Biography:

Minna Chang graduated from Imperial College London. She has a special interest in medical ethics, particularly in psychiatric cases. She enjoys research and teaching outside her clinical duties.

Abstract:

Statement of the problem: In 2020, there were 5,224 deaths due to suicide registered in England and Wales (1). The Mental Health Foundation has reported that ~70% are in patients with depression (2). The number of attempted suicides are much higher – South West London and St George’s mental health trust estimates that at least 140,000 people attempt suicide in England and Wales every year (3). In suicidal depression, the psychological pain is often unbearable and feels overwhelmingly incompatible with life. One is no longer living, they are merely surviving and eventually, the exhaustion will lead to decompensation. This is marked by suicide. The goal is to end the suffering permanently and this is achieved through death.

Methodology & theoretical orientation: Depression, like all other physical and mental illnesses, runs a course. This is highly variable between individuals and can be the case even between separate relapse episodes in the same patient. Like many diagnoses, depression is known to lead to death in a significant number of people. Many suicidally depressed patients feel that death will be an inevitable result of the illness. Suicide is often viewed as a symptom of severe depression, but would it be justifiable to consider death as part of the disease process itself? Consequently, would it be justifiable to consider depression in these patients as a form of terminal illness? Since without treatment, the condition would lead to death? Accordingly, could there be a place for palliative care in a small minority of suicidally depressed patients? This would mean that instead of placing the focus on the prevention of deaths and prolonging lifespan, the focus would be on making the patient comfortable as the disease progresses, maintaining their dignity and promoting autonomy.

Findings: In this essay, I discuss the ethical and moral implications of suicidal depression from a doctor’s and patient’s perspectives. I also discuss the implications of depression on capacity and decision-making. Lastly, I discuss the ethical dilemmas surrounding assisted suicide and euthanasia for severe suicidal treatment resistant depression. Could these be considered a means of treatment in certain cases? Recognition.

Biography:

A firm believer in the dictim of "no health without mental health", Prof Dr Hussein Khairy, M.D is a vascular surgeon by profession, but a healer by practice and educator by passion. Through his career that spans four decades, he towers as the king of hearts, simply because he pays attention and cares. It is this intuitive, reflective approach to the profession that makes him able to speak at a psychiatry conference. He is currently the twice elected President of the Egyptian Medical syndicate, and was the last elected dean of Kasr Al Ainy Faculty of Medicine from 2011-2014 before deanship ceased to be by election. Through his administrative responsibilities he acquired an in depth knowledge of what pains people: doctors, patients and systems and continues to work with everyone to bring to the light the unique goodness in each.

Abstract:

Statement: This work presents the need for integrating emergency psychiatry across disciplines. It highlights the overlap in presentations and potential for misdiagnosis and thus delayed or even faulty intervention. Acute changes in mood, movement, sensorium or affect may be quickly dismissed as functional when indeed they may be organic or due to a medication adverse event. This population may present to the ER, but also to family medicine, internal medicine, psychiatry and neurology or even on a university campus, presenting as violence.

The need to have the mental set of accurate diagnosis paves the way for appropriate intervention. By analogy to CPR, ATLS and PALS, it is proposed that training in psychiatric emergencies be as basic and as widespread.

Three scenarios are shared to highlight the above.

Taking into consideration that emergencies do not occur in an organized manner nor in expected places, the task of the receiving medical team is to save the life of the person in the most efficient way. Emergencies with psychiatric presentations, affecting any of mental functions, including orientation, consciousness, movement, but also affect and thought, have not yet found their optimum place worldwide. This group of patients is subject to two types of cognitive errors when assessing them: unconscious bias, and psych-out whereby the likelihood that a patient with acute psychiatric symptoms be triaged against, is highest.

Findings: The skills, thus, both tacit, and tangible, that are required to address and serve the needs of this population are unique. It takes an orientation with a preventive inclination, a knowledge of medical mimics of psychiatric disorders and a genuine willingness to become aware of the bias that one holds against this population to ensure they are well served.

Biography:

Petronella Jonck is an Associate Research Professor at the North-West University in a talent management research entity (GIFT) within the Faculty of Economic and Management Sciences. Prof Petronella Jonck is a National Research Foundation C3 rated researcher. Petronella obtained her PhD in Psychology at the University of the Free State and is a registered Psychologist with the Health Professions Council of South Africa (HPCSA). To date her research outputs, include more than 30 accredited journal articles and numerous other research documents. Prof Jonck was a supervisor for the Southern African Young Scientist Summer Program (SA-YSSP) that was hosted at the University of the Free State in collaboration with the International Institute of Applied Systems Analysis in Vienna, Austria in addition to supervising other postgraduate students. Her research focus areas include career psychology, psychology, industrial psychology, human capital development and higher education. Prof Jonck lectured Psychology, Organizational Behavior, and Research Methodology.        

Abstract:

Problem statement: The influence of COVID-19 has not been fully realized, nevertheless it is hypothesized that the pandemic increased the anxiety response in adolescents. Also, an unintended consequence was the impact thereof on the world of work. Ambiguity relating to unemployment, career opportunities and expectations could exacerbate perceived anxiety labelled career choice anxiety. The research explored the theoretical link between career choice anxiety, psychological well-being and career self-efficacy to recommend a conceptual framework that could be applied as theoretical underpinning for the development of a psychometric stable measuring instrument. Psychological well-being has emerged as a public health concern especially for adolescents as some mental health problems have an early onset around the age of 14. While anxiety has been identified as prevalent in the age group. Moreover, career self-efficacy theoretically moderates the link between career choice anxiety and psychological well-being.

Theoretical orientation: Two theoretical perspectives could be utilized, namely a hedonic approach that emphasize constructs such as happiness, positive effect, low negative effect and life satisfaction or a eudemonic theory highlighting psychological functioning and human development through challenges, growth and life purpose. Last mentioned stance was adopted, namely psychological well-being as optimal psychological functioning and impetus to develop intrinsic career-related potential.

Findings: Assessment and possible interventions are pivotal in the context of COVID-19 as the intensity of anxiety have increased in an already at-risk age group with adverse consequences.

Conclusion and significance: Ascribed to the dearth of empirical evidence relating to career choice anxiety and psychological well-being the proposed conceptual framework not only contribute to the corpus of knowledge but could also be implemented to inform future career guidance practice. Besides the knowledge contribution the proposed conceptual framework could have a societal impact addressing goal three of the sustainable development goals notably good health and well-being.             

Biography:

Samir Aboalmagd, M.D is Professor of Psychiatry at Kasr Al Ainy Faculty of Medicine and past head of the Addiction Unit. His  interests are predominantly addiction and sports psychiatry but nevertheless works with patients and trainees with an all encompassing approach.  His approach is infused by the focus, depth and fortitude that characterize sportsmanship.  For 16 years he was a handball player in the National Handball League of Egypt. His career in psychiatry spans four decades and he has  supervised numerous thesis. He is cofounder of one of the very few private hospitals that retain a wholistic approach to treatment, addressing the national and regional need for personalized interventions. His experience in treating addiction disorders acknowledges the relapsing nature of the disorder and he is aware of cultural limitations and stigma of the disease. For the last ten years he has been teaching and training nationally and regionally extensively focusing on building generations of insighted aware psychologists and psychiatrists for safe and ethical delivery of care.

Abstract:

Statement: This work seeks to highlight the challenges that elite athletes and aspiring athletes in colleges may face during their intensive career that may last a glimpse or up to three decades. Among the myriad of challenges, mental health and addiction are the most stigmatizing and hence least talked about. A delay in recognizing the affliction and its causes, and timely intervention, may cause the loss of the athlete's career. While the athlete is the epitome of success, and an inspirer to the masses to follow their dreams, there is a price to be paid.  Injuries, and the pain associated with recovery, defeats and the required recuperation, anxiety about performance, and attention deficit disorder are among the reasons athletes may resort to drugs, if their need, and unacknowledged vulnerability are not recognized and addressed.

Intensive training becomes the center of the life of the athlete: the rise to fame and glory, the pressure to compete, the losses and defeats, the accolades,  and finally the requirement to step down even at the height of glory only to meet the social/sports culture standards.

Athletes find themselves forced to keep up performance for the dreaded fear of being shamed, either from their clubs, or themselves. Losing and retirement are among several of the mental health challenges that threaten athletes and the stigma of having a mental illness does not spare them. It is, thus, no wonder that they may start to abuse substances, either to enhance performance or to quieten the suffering experienced as a result of loss, or to artificially relieve pain sustained from injuries.

Special reference to adverse events of psychiatric medication and thus the required selection of medication to prescribe as well as emergencies of mental health presentations including but not confined to suicide is alluded to.

Biography:

Shima Algam is a Medical student in the College of AlNeelain University, Sudan. His area of expertise is Psychiatry and Mental Health, Suicidology and Suicide Prevention. He has published several research papers in the international journals.

Abstract:

Introduction: Psychological distress and suicidal behavior are mental health problems among students and necessitate research to inform strategies for prevention in this population. Although depressive symptoms and suicidal ideation are common in medical students, few programs address this problem, which is needed it to determine the prevalence of psychological distress and suicidal behavior among medical students.

Materials and methods: this is a cross sectional faculty-based study . we used Snowballing sampling technique and Kessler 10-item Questionnaire to assess psychological distress. We used SBQ-R (suicidal behavioral questionnaire _Revised) to assess suicidal behavior .The participants were students from 12 medical colleges in Khartoum state, from all academic levels.

Results: among 525 undergraduate medical students 136 (25.9%) were males and 389 (74.1%) were females, 23.3% were well, 18.7% had mild mental disorder, 19.2%had moderate mental disorder and 38.8% had severe mental disorder at the last 30 days. The higher of psychological distress was slightly significant among student in preclinical years than clinical years (P=0.08), 72% have poor risk for suicidal ideation and 28% have higher risk of suicidal behavior more significant among students in preclinical years (p= 0.02).

Conclusion: Psychological distress and suicidal behavior were more evident in pre-clinical years along with other many factor including, marital status, bad habits, chronic disease, and university type either public or private. We recommend implementing psychological and academic support programs across different undergraduate levels to enhance mental wellbeing, academic performance and prevent suicidal behavior.