28^th Euro Congress on Psychiatrists and Psychologists July 05-06, 2018 Vienna, Austria

Biography:

Yea-Pyng has completed her PhD from Chang Gung University. Now she is the director of Nursing Department at Mennonite Christian Hospital. She has published papers in reputed journals and has been serving as a reviewer board member of Nursing Journal.

Abstract:

Objective: Nurses constantly face the need to provide patient care, emphasis on physical, psychological, and spiritual within the health care system. To concern the nursing experience and perception in clinical caring is important. The purpose of the paper was to explore nursing experiences and perception in clinical caring from the nurse’s point of view.

Methods: A qualitative research method was applied to this paper with major assumptions from the symbolic interaction perspective. Forty subjects were recruited from regional hospital in Hualien city using purposive sampling, and were interviewed using structured method. Miles and Huberman qualitative method was used to analyze the data. Data was in the form of transcripts from tapes, analytic and process memos.

Results: Five element that were generated from the results of the study can be used to describe nurse’s concerns as follows: Function of nursing roles (to provide professional and holistic cares, satisfy requirements of commitment and conscience, to provide promptness and effectiveness of nursing service, and give a guiding principle for patient self-care), positive experiences in nursing processes (affirmation and feedback from patient, their families, and team member in the health care system; professional ability), frustrated experiences in nursing processes (insufficient support system from team member, especially from organization of nursing department, negative attitude from patients and their families), coping behaviors (include problem and emotion orientation) and expectation of administrators (to improve the professional competency, the shortage of nurses in clinical caring and upgrade the position of nurses).

Conclusions: The study successfully explores nursing experiences and perception in clinical caring.  The results of this paper can be used to help nursing administrators to catch the demand of nurses and to adequately resolve the associated problems.

Biography:

Michal Winnicki is a Psychologist who works in a Medical University of Gdansk and is a PhD student. Professionally, he is motivating patients to comply with therapeutic recommendations and implementing methods of effective communication between physicians and patients.

Abstract:

Introduction: According to various studies about half of chronically ill patients do not apply correctly to their physician's recommendations. This translates into relatively low treatment efficacy of various diseases, such as hypertension. In Poland, about 60% of hypertensive patients are non-adherent and effectiveness of blood pressure control is 26%. In order to understand this phenomenon well enough, we must consider the psychological factors associated with the patient. For this purpose, an attempt was made to create a psychological profile of the non-adherent patient.

Methods: Up to now, 200 patients from the Clinic of Hypertension and Diabetology participated in the study. To measure the level of adherence, probabilistic medication adherence scale (α=0.89) was used. Adherence was compared with the following psychological factors: sense of coherence (SOC), health locus of control, personal variables, anxiety and depression level, quality of life and social support. Additionally, the impact of medical and socio-economic factors was analyzed. The Pearson R correlation coefficient and ANOVA statistics were used for data analysis.

Results: Obtained results showed a significant relation of certain psychological factors and the level of adherence to treatment recommendations. The patients' sense of coherence (r=0.402) was the strongest factor affecting adherence. Another factor significantly related to adherence was the level of social support (r=0.386) and quality of life (r=0.450). The higher level of social support increases the probability of following physicians instructions. Personality traits as conscientiousness and agreeableness achieved the borderline statistical significance.

Conclusion: This is only the initial stage of research but it can be stated that adherent and non-adherent patients differ in some psychological characteristics. It gives opportunity to create a psychological profile of poorly co-operating patient. Thanks to that, physicians will be able to easily identify patients with high probability of non-adherence, already at the very beginning of treatment.

Biography:

Ariana Reli is a Board-Certified Psychiatrist with a certificate of additional qualifications in Addiction Psychiatry. She is a dedicated community psychiatrist with extensive experience in public and private inpatient and outpatient settings, and an experienced Psychiatric Administrator who continues active clinical practice with seriously mentally ill and dually diagnosed patients. She also consults on topics in general administrative psychiatry, including quality improvement, treatment planning, and physician management, and in clinical psychiatry, including recovery-oriented treatment for individuals with serious mental illness; training clinicians in attitudes, values, knowledge, and skills for treating individuals with serious mental illness; and family/consumer/provider collaboration.

Abstract:

Statement of the Problem: On March 15, 2008, a series of massive and deadly explosions ripped through an Albanian government munitions depot in the village of Gërdec near Tirana, resulting in 24 deaths, injuries to over 300 more people, and catastrophic damage to hundreds of homes and other civilian structures within a 2.5 kilometer radius. Thousands of artillery shells, most of them un-exploded, littered the area. The blast shattered all the windows of the terminal building at the country's only international airport, and all flights were suspended for some 40 minutes. Some 4,000 inhabitants of the zone were evacuated and offered shelter in state-owned resorts. The Government declared the zone a disaster area. The aim of the study was to assess the prevalence of post-traumatic stress disorder (PTSD) among the survivors in the population of Gërdec village.

Methodology & Theoretical Orientation: A cross-sectional study with the following collected data was conducted: (1) Demographics: sex; mean age; age range; mean time since injury; The DSM-5 criteria for PTSD were adopted, the PTSD checklist–civilian version was used to aid in the diagnosis and a higher cut-off score was implemented to minimize false positives; and (2) PTSD-related variables.

Findings: The prevalence of PTSD was 61 (37.4%). The rate of PTSD was higher among females (47.8%) than males, (29.8%) (p<0.01). The most common symptomatic responses that persisted in the long run were: (1) feeling very upset when something reminded of the stressful experience (51.5%); (2) loss of interest in things that were previously enjoyable (43.6%); and (3) feeling distant or cut-off from other people (33.1%).

Conclusion & Significance: The present paper is an attempt to stress the importance of psychological aspects of these incidents. More research is needed to study the interaction between trauma exposure, pre-existing psychological and biological vulnerabilities, and the post-trauma environment.

Biography:

Samar M.A. Attaelfadeel is a sixth year medical student at the University of Khartoum. She achieved first place in the Khartoum State Primary Certificate Examination in 2009 and third place in the Sudan Secondary Certificate Examination in 2012. She is considered by the faculty as one of the top ten students in the batch. This is the first research she conducted and published. She is interested in researches about stigma of mental diseases and some physical illnesses. 

Abstract:

Statement of the Problem: Studies found that there is stigma of mental illness among doctors and medical students. This will affect the care and treatment provided by doctors for their patients. The rate of undergraduates pursuing psychiatry as post-graduates has been declining in the course of recent years leading to a decrease in the number of therapists. This creates a treatment gap, especially in developing countries. The purpose of this study is to assess medical students’ attitude towards mental illness before and after the psychiatry course, and to determine the percentage of students who would like to become psychiatrists before and after the course.

Methodology & Theoretical Orientation: An analytical cross-sectional, institutional-based study was conducted. A self-administered questionnaire was distributed to fourth year medical students at the University of Khartoum before and after the psychiatry course. MICA-2 scale was used to assess attitude towards mental illness. Statistical analysis was done using Google Form and SPSS including Independent t-test, Chi-square and analysis of variance test.

Findings: 298 students participated (83%) before and 217 students participated both before and after (60.61%). The results showed that there was a significant change in MICA-2 score mean with P value 0.002. The percentage of students interested in psychiatry as a career did not change significantly. Less than 30% considered psychiatry seriously as their future career both before and after the course.

Conclusion and Significance: Stigma of mental illness can be reduced and attitude can be improved through medical education. Attitude towards mental illness improved after the psychiatry course but the interest in psychiatry as a future career did not change. Recommendations are to do further research to be a guide for psychiatrists in order to improve the gain from the psychiatry courses in changing students’ attitude, and to increase recruitment to psychiatry.

Biography:

Jennifer O’Connell is a Clinical Social Worker with 45 years’ experience, mostly in a rural community. She graduated from Social Work and a Bachelor of Arts at the University of Melbourne. In public organisations she initiated or promoted service development including childcare, parenting, child protection, foster care, residential services, a child and adolescent mental health service. She has worked with the aboriginal community for 45 years. In 2000 she conducted an evaluation of the first service sector response after a youth suicide. The evaluation led to the development of the program Leading from Within. She helped establish a not for profit organisation of the same name to address trauma recovery, focussing on Post Traumatic Growth. She and her husband run small groups for people who have suffered from all forms of trauma, including developmental, generational and specific incidents. Recently evaluated by the University of Melbourne it has been demonstrated that this program works and that once people have completed it they are able to mentor others. This aspect of the program - the Ripple Effect - has a community development aspect to it. Jennifer works in her family business: O’Connell Consultancy and also provides programs for Leading from Within (Greater Shepparton) Incorporated.

Abstract:

This presentation will outline the role taken by a Clinical Social Worker in a rural community both as advocate for new services and specifically in the development of a process to create growth after trauma. Following the death by suicide of a popular 18 year old star footballer and tennis coach, the impact in the local community was so great that the service sector mounted a response. However within 11 weeks, a 13 year old in the same community took his life. A similar event occurred in a community 45 minutes away and questions arose about whether the response had played a part in the second death. These deaths occurred in Mooroopna and Seymour in Northern Victoria, Australia. My consultancy was asked to evaluate the response. Following in-depth interviews with over 100 affected people, a number of recommendations were made. One of them, to provide a process for recovery, was handed back to me. The reason for the recommendation was the evidence of self-harming behaviour in many young people since the suicides. The result was the development of a program I called, “Leading from Within”. Based on the concept that growth can come from trauma, a small group trauma recovery, suicide prevention, leadership development program was established. In the first year, there were 17 small groups with almost 100 people of whom the majority were 12–25 years old, the rest were adults. The presentation will follow the development of the program from 1999 to 2017 with the outcomes of a recent evaluation by the University of Melbourne. The model has been validated and offers insight into ways that trauma can be addressed in a rural community. There will be opportunity for participants to discuss ways in which the model could be used in their own communities. In addition, given that I have worked for over 45 years as a clinician in a rural setting, I will underline the opportunities I have had, and that are available for social workers or other clinicians generally, to advocate on behalf of their community for new service development.

Biography:

Alsubaie M M is a PhD Researcher in Mental Health at the Durham University and is working as a Lecturer at King Faisal University in Saudi Arabia. His research interests encompass youth mental health and well-being, and more specifically, the role of risks and protective factors on the mental health of young people.

Abstract:

Statement of the Problem: A lack of social support is a determinant of mental health problems including depressive symptoms among university students and has negative impact on quality of life. More university students worldwide are currently being diagnosed with mental health problems, and many researchers attribute this to academic, financial and social stressors. Identifying the differential impact of sources of social support would be beneficial for the development of preventative programmes for the wellbeing of students.

Methodology: University students (aged 18 and over) completed an online survey measuring depressive symptoms (Patient Health Questionnaire (PHQ-9)), social support (multidimensional scale of perceived social support (MSPSS)), and quality of life (WHOQOL-BREF using the psychological and social relationships domains). Socio-demographic variables included age, gender, and year of study).

Findings: The sample was 461 students (82% female) with a mean age of 20.62 years (range 18–53 years). Using the PHQ-9 cut-off score of 10, the prevalence of depressive symptoms was 33%. Social support from family, and friends was a significant predictor of depressive symptoms at p=0.000*. Quality of life (psychological) was significantly predicted by social support from family and friends, while quality of life (social relationships) was predicted by social support from significant others and friends. Female students reported significantly higher levels of social support from significant others compared to male students.

Conclusion & Significance: Sources of social support showed a significant impact on depression and quality of life domains for university students and represent a valuable resource for universities in protecting the mental health of students. These findings provide knowledge for the development of effective strategies for both students and universities.

Biography:

Abstract:

More and more people the German population makes use from coaching and self-payed psychotherapy offered by non-medical psychotherapists. Coaches/therapists are faced with different challenges. They have to help the clients/patients to solve the problems in a quite short time. Especially coaches have to focus on the topics of the clients. They have to establish a therapeutic relation in a very short time. A third part of the German population is affected by mental illness. In addition, the hidden prevalence and the rate of 12 month prevalence are increasing. Because of that coaches and therapists have to be aware about the stress history and mental diseases about which the clients/patients do not speak or do not know. The Polyvagal-Theory describes the three parts and five states of the autonomous nervous system (ANS). The first and oldest part is the dorsal vagus nerve/complex (DVC, Freeze state), the second is the sympathetic nervous system (SNS, Fight/Flight state) and the third is the ventral vagus nerve/complex (VVC, Safety state, correlated with the Social Engagement System, SES). The Polyvagal-Theory helps to understand the behavior of the clients/patients as well as the possible root cause for several problems. The problems of the client/patients are often coupled with a situation and one of the stress states of the ANS. Coaching and therapy methods should mind the problem correlated stress state and the pre-dominant ANS state. The presentation will illustrate this presumption at three different cases of coaching clients. The three examples are physical and mental healthy, experienced scuba divers who reported the same problem. The coaching process and the methods were adapted to observations about the pre-dominant ANS state, used the SES activation method EmpAtECS^® and different interventions. The goal was to reach the ANS state SES for the process and the bygone situation.

Biography:

Peter Kyriakoulis is the Founder and Director of the Positive Psychology Centre. He is a Clinical Psychologist who specializes in the treatment of Depression, Anxiety Disorders and Complex Trauma. He completed his undergraduate studies with Honors at the University of Athens in 2000, and in 2003 he completed Masters in Clinical Psychology in Melbourne. In 2018, he also completed a Diploma in Clinical Hypnotherapy. Since 2003, he has been working in private practice as a Psychologist, and over the ensuing years has worked in community health and various psychiatric settings, becoming a Member of the Clinical College of the Australian Psychological Society in 2007. He has a wide interest in applying positive psychology and neuropsychotherapy principles in clinical practice whilst maintaining a cognitive behavioral framework. He also specializes in psychological assessment, including the Minnesota Multiphasic Personality Inventory (MMPI-2). He specializes in medico-legal assessments and has appeared in court as an expert witness. He is currently completing his PhD on Panic Disorder, particularly the implications of the diving response in reducing panic symptoms.

Abstract:

Background: The existence of a false suffocation alarm (FSA) monitor, which is sensitive to detecting CO₂ changes, such as those that occur with panic attacks, have been postulated by Klein in 1993. It has been speculated that panic disorder (PD) patients have enhanced CO₂ sensitivity which prompts the brain’s suffocation monitor to erroneously signal a lack of oxygen and trigger an FSA. The 35% CO₂ challenge has been widely used to study panic and CO₂ sensitivity. The diving response (DR) is an oxygen conserving adaptation that is activated by apnea and cold facial immersion (CFI). During the DR, individuals experience physiological changes including a significant decrease in heart rate. In many ways, the physiological changes that are experienced during the DR, a feeling of calmness and relaxation are the opposite of those experienced during a panic attack.

Aim: Two studies were conducted with an aim to investigate the immediate and short-term effects of breath holding and CFI on panic symptoms between panic participants and normal controls.

Methods: In the first study, participants undertook a number of challenges, including a CO₂ challenge, breath hold challenge and CFI task to establish group differences in anxiety measures and physiological responses between panics and controls. In the second preliminary study the CFI task was used to determine whether it has any effect on reducing panic symptoms and one’s response to the CO₂ challenge.

Results: Findings revealed that anxiety and panic symptoms reduced in response to the CFI.

Conclusions: Implications of the study point to the CFI reducing anxiety symptoms which warrants further investigation to determine the implications of the DR in treating panic disorder.

Biography:

Abstract:

Introduction: For a decade S. Korea has the highest suicide rate among OECD countries even with fabulous medical check-ups and insurances. But unfortunately, Thyroid Function Test (TFT) has not been included in routine check-ups. Even if asked, blood sampling and follow-up is relatively ignored compared with expensive ultrasonography to rule out cancer, which threatens to everyone. Many symptoms of psychiatric disorder are known to be interfered by dysthyroidism. But in the case of subclinical dysthyroidism, treatment strategies are controversial. We’ve found how many psychiatric outpatients are suffered from subclinical dysthyroidism and their relation with autonomic nerve system activity and clinical improvement.

Methods: The three-hundred three four outpatients who visited E&M psychiatry clinic from November 2016 to June 2017 were recruited and Two-hundred forty four subjects which met diagnostic criteria of schizophrenic spectrum disorder, affective spectrum disorder and anxiety spectrum disorder (F20 – F45 by ICD-10) were finally eligible for this study. Patients who were diagnosed with pervasive developmental disorder and any psychiatric disorder due to general medical condition were excluded for minimizing confounding variables. The 244 cases were divided into two groups as euthyroid hormone group (EH) and dysthyroid hormone group (DH), depending on whose blood concentration of either Thyroid Stimulating Hormone (TSH) or free T4 are in the normal range of reference values or not. Besides lots of psychiatric scales, Heart Rate Variability (HRV) Tests and Blood concentrations of Thyroid hormones were especially performed to all patients, both results of which are hardly interfered by transient affective state. SCL-90R and Clinical Global Improvement scale (CGI) were also performed to know the severity of symptoms and improvement in both groups. Descriptive statistics were used to know how many patients belong to dysthyroidism and incidences of co-morbidity, such as addictive disorder, which’s known as difficult to treat and have very poor clinical course. ANCOVA was used to evaluate the differences between euthyroid and dysthyroid group to check whether dysthyroid state relates with autonomic nerve system activities and CGI. Partial correlation and Multiple regression analysis were conducted to determine thyroid hormone as a predictive value.

Results: 1) 20.93% of psychiatric outpatients are turned out to have dysthyroidism: Which means nearly 21 of 100 people visit psychiatry clinics are in abnormal thyroid states. 2) Among those, 90% even didn't know that they had thyroid problems and 10% of them knew their thyroid problems, but just as unsignificant or unrelated with their affective states. 3) SCL-90R and CGI score (not shown above) in DH group after administration of T4 or PTU showed significant clinical improvement (p<0.01), including co-morbid addiction pathology with affective disorder and with panic disorder even without any anti-addictional agents. 4) The DH group, of which TSH or Free T4 values were out of normal range, was positively correlated with Total Power (TP) score of autonomic nervous system. This result might be due to over-compensation of parasympathetic nervous tone. 5) Multiple regression showed dysthyroid state could be the predictive value for assessment of clinical course and determinants of prescribing thyroid-related agents for improvement in a psychiatric perspective.

Conclusion: This Study has successfully showed that 1) TSH and Free T4, which are known to be related with oxidative stress and degeneration in neurons, are one of major predictive factors in planning treatment strategy and assuming prognosis. 2) Even though it’s been ignored and world-widely controversial, we’ve found that administration of T4 or PTU is absolutely required if blood concentration of TSH or Free T4 is out of normal range, regardless of any psychiatric diagnosis. 3) Co-morbid addictional disorders were improved so surprisingly without any anti-addictional drugs, irrespective of which patterns are substance or behavioral and clinical periods. 4) Repeated multi-centered study should be required as soon as possible to check and validate this result, so as to be one of references for establishing national policy of suicide prevention in South Korea.

Biography:

Abstract:

Spatial aesthetics in health settings remain a challenge due to the difficulty in balancing disease prevention, such as the aseptic and ergometric protective needs of clinical hospital design, with health promotion through exposure to beauty. The objective of this work is to identify the importance of the aesthetics of the environment in the treatment of mental health, through bibliographic research of qualitative character using PubMed and SciELO databases, between the years 1996 to 2018, with the key words: design, architecture, art, mental health, humanization, psychiatry and aesthetics. The indications of this work being that the aspects making up the design were extremely important as attributes of humanization because they produce a sense of belonging, respect and dignity in the patient, as well as the sense of control of the environment. The main variables influencing the aesthetic environment highlighted in this article are: light, sound, color, aroma, texture and shape. The design belongs to the aesthetic-artistic perspective, reinforces the protagonism of the sick human being in detriment of the disease, reinforces the expansion of the concept of care and enhances the patient's response to treatment. The conclusion reiterates that the multiaxial aspects brought about by the design of environments within hospitals, is in line with the biopsychosocial model of health, producing health promotion and positive responses to patients.

Biography:

Sabrina Mörkl is a Medical Doctor, Trained Psychotherapist (Integrative Behavioral Therapy), Acupuncturist, Deputy Student Teaching Coordinator for Psychiatry and Psychotherapeutic Medicine at the Medical University of Graz (MUG) and a Board Member of the Austrian Society of Medical Hypnosis (ÖGMH). In her doctoral thesis, she explored the gut microbiome of anorexia nervosa patients in comparison to other BMI groups and athletes. As nutrition is a critical influence factor for gut and brain health (which was also reflected by her study results), she began to focus on the important role of nutrition in psychiatric healthcare. In 2018, together with Dr Wagner-Skacel, she founded the first elective university course in Europe on nutrition-based- prevention and treatment approaches in psychiatric care.

Abstract:

Background: Despite the multifactorial genesis of psychiatric disorders, there is increasing evidence that nutrition not only influences the prevalence, but also the onset and the course of psychiatric disease. Nevertheless, study results show that nutrition is still not taught at medical universities and is not an integral part of undergraduate and graduate medical and psychiatric education.

Aim: This presentation highlights the important role of nutritional psychiatry as an essential pillar of the biopsychosocial treatment model of psychiatric patients. It underlines the importance of teaching nutrition to students of medicine and psychiatry trainees.

Methods: Interactive case vignettes are used to illustrate the role of nutrition in psychiatric and current scientific evidence. The impact of nutrition on the gut microbiome and the gut brain axis influencing our mood and behavior through regulation of neurotransmitters (such as serotonin, GABA and dopamine) is discussed. Further, an easy-to-handle nutritional interview approach for psychiatrists is presented. Secondly, this presentation focuses on dietary interventions for the treatment of depression and translates recent scientific evidence into concrete food prescriptions for patients.

Discussion: An adequate supply of micro- and macronutrients is essential for well-being and may also be a fundamental requirement for the efficacy of psychopharmacological treatment. As knowledge about dietary approaches appears to be as important for psychiatrists as for gastroenterologists and endocrinologists, nutritional psychiatry was implemented as an elective course for students and future psychiatrists at the Medical University of Graz and is an integrative part of our psychoeducational group for inpatients suffering from depression. We hope that this presentation helps to implement nutritional approaches in basic psychiatric care and in the curriculum of medical schools in Europe.

Biography:

Verena Hein is professionally qualified as a Personal Coach (2006 Institut für Lernsysteme, ILS), Hypno-Coach (2007 Dr. B. Migge Institut Westfalen-Lippe), Therapist for Dolphin Assisted Therapy (2012 B. Weitzmann, Benidorm, Spain) and Non-medical Psychotherapist (2017 Germany). She graduated with a BSc Psychology (2014 University of Hagen, Germany) and studies presently at the University of Hagen (MSc Psychology). She works in her own company, the Coaching Practice 4academy, since 2010 as Personal and Business Coach and Non-Medical Psychotherapist. In her first profession, she was a Scientist (1988 Diplom-Kristallograph, University Leipzig Germany), and works as a Technical Coordinator for global projects in reliability of microelectronics. She uses her experience in the industry to develop and to adapt coaching concepts for engineering offices and knowledge workers. Her special topics of interest are the management of complexity, techniques to encourage creativity, stress and anxiety and burnout prevention.

Abstract:

Counseling, coaching and short-term-therapy have become more and more popular in Germany. The problems, wishes and requirements of the clients/patients are varying in a wide range as well as their personalities, fates and experiences. For the coach/therapist it is challenging to build up a trustful client-coach-relationship in several hours. The polyvagal-theory describes the three stages of the autonomous system. These are the freeze state (dorsal vagus complex), the fight/flight state (sympathetic nervous system) and the social engagement system SES (ventral vagus complex). Clients/patients often remain in a pre-dominant stress mode. This stress state is sustained by the preferred perception of danger-implying cues, a negative belief system and distrust. Clients/patients who suffer from trauma or long-term stress tend to be passive in the first period of treatment. Especially persons with autism or depression have a limited expression in mimic and body-language. The missing reciprocity is demanding for the coach/therapist and impedes the therapeutic relation. The change from the freeze state to the fight/flight state due to a successful process can cause negative emotions (anger, fury, hate) and the wish to escape the situation. Although the change to this mode is natural because of the hierarchical structure of the autonomous nervous system, it makes the process difficult. The SES state is the most effective for a successful coaching/therapy process which is based on a positive social interaction, the feeling of safety and the re-learning accompanied by positive emotions. A method has been developed which activates the SES state as a kind of a mental warming up before the coaching session. The goal of the technique is a reduction of the arousal and the support of the communication between client and coach. The state can be reached quite quickly by safety mediating instructions and embodiment techniques which activate the SES related five brain nerves.