Day 1 :
Karlstad University, Sweden
Time : 09:00-09:40
Elizabeth Ekman is a PhD, Licensed Psychotherapist and Supervisor in CBT, was born in Gothenburg Sweden. She Started out in education for Chemical Engineering for some years. Bachelor of Science, Psychology – 1979 Hahnemann Medical College, Philadelphia, U.S.A. (Drexel University) Social work -1983 Gothenburg University, Sweden Psychotherapist program – 1994, and authorizing as Supervisor, 1997: Uppsala University and the Swedish association for Behavioral therapy – BTF, Uppsala, Sweden Karlstad University, Phd in psychology. Over 10 years of psychotherapeutic work in hospitals, with inpatients and outpatients, treating various disorders such as anxiety, eating disorders, depression, psychosis, autism /ADHD with CBT. Private Practice since – 1993. Worked with athletes and worked as a consultant to National sports federation and Swedish Olympic Committee. Supervision and lecturing for doctors, psychologists, psychotherapists, social workers, nurses as well as sport psychologist since 1993. Online Educational programs for CBT since 2009. Several national and international workshop presentations as well as open papers and case presentations such as Psychosis, ASD /ADHD and CBT
Statement: Attention deficit hyperactivity disorder (ADHD) symptoms are part of a spectrum, and genetic studies have proposed that ADHD should be regarded as a set of behavioral traits that are also present in the general population but in a less extreme way. In addition to the core symptoms is “selective attention,” This extreme form of attention (hyper focusing) is not discussed in current conceptions of ADHD. Studies has so far mostly focused on problems with this profile and less focus has been on how it can be to advantage for the individual. Several studies indicate that physical activity and environmental factors have a positive effect on inattention and hyperactivity as well as a positive effect on stress, negative affect, anxiety and depression, as well as decreasing bad conduct and poor impulse control. The purpose of the current study was to compare athletes to non-athletes in terms of ASRS criteria. Methodology: The ASRS instrument was administered as an interview to the two groups of participants by a trained psychotherapist with knowledge of ADHD regarding school activity and leisure time/their sport activity time. Results: Showed high scores in school and low scores during leisure/sport activities for athletes. Their performance in school and everyday life was well functioning. Conclusion: ADHD criteria are highly presented in the athlete group. Potentially these athletes are in the school environment able to inhibit the symptoms and have learned to show appropriate behavior with the training. Studies suggested that aspects of the ADHD cognitive profile might be beneficial in a various context such as sport, entrepreneurs. It is suggested that we should look at the profile as a “diversity perspective” and change from a model of “defect” to a model of “difference” and focus more on how the environmental conditions can influence the profile of ADHD.
- Mental Health, Psychiatric Disorders, Psychiatry and Psychology, Bipolar and Schizophrenia, Neuropsychiatry, Psychotherepy, Child and Adolescent Psychiatry, Self-harm and Suicide Prevention, Stress, Anxiety and Depression, Psychosomatic Disorders
Barnet Hospital, UK
Title: Are our paediatric trainee doctors confident to look after children and young people (0-18 years) with mental health difficulties?
Time : 09:40-10:10
Natasa Chrysodonta completed her medical degree at the University of Bristol and did her MSc degree in Genomic Medicine at Queen Marry University. She is a Paediatric Registrar at Barnet Hospital in London. She has an interest in Child Mental Health.
Mental health illness places a signicant global disease burden for illness and in injury in children and young adults. When these patients present in mental health crisis they pose a significant risk of harm to themselves, relatives and health care providers. It is essential that all parties involved in the management of these patients have adequate training and feel confident to provide care to children and young adults presenting to the emergency department with mental health difficulties. The paediatric trainees at Barnet Hospital in London have informally expressed their desire to further their competencies in this area in order to improve the safety and quality of care offered to this cohort of patients. A staff survey was performed with the aim to establish the level of confidence of Paediatric trainee doctors to manage children and young people, age 0-19 years of age, who present with mental health difficulites in the emergency department of Barnet Hospital. A questionnaire was used with a total of 13 questions. A total of 10 questions required responses on a likert scale and 3 questions required a free text response. The questionnaires were placed in the Paediatric doctors office, from where they were collected and returned to. All questionnaires were submitted anonymously over a 3 week period in March 2021. The questionnaire showed that 52% of Paediatric trainee doctors are frequently concerned for the safety of this cohort of patients presenting to the emergency department. Only 16% of Paediatric trainee doctors are satisfied that they have received appropriate training to effectively engage and safely manage these patients. Based on these findings a training plan will be created to focus on the learning needs of Paediatric trainee doctors in our department.
Rajouri Government Medical College, India
Time : 10:10-10:40
Samreen Naz has earned Doctorate in psychology. She has investigated the emotional competence, resilience, mental health and job satisfaction among health care employees in India. She has presented her research work many reputed conferences and seminars. She has also published her research work in national and international journals. Presently she is work as visiting clinical psychologist in government medical college at Rajouri, J&K, India.
Statement of the problem: Health care is one of the significant dimensions of modern human life. Common individuals are taken care of by the medical health care employees for the health issues. However, the health care employees in health care industry also need attention for their own health to maintain the quality of life. Ever increasing workload and specialization have added to the stress resulting in the poor mental health among hospital employees as well. In this backdrop it becomes vital to study the mental health of health care professionals. The current investigation attempted to assess the mental health of men and women health care employees working in public and private hospital of northern Indian states. It was hypothesized that there is no significant difference in mental health of health care employees in public and private hospitals. Methodology and Theoretical Orientation: Mental health survey was conducted implementing the quantitative research method of research in this study. Hospital employee having less than two years of health care experience was not considered as participant in this investigation. A total of 519 responses were collected during the study of which 39% were from medical and 61% were from paramedical male (47%) and female (53%) employees. To collect target data questions forms were distributed among the permitted hospitals of North India, specifically three states (Jammu & Kashmir, Punjab and Rajasthan). The inclusion of participants was on the basis of convenient sampling after due consent from the participants. Findings: Investigator administered Employees Mental Health Inventory (EMHI, Kumar, 2001) on 264 public and 255 private hospitals’ health care employees. Findings revealed that health care employees in private hospitals scored lower (M=16.90, SD=4.47) than health care employees in public hospitals (M=18.67, SD=4.09) on mental health. Furthermore, this difference in mental health was found to be statistically significant (F(1,518)=22.17, p<.001). The obtained results were in line with the findings of Kevric et al. (2018) which showed that surgical trainees suffered worse psychological health as equated to the universal population. Interestingly, medical health care employees reported higher mental health than paramedical employees. Conclusion and Significance: Results showed that private hospital employees have scored significantly lower than the public hospital employees on mental health. These results might be due to several other factors to be explored in future research, like over workload, limited manpower, poor human resource management, long duration of work shift, payments and facilities differences, etc. The quality of infrastructure could not be considered as a responsible factor in private sector being as competent as in public sector hospitals. This study is innovative in assessing the mental health of health care employees and highlighting good management of medical human resources to support their quality of life and ultimately quality health care services by them. The significance of findings is in guiding the health managers to offer adequate support to all health professionals towards their own mental health by arranging training workshop of meditation, yoga and coping strategies.
Hospital Center of São João, Portugal
Time : 10:40-11:10
Alda Mira Coelho is a Child psychiatrist / Child and Adolescent Psychiatry Service in Hospital S. João. /Invited Assistant of Child and Adolescent Psychiatry -Faculty of Medicine, University of Porto in Medicine/Specialization in Child and Adolescent Psychiatry/Master's degree in Developmental Psychology and Early Intervention, in Autistic children, in the Faculty of Psychology and Educational Sciences and Submitted PhD thesis in the area of Autism Spectrum Disorders. Prognostic Factors in Faculty of Medicine,Univ.of Porto. She contributed to develop an integrated intervention project in the area of Autism, with specialized support units for ASD in public schools, with an integrated psychoeducational approach, in addition to training actions and participation in scientific meetings. In 1998 she developed a Specialized Consultation on Autism Spectrum Disorders (ASD), having carried out numerous training and support actions in this area, enhancing the importance of parents’ in ASD..
Introduction: It has been studied that very early intervention may help improve neurodevelopmental disturbances arising from impoverished socio-emotional interactions in the first years of life, however, there is still a lack of knowledge regarding developmental prognostic indicators. Objectives: With this study we aimed to investigate developmental trajectories of children with Autism Spectrum Disorders in order to identify predictive prognosis factors. Methods: We examined clinical features of 55 children with Autism Spectrum Disorders, in two moments of evaluation, with an interval of three years. They were assessed with the Childhood Autism Rating Scale and with Autism Diagnostic Observation Schedule as a symptom of severity measure, at both moments, and with Ruth Griffiths Scale to evaluate developmental profile. We selected two groups, based on the results obtained at moment 2. We also selected questions from a questionnaire to parents in order to understand if early parents’ concerns can predict prognosis. Results: Over time, the number of worse cases decreased significantly. We found a strong correlation between Personal Relation (r=0.798, p<0.001), Imitation (r=0.622, p<0.001) and Verbal (r=0.730, p<0.001) and nonverbal communication (r=0.699, p<0.001) and the score obtained in the second evaluation. Also interactive gestures, joint attention, reciprocity and pleasure in interaction obtained strong correlations with the final score. Discussion: Personal relation, imitation and both verbal and non-verbal communication, as well as interactive gestures, joint attention, reciprocity and pleasure in interaction may have a good predictive value in the development of children with Autism Spectrum Disorder. Keywords: Autism Spectrum Disorder (ASD); Development; Predictors.
Sarojini Naidu Medical College, India
Title: Difficulty in high order linguistic processing - A relevant diagnostic marker for schizophrenia
Time : 11:10-11:40
Jayesh Srivastava is affiliated to Sarojini Naidu Medical College, India.
Objective: To develop Hindi Linguistic Function Test battery (HLFT Battery) as early detection tool for schizophrenia. Background: The Hallmark of schizophrenia is semantic deficit/language impairment. In order to detect subtle linguistic performance deficits in patients with schizophrenia, we attempted to develop a test battery in Hindi vernacular language. Methods: Total 68 participants namely 34 patients with schizophrenia and 34 controls, were recruited into study by using Clinical Global Impression (CGI-1) Scale and General Health Questionnaire -12 (GHQ-12 ) respectively. The patients with Schizophrenia (17 males and 17 females) were evaluated by using PANSS (positive and negative symptoms scale for schizophrenia) and HLFT battery for their symptoms and linguistic performance respectively. Control was evaluated using HLFT battery. HLFT battery was designed containing three blocks by using Antonyms, synonyms, homonyms, hyperonyms, homonyms, distractors and adages. Result: Patients with Schizophrenia scored significantly lower than the healthy controls in hyponym plus distractor combinations (p=0.001). At hyponym plus distractor combination score of 2.5, the sensitivity and specificity for using it as cut off for diagnosing schizophrenia are 79 % and 55 % respectively. Conclusion: The hyponym- distractor pairs seem to irritate the patients' brain more. Taxonomic representation such as hypo-/hyeronomia, synonomia and also adages might be significantly impaired in patients with schizophrenia and developing a pen and paper screening test and these high level linguistic features seem worth looking at. This HLFT battery seems useful and could be used as a screening tool for early detection of psychosis/schizophrenia; it might lead to a better understanding in the aetiology of schizophrenia in general. Keywords: Schizophrenia, Semantic deficit, Language impairment, PANSS, HLFT, CGI, GHQ.
Dolly Tejaswi Yalamanchili was born in Vijayawada, India. Currently working at Priory Hospital North London. She has a Master of Arts in Psychology and is registered with the HCPC as a Practitioner Psychologist. She has significant experience in counselling adults, children and adolescents with depression, suicidal ideation, anxiety and engaging in behavioural management for personality disorders. Also patients with physiological issues benefitting from therapeutic intervention. She is currently working in a private mental health facility in London. Her broad area of interest in the field of psychology is towards personality disorders and in particular Borderline Personality Disorder. She finds it extremely intriguing to gain a deeper knowledge of the intricacies and nuances of the complex thought processes of individuals and to understand their motive. She considers herself an agent of change and her approach towards therapy is influenced by Carl Rogers ideology of “unconditional love”. She believes that the essence of life is to be explored.
The current paper will discuss in detail, a complex case of emotional dysregulation. A sixteen-year-old young person, female, was admitted to an acute ward with a presentation of suicidal ideation, non-suicidal self-injury and feelings of emptiness, emotional dysregulation and difficulties with interpersonal relationships. Family environment was described to be chaotic where the young person felt that her voice was not heard. She often displayed black and white thinking and interpersonal relationships were fraught with extreme emotions. The young person expressed fear of abandonment, the need to engage in impulsive behaviour in order to fill the void and the urge to self-harm. The repetitive patterns of manipulative thought accompanied with impulsive behaviour are especially observed with relation to sabotaging herself. Given the level of emotional dysregulation and with the other dysfunctional behaviour, the working diagnosis is of the Emerging unstable personality disorder. Taking into consideration her presentation and significant past events the case formulation at a therapeutic level is of identifying the core elements of the maintenance cycle and managing the behavioural aspects. The intervention was delivered as a synthesis of pharmacology and integrated psychotherapy. The study would present the intensity of the urges to engage in self-harm and suicidal ideation pre and post the therapy sessions. It is further a review of the progress the subject had made with respect to integrated psychotherapy including CBT, DBT and existential therapy in individual therapy sessions as well as the group therapy sessions. Although it is observed that the young person may appear to regress at times, evidence suggests that there is a significant refinement of thought processes indicated by the substantial ongoing positive changes in the condition of the subject after each session, accompanied by greater self-reflection.
Larkin Community Hospital, USA
Title: Role of circumventricular organ in Covid-19 and progression of depression: Immunologic mechanism and novel treatment: A systematic review and meta-analysis
Time : 12:10-12:40
Elona Greca is an experienced resident Doctor ready to take career to the next level. Areas of expertise and passions include clinical research and medical care, advocating for better accessibility to healthcare, health policy and education. Believing that quality education is essential to develop all the attributes and skills to achieve potential as human being, regardless of age or academic background. I have done Harvard Medical School Fundamentals courses that improved my knowledge for work on health care applicants, projects, and research. Being part of Larkin Hospital Research team have built me strong foundation in the field of research, had provide me exciting opportunities to work as part of team and most importantly add to the evidence base ,leading to better outcomes for patients.
Background: Circumventricular organs (CVOs) are unique areas of brain outside the blood-brain barrier (BBB) bordering the third and fourth ventricle. Covid-19 may cross the BBB through CVOs infecting the brain, culminating in the secretion of cytokines. Pathogenesis of depression has been linked to proinflammatory cytokines like IL- 6. Our objective is to evaluate the relationship between IL-6 and depression due to Covid-19 and explore the possible treatment option with Tocilizumab. Method: We conducted a systematic review and meta-analysis of Randomized Controlled Trials, Controlled Clinical Trials and Observational Designs published between 2019 -2021 through PubMed, Clinical Trials.gov, Cochrane data search. The receiver operating characteristic (ROC) curve was utilized to analyze the prognostic ability of cytokine in depression in Covid 19 patients. Heterogeneity was assessed using Cochran's Q test and I2 test and the bias was evaluated by visual inspection of the symmetry in funnel plots. Results: Fourteen studies met the inclusion criteria, 11 studies were included in meta-analysis with more than 2000 participants and 3 studies are included in qualitative synthesis with more than 3000 participants. The ROC curve shows that AUC (IL-6) =87% (95% CI of 0.87037 to 1) and Youden index optimum cut-off point selected is 19. The Kaplan-Meier curve and the log-rank test were applied to further assess the potential risk factors associated with the progression of depression from COVID-19. The Data analysis was conducted using StasDirect software. Conclusion: This systematic review and meta-analysis implies that IL-6 could be a marker to anticipate depression from COVID-19 and provide the evidence of an immunosuppressive drug Tocilizumab to improve depression. However, more studies should be lead to confirm this conclusion.
Saf Buxy is a Social Behavioral and Addiction Counselling Psychotherapist. He is an Author, Speaker, TV and Social Media personality, and respected pioneer in Addiction Consulting. He delivers life-changing material and personal expertise to shift clients towards a more fulfilling future. Through gaining personal empirical knowledge, he incorporates this experience along with research, training, and vocation in guiding those afflicted by trauma and addiction. The complexity of human behaviour requires a non-prescriptive approach; Saf transforms people's lives through mentally disbanding the cause of their pain. As a proponent of breaking free from 'the madness', he has successfully liberated numberless individuals from tribulation so that they continue to lead a fruitful and inspiring life. His process, The Buxy Recovery Process, will liberate thousands of people from their burdens. He can candidly talk about his experiences to help others liberate themselves from the attachments to any addiction.
Behavioural and medical interventions assume that young people are particularly at risk of addiction due to the fact that their brain is still developing and they lack adult-level judgment and ability to regulate emotions. Thus, drug prevention programmes should be made and tailored to young people and focus on enhancing social skills and improving self-regulation ability (e.g. ‘self-control). As young people with depression and ADHD are also at risk, intervention programmes should focus on the young as well. Medical treatments can help restore healthy function in affected parts of the brain improving emotional and decision-making capacities. Methadone can help control withdrawal/ cravings and behavioural interventions – e.g. emphasis on healthy rewards from social contact or exercise and changing lifestyle to avoid drug-related environments/ peer groups- can change addicts cognitive and behavioural patterns and responses. Public health policy is based on the assumption that as brains do not emotionally mature until 21-25 years of age, policies such as the minimum age for buying alcohol in US (25 years old) are relevant. Therefore, smoking age could be increased to reflect this fact. The brain disease model has been used by MHPAEA to understand and treat addiction and this has resulted in increased enrolment and engagement by addicts. The disease model treats addicts as suffering from a disease and this reduces stigma and personal blame. Treatment of addiction can be much better managed by health providers if it is viewed as comparable to other illnesses. Snoek et al. (2016) argues that despite biological risk factors leading to a high predisposition to addiction, from the perspective of free-will as being defined as an ability to choose from multiple options, addicts are ‘free to choose’ and that addiction-type behaviours are always voluntary. Indeed many severely addicted individuals exercise freewill to quit when costs outweigh rewards. Strategies such as contingency management, cognitive training and Systematic Motivational Counselling can aid exercise of free-will to quit.
Eva Andersson, Karolinska institute, Sweden
Title: Understanding pain of stress etiology, comprising changes in muscle exitability, harmones and the nervous system
Time : 13:10-13:40