Introduction
Studing the scope of differences found in terms of gender in First Psychotic Episodes patients, should enhance our understanding of such disorders and improve the therapeutic approaches.
...Objectives
Our main objective was to compare the sociodemographic variables between men and women included in the Early Intervention Program in Psychosis of the Regional University Hospital of Malaga between the years 2016-2020.
Methods
Retrospective study in which the characteristics of 135 patients who started the Early Intervention Program in Psychosis of the Regional University Hospital of Malaga between the years 2016-2020 were analyzed. Statistical analysis was performed using SPSS 25.0. For the comparison of variables, Student’s t was used for quantitative variables and Chi square for dichotomous variables.
Results
Patients included in the Program; 32% were women and 68% were men. The average of age at the beginning was 35.56 for women and 28,47 for men. Most of the women were married and most of the men were single. The majority of men lived with their original family and for women with their own family. In relation with the consumption of toxins, alcohol and to smoke, were more frequent in men. More results in poster.
Conclusions
Despite the limitations due to our study design, the results obtained are in agreement with some of the discussions that are currently in force. Given that, female gender is associated with lower risk of psychosis, better premorbid adjustment, lower drug consumption and a later onset of the disease in the first-episode psychosis.
Disclosure
No significant relationships.
Introduction
The first years after a first-episode psychosis are crucial, and a comprehensive approach is essential.
Objectives
Our objective is to observe the characteristics of patients attending ...Early Psychosis Intervention Programme in (PITP) of the Mental Health Clinical Management Unit (UGC) of the Hospital Regional Universitario de Málaga between the years 2016-2020.
Methods
Data for this retrospective study were derived from 135 patients included in the PITP database between the years 2016-2020 from the Mental Health UGC of the Hospital Regional Universitario de Málaga. Descriptive analysis was performed using SPSS 25.0. For the comparison of variables, Student’s t was used for quantitative variables and Chi square for dichotomous ones.
Results
68% of the patients were men, compared to 32% women. The mean age of the patients at the beginning of the Programme was 30.76 years. 85% were 40 years or younger. 67.4% lived with their family of origin. 58.5% of the patients have had at least one hospitalization in Psychiatry. 45.9% of the patients were smokers, 33.3% consumed alcohol and 59.3% consumed other drugs. From the patients who started the Programme, 38.5% continue with the follow-up, 22.2% were discharged and 39.3% abandoned it. More results will be presented on the poster.
Conclusions
In conclusion, the patients included in the PITP of our UGC present characteristics compatible with the current bibliography. The high percentage of withdrawal from the Programme stands out, this being a very important point to address and improve.
Disclosure
No significant relationships.
Introduction
Indomethacin, a non-steroidal anti-inflammatory treatment used in various inflammatory diseases, is one of the drugs that has been related to the appearance of psychotic symptoms as a ...side effect.
Objectives
Point out the importance of knowing the possible psychiatric symptoms that some drugs can cause as a side effect.
Methods
Description of a clinical case and bibliography review.
Results
We present the case of a 71-year-old woman, with no previous mental health history, who is referred by her primary care physician due to the presence of auditory hallucinations and self-referential ideas. As a somatic history, the patient presented Rheumatoid Arthritis under control by rheumatology and acoustic neuroma, under control by neurosurgery. Treatment with Risperidone was started, up to 2 mg, which helped control her symptoms. After an exhaustive study of her situation, the possibility that her symptoms were a side effect of her usual treatment was raised. It was evidenced that the patient had taken a higher dose of Indomethacin than prescribed by the rheumatologist, reason why its daily intake was suspended, and subsequently an improvement and even suppression of symptoms was seen. Later, due to a misunderstanding, the drug was reintroduced, and symptoms appeared again.
Conclusions
The appearance of psychotic symptoms has been related to the intake of various drugs, including Indomethacin. It is essential to carry out a differential diagnosis if psychotic symptoms appear in the subject.
Disclosure
No significant relationships.
Introduction Patient adherence to a treatment regimen is of utmost importance for successful outcomes in schizophrenia. Long acting aripiprazole (LAA) is a new drug of depot antipsychotic type placed ...in the market recently that could prevent non-adherence and in reducing relapse in schizoprenia administered every 28 days. Objective A descriptive, observational study designed to explore the efficacy and tolerability of long acting aripiprazole in a sample of patients diagnosed with paranoid schizophrenia that were admitted to Acute Unit in 2014. LAA was introduced on the admission. Methods Sociodemographic variables: age, sex, and marital status. Clinical variables: average time since diagnosis, concomitant consumption of toxic substances, reason to change medication, subsequent readmissions after LAA was introduced, evaluation of the modification of the oral regimen. PANSS and CGI. Metabolic profile: weight, glycaemia, and total cholesterol, LDL and HDL, triglycerides. Cost at the beginning and after 6 months. Results Mean age: 44.50 years, 54% women. Marital status: 54% single, 27% married, 27% divorced. Mean time from diagnosis: 11 years. Toxic consumption: 27% active, 18% ex-drug users. Three patients were readmitted after introducing LAA, 2 of them were for abandoning medication (including LAA). PANSS at 6 months showed statistically significant differences in negative subscale (3 points). No statistical differences in positive and general psychopathology subscales. No metabolic side effect was found. Average saving per patient 37.05 euros per month ( Fig. 1 ). Conclusion This study signalizes that LAA is an effective treatment. Clinically, it has been shown that our patients improve adherence and prevent relapse. Moreover, no metabolic side effects were found. Besides, LAA is also efficient and we would save 407,55 euros per month.
Introduction High rates of substance abuse have been reported in the general population and users of mental health services. In our environment, relationship between substance abuse and manic phase ...has not been well characterized. Aims Determining the prevalence of active substance abuse among patients admitted to acute mental health unit at Virgen de la Victoria Hospital at Malaga, diagnosed with mania or hipomanía. Methods We analysed urine and blood seeking for ethanol, cannabis and other 11 substances in 140 patients previously diagnosed with bipolar disorder prior to their admission at the Hospital for mania or hipomanía phase. Results Thirty-seven percent of the patients were positive for drugs. Eighteen percent were positive for two or more drugs. Males had higher rates of abuse than females, except in MDMA and amphetamines. By subtypes, cannabis (37.2%) and ethanol (29.62%) were the most consumed drugs. In young age cohorts had higher rates of active substance abuse. Dual patients had longer average stays at hospital (2.6 days more) ( Fig. 1 ). Conclusions Substance abuse is a major comorbidity in bipolar patients with manic phase. The active consumption of cannabis and ethanol especially emphasizes in men younger than 35 years. We believe priority should be given to recognition and multidisclipinary approach to substance use disorders in bipolar patients. Bipolar patients with comorbid substance abuse may have a more severe course, and may be a preventable factor of new relapses. This rate could increase healthcare costs and worse quality of life of these patients.
Introduction Lack of adherence is a common cause of relapse in schizophrenia. Long-acting antipsychotics have shown in recent studies that they improve compliance. However, some randomised controlled ...trials showed no difference in relapse rates between oral medication and long-acting injections. Objective To report the use of paliperidone palmitate in an Acute Psychiatrist Unit in Spain. Method Retrospective observational study of 42 patients prescribed paliperidone palmitate (PLAI) during an admission at Acute Psychiatric unit in Málaga. In the mirror image analysis, the main outcome measure was the total number of days of psychiatric inpatient care twelve months before and after patients started Paliperidone palmitate. Results Most common reason for starting paliperidone palmitate was lack of adherence to oral medication (54%) followed by lack of efficacy on previous medication (31%). Olanzapine (47%) and risperidone (41%) were most commonly antipsychotics prescribed before PLAI. Thirty-four patients continued PLAI over twelve months (80%). Poor compliance was the most common reason of withdrawal. Three patients had a movement disorder adverse effect. Only one was lost because adverse effects. Total admissions and inpatients days were significantly reduced from the previous treatment to PLAI-treatment period ( Table 1 ). Conclusion PLAI was associated with a reduction in total inpatient days. The financial saving from reduced admissions stays exceeded the acquisition and administration cost of PLAI. Improved compliance because of PLAI is the most plausible explanation of this result ( Fig. 1 ).
Introduction Recently, depot aripiprazole was approved as a maintenance treatment for schizophrenia. However, long-acting antipsychotics has not been established efficacy in manic episode or ...maintenance treatment of bipolar disorder. Aims Describe a clinical case of multiresistant bipolar disorder. Methods Thirty-nine years old male, diagnosed since 8 years ago with bipolar disorder, current episode manic with psychotic symptoms, admitted to Acute Psychiatrist Unit. It was his seventh internment. He was dysphoric, had insomnia, and showed many psychotic symptoms like grandiose delusions and delusions of reference. He thought he was a famous painter from nineteenth century. His disorder was refractory to mood stabilizers monotherapy and to many neuroleptic and, like olanzapine 30 mg/day, depot risperidone, zuclopenthixol, haloperidol, palmitate paliperidone, He was on treatment with lithium 1200 mg/day (lithemia 0.62 prior to admission) and oral aripiprazole 15 mg/day that he was not taking regularly. Poor compliance to oral treatment. No awareness of illness. Results during the patient admission, we started long-acting aripiprazole 400 mg per 28–30 days. First 3 days he persisted dysphoric, hostile, and showing delusions of mind being read. From the fourth day, delusions disappeared and later he was calmer and more friendly, He was discharged 9 days later fully euthymic. For 6 months follow-up, the patient came once a month to community center for aripiprazole injection and he was taking lithium regularly. Last lithemia 0.65 mEQ/L. Conclusion Long-acting antipsychotics, like depot aripiprazole could be a useful alternative to oral medication, specially when there is no awareness of illness and there is low adherence to oral treatment.
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