Welcome to the 22nd WCP Congress Program Scheduling

Objectives

The goal of this presentation is to evaluate the role of the treatment methods in interventional psychiatry, including ECT, rTMS and ketamine treatment (IV ketamine and intranasal esketamine) in the management of patients with treatment-resistant unipolar and bipolar depression. Special attention in this presentation will be given to the maintenance treatments following the acute series of treatment.

Methods

The author will present current evidence on neurostimulation methods, IV ketamine infusions and intranasal esketamine in the treatment of patients with treatment-resistant depression (TRD). This will include an overview of randomized clinical trials and meta-analyses on the efficacy of interventional psychiatry methods in treating patients with TRD. Evidence of maintenance treatments and its efficacy will be discussed based on the available research, mostly RCT and meta-analyses.

Results

Neurostimulation, particularly ECT is a very effective treatment for patients with TRD. However, ECT does not have sustained benefits and the majority of patients relapse even with optimal medication maintenance.

Repetitive transcranial magnetic stimulation (rTMS) is a first-line treatment option for patients with TRD. However, the majority of patients may have a relapse of depression following the course of rTMS.

Ketamine infusions and intranasal esketamine have rapid therapeutic effects, but these effects are short-lived. Concerns over cognitive impairment, interstitial cystitis and addiction limit its longer use.

The maintenance treatment options such as maintenance ECT, pharmacological maintenance strategies, portable TMS machines for home use, intranasal esketamine, and adjunctive psychotherapy will be discussed.

Conclusions

Possible options for extending treatment benefits following the acute series of neurostimulation and ketamine treatment have been discussed.

Objectives

Depression symptoms are common in the general population, and they can be caused by a variety of biological and psychosocial variables, many of which are linked to lifestyle. Health promotion and lifestyle modification programmes (LMPs) might help to alleviate the symptoms. This study aims to analyse the one-year follow-up results about the effectiveness of an LMP and an LMP plus Information and Communication Technologies (LMP+ICTs) when compared to Treatment as Usual (TAU). Participants with depressive symptoms received the treatments as adjuvant therapy in a Primary Health Care Center (PHC).

Methods

A randomised, multicenter pragmatic clinical trial was conducted. The LMP consisted of six weekly 90-minute group sessions aimed at improving lifestyle factors; the LMP + ICTs was similar to the LMP but included a wearable smartwatch. A total of 188 participants were randomised and analysed. To assess the impact of the interventions compared to TAU, we used linear mixed models (LMMs), with a random intercept and an unstructured. We used an intention-to-treat analysis (ITT) and Multiple Imputation technique (MI) for handling missing data.

Results

The LMP+ICTs intervention showed a statistically significant reduction on depressive symptoms compared to TAU (slope difference b = -2.68, 95% CI = [-4.24, -1.13], p < 0.001).

Conclusions

LMPs plus ICTs administered in PHCs to people experiencing depression symptoms were effective in reducing these symptoms and reducing the time that participants spend sitting compared to TAU in the long term. LMPs in combination with ICTs might be a potential therapy option for PHCs.

Objectives

The aim of this study is to evaluate the circadian rhythm related neuropeptides; Somatostatin (SST), Vasoactive Intestinal Peptide (VIP), Neuropeptide Y (NPY), Melatonin (MLT) and Corticotrophin Releasing Hormone (CRH) in plasma and hippocampus tissue of rats with posttraumatic stress disorder (PTSD) model.

Methods

34 adult male Spraque Dawley rats randomly divided into control and PTSD groups. Single prolonged stress model was used to mimic PTSD. Elevated Plus Maze Test (EPMT) was performed. Rats were sacrificed under anesthesia. Wet weight of hippocampus was determined and SST, NPY, CRH, MLT, VIP levels in wet hippocampus tissue per gram were measured by ELISA method.

Results

Among the groups, the time spent in the open arms were significantly lower in the PTSD group in EPMT. Hippocampus weights in the PTSD group were lower compared to controls. NPY hippocampus tissue levels and MLT hippocampus tissue and plasma levels were significantly higher in PTSD group. CRH, VIP, SST levels in hippocampus tissue and CRH, NPY, VIP, and SST in plasma did not differ between groups. A positive correlation was found between MLT hippocampus and VIP hippocampus tissue levels. There was a positive correlation between NPY and VIP hippocampus tissue levels and plasma levels.

Conclusions

As we know, this is the first study in which 5 neuropeptides’ associated with circadian rhythm were evaluated together in the PTSD model. Especially, NPY and MLT from circadian rhythm neuropeptides play an important role in PTSD etiology. Further studies, re-evaluation of hormone levels at different time intervals will be a guide for better understanding.

Objectives

The aim is to study the difference in the common people's philosophy of mental illness. The stigma compared across a material society like England where the mental illness is perceived with utilitarian view point and the Indian and Pakistani societies where it is looked through the prism of spiritual dimension as well.

Methods

Theoretical and ideological analysis of philosophy of mental illness and stigma using the ideas of Michel Foucault, Erwing Goffman, R. D Laing, Thomas Szasz etc and the material and spiritual dimensional thinking looking at mental illness as viewed from purely utilitarian/material perspectives in England and the departure in India and Pakistan with some mentally ill people with OCD, Schizotypal disorder etc getting reverred as spiritual and Godly. The change over time and the new understandings

Results

There is a significant philosophical gap in the perception of mental illness in material societies and the spiritually oriented socities

Conclusions

There is scope for further philosophical exploraton in the area of difference in stigma across material ( England ) and spiritual ( India/Pakistan ) societies. Patterns of stigma also varies according to whether it is more of a material or spiritual society.

Objectives

Traditional healers (THs) play a valuable role in the lives of African people, especially in rural settings. Therefore, it is essential to understand their role in mental health care. We aim to address this subject focusing on Sub-Saharan countries.

Methods

A qualitative review of the topic, considering the recent evidence published in PubMed database. MeSH terms used: “traditional healer”, “mental health”, “Africa”.

Results

Our review yielded eleven publications, most of them were from South Africa, Kenya and Ghana. Studies addressed the THs training, the provision of mental health services by the THs, the type of mental illness usually treated and the methods they use, and also their collaboration with mental health systems. The main objective was to understand how THs can collaborate with mental health providers. Traditional healing is perceived to be more easily accessible, more affordable and generally assigns similar causal beliefs to those of the community. Mental illness in African cultures is conceptualised as caused by multiple factors which may have implications for the patients treatment. The methods used by THs vary widely, including counselling, the use of medical herbs, animal parts, divination and spiritual therapy.

Conclusions

Given the influence of THs and their unique capacity to engage with the patients, there is a necessity to collaborate with them in order to provide a holistic and more inclusive approach of the mentally ill in African communities. Therefore, additional efforts should be made to create strategies that can provide constructive supervision and continuous education.

Objectives

This presentation aims to review the most recent literature on delirium among cancer adult patients, its challenges and more effective approaches.

Methods

An extensive literature review was conducted, searching for the key-words "delirium" "cancer" and "patients" on scientific databases such as PubMed and Embase. The selected articles were published from 2014 to 2021.

Results

Delirium is a neurocognitive syndrome that commonly occurs in patients of advanced age and multiple comorbidities. Among patients with cancer, this is a clinical picture frequently observed with advanced disease and in the last days or hours of life - reaching an inicidence of up to 88%. Nevertheless, its prompt recognition and appropriate management is essential, because Delirium not only increases the mortality risk, but is often a severely distressing experience for patients, families and caregivers.

Despite its importance, Delirium is still underdiagnosed, specially the hipoactive subtype - the most frequent in cancer patients. Risk-factors include not only those related to the illness - CNS involvement, electrolyte abnormalities, nutritional deficiencies, but also those related to the treatment:brain radiation, chemotherapy, CNS-acting medications... An integrative approach is recomended, including non-pharmacological and pharmacological interventions.

Conclusions

Delirium is a frequent complication in patients with cancer, specially those with advanced disease. Its aetiology is typically multifactorial and includes factores related to the disease, its treatment and individual factors conditioning predisposing vulnerability. Its prevention, prompt recognition and effective treatment is of the uttermost importance, since part or complete reversal might be possible, thus minimizing the potentially serious consequences of its development.

Objectives

Although observational studies have already shown promising results of “flourishing” in mental health, there is still a gap in the literature regarding intervention studies.

To develop a comprehensive and integrative flourishing intervention based on the positive psychology aimed to improve mental health outcomes and quality of life in individuals with depressive symptoms.

Methods

The following stages were conducted: (1) a comprehensive literature review; (2) the design of a 12-session group-intervention based on the values, virtues and characters of “flourishing”; (3) a non-structured open-question panel of 8 healthcare professionals that assessed the rationale, coherence, and feasibility of the intervention and; (4) an e-Delphi technique including mental health experts and reaching a consensus if 80% of them agreed or strongly agreed to each item.

Results

A total of 25 specialists participated in the study, 8 in the non-structured panel and 17 in the e-Delphi. A three round e-Delphi was needed to reach consensus for all items/interventions. In the first round, 59/69 items reached consensus (85.5%). The non-consensual items (14.5%) were either excluded or reformulated. After modifications, the second round did not reach consensus in only one item, which was reformulated and approved by the third round. Qualitative analyses of the open questions were carried out and suggestions for the protocol were absorbed by the team.

Conclusions

The development of a “flourishing” intervention was successfully developed using an e-Delphi technique. The intervention is now ready to be tested in an experimental study to verify its feasibility and efficacy.

Objectives

Professional burnout syndrome is chronic stress caused by professional activity in the social sphere. This phenomenon recognized by World Health Organization as a syndrome and included in ICD-11 under the code QD85. The purpose of the study is to light sensitive periods of professional identity crisis in doctors of different specialties, determined by burnout syndrome

Methods

The study involved doctors of State hospitals: anesthesiologists-resuscitators, infectious disease specialists, neurologists (department of acute disorders of cerebral circulation), emergency specialists, psychiatrists and psychotherapists. In total, 142 doctors of different sexes and ages with different work experience examined. The number of respondents in the groups was 28±4 doctors. The method "Diagnosis of the level of emotional burnout" by V.V. Boyko was research tooi

Results

The maximum number of doctors indicating a crisis of professional identity has a completed burnout syndrome (the presence of all three phases of the syndrome: exhaustion, resistance and tension). Regardless of gender and age, three sensitive periods of the crisis of professional identity revealed: firstly, the so-called "average professional age", 16-20 years, secondly, the period of adaptation to the profession is 0-5 years, and thirdly, the period of completion of professional activity - work experience of more than 20 years. For anesthesiologists-resuscitators, the crisis of professional identity and emotional burnout observed with a work experience of 11-15 years.

Conclusions

Prevention of the crisis of professional identity as the professional crisis caused by the burnout in doctors of all specialties requires overcoming the traditional professional mentality and developing a system of social and corporation support.

Objectives

It is now widely recognized that the field of mental health must grapple with an internal critique grounded in human rights claims. Simply put, there a pressing need to reduce – or eliminate altogether – the use of coercive measures. In this talk, we make the case for direct and substantive engagement with the challenges associated with this moral imperative.

Methods

We restrict the discussion to several key issues, evaluated from the perspective of human rights frameworks.

Results

First, there is ongoing consternation about how best to understand the concept of coercion and its application to debates in psychiatry. Here we recommend a relatively inclusive definition, with a practical emphasis on involuntary detention, forced medication, seclusion, and restraint, alongside consideration of the more subtle ways that service users can be influenced or pressured. Next, we briefly consider the state of play in research on initiatives to reduce the use of coercive practices. There is clearly more room for work in this area, and we suggest that future efforts prioritize alternatives to hospitalization. Lastly, guiding all of this is the legal and policy-based backdrop. Animating much of the current debate is the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD), and a number of member states have recently attempted to reform mental health legislation in order to comply with the CRPD.

Conclusions

We suggest that expansion of alternatives to coercion alongside monitoring of the implementation of new mental health laws will help decide the future of coercion in mental health

Objectives

Anxiety, depression and burnout have become common among teachers, especially after the COVID-19 pandemic. The closure of schools and universities has been one of the most widely implemented measures to control the spreading of the virus. Since then, research has shown that teachers have accumulated psychological symptoms worldwide and UNESCO has already identified confusion and stress among teachers as one of the adverse consequences of social distancing measures. The main objective of this work is to review the impact of COVID19 pandemic for teacher mental health.

Methods

Nonsystematic review of articles published after 2019, searched in Pubmed using keywords “teachers”, “mental health”, “COVID19” and “pandemic”.

Results

Rapid change to virtual teaching has been perceived as a sudden and unexpected change, with implications in both professional and personal life. This symptomatology has been predominantly found to be higher in women, especially in an even more feminized subgroup of early childhood and primary education teachers. Female teachers had also to take on the burden of caring responsibilities at home. Young teacher shows higher levels of stress compared with more aged peers, probably linked to job insecurity. The reopening of schools and universities was also a new focus of uncertainty, being perceived as an increased risk of becoming infected, especially among preschool and primary education teachers.

Conclusions

It is crucial to improve and protect teachers’ mental health, avoiding job losses due to emotional distress and improving the quality of education for future citizens.