F. Andrade, Portugal
Centro Hospitalar Universitário de São João Psychiatric ServicePresenter of 3 Presentations
EPP0844 - Dementia and suicide: what relationship to establish and what risks to consider?
ABSTRACT
Introduction
Given the marked population aging in the world, the incidence of dementia has significantly increased, becoming a growing health care problem. Suicide is a considerable health issue throughout the life span, being prevalent in older adults, and in many countries the highest suicide rates are found in the elderly. Thus far, the relationship between dementia and suicide remains poorly understood and inconsistent.
Objectives
The aim of this study is to do a non-systematic review of the current literature regarding the association between suicide risk and dementia.
Methods
We conducted a research using the Medline database, through the Pubmed search engine, using the following key-words: “dementia”, “suicide” and “risk factors”.
Results
Overall, the risk of suicide in people with dementia appears to be the same as that of age-matched general population. However, studies point to the existence of a number of factors that can increase this risk, such as: early age of dementia diagnosis, recent diagnosis, disease awareness and depression, hopelessness, male gender, failure to respond to anti-dementia medication, history of inpatient psychiatric hospitalizations, concurrent medical comorbidities.
Conclusions
Studies have reported mixed results as to whether dementia itself is an independent risk factor for suicide. Despite these findings, understanding the risk factors for suicide among people with dementia is crucial and suicide prevention efforts should be carried out in this population.
EPP1233 - First vs. Multiple cannabis-induced psychotic episodes: Is inpatient treatment any different?
ABSTRACT
Introduction
Recent studies reported very high cumulative risk for a patient who had cannabis-induced psychosis to be diagnosed with a schizophrenia spectrum disorder.
Objectives
We aim to compare sociodemographic and clinical characteristics, treatment and discharge plan in cannabis-induced first psychosis episode (CI-FEP) vs. multiple cannabis-induced psychotic episodes (CI-MEP) inpatients.
Methods
Retrospective observational study of inpatient episodes with a discharge diagnosis of cannabis-induced psychosis between January 1st, 2018 and December 31st, 2019 in the Psychiatry Service of CHUSJ. Descriptive analysis of the results was performed using the SPSS software, version 26.0.
Results
Our sample included 61 inpatients, 19 (31.1%) with CI-FEP and 42 (68.9%) with CI-MEP. CI-MEP group had a median of 1±0,234 previous hospital admissions. CI-MEP group has 10,0 higher odds of being discharged in outpatient compulsory treatment (CI 95% 1,21-82,50, p=0,013) and 6.0 odds of being treated with long-acting injectable antipsychotics (LAIAP) (CI 95% 1,79-20,31, p=0,002) when compared to CI-FEP group. Having multiple cannabis-induced psychotic episodes was associated with future admissions to psychiatry unit (OR 4,85 (95% CI 1,23-19,15, p=0,018). We found no statistically significant differences regarding the sociodemographic and clinical characteristics, use habits and discharge plan between the two groups.
Conclusions
Patients with multiple psychotic episodes due to cannabis use are more likely to have a LAIAP prescription, be discharged in compulsory outpatient regimen and be readmitted in to psychiatric inpatient unit. Considering the prevalence of CI-MEP and the risk of chronicity, we need integrative treatment programs to address the specificities of these patients.
O023 - Bipolar mania with Psychosis vs without Psychosis: a clinical characterization with indirect measures of severity
ABSTRACT
Introduction
The presence of psychotic symptoms is highest during acute episodes of bipolar mania. There is no evidence base regarding the implications of psychosis in the prognosis of bipolar disorder, despite common assumption that their occurrence reflects greater disease severity.
Objectives
We aim to compare sociodemographic and clinical characteristics of inpatients admitted for bipolar mania with and without psychotic features.
Methods
Retrospective observational study of inpatients admitted between January 1st 2017 and 31 October 2020 in a psychiatry inpatient unit of a tertiary hospital. Descriptive analysis of the results was performed using the SPSS software, version 26.0.
Results
Between 2017 and October 2020 there were 103 admissions due to mania bipolar I disorder, 53.4% (n=55) with psychotic symptoms. When compared with mania without psychosis, psychotic mania was associated to male gender (71.1% to 39.7%; c2(1, N = 103) = 10,06; p = 0.02) and younger age (t(103) = -2.43; p = 0.017). The proportion of compulsory admissions and average length of stay were similar between mania with psychosis and mania without psychosis. Also, having a manic bipolar episode with psychotic symptoms was not associated to being prescribed a long-acting injectable antipsychotic.
Conclusions
The presence of psychotic symptoms in bipolar manic episodes were associated to male gender and younger age but not to indirect measures of illness severity.