Psychiatria Danubina最新文献

Background: In liaison psychiatry, issues related to multiple substance use disorders are encountered, but systematic assessment and treatment protocols are lacking. The implementation of psychoeducation groups with earlier access could be one solution, but it raises the question of how to systematically approach psychoeducation for multiple substance use disorders.

Subject and method: Based on a narrative review of multiple substance use disorders in liaison psychiatry and the proposed treatments, we aimed to identify the possible systematisation of standardised psychoeducation.

Results: The triadic model of interoception-impulsivity-addiction emerged as a general approach to addressing addiction issues and could serve as a foundation for the standardisation of psychoeducation.

Conclusion: Prospective studies on the impact of systematised brief psychoeducational interventions on multiple substance use disorders in the patient treatment plan are to be developed.

Background: Suicide pacts are always tragic though they remain under-identified and under-reported. History and fiction are full of them, though they would only represent less than one percent of all suicides in Occident. A suicide pact is an agreement made between two or more people to commit suicide together and requires a reciprocal consent but also intent, volition and capability. Victims, motivations and operating methods are multiple, and continue to diversify even more with Internet and social media. How can we identify people at risk?

Subjects and methods: Between November 2023 and May 2024, a literature search based on electronic bibliographic databases as well as other sources of information (grey literature) was conducted in order to investigate the most recent data on suicide pacts and especially how they evolved with Internet and social media.

Results: Different categories of suicide pacts can be made, but the typical template for a prospective suicide pact describes as two withdrawn individuals, in a tight and close relationship, who feel ensnared in a desperate and unmitigable situation.

Conclusions: Prevention can done at various levels, but screening individuals who fit the profile for risk would certainly be a start. To identify a suicide pact, forensics, criminology and sociology need to be considered.

Background: This article proposes a reflection on the use of the genogram in the management of (psycho)geriatric patients. Understanding family dynamics seems essential in the management of elderly patients, confronted with multiple changes in psychological, physical, social, financial aspects etc, and who present chronic complaints, despite multiple treatments and cares.

Subjects and methods: We realized a literature review based on articles dating from 2005 to 2023 and selected from following danabases: Pubmed, Cochrane, Scopus, Cairn, Psychinfo and Google. Used key words are "genogram", "family", "(psycho)geriatrics", "symptom".

Results: Thanks to the analysis of the patient's symptomatology through the prism of relational and contextual dynamics, the genogram offers a reading grid on the family system. It allows us to understand the places and functions occupied by each person, their life story, relational issues, the open and hidden conflicts, their family and social representations… This is done by taking into account the context in which we meet a patient and his/her entourage. This reading grid also allows caregivers to avoid reproducing the same interactional modes in the care of the patient and his or her family, which makes it possible to fight against the chronicization of the symptom.

Conclusion: The creation and analyse of the genogram aim to offer another point of view, in relation to the management of complicated families and/or patients with chronic symptoms, without associated organic origins. The goal is to move away from a linear vision and causality (cause-consequence) to offer a systemic reading grid. This is in order to understand the various relational issues associated with these complex family and interactional dynamics.

Background: The prevalence of depressive disorders in the general population increased significantly during the COVID-19 pandemic. The aim of this study is to examine the relationship between history of anxiety and depressive disorders and COVID-19 outcome, hospitalization and severity of anxiety and depression, and whether such relationships are explicable by direct impact of the disease.

Subjects and methods: We conducted a questionnaire survey among 98 inpatients in the Department of Infectious Diseases of the Clinics of Samara State Medical University. The self-report questionnaire consisted of 120 items, including socio-demographic characteristics of participants, State-Trait Anxiety Inventory, and the Center for Epidemiologic Studies Depression Scale, with items reflecting subjective feelings about the COVID-19 pandemic. We used one-factor analysis of variance to compare between groups for those indicators that conformed to a normal distribution, and the chi-square test (χ²) or Fisher's exact test to analyze group differences in the distribution of categorical variables was used.

Results: The mean (SD) total score on the STAI anxiety scale among hospitalized patients (51 (10.1)) significantly exceeded that of the COMET-G control group (44.9 (11.7) (H=22.8, p<0.001). There was a similar difference in the severity of depression as measured by the CES-D scale (23.4 (12.6) versus 18.0 (11.8), H=15.2 and p<0.001). In contrast to the general population, there were no statistically significant differences in anxiety and depression severity in the matched samples 52 subjects fulfilling the criteria of age, gender, and general perception of health condition.

Conclusions: Anxiety and depression scores among ICU (red zone) inpatients significantly exceeded the scores observed in the COMET-G general population group. Our study did not confirm expected relationship between symptoms of anxiety and depression (based on questionnaire response) and the risk of severe course of COVID-19 (e.g. hospitalization) in matched samples, but proved that the factor of self-awareness of health state may be related to the COVID-19 course severity. Future research would benefit from clinical interview of inpatients and follow-up monitoring of affective disorders to specify whether anxiety and particular type of depression (e.g., anxious) are selectively related to the severity of COVID-19 course and risks of affective disorders persistence after somatic recovery. The accumulation of mental disorders with age, and the bidirectional association of mood disorders and infectious diseases should be considered when assessing the risk factors.

We examine whether Sandra Sabattini, a young Medical Student who was beatified by Pope Francis in 2021 should be seen as a role model for medical students, and potentially seen as their patron saint. We examine the difference between Patron Saint and Role Model. We make the case that, given the importance of the Doctor-Patient Relationship, there is need for Medical Students to have a Role Model. We examine the environment, philosophy, and methodology in which Sandra Sabattini worked and we examine how she related to patients, based on Eyewitness accounts. We identify that Sandra worked in a holistic way and related to patients in a very personal way. Thus we conclude that Sandra Sabattini is indeed a useful role model for medical students, further, we note her ''pro-life'' philosophy.

Background: To evaluate the eligibility and feasibility of the "Voice Modules in Narcology" (VMIN) program.

Material and methods: We developed a computer program to screen for risky alcohol or drug use, utilizing an interactive voice assistant as a motivational component. Given the low detection of such risks during population health examinations and medical check-ups, this program could allow the primary healthcare sector to expand screening coverage for risky alcohol and drug use without additional medical personnel. VMIN includes an anonymous short questionnaire (CAGE) and a question about drug use, offering a short (3-4 minutes) voice file with motivational information encouraging specialist consultation if risks are detected. The program also assesses the usefulness of the information received and the readiness to consult a narcologist for diagnosing substance use disorders. 51 outpatients under treatment at Samara State Medical University Hospital were included in the pilot project for evaluation the eligibility and feasibility program.

Results: 11 patients (21.6%) who were identified as at risk of alcohol or drug consumption listened to the voice modules after screening. Among these, 8 (72.7%) respondents provided feedback: 8 (72.7%) respondents found the information useful, 5 (45.5%) expressed willingness to change their behavior to reduce substance or alcohol use, 2 (18.2%) expressed readiness to seek specialized help, and 1 (9.1%) provided contact information for follow-up assessment of substance or alcohol use risk.

Conclusions: A significant proportion of patients in multi-profile hospitals' cardiology and gastroenterology units (21.6%) reported risky alcohol consumption; drug use was reported by one man (1.9%). The majority of respondents who listened to the voice modules considered the provided information useful, but only one (1.9%) shared contact information for the follow-up assessment, and 3 (27.3%) did not give feedback. The high proportion of individuals giving positive feedback provides preliminary support for the feasibility of the method.

Among antidepressants, selective serotonin and noradrenaline reuptake inhibitors (SSRIs and SNRIs) have been widely used in the treatment of major depression and may induce sleep disorders and bruxism. In the present study, the effects of SSRIs and SNRIs on awake and sleep bruxism have been evaluated. A total of 125 patients who had been prescribed SSRIs or SNRIs for the treatment of major depression have been evaluated for bruxism. For the purpose of the study, data from the first week (T1) and the fourth week (T2) of antidepressant treatment have been considered. In conclusion, in the early period, the presence of bruxism has not been observed to be significantly influenced by the use of antidepressants. It has been determined that sleep bruxism increased in the fourth week only in males who were using antidepressants (p = 0.015; p < 0.05). An increase in the presence of sleep bruxism due to specific SSRIs and SNRIs has been determined in the fourth week of drug use. Paroxetine in the SSRI group and duloxetine in the SNRI group have been found to cause an increase in sleep bruxism (p = 0.013; p < 0.05). Other active substances have not been found to affect sleep or awake bruxism significantly. The present study has shown that although some antidepressants increase bruxism in the early period of drug use, the effects of similar drugs on sleep or awake bruxism need to be evaluated in detail in long-term studies.