European Psychiatry最新文献

When faced with perilous transmittable infections, individuals defend themselves or welcome them, such as the Samos Syndrome, a pathophilia (people attracted by illnesses). As borderline personality disorder (BPD), found in Samos Syndrome, becomes more common, so will people who reject primary protection from transmittable diseases and health behaviour as their choices. Pandemics would sinisterly draw pathophilies and persons with borderline personality disorder who migh surf pandemics risk as a parasuicidal behaviour.

To investigate why pandemics (HIV, COVID-19) cannot be stopped. We have conducted a long-term assessment of HIV-discordant couples where a female partner, HIV-negative, voluntarily chooses to decline any prevention during stable and consensual relationships with HIV+ve partners. We also explored sociodemographic data that could explain health behaviours and condom use in HIV serodiscordant couples at risk of pandemic diffusion, those where one of the partners, usually male, already has a transmissible disease.

We used a mix of naturalistic and ethnographic approaches to understand the dynamics of Samos Syndrome. We also utilised a questionnaire to extract salient points in the sexual prevention of HIV infection. We assessed 475 HIV-serodiscordant couples.

Pathophilia is defined as an excessive, abnormal desire to be sick, also known as nosophilia, from the Greek word ‘pathos’ indicating illness and ‘philia’, meaning attraction. Women diagnosed with BPD can become high diffusers during pandemics of transmissible diseases as suffering from pathophila, a form of parasuicidal behaviour. In the couples assessed, when the HIV-negative woman comes from a socially disadvantaged family, the couple uses condoms in 87% of cases (p<0.001); when she comes from a middle-high class, the couple uses condoms in 59% (p<0.001) of sexual relationships. Suppose the HIV-negative female partner has conflicting relationships with their parents. In that case, condom use is only in 40% (p<0.001) of cases, compared to 83% (p<0.001) of instances where she has a good relationship with parents. If the female partner with BPD has a higher level of education than the HIV+ve partner the frequency of use if 90% (p<0.001) of cases compared to 60% (p<0.001) of instances where she has the same level of education as the male partner.

The current study confirms that female persons diagnosed with BPD are at high risk of becoming high diffusers during transmissible diseases and pandemics. Parasuicidal behaviours and self-harm in BPD could increase the risk of entering into relationships with persons who are already infected by sexually communicable diseases or are at risk of diffusing viral infections (HIV and COVID-19).

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The purpose of my presentation is to introduce the Hungarian Association of Psychiatric Trainees (HAPT), - our NAT - to you, which includes residents and young specialists within five years of training.

Currently we have 108 members, from 15 cities and villages throughout Hungary, and one person is working in Denmark. The vast majority (58 %) of the members are from Budapest, our capital city. There are 14 members, who are young specialists, the others are doing residency training. We have 21 members who are working in child and adolescent psychiatry.

HAPT has been existed since 2013, so in the previous years, our founder members have reached the point when they no longer meet the criteria of being ‘psychiatric trainee’ or ‘young specialists’, however every year we encourage the new residents to join us.

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OUR DUTY: The main goals of HAPT are educating ourselves, forming a community and making connections with colleagues country-wide and last but not least, trying to stand up for our interests, when needed.

Throughout the year we organize educative presentations about topics that are somehow left out of focus during the official training program. Every year our main event is a three-day long weekend, where we can go deeper into a couple of topics via presentations or workshops, and it is also a great opportunity to get to know each other better.

We also organize case-discussion-groups according to the Balint method, considering the residents’ daily difficulties and trying to pay more attention to their mental well-being.

Last year we tried some other ways to broaden our perspectives in the form of cultural events, when we watched a movie or a play and then discussed it together as a group, had been led by a psychotherapist.

HAPT is part of the Hungarian Psychiatric Association and the relationship between the two Organizations has a constantly changing dynamics – in some ways we are trying to be more independent, however, there are common goals that are important for all of us, for example being present on at international events.

FUTURE GOALS: One of our future plans include being more active in the European community, like getting to know the EFPT or the ECP better. This conference is a perfect opportunity for all of us to make new professional connections.

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Somatic disorders in patients suffering from psychiatric disorders have become an important issue in the overall care of these patients

Comorbidity studies show that 30 to 60% of patients consulted or hospitalized in psychiatry present an associated organic pathology

However, the detection of somatic conditions in psychiatric patients remains too late and this exposes them to sometimes lethal somatic complications

To evaluate the prevalence of somatic disorders in patients followed for a psychiatric disorder at Ar Razi hospital in Salé – Morocco, and to determine the associated factors

We carried out a cross-sectional study with 80 patients followed for a psychiatric disorder at Ar Razi hospital in Salé presenting clinical signs in favor of an organic pathology and transferred for specialized advice to the medical-surgical services, in the period from September 1st, 2022 until August 31st, 2023.

Most of our patients were male (65%) with ages ranging from 18 to 65 years. Addictive behaviors were found in more than half of our patients.

The most frequent reasons for requests for advice from medical-surgical services was the suspicion of an organic cause of psychiatric symptoms in 25% of cases or the presence of an organic warning sign in 30% of cases.

The comorbidity of somatic illness and psychiatric disorder was noted in 35% of cases.

Somatic comorbidities were essentially: infections and cardiovascular diseases.

Side effects of psychotropic drugs were predominantly neurological in 40 % of cases

Somatic comorbidities in patients hospitalized or in consultation in psychiatric hospitals are very common, often unrecognized, hence the need for early screening in order to improve care.

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The delicate balance between the need to ensure quality patient care and the reality of physicians dealing with psychiatric diseases poses a major challenge within the medical field. This issue raises fundamental ethical, legal, and medical questions, highlighting the complexity of decision-making regarding professional aptitude for practitioners affected by mental disorders.

To examine the impact of psychiatric diseases on the medical aptitude of physicians.

This was a retrospective descriptive study that focused on physicians with psychiatric diseases referred to the occupational pathology clinic at Charles Nicolle Hospital in Tunis for medical evaluations of their work aptitude between January 1, 2021, and September 15, 2023.

During the study period, we collected data from 20 patients. The mean age was 38 ± 11 years, with a sex-ratio (F/M)of 4.5. Five examined physicians had family histories of psychiatric disorders. Medical specialties were the most represented (N=17), including three general practitioners, two family medicine practitioners, and two anesthesiologists. The study population included 10 residents, eight hospital assistants, and two medical interns. The most common psychiatric diagnosis was depression (N=7), followed by bipolar disorder (N=5). The medical treatment prescribed was combinations of antidepressants and anxiolytics in seven cases, antipsychotics in five cases, and antidepressants in two cases. Medication adherence was noted in 10 physicians. Fourteen physicians had taken long-term sick leave, with an average duration of 203 days. Five physicians were declared fit to continue their regular professional activities, seven physicians were declared fit with restrictions on night work, and one physician was declared fit with workplace accommodations.

This study highlights the challenges surrounding the medical aptitude of physicians with psychiatric diseases. However, it is imperative to promote mental health awareness and to implementsupport measures to ensure both compassion for physicians and patient safety.

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Being a doctor is a profession with special medical requirements. Therefore, the assessment of medical fitness for work among physicians remains a complex decision, particularly for those with psychiatric disorders.

To assess the fitness for work decisions among physicians with psychiatric disorders.

Descriptive and retrospective study including physicians with psychiatric disorders referred to the occupational department of the Charles Nicolle Hospital in Tunis for a medical fitness for work from January 1, 2018 to August 30, 2023.

The study included 28 patients with a female predominance (sex ratio M/F at 0.3) and a mean age of 44.1 ± 12 years. Participants were general practitioners (N=12), junior doctors (N=10), specialists (N=5) and one dentist. They worked in the public health sector in 93% of cases, and had a mean professional seniority of 12.4 ± 9.3 years. A psychiatric history was found in 20 patients. Current psychiatric disorders recorded were: depression (N=15), bipolar disorder (N=7), anxiety-depressive disorder (N=4), personality disorders (N=1) and addiction (N=1). Concerning the fitness for work, six patients were fit for work and 11 were temporarily unfit. Job adjustments were proposed for 11 physicians, mainly night shift exemption.

Physicians are exposed to several occupational hazards and require strict medical qualifications. The impact of psychiatric disorders on medical fitness for work is considerable, and could be avoided by appropriate prevention by occupational health practionnairers, starting from professional orientation.

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Psychiatry is one of the most fast developing and agile discipline within human medicine. But more work is necessary to complete these advances.

I address the following questions:

How does the future of psychiatry look in the eyes of early career psychiatrists?

What strengths, weaknesses opportunities and threats will come?

And what can we learn from different mental health systems and reagions?

Oral or written statements to the raised questions followed optimally by a discussion

In low- and middle-income countries, a vast majority of people with mental disorders do not receive adequate treatment. Even in high income countries, roughly a third of people with severe forms of mental illness are not receiving the appropriate therapy. Laws concerning mental health are outdated in different countries. The protection of the human rights of the mentally ill is still incomplete and imperfect. The emphasis on economic gain and the digitalization of medicine in recent years has not helped. And new technical advancements such as artifical intelligence are becoming more important.

More discussion needs to be done on the identity and understanding of the psychiatric profession.

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Psychiatrists being one of the significant groups associated with one of the highest risks of emotional burnout (EB). The risks of EB increase significantly in the conditions of war, which places increased demands on their physical, mental and psychological resources, and determines the relevance and necessity of studying the predictors, clinical phenomenology, psychological and psychopathological mechanisms of EB, and necessitates the development of innovative approaches to its corrections.

The study the features of EB among psychiatrists in war period.

The examination included the usage of clinical-psychopathological, psychodiagnostic and psychometric research methods.

The study sample consisted of 120 psychiatrists who worked in Kyiv in the period from February 24, 2022, during 2022. 69.2 of psychiatrists working in Kyiv during the war have manifestations of EB of varying intensity and clinical variability. All of them have signs of professional maladaptation (PM), deterioration of well-being, somatovegetative and dyssomnia disorders, deformation of social ties and decrease in motivation to work. In 47.5%, the formation of symptoms of tension, resistance and exhaustion are observed, 21.7% have clinically complited and formed all manifestations of EB and PM.

The leading diagnostic and prognostic marker of EB is PM, the manifestations of which are the first consequence of the imbalance of the processes of performing professional duties and internal resources, which will ensure their optimal implementation.

A mathematical model of the development and forecast of PM, as a leading descriptor of EB, was developed, which considers the state of socio-demographic characteristics (age, work experience, and the total quality of life indicator), affective indicators (objective and subjective manifestations of depression and anxiety) and psychosocial features (social-psychological adaptation). The use of this model makes it possible to determine 4 risk groups for the development of PM (low, moderate, high, very high), based on which personalized approaches to the diagnosis, therapy and prevention of EB among psychiatrists during the war have been developed.

The implementation and further evaluation of these approaches proved their effectiveness in eliminating the manifestations of EB and PM, normalizing the mental state with the levelling of psychopathological symptoms, improving the socio-psychological adaptation and quality of life of psychiatrists.

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Fahr’s Disease, also known as Fahr’s Syndrome, is a rare genetically dominant disease, characterized by the abnormal accumulation of calcium deposits, or calcifications, in various areas of the brain, particularly the basal ganglia. These calcifications, which are typically bilateral and symmetrical, can lead to a wide range of neurological and psychiatric symptoms, making diagnosis and management challenging. It usually manifests between the ages of 40 and 60, primarily after the age of 30.

To contribute to the medical literature by sharing this rare case, thereby increasing awareness and knowledge about Fahr’s Disease among healthcare professionals.

Non systematic review of the literature and access to the medical history of the patient.

We present a case of a 42 year old woman, who came to our hospital with behavior changes, with increasing confusion and new mystical beliefs, insomnia and agitation.

According to the patient’s husband, the patient sounded confused and inappropriate in her speech. The patient was admitted for evaluation of altered mental status. The patient was alert and oriented to person, place, time, and situation in the emergency department, with shudder while neurologically intact. The patient was unpolite, agitated.

Psychiatry was consulted for evaluation. We decided to admit the patient and did a posterior study with a CT scan and MRI. The MRI, as well as CT scan revealed “dense calcification of the dentate nuclei and the basal ganglia”, highly suggestive of Fahr’s syndrome. The patient’s phosphorus level was 3.5 mg/dl (normal level: 2.5-4.5 mg/dl). Parathyroid hormone (PTH) intact was 53 pg/ml (normal level: 15-65 pg/ml), and calcium level was 10,3 mg/dl (normal level: 8.4-10.5 mg/dl). The vitamin D 25-hydroxy concentration was 43,5 ng/ml (normal level: 30-60 ng/ml).

In conclusion, Fahr’s Disease is a rare and complex neurological disorder characterized by idiopathic calcification of the bilateral basal ganglia, resulting in a diverse range of neurological and psychiatric symptoms. Diagnosis involves clinical evaluation and neuroimaging, while treatment is primarily symptomatic. Further research is needed to better understand the underlying genetic and biochemical mechanisms driving calcification in the brain and to develop more effective therapeutic strategies for this challenging condition.

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It is important to prevent school dropout and to help students who have dropped out re-enroll in school. Dropping out of school is associated with an increased risk of unemployment, low salaries, and receiving social security or disability benefits. In this study, we interviewed participants in ‘Guttas Campus’ (The Boys’ Camp), which is a group-based intervention that aims to support disengaged boys from the 9th grade and through their transition to high school. The intervention consists of a two-week learning camp. The students subsequently participate in mentoring groups, with teachers and other camp participants, for a period of 18 months.

We present a study of a school dropout prevention program.

16 students were interviewed qualitatively. The interview data were analysed by drawing on the method of Grounded Theory.

When the students who have completed the learning camp were asked what they believed were the most important and useful parts of the intervention, some common themes emerged: 1) The learning camp community provided a safe environment and helped give the participants learning and coping experiences that increased their self-confidence. 2) The students brought up the method of teaching, which they described as more persistent, adaptive and encouraging than they had been used to from regular school. 3) The students also mentioned the intervention’s focus on character strengths such as willpower, self-control and optimism as central to increasing their motivation to learn.

The students that were interviewed were generally positive to the intervention, as mentioned several factors that they believed were useful in increasing their motivation and ability to learn.

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