M. Jesus, Portugal

Centro Hospitalar e Universitário de Coimbra Centro de Responsabilidade Integrada de Psiquiatria

Presenter of 4 Presentations

e-Poster Viewing (ID 1107) AS08. Cultural Psychiatry

EPV0221 - Intercultural communication: an issue of modern times

Session Name
e-Poster Viewing (ID 1107)
Date
Sun, 11.04.2021
Session Time
07:30 - 23:59
Room
e-Poster Gallery
Lecture Time
07:30 - 07:30
Presenter

ABSTRACT

Introduction

Globalization as lead to a more heterogeneous population than ever which makes intercultural communication an issue of modern times. Although this is positive in many ways, the differences in culture and beliefs, as well as a linguist barrier may impair clinical communication.

Objectives

The authors aim to shed light in the issues regarding intercultural communication.

Methods

Review of the literature including studies focusing on the the various facets of intercultural communication.

Results

People from different cultural backgrounds have less access to health care and are less referenced to specialized care. Also, these patients report less satisfaction after their appointments. Although language proficiency in pointed as one of the most determinant factors, acceptance and comprehension of the patient beliefs regarding health and disease seems to play a very important role. Different cultures express symptoms differently and have different expectations when meeting a doctor. When these factors are overlooked, the doctor-patient relationship suffers and so does the treatment adherence. Doctors tend to have an identical approach to intercultural patients and native patients and to evaluate their interview as very positive, even when the same doesn’t happen with the patients.

Conclusions

Although the difficulties regarding intercultural communication are widely known, most doctors fail adequate their interventions to the specific needs of their patients, not taking into consideration their different beliefs and expectations. This raises very important questions as patient dissatisfaction leads to failure to report symptoms and consequent misdiagnosis and non-compliance to the proposed treatment which ultimately results in a less efficient health care in these populations.

Hide
e-Poster Viewing (ID 1107) AS43. Schizophrenia and other psychotic disorders

EPV0604 - Paraphrenia in modern times? Revisiting an elder concept

Session Name
e-Poster Viewing (ID 1107)
Date
Sun, 11.04.2021
Session Time
07:30 - 23:59
Room
e-Poster Gallery
Lecture Time
07:30 - 07:30
Presenter

ABSTRACT

Introduction

The concept of paraphrenia was first introduced by Kraeplin and has since been a controversial issue. However, a group of patients still represent a diagnostic problem and many remind us of the initial description of Paraphrenia: “The uncertain group between paranoia and dementia preacox”.

Objectives

Revisit paraphrenia and to transpose it to modern times.

Methods

Clinical report and literature review.

Results

“M”., a 68 yo women with no psychiatric history was admitted in with depressive humor, anhedonia, asthenia and structured delusional ideas of guilt and persecution and auditory hallucinations. Antidepressant therapy improved the mood, but with worsening of the psychotic symptoms. With further exploration it was was clear that the mood disorder was secondary to the psychotic symptoms that arose in insidiously. The family described her as very reserved and suspicious and notice that she abandoned many of her daily tasks. MMSE was 26 points and the laboratory results and the Cranial Computed Tomography were normal. There was little response to antipsychotics and the patient is undergoing electroconvulsive therapy with positive results.

Conclusions

Initially thought to be a depressive episode, the psychotic symptoms were the primary manifestation. Although the insidious installation, structured delusional ideas and the preservation of the affects pointed to a delusional disorder, the presence of auditory hallucinations and gradual loss of functionality are characteristic of schizophrenia. Some authors rejected the classic definition of Paraphrenia, but accepted that schizophrenia in the elderly could assume a paraphrenic form. In this case, the clinical picture and evolution are close to the classical description of the disorder.

Hide
Oral Communications (ID 1110) AS15. Forensic Psychiatry

O151 - Gender differences in a Forensic Psychiatric ward: a retrospective study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
05:48 - 06:00
Presenter

ABSTRACT

Introduction

The criminality associated with psychiatric disorders has been extensively studied with some studies showing a greater risk of violence in these patients. The gender differences in the general psychiatric population and can have an impact in the characteristics of a forensic population.

Objectives

The authors aim to study the gender differences regarding diagnosis, type of crime and other characteristics in a forensic ward population.

Methods

A retrospective study was designed, including patients admitted in the Forensic ward of Coimbra Hospital and University Center between 2018 and 2020.

Results

Our study included 110 patients, 19 women and 91 men. Although psychotic disorders were the most common in both groups, particularly schizophrenia, mood disorders were significantly more common in women, with a risk of 7,768. This was explained by a greater prevalence of depressive episodes in women. These were associated with a particular type of crime, infanticide, that was not found in the men group. This might contribute to a greater prevalence of violent crimes in women.

There was a chance of committing crimes against the offspring of 24 in women. The use of psychoactive substances was significantly greater in men, with a chance of 12,906.

Conclusions

Considering that mood disorders are more common in women, these findings are easy to understand. The predominance of female perpetrators in infanticide is well described in the literature and can be associated with peripartum depression and gender roles. In this sample substance abuse was more common in man, like it’s seen in the general population.

Hide
Oral Communications (ID 1110) AS15. Forensic Psychiatry

O152 - Comorbidity with Substance Abuse and its influence in a forensic population: a retrospective study

Date
Sat, 10.04.2021
Session Time
07:00 - 21:00
Room
On Demand
Lecture Time
06:00 - 06:12
Presenter

ABSTRACT

Introduction

The criminality associated with psychiatric disorders has been extensively studied with some studies showing a greater risk of violence in these patients. Substance abuse has been long linked to criminal and antisocial behaviours, but what happens when is in comorbidity with other psychiatric disorders.

Objectives

The authors aim to study the impact of substance abuse comorbidity in type of crime and other characteristics in a forensic ward population.

Methods

A retrospective study was designed, including patients admitted in the Forensic ward of Coimbra Hospital and University Center between 2018 and 2020.

Results

Our study included 110 patients, 39 of which had comorbidity with substance abuse. Although the authors couldn’t find differences in the type of crime committed regarding the patient’s primary diagnosis, substance abuse was significantly associated with non-violent crimes. The prevalence of homicide was significantly inferior in psychoactive substance users and the prevalence of domestic violence was significantly greater. However, the prevalence of a criminal history was significantly higher in patients with comorbidity with substance abuse. Patients with substance abuse had significantly higher childhood adverse events reports.

Conclusions

Interestingly, criminal behaviors prior to admission were more frequent in patients with substance abuse, which is understandable. However, the type of crimes were significantly less serious in this patients, which can mean that, although these consumptions are a risk factor for criminal behavior, the association in less important in crimes like murder. The exposition to childhood adverse events is a well-known risk factor for substance abuse in adulthood.

Hide