Psychological Management Research Articles

A-278 Neuropsychological Profile of a Child with KCNQ2

Abstract Objective: The KCNQ2 gene mutations (KCNQ2), a known cause of neuronal potassium channel dysfunction in brain cells, causes susceptibility to seizures beginning within the first days of life. Seizure semiology, severity and cognitive sequela can vary depending on the type of KCNQ2 mutation. Cognitive impact ranges from moderate to severe; no known consistent presentation. KCNQ2 affects approximately 2.8 in 100,000 births: over 3,000 annual cases worldwide. We describe the neuropsychological findings of an 11-year-old female with a monoallelic mutation of the KCNQ2 gene, and history of seizures. EEG indicated generalized epilepsy syndrome with a right occipital focal area of dysfunction. We highlight the importance of neuropsychological evaluation in medical and psychological management of children with KCNQ2. Methods: Medical history includes multifocal seizures beginning at 2 days old and significant anxiety, both managed with medication, language delay, and a diagnosis of KCNQ2 at age 9. A comprehensive neuropsychological evaluation was conducted to assess slower processing speed, behavioral concerns, and anxiety. Results: Evaluation revealed low average overall cognition and average academic performances, with strengths in verbal comprehension, fluid reasoning, and written expression. Cognitive processing speed was atypical, with slow processing speed affecting her performance across multiple domains. Behavior assessment supports Generalized Anxiety Disorder. Conclusion: This case of a girl with KCNQ2 demonstrated an atypical cognitive and behavioral profile, contributing to our limited knowledge of how KCNQ2 presents. The patterns of her performances add to the literature of the KCNQ2 gene mutation and raise important questions regarding the role of KCNQ2 in manifestations of cognitive and behavioral symptoms.

ORO-GENITAL LICHEN PLANUS: REPORT OF TWO CASES

We report 2 cases of lichen planus affecting oral and genital mucosa. A 47-year-old male patient presented with striated keratotic white plaques located in bilateral buccal mucosa, tongue, and upper and lower lip mucosa. Erosion and desquamation in the upper and lower gingiva associated with diffuse white striae were also observed. The patient also had striated lesions on the penile mucosa and scalp ulcers. A 58-year-old female patient with a diagnosis of genital and perianal lichen planus displayed keratotic white plaques on bilateral buccal mucosa and erosion throughout the upper gingiva associated with diffuse white striae. After clinical and histopathologic analyses, the definitive diagnosis for the 2 cases was oro-genital lichen planus. The patients were treated with topical dexamethasone and psychological support management. The patients are in clinical and psychological follow-up without exacerbation of the oral lesions.

Feasibility of telepsychology support for patients with advanced cardiorespiratory diseases and their caregivers.

ObjectiveThe aim of this study was to test the feasibility of telepsychology support for patients with severe cardiorespiratory disease and their caregivers. A secondary objective was to explore pre-post relationships between patients' and caregivers' clinical measures.MethodsA telehealth program incorporating telepsychology support, i.e., an “on-demand” phone service with a psychologist, was provided to consecutive cardiorespiratory patients at discharge from inpatient rehabilitation and to their caregivers. At the start and end of the 1-year program, participants were interviewed “face-to-face,” and their anxiety/depression level, patients' quality of life (MRF-28, SF-36, and MQOL), and caregivers' (n = 18) family strain (FSQ) and needs (CNA) were assessed: we analyzed the correlations and evaluated customer satisfaction.ResultsOf 80 eligible individuals, 40 took part in this study: 22 patients (FVC = 39 ± 14%; EF = 39 ± 13%) and 18 caregivers. Eleven (28%, 6 patients and 5 caregivers) requested tele-psychological support, resulting in 51 consultations focused on anxiety, difficulty in patient management, worry about the patient's emotional state, and need for emotional support; 3 participants underwent a tailored psychotherapy program. All participants expressed high satisfaction with the service. At enrolment, anxiety was less evident in patients (73% men) than in caregivers, while depressive symptoms were more evident (6.5 ± 3.1), and correlated with MRF-28 and MQOL. Caregivers' (94% women) FSQ showed a “strongly recommended” need for support; at enrolment, high levels of anxiety/depression were correlated with high FSQ (for both, p < 0.05); depressive symptoms correlated negatively with age (p = 0.025) and positively with emotional needs (p = 0.025); anxiety was positively correlated with education level (p = 0.048). At follow-up, patients' perception of support (n = 13/22) tended to increase (p = 0.089), while caregivers' strain (n = 10/18) tended to decline (to within the “range of attention”). At enrolment, caregivers' anxiety/depression and strain correlated with patients' quality of life (for both; p < 0.05). At follow-up, caregivers' strain correlated with patients' quality of life (p = 0.028) and cognitive performance (p = 0.048).ConclusionTelepsychology support associated with a telehealth service is feasible and satisfying for both participants and psychological management. A suitable support program can benefit both patients and caregivers, particularly those at higher risk of depressive symptoms (younger caregivers) and anxiety (all caregivers).

State of Psychological Well-being and Self-Care Patterns Among Paramedic Trainees During the First Wave of COVID-19

Introduction: Several studies suggest that health workers and medical students suffer from psychological problems during the pandemic. Paramedic trainees were doing duty at the hospital round the clock as other trainee health care workers during the first wave of COVID-19, but there was no published study regarding mental health issues of paramedic trainees till the date in Nepal. This study aims to assess their well-being to full fill the gap. Methods: This is a descriptive, cross-sectional study design carried out with 280 paramedics. The study period was September - October 2020. Depression, anxiety and stress scale – 21 (DASS 21) and self - care assessment worksheet was used to collect the data after getting permission from the concerned authors. Results: The point prevalence of psychological problems as defined by DASS-21 was 117 (45.3%). Specifically, DASS-21 sub-scales-defined caseness was: Depression 31 (12.0%), anxiety 55 (21.3%) and stress 31 (12.0%), where 218 (80%) of participants were not taking any self-help care-related training to enhance their coping skills to date. Chi-square (χ2) test found that there was a significant association between emotional self-care and severity of depression (P = 0.001), anxiety (P = 0.03) and stress (P = 0.04). Conclusions: A significant number of paramedic trainees suffered from depression, anxiety and stress during the first wave of the COVID-19 Pandemic. Therefore, psychological interventions like stress management, positive coping skills, and self-care training may be beneficial to help them cope with the situation.

Top 10 Research Themes for Dystonia in Cerebral Palsy: A Community-Driven Research Agenda.

Dystonia in cerebral palsy (DCP) is a common, debilitating, but understudied condition. The CP community (people with CP and caregivers) is uniquely equipped to help determine the research questions that best address their needs. We developed a community-driven DCP research agenda using the well-established James Lind Alliance methodology. CP community members, researchers, and clinicians were recruited through multiple advocacy, research, and professional organizations. To ensure shared baseline knowledge, participants watched webinars outlining our current knowledge on DCP prepared by a Steering Group of field experts (cprn.org/research-cp-dystonia-edition). Participants next submitted their remaining uncertainties about DCP. These were vetted by the Steering Group and consolidated to eliminate redundancy to generate a list of unique uncertainties, which were then prioritized by the participants. The top-prioritized uncertainties were aggregated into themes through iterative consensus-building discussions within the Steering Group. 166 webinar viewers generated 67 unique uncertainties. 29 uncertainties (17 generated by community members) were prioritized higher than their randomly matched pairs. These were coalesced into the following top 10 DCP research themes: (1) develop new treatments; (2) assess rehabilitation, psychological, and environmental management approaches; (3) compare effectiveness of current treatments; (4) improve diagnosis and severity assessments; (5) assess the effect of mixed tone (spasticity and dystonia) in outcomes and approaches; (6) assess predictors of treatment responsiveness; (7) identify pathophysiologic mechanisms; (8) characterize the natural history; (9) determine the best treatments for pain; and (10) increase family awareness. This community-driven research agenda reflects the concerns most important to the community, both in perception and in practice. We therefore encourage future DCP research to center around these themes. Furthermore, noting that community members (not clinicians or researchers) generated the majority of top-prioritized uncertainties, our results highlight the important contributions community members can make to research agendas, even beyond DCP.

Thematic analysis of the psycho-sexual symptoms in patients with Peyronie’s disease present on online forums

Peyronie’s disease (PD) is a fibrotic disorder of the tunica albuginea that may result in penile deformity, pain, a palpable plaque, and erectile dysfunction. In order to understand the psycho-sexual impacts of PD on patients and their partners, we selected three online forums containing the largest number of threads on PD. Threads focusing on the psycho-sexual impacts posted from January 1, 2011 to January 1, 2021 were compiled, and thematic analysis was performed on Dedoose. There were 277 unique posters, including 225 patients and 52 partners. Eighty-four categories and five themes were developed including information and social support, physical symptoms, psycho-sexual symptoms, treatment and effect, and impacts on partners and relationship. Emotional distress including depressed mood (n = 75, 33.3%) and feelings of isolation (n = 41, 18.2%) was prevalent. Partners developed sexual dysfunction including sexual dissatisfaction (n = 11, 21.2%) and dyspareunia (n = 4, 7.7%). Relationships experienced disruption (n = 14, 5.1%) or termination (n = 10, 3.6%). Posters received psychological treatment including psychotherapy (n = 20, 8.9%) and antidepressants (n = 17, 7.6%). Of these, 12 reported improvement and 11 stated no improvement. On these forums, psychological burden affecting individuals with PD and their partners is reported. Few seek help from a psychologist or therapist, and psychological distress may persist even after successful PD treatment. Further research is needed to identify strategies for effective psychological management.

The Influence of Adverse Childhood Experiences in Pain Management: Mechanisms, Processes, and Trauma-Informed Care.

Adverse childhood experiences (ACEs) increase the likelihood of reduced physical and psychological health in adulthood. Though understanding and psychological management of traumatic experiences is growing, the empirical exploration of ACEs and physical clinical outcomes remains under-represented and under-explored. This topical review aimed to highlight the role of ACEs in the experience of chronic pain, pain management services and clinical decision making by: (1) providing an overview of the relationship between ACEs and chronic pain; (2) identifying biopsychosocial mechanisms through which ACEs may increase risk of persistent pain; (3) highlighting the impact of ACEs on patient adherence and completion of pain management treatment; and (4) providing practical clinical implications for pain management. Review findings demonstrated that in chronic pain, ACEs are associated with increased pain complications, pain catastrophizing and depression and the combination of these factors further heightens the risk of early treatment attrition. The pervasive detrimental impacts of the COVID-19 pandemic on ACEs and their cyclical effects on pain are discussed in the context of psychological decline during long treatment waitlists. The review highlights how people with pain can be further supported in pain services by maintaining trauma-informed practices and acknowledging the impact of ACEs on chronic pain and detrimental health outcomes. Clinicians who are ACE-informed have the potential to minimize the negative influence of ACEs on treatment outcomes, ultimately optimizing the impact of pain management services.

The Impact of VR-CALM Intervention Based on VR on Psychological Distress and Symptom Management in Breast Cancer Survivors.

Objective To evaluate the effectiveness and feasibility of Managing Cancer and Living Meaningfully based on VR (VR-CALM), which is used to manage expected symptoms of cancer itself, relieve psychological distress, and improve quality of life (QOL) in the Chinese breast cancer survivors (BCs). Methods Ninety-eight patients with breast cancer were recruited in this study. These patients were randomly assigned to the VR-CALM group or the care as usual (CAU) group. All patients were evaluated by the Functional Assessment of Cancer Therapy-Breast cancer patient (FACT-B), Distress Thermometer (DT), Concerns About Recurrence Scale (CARS), Piper Fatigue Scale (PFS), Pittsburgh Sleep Quality Index (PSQI), The Self-Rating Anxiety Scale (SAS), and The Self-Rating Depression Scale (SDS) before and after VR-CALM or CAU application to BCs. We compared the differences in all these scores between the VR-CALM group and the control group. Results Patients in the VR-CALM group showed a significant decrease in levels of distress, anxiety, depression, sleep disorders, and fatigue (t = −6.829, t = −5.819, t = −2.094, t = −3.031, t = −10.082, P ≤ 0.001, 0.001, 0.05, 0.01, 0.001, respectively) and had higher level of quality of life (t = 8.216, P ≤ 0.001) compared with the CAU group after intervention. And postintervention patients in VR-CALM group compared with preintervention showed lower level of distress and remarkable improvement of QOL (t = 11.521, t = −10.379, P ≤ 0.001, 0.001). The preintervention questionnaire revealed no significant between-group differences regarding distress, anxiety, depression, sleep disorders, fatigue, and quality of life. Conclusion VR-CALM is a psychotherapy tailored to the needs of patients with breast cancer. This research innovatively used VR-based CALM intervention to improve psychological and chronic symptoms in BCs. The results of the present study indicate that VR-CALM has salutary effects on the improvement of QOL and relieves psychological distress, anxiety, depression, sleep disorders, and fatigue in BCs.

A systematic review and meta-analysis on prevalence of and risk factors associated with depression, anxiety and insomnia in infectious diseases, including COVID-19: a call to action.

Infectious disease epidemics have become more frequent and more complex during the 21st century, posing a health threat to the general public and leading to psychological symptoms. The current study was designed to investigate the prevalence of and risk factors associated with depression, anxiety and insomnia symptoms during epidemic outbreaks, including COVID-19. We systematically searched the PubMed, Embase, Web of Science, OVID, Medline, Cochrane databases, bioRxiv and medRxiv to identify studies that reported the prevalence of depression, anxiety or insomnia during infectious disease epidemics, up to August 14th, 2020. Prevalence of mental symptoms among different populations including the general public, health workers, university students, older adults, infected patients, survivors of infection, and pregnant women across all types of epidemics was pooled. In addition, prevalence of mental symptoms during COVID-19 was estimated by time using meta-regression analysis. A total of 17,506 papers were initially retrieved, and a final of 283 studies met the inclusion criteria, representing a total of 948,882 individuals. The pooled prevalence of depression ranged from 23.1%, 95% confidential intervals (95% CI: [13.9–32.2]) in survivors to 43.3% (95% CI: [27.1–59.6]) in university students, the pooled prevalence of anxiety ranged from 25.0% (95% CI: [12.0–38.0]) in older adults to 43.3% (95% CI: [23.3–63.3]) in pregnant women, and insomnia symptoms ranged from 29.7% (95% CI: [24.4–34.9]) in the general public to 58.4% (95% CI: [28.1–88.6]) in university students. Prevalence of moderate-to-severe mental symptoms was lower but had substantial variation across different populations. The prevalence of mental problems increased over time during the COVID-19 pandemic among the general public, health workers and university students, and decreased among infected patients. Factors associated with increased prevalence for all three mental health symptoms included female sex, and having physical disorders, psychiatric disorders, COVID infection, colleagues or family members infected, experience of frontline work, close contact with infected patients, high exposure risk, quarantine experience and high concern about epidemics. Frequent exercise and good social support were associated with lower risk for these three mental symptoms. In conclusion, mental symptoms are common during epidemics with substantial variation across populations. The population-specific psychological crisis management are needed to decrease the burden of psychological problem and improve the mental wellbeing during epidemic.

'Is hearing believing?': A study of voices and beliefs in psychosis and trauma.

This study compared voice characteristics and beliefs in participants diagnosed with post-traumatic stress disorder (PTSD) with dissociation, schizophrenia (SCZ) and both diagnoses of SCZ and PTSD. The relationship between dissociation and voice beliefs was also assessed. We identified 56 participants meeting the diagnostic criteria for PTSD with dissociation, SCZ or both diagnoses (PTSD + SCZ) who also experienced auditory hallucinations. Measures included PTSD Symptoms Scales Interview (PSSI-5), Psychotic Symptoms Rating Scale (PSYRAT), Clinician Administered Dissociative States Scale (CADSS), Beliefs about Voices Questionnaire (BAVQ) and Positive and Negative Syndrome Scale (PANSS). Beliefs about voices were similar across diagnostic groups. Participants with SCZ were more likely to attribute their voices to an external origin, and participants with dual diagnosis were less able to control their voices. The PTSD-only group scored higher in dissociation scores than either the SCZ-only or dual diagnosis group. Malevolent voice appraisals correlated with dissociation scores only in the dual diagnosis group. This research supports the hypothesis that voice beliefs are similar across diagnoses of PTSD and SCZ. However, differences in voice characteristics, emotional responses and relationship to dissociation may need to be considered in the psychological management of voices.

Insight to Psychological Aspects of Cancer

AimsThe baseline of this study 1)What is the type of psychiatric disturbances in oncology settings?2)Is there any importance in cancer education?3)How to manage psychiatric disturbances?MethodsAs of lockdown concerning COVID-19, this study is conducted online among 20 cancer patients. This is a cross-sectional study where Each patient has explained the purpose of the study, procedures, and consent was taken from patients then a questionnaire was given, and this was assessed. Among the profile of the study population, 50% were males and 50% were females of the total study population, 60% were married and 40% were unmarried, Participants were aged between 22 and 63 years. The study population also consists of 20% are breast cancer, 25% lung cancer,10% lung cancer, and the rest are other types of cancers. Patient details are collected from the Facebook groups for cancer patients. Assessment has 2 parts, one is based on CES-D Test where each individual was each patient answered 20 question and next part is based on 5 questions regarding Financial Depression, Behavioral changes, Feelings, Education about cancer and Psychiatric support.ResultsIt is found that 60% population are normal, 25% had mild Depression, 10% have moderate Depression followed by 5% with severe depression.Among associations between marital status and various disorders, it was found that psychological disturbances are 2 times fold more in married people while compared to unmarried. There is also an association between treatment modalities are observed, in that anxiety is prevalent with people who had chemotherapy. Based on education and financial status, those who are with less education about cancer and less financially stable have also prominent disturbances.ConclusionThe study was based on other research study related to the spectrum of psychological disturbance based on treatment stage, financial status, awareness of cancer among patients, and role of marital status among individuals Offering mental health services to patients with cancer is becoming an integral part of oncologic treatments because psychological problems harm cancer management. The most common psychiatric disorders in cancer patients are depression, anxiety disorders, and adjustment disorders. Psychiatrists should be involved in the multidisciplinary treatment team that works with cancer patients. Further research is needed to determine the effectiveness of different psychological and psychopharmacological interventions in psycho-oncology and palliative medicine

Manipulation checks in the managerial psychology experiment in China: Current status, problems, and suggestions

<p id="p00005">Manipulation checks are important method to ensure the construct validity of managerial psychology experiment, which are also regarded as the basic technology of modern psychology experiments. Although manipulation checks have many advantages and have received widespread attention, current experimental method in managerial psychology literatures mainly focus on the overall experiment design and the strategy of data analysis, rarely investigating the details of manipulation checks design. Although some psychological research published in top international journals has discussed the problem of construct validity and the statistical analysis of manipulation checks, these limited studies have not carried out an integrated review from the key design process of manipulation checks and provided targeted coping strategies. This may lead researchers to undertake manipulation checks designs without solid theoretical support, and even conduct subjective design based on incomplete understanding and draw biased experimental conclusions. <break/>In order to effectively improve the normativity of manipulation checks in the managerial psychology field in China, this study summarized the functions of direct manipulation checks, discriminant manipulation checks and instructional manipulation checks, and then coded 144 experiments drawn from 49 studies in the field of managerial psychology which were published in 4 top-tier journals in 2020 (i.e., Acta Psychologica Sinica, Journal of Psychological Science, Management World, and Nankai Business Review). The present study analyzed the current status, problems and coping strategies of manipulation checks in the managerial psychology field in China from the perspective of the implementation form, the error control, the location choice, the implementation timing and the analytic strategy. <break/>Results showed that the application of manipulation checks in the managerial psychology field were not normative enough in China. Specifically, the way to implement manipulation checks appeared monistic with self-report dominating among these experiments. In terms of error control, many studies did not use maturity measurement scale, and seldomly employed new manipulation checks strategies (e.g., discriminant manipulation checks and instructional manipulation checks) to exclude competitive explanations and invalid experimental samples. For the choice of location, only a few managerial psychology studies paid attention to the influence of manipulation checks location on experiments, and most managerial psychology experiments placed manipulation checks in front of dependent variable. Furthermore, in the aspect of the implementation timing, most managerial psychology experiments completed manipulation checks during the experiment process, and manipulation checks were less implemented in the form of pre manipulation checks (e.g., pilot experiment) and post manipulation checks (e.g., qualitative coding). Finally, as for the strategy of experimental data analysis, the utilization rate of manipulation checks data was low. For example, most managerial psychology studies only focused on analysis of variance of the independent variable between groups and ignored the strength and mediation analysis strategy of the experimental manipulation. <break/>Manipulation checks without enough normativity cannot strongly guarantee the construct validity of experiment and may even interference the experimental process and get incorrect conclusions. To avoid it, future managerial psychology research should pay attention to the application of non-interventional forms to reduce the interference of manipulation checks on the experimental process. Besides, implementing error control strategies should be advocated to eliminate invalid data and competitive explanations. At the same time, the present study suggest that researchers should consider the characteristics of manipulation checks when they decide the appropriate position of manipulation checks included in the experiment material. Researchers are also encouraged to use pre and post manipulation checks to ensure flexibility. In the data analysis phase, we recommend researchers use manipulation strength and mediation analysis to guarantee the internal and external validity of the managerial psychology experiment. By doing so, this study expects the normativity of manipulation checks will be improved to a great extent.

The difficult symbolic construction of physicians’ and nurses’ experiences working in COVID-19 intensive care units: A qualitative study on reports at a university public hospital in Southeastern Brazil

IntroductionHumanistic studies that explore symbolic aspects of the experience of working on the COVID-19 frontline are necessary. Do these professionals have psychic time to symbolize such acute experiences? We expect these preliminary findings of this research provide subsidies for discussing psychological management in groups with these professionals.ObjectivesTo interpret emotional meanings reported by physicians and nurses on their experiences of working at COVID-19 intensive care units.MethodsClinical-qualitative design. Data collection with semi-directed interviews with open-ended questions in-depth applied to a sample of six professionals, closed by theoretical information saturation, in a Brazilian university general hospital. Trigger question: “Talk about psychological meanings of your experience in face of management of patients with COVID-19 at ICU”. Data treatment by the Seven Steps of the Clinical-Qualitative Content Analysis. Theoretical framework of Medical Psychology using Balintian concepts.ResultsWe raised 3 categories. (1) Psychic time and absence of symbolization in face of the pandemic; (2) Denial as a defense or psychosocial adaptation mechanisms; (3) Tensions and family support: triggers of ambivalent emotional experiences.ConclusionsRaw experience of COVID-19 pandemic did not allow for realization of symbolization. Psychological defenses are manifested, either to maintain balance or to deny the existence of dangers related to mental health. Presence of families and health team confirm that the feeling of loneliness is avoided. Anxieties related to the fear of contamination are recurrent. There is dual relationship regarding the emotional experiences of health professionals, but the data point to importance of looking at how these individuals perceive and experience the pandemic.DisclosureNo significant relationships.

Symptom Management of Individuals with Post-COVID-19 Syndrome: A Multiple-Case Study

Purpose: This study aimed to understand the symptom management experiences of patients with post-COVID-19 syndrome and to identify patterns therein. Methods: Yin's multiple-case study design was utilized. Purposive sampling was used to recruit participants who experienced post-COVID-19 syndrome symptoms. One-on-one interviews and surveys were conducted with six participants between October 22, 2021 and November 28, 2021. Data analysis, which included content analysis for in-depth interview data and survey data, followed the process suggested by Yin. Results: Common themes identified between the cases were experiencing deterioration of health compared to the before getting COVID-19, utilizing various methods to relieve physical symptoms, coping passively with psychological symptom management, and difficultly in managing symptoms due to the lack of a post-COVID-19 syndrome management system. Differences between cases included various degrees of utilizing healthcare system for symptom, attitude toward accepting symptoms, and taking the lead in managing symptoms according to returning to work. Three patterns of symptom management of individuals with post-COVID-19 syndrome were identified: self-management, treatment focus, lethargy. Conclusion: This study highlights the need for a nursing environment in which individuals experiencing post-COVID-19 syndrome can lead and take responsibility for health care, and it is suggested that future studies should develop high-quality nursing intervention programs for post-COVID-19 syndrome.

Daily Life Impact of Brachial Plexus Reconstruction in Adults: 10 Years Follow-Up

Reconstructive surgery of brachial plexus injury in adults remains a challenge. Short- and midterm follow-up results have been described in terms of impairments, such as muscle strength grading. However, psychologic management has been shown to be a major contributor in long-term results. A new, specific brachial plexus injury scale, including functional and psychologic components, was described. Objectives of this study were: (1) to assess functional long-term brachial plexus reconstruction outcomes; and (2) to validate the Mancuso scale at 10 years of follow-up. Twenty patients with at least 10 years of follow-up were included in the study. Four patients had C5-C6 palsy and 16 had a C5-T1 injury. Shoulder abduction and elbow flexion were assessed with Medical Research Council grades. Shoulder function was evaluated with a Constant score. The 36-item short-form survey (SF36) was used to assess quality of life, and the quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) was used for patient reports of disability. The Mancuso scale was assessed and correlated to the different scores used. At the last follow-up, the Medical Research Council grade was at least grade 3 in 10 cases (50%) of shoulder abduction and in 12 cases (60%) of elbow flexion. The Constant score was 31.4 (SD, 15.1). The SF36 score was 67.5 (SD, 4.25) and the QuickDASH was 50 (SD, 15.9). We found a correlation between the symptom score (Mancuso score) and the different quality-of-life scores (QuickDASH: coefficient, 0.491; SF36: coefficient,-0.565; limitations score: coefficient, 0.445). This study reported results from the Mancuso scale at a minimum of 10 years of follow-up of reconstructive surgery for brachial plexus injury in adults. Correlations between this composite scale and the SF36 and QuickDASH scores suggest construct validity. Therapeutic IV.

Construction and Application of Psychological Quality Assessment Model for College Students Based on Extensive Data Analysis.

This paper constructs a platform framework for extensive data analysis of college students' psychological quality with the help of the thinking mode of big data and related technologies and proposes the construction principles, data sources, data processing methods, data platform construction, and platform application of big data analysis platform for college students' psychological quality assessment. This paper combines the application methods of big data technology, collects the management data related to the psychological quality assessment of college students, saves them into the system database with certain storage logic, and realizes the function of psychological quality assessment through the design of selected psychological quality assessment data, data management and data resource management and other parts based on the data results of extensive data analysis. This study provides some insights into the psychological quality assessment of college students. The strength of association between the variables of psychological quality assessment of college students changes over time, but the overall psychological structure is more stable. This stable psychological structure characteristic is conducive to constructing the policy of constant psychological education in large universities.

Gender differences in arrhythmias and psychological discomfort management

Abstract Funding Acknowledgements Type of funding sources: None. Background Palpitations and/or syncope are common in patients with psychoneurological disorders [1]. Arrhythmias may be associated to psychological discomfort as well [2]. Psychiatrics, epidemiology and commonplace agree that gender may lead to difference in symptom perception, and management [3-4] Purpose To investigate the abovementioned association we realized a retrospective multicentric registry including, after definite instrumental diagnosis, patients with previous mental disorder diagnosis, referring to arrhythmology ambulatories. Results 64 pts (48 F, 75%), mean age 54±18y, were enrolled in 7 centers. Psychiatric diagnoses were: anxiety-depression disorder (N=50), panic attack (N=5), behavioural disorder (N=4), epilepsy (N=3), psychosis (N=1), diagnosed in 83% by General Practitioners and in 14% by Psychiatrists. 55 pts (86%) were on drug therapy: benzodiazepines (67%), SSRI (22%), neuroleptics (3%), antidepressants (2%), and natural products (5%). Among these, 89% reported no symptoms relief. 57 pts complained palpitations, 17 extrasystoles and 19 reported syncope. EPS study was performed in 48%, 24 h Holter ECG in 28%, and LR implantation in 5% of patients. We diagnosed AF (N=11), typical AFL (N=4), AT (N=8), AVNRT (N=16), AVRT (N=4), PAC (N=1), PVC (N=10), AV block (N=4), VT (N=3) and unspecified SVT (N=3). 44 pts underwent ablation. 62 pts (96,8) experienced strong symptoms reduction or resolution, and 42 psychiatric drugs withdrawal. One pt underwent PMK implantation. Conclusions In our series of cardiac symptoms ascribed to psychiatric disorders, women markedly prevailed. Psychologic discomfort could be caused by arrhythmias, as resolved or dramatically ameliorated by diagnosis and treatment. Further investigation in Psychiatric context is warranted.

Validation of the Subgroups for Targeted Treatment for Back (STarT Back) screening tool at a tertiary care centre.

Background:The Subgroups for Targeted Treatment for Back (STarT Back) tool is a screening questionnaire developed to identify modifiable risk factors for back pain disability in primary care. Given the ability of this tool to assist with early identification of patients at high risk, we examined its concurrent convergent and known-group construct validity in tertiary care.Methods:This was a case–control study of adult (age > 18 yr) patients with and without an active work-related compensation claim recruited from an academic health centre between August 2017 and May 2019. Patients in the study group were assessed by a physiotherapist and an orthopedic surgeon in a spine specialty program designed to assess and treat workplace injuries. The control group included patients referred to an orthopedic spine surgeon in a publicly funded specialty clinic where an advanced practice physiotherapist determined the need for surgical consultation. We used the Roland–Morris Disability Questionnaire (RMDQ) and the Hospital Anxiety and Depression Scale (HADS) to determine the convergent and known-group construct validity of the STarT Back tool.Results:Fifty case and 50 control participants were included. We observed moderate to high association between the STarT Back total score, psychosocial subscore and risk categories and the RMDQ and HADS scores in the expected direction (p < 0.001). A significant association was observed between risk group allocation and depression (area under the curve values > 80), having a compensable injury and work status (p = 0.002–0.001).Conclusion:The STarT Back tool was able to differentiate between patients with and without a compensable injury and patients with different levels of work status. The tool has acceptable convergent and known-group construct validity and can assist in clinical decision-making in a tertiary care setting where adjunct psychologic management may be indicated.

β-Blockers and Erectile Dysfunction in Heart Failure. Between Myth and Reality.

Erectile dysfunction (ED) is a major concern in heart failure (HF) due its high prevalence as well as its negative impact on the quality of life, this condition being usually unrecognized and thus untreated. A number of possible causes might contribute to the above mentioned tight association, i.e., shared risk factors, comorbidities and several physiologic HF abnormalities such as impaired exercise tolerance, psychogenic factors and neurohumoral, metabolic and vascular changes. Medications have been blamed for playing also a pivotal role in the ED occurrence and, particularly, the -blockers. Remarkably, the underlying mechanisms have not been fully identified. All the available scientific literature dealing with this topic derives from studies not addressing this issue in HF, but in other settings, (e.g., arterial hypertension) and are also characterized by important methodological flaws. Thus, given the solid evidences arguing in favor of -blockers in HF in terms of morbidity, mortality and quality of life, -blockers at the maximal tolerated dosage in this patients' category should be recommended, regardless of ED. However, the ED-related issues should not be neglected, and adequate psychological counseling and management should be provided, pursuing the correction of risk factors, the choice of more suitable medications and, in selected cases, adopting specific drugs or devices. The purpose of this narrative review is to highlight the close relationship between ED and HF and, specifically, to focus on a possible -blockers' role in determining or, at least, worsening this condition.

MO823: Psychological Impact of COVID-19 in Hemodialysis Patients

BACKGROUND AND AIMSThe COVID-19 pandemic has required containment measures in Morocco, as well as practice changes in haemodialysis centres. Haemodialysis patients are at risk of aggressive symptoms of COVID-19, which significantly increases mortality. This particular situation creates psychological disorders in those patients, such as anxiety, sleep disorders and irritability. The objective of our study is to assess the mental health status of haemodialysis patients during the pandemic and the psychological impact of confinement. This assessment will allow the adaptation of a supportive relationship with the patient through adequate psychological management.METHODThis is a mono-centric, non-interventional study that included all haemodialysis patients at the haemodialysis centre of the nephrology department at Ibn Rochd University Hospital during the confinement period (March 2020–June 2020).This study is based on a pseudonymized paper questionnaire, during confinement, based on two psychiatric scores (GAD-7, PHQ-9) that assess anxiety, depression as well as sleep disorders, which allowed us to collect socio-demographic data, anxiety depressive symptomatology and an assessment of sleep disorders.RESULTSThe average age of our population is 47.4 years old, 54% of whom are men. Almost 34.54% have a primary level of education The higher level of education was 14.45%, while 14.54% are illiterate. Regarding family status, 45% are married. Those who are living alone accounted for 55%. Before confinement, 57.15% patients were daily workers; 10 others had no work, among 3 of them were students; the 5 others were managers. After starting haemodialysis, 65.7% patients stopped their work.We noted that 38% of patients had a feeling of nervousness and anxiety for several days, while 9% had the same symptoms for more than half of the day. Concerning excessive anxiety, it was noted in 34% of patients for several days, while 16% showed excessive anxiety for more than half of the days. Concentration difficulties were noted in 41% of the patients for over several days and 5% more than half of days, while 58% of patients never had difficulties of concentration. The irritability feeling over several days was noted in 43% of patients, while 5.4% presented a feeling of irritability more than half of the days. Difficulty falling asleep is noted in 49% of patients, while 51% of patients have no difficulty falling asleep. The feelings of sadness, depression and despair are noted in 49% of patients for several days and 5% for more than half of the days. Sleep disorders were noted in 60% of patients on several days, while 40% had sleep disorders on more than half of the days. Loss of appetite was noted in 65% of patients. A lack of self-confidence was noted for several days in 43% of patients. 29% of patients lost the pleasure of having fun for several days. A total of 36% were slow or restless for several days. None of our patients expressed a desire to end their life, and 49% did not lose the pleasure of doing their daily activity.CONCLUSIONThe mental health of dialysis patients assessed appears to be unaffected during this first wave of the pandemic. This could be due to high resilience, higher unemployment among dialysis patients, a reduced impact of social distancing on the haemodialysis population, strict precautionary measures and perceived support from health workers, who can all contribute to addressing this pandemic.