Introduction
Many internationally studies, in the last two decades, found problematic internet use associated with a variety of psychosocial problems, but in Portugal this is a recent research ...question specially in adults.
Objectives
To explore the relationship between problematic Internet use, emotional regulation and self-esteem.
Methods
138 Portuguese subjects (77.5% females), with a mean age of 27.76 years old (
SD
= 8.98, range: 18-58) filled in the Portuguese versions of the Generalized Problematic Internet Use Scale-2, the Difficulties in Emotion Regulation Scale and the Rosenberg Self-Esteem Scale.
Results
Negative consequences subscale of generalized problematic internet use was positively correlated with all the emotional regulation difficulties subscales and negatively with Self-Esteem, and positively with daily hours of internet usage. A similar result was found for Self-Deficient Regulation subscale, except for Clarity subscale. Mood Regulation was correlated with Strategies, Goals and Self-Esteem. Males showed higher levels of Negative Consequences. Age and age onset of Internet use were negatively correlated with Mood Regulation, Self-Deficient Regulation and Negative Consequences. A statistically significant difference in Mood Regulation, Self-Deficient Regulation and Negative Consequences in marital status levels, and in professional situation, with higher median scores in divorced and single without a relationship and in student subjects; no significant differences were found in educational level.
Conclusions
Generalized problematic Internet use, especially their Negative Consequences, is associated with higher emotional dysregulation, low self-esteem, lower age and lower age of Internet onset, being divorced or single without a relationship and being student, and it is more prevalent in males.
Disclosure
No significant relationships.
In response to the emerging crisis and growing calls from patients and clinicians for guidance 5, a working group of clinical experts from the International College of Obsessive Compulsive Spectrum ...Disorders (ICOCS) and the Obsessive-Compulsive and Related Disorders Research Network of the European College of Neuropsychopharmacology (OCRN) have produced this consensus statement with the aim of delivering pragmatic guidance at the earliest opportunity to clinicians for managing this complex challenge. Based on the risks associated with exposure and response prevention (ERP) in the pandemic (see below), and uncertainty as to which of the two evidence-based treatments, pharmacotherapy or cognitive behaviour therapy (CBT), represents the most efficacious first line treatment modality 11, pharmacotherapy should be the first option for adults and children with OCD with contamination, washing or cleaning symptoms during the COVID-19 pandemic. Consider A) type of medication; most patients should receive an SSRI, or if not responsive, another SSRI and as a third choice clomipramine (for which an ECG may be required in certain patient groups); Note US Food and Drug Administration "black box" warnings or advice from equivalent national regulatory authorities regarding increased risk in young people and other vulnerable patient groups. Check for adverse effects and be available for any concerns related to "activation" or newly emergent or increased suicidal ideation, which in the young can be mitigated by starting treatment at a low dose and titrating more gradually; B) dosage; if the patient is on a suboptimal dose, consider increasing it, paying attention to any contraindications; C) SSRI-resistance; consider a low dose of adjunctive antipsychotic (aripiprazole, risperidone, quetiapine, olanzapine), especially if a tic is present; D) adherence; ensure the patient is able to obtain an adequate supply and is taking the treatment regularly.
A closed-form expression is proposed for evaluating the mean inter-core crosstalk (ICXT) power in weakly-coupled multi-core fibers (WC-MCFs), with cores' propagation constants perturbed by bending, ...twist, and random structure fluctuations. This expression generalizes the expression proposed by Koshiba et al. by taking the dependence of the propagation constants on the longitudinal coordinate of the fiber (induced by constant bending and twist along the MCF) into account in a more rigorous way. We provide a physical interpretation of the proposed expression as the convolution of the spectrum of the <inline-formula><tex-math notation="LaTeX">z</tex-math></inline-formula>-dependent component of the propagation constant induced by the bending and the spectrum of the perturbation induced by the structure fluctuation. The accuracy of the proposed closed-form expression is assessed by comparing simulation results of the coupled-mode equations with the theoretical predictions from the proposed expression. Very good agreement of the mean ICXT power estimates is shown in the whole range of tested bending radius, difference of intrinsic effective refractive indexes of cores, twisting period and correlation length, for fiber lengths longer than one half of the twisting period and five times the correlation length. We show that the proposed expression enables evaluating the mean ICXT power in WC-MCFs with improved accuracy relative to Koshiba's expression: remarkable differences of mean ICXT power, that may exceed <inline-formula><tex-math notation="LaTeX">\text{6}\;\text{d}\text{B}</tex-math></inline-formula>, can occur between the estimates provided by the Koshiba's expression and the closed-form expression derived in this article, particularly for high correlation length and twisting rate. Differently from the expression proposed by Koshiba et al. , the proposed closed-form expression predicts that the twisting period may have a significant influence on the mean ICXT power, in qualitative agreement with experimental results reported by other authors.
Introduction
Although not the most prevalent clinical presentation, obsessive compulsive (OC) symptoms have been reported after TBI. Post-TBI OC disorder (OCD) cases are rare, so that OC symptoms in ...this setting are frequently described as OC personality disorders (OCPD).
Generally, the clinical features of post-TBI OCD are thought to be similar to those observed in idiopathic OCD, assuming the probable involvement of structures such as the orbitofrontal cortex, basal ganglia, limbic and thalamic systems in its pathophysiology, although no anatomical location clearly associated with post-TBI OCD being recognized.
Objectives
Brief systematic review of OCD post-TBI and case report.
Methods
Bibliographic research using Pubmed. Clinical interviews and file consultation, with patient informed consent.
Results
We present a case of a 63-year-old patient referred to the Psychiatry Consultation due to obsessive thoughts of dirt and contamination, accompanied by compulsive cleaning and sanitizing behaviors with at least 3 years of evolution with a history of TBI and right frontopolar hemorrhage 5 years ago. These behaviors significantly impaired his functionality (cleaning objects on average 300 to 700 times a day, spending hours in the shower). The patient had insight for the excessive behaviors and its daily impairment.
Conclusions
Psychopathology in the post-TBI context is not infrequent, however reported cases of post-TBI OCD are described as rare in the current literature. The short description of this phenomenon implies the need for more studies focused on the study of the phenomenology of post-TBI OCD. For example, while OCD and obsessive-compulsive symptoms tend to be recognizable psychiatric phenomena, neurobehavioral sequelae in a post-TBI context can present multiple manifestations and resemble OC phenomena, without actually constituting OCD.
Disclosure of Interest
None Declared
Pharmacist interventions to enhance blood pressure (BP) control and adherence to antihypertensive therapy in adults with essential hypertension were reviewed.
A literature search was conducted to ...identify relevant articles describing pharmacist interventions intended to improve adherence to antihypertensive medications. Studies were included if they described a pharmacist intervention to improve medication adherence and analyzed adherence to therapy and BP control as outcomes. A fixed-effects model was used to combine data from randomized controlled trials.
A total of 15 studies were identified, testing 16 different interventions and containing data on 3280 enrolled patients. Although 87.5% of the interventions resulted in significant improvements in treatment outcomes, only 43.8% of the interventions were associated with significant increases in medication adherence. All interventions that increased antihypertensive medication adherence also significantly reduced BP. Almost all the interventions that were effective in increasing adherence to medication were complex, including combinations of different strategies. Meta-analysis of 2619 patients in 8 studies found that pharmacist interventions significantly reduced systolic blood pressure (SBP) (p < 0.001) and diastolic blood pressure (DBP) (p = 0.002) and that the meta-analytic differences in SBP and DBP changes from baseline to endpoint in intervention and control groups were -4.9 ± 0.9 mm Hg (p < 0.001) and -2.6 ± 0.9 mm Hg (p < 0.001), respectively.
A literature review and meta-analysis showed that pharmacist interventions can significantly improve medication adherence, SBP, DBP, and BP control in patients with essential hypertension. Interventions were complex and multifaceted and included medication management in all analyzed studies.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
IntroductionObsessive-Compulsive Disorder (OCD) is a chronic disabling condition, with considerable lifetime prevalence. There are interindividual differences regarding personality dimensions and how ...they affect obsessive- compulsive (OC) symptomatology. Furthermore, there is a connection between OC symptoms and the use of maladaptive emotion regulation strategies (expressive suppression) instead of using more cognitive reappraisal.ObjectivesExplore the relationship between personality, emotion regulation strategies and OC symptoms by testing a path analytic model in a sample of healthy participants and in a sample of OCD patients.MethodsTwo samples of participants were utilized. Sample 1 consists of 787 healthy participants from the general Portuguese population. Sample 2 is composed of 33 OCD patients and 32 Healthy Controls (HC). Participants completed different scales: Emotion Regulation Questionnaire (ERQ), Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) and Obsessive-Compulsive Inventory-Revised (OCI-R), through online surveys (sample 1) or a clinical interview (sample 2). These questionnaires were then analyzed with a path-analytic approach.ResultsIn sample 2, we found significant differences between OCD patients and HC in every OCI-R subscale, except Hoarding and Neutralizing. In the NEO-FFI, OCD patients scored higher on Neuroticism and lower on Extraversion. No significant differences were found regarding the ERQ. Relatively to sample 1: path analysis results showed that 13,4% of the variance of OC symptoms was explained by the best-fitting model. Only Neuroticism and Extraversion were directly associated with higher OCI-R Total scores, whereas Agreeableness predicted less OC symptoms. The use of Expressive Suppression was associated with more OC symptomology, but no significant connection was found with Cognitive Reappraisal. Regarding sample 2, no model was found, showing no modifying effect of emotion regulation strategies on OC Symptoms.ConclusionsThere is a deep-rooted interconnection between personality and emotion regulation regarding OC symptomatology in a sample of healthy participants but no effect of emotion regulation was seen regarding OCD patients.To sum up, promising results were obtained and it could be an important field for the OCD in terms of diagnostic, severity and treatment.Disclosure of InterestNone Declared
Monitoring bioelectric phase angle (PhA) provides important information on the health and the condition of the athlete. Together with the vector length, PhA constitutes the bioimpedance vector ...analysis (BIVA) patterns, and their joint interpretation exceeds the limits of the evaluation of the PhA alone. The present investigation aimed to monitor changes in the BIVA patterns during a training macrocycle in swimmers, trying to ascertain if these parameters are sensitive to training load changes across a 13-week training period.
Twelve national and international level swimmers (four females; eight males; 20.9 ± 1.9 years; with a competitive swimming background of 11.3 ± 1.8 years; undertaking 16-20 h of pool training and 4-5 h of dry-land training per week and 822.0 ± 59.0 International Swimming Federation (FINA) points) were evaluated for resistance (R) and reactance (Xc) using a single frequency phase sensitive bioimpedance device at the beginning of the macrocycle (M1), just before the beginning of the taper period (M2), and just before the main competition of the macrocycle (M3). At the three-time assessment points, swimmers also performed a 50 m all-out first stroke sprint with track start (T50 m) while time was recorded.
The results of the Hotelling T
test showed a significant vector displacement due to simultaneous R and Xc changes (
< 0.001), where shifting from top to bottom along the major axis of the R-Xc graph from M1 to M2 was observed. From M2 to M3, a vector displacement up and left along the minor axis of the tolerance ellipses resulted in an increase in PhA (
< 0.01). The results suggest a gain in fluid with a decrease in cellular density from M1 to M2 due to decrements in R and Xc. Nevertheless, the reduced training load characterizing taper seemed to allow for an increase in PhA and, most importantly, an increase of Xc, thus demonstrating improved cellular health and physical condition, which was concomitant with a significant increase in the T50 m performance (
< 0.01).
PhA, obtained by bioelectrical R and Xc, can be useful in monitoring the condition of swimmers preparing for competition. Monitoring BIVA patterns allows for an ecological approach to the swimmers' health and condition assessment without resorting to equations to predict the related body composition variables.
Introduction
The COVID-19 outbreak imposed several periods of lockdown to stop the pandemic, with a determinant impact on access to mental health services. In Portugal, the first State of Emergency ...was declared on the 18th of March 2020, with the obligation of mandatory confinement and circulation restriction. Restrictive measures were alleviated on the 2nd of May 2020.
Objectives
We aimed to investigate the impact of the first confinement on the maintenance or loss of psychiatric and psychological follow-up. Also, we aimed to explore the outcomes in the mental health of losing psychiatric or psychological consultations.
Methods
We conducted an online survey among the Portuguese population to evaluate demographic, clinical and mental health variables (STAI, DASS-21, PHQ, OCI-R, Quality of Life QoL and PSS). Individuals were invited to answer the survey at two timepoints: third week of March 2020 and third week of May 2020. Concerning the first timepoint, we used independent t-tests to compare the mental health variables in the individuals who loss and who did not lose consultations. Then, we evaluated the impact of losing consultations across time in those individuals who continued responding in the second timepoint, through a Linear Fixed Model. All the analyses were performed using JASP software.
Results
From the total sample (n=2040), 334 individuals (84.4% female gender) had psychiatric and/or psychological consultations previously to the confinement. In March 2020, the individuals who maintained the consultations (35.0%) showed best mental health indicators in the QoL Self Evaluation (p=0.002), QoL Satisfaction (p=0.037), STAI State (p<0.001), DASS-21 (p=0.001), PHQ (p<0.001), OCI-R (p=0.002) and PSS (p<0.001). Among the matched individuals who answered the survey in May 2020 (n=93), we found that the group who maintained follow-up (n=24) did not improve significantly more than the other group (n=69) for any of the mental health variables in study.
Conclusions
The results indicate that stopping psychiatric and psychological follow-up represented worse mental health outcomes at the beginning of the first confinement. However, anxiety feelings improved at the end of the first confinement, which happened independently of psychiatric/ psychological follow-up.
Disclosure of Interest
None Declared
Competitive swimming requires high training load cycles including consecutive sessions with little recovery in between which may contribute to the onset of fatigue and eventually illness. We aimed to ...investigate immune changes over a 7-month swimming season. Fifty-four national and international level swimmers (25 females, 29 males), ranging from 13 to 20 years of age, were evaluated at rest at: M1 (beginning of the season), M2 (after the 1st macrocycle’s main competition), M3 (highest training load phase of the 2nd macrocycle) and M4 (after the 2nd macrocycle’s main competition) and grouped according to sex, competitive age-groups, or pubertal Tanner stages. Hemogram and the lymphocytes subsets were assessed by automatic cell counting and by flow cytometry, respectively. Self-reported Upper Respiratory Symptoms (URS) and training load were quantified. Although the values remained within the normal range reference, at M2, CD8
+
decreased (M1 = 703 ± 245 vs. M2 = 665 ± 278 cell μL
−1
;
p
= 0.032) and total lymphocytes (TL, M1 = 2831 ± 734 vs. M2 = 2417 ± 714 cell μL
−1
;
p
= 0.007), CD3
+
(M1 = 1974 ± 581 vs. M2 = 1672 ± 603 cell μL
−1
;
p
= 0.003), and CD4
+
(M1 = 1102 ± 353 vs. M2 = 929 ± 329 cell μL
−1
;
p
= 0.002) decreased in youth. At M3, CD8
+
remained below baseline (M3 = 622 ± 245 cell μL
−1
;
p
= 0.008), eosinophils (M1 = 0.30 ± 0.04 vs. M3 = 0.25 ± 0.03 10
9
L
–1
;
p
= 0.003) and CD16
+
56
+
(M1 = 403 ± 184 vs. M3 = 339 ± 135 cell μL
−1
;
p
= 0.019) decreased, and TL, CD3
+
, and CD4
+
recovered in youth. At M4, CD19
+
were elevated (M1 = 403 ± 170 vs. M4 = 473 ± 151 cell μL
−1
;
p
= 0.022), CD16
+
56
+
continued to decrease (M4 = 284 ± 131 cell μL
−1
;
p
< 0.001), eosinophils remained below baseline (M4 = 0.29 ± 0.05 10
9
L
–1
;
p
= 0.002) and CD8
+
recovered; monocytes were also decreased in male seniors (M1 = 0.77 ± 0.22 vs. M4 = 0.57 ± 0.16 10
9
L
–1
;
p
= 0.031). The heaviest training load and higher frequency of URS episodes happened at M3. The swimming season induced a cumulative effect toward a decrease of the number of innate immune cells, while acquired immunity appeared to be more affected at the most intense period, recovering after tapering. Younger athletes were more susceptible at the beginning of the training season than older ones.
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