiety. In this context, brief psychotherapeutic interventions such as nutritional education, cognitive restructuring, and behavioral activation have been shown to enhance pre-surgery weight loss and improve the likelihood of successful surgical outcomes. Furthermore, anorexigenic pharmacological treatments involving fluoxetine, bupropion, naltrexone, eslicarbazepine, zonisamide, and topiramate have been associated with increased success rates of the bariatric intervention.

To assess the impact of brief psychotherapeutic interventions and psychopharmacological treatments on the success of bariatric surgery in anxious-impulsive patients, investigating the effectiveness of combined strategies in enhancing preoperative weight loss and surgical outcomes.

Within the framework of a third-level hospital’s Bariatric Surgery Protocol, a total of 63 obese patients were assessed using the MINI International Neuropsychiatric Interview (MINI), Hamilton Anxiety Rating Scale (HARS), and Barratt Impulsiveness Scale (BIS-11) during the pre-surgical evaluation. Patients with Axis I pathologies were excluded, leaving a sample of 56 participants (38 females; BMI: 43.58±8.72 kg/m2; age: 48.5±9.7 years). Individuals displaying mild anxiety (6-14 points on HARS) and moderate/severe anxiety (>14 points on HARS) and/or those with a BIS-11 score exceeding 32.5 were selected for combined psychotherapeutic and psychopharmacological interventions.

Categorized by anxiety and impulsiveness levels, the patient distribution was as follows:

Mild anxiety without impulsiveness: 19 patients

Mild anxiety with impulsiveness: 31 patients

Moderate/severe anxiety without impulsiveness: 2 patients

Moderate/severe anxiety with impulsiveness: 15 patients

This pilot study explores the potential synergy between brief psychotherapeutic interventions and psychopharmacological approaches in enhancing the outcomes of bariatric surgery for patients within the anxious-impulsive spectrum.

The results shed light on the feasibility and potential benefits of a combined treatment strategy, contributing to the optimization of bariatric surgery success in this specific patient population. Further research is warranted to confirm and generalize these findings.

None Declared

Over the last two decades, a growing volume of research has discovered a correlation between severe mental disorders (SMD) and early mortality. This is attributed to the elevated incidence of chronic physical illnesses s and multimorbidity, resulting in a reduction of life expectancy by 10-20 years. Individuals with SMD exhibit lower rates of prevention, diagnosis, and treatment for medical comorbidities when contrasted with the general population (GP).

The objective is to assess the prevalence of CPM and its impact on psychiatric treatment outcomes in individuals with SMD, and to propose preventive interventions to enhance physical health.

This nested cross-sectional study enrolled 343 SSD patients and 620 GEP.

Individuals diagnosed with SMD encounter CPM earlier in life compared to the GP. Notably, individuals under 35 years old within the schizophrenia spectrum disorder have almost three times higher odds for experiencing CPM compared to their GP counterparts, a difference that is both clinically and theoretically significant. This disparity is especially pronounced among younger women, with the gap widening the younger the patient is in comparison to peers in the general population. CPM has been identified as a factor affecting the outcomes of psychiatric treatment.

The treatment approach for SMD should be tailored to accommodate the diverse physical multimorbidity patterns of patients. It’s imperative for future research to delve into how CPM impacts the outcomes of SMD treatments. There’s a pressing need for detailed treatment guidelines addressing CPM in patients with SMD.

None Declared

he present study investigates irritable bowel syndrome in mental health professionals and the characteristics of psychosocial factors that affect this.

The present study selected an irritable bowel syndrome group among 291 mental health professionals based on the Rome III criteria, and investigated demographic variables. The Hospital Anxiety Depression Scale (HADS), Psychosocial Well-being Index (PWI), and Korean Occupational Stress Scale (KOSS) were used to evaluate psychosocial factors. An independent t-test and chi-square test were used to determine differences between the groups, and a logistic regression analysis was used to determine the odds ratio (OR) of IBS based on occupational stress. SPSS 21.0 (IBM Statistical Package for the Social Sciences 21.0) was utilized for all statistics.

Differences in demographic variables based on IBS group were not statistically significant. Depressive symptoms (t = -4.767, p<0.001) and anxiety (t = -4.068, p<0.001) were higher in the IBS group, and psychosocial well-being was lower (t = 2.288, p<0.05). The OR of IBS based on depressive symptoms was 5.737 (95% CI = 2.24–14.69). There were significant differences in occupational stress based on IBS within the subordinate domains of physical environment (t = -3.160, p<0.01), job demand (t = -3.273, p<0.01), interpersonal conflict (t = -2.295, p<0.05), job security (t = -3.005, p<0.01), and lack of reward (t = -2.046, p<0.05). The OR of IBS based on the subordinate domains of occupational stress was 3.708 (95% CI = 1.20-11.41) in physical environment, and 3.759 (95% CI = 1.33-10.56) in job demand.

The results of the present study verify that psychosocial factors in mental health professionals have a close correlation with IBS. Accordingly, improvements in both IBS symptoms and quality of life should occur through proactive intervention in these variables.

None Declared

Exercise and other lifestyles are key treatment strategies to improve diabetes outcome, prevent cardiovascular risk and may also result in further results in quality if life and emotional symptoms.

To evaluate the effectiveness of an exercise intervention program for people with diabetes or cardiovascular risk.

To evaluate the influence of previous metal health and quality of life status in the results.

61 people with a type 2 diabetes or cardiovascular risk factors were recruited from health primary health centers in Ponferrada (EL Bierzo), including patients from the mental health association. After informed consent they were included in a 20 week, twice a week supervised walking training program to improve exercise and other lifestyles. A poster used for advertisement of the adtivity (“the way/walk to change diabetes”) is displayed in image 1). Baseline and after 20 weeks BMI and Waist perimeter were assessed, quality of life was evaluated with EQ-5D-5L and WHO-5 scales and the weekly steps walked were recorded previously and after the intervention with the subject usual mobile device.

Differences in the variables were compared with Paired Ts and repeated ANCOVAs measures adjusted by gender, age and initial steps.

46 subjects (75.4%) completed more than 90% of the sessions and 3 more 70-90%. The 19.7% that did not complete had worse scores in SF-12 Role Physical (t 2.261, p=0.041) and Role Emotional (t:2.048, p=0.045) and Mental Component Summary (t:2,313; p=0,036) and WHO5 Total Score (t:2.101; p=0,040) at Baseline. Main reasons for dropout (Image 2) were health related problems (50%) and adherence to exercise and motivation problems (31.25%).

Those who completed the training improve number of weekly steps (baseline: 42022,92 +- 18836,35, final: 66448.06 +-28914,58; t:5.038; p<0.001), BMI (29.45 +-4.66 to 28.25 +-4.09 kg/m2; t:5.629; p<0.001), waist (from 107,34 + 9.98 to 102,88 +9,79 cm; t:6,840; p<0.001) and the EoQ-5D-EL VAS (form 72.88 to 82.42; t:6.122; p<0.001, image 3). The increase in the steps correlated directly with the improvement in the EoQ VAS (r:0.308; p=0.033).

Image:

Image 2:

Image 3:

Exercise and lifestyle supervised intervention programs appear to be useful to improve physical health, wellbeing, emotional symptoms and quality of life in people with diabetes and cardiovascular risk.

Factors associated to higher dropout rates were previous limited quality of life scores and mental health worse status. These could be related with limited motivation and adherence to the program and may be of interest to develop specific strategies for these high-risk groups.

Studies focused on the long-term effect of the program are warranted.

None Declared

Self-perceived health (SPH) is an epidemiologically used variable, recognized as a subjective yet predictive indicator of mortality (Bopp et al. Plos One 2012; 7:e30795) SPH, among other subjective indicators, such as quality of life, contributes to understanding an individual’s overall experience and well-being. While health information, including medical diagnoses given by physicians, forms a substantial part of an individual’s subjective health (Falconer & Quesnel-Vallée, 2017; 190 227-236) the World Health Organization (WHO, 2014) defines health not only by the absence of somatic diseases but also encompasses components of social and mental well-being.

This study aims to explore factors associated with a poorer level of self-perceived health in inpatients due to non-psychiatric conditions with a focus on mental health and substance use-related factors.

We recruited 800 patients during their hospital stay for various pathologies in cardiology, pneumology, internal medicine, and gastroenterology units. Self-reported sociodemographic variables and well-being-related variables, such as SPH, were collected during admission. The MINI Neuropsychiatric Interview was administered to screen for psychiatric conditions, the ASSIST scale assessed the risk related to the use of various substances. Data on the frequency and quantity of substance use, in the three months prior to admission, were also recorded by timeline follow-back. Information on the severity of somatic comorbidity was gathered using the Charlson Comorbidity Index. Non-parametric tests compared SPH in different groups, and variables showing significant differences were included in a multivariate linear regression analysis. This study obtained approval from the ethics committee.

Significant and clinically relevant differences were found in the SPH of patients with anxiety disorders, depressive disorders, and bipolar disorders. These patients reported lower SPH than those without these comorbidities. Patients scoring medium or high risk on the ASSIST scale for tobacco, alcohol, and cannabis also demonstrated lower SPH compared to those with low-risk scores. In the multivariate analysis, accounting for confounding factors, including comorbidity severity, patients with depressive disorders maintained statistically significant lower levels of SPH (ß = -13.391, p < 0.001), as did those with bipolar disorders (ß = -6.096, p = 0.019).

Patients with anxiety, depressive, or bipolar disorders, as well as those with higher-risk use of tobacco, alcohol, and cannabis, exhibited lower SPH. After adjusting for other relevant factors, such as diagnosed somatic pathology, patients with affective disorders continued to score lower in SPH levels. Proper attention and management of psychiatric comorbidities and substance use are crucial in medical hospital settings.

M. Pons-Cabrera Employee of: This work has been funded by Contractes Clínic de Recerca “Emili Letang - Josep Font” 2021 granted by Hospital Clínic of Barcelona, E. Caballería-Lamora: None Declared, L. Navarro-Cortés: None Declared, M. Balcells-Oliveró: None Declared, L. Pintor-Pérez: None Declared, H. López-Pelayo: None Declared

Multi-staged and personalized in nature, psychosocial interventions for cardiac surgery patients explain the necessity of relying on the potential of interdisciplinary interaction

To present the review of the model of interdisciplinary interaction of experts and institutions in the course of psychosocial interventions for cardiac surgery patients, which is currently used in the Chuvash Republic.

This model involves the experts and institutions of the regional healthcare system, the regional system of social care, the regional and federal system of education, non-governmental medical and health resort institutions, and private practitioners.

In the center of this model is the Regional Cardiology Center, which interacts with the Psychotherapeutic Center and the Republican Mental Hospital’s Helpline. It also involves the town hospitals and the central district hospitals, non-governmental clinics and private practitioners. The process of rehabilitation and follow-up care continues in the regional health resorts. The social service centers provide additional support. The institute of chief experts of the regional Health Care Ministry, which includes a psychiatrist, cardiologist, psychotherapist, and psychologist, oversees the overall activity. The clinic faculty professors and associate professors are involved in the development of the programs.

The practical results of using the regional model of interdisciplinary interaction enhance the potential of psychosocial interventions for cardiac surgery patients.

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Hypertension is a major risk factor for premature death, cardiovascular disease, and stroke worldwide. However, due to the chronic nature of hypertension, patients are at an increased risk of developing mental and emotional disorders, which can affect their adherence to self-care.

To conduct a systematic review to investigate the psychological profile, psychological characteristics, and personality traits of hypertensive patients and their role in self-care adherence.

A thorough and comprehensive literature search was conducted to identify relevant studies for this review. PubMed, Scopus, and APA PsycInfo databases were searched from their inception until March 7th, 2023. The protocol for this review will be registered in the International Prospective Register of Systematic Review (PROSPERO) in the future.

After applying inclusion and exclusion criteria and removing duplicate results, 55 articles were selected, the majority of which were grouped into three main categories based on psychological profiles for accurate analysis and comparison.

This systematic review contributes to the investigation of the relationship between psychological profiles and self-care in hypertensive patients. Despite the prevailing controversy in the literature, a greater proportion of studies indicate that depression, anxiety, low quality of life, type D personality and neurotic personality have a negative impact on self-care in hypertension.

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Tuberous sclerosis complex (TSC) is a disorder that affects multiple systems and was first described in 1880. Its symptoms include seizures, intellectual disability, and adenoma sebaceum. TSC is caused by mutations in the TSC1 and TSC2 genes and is inherited in an autosomal dominant manner.

This report highlights a case of a patient with an unusual psychological presentation evaluated in a psychiatric hospital.

The patient presented with psychotic features and abnormal behavior. A physical examination showed neurocutaneous lesions. After assessment a diagnosis of Tuberous sclerosis complex was confirmed through MRI Brain and genetic testing. Some of his relatives also showed similar neuropsychiatric symptoms.

Tuberous sclerosis complex is diagnosed based on TSC Clinical Consensus Group guidelines of 2012. Our patient fulfilled 4 of the major criteria and genetic testing also yielded a pathogenic variant. A TAND checklist (TSC-Associated Neuropsychiatric Disorders) is used to guide clinicians on areas to prioritize when managing TSC patients.

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Given that psychiatry may be the first contact for TSC patients, especially in low-resource settings. Patients referred to psychiatry, therefore, need to be thoroughly examined to exclude neuropsychiatric disorders, and a multidisciplinary team approach is vital in investigating and managing these cases.

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