Day 2 :
- Psychology | Anxiety & Depression Disorders | Regulation & Case reports
Location: Salon A
Session Introduction
Guy Hugues Fontaine
Université Pierre et Marie Curie, France
Title: First case of brain protection in out of hospital cardiac arrest
Time : 09:00-0930
Biography:
Guy Hugues Fontaine has made 17 original contributions in the design and the use of the first cardiac pacemakers in the early 60s. He has serendipitously identified ARVD during his contributions to antiarrhythmic surgery in the early 70s. He has developed the technique of Fulguration to replace surgery in the early 80s. He has 900+ publications including 201 book chapters. He has been the Reviewer of 26 scientific journals both in basic and clinical science. He has served for 5 years as a Member of the Editorial Board of Circulation.
Abstract:
The case of my wife, a 73 year-old psychiatrist, experienced OHCA on June 2011 in the living room where she was watching the BBC world channel on TV. I immediately laid her down on the floor. There was no femoral pulse. I initiated standard CPR including chest compression (90 compressions per minute) for about 30 seconds followed by mouth to mouth breathing. I then resumed cardiac massage since she did not regain consciousness and there was no femoral pulse. I had a defibrillator in the basement of my house because of my interest in the Fulguration procedure. Since I had no gel to apply between the electrodes and the skin to decrease the impedance, I applied saliva to the electrodes and then gave a third shock. This last shock was successful, and the femoral pulse returned strong and regular. The femoral pulse remained stable, regular and strong. I estimated that about 6 minutes elapsed between her loss of consciousness and the return to a stable circulation. I then addressed the issue of possible brain protection. Fortunately, I had a smaller portable bottle now called the “Fontaine bottle” that was designed with a gas regulator to be used with a nasal cannula inserted into the nose to provide protection of the brain by nasal cooling. When the injector was in position I opened the valve of the cylinder and induced nasal cooling by expansion of the CO2. Her hospital course was notable for repeated episodes of ventricular fibrillation with the same ECG pattern of Torsade de Pointes-like tachycardia degenerating in Ventricular Fibrillation in a few seconds. The absence of Troponin release demonstrated that she had no acute myocardial infarction which was my main concern. When sedation was stopped, she was fully awake and the tracheal tube was removed. Psychological test showed that she had absolutely no neurologic deficit. In particular, she could remember 9 telephone numbers. During the follow-up, she experienced three more episodes of sudden death with drop (one with injury of the face) immediately converted by the defibrillator leading to an increase of Bisoprolol. No more episode of arrhythmia up to now almost 7 years since the SD episode.
Arif Pendi
University of California Irvine, USA
Title: Depression severity and stigmatized beliefs in Emirati university students: Preliminary findings of a crosssectional study
Biography:
Arif Pendi has recently completed his Master of Science degree in Global Medicine after which he continued his research in the fields of psychiatry and orthopedic surgery. His current research interests include studying common mental disorders in college-aged men and women, the mental health consequences of intimate partner violence and the role of anxiety in predicting surgical outcomes after spine surgery. He also directs the operations of Free Minds United, a grassroots non-profit organization dedicated to mental health advocacy in the community.
Abstract:
Introduction: Depressive disorders constitute a serious mental health issue in university students across the world. However, the social stigma surrounding mental illness and depression in particular, must be accounted due to emerging evidence indicating that stigmatized beliefs mediate treatment-seeking behavior. Depression specific stigma can be divided into two components: Personal and perceived beliefs. The former refers to one’s own beliefs surrounding depression while the latter refers to one’s beliefs about others’ perceptions of depression. It was hypothesized that greater depression severity would be associated with more stigmatized beliefs.
Methodology: A cross-sectional study was conducted at a university in Dubai, United Arab Emirates. The survey contained a socio-demographic questionnaire, Patient Health Questionnaire-9 (PHQ-9) and Depression Stigma Scale (DSS) and was disseminated online to university students. Depression severity in the sample was determined by applying the PHQ-9 summed-item scoring method and the relationship to personal and perceived stigmatized beliefs (DSS) was explored with t-test. A series of linear regressions were used to identify predictors of personal and perceived stigma.
Findings: In the sample, 39.5% of respondents reported moderate to severe depression severity. This more depressed group exhibited less perceived stigmatized beliefs compared to their counterparts (p=0.048). In addition, heterosexuality and non-Indian ethnicity constituted predictors of perceived stigma (p=0.004 and p=0.007, respectively).
Conclusions: Depression severity was not associated with greater personal of perceived stigma; in fact, moderate to severe depression was associated with less perceived stigma. Nevertheless, heterosexual and ethnic Indian students may benefit from efforts to reduce perceived stigma.
Arif Pendi
University of California Irvine, USA
Title: The association between intimate partner violence and anxiety and depression: Preliminary findings of a survey of University students
Biography:
Arif Pendi has recently completed his Master of Science degree in Global Medicine after which he continued his research in the fields of psychiatry and orthopedic surgery. His current research interests include studying common mental disorders in college-aged men and women, the mental health consequences of intimate partner violence and the role of anxiety in predicting surgical outcomes after spine surgery. He also directs the operations of Free Minds United, a grassroots non-profit organization dedicated to mental health advocacy in the community.
Abstract:
Introduction: Intimate partner violence (IPV) has been linked to the development of mental disorders such as anxiety and depression. However, the link between IPV and mental illnesses such as anxiety and depression has not been well-studied in university students. Given the large burden of anxiety and depressive disorders among university students and the high prevalence of dating violence, investigating the association between IPV and anxiety or depression has serious implications for on-campus screening efforts as well as the practice of psychiatry.
Methodology: An anonymous survey was disseminated via email to invite undergraduate and graduate students to complete an online survey form regarding their beliefs surrounding IPV, anxiety and depression. The survey included socio-demographic questions, HITS Domestic Violence Screening Tool, Generalized Anxiety Scale (GAS-7) and Patient Health Questionnaire-9 (PHQ-9). Respondents that were considered positive for IPV according to HITS were compared to the remaining respondents in terms of continuous scores on GAS-7 and PHQ-9 for anxiety and depression, respectively. Comparisons were made using t-test, two-tailed and assuming unequal variances.
Findings: Of 396 respondents, 18 students showed signs of IPV according to the HITS tool. This group exhibited greater intensity of anxiety (10.83±5.711 versus 6.23±5.355; p=0.003) and depression (12.06±6.384 versus 7.34±6.266; p=0.007) compared to the remaining respondents.
Conclusions: These preliminary findings indicate IPV was significantly associated with both anxiety and depression in a large sample of university students. Psychiatrists treating students that have experienced IPV may need to be aware of symptoms of anxiety as well as depression. Universities may need to screen for anxiety and depression in students that report IPV on-campus.
Hadis Yousefi
University of Mohaghegh Ardabilli, Iran
Title: The effect of self-control training on alexithymia and tempting ideas in drug-dependent patients
Biography:
Hadis Yousefi has completed her Master’s degree in Psychology from the University of Mohaghegh Ardabilli and Bachelor’s degree in Clinical Psychology from Allameh Tabatabaii University in Iran. She has submitted 7 papers in the field of addiction and has 8 years of work experience and research in the field of psychoanalysis and also new treatments for addiction.
Abstract:
Aim: The aim of the present paper is to study the effectiveness of self-control training on alexithymia and tempting ideas in drug-dependent patients.
Method: This research is performed using pre-testing and post-testing plan with control group. The statistical society in this research constitutes all addicted male individuals who voluntarily visited a detoxification centers in Tehran in 2013. The research sample includes 50 addicted men who were chosen by clinical randomly assigned into the two test and control groups. The test group received self-control training for 10 sessions of 45 minutes. To collect the data, we used the Emotion Regulation Questionnaire (short version), Toronto Alexithymia Scale, scale tempting ideas and morphine test.
Results: The results of the monotype variance analysis (MANOVA) showed that self-control training has been effective on emotional well-being of individuals who are dependent on drugs.
Conclusion & Discussion: Emotional problems are among the most significant factors involved in drug-addiction; drug abusers have considerable problems in regulating and managing their emotions. Self-control skills and the ability to manage one’s emotions can help people, in situations with high risk of substance abuse, to acquire coping strategies, to better withstand the unwanted pressure from their friends and to control their own emotions more effectively, all resulting in demonstrating a higher resistance to drug consumption.
- Video Presentation
Location: Salon A
Session Introduction
Jorge Tomas Balseiro Estevez
Georgetown Public Hospital, Guyana
Title: Profile and Psychosocial factors associated with suicidal behavior in Guyana
Biography:
Jorge Tomas Balseiro Estevez is currently working as a Psychiatrist at Georgetown Public Hospital and Professor of University of Guyana. His expertise is in different areas of mental health, especially in psychosocial intervention, programs and plans to improve the mental health and wellbeing. His well-structured diagnosis based in a holistic approach to address individual, community and social psychosocial factors involved in suicide behavior offer new opportunity to develop similar interventions in low income countries.
Abstract:
Statement of the Problem: The WHO report, published in 2014, gives Guyana in the top worldwide with an age-standardized suicide rate of 44.2 per 100,000 inhabitants.
Methodology & Theoretical Orientation: A nationally represented sample of 899 cases involved in suicidal behavior, 555 who committed suicide and another 344 attempted suicides from 2010-2012, were surveyed using an epidemiologic study to identify the psychosocial factors associated.
Findings: As results founded most affected in suicide deaths is 20 to 49 years (50%). Males commit suicide more frequently with a ratio of almost 4:1. Most commonly used methods are poisoning (pesticide/herbicide) more than 65% of cases, followed by hanging (>20%). East Indians account for >80%; geographically concentrated in regions 6, 5, 4, 3 and 2. In suicide attempt were collected more detailed information, where age groups more affected are 12-18 (30%) and 19-25 (>20%). Females attempt suicide more frequently (>75%) with a proportion of 3:1. East Indians account for >50% and Afro Guyanese provide 25.9% of cases. Similar geographical area is affected in suicidal attempts and isolated cases are reported from rest of regions. More cases of suicidal attempt were single (60%), without children (68%), living with family (>50%), belong to Hindu (>30%) and Pentecostal (>30%) religions, less common frequent are other factors as low income and unemployed. Persons involved in suicide behavior are related with hopelessness, depression and uncontrollable anger in more than 60% of cases of this study, usually associated to family discord (31%), couple problems (25%), domestic violence (11%) and interpersonal conflict (16%). Other risk factors identified were, acute emotional distress and depression (36.6%), the accessibility of lethal substances (herbicides, pesticides and others) in the 63.7% of cases, alcohol and drug use (32%), family dysfunction (34.5%).
Conclusion & Significance: Profile and psychosocial factors associated to suicidal behavior were identified. Implementation of the national suicide prevention plan designed as imperative of the problem.
- Poster Presentation
Location: Salon A
Session Introduction
Heela Azizi and Alexa Kahn
American University of Antigua, USA
Title: Body dysmorphic disorder: A systematic review of treatment and management
Biography:
Heela Azizi is currently a Medical student at the American University of Antigua. She has received her Master’s degree in Business Administration from Urbana University and her Masters in Health Administration from Franklin University.
Alexa Blair Kahn is currently a Medical student at American University of Antigua. She has received her Bachelor’s degree of Science in Biology and minor in Global Health, Culture and Society from Emory University.
Abstract:
Objective: Body dysmorphic disorder (BDD) is a severe psychiatric disorder that affects many around the world. Patients with BDD exhibit a preoccupation with one or more perceived defects in their physical appearance which is exacerbated by poor insight and delusions regarding the perceived bodily flaw. BDD is more prevalent in an all clinical setting than in the general community population, but goes undiagnosed due to lack of screening for the disorder. Therefore, this literature review is aimed to determine most effective treatment for BDD.
Method: A systematic literature review was piloted using PubMed, ScienceDirect, Embase and the American Psychological Association PsycINFO to determine the most effective treatment for BDD.
Results: We found that serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT) are efficacious in treating body dysmorphic disorder. Randomized control studies found both SSRIs and CBT (especially with imagery restructuring) to be successful in treating BDD if used for longer than six months. Recent case studies suggest electroconvulsive therapy (ECT) and adjunctive antipsychotic use are viable treatment modalities for treatment resistant BDD.
Conclusions: SSRIs are the recommended pharmacologic agent for treatment, primarily fluoxetine. It should be continued for 12-16 weeks although increasing the medication to maximum dose for additional 24 weeks duration is more appropriate. Furthermore, newer research has shown imagery restructuring as an efficacious treatment for mild to moderate BDD as it is faster than CBT and can give patients more insight on the disorder.
Karin Sernec and Gorazd V Mrevlje
University Psychiatric Clinic Ljubljana, Slovenia
Title: Inpatient treatment and family involvement of patients with eating disorders: Experience from Slovenia
Biography:
Karin Sernec is an Associate Professor at University of Ljubljana. She has earned her PhD in 2010. She has been the Head of Slovenia’s Unit for Treatment of Eating Disorders ever since it was founded in 1999. She built a multidimensional, mixed-gender inpatient treatment program in addition to group and individual outpatient treatment of persons with eating disorders. She is leading Slovenian Expert Group for Eating Disorders and continues to contribute to this field as an author and co-author of numerous scientific publications.
Abstract:
Problem & Aim: Eating disorders (ED) are chronic mental disorders that commonly involve not only patients but their entire families. The involvement of family members in the treatment of ED has been known to have beneficial effects on patient motivation which is partly reflected by the patients’ adherence to the treatment program. The purpose of this study is to assess whether participation of family members in educational support group contributes to the outcome of inpatient treatment. Educational support group for family members is held weekly at the Unit for Treatment of Eating Disorders (UED) in Ljubljana, Slovenia, in addition to the multidimensional inpatient program consisting of group psychotherapy (cognitive, behavioral and psychodynamic), psychodrama, educational groups and music, art and dance/movement therapy.
Methodology: Our retrospective cohort study included patients with ED hospitalized at the UED between January 1st 2010 and December 31st 2015 and their family members. Of the 135 admissions to our inpatient program in this time period, 55 (40.7%) terminated prematurely. Most of these (58.2%) were due to dropout by patients who were insufficiently motivated. We were able to retrieve information about family members' participation during 105 inpatient admissions. In 72 cases, family members participated actively. In 33 cases, family members did not attend the educational support group consistently (two visits or less, mostly none).
Findings: There was a statistically significant, if small, association between whether or not the patient completed our program and whether or not their family members actively participated in the treatment (χ2=6.243, p<0.05, p=0.017, Cramer's V test=0.244).
Conclusions: Those patients whose family members did attend our educational support group were more likely to complete the treatment program. This encourages us to continue to provide education and support to family members of our ED inpatients.